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Background: The inherent property of brachytherapy is its steep dose gradient and parametrium, near the pelvic wall, which gets little contribution in dose from brachytherapy. As parametria are the common sites for treatment failure, parametrial boost (PMB) may increase the disease control in case of locally advanced cervical carcinomas after 45–50 Gy of external-beam radiotherapy (EBRT) to the whole pelvis. Aims and Objectives: This study aimed to find whether a satisfactory control of the parametrial disease can be achieved with acceptable toxicity. Materials and Methods: Between December 2014 and December 2017, 92 patients were treated by concomitant chemoradiation with whole pelvic EBRT of 50 Gy in 25 fractions and weekly Cisplatin (40 mg/m2) followed by brachytherapy. Out of 89 patients, 46 patients were given an additional PMB of 10 Gy in five fractions and 46 were given no boost. Results: The local control of the disease in terms of CR or PR was comparable in the two arms (i.e., with or without PMB), with P=0.542. The central recurrences between the two arms were also comparable, 13.9% without PMB, and 9.76% with PMB, P=0.726. When parametrial recurrence is concerned, there were four parametrial recurrences (11.11%) in the arm without boost, in comparison to no parametrial recurrence (0%) in the boost arm, and this was statistically significant (P=0.044). Conclusion: In locally advanced carcinoma cervix patients, in terms of parametrial recurrence, this study showed a significant clinical benefit of an additional external beam PMB.

Background: The use of combined modality therapy including surgery, chemotherapy, and radiotherapy increases five survival rates in stage IIA and stage IIIB disease to 80% and 45%, respectively. Neoadjuvant chemotherapy (NACT) eradicates micro metastasis present in the body and also improves resectability. Aims and Objectives: The main aim of this study was to determine the locoregional recurrence and distant recurrence rates and thereby define clinical and pathological predictive factors for recurrence. Materials and Methods: This was a single institutional prospective study carried out in the Department of Radiotherapy, RG Kar Medical College and Hospital, Kolkata. From January 2017 to December 2019, according to inclusion and exclusions criteria, a total of 1183 histologically and/or cytologically proven breast carcinoma patients were included in this prospective study. Results: Breast conservative surgery was done in 16.5% of patients and the rest of the patients underwent modified radical mastectomy. Seven patients had undergone toilet mastectomy with the specimen. From the pathological review of the surgical specimens, 15.0% of patients achieved pathological complete response, while 19.4% of patients had clinical complete response. A total of 150 patients out of 1183 patients (12.67%) had disease recurrence. Conclusion: Local treatments, either surgery alone and/or RT alone, are inadequate therapies for locally advanced breast cancer patients, and multidisciplinary treatment should be used, to reach better management. Inoperable locally advanced breast carcinoma can be converted into operable by NACT.

Background: Sequential chemoradiotherapy and concurrent chemoradiotherapy are two treatment options for locally advanced non-small cell lung cancer (NSCLC). Still there is limited data regarding which is the better treatment option. Aims and Objectives: This study is to compare the response rate and toxicity pattern between induction (neoadjuvant) chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locally advanced NSCLC patients. Materials and Methods: A total of 48 Stage III NSCLC patients were selected for the study and were randomized into two arms with a 1:1 ratio. Patients of ARM-1 received concurrent chemoradiotherapy alone of a total dose of 66Gy/33# over 6 and ⅟2 weeks with paclitaxel (50 mg/m2) and carboplatin (Area under curve [AUC] 2) once every week. The study arm (ARM-2) received two cycles of induction chemotherapy with paclitaxel (175 mg/m2) and carboplatin (AUC 6) every 3 weeks and concurrent chemoradiotherapy (same CRT as on ARM-1). Results: In our study, overall response rate (Complete response+Partial response) in Arm 1 and Arm 2 was 62% and 71%, respectively. The treatment was very tolerated in our study. A mean follow-up of 12 months by Kaplan–Meier survival analysis showed a statistically non-significant difference in disease-free survival in both arms. Progression-free survival was numerically superior in the induction chemotherapy arm but the difference was statistically non-significant. Acute hematological toxicity was numerically more in the concurrent chemoradiotherapy arm, but statistically not significant. Acute lung toxicity, acute pharynx, and esophagus toxicity were numerically more in the induction chemotherapy arm but statistically non-significant. Conclusion: There was no significant difference between induction chemotherapy followed by concurrent chemoradiotherapy and concurrent chemoradiotherapy alone in the present study population.

Background: Marjolin’s ulcer (MU) reflects the malignant transformation of scar tissue or chronic inflammatory skin lesions. Due to the low incidence, only a few case reports and case series were reported in the literature to date. Aims and Objectives: In our retrospective analysis, we report our experience regarding MU over the past 16 years with a significant range of latent period, histology, and as well as underlying skin conditions, from Kolkata, India. Materials and Methods: This was a single institutional retrospective study carried out in the department of radiotherapy at the tertiary cancer, Kolkata. We focus mainly on data pertaining to the type of injury, the time gap between the initial injury and development of MU, histology, clinical stage, and treatment received, along with demographic details. Results: A total of 39 patients with histopathologically proved MUs were included according to the inclusion and exclusion criteria. The median age of patients at the time of development of MU was 52 years and with a range of 32–71 years. Out of 39 patients who participated in this study, 29 were male (74%) and ten were female (26%), 31 patients have localized disease (80%) and eight patients have metastatic disease (20%). The most common histology is squamous cell carcinoma and the least common histology was spindle cell sarcoma. The majority of the patients were treated with curative intention and a small proportion of patients were offered palliative therapy. Conclusion: Ulcers refractory to basic wound care, chronic in nature, and recent change of character of long-standing scar or wound, diagnosis of MU should be ruled out by biopsy. The management of MU should be supervised by a multidisciplinary tumor board and in the areas of epidemiology and treatment, more research is needed.

Giant cell tumor (GCT) of the bone also known as osteoclastoma typically arises from the meta-epiphyseal region of the long bone and comprises 5% of all bone tumors and 20% of benign bone tumors. Understanding pathogenesis is the key to successful systemic therapy with denosumab, a RANK-ligand inhibitor. In this context, we report seven GCT bone-treated denosumab and radiotherapy cases with a diverse clinical presentation from our institute, NRS Medical College, and Hospital Kolkata.

Background: Health-related quality of life (HRQoL) is defined as a specific subset of QoL, assessing symptoms, psychological aspects, and function. It is very important for healthcare professionals to recognize the issue-related to the QoL of head and neck cancer patients. Aims and Objectives: This study intended to measure different domains of QoL in head and neck cancer patients before and at the time of radiotherapy (RT) treatment completion, 3 and 6 months after treatment completion, and to discover the relationship between the type of treatment and QoL. Materials and Methods: An assessment of pre- and post-RT QoL of sixty head and neck cancer patients was done at our RT department, using the European Organization for Research and treatment of cancer QoL questionnaire head and neck cancer module (EORTC QLQ H&N 35). Results: Statistically significant differences were observed compared to baseline (P < 0.001) at the completion of radiotherapy in pain, swallowing, speech, cough, dry mouth, mouth opening, and senses scale and at 3.6 months of follow-up, while the HNSS (sticky saliva) scale showed statistically insignificant result at Zero (0) months (at the time of completion of radiation). Conclusion: The results of our study showed that QoL in head and neck carcinoma patients is affected in various functional and symptoms-related domains and their overall health and QoL perceived were not very satisfactory. These post-treatment-related complications were not preventable and should be talked about with the patients before starting RT.