No abstract

No abstract

Background: Craniospinal irradiation (CSI) of medulloblastoma poses technological challenges due to the involvement of large treatment volume. Commonly, the whole treatment length is covered with two different isocentric plans in which the junction is shifted after every five fractions to overcome the possibility of hot and cold spot.Objective: This study aims to evaluate dosimetrically and clinically the innovative planning technique for the CSI which doesn’t need re-planning and re-setup of patients after every five fractions.Material and Methods: Computed tomography was done for fifteen (ten children and five adults) patients diagnosed with medulloblastoma. Treatment planning for 36 Gray (Gy) in 20 fractions (#) at the rate of 1.8Gy/# was done on the treatment planning system. A single plan for children was created with two bilateral fields of 6 Mega Voltage (MV) energy for cranium and one posterior field of 6 MV for spinal cord (C1-S2). Two plans for adult patients were created, first plan was with two bilateral fields of 6 MV for cranium and two posterior oblique fields of 6 MV for cervical and the part of thoracic spinal cord (up to T8-T9). The second plan was with a single posterior field of 15 MV covering remaining thoracic (T8-T9 to T12), lumbar and sacrum (up to lower border of S2) spine. After careful evaluation of all the plans, treatment was delivered; acute toxicities were recorded.Results: 95% of prescribed dose was received by more than 95% of planning target volume in all the plans with the acceptable hot spot and good homogeneity index. All the patients reported common radiation induced acute toxicities (headache, vomiting, weakness) during radiotherapy.Conclusion: The new planning technique for CSI has acceptable dosimetric and acute clinical possibilities; therefore it can be used for CSI for improved homogeneous dose delivery.

Introduction:The Human immunodeficiency virus (HIV) infection remains a serious public health concern in India and around the world at large. Malignancy is frequent among people living with HIV (PLWH) has become the leading cause of death. The incidence of malignancy among PLWH depends on various factors; virological control under combined antiretroviral therapy (cART), the exposure to oncogenic virus is of utmost importance, which can be prevented with the implementation of specific screening programs. Drug-drug interactions between cART and oncologic treatments can lead to serious adverse effects or to a reduction in the therapeutic effects requiring close monitoring. Methods: This is a single center retrospective study conducted on 42 seropositive patients attending a tertiary care oncology department from July 2005 to June 2021 to assess the demographic profile; laboratory investigations, clinico-pathological correlation, treatment outcome and survival follow up. Results: A total of 26410 patients were registered in the department during this period, out of which 42 (0.16%) were found to be HIV positive. These included head & neck -13; uterine cervix-7; lung -4; esophagus-4; NHL-4; recto sigmoid -3; breast-3; gall bladder; endometrium, choriocarcinoma (CCA) and acute myeloid leukemia (AML) one each. Conclusion; Seropositive patients often present in advanced stage of disease but have a good prognosis if treated appropriately with anti-retroviral therapy (ART). Very few studies have been published in India regarding the incidence of malignancy in HIV patients credited as one of the largest study published till date.

Background -Primitive neurocetodermal tumor / Ewing's sarcoma (PNET/ES) of uterine cervix is extremely rare tumor and only 27 cases have so far been reported in the literature. We hereby present one case report diagnosed by histopathology and IHC and review of literature. Objective -A young girl aged 20 years was admitted. Her routine investigations and CT and MRI scan of chest, abdomen and pelvis were performed. Biopsy was taken from vaginal mass and histopathologist reported as round cell tumor. The slides were reviewed by another pathologist and found to be rhabdomyosarcoma. Thus immunohistopathology was done and a diagnosis of PNET/ES was established. Methods -The patient presented with complains of vaginal bleeding, generalized body ache, poor nutritional intake, found extensive loco regional disease with metastases to liver, lung and multiple bones, stage FIGO IV, performance score ECOG -4. Owing to her low general condition, we could not plan any anti-cancer treatment like chemotherapy or radiation therapy. She was discharged on symptomatic treatment. Results -Her biopsy and immunohistopathology turn out to be PNET/ES of uterine cervix. Conclusion -The rarity of this entity poses a challenge to pathologists and oncologists. The PNET/ES of uterine cervix can be potentially curable if presented at an early stage and found operable. IHC plays an important role in establishing this rare diagnosis.