post-operative pancreatic fistulae or delayed gastric emptying. There were no differences in median OS (32 vs 48 months, p = 0.86), median RFS(16 vs 36 months, p = 0.17), or patterns of recurrence (local, regional, or distant) between MD and PD tumors. Conclusions: Poorly differentiated PDAC is characterized by more frequent or persistent perineural invasion relative to moderately differentiated tumors following preoperative therapy. However, tumor differentiation has no impact on postoperative patterns of local or distant tumor recurrence or the incidence or severity of post-operative complications.

No abstract

Cancer cervix is the most common malignancy in the developed country and one of the most curable disease. Radiation treatment is the mainstay treatment for carcinoma cervix. There is also long follow up noted. After radiation treatment, radiation related late side effects like cystitis, proctitis which are seen in regular practice but one radiation related side effect called pelvic insufficiency fracture which is not very common but one of the under diagnosed, misdiagnosed and mismanaged entity is observed. Here we are explaining this entity from diagnosis to treatment with review literature.

ABSTRACT:Here we are reporting a case of cemento ossifying fibroma (COF) of paranasal sinus in a 45 year female presented with large mass in maxilla and extraosseous component, pain and disfigurement due to facial asymmetry and planned for surgery as the surgery is the main stay of treatment, reviewed with surgical oncologist and it was unresectable because of large extensive mass. Then we planned for radiation therapy as there was no other option available. We reviewed with literature there was not a single case treated with radiation in human being but reports are available treated with radiation therapy in horses and in other animals. On the basis of animal case reports we treated with radiation therapy. After treatment patient was improved symptomatically and living for 2 years till today. Here we are reporting this case and this may be the first reported case treated with radiation therapy in human being as per the literature available.CASE DETAIL: 45 year old female presented with nasal obstruction, Facial swelling, Proptosis left eye [ Fig. 1], Pain due to expansion of tumour, duration of more than one year. CT scan showed Mass involving bilateral maxillary sinus, eroding the pterygoid plates, destruction of sphenoid sinus, involving the orbital cavity and pushing of right eye outwards [ Fig. 2]. Tumour volume on imaging was 250cc approx. biopsy of the tumour showed [ Fig. 5] cement ossifying fibroma. Because of huge mass, bony involvement, surgery was not feasible sent for radiation oncologist for opinion. Radiation planning was done by intensity modulated radiotherapy technique [ Fig. 3] with an aim of sparing the opposite optical apparatus. Plan evaluated with acceptable constraint specification planned for 50Gy in 25 fractions. Patient completed radiation therapy over 5 weeks and with dry desquamation of skin [RTOG grade II]. Patient planned for radiation and total dose delivered 50Gy @2Gy/# Over 5 weeks. Only primary treated and lymph node spared. Patient completed radiation with RTOG grade 2 skin reactions [dry desquamation]. There was no significant morphological change at the end of radiation. At 3 month follow-up Proptosis decreased, facial swelling came down [ Fig. 4], Patient was symptom free, planned for imaging, CT scan showed decrease in tumour volume to 170cc and planned for next visit after 3 months. At the end of the treatment the response evaluated morphologically and which is an insignificant response, then patient was kept under follow up. After 3 months the Proptosis decreased, pain was minimal and patient was better than before. CT scan volume revealed around 170 cc comparing pre radiation volume of 250cc.DISCUSSION: Cemento ossifying fibroma [COF] IS a bony origin of benign cause. [1] WHO classifies COF as a fibro-osseous neoplasm, included among the non-odontogenic tumors, derived from the mesenchymal blast cells of the periodontal ligament, and with a potential to form fibrous tissue,

JOURNAL/crsat/04.03/02201859-202306020-00008/figure1/v/2023-08-03T140821Z/r/image-tiff JOURNAL/crsat/04.03/02201859-202306020-00008/figure2/v/2023-08-03T140821Z/r/image-tiff Background: Interruptions in radiation treatment are known to have a deleterious effect on oncologic outcomes,specifically, an increase in tumor recurrence and decrease in cancer cure rate. Objectives: Our primary aim was to determine the factors influencing radiotherapy interruptions and provide solutions to decrease these dropouts. Materials and Methods: This was a retrospective observational study conducted between May 2009 and July 2010 at Mahatma Gandhi Cancer Hospital and Research Institute, a tertiary cancer center in Vishakhapatnam, Andhra Pradesh, India, on patients with histopathologically proven cancer, who were receiving radiation, either as definitive concurrent chemoradiation or in the adjuvant or palliative setting. Before the start and during treatment, patients were counseled by radiation oncologists, radiation coordinators, and radiation therapy technologists. During radiotherapy, an interruption of more than five consecutive days was considered a treatment interruption. Following a treatment interruption, patients were called on the telephone, counseling was done, and the cause of the treatment interruption was recorded and attempts were made to resolve the problem. Results: We enrolled 1200 patients in the study. There were more male (n = 724 [60.4%]) than female (n = 476 [39.6%]) patients. The cohort included 379 patients (31.6%) with carcinoma of the head-and-neck and 301 patients (25.1%) with gynecological malignancies. There were 100 (8.3%) treatment interruptions recorded during the study period. The common causes of radiation interruption were radiation-induced toxicity (n = 20 [20%]), patient death (n = 15 [15%]), financial (n = 15 [15%]), and social (n = 12 [12%]) issues. After counseling over the telephone, treatment could be restarted in 25 (25%) of the 100 patients who had interrupted and stopped radiotherapy. Conclusion: Treatment interruption is relatively common in our patients receiving radiotherapy. To prevent such dropouts and increase compliance to treatment, adequate and frequent counseling before and during radiation treatment is needed.