Identification of variables and development of a prediction model for DIBH eligibility in left-sided breast cancer radiotherapy: a prospective cohort study with temporal validation.

Objective: To identify variables associated with a patients' ability to reproducibly hold their breath for deep-inspiration breath-hold (DIBH) radiotherapy (RT) and to develop a predictive model for DIBH eligibility.

Methods: This prospective, single-institution, IRB-approved observational study included women with left-sided breast cancer treated between January 2023 and March 2024. Patients underwent multiple breath-hold sessions over 2-3 consecutive days.

Is it too early to recommend local treatment in oligometastatic non-small cell lung cancer: a plea for equipoise.

Oligometastatic non-small cell lung cancer (OMD NSCLC) has been proposed to bridge the spectrum between non-metastatic and widely metastatic states and is perceived as an opportunity for potential cure if removed. Twelve clinical trials on local treatment have been reported, yet none are conclusive. These trials informed the development of a joint clinical practice guideline by the American & European Societies for Radiation Oncology, which endorses local treatment for OMD NSCLC.

Intuitive evaluation of contemporary management strategies in thymoma - the largest Indian experience.

Background: The aim was perusal of the treatment strategies, clinical outcomes and factors impacting these outcomes in thymoma.

Materials And Methods: A total of 119 patients diagnosed and treated cases of thymoma, at our hospital, were taken for analysis. Thirty-one patients were excluded due to inadequate medical records.

Risk-Adapted Target Delineation for Breast Cancer: Controversies and Considerations.

The advent of computed tomography-based planning coupled with modern tools for target delineation and hypofractionated treatment schedules has increased efficiency and throughput for patients with breast cancer. While the benefit of adjuvant radiation therapy (RT) in reducing locoregional recurrences is established, disentangling local versus regional recurrence risks with modern treatment protocols has become an area of active research to de-escalate treatment. Delineation guidelines for nodal regions either attempt to replicate results of conventional RT techniques by translating bony landmarks to clinical target volumes or use landmarks based on the fact that lymphatic channels run along the vasculature.

Tri-modality therapy in advanced esophageal carcinoma: long-term results and insights from a developing world, institutional cohort.

Objective: To evaluate treatment outcomes in patients from a low-middle income country (LMIC) with esophageal carcinoma who underwent esophagectomy after neoadjuvant chemoradiation (NACRT/S).

Methods: Between 2010 and 2020, 254 patients (median follow-up: 53 months) met our inclusion criteria. Out-of-field nodal regions were determined by reviewing individual radiotherapy plans.

Treatment Delay during Radiotherapy of Cancer Patients due to COVID-19 Pandemic.

Purpose: To analyze the impact of treatment delay caused by COVID-19 infection on patients scheduled for radiotherapy treatment.

Methods And Materials: In this descriptive study, we analyzed all patients who were COVID-19 positive during the scheduled radiotherapy course, those who had an infection while on neoadjuvant treatment period, or during surgery before the start of radiation. The study period was from June 2020 to May 2021.

Immunotherapy in advanced non-small-cell lung cancer (NSCLC) after progression on chemotherapy: real-world results from a prospective institutional cohort.

To analyze the outcomes of patients receiving immunotherapy (IO) with advanced non-driver mutated non-small-cell lung cancer (NSCLC) after progression on systemic treatment. The overall survival (OS), progression-free survival (PFS) and best response to IO of 64 patients who met our inclusion criteria were analyzed. Median follow-up, OS and PFS were 35.

Plan quality assessment of modern radiotherapy delivery techniques in left-sided breast cancer: an analysis stratified by target delineation guidelines.

Objective: This study compares planning techniques stratified by consensus delineation guidelines in patients undergoing whole-breast radiotherapy based on an objective plan quality assessment scale.

Methods: 10 patients with left-sided breast cancer were randomly selected, and target delineation for intact breast was performed using Tangent (RTOG 0413), ESTRO, and RTOG guidelines. Consensus Plan Quality Metric (PQM) scoring was defined and communicated to the physicist before commencing treatment planning.

Malignant esophagorespiratory fistulas: a comparative effectiveness survival analysis.

Objectives: To analyse the survival of patients with malignant esophagorespiratory fistulas (ERF) and perform a comparative effectiveness analysis of ERF-directed interventions.

Methods: Fifty-five patients met our inclusion criteria, and data on ERF-directed interventions (stent placement, surgical repair and best supportive care) and their outcomes, along with clinical and treatment details, were recorded. The primary endpoints were overall survival (OS) and survival after developing ERF (F-OS).

Impact of acuros XB algorithm in deep-inspiration breath-hold (DIBH) respiratory techniques used for the treatment of left breast cancer.

Aim: To investigate the impact of Acuros XB (AXB) algorithm in the deep-inspiration breath-hold (DIBH) technique used for treatment of left sided breast cancer.

Background: AXB may estimate better lung toxicities and treatment outcome in DIBH.

Materials And Methods: Treatment plans were computed using the field-in-field technique for a 6 MV beam in two respiratory phases - free breathing (FB) and DIBH.

A case report evaluating combined effect of intensity-modulated radiotherapy and deep inspiratory breath-hold for mediastinal lymphoma: A dosimetric analysis.

Excellent survival has been reported after combined modality treatment in bulky mediastinal Hodgkin's lymphoma. Late effects such as cardiac morbidity and secondary cancers have been reported after radiotherapy (RT), especially in young adults. Advanced RT techniques such as deep inspiratory breath-hold (DIBH), intensity-modulated RT (IMRT), and volumetric arc therapy have been used recently to reduce these late effects with encouraging results.

Primary angiosarcoma of the breast: a radiation oncologist's perspective with a concise review of the literature.

A 28-year-old premenopausal woman presented with a painful rapidly growing mass in her right breast and was evaluated with a core needle biopsy, which was suggestive of poorly differentiated carcinoma. Immunohistochemical evaluation revealed primary angiosarcoma of breast. Whole body flouro-deoxyglucose positron emission tomography CT showed few metabolically active soft tissue lesions in upper inner quadrant of right breast.

Image-guided volumetric modulated arc therapy (IG-VMAT) for unresectable ACC of the trachea: a feasible curative option.

A middle-aged man presented with progressively worsening breathlessness and non-productive cough for the last 3 months. On examination, his breathing was stridulous and air entry was decreased bilaterally. He underwent emergency fibre-optic bronchoscopy, which revealed a tracheal growth causing luminal narrowing, and after tumour debulking, he improved symptomatically.

Nodal volume as a prognostic factor in locally advanced head and neck cancer: Identifying candidates for elective neck dissection after chemoradiation with IGRT from a single institutional prospective series from the Indian subcontinent.

Objective: Nodal volume as a prognostic factor has been extensively evaluated in head and neck cancer, however there is still no consensus. We attempted to analyze nodal volume as a prognostic factor in head and neck cancer treated with chemoradiation (CCRT) without an elective neck dissection with image guided intensity modulated radiotherapy (IG-IMRT).

Material And Methods: We prospectively analysed 87 patients of Stage III-IV cancer of the oropharynx (57), and hypopharynx (30), who subsequently received definitive concurrent chemoradiation.

Simultaneous integrated boost by Intensity Modulated Radiotherapy (SIB-IMRT) in patients undergoing breast conserving surgery - A clinical and dosimetric perspective.

Aim: To study feasibility of simultaneous integrated boost by intensity modulated radiotherapy (SIB-IMRT) in patients undergoing breast conserving surgery and its impact on cosmesis and dosimetry.

Patients And Methods: Between January 2014 and June 2017, all breast cancer patients fulfilling inclusion and exclusion criteria were enrolled in a prospective study conducted at a tertiary cancer centre in North India. All patients received adjuvant radiotherapy by simultaneous integrated boost technique following breast conserving surgery.

Early Clinical Outcomes, Patterns of Failure, and Acute Haematologic Toxicity of Image-Guided Volumetric Modulated Arc Therapy (IG-VMAT) in the Definitive Treatment of Locally Advanced Carcinoma Cervix.

Purpose: To evaluate clinical outcomes and failure patterns in patients with locally advanced cervical cancer (LACC) treated definitively using image-guided volumetric-modulated arc therapy (IG-VMAT).

Methods And Materials: This retrospective review included 18 consecutively treated patients with LACC. Treatment consisted of IG-VMAT and concurrent chemotherapy followed by intracavitary radiotherapy.

Hypercellular round cell liposarcoma: A comprehensive cytomorphologic study and review of 8 cases.

Background: Myxoid and round cell liposarcomas (RCL) are low and high-grade counterparts of a common subtype of liposarcomas (LPS), representing a histologic continuum.

Aims: The aim was to study the cytomorphology of hypercellular RCL and to look for features that differentiate RCL from other sarcomas displaying round cells with myxoid change.

Materials And Methods: Eight cases of hypercellular RCL were identified retrospectively in which round cell component constituted greater than 75% of the area.

Primary vertebral leiomyosarcoma masquerading as a nerve sheath tumour.

A 47-year-old woman presented with symptoms of low back pain and weakness in bilateral lower limbs. MRI of the spine revealed a mass arising from T11 vertebra involving neural foramina at bilateral T11-12 and right T10-11 levels with extension to the right paravertebral region. Suspecting a nerve sheath tumour, she underwent posterior spinal decompression, stabilisation and debulking, following which her neurological symptoms resolved.