Radhika Srinivasan

Publications (124) View all

• Article: Uterine sarcoma-current management and experience from a regional cancer centre in North India.

  Ahitagni Biswas, Firuza Patel, Pankaj Kumar, Radhika Srinivasan, Anjan Bera, Suresh C Sharma, Arvind Rajwanshi
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  ABSTRACT: PURPOSE: We intended to assess the clinicopathological features and treatment outcome in patients of uterine sarcoma. METHOD: A retrospective review of medical records of patients of uterine sarcoma (2002-2007) was conducted. Overall survival (OS) was analyzed by Kaplan-Meier method. RESULTS: Forty-two patients met the study criterion [15 carcinosarcoma, 12 endometrial stromal sarcoma, 11 leiomyosarcoma, 3 undifferentiated endometrial sarcoma (UES), and 1 mixed sarcoma]. Median age and performance status were 52 years and ECOG 0, respectively. All patients underwent primary surgery out of which 66.7 % was total abdominal hysterectomy and bilateral salpingo-oophorectomy. FIGO (2009) stage was I, II, III, IV and unknown in 66.7, 7.1, 14.3, 9.5, and 2.4 % of the patients. Eight patients were kept on follow-up only. Adjuvant radiation, chemoradiation, and chemotherapy were offered in 8, 9, and 3 patients, respectively. Pelvic radiation: 46 Gray/23 fractions/4.5 weeks and vincristine, adriamycin, cyclophosphamide (VAC) regimen were most commonly used. Overall clinical complete response (CR), stable disease (SD), and progressive disease (PD) were, respectively, 59.5, 2.4, and 26.2 % (response not evaluable in 12 %). In the evaluable patients (N = 33), median OS was noted to be 7.67 months (mean 30.19 months). 1- and 2-year actuarial survival were 45.45 and 36.36 %. Stratified by histology, median survival in patients with carcinosarcoma, endometrial stromal sarcoma, leiomyosarcoma, and UES were, respectively, 6.57, 18.7, 6.8, and 9.38 months. On univariate analysis, response to therapy (p = 0.0003), disease stage (p = 0.00001), tumor size (p = 0.02), and performance status (p = 0.03) were significant predictors of OS. Disease stage (p = 0.005) and response to therapy (p = 0.01) retained significance on multivariate analysis. CONCLUSIONS: Median OS of only 6.57, 6.8, and 9.38 months, respectively, in patients with carcinosarcoma, leiomyosarcoma, and UES in our series reflect the aggressive clinical course and poor prognosis of these rare neoplasms, which mandate intensive multimodality therapy. Even in low-grade endometrial stromal sarcoma, median survival of 18.7 months in our series is far from satisfying. However, small series, poor treatment compliance and socio-economic constraints in the Indian scenario are limiting factors in the result analysis.
  Archives of Gynecology 04/2013; · 0.91 Impact Factor
• Article: Potential importance of Maackia amurensis agglutinin in non-small cell lung cancer.

  Sangeeta Mehta, Rakhee Chhetra, Radhika Srinivasan, Suresh C Sharma, Digambar Behera, Sujata Ghosh
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  ABSTRACT: Abstract Maackia amurensis agglutinin is a NeuNAcα (2-3) Galβ (1-4) GlcNAc/Glc specific lectin, which was shown to have diagnostic potential in cancer of different origin. In the previous report, we have demonstrated that GM3 specific IgG from bronchoalveolar lavage fluid (BALF) of non-small cell lung cancer (NSCLC) patients interacted with ~66kDa membrane glycoprotein band of NSCLC cell lines, which was also recognized by this lectin. This observation prompted us to assess the potential of Maackia amurensis agglutinin in NSCLC. Accordingly, we examined the reactivity of this lectin with NSCLC cell lines as well as the tissue biopsies and cells obtained from fine needle aspirations of NSCLC patients. Maackiaamurensis agglutinin showed strong reactivity specifically with cells and biopsy samples of NSCLC origin. Further, this lectin was found to induce apoptosis in NSCLC cells. The mechanism of this lectin induced apoptosis involved downregulation of Bcl-XL, upregulation of Bax, release of cytochrome c and activation of procaspase-3. Collectively our results have suggested that Maackia amurensis agglutinin may have the potential to serve as a unique probe for detection of NSCLC and also as a specific apoptosis inducing agent in NSCLC cells.
  Biological Chemistry 03/2013; · 2.96 Impact Factor
• Article: Surveillance without chemotherapy in a woman with recurrent molar pregnancy.

  Rashmi Bagga, Sujata Siwatch, Radhika Srinivasan, Lakhbir Kaur Dhaliwal
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  ABSTRACT: A 27-year-old fouth gravida patient with previous two partial molar pregnancies and one missed abortion underwent a suction evacuation for partial molar pregnancy at 9 weeks of gestation. She was followed up with serum HCG values. Though the HCG level reduced from a pre-evacuation value of 1 40 223-31 157 mIU/ml 1 week post procedure, the levels continued to be positive in low titres 6 months after suction evacuation. The management options were discussed with the patient and a decision was taken to continue surveillance with serial HCG titres. HCG levels normalised after 11 months without the need for chemotherapy.
  Case Reports 01/2013; 2013.
• Article: Role of (18)F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Characterization of Pancreatic Masses: Experience from Tropics.

  Sampath Santhosh, Bhagwant Rai Mittal, Deepak Bhasin, Radhika Srinivasan, Surinder Rana, Ashim Das, Ritambhra Nada, Anish Bhattacharya, Rajesh Gupta, Rakesh Kapoor
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  ABSTRACT: BACKGROUND AND AIM: Early detection and differentiation of malignant from benign pancreatic tumors is very essential as mass-forming pancreatitis is a frequently encountered problem. PET has a role in establishing the diagnosis of pancreatic carcinoma when the conventional imaging modalities or biopsy are nondiagnostic. In this prospective study, we report the utility of FDG-PET/CT in the characterisation of mass forming lesions of the pancreas. METHODS: F-18 FDG PET/CT was prospectively performed in 87 patients diagnosed to have periampullary or pancreatic mass. Lesions with focally increased FDG uptake in PET/CT were considered malignant whereas, those with diffuse or no FDG uptake were considered benign. Semi quantitative analysis with SUVmax was also calculated. The PET/CT results were compared with histopathological results in all patients. RESULTS: Based on the FDG uptake pattern, sensitivity, specificity, PPV, NPV and accuracy for FDG-PET/CT in characterising the periampullary and pancreatic masses into benign and malignant lesions were 93%, 90%, 95%, 87% and 92% respectively. ROC analysis of the SUVmax of the lesions yielded a cut-off value of 2.8, with a sensitivity and specificity of 87.5% and 45% respectively. CONCLUSION: The FDG uptake pattern in PET/CT can differentiate malignant from benign mass-forming lesions of the pancreas with high accuracy and a discrete cut-off value of SUVmax could not be defined for the same as even lesions with pancreatic tuberculosis showed very high FDG uptake. Hence, in patients with a suspicion of malignancy in the pancreas, a focally increase FDG uptake in PET/CT suggests the diagnosis of malignancy.
  Journal of Gastroenterology and Hepatology 11/2012; · 2.87 Impact Factor
• Article: Role of F-18 FDG PET/CT in assessing bone marrow involvement in pediatric Hodgkin's lymphoma.

  Kanhaiyalal Agrawal, Bhagwant Rai Mittal, Deepak Bansal, Neelam Varma, Radhika Srinivasan, Amita Trehan, Kuruva Manohar, Raghava Kashyap, Anish Bhattacharya, Ram K Marwaha
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  ABSTRACT: OBJECTIVES: The aim of the current study was to assess the utility of F-18-fluoro-2-deoxy-D-glucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) in assessing bone marrow involvement (BMI) compared to bone marrow biopsy (BMB) in initial staging of Hodgkin's lymphoma (HL) in pediatric patients. METHODS: Data of 38 pediatric patients (mean age 9.8 years, range 3-18 years) with HL were analyzed for the involvement of bone marrow. All patients underwent non-contrast F-18 FDG PET/CT study. BMB was done in 31 patients from the bilateral iliac crests. Scans were interpreted by two nuclear medicine physicians blinded to the details of BMB. RESULTS: Of the 31 patients who underwent BMB, 5 patients had lymphomatous involvement on BMB. PET/CT was positive in four of these five patients. In 26 patients negative on BMB, PET was negative in 23 patients and positive in 3 patients for BMI. The sensitivity and negative predictive value of F-18 FDG PET/CT was 87.5 and 96 %, respectively, for BMI. CONCLUSIONS: F-18 FDG PET/CT can predict BMB results with high accuracy. F-18 FDG PET/CT may be used at initial staging of pediatric Hodgkin's lymphoma as it uncovers unsuspected BMI and BMB may be omitted in patients with PET-positive BMI.
  Annals of Nuclear Medicine 11/2012; · 1.50 Impact Factor