Aim: This retrospective study in geriatric patients was done to analyze the toxicity profile and their tolerance to radiation therapy. Materials and Methods: A total of 222 patients from January 2019 to May 2022 with histopathologically proven carcinoma, who underwent radiotherapy (RT) on linear accelerator 6MV machine were included in the study with different techniques. We have searched patient's RT details in the records division of our institute and observations were noted down. Patients who received 50–70 Gy/30–35 fractions in radical or adjuvant setting were included. Results: Two hundred and twenty-two patients with age >65 years were included in the study of which 84% received curative treatment and 16% patients received adjuvant treatment. Ten (4.5%) patients were diagnosed the cases of brain tumors and the observed toxicities were three (30%) patients developed headache, rest of the patients experienced symptoms such as dizziness, one (10%) patient had quadriplegia, and one (10%) patient had mild cognitive disturbance. In head-and-neck cancers, 55 (24.7%) patients had Grade I mucositis and oral pain, 25% had Grade II mucositis, and 36% suffered Grade II oral pain. One patient had Grade IV oral mucositis and pain. Forty-one percent patients experienced gastrointestinal (GI) toxicity out of which 40% of anorectal patients had Grade I/II toxicities. Seven patients experiencing abdominal pain out of which three patients were diagnosed cases of anorectum and the rest were cervical cancer patients. Dysuria was reported in all the 11 patients of prostatic cancer and 9 bladder carcinoma patients. One patient had Grade III dysuria. Vaginal dryness Grade I was reported in five patients of endometrial carcinoma. 19% reported continuation of vaginal hemorrhage, 33% had Grade II vaginal discharge, and one patient had Grade III vaginal discharge associated with foul smell. Forty-one percent patients experienced GI toxicity out of which 40% of anorectal patients had grade–I/II toxicities, despite toxicity patients completed the treatment. Rest 60% of patients were cervical cancer patients, and in these patients, two cases of cervical carcinoma with vulva developed moist desquamation of localized skin. 27 patients with breast cancer, 44% of whom experienced low grade breast pain and ipsilateral arm pain after surgery. Conclusions: Our study shows that severity of toxicity is not directly proportional to age and the decision of radiation therapy in elderly cancer patients should not be limited to or compromised in a curative setting. The performance status as well as the extent and severity of comorbidity should be considered. The optimal risk benefit ratio should be assessed and discussed in detail with the family before decision.

Context: Adult medulloblastomas are very rare and constitute only 1% of the central nervous system tumors in adults. CSI treatment is challenging in adults due to the long, irregular target volume, critical structures, and field matchings due to multiple fields. Aims: This retrospective dosimetric study of adult patients who underwent Craniospinal irradiation was done to get insight into the challenges in the treatment and advantages of using RapidArc technique. Materials and Methods: The computed dosimetric rapid arc planning data of 3 adult cases who underwent Craniospinal irradiation between November 2018 and June 2021 were studied. Results: In our study mean conformity index (range) was 0.95 (0.91–1) and Mean homogeneity index (range) was 0.11 (0.06–0.15). Mean dose to the lenses, lungs, heart, and kidneys was 6.4 Gy, 9.4 Gy, 5 Gy, and 7 Gy, respectively. Conclusions: Volumetric modulated arc therapy technique for Craniospinal irradiation gives conformal dose distribution within the target, better normal tissue sparing, and more homogeneous dose distribution in the field junctions without the need to move the junction.

Context: The COVID-19 pandemic has posed a big challenge to provision of health care. Cancer patients are considered to be at higher risk of developing complications from COVID-19 as they are often immunosuppressed. At the same time, treatment delays and late diagnosis during the pandemic due to travel restrictions, staff shortage, active COVID infections to patients or family members, etc., can lead to tumor progression and poor oncological outcomes. Aims: This retrospective observational study was undertaken to know the effect of the corona pandemic and consequent lockdown on the radiation treatment of oncology patients in our department. Materials and Methods: Subjects of the study were the patients who attended the Oncology Department of Kamineni Academy of Medical Sciences, Hyderabad, which is a tertiary care center, during the COVID-19 pandemic. The study period was 6 months starting from the lockdown on April 24, 2020. Results: In our study, treatment of 16 out of 150 patients (10.67%) was affected due to the lockdown situation consequent to COVID-19 pandemic. Eight patients had treatment interruptions for more than 5 days, six patients discontinued their treatment, and two patients delayed their treatment due to lockdown. Eight patients tested positive for COVID-19 before starting treatment. Out of them, four did not come back for treatment. The mean delay in radiation treatment in the other four patients was 35 days. Two patients had CORAD scores consistent with COVID-19 but were reverse transcription–polymerase chain reaction negative. Two patients turned positive during treatment after which they did not come back. Totally 9.3% (14/150) of the patients' treatment was affected due to corona infection. Conclusions: In our study, almost 20% of the patients' treatment was affected directly or indirectly by the COVID-19 pandemic situation. This in turn may lead to rise in cancer mortality in future.