Academic literature on the topic 'Mouth Cancer Chemotherapy'
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Journal articles on the topic "Mouth Cancer Chemotherapy":
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Kalavrezos, Nicholas, and Crispian Scully. "Mouth cancer for clinicians part 12: cancer treatment (chemotherapy and targeted therapy)." Dental Update 43, no. 6 (July 2, 2016): 567–74. http://dx.doi.org/10.12968/denu.2016.43.6.567.
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Brown, Carlton G., Susan L. Beck, Douglas E. Peterson, Deborah B. McGuire, William N. Dudley, and Kathleen H. Mooney. "Patterns of sore mouth in outpatients with cancer receiving chemotherapy." Supportive Care in Cancer 17, no. 4 (October 7, 2008): 413–28. http://dx.doi.org/10.1007/s00520-008-0509-y.
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Earlam, S., C. Glover, M. Davies, C. Fordy, and T. G. Allen-Mersh. "Effect of regional and systemic fluorinated pyrimidine chemotherapy on quality of life in colorectal liver metastasis patients." Journal of Clinical Oncology 15, no. 5 (May 1997): 2022–29. http://dx.doi.org/10.1200/jco.1997.15.5.2022.
Abstract:
PURPOSE Since systemic and regional (HAI) fluorinated pyrimidine chemotherapies offer similar survival benefit in treatment of colorectal liver metastases (CLM), we sought to identify their impact on quality of life (QoL), which might be a useful indicator of treatment preference. METHODS We compared QoL in 135 CLM patients managed by symptom control (n = 49 patients), systemic fluorouracil (5FU)/folinic acid (n = 35), or hepatic arterial floxuridine (FUDR) (n = 51). Full blood count and liver function tests, World Health Organization (WHO) toxicity criteria, and QoL (Rotterdam Symptom Checklist [RSC], the Sickness Impact Profile [SIP], and the Hospital Anxiety and Depression scale [HAD]) were measured monthly in all patients. RESULTS The HAD anxiety score was significantly increased in symptom control compared with chemotherapy patients 1 month after randomization. There was a significant increase in RSC physical score (repeated measures, P = .05), and in scores for sore mouth (P < .01), dry mouth (P < .01), and tingling hands and feet (P < .01) in systemic chemotherapy compared with symptom control patients. Significant QoL differences (repeated measures and Mann-Whitney U [MWU]) between HAI and symptom control patients were not detected. Systemic chemotherapy patients lived for significantly longer (log-rank test, P < or = .0001) with abnormal HAD anxiety, RSC psychosocial, or RSC sore mouth scores compared with HAI patients, but there were no overall survival differences. CONCLUSION Randomization to symptom control only was associated with increased anxiety. QoL with systemic chemotherapy was impaired by side effects. HAI was associated with similar survival to systemic chemotherapy but with better sustained QoL.
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Loprinzi, C. L., C. Ghosh, J. Camoriano, J. Sloan, P. D. Steen, J. C. Michalak, P. L. Schaefer, et al. "Phase III controlled evaluation of sucralfate to alleviate stomatitis in patients receiving fluorouracil-based chemotherapy." Journal of Clinical Oncology 15, no. 3 (March 1997): 1235–38. http://dx.doi.org/10.1200/jco.1997.15.3.1235.
Abstract:
PURPOSE Stomatitis is a major dose-limiting toxicity of bolus fluorouracil (5FU)-based chemotherapy regimens, despite the use of oral cryotherapy. Pursuant to preliminary data that suggested a sucralfate oral solution could alleviate chemotherapy-induced oral mucositis, we developed a prospective trial to test this contention. PATIENTS AND METHODS A phase III, double-blind, placebo-controlled clinical trial was designed. Patients were entered onto the study at the time of the first cycle of 5FU-based chemotherapy. All patients received oral cryotherapy for 30 minutes with each dose of 5FU. In addition, each patient was randomized to receive either a sucralfate solution or a placebo solution to be used if they developed mouth tenderness or mouth sores. The study solution was to be used four times daily for 7 days starting on the first day of mouth tenderness or mouth sores. Stomatitis scores were determined by health care providers and by patients themselves. RESULTS There was a total of 131 assessable patients entered onto this trial, 50 of whom developed mucositis and used the study medication (27 sucralfate and 23 placebo). There was no suggestion of any difference in stomatitis severity or duration on either protocol arm. CONCLUSION The resultant data from this clinical trial did not support the prestudy hypothesis that sucralfate would be beneficial for the treatment of 5FU-induced stomatitis.
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Khairani, Sondang, Sesilia A. Keban, and Meyke Afrianty. "Evaluation of Drug Side Effects Chemotherapy on Quality of Life (QOL) Breast Cancer Patients at Hospital X in Jakarta." JURNAL ILMU KEFARMASIAN INDONESIA 17, no. 1 (April 24, 2019): 9. http://dx.doi.org/10.35814/jifi.v17i1.705.
Abstract:
Breast cancer is the number one cancer type discovered at women in the world. Most causes are genetic factors and hormonal factors. One cancer treatments with chemotherapy. Chemotherapy drugs active in cells dividing and reproducing, but cells normally to be affected by chemotherapy and side effects from chemotherapy drugs affect quality of life. The aim of the study to evaluate side effects of chemotherapy drugs on the quality of life of breast cancer patients. Sampling technique observational prospective breast cancer patients with completed the chemotherapy cycle from September 2017 to April 2018 with descriptive analysis and statistics by looking correlation between drug side effects and Quality of Life (QoL). Results of the study were side effects of fatigue 100%, nausea 67,5%, vomiting 60%, no appetite 63,75%, fever 42,5%, joint pain 43,75%, diarrhea 16,25%, difficulty swallowing 16,25%, allergies 5%, itching 1,25%, mouth sores 3,75%, swollen right hand 1,25%, constipation 3,75%. QoL results are physical 6,2%; psychology 5,3%; social 4,9%; spiritual 6,8%. Results of Sperman test showed no correlation between the side effects of chemotherapy and QoL P> 0,05. This study shows that there is no relationship between the side effects drug chemotherapy and QoL in breast cancer patients.
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El –Housseiny, Azza, Susan Saleh, Ashraf El –Masry, and Amany Allam. "Assessment of Oral Complications in Children Receiving Chemotherapy." Journal of Clinical Pediatric Dentistry 31, no. 4 (July 1, 2007): 267–73. http://dx.doi.org/10.17796/jcpd.31.4.cq752m6173142r28.
Abstract:
The aim of this study was to assess the early oral complications in pediatric patients receiving chemotherapy. An interview and oral examination was conducted on 150 pediatric cancer patients receiving standard dose chemotherapy. Results showed that oral pain and dry mouth were the most frequent patients' complaints. The prevalences of chemotherapy-induced oral mucositis and oral infections were relatively high. The chemotherapeutic antimetabolites were the most frequently associated with oral complications than other types of chemotherapy. The present results indicate that the oral complications among patients receiving chemotherapy are common
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Yang, James Chih-Hsin, Vera Hirsh, Martin Schuler, Nobuyuki Yamamoto, Kenneth J. O'Byrne, Tony S. K. Mok, Victoria Zazulina, et al. "Symptom Control and Quality of Life in LUX-Lung 3: A Phase III Study of Afatinib or Cisplatin/Pemetrexed in Patients With Advanced Lung Adenocarcinoma With EGFR Mutations." Journal of Clinical Oncology 31, no. 27 (September 20, 2013): 3342–50. http://dx.doi.org/10.1200/jco.2012.46.1764.
Abstract:
Purpose Patient-reported symptoms and health-related quality of life (QoL) benefits were investigated in a randomized, phase III trial of afatinib or cisplatin/pemetrexed. Patients and Methods Three hundred forty-five patients with advanced epidermal growth factor receptor (EGFR) mutation–positive lung adenocarcinoma were randomly assigned 2:1 to afatinib 40 mg per day or up to six cycles of cisplatin/pemetrexed. Lung cancer symptoms and health-related QoL were assessed every 21 days until progression using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Lung Cancer-13 questionnaires. Analyses of cough, dyspnea, and pain were preplanned, including percentage of patients who improved on therapy, time to deterioration of symptoms, and change in symptoms over time. Results Questionnaire compliance was high. Compared with chemotherapy, afatinib significantly delayed the time to deterioration for cough (hazard ratio [HR], 0.60; 95% CI, 0.41 to 0.87; P = .007) and dyspnea (HR, 0.68; 95% CI, 0.50 to 0.93; P = .015), but not pain (HR, 0.83; 95% CI, 0.62 to 1.10; P = .19). More patients on afatinib (64%) versus chemotherapy (50%) experienced improvements in dyspnea scores (P = .010). Differences in mean scores over time significantly favored afatinib over chemotherapy for cough (P < .001) and dyspnea (P < .001). Afatinib showed significantly better mean scores over time in global health status/QoL (P = .015) and physical (P < .001), role (P = .004), and cognitive (P = .007) functioning compared with chemotherapy. Fatigue and nausea were worse with chemotherapy, whereas diarrhea, dysphagia, and sore mouth were worse with afatinib (all P < .01). Conclusion In patients with lung adenocarcinoma with EGFR mutations, first-line afatinib was associated with better control of cough and dyspnea compared with chemotherapy, although diarrhea, dysphagia, and sore mouth were worse. Global health status/QoL was also improved over time with afatinib compared with chemotherapy.
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Korytova, L. I., V. P. Sokurenko, E. A. Maslyukova, A. V. Meshechkin, N. D. Oltarzhevskaya, M. A. Korovina, I. V. Gusev, A. D. Kuznetsov, V. G. Krasnikova, and E. M. Obuhov. "EVALUATING THE EFFECTIVENESS OF THE COMBINED TREATMENT OF PATIENTS WITH COLORECTAL CANCER, BREAST CANCERAND CANCER OF THE FLOOR OF THE MOUTH USING A STERILE HYDROGEL MATERIAL "KOLEGEL 5-FTUR"." Russian Journal of Biotherapy 14, no. 4 (December 30, 2015): 99–103. http://dx.doi.org/10.17650/1726-9784-2015-14-4-99-103.
Abstract:
The article is devoted to the effectiveness evaluation of the use of sterile material «Kolegel 5-ftur» on the basis of sodium alginate with 5-fluorouracil, as of shape of disk, in the course of chemoradiotherapy in patients with rectal cancer, breast cancer and cancer of the floor of the mouth. The study group included 38 patients: 19 patients diagnosed with CRR, 10 patients -BC, 9 patients - a cancer of the mouth floor. The study used a hydrogel material «Kolegel 5-ftur» during chemoradia- tion therapy for histologically confirmed diagnosis of a malignant tumor. The effectiveness of the combined treatment is proved by the following criteria: local control of the tumor, the analysis of toxicity and immediate effect. Thus, the use of hydrogel materials «Kolegel-5-ftur» in group of patients with primary malignant tumor localization in the floor of the mouth, with the aggressive chemotherapy provided enhancing the effectiveness of therapy.
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CAETANO, Rafael da Silva, Paula Gabrielle de CASTRO, Paulo Henrique de Souza CASTRO, Alexandre Meireles BORBA, Álvaro Henrique BORGES, and Luiz Evaristo Ricci VOLPATO. "Limitation of mouth opening after radiotherapy for head and neck." RGO - Revista Gaúcha de Odontologia 64, no. 1 (March 2016): 24–29. http://dx.doi.org/10.1590/1981-863720160001000032923.
Abstract:
ABSTRACT Objective: To evaluate the ability to open the mouth in patients undergoing radiotherapy for head and neck and the variables related to this limitation. Methods: 32 patients were evaluated six months after completion of radiotherapy sessions to treat cancer in the head and neck. The maximum mouth opening was measured using digital calipers and its association with gender, age, smoking, alcohol consumption, tumor location, chemotherapy and surgery were analyzed using the Mann-Whitney and Kruskal-Wallis tests at a level of significance of 95%. Results: The mean age of patients was 60.44 years; 87.5% were male; 81.2% were smokers; 65.6% regularly consumed alcohol. The average mouth opening was 43.17 mm and seven (21.9%) patients had trismus. The most common locations of the tumors were the tongue (31.3%) followed by the larynx and vocal folds with five (15.6%) each. No association was found between limited mouth opening and the other variables. Conclusion: In this sample, 21.9% of patients had trismus six months after completing radiotherapy. The variables gender, age, smoking habits and alcohol consumption, tumor location, previous surgery and adjunctive chemotherapy were not associated with limited mouth opening.
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Wilson, S. Darsana, Chitra C. Nair, Christy Johns, Christy Mathew, Dani Joseph, and Precilla DSilva. "A Correlational Study on Taste Alterations and Quality of Life Among Cancer Patients." Journal of Health and Allied Sciences NU 11, no. 03 (April 15, 2021): 147–53. http://dx.doi.org/10.1055/s-0041-1726574.
Abstract:
Abstract Introduction One of the major problems faced by the world today is cancer. Cancer is an abnormal growth of cells. Chemotherapy, surgery, and radiation therapy are the treatment regimen for cancer. Prolonged use of chemotherapy drugs can cause different side effects such as alopecia, weight loss, sexual dysfunction, mood swings, and the most important one is taste alterations. The aim of the study is to determine the taste alterations (TAs) and quality of life (QOL) among cancer patients who have undergone three cycles of chemotherapy. Methods The approach used is descriptive survey design. The sample comprised 62 cancer patients selected by convenient sampling. The tool used was baseline proforma, University of Washington Quality of Life (UW-QOL) questionnaire version 4.1, chemotherapy-induced taste alteration scale (CiTAS). Results The majority of the patients belonged to the age group of 41 to 50 years (37.09%) among whom 40% were females. The majority of the patients were not diagnosed with any other disease (91.9%). Around 80.6% of patients reported to have sore mouth, out of whom 45.2% maintained oral care by brushing teeth. The most commonly seen type of tumor was head and neck (37.1%) whereas the tumor type genitourinary was the least seen (3.2%). The majority of the patients had stage II cancer (53.2%) and about 62% of them did not have metastasis. There is significant association with selected demographic variables and QOL (sore mouth, oral care, and tumor type). There is also a significant association with selected demographic variable and TAs, (oral care and tumor type) and there is a negative correlation between TAs and QOL. Conclusion Identification of the severity of TA helps in providing alternative measures to improve the taste buds which may help in improving the QOL.
Dissertations / Theses on the topic "Mouth Cancer Chemotherapy":
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Cameron, Barbara. "Palliative Care Services Utilization and Location of Death." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/22907.
Abstract:
In this study, the utilization of palliative care services, acute care services, and location of death for clients who were palliative and receiving services from Champlain Community Care Access Centre (CCAC) in Ontario during their last month of life were investigated. An adaptation of Andersen?s Behavioral Model of Health Services Utilization provided context and structure to this study. This is an historical, quantitative descriptive study using chart audits for data collection. The data on CCAC clients who were palliative and who died during the month of July 2009 were tracked during their last month of life. Collection of socio-demographic data, services provided through CCAC, emergency department visits, hospital admissions, and location of death provided the data for this study. The clients who died at home used more CCAC services than those who died at other locations and frequently community palliative care physicians provided their medical care. The findings of this study included: 1) The majority of the clients, who expressed a preference, died in their preferred location. 2) The role of community palliative care physicians was an important component of the services that supported the clients to die in their location of choice. 3) Over 25% of the study sample died in a hospital and the clients used a large number of in-patient hospital days with one quarter of the hospital deaths taking place in an emergency department or an intensive care unit. 4) During the last month of life, 25% of the clients received chemotherapy and/or radiation therapy. 5) The clients who died at home used more CCAC services than those who died in other locations and who used institutional resources. The implications for practice, policy, research, and education are discussed.
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"Oral care intervention to alleviate chemotherapy-induced oral mucositis in children with cancer." 2001. http://library.cuhk.edu.hk/record=b6073393.
Abstract:
Cheng Kin Fong."November 2001."
Thesis (Ph.D.)--Chinese University of Hong Kong, 2001.
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Mode of access: World Wide Web.
Abstracts in English and Chinese.
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Dodridge, M. E. (Miles Edward). "The effects of variable dose methotrexate infusion in the laboratory rat." 1987. http://web4.library.adelaide.edu.au/theses/09DM/09dmd641.pdf.
Books on the topic "Mouth Cancer Chemotherapy":
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Abrams, Estelle J. Oral complications of cancer therapies: January 1980 through February 1989 : 288 citations. Bethesda, Md: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Library of Medicine, Reference Section, 1989.
Book chapters on the topic "Mouth Cancer Chemotherapy":
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MacEntee, Michael I. "Oral health and mouth diseases." In Oxford Textbook of Geriatric Medicine, 1097–104. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198701590.003.0142.
Abstract:
The mouth contributes to nutrition, respiration, and communications but it also contains potential pathogens that threaten other parts of the body. It is readily accessible to spot early signs of immune, endocrine, haematological, gastrointestinal, metabolic, and neoplastic disorders. Teeth are destroyed rapidly by the sugar-laden diets and poor oral hygiene that are common occurrences among residents of long-term care facilities. Moreover, the adverse effect of rampant dental caries from medications that disturb salivary flow is too often overlooked by physicians and pharmacists. Oral cancer causes more deaths than each of colorectal, gastric, prostate, and breast cancers, while oral mucositis can be an excruciatingly painful side effect of chemotherapy and radiotherapy. Overall, impairments and disabilities of the mouth and teeth influence physical and cognitive homeostasis and frailty, whereas effective management of oral disorder is an essential component of good geriatric care for successful ageing and quality of life in old age.
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Riddell, Anna, and Marta Gonzalez Sanz. "Infections in the Immunocompromised Host." In Tutorial Topics in Infection for the Combined Infection Training Programme. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780198801740.003.0050.
Abstract:
An understanding of the main aspects and functions of the immune system is important, i.e. physical barriers, innate, humoral, and cell-mediated immunity (see Chapter 6, Basic Immunology), when caring for the immunocompromised patient. In adults, secondary immunodeficiency is much more common than primary, and is most often due to iatrogenic immunosuppression with drugs, e.g. corticosteroids, chemotherapy agents, immunosuppressive agents, ‘biological’ therapies. For example, treatment with corticosteroids for more than one month is enough to increase the risk of some fungal infections such as Candida and Pneumocystis jirovecii, such that PCP prophylaxis should be considered in patients receiving ≤ 20mg/day prednisolone for four or more weeks. Chemotherapy and immunosuppressive agents may cause profound immunosuppression. The degree and duration of immunosuppression following a transplant, and the conditioning regimen used before the transplant varies with respect to the type of transplant: heart and lung transplant recipients typically receive more significant immunosuppression, and so are at increased risk of opportunistic infection compared to other solid-organ transplant recipients. Infections (e.g. HIV), cancer, and autoimmune disorders and the treatment of these conditions can also affect the immune system. Other diseases are also considered immunosuppressive although the exact nature of this is less well defined, for example, poorly controlled diabetes mellitus increases the risk of candidal infections and common bacterial infections. Cirrhosis is also considered to be a relatively immunosuppressed state. Understanding the nature of immune defects in both primary and secondary immunodeficiency allows more accurate prediction of overall infection risk and risk of specific pathogens, allowing a rational approach to infection prevention and investigation when patients become unwell. The initial assessment of the immunocompromised host should be to identify why the patient is immunocompromised, how long they have been immunocompromised (is it a congenital or acquired immunodeficiency?), and whether there is potential for immune recovery. Clearly, a person with a congenital immunodeficiency will have lifelong susceptibility to specific infections, unlike an acquired deficiency due to chemotherapy or transplantation which may be transient. If the immunosuppression is due to a drug, is it possible to reduce or change the immunosuppression? If an infection is suspected, pre-immunosuppression infection screening results can help identify whether the current presentation represents reactivation of a latent infection or primary infection.
Conference papers on the topic "Mouth Cancer Chemotherapy":
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Krishnan, Chandralekha, and Latha K. Vivek Subramani. "Psychological Status and Attitude of Breast Cancer Patients Post-COVID-19 Outbreak in Chennai: A Observational Survey Study." In Annual Conference of Indian Society of Medical and Paediatric Oncology (ISMPO). Thieme Medical and Scientific Publishers Pvt. Ltd., 2021. http://dx.doi.org/10.1055/s-0041-1735367.
Abstract:
Abstract Introduction The global threat caused by COVID-19 pandemic and the unprecedented lockdown imposed had created emotional stress among the breast cancer patients with dilemma regarding risk of progression of cancer due to interruptions of standard medical care and panic about acquiring the COVID-infection during their frequent visits to the hospital. Objectives We conducted a questionnaire-based study to assess the psychological impact in this situation affecting their quality of life and their perspective in this current situation. Materials and Methods Breast cancer patients who had been recently diagnosed, those who were on chemotherapy and visited our OPD in the month of July during the COVID-19 pandemic were assessed for their treatment-related perspectives with a questionnaire. Psychological status was analyzed with GAD-7 (generalized anxiety disorder questionnaire) and PHQ-9 (patient health questionnaire). Results A total of 202 breast cancer patients were included when lockdown was relaxed after a period of 3 months and COVID-19 status was still up trending. The clinical profile and patient-related information were collected from the medical records. Of them, 55.4% (112 patients) were within the city, 35.1% (71 patients) were from suburban areas of the city, and 9.4% (19 patients) were from adjacent districts/rural areas. Also, 56% were educated. Of these, 87% wanted to continue treatment and did not bother about the spread of the infection, while remaining patients’ main concern was to avoid infection than to get oncological management. Also, 76% were aware about the COVID-19 infection and sequelae. A total of 80% patients were aware of the consequences due to delay in cancer treatment. Of these patients, 51%, 42% and 7% had mild, moderate, and severe anxiety respectively and 69%, 25% and 6% had mild, moderate, and severe depression respectively. The severe anxiety and depression correlated with metastatic breast cancer and educated patients. Conclusion This study reflected that the breast cancer patients were more bothered to continue the treatment in spite of the existing pandemic.
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"Immature teratoma." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685328.
Abstract:
Introduction: Immature teratoma represents 3% of all teratomas, 1 % of all ovarian cancers and 20% of malignant ovarian germ cell tumors. It is found either in pure form or as a component of a mixed germ cell tumor. It occurs essentially during the first two decades of life. According to WHO, immature teratoma is defined as a teratoma containing a variable amount of immature embryonal type neuroectodermal tissue Case: We present here a report of 23 years old unmarried female who presented with complaint of abdominal pain since 1 month and her CT scan done outside, showed fibroid uterus. She had history of typhoid fever 1 month back for which USG was done which suggested large uterine fibroid. On examination she was hemodynamically stable. On abdominal examination a non-tender supra-pubic mass of 24 weeks size with firm consistency, irregular margin was felt. On investigation CA 125 was 64.90 IU/L, LD- 223, beta HCG- 1.14. On MRI a large abdomino-pelvic lesion, likely left adnexal lesion with multiple cystic areas, with hemorrhage, with ascites and enlarged retroperitoneal lymph nodes with omental infiltration suggestive of a possibility of malignant germ cell tumor. In view of large ovarian tumor, possibly malignant decision for staging laparotomy was taken. Intra-operatively a large irregular vascular solid mass of 20 x 20 cms with bosselated appearance with few cystic lesions over it was seen, arising from left ovary and was sent for frozen section which reported malignant mature teratoma with components of immature teratoma. She underwent laparotomy with left salpingo-oophorectomy with right ovarian biopsy, omentectomy, appendectomy with B/L pelvic lymphadenectomy. Histopathology was suggestive of grade III immature teratoma. In view of grade III immature teratoma, she received chemotherapy (BEP regimen) post-operatively and is currently under follow up. Conclusion: This case reflects the importance of early diagnosis in cases of pelvic masses in young females. Fertility preservation should be considered in young women with germ cell tumors. Patients with grade II or III tumors or a mere advanced stage disease should be treated with adjuvant chemotherapy (BEP) in addition to surgery.
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Batra, Ankit. "Clinical comparison of toxicity pattern of two linear quadratic model-baesd fractionation schemes of high-dose-rate intracavitary brachytherapy for cervical cancer." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685255.
Abstract:
Introduction: Carcinoma cervix is the fourth (GLOBACON 2012) most common cancer among women worldwide, and the main cancer affecting women in Sub-Saharan Africa, Central America and south-central Asia. In India, approx. 1,23,000 (GLOBACON 2012) new cases of carcinoma cervix are diagnosed each year. Brachytherapy is an integral part of treatment of cancer cervix. In the context of a developing country like us where maximum utilization of the resource is of prime importance to provide treatment to the large patient cohort, shortening the treatment duration and number of fractions always increases efficiency. In order to maximize the logistic benefits of HDR-BT while improving patient compliance and resource sparing, various fractionation regimens are used. Fractionation and dose adjustments of the total dose are radiobiologically important factors in lowering the incidence of complications without compromising the treatment results. Aim: To compare patient outcomes and complications using two linear-quadratic model-based fractionation schemes of high-dose-rate intracavitary brachytherapy (HDR-IC) used to treat cervical cancer. Materials and Methods: A prospective randomized study on 318 patients, with histologically proven advanced carcinoma cervix (stages IIB-IIIB) was enrolled in the study. All patients received External Beam Radio Therapy (EBRT) 50 Gy in 25 fractions with concurrent chemotherapy (cisplatin 35 mg/m2) followed by IntraCavitary brachytherapy using high dose rate equipment. Patients were randomised after completion of EBRT into two arms: (1) Arm 1: HDR ICRT 6.5 Gy per fraction for 3 fractions, a week apart. (2) Arm 2: HDR ICRT, 9 Gy per fraction for 2 fractions, 1 week apart. On completion of treatment, patients were assessed monthly for 3 months followed by 3 monthly thereafter. Treatment response was assessed according to WHO criteria after one month of completion of radiotherapy. The RTOG criteria were used for radiation induced toxicities. We analyzed late toxicities in terms of Rectal, Bladder, Small Bowel toxicity and Vaginal Stenosis. Results: Acute reactions in both the groups were comparable. None of the patient developed Grade 4 toxicity in our study and no toxicity related mortality was encountered. A slightly high frequency of late toxicity was observed in 9Gy Arm patients but was not statistically significant. Conclusion: In our setup, HDR brachytherapy at 9 Gy per fraction in two fractions is safe, effective and resource saving method with good local control, survival, and manageable normal tissue toxicity.