J Cancer Res Ther [JOURNAL]
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200 papers
Clear cell sarcoma like tumor of the rectum: A rare entity.
Amariyil A, Das B, Akhtar S … +1 more , Mallick S
J Cancer Res Ther · 2025 Oct · PMID 41474580 · Publisher ↗
Clear Cell Sarcoma-like tumors of the gastrointestinal tract (CCSGT) are extremely rare entities to be diagnosed and treated. Histopathological diagnosis and treatment of such rare malignancies is a challenge. This case...
Clear Cell Sarcoma-like tumors of the gastrointestinal tract (CCSGT) are extremely rare entities to be diagnosed and treated. Histopathological diagnosis and treatment of such rare malignancies is a challenge. This case report describes the treatment of a non-metastatic rectal CCSGT. The patient underwent abdominoperineal resection (APR) followed by adjuvant radiation to a dose of 60Gy over 30 fractions over 6 weeks. This report represents the first documented case of a localized clear cell sarcoma-like tumor of the rectum successfully treated with adjuvant radiation therapy, highlighting the potential role of radiotherapy in managing this rare malignancy.
Intracavitary brachytherapy challenge in cervical cancer with a large cervical fibroid: A case report.
Sharma H, Soni KK, Thakur N … +2 more , Kumar M, Sharma DN
J Cancer Res Ther · 2025 Oct · PMID 41474579 · Publisher ↗
Among women, cervical cancer continues to be a significant cause of cancer-related death, especially in low- and middle-income nations. Brachytherapy (BT), which provides excellent tumor dose delivery while preserving su...
Among women, cervical cancer continues to be a significant cause of cancer-related death, especially in low- and middle-income nations. Brachytherapy (BT), which provides excellent tumor dose delivery while preserving surrounding tissues, is an essential part of the treatment for locally advanced cervical cancer. Anatomical issues, such as large cervical fibroids, may complicate the placement of the intracavitary brachytherapy (ICBT) applicator. We describe a 74-year-old woman whose stage IIIB cervical cancer was complicated by a large cervical fibroid, which presented a significant BT issue. The successful management of this case, which involved careful uterine sounding and tandem placement under general anesthesia using transrectal and transabdominal ultrasound guidance, and the patient's completion of three high-dose-rate ICBT sessions with favorable outcomes, is a testament to the expertise and dedication of the medical professionals involved. This case underscores the importance of their specialized skills, image-guided techniques, and meticulous planning in overcoming anatomical barriers and ensuring effective BT delivery in complex cervical cancer cases.
Rare extraocular sebaceous carcinoma of the scalp: A case of cauliflower-like lesion treated with radiotherapy and surgery.
Shereef O, Kaur A
J Cancer Res Ther · 2025 Oct · PMID 41474578 · Publisher ↗
Sebaceous carcinoma at the extraocular sites is an extremely rare tumor. This is the case report of sebaceous carcinoma of the scalp in a 35-year-old male presenting with a fungating cauliflower-like mass on the scalp. T...
Sebaceous carcinoma at the extraocular sites is an extremely rare tumor. This is the case report of sebaceous carcinoma of the scalp in a 35-year-old male presenting with a fungating cauliflower-like mass on the scalp. There is no standardized treatment for such presentation, which is why it is important to highlight such rare cases, for optimizing treatment plans in the future. A 35-year-old male presented with a fungating, disfiguring lesion on the scalp, which started as a small lesion 3-4 years ago. The patient took ayurvedic treatment, followed by four surgical excisions at other facilities, which did not provide relief. Besides mild discomfort and social embarrassment, the patient did not report any symptoms. The past medical, social, and family history of the patient were unremarkable. At the presentation, the patient looked pale and had edema in the left ankle. On examination, multiple mobile subcentimeter lymph nodes were noted in the head and neck region. The lab assessments revealed hemoglobin of 4.2 g/dL. The patient was admitted and transfused with four units of packed red blood cells. CT scan of the brain showed an irregular mass in the parietal, frontal, and occipital region, causing lytic erosion of the high parietal bone and infiltrating the adjacent dura. Histopathological report revealed the lesion to be sebaceous carcinoma. PET-CT scan showed increased fluorodeoxyglucose uptake in the head, neck, and lungs. The case was discussed in a multidisciplinary tumor board, and radiation was planned. Radiotherapy effectively reduced the size of the tumor, making surgical intervention feasible. This case emphasizes the importance of individualized treatment and thorough evaluation with a multidisciplinary approach for appropriate treatment planning.
Initial experience with a novel device for supporting a debilitated patient during total skin electron beam therapy.
Okuma K, Okamoto H, Oguchi H … +1 more , Igaki H
J Cancer Res Ther · 2025 Oct · PMID 41474577 · Publisher ↗
Total skin electron beam therapy (TSET) is the specialized and effective therapy for mycosis fungoides and Sézary syndrome. The Stanford TSET technique, which is the one most often used, requires the patient to remain st...
Total skin electron beam therapy (TSET) is the specialized and effective therapy for mycosis fungoides and Sézary syndrome. The Stanford TSET technique, which is the one most often used, requires the patient to remain standing for an extended time. Here, we report on the invention of a device to assist in patient positioning for TSET and how the device is used in clinical care. Our novel device comprises supports for the patient's head and upper limbs plus a bicycle-style saddle seat. We used the device during delivery of TSET for Sézary syndrome in a 30-year-old woman. Radiation was delivered from six angles every 2 days (three angles daily) by the Stanford technique using 6 MeV, 2 Gy per fraction, for a total of 12 Gy every 2 days. The total treatment time each day was about 1 hour. During the first 5 days of treatment, the patient required breaks during irradiation because of general malaise and nausea caused by chemotherapy. At each treatment session, glass dosimeters were used to measure the delivered doses to the parietal, bilateral axillary, anterior chest, bilateral medial thigh, and bilateral plantar areas. Glass dosimeter measurements showed underdoses in the medial thigh dose on both sides, thereby suggesting scattering and attenuation caused by the saddle seat. However, the patient experienced great relief from being able to straddle the seat, given her debilitated physical condition and the imposed blindness from lead contact lenses that she wore to protect her corneas. The patient's risk of falling was ameliorated, and she underwent treatment in safety. Our novel device to support a patient in debilitated physical condition receiving TSET carries a risk of dose reduction to the medial thigh, but the risk of falling is significantly reduced.
The radiation oncology department: A barometer for cancer center health.
Muzumder S
J Cancer Res Ther · 2025 Oct · PMID 41474576 · Publisher ↗
The Radiation Oncology Department serves as a vital barometer for a cancer center's overall health. Its performance reflects the entire institution's efficacy, technological commitment, and collaborative spirit. Patient...
The Radiation Oncology Department serves as a vital barometer for a cancer center's overall health. Its performance reflects the entire institution's efficacy, technological commitment, and collaborative spirit. Patient volume indicates referral efficiency and reputation, while investment in cutting-edge technology signals a commitment to excellence. As a hub for multidisciplinary collaboration and a model of operational efficiency, this department's function reveals the quality of care provided by the entire cancer center. To truly understand an oncology program, one must first look at its Radiation Oncology Department.
Don't kill the patient before he dies.
Patro KC, Lakshmi K, Avinash A … +2 more , Sharma DN, Kamboj K
J Cancer Res Ther · 2025 Oct · PMID 41474575 · Publisher ↗
In oncology practice, the pursuit of life-prolonging treatments often raises critical ethical and clinical questions about the balance between aggressive interventions and the preservation of quality of life. As cancer t...
In oncology practice, the pursuit of life-prolonging treatments often raises critical ethical and clinical questions about the balance between aggressive interventions and the preservation of quality of life. As cancer therapies continue to advance, there is an increasing risk of over-treatment, where the focus on extending life may inadvertently compromise a patient's comfort, dignity, and overall well-being. This article explores the concept of "Do Not Kill the Patient before He Dies," urging oncologists to adopt a patient-centered approach that prioritizes thoughtful decision-making and individualized care. This article examines the challenges of navigating the fine line between curative and palliative intents, particularly in advanced-stage cancer, where the benefits of treatment may diminish relative to its side effects. The article highlights the consequences of over-treatment, drawing on case studies, patient narratives, and evidence-based research to illustrate how aggressive interventions can lead to physical, emotional, and financial burdens for patients and their families. Key strategies to mitigate these risks are discussed, including the role of shared decision-making, honest communication about prognosis and treatment goals, and the timely integration of palliative care. By fostering a culture of empathy, collaboration, and respect for patient autonomy, oncology practitioners can ensure that therapeutic choices align with the values and priorities of those they serve. This article advocates for a paradigm shift in oncology, emphasizing the importance of not just prolonging life but enhancing its quality.
Primary retroperitoneal masses: Uncommon presentations with literature review.
Gupta Y, John A, Kumar A
J Cancer Res Ther · 2025 Oct · PMID 41474574 · Publisher ↗
INTRODUCTION: Primary retroperitoneal masses are neoplasms that originate within the retroperitoneal space, independent of any retroperitoneal organs. Although rare, they present significant diagnostic and therapeutic ch...
INTRODUCTION: Primary retroperitoneal masses are neoplasms that originate within the retroperitoneal space, independent of any retroperitoneal organs. Although rare, they present significant diagnostic and therapeutic challenges. MATERIALS AND METHODS: This study was performed in the Department of Pathology and Lab Medicine at AIIMS Raipur over a period of 2 years. It included both retrospective and prospective cases. Relevant clinical details and radiological investigations were reviewed. Histopathological findings and results from ancillary studies were analyzed and correlated with the clinical data. RESULTS: The study reported 15 cases of primary retroperitoneal masses, with a higher occurrence in males. Most patients were in their 50s to 60s. Both benign and malignant neoplasms were observed. Three uncommon cases included one extra-skeletal osteosarcoma and two extra-skeletal Ewing sarcomas. CONCLUSION: Retroperitoneal tumors present diagnostic challenges and therapeutic complexities due to their rarity, often late presentation, and anatomical location near vital structures in the retroperitoneal space. Accurate diagnosis is crucial for appropriate management and prognostication.
A correlation of Worst Pattern of Invasion (WPOI) and Tumor budding (TB) with clinicopathological factors in oral squamous cell carcinoma (OSCC).
Singh K, Jain P, Marachapu J … +2 more , Prasad S, Sharma S
J Cancer Res Ther · 2025 Oct · PMID 41474573 · Publisher ↗
BACKGROUND: Squamous Cell Carcinoma (SCC) of the oral cavity is the most common malignancy of the head and neck region and is known for its aggressive behavior with a high rates of recurrence and metastasis. MATERIALS AN...
BACKGROUND: Squamous Cell Carcinoma (SCC) of the oral cavity is the most common malignancy of the head and neck region and is known for its aggressive behavior with a high rates of recurrence and metastasis. MATERIALS AND METHODS: A total of 73 patients of surgically resected cases of oral squamous cell carcinoma from January 2021 to December 2021 with or without adjuvant therapy were included. Worst Pattern of Invasion (WPOI) and Tumor budding (TB) were evaluated on routine hematoxylin and eosin-stained sections and these were correlated with clinicopathological parameters. Statistical analysis was conducted by using Chi-square test and multivariate logistic regression model. A P value < .05 considered significant. RESULT: The mean age was 44 ± 12.57 and M: F of 6.3:1. Most of the tumors were located on buccal mucosa (47.9%) and tongue (32.8%). Lip, alveolus and floor of the mouth were the other sites involved constituting 9.5% (n = 7), 6.8% (n = 5) and 2.7% (n = 2), respectively. Both WPOI and TB in oral squamous cell carcinoma (OSCC) was found to be significantly associated with stage of the tumor and metastasis to lymph node with P value <0.5. Depth of invasion >1 cm was found in 64.3% of the cases (n = 47), which was found to be significantly associated with WPOI (P = 0.004) and TB (P = 0.04). We also found a significant association of TB with Perineural invasion (PNI) (0.003). A significant association of WPOI and TB with a P value of 0.012 was also found. On multivariate analysis the lymph node metastasis was found to be significantly associated with high WPOI (IV, V) and PNI. CONCLUSION: Both WPOI and TB are found to be significantly associated with the clinicopathological factors like stage, Depth of invasion (DOI), and metastatic lymph nodes. They are highly reproducible and can be easily evaluated on routine H and E sections, thus proving to be cost effective in a resource poor setting. They can be used as independent prognostic markers in OSCC and thus help in deciding the treatment plan for the patients.
Assessment of quality of life in locally advanced carcinoma rectum undergoing total neoadjuvant therapy: An eastern Indian subcontinent prospective study.
Mahajan A, Barik SK, Mukherjee P … +15 more , Majumdar SKD, Parida SP, Das DK, Muduly DK, Mishra TS, Sasmal PK, Pattnaik B, Dutta T, Gupta S, Swain PK, Ahmed SKS, Muraleedharan A, Abdulla SS, Sarkar A, Parida DK
J Cancer Res Ther · 2025 Oct · PMID 41474572 · Publisher ↗
BACKGROUND: Total neoadjuvant treatment has revolutionized the treatment algorithm in the management of locally advanced rectal carcinoma (LARC). This increase in the lifespan should be translated into an improved qualit...
BACKGROUND: Total neoadjuvant treatment has revolutionized the treatment algorithm in the management of locally advanced rectal carcinoma (LARC). This increase in the lifespan should be translated into an improved quality of life (QOL) so as to have a holistic treatment approach. MATERIALS AND METHODS: This is a prospective study of LARC patients (n = 39) undergoing total neoadjuvant therapy (TNT): SCRT 25Gy/5# followed by 6 cycles of NACT followed by surgery. QOL was analyzed at 3 months and 6 months post-treatment using the EORTC QLQ C30 and CR29 questionnaire. Wilcoxon signed rank test was used to analyze mean scores of Health-Related Quality of life (HRQL) between 3 and 6 months as Global Health Status, five functional scales (physical, role, emotional, cognitive, social functioning), and symptoms scales. RESULTS: Global health status showed a statistically significant difference (P = 0.001) along with a minor clinical improvement. Under functional items, physical functioning (P < 0.01), role functioning (P = 0.03), emotional functioning (P = 0.01), and social functioning (P = 0.01) all showed statistically significant differences with clinical improvement. For the symptom scales, most of them showed a statistically significant difference and a clinical reduction of scores. CONCLUSION: TNT has become the new standard of care in LARC. This study shows a statistical and clinical improvement in global health status with the improvement in functional status of QOL. There is also a statistically significant decrease in symptom scales, which is corroborated by clinical improvement. TNT improves both the survival and the QOL, thus making it a comprehensive treatment option for LARC.
Correlation of EZH2 expression and response to chemoradiation in patients with locally advanced inoperable oral cavity and oropharyngeal squamous cell cancers.
Ahmed SKS, Majumdar SKD, Adhya AK … +13 more , Barik SK, Das DK, Ramasubbu MK, Mukherjee P, Muraleedharan A, Haroon N, Mahajan A, Abdulla SS, Sarkar A, Swain PK, Parida PK, Muduly DK, Parida DK
J Cancer Res Ther · 2025 Oct · PMID 41474571 · Publisher ↗
BACKGROUND: Head and neck cancer (HNC) is a major global health concern. Despite advances in treatment, the outcome is poor due to locoregional failure. Enhancer of zeste homolog 2 (EZH2), an epigenetic modifier, plays a...
BACKGROUND: Head and neck cancer (HNC) is a major global health concern. Despite advances in treatment, the outcome is poor due to locoregional failure. Enhancer of zeste homolog 2 (EZH2), an epigenetic modifier, plays a role in cancer development by promoting growth, invasion, and dissemination of tumor cells. This study aims to investigate the correlation between EZH2 expression and the response to chemoradiation (CRT) in patients with locally advanced, inoperable oral cavity and oropharyngeal squamous cell cancers. METHODS: Fifty patients were prospectively included in this study. All of the patients received definitive CRT. A second biopsy was retrieved between the third and fourth fractions of radiotherapy (RT). Immunohistochemistry (IHC) was performed on pre-RT and postthird fraction biopsy samples to evaluate EZH2 status. The IHC score was calculated based on EZH2 intensity and the percentage of positive cells. A score of 4 or more indicated high expression. After 12 weeks of treatment completion, the response was assessed and correlated with EZH2 status, and the statistical analysis was done. RESULTS: The EZH2 score was significantly higher in tumor tissue than in normal tissue samples (P value: 0.001). High expression of EZH2 was found in 78% of pre-RT and 81% of postthird fraction tumor samples. High expression of EZH2 did not show a statistically significant correlation with response to CRT (P value: 0.809). However, the EZH2 score increased significantly in the postthird fraction samples of patients who did not achieve a complete response (P value: 0.03). CONCLUSION: The study indicates that EZH2 can be a valuable predictive marker in HNC. Anti-EZH2 therapy should be explored to improve the treatment outcomes in patients with high expression of EZH2.
Comprehensive analysis of factors affecting toxicities and oncological outcomes in head and neck cancer patients undergoing definitive radiotherapy or chemoradiotherapy.
Rahman A, Sethi P, Subramaniyam V … +3 more , Nanda N, Murugesan R, Muralitharan KM
J Cancer Res Ther · 2025 Oct · PMID 41474570 · Publisher ↗
INTRODUCTION: There is significant variation in normal tissue toxicity and outcomes in terms of tumor response among patients with the same tumor, node, metastasis (TNM) stage and treatment. The aim of the study was to a...
INTRODUCTION: There is significant variation in normal tissue toxicity and outcomes in terms of tumor response among patients with the same tumor, node, metastasis (TNM) stage and treatment. The aim of the study was to analyze various patient, tumor, and treatment parameters and evaluate their impact on acute treatment toxicities, as well as the treatment responses in adult head and neck cancer patients. MATERIALS AND METHODS: This prospective observational study was conducted between November 2021 and April 2023 at a tertiary cancer care center in South India. For the acute toxicity, data from 108 patients were available for analysis. For the clinical outcome, data from 86 patients were available for analysis. RESULTS: Low hemoglobin levels were predictive of both acute severe dermatitis (<11.15 g/dL; P value of 0.02) and severe mucositis (<11.45 g/dL, P value of 0.01). Other factors associated with severe dermatitis included low serum albumin, high lactate dehydrogenase to albumin ratio, high lean body mass, and elevated body mass index. The use of concurrent chemotherapy and triweekly chemotherapy was independently associated with a higher incidence of severe neutropenia when compared to no chemotherapy or weekly chemotherapy. Low skeletal muscle index, smaller gross tumor volume, and a shorter overall radiotherapy completion time were statistically significant factors correlated with a higher percentage of complete responses. CONCLUSION: Various patient, tumor, and treatment-related factors significantly influence the severity of toxicities and treatment response outcomes in head and neck cancer patients undergoing definitive radiotherapy/chemoradiotherapy.
Normal brain sparing approach for static field intensity modulated radiosurgery of single brain metastasis using a distance driven dose gradient function.
Ahamed S, Suvarna RP, Singh N
J Cancer Res Ther · 2025 Oct · PMID 41474569 · Publisher ↗
PURPOSE: To determine the cause and effects of sparing normal brain using a distance driven normal tissue dose gradient function for static field intensity modulated stereotactic radiosurgery planning of single brain met...
PURPOSE: To determine the cause and effects of sparing normal brain using a distance driven normal tissue dose gradient function for static field intensity modulated stereotactic radiosurgery planning of single brain metastasis (SBM). MATERIALS AND METHODS: Twenty seven SBM cases were planned for a dose of 20 Gy using 6 MV beams, to examine the cause and effects of dose gradients due to six NTO combinations formed from fall-off = 0.2, 0.6, and 1.0 mm-1, final-dose + priority = 10% +100 and 30% + 200. For comparative analysis, NTO combination of fall-off = 1.0 mm-1, final-dose + priority = 10% +100 was chosen as the control. Each combination was assessed for changes in field size (FS), high-to-low brain dose volumes (V14, V12, and V8), gradient index (GI), conformity index (CI), prescription isodose level (PIDL), and MU/Gy. Correlational analysis was performed to find meaningful relationships between FS, V12 and GI for all NTO combinations. RESULTS: Groups with fall-off ≥0.6 mm-1 plus priority = 200 showed considerable reductions for FS, V14, V12, V8, GI and PIDL (P < 0.0001). Substantial high-to-low brain dose volume decrease was observed because of increasing fluence conformity and consequent FS regression. CI was constant (±0.01), while GI improved significantly and PIDL decreased with associated MU/Gy increase, (P < 0.0001). Strong positive correlation between FS and V12 (r > 0.9) was observed meaning GI correlated inversely (r < -0.7). CONCLUSION: NTO strictness causes fluence contraction that spares normal brain, yielding better dose metrics to attain balanced plan goals.
Raised blood markers of chronic inflammation confer poor prognosis in gallbladder cancer.
Gaba S, Tewari M, Ansari MA
J Cancer Res Ther · 2025 Oct · PMID 41474568 · Publisher ↗
BACKGROUND: Various pre-operative blood inflammatory markers and ratios have been used to prognosticate different cancers. We investigated a few and correlated it with Disease-Free Survival (DFS) and Overall Survival (OS...
BACKGROUND: Various pre-operative blood inflammatory markers and ratios have been used to prognosticate different cancers. We investigated a few and correlated it with Disease-Free Survival (DFS) and Overall Survival (OS) in Gallbladder Cancer (GBC) patients. METHODS: Neutrophil to Lymphocyte ratio (NLR), Platelet to Lymphocyte ratio (PLR), Lymphocyte to Monocyte ratio (LMR), C-Reactive Protein (CRP), Lymphocyte to CRP ratio (LCR), modified Glasgow Prognostic Score (mGPS), CRP to Albumin ratio (CAR), and D dimer values were measured in 139 GBC patients (50 surgically resected and 89 not-operated). RESULTS: Significantly higher risk of mortality was observed in patients with the high NLR, PLR, CRP, CAR, mGPS, and D dimer with hazard ratio of 6.935 (4.048 to 11.881), 17.101 (7.652 to 38.218), 5.916 (3.167 to 11.049), 5.532 (3.157 to 9.695), 6.912 (4.249 to 11.245), and 1.810 (1.203 to 2.725), respectively, on Univariate analysis. High LMR and LCR had significantly lower risk of mortality with hazard ratio of 0.066 (0.026 to 0.166) and 0.183 (0.11 to 0.303), respectively. Upon multivariate analysis, only high NLR, PLR, and mGPS remained statistically significant with adjusted hazard ratio of 8.278 (2.046 to 33.492), 3.907 (1.236 to 12.356), and 3.350 (1.796 to 6.249), respectively. CONCLUSIONS: High NLR, PLR, and mGPS were significantly and independently associated with higher risk of mortality.
Stereotactic radiosurgery versus whole brain radiotherapy in patients of breast cancer with brain metastasis - A retrospective single-institution analysis.
Singh B, Gade VKV, Robert N
J Cancer Res Ther · 2025 Oct · PMID 41474567 · Publisher ↗
INTRODUCTION: Surgery, stereotactic radiosurgery (SRS), whole brain radiotherapy (WBRT), or a combination of any of these are all local therapy options for brain metastasis. In this study, we report outcomes of patients...
INTRODUCTION: Surgery, stereotactic radiosurgery (SRS), whole brain radiotherapy (WBRT), or a combination of any of these are all local therapy options for brain metastasis. In this study, we report outcomes of patients with brain metastasis from breast cancer. MATERIALS AND METHODS: This was a retrospective single-institution study. Records of patients with breast cancer registered in our department from 2016 to 2023 were evaluated. Patients with radiological or histopathological proof of brain metastasis who had received any form of cranial radiotherapy were included in the study. Various patient-related, disease-related, treatment-related, and dosimetric variables were recorded in this study. For the patients receiving WBRT, time dose and fractionation were recorded. Patients were stratified into WBRT group and SRS group for the purpose of survival analysis. Survival analysis was performed using Kaplan-Meir method, and survival between groups was compared using the log rank test. RESULTS: A total 98 patients were included for analysis in the study. The mean age of the study population was 46.42 years. All were female. Forty-four (45%) patients were Stage III at diagnosis, and 46 (47%) patients were metastatic at diagnosis. The median interval from diagnosis to brain metastasis was 18.1 months (IQR 9.5-34.4 months). Fourteen (14.3%) patients presented with brain metastasis at diagnosis. Sixty-eight (69.4%) patients had less than or equal to 5 lesions. Fourteen (14.3%) patients underwent surgery for brain metastasis. All patients received some form of cranial radiotherapy. Forty-seven (48%) patients received SRS, and 51 (52%) received WBRT. Twenty-nine (61.7%) patients received single-fraction SRS, whereas 18 (18.3%) received fractionated SRT. The 1-year event-free survival (EFS) was 41% in the WBRT group and 49% in the SRS group (P = 0.410). The 1-year overall survival (OS) was 49% in the SRS group and 54% in the SRS group (P = 0.293). CONCLUSION: In this retrospective study, there was no significant difference in survival outcomes with SRS or WBRT in breast cancer patients with brain metastasis. There is a need for dedicated prospective randomized trials to determine the optimal treatment sequence in metastatic breast cancer with brain metastasis.
Prospective evaluation of pathological complete response, toxicity, and compliance of total neoadjuvant therapy with short course radiotherapy in the management of locally advanced rectal cancers.
Kumari P, Rastogi M, Gandhi AK … +9 more , Bhutia TD, Khurana R, Hadi R, Srivastava AK, Sharma V, Pandey A, Singhal A, Chauhan A, Husain N
J Cancer Res Ther · 2025 Oct · PMID 41474566 · Publisher ↗
BACKGROUND: The aim of total neoadjuvant therapy (TNT), which includes neoadjuvant radiation therapy followed by neo-adjuvant chemotherapy (NACT) and surgery, is to improve systemic control rates, while maintaining loco-...
BACKGROUND: The aim of total neoadjuvant therapy (TNT), which includes neoadjuvant radiation therapy followed by neo-adjuvant chemotherapy (NACT) and surgery, is to improve systemic control rates, while maintaining loco-regional control for locally advanced rectal cancers (LARC). We investigated this approach of TNT with short course radiotherapy (SCRT). METHODS: In this single-arm prospective interventional study, 25 LARC patients were enrolled and treated with SCRT of 25 Gray in five fractions over 1 week followed by NACT (oxaliplatin and capecitabine) for six cycles, followed by definitive surgery with total mesorectal excision (TME). The end point was to evaluate pathological complete response (pCR), acute toxicity (measured using Common Terminology Criteria for Adverse Events version 5.0), and loco-regional control (LRC). RESULTS: Male: Female ratio was 17:8 and median age was 47 years. The clinical stages were T2: T3: T4 and N0: N1: N2 in 3: 20: 2 and 5: 8: 12 patients, respectively. Twenty (80%) of the 25 patients that were recruited underwent the entire course of treatment. Two patients defaulted, one expired, and two achieved clinical complete response (cCR) and did not agree to surgery. The median follow-up period was 15.5 months (8.8 to 18.2 months). 1/25 patients (4%) experienced grade 3 gastrointestinal toxicity during SCRT. Seven (30%) out of twenty-three patients receiving NACT developed Grade 3 toxicity. Six (30%) out of 12 patients undergoing surgery achieved pCR. Two patients developed loco-regional relapse and crude LRC rate for the entire cohort of enrolled patient at 1-year was 86.95%. CONCLUSION: The TNT approach with SCRT demonstrated favorable pathological complete response (pCR) rates, acceptable toxicity, and excellent short-term locoregional control.
Combined use of Indocyanine Green, intraoperative ultrasound, and three-dimensional model of kidney for nephron-sparing surgery in complex renal masses.
Gupta P, Nayyar R, Kumar S
J Cancer Res Ther · 2025 Oct · PMID 41474565 · Publisher ↗
PURPOSE: Operating for partial nephrectomy in complex renal tumor is always challenging. A wide variation in vascular architecture, depth of tumor, relation with the collecting system, and hilar location make it further...
PURPOSE: Operating for partial nephrectomy in complex renal tumor is always challenging. A wide variation in vascular architecture, depth of tumor, relation with the collecting system, and hilar location make it further difficult to finish the procedure with minimum complications and negative surgical margin. Our aim in this study is to share the benefits of combined use of Indocyanine Green (ICG), intraoperative ultrasound (USG), and three-dimensional (3D) modeling of kidney in complex robotic-assisted partial nephrectomy (RAPN) and also demonstrate various methods of using ICG in renal tumors. MATERIALS AND METHODS: This is a retrospective study done in our institute from January 2020 to July 2023; a total of 70 cases identified with renal tumor were operated for RAPN in hospital records. Intraoperative USG is a standard procedure in RAPN in our department combined with ICG in 23 complex renal tumor patients, and eight patients had 3D model printing. Various parameters and data are collected from the department record. RESULTS: 48 male patients and 22 females among the total 70 patients underwent RAPN during this period. The tumor size ranges from 2 to 8.5 cm, which has a mean of 4.52 ± 1.42 cm, in vivo USG alone (n = 37), USG combined with intraoperative ICG (n = 23), and USG combined with 3D model printing (n = 8). The mean warm ischemia time was 24.97 minutes, and the median blood loss and total operative time were 200 [interquartile range (IQR): 150-305] mL and 180 (IQR: 150-187) minutes, respectively. CONCLUSION: Combined use of ICG, intraoperative USG, and 3D kidney modeling in RAPN can be highly valuable in complex renal tumors. As per our observation, it is a better strategy in achieving trifecta outcomes in these complex cases. However, in our small study, statistical significance from either of the modality alone is lacking.
Whole-body DWI-MRI as an alternative to 18-FDG-PET/CT in the evaluation of lymphoma.
Ali K, Bhat M, Shera T … +5 more , Shah A, Maqsood S, Hussain MM, Rather T, Gojwari T
J Cancer Res Ther · 2025 Oct · PMID 41474564 · Publisher ↗
OBJECTIVE: Whole-body diffusion-weighted (DW) magnetic resonance imaging (MRI) in lymphoma patients and its comparison with 18F fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT). MATERIAL...
OBJECTIVE: Whole-body diffusion-weighted (DW) magnetic resonance imaging (MRI) in lymphoma patients and its comparison with 18F fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT). MATERIALS AND METHODS: This prospective study was performed on 33 patients with histopathologically proven lymphoma. Fifteen patients were diagnosed with Hodgkin's lymphoma (HL), and 18 patients had non-Hodgkin's lymphoma (NHL). All patients underwent PET-CT followed by DWI-MRI, and the performance of DWI-MRI was compared with PET-CT, taking PET-CT as the gold standard. RESULTS: Agreement on staging between DWI-MRI and PET-CT was found in 30 out of 33 patients. The overall sensitivity, specificity, area under the curve (AUC), positive predictive value, negative predictive value, and diagnostic accuracy of MRI were 87%, 100%, 0.93, 100%, 96%, and 96.7%, respectively, taking 18F-FDG/PET as the reference standard. CONCLUSION: Whole-body DWI-MRI is a highly sensitive method for lymphoma staging. It has excellent agreement with 18-FDG-PET/CT and is a great alternative for managing lymphoma patients without using ionizing radiation or an intravenous contrast agent.
Diagnostic performance of the deep learning method trained using MRI and F-18 FDG-PET/CT images in the evaluation of axillary lymph node metastasis in breast cancer patients.
Aydede YS, Turan U, Ata B … +5 more , Sarıgul M, Yetim AI, Kuvvetli A, Kelle AP, Cavus Y
J Cancer Res Ther · 2025 Oct · PMID 41474563 · Publisher ↗
AIM: The aim of this study is to investigate the diagnostic performance of the deep learning method using Magnetic Resonance Images (MRI) and 18F-fluorodeoxyglucose and Positron Emission Tomography (F-18 FDG-PET/CT) in d...
AIM: The aim of this study is to investigate the diagnostic performance of the deep learning method using Magnetic Resonance Images (MRI) and 18F-fluorodeoxyglucose and Positron Emission Tomography (F-18 FDG-PET/CT) in determining axillary lymph node metastasis (ALNM) in breast cancer patients. MATERIALS AND METHODS: In our study, all patients aged 18 and over who were diagnosed with breast cancer and operated on in the General Surgery Clinic of Adana City Training and Research Hospital between November 2017 and April 2023 were retrospectively examined from the hospital system. Demographic characteristics of the patients included in the study, menopausal status, type of operation performed, metastasis status in the postoperative histopathological evaluation of the axilla, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) status, Ki-67 proliferation index, lymphovascular and perineural invasion status, MRI and F-18 FDG-PET/CT images, and histopathological features, size and grade of the tumor were recorded. MRI and F-18 FDG-PET/CT images of the patients were evaluated by experts in the field, and the diagnostic performance results of the Convolutional neural network (CNN) model trained with the same images were also recorded. RESULTS: 177 patients were included in our study. When the patients' demographic and clinicopathological parameters and ALNM status were compared, a statistically significant difference was found between ER status, lymphovascular-perineural invasion and ALNM status (P < 0.05). The model trained using both MRI and PET/CT achieved the best performance: sensitivity 89.35%, specificity 63.21%, accuracy 68.04%, and F1 score 79.84%. The CNN model outperformed expert interpretation of either modality alone. CONCLUSION: The deep learning model demonstrated promising diagnostic capability for noninvasively detecting ALNM. While not yet a replacement for SLNB, such models may assist clinical decision-making and reduce the need for invasive procedures in the future.
Prospective cohort study on acute toxicity, quality of life, and cosmesis in patients treated with moderate hypofractionated radiotherapy following breast-conserving surgery.
Jose M, Sasidharan A, Kalavagunta S … +3 more , Vijaykumar DK, Pavithran K, Dutta D
J Cancer Res Ther · 2025 Oct · PMID 41474562 · Publisher ↗
BACKGROUND: The aim of this study was to report the acute toxicity, quality of life (QoL), and cosmesis in patients treated with moderate hypofractionated radiotherapy following breast-conserving surgery. MATERIALS AND M...
BACKGROUND: The aim of this study was to report the acute toxicity, quality of life (QoL), and cosmesis in patients treated with moderate hypofractionated radiotherapy following breast-conserving surgery. MATERIALS AND METHODS: This prospective cohort study included consecutive female breast cancer patients who underwent adjuvant moderate hypofractionated radiotherapy following breast-conserving surgery from April 2021 to October 2022. Acute toxicity was documented using the Radiation Therapy Oncology Group (RTOG) criteria and Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 (NCI). At baseline, 3 months, and 6 months, QoL was documented using the European Organization for the Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ). C30 and BR-23, and cosmesis was assessed using the Harvard Cosmesis Scale. RESULTS: Two hundred and eleven patients were included, among whom 149 (71%) were treated with three-dimensional conformal radiotherapy (3DCRT) and 62 (29%) with image-guided radiotherapy (IGRT). Twenty patients (9.5%) had Grade 2 skin reaction, and one patient (0.5%) had Grade 3 skin reaction. Skin toxicity was not significantly different between 3DCRT and IGRT (P = 0.20). At baseline, the worst QoL scores were sexual function, emotional function, upset by hair loss, and fatigue. All QoL scores improved at 3 and 6 months, except the mean breast symptom score, which slightly worsened at 3 months, then improved at 6 months. The mean Global Health Status Score at baseline was 69.87 ± 12.76 and improved to 85.89 ± 9.45 at 6 months (P < 0.001). Fourteen patients (6.6%) had a change in cosmesis to "fair" at 6 months. CONCLUSION: Significant acute skin reactions are less after moderate hypofractionated breast radiotherapy, and cosmesis is good to excellent in the majority of patients. Overall QoL is not affected and is preserved after radiotherapy.
Thyroid gland metastasis: A diagnostically challenging entity.
Mathur P, Rana C, Agarwal S … +4 more , Makkar I, Nigam N, Ramakant P, Mishra A
J Cancer Res Ther · 2025 Oct · PMID 41474561 · Publisher ↗
BACKGROUND: The thyroid gland is a richly vascularized organ, yet it is a rare site for metastasis. Metastasis can sometimes mimic certain primary thyroid malignancies morphologically, thus making the diagnosis and manag...
BACKGROUND: The thyroid gland is a richly vascularized organ, yet it is a rare site for metastasis. Metastasis can sometimes mimic certain primary thyroid malignancies morphologically, thus making the diagnosis and management decision a challenge. The present multi-institutional study highlights these challenges with an aim to discuss the diagnostic approach in such scenarios. MATERIAL AND METHODS: A retrospective multi-institutional study conducted in three high-patient input tertiary care centers from north India. Clinically proven cases of metastasis to the thyroid gland were retrieved and relevant slides were reviewed. RESULT: A total of 16 cases of thyroid gland metastasis were included, which constituted 3.8% of all thyroid malignancy and 0.7% of all thyroid resection specimens. Synchronous metastasis was encountered in 43.7% of the cases. Lung was the most common primary site of metastasis with squamous cell carcinoma being the most common morphological variant. Thyroglobulin, TTF-1, calcitonin, CK7, CK20, and Ki 67 were the most commonly used immunohistochemical markers. Two interesting cases with metastasis from carcinoma cervix and leiomyosarcoma uterus were also documented. Follow-up details were available on ten cases of which nine had died due to complications related to metastasis. CONCLUSION: Metastasis to the thyroid gland is an exceedingly rare phenomenon and can be difficult to differentiate from primary thyroid malignancy based on clinical presentation especially when the primary site is unknown. The cytomorphological features may also be diagnostically challenging. Detailed clinical and radiological information combined with astute analysis of morphological features as well as the judicious application of immunomarker panels may be valuable. Patient prognosis and management are greatly influenced by early diagnosis and differentiating metastasis from primary malignancies.
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