Budhi Singh Yadav

Post Graduate Institute of Medical Education and Research | PGIMER · Radiotherapy & Oncology

The review article by Pavlidis et al published in World J Clin Oncol provides a meticulous analysis of the intricacies surrounding anaplastic carcinoma of the thyroid. Thyroid carcinoma encompasses a spectrum of diseases, each characterized by distinct behaviors and outcomes. Diagnostic approaches encompass a diverse array of tools. Surgery remains...

Purpose/Objective: To compare Whole Brain Radiotherapy(WBRT) with Stereotactic Radiosurgery (SRS) in patients with brain metastases from breast cancer. Material/Methods: Breast cancer patients who developed or presented with brain metastases were included in this study. Patients with 1 to 5 brain lesions, each with a maximum diameter of ≤3.5 cm on...

In this editorial we comment on the article by Wei et al , published in the recent issue of the World Journal of Clinical Oncology . The authors investigated the role of Transmembrane 9 superfamily member 1 (TM9SF1) protein in bladder cancer (BC) carcinogenesis. Lentiviral vectors were used to achieve silencing or overexpression of TM9SF1 gene in t...

In this editorial I comment on the article, published in the current issue of the World Journal of Clinical Oncology . Primary central nervous system lymphoma (PCNSL) is a disease of elderly and immunocompromised patients. The authors reported clinical results of 19 patients with PCNSL treated with zanubrutinib/ high dose methotrexate (HD-MTX) unti...

Background Globally, most of the randomised trials with hypofractionation in patients with breast cancer have used 3-dimensional conformal radiotherapy technique (3D-CRT). As facilities for 3D-CRT technique may not be available in low-resource settings, there is a need to see if hypofractionation is feasible and safe with 2-dimensional (2-D) techni...

Background Breast cancer is the most common cancer in women. Radiotherapy is an important part of breast cancer treatment after surgery. Breast cancer radiotherapy is usually delivered in 3–5 weeks. This is a long duration for women with breast cancer to stay away from the family and work. We wanted to reduce this duration so that the wages loss an...

Purpose: The standard treatment of non-Hodgkin lymphoma (NHL) comprises combined modality treatment, radiotherapy (RT), and chemotherapy with rituximab which has significantly improved both disease-free survival (DFS) and overall survival (OS). However, there is no uniformity in radiation dose usage in these patients. In this retrospective study, w...

Background: High-grade non-Hodgkin B-cell lymphoma is an aggressive mature B-cell lymphoma that depicts poor treatment response and worse prognosis. e presence of MYC and B-cell lymphoma 2 (BCL2) and/or B-cell lymphoma 6 (BCL6) rearrangements qualifies for triple-hit and double-hit lymphomas (THL/DHL), respectively. We attempted to explore the inc...

Background To test a 1-weeks chedule of hypofractionated adjuvant whole breast/chest wall and/or regional nodal radiotherapy against 2 weeks for loco-regional control, acute and late toxicities, quality of life (QoL), survival and second cancers after primary surgery in patients with breast cancer. Methods Eligible patients with breast cancer after...

The purpose of this study was to estimate and incorporate rotational error to translational error for clinical target volume (CTV) to planning target volume (PTV) margin calculations for non‑6D couch. Materials and Methods: The study involved cone‑beam computed tomography (CBCT) images of the patients who already had treatment in Varian Trilogy Cli...

Introduction Total skin electron beam therapy, commonly known as TSET, is a good choice of treatment for patients suffering from mycosis fungoides. The aim of this study was to introduce a new approach to the beam profile measurement using diodes and to calculate the monitor units required for the TSET treatment by the use of a simple setup of outp...

Background: In this study, we compared outcomes in young and very young patients with breast cancer (BC). Materials and methods: Between January 1990 to December 2010, 414 young women (age ≤35 years) with BC were registered in the radiotherapy (RT) outpatient department. Patients were divided into young (31-35 years) and very young (18-30 years)...

Background HRBC is a phase III randomized open label study of adjuvant radiotherapy in patients with breast cancer. In this study we compared a 3 weeks radiation schedule with 2 weeks. Materials and methods Patients with breast cancer, stage I-III, post mastectomy or after breast conservative surgery who needed adjuvant locoregional radiotherapy we...

Purpose: Chemotherapy-related cognitive impairments (CRCIs) are one of the adverse effects of chemotherapy, so there is a need to explore alternative measures to maintain normal cognitive functions or to prevent decline in cognitive abilities. This study was conducted to assess the effectiveness of Cognitive Training Interventions Package on cognit...

Background The COVID-19 pandemic has deeply disrupted cancer care, both during and after lockdowns. In this study, we analysed the treatment delay in patients with breast cancer due to COVID-19 pandemic in India. Methods From March 2, 2020, to March 31, 2021, patients with breast cancer who presented to the breast clinic in the department of Radio...

Purpose: To assess the feasibility of accelerated hypofractionated radiotherapy with simultaneous integrated boost (SIB) in patients with breast cancer. Materials and methods: A total of 27 patients after breast-conserving surgery were included in this study. Patients were planned on a four-dimensional computerized tomogram, and contouring was d...

Background: Young women with breast cancer (BC) are not represented in the trials on hypofractionation. In this study we compared outcomes in young patients with BC to their older counterparts treated with hypofractionated radiotherapy (RT) in a regional cancer centre in India. Materials and methods: Between January 1990 to December 2010, women...

Background Primary non-Hodgkin’s lymphoma (NHL) of the orbit is rare. Orbital NHLs show good response to both radiotherapy (RT) and chemotherapy, and hence, the emphasis should be to ensure maximum cure rate with minimum morbidity. In this study, we present the clinical profile and treatment outcomes of patients with NHL who had initial presentatio...

PURPOSE This study aimed to identify and categorize the delays and disruptions in breast cancer care and its impact on disease outcome during the first wave of the coronavirus disease-2019 (COVID-19) pandemic. METHODS Patients with newly diagnosed or relapsed breast cancer who were treated between May 2020 and March 2021 were evaluated. Patients w...

Background Primary central nervous system-diffuse large B-cell lymphoma (PCNS-DLBCL) is a rare, extranodal malignant lymphoma carrying poor prognosis. The prognostic impact of tumor microenvironment (TME) composition and PD-1/PD-L1 immune checkpoint pathway are still undetermined in PCNS-DLBCL. We aimed to quantify the tumor-infiltrating lymphocyte...

Gamma angle plays a major role in Gamma Knife Radiosurgery (GKRS) treatment planning. Selecting an appropriate gamma angle may help in mitigating unnecessary radiation exposure to organs at risk (OARs). The aims in GKRS of vestibular schwannoma (VS) is to deliver sufficient radiation to the tumor extending into internal auditory canal (IAC) while k...

Introduction In this study we compared radiation dose received by organs at risk (OARs) after breast conservation surgery(BCS) and mastectomy in patients with left breast cancer. Materials and methods Total 30 patients, 15 each of BCS and mastectomy were included in this study. Planning Computerised Tomography (CT) was done for each patient. Chest...

Object Conservative approaches in muscle-invasive bladder cancer (MIBC) have been evolved to avoid aggressive surgery, but are limited to elderly, frail, and patients medically unfit for surgery. Our study aimed to assess the response rate of neoadjuvant chemotherapy (NACT) before radiotherapy (RT) in MIBC patients. Methods Forty patients with uro...

BACKGROUND Survival for breast cancer (BC) patients has improved significantly because of better treatment availability. However, patients may experience side effects after the completion of the treatment, which consequently affect their quality of life (QoL). The present study was planned to assess the QoL of BC patients after the completion of tr...

BackgroundA wide range of adjuvant treatment regimens exist in gastric carcinoma patients which include chemotherapy, radiotherapy, and/or both either sequential or concurrent. The study aimed to assess the benefit of adjuvant sequential chemotherapy followed by radiotherapy for operable gastric cancers and evaluate the prognostic factors associate...

Purpose To assess feasibility of accelerated hypofractionated radiotherapy with simultaneous integrated boost (SIB) with volumetric modulated arc technique (VMAT) in patients with breast cancer. Methods Total 27 patients after breast conserving surgery (BCS) were included in this study. Patients were planned on 4-dimensional computerized tomogram (...

Objective: Breast cancer is the most common cancer among Indian females and chemotherapy is the most extensively used modality for these patients. Diagnosis of breast cancer is dreadful in itself and the initiation of chemotherapy causes stress and fear among patients. Breast cancer survivors (BCS) use different coping mechanisms to deal with these...

Background The impact of loco-regional treatment (LRT) with radiotherapy (RT) in patients presenting with metastatic breast cancer (MBC) has not been widely studied. The aim of this study was to review the treatment outcomes of LRT including RT in patients with MBC. Materials and methods Patients who presented with MBC were included in this retros...

Background: To report clinical outcomes and late toxicities of a 2-week hypofractionated post-operative loco-regional radiotherapy in patients with breast cancer. Materials and methods: This trial was approved by the Institutional Ethics Committee and registered with gov, no. NCT02460744. Between June 2013 and October 2014, 50 patients with brea...

Background Brain metastases (BM) are common in patients with HER2-positive and triple-negative breast cancer. In this study we aim to report clinical outcomes with LINAC-based stereotactic radiosurgery/radiotherapy (SRS/SRT) for BM in patients of breast cancer. Methods Clinical and dosimetric records of breast cancer patients treated for BM at our...

Triple-negative breast cancers (TNBCs) are aggressive tumors with a high risk of visceral metastasis and poor prognosis. Here, we report a case of a 57-year-old postmenopausal female with gBRCA1-positive metastatic breast cancer. She was treated for endometrioid type, Stage IB Grade 2 endometrial carcinoma with pelvic external beam radiation in 201...

BACKGROUND There have been inconsistent results on the association of body mass index (BMI) with tumor characteristics, hormone, and menopausal status in breast cancer (BC) patients. OBJECTIVE This study was intended to analyze the association of BMI with menopausal status, tumor characteristics, and hormone receptor status in BC patients. We also...

A 45-year-old female was diagnosed with infiltrating duct carcinoma (IDC) left breast in 1982. She underwent a mastectomy followed by locoregional radiotherapy and chemotherapy with cyclophosphamide, methotrexate, 5-fluorouracil. The patient developed left axillary swelling (3 cm × 3 cm) in 2004; fine-needle aspiration cytology (FNAC) was suggestiv...

Background Primary central nervous system-diffuse large B-cell lymphoma (PCNS-DLBCL) is a rare extra-nodal Non-Hodgkin lymphoma. There is relative paucity of literature on PCNSL from Indian subcontinent. We aimed to analyze the clinicopathological features of PCNSL and categorize them into germinal center B cell (GCB) and non-GCB subtypes to assess...

The rapid spread of COVID-19 has caused massive mortality worldwide. Healthcare systems are presently being put in jeopardy as they are stretched to their maximum capacity. Oncology patients are at an increased risk, not only because of their compromised immunity, but also because of the possibility that their cancer will progress from early stage...

Objectives Early-stage breast cancer patients survive longer so a radiotherapy technique which can reduce late toxicity is important. In this study, we made a dosimetric comparison of supine and prone breast irradiation techniques in patients with left breast cancer. Methods Ten patients scheduled for whole-breast radiotherapy after lumpectomy wer...

Primary Mediastinal Germ Cell Tumor (PMGCT) is a rare and heterogeneous entity. These tumors are typically diagnosed in young adults and carry a poor prognosis. We conducted this study to evaluate the role of radiotherapy on treatment outcomes and prognostic factors in PMGCT that may allow a more adapted treatment strategy to improve survival. Case...

Background: We have been practicing hypofractionation, 40 Gy in 16 fractions over 3 weeks for whole breast irradiation (WBI) for the past five decades with or without boost at our center. In this study, we compared two boost schedules of 10 Gy/5#/1 week with 16 Gy/8#/1.5 weeks in postlumpectomy patients with breast cancer after WBI. Materials and...

Background Primary bone lymphoma (PBL) is a rare disease, representing 60 years. Out of all, 18 were males and 4 were females. Ann Arbor clinical staging at diagnosis was Stage I in 13 (59.1%), Stage II in 3 (13.6%), Stage III in 2 (9.1%), and Stage IV in 4 (18.2%) patients. Spine was the most common site of involvement seen in 12 (54.5%) patients....

Radiotherapy Basics: Viva Voce

Purpose: Hypofractionated radiotherapy (RT) is becoming a new standard in postoperative treatment of patients with early stage breast cancer after breast conservation surgery. However, data on hypofractionation in patients with advanced stage disease who undergo mastectomy followed by local and regional nodal irradiation (RNI) is lacking. In this...

Objectives Haematological toxicity and treatment breaks are common during cranio-spinal irradiation (CSI) due to irradiation of large volume of bone marrow. We conducted this study to see the effect of prophylactic granulocyte colony stimulating factor (GCSF) in reducing treatment breaks. Patients and methods The study was conducted over a period...

Background Hypofractionated radiotherapy (RT) is becoming a new standard in the adjuvant treatment for patients with breast cancer. However, data are lacking on late-term arm and shoulder morbidity with hypofractionation in patients with advanced stage disease who undergo mastectomy followed by local and regional nodal irradiation (RNI). In this st...

Objectives: To determine various health problems and their home-based management among breast cancer survivors after three months of completion of hospital-based treatment (surgery, chemotherapy and radiotherapy)..48 years, respectively. Most of the participants were diagnosed with early stage of breast cancer. Treatment profile of participants ref...

BACKGROUND Glioblastoma (GBM) is the most aggressive primary brain tumor. Although treatment advances and introduction of temozolomide has improved the outcome in young patients, it is still a concern in elderly patients. Elderly population is often excluded from the trials, thus established treatment guidelines are not available. Trials have shown...

Purpose To compare rates of acute and late skin toxicities and cosmetic outcomes after accelerated partial breast irradiation (APBI) or whole breast irradiation (WBI) using 3-dimensional conformal external beam radiation therapy in women with breast cancer after breast conservation surgery (BCS). Methods and Materials Women >35 years of age with i...

Background: Bleomycin, cisplatin and etoposide (BEP) based combination chemotherapy is established as standard treatment for testicular germ cell tumors. As these tumors are highly curable, so management is crucial in terms of long-term toxicity particularly lung toxicity. With standard BEP there is increased toxicity which leads to poor compliance...

Background Though conformal partial-brain irradiation is the standard adjuvant treatment for glioblastoma, there is no consensus regarding the optimal volume that needs to be irradiated. European Organisation for Research and Treatment of Cancer (EORTC) and The University of Texas MD Anderson Cancer Center (MDACC) guidelines differ from the Radiati...

Background Definitive concurrent chemoradiation is the standard of care for patients with inoperable oesophageal cancer. Intraluminal brachytherapy (ILBT) given as boost following concurrent chemoradiation increases the dose to tumor with sparing of adjacent normal structures. The aim of the present study was to analyse the response to concurrent c...

Purpose: To compare accelerated partial breast irradiation with whole breast irradiation in post breast conservation surgery (BCS) women with breast cancer. Material and methods: Women >35 years of age with invasive or noninvasive breast cancer ≤4 cm treated by BCS were randomized to 3D CRT APBI (34 Gy in 10 fractions given twice daily) or WBI (40...

Background: Primary central nervous system lymphoma (PCNSL) is a rare malignant non-Hodgkin's lymphoma and it accounts for 1% of all intracranial tumors. Only a few PCNSL studies have been reported from India, and hence, we conducted the retrospective study in our institute to analyze the main clinical features at diagnosis and the treatment result...

Objective Integration of treatment planning and delivery is paramount for efficient functioning of radiotherapy departments. Workflow management software is a tool available for effective resource management in radiotherapy. The purpose of this study is to evaluate the impact of workflow-management on work-efficiency and organisational ergonomics i...

Introduction: Male breast cancer (MBC) incidence is <1%, but it is increasing. MBC incidence increases with age. There are no randomized trials on MBC because of low number of patients seen in any institution and hence its management is derived from breast cancer (BC) in women. In this study, we analyzed outcome in MBC patients with adjuvant treat...

Background: Hodgkin's lymphoma (HL) can be treated with combined modality treatment (CMT) to limit long-term toxicities in the early favorable stage. Early unfavorable and advanced stage HL is mainly treated with chemotherapy followed by radiation to the bulky site. This study examines the impact of CMT in early as well as advanced stage HL. Mate...

Purpose: To report the results in terms of feasibility and early toxicity of hypofractionated adjuvant whole breast/chest wall and/or regional nodal radiation therapy for patients with breast cancer. Methods and materials: From June 2013 to October 2014, 50 patients with breast cancer after mastectomy or after breast conservation surgery (BCS) w...

To analyze treatment interruptions due to acute hematological toxicity in patients of medulloblastoma receiving cranio-spinal irradiation (CSI). Prospectively collected data from case records of 52 patients of medulloblastoma treated between 2011 and 2014 was evaluated. Blood counts were monitored twice a week during CSI. Spinal irradiation was int...

Purpose: The aim of this study was to determine the incidence and risk factors for gynecological cancer as second malignancy (SM) after treatment of breast cancer (BC). Methods and materials: Between January 1985 and December 2007, a total of 2756 patients with BC were analyzed for gynecological cancers as an SM. Analysis was carried out for pat...