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Akhtar P.S.,National Institute of Cancer Research and Hospital | Hossain M.Md.S.,Delta Medical College Hospital | Masud Z.Md.,Bangladesh Medical College Hospital | Ruksana N.,Delta Medical College Hospital | And 4 more authors.
Bangladesh Journal of Obstetrics and Gynecology | Year: 2010

Background: Cervical cancer is the most common cancer of Bangladeshi women diagnosed mostly (>80%) at stage II and stage III. Rdaiotherapy (both teletherapy and brachytherapy) is the most important modality of treatment at these stages. Objective: To compare the local control, diseases free survival and overall survival between the (cancer cervix) patients treated randomly by two schedules of radiotherapy. Method: From June 1996 to June 2005, patients with histologically confirmed carcinoma cervix (Ca.cervix) were treated by external beam therapy (EBRT) as well as intra cavitery brachytherapy (ICRT) along with concurrent/sequential chemotherapy with cisplatin and 5-Fluorouracil. EBRT was given by cobalt 60 teletherapy machine and ICRT by caesium 137 low dose rate machine. The patients were divided into two groups according to treatment schedules. Group I: the patients in this group received EBRT in whole pelvis in two steps, first with open field upto 10-20 Gy then by applying midline shield with lead block 30-40Gy in 25-28 total fractions, five days a week; they also received 50-70 Gy to point A by ICRT in 2-4 weekly fractions. Group II: patients in this group received with open field a dose of 45-50Gy in 25-28 fractions, 5 days a week by EBRT and 25-30 Gy at point A by ICRT in 1-2 weekly fractions. Result: In Group I, 96 out of 101 and in Group II, 104 out of 118 patients were eligible for evaluation. In both groups patients were distributed according to stages and age more or less equally; their age range were 30-70 years and mean age was 47.2 years in Group I and age range were 25-80 years and mean age was 46 years in Group II. Squamous cell carcinoma were found (90%) and performance status was WHO grade 0-1 (>75%) in both groups. Local control of disease at 5 years was 65% in group I and 51% in group II. Overall survival at 2 years, 5 years, 7 years and 9 years in group I, was 71%, 64%, 55%, 46% and in group II, 54%,50%, 43%,32% respectively. Distant metastasis occurred in 22% in-group I and 28% in-group II. Lymph node, lung, liver, peritoneum were common site of metastasis. Proctitis, cystitis, vaginal stenosis in group I was 80%, 33% 16% and in Group II 29%, 13% and 5% respectively. Conclusion: External beam therapy and brachytherapy was effective treatment in carcinoma. Cervix in both operable and inoperable stages. In small volume of tumor, both schedules of radiotherapy were more or less equivalent but in bulky diseases Group I schedule that was higher dose by brachytherapy at point A showed better result; though the complication was more:. Source


Akhtar P.S.,National Institute of Cancer Research and Hospital | Masud Z.M.,Bangladesh Medical College Hospital | Alam M.T.,Bangladesh Medical College Hospital | Begum M.,National Institute of Cancer Research and Hospital
Journal of Medicine | Year: 2011

Background: Lung cancer has been the most common cancer in the world since 1985 and the leading cause of cancer death. Worldwide it is by far the most common cancer of men and increasingly being recognized in Bangladesh. Objective: To observe the profile of lung cancer patients and the outcome of chemotherapy. Method: In one year (1st January'08 to 31st December'08) the lung cancer patients who attended the dept. of Medical Oncology were included in this study. The patient's history, clinical evaluation, previous treatment record (surgical intervention, chemotherapy and radiotherapy), histopathology and other investigation reports were documented. Chemotherapy and or supportive and symptomatic treatment carried out in the department were noted and response of the treatment were observed and documented. Result: Total number of patients was 701.Of them, 608 males and 93 females; male female ratio: 6.53:1. Common occurrence (> 85%) at and above 50 years of old; age range 25 years to 95 years and mean age 62 years; 44% was illiterate and 40% had primary school education; more than 82% belonged to poor and bellow average socioeconomic status. Previous records showed 524 patients (about 75%) attended after diagnosis and 177 cases (25%) had had prior treatment (6 by surgery, 22 by radiotherapy and 147 by chemotherapy). On clinical evaluation, almost all patients were symptomatic with WHO Grade-2 (44.51%) and Grade -3 (26.68%) performance status. Right lung was affected more (55%). Pathologically non-small cell carcinoma was 81.45% and small cell carcinoma 18.55%. But histopathology differed by sex; squamous cell carcinoma (43.42%) was most common in male but in female it was adenocarcinoma (55.92%). All most all cases were at inoperable stage (locally advanced/metastatic cancer/ medically unfit). Thirty percent of male patients and 45% of females dropped out after first and second visit. Around 20% patients got only supportive symptomatic management in both sexes and 326 patients (296 male and 30 female) were treated by chemotherapy. Within three to six months of treatment, 10% of the patients showed complete symptomatic relief, weight gaining and radiological disappearance of tumor and all most all patients benefited of some sorts of symptoms relief. Conclusion: The lung cancer patients were at inoperable stages with WHO Grade 2 and Grade 3 performance status in most of the cases; needed much more supportive and symptomatic treatment. Chemotherapy was effective; complete clinical and radiological response in 10% of cases and others got benefit with some sorts of symptoms relief and radiological improvement. Source

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