Browsing by Author "Pandey, Ankita"

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    Clinico.epidemiological profile and treatment outcome in adolescents and young patients of rectal cancer attending a tertiary cancer center
    (Wolters Kluwer Medknow Publications, 2023) Mishra, Ritusha; Pandey, Ankita; Mishra, Himanshu; Singh, Tej B.; Mandal, Abhijit; Asthana, Anupam K.
    Introduction: The incidence of colorectal cancer in young adults is on an increasing trend. It is observed that this subgroup of patients has an aggressive disease and carries a poorer prognosis compared to its older counterpart. This study aimed to analyze the incidence, treatment outcome, and prognostic factors in adolescents and young adults with rectal cancer attending a tertiary cancer center in North India. Materials and Methods: We retrospectively analyzed 50 patients of histologically proven rectal cancer, aged up to 30 years, treated at our center between 2015 and 2019. The clinical, demographic, and pathological parameters were studied in all these patients. Kaplan-Meier survival analysis was used to find out survival. Univariate analysis was performed to assess prognostic factors. Results: The incidence was 26.4% at our center with a median age of 28 years. Bleeding per rectum was the commonest complaint. Most of them had signet ring cell histology (26%). The median overall survival was 16 months. Survival was significantly better in patients having bleeding per rectum as an initial complaint (P = 0.009), absence of lymphovascular invasion (LVI) (P = 0.005), and perineural invasion (PNI) (P = 0.002), who received complete planned treatment compared to patients who could not receive either of the modality (P < 0.001). Patients who did not receive radiotherapy (RT) had the worst outcomes compared to those who received RT in any form. RT dose of 50.4 Gy was found to be superior as compared to other schedules. There was no significant difference in survival with gender, tumor stage, grade, type of surgery, or chemotherapy regimen. Conclusion: The majority of patients presented in an advanced stage. Therefore, bleeding per rectum should be properly and timely investigated in all these young patients. Early detection and complete treatment are paramount to improving the outcome. � 2023 Copyright:
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    Evaluation of survival outcome and prognostic factors for oral cavity cancer treated with volumetric arc therapy
    (Springer Science and Business Media Deutschland GmbH, 2023) Mishra, Himanshu; Singh, Shreya; Mishra, Ritusha; Pandey, Ankita; Mandal, Abhijit; Prakash, Ekta; Patel, Ganeshkumar; Shah, Manav; Singh, Tej Bali
    Purpose: This study aimed to evaluate the survival outcomes and identify prognostic factors for patients with oral cavity cancer (OCC) who underwent adjuvant treatment with volumetric arc therapy (VMAT) using simultaneous integrated boost (SIB). Methods: Data was collected for post-operated patients of carcinoma of oral cavity who received adjuvant VMAT with SIB between June 2018 and December 2022. The data was entered and analyzed using SPSS software version 20.0. Survival rates were estimated using Kaplan Meier method. To determine survival difference between the groups, log rank test was used. Multivariate analyses were performed with Cox proportional hazard model and p value < 0.05 was considered as significant. Results: A total of 178 patients were included in the study. The median follow-up period was 26�months (range 3�56�months). The 3-year OS, DFS, and LRC rates were 78% (95% CI 77�79%), 76% (95% CI 74�77%), and 81% (95% CI 80�82%), respectively. Univariate analysis identified age ? 50�years, lymph node involvement, extracapsular extension (ECE), and N2�N3 disease as significant adverse prognostic factors for OS, DFS, and LRC. Multivariate analysis confirmed age ? 50�years and nodal involvement as independent predictors of worse OS, DFS, and LRC. Additionally, ECE independently affected OS and DFS. Conclusion: Adjuvant treatment with VMAT using SIBin patients with OCC is effective. Age and nodal involvement had significant impact on LRC, DFSand OS while ECE on DFSand OS. � 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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    Hiccups: An atypical side effect experienced during chemo-radiotherapy in carcinoma nasopharynx
    (Wolters Kluwer Medknow Publications, 2023) Pandey, Ankita; Mishra, Himanshu; Singh, Pramod Kumar; Mishra, Ritusha
    Nasopharyngeal carcinoma is an uncommon cancer but has a distinct racial and geographic distribution. Patient presents with constellation of signs and symptoms due to its vicinity to critical structures and are best treated by conformal concurrent chemo-radiotherapy. We present a case of 45-year-old male diagnosed with carcinoma nasopharynx, referred to us for radiotherapy after three cycles of neoadjuvant chemotherapy. As per the prevailing standard of care, patient was planned for radiotherapy by volumetric arc technique with concurrent cisplatin. Initial days of treatment were uneventful. After fourth week of treatment, patient developed persistent hiccup which was not relieved on conservative medications. Plan was re-evaluated and it revealed maximum dose of 54.6 Gy to the brainstem. Radiotherapy induced edema that could have stimulated vagus nerve leading to hiccups was suspected. Patient was started on injectable steroid and chlorpromazine. There was prompt recovery from the symptom within five days of conservative treatment. Copyright � 2023 Journal of Cancer Research and Therapeutics.
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    Survival outcome and prognostic factors post inadvertent hysterectomy in carcinoma cervix treated with salvage chemo-radiation
    (Springer Science and Business Media Deutschland GmbH, 2023) Mishra, Ritusha; Pandey, Ankita; Mishra, Himanshu; Singh, Shreya; Jain, Pallavi; Singh, Tej Bali; Mandal, Abhijit; Singh, Pramod Kumar
    Introduction: The standard of care for treating early invasive cervical cancer is radical hysterectomy or radiation alone while chemo-radiation is a definitive treatment for advanced disease. Occasionally, a simple hysterectomy is performed in the cancer cervix and these patients merit adjuvant treatment in view of the high chances of loco-regional recurrences. The aim of the study was to analyze the survival outcome of these patients treated with salvage chemo-radiotherapy and also to determine the prognostic factors affecting survival. Materials and methods: The medical records of all patients with cervical cancer post simple hysterectomy outside and who received salvage treatment in our department between 2014 and 2020 were retrieved. The data regarding clinical, treatment details and survival were analyzed. Results: A total of 198 patients were included. Median follow-up duration was 45.5�months. Gross disease and lymphadenopathy were seen in 60% and 28% patients, respectively. The 5-year progression-free survival(PFS) and overall survival(OS) was 75% and 76%, respectively. Concurrent chemotherapy alone or in combination with induction chemotherapy using three-drug regimens showed better survival compared to those treated by radiation alone. On multivariate analysis, factors found to be adversely affecting OS and PFS were lymph node (LN) size of more than 2�cm, non-squamous histology, overall treatment time(OTT) of more than 12�weeks and use of non three-drug chemotherapy regimen. Conclusion: Subtotal hysterectomy results in a higher incidence of local recurrence of disease. Factors that impair the outcome in this sub-group of patients are gross lymphadenopathy, non-squamous histology and prolong OTT. � 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.