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  Citation statistics : Table of Contents
   2015| January-March  | Volume 4 | Issue 1  
    Online since January 23, 2015

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Novel formulation of cytarabine and daunorubicin: A new hope in AML treatment
Lalit S Raut
January-March 2015, 4(1):38-40
DOI:10.4103/2278-330X.149950  PMID:25839020
Acute myeloid leukemia (AML) treatment has always been a challenge to the treating physician. Continuous efforts are being made to improve treatment outcomes in AML. CPX-351 is a pharmacologic advancement in this direction. It is a liposomal fixed drug combination of cytarabine and daunorubicin. Early studies indicate that it will play a big role in AML treatment. This is a short review about this drug.
  11 2,280 497
Cancer related fatigue: A ubiquitous problem yet so under reported, under recognized and under treated
Akhil Kapoor, Mukesh Kumar Singhal, Puneet Kumar Bagri, Satya Narayan, Surender Beniwal, Harvindra Singh Kumar
January-March 2015, 4(1):21-23
DOI:10.4103/2278-330X.149942  PMID:25839015
Background: Cancer related fatigue (CRF) is a problem that is highly under reported, under recognized and thus, under treated. About 80% of patients receiving chemotherapy/radiotherapy experience CRF, making it the most common side effect of cancer treatment. Functional assessment of chronic illness therapy fatigue (FACIT-F) version-4 is a 13 item questionnaire that has been used to measure the level of fatigue of cancer patients during their daily activities over the past 7 days. Materials and Methods: 92 patients of age 18 years and above attending the oncology Out Patient Department (OPD) of a regional cancer center were recruited in this study and were given FACIT-F questionnaire. The relevant sociodemographic parameters were obtained from the medical records of the patients. The internal consistency of the 13 items was measured using the Cronbach's alpha. Results: The Cronbach alpha coefficient for FACIT-F scale in our study was found to be 0.74. Kendall's coefficient of concordance was estimated to be 0.080. The correlation between Eastern Cooperative Oncology Group (ECOG) performance status and mean score of FACIT-F was studied, Pearson correlation coefficient was estimated to be 0.271 (P = 0.009). Conclusions: FACIT-F is a brief, simple, easy to administer and patient friendly tool to measure the fatigue in last 7 days. CRF should be given adequate attention from the beginning of the treatment to improve the quality of life of cancer patients.
  7 1,738 300
Cytological grading of breast carcinoma on fine needle aspirates and its relation with histological grading
Jyoti Prakash Phukan, Anuradha Sinha, Jatindra Prasad Deka
January-March 2015, 4(1):32-34
DOI:10.4103/2278-330X.149948  PMID:25839018
Background: Grading of breast carcinoma on fine needle aspiration cytology (FNAC) is beneficial for selecting patients for neoadjuvant chemotherapy. Aims: To grade the breast carcinoma on FNAC using Robinson grading system and to assess the concordance of cytological grading (CG) with histological grading (HG) using Elston-Ellis modification of Scarff-Bloom-Richardson grading system. Materials and Methods: The study was conducted for 1-year, comprising of 50 female patients attending outpatient departments (OPD) as well as admitted in various surgical wards of a teaching hospital, diagnosed as breast carcinoma. FNAC smears were stained with May-Grunwald-Giemsa and Papanicolaou (Pap) stains and CG was done using Robinson system on Pap stained smears. The results were compared with HG system after resection of tumors. Results: Of 50 cases, 14 (28%) cases were graded as grade I, 24 (48%) grade II, and 12 (24%) grade III by CG, whereas 9 (18%), 28 (56%) and 13 (26%) cases were graded as grade I, II and III by HG. The result showed overall 72% concordance of CG with HG, with grade II and grade III showing highest degree of concordance (83.33%), which is comparable to previous studies. Kappa measurement showed a higher degree of agreement in high-grade tumors compared with low-grade tumors (0.73 in grade III, 0.53 in grade II and 0.39 in grade I). Conclusion: Cytological grading is comparable to HG in majority of cases. Because neoadjuvant chemotherapy is becoming increasingly popular as primary treatment modality of breast cancer, CG could be a useful parameter in selecting the mode of therapy and predicting tumor behavior.
  4 1,799 335
Role of low dose cytarabine in elderly patients with acute myeloid leukemia: An experience
Yasir Bashir, Sajjad Geelani, Nusrat Bashir, Shabeer A Mir, Mosin Mushtaq, M Aleem Jan, Javid Rasool
January-March 2015, 4(1):4-6
DOI:10.4103/2278-330X.149918  PMID:25839010
Purpose: To highlight the acceptable results seen after use of low dose cytarabine in elderly patients of acute myeloid leukemia (AML) with comorbidities. Materials and Methods: This was a prospective study carried on 30 newly diagnosed patients of AML over 60 years of age who were unfit for standard treatment regimens. We did not use azacytidine and decitabine in our patients because these therapeutic modalities being extremely costly and our patient affordability being poor. After taking patient consent and institutional ethical clearance these patients were treated with 20 mg/m 2 cytarabine subcutaneously in two divided doses 12 h apart for 4 days every week for 4 weeks which constituted a cycle before disease, re-assessment was done. A repeat cycle was administered where ever needed and after attainment of remission, we continued low dose cytarabine for 2 days/week as maintenance after complete or partial response was documented. Results: In our study, we found that around 20% of patients achieved complete remission and 30% partial remission. The remission rates were definitely influenced by counts at presentation, performance at presentation, comorbidities, underlying myelodysplastic syndrome and baseline cytogenetics. Conclusion: Low dose cytarabine is effective treatment option for elderly patients with AML when standard treatment options are not warranted.
  4 2,233 421
Open-label observational study to assess the efficacy and safety of aprepitant for chemotherapy-induced nausea and vomiting prophylaxis in Indian patients receiving chemotherapy with highly emetogenic chemotherapy/moderately emetogenic chemotherapy regimens
Hingmire Sachin, Raut Nirmal
January-March 2015, 4(1):7-10
DOI:10.4103/2278-330X.149923  PMID:25839011
Context: Currently, there is limited data on the prevention of chemotherapy-induced nausea and vomiting (CINV) in Indian population with aprepitant containing regimens. Aims: The aim was to assess the Efficacy and Safety of Aprepitant for the prevention of nausea and vomiting associated with highly emetogenic chemotherapy/moderately emetogenic chemotherapy (HEC/MEC) regimens. Settings and Design: Investigator initiated, multicentric, open-label, prospective, noncomparative, observational trial. Subjects and Methods: Triple drug regimen with aprepitant, palonosetron, and dexamethasaone administration was assessed for the prevention of CINV during acute, delayed, and the overall phase (OP) for HEC/MEC Regimens. The primary endpoint was complete response (CR; no emesis and no use of rescue medication) and the key secondary endpoint was the complete control (CC; no emesis, no rescue medication and no more than mild nausea) during the OP. Statistical Analysis Used: Perprotocol efficacy was analyzed for the first cycle with results represented in terms of CR/CC rates using descriptive statistics. Results: Seventy-five patients were included in the study with median age of 49.7 years and 89.7% being females. The CR rate (OP) for patients administered HEC or MEC regimens during the first cycle were 92% and 90.9%, respectively. Similarly, the CC rates (OP) were 75% and 90% for these regimens, respectively. 7 (9.2%) patients reported adverse drug reactions that were mild and transient with no reports of any serious adverse events. Conclusions: Use of aprepitant containing regimen for patients receiving HEC/MEC regimen resulted in significantly high CR and CC response rates, which further consolidate its potential role to improve patient quality of life and compliance to disease management.
  3 2,182 390
Epidemiological research on cancers by cancer registries: A view point
Manigreeva Krishnatreya
January-March 2015, 4(1):50-50
DOI:10.4103/2278-330X.149957  PMID:25839027
  3 1,214 202
Impact of changing trends of treatment on outcome of cerebral gliosarcoma: A tertiary care centre experience
Narendra Kumar, Tapesh Bhattacharyya, Karan Chanchalani, Praveen Shalunke, BD Radotra, Budhi Singh Yadav
January-March 2015, 4(1):15-17
DOI:10.4103/2278-330X.149931  PMID:25839013
Aim: To assess clinicopathological features and outcomes in patients of primary gliosarcoma with changing trends of treatment. Materials and Methods: Medical records were reviewed and data collected on primary gliosarcoma over a 5-year period (2009-2013) from the departmental case files. Results: A total 27 patients were included in this study. The median age of presentation was 54 years. There was a slight male preponderance, with male to female ratio of 1.25:1. The most common location of the tumor was temporal lobe (44.4%). Gross total resection was possible in 19 cases, near total excision was done in five cases, and only partial excision with decompression in three cases. Of the 27 patients, 80.8% patients received post-operative radical external beam radiotherapy of 60 Gy/30#/6 weeks. Concurrent and adjuvant temozolomide was used in 42.3% cases, depending on affordability and tolerance. Median overall survival was 9 months. On subgroup analysis, median overall survival in the radiotherapy plus temozolomide group was 10 months as compared to 9 months in the radiotherapy alone group; however, this was not statistically significant.(P = 0.244). Conclusion: Treating Gliosarcoma is a major therapeutic challenge for a clinician because of its poor prognosis, aggressive clinical behavior, rarity, and limited clinical experience. With surgery and concurrent chemoradiation, we were able to achieve a median overall survival of 9 months. Addition of temozolomide has shown a better trend in survival though it is not statistically significant.
  3 2,027 253
Giant solitary trichoepithelioma
Bhavuray Teli, PB Thrishuli, R Santhosh, DN Amar, Shravan Rajpurohit
January-March 2015, 4(1):41-44
DOI:10.4103/2278-330X.149951  PMID:25839021
Adnexal tumors like giant solitary trichoepitheliomas are uncommon to most of us to permit a ready familiarity with them. Information regarding the genesis, clinical profile, behavior, and management options for this tumor is limited. There are 18 cases reported in the world literature till date. This review attempts to provide insight to this rare tumor. Our search included indexed literature from Pubmed, Directory of Open Access Journals, Health Inter Network Access to Research Initiative and Google databases in addition to standard dermatology texts. Giant solitary trichoepithelioma is a rare trichogenic tumor with potential for local recurrence. It has predilection for the older age, but may present at any age including at birth. It has close resemblance to basal cell carcinoma and other skin adnexal tumors - clinically, cytologically, and histologically. CD10, CD 34, PHLDA1 but not p75NTR are useful adjunct markers. Surgical excision is the standard treatment. Recurrence and possible transformation into BCC cautions follow up at regular intervals.
  2 2,055 279
Immunohistochemical detection of axillary lymph node micrometastases in node negative breast cancer patients using cytokeratin and epithelial membrane antigen
Monisha Choudhury, Sapna Agrawal, Mukta Pujani, Shaji Thomas, Meenu Pujani
January-March 2015, 4(1):28-31
DOI:10.4103/2278-330X.149946  PMID:25839017
Background and Objective: The study was conducted to detect occult metastases in lymph node negative breast cancer patients using cytokeratin (CK) and epithelial membrane antigen (EMA) immunohistochemistry (IHC) and correlate this with primary tumor size and grade. Materials and Methods: A total of 32 cases including 12 prospective and 20 retrospective cases of axillary lymph node negative breast cancer were studied. CK and EMA IHC were performed to detect micrometastases. Results: Axillary lymph node metastases were detected in 18.75% of previously node negative cases using CK and EMA IHC. CK was found to be more sensitive for detection of metastases compared to EMA. A highly significant correlation was observed between tumor grade and axillary lymph node metastases detected by CK and EMA. However, no significant correlation was found between tumor size and axillary lymph node metastases detected by IHC. Conclusion: In the present study, there was an increase of 18.75% in the occult metastases detection rate using CK and EMA. To conclude, IHC detection of occult metastases should be done using CK in all axillary node negative cases, especially in T1 and T2 stage tumors.
  1 2,414 226
Subcutaneous implantation of metastatic carcinoma: An unpredicted event following endoscopic parathroidectomy for adenoma
Shreya Bhattacharya, Harit K Chaturvedi, Andleeb Abrari, Biswajyoti Hazarika
January-March 2015, 4(1):45-46
DOI:10.4103/2278-330X.149953  PMID:25839023
  1 986 146
Gastric and colonic metastasis from cancer cervix: An unusual progression with an uncommon cause of mortality
Ashish Singhal, Shakeel Masood, Charu Mahajan, Rahat Hadi, Shalini Bhalla
January-March 2015, 4(1):51-53
DOI:10.4103/2278-330X.149959  PMID:25839029
  1 1,237 197
Addition of magnetic resonance imaging to computed tomography-based three-dimensional conformal radiotherapy planning for postoperative treatment of astrocytomas: Changes in tumor volume and isocenter shift
Puneet Kumar Bagri, Akhil Kapoor, Daleep Singh, Mukesh Kumar Singhal, Satya Narayan, Harvindra Singh Kumar
January-March 2015, 4(1):18-20
DOI:10.4103/2278-330X.149939  PMID:25839014
Introduction: Postoperative radiotherapy is the current gold standard treatment in astrocytomas. Computed tomography (CT)-based radiotherapy planning leads to either missing of the tumor volume or underdosing. The aim of this prospective study was to study the changes in tumor volume on addition of magnetic resonance imaging (MRI) to CT-based three-dimensional radiotherapy treatment planning of astrocytomas. Materials and Methods: Twenty-five consecutive patients of astrocytoma (WHO grades I-IV) for postoperative three-dimensional conformal radiotherapy were included in this prospective study. Postoperative tumor volumes were contoured on CT-based images and recontoured on CT-MRI images after automated MRI co-registration on treatment planning system Eclipse 8.9.15 as per ICRU-50 report. Tumor volumes were compared with each other. Result: The MRI-based mean and median tumor volume was 24.24 cc ± 13.489 and 18.72 cc (range 5.6-46.48 cc), respectively, while for CT it was 19.4 cc ± 11.218 and 16.24 cc (range: 5.1-38.72 cc), respectively. The mean and median isocenter shift between CT and MRI was 4.05 mm and 4.39 mm (range 0.92-6.32 mm), respectively. There is a linear relationship between MRI and CT volume with a good correlation coefficient of R2 = 0.989, and MRI-based tumor volume was 1.208 times as compared to CT volume. Statistical analysis using paired sample t-test for the difference in CT and MRI tumor volume was highly significant (P < 0.001). Conclusion: Addition of MRI to the CT-based three-dimensional radiation treatment planning reduces the chances of geographical miss or tumor under dosing. Thus, MRI should be an integral part of three-dimensional planning of astrocytomas.
  1 1,234 184
Simultaneous integrated boost with intensity modulated radiation therapy in brain oligometastases: A feasible technique for developing countries
Vivek Tiwari, Subodh C Pande, Kamal Verma, Sandeep Goel
January-March 2015, 4(1):11-14
DOI:10.4103/2278-330X.149927  PMID:25839012
Introduction: To analyze the pattern of brain metastasis (BM), and to use intensity modulated radiation therapy (IMRT) for target dose escalation in cases with ≤3 metastatic lesions (oligometastases). Materials and Methods: Thirty-two consecutive cases of BM treated during September 2009 to August 2012 were analyzed retrospectively. Results: The study comprised 13 males (40.62%) and 19 females (59.37%). Thirteen (40%) patients presented with disseminated intracranial metastases, while 19 (60%) had ≤3 foci. In 25 cases (78%), the primary was located either in the breast (14 cases) or lung (11 cases). The 13 patients with disseminated intracranial metastases received whole brain radiation therapy to a dose of 30 Gy/10-12 daily fractions (Group A) while the 19 cases with ≤3 lesions received an additional dose of 6-10 Gy to gross lesions using a simultaneous integrated boost (SIB) with IMRT thus receiving a total dose of 36-40 Gy/12-15 fractions (Group B). Overall survival (OS) for the breast primary was 6.3 and lung primary was 5.3 months, respectively. The mean OS for breast cases in Group B was higher (9.5 months) as compared to Group A cases (1.9 months) and was statistically significant (P = 0.0056). Similarly, primary lung cancer cases in Group B showed a mean OS of 8.75 months versus 2.6 months for Group A cases (P = 0.213). Conclusions: IMRT is a safe and effective technique in cases with oligometastases for dose escalation in the form of SIB.
  1 2,027 330
Denominators: An attempt to adjust for cancer incidence and mortality rates and its role in cancer registries
Manoj Kalita, Tulika Nirmolia
January-March 2015, 4(1):24-27
DOI:10.4103/2278-330X.149943  PMID:25839016
Cancer is an important public health burden in India and around the Globe. Incident cases of cancer are reported continuously, and trends in incidence rates vary among five yearly age group. In India National census is carried out after every 10 years since 1951, the latest census is carried out in 2011. As Incident cases of cancer are reported continuously for 5 year age group and estimation of rates and trends for a given year of interest fall in-between two census period population estimation of five yearly age group, which serves as Denominator sense importance. Denominator serves as the most essential part of any cancer registry program as it used for calculation of various rates for five yearly age group such as age-standardized rate, crude rate, truncated rate, cumulative risk etc., Calculated by different registries and Individual Researchers, Government organizations, etc. Currently most of the registries used individual exponential growth rate and differential distribution method to estimate the growth rate. However, it is found that the calculated rates and risk be suffering from bias most of the time since some method over and underestimate the growth rate while some does not able to maintain consistency. Here, an attempt is made to adjust the world standard population with two census period to estimate the five yearly age group for a given year of interest of a geographical region falls in-between two census period. It is also shown here that how the proposed model "age-adjusted population growth model" maintain the overall growth as in exponential growth model and difference distribution method also maintains the estimated growth rate is as found in difference distribution method. Further, it is tried to highlight the points how these method overcomes the problems compared with other methods that are currently used by registries.
  - 1,168 155
What is the way forward for unresectable oral cavity cancers among Indian patients?
Santam Chakraborty
January-March 2015, 4(1):3-3
DOI:10.4103/2278-330X.149902  PMID:25839009
  - 1,402 284
The changing face of acute myeloid leukemia therapeutics in the elderly population
Naval Daver, Jorge Cortes
January-March 2015, 4(1):1-2
DOI:10.4103/2278-330X.149900  PMID:25839008
  - 2,162 254
Role of FNAC in Hepatic lesions: Risk of track metastases
Challa Vasu Reddy, YG Basavana Goud, R Poornima, Vijayalakshmi Deshmane, BA Madhusudhana, M Gayathridevi
January-March 2015, 4(1):35-37
DOI:10.4103/2278-330X.149949  PMID:25839019
Background: Liver is one of the most common site of metastases in patients with malignancy and the evaluation of space occupying lesions (SOL) of liver in patients with malignancy is important. Its important to differentiate benign from malignant to take necessary decisions. Materials and Methods: We have performed a retrospective analysis of liver SOLs for which fine needle aspiration cytology (FNAC) was done in the year 2011. Risks and benefits associated with FNAC were evaluated. Results: We analyzed 755 patients who underwent FNAC of which 524 patients had secondary metastases to liver, 148 patients had primary hepatocellular carcinoma, 14 cases were benign neoplasms and 53 were nonneoplastic conditions. Histological correlation with FNAC was available in 112 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93%, 90.9%, 98.9%, 58.8%, and 92.8%, respectively. Though there were no incidence of bleeding, two patients developed track metastases following FNAC. One was a case of Hepatocellular carcinoma and the other a case of metastatic breast cancer. Conclusion: FNAC was very much useful in our setup where most of the patients could not afford for Computer tomography (CT) scan and was useful in counseling them especially in patients with advanced malignancy where no active cancer directed therapy is required.
  - 2,867 199
Oncocytic adenoma of thyroid with papillary architecture: A diagnostic dilemma
Sanjay D Deshmukh, Pallavi A Patil, Siddhi G. S. Khandeparker, Chetana Naik
January-March 2015, 4(1):50-51
DOI:10.4103/2278-330X.149958  PMID:25839028
  - 1,153 231
Unusual etiology of secondary thyrotoxicosis and its presentation
Vinayak V Maka, S Murali, Nalini Kilara
January-March 2015, 4(1):46-47
DOI:10.4103/2278-330X.149954  PMID:25839024
  - 1,172 186
A retrospective analysis of occupational exposure to pesticides as a possible risk factor for non-melanoma skin cancers
Manigreeva Krishnatreya, Amal C Kataki, Jagannath D Sharma, Kaberi Lahkar
January-March 2015, 4(1):47-48
DOI:10.4103/2278-330X.149955  PMID:25839025
  - 1,125 204
Spontaneous rupture of renal cell carcinoma: A series of three cases
Bhuvanesh Nanjappa, Mallikarjuna Chiruvella, Purna Chandra Reddy, Deepak Ragoori, Mohammed Taif Bendigeri
January-March 2015, 4(1):48-49
DOI:10.4103/2278-330X.149956  PMID:25839026
  - 1,119 181
Laparoscopic management of sigmoidorectal intussusception caused by sigmoid carcinoma
Vishwas D Pai, Ashwin Desouza, Manish Bhandare, AP Saklani
January-March 2015, 4(1):45-45
DOI:10.4103/2278-330X.149952  PMID:25839022
  - 1,030 157