Aims:This prospective study was designed to monitor and analyze the pattern of occurrence of adverse drug reactions (ADRs) to cisplatin-based chemotherapy regimen in the cancer ward of a tertiary care hospital.Materials and Methods:Cancer patients who received cisplatin-based cancer chemotherapy were monitored for adverse reactions. The collected reports were analyzed for demographic and drug details, causality, preventability and severity of adverse effects. Causality was assessed by the World Health Organization (WHO) causality assessment scale and Naranjo's Algorithm. Preventability and severity of ADRs were assessed by modified Schumock and Thornton scale, modified Hartwig and Siegel scale respectively.Results:Among 51 patients, 48 developed ADRs to cisplatin chemotherapy. The reactions observed were nausea, alopecia, anorexia, vomiting, taste alteration, diarrhea, constipation, tinnitus, and hypocalcaemia. The WHO causality assessment scale indicated 69% “possible” and 31% “probable” but no “certain” reactions. Naranjo's Algorithm showed 62% “probable” and 38% “possible” reactions. Most of the reactions belonged to the category of “not preventable”. Reactions like nausea and vomiting belonged to the category of “definitely preventable”. Modified Hartwig and Siegel scale of severity assessment showed that most of the reactions were of “mild level 1” severity except for vomiting, diarrhea and hypocalcaemia, which were of “moderate level 3” severity.Conclusion:Cisplatin-based chemotherapy has a high potential to cause adverse effects. Most of the reactions were of milder nature but not preventable. The common adverse effects such as nausea and vomiting were preventable, but reactions like hypersensitivity reactions and anaphylaxis were not predictable.

Background: Early diagnosis is an important aspect of quality of cancer care.Analysis of the diagnostic delays and the reasons for delay helps to plan strategies to improve cancer care. Objectives: To determine the primary, secondary, and total diagnostic delay of patients diagnosed with head and neck cancer and to explore the reasons for the delay from the patient perspective. Methods: Explanatory mixed method design was used. Two hundred persons with a confirmed diagnosis of head and neck cancer attending the ENT (ear, nose, throat) cancer clinic in a teaching hospital before the initiation of treatment were included in the study. The median delay and the association of the delay with the various factors were analyzed. Sixteen one-to-one interviews of patients were done to identify the reasons for the delays from the patient perspective. Results: Median primary, secondary, and total diagnostic delays were 30 days, 30 days, and 73 days, respectively. Statistically, primary delay was found significantly longer among ever users of smokeless tobacco and significantly longer secondary delay was found among those with age less than 60 years. The reasons for the delay were grouped in the categories (i) Symptom appraisal delay due to low perceived seriousness and (ii) health-seeking behavior delay. Conclusions: The diagnostic delay was considerable. Measures to enhance symptom appraisal by improving health literacy, opportunistic screening, and strengthening the referral system would decrease diagnostic delay.

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Introduction: During postmastectomy radiotherapy (PMRT), it is recommended to boost the postmastectomy surgical scar with additional 10 Gy in 5 fractions in the patients with close or positive surgical margins. The electron beam therapy, though cumbersome, is usually preferred since it has the desired rapid fall of a dose beyond R 85 . An alternative but easier and reproducible treatment method for PMRT surgical scar boost using 3D CT image-based HDR surface mould brachytherapy is introduced and analyses of the target coverage and dose nearby organs-at-risk (OARs) using this method are evaluated in this study. Methods and Materials: This study includes twelve patients (five left-sided and seven right-sided chest wall), who were planned and treated with CT-image based surface mould HDR brachytherapy for chest wall scar boost (CWB) using Catheter Flap Set TM (Varian Medical Systems, USA) that were given concurrently during external beam radiotherapy (EBRT) treatments. Since no guidelines are available for delineating clinical target volume (CTV) structure to be used for postmastectomy scar boost, the CTV in this study was a uniform 5-mm thick volume drawn at 5 mm beneath the skin (CTVhdr_evl) and its extent was made conforming to the boost area marked on the skin and made visible in CT images by radiopaque wires. Results: Prescribed dose (PD) to CTVhdr_evl is 7.5 Gy in 3 fractions, and 2.5 Gy per fraction. The CTVhdr_evl volume receives the PD with mean V 100% , V 98% and V 95% values which are 98.57%, 99.63% and 100% respectively. The mean dose for heart (MHD) is 2.71 Gy in left-sided CWB and 1.80 Gy in right-sided CWB plans. Mean lung dose (MLD) is 2.48 Gy for ipsilateral lung and 0.76 Gy for contralateral lung. Maximum dose to contralateral breast is 4.93 Gy and the mean dose is 0.79 Gy. The mean percent dose to the skin volume overlying the CTVhdr_evl is 138.6% and 3.7% of skin volume received 200% of the PD. Conclusion: The 3D image-based HDR surface mould achieved good CTV coverage with acceptable doses to OARs. Patient preparation, treatment planning, and execution in this method are less cumbersome and reproducible. Thus surface mould using flap applicator can be used whenever postmastectomy surgical scar boost is required.

Various DNA repair pathways protect the structural and chemical integrity of the human genome from environmental and endogenous threats. Polymorphisms of genes encoding the proteins involved in DNA repair have been found to be associated with cancer risk and chemotherapeutic response. In this study, we aim to establish the normative frequencies of DNA repair genes in South Indian healthy population and compare with HapMap populations. Genotyping was done on 128 healthy volunteers from South India, and the allele and genotype distributions were established. The minor allele frequency of Xeroderma pigmentosum group A (XPA) G23A, Excision repair cross-complementing 2 (ERCC2)/Xeroderma pigmentosum group D (XPD) Lys751Gln, Xeroderma pigmentosum group G (XPG) His46His, XPG Asp1104His, and X-ray repair cross-complementing group 1 (XRCC1) Arg399Gln polymorphisms were 49.2%, 36.3%, 48.0%, 23.0%, and 34.0% respectively. Ethnic variations were observed in the frequency distribution of these polymorphisms between the South Indians and other HapMap populations. The present work forms the groundwork for cancer association studies and biomarker identification for treatment response and prognosis.