المؤلفون: Budhi Singh Yadav, Divya Dahiya, Manish Gupta, Ankita Gupta, Arun S. Oinam, Siddhant Khare, Santhosh Irrinki, Ngangom Robert, Yashwant Raj Sakaray, Satish S. Nagaraj, Reena Kumari

المصدر: The Lancet Regional Health - Southeast Asia, Vol 24, Iss , Pp 100392- (2024)

مصطلحات موضوعية: Breast cancer, Radiotherapy, Hypofractionation, Acute toxicity, Cosmesis, Public aspects of medicine, RA1-1270

الوصف: Summary: Background: Globally, most of the randomised trials with hypofractionation in patients with breast cancer have used 3-dimensional conformal radiotherapy technique (3D-CRT). As facilities for 3D-CRT technique may not be available in low-resource settings, there is a need to see if hypofractionation is feasible and safe with 2-dimensional (2-D) technique. In this study, we compared a 3-week radiation schedule with a 2-week schedule of hypofractionated radiotherapy in patients with breast cancer with 2-D technique. Methods: The current study was an open-label, randomised, phase 3 trial. Patients with breast cancer, stage I-III, post mastectomy or after breast conservative surgery who needed adjuvant locoregional radiotherapy were randomised in the Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India; to 34Gy in 10 fractions over 2 weeks (2-week arm) or 35Gy in 15 fractions over 3 weeks to the chest wall and 40Gy/15#/3wks to breast and supraclavicular fossa (3-week arm). Boost dose when indicated was 8–10Gy/2–4#/2–4 days in both the arms. Patients were planned on a 2-dimensional (2D) simulator with 2 tangential fields to breast/chest wall and incident supraclavicular fossa field. Acute toxicity was assessed using the Radiation Therapy Oncology Group (RTOG) grading scale. Assessments were carried out weekly during radiotherapy and at 4 weeks after treatment by the physician. Cosmetic outcome was assessed using the Harvard/National Surgical Adjuvant Breast and Bowel Project (NSABP)/RTOG scale. The toxicity rates between the two arms were compared using Fisher's exact tests. The trial was approved by institutional ethics committee and registered with ClinicalTrials.gov, number NCT04075058. Findings: This study included 1121 eligible patients from June 2015 to December 2020. Median follow-up was 35 months (6–84 months). Mean age was 48 years (24–75 years). The patient characteristics were comparable between the two arms except for more mastectomies in the 3-week arm and more node-positive patients in the 2-week arm. There were more oestrogen receptor-positive tumors in the 3-week arm. Acute skin toxicities were comparable between the two arms. Grade 2 and 3 skin toxicity was 100 (18%) and 82 (15%); and 16 (3%) and 12 (2%) in the 3-week and 2-week arm (p = 0.21), respectively. Cosmetic outcome was assessed as Excellent or Good for 89% of patients in the 3-week arm as compared to 94% in the 2-week arm (p = 0.004). Interpretation: The two radiation schedules were comparable in terms of acute skin toxicity. The cosmetic outcome was better with the 2-week schedule. The preliminary findings indicate 2-week radiotherapy schedule with 2-D technique was better than the 3-week schedule in patients with breast cancer. However, disease outcomes and late-term toxicities need to be further checked. Funding: This study was funded by Science and Engineering Research Board (SERB), India.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2772368224000428Test; https://doaj.org/toc/2772-3682Test

الوصول الحر: https://doaj.org/article/1cd571d1adf64cc4846d4f826ce61853Test

المؤلفون: Siddhant Khare, Irrinki Santosh, Ishita Laroiya, Tulika Singh, Amanjit Bal, Gurpreet Singh

المصدر: Breast Cancer: Basic and Clinical Research, Vol 17 (2023)

مصطلحات موضوعية: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Background: Any treatment protocol that leads to complete elimination of surgery may lead to a better patient acceptance of breast cancer treatments. Objectives: We conducted this study to assess the feasibility of preoperative vacuum-assisted biopsies in identifying pathological complete response (pCR) and its accuracy in correlation to final histopathology report (HPR), in an Indian setting. Methods: This was a prospective study conducted between October 1, 2019, and March 31, 2021. Patients with early breast cancer, estrogen and progesterone receptors negative and either Her2 positive or negative, and who were fit to undergo marker placement at the centre of the tumour and to receive third-generation chemotherapy (4 cycles of 3 weekly doxorubicin and cyclophosphamide followed by 4 cycles of 3 weekly docetaxel) were included in the study. Following the enrolment, a tissue marker was placed at the centre of the tumour and appropriate chemotherapy was started. Patients who achieved clinical complete response were subjected to ultrasound-guided vacuum-assisted biopsy (VAB) from the tumour bed before surgery. Pathology results of the VAB and resected specimen were then compared. Descriptive statistics were used in the study. Results: Eighteen patients were enrolled in the study, with a mean age of 43.6 ± 9.8 years. However, only 10 were eligible for VAB procedure, and sensitivity and specificity were calculated based on the results of these 10 patients only. Vacuum-assisted biopsy showed sensitivity of 50% and specificity of 100% in identifying pCR. Combination of mammography, ultrasonography, and VAB showed sensitivity of 77.8% and specificity of 66.7% in identifying pCR. Conclusion: Vacuum-assisted biopsy of tumour bed may not be sensitive enough to eliminate surgery even in patients who have had exceptional response to neo-adjuvant chemotherapy.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1178-2234Test

الوصول الحر: https://doaj.org/article/13bccd1ca6a3460f827aecb37edc9537Test

المؤلفون: Dinesh Chandra Doval, Anurag Mehta, S.P. Somashekhar, Aparna Gunda, Gurpreet Singh, Amanjit Bal, Siddhant Khare, Chandra Prakash V Serkad, Manjula Adinarayan, Naveen Krishnamoorthy, Devanhalli Govinda Vijay, Radha Anantakrishnan, G.S. Bhattacharyya, Manjiri M. Bakre

المصدر: Breast, Vol 59, Iss , Pp 1-7 (2021)

مصطلحات موضوعية: CanAssist breast, Prognostication, Early-stage, Hormone-receptor, Luminal subtypes, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Accurate recurrence risk assessment in hormone receptor positive, HER2/neu negative breast cancer is critical to plan precise therapy. CanAssist Breast (CAB) assesses recurrence risk based on tumor biology using artificial intelligence-based approach. We report CAB risk assessment correlating with disease outcomes in multiple clinically high- and low-risk subgroups. In this retrospective cohort of 925 patients [median age-54 (22–86)] CAB had hazard ratio (HR) of 3 (1.83–5.21) and 2.5 (1.45–4.29), P = 0.0009) in univariate and multivariate analysis. CAB's HR in sub-groups with the other determinants of outcome, T2 (HR: 2.79 (1.49–5.25), P = 0.0001); age [< 50 (HR: 3.14 (1.39–7), P = 0.0008)]. Besides application in node-negative patients, CAB's HR was 2.45 (1.34–4.47), P = 0.0023) in node-positive patients. In clinically low-risk patients (N0 tumors up to 5 cms) (HR: 2.48 (0.79–7.8), P = 0.03) and with luminal-A characteristics (HR: 4.54 (1–19.75), P = 0.004), CAB identified >16% as high-risk with recurrence rates of up to 12%. In clinically high-risk patients (T2N1 tumors (HR: 2.65 (1.31–5.36), P = 0.003; low-risk DMFS: 92.66 ± 1.88) and in women with luminal-B characteristics (HR: 3.24; (1.69–6.22), P 64% as low-risk. Thus, CAB prognostication was significant in women with clinically low- and high-risk disease. The data imply the use of CAB for providing helpful information to stratify tumors based on biology incorporated with clinical features for Indian patients, which can be extrapolated to regions with similarly characterized patients, South-East Asia.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S0960977621003799Test; https://doaj.org/toc/1532-3080Test

الوصول الحر: https://doaj.org/article/37d33ca9bd764c319e1199039a81fc60Test

المؤلفون: Thammannagowda Prarthana, Hitaishi Mehta, Siddhant Khare, Keshavamurthy Vinay

المصدر: Indian Dermatology Online Journal, Vol 13, Iss 4, Pp 514-516 (2022)

مصطلحات موضوعية: Dermatology, RL1-803

وصف الملف: electronic resource

العلاقة: http://www.idoj.in/article.asp?issn=2229-5178;year=2022;volume=13;issue=4;spage=514;epage=516;aulast=PrarthanaTest; https://doaj.org/toc/2229-5178Test

الوصول الحر: https://doaj.org/article/d7cd465a917045bcb356397e655d3dbaTest

المؤلفون: Siddhant Khare, Santhosh Irrinki, Yashwant Raj Sakaray, Amanjit Bal, Tulika Singh, Gurpreet Singh

المصدر: Breast Cancer: Basic and Clinical Research, Vol 15 (2021)

مصطلحات موضوعية: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Background: The reported association between metabolic syndrome (MetS) and breast cancer may have a significant impact on the incidence and mortality related to breast cancer. We undertook this study to find if the disease is different in patients with MetS. Materials and Methods: Patients with biopsy-proven breast cancer were divided into groups based on the presence or absence of MetS (according to the IDF definition of 2006) and also based on menopausal status. The presence of known risk and prognostic factors were also recorded, and the groups were compared. Results: A total of 305 patients were recruited, of which 191 (62.6%) had MetS. Patients with MetS were older than those without (52.1 versus 48.3 years, P = .014) and had a lower incidence of nulliparity (4.1% vs 12.8%, P = .005) and dense breasts (2.9% in MetS vs 10.8% in no MetS, P = .009). On further dividing into premenopausal and postmenopausal, these differences persisted only in premenopausal patients. MetS group had a lower number of HER2-positive tumours (14.3% for MetS, 23.9% for no MetS; P = .036). After dividing into premenopausal and postmenopausal, significant differences were observed in distant metastases (5.4% in MetS vs 16.1% in no MetS, P = .045) and in grade (higher grade in MetS, P = .05) in premenopausal patients. In postmenopausal patients, difference was observed in HER2 positivity (12.3% in MetS vs 28.8% in no MetS, P = .008). Conclusions: Breast cancer in patients with MetS may not be significantly different from breast cancer in patients without MetS.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1178-2234Test

الوصول الحر: https://doaj.org/article/07584ebcab784326bbece90fcd093edaTest

المؤلفون: Siddhant Khare, Tulika Singh, Irrinki Santosh, Ishita Laroiya, Gurpreet Singh

المصدر: Breast Cancer: Basic and Clinical Research, Vol 14 (2020)

مصطلحات موضوعية: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Background: Excision of nonpalpable breast lesions requires intraoperative guidance. Wire-guided localization and intraoperative ultrasounds have been used successfully but suffer from some disadvantages. We describe a new modification of the standard technique using a combination of preoperative ultrasound in conjunction with standard wire-guided localization. Methods: Wire and ultrasound-guided localization (WUGL) technique was used for the excision of nonpalpable breast lesions. Results: Sixty-nine patients with nonpalpable breast lesions were subjected to excision using WUGL, out of whom 63 patients had a preoperative diagnosis of invasive/noninvasive breast cancer. Six patients had a preoperative diagnosis of benign lesions, out of which 3 patients were converted to invasive breast cancer on final pathology. Only 1 patient had positive margin. Conclusions: WUGL is a technique that uses a combination of well-accepted and easily available techniques. It has given good results and has the potential for widespread acceptance in resource-constrained situations.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1178-2234Test

الوصول الحر: https://doaj.org/article/776f0d4fad4e435ea0bd8676ed49dc98Test

المؤلفون: R N NAGA SANTOSH IRRINKI, SIDDHANT KHARE, gurpreet Singh, ishita laroiya, aniket mishra

المصدر: Cancer Research. 83:P1-09

مصطلحات موضوعية: Cancer Research, Oncology

الوصف: Background For early-stage breast cancer BCS followed by radiation therapy has been validated as safe alternative to Radical Mastectomy. One peculiar problem faced in developing countries is patients in whom primary tumor has been excised elsewhere. There is a lack of clear treatment history and pre-operative examination and imaging in such patients, which makes accurate staging and planning for definitive surgery much more challenging. We did this retrospective analysis to assess clinical, cosmetic and QOL outcomes in the above-mentioned group of patients. Methods Patients between 18 and 80 years diagnosed with biopsy proven carcinoma breast that had the primary tumor excised outside and underwent BCS at our institute were included. They were subjected to routine history and physical examination as per the institute standard of care. Overall survival was estimated using Kaplan Meier curve. Expected 4 years survival was calculated using percentage of people who were alive out of those patients whose follow up was known at the end of 4 years. Cosmetic outcome was assessed using patient reported BCTOS 12 scores whereas quality of life outcome was assessed using patient reported EORTC and SF 36 questionnaire scores. Results Twenty-two patients were enrolled. Overall survival at 4 years was 72% comparable in NACT and No NACT (p< 0.29). 5.45% patients had local recurrence. Cosmetic outcome was excellent to good in 90% patients, similar between NACT and No NACT (p 0.69). Quality of life was excellent-good in 65% patients (EORTC) which was significantly higher in No NACT group (p 0.05) Conclusion BCS after scar excision following non oncological resection of breast primary may be an acceptable modality of treatment with good cosmetic and Quality of life outcomes. Citation Format: R N NAGA SANTOSH IRRINKI, SIDDHANT KHARE, gurpreet Singh, ishita laroiya, aniket mishra. Oncological, Cosmetic and Quality of life outcomes following breast conservation surgery in patients presenting after non-oncological excsion of breast primary: A prospective follow up study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-09-02.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::80bba63d9d8a245bc12dfe87835fce40Test
https://doi.org/10.1158/1538-7445.sabcs22-p1-09-02Test

المؤلفون: AKHIL GOUD PACHIMATLA, R N NAGA SANTOSH IRRINKI, ISHITA LAROIYA, SIDDHANT KHARE

المصدر: Cancer Research. 83:P2-14

مصطلحات موضوعية: Cancer Research, Oncology

الوصف: TITLE: Effect of intra-operative and post-operative topical tranexamic acid on early post-operative complications in patients undergoing axillary lymph node dissection for breast cancer. Authors: PACHIMATLA AKHIL GOUD1, ISHITHA LARAOIYA2, SIDDHANT KHARE3, R N NAGA SANTHOSH IRRINKI2, GURPREET SINGH4. Affiliation: 1. Junior Resident, Department of General Surgery, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh. 2. Assistant professor, Department of General Surgery, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh. 3. Associate professor, Department of General Surgery, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh. 4. Professor and Head (retired), Department of General Surgery, Post Graduate Institute of Medical Education & Research (P.G.I.M.E.R.), Chandigarh. BACKGROUND: Seroma formation after breast surgery has been a consistent problem with no established causes or risk factors. The role of topical tranexamic acid in reducing the incidence of seroma after axillary clearance in breast cancer is controversial. AIMS & OBJECTIVES: To study the effect of intra-operative and post-operative topical Tranexamic acid on the duration of drain and volume of seroma in patients undergoing axillary lymph node dissection (ALND) for breast cancer. MATERIALS AND METHODS: In this prospective, non-blinded, triple-arm randomized controlled trial conducted at the Department of General Surgery, PGIMER, 154 breast cancer patients were enrolled and studied from July 2020-July 2021. They were randomized into three groups. Group A (n=51) received a single dose of diluted topical tranexamic acid intra-operatively, Group B (n=52) received intra-operative dose and daily post-operative doses till day-5 through the suction drain placed intra-operatively, and Group C(n=51) did not receive any topical tranexamic acid. The study groups were primarily compared for the total drain duration and total drainage volume. Daily drain volume for the first five days, complications like seroma, wound infection and severity of surgical site infections using Southampton score, and adverse reactions of the drug were compared. RESULTS Out of the 154 patients, four have failed to maintain appropriate records and analysis was done with 150 patients. The mean age of the study population was 52.17±8.69 yrs, with a mean BMI of 26.20±4.14. The final analysis showed no significant difference in total drain volume across the three groups, but patients receiving multiple doses of topical tranexamic acid had the lowest total volume drained compared to patients receiving a single dose or no dose (1763ml Vs 1597 Vs 1773ml: p=0.269. There was no significant change in the duration of the post-operative drain (21.6 Vs 19.2 Vs 19.55 days: p=0.54). There was no statistically significant difference in complications between the groups. Seroma was seen in 6 vs 7 vs 4%(p=0.629) patients in groups A, B and C respectively. Wound site infection was noted in 11 vs 13 vs 10% of patients (p= 0.766). None of the patient characteristics like age, BMI, co-morbidities, previous lumpectomy, menopause, and length of history significantly correlated with seroma formation in the study population. CONCLUSION There was no significant reduction in drain volume or duration with either single or multiple doses of topical tranexamic acid after the axillary clearance for breast cancer. Even though not significant, an increasing trend in wound site infections was noted among the patients who received multiple doses of tranexamic acid was noted. Citation Format: AKHIL GOUD PACHIMATLA, R N NAGA SANTOSH IRRINKI, ISHITA LAROIYA, SIDDHANT KHARE. Effect Of Intra-operative And Post-operative Topical Tranexamic Acid On early post-operative complications In Patients Undergoing Axillary Lymph Node Dissection For Breast Cancer- A randomized controlled study. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-14-14.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::09e207dae25d9a3f427020d1afd673c7Test
https://doi.org/10.1158/1538-7445.sabcs22-p2-14-14Test

المؤلفون: Lipika Singhal, Swati Kaushik, Rajendra Kumar Panda, Yashpal Singh Malik, Rahul K Verma, Deepa Ghosh, Navdeep Singh, Paviter Kaur, Priyam Batra, Siddhant Khare, Vipul Thakur, Rajesh Kumar, Nishant Shekhar, Surajit Chakraborty, Shalmoli Bhattacharya, Inderjeet Singh, Karan Vasisht, Ashish Sharma, Kanwar Arshjot Singh, Vikas Gautam

الوصف: VG111, a novel natural product formulation developed at PGIMER, Chandigarh is an attempt to meet the requirements of an ideal wound healing product. The present study demonstrates the efficacy of VG111 in antimicrobial assay, in tissue-regeneration,and in direct application-based wound healing. VG111 was able to kill major human pathogens, including methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, carbapenem-resistant Acinetobacter baumannii (CRAB), while biofilm clearance was observed for Pseudomonas aeruginosa PA14 and Stenotrophomonas sepilia. Scratch assay and cytokine estimation in VG111-treated RAW464.7 cell lines show that it enhances cell migration and limits host inflammatory response by lowering IL-6 and TNF-α levels. VG111 application in canine and human patients’ representative cases provides evidence of remarkable wound healing and improved recovery. In particular, its potential to treat aggravated wounds in diabetic patients without the need of administering additional antibiotics in patients on steroids and obviating the need of skin graft adds on to make this natural product formulation to be a game-changer in the segment.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::5b759c3033ea3577e193902b67279178Test
https://doi.org/10.21203/rs.3.rs-2885471/v1Test

المؤلفون: Abhinav Singh, Siddhant Khare, Palak Singhai, Rajender Kumar, Debajyoti Chatterjee, Santosh Irrinki

المصدر: Journal of Postgraduate Medicine, Education and Research. 56:63-69

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::b817ebba493d38591f41d515c7758b9aTest
https://doi.org/10.5005/jp-journals-10028-1567Test