Browsing by Author "Biswas, Linkon"

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    Carcinoma stomach in Eastern India—An audit from a tertiary health care center
    (Wolters Kluwer - Medknow, 2024-01) Banik, Arijit; Biswas, Linkon; Saha, Asis; Ojha, Debankan
    Background: In spite of declining incidence and fatality over the past decade, stomach cancer still remains a global health issue due to its aggressiveness and heterogeneity. There is wide variation in the epidemiology of stomach cancer, not only worldwide but also among different regions of India. However, there is very limited data available for the Indian population. Aims and Objective: This study was aimed at establishing the incidence and role of risk factors, analyzing the symptoms, stage of disease, and mode of various surgical treatments of patients in the eastern region of India, and comparing them with the results of other studies in India and regions outside India. Methods and Material: An audit of the database of carcinoma stomach patients attending the radiotherapy and surgery outpatient department (OPD) between January 2020 and June 2021 was performed. Demographic, clinical, and treatment?related data were collected and analyzed with respect to other regions of India and the worldwide pattern of carcinoma stomach. Results: The mean age of the study population was 58 years with male dominance (70%). The antrum was the most common (60%) primary site, and stage III was the most common (47.6%) stage at presentation. Around 73.4% of patients underwent radical surgery. Most patients (50%) had an eventless post?operative period, and 76% received peri?operative chemotherapy. Also, 20% of patients received adjuvant chemoradiation. Conclusion: Our analysis suggests that there are certain differences (like dietary habits), as well as similarities (like socio?demographic factors), among the risk factors of carcinoma in this part of the country than other parts. Further studies into the risk factors and different clinical presentations are required for prevention and early detection.
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    A prospective comparative study of concurrent chemoradiation in advanced carcinoma cervix patients with weekly cisplatin vs. weekly cisplatin and paclitaxel
    (Wolters Kluwer – Medknow, 2022-07) Mukherjee, Amit K.; Biswas, Linkon; Bose, Soumyo; Sharma, Shyam; Mandal, Srikrishna
    Background: Cisplatin-based concurrent chemoradiation is the standard treatment for carcinoma cervix. However, there is a need to explore alternative chemotherapeutic agents to further improve the treatment outcome. In this study, weekly paclitaxel and cisplatin-based chemoradiation was compared with weekly cisplatin-based chemoradiation in terms of disease control and toxicity profile. Materials and Methods: Sixty-four patients with FIGO stage IB2-IIIB squamous cell carcinoma of the uterine cervix were divided (by simple random sampling) into two groups: control arm patients who received radiotherapy (50 Gy in 25 fractions over 5 weeks) with concurrent weekly cisplatin (40 mg/m 2 ) and study arm patients received same radiation dose with weekly cisplatin (30 mg/m2 ) and paclitaxel (40 mg/m2 ). After that, all patients received brachytherapy 21 Gy/three fractions, one fraction/week. All patients were followed up weekly during treatment, then 4–6 weeks after treatment completion, and thereafter monthly for at least 6 months. Results: The overall treatment response (complete+ partial response) was numerically higher in the cisplatin- containing control arm, but not significant (93% vs. 80%, P-value = 0.406). High-grade early rectal (60% vs. 25%, P-value = 0.014) and acute gastrointestinal toxicity (66% vs. 6%, P-value <0.001) were significantly higher in the cisplatin and paclitaxel-containing arm. Hematological, renal, late rectal, and bladder toxicities were also numerically higher in the study arm, but not statistically significant. Conclusion: There was no significant benefit of weekly paclitaxel and cisplatin as an alternative to weekly cisplatin-based chemoradiation in the treatment of carcinoma cervix.
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    A study on treatment of locally advanced squamous cell carcinoma of head and neck with radiation along with cisplatin or gefitinib
    (B.V.V. Sangha’s S. Nijalingappa Medical College, 2022-12) Sharma, Shyam; Biswas, Linkon; Roy, Arabinda; Biswas, Koustav; Bose, Rajdeep; Mandal, Srikrishna
    Background: Cisplatin based Concurrent chemo-radiation (CTRT) is the corner stone for treatment of locally advanced head and neck carcinoma. Epidermal growth factor receptor(EGFR) expression by squamous cell carcinoma which is associated with cancer development and progression,leads to emergence of anti-EGFR agents as a therapeutic option. In this study we compare cisplatin based CTRT against gefitinib based CTRT in terms of disease control and acute toxicity profile. Material and Methods: Stage III and IV squamous cell carcinoma of Head and neck region (excluding nasopharynx) were randomised into two groups. Control group received conventionally fractionated radiotherapy of 66Gy in 33fractions, over six and half weeks with concurrent weekly cisplatin. Study group received same dose of radiation with concurrent daily oral Gefitinib. All patients were followed up weekly during the treatment and then 6-8 weeks after completion of treatment and thereafter 3 monthly. Results: Overall response rate (complete response + partial response) was comparable for both arms (75% vs 76.2%, p value-0.881). Radiation with cisplatin was associated with significantly higher skin (28.6% vs 15%,p value-0.037) and mucosal (23.8% vs 5%,p-value-0.047) toxicities. Gefitinib containing arm showed significantly higher grade 3 diarrhoea (10% vs 0%, p-value-0.01) and skin rash (6% vs 0%, p -value-<0.001).With a median follow-up of 12.5 months Disease free survival (DFS) was not significantly different between the arms(12 vs 13 months). Conclusion: Gefitinib based CTRT is non-inferior to cisplatin based CTRT for the treatment of locally advanced head and neck carcinoma with acceptable toxicity profile.