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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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Background: Lung cancer is one of the most common cancers in males worldwide and its number is increasing every year. Of these cases 75-80% case are of non-small cell type. Methods: This study was conducted on 30 patients of stage IV non-small cell lung cancer in the department of radiation oncology at tertiary care center, Shimla, Himachal Pradesh India from 1st Jun 2019 to 30th Jun 2020 by dividing them into study and control arm for assessing quality of life (QOL) with EORTC QLQ-C30 version3.0. Results: We observed significant improvement in Global health scale of control arm (p=0.005) but it got worse in study arm (p=0.743). All the parameters of Functional scale i.e. Physical (p=0.584; 0.170), Role (p=0.213; 0.016), Emotional (p=0.239; 0.002), Cognitive (p=0.793; 0.247) and Social functioning (p=0.030; 0.231) got worse in study arm while they improved in control arm. As far as Symptom scale is concerned, in the study arm; dyspnea (p=0.724), appetite (p=0.836), constipation (0.192), diarrhea (p=0.341) improved but other symptoms like fatigue (p=0.566), nausea (p=0.347), pain (p=0.305), insomnia (p=0.025), financial difficulties (p=0.082) got worse while in control arm; fatigue (p=0.003), pain (p=0.000), dyspnea (p=0.022), insomnia (p=0.336), appetite (p=0.028), constipation (0.019), diarrhea (p=0.336), financial difficulties (p=0.336) improved and nausea (p=0.120) got worse. Conclusion: QOL assessment by the physician before commencement of the treatment and later on at every visit seems to be beneficial for symptom relief and to allay the anxiety of both patient and their attendants.
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Background: Human epidermal growth factor receptor 2 (HER2)/neuprotooncogene (neu) is a proven molecular prognostic marker in breast, ovarian, gastric, and ovarian cancers. In head-and-neck cancers, varied expression is documented and therefore its prognostic role is debatable. Aim of the Study: To find the rate of overexpression of HER2/neu in head-and-neck cancers and to understand its prognostic role by evaluating its association with nodal stage and overall stage of the patient. Methodology: A total of 70 surgically resected cases of head-and-neck cancers were evaluated for expression of HER2/neu by immunohistochemistry. Scoring was done according to the American Society of Clinical Oncologists/College of American Pathologistsguidelines for Her2/neu testing in breast cancer. Results: Of the 70 cases studied, 57 were of oral cavity and 13 were laryngeal squamous cell cancers and 14 (20%) were Her2/neu positive. On correlating the expression of HER2/neu in T1/T2 (41 cases) versus T3/T4 (27 cases), the P value was found to be 0.8273 which was statistically insignificant. Furthermore, no statistically significant difference in expression of HER2/neu was found in between node negative and node positive cases (49 vs. 19 cases, respectively), with P = 0.512. Conclusion: In the current settings, HER2/neu is not found to be a prognostic marker in head-and-neck cancers. Standard immunohistochemistry staining protocols need to be established like in breast cancers to aid uniform reporting and further evaluate the role of this important protooncogene in head-and-neck cancers.
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PURPOSE: To study the epidemiology and clinical profile of victims of ocular trauma in an urban slum population. MATERIALS AND METHODS: This cross-sectional study, conducted on 500 families each in three randomly selected urban slums in Delhi, collected demographic data for all members of these families, and clinical data for all those who suffered ocular trauma at any time, that required medical attention. Data was managed on SPSS 11.0. RESULTS: Of 6704 participants interviewed, 163 episodes of ocular trauma were reported by 158 participants (prevalence = 2.4%, confidence interval = 2.0 to 2.7) Mean age at trauma was 24.2 years. The association between the age of participants and the history of ocular trauma was significant ( P < 0.001), when adjusted for sex, education and occupation. Males were significantly more affected. Blunt trauma was the commonest mode of injury (41.7%). Blindness resulted in 11.4% of injured eyes ( P = 0.028). Of 6704 participants, 1567 (23.4%) were illiterate, and no association was seen between education status and trauma, when adjusted for sex and age at injury. A significant association was noted between ocular trauma and workplace (Chi-square = 43.80, P < 0.001), and between blindness and place (Chi-square = 9.98, P = 0.041) and source (Chi-square = 10.88, P = 0.028) of ocular trauma. No association was found between visual outcome and the time interval between trauma and first consultation (Chi-square = 0.50, P = 0.78), between receiving treatment and the best corrected visual acuity (Chi-square = 0.81, P = 0.81), and between the person consulted and blinding ocular trauma (Chi-square = 1.88, P = 0.170). CONCLUSION: A significant burden of ocular trauma in the community requires that its prevention and early management be a public health priority.