Anusheel Munshi

• Additional Director at Fortis Memorial Research Institute

Aim The occurrence of setup errors in external beam radiation is an inevitable aspect. As a result of technological progress in image verification, it became feasible to decrease its occurrence; however, complete eradication remained unattainable. Various methodologies have been implemented in clinical settings to measure and evaluate the extent of...

The decline in interest in the medical profession among the new generation is a complex issue influenced by various factors. This article explores the multifaceted reasons behind this phenomenon and proposes some strategies to address this concerning trend. Understanding these factors and taking appropriate measures is crucial for ensuring the futu...

Aim This article examines India’s present radiotherapy (RT) machine status and requirements, geographical distribution, and infrastructure need in six regional areas, which include 31 member states and union territories (UTs). It also considers the influence of the COVID-19 pandemic on India’s teletherapy sector. Materials and Methods Data from re...

Aim Cancer is a significant public health concern, and National Cancer Control Programs (NCCPs) are crucial for reducing its burden. However, assessing the progress of NCCPs is challenging due to the complexity of cancer control outcomes and the various factors that influence them. Composite indicators can provide a comprehensive and accurate asses...

Radiotherapy is an essential treatment modality for CNS tumors, but it has its own fair share of side effects and toxicities. CNS side effects greatly impair quality of life of patient. Radiation toxicity damages glial oligodendrocytes and glial astrocytes. Radiation induced brain injury can be described into 3 phases. Acute side effects like fatig...

This study aims to compare dose escalation between two groups of reirradiated cancer patients, one with the previous contour and radiotherapy plan available on the treatment planning system and the other without. First group is identified as DICOM-group, while the other one is called non-DICOM group. The current study included 89 patients, 57 in th...

Purpose: Rising cancer incidences, complex treatment techniques, and workflows have all impacted the radiotherapy scheduling process. Intelligent appointment scheduling is needed to help radiotherapy users adapt to new practices. Materials and methods: We utilized van Herk's safety margin formula to determine the radiotherapy department's treatm...

Background and purpose: In recent years, data science approaches have entered health-care systems such as radiology, pathology, and radiation oncology. In our pilot study, we developed an automated data mining approach to extract data from a treatment planning system (TPS) with high speed, maximum accuracy, and little human interaction. We compare...

Purpose Patient wait time for every single fraction of every patient treated at our centre for the past year has been presented in this study. The waiting time data were analysed across different treatment sites and modalities. Materials and Methods Between March 2021 and March 2022, all patients and their corresponding recorded measurements of wa...

Open access journals (OAJ) in biomedicine are promoted to improve the reach and distribution of global health research (GHR).However, in the last 20 years, article publishing charge (APC) is attracting and publishing the vast majority of papers from high-income countries (HIC) in 'oncology' journals under OAJ. This paper outlines the impediments fo...

Non-small cell lung cancer (NSCLC) is considered the most common type of lung cancer (>80% of all lung cancers); patients are often diagnosed at advanced stages of the disease. The management of NSCLC is considered challenging owing to variations in size, an extension of the tumors, involvement patterns, and classification. Although adequate litera...

Purpose/Objective(s) This study aims to compare the dose-escalation between two groups of head and neck reirradiation patients with or without availability of appropriate DICOM based dose-volume and planning information of primary RT Materials/Methods A total of 89 patients who received reirradiation for recurrent/second primary head and neck canc...

Aims: The objective of this audit was to analyze the radiotherapy (RT) practice in a newly established tertiary private hospital. With increasing radiation oncology (RO) facilities in private sector, this report is the first audit from a private health organization in India. Subjects and methods: The audit of all consecutively registered patient...

Objectives : The purpose of this study is to analyze the challenges that overseas cancer patients face while receiving treatment in a Tier 1 city in India. Methods : A total of 2835 overseas patients from 55 countries received cancer treatment in two hospitals in Delhi, India between November 2013 and April 2019. Of these, 937 patients participate...

Context: Rotation corrected set-up margins in stereotactic radiotherapy (SRT). Aims: This study aimed to calculate the rotational positional error corrected set-up margin in frameless SRT. Settings and Design: 6D setup errors for the steriotactic radiotherapy patients were converted to 3D translational only error mathematically. Setup margins were...

Aim To evaluate the temporal growth pattern of female radiation/clinical oncologists (FRCOs) and, if applicable, predict the gender neutrality in different countries of South Asia. Materials and methods South Asia is composed of Afghanistan, Bhutan, Maldives, Bangladesh, India, Nepal, Pakistan and Sri Lanka. The growth pattern of FRCOs in the latt...

Lung cancer is reported as the leading cause of cancer-related mortality worldwide. Non-small cell lung cancer (NSCLC) constitutes 80%-85% of all lung cancers. Diagnosis of NSCLC is a complex multistep process. The prognosis of NSCLC is poor as most of the patients are presented at the metastatic stage. The management of these patients needs the ex...

Aim This study was designed to evaluate the personal challenges, work environment, and financial satisfaction of female radiation oncologists (FRO) in South Asia. Material and method A 28-point online survey was answered by 296 FRO from south Asia. The study comprised of seven sections: personal, professional, family, economic, workplace burnout,...

Purpose: Radiation dermatitis is most common and debilitating side effects of radiotherapy leading to treatment interruption, thereby compromising the local control, and effecting quality of life. With the invent of modern imaging and recent advances in megavoltage radiotherapy, radiation-related side effects have reduced. In this audit, we report...

Aim This study aimed to evaluate the compatibility of robotic couch-assisted six-dimensional (6D) patient positioning systems with gantry-mounted and in-room independent imaging modalities in two different accelerators. Materials and Methods Imaging and 6D patient setup workflow were evaluated for both machines. The imaging workflow consists of on...

Purpose/Objective(s) Historically south Asia had the second highest gender disparity in the world which reflected in professional attributes, like medical practice as well. The purpose of this study was to evaluate the growth pattern and leadership position of woman radiation oncologists (WRO) in South Asia; and, if applicable, forecast the time re...

South Asia is the second-highest genderbiased region globally, yielding higher social, economic and professional challenges to the female workforce [1,2]. Here we present the challenges faced by female radiation oncologists (FRO) in South Asia, comprising five countries (India, Bangladesh, Sri Lanka, Pakistan and Nepal) having a radiation oncology...

Context: This research describe the characteristic volume expansion of a moving target as a function of differential margins. Aim: We aimed to ascertain the volume change after giving margin for clinical and set up uncertainties including generating internal target volume (ITV) for moving target. Materials and methods: Settings and Design - Sp...

Background: Medulloblastoma is the commonest embryonal brain tumor in children. It has shown improved outcomes with combined modality treatment. We aimed to study patient characteristics and survival outcomes of patients with this disease across two tertiary care centers in India. Methods: We analyzed data of patients with histological diagnosis...

Objective: Accurate calculation of set-up margin is a prerequisite to arrive at the most optimal clinical to planning target volume margin. The aim of this study was to evaluate the compatibility of different on-board and in-room stereoscopic imaging modalities by calculating the set-up margins (SM) in stereotactic body radiotherapy technique acco...

Collusion is an unharmonious bond between the doctor and a patient or between patients and caregivers. This case report exemplifies one such experience and highlights the hurdles we face when dealing with collusion. A 31-year-old woman was diagnosed with rectal carcinoma during her pregnancy and underwent diversion colostomy (for intestinal obstruc...

Psychological distress is often an under-diagnosed problem in cancer care. Addressing psychosocial issues would enhance treatment compliance, physician-patient relationship, treatment efficacy and quality of life. This article emphasizes the importance of integrating psycho-oncology services in cancer care and attempts to define the various roles t...

Purpose/Objective(s): This study aimed to evaluate the work, environment, personal challenges and financial satisfaction of woman radiation oncologists (WRO) in South Asia. Materials/Methods: A 28-point online questionnaire was responded by 258 WRO from south Asia. The questionnaire consisted of 7 sections: personal, professional/academic, family,...

Purpose/Objective(s): To analyze the causes for medical tourism of cancer patients and associated financial toxicity in Asia-Africa-Oceania region. Materials/Methods: India has emerged as a major country for medical tourism and it received 0.5 million overseas patients in 2015-16. Patients come from Pacific islands, African countries, Eurasian plan...

Purpose/Objective(s): This study aimed to analyses the characteristics ofunplanned treatment interruptions (UPTI) in a large population of radiotherapy patients Materials/Methods: All consecutive UPTIs for a 4-year period were grouped as due to clinical (C) and nonclinical (NC) reasons. Reasons for CUPTI were A- mucositis, B-other comorbidities/ ho...

Purpose: T1-contrast and T2-flair images of magnetic resonance imaging (MRI) are commonly fused with computed tomography (CT) and used for delineation of postoperative residual tumor and bed after surgery in patients with glioblastoma multiforme (GBM). Our prospective study was aimed to see the feasibility of incorporating perfusion MRI in delinea...

Background: This study aims to analyze the dynamics of the published articles and preprints of Covid 19 related literature from different scientific databases and sharing platforms. Methods: The PubMed, Elsevier, and Research Gate (RG) databases were under consideration in this study over a specific time. Analyses were carried out on the number of...

Purpose: We present our data for every single fraction for every patient treated at our center for the past 4 years, analyzing the waiting and treatment times. Materials and Methods: Between January 2014 and February 2018, all patients and their corresponding recorded measurements of waiting time and machine treatment time were analyzed. Times reco...

Between 2013 and 2019, 298 patients were treated with stereotactic radiation therapy (SRT) and radiosurgery (SRS) techniques in our center. The dose fractionation schedules ranged from 30 Gy in 5 fractions to 30 Gy in 1 fraction. A mixture of centrally and peripherally located lesions was seen among the treated patients. Of these patients, 2 report...

Between 2013 and 2019, 298 patients were treated with stereotactic radiation therapy (SRT) and radiosurgery (SRS) techniques in our center. The dose fractionation schedules ranged from 30 Gy in 5 fractions to 30 Gy in 1 fraction. A mixture of centrally and peripherally located lesions was seen among the treated patients. Of these patients, 2 report...

Purpose The aim of this study is to calculate setup margin based on six‐dimensional (6D) corrected residual positional errors from kV cone beam computed tomography (CBCT) and from intrafraction projection kV imaging in coplanar and in noncoplanar couch positions in stereotactic radiotherapy. Methods Six dimensional positional corrections were carr...

The history and current status of a biomedical discipline in a country or region provide important health system indicators. During the last one hundred years, radiotherapy has established its position as a vital specialty in cancer management. It has proved to be one of the most cost effective ways of treating cancer providing both radical and pal...

Purpose: The concept of 4πc radiotherapy is a radiotherapy planning technique receiving much attention in recent times. The aim of this article is to disprove the feasibility of the 4π radiotherapy using a cantilever-type linear accelerator or any other external-beam delivery machines. Materials and methods: A surface integral-based mathematical...

Purpose/Objective(s) India has emerged as one of the leading medical tourism destination in the recent times. Patients come from sub-Saharan countries, pacific island nations, west Asia, and post-Soviet republics (CIS) .We analyzed the issues and concerns of overseas cancer patients who come to New Delhi for their cancer treatment. Materials/Method...

Delta Function based analysis of why FFF does not exhibit any dosimetric advantage over flatten beam. Aim: To mathematically evaluate why FFF beam does not exhibit any dosimetric advantage over the flatten beam for small lesions or in out of field dose, except reduced MU. Material and Method: Flatten beam can be approximated by a square function....

Objective: Evaluation of effect of interval between surgery to adjuvant radiotherapy (Sx-ART) start and its early tolerance in glioma patients. Method: A retrospective study of 155 adult glioma patients (WHO Grade II-IV) who underwent adjuvant radiotherapy (ART) post-surgery with confirmed histopathology was done in our institution from Sept, 2012...

Purpose Aim of this article is to describe a new knowledge‐based planning (KBP) methodology using volumetric modulated arc therapy (VMAT) for stereotactic radiosurgery (SRS) and radiotherapy (SRT) assisted by an ensemble mapping technique for use in a Monte Carlo planning system. Methods Libraries of 121 stereotactic patients were assembled on the...

Since 2011 when it was first described, the volumetric-modulated arc therapy (VMAT) technique for craniospinal irradiation (CSI) has always seen the use of large arc lengths for the spine fields ranging from 200° to 360°. This study was aimed to do a dosimetric comparison between the large and shorter spinal arc for CSI. For a cohort of 10 patients...

Purpose: This study aimed to evaluate characteristics of dose fall-off pattern for linear accelerator based frameless stereotactic radiotherapy and radiosurgery using two different techniques, three-dimensional conformal radiotherapy and volumetric modulated arc therapy. Materials and methods: The data from thirty patients who underwent frameles...

Purpose or Objective Radiation therapy (RT) is a mainstay of treatment for primary and metastatic brain tumours. Various toxicities, ranging from asymptomatic to fatal, occur in the central nervous system after RT to the brain. MR imaging is useful in detecting these toxicities and complications. White matter changes in the brain after RT is well-k...

Purpose or Objective Radiation therapy (RT) is a mainstay of treatment for primary and metastatic brain tumours. Various toxicities, ranging from asymptomatic to fatal, occur in the central nervous system after RT to the brain. MR imaging is useful in detecting these toxicities and complications. White matter changes in the brain after RT is well-k...

Purpose or Objective Knowledge based planning (KBP) is an emerging technique in a radiation therapy planning.This study attributed to standardisation of stereotactic treatment plan by ensemble matching technique. This study divided in two part, primary aim of this study is standardisation of the treatment plan that is minimization of the influence...

Purpose or Objective Radiation therapy (RT) is a mainstay of treatment for primary and metastatic brain tumours. Various toxicities, ranging from asymptomatic to fatal, occur in the central nervous system after RT to the brain. MR imaging is useful in detecting these toxicities and complications. White matter changes in the brain after RT is well-k...

Most modern radiotherapy centers have adopted contouring based treatment. Sparing of the normal structures has been made more achievable than ever before by use of technologies such as Intensity Modulated Radiotherapy (IMRT) and Image guided radiotherapy (IGRT). However, unlike, sites such as brain or head neck, thorax is a site in active motion, m...

Objective: To compare the accuracy of 3 different known geometry objects drawn on CT (Computed tomography), MR (Magnetic Resonance) and DSA (Digital subtraction Angiography) images on a phantom with stereotactic frameless mask on Brainlab iPlan RT Image contouring workstation. Methods and material: A phantom study was done for images registration a...

Aim: To standardise stereotactic treatment planning for new cases through compiling and categorization of a large number of treatment plans for a variety of clinical scenarios and automating plan selection from this plan library based on patient specific parameters. Materials and methods: One hundred and seventeen patients who were treated by stere...

Introduction: The linear accelerator based radiosurgery is initially started with invasive frame, like Lakshell frame and BRW frame. However in recent times improvement of setup imaging and other accessories like six dimensional motion enabled couch empower the community to move towards a frameless radiosurgery. Stereotactic radiosurgery (SRS) and...

Objectives: To evaluate long term risk of cardiac morbidity in patients treated with cranio-spinal radiotherapy (CSI). Approx Odds ratio of development of cardiac morbidity for non radiated medulloblastomas is 2.3. Methods: The study included six medulloblastoma patients that were simulated in supine position after immobilization using thermoplast...