J Cancer Res Ther
· 2026 Jan · PMID 41910281
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BACKGROUND: Adjuvant chest wall radiation therapy for postmastectomy breast cancer patients is highly effective in reducing the risk of locoregional recurrence. Hypofractionated regimen is increasingly being adopted in a...BACKGROUND: Adjuvant chest wall radiation therapy for postmastectomy breast cancer patients is highly effective in reducing the risk of locoregional recurrence. Hypofractionated regimen is increasingly being adopted in adjuvant radiotherapy. One of the reasons for its slow adoption is the concern that a hypofractionated regimen can lead to higher side effects, such as radiation-induced dermatitis. Even while modern techniques like intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT) have made great strides in protecting healthy tissues, the use of two-dimensional treatments with a telecobalt machine is still prevalent in many parts of developing countries like India. Hence, we conducted a retrospective study of the incidence and severity of radiation-induced dermatitis in breast cancer patients undergoing hypofractionated chest wall radiation therapy on a telecobalt machine. OBJECTIVES: 1. To evaluate acute skin reaction in patients treated with chest wall hypofractionated adjuvant radiation in carcinoma of the breast on a telecobalt machine. 2. To evaluate the incidence of severity of odynophagia. 3. To evaluate the weight change during treatment. MATERIALS AND METHODS: In this retrospective study, we analyzed the data from postmodified radical mastectomy (PMRM) breast cancer patients treated with adjuvant chest wall radiotherapy using a hypofractionated regimen on a telecobalt machine at our hospital from 2017 to 2023 after institutional ethical committee approval. One hundred and fifty-six patients were treated with a hypofractionated regimen during this time period. The hypofractionated radiation schedule used was 40 Gy in 15 fractions with 2.66 Gy per fraction over 3 weeks, with 5 fractions per week on a telecobalt machine. Patient demographics, disease characteristics, treatment details, comorbidities, and skin reactions during treatment were retrieved from patient records and analyzed. RESULTS: In our study, 148 (89.74%) patients had no skin reaction, and 16 patients had grade I radiation induced dermatitis during first week. During second week 88 (56.41%) patients had no skin reaction and 70 (56.41%) patients had grade I radiation induced dermatitis During third week, 137 (87.82%) patients had grade 1 and 9 (5.76%) patients developed grade 2 radiation induced dermatitis. None of the patient had grade III or IV radiation dermatitis during the treatment. During week 1 no patients had odynophagia and during week 2, grade 1 and 2 odynophagia was observed in 3 and 2 patients, respectively. Grade I odynophagia was observed in 16 patients and grade 2 odynophagia was documented in 9 patients during 3rd week of treatment and none of the patients had significant weight loss during treatment. CONCLUSION: Our study demonstrates that hypofractionated adjuvant chest wall radiation therapy using a telecobalt machine is associated with a low incidence of severe acute skin reactions and odynophagia. The regimen appears to be well-tolerated, with minimal impact on weight and nutritional status.
Rondelli E, Romiti E, Gavlasova D
… +6 more, Foppiani JA, Choudry U, Cayci C, Raska O, Ali B, Lin SJ
J Cancer Res Ther
· 2026 Jan · PMID 41910280
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BACKGROUND: Oral mucositis (OM) is a frequent and debilitating side effect of chemotherapy and radiotherapy, affecting up to 80% of patients receiving high-dose regimens or head and neck radiation. It severely compromise...BACKGROUND: Oral mucositis (OM) is a frequent and debilitating side effect of chemotherapy and radiotherapy, affecting up to 80% of patients receiving high-dose regimens or head and neck radiation. It severely compromises oral function, quality of life, and treatment adherence, often necessitating opioid analgesia and nutritional support. Methylene blue (MB), known for its anti-inflammatory and analgesic properties, has recently emerged as a potential therapeutic agent for OM pain. OBJECTIVES: This systematic review aimed to evaluate the analgesic efficacy of methylene blue in the management of chemotherapy- and radiotherapy-induced OM, either as a topical oral rinse or as a photosensitizer in photodynamic therapy (PDT). METHODS: Following PROSPERO registration (CRD42024594258), we conducted a comprehensive search of five databases up to September 2024. Studies were eligible if they included cancer patients with chemotherapy- or radiotherapy-induced OM treated with MB. Data extraction and quality assessment were performed independently by two reviewers following PRISMA guidelines. Pain reduction was the primary outcome. A random-effects meta-analysis using inverse variance weighting was conducted; heterogeneity was assessed with I2 statistics. RESULTS: Out of 137 screened records, 6 studies comprising 9 treatment groups and 432 patients met inclusion criteria. MB was administered either as an oral rinse alone (7 groups) or in combination with laser therapy (2 groups). The pooled mean reduction in pain was -4.81 points on a 0-10 scale (95% CI -5.57 to -4.05; P < 0.001). Subgroup analysis showed a mean change of -5.01 with oral rinse alone and -3.80 with the combination, with no significant difference between the two strategies (P = 0.30). Sensitivity analyses confirmed the robustness of these findings. CONCLUSION: Methylene blue appears to be a safe and effective option for pain relief in OM, with significant reductions in pain scores observed across studies. Its simplicity, affordability, and favorable safety profile make it a promising adjunctive therapy. Larger randomized trials are needed to validate these findings and explore long-term outcomes.
Chatterjee P, Halder A, Biswas R
… +2 more, Biswal SS, Sarkar B
J Cancer Res Ther
· 2026 Jan · PMID 41910279
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Osteoradionecrosis (ORN) of the jaw is a debilitating late complication of head and neck radiotherapy (RT), characterized by necrotic bone within an irradiated field, persisting without tumor recurrence. Advances in radi...Osteoradionecrosis (ORN) of the jaw is a debilitating late complication of head and neck radiotherapy (RT), characterized by necrotic bone within an irradiated field, persisting without tumor recurrence. Advances in radiation techniques and preventive dental management have reduced its incidence, yet ORN remains a major cause of morbidity. This review synthesizes current understanding of ORN pathophysiology, risk factors, diagnostic strategies, and contemporary prevention and management approaches, with a focus on the updated 2024 ISOO-MASCC-ASCO guidelines. Preventive measures include pre-RT dental optimization, dose reduction to jaw bones, and avoidance of post-RT extractions when possible. Management ranges from conservative pharmacologic regimens to radical resection with vascularized flap reconstruction. Multidisciplinary care and patient education are key to minimizing risk and improving outcomes. Additionally, we report a comparable case of mandibular osteoradionecrosis in a postoperative patient with carcinoma of the buccal mucosa, which developed despite the administration of adjuvant radiotherapy using an advanced radiation delivery technique.
J Cancer Res Ther
· 2026 Jan · PMID 41910278
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Radiation therapy is a cornerstone of treatment for solid tumors, yet it often induces lymphopenia, a condition linked to poorer clinical outcomes. This scoping review synthesizes evidence from systematic reviews to eval...Radiation therapy is a cornerstone of treatment for solid tumors, yet it often induces lymphopenia, a condition linked to poorer clinical outcomes. This scoping review synthesizes evidence from systematic reviews to evaluate the prognostic impact of severe radiation-induced lymphopenia (RIL) on overall survival (OS) in patients with solid tumors. A systematic literature search was conducted across PubMed, Cochrane Central, and EMBASE using the following keywords: "radiation," "lymphopenia," "solid tumors," "survival AND mortality," and "systematic review AND meta-analysis," up to November 30, 2023. Reviews reporting the prognostic relationship between RIL and survival were included, and pooled adjusted hazard ratios (aHRs) were calculated using a random-effects model. Subgroup analyses examined the impact of grade 3 or higher RIL across different tumor types. Of 21 identified reviews, 10 were included, covering 93 studies and 11,565 patients. The adjusted incidence rate of severe lymphopenia averaged 26.7% (range: 18.6-88.0%). The pooled aHR for OS was 1.72 (95% CI: 1.33-1.87) for grade ≥3 RIL versus grade 0-2 RIL, and 1.59 (95% CI: 1.31-1.92) for grade 4 RIL versus grade 0-3 RIL. Significant prognostic effects were observed in esophageal, head and neck, pancreatic, cervical, central nervous system, and lung cancers. Genitourinary tumors showed associations with medium-high radiation doses to pelvic and iliac bone marrow. Severe RIL consistently predicts poorer OS, emphasizing the need for prospective studies to address RIL prevention and management, especially in the era of immunotherapy.
J Cancer Res Ther
· 2026 May · PMID 41837312
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Metabolic reprogramming alters the processes by which tumor cells generate energy and synthesize products, affecting their growth and survival. It also reshapes the tumor microenvironment by influencing immune cell funct...Metabolic reprogramming alters the processes by which tumor cells generate energy and synthesize products, affecting their growth and survival. It also reshapes the tumor microenvironment by influencing immune cell function and interaction. Current literature suggests that the metabolic characteristics of gastric malignancies are closely associated with tumor immune evasion and inflammatory responses, thereby influencing immune cell infiltration, tumor progression, and patient prognosis. Despite some progress, research on metabolic reprogramming in gastric cancer (GC) is challenging, particularly in understanding the specific mechanisms involved and their clinical applications. This review aims to comprehensively explore the mechanisms of metabolic reprogramming in GC and analyze its impact on the tumor immune microenvironment. We also propose potential metabolic-immune therapeutic strategies, such as glutaminase inhibitors, lactate transport blockers, and immune checkpoint therapy combined with metabolic regulators, providing new ideas and directions for immunotherapy in GC.
Luo H, Zhu S, Lu X
… +4 more, Diao S, Li Z, Wang X, Chen J
J Cancer Res Ther
· 2026 May · PMID 41837311
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BACKGROUND: Gamma knife radiosurgery (GKRS) is a key treatment method for intracranial neoplasms, particularly primary jugular foramen tumors. The risks associated with surgical resection and conventional radiotherapy ha...BACKGROUND: Gamma knife radiosurgery (GKRS) is a key treatment method for intracranial neoplasms, particularly primary jugular foramen tumors. The risks associated with surgical resection and conventional radiotherapy have prompted interest in GKRS, which facilitates precise, high-dose delivery with minimal collateral damage. METHODS: This retrospective study comprised 219 patients with primary jugular foramen tumors treated from June 2014 to June 2024. The patients were divided into two groups based on the treatment received: conventional fractionated external beam radiotherapy (EBRT, n = 103) and GKRS ( n = 116). Treatment efficacy was evaluated using magnetic resonance imaging and the Response Evaluation Criteria in Solid Tumors criteria 6 months post-treatment. Correlation and regression analyses were conducted to identify factors affecting the treatment outcomes. RESULTS: The GKRS group exhibited a significantly higher complete and partial response rates compared to the EBRT group (25.86% vs. 9.71% and 30.17% vs. 22.33%, respectively). The GKRS group showed a significantly lower rate of progressive disease (5.17% vs. 23.3%, P < 0.001) and fewer cranial nerve-related adverse effects ( P = 0.008) compared to the EBRT group. The factors predicting poor GKRS efficacy included a large tumor volume, intra-/extracranial extension, and transient expansion ( P = 0.005, 0.010, and 0.005, respectively). CONCLUSION: GKRS demonstrated superior efficacy and a better safety profile than EBRT for managing primary jugular foramen tumors. Tumor type, volume, and morphology significantly influenced GKRS outcomes, highlighting the need for tailored treatment strategies based on individual tumor characteristics.
Mauryakrishna G, Parashar E, Verma R
… +2 more, Rani A, Dey T
J Cancer Res Ther
· 2025 Oct · PMID 41474586
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Primary ovarian rhabdomyosarcoma (RMS) is an extremely rare and aggressive malignancy, with limited reported cases and no standardized treatment protocol. We present the case of a 17-year-old female who initially present...Primary ovarian rhabdomyosarcoma (RMS) is an extremely rare and aggressive malignancy, with limited reported cases and no standardized treatment protocol. We present the case of a 17-year-old female who initially presented with progressive abdominal distension and was diagnosed with ovarian RMS. Imaging revealed a large solid-cystic pelvic mass, and histopathological evaluation, along with immunohistochemical markers such as desmin, myogenin, and WT1, confirmed the diagnosis. The patient underwent surgical resection, but recurrence occurred within 3 months, necessitating further evaluation. Early relapse suggested the aggressive nature of the tumor, requiring chemotherapy with VAC (vincristine, actinomycin D, and cyclophosphamide). This case highlights the importance of early diagnosis, and the urgent need for standardized therapeutic approaches to improve patient outcomes in ovarian RMS.
J Cancer Res Ther
· 2025 Oct · PMID 41474585
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Gastro-esophageal Stromal Tumor (GIST) is the type of mesenchymal tumor that arises from specialized cells called interstitial cells of Cajal (ICC) or their precursors. The most common site is stomach (60%-70%) followed...Gastro-esophageal Stromal Tumor (GIST) is the type of mesenchymal tumor that arises from specialized cells called interstitial cells of Cajal (ICC) or their precursors. The most common site is stomach (60%-70%) followed by small intestine (20%-30%). Esophageal GISTs comprises 0.7% of all GISTs, making them incredibly rare. Treatment options for esophageal GISTs typically involve a multidisciplinary approach and depend on the several factors, including the tumor size, location, and the presence of metastasis. The primary treatment for localized esophageal GISTs is surgical removal, often involving a partial or complete esophagectomy. In some cases, targeted therapy with drugs such as imatinib may be used before or after surgery to shrink the tumor or prevent its recurrence. We report a case of middle-aged man, who presented with dysphagia and was diagnosed as gastrointestinal stromal tumor of lower thoracic esophagus, positive for c-kit, and SMA, and negative for desmin. Patient was treated with targeted therapy and surgery that resulted in excellent outcome with prolonged survival. Although esophageal GIST is a rare scenario, outcome in this subset of patients can be improved with the use of targeted therapy that hasten the symptomatic relief and adds to survival benefit.
Putra JA, Anggraheni R, Hilda S
… +1 more, Angeline D
J Cancer Res Ther
· 2025 Oct · PMID 41474584
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Chemotherapy extravasation is a serious iatrogenic complication, especially with vesicant agents such as epirubicin. In severe cases, it can lead to extensive tissue necrosis and compartment syndrome. While surgical inte...Chemotherapy extravasation is a serious iatrogenic complication, especially with vesicant agents such as epirubicin. In severe cases, it can lead to extensive tissue necrosis and compartment syndrome. While surgical intervention is the mainstay treatment for acute complications, novel adjuncts like platelet-rich plasma (PRP) may support wound healing in the recovery phase. A 66-year-old woman with a history of non-Hodgkin's lymphoma developed swelling, bullae, and pain in her right hand following intravenous epirubicin infusion. Compartment syndrome was suspected, and emergency fasciotomy with debridement was performed. Despite initial surgical and medical management, delayed wound healing and recurrent necrosis were observed. Autologous PRP mixed with mupirocin was applied topically twice daily. Accelerated granulation, epithelialization, and functional recovery of the hand were noted within days of PRP initiation. This case illustrates the regenerative potential of PRP in promoting wound healing following chemotherapeutic tissue injury. Its application in extravasation wounds remains rare in the literature, and this report adds to growing interest in PRP as a safe and potentially effective adjunctive therapy in complex oncologic wounds.
J Cancer Res Ther
· 2025 Oct · PMID 41474583
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EGFR gene mutations are the second most common oncogenic driver of tumorigenesis in non-small cell lung cancer (NSCLC). Exon 19 deletions and L858R point mutation are strong predictors of response to TKIs, whereas rare E...EGFR gene mutations are the second most common oncogenic driver of tumorigenesis in non-small cell lung cancer (NSCLC). Exon 19 deletions and L858R point mutation are strong predictors of response to TKIs, whereas rare EGFR mutations are generally associated with suboptimal TKIs response. Notably, rare mutations G719X and S768I can co-exist as complex mutations within the same tumor. In this context, we report a case of a 55-year-old female patient with left lower lobe lung adenocarcinoma along with metastases in the liver, skull, and bony pelvis. Histopathological examination of the right iliac bone confirmed the moderately differentiated metastatic adenocarcinoma. Findings of this report present the rare EGFR double mutations (G719X + S768I), along with concurrent ROS1positivity, which can directly affect treatment choices. There is ongoing debate about the optimal choice of TKI for the rare EGFR mutations, but earlier reports indicate that these mutations may respond more favorably to second-generation TKIs compared to first-generation. This report underscores the significance of thorough molecular profiling in NSCLC.
Kapatia G, Jindal A, Matia M
… +2 more, Goyal LD, Rana MK
J Cancer Res Ther
· 2025 Oct · PMID 41474582
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Schwannoma is a benign mesenchymal tumor that arises from the Schwann cells. It can occur in both males and females with an equal incidence (M: F-1:1), with the most common age being the third to fourth decade. The tumor...Schwannoma is a benign mesenchymal tumor that arises from the Schwann cells. It can occur in both males and females with an equal incidence (M: F-1:1), with the most common age being the third to fourth decade. The tumors show a predilection for the head and neck region, flexural surfaces of extremities, posterior mediastinum, and retroperitoneum. However, the external female genitals are an extremely rare anatomical site for their occurrence. Herein, we outline one such rare case of a benign vulvar schwannoma on the labia minora in a 34-year-old woman. Most patients of vulvar schwannoma present with a characteristically painless mass, making clinical diagnosis difficult. Hematoxylin and Eosin staining of a conventional schwannoma reveals a characteristic pattern of Antoni type A and B areas along with Verocay bodies. On IHC, schwannomas characteristically stain positive for S-100, indicating the neural origin of the tumor. Surgical removal of the mass is the standard treatment of choice with an excellent prognosis.
Govind AP, Varshney H, Kumar B
… +1 more, Maurya P
J Cancer Res Ther
· 2025 Oct · PMID 41474581
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Home-based palliative care offers a compassionate way to support terminally ill patients in familiar settings, but its implementation in resource-limited environments is challenging. We share our experience with a 35-yea...Home-based palliative care offers a compassionate way to support terminally ill patients in familiar settings, but its implementation in resource-limited environments is challenging. We share our experience with a 35-year-old man with advanced squamous cell carcinoma of the tongue, previously treated with radiotherapy and brachytherapy, who presented with metastatic pleural effusion and severe respiratory distress. Despite comprehensive symptom management in the palliative care ward-including opioid titration, nerve blocks, and psychological support-his wife faced substantial barriers to providing home care. Financial hardship, lack of family support, and living on a third floor hindered timely crisis management. Although we trained the caregiver, resource limitations led to complications like empyema and sepsis, necessitating readmission. The patient passed away after 5 weeks. This case emphasizes the need for systemic investment in caregiver training, community support, and healthcare infrastructure to address the multifaceted challenges of home-based palliative care in resource-constrained settings.