Objectives To evaluate local disease control and early complications of concomitant brachytherapy with external beam-radiotherapy in early stage carcinoma cervix. Methods Fifty patients of early stage carcinoma cervix (FIGO-IB/IIA) were randomly divided into study group concomitant external beam irradiation (EBRT) and HDR-ICBT (intra-cavitary brachytherapy, xrt = 50 Gy/25 Fr, HDR 5.2 Gy*5 Fr) and the control group EBRT followed by HDR-ICBT (xrt = 50 Gy/25 Fr, HDR 7.5 Gy*3 Fr). Acute reactions and local disease response were compared between treatment and at 6-month follow up. Results Median overall treatment times were 38 and 61 days in the study and the control groups, respectively. Acute skin reactions and diarrhea were more in the study but manageable. At the completion of the study, there were 80 and 68 % complete responses, 16 and 20 % partial responses, 0 and 8 % stable diseases in the study group and the control group, respectively.
Objective: To compare internal target volume (ITV) generated using population-based displacements (ITV_study) with empty and full bladder scan fusion (ITV_EBFB) for organ-at-risk (OAR) doses during adjuvant intensitymodulated radiation therapy (IMRT) for cervical cancer. Methods: From January 2011 to October 2012, patients undergoing IMRT were included. CT simulation was carried out after inserting vault markers. Planning target volume (PTV)_EBFB received 50 Gy per 25 fractions. Pre-treatment megavoltage CT (MVCT) was performed. MVCTs were registered using bony landmarks with Day 1 MVCT. Displacement of the centre of mass of markers was measured along each axis. Directional ITV was calculated using mean 6 2 standard deviations (SDs) (ITV_study). Replanning was performed using PTV study, and OAR doses were compared with PTV_EBFB using Wilcoxon test.Results: A total of 348/386 data sets were evaluable for 16 patients. The median vaginal displacement was 1.2 mm (SD, 1.3 mm), 4.0 mm (SD, 3.5 mm) and 2.8 mm (SD, 3.3
Introduction: Postdated pregnancy is defined as pregnancy extended beyond 40 weeks of gestation or 280 days. FIGO and WHO defined post term pregnancy as a pregnancy which has gestational length of 294 days or more, Post term pregnancy is defined as pregnancy that has extended to or beyond 42 weeks of gestation, or estimated date of delivery (EDD)+14 days. Therefore we conducted this study to evaluate fetomaternal outcome in post dated pregnancies. Material & Methods: This was a retrospective hospital based study conducted on 400 pregnant women beyond 40 weeks of gestational age from the period of November 2018 to October 2019. A detailed history and clinical examination were recorded in performa from hospital records. Data pertaining to the onset of labour, mode of delivery, caesarean section due to fetal distress/ meconium stained liquor birth weight, Apgar score at 1minute and 5minute,NICU admission and perinatal death were analysed. The data obtained were entered in Microsoft excel and were analysed using appropriate statistical test (chi square test). P value of <0.05 was taken as significant. Results: Majority of cases belonged to rural area where total 57.3% cases were found while 171(42.7%) cases belonged to urban area. 184(46%) cases were booked and 216(54%) cases were unbooked. 260(65%) cases were referred from other centers, 140(35%) cases were not referred. 253(63.3%) cases were primigravida, 87(21.8%) cases were second gravida and 14.9% cases were multigravida.As a induction of labour oxytocin was used in 126(31.5%)cases, CP gel was used in 73(18.3%) of cases while miso was used in 26(6.5%) of cases. Conclusion: Maternal morbidity increased in the form of emergency LSCS, postpartum hemorrhage, instrumental deliveries, as the gestational age increased beyond 40 weeks. Maternal and fetal morbidity and mortality can be reduced by electively inducing pregnant women at 40 weeks as allowing them to continue beyond this gestational age has shown adverse feto-maternal outcomes. Keywords: Fetomaternal, LSCS, Maternal Morbidity
Background: Brain metastases are unfortunate consequences frequently found in patients with advanced cancer. The prognosis is poor with an average expected survival time of <6 months by all possible efforts (including radiotherapy). This retrospective study aims to determine survival and prognostic factors in patients with brain metastases who underwent whole brain radiotherapy (WBRT). Materials and Methods: From January 2005 to August 2010, a total of 186 patients with brain metastasis was analyzed with the help of available medical records. Of these, 140 patients who received WBRT ± chemotherapy were included in this study. The prognostic factors evaluated for overall survival were age, gender, Eastern Cooperative Oncology Group performance status, number of lesions, primary tumor site, extracranial metastases, chemotherapy, and radiotherapy. Results: The median overall survival was 4 months (95% confidence interval: 3.56-4.43), while 1-and 2-year survival rates were 8.57% and 3.57%, respectively. The most common primary tumor sites were the lung (n = 82; 44.08%) followed by the breast (n = 46; 24.73%), kidney (n = 11; 5.91%), and unknown primary (n = 11; 5.91%). The median overall survival was maximum (4 months) in patients with breast cancer. The 1-year overall survival rate was 8.57% (n = 12) for the whole group and 18.2% (6/33) in breast cancer patients (P = 0.058). In this study, the patients with higher performance status (P = 0.199), solitary brain metastasis (P < 0.0001), female (P = 0.201), and primary tumor under control (P = 0.223) had better survival. Conclusion: This study suggests that overall prognosis of patients with brain metastasis remains to be poor, 1-year survival being <10%. Patients with solitary metastasis and carcinoma breast have comparatively better prognosis.
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