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  Citation statistics : Table of Contents
   2005| July-September  | Volume 1 | Issue 3  
 
 
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ORIGINAL ARTICLE
Analytical approach to estimate normal tissue complication probability using best fit of normal tissue tolerance doses into the NTCP equation of the linear quadratic model.
TS Kehwar
July-September 2005, 1(3):168-179
DOI:10.4103/0973-1482.19597  PMID:17998649
Aims and Objectives: Aims and objectives of this study are to get the best fit of the normal tissue tolerance doses to the NTCP model of the linear quadratic model. Methods and Materials: To compute the NTCP, the modified form of the Poisson cell kill model of NTCP, based on linear-quadratic model, is used. The model has been applied to compute the parameters of the NTCP model using clinical tolerance doses of various normal tissues / organs extracted from published reports of various authors. The normal tissue tolerance doses are calculated for partial volumes of the organs using the values of above-said parameters for published data on normal tissue tolerance doses. In this article, a graphical representation of the computed NTCP for bladder, brain, heart and rectum is presented. Results and Conclusion: A fairly good correspondence is found between the curves of 2 sets of data for brain, heart and rectum. Hence the model may, therefore, be used to interpolate clinical data to provide an estimate of NTCP for these organs for any altered fractionated treatment schedule.
  41 19,577 1,494
REVIEW ARTICLE
Potential of radiosensitizing agents in cancer chemo-radiotherapy
S Girdhani, SM Bhosle, SA Thulsidas, A Kumar, KP Mishra
July-September 2005, 1(3):129-131
DOI:10.4103/0973-1482.19585  PMID:17998642
Potential of herbs and other plant-based formulations have been increasingly recognized in prevention and treatment of human diseases including cancer. There exist enormous prospect for screening and evaluation of herbal/plant products for developing effective radiosensitization and radioprotection relevant to nuclear research program. Investigations in our laboratory have focused on the mechanism of activity of variety of anticancer and antioxidant agents, namely, Eugenol, (EU), Ellagic acid (EA), Triphala (TPL), Tocopherol Succinate (TOS) and Arachidonic acid on normal and cancer cells with view to design effective protocols in practical radioprotection and cancer radiotherapy. This paper is mainly focused on studies on cytotoxic effects on cancer cell lines. Results have shown that these agents produced radiosensitizing action involving oxidative damage, membrane alteration and damage to nucleic acid in various human cell lines. Studies were performed employing fluorescence probes and electron spin resonance methods and gel electrophoresis protocols. It has been found that cytotoxic effect was induced by initiating membrane oxidative damage and by triggering intracellular generation of reactive oxygen species (ROS) by gamma radiation in combination with phytochemicals like TPL, EA and TOS in tumor cell line Ehrlich Ascites (EAC), Human cervical (HeLa) and breast (MCF-7) cells. Membrane damage and ROS generation was measured by DPH and DCF-FDA fluorescent probes respectively after exposure to low to moderate doses of gamma radiation. This talk will present the cytotoxic effects of phytochemicals in combination with ionizing radiation. It is emphasized that modulation of membrane peroxidative damage and intra cellular ROS may help achieve efficient killing of cancer cells which may provide a new approach to developing effective treatment of cancer.
  30 15,179 1,908
ORIGINAL ARTICLE
Surface activity, lipid profiles and their implications in cervical cancer.
A Preetha, R Banerjee, Nagraj Huilgol
July-September 2005, 1(3):180-186
DOI:10.4103/0973-1482.19600  PMID:17998650
Background: The profiles of lipids in normal and cancerous tissues may differ revealing information about cancer development and progression. Lipids being surface active, changes in lipid profiles can manifest as altered surface activity profiles. Langmuir monolayers offer a convenient model for evaluating surface activity of biological membranes. Aims: The aims of this study were to quantify phospholipids and their effects on surface activity of normal and cancerous human cervical tissues as well as to evaluate the role of phosphatidylcholine (PC) and sphingomyelin (SM) in cervical cancer using Langmuir monolayers. Methods and Materials: Lipid quantification was done using thin layer chromatography and phosphorus assay. Surface activity was evaluated using Langmuir monolayers. Monolayers were formed on the surface of deionized water by spreading tissue organic phase corresponding to 1 mg of tissue and studying their surface pressure-area isotherms at body temperature. The PC and SM contents of cancerous human cervical tissues were higher than those of the normal human cervical tissues. Role of PC and SM were evaluated by adding varying amounts of these lipids to normal cervical pooled organic phase. Statistical analysis: Student's t-test (p < 0.05) and one-way analysis of variance (ANOVA) was used. Results: Our results reveals that the phosphatidylglycerol level in cancerous cervical tissue was nearly five folds higher than that in normal cervical tissue. Also PC and sphingomyelin SM were found to be the major phospholipid components in cancerous and normal cervical tissues respectively. The addition of either 1.5 g DPPC or 0.5 g SM /mg of tissue to the normal organic phase changed its surface activity profile to that of the cancerous tissues. Statistically significant surface activity parameters showed that PC and SM have remarkable roles in shifting the normal cervical lipophilic surface activity towards that of cancerous lipophilic component. Conclusion: The Langmuir monolayer technique was sensitive to detect changes in tensiometric profiles of cervical cancers and these could be modulated by alterations in phosphatidylcholine and sphingomyelin levels. Therapeutic strategies may be designed to modulate these tensiometric profiles and lipid constituents of cancerous tissues.
  23 11,129 647
Iatrogenc hypothyroidism: A consequence of external beam radiotherapy to the head & neck malignancies
Ranen Kanti Aich, Asit Ranjan Deb, Santanu Pal, Biswas Litan Naha, Amitabh Ray
July-September 2005, 1(3):142-146
DOI:10.4103/0973-1482.19593  PMID:17998645
Background: Hypothyroidism is a known consequence of external beam radiotherapy to the neck encompassing part or whole of the thyroid gland for over 40 years. Still thyroid function tests are not a part of routine follow up of head - neck cancer patients treated with radiotherapy with or without surgery and / or chemotherapy. Aim: Aim of this study was to find out the incidence of hypothyroidism in head - neck cancer patients treated with radiotherapy with or without chemotherapy where radiation portals included most or whole of the thyroid gland. Materials and Methods: From September 2001 to November 2003, 187 patients with head-neck malignancies were treated with external beam radiotherapy whose radiation portals included part or whole of the thyroid gland with / without chemotherapy. Thyroid function tests were done at the beginning of treatment, at six weeks after completion of radiotherapy and thereafter at six weeks interval for two years. Results: Out of 187 patients, five were excluded from the study as they were found to be hypothyroid before the initiation of treatment. Another four were excluded from result analysis because they underwent laryngectomy for uncontrolled disease. Of the patients attending the follow up clinic, 17.8 % and 21.8 % were found to have clinical and sub-clinical hypothyroidism at two year. Conclusion: As a significant number of patients develop hypothyroidism following radiotherapy to the neck, thyroid function tests should be included in the routine follow up protocol of such patients. But certain questions have emerged from this study which need a large randomized study to find out the answers.
  22 6,926 649
Heterogeneity in the radiosensitizing effects of the DNA ligand hoechst-33342 in human tumor cell lines.
JS Adhikari, Divya Khaitan, MB Arya, BS Dwarakanath
July-September 2005, 1(3):151-161
DOI:10.4103/0973-1482.19595  PMID:17998647
The AT specific minor grove DNA binding ligands bisbenzimidazole derivatives like hoechst-33342 and hoechst-33258 which scavenge free radicals and stabilize macromolecular structure have been shown to afford radioprotection by reducing the induction of DNA damage. However, their ability to inhibit topoisomerases I & II, which play important roles in damage response pathways including DNA repair can enhance radiation damage under certain conditions. Since pool sizes of the topoisomerases differ not only between normal and tumor cells, but also among different tumors, it is anticipated that radiosensitization by hoechst-33342 can vary among tumors. The present studies were, therefore, undertaken to verify this proposition in human glioma (BMG-1 & U-87) and squamous carcinoma (4197 & 4451) cell lines which differ in their biological behavior (ploidy, p53, cyclins, bcl, bax etc).Isotoxic concentrations of hoechst-33342 (IC50 i.e producing 50% cell kill) administered immediately following irradiation resulted in the radiosensitization of all cell lines, with a 4&7 fold increase in the cell death (loss of clonogenic cell survival) in U-87& BMG-1 and a 3 fold increase in 4197 &4451 cells. Growth inhibition and increase in cytogenetic damage (micronuclei formation) as well as delayed apoptosis observed under these conditions corroborated well with the enhanced cell death. The ligand induced a significant cell cycle delay, particularly in the late S and G2 phases of BMG-1, U-87 and 4197 cells, while no significant changes could be observed in 4451 cells. Higher endogenous levels of cyclin B1 found in both the glioma cell lines, was enhanced further by the ligand as compared to the squamous carcinoma cells. These results clearly demonstrate that the radiosensitizing effects of the ligand are indeed heterogeneous among different human tumor cell lines. The radiaosensitization is p53 independent and accompanied by enhanced mitotic death (linked to cytogenetic damage) as well as induction of cyclin B1 mediated apoptosis.
  15 9,074 506
The role of the p53 molecule in cancer therapies with radiation and/or hyperthermia.
Takeo Ohnishi
July-September 2005, 1(3):147-150
DOI:10.4103/0973-1482.19594  PMID:17998646
In recent years, cancer-related genes have been analyzed as predictive indicators for cancer therapies. Among those genes, the gene product of a tumor suppressor gene p53 plays an important role in cancer therapy, because the p53 molecule induces cell-cycle arrest, apoptosis and depression of DNA repair after cancer therapies such as radiation, hyperthermia and anti-cancer agents. An abnormality of the p53 gene might introduce low efficiency in their cancer therapies. Mutations of p53 are observed at a high frequency in human tumors, and are recognized in about half of all malignant tumors in human. In the both systems of a human cell culture and their transplanted tumor, the sensitivities to radiation, heat and anti-cancer agents were observed in wild-type p53 cells, but not in mutated or deleted p53 cells. In this review, we discuss the p53 activation signaling pathways through the modification of p53 molecules such as phosphorylation after radiation and/or hyperthermia treatments.
  12 8,356 1,315
The optimal use of granulocyte macrophage colony stimulating factor in radiation induced mucositis in head and neck squamous cell carcinoma.
Nidhi Patni, Sanjeev Patni, Ajay Bapna
July-September 2005, 1(3):136-141
DOI:10.4103/0973-1482.19589  PMID:17998644
Objective: Evaluation of response of granulocyte macrophage colony stimulating factor (GM-CSF) on acute radiation toxicity profile in head and neck squamous cell carcinoma. Methods and Materials: Thirty three patients with proven stage I or II head & neck carcinoma received conventional external beam radiation therapy. Out of these, six patients received postoperative adjuvant therapy while remaining 27 received definitive RT. Patients were given 100 mcg GM-CSF subcutaneously per day along with radiation after they developed grade 2 mucositis and /or grade 2 dysphagia and / or complained of moderate pain. GM-CSF was administered till there was a subjective relief or objective response. Patients were evaluated for oral ulceration, swallowing status, pain and weight loss. Response to the treatment and patient outcome was assessed. Results: There was a decreased severity of mucositis and dysphagia in the evaluated patients. None of the patients suffered severe pain or required opioids. The mean weight loss was only 1.94%. Minimal side effects were experienced with GM-CSF. Conclusions: GM-CSF reduces the severity of acute side effects of radiation therapy thereby allowing completion of the treatment without interruption. Its remarkable response needs to be evaluated further in large randomized trials. The time of initiation and cessation of GM-CSF during radiation therapy and the required dose needs to be established.
  9 6,513 472
Karyoanomalic frequency during radiation therapy.
Rimpu Kumari, Arun Chaugule, PK Goyal
July-September 2005, 1(3):187-190
DOI:10.4103/0973-1482.19604  PMID:17998651
Aim: To identify the relationship between the radiosensitivity of oral cancers and to evaluate the dose-dependent relationship of nuclear abnormalities by serial cytology during fractionated radiotherapy in head and neck cancer patients. Materials and Methods: 30 patients with histologically proven cases of squamous cell carcinoma were included in the study. Serial scrape smear were taken from the tumor before and during radiotherapy (0 to 24 Gy), and stained with Giemsa and May Grunwald's stain and frequency of micronucleated, binucleated and multinucleated cells were evaluated with the help of light microscope. The counts were expressed per 1000 uninucleated cells. Results: Each parameter showed a statistical increase with increase dose. Before treatment, the mean values of micronucleated cells, binucleated cells and multinucleated cells were 3.5, 10.1 and 4.2. At 4 Gy these were 7.7, 12.0 and 6.2 which further increased with radiation dose; and the mean values were 8.8, 16.2 and 14.9 at 14 Gy and 12.8, 18.5 and 15.1 at 24 Gy. After analysis of p-value, all such abnormal cells showed significant difference (p < 0.0001) with respect to normal subjects. Conclusion: Our study results that micronucleus assay is a very useful tool in the assessment of biological damage that can help to identify tumor radiosensitivity.
  7 6,951 341
Thermometry studies of radio-frequency induced hyperthermia on hydrogel based neck phantoms.
Shantesh Hede, Naresh Trivedi, Mekala , Nagraj Huilgol
July-September 2005, 1(3):162-167
DOI:10.4103/0973-1482.19596  PMID:17998648
A cylindrical phantom, resembling average human neck, was prepared by using hydrogel sheets containing vinyl and polysaccharide. The phantom was used to obtain temperature distributions for 6 values of input power of radio frequency (RF) at 8MHz,by invasive thermometry technique, using thermistor probes.The inclusion of cervical vertebrae and calcium carbonate pieces (human bone representative) with a hollow tube (windpipe equivalent) in the phantom simulates the change in thermal distributions. This is similar to the alterations in heat disposition obtained in the real human neck, during RF induced heating, without extensive distortion of the uniform temperature distribution provided by the RF heating instrument.This paper compares the hydrogel neck phantom with other phantoms, that have been developed for studying thermal distributions and optimization of novel non invasive thermometry techniques in hyperthermic oncology.
  1 8,216 342
BOOK REVIEWS
Imaging in Oncology
Deepak Patkar
July-September 2005, 1(3):191-191
  - 2,469 172
EDITORIAL
War games and cancer
Huilgol G Nagraj, Sarin Rajiv
July-September 2005, 1(3):125-125
DOI:10.4103/0973-1482.19583  PMID:17998640
  - 3,647 206
INVITED EDITORIAL
Accelerated partial breast irradiation with high dose rate brachytherapy for early breast cancer
GK Rath, DN Sharma
July-September 2005, 1(3):126-128
DOI:10.4103/0973-1482.19584  PMID:17998641
  - 5,025 357
REVIEW ARTICLE
Supraestructure maxillectomy and orbital exenteration for treatment of basal cell carcinoma of inferior eyelid: Case report and review.
Villalon-Lopez Jose Sebastian, Valle-Mejia Carlos Arturo, Patino-Lara Antonio, Moreno-Perez Bertha Alicia, Munoz-Lopez Jorge Alejo, Alcantar-Andrade Antonio
July-September 2005, 1(3):132-135
DOI:10.4103/0973-1482.19586  PMID:17998643
Basal cell carcinoma (BCC) is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation (UVR) as important risk factor for development of the illness as such as severe solar burns during childhood or adolescence. BCC is mainly located on sun exposed sites, being head and neck the areas of more incidence; although nose, eyelids and periorbitary tissue are unfavorable due to cosmetic results that BCC involves. Tumors can be classified as: nodular, superficial, micronodular, morphea variety, infiltrating, pigmented, metatypic and fibroepithelioma of Pinkus. Several treatment options as surgical and non-surgical are available. The goal of treatment is complete excision of the tumor with preservation of surrounding structures in a way aesthetically acceptable. Mohs' micrographic surgery is the standard treatment for all non-melanoma skin cancer. Orbital exenteration is also used for treatment of malignancies of ocular tissues, mainly squamous cell carcinoma, sebaceous cell carcinoma and BCC. The tissue beneath the surgical site can be left for second-intention granulation or covered with a cutaneous implant of partial thickness. The case of a 77 year-old patient is presented with BCC of inferior eyelid of 14 years duration, formerly managed with radiotherapy and, due to recurrent illness and invasion to the maxillary antrum; he needed supraestructure maxillectomy with left orbital exenteration.
  - 7,853 520