Introduction
The COVID‐19 outbreak and the subsequent declaration of pandemic was an unprecedented event, which created different complex situations for treatment of cancer patients. A critical assessment of the response to this calamity and its impact on healthcare workers (HCWs) and patient care in a dedicated cancer hospital is analyzed.
Site of Study
Indrayani Cancer Hospital, Alandi, Pune, India.
Materials and Methods
Due to the pandemic, standard operating protocols were decided on for each department. Analysis of the impact on healthcare was done by comparing the number of patients taking treatment in the lockdown period in India with the previous year's data in the same corresponding period in all three departments. The impact of COVID infection on the HCW and its repercussions were analyzed.
Results
There was a marked decrease in the total number of patients during the lockdown period. The most affected department was surgical oncology. None of our patients contracted COVID‐19, but one HCW was found to be positive.
Conclusion
Strict adherence to protocols along with the support of the government authorities can prevent the spread of this virus thus providing optimal patient outcomes. The treatment of patients with cancer should not be delayed, even in times of a pandemic.
A retrospective study was undertaken of breast cancer patients in India, according to subtypes based on immunohistochemistry. Luminal A had prognostic features and survival which was better as compared to other subgroups (Luminal B, Her 2 enriched and Triple negative). Incidence of patients with Triple negative breast cancer was higher in the premenopausal period. Patients with Her 2 enriched breast cancer had the worst survival among all the subgroups.
In static intensity‐modulated radiation therapy (IMRT), the fundamental factors that determine the quality of a plan are the number of beams and their angles. The objective of this study is to investigate the effect of beam angle optimization (BAO) on the beam number in IMRT. We used six head and neck cases to carry out the study. Basically the methodology uses a parameter called “Beam Intensity Profile Perturbation Score” (BIPPS) to determine the suitable beam angles in IMRT. We used two set of plans in which one set contains plans with equispaced beam configuration starting from beam numbers 3 to 18, and another set contains plans with optimal beam angles chosen using the in‐house BAO algorithm. We used quadratic dose‐based single criteria objective function as a measure of the quality of a plan. The objective function scores obtained for equispaced beam plans and optimal beam angle plans for six head and neck cases were plotted against the beam numbers in a single graphical plot for effective comparison. It is observed that the optimization of beam angles reduces the beam numbers required to produce clinically acceptable dose distribution in IMRT of head and neck tumors. Especially N0.1 (represents the beam number at which the objective function reaches a value of 0.1) is considerably reduced by beam angle optimization in almost all the cases included in the study. We believe that the experimental findings of this study will be helpful in understanding the interplay between beam angle optimization and beam number selection process in IMRT which, in turn, can be used to improve the performance of BAO algorithms and beam number selection process in IMRT.PACS number: 87.55.de
Primitive neuroectodermal tumors (PNETs) are a type of small round cell tumors developing from migrating embryonal cells of the neural crest. Peripheral primitive neuroectodermal tumors (pPNETs) are less common with varying incidence of occurrence in head and neck region. Only 8 reported cases of primary PNET of maxilla are available in English literature. We report a case of 8-year-old boy diagnosed as pPNET of maxilla after detailed radiologic, histopathologic, including immuno-histochemical examination and molecular diagnosis using reverse transcription-polymerase chain reaction showing EWS-FLI1 translocation. The boy was treated with multiagent combination chemotherapy to be followed by definitive radiation therapy. A brief literature review of diagnosis and management of the previous 8 reported cases is done. In view of no definitive guideline for management of such cases, treatment on the lines of other pPNET is suggested.
Prophylactic cranial irradiation has been a part of multimodality management of acute lymphoblastic leukemia (ALL). With optimum treatment and the resultant long-term cure rates, long-term side effects of radiation including radiation-induced neoplasms have been increasingly unearthed. We report a rare case of development of both a meningioma and a cavernous angioma following prophylactic cranial irradiation as a part of treatment of ALL. Regular follow-up and high index of suspicion for late radiation sequelae after treatment are therefore justifiable in leukemia survivors with history of prophylactic cranial irradiation.
The modified pectoral nerves (Pecs II) block as a method of analgesia after breast cancer surgery has proven highly efficacious. This technique blocks the pectoral nerves, long thoracic nerve, thoracic intercostal nerves from T2-T6, and thoracodorsal nerve and can be effectively used as a postoperative analgesic after breast cancer surgeries. The aim of the study is to evaluate the effectiveness of the Pecs II block given intraoperatively for pain relief in the postoperative period of patients undergoing modified radical mastectomy. The outcome after intraoperative Pecs II block administration was analyzed and compared in test (general anesthesia with endotracheal intubation with Pecs II block) and control (general anesthesia with endotracheal intubation only) groups of patients (50 each) scheduled to undergo modified radical mastectomy. In the postoperative period, the patients were evaluated using a visual analogue scale to determine pain scores at 6, 12, and 24 h, and their analgesic requirements were documented. Hundred patients (50 in each group), between the ages of 24 to 76 years (54.76 ± 10), were included in the study. There was no significant difference in ages or comorbidities for test and control groups. In the postoperative period, the test group had significantly lower median pain scores at 6 and 12 h as compared with control group. The modified pectoral nerves (Pecs II) block given intraoperatively is an effective technique for postoperative analgesia in patients undergoing modified radical mastectomy.
In young women with breast cancer, the factors significantly associated with survival were clinical stage at presentation, the presence of lymphovascular emboli and perinodal extension and grade of tumor.
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