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  Citation statistics : Table of Contents
   2007| October-December  | Volume 3 | Issue 4  
    Online since February 6, 2008

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Vitamin D and cancer
Minu M Ali, V Vaidya
October-December 2007, 3(4):225-230
DOI:10.4103/0973-1482.38998  PMID:18270398
Vitamin D, a fat-soluble prohormone is synthesized in response to sunlight. Experimental evidence suggests that vitamin D may reduce the risk of cancer through regulation of cellular proliferation and differentiation as well as inhibition of angiogenesis. These anticancer properties have been attributed primarily to 1,25-dihydroxyvitamin D [1,25(OH) 2 D] (calcitriol), the hormonal form of vitamin D. Extensive research has shown that cells, including cancer cells, express specific receptors (VDR) for 1,25-dihydroxyvitamin D. When bound to the VDR, 1,25-dihydroxyvitamin D regulates >60 genes that exert prodifferentiating, antiproliferative and antimetastatic effects on cells, including effects on cell cycle. The amount of exposure to the sun has been found to correlate inversely with cancer mortality and survival in numerous epidemiological studies. An inverse relationship between solar ultraviolet-B (UV-B) exposure and non-skin cancer mortality has long been reported. Several ecological studies suggest that sunlight may protect against prostate, colon, rectal, female breast and ovarian cancer, all diseases that contribute to a substantially higher proportion of cancer mortality in the western industrialized world. Some analytical studies also suggest a protective association between circulating vitamin D in blood, which is largely derived from sunlight, or dietary vitamin D. Paricalcitol (calcitriol analogue) is as effective as 1,25-dihydroxyvitamin D in transactivating the prostatic VDR and in inhibiting the growth of prostate cancer cell lines and primary cultures of prostate cancer cells in vitro. Promising preclinical evaluations of calcitriol and analogues have appeared in prostate cancer animal models.
  38 18,561 3,729
Surface and antitumor activity of some novel metal-based cationic surfactants
AM Badawi, Mekawi AS Mohamed, MZ Mohamed, MM Khowdairy
October-December 2007, 3(4):198-206
DOI:10.4103/0973-1482.38994  PMID:18270394
The development of anticancer metal-based drugs was attempted by reacting dodecyl amine with selenious acid to produce a quaternary ammonium salt which was then converted to copper and cobalt cationic complexes via complexing the first compounds with copper (II) or cobalt (II) ions. The surface properties of these surfactants were investigated. The surface properties studied included critical micelle concentration (CMC), maximum surface excess (Γmax ), and minimum surface area (Amin ). Free energy of micellization (∆G o mic ) and adsorption (∆Go ads ) were calculated. Antitumor activity was tested by using Ehrlich ascites carcinoma (EAC) as a model system of mice cell tumor. The compounds were also tested in vitro on five human monolayer tumor cell lines: MCF 7 (breast carcinoma), HEPG 2 (liver carcinoma), U 251 (brain tumor), HCT116 (colon carcinoma), and H460 (lung carcinoma). FTIR spectra, elemental analysis, and H 1 NMR spectra were performed to insure the purity of the prepared compounds.
  23 9,551 592
Estimation of BCL-2 protein in carcinoma of the breast and its clinical correlation in locally advanced breast cancer
Himanshu Aggarwal, Parvinder S Lubana, DK Jain, RK Mathur
October-December 2007, 3(4):207-210
DOI:10.4103/0973-1482.38995  PMID:18270395
The change in expression of apoptotic markers (Bcl-2 and Bax proteins) brought about by various chemotherapeutic regimens is being used for its predictive value for assessing response to neoadjuvant chemotherapy (NACT) in locally advanced breast carcinoma (LABC). Aims: (1) Estimation of Bcl 2 expression in LABC, (2) Any change in Bcl 2 expression following chemotherapy in LABC, (3) Any relation of Bcl 2 estimation to changes in size of tumor, nodal status, age, and menopausal status. Settings and Design: This was a prospective study of 120 cases of LABC. Materials and Methods: All cases were subjected to biopsy and the tissue was evaluated immunohistochemically for apoptotic marker Bcl-2 family protein. Three cycles of NACT were given at three-weekly intervals. Modified radical mastectomy was performed and the specimens were re-evaluated for any change in the Bcl-2 family protein. The clinical response and immunohistochemical response were correlated and compared. Statistical Analysis: Coefficient of correlation was calculated by Pearson correlation coefficient (P-value). Results: Clinical response, as measured by reduction in the tumor size, was observed in 81 (67.5%) patients while immunohistochemical response was observed in 67 (55.8%) patients. Correlation between immunohistochemical and clinical response was found to be statistically significant (P = 0.02). Nodal response was seen in 72 (60%) patients. There were no patients in the N o group; 22 (53.7%) of the N 1 patients were down-staged to N o , while 19 (46.3%) remained N 1 . In patients with N 2 disease, 11 (13.9%) were down-staged to N o status, 39 (49.4%) were down-staged to N 1 status, and 29 (36.7%) did not show any response. Immunohistochemical response was observed in 67 (55.8%) patients. Correlation between immunohistochemical and nodal responses was also found to be statistically significant (P = 0.03). Conclusions: This significant positive correlation between clinical and immunohistochemical responses highlights the importance of apoptotic marker Bcl-2 family protein in predicting the response of LABC to NACT.
  11 5,067 580
Postmastectomy radiation and survival in patients with breast cancer
BS Yadav, SC Sharma, R Singh, G Singh, V Kumar
October-December 2007, 3(4):218-224
DOI:10.4103/0973-1482.38997  PMID:18270397
Purpose: To analyze the impact of postmastectomy radiotherapy on locoregional control and overall survival in patients with carcinoma breast. Materials and Methods: Between 1995 and 2000, 688 patients of carcinoma breast were analyzed. Out of these, 608 received postmastectomy radiotherapy and 80 patients were not given any radiation therapy. At a median follow-up of 67 months, the outcomes studied were locoregional recurrence (LRR), distant metastases, disease-free survival (DFS) and overall survival (OS) using univariate and multivariate analyses. Results: The frequency of LRR with or without distant metastases was 8.5%, and distant metastases was seen in 18.7% of patients. On univariate analyses, factors affecting LRR were age <40 years (0.019), tumor stage ( P = 0.001 ), grade ( P = 0.027 ), pathological nodal status ( P < 0.0001 ), deep resection plane (0.041), ER/PR status ( P = 0.032 ) and postmastectomy radiation therapy (PMRT) ( P < 0.0001 ). DFS rate was 69% at 5 years. Factors affecting distant metastases were age <40 years (0.005), tumor stage ( P < 0.0001 ), grade ( P = 0.0007 ), pathological nodal status ( P < 0.0001 ), extra capsular extension (ECE) ( P = 0.002 ), hormonal therapy ( P < 0.0001 ) and PMRT ( P < 0.0001 ). The OS rate was 81% at 5 years. Factors affecting OS were tumor stage ( P < 0.0001 ), grade ( P = 0.0001 ), pathological nodal status ( P < 0.0001 ), ECE ( P = 0.002 ) ER/PR status ( P = 0.008 ), hormonal therapy ( P = 0.001 ) and PMRT ( P = 0.004 ). On multivariate analysis, factors affecting LRR were age ( P = 0.001 ), tumor stage ( P = 0.021 ), deep resection plane (0.003), ECE ( P = 0.022 ) and PMRT ( P = 0.047 ). Factors affecting distant metastases were menopause ( P = 0.044 ), grade ( P = 0.012 ), ECE ( P = 0.017 ) and PMRT ( P = 0.012 ). Factors affecting OS were menopausal status ( P = 0.017 ), tumor stage ( P = 0.029 ), pathological nodal status ( P = 0.011 ) and PMRT ( P = 0.002 ). Conclusion: PMRT improves LRR as well as OS in patients with carcinoma breast. Other factors of prognostic importance were menopausal status, tumor stage and pathological nodal status.
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Malignant pilar tumor of the scalp: A case report and review of literature
Manish Siddha, Ashwini Budrukkar, Tanuja Shet, Mandar Deshpande, Ayan Basu, Nikhilesh Patil, Rajendra Bhalavat
October-December 2007, 3(4):240-243
DOI:10.4103/0973-1482.39001  PMID:18270401
Pilar tumor is a rare neoplasm arising from the external root sheath of the hair follicle and is most commonly observed on the scalp. These tumors are largely benign, often cystic, and are characterized by trichilemmal keratinization. Wide local excision has been the standard treatment. Recent reports have described a rare malignant variant with an aggressive clinical course and a propensity for nodal and distant metastases which, therefore, merits aggressive treatment. In this report, we present a case of malignant pilar tumor of the scalp with multiple nodal metastases at presentation. Diagnostic and therapeutic considerations, in the form of adjuvant radiotherapy, are subsequently discussed.
  10 71,054 866
Surgical voice restoration following total laryngectomy
Rehan Kazi
October-December 2007, 3(4):188-189
DOI:10.4103/0973-1482.38991  PMID:18270391
  9 6,883 461
Isolated non-Hodgkin's lymphoma of the pancreas: Case report and review of literature
Ayan Basu, Nikhilesh Patil, Pranshu Mohindra, Bhooshan Zade, Sumeet Gujral, Mary Ann Muckaden, Siddhartha Laskar
October-December 2007, 3(4):236-239
DOI:10.4103/0973-1482.39000  PMID:18270400
Background: Isolated primary pancreatic lymphoma (PPL) is a rare extra-lymphatic non-Hodgkin's lymphoma comprising less than 1% of all extra-lymphatic lymphomas. It is seen in people of advanced age and there is a slight male preponderance. It is difficult to diagnose; the vague presenting symptoms and nonspecific laboratory/radiological findings make it difficult to differentiate the condition from pancreatic adenocarcinoma. Histopathological examination is of paramount importance to conclusively establish the diagnosis since the treatment involves lymphoma protocols, and prognosis and survival in PPL are considerably superior to that in adenocarcinoma pancreas. Case Report: We report a case of isolated PPL diagnosed after Tru-Cut biopsy and immunohistochemistry after a thorough staging workup. Result: The patient was treated with multi-agent combination chemotherapy followed by radiotherapy. Discussion: A review of literature was done using a Medline search to determine the incidence and prevalence of isolated PPL and to note the diagnosis and management of previously reported cases. Conclusion: An exceedingly rare entity, isolated PPLs need to be differentiated from pancreatic adenocarcinomas by histopathological evaluation since management is on the lines of other extralymphatic lymphomas and prognosis is significantly better.
  8 18,981 731
Breast cancer radiotherapy and cardiac risk: The 15-year paradox!
Anusheel Munshi
October-December 2007, 3(4):190-192
DOI:10.4103/0973-1482.38992  PMID:18270392
  7 6,340 661
Radical radiotherapy treatment (EBRT + HDR-ICRT) of carcinoma of the uterine cervix: Outcome in patients treated at a rural center in India
Vandana S Jain, Kailash K Singh, Rajeev Shrivastava, KV Saumsundaram, Mukund B Sarje, Shailendra M Jain
October-December 2007, 3(4):211-217
DOI:10.4103/0973-1482.38996  PMID:18270396
Aim: To report the outcome of carcinoma of the uterine cervix patients treated radically by external beam radiotherapy (EBRT) and high-dose-rate (HDR) intracavitary radiotherapy (ICRT). Materials and Methods: Between January 1997 to December 2001, a total of 550 newly diagnosed cases of carcinoma of the uterine cervix were reported in the department. All cases were staged according to the International Federation of Gynecologists and Oncologists (FIGO) staging system, but for analytical convenience, the staging was limited to stages I, II, III, and IV. Out of the 550 cases, 214 completed radical radiotherapy (EBRT + HDR-ICRT) and were retrospectively analyzed for presence of local residual disease, local recurrence, distant metastases, radiation reactions, and disease-free survival. Results: There were 7 (3.27%), 88 (41.1%), 101 (47.1%), and 18 (8.4%) patients in stage I, II, III, and IV, respectively. The median follow-up time for all patients was 43 months (range: 3-93 months) and for patients who were disease free till the last follow-up it was 59 months (range: 24-93 months). The overall treatment time (OTT) ranged from 52 to 73 days (median 61 days). The 5-year disease-free mean survival rate was 58%, 44%, 33%, and 15%, with 95% confidence interval of 48 to 68, 37 to 51, 24 to 35, and 6 to 24 for stages I, II, III, and IV, respectively. There were 62 (28.97%) cases with local residual disease, 35 (16.3%) developed local recurrence/distant metastases, 17 (7.9%) developed distant metastases, and 9 (4.2%) had local recurrence as well. Discussion and Conclusion: The overall outcome was poor in advanced stage disease, but might be improved by increasing the total dose, decreasing overall duration of treatment, and by adding chemotherapy in patients with disease limited to the pelvis.
  5 12,023 667
External hypofractionated whole-breast radiotherapy: Now where does accelerated partial breast irradiation stand?
Anusheel Munshi
October-December 2007, 3(4):231-235
DOI:10.4103/0973-1482.38999  PMID:18270399
Breast-conserving therapy (BCT) has emerged as a viable option for suitable breast cancer patients who are desirous of preserving the breast. The major advantage of BCT is the good cosmetic outcome with disease-free and overall survival similar to mastectomy. In this article, I have compared two emerging modalities for treating a preserved breast with radiotherapy. These two techniques in breast cancer - accelerated partial breast irradiation (APBI) and hypofractionated whole breast external beam radiotherapy - have their respective merits and drawbacks, and this article attempts to dissect the issue.
  3 6,580 753
Methods of intervention in reducing the psychosocial impact while dealing with cancer as a disease: A clinician's point of view
S Trivedi, J Petera, S Fillip, Z Hrstka
October-December 2007, 3(4):193-197
DOI:10.4103/0973-1482.38993  PMID:18270393
Aims and Objective: We searched for the clinically relevant suggestions, recommendations and findings amongst the papers on psycho oncology. The term clinically relevant for us meant 'practical and implemental modes of intervention that contribute but would not affect or interfere with the normal functioning of the present system and treatment modality of the patients.' Our intention was to use the available information for the benefit of our patients. We also searched for the data that would prove the significance of these methods. In most parts of the world it is not possible to involve a psychologist at every level of cancer care. Based on the findings, we intend to carry out our own project for the psychosocial intervention in cancer patients and make suggestions that could be adopted even by those who have little or no experience in psychology. Conclusion: The field of psycho oncology is a relatively new and evolving subspecialty of oncology and psychology at the same time. Current data and papers, which would make simple and implemental modes of intervention at psychosocial level, are limited. There is a dire necessity of solid data and list of suggestion to the specialists, non-specialists and those who take care of the cancer patients, to enhance the care they provide to the cancer patients.
  1 5,695 441
NANO: A paradigm shift
Nagraj G Huilgol
October-December 2007, 3(4):187-187
DOI:10.4103/0973-1482.38990  PMID:18270390
  - 3,282 415