Publications by authors named "Mahantshetty U"
Purpose: This consensus statement of Indian Brachytherapy Society (IBS) aims to generate practical and reproducible guidelines allowing for direct implementation in the Indian scenario.
Material And Methods: IBS board of directors appointed a panel of physicians with expertise in breast cancer and, in particular, breast brachytherapy, to develop a consensus statement. First, a literature review on breast brachytherapy was conducted, focusing on randomized trials, prospective studies, and multi-institutional series.
Assessment of usage, reuse and disposal of thermoplastic masks among radiotherapy technologists in India: A nationwide perspective.
Tech Innov Patient Support Radiat Oncol
December 2024
Article Synopsis
- The study investigates how radiation therapy technologists (RTTs) in India use and reuse thermoplastic masks (TMs) and their awareness of the environmental impact of TM disposal.
- A survey involving 430 RTTs revealed that a majority reuse TMs, particularly in government facilities, and 74.4% are aware of the adverse environmental effects related to TM disposal.
- The findings underscore the need for improved biomedical waste management to ensure proper handling and disposal of used TMs in healthcare settings.
Purpose: The purpose of this study was to provide risk estimations for vaginal morbidity with regard to vaginal dilation (summarizing the use of dilators and/or sexual activity) in patients with locally advanced cervical cancer treated with definitive radiochemotherapy and image guided adaptive brachytherapy within the prospective, multi-institutional EMBRACE-I study.
Methods And Materials: Physician-assessed vaginal morbidity (National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0), use of vaginal dilators, and patient-reported sexual activity (EORTC-CX24) were prospectively assessed at baseline and during regular follow-ups.
Background And Objectives: Despite decades of experience with definitive chemo-radiotherapy (CRT) in cervical oesophageal cancer (CEC), the loco-regional control and survival outcomes are dismal. This review evaluated the outcomes of various treatment strategies being commonly utilized.
Materials And Methods: A literature review was conducted to identify relevant articles on CEC published from years 2000-2023 addressing the predefined key questions.
Aim: To commission and validate commercial deformable image registration (DIR) systems (SmartAdapt and Velocity™) using task group 132 (TG-132) digital phantom datasets. Additionally, the study compares and verifies the DIR algorithms of the two systems.
Materials And Methods: TG-132 digital phantoms were obtained from the American Association of Physicists in Medicine website and imported into SmartAdapt and Velocity™ systems for commissioning and validation.
Purpose: BIOEMBRACE was designed to study the impact of biomarkers in addition to clinicopathological factors on disease outcomes in patients treated with chemoradiation and magnetic resonance imaging (MRI)-guided brachytherapy (BT) for locally advanced cervical cancer in the EMBRACE study.
Methods And Materials: Between 2018 and 2021, 8 EMBRACE-I sites contributed tumor tissue for the immunohistochemistry of p16, PD-L1, and L1CAM. These biomarkers and clinicopathological factors (International Federation of Gynecology and Obstetrics 2009 stage, nodal status, histology, and necrosis on MRI) were analyzed to predict poor response at BT (high-risk clinical target volume [HR-CTV] ≥ 40 cc) at BT) and 5-year local control, pelvic control, and disease-free survival.
Major improvements in radiotherapy over the past two decades in the definitive treatment of locally advanced cervical cancer have significantly improved loco-regional control and survival, whereas little progress has been made with chemotherapy since the implementation of concomitant cisplatin 25 years ago. However, the randomized study INTERLACE (A phase III multicenter trial of weekly induction chemotherapy followed by standard chemoradiation versus standard chemoradiation alone in patients with locally advanced cervical cancer) of neoadjuvant chemotherapy presented recently, has shown significant improvement in survival with the use of six cycles of weekly carboplatin and paclitaxel. Although INTERLACE is yet to be published, neoadjuvant chemotherapy is already being advocated as the new standard, and studies are being designed with neoadjuvant chemotherapy followed by chemoradiation and brachytherapy as the standard arm.
View Article and Find Full Text PDFPurpose: To evaluate clinical outcomes of CT-based adaptive intracavitary and interstitial brachytherapy (IC followed by IC-ISBT) in locally advanced cervical cancer (LACC) in resource-constrained settings.
Methods And Materials: LACC patients treated with adaptive brachytherapy techniques were analyzed to evaluate treatment characteristics and clinical outcomes. The Kaplan-Meier method was used for survival analysis, and the log-rank test for univariate analysis.
The purpose of this study was to validate an electronic portal imaging device (EPID) based 3-dimensional (3D) dosimetry system for the commissioning of volumetric modulated arc therapy (VMAT) delivery for flattening filter (FF) and flattening filter free (FFF) modalities based on test suites developed according to American Association of Physicists in Medicine Task Group 119 (AAPM TG 119) and pre-treatment patient specific quality assurance (PSQA).With ionisation chamber, multiple-point measurement in various planes becomes extremely difficult and time-consuming, necessitating repeated exposure of the plan. The average agreement between measured and planned doses for TG plans is recommended to be within 3%, and both the ionisation chamber and PerFRACTION™ measurement were well within this prescribed limit.
View Article and Find Full Text PDFArticle Synopsis
- - The survey aimed to gauge Indian radiation oncologists' attitudes and practices surrounding prostate brachytherapy, using a 21-point questionnaire distributed through various channels.
- - Out of 212 responding oncologists, a significant 66% had over 6 years of post-specialty training, yet 44.3% do not perform any interstitial brachytherapy, and 83.3% avoid high-dose-rate (HDR) prostate brachytherapy, primarily due to a lack of training (84.8%).
- - Many oncologists expressed a willingness to adopt prostate brachytherapy if provided with adequate training and facilities, indicating potential for increased implementation with professional development opportunities.
Article Synopsis
- - The study evaluated the effectiveness of adding durvalumab, a PD-L1 antibody, to standard chemoradiotherapy for patients with locally advanced cervical cancer, aiming to improve outcomes due to high recurrence rates despite existing treatments.
- - The CALLA trial was a phase 3, double-blind study involving 105 hospitals in 15 countries, focusing on patients with untreated cervical cancer who were randomly assigned to receive either durvalumab or a placebo alongside chemoradiotherapy.
- - The primary goal was to measure progression-free survival, while safety was assessed for those receiving at least one dose of the treatment, highlighting the rigorous methodology and safety monitoring throughout the trial.
Article Synopsis
- The study focuses on improving the accuracy of pelvic intensity modulated radiation therapy (IMRT) for cervical cancer, which can sometimes miss its target due to variations in patient positioning and organ shapes.
- A phase 2 study involved 50 patients undergoing treated chemoradiotherapy with specific protocols for bladder and rectum filling, while utilizing adaptive image-guided radiotherapy (IGRT) to adjust treatment plans based on daily imaging.
- Results showed significant variation in bladder volume between treatment sessions, with findings indicating that certain factors like chemotherapy sessions affect this variation, which underscores the importance of personalized treatment plans.
Purpose: To evaluate clinical outcomes of recurrent gynaecological cancers treated with reirradiation (reRT) using advanced brachytherapy (BT) technique.
Methods And Materials: Seventy-six women who underwent reRT with BT for gynaecological cancers at our institute between January 2000 and December 2019 were analysed to determine patient, disease and treatment characteristics and clinical outcomes. Descriptive analysis was used for demographics, and the Kaplan Meir method was used for survival analysis.
Article Synopsis
- There is a big problem with cervical cancer in poorer countries because they often don't have good screening and treatment options.
- High-dose-rate (HDR) brachytherapy is a type of treatment that helps people survive and control the cancer better.
- The American Brachytherapy Society and Indian Brachytherapy Society made a guide to help set up these treatment programs in places that lack resources.
Purpose: Variations in the levels of systemic inflammatory biomarker levels have been linked with outcomes in various malignancies including cervical cancer. In this study, we investigated prognostic implications of pretreatment hematological factors/indices in locally advanced cervical cancers treated with radical radio(chemo)therapy.
Methods And Materials: Electronic medical records of 1051 patients with cervical cancer of FIGO (International Federation of Gynecology and Obstetrics) stage IB2-IVA treated in various prospective trials at our institute between 2003 and 2017 were reviewed.
Advancements in therapeutic interventions have led to significant improvement in the overall management of childhood cancer. Radiotherapy forms an important component of their treatment. Modern radiotherapy technique where an optimal therapeutic ratio can be obtained demands proper and adequate immobilization of the child.
View Article and Find Full Text PDFBackground: In India, cervical cancer is the second-leading cause of cancer incidence among women. Socioeconomic factors play a vital role in cervical cancer survival.
Objectives: This study assessed the role of education and income on disparities in time-to-treatment initiation (TTI) and its impact on cervical cancer survival.
In 2018, the European Society of Gynecological Oncology (ESGO) jointly with the European Society for Radiotherapy and Oncology (ESTRO) and the European Society of Pathology (ESP) published evidence-based guidelines for the management of patients with cervical cancer. Given the large body of new evidence addressing the management of cervical cancer, the three sister societies jointly decided to update these evidence-based guidelines. The update includes new topics to provide comprehensive guidelines on all relevant issues of diagnosis and treatment in cervical cancer.
View Article and Find Full Text PDFIn 2018, the European Society of Gynecological Oncology (ESGO) jointly with the European Society for Radiotherapy and Oncology (ESTRO) and the European Society of Pathology (ESP) published evidence-based guidelines for the management of patients with cervical cancer. Given the large body of new evidence addressing the management of cervical cancer, the three sister societies jointly decided to update these evidence-based guidelines. The update includes new topics to provide comprehensive guidelines on all relevant issues of diagnosis and treatment in cervical cancer.
View Article and Find Full Text PDFArticle Synopsis
- In 2018, ESGO, ESTRO, and ESP published guidelines for cervical cancer management, which were later updated due to new evidence.
- An expert panel of 27 clinicians across Europe was formed to review the guidelines, ensuring they are evidence-based and reflective of current research and clinical practices.
- The updated guidelines cover various topics including diagnosis, treatment strategies, survivorship, quality of life, and include specific management approaches for different stages and scenarios of cervical cancer.
Purpose: To report the clinical outcomes in patients treated with Martinez universal perineal interstitial template (MUPIT)-based interstitial brachytherapy boost for primary and recurrent vault and vaginal cancers, and to perform a comparative analysis with our previously published series of similar patients.
Material And Methods: One hundred and seventeen patients treated between January, 2009 and December, 2015 were evaluated. Descriptive statistics for the patterns of relapse, local recurrence-free survival (LRFS), disease-free survival (DFS), overall survival (OS), and late toxicities were carried out.
Article Synopsis
- The study aimed to assess how ongoing health issues affect quality of life (QOL) in survivors of locally advanced cervical cancer (LACC).
- It involved analyzing data from the EMBRACE-I study, measuring patient-reported symptoms and QOL over time using specific scoring systems, and identifying persistent symptoms throughout follow-ups.
- Results revealed that persistent symptoms significantly impact QOL, especially in areas like role functioning and general well-being, highlighting the need for better management of both general and organ-related symptoms post-treatment.
Article Synopsis
- The ESMO Clinical Practice Guidelines for endometrial cancer were updated in 2022, prompting a virtual meeting in July 2022 to adapt these guidelines for the Asian context.
- A panel of experts from various Asian oncological societies participated in creating these adapted guidelines, focusing on variations in patient management across different countries.
- The goal is to optimize and harmonize endometrial cancer treatment in Asia by integrating Western and Asian research while considering local differences in clinical practices and access to treatments.
Overall Severe Morbidity After Chemo-Radiation Therapy and Magnetic Resonance Imaging-Guided Adaptive Brachytherapy in Locally Advanced Cervical Cancer: Results From the EMBRACE-I Study.
Int J Radiat Oncol Biol Phys
July 2023
Purpose: To evaluate overall severe late morbidity (grade ≥3) in patients with locally advanced cervical cancer treated with chemo-radiation therapy and magnetic resonance image guided adaptive brachytherapy within the prospective EMBRACE-I study, and to compare the results with published literature after standard radiograph based brachytherapy (BT).
Methods And Materials: From 2008 to 2015 the EMBRACE-I study enrolled 1416 patients. Morbidity was assessed (Common Terminology Criteria for Adverse Events version 3.