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Hadi R.,Dr BRA Institute Rotary Cancer Hospital
The Gulf journal of oncology | Year: 2011

Anal Canal squamous cell carcinoma (SCC) accounts for nearly 2% of all cancers of the alimentary tract. Over the past few years, the management of anal canal cancer has changed from primary surgery to primary chemo-radiotherapy (CRT). A total of 83 patients' (pts) records (62 males, 21 females) were retrospectively reviewed. Length of disease was <5 cm in 44 pts and confined to primary in 46 pts. Ten pts have anti-cancer therapy outside. We delivered radiotherapy (RT) alone to 16 pts, chemotherapy (CT) alone to 4 pts, CRT in 51 pts and pre-operative (pre-op) RT in 2 pts. RT dose was up to 30 Gray (Gy) =16; 30-50 Gy=12 and >50 Gy=41 pts. RT compliance was optimal in 64/69, grade (Gr) ≤ 2 toxicity in 56/69 and Gr ≥ 2 in 13/69 pts. Thirteen pts (18.84%) were hospitalized during RT. No response (NR) was found in 4/83, <50% in 18/83, >50-<100% in 39/83 and complete response (CR) in 22/83 pts. Recurrence at primary site was seen in 7 and loco-regional in 2 pts. Salvage therapy was done in all 9 pts (surgery=8 and CT=1). Status at last follow up, alive without disease = 22/83 and with disease = 61/83 pts. This retrospective analysis revealed that the advanced disease was in 47%, the optimal anti-cancer therapy could be delivered to 63.9%. Despite heterogeneity of patient population and management, the overall disease-free survival (DFS) with sphincter-preservation was achieved in 26.5% pts. Source


Bakhshi S.,All India Institute of Medical Sciences | Bakhshi S.,Dr BRA Institute Rotary Cancer Hospital | Meel R.,All India Institute of Medical Sciences | Meel R.,Dr Rajendra Prasad Center For Ophthalmic Science | And 4 more authors.
Journal of Pediatric Hematology/Oncology | Year: 2011

Background: Few studies have suggested that routine bone marrow (BM) and cerebrospinal fluid (CSF) evaluation is not needed in all patients with retinoblastoma. Although the International Retinoblastoma Staging System was developed recently, there remain no clear stage-specific guidelines with regard to the need for BM and CSF evaluations as part of the metastatic workup for patients with retinoblastoma. Methods: This is a retrospective study analyzing results of CSF cytology and BM evaluation at presentation/diagnosis in patients with retinoblastoma registered at our center from June, 2003 to June, 2009. Only cases with both BM biopsy and lumbar puncture were included. Results: Of the 259 evaluable patients, 18 (7%) were positive for metastasis either in CSF and/or BM. Although 7 of these had overt metastasis at presentation (stage IV), 1 belonged to stage II and 10 to stage IIIa. No stage 0 or I patient tested positive despite presence of histopathologic high-risk factors. Conclusions: This is the largest study evaluating the role of metastatic workup in patients with retinoblastoma at presentation. We conclude that CSF and BM evaluation is not required in patients with stage 0 and I retinoblastoma at presentation. No definitive recommendation could be made for stage II patients; while stage III and IV patients must certainly be evaluated. Copyright © 2011 by Lippincott Williams & Wilkins. Source


Radhakrishnan V.,Dr BRA Institute Rotary Cancer Hospital | Rastogi S.,All India Institute of Medical Sciences | Bakhshi S.,Dr BRA Institute Rotary Cancer Hospital
Indian Pediatrics | Year: 2011

Clavicle is a rare primary site for Ewing sarcoma (ES). We analyzed 4 patients with clavicular ES under our follow up and reviewed the literature on management of this rare tumor. All our patients were females with a median age of 16 years and were non metastatic at presentation. After a median follow-up of 21.5 months, 3 out of 4 patients are in complete remission. Clavicular ES in contrast to ES of other sites seems to have a female preponderance and outcomes are similar to non metastatic ES of other common sites. © 2011 Indian Academy of Pediatrics. Source


Meel R.,Oculoplastics and Ocular Oncology Service | Meel R.,Dr Rajendra Prasad Center For Ophthalmic Science | Meel R.,All India Institute of Medical Sciences | Radhakrishnan V.,All India Institute of Medical Sciences | And 3 more authors.
Indian Journal of Medical and Paediatric Oncology | Year: 2012

Retinoblastoma is the most common intraocular malignancy in children. The survival of retinoblastoma patients and visual outcome has improved dramatically in the developed world. This can be attributed to early tumor recognition and advances in the management of retinoblastoma. Chemoreduction followed by adjuvant consolidative treatment has replaced external beam radiotherapy as the primary modality of treatment for intraocular retinoblastoma. Further, histopathological high-risk factors have been identified in enucleated eyes, allowing use of prophylactic chemotherapy to take care of possible micrometastasis. The survival in case of extraocular retinoblastoma is still low, and the reported survival rate ranges between 50% and 70%. In developing countries, the overall survival of retinoblastoma patients remains low, primarily due to a delayed presentation, resulting in larger proportions of extraocular disease compared with the developed world, where majority of the disease is intraocular. Greater efforts need to be directed toward early tumor recognition in order to improve the survival of retinoblastoma patients in the developing world. In this article, we provide an overview of the current clinical management of retinoblastoma. Source


Malik P.S.,Dr BRA Institute Rotary Cancer Hospital | Malik A.,Dr BRA Institute Rotary Cancer Hospital | Deo S.V.,Dr BRA Institute Rotary Cancer Hospital | Mohan A.,All India Institute of Medical Sciences | And 2 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2014

Background: Lung cancer is one of the commonest and most lethal cancers throughout the world. The majority of the patients present at advance stage and are not suitable for curative intent treatment. Even among patients with localized disease, there has been underutilization of curative treatment modalities. The aim of this study was to analyze the radical treatment utilization rates in patients with non small cell lung cancer (NSCLC) treated at our centre. Materials and Methods: We analyzed case records of 104 patients with a pathologically confirmed diagnosis of NSCLC having stage 1-3B disease who were treated at our centre over last 3 years, to assess the utilization of curative treatment modalities i.e. surgery or radical radiotherapy. Results: The median age of this cohort was 58 years. Out of 104 patients only 33 (31.7%) received curative intent treatment, 14 undergoing curative resection and 19 receiving radical doses of radiotherapy. The baseline characteristics of both the groups (with or without radical treatment) were not different. Major factors associated with underutilization with curative treatment were progressive disease or loss of follow up after chemotherapy and inappropriate use of TKI and/ or palliative radiotherapy in patients with stage 1-3B disease. Patients who did not receive radical treatment had inferior PFS and OS than those who received radical treatment. Conclusions: In our practice we observed gross underutilization of curative intent treatment modalities in patients with NSCLCs which is associated with inferior survival. Source

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