Indian Journal of Cancer
Permanent URI for this collection
Browse
Recent Submissions
Item Evolving trends in lung cancer: Epidemiology, diagnosis, and management(Wolters Kluwer - Medknow, 2022-03) Deshpande, Ramakant; Chandra, Manish; Rauthan, AmitLung cancer is one of the deadliest cancers globally and accounts for most of the cancer?related deaths in India. Comprehensive data on lung cancer in India are lacking. This review aimed to discuss the epidemiological trends of lung cancers and driver mutations as well as the recent advancements in molecular diagnostics and therapeutic options primarily in non杝mall cell lung cancer (NSCLC) in India. Electronic databases, such as PubMed and Google Scholar, were searched to retrieve the relevant literature published in the past 5 years. As per the GLOBOCAN 2018 report, lung cancer was ranked the fourth leading cause of cancer (5.9% cases) in India, in all ages and sexes. Furthermore, 63,475 of all cancer?related deaths (8.1%) were attributed to lung cancer (cumulative risk 0.60), making it the third leading cause of cancer?related mortality. The common targets for treatment in lung cancer patients mainly include EGFR mutation, ALK and ROS1 rearrangements and PDL1 expression. In India, EGFR mutations and ALK re?arrangement are commonly reported, but there is limited data of PD?L1 expression. Molecular testing has gained importance as several biomarkers are being targeted to treat lung cancer patients. Surgery, radiotherapy, systemic chemotherapy, and personalized molecular?targeted therapy prolong the overall survival (OS) in patients with NSCLC. Although chemotherapy and molecular?targeted therapies have greatly improved the clinical outcomes, prolonged disease control could not be attained in NSCLC patients without a driver mutation. In this situation, immunotherapy seems to be potentially beneficial to obtain long?lasting disease control with minimal adverse events.Item Significance of emerging clinical oncology endpoints in support of overall survival(Wolters Kluwer - Medknow, 2022-03) Patil, Shekar; Agarwal, Vijay; HS, DrupadDespite a better understanding of the pathophysiology and development of newer therapeutic options, cancer remains an area with several unmet needs. Although overall survival (OS) remains a gold standard endpoint for all cancer therapies, it poses challenges such as the requirement of a long?term follow?up, a higher number of patients, and a higher financial burden. Therefore, surrogate endpoints such as progression?free survival, time to progression, duration of response, and objective response rate are being investigated and used in oncology studies. Patient?related outcomes that measure the patient抯 overall health, quality of life, and satisfaction in the long term are crucial surrogate endpoints considered for drug approval. Surrogate endpoints shorten oncology clinical studies and accelerate the evaluation and implementation of newer therapies. Emerging surrogate endpoints such as biomarkers, immune?related response criteria, minimal residual disease, and pathological complete response are increasingly being considered in oncology trials. Validation of surrogate endpoints enables their substitution for OS and gain market approval. The selection of surrogate endpoints for an oncology trial depends on cancer type and stage, the purpose of treatment, and expected duration of survival for the relevant disease. With the advent of individualized approach and complex study designs, the field of oncology is currently undergoing a paradigm shift. The use of newer surrogate endpoints will aid in accelerating the drug development process, making patient care for oncology more accessibleItem Ideal sequencing in Stage IV epidermal growth factor receptor mutant Non朣mall?Cell Lung Cancer(Wolters Kluwer - Medknow, 2022-03) Walia, Meenu; Singhal, Manish K.; Kamle, Mangesh S.Evidence from several studies has shown improved progression?free survival (PFS) with first? or second?generation epidermal growth factor receptor (EGFR)杢yrosine kinase inhibitors (TKIs) compared with chemotherapy for advanced NSCLC patients. But resistance to first or second?generation TKI therapies after 9 to 12 months of treatment initiation is a concern. Osimertinib is a third?generation, irreversible, oral EGFR?TKI that potently and selectively inhibits both EGFRm (epidermal growth factor receptor mutated) and EGFR T790M and has demonstrated efficacy in NSCLC central nervous system (CNS) metastases. Trials have reported significantly longer PFS and higher median duration of response with osimertinib compared with first?generation EGFR?TKIs (erlotinib, gefitinib) and chemotherapy, respectively. And relatively lower rates of discontinuation due to adverse events (AEs). Significant improvement in overall survival was also observed when used as first?line treatment. Because EGFR?mutated tumors are highly dependent on EGFR signaling, optimal sequence of available TKIs � erlotinib, gefitinib, afatinib, dacomitinib, and osimertinib � is necessary. The sequencing of EGFR?TKIs has changed over the past decade and depends on factors such as expected efficacy, CNS activity, tolerability, and options available after progression. Third?generation TKI may be the preferred first?line treatment because patients may not opt for or die before the start of second?line therapy, and it is difficult to predict which patients will eventually develop T790M mutation. The favorable tolerability profile alongside a longer time to disease progression makes osimertinib a preferred first?line treatment. Though clinical practice guidelines do not provide clear consensus on the most preferred EGFR?TKI, recent updates recommend osimertinib as a first?line treatment for advanced NSCLC patients. Also, improved patient selection incorporating clinical and molecular characteristics will help translate to better survival outcomes and improved quality of life. This review aims to determine the optimal sequence of administration of the EGFR?TKIs considering toxicity, quality of life, and survival outcomes among advanced NSCLC patients.Item BRCA mutations: Implications of genetic testing in ovarian Cancer(Wolters Kluwer - Medknow, 2022-03) Talwar, Vineet; Rauthan, AmitOvarian cancer (OC) is one of the most lethal gynecological cancers with a 5?year survival rate that ranges from 30% to 40%. Breast cancer genes (BRCA1 and BRCA2) play a key role in maintaining genomic stability. Mutations in BRCA1/2 genes lead to the accumulation of double?strand breaks, resulting in tumorigenesis. The risk of developing OC in women with BRCA1 and BRCA2 mutations is 39% and 11%, respectively, by 70 years of age. BRCA1/2 mutation testing is thus important to identify women at greatest risk of developing OC in addition to its impact on diagnosis, prognosis, and targeted therapy. Genetic testing is required to identify the BRCA mutations and thus select patients who can benefit from polyadenosine diphosphate (ADP)杛ibose polymerase (PARP) inhibitor therapy. Tumor BRCA mutation testing can detect both germline and somatic mutations allowing implementation of preventive strategies on a broader population. Various international guidelines recommend BRCA1/2 mutation genetic testing in all OC patients irrespective of age and family history. This review focuses on the role of BRCA mutation testing in OCItem Role of methylprednisolone in the prevention of seroma formation after mastectomy: A randomized controlled trial(Wolters Kluwer - Medknow, 2023-06) Subramanian, Preethi; Arumugam, Murugan; Vaithianathan, RajanBackground: Seroma formation after mastectomy with axillary dissection is a major source of morbidity and results in a significant delay in starting the adjuvant treatment. Many different strategies, including the usage of steroids, have been tried to reduce the incidence of seroma with varying outcomes. This study aimed to assess the effect of a single dose of intracavitary methylprednisolone (MP) on seroma formation in patients undergoing total mastectomy with axillary lymph node dissection (ALND). Methods: A randomized controlled trial was conducted at our institute, from January 2018 till June 2019. In the intervention group of 36 patients, 80 mg of MP solution was injected into the wound on post operative day 1. The drain was clamped for 8 hours and then released. In the control group of 36 patients, saline was administered and the drain output was compared between the groups. Results: The mean drain volume in the intervention group was 409.08 mL and in the control group it was 566.97 mL (P < 0.005). The mean drain removal time was 7.86 days and 10.33 days in the intervention and control group, respectively (P < 0.0004). Conclusion: A single dose of intracavitary MP significantly reduced seroma formation and facilitated early removal of drain in patients undergoing total mastectomy with ALND.Item Chondroid syringoma of an upper eyelid tumor: Unusual case report(Wolters Kluwer - Medknow, 2023-06) Prajapati, Chinmay K.; Mehta, Maitrik J.; Kunikullaya, U. SuryanarayanWe present the case report of a 58?year?old man with recurrent chondroid syringoma, which was histopathologically confirmed, who underwent exenteration surgery of the right eye. Furthermore, the patient was receiving postoperative radiation therapy, and presently there is no local and/or distant evidence of disease in the patientItem The prognostic values of the IL?10 (G1082A) and TNF?? (G308A) polymorphisms in Egyptian patients with acute lymphoblastic leukemia: A single?center study(Wolters Kluwer - Medknow, 2023-06) Baiomy, Mohamed A. El; Akl, Tamer; El-Menshawy, Nadia; El?Sebaie, Ahmed H.; Morkos, Hanna; El?Ashwah, Shaimaa; El?Sabbagh, Amr M.; Wahba, Yahya; El?Ghonemy, MohamedBackground: Interleukin?10 (IL?10) and tumor necrosis factor?alpha (TNF??) genes contribute to oncogenesis. We evaluated the influence of the IL?10 (G1082A) and TNF?? (G308A) polymorphisms on the prognosis and outcomes of Egyptian patients with acute lymphoblastic leukemia (ALL). Materials and Methods: We investigated 64 children and 76 adults with ALL, between 2016 and 2019, for the IL?10 (G1082A) and TNF?? (G308A) polymorphisms using allele?specific polymerase chain reaction and polymerase chain reaction杛estriction fragment length polymorphism. Survival analyses were performed using the Kaplan朚eier estimator and the log?rank test. Results: In children with ALL, the A allele of TNF?? and IL?10 polymorphisms was associated with older age (P = 0.04 and 0.03), more extramedullary disease (P = 0.02 and 0.001), positive breakpoint cluster region朅belson (BCR?ABL) rearrangement (p190; P = 0.04 and 0.001), and more relapse (P = 0.002). The IL?10 GG genotype was associated with higher overall survival in children (P = 0.026). Adults carrying the TNF?? A allele showed more extramedullary disease (P = 0.009) and relapse (P = 0.003). We also found a higher frequency of IL?10 A allele in adults with older age (P = 0.03), lower hemoglobin level (P = 0.04), positive BCR?ABL rearrangement (P = 0.001), more extramedullary disease (P = 0.001), more relapse (P = 0.002), and a longer time for the first complete remission (P = 0.003). Conclusion: A possible association exists between the A allele of IL?10 and TNF?? polymorphisms and poor prognosis in Egyptian patients with ALL, while the IL?10 GG genotype may be associated with better survival in children with ALL.Item Determinants of breast cancer screening mammography uptake: Results from Jordan population and family health survey(Wolters Kluwer - Medknow, 2023-06) Obeidat, Rana F; Lally, Robin MBackground: Screening for breast cancer utilizing mammography is associated with reduced advanced cancer diagnosis and reduced breast cancer mortality. We aimed to assess the lifetime history of breast cancer screening utilization for Jordanian women aged 40 and 49 years and determinants of this utilization. Methods: This paper reports the analyzed data from the seventh cycle of the Jordan Population and Family Health Survey (JPFHS). For this study, the analysis was confined to 4486 women aged between 40 and 49 years at the time of data collection who reported their nationality as Jordanian. We used multivariate logistic regression analysis to assess whether any socio?demographic variables could predict greater breast cancer screening utilization. Results: Only 14% of all respondents aged 40� years reported ever having a mammogram. Results of multivariate logistic regression showed that area of residence, husband抯 level of education, younger age, and living in a wealthy status were strong predictors of lifetime history of breast cancer screening. Conclusions: This study elucidates that breast cancer screening mammography among Jordanian women has remained opportunistic and underutilized despite the efforts of national entities to promote screening and early detection of breast cancer. There is a geographic and social disparity in the utilization of mammography screening among Jordanian women.Item Can music and medicine be effective on anxiety, depression and chemotherapy?related nausea and vomiting? (PEGASUS study)(Wolters Kluwer - Medknow, 2023-06) Tanriverdi, Ozgur; Karaoglu, Turan; Aydemir, Fatma NilBackground: Music and medicine can be used in patients with cancer as a palliative complementary therapy. It is aimed to show the effect of music therapy performed on anxiety, depression, and chemotherapy?related nausea/vomiting. Methods: A total of 62 patients with colon cancer who previously experienced grade 1 or 2 chemotherapy?related nausea and vomiting were divided into two groups as intervention and control group based on the addition of music and medicine to infusion chemotherapies and 1:1 randomized. The groups were compared in terms of the effect of music and medicine on anxiety, depression, heart rate, blood pressure, and chemotherapy?related nausea?vomiting. Statistical analysis was done using SPSS Statistics for Windows, Version 19.0. A value of P < 0.05 was found statistically significant. Results: The patients were evaluated in terms of study variables at the beginning and after the completion of a chemotherapy session. As a result, there was a significant decrease in systolic blood pressure (P = 0.042), diastolic blood pressure (P = 0.44), heart rate (P = 0.046), state and trait sections of the state?trait anxiety inventory scores (P = 0.047 and P = 0.046, respectively), as well as a significant decrease in anxiety degree (P = 0.036) and a significant improvement in chemotherapy?related nausea (P = 0.021) and vomiting (P = 0.038) experience in the intervention group. However, no significant effect of music and medicine on depression was detected (P = 0.218). Conclusion: Although it has not been shown to have an effect on depression, it was concluded that music and medicine with classical music integrated into the chemotherapy session can reduce the degree of nausea/vomiting and anxiety levels.Item The association of polypoid growth pattern with lymphnode involvement in endometrioid type endometrial adenocarcinoma(Wolters Kluwer - Medknow, 2023-06) Bezircioglu, Incim; Yetimalar, Mehmet H.; Kilic, Derya; Yigit, SeyranBackground: Tumor size is an independent predictor of lymph node metastasis and survival in the endometrioid type endometrial adenocarcinoma (EC). However, some of the ECs tend to grow towards the cavity in the polypoid pattern, which can reach very large sizes. In this study, we aimed to analyze the association of growing in the polypoid pattern of the tumor with the proportion of lymph node metastasis and extrauterine tumor spread. Methods: Four hundred seven patients were analyzed retrospectively. The effect of tumor size, tumor growing pattern, myometrial invasion, grade, and lymphovascular space invasion on the lymph node metastasis and extrauterine tumor spread were investigated. Statistical analysis consisted of unpaired t?tests for parametric data and Mann Whitney?U test for non?parametric data, whereas the Chi?square test for categorical variables. Logistic Regression, Cox Regression and multivariate analysis were used to estimate the risk predictors. Results: No association was found between the growing in polypoid pattern and lymph node metastasis (P > 0.05). In the analysis of endometrioid type EC patients who had myometrial invasion less than � as a subgroup, no association was found between the growing pattern and lymph node metastasis and extrauterine disease. Tumor size was found to be a statistically significant predictor of lymph node metastasis and extrauterine disease (P < 0.05). Conclusions: Lymphovascular space invasion, grade, and myometrial invasion are associated with a higher proportion of lymph node metastasis. The polypoid growth pattern of the tumor does not correlate with any histopathological parametersItem Post mastectomy pain syndrome at an Indian tertiary cancer centre and its impact on quality of life(Wolters Kluwer - Medknow, 2023-06) Kakati, Barnali; Nair, Nita; Chatterjee, AparnaBackground: Literature on Post mastectomy pain in the Indian population is scarce. Most literature is from the West. The current study aimed to identify the incidence of post?mastectomy pain syndrome (PMPS), pain severity, and its impact on quality of life in Indian patients. Method: Prospective observational study of 120 women undergoing mastectomy between March and December 2017, followed until 6 months after surgery. The Brief Pain Inventory (BPI) questionnaire and the quality of life questionnaire (QLQ) by the European Organization for Research and Treatment of Cancer (EORTC) and known as (EORTC?QLQ 30) were used to identify the impact on function and quality of life. Results: A 35.8% PMPS incidence was identified at 6 months after mastectomy. Pain was located in the anterior chest wall (41.8%), axilla (32.6%), and medial upper arm (25.6%). Most (48.8%) patients described it as dull aching and of mild intensity (55.8%). No significant association of age, BMI, surgery, Intercostobrachial nerve (ICBN) dissection, postoperative pain severity, pain history {dysmenorrhea, headache}, and postoperative radiotherapy with PMPS was found. Pain interfered with daily activities and quality of life in those with PMPS, as deduced from BPI and EORTC?QLQ. Conclusion: PMPS is very much a problem affecting the quality of life in our set of patients. Most women tried to cope and accept the pain as part of the treatment process. This shows the need for creating awareness about PMPS among healthcare providers and patients alike. Early identification and treatment of post mastectomy pain should be an essential aspect of patient careItem Sentinel lymph node biopsy after nipple?sparing mastectomy in early postoperative period: Is it feasible?(Wolters Kluwer - Medknow, 2023-06) Kara, Halil; Arikan, Akif Enes; D黮gero?lu, Onur; Uras, CihanBackground: Axillary lymph node status is one of the most important prognostic factors for breast cancer. Sentinel lymph node biopsy (SLNB) after mastectomy is highly controversial. There is not enough data about SLNB in the early period after nipple?sparing mastectomy (NSM). This study investigated the feasibility of SLNB in the early postoperative period of NSM. Materials and Methods: Patients who were operated on for breast cancer in Acibadem Maslak Hospital between 2009 and 2018 were searched retrospectively. Results of SLNB as the second session in patients whose final pathology report revealed breast carcinoma after contralateral/bilateral prophylactic mastectomy and mastectomy for benign lesions were evaluated. Results: In the early period (median 14 days) after NSM, SLNB was performed by intradermal radioisotope injection in five patients with occult breast cancer in contralateral/bilateral prophylactic mastectomy and in one patient with preoperatively suspicious mass which yielded breast cancer at final pathology. In five (80%) patients, SLNB was performed, whereas in one patient axillary lymph node dissection (ALND) was performed due to the undetectability of SLN. In one patient, micrometastasis was observed, whereas no metastasis was observed in other patients including the one who underwent ALND. No complication due to SLNB was detected. No recurrence and distant metastasis were detected in a mean follow?up of 42.82 (19�) months. While SLNB did not change the treatment of patients with contralateral occult carcinoma, other patients had hormonal therapy due to negative SLNB. Conclusion: SLNB in the early postoperative period of NSM can be performed by intradermal radioisotope injection. However, further studies are needed to determine the feasibility of SLNB in the early postoperative period of NSMItem Role of immunotherapy in metastatic EGFRm NSCLC: Is it relevant?(Wolters Kluwer - Medknow, 2022-03) Dhabhar, Boman; Sahoo, Tarini P.; Akshay, J. K.EGFR?TKIs have changed the landscape of metastatic NSCLC treatment with a significant improvement in survival of EGFRm patients compared to wild?type EGFR. Even with the newer third generation EGFR TKIs like, Osimertinib, which has proven efficacy against the resistance mutation of EGFRm T790M, progression eventually occurs. There are limited treatment options for patients with metastatic EGFRm NSCLC with other acquired resistance. Therefore, novel therapeutic combination strategies are being researched to overcome potential resistance to EGFR?TKI?targeted therapy. The ICIs targeting the programmed cell death?1 pathway in patients with EGFRm NSCLC were greatly anticipated based on preclinical studies showing increased PD?L1 expression. In clinical settings, this increased expression did not translate into a survival benefit. Treatment with ICIs failed to positively affect EGFRm patients because of multiple reasons: nonsynonymous tumor mutational burden, lower PD?L1 expression in tumors, and cancer cells utilizing alternate immune escape mechanisms. The NCCN guidelines currently do not recommend immunotherapy in patients with metastatic EGFRm NSCLC. Recently, a subgroup analysis in the IMpower150 study provided a signal for overall survival of atezolizumab with bevacizumab plus chemotherapy in EGFRm?TKI progressed patients. Based on these encouraging findings, several combinations of ICIs and EGFR?TKIs are being evaluated in TKI?failed EGFRm patients. These regimens might provide a favorable therapeutic effect by combining higher response rates of TKIs and durable disease control of ICIs. However, further research is warranted to understand the exact underlying molecular and cellular mechanisms responsible for the clinical benefits. In this article, we explored the TKI failed metastatic EGFRm NSCLC, reviewed the available clinical data of ICI use in metastatic EGFRm NSCLC, and discussed its emerging role as a combination regimen in this patient populationItem Prognostic role of metabolic 18F?FDG PET/CT parameters and hematological prognostic indicators in patients with colorectal cancer(Wolters Kluwer - Medknow, 2023-06) Cengiz, Arzu; Yersal, 謟lem; 謒黵l�, ?mran Kurt; Y黵ekli, YakupBackground: The aim of this study is to evaluate the role of preoperative 18F?fluorodeoxyglucose (FDG) positron emission tomography朿omputed tomography (PET/CT) parameters, including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), hematologic prognostic indicators in patients with colorectal cancer (CRC) in terms of predicting prognosis. Methods: One hundred and one patients who had undergone 18F?FDG PET/CT for initial staging were evaluated retrospectively. Patient data including pathologic stage at presentation, histology, tumor location, and overall survival (OS) were analyzed. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), serum carcinoembryonic antigen (CEA) (ng/mL), CA?125 (cancer antigen 125) (U/mL), and CA19?9 (U/mL) levels, which were obtained within 2 weeks of the PET/CT examination, were used for hematological data. Results: The TNM Classification of Malignant Tumors stage and PET/CT parameters, including SUVmax, MTV, and TLG, were found to be correlated with survival rate in univariate analysis (P < 0.05). All hematological markers excluding PLR were also significantly associated with survival time. Receiver operating characteristics (ROC) analysis revealed that the optimal SUVmax cutoff value for predicting survival time in patients with CRC was >17.9 (Area under curve (AUC) = 0.625; P < 0.05). The calculated sensitivity and specificity values for this cutoff were 60% and 65.7%, respectively. To predict the survival time in these patients, the optimal MTV cutoff value was >34.29 (AUC = 0.775; P < 0.001; sensitivity = 85%; specificity = 62.3%). The optimal TLG cutoff value for predicting survival time was >270.4 (AUC = 0.790; P < 0.001; sensitivity = 77.5%; specificity = 68.9%). Conclusions: FDG PET/CT metabolical parameters are useful for predicting the prognosis in patients with CRC. High preoperative NLR and high tumor markers were also shown to be negative independent prognostic factors in these patientsItem Nine 揜� Principles in the management of head and neck cancers(Wolters Kluwer - Medknow, 2023-06) Sakthivel, Pirabu; Raveendran, Sarath; Panda, SmritiItem Analysis of Watson for oncology and clinicians� treatment recommendations for patients with breast cancer in Korea: A single center experience(Wolters Kluwer - Medknow, 2023-06) Park, Heeseung; Kim, Kyoung Eun; Choi, Young?Jin; Kim, Hyojeong; Kim, Dong?Hyun; Kim, Keun Young; Kim, Jin You; Bae, Seong?Hwan; Yoon, Jin A; Kang, TaewooBackground: Various clinical applications have been attempted using artificial intelligence (AI) clinical decision support system (CDSS), and it has become a starting point for personalized cancer treatment. We aimed to identify the degree of agreement between the AI?CDSS, Watson for Oncology (WFO), and the clinician in treatment recommendations for Korean breast cancer patients and to provide guidelines for future improvement. Methods: One hundred and eighty?three breast cancer patients who underwent treatment at the Pusan National University Hospital between January 1, 2016 and May 31, 2017 were enrolled in this study. The concordance between WFO抯 and clinicians� treatment recommendations were examined according to various factors. Results: WFO gave the same treatment option recommendations as clinicians in 74 (40.4%) of the cases. According to the logistic regression, the difference in recommendation concordance between stage I and stage III was statistically significant (P = 0.004), and there was no difference among other factors. Conclusion: The concordance of treatment recommendations was low overall. However, this is largely attributable to the differences of medical insurance system and healthcare environment between the United States and Korea. In the future, region?specific features should be considered or reflected during the development of AI?CDSS.Item Nasal chondrogenic tumors: Case reports of primary chondroma and recurrence of atypical cartilaginous tumor (chondrosarcoma grade I) with review of the Literature(Wolters Kluwer - Medknow, 2023-06) Giotakis, Aris I; Yiotakis, Ioannis; Mellou, Argiro; Koufopoulos, Nektarios; Giotakis, Evangelos INasal chondromas and nasal atypical cartilaginous tumors (or chondrosarcoma grade 1) are very rare chondrogenic tumors. Approximately 150 cases of nasal chondroma and fewer than 50 cases of nasal atypical cartilaginous tumors have been described. We reported a case with nasal chondroma in the right ethmoid area and a case with a nasal atypical cartilaginous tumor of the anterior septum. No chondroma recurrence was noted for 17 years after endoscopic resection. Recurrence was noted for the nasal atypical cartilaginous tumor 36 months after wide surgical excision via midfacial degloving. Revision surgery was performed again via midfacial degloving. Recurrences of nasal chondroma and atypical cartilaginous tumors are extremely rare. The current data indicate adequate surgical excision, in some cases even radical, as the most important parameter to avoid recurrence. For inoperable recurrent cases of atypical cartilaginous tumors, observation may be followed.Item Choroid plexus papilloma in a mature cystic teratoma of ovary: A rare case report(Wolters Kluwer - Medknow, 2023-06) Singh, Shikha; Patil, Bharat U; Gangane, Nitin M.Mature cystic teratoma of the ovary is the most common type of germ cell tumor. It constitutes approximately 20% of all ovarian neoplasms. As a rare occurrence, however, several types of benign and malignant tumours developing secondarily in dermoid cysts have been reported. Those of central nervous origin are almost exclusively gliomas of astrocytic, ependymal or oligodendroglial lineage. Choroid plexus tumors are unusual intracranial tumors which comprised of only 0.4?0.6% of all brain tumors. These are neuroectodermal in origin and similar in structure to a normal choroid plexus in the form of multiple papillary fronds mounted on a well vascularized connective tissue stroma. The present case report highlights the presence of a choroid plexus tumor in a mature cystic teratoma of the ovary in a 27?year?old woman who came for safe confinement and cesarean section.Item Dosimetric comparison of three?dimensional conformal radiation therapy, intensity?modulated radiation therapy, and volumetric?modulated arc therapy for free?breathing whole?breast irradiation: A planning study(Wolters Kluwer - Medknow, 2023-06) Czeremszynska, Beata; Socha, Joanna; Rygielska, Anna; Walewska, Agnieszka; Gabor, Marta; Pruska?Pich, Dorota; Osowiecka, Karolina; Kepka, LucynaBackground: Currently, recommended heart dose constraints are difficult to meet in whole?breast irradiation (WBI) for left?sided breast cancer patients, who cannot be treated with the deep inspiration breath hold. We performed a radiotherapy planning study to establish if the use of intensity?modulated radiation therapy (IMRT) or volumetric?modulated arc therapy (VMAT) allows for better sparing of the heart and its subvolumes than the three?dimensional conformal radiation therapy (3D?CRT), and how these attempts affect the dose delivered to the other organs. Methods: A total of 17 left?sided and 10 right?sided consecutive patients treated with free?breathing WBI were retrospectively included. The 3D?CRT, IMRT, and VMAT plans were generated. Several dose杤olume parameters and plan quality indices were compared, separately for the left? and right?sided plans. Results: All the techniques fulfilled the planning objectives. In the left?sided plans, there was no heart or left ventricle dose reduction with IMRT, nor with VMAT; the maximum dose in the left anterior descending coronary artery was reduced with VMAT (P = 0.005); V5 for the contralateral breast, contralateral lung, and total?body increased markedly in VMAT, and for the ipsilateral lung (V5IL) also in IMRT, compared with 3D?CRT (P < 0.001). In the right?sided plans, the V5 values, except for V5IL, did not differ between the three techniques. Conclusions: IMRT and VMAT had a limited heart?sparing benefit in the left?sided free?breathing WBI, at the cost of increased low?dose volumes, measured by V5. The low?dose volumes are not increased by IMRT or VMAT in the right?sided WBI, where heart sparing is not a problem, but the attempts to reduce cardiac doses in the left?sided WBI increase them.Item Marathi translation, linguistic validation, and cross?cultural adaptation of M.D. Anderson dysphagia inventory in patients of head and neck squamous cell cancer(Wolters Kluwer - Medknow, 2023-06) Waghmare, Chaitali M; Aggarwal, Vasundhara V; Bhanu, Arya; Ravichandran, MeenakshiBackground: Self?reported treatment outcome is a better way to measure patient抯 quality of life (QOL). This study was undertaken to translate dysphagia?specific QOL questionnaire M. D. Anderson Dysphagia Inventory (MDADI) in Marathi language, its linguistic validation, and cross?cultural adaptation in patients of head and neck squamous cell cancer (HNSCC). Methods: After Institutional ethics committee approval, MDADI was translated into Marathi with prior permission from the author of original English questionnaire (AOEQ). The translation procedure included � two forward translations (English to Marathi), formation of first intermediate Marathi translation (FIMT), two back translations (BT) (Marathi to English) of FIMT and interim Marathi translation (IMT) formation. Second intermediate Marathi translation (SIMT) was prepared after face validation of IMT by Marathi subject expert. Pretesting of SIMT was done in 10 patients of HNSCC for linguistic validation and cross?cultural adaptation. After incorporating the patients� suggestions, final Marathi translation was formulated and forwarded to primary author for approval. Results: The grammatically acceptable and conceptually equivalent face?validated SIMT was prepared and given to HNSCC patients. The questionnaire was well understood and unobjectionable reflecting its linguistic validity and cross?cultural adaptation. Some of the patients suggested changes in a few words which were then rectified, rechecked with BT, and the final Marathi translated questionnaire was prepared. The credit statement for AOEQ was used as a footnote in the translated questionnaire. Conclusion: Marathi translation of MDADI is well accepted and comprehensible. It can be used for future studies.