The first cross sectional survey on intracranial malignancy in Kolkata, India: reflection of the state of the art in southern West Bengal.

Recent increase in the occurrence of intracranial malignancies and poor performance of therapeutic measures have established the disease as an important concern of medical sciences. The lack of information about the disease pattern throughout India creates problems for maintaining community health for prevention. The present study on the hospital population of Kolkata was conducted to determine the incidence pattern of the disease in the population of southern West Bengal, focusing on distribution with age, sex, occupation and religion in different districts of the region, and characterizing diagnostic and therapeutic measures. Among a total of 39,509 cancer patients from 21 health centers of Kolkata, 2.4% had brain cancers and among these more than 60% are gliomas. A cross-sectional study for a period of 3 years reported the occurrence of 15 types of intracranial malignancy, which demonstrated astrocytomas (36.8%), glioblastoma multiforme (GBM) (7.9%) and meningiomas (11.6%) to be predominant. Brain tumors occur more frequently in males with few exceptions and the incidence was found to be highest among the 40-49 year old group (20.2%). No specific trend for religion and occupation was apparent. However, the district wise distribution showed maximum incidences among industrial areas, namely, Kolkata (33.1%), North 24-Parganas (18.2%), Howrah (9.3%) and Hoogly (7.6%). Diagnosis of the disease was by CT scan, MRI and histological identification (pre and post operative). Therapeutic procedures rely mainly on surgery and radiotherapy, whereas chemotherapy was used as an adjuvant for about 10% of the cases. Evaluation of the scenario regarding intracranial malignancy in this region was a long awaited requirement which should ultimately serve an important function in pointing to risk zones within the population and allow better control measures to be introduced for the disease.

Brain tumor inhibition in experimental model by restorative immunotherapy with a corpuscular antigen.

In view of the advances in our understanding of anti-tumor immune response, it is now tempting to contemplate the development of immunotherapies for malignant brain tumors, for which no effective treatment exists. Immunotherapy, with agents known as biological response modifiers (BRMs) are thus gaining increasing interest as the fourth modality of treatment. A non-specific BRM, sheep erythrocytes (SRBC) when administered (ip, 7% PCV/V, 0.5 ml) in a group of animals at the end of seventh month of ethylnitrosourea administration, resulted in significant increase in the mean survival time (> 350 days). Studies conducted for growth kinetics pattern with proliferation index and fluorochrome (HO-33342) uptake techniques at the tissue culture level exhibited a regulatory inhibition of the cells isolated from tissue excised from the tumor susceptible area of brain of SRBC treated animals. Moreover, histological examination of brain from animals showed immunomodulatory role of SRBC in experimentally induced brain tumor. Further probe into the mechanisms involving immunological investigations at the cellular level in these animals indicated an augmented and potentiated cell mediated immune response (CMI) as evidenced by enhanced spontaneous rosette forming capacity and cytotoxic activity of lymphocytes and neutrophil (PMN) mediated phagocytosis respectively. The observations suggest that SRBC down regulate malignant growth pattern of experimental brain tumors either by an immunologically enhanced killing of tumor cells and/or by directly inhibiting the tumor growth possibly via a stimulated cytokine network. Thus, a corpuscular antigen, can potentiate CMI response in experimentally induced brain tumor animal model, in which response induced in the periphery are able to mediate anti-tumor effects in the brain.