Geethi M. H.’s research while affiliated with Regional Cancer Centre and other places

Introduction Small cell lung cancer (SCLC) represents about 15% of all lung cancers. Extensive stage (ES) SCLC represents around 60% of diagnosed SCLC cancers. The median survival in untreated ES SCLC is 2 to 4 months and that of treated cases is 8 to 13 months. Aim and Objectives This retrospective analysis aims to find out the clinical outcome of patients with ES SCLC and the prognostic factors affecting their survival. Methods Details of patients registered in the department of radiation oncology from January 1, 2010 to September 30, 2019 were retrieved from the hospital records. This includes the demographic characteristics, treatment received, toxicity, and follow-up details. Results Two-hundred eighty-three patients were included. Median age of presentation was 62 years. Around 97.5% of patients were men. Smokers constitute 94% of all cases. About 86.9% (246 patients) of cases were not alive at the end of the study period. The median estimated overall survival (OS) was 7 months ± 0.47 (95% confidence interval [CI]: 6.026–7.974) and progression-free survival (PFS) was 5 months ± 0.535 (95% CI: 3.952–6.048). Multivariate analysis showed that Eastern Cooperative Oncology Group performance status (ECOG PS), hyponatremia, number of chemotherapy cycles, consolidative radiotherapy (RT) and prophylactic cranial irradiation (PCI) were found to have prognostic effect on OS. Smoking, ECOG PS, number of chemotherapy cycles, consolidative RT, and PCI were found to have prognostic effects on PFS. Conclusion There is a difference in OS and PFS patterns of ES SCLC patients among various Indian studies even though the available data is scarce. Our study shows that the OS and PFS of our study population are comparable to other South Indian studies available. PS, serum sodium level, number of chemotherapy cycles, consolidative RT, and PCI were found to be independent prognostic factors for survival of ES SCLC. The identification of these factors will help physicians to tailor treatment.

Background Radical chemoradiation is the standard of treatment for locally advanced squamous cell carcinoma of esophagus and for patients with operable disease, but who are medically unfit or unwilling for surgery. As the esophagus is a central organ, the planning target volume (PTV) is central, lies close to the spinal cord and heart, and is surrounded by the lung, which is a radiosensitive organ. Irradiation of these critical structures is reduced by the use of three-dimensional conformal radiation therapy (3DCRT). Intensity-modulated radiation therapy (IMRT) has the potential to improve the uniformity of dose distribution to the tumor and reduce the dose received by surrounding normal tissues. Aim and Objectives 1. To compare the dose distribution, conformity, and homogeneity indices in radical radiotherapy of squamous cell carcinoma of esophagus using 3DCRT and IMRT techniques 2. To compare the doses received by critical structures such as heart, lung, spinal cord, and liver Materials and Methods All cases of squamous cell carcinoma esophagus treated with radical chemoradiation to a dose of 50 Gy in 25 fractions using 3DCRT technique from January 2018 to July 2019 were included. IMRT plans were generated for these cases. The parameters that represent dose distribution to the target volume and the dose received by the organs at risk were obtained from the dose–volume histogram. The difference in the mean values of the parameters between the two techniques was calculated. The statistical significance of the difference was determined using Student’s t-test and Wilcoxon signed-rank test. Results The volume of PTV receiving 105% and 107% of prescribed dose was significantly lower with IMRT (3.540% and 0.008%, respectively) compared to 3DCRT (7.654% and 0.623%). The homogeneity index was better with IMRT (0.088 vs. 0.107) than 3DCRT. Conformity index was found to be better with IMRT (1.149 vs. 1.573). Mean heart dose (18.216 vs. 24.591 Gy) and the volume of heart receiving 30 Gy were reduced with IMRT. The volume of lung receiving 20 Gy and the volume receiving 5 Gy were not significantly different between 3DCRT and IMRT. Maximum dose to spinal cord was similar with 3DCRT and IMRT. Conclusions IMRT avoids areas of excessive irradiation within the PTV. IMRT improves dose conformity to the target volume and homogeneity of dose distribution within the PTV. The cardiac dose is significantly reduced with IMRT. The mean lung dose remains similar to 3DCRT. There is no significant increase in the volume of lung receiving low-dose radiation with IMRT.

Globally and in India, lung cancer is one of the leading malignancies in terms of incidence and mortality. Smoking and environmental pollution are the common risk factors for developing lung cancer. Traditionally, lung cancer is divided into small cell and nonsmall cell types, with nonsmall cell carcinomas including squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. In this review article, we describe the imaging recommendations and findings in the diagnosis, staging, and management of lung cancer, including the imaging of treatment-related complications.

Purpose: This retrospective analysis is aimed to report the single institution experience from an Asian country utilizing Intensity Modulated Radiotherapy (IMRT) based Chemo radiation in Anal Canal Squamous Cell Carcinoma (ASCC) with an emphasis on efcacy, toxicity and disease and treatment-related variables associated with outcomes. Study was conduc Materials And Methods: ted in the department of Radiation Oncology at Regional Cancer Center, Thiruvananthapuram. All Patients with biopsy proven ASCC diagnosed between January 2014 and December 2018 and receiving curative intent IMRT were identied and follow up data till December 2020 was collected. Primary end point was Disease-free survival (DFS). Secondary end points were Overall Survival (OS), Colostomy-free survival (CFS) Loco regional Failure (LRF) and Toxicities. A total of 34 patients were analyzed during a median follow up of Results: 34 months. Twenty ve patients (73.5%) were in stage IIIB. Median overall treatment time was 36 days. The estimated two year DFS, OS and CFS were 79.4 %, 93.9 %and 97% respectively. Disease recurrence at any point on follow up occurred in ve patients (14.7%). Primary Tumor size of more than or equal to 5 cm and development of grade three anemia during RT was associated with inferior DFS in Univariate analysis. Patients taken less than two cycles of chemotherapy, there was a trend for inferior OS. Acute grade 3 or more dermatological toxicities was 44% and hematological toxicity was 35.3%. Radiotherapy break occurred in 38.2%of patients with a median of 5.5 days (range 2-13). Of the available patients chronic toxicities were reported for 40% and were of grade 2. IMRT is associated with favorable toxicity rates and excellent Conclusion: long-term efcacy in Asian population also where patients are presenting in an advanced stage. Reducing the total treatment time by SIB technique may improve the clinical outcome.