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Background: Brain metastasis is a common, debilitating and undesirable neurological complication of systemic cancer and a significant cause of morbidity and mortality. Methods: 39 patients of brain metastasis with Ca breast/Ca lung as primaries were randomized into a study arm and control arm in between 1st August 2018 to 31st July 2019 at IGMC Shimla. Control arm consisted of WBRT (30 GY/10 fractions/5 days a week). Study arm consisted of WBRT with same dose and temozolamide administered 75mg /m2/day during RT days. Results: Out of 39 patients 34 patients completed treatment out of which 17 in study and 17 in control arm. Response to brain lesions could not be assessed in 20 out of 39 patients. In remaining 19 patients 36.8% patients in study arm and 20% patients in control arm had partial response (PR). 5.3% patient in study arm and none in control arm has complete response (CR). 25% patients in control arm and 15.8% patients in study arm had stable disease. Improvement in QOL (FACT- G) seen in both study and control arm post Rx, however improvement sustained in study arm at 1st F/u. Conclusions: Leveraging the additional radio-sensitizing effect of TMZ may hold promise as an attractive strategy to enhance the quality of life in patients with a favourable performance status. Moreover, RPA could serve as a decisive factor in tailoring the treatment approach, guiding the choice between palliative radiotherapy and best supportive care for these individuals.
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Primary malignant melanoma of the uterine cervix is a rare neoplasm and the overall prognosis of patients with this disease is very poor. Herein, authors report a case of 45-year-old woman who presented with vaginal bleeding for one months and examination showed an exophytic, 6 cm polypoid blackish-pigmented tumor on the cervix involving vaginal fornix. She underwent abdominal radical hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy and further received adjuvant concurrent chemo-radiation with cisplatin (CDDP) and temozolamide but died 7 months after surgery.
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Background: Patients with high grade gliomas have poor survival even with aggressive multimodality approach. The aim of our study is to evaluate the predicting factors affecting the survival outcome in patients with high grade gliomas (HGG). Materials and methods: 46 patients diagnosed to have high grade gliomas (HGG) treated in our Radiotherapy department during the period of March 2014 to March 2017 were analyzed in this single centre retrospective study. All patients underwent maximal safe surgery followed by postoperative radiotherapy with or without temozolamide chemotherapy. Data regarding the patient age, gender, performance status, histology, grade of the tumor, tumor location, extent of surgery, radiotherapy, and chemotherapy details were collected and analyzed. The differences in clinical characteristics and treatment variables were analyzed by chi square test and overall survival analysis using Kaplan Mayer method. The Cox proportional hazards regression model was used to determine statistically significant variables related to survival. Results: The median survival of patients with HGG in this study was 9 months. The median survival of patients with grade III and IV glioma was 19 and 4 months respectively. In univariate analysis histology, grade, laterality were identified to have prognostic significance. The result of multivariate analysis showed that performance status, grade, histology, extent of surgery is significant for survival. S. Jeeva, V. Vanitha, K. Chandralekha, M. Sornam, Balasubramanium, P. Vidya. Predictive factors for survival and outcome in patients with high grade gliomas: A single centre retrospective study. IAIM, 2019; 6(3): 24-31. Page 25 Conclusion: Our study showed that histology, grade, extent of surgery is the significant factors in assessing the prognosis of patients with HGG. The survival of HGG was poor in spite of combined modality treatment.
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Objective: To perform a retrospective analysis of the prognosis and influence factors of radiotherapy concurrent with che-motherapy and adjuvant temozolomide therapy in adult patients with high-grade brainstem glioma. Methods: Twenty-nine patients with pathological diagnosis of high-grade glioma (World Health Organization [WHO] Ⅲ and Ⅳ) from June 2012 to December 2013 were eligible for inclusion in the analysis. Demographic and clinical characteristics including age, gender, the time from morbidity to operation, the size of the lesion, the method of operation, the Karnofsky Performance Status (KPS) score, and the pathological grade were examined. The significance of related prognostic factors was evaluated via univariate and multivariate Logistic regression analy-sis. A P-value of<0.05 was considered to be statistically significant. Results: The median overall survival (OS) was 11.5 months. Univari-ate analysis showed that low WHO grade index was associated with better outcome (P<0.05). Multivariate analysis suggested that high KPS score (>60) and low WHO grade were associated with better survival. Conclusions: In this study, low pathological grade and high KPS score were independently associated with better survival among patients with high-grade brainstem glioma.
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Objetivos: conocer la sobrevida a dos años de pacientes con diagnóstico de Glioblastoma multiforme (GBM) tratados con Temozolamida con cobertura del Fondo Nacional de Recursos (FNR), evaluar la seguridad del tratamiento y los factores pronósticos. Metodología: cohorte de pacientes portadores de GBM, tratados con Temozolamida entre mayo de 2009 y diciembre 2011. Fuente de información: base de datos del FNR. Resultados: Se incluyeron 81 pacientes. La mediana de sobrevida global fue de 18 meses. Vivos a dos años: 33 de los pacientes. El análisis multivariado encontró a la edad y al peor estado funcional del paciente como los factores de riesgo para mortalidad. 8 pacientes tuvieron efectos adversos severos. Discusión: Se presentan los primeros resultados nacionales vinculados al tratamiento combinado de los GBM. La sobrevida fue similar a la reportada en los estudios de referencia internacionales y mayor que la descripta para el tratamiento radiante exclusivo. El beneficio es mayor en aquellos pacientes jóvenes con buena capacidad funcional previa al inicio del tratamiento. Su seguridad fue considerada como aceptable.
Objectives: find out the two-year survival of patients diagnosed with Multiform Glioblastoma (MGB) treated with Temozolamide funded by the National Resource Fund (FNR), and evaluate the safety of therapy and prognostic factors. Methodology: cohort of patients with MGB, treated with Temozolamide between May 2009 and December 2011. Data source: database of the FNR. Results: the 81 patients included had a median overall survival of 18 months; 33 of them were still alive at two years. The multivariate analysis found that the patient’s age and functional status were the risk factors for mortality. Eight patients had severe adverse effects. Discussion: Presentation of the first national results related to the combined therapy of MGB. Survival was similar to that reported in the international reference studies and greater than that described for radiation therapy alone. Benefits were greater in young patients presenting with a good functional capacity before starting therapy. The safety of therapy was deemed acceptable.