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Biomedical subjects

Niloy R Datta

Publications and source records attributed to Niloy R Datta.

7 recordsLinked to original sources

Does pretreatment human papillomavirus (HPV) titers predict radiation response and survival outcomes in cancer cervix?--a pilot study.

OBJECTIVE: To evaluate if pretreatment HPV titers in cancer cervix could predict radiation response and survival outcomes. METHODS: Twenty-one patients of cancer cervix were treated by radiotherapy (RT) alone. HPV titers were estimated using DNA Hybrid Capture II test. Loco-regional response at 1 month of RT--complete or partial response (CR and PR respectively) and survival outcomes--local disease-free (LDFS), disease-free (DFS) and overall (OS) survivals were evaluated against pre- and posttreatment HPV titers. RESULTS: Pretreatment HPV titers ranged from 0.81 to 3966.10 RLU/cut off (mean +/- SD: 1264.39 +/- 1148.22, median: 1129.98). Of the demographic features evaluated, mean HPV titers were significantly different only for patients achieving CR or PR at completion of RT (mean +/- SD for CR vs. PR: 1616.31 +/- 1146.86 vs. 384.57 +/- 538.80, P = 0.022). HPV titers at end of RT ranged from 0.12 to 487.42 RLU/cut off (mean +/- SD: 37.31 +/- 108.60, median: 2.33). Patients with higher pretreatment HPV titers (>1000 RLU/cutoff) had a higher CR (P = 0.022) and better survival compared to those with < or =1000 RLU/cutoff (LDFS, P = 0.004; DFS, P = 0.005; OS, P = 0.012). At completion of RT, those having > or =99.5% fall in HPV had superior survival outcomes than those with <99.5% reduction (LDFS, P = 0.002; DFS, P = 0.002; OS, P = 0.004). CONCLUSIONS: Higher pretreatment HPV titers (>1000 RLU/cutoff) could be considered as a predictor of radiotherapy response and survival in cancer cervix. A reduction in these titers to 99.5% of their baseline values at end of radiotherapy is also associated with better survival outcomes.

Brachytherapy↗

Role of radiotherapy in a recurrent aneurysmal bone cyst of the temporal bone: case report.

OBJECTIVE AND IMPORTANCE: A rare case of aneurysmal bone cyst (ABC) of the temporal bone is presented which, following recurrence after surgery, was successfully treated with radiotherapy. The role of radiotherapy in such cases is reviewed. CLINICAL PRESENTATION: A 30-year-old man presented with a recurrent swelling and pain in right temporal region following surgery for ABC at that site. INTERVENTION: Local radiotherapy to a dose of 31.5 Gy in 18 fractions over 3.5 weeks was delivered to the site of recurrence. The patient had a near total regression of the ABC as evident clinically and on radiological images. CONCLUSION: To the best of our knowledge, radiation for the recurrent ABC at the temporal bone has not been described in the literature. However, in view of the response evident in this patient, radiotherapy seems to be effective for recurrent cases of ABC at the temporal bone and a dose of around 30 to 36 Gy could be effectively delivered with satisfactory results.

Adult↗

Radiation therapy induced micronuclei in cervical cancer--does it have a predictive value for local disease control?

OBJECTIVE: To evaluate the predictive value of serial changes in micronuclei induction during external radiotherapy (EXRT) in cervical cancer with respect to local response at the end of EXRT and local disease free survival (LDFS). METHODS: Twenty-five patients of squamous cell cancer of the cervix were treated by 50 Gy of EXRT delivered over 5 weeks followed by intracavitary brachytherapy. Serial cytological smears were taken from cervical growth at weekly intervals during the course of EXRT and stained by Giemsa and May-Grunwald's stain. Micronuclei induction were scored as (a) number of cells expressing micronuclei (MN), and (b) total number of micronuclei (TMN) in 1000 tumor cells from each of the serial smears. RESULTS: A significant rise in micronuclei count was seen for both MN and TMN from pretreatment (week 0) to successive weeks of EXRT. For those having a near total tumor regression by end of EXRT, a significant rise in micronuclei was evident even at the end of first week of EXRT (MN: P = 0.05, TMN: P = 0.04). A superior LDFS was observed in patients showing greater than 50% increment in MN value in the first week (median survival for <50% vs. > or =50% rise: 5 months vs. not reached, P = 0.21), while it reached significance for a similar rise of TMN (median survival <50% vs. > or =50% rise: 5 months vs. not reached, P = 0.04). CONCLUSIONS: The significant rise of micronuclei at the end of first week of EXRT in cervical cancers as observed from serial cytological smears could predict for a better local response and LDFS.

Carcinoma, Squamous Cell↗

A graphical user interface for automatic image registration software designed for radiotherapy treatment planning.

Medical imaging forms a vital component of radiotherapy treatment planning and its evaluation. The integration of the useful data obtained from multiple imaging modalities for radiotherapy planning is achieved by image registration softwares. In radiotherapy planning systems, normally the computed tomography (CT) slices are kept as a standard upon which other modality images (magnetic resonance imaging [MRI], single photon emission computed tomography [SPECT], positron emission tomography [PET], etc.) are aligned--automatically or interactively. Following validation of successful registration, they are resampled and reformatted, as per the requirements. This paper defines the minimum requirements of automatic image registration software for 3-dimensional (3D) radiotherapy planning and describes the implementation of a suitable graphical user interface developed in Visual Basic (version 5). The automatic image registration (AIR) routines freely available from Dr. Roger P. Woods, UCLA, (USA) were used in this software. This software could be easily implemented and was easy to use for image processing suitable for radiotherapy planning systems.

Algorithms↗

Problems in reporting doses and volumes during multiple high-dose-rate intracavitary brachytherapy for carcinoma cervix as per ICRU Report 38: a comparative study using flexible and rigid applicators.

OBJECTIVE: The objective was to evaluate the extent of geometric and positional variations of two different applicators during multiple high-dose-rate (HDR) intracavitary brachytherapy (ICBT) in carcinoma cervix and its implication on reporting as per International Commission on Radiation Units and Measurement (ICRU) Report 38. METHODS: Fifty patients, following teletherapy, were randomly allocated to two groups of 25 each. They received a dose of 6 Gy to point A during each of the three HDR ICBT applications by either a flexible Ralstron or a rigid geometry Rotterdam applicator. The various applicator components related to its geometry and their Cartesian coordinates were evaluated from orthogonal films. The doses to ICRU bladder, rectal, pelvic, lymphatic trapezoid points, and dimensions of 6-Gy ICRU height, width, thickness, and volume were estimated for each application. RESULTS: Significant variation was observed with the three HDR ICBT applications for each group, for all components and for both applicators, although it was relatively more with the flexible Ralstron applicator. The average shift in each of the coordinates of os, uterine tip, and ovoids was around 10 mm for both groups. These resulted in significant variations in all the ICRU Report 38 reporting parameters for three insertions in any given patient and across 25 patients of both groups. CONCLUSIONS: Multiple HDR ICBT applications led to significant variation in the applicator geometry and its positions in pelvis, irrespective of the applicator rigidity. This results in uncertainties in reporting as per ICRU Report 38 guidelines, and thus calls for its revision.

Brachytherapy↗

Total reference air kerma: to what extent can it predict intracavitary volume enclosed by isodose surfaces during multiple high-dose rate brachytherapy?

BACKGROUND: The International Commission on Radiation Units and Measurements (ICRU) report 38 recommends reporting of total reference air kerma (TRAK) and reference ICRU isodose volumes during intracavitary brachytherapy (ICBT) in cancer of the cervix. The present study attempts to estimate the volumes enclosed by isodose surfaces from TRAK and evaluate its utility to represent doses to organs of interest. MATERIAL AND METHODS: Volumes encompassed by isodose surfaces of 3 Gy, 6 Gy, 9 Gy, and 12 Gy were obtained for 90 high-dose rate (HDR) ICBT procedures. These were used to derive a relation between isodose volumes, TRAK/dose (K/D), and rectal and bladder doses. RESULTS: Actual volumes (V) encompassed by isodose surfaces were reflected as a quadratic function of K/D (r(2)=0.998) and the expression, V=-23.09+1295.99(K/D)+5661.65(K/D)(2) gave the best estimates for various volumes. No correlation was observed between TRAK and bladder (r(2)=0.086) or rectal doses (r(2)=0.082). CONCLUSIONS: Estimates of volumes encompassed by different dose levels from TRAK could be derived with reasonable certainty. However, TRAK fails to correlate with rectal and bladder doses.

Body Burden↗

Safety and efficacy of concurrent cisplatin and radiotherapy in inoperable or metastatic squamous cell esophageal cancer.

Between August 1996 and May 1999, 50 consecutive, previously untreated patients with carcinoma of the esophagus and who were inoperable for various reasons were treated with weekly doses of cisplatin (35 mg/m2, maximum 7 cycles) concurrent with either 66 Gy/33 fractions external beam radiotherapy (EBRT) (n = 42) or 50 Gy/25 fractions EBRT and two insertions of high-dose-rate intraluminal radiotherapy of 6 Gy each, spaced a week apart (n = 8). Eighty-two percent (41/50) of the patients received the stipulated radiotherapy (RT) dose. Seventy-six percent (38/50) received at least 6 cycles of chemotherapy. Neutropenia in the form of WHO grade 11-12%, (6/50) and grade III-2% (1/50) was observed. Grade III emesis was seen in 8% (4/50). Improvement in the swallowing status was seen in 84% (42/50). Median duration of dysphagia relief was 6 months. The median overall survival was 9 months with 17% estimated to be alive after 4 years. Combined treatment with single agent cisplatin and definitive radiotherapy for inoperable cancer of the esophagus is safe, well tolerated and reasonably efficacious.

Adult↗