BACKGROUND Brain metastasis are a major cause of mortality and morbidity in cancer patients. Most common primary sites are lung, breast, malignant melanoma and kidney. Whole brain radiation treatment has remained the treatment of choice for brain metastasis. Though it provides early symptomatic relief, survival is limited to 3-6 months. AIM To study the effect of radiation on relief of symptoms and on the survival of patients with brain metastasis, also analysing the incidence of brain metastasis from different primary sites. METHODS This study was conducted in Radiotherapy department of Government Medical College, Calicut during 1997-1999, involving 50 patients with radiologically proven brain metastasis. All patients received whole brain radiation treatment to a dose of 3000 cGY /10 F/2 weeks and were analysed for symptomatic relief and survival. RESULT About ¾th of the patients obtained symptomatic relief within 2 weeks after starting radiation treatment. 72% of patients survived upto 6 months after radiotherapy. CONCLUSION External beam irradiation to whole brain in the dose of 3000 cGY/10F/2 weeks is an effective method of treatment of brain metastasis both in terms of early symptomatic relief and survival.

INTRODUCTION Mediastinum is a site for neoplastic and non-neoplastic lesions and many of them present as mediastinal mass. The location and composition of these lesions are critical in arriving at a clinical diagnosis. This study of different mediastinal masses is aimed to find out frequency of malignancy, their compartmental distribution and characteristics through computed tomography. MATERIALS AND METHODS A prospective study was conducted at Government Medical College, Thrissur, India, during the period 2010-2012 with a total of 50 patients with suspected mediastinal masses. All patients were subjected to investigations like chest X-ray, CT scan along with guided fine needle aspiration/biopsy for definite tissue diagnosis. The major variables were age, clinical symptoms, mass location, imaging studies, and tissue pathology. RESULT Fifty patients enrolled in this study were analysed and compared with existing studies in the literature. 34 cases (68%) were malignant and 16 cases (32%) were benign. Majority of the lesions were seen in the anterior compartment, followed by posterior compartment. Bronchogenic carcinoma and lymphoma were the common malignant tumours seen in the anterior and middle compartments of the mediastinum, whereas neurogenic tumours, mostly benign, were the common tumours in the posterior compartment. CONCLUSION CT scan is an effective tool in evaluating mediastinal masses. Moreover, sampling the mass is important in obtaining pathological diagnosis. Surgery, radiotherapy and chemotherapy either as single or in combination are the main modalities of treatment. Accurate preoperative pathological diagnosis, invasion and infiltration of the tumour were the key to successful treatment.

BACKGROUND Multiple myeloma is a plasma cell neoplasm that accounts for about 10% of haematological malignancies. It is characterised by a single clone of plasma cells producing a monoclonal protein (M protein), which results in end-organ damage resulting in hypercalcemia, renal insufficiency, anaemia, and skeletal lesions. Multiple myeloma is classified as high-risk or standard-risk disease based on fluorescence in situ hybridisation (FISH), metaphase cytogenetics and the plasma cell labelling index. MATERIALS AND METHODS A prospective study was conducted at Government Medical College, Thrissur, India during the period 2014-2015 with a total of 30 patients with newly diagnosed multiple myeloma. All patients were subjected to investigations like complete haemogram, ESR, serum calcium level, renal function tests, serum protein electrophoresis, β2 microglobulin level, bone marrow trephine biopsy and skeletal survey. RESULTS Thirty patients enrolled in this study were analysed and compared with the existing studies. The commonest symptom was bone pain due to lytic bone lesions, seen in 73.3% of patients. Only ten patients (33%) presented with stage 1 disease, while about 60% of the patients were in the third stage of the disease, having poor prognosis, which indicates the multiple myeloma is in the late stage of the disease. β2 microglobulin was increased in 60% of patients. CONCLUSION In this study, about 60% of the patients are having poor prognostic features such as stage 3 disease, raised β2 microglobulin, more than three lytic bone lesions. The initial staging can be quantitatively related to follow up, using tumour cell mass changes and changes in M component production. So, use of the clinical staging system provides better initial assessment and follow up of individual patients. The current approach to the diagnosis, staging, and prognosis is reviewed.