Background: Radiotherapy (RT) plays an integral part in the management of breast cancer. In BCT there is 20% reduction in loco regional failure and 15 years breast cancer mortality reduction by 5% when RT is used as adjuvant therapy. Adjuvant radiation therapy can be delivered by External Beam Radiotherapy (EBRT) with brachytherapy (BT) or BT alone. Aims: Loco regional control of disease with good cosmesis. Primary end point is loco regional failure. Methods: A total of 30 cases of early breast cancers (T1, T2 N0M0) treated during May 2008 to Dec 2012 and followed up till July 2015 were studied. External radiation dose of 45 to 50 Gy by Telecobalt-60 followed by boost implant BT with dose of 15 to 20Gy in 3 to 4 fractions was used (BED = 84.4 ± 1.1 Gy) for combined external plus BT as per departmental protocol. A total of 30 Gy in 6 fractions was used (BED = 47.8 Gy) for BT alone as per departmental protocol. Ir-192 Micro selectron HDR rigid needle template or flexible catheter implant to primary site was used. Dosimetry was done with Plato sunrise treatment planning System. Results: Age ranges from 23 to 50 years. Median follow up was 54 months. None had local recurrence. Only 1 had mild needle wound sepsis and all had good to excellent acceptable cosmetic results. Radiation skin reaction and sub cutaneous fibrosis were grade I and 2. Three had disease recurrence at distant sites and one patient had moderate telangiectasia at the irradiated site. Conclusion: BCT with EBRT and HDR BT boost or HDR BT alone has shown good results in both loco regional control of disease with good to excellent cosmesis.
Background: Nasopharyngeal Carcinoma (NPC) is the most frequently encountered malignancy amongst the neoplasms of nasopharynx. In India, NPC is uncommon in most regions, but high prevalence is observed in North-eastern part of the country. The National Cancer Registry has reported the prevalence of NPC to be 1.82% among all cancers in this region, constituting the eighth most common cancer in the North-eastern states. Methods: Newly diagnosed cases of NPC were studied for a period of 3 years in an institute in Manipur. The origin of the patient (hill or valley) were identified, dietary addiction, clinical presentations, histopathological types and stage at presentation were studied and analysed in the two regions. Results: The study consisted 121 cases of diagnosed NPC, consisting of higher numbers of males then females, making a ratio of 1.95:1. Mean age of the patients was 46±12.34. 74.4% originated from hills and 25.6% from valleys. Consumption of smoked meat comprised 77.7% and was seen more in hilly areas with strong statistical significance. Addiction to smoking, alcohol and smokeless tobacco was seen more among valley patients. Swelling neck was the commonest clinical presentation (93.4%), followed by nasal symptoms (63.6%), auricular features (34.7%), cranio-facial pain (34.7%) and neurological symptoms (12.4%), with greater percentage among hilly populations. Undifferentiated carcinoma was the commonest histological type (73.6%), followed by Non-keratinizing carcinoma (20.7%) and keratinizing squamous cell carcinoma (5.8%). Commonest stage at presentation was stage 4 (38.8%). Conclusion: There is a marked significant difference in the incidence of NPC among the different populations of hills and the valleys. A detailed study of genetic and immuno-histochemical analysis of NPC between the two groups of origin in this part of the country is a necessity.
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