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Objective: To analyse the frequency and management outcome of Neutropenia in women with breast cancer receiving Anthracycline chemotherapy. Study Design: Comparative Cross-sectional study. Place and Duration of Study: Oncology Department, Combined Military Hospital, Rawalpindi Pakistan, from Feb to Nov 2021. Methodology: This study was conducted on 200 patients who have breast cancer who were put on an Anthracycline-based chemotherapy regimen. They underwent three or four cycles of chemotherapy as per the treatment plan. A complete blood picture was carried out on all patients after the cycle, and Neutropenia was graded according to the National Cancer Institute's Common Toxicity Criteria. Grade III and IV neutropenia patients were administered Granulocyte colony-stimulating factor and the response was observed. Results: A total of 200 patients with breast cancer receiving Anthracycline-based chemotherapy were included. The mean age of the patients was 54.775±9.649 years. Seven hundred sixty-two cycles were recorded on these patients during the study period. Of these 762 cycles, 245(32.1%) episodes of Neutropenia were recorded. 60(24.4%) had either Grade III or IV neutropenia. Out of those having Grade III or IV neutropenia, 50(83.3%) had improvement after administration of G-CSF, while 10(16.7%) did not show any improvement. The advancing age of patients had a statistically significant relationship (p-value-0.001) with poor response to G-CSF treatment in our study participants. Conclusion: Considerable number of post-menopausal patients with advanced breast cancer taking Anthracycline-based chemotherapy showed the presence of Neutropenia. G-CSF emerged as an effective treatment for high-grade Neutropenia in these patients.

Objective: To look for adverse event profiles in advance of hepatocellular carcinoma treated with Sorafenib presenting to CMH Rawalpindi and study associated socio-demographic factors Study Design: Comparative cross-sectional study Place and Duration of Study: Oncology Department, Combined Military Hospital, Rawalpindi Pakistan, from Dec 2020 to Nov 2021. Methodology: Three hundred patients with diagnosed hepatocellular carcinoma in advanced stage taking Sorafenib chemotherapy for more than three months and less than one year were included in the study. Each patient was assessed for relevant adverse effects in the follow-up outpatient visits by a consultant oncologist. Results: Out of 300 cancer patients using Sorafenib for more than three months and less than one year, 212(70.7%) patients had at least one or more adverse effects, while 88(29.3%) did not experience any adverse effects. Diarrhoea 120(40%) was the most common adverse effect, followed by rash/desquamation 110(36.7%). Advancing age was statistically significantly associated (p-value-0.001) with adverse effects among the target population. Conclusion: A significant number of patients suffering from hepatocellular carcinoma using Sorafenib had mild to moderate adverse effects. Physicians should keep an eye on patients with advancing age for adverse effects of this medication.

Objective: To look for an association of Paclitaxel induced neuropathy with the quality of Life of patients with non-metastatic breast cancer. Study Design: Comparative cross-sectional study. Place and Duration of Study: Oncology Department, Combined Military Hospital, Rawalpindi Pakistan, from Nov 2021 to Feb 2022. Methodology: The study included one hundred and twenty patients with diagnosed non-metastatic breast cancer taking Paclitaxel chemotherapy for more than one month. Peripheral neurotoxicity was assessed by a consultant oncologist based on the Eastern Cooperative Oncology Group (ECOG) score. In addition, quality of Life was recorded with the help of the World Health Organization Quality of Life (WHOQOL)-BREF scale in all the study participants and associated with the presence and severity of neuropathy. Results: Out of 120 non-metastatic breast cancer patients using Paclitaxel for more than one month included in the study, 113 (94.2%) were female, while 7(5.8%) were male. 52(48.3%) had good quality of Life, while 68(51.7%) had poor quality of Life. 34(28.3%) had Grade-0 neuropathy, 54 (45%) had Grade-I, 30(25%) had Grade-II, and 2(1.6%) had Grade-III neuropathy.Statistical analysis showed that the presence and severity of neurotoxicity had a statistically significant relationship with poor quality of Life (p-value=0.001). Conclusion: Many patients having breast cancer using Paclitaxel had the presence of neuropathy. The presence and severity of neuropathy are strongly associated with poor quality of Life in patients included in our study. Keywords: Breast cancer, Neurotoxicity, Paclitaxel, Quality of life.