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Context: In India, most breast cancer patients present with advanced stage requiring postmastectomy radiotherapy. Lymphedema is a long-term side effect that causes both physical and psychological distresses.Aims: The present prospective study was carried out to study various factors affecting breast cancer-related lymphedema (BCRL).Subjects and Methods: From January 2015 to March 2016, 100 postmastectomy patients who received adjuvant irradiation to chest wall were selected prospectively. Circumference of both arms was measured before surgery, at start, and at end of radiotherapy followed by 3 monthly intervals till last follow-up. Lymphedema was defined as a difference of ≥2 cm from the baseline in the arm circumference on the side of surgery.Results: At a median follow-up of 24 months, the cumulative incidence of BCRL was 13%. On multivariate analysis, risk of BCRL was significantly associated with higher body mass index (BMI) (P = 0.004), greater number of lymph nodes (LNs) dissected (P = 0.005), higher nodal ratio (P = 0.006), and regional LN radiation (RLNR) (P = 0.048) but not with the type of fractionation (P = 0.094).Conclusions: Adjuvant RLNR, higher BMI, greater number of LNs dissected, and higher nodal ratio significantly increases the risk of development of BCRL. There was no significant difference in the lymphedema with the type of fractionation. Females receiving RLNR should be prospectively monitored for lymphedema to ensure early detection and possible intervention. [ABSTRACT FROM AUTHOR]

Background: Brachytherapy is an integral component of the definitive treatment of locally advanced cancer cervix. Cervical Brachytherapy has evolved from the time when dose prescription was largely empirical, to the image based conformal brachytherapy advocated by Groupe Europeen de Curie Therapie-European society for therapeutic radiology and oncology (GEC-ESTRO) and American brachytherapy society (ABS). Objectives: To explore the feasibility of transabdominal ultrasound (USG) as an imaging modality for conformal brachytherapy (intracavitary) in locally advanced cancer cervix. Methods: Twenty-five patients with locally advanced cervix cancer (FIGO 2009 IB2 to IIIB) treated with definitive chemoradiation and brachytherapy were included in this study. Two plans were generated for each patient at each brachytherapy session - 1) standard orthogonal X-Ray plan with dose presciption to Point A and 2) plan based on USG imaging and clinical assessment. The two plans were compared with respect to doses received at point A, international commission on radiation units and measurements (ICRU) 38 urinary bladder and rectal points. Actual Brachytherapy doses were prescribed to the USG (and clinically) delineated target and patients followed up to 15 months minimum for assessing local control and late toxicity. Results: USG based planning resulted in statistically significant reduction of doses received at organs at risk (OAR) i.e. ICRU 38 bladder (P < 0.001) and rectal (P = 0.002) points, when compared with the standard X-Ray plans. Disease free status was achieved by 73.68% patients in 15 months. 4 patients had pelvic failure and 1 had both pevic and distant (lung) failure. Two patients developed Grade 1 Bladder toxicity. Three patients had grade 1 and one had Grade 2 Rectal toxicities. Grade 3 and 4 toxicities were not observed. Conclusions: Considering the ease of availability, inexpensiveness, quick and good soft tissue imaging offered by ultrasound, this modality's potential for conformal brachytherapy should be further explored, especially in limited resource settings and where the disease burden is high. [ABSTRACT FROM AUTHOR]

Background: This study evaluated sexual function in cervical cancer survivors after concurrent chemoradiotherapy. Methods: Study participants comprised survivors of locally advanced cervical cancer (stages IIB-IVA) who completed concurrent chemoradiotherapy along with intracavitary brachytherapy at least two years prior at Dr S.N.Medical College, Jodhpur, Rajasthan, India. We used the Female Sexual Function Index questionnaire to assess sexual function. The cut-off score of the Female Sexual Function Index that identified female sexual arousal disorder was 26.55. A score less than 26.55 indicated the presence of female sexual arousal disorder. Results:A total of 48 locally advanced cervical cancer survivors enrolled in the study. Survivors had a mean age of 46.5 years. All received chemoradiotherapy along with intracavitary brachytherapy. The average time for treatment was 53.5 days. Patients had an average score for sexual desire of 2, 2.3 for arousal, 2.3 for sexual satisfaction, and 2.1 for pain during intercourse. The overall average score was 11.84 (range: 3.2-19.5) with a cut-off of 26.55. All survivors suffered from female sexual arousal disorder. Conclusion: Cervical cancer survivors had decreased sexual function which indicated female sexual arousal disorder. Patient education and active treatment of complications related to cancer treatments is a must for improvement of sexual function among survivors. Long-term complications should be considered in terms of treatment planning and follow-up treatment to improve the quality of life of cancer survivors. [ABSTRACT FROM AUTHOR]

Neuroendocrine tumors comprise a broad family of tumors that arise from the diffuse neuroendocrine cell system. Small-cell neuroendocrine carcinoma cervix is a rare tumor, accounting for up to 2% of cervical carcinomas. These are highly aggressive tumors, characterized by early distant metastasis and worse prognosis compared to other histological types occurring in the cervix. Distant sites of recurrence including lung and bone are more common (28%) than local failure (13%). We report a case of a 60-year-old woman whose disease progressed during treatment with an eventual fatal outcome. [ABSTRACT FROM AUTHOR]

The skeleton is the most common site of distant metastasis from nasopharyngeal carcinoma. The commonly affected sites are the spine, and the pelvis and lesions are multifocal. However, solitary bone involvement with no evidence of loco-regional failure nor any other metastasis, 7 years after achieving a complete response to initial definitive chemoradiotherapy, is rare. We report the case of a 41-year-old man who developed a solitary femoral bone recurrence. He received local radiotherapy to the femur followed by cisplatin-based chemotherapy. He presently enjoys good functional status. [ABSTRACT FROM AUTHOR]