High dose rate intraluminal brachytherapy in combination with external beam radiotherapy for palliative treatment of cancer rectum

To evaluate the feasibility, efficacy and toxicity of High Dose Rate Intraluminal Brachytherapy [HDRILB] in combination with External Beam Radiotherapy [EBR] used in the palliative treatment of selected patients of adenocarcinoma rectum. Design: A prospective pilot study. Place and Duration of Study: The study was conducted at the Institute of Radiotherapy and Nuclear Medicine [IRNUM], Peshawar. The study started in April 1996 and the patients' accrual was completed in June 1997. Patients and The patients with adenocarcinoma rectum, who refused surgery, had contraindications for surgery or had advanced and/or metastatic disease were treated with HDRILB in combination with external beam radiotherapy [EBR]. The apparatus used for HDRILB was Ralstron 20B remote afterloading unit with 60Co stepping source. Indigenously designed rectal applicators were used. The EBR was delivered through Pheonix 60Co teletherapy machine [Theratron AECL]. The data for symptom burden and symptomatic relief was analyzed by applying Likert's method of summated scales. Data was analyzed after one week and at the end of the treatment. After one week of treatment, the relief in pain and bleeding per rectum [P/R] was 97%. Excellent palliation was achieved at the end of the treatment when perineal pain and bleeding P/R were relieved in 100%, discharge P/R in 87% and tenesmus in 93% of the cases. Conclusion:The use of HDRILB in combination with EBR can provide quick relief of symptoms in selected patients of adenocarcinoma rectum. This combination has an excellent palliative value because of its effectiveness, acceptable toxicity and overall short treatment duration

Candidiasis in cancer patients

One hundred clinical specimens from hospitalized cancer patients were examined microscopically for evidence of yeast cells and cultured for Candida colonization. Candida cells were observed microscopically in both unstained and Gram-stained preparations and culture in 60% of specimens

Cancer in north west Pakistan

From 1990 to 1994 all patients with biopsy proven cancer who referred to the Institute of Radiotherapy and Nuclear Medicine [IRNUM], Peshawar were included in the study. IRNUM is the only hospital in the North West Frontier Province [NWFP] where majority of the patients are referred. There were 10, 371 adult patients which included 5, 707 males and 4, 664 females. [122 males per 100 females]. Patients whose histopathology was doubtful or not available were excluded from the study. Skin cancer was the most common cancer among males followed by lymphoma, oral cancer, bladder cancer, lung cancer, oesophageal cancer, soft tissue tumor, prostate cancer, brain tumours and myeloid leukaemia. In women, breast cancer was the leading malignancy, followed by skin, ovary, oral cancer, oesopheagus, cervix, lymphoma, uterus, myeloid leukaemia and soft tissue. The annual incidence rate has also been calculated keeping in view that all or nearly all cancer cases occurring in NWFP have been covered and secondly, all cases registered who were residents of NWFP as Afghan refugees, were excluded. The incidence rate is based calculated increase after the 1981 Census

Demonstration of a renoperitoneal fistula by radionuclide renal scanning: a case report

Radionuclide renal studies are minimally invasive, easy to perform and give information about both renal structure and function. These studies may be safely used to detect urinary extravasations from the upper urinary tract. A case of renoperitoneal fistula imaged by nuclear medicine technique is described. [JPMA 36: 118, 1986] The diagnosis of urinary extravasation using nuclear medicine procedures after trauma and renal transplants is well documented1-4 but radionuclide scanning for urinary extravasation in conditions other than these has rarely been reported 5-6. Surgically related extravasations are common but they are usually small and retroperi-toneal. We describe here an iatrogenic renoperitoneal fistula which presented with tense ascites