Acute treatment-related toxicity in elderly patients with good performance status compared to young patients in locally advanced esophageal carcinoma treated by definitive chemoradiation: A retrospective comparative study.

INTRODUCTION: The benefit of definitive chemoradiotherapy (CRT) in elderly patients with locally advanced esophageal cancer is not well established. We perform a single institutional retrospective study of CRT in terms of toxicity in elderly patients (age more than 60 years) as compared with young cohort (age <60 years) in locally advanced nonmetastatic esophageal cancer. PATIENTS AND METHODS: A total 145 of patients, 79 in young age (Group A) and 66 patients of elder age (Group B) with Stage II and III squamous cell carcinoma of the esophagus with ECOG PS of 0-1, who had undergone definitive CRT at our institute from January 2015 to November 2018 were selected for this analysis. Chemotherapy was cisplatin (40 mg/m2) given concurrently on weekly basis with radiotherapy (RT). Total prescribed dose of RT was 50.4 Gy at the rate of 1.8 Gy per fraction. Median age was 40 years (25-60 years) and 65 years (60-75 years) in young and elderly group, respectively. Follow-up is done at median of 28 months (1-48 months) after treatment. RESULTS: Acute Grade 2-3 esophagitis was seen in 48.10% in young cohort, while it was 60.6% in older group. Grade 2-3 nausea and vomiting was seen in 32.91% in young age patients, while it was 45.5% in elder patients. No statistically significant difference is seen in acute treatment-related toxicity in young and elderly group. CONCLUSION: Our conclusion is that patients with adequate functional status should not be excluded from curative CRT based on age alone.

Pros and Cons of Adding of Neoadjuvant Chemotherapy to Standard Concurrent Chemoradiotherapy in Cervical Cancer: A Regional Cancer Center Experience.

BACKGROUND: The present study summarizes the results of treatment in the form of disease-free survival and overall survival in bulky stage IB2 and locally advanced (stages II-IVA) squamous cell carcinoma of the uterine cervix. The treatment has been given in the form of NACT followed by CCRT in one arm and CCRT in the other arm. MATERIALS AND METHODS: This retrospective study analyzed 713 cervical cancer patients who were treated at our center during 2007 and 2008; out of 713 patients, data of 612 patients have been compared. The patients' data were analyzed retrospectively. Patients had undergone PF 28.6 %, TPF 21.5 %, and only CCRT 49.9 %. Majority of patients were in the age group 41-50 years, while stage wise, mainly stage IIIb and IIb. Disease-free survival was observed on the basis of stage and NACT. The survival analyses were performed using the Kaplan-Meier method. All statistical calculations were done with SPSS Statistics version 20.0. RESULTS: For cancer cervix NACT versus CCRT, the DFS rate was at 5 years (58.3 vs. 41.8 % p = 0.001). NACT followed by CCRT demonstrated significantly superior DFS as compared to definitive CCRT, respectively, TPF (hazard ratio (HR) = 0.248, 95 % confidence interval (CI) 0.123-0.500; p < 0.001), PF (HR = 0.445, 95 % CI 0.266-0.722; p = 0.002). The results of univariate stage, age, and multivariate study show that stage hemoglobin level, interval between external-intracavitary radiation, and type of neoadjuvant chemotherapy were the factors affected survival cervical patients treated with radiation. The grade 3/4 hematologic toxicities were more in the NACT group than CCRT (p < 0.001) while the non-hematological toxicity was not significant; the TPF group experienced more toxicity than PF (p = 0.029). This treatment regimen is feasible as evidenced by the acceptable toxicity of NACT and by the high compliance to radiotherapy. The grade 3/4 hematologic toxicities were more in NACT groups than CCRT (p < 0.001); the TPF group experienced more toxicity than PF (p = 0.029). CONCLUSION: TPF/PF as NACT is feasible and produces impressive responses in cancer cervix.

Defect detection around rebars in concrete using focused ultrasound and reverse time migration.

Experimental and numerical investigations have been performed to assess the feasibility of damage detection around rebars in concrete using focused ultrasound and a Reverse Time Migration (RTM) based subsurface imaging algorithm. Since concrete is heterogeneous, an unfocused ultrasonic field will be randomly scattered by the aggregates, thereby masking information about damage(s). A focused ultrasonic field, on the other hand, increases the possibility of detection of an anomaly due to enhanced amplitude of the incident field in the focal region. Further, the RTM based reconstruction using scattered focused field data is capable of creating clear images of the inspected region of interest. Since scattering of a focused field by a damaged rebar differs qualitatively from that of an undamaged rebar, distinct images of damaged and undamaged situations are obtained in the RTM generated images. This is demonstrated with both numerical and experimental investigations. The total scattered field, acquired on the surface of the concrete medium, is used as input for the RTM algorithm to generate the subsurface image that helps to identify the damage. The proposed technique, therefore, has some advantage since knowledge about the undamaged scenario for the concrete medium is not necessary to assess its integrity.

Malignant mesenchymal tumor of male breast: primary chondrosarcoma.

Breast Sarcomas have relatively been rare and accounted for 1% of all primary malignant tumors of the breast. Pure and primary chondrosarcoma of the male breast would be an extremely rare tumor. It might arise either from the breast stroma itself, or from underlying bone or cartilage. A 65-year-old man has presented with a rapidly growing breast mass since 5 months. Physical examination has established a large firm to hard mass with regular margins in the region of right breast. There was no axillary lymphadenopathy. Contrast enhanced MRI of breasts has shown a mixed-signal intensity multi lobulated cystic-solid mass (10.4 cm × 10.3 cm ×9.9 cm) appearing predominantly hyper intense on T2W and hypo intense on T1W. The tumor has diagnosed as a low-grade chondrosarcoma of the breast by histopathological and immunohistochemistry analysis. Right sided radical mastectomy with grafting has done. It has seemed to be very important to identify the mammary primary sarcomas as entity separated from the carcinomas of the breast.

ExcellmiRDB for translational genomics: a curated online resource for extracellular microRNAs.

A large number of studies have suggested extracellular microRNAs (microRNAs in biofluids) as potential noninvasive biomarkers for pathophysiological conditions such as cancer. However, reported differentially expressed signatures of extracellular miRNAs in diseases are not uniformly consistent among studies. Here, we present "ExcellmiRDB", a curated online database that provides integrated information about miRNAs levels in biofluids in a user-friendly way. Although many miRNA databases, including disease-oriented databases, have been launched before, the ExcellmiRDB is so far the only one specialized for storing curated data on miRNA levels in biofluid samples. At present, ExcellmiRDB has 2773 disease-extracellular miRNAs and 1108 biofluid-extracellular miRNAs relationships curated from 108 articles selected from more than 600 surveyed PubMed abstracts. Information about 992 miRNAs, 82 diseases, 21 biofluids, 8 species, 63 normalization reference genes, 5 techniques, 14 GEO profiles accession numbers, 7 human ethnic groups, and 18 compared clinical biomarkers have been provided in the database. A user can query ExcellmiRDB by selecting a disease or a miRNA or a biofluid. Additionally, the database provides two online network graphs to visualize and interact with the content of the database. The first network shows disease-extracellular miRNAs relationships, along with expression patterns and number of articles for a relationship. The second network visualizes biofluid-extracellular miRNAs relationships showing miRNAs spectrum across different types of biofluids. In conclusion, ExcellmiRDB is a new innovative resource for both academic and industrial researchers in translational omics who are developing miRNA biomarkers for noninvasive diagnostic or prognostic technologies. ExcellmiRDB is publicly available on www.excellmirdb.brfjaisalmer.com/.