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Rastogi M.,Regional Cancer Center | Revannasiddaiah S.,HCG Bangalore Institute of Oncology | Thakur P.,Regional Cancer Center | Gupta M.,Regional Cancer Center | And 2 more authors.
Chinese Journal of Cancer | Year: 2013

Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on the anatomy of the organ and patterns of local and nodal spread. However, in patients with distorted anatomy, several practical issues arise in the delivery of optimal radiotherapy, especially with brachytherapy. Müllerian duct anomalies result in congenital malformations of the female genital tract. Though being very commonly studied for their deleterious effects on fertility and pregnancy, they have not been recognized for their potential to interfere with the delivery of radiotherapy among patients with cervical cancer. Here, we discuss the management of cervical cancer among patients with Müllerian duct anomalies and review the very sparse amount of published literature on this topic.


Lewis S.,Bangalore Medical College and Research Institute | Salins N.,HCG Bangalore Institute of Oncology | Kadam A.,Bangalore Medical College and Research Institute | Rao R.,Bangalore Institute of Oncology
Indian Journal of Palliative Care | Year: 2013

Introduction: Distress is commonly seen in head and neck cancer patients undergoing radiotherapy. Causal factors of distress are multifactorial; which encompasses physical, psychological, spiritual, and existential factors with complex interrelationship among the factors. Materials and Methods: Thirty patients undergoing head and neck radiotherapy were included in the study. Patients were screened for pain scores, distress scores, physical and psychological symptoms, and spiritual and emotional distress. Results: Significant increasing trend seen for pain score, distress score, and total number of symptoms during 2 nd week, 4 th week, and on completion of radiotherapy treatment (all P′s < 0.001) compared to pretreatment. Those who had chemotherapy (CT) along with radiation had significantly greater pain score (t = 5.54, P = 0.03) and distress score (t = 3.9, P = 0.05) at 2 weeks into radiotherapy compared to those who did not receive CT. There was significantly higher grade of skin toxicity in those with spiritual distress (Somers′ d = 0.36, P = 0.02) and higher grade of mucositis in those with existential distress (d = 0.34, P = 0.02) at 4 weeks into radiotherapy. Conclusion: Positive correlation between distress score and pain score and occurrence of physical symptoms. Increasing trend seen for pain score, distress score, and total number of symptoms during 2 nd week, 4 th week, and completion of radiotherapy treatment compared to pretreatment. Increase in distress score in those with existential and spiritual distress.


Sellakumar P.,HCG Bangalore Institute of Oncology | Samuel E.J.J.,Vellore Institute of Technology | Kumar D.S.,Vellore Institute of Technology
Journal of Physics: Conference Series | Year: 2010

In recent years, X-ray CT imaging of polymer gel dosimeter has been applied to direct measurement of 3D dose distributions. This work presents the dependence of PAGAT polymer gel dosimeter response to different beam dose rate using X-ray CT scanner as an evaluation tool. The normoxic PAGAT polymer gel was prepared on bench top and irradiated to different doses at different dose-rate ranging from 0.5 to 5 Gy/min. After irradiation the dosimeter samples were imaged with X-ray CT scanner using appropriate scanning protocol. The results showed that PAGAT gel dosimeter formulations investigated in this study has the smallest dose rate dependence and the change in dose sensitivity amounts to 2 % over the dose rate interval studied. © 2010 IOP Publishing Ltd.


Anbumani S.,HCG Bangalore Institute of Oncology | Palled S.R.,Kidwai Memorial Institute of Oncology | Prabhakar G.S.,HCG Bangalore Institute of Oncology | Nambiraj N.A.,Vellore Institute of Technology | Pichandi A.,HCG Bangalore Institute of Oncology
Reports of Practical Oncology and Radiotherapy | Year: 2012

Aim: To investigate the feasibility of using External Beam radiotherapy for accelerated partial breast irradiation by a comparative tumour and normal tissue dose volume analysis with that of high dose rate interstitial brachytherapy. Background: Accelerated Partial Breast Irradiation (APBI) is more clinically appealing because of the reduced treatment course duration and the irradiated area. Brachytherapy application is more dependent on the clinician's expertise when it is practised free hand without image guidance and a template. It happens to be an invasive procedure with the use of local anaesthesia which adds patient discomfort apart from its cost compared to External Beam Radiotherapy. But APBI with brachytherapy is more commonly practised procedure compared to EBRT owing to its previous reults. Hence in this research study, we intend to explore the use of EBRT with the radiobiological corrections for APBI in the place of brachytherapy. It is done as a dosimetric comparison of Brachytherapy treatment plans with that of EBRT plans. Materials and methods: The computed tomography images of 15 patients undergoing ISBT planning were simulated with conformal photon fields. Various dose volume parameters of each structure were obtained from the DVH generated in the brachytherapy and the simulated external beam planning which can correlate well with the late toxicity. The plan quality indices such as conformity index and homogeneity index for the target volume were computed from the dosimetric factors. The statistical p values for CI, HI and normal tissue dosimetric parameters were calculated and the confidence levels achievable were analysed. The dose prescribed in brachytherapy was 3400cGy in ten fractions. The equivalent prescription dose for the external beam radiotherapy planning was 3000cGy in five fractions applied with radiobiological correction. Results: All the fifteen patients were with complete lung data and six were with left sided tumours having complete cardiac data. The lung dosimetry data and the cardiac dosimetry data of the patients were studied. Lower percentages of lung and cardiac V20 and V5 volumes were obtained with conformal planning. The conformity of radiation dose to the tumour volume was akin to the interstitial brachytherapy planning. Moreover the external beam planning resulted in more homogenous dose distribution. For the sampled population, the statistical analysis showed a confidence level of 95% for using EBRT as an alternate to multi catheter ISBT. Conclusion: The EBRT planning for Accelerated Partial Breast Irradiation was found to be technically feasible in the institution where the interstitial brachytherapy happens to be the only available technique as evident from the dose volume parameters and the statistical analysis. © 2012 Greater Poland Cancer Centre.


Ravind R.,HCG Bangalore Institute of Oncology | Kumar P.V.,HCG Bangalore Institute of Oncology | Prabaharan S.,HCG Bangalore Institute of Oncology
BMJ Case Reports | Year: 2016

Inflammatory breast cancer (IBC) is a relatively rare and aggressive subtype, accounting for nearly 2.5% of all diagnosed breast cancers worldwide. It is usually characterised by an acute onset, rapid clinical progression, poor prognosis and micrometastasis at the time of presentation. Prompt recognition of clinical symptoms and identification of warning signs are vital in diagnosing and appropriately treating a patient with IBC. © 2016 BMJ Publishing Group. All rights reserved.

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