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   Table of Contents - Current issue
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March-April 2021
Volume 10 | Issue 2
Page Nos. 53-96

Online since Friday, April 23, 2021

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REVIEW ARTICLE  

Role of altered fractionation in radiation therapy with or without chemotherapy in management of carcinoma cervix: Time to revisit in the current COVID-19 pandemic p. 53
Deepak Kumar Agrawal, Neha Agrawal, Sovan Sarangdhar, Vinita Kumari, Narvada Narain, Neelam Lader, Sanjog Pal, Satyajit Pradhan
DOI:10.4103/ccij.ccij_155_20  
Severe acute respiratory syndrome coronavirus 2 as COVID-19 virus has affected the entire world and so to the cancer care and health-care facility. Cancer cervix is one of the common malignancies among women in developing and underdeveloped countries. Various challenges are being faced by patients and health-care providers to deliver optimal treatment under prescribed time frame. Faster delivery of whole treatment is desirable in the current pandemic. Overall treatment time in cancer cervix has prognostic value. Adoption of altered fractionation to delivered external beam radiation therapy could be a method for faster delivery of whole treatment. Altered fractionation such as hyperfractionation (HFX), hypofractionation, and accelerated fraction alone or with HFX has already been experimented for the past three decades. The total duration of treatment has been significantly reduced without addition of much toxicity. Few studies had also highlighted the feasibility of addition of chemotherapy to such fractionation schedule. However, prospective studies are still warranted to generate data to further support its use in the future.
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ORIGINAL ARTICLES Top

The expression profile evaluation of Mir-125b in tuberculosis and non-small cell lung cancer patients p. 60
Mahboubeh Shahsavani, Fahimeh Baghbani-Arani, Mojgan Sheikhpour
DOI:10.4103/ccij.ccij_180_20  
Background and Aim: Worldwide, lung cancer, specifically nonsmall-cell lung cancer (NSCLC), is one of the most preventable and common cancer types. Tuberculosis (TB) is a major global public health threat, and the most important infectious disease throughout history in the world. Having TB before lung cancer significantly correlates with mortality due to lung cancer. TB and lung cancer have similar symptoms, and TB has symptoms identical to malignancy, so sometimes its diagnosis is confused with lung cancer. The miRNAs are biological molecules that play critical regulatory roles in the physiological and pathological processes. In several research types, many miRNAs have been studied, which showed the alternation of expression in TB and NSCLC separately. In this research paper, the expression of mir-125b was examined, which is commonly altered in TB and NSCLC. Materials and Methods: Thirty patients with NSCLC, thirty patients with TB who were new cases, and thirty healthy individuals were contributed to this research. The expression pattern of mir-125b was evaluated and compared in TB and NSCLC patients with healthy controls, using the real-time polymerase chain reaction method. Results: As a result, the expression of mir-125b was lower in TB and NSCLC patients than in healthy controls. Conclusion: Therefore, mir-125b can be used as a prognostic biomarker in TB and NSCLC diseases. The expression pattern of mir-125b could be useful to follow-up on the biological pathways that have essential roles in these diseases.
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Risk of ovarian and cervical cancer in women with positive cancer family history: Results of tabari cohort study p. 65
Mahmood Moosazadeh, Amir Mohmmad Karimi, Ehsan Zaboli, Akbar Hedayatizadeh-Omran, Alizadeh Navaei Reza, Motahareh Kheradmand
DOI:10.4103/ccij.ccij_183_20  
Aim and Background: Positive association between cancer family history and cervical/ovarian cancer could be due to genetic susceptibility or shared environment. The aim of the present study was to identify the association between positive cancer family history and risk of ovarian and cervical cancer. Materials and Methods: In the present case–control study, we have utilized the data collected in the enrollment phase of population-based Tabari cohort study. The case group consisted of participants with ovarian and cervical cancer (17 and 39 individuals, respectively) were selected by the census method. Participants in control groups were matched by age and were selected randomly from the study population. Participants in the control group were twice as participants with cervical cancer and three times as participants with ovarian cancer. Results: There was no association between ovarian cancer family history and other kinds of cancer family history with ovarian cancer (P value: 1.000, 0.146, respectively). Our finding showed no association between cervical cancer family history as well as other kinds of cancer family history with ovarian cancer ovarian (P value: 0.439 and 0.713, respectively). Conclusions: The findings of the present study showed that there is no significant association between cancer family history with ovarian cancer as well as cervical cancer. Among our selected variables, menopause and residency were significantly associated with ovarian and cervical cancer.
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Assessment of oral cancer awareness among medical professionals working in Bergama District of Izmir Province, Turkey p. 69
Gaye Keser, Dilara Altun, Filiz Namdar Pekiner
DOI:10.4103/ccij.ccij_159_20  
Introduction: The aim of this study is to assess awareness of oral cancer in a group of medical professionals working in Bergama district of Izmir province, Turkey. Materials and Methods: The study group consisted of 90 medical doctors and a questionnaire was submitted to the study group consisting of 25 questions related to risk factors and screening methods, attitude toward oral cancer, control of oral cancer care, and knowledge on oral cancer. Results: All participants regard the use of cigarettes and viral diseases as a risk factor and 95.6% of them consider the use of alcohol as a risk factor. 15.6% of all participants reported erythroplakia and Morbus Bowen as two lesions with the greatest cancerous tendency, while 47.8% of participants reported leukoplakia and erythroplakia. Among age groups, rates of assessment of alcohol usage as a risk factor (P = 0.002), rates of assessment of high age as a risk factor (P = 0.007), rates of distribution of the most prevalent oral cancer regions (P = 0.001), rates of distribution of the two lesion groups with the greatest sensitivity to cancer (P = 0021), and rates of assessment of prior alcohol use of the patient when taking medical history (P = 0.008) were statistically significant. Conclusion: The ability of medical professionals to recognize and diagnose oral cancer as early as possible concerning diagnostic and treatment progress is a very crucial point. This study suggests that medical doctors show a sensitive attitude toward oral cancers. However, it also reveals that there is a need for improvement of the undergraduate curriculum in oral cancer in medical schools and for the provision of postgraduate and continuing education on this topic.
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Is it time to include p40 as a standard myoepithelial marker of breast? A comparative study of expression of p63 and p40 in benign breast diseases and invasive ductal carcinomas of the breast p. 78
Richa Ranjan, Alpana Gupta, Samresh Singh, Aatirah Cheriaparambath, Raj Singh
DOI:10.4103/ccij.ccij_158_20  
Context: The expression of p40 in breast tissue as a myoepithelial marker is not extensively studied. This study was designed to find the expression of two markers p63 and p40 in benign breast diseases and Invasive ductal carcinomas (IDCs) of the breast. Aim: A series of cases of fibroadenoma and IDC of breast were studied for expression of p40 and compared to the p63 staining profile. Settings and Design: A total of 118 cases of breast disease were selected for this study from the archives of a tertiary care hospital, which included 41 cases of benign and 77 cases of malignant etiology. After the exclusion, 30 cases of fibroadenoma and 68 cases of IDC, were selected for the study. Subjects and Methods: Samples (n = 98) included fibroadenoma (n = 30) and IDC (n = 68). IDC was studied as a whole group and was also divided as triple negative breast cancer (TNBCs, n = 12) and Non-Triple TNBCs (NTNBC, n = 56). The expression of p63 and p40 was assessed in myoepithelial cells (MECs) in fibroadenoma and tumor cells in IDC. Results: Both the antibodies performed similarly to highlight MECs in fibroadenoma in all 30 cases. In IDC, TNBC and NTNBC subgroups p63 stained the tumor cells more than p40. None of the tumor cells in the NTNBC group exhibited positivity for p40. Conclusions: As a MEC marker, both p63 and p40 perform similarly but in IDC (TNBC and NTNBC), the tumor cells of IDC stain significantly more for p63 than p40. It appears that p40 does not come positive in the tumor cells of NTNBC.
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Combined hyperthermic intraperitoneal chemotherapy and hyperthermic intrathoracic chemotherapy in stage IVA ovarian carcinoma: Single institution experience from North India p. 84
MD Ray, K Raghuram, Navin Kumar
DOI:10.4103/ccij.ccij_154_20  
Introduction: Treatment of Stage IVA ovarian carcinoma needs a combined multidisciplinary team approach. The peritoneal disease needs adequate local treatment with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Hyperthermic intrathoracic chemotherapy (HITHOC) is a reasonable treatment option for ovarian carcinoma with malignant pleural effusion or pleural deposits. The CRS with HIPEC and HITHOC needs collaborative surgical and anesthetic skills and is a more technically demanding procedure. Methods: We are sharing the experience of three advanced cases diagnosed with Stage IVA ovarian carcinoma with subdiaphragmatic deposits along with malignant pleural effusion, which were treated with CRS with combined HIPEC and HITHOC. The feasibility of combined HIPEC and HITHOC along with surgical sequelae and follow-up treatment outcomes are individually summarized. Results: All patients underwent the proposed surgery without any significant intraoperative complications. The postoperative morbidity was acceptable with no recorded mortality. One patient developed recurrent pleural disease on follow-up. Conclusions: HIPEC/HITHOC is an effective and safe therapeutic option to prevent recurrence in Stage IVA ovarian carcinoma, which has previously a dismal prognosis. In addition, the patient's general condition improved symptomatically and the respiratory distress level significantly reduced after the curative-intent treatment.
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CASE REPORT Top

Novel skin toxicity of epidermal growth factor receptor inhibitors: A case of intertrigo-like eruption in a patient with metastatic colorectal cancer treated with cetuximab p. 91
Rosa Coppola, Bianca Santo, Sara Ramella, Vincenzo Panasiti
DOI:10.4103/ccij.ccij_144_20  
Over the recent years, targeted therapy has become one of the most important innovations in cancer treatment. Agents targeting the epidermal growth factor receptor (EGFR) are administered in patients with advanced, recurrent, and metastatic malignancy. Skin toxicity is one of the most common side effects of EGFR inhibitors. In this report, we present the case of a 70 year-old male patient with metastatic colorectal cancer who developed an intertrigo-like eruption during molecular target therapy with cetuximab treated with topical corticosteroid. A complete remission was obtained after 4 weeks.
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LETTER TO EDITOR Top

Disseminated peritoneal tuberculosis with elevated CA 125 mimicking ovarian carcinoma p. 93
Navin Kumar, MD Ray, Kanak Lata
DOI:10.4103/ccij.ccij_182_20  
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IMAGES FOR SURGEONS Top

Right lung cancer with cardiac infiltration masquerading as left atrial myxoma p. 95
Navin Kumar, Kanak Lata, Sunil Kumar
DOI:10.4103/ccij.ccij_143_20  
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