A K Bahadur

Maulana Azad Medical College, New Dilli, NCT, India

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Publications (27)32.52 Total impact

  • Radiotherapy and Oncology 01/2014; 111:S40. DOI:10.1016/S0167-8140(15)31276-7 · 4.86 Impact Factor
  • Radiotherapy and Oncology 05/2011; 99. DOI:10.1016/S0167-8140(11)70984-7 · 4.86 Impact Factor
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    ABSTRACT: Colorectal cancer is rare in younger age group. Most cases occur in the second decade of life and are clinically aggressive. The prognosis of these patients is generally poor. This is a retrospective study in which data of Indian patients was compared to standard literature. Data on 32 young patients with colorectal cancer between ages of 10-25 years treated between January 2000 and December 2006 was reviewed. Clinical presentation, natural history and response to therapy were evaluated. Studied cases comprised 9.9% of the total number of colorectal cancer patients. The median age of presentation was 21.5 years. Four-fifths of the cases presented in late stage. Nodal involvement was seen in 38% cases and metastatic disease in 12% cases. The rectum was the most commonly involved site. A majority of the patients presented with pain (81%), altered bowel habits (72%) and bleeding per rectum (78%). Surgery was done in 16 cases; radiotherapy in 16 patients; while chemotherapy was used in 19 cases. Responses at completion of treatment were seen in 28% cases; while 1 year post treatment only 12% cases were alive and only 6% at 2 years. Colorectal cancer in younger age is rare and a high level of suspicion is necessary to diagnose it at an early and curable stage. Rectal bleeding therefore should not be ignored but evaluated further with at least a digital rectal examination and a sigmoidoscopy. Failure to do so results in late presentation with consequent dismal survival rates.
    Tropical gastroenterology: official journal of the Digestive Diseases Foundation 01/2011; 32(2):122-7.
  • Fuel and Energy Abstracts 11/2010; 78(3). DOI:10.1016/j.ijrobp.2010.07.422
  • V Roy, D Saxena, M Agarwal, A K Bahadur, B Mishra
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    ABSTRACT: Use of antimicrobials (AM) and granulocyte colony stimulating factors (G-CSF) affect the outcome and cost of treatment of febrile neutropenia (FN). There are no studies describing the AM utilization pattern or the use of G-CSF and cost incurred on them in cancer patients with FN from India. A study was conducted in a tertiary care, teaching hospital in New Delhi, India, with the objectives of describing the utilization pattern of AM and G-CSF in cancer patients with FN. The efficacy and costs of AM and G-CSF prescribed were also assessed. A total of 211 patients with FN were enrolled in the study. A majority of 207 (98.1%) were in the low-risk category. The average number of AM used per patient was 2.45 ± 0.02 and the AM exposure density was 1.19. All patients were administered five different combinations of AM regimens and G-CSF, irrespective of the risk category. No difference in the time to defervesence or in the recovery of ANC counts were observed with the different AM regimens. The average drug cost per febrile neutropenia episode (FNE) was Rs 4694.45 ± 296.35 (113.95 ± 7.19$). G-CSF accounted for 76.14 - 97.58% of the total costs. Large variations in the pattern of AM prescribed with routine use of G-CSF, irrespective of the risk status, was observed. Guidelines for the rational and cost-effective use of AM and G-CSF in patients with FN needed to be prepared. This was especially important as treatment was given free of cost to all patients admitted in the government health facility.
    Indian Journal of Cancer 10/2010; 47(4):430-6. DOI:10.4103/0019-509X.73568 · 1.13 Impact Factor
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    ABSTRACT: Adenoid cystic carcinoma (ACC) is a rare neoplasm that usually arises from the salivary, lacrimal, or other exocrine glands. It is characteristically locally infiltrative in nature and has a tendency toward local recurrence, high propensity for perineural invasion, and prolonged clinical course. To analyze the presentation and natural history of cases of adenoid cystic tumors of salivary glands in our institution; and to compare with the existing literature. Retrospective study at the Department of Radiotherapy. Data on 18 patients of ACC of the salivary glands treated between 2004 and 2008 were reviewed with respect to clinical presentation, stage, and histology. There were 8 cases of major salivary gland tumors (47%), of which 2 were in the submandibular and 6 were involving the parotid. Ten patients (53%) had minor salivary gland involvement. Two patients had metastasis at the time of presentation. All patients underwent surgery. Radiotherapy was delivered to 16 patients and chemotherapy to 6 patients (concurrent, n = 3 and adjuvant, n = 3) and no adjuvant therapy was given to 2 patients. All patients were alive at a median follow-up of 3 years. No patient developed local or distant failure during the study duration. ACC has locally aggressive behavior. Radiotherapy adjuvant to surgery improves local control in locally advanced disease. Longer follow-up is mandatory in view of incidence of late metastasis.
    Indian Journal of Cancer 10/2010; 47(4):424-9. DOI:10.4103/0019-509X.73571 · 1.13 Impact Factor
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    ABSTRACT: Breast cancer is the most common cancer in urban India, but no study has been carried out on psychosocial disorders in breast cancer patients. The present study has been undertaken to evaluate behavioural and psychosocial impacts before and after treatment of women with breast cancer. The study was carried out in a reputed hospital in Delhi. A total of 97 breast cancer patients matched for age and economic status were divided into group A (66) and group B (31) on the basis of treatment modalities offered to the patient. These women were interviewed, before and after the treatment, and the observations were recorded in a pre-tested structured questionnaire. Chi-square test and Fisher's exact test were used to calculate statistical significance. Although the extent of sociobehavioral disorders were higher in patients on postoperative adjuvant chemotherapy and radiotherapy when compared with those on postoperative adjuvant chemotherapy alone, the difference was, however, not statistically significant. Psychological reactions were observed in 31% of patients but after intervention, 65% showed adjustment within 4 to 12 weeks, whereas the rest showed late adjustments. Breast disfigurement and sexuality were found to be least important, but psychological and social support appears to significantly influence the treatment outcome and rehabilitation of breast cancer patients in India.
    Indian Journal of Cancer 07/2010; 47(3):296-303. DOI:10.4103/0019-509X.64729 · 1.13 Impact Factor
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    ABSTRACT: We present the case of a 45-year-old female patient who harbored two synchronous primary malignant neoplasms-an anaplastic oligodendroglioma of the right frontal lobe and a squamous cell carcinoma of the tongue. Both neoplasms were in advanced stage and carried a dismal prognosis. To the best of our knowledge, this is the first documentation in the english literature of such a presentation. The purpose of this article is to alert clinicians to this possibility and to outline the management approach in a different manner in patients presenting with multiple primary neoplasms.
    Journal of cancer research and therapeutics 04/2010; 6(2):227-9. DOI:10.4103/0973-1482.65241 · 0.95 Impact Factor
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    ABSTRACT: The incidence of breast cancer is on the rise in India, breast cancer is the second most common malignancy in Indian women. The aim of this study was to find out the association of various risk factors with breast cancer among women in Delhi. This was a case-control study in Lok Nayak Hospital, Delhi. 332 women were studied. Subjects were women with breast cancer (N = 115) and age matched Control subjects (N-217) without breast cancer, attending Lok Nayak Hospital during 2006. Subjects were interviewed using a pretested questionnaire. The risk factors studied were: age, parity, socioeconomic status, marital status, breast feeding, menarche, menopause, family history. Data was expressed in proportion. Age of the patient ranged from 25 to 80 years. In this study, 69 (60%) cases and 127 (58.5%) controls were illiterate, the mean duration sum of total breast feeding for all children was 6.58 years in cases and 7.4 years in controls (OR = 1.91; 95% CI, 1.17 - 3.13) (P P P< 0.05). There was a significant difference between breast cancer cases and controls in relation to place of residence, occupation, marital status, body mass index and breast feeding.
    Indian Journal of Cancer 01/2009; 46(2):132-8. DOI:10.4103/0019-509X.49151 · 1.13 Impact Factor
  • International Journal of Radiation OncologyBiologyPhysics 09/2008; 72(1). DOI:10.1016/j.ijrobp.2008.06.1272 · 4.18 Impact Factor
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    ABSTRACT: Metastatic bone pain is acommonly encountered clinical condition seen in oncology clinical practice. About 50% of all cancer patients develop metastases in their lifetime and half of them develop skeletal metastases. Despite its importance, no specific therapeutic strategy, to prevent or treat this complication of cancer has been demonstrated. This study comparing two radiotherapy regimens was conducted at a cancer center in New Delhi, India. Patients with confirmed bone metastases were randomized into two treatment arms, Group A (single fraction) and Group B (multiple fractions). Patients were followed up for 12 weeks. Pain relief was the primary endpoint of the treatment. Other parameters were improvement in analgesic score, performance status, and acute side effects like nausea, vomiting, tiredness, and lassitude. Fifty patients were evaluated at the end of the study. Overall response rate was seen in 86% of cases, whereas complete response was seen in 36% of cases. The two treatment regimens were found to be comparable with respect to other endpoints. Hence, a single fraction treatment, which is more convenient and cost effective, is a more logical approach in the Indian scenario in selected cases.
    Indian Journal of Palliative Care 01/2008; DOI:10.4103/0973-1075.41924
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    ABSTRACT: Rectal bleeding secondary to radiation proctitis is the most dreaded complication of pelvic radiotherapy. Its management remains a perplexing problem despite the availability of multiple treatment modalities. Patients are usually managed on a “hit and miss” basis at most centers. Steroid, 5-aminosalicylic acid, short chain fatty acids and sucralfate enemas, hyperbaric oxygen therapy, and topical application of 4% formaldehyde all have been used with varying results. Surgical procedures such diversion colostomy or resection of involved segment have been proposed for refractory bleeding. Endoscopic methods are being increasingly adopted in the form of bipolar electrocoagulation, heat probe coagulation, photoablation, Nd:YAG laser and preferably argon plasma coagulation. The utility of conservative approaches remains far below desirable levels. Onset of hemorrhagic recurrence represents a major obstacle that leads to a need for repeated therapeutic sessions and sometimes invocation of radical techniques. This review discusses various treatment modalities and aims to identify their efficacy and limitations. A critical review was conducted of published reports regarding management of chronic hemorrhagic radiation proctitis (CHRP). Although there are few prospective randomized trials, enough evidence is available to conclude that argon plasma coagulation represents the current treatment of choice.
    Asia-Pacific Journal of Clinical Oncology 02/2007; 3(1):19 - 29. DOI:10.1111/j.1743-7563.2006.00084.x · 1.06 Impact Factor
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    ABSTRACT: Background: Osteosarcomas, despite their aggressive nature and propensity to metastasize, only rarely give rise to skin deposits. Case: We report a case of a femoral osteosarcoma in which cutaneous scalp and neck metastases developed 3 years after treatment of the primary disease. Fine needle aspiration was pivotal in diagnosing the secondary disease. Conclusion: Only 8 instances of cutaneous metastases from an osteosarcoma have been previously reported. We recommend early investigation of such nodules with fine needle aspiration cytology and inclusion of multiagent chemotherapy as part of the treatment protocol in all patients with osteosarcoma.
    01/2007; 51(1):102-106. DOI:10.1159/000325695
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    ABSTRACT: Osteosarcomas, despite their aggressive nature and propensity to metastasize, only rarely give rise to skin deposits. We report a case of a femoral osteosarcoma in which cutaneous scalp and neck metastases developed 3 years after treatment of the primary disease. Fine needle aspiration was pivotal in diagnosing the secondary disease. Only 8 instances of cutaneous metastases from an osteosarcoma have been previously reported. We recommend early investigation of such nodules with fine needle aspiration cytology and inclusion of multiagent chemotherapy as part of the treatment protocol in all patients with osteosarcoma.
    Acta cytologica 01/2007; 51(1):102-6. · 1.56 Impact Factor
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    ABSTRACT: Nine patients with a histologically proven diagnosis of chordoma seen at the Department of Radiation Oncology, Maulana Azad Medical College and Lok Nayak Hospital between January 1999 and December 2004 were retrospectively reviewed with respect to age, sex, presentation, location of tumour, treatment, response, recurrence, metastasis and follow up. Chordoma constituted 0.07% of total cancer cases registered over 6 years. Out of nine patients, eight were males and one was female with median age at time of diagnosis 52 years (range 34-68 years). All had sacrococcygeal lesions except one who had a spheno-occipital lesion. Seven patients had undergone either subtotal or gross total resection whereas only biopsy had been carried out in two of them. All patients received radiation therapy, seven in a postoperative setting and two for palliation. Follow-up period ranged from 2 to 50 months. Four patients died--the first after fourth fraction of radiation, second after 10 days of treatment, third of progressive lesion in sphenoidal region despite resection and radiation and fourth of local recurrence in the sacrococcyx. One patient developed distant metastases in the lungs and subcutaneous tissue over the scalp along with local recurrence; he is still alive. Two patients are locally free of disease whereas the other two were lost to follow up. The present analysis was undertaken to review our institutional experience with an aim to provide a practical approach to these tumours. In this report, these cases are discussed and the published works have been reviewed for the optimal management of patients with chordoma.
    Australasian Radiology 07/2006; 50(3):201-5. DOI:10.1111/j.1440-1673.2006.01562.x · 0.51 Impact Factor
  • Community Oncology 06/2006; 3(6):367–368. DOI:10.1016/S1548-5315(11)70714-8
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    ABSTRACT: Cytologic diagnosis of malignant fibrous histiocytoma can be problematic, as these neoplasms are known to mimic multiple other conditions. A fine needle aspirate from a 60-year-old woman was diagnosed at 2 institutions as medullary carcinoma of the breast. The patient received neo-adjuvant chemoradiotherapy before the tumor war excised. Gross pathologic examination and histomorphology on routine staining were compatible with the cytologic diagnosis. The accurate diagnosis of pleomorphic-storiform-type malignant fibrous histiocytoma was a surprise and was established with immunocytochemical stains. In retrospect, it was thought that clinical and radiologic overlap, creating a high index of suspicion for a breast neoplasm and compounding the cytologic appearance of a medullary carcinoma with spindle cell metaplasia and syncytial cells, was responsible for the error. This case highlights a potential cytodiagnostic pitfall and the importance of establishing a definitive tissue diagnosis in the face of equivocal cytologic findings.
    Acta cytologica 01/2006; 50(5):577-80. DOI:10.1159/000326020 · 1.56 Impact Factor
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    ABSTRACT: Cystosarcoma phyllodes is a rare breast tumor with a low incidence of metastasis. Lymph node metastasis is even rarer. We report here a case of a 45-year-old woman who presented with a large lump in her left breast and involvement of multiple ipsilateral axillary lymph nodes. Clinical findings and cytologic examination (fine-needle aspiration) were suggestive of cystosarcoma phyllodes, for which she underwent a radical mastectomy. Postoperative histopathologic findings revealed cystosarcoma phyllodes with multiple lymph node metastases. Postoperative radiotherapy was given to the locoregional area.
    Community Oncology 01/2006; 3(1). DOI:10.1016/S1548-5315(11)70642-8
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    ABSTRACT: Brachytherapy plays a major role in the treatment of patients with carcinoma of the cervix. However, routine intracavitary brachytherapy may not be feasible or adequate to treat locally advanced disease. The purpose of this prospective study was to assess treatment outcome for patients with locally advanced gynecological malignancies treated with interstitial brachytherapy using Martinez Universal Perineal Interstitial Template (MUPIT) and to study the acute and late sequelae after treatment by this technique. Thirty previously untreated patients with histologically confirmed carcinoma of the cervix (20 patients), vault (7 patients), and vagina (3 patients) were treated by a combination of external beam radiotherapy using megavoltage irradiation to the pelvis to a dose of 4000 to 5000 cGy followed by interstitial brachytherapy using MUPIT between June 2000 to August 2001 at Gujarat Cancer and Research Institute, Ahmedabad. Only those patients who were found unsuitable for conventional brachytherapy or in whom intracavitary radiotherapy was found to be unlikely to encompass the tumor volume were treated with interstitial template brachytherapy using MUPIT applicator and were enrolled for this study. Criteria for inclusion in this study were as follows: Hemoglobin--minimum 10 gm%; Performance Status--70% or more (Karnofsky Scale); Histopathological confirmation; FIGO Stage--IIb-IIIb (excluding frozen pelvis). Among the 30 patients studied, 4 lost to follow-up and they were excluded from the study. With a median follow up of 9 months, local control was achieved in (20/26) 76.92% patients. The local control was better for nonbulky tumors compared to bulky tumors irrespective of stage of disease. Local control rate was better in patients with good regression of disease after EBRT. The time gap between EBRT and implant also had an impact on the outcome. Interstitial template brachytherapy by MUPIT is a good alternative to deliver high-dose radiation in locally advanced gynecological malignancies where conventional brachytherapy application is either not feasible or unlikely to encompass tumor volume adequately. The locoregional control obtained is definitely better than external beam therapy alone and within the accepted range of complications. However, long-term follow-up is needed to comment on late morbidities.
    Gynecologic Oncology 11/2005; 99(1):169-75. DOI:10.1016/j.ygyno.2005.06.001 · 3.69 Impact Factor