Background: For carcinoma breast patients requiring post mastectomy radiation therapy (PMRT), tangential photon beam (PB) is commonly used technique. The physical nature of electrons results in sharp dose fall off and reduces organs at risk (OAR) doses. Aim of the present study is to compare the coverage of chest wall and doses received by OARs – heart and lung between electron and photon beam plans in left sided breast cancer patients requiring PMRT.Methods: This study was done in 22 left sided carcinoma breast patients treated at GSL Medical College between May to December 2017. Both tangential PB plans and electron beam (EB) plans were generated on simulation computed tomography (CT) for each patient and both plans were compared. A dose of 50 Gy was prescribed to planning target volume (PTV) in 25 fractions.Results: The PB plans provided superior homogeneity index (HI) and conformity index CI compared to the EB plans (p<0.05). There was significant difference in favour of electron-beam plans for mean heart dose (p=0.0312), V25 Gy (p=0.029), V45 Gy (p=0.001) and V20 Gy of left lung (p=0.042). There was no significant difference in mean lung dose.Conclusions: Dosimetric data from this study suggests that PMRT with the electron beam can reduce doses to the heart and left lung with acceptable target coverage. It needs further research in the clinical setting.

Background: Gliomas are the most common tumors that develop from glial cells in the brain. As per WHO classification, grade III (high-grade) gliomas are usually treated by surgery followed by radiotherapy. Concurrent and adjuvant chemotherapy with temozolomide (TMZ) is showing new hope in the management.Methods: Prospective study was conducted in 20 WHO grade III glioma patients at GSL medical college and general hospital for a period of 2 years (August 2019 to July 2021) to evaluate the role of concurrent and adjuvant TMZ with radiation in the treatment of grade III gliomas. The primary objectives of the study were to determine toxicity and response rates in our set of patients. The secondary objectives were to determine progression-free survival and overall survival.Results: Majority were males (80%) in the age group of 30 to 49 (75%). 40% of gliomas were in the temporal lobe. Headache was the most presenting symptom (60%) followed by seizures (35%).70 to 80 Karnofsky performance status/ KPS score was seen in 70% of cases. None of the patients in the study had grade 3 or 4 toxicities. 40% had a complete response according to MacDonald’s criteria. At a median follow-up of 10 months, 25% of patients had disease progression and 1yr overall survival was 95%.Conclusions: TMZ combined with radiation was well tolerated in our set of patients with grade III gliomas without any significant toxicity.