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Purpose: The study purpose included dosimetric comparison of cobalt 60 (60Co) and iridium 192 (192Ir) high dose rate (HDR) source used in brachytherapy treatment of cervical cancer. Materials and Methods: Computed tomography (CT) scans for 15 patients of carcinoma of uterine cervix using 3-mm slice thickness were considered for the study The contouring of high-risk clinical target volume (HRCTV), bladder, and rectum on CT images was done as per the GEC ESTRO guidelines with the help of magnetic resonance imaging images in the treatment planning system. All parameters were kept the same for 60Co (3.5 mm active length, 0.5 mm active dia, Bebig) and 192Ir (3.5 mm active length, 0.6 mm active dia, Bebig) HDR source with 2.5-mm step size and dose prescription to Point A. As per the International Commission on Radiation Unit (ICRU)-89 guidelines, the dose–volume parameters such as D50(Gy), D90(Gy), and D98(Gy) for HRCTV and D0.1cc (Gy), D1cc (Gy), D2cc (Gy), and D5cc (Gy) to the bladder and rectum were calculated for both the HDR sources. Results: The difference in dose–volume histogram parameters such as D50,D90,and D98 of HRCTV was 3.19%, 1.13%, and 0.50%, respectively, for the two radioisotopes. The difference in dose values of D0.1cc, D1cc, D2cc, D5cc, and ICRU reference points of bladder was –0.58%, –0.67%, –0.99%, –0.94%, and –1.75%, respectively. On the other hand, dose difference for D0.1cc, D1cc, D2cc, D5cc, and ICRU reference points of rectum was 0.67%, 0.26%, 0.56%, 0.63%, and –0.33%, respectively. Conclusions: The present study results show that all the dose parameters of HRCTV, bladder, and rectum with 60Co were comparable with those of 192Ir HDR source. The isodose distribution is more bulge out for 60Co in cranial-caudal direction compared to that of 192Ir. However, these differences can be reduced by treatment planning optimization techniques. The clinical plan evaluation in each slice and plane is necessary to explore the logistic and financial benefits of miniaturized 60Co source over 192Ir HDR source
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CNS PNET are infrequent in children and very rare in adults. Even rarer is the development of PNET from low grade astrocytoma. We hereby report a case of PNET arising from astrocytoma. Some similar cases have been reported in the past in which radiation was considered to be the etiological factor in the development of PNET from glial neoplasms but in this case the duration of conversion does not go in favour of radiation as the cause.
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Background: Carcinoma cervix is the second most common malignancy among females of India (1). The low incidence rate in developed countries is because of well-developed screening programs and awareness among women. But in developing countries like India, because of lack of health awareness and lack of proper screening facilities, patients usually present in advanced stages. They also have a lot of associated co-morbidities like obstructive uropathy with or without deranged RFT, anaemia, poor nutrition, tuberculosis, diabetes, hypertension, multiple genital infections etc. The standard treatment of advanced carcinoma cervix is radiotherapy with weekly cisplatin as radio-sensitizer but it has been observed that a lot of patients are not able to tolerate toxic side effects of concurrent chemo radiotherapy. Methods: We have chosen only one co-morbid condition i.e. obstructive uropathy with or without deranged RFT because of small sample size. So the aim of this study was to compare the compliance and response rate of concurrent chemo radiotherapy versus radiotherapy alone in patients of locally advanced carcinoma cervix having obstructive uropathy with or without deranged RFT. Results: Only 36% (n=9) patients in the RT+CT group received the complete planned five cycles of weekly cisplatin. Average number of cycles of cisplatin missed in the chemo-radiotherapy group was one (range 0-3). Compliance was better in the RT alone group. The average time in the RT alone group to complete radiotherapy was 57.72 days and in RT+CT group was 60.72 days. In the RT alone group the treatment time was prolonged by an average of 1.72 days (range 3-6) while in the CT+RT group it was prolonged by 4.72 days (range 2-14). Conclusions: It is hereby concluded that radiotherapy alone for locally advanced squamous cell cervical carcinoma patients having associated co morbid conditions like deranged RFT had a better compliance then with the concurrent chemoradiotherapy regime.