ABSTRACT
Background: Whole brain radiotherapy for patients with brain metastasis from lung cancer – prognostic significance of RTOG-RPA score. Aim: To evaluate the prognostic significance of Recursive partition Analysis (RPA) score in predicting the survival in patients with brain metastasis from Non-Small Cell Lung Cancer (NSCLC). Materials and methods: 35 patients diagnosed to have brain metastasis (BM) from primary NSCLC who had received palliative whole brain radiotherapy (WBRT) with or without chemotherapy from March 2014 to Mar 2017 were analyzed in this study. Data regarding the patient age, gender, performance status, histology, number of BM, time of metastasis, neurosurgical resection, radiotherapy details were collected and analyzed. Patients were divided into 3 groups according to RPA classification. The differences in clinical characteristics and treatment variables were analyzed by chi square test and overall survival analysis using Kaplan Mayer. The Cox proportional hazards regression model was used to determine statistically significant variables related to survival. Results: In univariate analysis histology, number of BM, extra cranial metastases, KPS and RPA score were identified to have prognostic significance. The result of multivariate analysis by the Cox proportional hazard model showed that RPA, no of mets and Extra cranial mets were significant. S. Jeeva, K. Chandralekha, V. Vanitha, M. Sornam, Balasubramanium, P. Vidya. Whole brain radiotherapy for patients with brain metastasis from lung cancer – Prognostic significance of RTOG-RPA score. IAIM, 2019; 6(5): 32-39. Page 33 Conclusions: Our study showed that RPA is good prognostic indicator in assessing the prognosis of patients with brain metastasis in NSCLC.
ABSTRACT
Introduction: Initiation of breastfeeding within one hour of birth is an important determinant of successful breastfeeding. National Family and Health Survey -3(NFHS-3) reported that only 23.4% of children <3 years were breastfed within one hour of birth. Objectives: the purpose of this study is to study the determinant of initiation of breastfeeding within one hour of birth. Setting: Tertiary –level neonatal unit. Material and Methods: All mothers admitted in in the postnatal ward were eligible for inclusion; mothers of sick and /or preterm infants were excluded. Enrolled mothers were interviewed between 24 and 72 hours after delivery. Results: The proportion of mothers who initiated breast feeding within one hour of delivery was 32%, between 1-6 hrs were 47% and between 6 to 48 hrs were 21%. Maternal age, education, socioeconomic status, occupation and antenatal or labor room counseling did not influence the initiation of breast feeding within one hour of delivery in univariate analysis. On multivariate analysis, admission in the general ward and delivery by caesarean section were found to be significantly associated with not initiating breastfeeding within one hour (adjusted ORs: 8.79, 2.48 to 31.08, p=0.001 and 6.79, 4.07 to 22.02 p=0.001 respectively). Only about 13% of the infants received prelacteal feeds. Conclusion: Mothers delivering by caesarean section or admitted in the general ward were at high risk of not initiating breastfeeding within one hour. Innovative strategies are required to ensure timely ignition of breastfeeding.