J Cancer Res Ther [JOURNAL]
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200 papers
A case study and literature analysis of an uncommon instance of metachronous non-Hodgkin lymphoma in a patient with colon cancer.
Pandey A, Kumar D, Nada R
J Cancer Res Ther · 2025 Apr · PMID 40616565 · Publisher ↗
Lymphoma can develop before and complicate colorectal cancer in the same patient. However, occurrence of lymphoma years after the complete treatment of colorectal cancer is extremely rare. We here report a case of a 55-y...
Lymphoma can develop before and complicate colorectal cancer in the same patient. However, occurrence of lymphoma years after the complete treatment of colorectal cancer is extremely rare. We here report a case of a 55-year-old gentleman diagnosed with adenocarcinoma of colon treated by standard protocol of surgery, and chemotherapy, later after 10 years of treatment completion, was diagnosed with generalized lymphadenopathy suggestive of non-Hodgkin lymphoma. He was treated with six cycles of chemotherapy (RCHOP regimen). The major concern for multiple primaries is that it is easy to miss and may be misdiagnosed as metastatic disease. Correct diagnosis and early treatment are of utmost importance.
Pediatric sinonasal undifferentiated carcinoma resolved with chemoradiotherapy: A case report and literature review.
Herdini C, Setiawan DA, Yudistira D … +1 more , Indrasari SR
J Cancer Res Ther · 2025 Apr · PMID 40616564 · Publisher ↗
Sinonasal undifferentiated carcinoma (SNUC) rarely occurs in the pediatric population. Surgical resection with or without postoperative radiation or chemoradiotherapy is the gold standard for treating malignant sinonasal...
Sinonasal undifferentiated carcinoma (SNUC) rarely occurs in the pediatric population. Surgical resection with or without postoperative radiation or chemoradiotherapy is the gold standard for treating malignant sinonasal tumors. However, some patients may decline surgery. This paper discusses the experience of SNUC in a child who was treated with only chemoradiotherapy. A 10-year-old child presented with complaints of left-sided nasal congestion, facial asymmetry, and a growing lump on the left side of the neck over the past year. Physical examination revealed a red mass filling the left nostril. Histopathological examination of the mass confirmed a diagnosis of undifferentiated sinonasal carcinoma. The child's parents refused surgery and chose for chemoradiotherapy instead. On reassessment 3 months after the completion of therapy, the patient had achieved complete remission. Although surgery remains the primary treatment for SNUC, in certain cases, as demonstrated in this report, chemoradiotherapy alone may be a viable option.
A rare presentation of a cutaneous metastasis from an undifferentiated pleomorphic sarcoma.
Harish M, Yadala A, Joshi RP … +1 more , Parameswari R
J Cancer Res Ther · 2025 Apr · PMID 40616563 · Publisher ↗
Undifferentiated pleomorphic sarcoma, a rare and aggressive soft tissue sarcoma, commonly affects the extremities and has a high propensity for local recurrence and metastasis. This case study presents a 57-year-old male...
Undifferentiated pleomorphic sarcoma, a rare and aggressive soft tissue sarcoma, commonly affects the extremities and has a high propensity for local recurrence and metastasis. This case study presents a 57-year-old male with UPS in the right forearm, which progressed to rare cutaneous metastasis on the right chest wall following initial treatment. Despite undergoing wide local excision, flap reconstruction, and adjuvant radiation, the patient later developed disseminated metastases, including in the lungs, bones, liver, and skin. Immunohistochemistry confirmed metastatic pleomorphic sarcoma, leading to palliative chemotherapy. This case highlights the rarity of cutaneous metastasis in UPS, documented in less than 1% of cases, and underscores the diagnostic challenges posed by undifferentiated or poorly differentiated sarcomas. Timely diagnosis and multidisciplinary treatment are crucial in managing this aggressive malignancy, particularly when it presents with rare metastasis patterns. Further research is necessary to better understand UPS and improve therapeutic strategies.
A giant peritoneal mesothelioma extending to the pelvic floor: A case report and review of the literature.
Thomas M, Nandakumar H, Sampat P … +1 more , Graziano S
J Cancer Res Ther · 2025 Apr · PMID 40616562 · Publisher ↗
Malignant peritoneal mesothelioma (MPM) is a rare malignancy originating from the peritoneal serosa and is the second most common site of mesothelioma after the pleura. Localized disease presents as a focal circumscribed...
Malignant peritoneal mesothelioma (MPM) is a rare malignancy originating from the peritoneal serosa and is the second most common site of mesothelioma after the pleura. Localized disease presents as a focal circumscribed mass, whereas diffuse disease is usually associated with ascites and may metastasize to abdominal and pelvic lymph nodes. Cytoreductive surgery with heated intraperitoneal chemotherapy has been shown to improve progression-free survival and overall survival. Systemic chemotherapy with pemetrexed and platinum-based chemotherapy has also demonstrated a good treatment response. Recently, there has been an increased interest in the use of immune checkpoint inhibitors in the treatment of MPM. We present the case of a 59-year-old female with progressively worsening abdominal pain and constipation, who on further evaluation was found to have a huge MPM (17.3 × 17.1 × 13.3 cm) extending into the pelvic cavity with associated compression of the vagina, sigmoid colon, and ureters complicated by bilateral hydronephrosis. The tumor was deemed unresectable, and the patient was started on dual immunotherapy with ipilimumab and nivolumab. The patient had symptomatic improvement and a reduction in tumor size to 15.1 × 11 × 8.6 cm. Despite the initial response, the disease progressed (15.6 × 13.8 × 23.8 cm) and the patient ultimately succumbed to it. This case highlights the unique presentation of a massive localized MPM and emphasizes the need for further research to optimize treatment strategies.
Navigating the complexity of pineal parenchymal tumors of intermediate differentiation: A case report and literature review.
Soni S, Gupta G, Gupta P … +1 more , Patel RP
J Cancer Res Ther · 2025 Apr · PMID 40616561 · Publisher ↗
Pineal parenchymal lesions are uncommon central nervous system neoplasms. Pineal parenchymal tumors of intermediate differentiation (PPTID) exhibit intermediate features between pineocytomas and pineoblastoma, which affe...
Pineal parenchymal lesions are uncommon central nervous system neoplasms. Pineal parenchymal tumors of intermediate differentiation (PPTID) exhibit intermediate features between pineocytomas and pineoblastoma, which affects both their biological behavior and prognosis. Surgery remains the cornerstone of the treatment. However, the extent of radiotherapy is a controversial issue because it is challenging to balance treatment efficacy with long-term toxicity. Given the long-term survival of PPTID, late adverse events are a significant concern as craniospinal irradiation followed by a focal boost can not only lead to neurocognitive disorders and systemic sequelae but also increase the risk of second malignancies. The role of whole ventricular irradiation combined with a focal boost with or without concurrent and adjuvant chemotherapy should be explored to mitigate neurological toxicity and second malignancy risk. In addition, there is a paucity of literature supporting systemic therapy. Further clinical studies are necessary to explore adjuvant treatment options and improve the outcomes in PPTID patients.
Extended field chemoradiation in M1a bladder carcinoma: A case report.
Periasamy K, Goyal S, Kumar S … +2 more , Chandran V, Kumar R
J Cancer Res Ther · 2025 Apr · PMID 40616560 · Publisher ↗
Currently, the recommended management in stage IVA bladder cancer is platinum-based chemotherapy followed by maintenance immunotherapy in those with no evidence of disease progression. Consolidative surgery may be consid...
Currently, the recommended management in stage IVA bladder cancer is platinum-based chemotherapy followed by maintenance immunotherapy in those with no evidence of disease progression. Consolidative surgery may be considered in selected cases after chemotherapy. However, consolidative radiotherapy and consolidative local treatment after second-line systemic therapy are rarely reported. We present the case of a 59-year-old man who was found to have muscle invasive urothelial carcinoma of the bladder with distant metastases limited to para-aortic nodes and offered consolidative extended field chemoradiation therapy encompassing bladder, pelvis, and para-aortic areas after an excellent response to second-line chemotherapy with paclitaxel and carboplatin. The patient is systemically well with no evidence of disease progression at 20 months of follow-up. Aggressive multimodality management involving consolidative radiation therapy may be attempted to improve the disease control in a small subset with stage IVA urothelial bladder carcinoma even after first-line systemic therapy, especially in the setting of nonaffordability to immune check point inhibitors.
Gallbladder cancer in a young male: An insight into an integrative approach for improving survival.
Sahai P, Mall A, Yadav A … +4 more , Yadav HP, Rastogi A, Shasthry SM, Pamecha V
J Cancer Res Ther · 2025 Apr · PMID 40616559 · Publisher ↗
A 30-year-old male presented with a mass in the gallbladder fossa infiltrating the liver, abdominal lymph nodes, port site lesion, and peritoneal nodularity, with a prior history of laparoscopic cholecystectomy. Cytology...
A 30-year-old male presented with a mass in the gallbladder fossa infiltrating the liver, abdominal lymph nodes, port site lesion, and peritoneal nodularity, with a prior history of laparoscopic cholecystectomy. Cytology from the gallbladder fossa mass and port site intercostal lesion revealed features of adenocarcinoma. The patient was treated with six cycles of modified gemcitabine and oxaliplatin based chemotherapy, which resulted in complete metabolic response. The patient underwent extended cholecystectomy and wide local excision of the port site lesion. The patient had pathologic response with minimal microscopic residual disease of <1 mm size infiltrating liver. The patient received adjuvant chemoradiation. The patient is in remission at 4.1 years after the diagnosis of cancer. Resection with chemotherapy and radiotherapy can be considered if the metastatic lesions are isolated to prolong survival in gallbladder cancer.
Adenoid cystic carcinoma of the lacrimal gland: A rare case report with literature review.
Singh A, Rawat S, Sagar M … +1 more , Singh US
J Cancer Res Ther · 2025 Apr · PMID 40616558 · Publisher ↗
Adenoid cystic carcinoma (ACC) primarily originates from the minor and major salivary glands of the head and neck regions. ACC affecting the eye and orbit (including the lacrimal gland, sac, and duct) was determined to a...
Adenoid cystic carcinoma (ACC) primarily originates from the minor and major salivary glands of the head and neck regions. ACC affecting the eye and orbit (including the lacrimal gland, sac, and duct) was determined to account for about 1.8% of all cases. A poor overall prognosis and a tendency for local recurrence and metastasis despite vigorous therapy characterize lacrimal gland ACCs. There are no clear-cut guidelines for treating these rare tumors in unusual places, but recent literature suggests orbital excision with or without bone removal instead of globe-sparing resection and adjuvant radiation therapy. In this case study, we show an unusual case of an ACC in the left superolateral orbit with the demonstration of clinical, radiological, morphology, and immunohistochemistry findings along with management protocols and a review of the relevant literature.
Total skin radiation therapy with low-dose helical tomotherapy for a patient with mycosis fungoides.
Katano A, Yamashita H
J Cancer Res Ther · 2025 Apr · PMID 40616557 · Publisher ↗
Total body skin irradiation with electron beams has been used for patients with mycosis fungoides (MF). Recently, helical tomotherapy was considered available for total body irradiation, although severe myelosuppression...
Total body skin irradiation with electron beams has been used for patients with mycosis fungoides (MF). Recently, helical tomotherapy was considered available for total body irradiation, although severe myelosuppression was frequently observed as an adverse event. We report the first case of low-dose helical tomotherapy in a patient with MF. An 87-year-old Asian male with an 18-year medical history of MF was referred to our department due to a rapidly growing skin lesion during systemic therapy. He decided to undergo low-dose total skin radiotherapy with helical tomotherapy. The total skin was treated by dividing into three parts (trunk, head, and lower extremities). Each part was treated with helical radiotherapy consisting of 10 Gy in 5 fractions, with the administration of 5 fractions per week. Once the skin lesion clearly disappeared after total skin radiotherapy, recurrence was detected in the lower abdominal wall in the radiation-treated field. Insufficient doses of radiation therapy cause early relapse. There is still no optimized dose for total skin irradiation in helical tomotherapy. Further radiation therapy dose trials are required to optimize the treatment schedule.
A prospective comparative study on conformal pelvic radiation with 6 MV vs. mixed energy beam for carcinoma cervix.
Bose R, De S, Biswas B … +2 more , Biswas L, Ghosh S
J Cancer Res Ther · 2025 Apr · PMID 40616556 · Publisher ↗
BACKGROUND: Both low and high energy beams have their own pros and cons. But, there are very limited data available in the literature comparing monoenergetic and mixed energy beam for radiotherapy of carcinoma cervix. Th...
BACKGROUND: Both low and high energy beams have their own pros and cons. But, there are very limited data available in the literature comparing monoenergetic and mixed energy beam for radiotherapy of carcinoma cervix. This study was aimed at comparing monoenergetic (6 MV) versus mixed energy beam (6 MV and 10 MV) used for treatment of carcinoma cervix in terms of dosimetric parameters and acute toxicity profile. MATERIALS AND METHODS: It was a single-institutional, prospective, comparative study among 60 patients with non-metastatic carcinoma cervix who received radical Radiotherapy between March 2021 and September 2022. Two radiotherapy planning were performed for each patient, one with mixed energy beam and another with 6MV energy, and treated with one of the treatment plans in a 1:1 fashion using two different energies. We compared the two plans in terms of dosimetric parameters and clinically by the acute toxicity profile. RESULTS: The mean V95 of planning target volume (PTV) was numerically higher in the mixed beam arm (99.83 ± 0.11% vs. 99.28 ± 0.21%, P value - 0.812). Bowel sparing was slightly better in mixed beam therapy in terms of V20 of bowel (63.88% ± 8.26 vs. 64.03% ± 10.23, P value - 0.067). Mean V50 of the urinary bladder was also almost the same in both mixed and monoenergetic beam arms. Skin toxicity was significantly less in mixed beam treatment (P value < 0.05). CONCLUSION: For pelvic irradiation, mixed energy beam has better planning target volume coverage, better sparing of organ at risks (OARs), and better acute toxicity profile than monoenergetic beam.
Fibrothecoma/Fibroma of ovary-rare ovarian tumors with varied presentation and different modes of management: 14 years' experience from tertiary care hospitals.
Goyal LD, Madhuchandra D, Kaur M … +1 more , Ganjoo S
J Cancer Res Ther · 2025 Apr · PMID 40616555 · Publisher ↗
CONTEXT: Fibrothecomas are a rare group of tumors of stromal cell origin, accounting for approximately 5%-8% of all ovarian tumors. These tumors are frequently mistaken as malignant due to solid consistency, association...
CONTEXT: Fibrothecomas are a rare group of tumors of stromal cell origin, accounting for approximately 5%-8% of all ovarian tumors. These tumors are frequently mistaken as malignant due to solid consistency, association with ascites, and pleural effusion leading to unnecessary radical surgery. Due to the relative rarity of these tumors, we want to highlight eleven cases of fibrothecoma/fibromas encountered in our experience with different clinical presentations in various age groups requiring different treatment strategies based on the clinical, radiological, cytological, histopathological, and immunochemical characteristics. AIMS: Our primary aim is to emphasize the diverse presentation of rare tumors, such as fibrothecoma/fibromas, and their management across different age groups. SETTINGS AND DESIGN: The present study was conducted over 14 years in the Department of Obstetrics and Gynecology and the Department of Pathology at Guru Gobind Singh Medical College and Hospital, Faridkot, as well as at All India Institute of Medical Sciences Bathinda. MATERIALS AND METHODS: Among 526 patients with ovarian masses who were surgically managed over 14 years at our institute, we identified only 11 cases that were diagnosed as fibrothecomas or fibromas based on histopathology. We studied the detailed clinical presentations, diagnostic modalities, and management of all these patients, who were all normal at a mean follow-up of 2 years and 5 months. RESULTS: Over 14 years, we evaluated 526 patients presenting with ovarian masses diagnosed through clinical examination, imaging techniques, fine-needle aspiration cytology (FNAC), histopathology, and immunohistochemistry. Only 11 cases (2.09%) were identified as fibroma or fibrosarcoma. Age of the patients ranged from 14 to 76 years, with a mean age of 44.22 years. Of the 11 cases, nine patients presented with an abdominopelvic mass. Ultrasonography and contrast-enhanced CT scans typically revealed solid masses accompanied by ascites. FNAC was effective in eight cases, identifying spindle cells upon microscopic examination. Final diagnoses were confirmed through histopathology, which classified two cases as fibroma and nine as fibrothecoma. Immunohistochemistry results showed vimentin positivity in nine cases. All patients remained healthy during a mean follow-up period of 2 years and 5 months. STATISTICAL ANALYSIS USED: Observational study. CONCLUSIONS: This article highlights a rare ovarian tumor with details of its different clinical presentations, radiological details, cytological findings, and histopathological and immunochemical findings. According to the patient's age, these can be treated using minimally invasive and fertility-sparing techniques.
Assessing the cause and effects of objective function variation approach on volumetric modulated arc radiosurgery of solitary brain metastasis for efficient dosimetry.
Ahamed S, Padma Suvarna R, Singh N
J Cancer Res Ther · 2025 Apr · PMID 40616554 · Publisher ↗
PURPOSE: To demonstrate the cause and effects of dose gradients in normal brain and resulting plan metrics using varied objective functions for generating efficient volumetric modulated arc radiosurgery plans for solitar...
PURPOSE: To demonstrate the cause and effects of dose gradients in normal brain and resulting plan metrics using varied objective functions for generating efficient volumetric modulated arc radiosurgery plans for solitary brain metastasis. MATERIALS AND METHODS: Normal tissue and dose volume objective function (NTO and DVO) variations were applied to the virtual phantom and 23 solitary brain metastasis (SBM) cases to plan 20 Gray (Gy) doses. Initial testing on the phantom used eight variations manipulating NTO priority (50, 100, 150, 200), end-dose (25% and 10%), and DVO target dose maximum (25 and 27 Gy). Two strategies were then tested on SBM cases. First strategy (S1) used NTO priority = 100, end-dose = 25%, target maximum dose < 25 Gy. The second strategy (S2) tightened NTO and relaxed DVO by changing the corresponding parameters to 200 and 10%, and 27 Gy. Plans were analyzed comparing and correlating relevant metrics. RESULTS: For the phantom case, the mean multi-leaf collimator aperture area (AA) variation between the highest NTO priority S2 plan and lowest priority S1 plan was about 46%, which brought substantial changes to 12 Gy spill outside tumor (V12), efficiency index, and prescription isodose level (PIDL). SBM cases showed about 14% lower PIDL and associated V12 reduction of about 0.7 cm3 for S2 than S1. V12 reduction was explained by AA reduction (r ≥ 0.966). For the studied PTVs, monitor units per Gy (MU/Gy) and AA product were lower for S2 indicating one or either factor was lower. CONCLUSION: Stringent NTO and relaxed DVO functions cause aperture shrinkage to create dose gradients for overall plan efficacy.
Hidden cost of paediatric cancer: Effect of childhood cancer on sibling's psychological well-being.
Arora M, Jain V, Priyadarshini S … +5 more , Sharma R, Goel P, Agarwala S, Yadav D, Dhua A
J Cancer Res Ther · 2025 Apr · PMID 40616553 · Publisher ↗
AIM: This cross-sectional study addresses the limited attention given to the psychosocial impact of childhood cancer on siblings. It aims to investigate the psychological well-being among the siblings of childhood cancer...
AIM: This cross-sectional study addresses the limited attention given to the psychosocial impact of childhood cancer on siblings. It aims to investigate the psychological well-being among the siblings of childhood cancer survivors. SUBJECTS AND METHODS: This cross-sectional study includes 37 siblings of children with cancer, ages 11-17 years, who completed assessments measuring emotional intelligence, self-efficacy, resilience, coping strategies, rejection sensitivity, self-esteem, and quality of life. RESULTS: A significant negative correlation (r = -0.595, P < 0.05) was found between the rejection sensitivity and quality of life. Additionally, 81.08% of siblings showed scores on the emotional intelligence scale that fell within the high range, and 75.67% demonstrated high levels of resilience, both of which were positively associated with self-esteem (r = 0.465, P < 0.01) and self-efficacy (r = 0.518, P < 0.01). Coping strategies, particularly task-oriented coping, were associated with the higher overall quality of life (r = 0.480, P < 0.01). CONCLUSION: The findings highlight the complex psychological responses of siblings to a childhood cancer diagnosis. The study emphasizes the importance of considering individual and family characteristics, as well as temporal factors, to better understand and support the psychological well-being of these siblings.
Developing an indigenous anthropomorphic heterogeneous female pelvic phantom for dosimetric audit in radiotherapy centers.
Katake A, Kumar L, Singh B … +3 more , Haraniya K, Vashistha R, Basandrai D
J Cancer Res Ther · 2025 Apr · PMID 40616552 · Publisher ↗
AIM: The aim of the present study was to create an indigenous anthropomorphic heterogeneous female pelvis (AHFP) phantom for quality assurance and dosimetric audits in advance radiotherapy centers. MATERIAL AND METHODS:...
AIM: The aim of the present study was to create an indigenous anthropomorphic heterogeneous female pelvis (AHFP) phantom for quality assurance and dosimetric audits in advance radiotherapy centers. MATERIAL AND METHODS: The AHFP phantom was designed using paraffin wax, epoxy, water, polyvinyl chloride (PVC), and a hardener. A dosimetric audit was conducted using the fabricated phantom among four different hospitals. The hospitals were instructed to perform the procedure of treatment planning and delivery as per their institutional protocol. Each institute was asked to make optimized plans using available intensity-modulated radiation therapy (IMRT) and rapid arc (RA) delivery technique. Apart from this, additional plans were generated for using single field (1F), double field (2F), three field (3F), and four field (4F) for 5 cm × 5 cm and 10 cm × 10 cm geometry, 3dimensional conformal radiotherapy (3F, 4F), and IMRT (5F, 7F and 9F). RESULTS: With regard to the measured radiological properties, the mean Hounsfield units (HUs) were 87.3 ± 39.45, 1122.5 ± 270.1, 1312.2 ± 232.5, 10.1 ± 58.5, and 20.2 ± 33.8; the mean relative electron densities (REDs) were 1.087 ± 0.04, 1.673 ± 0.16, 1.765 ± 0.14, 1.010 ± 0.06, and 1.021 ± 0.03 g/cc and the mean mass densities (MDs) were 1.074 ± 0.03, 1.673 ± 0.15, 1.765 ± 0.16, 1.011 ± 0.06, and 1.021 ± 0.03 g/cc for soft tissue, femoral head, bones, rectum, and bladder of AHFP phantom, respectively. The percentage deviations between measured and computed doses were within ± 3% for all measurements performed under the study in each hospital. CONCLUSION: The fabricated AHFP phantom mimics the size, shape, and radiological properties of female pelvis. The dosimetric results from participant hospitals were within prescribed tolerance. The present study confirms the efficacy of the AHFP phantom as a trustworthy quality assurance tool in radiotherapy. Hence, it can be used for end-to-end validation and dosimetric audit of advanced radiation therapy centers.
Outcomes of curative surgery and adjuvant radiation therapy in salivary duct carcinoma.
Chowdhury D, Sarkar N, Sai Hanuman PHHM … +8 more , Sinha A, Pati S, Chatterjee S, Jain PV, Arun P, Roy P, Arun I, Mallick I
J Cancer Res Ther · 2025 Apr · PMID 40616551 · Publisher ↗
INTRODUCTION: Salivary duct carcinoma (SDC) forms an uncommon and aggressive subtype of salivary gland neoplasms with early recurrences and metastases. Their treatment includes surgery and adjuvant radiotherapy. They ove...
INTRODUCTION: Salivary duct carcinoma (SDC) forms an uncommon and aggressive subtype of salivary gland neoplasms with early recurrences and metastases. Their treatment includes surgery and adjuvant radiotherapy. They overexpress androgen receptors (AR) and human epidermal receptor 2 (HER2), similar to breast carcinomas. There is limited data on SDCs treated with curative intent from Asia. OBJECTIVE: In this retrospective analysis, we reviewed SDCs treated between 2012 and 2022. The aim of this study was to study the outcome of SDCs in patients who were treated with curative intent. The primary objectives of the study were to study the overall survival (OS) and disease-free survival (DFS) in patients of salivary duct cancer treated with curative intent, compare OS and DFS among various groups, and identify certain critical clinical or pathological attributes that may affect disease outcomes. MATERIALS AND METHODS: Patient demographics, tumor characteristics, treatment details, and outcomes were recorded for 48 patients in REDCap (electronic data collection system) and all eligible patients were contacted for survival status. STATISTICAL ANALYSIS: Statistical analysis was done using SPSS software and survival analysis using the log-rank test and Cox regression. RESULTS: After a median follow-up of 13.8 months ranging from 0.5 to 125.2 months, median DFS and OS were 11.4 and 13.8 months. Node (s) positive patients showed numerically inferior DFS, 66.6% vs. 81.7% at one year and 22.8% vs. 67.4% at two years (P = 0.061) with a hazard ratio (HR) 2.23 (95% confidence interval [CI]: 0.94-5.29, P = 0.068) and inferior OS, 91.7% vs. 100% at one year and 72.2% vs. 86.7% at two years (P = 0.068) with HR 3.41 (95% CI: 0.84-13.79, P = 0.085). Patients with extranodal extension had numerically inferior DFS, 59.1% vs. 85.9% (P = 0.119) with HR 1.96 (95% CI of 0.82-4.68, P = 0.126) and lower OS, 90.9% vs. 100% (P = 0.112) at one year with HR 2.96 (95% CI of 0.72-12.02, P = 0.129). Despite the large numerical difference, the P value was not statistically significant due to limited sample size. CONCLUSION: Salivary duct cancers, even when treated curatively, have early and distant failures. Over-expression of HER2-neu and AR provide an opportunity to improve the outcomes of curative intent treatment for this cancer with targeted agents and robust data is required to investigate the role of adjuvant endocrine or HER-2 targeted therapies.
Mathematical analysis of gamma index on pretreatment patient-specific quality assurance with octavius 4D rotational phantom for 2d and 3d space.
Tiwari S, Pandey VP, Verma T … +2 more , Pandey DP, Ansari GF
J Cancer Res Ther · 2025 Apr · PMID 40616550 · Publisher ↗
INTRODUCTION: Gamma index is one of the widely used metrics to evaluate the patient-specific quality assurance parameters for the delivery of accepted treatment plans. The dimensionality of gamma metric has changed from...
INTRODUCTION: Gamma index is one of the widely used metrics to evaluate the patient-specific quality assurance parameters for the delivery of accepted treatment plans. The dimensionality of gamma metric has changed from two-dimensional to three-dimensional with due course of time, and presently, we are in a verge to assess the three-dimensional metric in a volumetric scale. The present study aimed at determining the mathematical relationship between 2D, 3D, and 3D volumetric gamma index for patient-specific quality assurance parameters using the Octavius 4D rotational phantom. METHODS AND MATERIALS: Twenty-five patients planned with volumetric modulated radiotherapy for different sites were selected for the study to analyze the pretreatment parameters correlation using 2D- Array 1500 rotational Octavius phantom. The data were collected in both local and global dose modes at 5%/5 mm, 4%/4 mm, 3%/3 mm, and 2%/2 mm for 2D, 3D, and Volmetric 3D gamma index. The passing criterion of Gamma <=1.0 is applicable throughout the study. RESULTS: A significant jump in the passing rate percentage was found from 2D planar to 3D planar mode analysis. Decreased passing percentage values in both local and global modes from 3D planar to 3D volumetric mode analysis were recorded. The 2D and 3D planar analysis shows a significant level of correlation which is less pronounced in 3D planar to 3D volumetric gamma metric evaluation. CONCLUSION: The radiotherapy centers having the license for 2D planar gamma index analysis can retrace the results into 3D planar analysis, which is always a better passing percentage rate, and no such implication of 3D volumetric analysis was found as the passing rate significantly shows a high degree of entropy in results. The effective use of 3D volumetric gamma metric can be appreciable if the CT overlay parameter is used in assessment and qualitatively the quantification can be predicted.
Imaging-based skeletal muscle quality and clinical outcomes in Indian older patients with cancer: A retrospective analysis.
Rao AR, Noronha V, Ramaswamy A … +7 more , Dhekle R, Kumar A, Pillai A, Rane PP, Chakrabarty N, Mahajan A, Prabhash K
J Cancer Res Ther · 2025 Apr · PMID 40616549 · Publisher ↗
OBJECTIVES: Computer tomography (CT) measurements of cross-sectional area and density reflect muscle performance and function, but their use is limited in practice. We aimed to evaluate the association of CT-based skelet...
OBJECTIVES: Computer tomography (CT) measurements of cross-sectional area and density reflect muscle performance and function, but their use is limited in practice. We aimed to evaluate the association of CT-based skeletal muscle quality (qSMQ) with geriatric assessment (GA) and outcomes in older Indian patients with cancer. METHODS: Retrospective observational study in the geriatric oncology clinic in Mumbai, India. Patients aged ≥60 years with cancer who had undergone GA and had CT scan were included. To evaluate skeletal muscle quality, region of interest was drawn on bilateral paraspinal muscle at L3 vertebral level, one section above and below. RESULTS: Between June 2018 and November 2021, 277 patients were included. At a median follow-up of 23.8 (21.4-28.4) months, 174 deaths had occurred. Using the lower quartile as a cutoff to define poor and good qSMQ, the median overall survivals were 10.7 and 17.5 months in the patients with poor and good qSMQ, respectively (P = 0.124), which was significant after adjusting for body mass index (BMI), primary tumor, metastasis, and performance status (hazard ratio (HR): 1.53; 1.08-2.18, P = 0.017). The likelihood ratio test (LR-test) comparing the full model (qSMQ with nested model) with the nested model (age, sex, BMI, primary tumor, performance status) found that the addition of qSMQ was a significantly better fit (P = 0.015). DISCUSSION: The utilization of CT scans for older Indian patients with cancer is an effective and crucial means of evaluating skeletal muscle quality. It is closely associated with anthropometric measures, frailty, and overall survival (OS).
Prospective evaluation of small bowel dose and acute gastrointestinal toxicity during pelvic radiotherapy for gynaecologic malignancies.
Antony F, Philip M, Raphael CJ … +5 more , Varghese KM, Rajkrishna B, Jiniw MP, Boban M, Narayan V
J Cancer Res Ther · 2025 Apr · PMID 40616548 · Publisher ↗
INTRODUCTION: Acute gastrointestinal (GI) toxicity is common in patients receiving pelvic radiotherapy (RT) and the small bowel (SB) is a dose-limiting organ at risk. There is a quandary in the dose constraints for SB wh...
INTRODUCTION: Acute gastrointestinal (GI) toxicity is common in patients receiving pelvic radiotherapy (RT) and the small bowel (SB) is a dose-limiting organ at risk. There is a quandary in the dose constraints for SB while using intensity-modulated radiotherapy (IMRT) for gynecological malignancies. OBJECTIVES: To investigate the correlation between the radiation dose received by SB and the incidence of acute lower GI toxicities, and to identify dose parameters that may reduce toxicity risk. MATERIALS AND METHODS: Fifty-eight patients diagnosed with gynecological cancers and received RT with IMRT technique were analyzed in this prospective observational study. Oral contrast was administered during the simulation scan as per institution protocol. The individual SB loops were delineated as per Radiation Therapy Oncology Group (RTOG) consensus guidelines. The volume of SB (cc) receiving 10, 15, 20, 30, and 40 Gy were analyzed. Grades of acute GI toxicities were assessed weekly according to RTOG scoring criteria. The odds of developing GI toxicities were analyzed using a logistic regression test. RESULTS: Out of the study population, 26 patients (45%) were diagnosed with carcinoma of the cervix, and 32 patients (55%) were diagnosed with carcinoma of the endometrium. 33 patients (57%) also received concurrent chemotherapy. Overall, Grade I, II, and III GI toxicities were observed in 32%, 62%, and 5% of patients, respectively. None of the patients developed GI toxicity during weeks 1 and 2 of RT. A significantly higher incidence of ≥grade 2 GI toxicity was observed with a mean SB-V30 Gy >210 cc (P = 0.001) and SB-V40 Gy >103 cc (P = 0.001). Patients with SB-V30 Gy ≥210 cc had 2.2 times higher odds of developing ≥ grade 2 enteritis compared to those with SB-V30 Gy <210 cc (OR = 2.2; 95% CI, 1.5-6.3; P = 0.003). Likewise, the odds of developing ≥grade 2 enteritis were 2.9 times higher in patients with SB-V40 Gy ≥103 cc compared to those with SB-V40 Gy <103 cc (OR = 2.90; 95% CI, 2.1-5.1; P = 0.002). CONCLUSIONS: Higher radiation doses to individual SB loops lead to a decrease in cellular reserves of intestinal mucosa resulting in ≥grade 2 acute GI toxicity in patients receiving IMRT for gynecological malignancies.
Dosimetric evaluation and feasibility of total body irradiation with multiple isocenter VMAT technique on the halcyon E ring gantry linear accelerator using photon optimizer algorithm.
Venugopal S, Khanna D, Mohandass P … +1 more , Arya R
J Cancer Res Ther · 2025 Apr · PMID 40616547 · Publisher ↗
AIM: The current planning study sought to assess the potential clinical feasibility and dosimetrics of employing volumetric modulated arc therapy (VMAT) with the HalcyonTM linear accelerator (Linac) using photon optimize...
AIM: The current planning study sought to assess the potential clinical feasibility and dosimetrics of employing volumetric modulated arc therapy (VMAT) with the HalcyonTM linear accelerator (Linac) using photon optimizer algorithm for total body irradiation (TBI). MATERIALS AND METHODS: The upper body and lower body PTVs were optimized independently using a 6 MV FFF beam energy with ten isocenters in the Eclipse treatment planning system (TPS) and photon optimizer algorithm. The treatment plans were delivered using a HalcyonTM E linac (Varian Medical Systems Inc., Palo Alto, CA). A dose of 300 cGy in single fractions was prescribed for the whole-body PTV. Pretreatment quality assurance included portal dosimetry comparisons and ArcCheckTM (Sun Nuclear), assessing the delivery-to-calculation agreement with the gamma agreement index. RESULTS: The PTV D98%, D95%, D50%, D5%, D2%, and Dmean were 292.4 cGy (97.5%), 301.6 cGy (100.5%), 324.9 cGy (108.3%), 346 cGy (115.3%), 351 cGy (117%), and 325 cGy (108.3%), respectively. The dose at the Dmax within the PTV body was 377.0 cGy (125.7% of the prescribed dose). Portal dosimetry and arc check patient-specific quality assurance results demonstrated mean and standard deviation values within acceptable tolerances: 3%/3 mm and 2%/2 mm with individual measurements of 100 ± 0.05, 99.9 ± 0.15, 99.9 ± 0.41, and 98.2 ± 1.28, respectively. Overall portal dose gamma pass rates were greater than 96%. Target delineation took 6 hours. Optimization and dose calculation were performed 13 to 14 hours for one time. To create clinically acceptable plans, multiple repeated reoptimization and calculation are required. The overall time required to create clinical acceptable plans is 38 to 40 hours. Quality assurance took 6 to 8 hours. CONCLUSION: HalcyonTM VMAT TBI achieves a satisfactory dose distribution within the PTV. Nevertheless, the planning and optimization time is considerably extensive. It is recommended to have more than two linear accelerators and high-end hardware for the TPS to ensure optimal performance.
Impact of clinicopathological factors and treatment outcomes on gastric cancer survival: A tertiary care hospital-based study in Eastern India.
Ghosh S, Banerjee R, Chakrabarti J … +4 more , Alam N, Nath P, Mukherjee KK, Nasare VD
J Cancer Res Ther · 2025 Apr · PMID 40616546 · Publisher ↗
OBJECTIVE: The late diagnosis of GC poses a significant health burden worldwide, particularly in Asia. Despite the declining incidence, the heterogeneous diversity of India exhibits pronounced regional disparity in survi...
OBJECTIVE: The late diagnosis of GC poses a significant health burden worldwide, particularly in Asia. Despite the declining incidence, the heterogeneous diversity of India exhibits pronounced regional disparity in survival rates among the patients. The study observed the clinicopathological factors and treatment outcomes influencing the survival of gastric cancer (GC) patients. METHODS: A total of 78 newly diagnosed GC patients were enrolled (from 2019 to 2023). Overall survival (OS) and hazard risk (HR) for sociodemographic, clinicopathological factors, and treatment outcomes of the patients were assessed by univariate Kaplan-Meier and multivariate Cox-Regression analysis. RESULTS: The frequency of GC was highly prevalent among males (69.2%), with a median age of 52 ± 11.35 years. The majority of them are associated with mixed diet (88.5%), grade-III tumors (57.7%) located in the antrum (60.3%) at ≥5 cm (56.4%) classified as pTNM stage-III (64.1%) exhibiting lymphovascular invasion (75.6%). Clinical features, including initial symptoms, treatment response, and pTNM-stage presented increased hazard risks in the patients (HR >1) but presented no significant difference. Nearly 63% of the patients operated upfront and 37% received neoadjuvant FLOT chemotherapy. The mean overall survival of the patients was 19.7 months [95% CI: 15.9-23.5]. The hazard of death was significantly allied with older age (P < 0.001), and neoadjuvant-FLOT-chemotherapy (P < 0.001); however, a higher number of cycles of adjuvant-CAPOX-chemotherapy associated with improved overall survival (P < 0.001) and relatively lower HR. CONCLUSION: The clinicopathological attributes and treatment outcomes like older age, weight loss, tumor size, type of gastrectomy, FLOT regimen, number of cycles, and postoperative undernourishment demonstrated higher HR and compromised survival in GC patients of Eastern India.
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