Trends in oesophagus and Stomach cancer incidence in Bangalore, India.

BACKGROUND: During recent decades, an increase in the incidence of certain oesophago-gastric cancer has been reported in some countries and in India. This study sought to analyze oesophageal and gastric cancer incidence trends in Bangalore by sex and morphology for the period 1982-2007. PATIENTS AND METHODS: Oesophageal and gastric cancer cases were drawn from Bangalore population-based cancer registry locating in Kidwai memorial Institute of Oncology started in 1982 under national cancer Registry Programme funded by Indian Council of Medical Research. Time trends in sex- and age-standardized cancer incidence rates were analyzed by site and histology over the study period, using relative change. RESULTS: Age-standardised oesophageal cancer incidence rates increased in males, in females failed to register a significant trend over the study period. Overall, gastric cancer decreased from 9.81 and 5.48 rates per 100 000 person-years in 1982-86 to 9.45 and 5.25 in 2002-07, among men and women, respectively. Where as oesophageal adenocarcinomas increased sharply in both sex, among men, oesophageal squamous cell cancer rates increased steadily from the mid-1982s onwards a bit decline was observed from 1997, the same trend observed in females. The gastric cancer decreased over the study period. There was a marked decrease in the incidence of oesophago-gastric cancer presenting with unknown and unspecified morphology reported. KEYWORDS: adenocarcinoma, Oesophageal and stomach, incidence, age specific rate, age adjusted rate, population-based registry, trends.

Determination of IAA in brassinolide treated coleoptiles of wheat by a modified indirect ELISA with polyclonal antibodies.

An indirect enzyme immunoassay for detection of as little as 10-50 pmole IAA is described for the first time. The assay is based on the development of highly specific polyclonal antibodies against the carboxyl site of IAA. The binding specificity is nearly as high as the radioimmunoassay and the titre of the specific antibody was also remarkably high (1:40,000 of the primary antibody). Such an easy, rapid, specific and highly sensitive assay would be extremely useful in gaining more information on the mode of action of phytohormones, and their effects on physiological processes.

Influence of intraluminal brachytherapy dose on complications in the treatment of esophageal cancer.

PURPOSE: Demonstration of the influence of intraluminal brachytherapy dose on complications in the treatment of esophageal carcinoma. METHODS AND MATERIALS: Between January 1990 and June 1991, 75 patients with esophageal cancer were treated with external radiotherapy followed by intraluminal brachytherapy. Patients had a Karnofsky score of over 70, with no supra-clavicular nodal or distant disease. An external radiotherapy dose between 40 and 55 Gy (mean 52 Gy), 5 times a week, 2 to 2.06 Gy/fraction, followed by a single session of Intraluminal brachytherapy using a locally developed, manual, afterloading applicator with Cs-137 sources with dose ranges of 8-10 Gy (Group 1: 42 patients), 10-12 Gy (Group 2: 11 patients), and 12-15 Gy (Group 3: 22 patients) at a mean dose rate of 2.09 Gy/hr was delivered. RESULTS: The actuarial figures at 1 year were 39% for overall survival, 29% for disease-free survival, and 38% for local control. Fourteen patients (18.6%) developed complications of either an esophageal stricture or fistula. These were dependent on intra-luminal brachytherapy dose, whereas external radiotherapy and intra-luminal brachytherapy doses did not contribute significantly to local control. For Groups 1, 2, and 3, actuarial local control were 28%, 45%, and 63% (p < 0.1) and of complications were 6%, 20%, and 70% (p < 0.001), respectively. Also, on applying the Time/Dose/Fractionation formula on brachytherapy doses, it was found that the complication rate was 6% for TDF of < 31, 25% for TDF of 32-37, and 70% for TDF of > 38 (p < 0.001). CONCLUSION: External radiotherapy doses in the range of 50 to 55 Gy followed by a dose of 10-12 Gy of intraluminal brachytherapy was found optimal with respect to complications and local control in the radiotherapeutic management of esophageal cancer.

Intraluminal brachytherapy in carcinoma of the oesophagus: comparison of afterloading techniques.

For improved local control or palliation of oesophageal cancers, Intra-luminal brachytherapy (ILB) has emerged as an increasingly popular treatment modality of therapy in recent years. In combination with external radiotherapy, afterloaded ILB can increase local control rates and may prolong survival of these patients. In this paper two techniques of ILB viz., manual and low dose-rate remote after loading methods, using Caesium-137 tubes and pellets respectively, are described in detail. On comparison of these two techniques it was found that both of them were similar with respect to their physical characteristics (dose rate, dose fall-off, maximum spinal cord dose, total reference air kerma, etc.). Clinically, the manual afterloaded ILB technique was found to be easier to use when compared with the low-dose rate remote afterloader. In addition, the number of patients with uterine cancers being high in a developing country, it was found that it was inappropriate to use the low dose remote afterloaders, designed for use in gynaecological cancers, for ILB of oesophageal cancers. Therefore, in the absence of high dose rate afterloaders, which can be utilized for intracavitary treatments of both uterine and oesophageal malignancies effectively, the manual after-loading ILB system as described in this paper could be a practical alternative. Cancer Oesophagus, Intraluminal radiotherapy technique.

The dose time relationship in the radiotherapy of carcinoma of the cervix--application of CRE formalism.

A retrospective analysis of 291 patients with cancer of the uterine cervix treated with a combination of external and intracavitary radiotherapy was carried out. Patients were either treated with 45 Gy in 20 fractions by five fractions per week or with 42 Gy in 14 fractions by three fractions per week or with 42 Gy in 14 fractions by three fraction per week schedule by external radiotherapy. For brachytherapy the total dose was 24 to 32 Gy at a dose rate of 1.4 to 2.2 Gy per hour. Complication were correlated with total CRE values for point A (CRE TA) and for rectum CRE TR. Correlations of CRE TA with overall complication rate (p value < 0.05) and rectal complication rate (p value < 0.01) were excellent. Lack of correlation was observed between CRETR and overall complication rate (p value > 0.1) as well as rectal complication rate (p value > 0.1). In order to limit Grade II and III rectal and bladder complications to acceptable level, in combined external and intracavitary treatments, CRETA value of less than 2500 reu is suggested.

Intraluminal brachytherapy in oesophageal cancer: a simple afterloading technique.

Carcinoma of the oesophagus occurs in a good number of patients in any oncology department. Management is either by surgery or radiotherapy. In view of the proximity of the oesophagus to the critical organs in the thorax, effective external beam radiotherapy becomes difficult. A possible solution could be the use of intraluminal brachytherapy (ILB) in addition to external radiotherapy. In this paper a simple and locally developed method of ILB is described which delivers an effective boost to the oesophageal lesion in radical treatments and gives good palliation in advanced cases. Also, this system takes the load off the low dose rate afterloading machines used for intracavitary therapy in gynaecological cancers which otherwise would have also been used for the ILB treatment of oesophageal cancers. A description of the manual afterloading ILB applicator, the technique of its application, and a review of literature, is presented.

Application of radiation effect models in combined external and intracavitary radiotherapy of carcinoma of the uterine cervix.

A retrospective analysis of 291 patients with cancer of the uterine cervix treated with a combination of external and intracavitary radiotherapy was carried out. Patients were treated with an external radiotherapy dose of 45 Gy in 20 fractions, 5 fractions per week, or 42 Gy in 14 fractions, 3 fractions per week. For brachytherapy the total dose was 24 to 32 Gy at a dose rate of 1.4 to 2.2 Gy per hour. Treatment results in terms of survival, local disease-free survival and complication rates were compared with cumulative radiation effect (CRE) and extrapolated response dose (ERD) values for point A (CRETA and ERDTA respectively) and for rectum (CRETr and ERDTr respectively). CRETA and ERDTA values did not significantly correlate with local disease-free and survival rates. Correlations of CRETA and ERDTA with overall complication rate and with rectal complication rate (p-value less than 0.025) were good. No significant correlation was observed between CRETr or ERDTr and overall complication rate and rectal complication rate. In order to limit grades II and III rectal complications to acceptable level, in combined external and intracavitary treatment, CRETA and ERDTA values of less than 2,500 and 93 respectively are suggested.

The time dose fractionation (TDF) relationship in the radiotherapy of carcinoma of the cervix.

A retrospective analysis of 291 patients with cancer of the uterine cervix treated with a combination of external and intracavitary radiotherapy was carried out. Patients were either treated with 45 Gy in 20 fractions by five fractions per week or with 42 Gy in 14 fractions by three fractions per week schedule by external radiotherapy. For brachytherapy the total dose was 24 to 32 Gy at a dose rate of 1.4 to 2.2 Gy per hour. Treatment results in terms of response, survival, recurrence and complication were correlated with total TDF values for point A (TDFTA) and for rectum TDFTR. Correlations of TDFTA with overall complication rate (p value less than 0.05) and rectal complications rate (p value less than 0.01) were excellent. TDFTA values did not correlate with response, recurrence and survival rates (p value greater than 0.1). Lack of correlation was observed between TDFTR and overall complication rate (p value greater than 0.1) as well as rectal complication rate (p value greater than 0.1). In order to limit grade II and III rectal and bladder complications to acceptable level, in combined external and intracavitary treatments, TDFTA value of less than 150 is suggested.