Background and Aims: The failure to reduce the mortality of patients with solid tumours is mainly a result of the early dissemination of cancer cells to secondary site, which is usually missed by conventional diagnostic procedures used for tumour staging. The possibility to use easily accessible body fluids as a source for circulating tumour cells (CTCs) detection enables longitudinal observations of the disease. In the study, we evaluated the CTCs in lung cancer following locoregional radiation therapy. Methods: Samples of 5ml peripheral blood was taken from each lung cancer patients (n=15) both before and after the radiotherapy course. Meanwhile tumour size was determined by chest X-ray or computed tomography. Using cytokeratin 19(CK19) as marker,the blood samples were subjected to real time RT-PCR assay. All patients with lung cancer were treated with primary definitive and mediastinal radiotherapy. Results Compare to that of pre-treatment, the value of CK19 mRNA in peripheral blood after therapy decreased dramatically(5.0932±1.0628 vs. 4.2493±0.8323,t=3.192,P=0.007). The change of CK19 mRNA level before and after radiotherapy was closely related to the type (NSCLC vs. SCLC, 0.5389±0.9030 vs. 1.6826±0.9467,t=2.1465,P=0.051). Meanwhile, there appeared to be a close link between the grade (Well/Mod vs. Poor) and the change of CK19 mRNA (0.5024 vs. 1.5271,t=2.017,P=0.065). The change of CK19 mRNA level was related to variation of tumour burden during radiotherapy(r=0.0575,P=0.025). Of the 15 cases studied, 12 cases were positive before radiotherapy (12/15,80%). The positive rate was 53%(8/15) after radiotherapy, meaning that four patients converted into negative after radiotherapy. Conclusions: The disseminated circulating cancer cells can be affected by radiotherapy; meanwhile further more systemic adjuvant treatment should be conducted. Due to concordance between molecular response and radiological remission, assessment of the therapeutic response might be possible by serial quantitative of CTCs.

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Background: The need for effective, well tolerated, and convenient therapies for inoperable Head and Neck cancer has led researchers to continually refine chemotherapeutic regimens with radiotherapy to balance efficacy with safety and tolerability in order to maintain or improve quality of life and chemotherapy either induction or concurrent with radiation have emerged as a viable alternative. Aim: This study was performed to analyze the efficacy and safety of induction chemotherapy with radiotherapy and con-current radiotherapy on survival, functional and quality of life outcomes. Material and Method: From Dec. 2001 to July 2003, hundred inoperable Head & Neck cancer patients were planned to be treated with methotrexate, Bleocin and cis-platin. On Completion of 3 cycles at 21 days interval, after 2 weeks of last cycles, fifty patients were planned to receive only radiotherapy (Group A) and rest 50 patients (Group B) were given cisplatin 50 mg weekly before Rt. on every Monday. All 100 patients received radiotherapy (66-70 cGy) to the locoregional sites by cobalt 60 units. Result: After completion of therapy in group A complete response was observed in 56% patients which was 68% in group B. After 2 years of follow up only 54% patient alive and 34% patients were disease free in group A where as in group B. 60% patient alive in which 42% were disease free. The survived patient enjoyed good quality of life. Conclusion: Patients responded better with induction chemotherapy can be treated with radiotherapy and those who failed to show satisfactory response may be treated with concurrent chemo radiotherapy to get additional benefit in term of survival with good organ preservation along with acceptable and manageable occurrence of schedule & dose related adverse events.

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Aim: To determine whether any changes in gross tumor volume occur between pre treatment MRI and week 5 MRI in high grade gliomas treated by conformal radiotherapy. Methods and Materials: Between july 2003-july 2005, 17 patients with WHO grades 3 and 4 malignant gliomas treated with conformal radiotherapy to a total dose of 60 Gy were included in this retrospective study. All patients had undergone T2 weighted MRI a day before treatment and then again at end of week 5 of treatment for definition of initial and boost fields respectively. Gross tumor volumes were delineated on the two MRI's of each patient and the differences were noted. Two patients with multifocal disease were excluded from the final analysis. Results: Of the 15 patients with unifocal disease, 12/15 cases (80%) showed a reduction in tumor volumes (median 54.85 cc). Of these, 4/15(26.6%) cases (two each of grade 3 and grade 4 gliomas) had an objective reduction in GTV (>=50%) and 3/15(20%) cases (two of grade 4 and one of grade 3 gliomas) demonstrated an increase in tumor volume (median 14 cc). Conclusions: This study has shown that a change in gross tumor volume occurred in almost all patients on week 5 MRI. The likelihood of treatment success would appear to be decreased if the tumour is not within the treatment field and hence it may be worthwhile to do a mid treatment MRI for definition of boost volumes especially in dose escalation trials employing highly conformal radiotherapy fields.

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Background: Patients with locally advanced cervical cancer are often severely distressed with incessant vaginal bleeding, offensive discharge and pelvic pain and are in some instances are beyond curative potential. At our institution we routinely use monthly palliative pelvic radiotherapy for these patients. Methods and Material: One hundred patients treated between 2000 & 2004 were included in this analysis. Patients were treated with parallel-opposed pelvic portals with megavoltage radiation monthly up to a maximum of three fractions (10Gy/ fraction). Patients with good response after second fraction were considered for intracavitary brachytherapy delivering 30Gy to point A. Response was documented with regard to relief of bleeding, vaginal discharge and pelvic pain. The other aspects evaluated were patient compliance, disease response, toxicity and survival. Results: Sixty-eight percent had FIGO stage IIIB, 12% had stage IVA and 14% had IVB disease. Twenty patients had metastatic disease. The median symptom duration was 5 months. Majority (67%) presented with vaginal bleeding, followed by discharge (69%) and pelvic pain (48%). All patients received at least one fraction of palliative pelvic radiotherapy. Sixty-one patients received the second fraction and 33 the third. Five patients received an intracavitary application. The overall response rates in terms of control of bleeding, discharge and pain were 100%, 49% and 33% respectively. The treatment was generally well tolerated with a median survival of 7 months. Conclusions: Monthly palliative pelvic radiotherapy results in satisfactory control of symptoms in patients with locally advanced carcinoma of cervix with acceptable complications.

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Background: The appropriate application of Endoscopic modalities for polypectomy depends on the likelihood that the adenoma in question harbors invasive cancer. While prior studies have evaluated polyp size and morphology in assessing the risk of malignancy, in recent decay some authorities have paid more attention to dysplasia. All in all, the relative risk of cancer based on polyp distribution in correlation with dysplasia has not been statistically studied which is done in our study. Methods and Materials: Between June 2001 and March 2004, the distribution of 130 adenomatous polyps was compared with synchronous invasive or in situ cancer. Factors such as Patient age, Patients gender, location of lesion, size of polyp, histological subtype of adenoma on biopsy, degree of dysplasia, synchronous cancer, color of polyp, and number of polyps were included in the data collection. Results: Multivariate logistic regression test was used to evaluate the association between malignancy and various clinical variables. It revealed histological subtype, high grade of dysplasia and size to be independent predictor of malignancy. However; left-sided location and histological subtype to be independent risk factor for high-grade dysplasia. Conclusion: Lesions greater than 1 cm in diameter with high-grade dysplasia after speleinc flexure should be managed as presumptive malignancies with segmental colon resection. In intermediate-risk lesions the physician should decide individually.

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The Gammamed Plus 192Ir high dose rate brachytherapy sources were calibrated using the therapy level ionization chambers (0.1 and 0.6 cc) and the well-type chamber. The aim of the present study was to assess the accuracy and suitability of use of the therapy level chambers for in-air calibration of brachytherapy sources in routine clinical practice. In a calibration procedure using therapy ion chambers, the air kerma was measured at several distances from the source in a specially designed jig. The room scatter correction factor was determined by superimposition method based on the inverse square law. Various other correction factors were applied on measured air kerma values at multiple distances and mean value was taken to determine the air kerma strength of the source. The results from four sources, the overall mean deviation between measured and quoted source strength by manufacturers was found -2.04% (N = 18) for well-type chamber. The mean deviation for the 0.6 cc chamber with buildup cap was found -1.48 % (N = 19) and without buildup cap was 0.11% (N = 22). The mean deviation for the 0.1 cc chamber was found -0.24% (N = 27). Result shows that probably the excess ionization in case of 0.6 cc therapy ion chamber without buildup cap was estimated about 2.74% and 1.99% at 10 and 20 cm from the source respectively. Scattered radiation measured by the 0.1 cc and 0.6 cc chamber at 10 cm measurement distance was about 1.1% and 0.33% of the primary radiation respectively. The study concludes that the results obtained with therapy level ionization chambers were extremely reproducible and in good agreement with the results of the well-type ionization chamber and source supplier quoted value. The calibration procedure with therapy ionization chambers is equally competent and suitable for routine calibration of the brachytherapy sources.

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Background : The incidence of testicular cancers has been increasing in many populations over the past decades and concerns have been expressed about the possible decrease in semen quality in the period. It may account for one of the factors responsible for increasing male infertility in Ilorin, Nigeria. Objective: To find out the incidence, age distribution clinical presentation, duration before presentation and the occurrence of various Histopathological subtypes of testicular tumours in Ilorin. Design: A retrospective study. Setting: A teaching hospital (University of Ilorin) Patients: Testicular biopsies were done on patients presenting at the hospital with suspected cases of malignancies. Materials and Mehtods: All consecutives cases of testicular malignancies diagnosed in the department of pathology, university of Ilorin Teaching Hospital, during the period of thirteen years (1990-2003) were included in this study. Relevant clinical details such as age, clinical presentation and side of involvement of the testis were also recorded. The slide preparations of this sample were retrieved and reviewed. Result: During the span of thirteen years (1990-2003), testicular cancers accounted for 0.05% of all sample received and 0.14% of the male biopsies. Most of the diagnosed cases were in the first decades of life and are mainly germ cells tumours of which yolk sac tumours are commonest subtypes. Conclusion: Incidence of testicular cancers is still low in this environment and may not account for major contributory factors in male infertility in Ilorin.

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An important approach for describing a region is to quantify its structure content. In this paper the use of functions for computing texture based on statistical measures is pescribed.MPM ( Maximizer of the posterior margins) algorithm is employed.The segmentation based on texture feature would classify the breast tissue under various categories. The algorithm evaluates the region properties of the mammogram image and thereby would classify the image into important segments.Images from mini-MIAS data base (Mammogram Image Analysis Society database(UK)) have been considered to conduct our experiments. The segmentation thus obtained is comparatively better than the other normal methods .The validation of the work has been done by visual inspection of the segmented image by an expert radiologist.This is our basic step for developing a computer aided detection (CAD)system for early detection of breast cancer.

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Vanishing bone disease is a rare condition characterized by progressive osteolysis of the bony structures by vascular tissue and their replacement by fibrous, vascular connective tissue. A 38-year-old lady who had a previous history of angioma of the left iliac bone presented with vague symptoms of a limping gait and pain during walking since 2 years duration. The radiologic findings were suggestive of degenerative changes. A possibility of metastatic disease was also considered. However the biopsy and Positron emission tomography (PET) scan ruled out any active disease. Like in most other cases this was possibly a self-limited disease where bone resorption had spontaneously arrested.

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