Objectives: In our study, radiation of a higher dose per fraction (2.75 Gy/fraction, total dose of 55 Gy/20 fractions/4 weeks) with concomitant chemotherapy was compared with conventional chemoradiation (2 Gy/fraction, a total dose of 66 Gy/33 fractions/6 and half weeks, with concomitant chemotherapy), in patients of locally advanced squamous cell carcinomas of head and neck in terms of efficacy and toxicities. Methods: A total of 75 patients registered at the Department of Radiotherapy, NRS Medical College and Hospital, Kolkata, were allotted in two arms chronologically in a 1:1 ratio. Arm A – Patients received hypofractionated radiotherapy, 55 Gy/20 fractions in 4 weeks with concomitant weekly cisplatin (40 mg/m2). Arm B – Patients received conventional radiotherapy, 66 Gy/33 fractions in 6½ weeks with concomitant weekly cisplatin (40 mg/m2). Results: Both in terms of efficacy and toxicities, the hypofractionation arm was comparable to the conventional arm, and no statistically significant difference was present between the arms. For the study arm, complete response was 56.6%, partial response was 36.6%, and for control arm, complete response 50% and partial response 37.5% (p=0.750). In terms of acute toxicities and late dysphagia, both the arms were almost similar. Conclusion: The hypofractionated regimen was associated with tolerable acute and late toxicities and satisfactory local control. Considering the patient load, the overall treatment time, and the cost of hospital stay, this hypofractionated regimen is a good treatment option in our low-resource setup.

Objectives: Medullary breast carcinoma is a very rare subtype of invasive ductal carcinoma breast which accounts for about 1–7% of all breast carcinoma. The natural history of this uncommon histological subtype is unknown because of the lack of adequate reported data in the literature and the rare variety of this tumor. In our retrospective analysis, we have tried to identify demographic clinicopathological features and treatment outcomes of this rare subtype. Methods: Between January 2012 and December 2017, total of 1271 breast carcinoma cases were identified, and clinic pathological, demographic profile, and treatment received were recorded from the medical records file. American joint committee on Cancer tumor, node, and metastasis system was used for staging. Results: Out of 1271 breast carcinomas, 19 histologically confirmed medullary carcinoma cases were identified and constitute about 1.5% of the total case. About 78% of patients were with Stage II and Stage III disease at the time of diagnosis. Eleven patients were initially treated with MRM followed by adjuvant chemotherapy and radiotherapy. Eight patients received neoadjuvant chemotherapy followed by surgery and radiotherapy. In addition to cytotoxic chemotherapy, two patients received trastuzumab also. None of the patients received hormone therapy as all the patients were hormone receptor-negative. Conclusions: Out of all invasive carcinoma, approximately 1.5% of cases were medullary carcinoma. About 90% of cases were triple-negative. Triple-negative breast cancer is usually associated with poor outcomes but medullary carcinoma despite being triple-negative, patients with medullary carcinoma have a good chance of long-term survival.

Objectives: The importance and relevance of double primary are increasing with time as the increasing use of advanced diagnostic investigation and an increasing number of cancer survivors lead to an increase in double primary malignancy. Methods: We have collected data retrospectively from our own departmental patient’s record section from January 2011 to December 2021. All the details such as histopathology of both the malignancy, site of primary and secondary cancer, the time gap between the two cancer, clinical stage, and treatment received, along with demographic details have been recorded. Patients are divided into two categories either synchronous or metachronous when a second tumor develops either simultaneously or within 6 months of the diagnosis of the first tumor or 6 months after the diagnosis of the primary malignancy, respectively. Results: The total number of registered cases in one decade at our institute was 25,638 and among them were 41 double primary cases (0.16%). Twenty-two cases were metachronous (59%) and 19 cases (41%) were synchronous double primary. The most common site of double primary site was the head and neck region (38 %) followed by the lung, and esophagus (13% each), and the least common site was the colon (<1%). In the case of metachronous double primary, the mean time interval (the time gap between two cancer devolvement) was 7.4 years with a range of 2–19 years. The majority of the patients are treated with curative intention. Conclusions: The incidence of double primary is increasing over time. The management of double primary should be supervised by a multidisciplinary tumor board and more research is needed in the areas of epidemiology and treatment.