Browsing by Author "Pai, P"
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Item Cetuximab with radiotherapy in patients with loco-regionally advanced squamous cell carcinoma of head and neck unsuitable or ineligible for concurrent platinum-based chemo-radiotherapy: Ready for routine clinical practice.(2011-04) Agarwal, J P; Gupta, T; Kalyani, N; Budrukkar, A; Laskar, S G; Murthy, V; Kumar, P; Narohna, V; Pai, P; Chaturvedi, P; D'cruz, A KPurpose : To report outcomes of cetuximab concurrent with radiotherapy in advanced head-neck cancer unsuitable for platinum-based chemo-radiotherapy. Materials and Methods : Retrospective chart review of 37 patients treated with cetuximab and radiotherapy at a comprehensive cancer centre. Results : Median age of study cohort was 59 years. Thirty four (92%) patients had advanced stage disease (stage III-IV). Reasons for ineligibility for platinum included impaired creatinine-clearance, old age, and/or co-morbidities. Thirty-two (86%) patients completed planned radiotherapy without interruption; 29 (80%) patients received ≥6 cycles of cetuximab. Fifteen patients (40.5%) developed ≥grade 3 dermatitis; 9 patients (25%) experienced ≥grade 3 mucositis. At a median follow-up of 16 months, the 2-year loco-regional control, disease-free survival, and overall survival was 35.5%, 29.5%, and 44.4% respectively. Stage grouping and severe dermatitis were significant predictors of outcome. Conclusions : Cetuximab concurrent with radiotherapy is a reasonable alternative in advanced head-neck cancer patients with acceptable compliance and outcomes, but higher skin toxicity.Item Clinicopathological Spectrum of Oncocytic Cell Lesions in the Thyroid.(Light House Polyclinic, 2024-12) Pai, P; Sharma, S; Pillai, S.Background: Oncocytic cells are thyroid follicular derived cells, associated with non-neoplastic and neoplastic thyroid lesions. Aim: The aim of the study is to discuss the spectrum of Oncocytic cell lesions with respect to their demographic, clinical, cytological and histopathological features. Materials and Methods: This is a 2-year retrospective study in which thyroidectomy specimens with diagnosis of Oncocytic cell lesions were analysed. Patient data was obtained from the Medical Records Department. Fine needle aspiration (FNA) and histopathology slides were retrieved from pathology archives. Results: Amongst 360 thyroid cases, 16 cases showed Oncocytic cell lesions. Of these 16 cases, 3 cases were Oncocytic cell nodules, 10 were Oncocytic adenomas, and 3 were Oncocytic carcinomas. In this study, ultrasound and FNA were not effective in differentiating benign and malignant Oncocytic cell lesions. Age range was 33-74 years, and male to female ratio was 1: 4.3. On FNA, cases ranged from Bethesda II to Bethesda V. On histology, Oncocytic cell lesions showed various patterns- follicular, trabecular, nested, solid and papillary. Association with lymphocytic thyroiditis and papillary carcinoma was observed. Follow up data was available for 12 cases. Conclusion: Oncocytes are found in non-neoplastic as well as in neoplastic conditions in the thyroid. While the clinical significance of oncocytic cells is still not well established in literature, identification of Oncocytic cell carcinomas is necessary, as these are aggressive neoplasms.Item Congenital ectopic encysted eye ball (a case report).(1984-07-01) Dash, R G; Boparai, M S; Pai, PItem Guidelines for treatment of recurrent or metastatic head and neck cancer.(2014-04) Parikh, P; Patil, V; Agarwal, J P; Chaturvedi, P; Vaidya, A; Rathod, S; Noronha, V; Joshi, A; Jamshed, A; Bhattacharya, G S; Gupta, S; Desai, C; Advani, S H; Pai, P; Laskar, S; Ramesh, A; Mohapatra, P N; Vaid, A K; Deshpande, M; Ranade, A A; Vora, A; Baral, R; Hussain, M A; Rajan, B; Dcruz, A K; Prabhash, KItem Immunophenotyping of T-cell acute lymphoblastic leukaemia: Practical hurdles.(Dr. M. V. Ghorpade, 2023-10) Pai, P; Belurkar, S; Sindhura, LKL.Background: The 2016 WHO classification of T cell acute lymphoblastic leukemia suggest that cases of pre and pro T- cell Acute Lymphoblastic Leukaemia (T-ALL) now fall under Early T-cell precursor ALL (ETP-ALL) or Near ETP- ALL. Accurate subtyping is essential as the subsets are characterized by distinct molecular profiles and identifying molecular aberrations allow patients to receive novel treatment agents. Aim and Objectives: To study the immuno- phenotypic characteristics in T-ALL cases and assess the diagnostic difficulties encountered in its subtyping. Material and Methods: Thirty-seven cases of T-ALL were analysed on flow cytometry using a 6/8 colour panel of monoclonal antibodies, including B cell, T-cell, myeloid and stem cell markers. The cases were categorized as ETP-ALL, near ETP-ALL, cortical T-ALL and medullary T-ALL. Clinical details were retrieved from patient case files. Results: Patient age ranged from 1 to 64 years. Male to female ratio was 2.1: 1 and 35.1% cases were documented to have 3 mediastinal mass. Mean haemoglobin level was 8.6 g/dl, and median total WBC count was 118.3 × 10 /?l. Blast percentage ranged from 39-98%, with mean of 84.8%. On flow cytometry analysis, all cases expressed CD7 and cytoplasmic CD3. CALLA+ (CD10+) were 32.4% cases. The aberrant expression of B-cell marker (CD79a) was observed in 5.4% cases. Majority of the cases were classified as medullary T-ALL, constituting 37.8% cases. ETP- ALL were 21.6% cases, 13.5% cases were near ETP-ALL and 24.3% cases were cortical T-ALL. One case could not be definitely assigned to a specific category. Conclusion: This study reflects the difficulties encountered in subtyping of T-ALL cases due to antigenic overlap and/or due to lack of an extended panel of secondary markers.Item Induction chemotherapy in technically unresectable locally advanced oral cavity cancers: Does it make a difference.(2013-01) Patil, V M; Noronha, V; Muddu, V K; Gulia, S; Bhosale, B; Arya, S; Juvekar, S; Chatturvedi, P; Chaukar, D A; Pai, P; D'cruz, A; Prabhash, KImpact Factor for 2013 is 1.131 Click here to download free Android Application for this and other journals Click here to view optimized website for mobile devices Journal is indexed with MEDLINE/Index Medicus and Science Citation Index ExpandedShare on facebookShare on twitterShare on citeulikeShare on connoteaShare on googleShare on linkedinMore Sharing Services MINI SYMPOSIUM: HEAD NECK CANCER Year : 2013 | Volume : 50 | Issue : 1 | Page : 1-8 Induction chemotherapy in technically unresectable locally advanced oral cavity cancers: Does it make a difference? VM Patil1, V Noronha1, VK Muddu1, S Gulia1, B Bhosale1, S Arya2, S Juvekar2, P Chatturvedi3, DA Chaukar3, P Pai3, A D'cruz3, K Prabhash1 1 Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India 2 Department of Radio-Diagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India 3 Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India Date of Web Publication 20-May-2013 Correspondence Address: K Prabhash Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra India DOI: 10.4103/0019-509X.112263 PMID: 23713035 » Abstract Background: Locally advanced and unresectable oral cavity cancers have a poor prognosis. Induction might be beneficial in this setting by reducing tumor bulk and allowing definitive surgery. Aim: To analyze the impact of induction chemotherapy on locally advanced, technically unresectable oral cavity cancers. Materials and Methods: Retrospective analysis of patients with locally advanced oral cavity cancers, who were treated with neoadjuvant chemotherapy (NACT) during the period between June 2009 and December 2010. Data from a prospectively filled database were analyzed for information on patient characteristics, chemotherapy received, toxicity, response rates, local treatment offered, patterns of failure, and overall survival. The statistical analysis was performed with SPSS version 16. Results: 123 patients, with a median age of 42 years were analyzed. Buccal mucosa was the most common subsite (68.30%). Three drug regimen was utilized in 26 patients (21.10%) and the rest received two drug regimen. Resectability was achieved in 17 patients treated with 3 drug regimen (68.00%) and 36 patients receiving 2 drug regimen. Febrile neutropenia was seen in 3 patients (3.09%) receiving 2 drug regimen and in 9 patients (34.62%) receiving 3 drug regimen. The estimated median OS was not reached in patients who had clinical response and underwent surgery as opposed to 8 months in patients treated with non-surgical modality post NACT (P = 0.0001). Conclusion: Induction chemotherapy was effective in converting technically unresectable oral cavity cancers to operable disease in approximately 40% of patients and was associated with significantly improved overall survival in comparison to nonsurgical treatment.Item Metastatic tumors to the jaw bones: Retrospective analysis from an Indian tertiary referral center.(2011-04) Muttagi, S S; Chaturvedi, P; D'Cruz, A; Kane, S; Chaukar, D; Pai, P; Singh, B; Pawar, PAim: Being a tertiary referral center, we encounter the highest number of oral cancer patients in India, and there is direct involvement of the jaw bone in approximately 40% of these cases. There are no large case series from the Indian subcontinent on metastatic tumors to the jaw bones. With this retrospective analysis, we intend to estimate the incidence of this rare manifestation in the jaw bones in our patients and compare it with the available literature. Materials and Methods: All patients with biopsy proven metastatic disease involving jaw bones having complete clinical data were included. Results: Nineteen out of 10,411 oral cancer patients who reported between the years 2000 and 2005 were included. Breast and thyroid malignancies (5/19 each) were commonest in the females to metastasize to the mandible, whereas in the males, there was no predominant site that resulted in jaw bone metastasis, although mandible was commonly affected. Neuroblastoma of adrenal gland metastasized to maxilla in the age group ranging from 4 months to 16 years. Maxilla was the commonest jaw bone affected in this age group. In five cases, jaw bone was found to be the first site of metastasis. Conclusions: There is variation in the primary site that causes metastasis to the jaw bones depending on age, sex and geographic distribution. Jaw bone metastases are rare and can be the first site of metastasis. We get approximately four cases in a year with metastatic disease manifesting in the jaw bones. Metastasis to jaw bone is associated with poor prognosis.Item Neo-adjuvant chemotherapy in advanced hypopharyngeal carcinoma.(2013-01) Joshi, P; Patil, V; Joshi, A; Norohna, V; Chaturvedi, P; Chaukar, D; Pai, P; Nair, D; Juvekar, S; Agarwal, J P; D'Cruz, A K; Prabhash, KObjective: The aim of this retrospective study was to find out the role of neo-adjuvant chemotherapy (NACT) in changing the management and outcome of advanced hypopharyngeal cancer patients. Materials and Methods: This is a retrospective analysis of 59 treatment naïve, advanced hypopharyngeal cancer patients presenting to our tertiary care center from April 2010 to October 2011. NACT was given as two (platinum with taxane) or three drug with (platinum, taxane with 5-flurouracil [5 FU]) as 3 weekly regimen with cisplatin and docetaxel as 75 mg/m 2 each, 5-FU as 1000 mg/m 2 . NACT was either given with the intent of achieving: (1) surgical resection (extensive soft tissue disease, oropharyngeal involvement, extensive disease with cartilage erosion) or (2) organ preservation (Bulky disease with inner cartilage erosion, exolaryngeal disease without cartilage erosion, large N3 nodes). Results: The mean age of this population was 55 years. Most (83%) of the patients had pyriform sinus (PFS) involvement. 69% patients had Stage IVa disease, 21% Stage IVb and 10% Stage III. The overall response rate was 66%, including 06% complete responses and 60% partial responses. Following NACT, resectability was achieved in 30% (10/33) and organ preservation protocol was planned after NACT in 73% (19/26) patients. The main toxicities were neutropenia (grade 3, 4, 04%; febrile neutropenia, 4%), mucositis 5%, diarrhea 5%. The median progression free survival was 20 months. Conclusions: NACT can be useful in patients with oropharyngeal involvement to achieve surgical resection and larynx preservation in patients with bulky T3 disease.Item A new approach to exfoliative cytology: A comparative cytomorphometric study.(2016-01) Shaila, M; Shetty, P; Pai, PCONTEXT: Early detection of oral premalignancy and malignancy using simple screening aids play a promising role in curbing the disease. AIM: The primary aim of this study is to evaluate and the secondary aim of this study is to compare the cytomorphometry and cellular atypia in keratinocytes obtained from oral rinse and conventional exfoliative cytology in normal oral mucosa and clinically diagnosed oral leukoplakia. MATERIALS AND METHODS: The study comprised of 55 clinically diagnosed cases of leukoplakia and 55 age and sex matched normal controls. Smears were prepared using oral rinse technique followed by the conventional exfoliative cytology. Papanicoloau stained smears were evaluated for atypia and subjected to image analysis. Based on the presence of atypia they were further divided into three groups (Group 1‑cases with atypia, Group 2‑without atypia and Group 3‑normal controls) and analyzed. Statistical analysis used one‑way analysis of variance followed by Tukey Honestly Significant Difference test for intergroup analysis and unpaired students t‑test to compare the two methods. RESULTS: Smears prepared with both methods demonstrated atypia in 18 cases. The cellular diameter and cellular area (CA) were progressively increased from Group 1 through Groups 2 and 3 in both the smears. Nuclear diameter and nuclear area and nuclear cytoplasmic ratio progressively decreased from Group 1 through Groups 2 and 3. Both the methods showed no significant differences among the cellular parameters except in normal controls. CONCLUSION: Cytomorphometric analysis of keratinocytes obtained with oral rinse method and wooden spatula can serve as a useful screening aid to detect oral leukoplakia. Oral rinse method being more convenient results in smears of better quality.Item Surgery for thyroid goiter in western India. A prospective analysis of 334 cases.(1993-10-01) Bapat, R D; Pai, P; Shah, S; Bhandarkar, S D334 consecutive cases of thyroid swellings operated by a single surgical unit over 9 years have been analysed prospectively. There was a female preponderence (4.39:1). The swellings were clinically differentiated into uninodular (39.52%), multinodular (47.31%) and diffuse (13.17%). Hyperthyroidism was manifested in 49 cases (14.67%). Pressure symptoms were present in only 1.5% cases. FNAC detected malignancy in 14 of 162 cases (8.64%). The initial 100 cases were operated upon by standard Lahey's technique and the latter 234 by modified technique described by Bapat et al for benign thyroid disease. Operations performed included nodulectomies (5.39%), hemithyroidectomies (41.92%), partial thyroidectomies (25.75%), subtotal (25.45%) and near total thyroidectomies (1.5%). Post-operative complications were higher in the first group and included unilateral cord palsies-5 (5%). hypocalcemia-4 (4%) hypoparathyroidism-1 (1%) haemorrhage-1 (1%) and mortality-1 (1%) vis a vis cord palsies-2 (0.85%), hypocalcemia-3 (1.28%), hypoparathyroidism-1 (0.43%) and there was no mortality. Histopathology revealed 83 (24.85%) colloid goiters, 193 (57.78%) nodular goiters, 21 (6.29%) follicular adenomas, 7 (2.10%) cases of thyroiditis and 30 (8.98%) malignancies. This study reveals the lower incidence of RLN palsy after modified thyroidectomies, and a low incidence of malignancy.Item Weekly chemotherapy as Induction chemotherapy in locally advanced head and neck cancer for patients ineligible for 3 weekly maximum tolerable dose chemotherapy.(2014-01) Patil, Vijay Maruti; Noronha, Vanita; Joshi, Amit; Muddu, Vamshi Krishna; Dhumal, Sachin; Arya, Supreeta; Juvekar, Shashikant; Pai, P; Chatturvedi, Pankaj; Devendra, Arvind Chaukar; Ghosh, Sarbani; D'cruz, Anil; Kumar, PrabhashOBJECTIVE: To study the safety and efficacy of weekly chemotherapy as part of induction chemotherapy, in locally advanced head and neck cancer for patients, who are unfit for upfront radical treatment. MATERIALS AND METHODS: It is a retrospective analysis of on‑use weekly chemotherapy as Induction chemotherapy in locally advanced head and neck cancer, who are technically unresectable are unfit for upfront radical treatment. Induction chemotherapy given was a 2 drug combination of paclitaxel (80 mg/m2) and carboplatin AUC 2. The decision to give weekly induction chemotherapy was given on the basis of presence of 2 more following features: Poor performance status (ECOG PS 2‑3), presence of uncontrolled co morbidities, BMI below 18.5 kg/m2 and age more than 60 years. The Statistical Package for the Social Sciences software (SPSS version 16.0) was used for analysis. The response rates, toxicity (accordance with CTCAE vs. 4.02), completion rate (Cp) of radical intent treatment post neoadjuvant chemotherapy (NACT), progression‑free survival (PFS) and overall survival (OS) are reported. RESULTS: Fifteen patients were considered for such therapy. Fourteen out of fifteen patients completed NACT. The median numbers of planned weekly cycles were 6 (3-8). Response (CR + PR) was seen in 10 patients. Overall grade 3-4 toxicity was seen in 6 patients. No toxicity related mortality was noted. The calculated completion rate (Cp) of radical intent treatment post NACT was 46.7%. The median PFS and OS were 10.36 months (95% CI 6.73-14.00 months) and 16.53 months (95% CI 4.22-28.84). CONCLUSION: Use of induction chemotherapy with weekly regimen is safe and effective selected cohort of patients with locally advanced disease who are unfit for upfront radical treatment.