The incidence and intensity of schistosomal infection in 50 African malignant bladders determined by quantitative analysis have been compared with a matched control group of nonmalignant cadaver bladders, and the incidence of radiological calcification in the former has been compared with that of 50 adult urinary bilharziasis patients without associated malignancy. Compared with 45% in the non-malignant group, schistosomal infection was present in an overwhelming 94% of the malignant cases. Radiological calcification in the malignant bladders (38%) was slightly more than in patients with urinary bilharziasis (35%). In the majority of the malignant bladders (55.3%) the parasitic infection was noted to be of moderate to low intensity. It has been suggested that the overall severity of schistosomal infection is unlikely to be the sole factor in the pathogenesis of carcinoma of the urinary bladder.

Background The present study summarizes the results of treatment in the form of disease-free survival and overall survival in bulky stage IB2 and locally advanced (stages II-IVA) squamous cell carcinoma of the uterine cervix. The treatment has been given in the form of NACT followed by CCRT in one arm and CCRT in the other arm. The grade 3/4 hematologic toxicities were more in the NACT group than CCRT (p \ 0.001) while the non-hematological toxicity was not significant; the TPF group experienced more toxicity than PF (p = 0.029). This treatment regimen is feasible as evidenced by the acceptable toxicity of NACT and by the high compliance to radiotherapy. The grade 3/4 hematologic toxicities were more in NACT groups than CCRT (p \ 0.001); the TPF group experienced more toxicity than PF (p = 0.029). Materials and Methods

Aim: Aim of this study was to compare dosimetric parameters of bone marrow (BM) and non bone marrow sparing with state of the art technique image guided volumetric modulated arc therapy in the treatment of Carcinoma Cervix. Methods and Materials: The retrospective Dosimetric study was conducted on 10 consecutive patients of biopsy-proven invasive cervical cancer attending the outpatient department of Geetanjali cancer centre. For treatment planning, patients were scanned on a GE Optima-520, 16 slice fan-beam CT (FBCT) scanner with 2.5 mm slice thickness in the supine position on a customized vacuum cushion with simulation tattoos and alignment lasers. All the simulation scans were taken after following a bladder and bowel preparation protocol, aimed at an empty rectum and full bladder, starting prior to the initial planning scan and continuing throughout the treatment. The prescribed dose to PTV was 50Gy in 25 fractions (2Gy/fraction) and from second week of radiotherapy 50mg/m 2 /week cisplatin chemotherapy was administered for five weeks. Two sets of plans were generated for all the 10 patients using Volumetric Arc Radiotherapy (VMAT) in Monaco v 5.11.02(Elekta, Crawley, UK) treatment planning system. Keeping all constraints in mind planning optimization was performed with no compromise in coverage of PTV. Results: In the present study V5 , V10 , V20 , V30 were all significantly lower in BMS-IG/VMAT plan. Maximum significance was noted at V20. Value of V40 is lower in BM-IG/VMAT plan, but statistically not significant. Conclusion: Treatment of carcinoma cervix is restricted as a result of toxicity of the surrounding normal structures and HT. HT could be significantly reduced by bone marrow sparing, which could be aided by IGRT/VMAT. This modality could allow completion of treatment with prescribed dose and concurrent chemotherapy in allotted stipulated time. More prospective randomized control trials are needed, to prove its efficacy.

The study concludes that this "octa shot" is an effective palliative radiotherapy schedule. With a decreased duration of hospital stay, it is also favorable for outpatients.

Neoadjuvant chemotherapy followed by concurrent chemoradiation is feasible and produces impressive disease-free and overall survival. This protocol is especially helpful for busy cancer centers with long waiting lists on radiotherapy machines.