VOL. 2:1994-2000














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1. N. Anantha, A. Nandakumar, N. Viswanath, T. Venkatesh, Y.G. Pallad, P. Manjunath, D.R. Kumar, S.G.S. Murthy, Shivashankaraiah, and C.S. Dayananda

Efficacy of an anti-tobacco community education program in India

Cancer Causes and Control, 1995; 6 : 119-129

In a study on ‘Assessment of Efficacy of an Anti-Tobacco Community Education Program’ on Kolar District of Karnataka, India, an experimental and two control areas were chosen based on comparable population, health, and socio-economic parameters. The two main objectives were to prevent individuals from taking up the tobacco habit among those who currently did not smoke or chew tobacco, and to stop the tobacco habit in those who did smoke or chew tobacco. A baseline tobacco-habit survey of the population was followed by anti-tobacco education of the community in the experimental area only. Two years later, a repeat survey of the population was conducted, followed by a final survey after a further three years. Methods of health education of the community included screening of films, exhibits, and personal contact with a display of photographs of the harmful effects of tobacco. The results were evaluated through changes in prevalence rates, quitters’ rates, and initiation rate. The final survey showed that in the experimental area, the decline in the prevalence rate in the combined sample compared with the baseline rates was 10.2 percent in males and 16.3 percent in females, with a corresponding quitter’s rate of 26.5 percent in males and 36.7 percent in females. Among men, a higher proportion (30.2 percent) had given up chewing compared with smoking (20.4 percent)

Key Words : Anti-smoking education, India program evaluation, tobacco control.

2. Anil K. Sharma, Sanjay S. Supe, N. Anantha and K. Subbarangaiah

Physical Characteristics of Photon and Electron Beams From a Dual Energy Linear Accelerator

Medical Dosimetry, 1995; 20:1, 55-56

Abstract : Clinically pertinent data of the photon beams of nominal energy 6 MV and 18 MV from a dual photon energy linear accelerator are measured using a radiation field analyser with semiconductor diodes and ionisation chambers. Percentage depth dose values are compared with available data from other linacs and BJR-17. Measurements made in the buildup region using a parallel plate chamber show a marked increase in the surface dose and dmax shifts by 3 mm and 14 mm for 6 MV and 18 MV photons, respectively as the field size is increased from 4 x 4 cm2 to the maximum. Variations of wedge angles with energy and field size are also determined up to wedge widths of 15 cm for all the four available wedge angles. Isodose plots of both the energies are plotted using semiconductor diodes in a RFA-3 system. Output factors, wedge transmission factors, and shielding tray factors were also measured in clean polystyrene phantom for both the photon energies at the depths of maximum ionisation. Beam characteristics of the electron beams of energies 6, 9, 12, 16 and 20 MeV produced by the Clinac-1800 have also been studied. The characteristics include percentage depth dose, isodose distribution, depth of maximum dose, surface dose, photon contamination, uniformity index, and penumbra. Most of the measurements were carried out using semiconductor detectors, whereas small volume ionization chambers and a plane-parallel chamber was kept as standards for comparison. Isodose distributions were drawn from the film dosimetry method. Range-energy parameters are obtained from the observed depth dose data. These parameters vary from machine to machine and must be ascertained for individual units. The parameters differ to a considerable extent from their theoretically predicted values but generally follow the trend, experimentally observed by others, for similar types of units.

Key words : Beam characteristics, Wedge angles, Surface dose, Range-energy parameters.

3. Anna Abraham & V. Kumaraiah

Electromyograph Feedback and Stress Inoculation : Responders and Dropouts

Nimhans Journal, 1994; 12:1, 27-31

A median split of a sample of 22 clients with anxiety neurosis resulted in 11 ‘adequate responders’ and 11 ‘inadequate responders’ to therapy. Data analysis revealed that those clients who reported less number of initial symptoms were significantly more responsive to the therapeutic programme.

Out of the 25 clients who participated in the therapeutic programme, 2 dropped out. The authors report their observations and offer certain speculations.

Keywords : EMG feedback, Stress inoculation, Responders, Dropouts

4. Anna Abraham & V. Kumaraiah

Electromyograph Feedback : Treatment Outcome in Anxiety Neurosis

Indian J. Psychiat., 1994; 36(2), 70-73

Twenty two clients were assessed before and after ten sessions of Electromyograph (EMG) feedback assisted relaxation on both psychological and physiological measures. Results demonstrated significant decreases in the symptom scores and anxiety, as seen on the self-report measures. The clients were found to be significantly less anxious on the Hamilton’s Anxiety Rating Scale. Though there was a significant reduction in resting EMG levels, there was no significant decrease in the GSR of the clients. Clients could acquire feedback control as well as self-control.

Key words : electromyograph feedback, feedback control, outcome, anxiety neurosis.

5. Anna Abraham and V. Kumaraiah

EMG Feedback and Stress Inoculation in Anxiety Neurosis : Follow-up Analysis

Nimhans Journal, 1994; 12:1, 33-40

A follow-up assessment done one month after termination of the therapeutic programme revealed that the ‘adequate responders’ to therapy could maintain improvement and that the ‘inadequate responders’ could continue to improve. A qualitative analysis of the follow-up data done subsequently, over a period of as long as 26 months, further strengthened the claim that the addition of cognitive treatment methods can result in powerful changes which are general across situations and stable over time.

Keywords : EMG feedback; Stress inoculation, Anxiety neurosis, Follow-up

6. Anna Abraham & V. Kumaraiah

Effect of EMG Feedback and SIT on the Reactivity to a Cognitive Stressor : Some Observations

Nimhans Journal, 1998; (Oct) 271-277

As part of a larger study, the authors used the physiological stress procedure to find out the effect of electromyograph (EMG) feedback assisted relaxation and stress inoculation training (SIT) on the reactivity to a cognitive stressor in a sample of 22 clients with anxiety neurosis. The observations made reinforce the fact that the effect of EMG feedback assisted relaxation is specific with no cross modality generalization effects. The observations also suggest the usefulness of these therapeutic strategies in clinically anxious clients under stress, especially in the long run. With the addition of SIT, a self instructional form of cognitive behaviour therapy to EMG feedback relaxation, one can speculate whether time is an important factor for positive changes to occur.

Key words : Electromyograph feedback, stress inoculation, reactivity, cognitive stressor, anxiety neurosis.

7. Anna Abraham

Psychological Support To A Terminally ILL Cancer Patient-A Case Study

Indian Journal of Palliative Care, 2000; 6:39-44

Summary : A single case of a terminally ill cancer patient was studied by the case study method. Four sessions of psychological support were provided over 8 days, each session lasting for about an hour. Therapy had to be conducted at the patient’s bedside in a General Ward. A close family member was present at each session. Direct observation during the sessions and the patient’s subjective report as elicited through interviews, were the tools of assessment used. Psychological support resulted in positive effects. The paper throws light on the psychological approach one has to take in the last weeks of a patient’s life.

Key Words : Cancer, Psychological support, Terminal.

8. Anu Sridhar, Uma Devi. K, Bafna U.D.

Squamous cell carcinoma arising in mature cystic teratoma

International Journal of Gynecology & Obstetrics India,

1999; 2:3, 77-78

Abstract : Squamous cell carcinoma arising from benign cystic teratoma carries a bad prognosis once capsular invasion is noted. The reported patient had a Stage IV disease and had disease progression inspite of postoperative chemotherapy administered after optimal cytoreduction. The patient was then given whole abdominal radiotherapy with pelvic boost to which there was complete clinical response. The patient later succumbed to suspected grade IV radiation eneritis two month following completion of radiotherapy.

Keywords : Ovarian teratoma; squamous cell carcinoma.

9. U.D. Bafna, T.M. Suresh, S. Balu

Primary Ovarian lymphoma

International Journal of Gynecology & Obstetrics
India, 2000; 3:3, 54-56

Abstract : Ovarian involvement by malignant lymphoma is rare, except as a manifestation of disseminated nodal lymphoma. We report a case of non-Hodgkin’s Lymphoma (NHL) of the ovary treated with Total Abdominal Hysterectomy with bilateral salpingo-oopherectomy and partial omentectomy followed by post operative combination chemotherapy (cyclophosphamide, adriamycin, vincristine and prednisolone : CHOP). The subject is well and apparently free of disease at 42 months after completion of chemotherapy and 48 months after surgery.

Keywords : Ovary; malignant lymphoma; combination chemotherapy.

10. U.D. Bafna, V.K. Ahuja, K. Umadevi, N. Srinivasan, K. Mani & E. Vallikad

Gestational trophoblastic tumors - situation analysis in a third world regional cancer center

Int J Gynecol Cancer 1997, 7, 197-204

Abstract : Bafna UD, Ahuja VK, Umadevi. K, Srinivasan. N, Mani. K, Vallikad E.

A retrospective analysis of 128 cases of gestational trophoblastic tumor (GTT), registered between the years 1980 and 1993 was undertaken. As per the WHO scoring system. 35 (27.3%) were classified as low risk (LR), 32 (25%) as medium risk (MR) and 61 (47.6%) as high risk (HR). Ninetyfive of 128 (34 LR, 24 MR and 37 HR) cases were considered evaluable for the purpose of treatment analysis. Complete remission (CR) was achieved in 100%, 83.3% and 83.7% of the LR, MR and HR categories respectively. While three patients were cured with surgery alone (one LR, two MR), 60/92 (26/33 LR, 13/22 MR and 21/37 HR) responded to first line chemotherapy, 22/92 (eight LR, five MR and 10 HR) were salvaged with alternative chemotherapy regimens and 10/92 (four MR and six HR) had progressive disease. There were four recurrences, all in the HR group, who could not be salvaged. It appears that at least two cycles should be administered as consolidation chemotherapy following CR, as recurrent disease (RD) was observed in 3/6 HR patients receiving one or no cycle and 1/25 HR patients receiving two or more cycles of consolidation chemotherapy (P=0.05). Three of six HR patients with CR and WHO score > 14 developed RD as compared to 1/25 HR patients with CR and WHO score <15 (P<0.001). The univariate analysis of the various prognostic factors in the HR cases revealed that the initial chemotherapeutic regimen was the most important prognostic factor.

Keywords : Chemotherapy, gestational trophoblastic tumor, prognostic factors.

11. Balu S., R.V. Kumar

Pathological Diagnosis.

Journal of Applied Medicine, 1998; 24:443-444

Case History

A 48 year old male presented with history of dysphagia to solids of 2 months duration. Upper gastrointestinal endoscopy revealed a polypoid growth in the lower one third of the oesophagus. Barium swallow examination showed an irregular filling defect at the same site measuring 7 cm longitudinally. Biopsy of the lesion revealed a poorly differentiated carcinoma for which a transhiatal oesophagectomy was done.

12. P.P. Bapsy

Tumor Markers

KMJ 1996, 66:15-17

Tumor markers - are markers or indicators of risk, presence, status or future behaviour of Tumors. During the first half of the century histopathologic description of fixed tissue essentially comprised the field of tumor marker research. With the advent of immunologic methodologies and molecular technologies, the ability to detect subtle charges associated with neo-transformation have begun to dawn. An "Ideal tumor" marker should satisfy the criteria of being "early detector, diagnostic agent, predictor of prognosis, and detector of early recurrence".

As on date there has been no "Ideal Tumor Marker" except for B-HCG for Germ cell tumors.

13. M.S. Belliappa, Sanjay S. Supe, M.H. Shariff, Anil K. Sharma and Anantha, N.

The role of extrapolated response dose concept in HBI treatments of disseminated painful osseous metastases.

Journal of Medical Physics, 1995; 20:2, 26-30

Abstract : Hemibody irradiation (HBI) has emerged as an efficient and effective treatment for the palliation of pain in patients with symptomatic widespread cancer. The rational for such unconventional radiation delivery is to try to achieve effective pain palliation to large affected body areas with prompt efficiency and minimal inconvenience to terminal cancer patients. In this report a prospective study is undertaken as to the existence of a correlation between ERD versus response rate in a series of patients with disseminated painful osseous metastases with megavoltage HBI treatments. Correlation of ERD with response rate was excellent. There was a sharp increase in response rate from ERD of 13 Gy onwards (p value < 0.05). From our results it is suggested that in the HBI treatments of disseminated painful osseous metastases ERD value 13 Gy as the minimum for a favourable response rate as per the treatment schedule that we have used.

14. Clementina Rama Rao, M.D., K.N. Naresh, M.D., D.C.P., V. Pattabhiraman, M.D., P.S. Prabhakaran, M.S., Diganta Hazarika, M.D.,

Hemangiopericytoma of Bone - A Case Report

Indian Journal of Cancer, 1994, 31-14, 264-267

Summary : A case of low grade hemangiopericytoma of three years duration occurring in the upper end of the femur of a 70 year old man is described. Radiologically, the upper third of the right femur showed a destructive expansile osteolytic lesion with soft tissue extension. The tumour was partially encapsulated. Mitosis were 0-1 per 10 high power fields, suggesting the low grade malignant nature of the lesion. It is felt that all hemangiopericytomas occurring in bone should be considered biologically malignant.

15. Clementine. Rama Rao, M.D., M. Srinivasulu, M.D., K.N. Naresh, M.D., D.C.P., D.C. Doval, M.D., M.A.M.S. D. Hazarika, M.D.,

Adult Paratesticular Sarcomas : A Report of Eight Cases

Journal of Surgical Oncology, 1994;56:89-93

Eight adult paratesticular sarcomas seen at a Regional Cancer Centre over a 7-year period are described. There were three cases of rhabdomyo sarcoma (RMS), three cases of leiomyosarcoma (LMS), and two cases of liposarcoma (LS). The RMS occurred in a younger age group (3rd decade) than the LMS and LS (6th and 7th decades). Most of our patients presented with advanced disease after orchiectomy at other hospitals, three with recurrent or residual disease and four with metastasis. The single patient with RMS who received intensive adjuvant therapy is free of disease at 84 months in spite of the advanced stage at presentation. All three patients with LMS had an unfavourable clinical course. Both the patients with LS had well differentiated (WD) tumours and presented with recurrences, one over several years, following initial local excisions.

The necessity for early adequate surgical and adjuvant therapy and the need for a uniform treatment policy are discussed.

Key words : mesenchymal tumours, testicular adnexal, multi-modal treatment.

16. Clementina Rama Rao, Marina I, Gutierrez, Kishor Bhatia, Falko Fend, Janet Franklin, L. Appaji, Guillermo Gallo, Gregory O’ Conor, N. Lalitha and Ian Magrath.

Association of Burkitt's Lymphoma with the Epslein-Barr virus in two developing countries.

Leukemia and Lymphoma, 2000; 39(3-4) 329-337

The clinical presentation of Burkitt’s lymphoma (BL) and it’s association with the Epstein-Barr virus (EBV) varies in different geographic areas, BL in developing countries being "intermediate" between the sporadic and endemic types, both in it’s clinical presentation and it’s association with EBV, which varies from 25-80%. In this study we have analysed the clinical features, EBV association, subtype and prevalence of the deleted variant of the Latent Membrane Protein-1 (LMP-1) of EBV in forty-two cases from two developing countries - India (n=25) and Argentina (n=17). In both countries the abdomen was the site most commonly involved while jaw involvement was rare. EBV was detected by in-situ hybridization using the EBER-1 RNA probe. 47% of cases from Argentina and 80% of cases from India were EBER positive. EBV typing using EBNA-3C primers showed a predominance of Type A in both countries (India-13/16 and Argentina-7/8). The 30bp deletion of the LMP-1 gene was detected in all evaluated cases from Argentina while the wild type of the gene was seen in all the evaluable Indian cases. Our study highlights the similarities and differences in the clinical presentation and EBV association of BL in two developing countries and also indicates that the subtype of EBV and prevalence of the LMP-1 deletion may reflect the predominant subtype in a particular population.

Keywords : Burkitt’s lymphoma, Epstein-Barr virus, India, Argentina, EBV subtype, LMP-1 deletion.

17. D. C. Doval, V. Kannan, Rani Acharya, Geethashree Mukherjee, Chandrashekar M, Ponamally Parthasarathy Bapsy.

Bronchial Embryonal Rhadbdomyoscarcoma - A Case Report

Acta Oncologica, 1994; 33:831-833

18. D.C. Doval, V. Kannan, R.S. Acharya, G. Mukherjee, A.M. Shenoy, P.P. Bapsy

Rhabdomyosarcoma of the tongue

British Journal of Oral and Maxillofacial Surgery (1994) 32, 183-186

Summary : Although rhabdomyosarcoma (RMS) has a predilection for the head and neck region its occurrence in the tongue is uncommon. We report 2 cases of RMS of the tongue, I pediatric and I adult patient. The child who had RMS of the alveolar type involving anterior two-thirds of the tongue was treated with surgery and chemotherapy and is disease-free at 84 months of follow-up. The adult patient had locally extensive embryonal RMS of posterior third of the tongue, received chemotherapy and radiotherapy but died with progressive disease at 24 months of follow-up.

19. D.C. Doval, M.D., M.A.M.S., C. Rama Rao, M.D., R. Acharya, M.D., B.K.M. Reddy, M.D., P.P. Bapsy, M.D., D.M.,

Hepatocellular Carcinoma Metastatic to Bones

Indian Journal of Cancer, 1995; 32-31-35

Summary : A seventy year old man presented with bone pains. Investigation revealed a metastatic bone lesion in the humerus. The primary was found in the liver. The patient achieved good palliation with chemotherapy and radiotherapy and survived for one year.

20. D.C. Doval, C. Rama Rao, K.S. Sabitha, M. Vijaykumar, S. Misra, K. Mani, P.P. Bapsy and S.V. Kumaraswamy

Malignant melanoma of the oral cavity : report of 14 cases from a regional cancer centre

European Journal of Surgical Oncology, 1996; 22 : 245-249

Fourteen patients with oral mucosal malignant melanomas seen at a regional cancer centre over a 10-year period were analysed. All the patients presented with symptoms of short duration, with extensive local disease at initial evaluation in 11 patients. The palate was the commonest site involved. Ten patients had regional nodal disease and of these four also had distant metastases to the liver and/or the lung. Coincidental melanosis was identified clinically in three patients and histologically confirmed in two patients. Only four patients underwent radical surgery. Of the patients who received DTIC-based chemotherapy, only one achieved a complete response. No significant correlation between stage of the disease at presentation, histological features or type of treatment and survival could be seen as the number of cases is small.

Key word : Mucosal melanomas; mouth; therapy.

21. D.C. Doval, C.R. Rao, S. Misra, L. Devi, V. Srinivas, M. Chandrashekar & P.B.Bapsy.

Isolated graulocytic sarcoma of the breast

Annals of Oncology, 1996; 7:424-425

22. D.C. Doval, R.V.Kumar, V. Kannan, K.S.Sabitha, M. Vijaykumar, P. Hegde, P.P. Bapsy, K. Mani, A.M. Shenoy, S.V. Kumaraswamy.

Osteosarcoma of the jaw bones

British Journal of Oral and Maxillofacial Surgery 1997, 35, 357-362

Summary : Osteosarcoma of the jaw bone is comparatively rare and accounts for about 6.5% of all osteosarcomas. We treated eight cases of osteosarcoma of the jaw bone involving the mandible and maxilla in equal proportions between 1986-1992. The median age was 31 years and male/female ratio was 5:3. Swelling and bony expansion were the most common presentation. Radiologically six patients six patients had lytic lesions, and histopathologically they were osteoblastic (n=4), chondroblastic (n=3) and fibroblastic (n=1). Three patients, two with mandibular and one with maxillary osteosarcoma underwent radical surgery and six courses of cisplatinum based chemotherapy. All were alive and disease free 24, 30 and 54 months after treatment. Histologically all three were chondroblastic. Five patients had incomplete or palliative treatment. All patients died of progressive or locally recurrent disease within 2 years.

23. D.C. Doval M.D., K. Pavithran, M.D., Rani. S. Acharya, M.D., V. Kannan, M.D.,Geethashree Mukherjee, M.D., P.P. Bapsy, M.D., D.M.

Ewings Sarcoma with Central Nervous System Metastasis - Report of two cases

Indian Journal of Cancer, 1997; 31:1, 26-29

Summary : Isolated central nervous metastatasis is rare in patients with Ewing’s sarcoma. Here we report two cases with CNS metastasis as the sole manifestation of relapse with a brief review of the literature.

24. Elizabeth Vallikad

Downstaging Cancer Cervix in the Indian Situation

International Journal of Gynecological Cancer, 1997; 7:Supp 2, 060

25. Girija Ramaswamy and Lakshmi Krishnamoorthy

Serum Carotene, Vitamin A, and Vitamin C Levels in Breast Cancer and Cancer of the Uterine Cervix

Nutr Cancer, 1996; 25-173-177

Levels of carotene, vitamin A, and vitamin C measured in the serum of patients with cancer of the breast and uterine cervix were compared with levels in healthy controls and patients with benign diseases of the breast and cervix. Serum ascorbate levels were significantly lower in patients with benign diseases of the breast and cervix than in controls. In cancer patients, there was a significant trend of lower serum vitamin levels with increasing stage of the disease.

26. Girija Ramaswamy, V.R. Rao, S.V. Kumaraswamy and N. Anantha

Serum Vitamins Status in Oral Leucoplakias a Preliminary Study

Oral Oncol : Eur J Cancer, 1996; 32B:2, 120-122

Vitamins, such as A, b carotene, C, E, B12 and folate, are the micronutrients with the strongest evidence of having a link to cancer prevention and control. Deficiency of these vitamins at the dietary, systemic or mucosal level will interact with tobacco use and increase the risk of oral precancerous lesions. The objective of this study was to (1) establish the baseline circulating levels of these vitamins in our normal population with and without tobacco use and (2) compare these levels with the values obtained in cases of oral leucoplakias. 50 normal controls with 25 each in chewers and non-chewers, matched for age and sex, were selected. 50 cases of oral leucoplakias (clinically detectable white patches) from the field constituted the study group. Simultaneous measurement of serum vitamin B12 and folate were carried out by radioassay. The other serum vitamins were estimated spectrophotometrically. Except for serum vitamin E, all the other serum vitamin levels were significantly decreased in oral leucoplakias compared to the controls. Cancer chemopreventive agents acting as inhibitors of both initiation and promotion, as analysed in our population, is promising for further intervention trials.

Keywords : vitamins, oral leucoplakia, tobacco.

27. Girija Ramaswamy, Vasanti R. Rao, Lakshmi Krishnamoorthy, G.Ramesh, Gomathy R. and Renukadevi. D.

Serum Levels of Bone Alkaline Phosphatase in Breast and Prostate Cancer with Bone Metastasis.

Indian Journal of Clinical Biochemistry, 2000; 15:110-113

Abstract : BALP activity in the sera of metastatic patients of breast and prostate malignancy is increased significantly. Our studies with patients in India conform the earlier reports that BALP may have a useful complementary role in the early diagnosis of bone metastasis.

28. K. Govind Babu


KMJ, 1996; 66:39-42

29. K. Govind Babu.

Multidrug Resistance Present Status

Indian Journal of Hematology & Blood Transfusion, 1994; 12:134-135

30. K. Govinda Babu, D.Radheshyam, N. Lalitha

Canities - Reversal With Chemotherapy

JAPI, 1995; 43-577

31. K. Govinda Babu, Radheshyam, N. Lalitha, C. Ramarao, Lakshmidevi

Hypertrophic Osteoarthropathy in Hodgkin’s Disease

JAPI 1995; 43:10, 704-705

Introduction : Hypertrophic osteoarthropathy (HOA) is a clinical situation in gross digital clubbing and thickened periosteum of the long bones. HOA is most commonly described in association with thoracic disease involving mainly the lung and rarely the pleura. We report the association of HOA in our patient of Hodgkins disease; an association that has not been so far described.

32. K. Govindbabu, Radheshyam, N. Lalitha, C. Rama Rao, Lakshmidevi

Carcinoma Colon With Mandible And Liver Metastases

British Journal of Oral and Maxillofacial Surgery, 1994; 34:133-134

33. Hazarika. D., M.D., Rekha V. Kumar, M.D., Clementina Rama Rao, M.D., Geetashree Mukherjee, M.D., V. Pattabhiraman, M.D., M. Chandrashekar, M.S.,

Fine Needle Aspiration Cytology of Chondroblastoma and Chondromyxoid Fibroma

Acta Cytol 1994; 38 : 592-596

The fine needle aspiration cytology in two cases of chondroblastoma and chondromyxoid fibroma are described. The diagnosis of chondroblastoma was made on a recurrent tumor of which the histopathology was known, whereas chondromyxoid fibroma was diagnosed initially on fine needle aspiration cytology. The radiologic appearances and differential diagnosis of these chondroid neoplasms are discussed.

Keywords : Chondroblastoma; fibroma; biopsy, needle.

34. Hazarika. D., M.D., K. Naresh Narasimhamurthy, M.D., D.C.P., Clementina Rama Rao, M.D., Kodagarnur S. Gopinath, M.S., F.I.C.S., M.A.M.S.

Fine Needle Aspiration Cytology of Wilm's Tumor : A Study of 17 cases

Acta Cytol, 1994; 38:355-360

The cytologic features of 17 cases of Wilms tumor are described. All three elements identifiable histologically are usually present in the fine needle aspiration smears. In our cases the blastemal component predominated, with varying degrees of epithelial and stromal differentiation, which was identifiable in the form of skeletal and smooth muscle. Early epithelial differentiation was identified as rosettelike and glandlike structures, groups of cells with peripheral palisading and spherical, tightly bound clusters of cells. More differentiated epithelial cells were seen individually, in small, loose clusters, in sheets with a honeycomb appearance and as elongated tubules. Coarse, magenta, granular material was seen in the background of the smears in the majority of our cases.

Fine needle aspiration under ultrasound guidance to accurately localize the tumor and a posterior approach to avoid peritoneal spillage are recommended. In difficult cases, a cell block of the aspirated material is a useful adjunct.

35. Hazarika. D., M.D., Rekha V. Kumar, M.D.,Gayathri Devi Muniyappa, M.D., Geetashree Mukherjee, M.D., Clementina Rama Rao, M.D., Naresh K. Narasimhamurthy, M.D., Ashok M. Shenoy, M.S., Nanjundappa, M.S.,

Diagnosis of Clival Chordoma by Fine Needle Aspiration of an Oropharyngeal Mass

Acta Cytol, 1995; 39:507-510

A sphenooccipital chordoma presenting as a large nasopharyngeal mass extending into the oropharynx was diagnosed by transoral fine needle aspiration biopsy (FNAB) and confirmed by subsequent histologic studies. The cytologic features of chordoma are presented, and the diagnostic utility of FNAB in evaluating similar lesions in the head and neck region is discussed.

36. Hema Sridhar, M.D., Jayashree R. Subramanyam, Ph.D., Appaji. L., M.D., D.M., Shafiulla M., M.Sc., Vijaykumar. B.R., M.Sc. (Med.)

Fusarium Solani Fungemia in a Patient with Acute Lymphoblastic Leukemia

Indian Journal of Cancer, 2000;38:1, 19-21

Summary : A patient with ALL on anticancer chemotherapy developed fever which was later attributed to be due to Fusarium fungemia. The details of the case & a review of literature follows.

37. Hema Sridhar

Antibiotic Sensitivity Testing : A Perspective on Stokes Method

Indian Journal of Internal Medicine, 1995, 5: 10-12, 100

Introduction : The common method used in most laboratories in our country for testing in vitro sensitivity of bacterial isolates is that of Bauer et al (1966) wherein the interpretation of sensitivity or resistance of a bacterium is based on the size of the zone of inhibition around the antibiotic disc.

Although this method enjoys the advantages of convenience and ease of technique, its pitfall is that there is no control organism grown in the same culture plate, and as such one is not sure of the validity of the zone of inhibition in a given test. The Stokes disc diffusion method (1980) takes care of this aspect by including both the test and known control organisms in the same plate. It can also be used on different media depending on the growth requirements of the organism.

In vitro sensitivity data based on Kirby Bauer methodology is made available periodically from several institutions in our country, but similar information based on Stokes methodology is comparatively rare for technical reasons mentioned above. The present study was thus aimed at evaluating the sensitivity patterns of bacterial isolates using the Stokes method in a hospital setting.

38. Hema Vaithiananthan, Sanjay S. Supe, Anil Kumar Sharma, N. Anantha, S.J. Supe, A.C. Deca

Determination of Dose Enhancement Factor and Therapeutic Gain Factor on the basis of Bioeffect Models.

J. Jpn. Soc. Ther. Radiol. Oncol. 1994; 6:31-37

Abstract : For enhancement of tumour control for advanced hypoxic head and neck cancers, radiotherapy-chemotherapy combination is an accepted modality. Treatment results for different chemotherapeutic drugs are compared on the basis of Dose Enhancement Factor (DEF) and Therapeutic Gain Factor (TGF). DEF has been conventionally defined on the basis of dose. Radiotherapy does is delivered as an optimum fractionation schedule. It is therefore necessary to determine DEF and TGF on the basis of Time Dose fractionation models. Cumulative Radiation Effect (CRE), Time Dose Fractionation factors (TDF) and Extrapolated Response Dose (ERD) concepts were applied to the retrospective date of head and neck cancer patients treated with a radiotherapy-methotrexate combination and DEF, TGF values were determined. DEF values for normal tissue early reaction were found to be 1.37, 1.18, 1.33, 1.35 and for tumour regression were 1.22, 1.11, 1.15, and 1.18 on the basis of dose, CRE, TDF and ERD, respectively. TGF values for these four criteria were 0.90, 0.94, 0.86 and 0.87, respectively. Routine use of the ERD concept is recommended to determine DEF and TGF value due to its versatility in terms of different a/b values for different tissues and different effects in the same tissue.

Key words : Head & Neck cancers, Bioeffect models, Chemo-Radio-therapy, Methorexate.

39. V. Hema, S.S. Supe, V. Kannaan, D.C. Doval, N. Anantha & S.J. Supe

Extrapolated response dose as a potential tool in radiotherapy and chemo-radiotherapy of head and neck cancers

Indian Journal of Experimental Biology, 1996; 34:9, 874-877

An analysis of head and neck cancer patients treated by radiotherapy (RT) alone (114 patients) and by chemo-radiotherapy (RT+CT) (115 patients) was carried out; the doses varied from 40-77 Gy and 35-71 Gy in RT and RT+CT groups respectively. The chemotherapy (CT) (induction/concurrent) drugs used were 5-FU, cisplatin, methotrexate either single or in combination Extrapolated response dose values were evaluated with a/b values of 10, 2.5 and 6 Gy for acute, late complications and tumour response, respectively. Dose enhancement factor (DEF) and Therapeutic gain factor (TGF) values were evaluated on the basis of ERD for patients receiving 5-FU RTCT (72 patients). ERD vs late complication rate and response rate curves were drawn for RT, RT+CT (<7 cycles), RT+CT (>6 cycles) and RT + CT (cumulative). DEF value for response rate were 0.95, 0.95 and 0.82 / or the three RT + CT group respectively. Similarly DEF values for late complication rate were evaluated as 0.87, 0.93 and 0.88. TGF values for RT + CT were 1.09, 1.02 and 0.93 TGF values indicated lack of significant influence of CT on clinical outcome. The correlation of ERD with late complication, response and status at last follow up (NED) was statistically significant for both groups (P<0.01). ERD did not correlated with acute complication in RT group (P>0.01) From the present analysis in RT + CT treatments of head and neck cancers, and ERD value of 69 Gy is suggested as the limit for an acceptable 5% late complication rate.

40. Hema Vaithianathan, M.G. Janaki, M.H. Shariff, S.L. Keshava and R. Ravichandran,

Relevance of ICRU 39 Recommendations in the Routine Intracavitary Brachytherapy Practice

Journal of Medical Physics, 1997; 22:3, 111-112

Introduction : Intracavitary brachytherapy is widely practised in the radiotherapy management of carcinoma uterine cervix. To overcome the institutional variations in terms of strength of radioactive sources, type of applicators etc., the definition of source strengths expressed in air kerma at 1 meter is recommended (ICRU 38, 1985). In addition, to compare treatment outcome in the international practice, ICRU also recommends 60 Gy reference isodose volume concept, Documentation of doses at critical structures (viz., bladder and rectum) has also been described. Most of the centres in India are routinely practising prescription of dose to ‘Manchester point A’ and therefore there is a need for implementation of ICRU recommendations in routine brachytherapy. Hence we have carried out a prospective study of these recommendations in a group of patients.

41. Hema, Vaithianathan and Sanjay S. Supe, A Scheneeweiss & R.N. Sharan. Eds. Forschungszentrum Julich GmbH, Germany, Vol. 50, 1999

A Review of Intrinsic Radiosensitivity as a Predictor of Patient Response to Radiotherapy

Recent Aspects of cellular and applied radiobiology. 1999; 30:138-140

Abstract : In radiotherapy of cancer, various options are available in terms of both treatment intensity and choice of modalities. In deciding among the various options available, oncologists consider prognostic factors. One such laboratory based prognostic factor is intrinsic radiosensitivity. Assays of radiosensitivity determine parameters that describe the cell survival curves. These parameters are surviving fraction at 2 Gy (SF2), the initial slope (a) and the mean inactivation dose (D). Experimental studies have subsequently supported these observations and show that in animal models SF2 measures in-vitro can predict response to in vivo irradiation. The clinical correlation emerging for tumour and normal tissue radiosensitivity and patient response to radiotherapy represent an exciting development in the field of experimental clinical oncology. A number of clinical projects have been set up to evaluate the usefulness of pretreatment assessment of intrinsic radiosensitivity. This review sets out to explain the importance of tumour and normal tissue radiosensitivity, the basis of variation in response and how this could be used to improve the therapeutic ratio of clinical radiotherapy.

42. Jayshree. R.S., Appaji. L., Hema Sridhar

Pneumocystis Carinii Pneumonia in Two Patients with Hodgkin’s Disease

Indian Journal of Cancer, 1995; 32:2, 74-76

Summary : The incidence of Pneumocystis carinii pneumonia (PCP) in immunocomprised patients is on the increase. We describe two patients with Hodgkin’s disease who were proved to have P. carinii pneumonia by toluidene blue "O" (TBO) staining of their induced sputa. To the best of our knowledge, there are no reports from our country regarding P. Carinii infection in patients with maligancy.

43. Jayshree. R.S., Rani S. Acharya, and Hema Sridhar

Isospora belli Infection in a Patient with Acute Lymphoblastic Leukemia in India

J. Diarrhoeal Dis Res. 1996; 14:44-45

44. Jayshree S. Rudrapatna, Vijaykumar, And Hema Sridhar

Intestinal Parasitic Infections in Patients with Malignancy

J. Diarrhoeal Dis Res. 1997; 15:71-74

Abstract : The frequency of intestinal parasitic infections was studied retrospectively in 1,029 cancer patients presenting with symptoms of diarrhoea. Intestinal parasites were diagnosed by stool examination, using both the direct and concentration techniques and also the modified acid fast stain. Parasitic infection was found in 16.5% of the cases. The majority of the patients with intestinal parasitosis had cancer of the haemopoietic system and were on anticancer chemotherapy. The most prevalent parasites were Entamoeba histolytical/Entamoeba dispar (8.5) and Giardia lambila (3.1%) and Isospora belli (0.1%). All the patients with intestinal parasites were negative for HIV antibodies.

Key words : Intestinal disease, Parasitic; Diarrhoea; Parasites, Neoplasms; Retrospective studies; Malignant carcinoid syndrome.

45. Jayshree. R.S., Govind K. Babu and Hema Sridhar

Immature Hymenolepis nana Worms in the Stools of a Patient Treated for Acure Lymphoblastic Leukemia : an Uncommon Observation.

J. Diarrhoeal Dis Res. 15:75-76, 1997

46. Jayshree. R.S., Rani S. Acharya, and Hema Sridhar

Cyclospora cayetanensis - associated Diarrhoea in a Patient with Acute Myeloid Leukemia

J. Diarrhoeal Dis Res. 16:254-255, 1998

47. Jayshree. R.S. and Hema Sridhar

p53 Tumor Suppressor Gene Mutations in Hepatocellular Carcinoma Patients in India

Cancer 2000; 89:2322-23

48. M. Krishna Murthy, M,Sc., Ph.D., M. Krishna Bhargava, M.D., F.A.M.S.,, Meena Augustus, M.Sc., Ph.D.,

Sister Chromatid Exchange Studies in Oral Cancer Patients

Indian Journal of Cancer, 1997; 34;34:2, 49-58

Summary : Sister chromatid exchange (SCE) was studied in PHA stimulated peripheral blood lymphocytes from 81 untreated patients with squamous cell carcinoma of the oral cavity and 50 age and sex matched controls. The SCE frequencies were found to be 10.80 + 1.38 and 4.15 + 1.15 in cancer cases and controls respectively. The SCE values of cancer cases deviate significantly from that of controls. The SCE frequency in patients who were addicted to the single habit of betel with tobacco chewing or bidi / cigarette smoking or combined habits of chewing and smoking was 9.38 + 1.28, 12.28 + 1.68 and 13.12 + 2.13 respectively. The SCE frequency in patients who were habituated to alcohol and tobacco usage was 13.43 + 2.16. These values were significantly higher as compared with the SCE values observed in normal controls. Single habit of bidi, cigarette and combined habit of bidi and cigarette smokers had a mean SCE per cell of 12.98 + 2.11, 10.18 + 1.25 and 13.48 + 1.32 respectively, which were significantly higher than the mean value of 4.15 + 1.15 found in controls. Higher frequencies of SCE were also observed in individuals who smoked more than 10 bidis or cigarettes per day compared with people who smoked less than 10 bidis on cigarettes per day. Individuals who smoked bidis or cigarettes for more than 10 years also showed an increase frequency of SCE as compared with those who smoked bidis or cigarettes for less than 10 years. Among chewers a significant difference was observed with regard to duration and frequency of chewing when compared to controls. An increase in the mean frequency of SCE for each cancer patient group is directly proportional to the clinical stage of the disease. Interchromosomal distributions of SCE revealed an increased frequency of SCE in almost all the groups of chromosomes in cancer patients when compared to controls.

49. Krishnamurthy Reddy, V.K. Ahuja, V. Kannan, E. Valiikad and Anantha

Dysgerminoma of the ovary : A retrospective study

Australasian Radiology, 1997; 41: 262-265

Summary : A retrospective analysis of 22 patients with ovarian dysgerminoma who were treated between 1980 and 1987 was carried out. The median age at presentation was 24.5 years. A total of 15 patients were in stage I, one patient was in stage II and six patients were in stage III. Bilateral ovarian involvement was present in four patients. Conservative surgery was carried out in nine patients and 11 patients underwent radical surgery. Two patients had biopsy only. Fourteen patients received adjuvant radiotherapy and three patients received salvage radiation for recurrent disease. The 10-year actuarial survival rate was 81.8%. All 15 patients in stage I were alive and disease - free at a median followup of 125 months. Four patients (one in stage II and three in stage III) died of progressive or recurrent abdominopelvic disease. Pelvic recurrence occurred after conservative surgery in two patients in stage 1A who had a tumour size greater than 10 cm, but they were salvaged with radical surgery, chemotherapy and radiotherapy. There were seven patients aged 20 years or less. All were alive and disease - free at a median follow-up of 127 months.

Key words : dysgerminoma; ovarian tumour; radiotherapy.

50. Kumaraswamy, Ambakumar Nandakumar, Thalagavadi Venugopal, and Nanjundappa Viswanathan

Survival in cancer of the cervix : treatment in a population-based cancer registry in a developing country (Bangalore, India)

Cancer Causes and Control, 1998; 9:117-123

A survival analysis of treated cases of cervix cancer that were registered in the Bangalore (India) Population Based Cancer Registry between 1 January 1987 and 31 December 1989 was performed. Information on vital status of patients was obtained principally through follow-up visits to homes of patients. Follow-up information was available for 860 (92.7 percent) of 928 registered cases. Of the 860 cases, information on treatment was available for 559 patients, on whom the analysis of treatment outcome was performed. The overall five year observed survival (5YS) was 41.1 percent with a relative survival of 46.3 percent. The 5YS was significantly (P=0.01) influenced by clinical stage and by addition of brachytherapy (BT) to external radiotherapy (EXT) (SYS=60.1 percent cf 27.4 percent, P<0.001). In 343 patients who received EXT only, comparatively better survival was seen in the group who had received between 4.800 to 5,999 centigray (cGY) (5YS=36.1 percent) when compared with those who received less than 3,000 and 3,000 to 4,799 cGY (5YS=16.7 percent and 24.9 percent, respectively). Doses of EXT higher than 5,999 cGY (in patients who were not suitable for BT) did not have any benefit in the 5YS (27.4 percent). The study has generated a specific hypothesis about possible needless excess dose of external radiotherapy.

Key words : Cervix cancer, dose of external radiotherapy, India, radiotherapy, survival, women.


51. Kumaraswamy, M.D., S.S. Supe, Ph.D., C. Ramesh., Ph.D.,

Factors Influencing the evaluation of an article in cancer literature.

The Indian Journal of Cancer, 1999; 36:2, 69-79

Summary : Casual Interpretation of results in a given article has several pitfalls. In order to assess the strengths and limitations of a given article several factors need to be considered. This review article is intended to list, classify and describe briefly the factors that should be considered in the evaluation of an article. The three primary criteria which help in proper assessment of an article are (1) Accurate and adequate description of materials and methods; (2) Data on the total sample size and elimination criteria; (3) Statistical methodology employed.

52. K.C. Lakshmaiah, D.M., D. Lokanath, M.D., T.M. Suresh, M.D., K. Govind Babu,M.D., C. Ramesh, Ph.D., C. Rama Rao, M.D., N. Lalitha, M.D., N. Anantha, M.D.

Spinal Cord Compression by Primary Non-Hodgkin’s Lymphoma

Indian Journal of Cancer, 1995; 32-2, 81-84

Summary : Epidural Cord Compression (ECC) by primary lymphoma is rare entity and constitutes less than 3% of total malignant lymphoma with Non-Hodgkin’s Lymphoma (NHL) diffuse large cell type being the most common histological subtype. In this paper 16 cases primary NHL. with cord compression seen at the Department of Medical Oncology, during the period 1988. 1990 are reviewed. At presentation all patients had undergone Laminectomy with decompression of epidural mass. The histological diagnosis of NHL was subclassified according to the International working formulation and was evaluated for disease process elsewhere in the body. All patients with ECC by lymphoma received high dose steroids with concurrent Radiotherapy (local) and combination Chemotherapy. These patients had longer duration of neurological deficit prior to treatment had poor response. After 6 courses of chemotherapy 50% of the patients had complete neurological recovery (PR). 31% had partial neurological recovery (PR) and m 19% there was no neurological recovery (NR)

53. K.C. Lakshmaiah, D.M., D. Lokanath, M.D., C.Ramesh, Ph.D., D.C.P., K.G. Govinda Babu, C. Rama Rao, M.D., Kumara Swamy, M.D.

Primary Central Nervous System Lymphoma a Report of Nine Cases

Indian Journal of Cancer, 1996; 33:2, 103-107

Summary : Primary Central Nervous System Lymphoma (PCNSL) is a rare neoplasm of B cell origin and constitute less than 1% of Non-Hodgkin’s lymphoma (NHL). Histology is mainly of high grade and intermediate type. Although NHL is known to be highly sensitive to both irradiation and cytotoxic drugs, being a curable malignancy, the therapeutic results remain disappointing. Clinical observations on nine cases of PCNSL seen in one of the major cancer centres in India is presented in this paper. Radiotherapy combined with Chemotherapy although yielded encouraging initial response in these patients, the long term response was unsatisfactory with median survival for these patients being only 19 months. This warrants an alternative therapeutic approach to improve the dismal prognosis of PCNSL.

54. Lakshmi Devi V., D. Hazarika

Fina Needle Aspiration Cytology of Hepatocellular Carcinoma

Indian J. Pathol, Microbiol. 1995; 389-392

Abstract : Fine needle aspiration cytology (FNAC) is an extremely useful technique in the evaluation of hepatic masses.

This study was undertaken with the aim of describing the morphological spectrum seen in the needle aspirates from hepatocellular carcinoma (HCC) seen in our patients hailing from South India. Thirty two cases of HCC were studied. Trabacular pattern covered by en Jothehum was the most common Pseudoglandular. spindle cell and dispersed patterns were also seen. Individual tumour cells were generally reminiscent of hepatocyles and had a prominent nucleous. The presence of intranuclear and intracytoplasmic industons were notable features FNA cytology in HCC is sufficiently distinctive to form an invaluable tool in the diagnosis of this malignancy.

Key words : Hefatocellular carcinoma, Trabacular Pattern, prominent nucleoli, Intra nuclear, Intracytoplasmic inclusions.

55. Lakshmi Devi. V., M.D., Dinesh Chandra Doval, M.D., Clementina Rama Rao, M.D., Poonamallee, Parthasarathy Bapsy, D.M.

Spinal Epidural Graulocytic Sarcoma : A Rare Presentation of Acute Myeloid Leukemia

Annals of Saudi Medicine, 1996; 16: 212-214

56. Lakshmi Krishnamoorthy, Elizabeth Zachariah, P.G., Ramaswamy and N. Anantha

Circulating Peptide and Steroid Hormone Levels in Patients with Breast Cancer.

Indian Journal of Clinical Biochemistry, 1994, 9(1) 37-39

Abstract : Circulating levels of gonadotropins (FSH, LH), prolactin (PRL), estradiol and progesterone were measured by radioimmunossay in the sera of 60 patients with histopathologically proven breast cancer. 30 patients belonged to the post and 30 to the premenopausal group. 30 healthy women, 15 each in the pre and post menopausal groups served as controls for the study.

Prolactin was elevated in 33% and 26% of pre and post menopausal breast cancer patients respectively. Lower levels of estradiol and progesterone were observed during the luteal phase of the menstrual cycle in premenopausal breast cancer patients. Among postmenopausal patients with breast cancer, LH was elevated in 32%, FSH in 15% and estradiol in 30% of the patients studied.

Key Words : hormones, breast cancer, gonadotropins, prolactin, estradiol, progesterone.

57. Lakshminarasimhan. S., M.D., D.C. Doval, M.D., M.A.M.S. Usha Rajashekar, M.D., Geethashree Mukherjee, M.D., V. Kannan, M.D., Lakshmi Devi, M.D., P.P. Bapsy M.D., D.M.

Pre Leukemic Granulocytic Sarcoma of Vagina - A Case Report with Review of Literature

Indian Journal of Cancer, 1996; 33:3, 145-148

Summary : Granulocytic sarcoma is an extramedullary tumour of malignant granulocytic progenitor cells, that may precede the onset of acute myeloid leukemia or appear during the leukemic manifestation or blastic crisis of chronic myeloproliferative disorders.

We describe a case of graulocytic sarcoma of vagina in a 27 year old woman treated with local radiotherapy. After seven months of follow up she developed acute myeloid leukemia. The case has been presented in view of its rarity and discussed in light of the available literature.

58. T. Mallana Goud, Ph.D., B.S. Dwarakanath, Ph.D., M. Augustus, Ph.D., M.K. Bhargava, M.D., F.A.M.S.

Flow Cytometry of Breast Tumors

Relevance to Clinicopathology and Survival

Analytical and Quantitative Cytology and Histology, 1995; 17:265-271

Nuclear DNA content and cell cycle distribution in fresh tissues from 40 malignant and 10 benign breast tumors were assessed by flow cytometry using a DNA-specific fluorochrome, 4, 6 diamidino-2 phenyl-indole hydrochloride. DNA indices (DIs) (relative DNA content of tumor cells with reference to normal cells : DI=2 diploid) ranged from 0.85 to 5.6 for malignant tumors and from 1.8 to 2.2 for benign tumors. Proliferating fraction (PF) (total cells in S and G2 + M phases) values were significantly higher in malignant tumors (35.4+14.75, mean + SD; P<.001) than in benign tumors (14.2+4.9) and adjacent normal tissues (6.6 + 2.73). DIs and cell cycle distribution correlated with clinicopathologic parameters, disease progression and survival. Four-year survival was greater in patients with a DI value of 1.8-2.2 as well as with SF values less than 10%.

Key words : breast neoplasms, flow cytometry.

59. Mohanti. B. K., M.D., Goura K. Rath, M.D., Naranappa Anantha, M.D., V. Kannan, M.D., Bhabani S. Das, M.Ch., A.R. Chandramouli, M.Ch., Ajit K. Banerjee, M.Ch., Sarala Das, M.D., Amarnath Jena, M.B., B.S., D.R.M., D.N.B., Ramamurthy Ravichandran, Ph.D., Uday P. Sahi, M.D., Rajinder Kumar, M.Sc., Neeru Kapoor, Ph.D., Vijay K. Kalia, Ph.D., Bilikere S. Dwarakanath, Ph.D., and Viney Jain, Dr. Phil. Nat.

Improving Cancer Radiotherapy with 2-Deoxy-D-Glucose : Phase I/II Clinical Trials on Human Cerebral Gliomas

Int. J. Radiation Oncology Biol. Phys., 1996; 35:1, 103-111

Purpose : Evaluation of tolerance, toxicity, and feasibility of combining large fraction (5 Gy) radiotherapy with 2-deoxy-D-glucose (2DG), an inhibitor of glucose transport and glycolysis, which has been shown to differentially inhibit repair of radiation damage in cancer cells.

Methods and Materials : Twenty patients with supratentorial glioma (Grade 3/4), following surgery were treated with four weekly fractions of oral 2DG (200 mg/kg body weight) followed by whole brain irradiation (5 Gy). Two weeks later, supplement focal radiation to the tumor site (14 Gy/7 fractions) was given. Routine clinical evaluation, x-ray computerized tomography (CT), and magnetic resonance (MR) imaging were carried out to study the acute and late radiation effects.

Results : All the 20 patients completed the treatment without any interruption. The vital parameters were within normal limits during the treatment. None reported headache during the treatment. Mild to moderate nausea and vomiting were observed during the days of combined therapy (2DG + RT) in 10 patients. No significant deterioration of the neurological status was observed during the treatment period. Seven patients were alive at 63, 43, 36, 28, 27, 19 and 18 months of follow-up. In these patients, the clinical and MR imaging studies did not reveal any late radiation effects.

Conclusions : Feasibility of administering the treatment (2DG + 5Gy) is demonstrated by the excellent tolerance observed in all 20 patients. Further, the clinical and MR studies also show the absence of any brain parenchymal damage.

2-Deoxy-D-glucose, Cerebral gliomas, Radiotherapy.

60. Nageshwara Rao. P., K.S. Venkatesh Murthy, S. Devaru, and R.P.S. Kumar

Unusual Images : What is the abnormal and interesting feature seen on the accompanying RENAL SCAN?

UNM, 1997; 12:46

61. Nandakumar. A., Narayanappa Anantha, L. Appaji, Kumara Swamy, Geethashree Mukherjee, Thalagavadi Venugopal, Sreerama Reddy, and Muralidhar.

Descriptive epidemiology of childhood cancers in Bangalore, India.

Cancer Causes and Control, 1996; 7:405-410

While fairly complete and reliable incident data on childhood cancers are available from the registers in India, mortality and survival information is not. Information concerning the latter was obtained by the Bangalore cancer registry through active follow-up involving visits to homes of patients. Between 1982 and 1989, 617 cases of cancers in childhood were registered, giving an age-standardized incidence rate of 84.8 and 48.4 per million in male and female children, respectively. Active follow-up provided mortality/survival information in 532 or 86.2 percent of these cases. Overall observed five-year survival was 36.8 percent (both genders combined) with a relative survival of 37.5 percent when childhood mortality in the general population was taken into account. The five-year relative survival was best for thyroid carcinoma (100 percent) followed by Hodgkin’s disease (73 percent) and retinoblastoma (72.9 percent). Survival was comparatively low, being 9.9 percent in acute nonlymphatic leukemia and less than 20 percent in rhabdomyosarcoma and the category grouped as ‘other malignant neoplasms’. Survival in Hodgkin’s disease was influenced by clinical stage at presentation, but was not statistically significant possibly due to small numbers.

Key words : Childhood cancers, incidence, India, mortality, survival.

62. Prasanna Kumari, M.Sc., Ph.D., Meena Augustus, M.Sc., Ph.D., Umakanth Naik, M.D., V. Ravi, M.D., Ashok, M. Shenoy, M.D., C.R. Rao, M.D., Rekha V. Kumar, M.D.,

Cytogenetic and Viral Studies in Nasopharyngeal Carcinomas in Patients of Indian Origin

Indian Journal of Cancer, 1995; 32:10-14

Summary : Four cases of undifferentiated nasopharyngeal carcinomas (NPC) (grade III-IV) in patients of Indian origin were investigated for specific chromosome markers and evidence of Epstein-Barr virus (EBV) positivity.

Abnormalities involving chromosome # 3, like del (3) (p24-pter) and 3q+(q27-qter) were found in these patients, similar to earlier reports in patients of Chinese and Kenyan origin 2, 4, 13 who however were EBV positive, unlike the patients in this study who were EBV negative. Implications of the cytogenetic and serological data in Indian patients with NPC, available for the first time, may throw some light on the etiology of the disease in this ethnic group where nasopharyngeal carcinoma is also endemic.

63. B.S. Premalatha, M.Sc., (Speech & Hearing), Ashok M. Shenoy, M.S., Anantha N., M.D., D.M.R.E.

Speech Evaluation after near total laryngectomy and total laryngectomy - A comparative Acoustic Analysis

Indian Journal of Cancer, 1994; 31:4, 244-249

Summary : The practice of Pearson’s (1981) technique of near total laryngectomy with speech shunt is evaluated acoustically in 11 subjects using matched esophageal speakers. Not only do these patients vocalize earliers with effortless cease, analysis of their speech both subjectively & by acoustic analysis of the parameters seems definitely to be of superior quality. The functional utility of this technique is addressed in this study justifying its more frequent practice in unilateral lesions of larynx and hypopharynx which defy satisfactory control by conventional conservation laryngeal surgery or radiation therapy. The Oncological outcome will be taken up as a part of a future report when follow up of adequate duration occurs in sufficient number of cases.

64. B.S. Premalatha, M.Sc., (Speech & Hearing), A.M. Shenoy, M.S., (E.N.T.), Nanjundappa, M.S., (E.N.T.), A.V. Sri Hari Prasad, M.S. (E.N.T.)

Vocal Rehabilation After Gastric Transposition - The Critical Over View

Indian Journal of Cancer, 1997; 34:3, 121-127

Summary : Re-establishment of effective communication following laryngopharyngo esophagectomy and gastric transposition requires thorough knowledge and flexibility of introducing the entire range of communication options. This study describes our experience with eleven patients of gastric transposition who attended intensive speech therapy and developed gastric speech using different method of speech producing and attaining various levels of proficiency. Application of digital pressure is one of the most effective technique for production of satisfactory and intelligible voice in gastric transposition cases who fail to develop speech by inhalation method.

65. Poonam Patil, M.D., R.S. Jayshree, Ph.D., Rani S. Acharya, M.D., Hema Sridhar, M.D., Govind Babu, D.M., and T.M. Suresh, D.M.

Fulminant Fatal Strongyloides stercoralis infection in a Postchemotherapy Immunosuppressed Cancer Patient

Medical and Pediatric Oncology 1999; 33:504-505

Key words : Strongyloides stercoralis; immunosupression; parasitic infection; cancer

66. Rani S. Acharya

Palliative Care

KMJ, 1996; 66:47-52

67. R. Ravichandran, V.K. Sathia Narayanan, S.S. Supe, M.H. Shariff and P.C.G. Kurup

Accuracy of patient set up and on-line imaging in Radiotherapy

Jr. Clin. Radiotherapy Oncology, 1996; 11:58-61

Meticulous individualized efforts are being put in to achieve optimal treatment plan in radical radiotherapy. Execution of therapy in the treatment machine is equally important to achieve desired treatment outcome after radiotherapy. Verification of beam portals during treatment against simulation films as well as confirmation of reproducibility of treatments are also necessary. On-line imaging systems facilitate quantitation of portal image data with storing and retrieval facility. A review of data available in the executive aspects of radiotherapy is outlined with a view that strategies should be worked out to achieve optimal results in radiotherapy.

Key words : Precision, positioning online Imaging, Set-up

68. R. Ravichandran, S.S. Supe, U. Jayasree, S. Devaru

Measurement of the radioactive body burden in patients receiving iodine-131 treatment for carcinoma of the thyroid.

European Journal of Nuclear Medicine, 1997; 24:464

69. R. Ravichandran

Standardisation of Cobalt-60 Beam Therapy Outputs Using Calibration Water Phantom and Comparison with In-Air Calibrations.

Journal of Medical Physics, 1997; 3, 99-100

70. R. Ravikumar, Mohammed Shafiulla, Hema Sridhar

Association of Tuberculosis with Malignancy at KIMIO-An Oncology Centre

Indian J. Pathol, Microbiol. 199; 42:31, 339-343

Abstract : The association of tuberculosis and malignancy was studied at an oncology centre in Bangalore. The study period was January 1981 to December 1995. A total of 8779 clinical material obtained from patients were screened for Mycobacterium tuberculosis infection. Out of which 675 were positive for acidfast bacilli, 385 from non malignant conditions and 290 from malignant conditions. Highest incidence is seen in Head and Neck cancer (42%) followed by Gastrointestinal cancer (14.1), Lung cancer (13.8%), Haematological cancer (10.7%), Reproductive cancer (10.3) and miscallaneous group (9%), Antibiogram of Mycobacterial cultures was done in 282 subjects. Resistance patterns to antitubercular drugs showed highest with Isonicotinic acid hydrochloride (INH) (17.7%), followed by para amino salicylic acid (PAS) (8.5%), Streptomycin (SM) (6.7%), Rifampicin (RIF) (4.6%) and Ethambutol (EM) 0.35%).

Key words : Mycobacterium tuberculosis, Malignancy, Pulmonary tuberculosis, Bronchogenic carcinoma, Lymphadenitis, Cancer.

71. R. Ravikumar, B.R. Vijaykumar, Mohammed Shafiulla, K.C. Lakshmaiah, Hema Sridhar

Fusarium solani Infection in a Patient with Acute Myeologenous Leukemia - A Case Report

Indian J. Pathol Microbiol, 1997; 40:4, 555-557

Multiple necrotizing skin lesions due to Fusarium solani in an elderly man with Acute myelogenous leukemia is described.

Key words : Fusarium, Immunocompromised Host, Acute myelogenous leukemia

72. R. Ravikumar, R.S. Jayshree, Hema Sridhar

Prevalence of HIV Infection in Voluntary Blood Donors and Cancer Patients

Indian J. Pathol Microbiol. 1996; 39:3, 187-189

Abstract : The HIV infection pattern amongst cancer patients and voluntary blood donors was studied at an oncology centre in South India. The study period was from May 1991 to March 1994. A total of 18,260 subjects were screened for HIV infection. Of which 14, 266 were voluntary blood donors and 3994 were cancer patients. The HIV infection rate amongst voluntary blood donors and cancer patients was 9.945% (6/14266) and 0.4 (16/3994) giving a seropositivity rate of 0.42 and 4.0 per 100 respectively.

Key words : Cancer, AIDS, Voluntary blood donors; HIV seroprevalence, HIV transfusion.

73. M. Ravikumar, M.Sc., Dip.R.P., R. Ravichandran, M.Sc., Dir. R.P., Ph.D. MICNM

Head Scatter Factors for High Energy Photon Beams From a Dual Energy Linear Accelerator at Longer Treatment Distances

Jr. Clin. Radiotherapy Oncology 1998; 13:2, 165-169

Abstract :

Aim : To compare measured head scatter factors at longer treatment distances with the factors obtained with the calculated equivalent collimator field width at isocentre.

Materials and Methods : Ionometric measurements were carried out using 0.6cc Farmer type ionisation chamber fitted with acrylic build-up caps of thickness 1.5 cm and 3.3 cm for 6 MV and 18 MV photon beams, respectively from a dual energy medical linear accelerator. The measurements were carried out at distances ranging from 100 to 300 cm with square fields ranging from 8 cm x 8 cm to 40 cm x 40 cm at isocentre.

Results : The head scatter factors for the equivalent collimator fields are within 1.3% for 6 MV and 1.5% for 18 MV photon beams. The head scatter factors for the square fields defined by the jaws differ by 0.9 to 2.5% for 6 MV and 1.2% to 2.5% for 18 MV photons from the measured values at extended distances. For 18 MV photons, slightly higher head scatter factors were observed compared to 6 MV beam.

Conclusion : The concept of obtaining head scatter factors from the equivalent collimator field size may be generalised for high energy photon accelerator because most of the scatter are in the forward direction and mainly originate from the beam flattening filter. Small deviation observed in this study could be due to differences in scatter patterns from the upper and lower jaws of the collimating systems.

74. M. Ravikumar, M.Sc., Dip. R.P.; R. Ravichandran, M.Sc., Dip. R.P., Ph.D., MICNM.

Estimation of Absolute Equivalent square fields and the Applicability of the Methods of Equivalent Squares for High Energy Photon Beams

Jr. Clin. Radiotherapy Oncology, 1998; 13:1, 83-88

Abstract :

Aim : To Check the validity of dose output for high energy photons by equivalent square field calculations for rectangular fields.

Material and Methods : The ionometric measurements were carried out using 0.6 cc Farmer type ion chamber (Capintec, USA) at Dmax in a polystyrene phantom at the nominal source to phantom surface distance of 100 cm. Six and 18 MV photons from Clinac-1800 (Varian, USA) dual photon energy linear accelerator were used. The relative outputs of square fields with respect to the standard field size of 10x10 cm were obtained. The relative output factors for rectangular fields of different dimensions were estimated altering the upper and lower collimator jaws.

Results : The equivalent square field size for rectangular fields obtained from measured relative output factors do not agree with the equivalent square field size obtained using BJR tables and Sterling’s formula for both energies. When the longer side of the field is set by lower jaws and smaller side with upper jaws, the BJR values hold good for both 6 and 18 MV photons with minimum deviation, while the Sterling’s method overestimates the size. The BJR table and Sterling’s equation values underestimate the equivalent square size when the field size is set in the reverse order. The deviation is pronounced for rectangular fields of higher elongation factors.

Conclusions : We recommend usage of BJR tables for the determination of equivalent square fields for the accelerator under study, with smaller dimension of the field defined by upper jaws and the longer side by the lower jaws.

75. M. Ravikumar, M.Sc., Dip.R.P.; R. Ravichandran, M.Sc., Dip., R.P., Ph.D., MICNM

Measurement of Tissue Air Ratios and Tissue Maximum Ratios for use in Clinical Radiotherapy

Jr. Clin. Radiotherapy Oncology, 1998; 13:171-175

Abstract :

Aim : To assess the feasibility of a locally designed phantom for measuring radiation beam parameters at the departmental level.

Materials and Methods : A 40 x 40 x 40 cm3 size phantom with a provision to mount the ionisation chamber at any depth was fabricated out of 4 mm thick acrylic sheets. The dose in-air and in-phantom at different depths was estimated from which tissue air ratios (TARs) and tissue maximum ratios (TMRs) were calculated. Measurements were carried out in three different tele-isotope units and in a dual photon energy linear accelerator.

Results : The measured TAR values for different models of tele-cobalt units and tele-caesium unit are comparable with the published data at most of the depths. For high-energy photon beam (6 and 18 MV), the TMR values measured agree within +*% from the values reported for a similar accelerator elsewhere.

Conclusion : The method reported appears to be simple, accurate, reproducible and easily adpatable. This would facilitate any small department to measure their own TAR and TMR values for the treatment planning systems and also for routine patient treatments. The phantom developed could also be used to measure TAR values in case of large and irregular radiotherapy fields and for routine quality assurance checks of beam energy in linear accelerator.

76. Ravikumar, M. Ravichandran, V.K. Sathyanarayanan.

Estimation of Virtual Source Position for Shielded Electron Beams

Journal of Medical Physics, 22:99, 1997

77. M. Ravikumar and R. Ravichandran

Measurement of Physical Parameters for Total Skin Electron Therapy with a Medical Linear Accelerator

Journal of Medical Physics, 1999; 24:11-14

Abstract : A few physical measurements relevant to TSET are presented in this paper. 6 MeV electron beam with 1 cm perspex degrader placed at 20 cm in front of the phantom was used. The longitudinal profile was measured in air using 0.6 cm3 Farmer type thimble chamber. The depth ionization and the absolute dose measurements were carried out with a PTW parallel plate chamber. It is observed that electron beams angled at 8" above and below horizontal gives a longitudinal homogeneity of + 6% over 210 cm. The relative surface dose over the anterior surface of the humanoid phantom estimated by TLD shows a dose variation between 93% and 104% with respect to 100% at the umbfical level (calibration point)

78. M. Ravikumar, R. Ravichandran, Sanjay S. Supe and Anil K. Sharma

Dosimetric Accuracy at Low Monitor Unit Setting in Electron Beams At Different Dose Rates

Journal of Medical Physics, 1999; 24: 25-27

Abstract : As electron beam with low monitor unit (LMU) settings are used in some dosimetric studies, better understanding of accuracy in dose delivery at LMU setting is necessary. The dose measurements were carried out with 0.6cm3 Farmer type ion chamber at dmax in a polystyrene phantom. Measurements at different MUs show that the Dose Linearity Ratio (DLR) increases as the MU setting decreases below 20 MU and DLRs are found to increase when the incident electron beams have higher energies. The increase in DLR is minimum for low dose rate setting for all five electron beam energies (6, 9, 12, 16 and 20 MeV). As the variation in dose delivery is machine-specific, a detailed study should be conducted before the low MU setting is implemented. Since errors in dose delivery are high at higher dose rates. low dose rate may be better at low MU unit setting.

79. M. Ravikumar and R. Ravichandran

Effect of Shielding on Virtual Source Position for Electron Beams from A Clinac-1800 Linear Accelerator

Journal of Medical Physics, 1999; 24:1, 21-24

Abstract : In the present study, the virtual point source positions were determined for field sizes defined by standard electron cones and cerroband field inserts for various electron energies. Ionometric measurements were carried out with a 0.6 cm3 Farmer type ion chamber at Dmax in a polystyrene phantoms. The virtual source positions obtained by inverse square law method were observed to change with the beam energies and the applicator size. It was also observed that the Virtual Source-to-Surface Distances (VSSD) are greater for the field sizes defined by the cerroband inserts in the standard 20 cm x 20 cm applicator for all energies. These observed variations in virtual source positions are due to the change in a electron scatter for different energies and beam sizes. When the cerroband cut-outs are introduced close to the chamber, the scattering conditions are likely to get altered, resulting in change in the virtual source position.

80. Ravikumar. M., Ramamoorthy Ravichandran

Dose Measurements in the Build-Up Region for the Photon Beams from Clinac-1800 Dual Energy Medical Linear Accelerator.

Strahlenther Onkol,2000; 176:223-8

Aim : Since the skin dose becomes the limiting factor while deciding the tumorcidal dose, the detailed analysis of dose distribution in the build-up region is necessary for high-energy photon beams. In this study the beam characteristics affecting the build-up and skin dose for 6 and 18-MV photons are analyzed.

Materials and Methods : Measurements were made with 6 and 18-MV photons using a PTW parallel-plate ionization chamber (B 23344-036) and a RDM-1F electrometer. Build-up ionization measurements were made with the chamber fitted into a 25 x 25 x 25 cm polystyrene phantom with a fixed SSD of 100 cm. The entrance and build-up dose measurements were made with a polycarbonate and a mesh type metallic shielding tray and a 45o wedge. Exit dose measurements were carried out for the graphite patient supporting assembly table top, 1.0 cm thick piece of wood and the 1.0 cm thick patient supporting perspex base frame for head and neck treatments.

Results : It was observed that the dmax decreased slightly with field size as with other accelerators. For both photon energies the surface dose was observed to increase with increase in field size. It was also noticed that the dose in the build-up region increases slightly when the polycarbonate secondary blocking tray is introduced with the increase in surface dose. The data show that the tray perturbation factor (TPF) at surface decreases steadily with tray surface distance for both photon beams for all field sizes. It was noted that the TPF was more when the polycarbonate tray was introduced at shorter tray-surface distances for both energies. At tray surface distances above 60 cm the TPF almost remained close to unity for 6-MV photons for all field sizes, Whereas the continuous decrease in TPF could be noted for 18-MV photon beams even after the TPF reached unity.

Conclusion : The increase in surface dose with field size for both photon energies is due to the electron scattering from the intervening materials. The use of wedge filters absorbs low-energy scattered electrons significantly and hence, the relative surface dose (RSD) is always less than unity. The increase in dose enhancement percentage with graphite compared to perspex supporting assembly indicates that the electron backscatter is proportional to the atomic number of the medium.

81. M. Ravikumar and R. Ravichandran

Entrance Absorbed Dose Measurements in Clinical Telecobalt Beams

Journal of Medical Physics, 2000; 25:1, 1-5

Abstract : As the telecobalt machines are made with different collimator designs, knowledge of the build-up profile and effect of different intervening materials in the beam is necessary In this study, the build-up dose measurements were performed in different telecobalt machines using a PTW parallel plate chamber. Results from the study showed that the surface dose drastically increases with the presence of lucite tray in the path of the beam at a short SSD. However, the effect is not significant at longer SSDs. Also, any conventional long SSD machine when used for short SSD treatment will result in clinically adverse skin reactions. The introduction of a 2.8 mm lead plate improves the beam characteristics at short SSD with clearance of 10 cm to surface level. The result has relevance in the design of suggested short SSD telecobalt machine in India for the treatment of head and neck cancers.

82. Rekha V. Kumar, Kumaraswamy, M. Vijaykumar

Indian Medical Institutions

The National Medical Journal of India, 2000; 13 : 263-266

Introduction : The rise in the incidence of cancer in Karnataka, as elsewhere in the country, created an acute need for a cancer centre in the state. The lack of infrastructure for such patients in the state compelled the poor and needy to travel to cancer centres in the neighbouring states which they could ill afford. The Kidwai Memorial Institute of Oncology was conceived as far back as 1957 as a private venture. When the Government of Karnataka took over the project in 1970 the ball was finally set rolling and the Institute was inaugurated on 27 June 1973. It had 50 beds, radiotherapy services and visiting speciality services. The campus, spread over 26 acres was located on the then Hosur Road (now Dr. M.H. Marigowda Road) in Bangalore. The Institute commemorates one of the most distinguished sons of India, Rafi Ahmed Kidwai, a freedom fighter and national leader. It has grown tremendously since its inception, metamorphosing from a nondescript cancer hospital into a well-known, comprehensive regional centre of cancer treatment. It receives major financial support from the Government of Karnataka in addition to a token grant from the Government of India as well as support from various public sector and voluntary service organizations and individuals.

83. Rekha V. Kumar, Geetashree Mukherjee, M. Chandrasekhar, Diganta Hazarika

Pulmonary Hamartoma

Jima 1994; 92:3, 90-92

Pulmonary hamartoma is a relatively uncommon, asymptomatic, benign, slowly growing tumour that occurs in approximately one out of every 400 autopsies. It is usually clinically silent and discovered by routine chest x-ray examination (when it has to be differentiated from a primary or secondary malignant neoplasm) or incidentally at autopsy. The peak incidence is in the sixth decade of life; this lesion has not been observed in infants. A case of pulmonary hamartoma which presented with symptoms related to the chest is reported.

84. Rekha V. Kumar,M.D., Geetashree Mukherjee, M.D., K. Umadevi, M.D., Diganta Hazarika, M.D.

Sclerosing Stromal Tumour of the Ovary

Indian Journal of Cancer, 1994; 31:2, 92-95

Summary : Sclerosing stromal tumour (SST) of the ovary is a rare entity. It is a benign neoplasm which forms a distinct subgroup separate from the other ovarian stromal tumours, including thecoma fibromas, by virtue of its unique histology. One such tumour in a 25-year old female is reported.

85. Rekha V. Kumar, Geetashree Mukherjee, Vijay K. Ahuja, Elizabeth Vallikad, Digantha Hazarika.

Aggressive Angiomyxoma

Indian J. Pathol Microbiol. 1997; 40 : 3, 389-391

Two cases of aggressive angiyomyxoma (AA) arising in the vulva and vagina respectively in women in the reproductive age group are reported.

Key words : Angiomyxoma, Vagina, Vulvar neoplasms.

86. Sanjay S. Supe, Anil K. Sharma and Vijay Khole

ModRe Talbes for Brachytherapy

Journal of Medical Physics, 1995; 20:36-38

87. Sanjay S. Supe, Anil K. Sharma, N. Anantha and Vijay Khole

More tables of Multiple daily fractionation

Journal of Clinical Radiotherapy Oncology, 1996; 11:72-74

Abstract : In radiotherapy, once daily fraction of 2 Gy given five days per week, to a total dose of 60 to 66 Gy is accepted as the standard method of fractionation. The results of radiotherapy could be improved in advanced tumours by appropriate alteration in treatment schedules as standard radiotherapy fails to achieve local control in these cases (20).

88. Sanjay S.Supe, Anil K. Sharma and K. Subbarangaiah

Variation of Virtual SSDs with Electron Beam Energy and Cone Size

Journal of Clinical Radiotherapy Oncology, 1996; 11:20-22

The physical characteristics of electron beams are affected by scattering and energy losses occuring along the beam path. It has become common practice to treat, for calculational purposes, a diverging broad beam of electrons as if originated from an effective extended source or a virtual point source which when placed in vacuum would produce exactly the same distribution of the electron fluence in position and angle as the actual beam. Many situations exist in radiotherapy, clinical electron beam dosimetry and treatment planning where a knowledge of the virtual point source position is required. The virtual source to skin distances (VSSD) were determined for a Varian Clinac-1800 linear accelerator as a function of the electron beam energies and electron beam sizes using the inverse slope method. Comparison of virtual SSD’s was done between present study and those of other various investigators. The results point to a very pronounced and systematic dependence on electron cone size and beam energy. The extent of this dependence varies with the type of accelerators and experimental method employed.

Key words: Electron beam energy, Cone size, S.S.D., Variation.

89. Sanjay S. Supe and Hema Vaithianathan

Methods of Determination of a/b values for the Linear Quadratic Model

Journal of Clinical Radiotherapy Oncology, 1996; 11:65-67

The Linear Quadratic model of dose effect relationship has more versatility in terms of specific a/b values for different tissues as well as for different effects in the same tissue, Application of LQ model to experimental and clinical radiotherapy requires accurate a/b values. For various tissues and different effects in these tissues a/b values has been reported in literature having a wide range of values. However in order to make meaningful predictions of the results of radiotherapy precise values of a/b are required. Various methods of determination of a/b values from isoeffect and dose response data have been proposed by investigators. A review of these methods has been presented with emphasis on the method giving precise a/b values.

90. Sanjay S. Supe, Anil K. Sharma, A.C. Deka, B.C. Deka

Can we use radiotherapy alone in the treatment of keloids?

Journal of the European Academy of Dermatology and Venereology 1995; 5:150-152

Abstract :

Objective : The use of radiation for the treatment of keloids has been the topic of debatic for years.

Methods In this study, 46 symptomatic cases were treated with
Sr - 90Y b-rays. Patients were given four fractions of 5 Gy per fraction either as weekly or twice weekly schedules.

Results : Radiation dose of 20 Gy given twice weekly in four fractions showed response in 92% of the cases as compared to 81% in those receiving four fractions of 5 Gy weekly.

Conclusion : Further studies with numerous dose fractionation schedules would open up new dimension in the radiotherapy of keloids.

Keywords : Keloids; radiotherapy; Radiotherapy.

91. Sanjay S. Supe, Anil K. Sharma and Hema Vaithiananthan

Itemod and ERD - Data Input Computer Programs to Calculate Integral TDF, ERD for Various Normal Tissues and ERD for Various Clinical Situations.

Journal of Medical Physics, 1995; 20:29-30

92. Sanjay S. Supe, Ph.D., J. Velumurugan, M.Sc.; GNS Prasad, Ph.D.

Validity of ERD for Radiation Myelitis over a wide range of Dose per Fraction Deducted from Compiled Retrospective Clinical Data

Journal of Clinical Radiotherapy & Oncology, 1998; 13:2, 161-163

Abstract :

Aim : The purpose of this analysis was to test the role of extrapolated response dose (ERD) for the probability of myelitis for lesser than conventional, conventional and higher than conventional dose per fraction.

Material and Methods : Clinical data of time-dose-fractionation schedules and incidence of myelitis for 3233 patients compiled from the data of Abbatucci, Cohen, Jeremic and Wara was used for the analysis, Radiotherapy schedules were 19 to 76 Gy in 2 to 46 fractions in 7 to 71 days with the dose per fraction of 0.96 to 10.0 Gy. ERD values were evaluated with a/b of 2.5 Gy with Orton’s variable exponent equation.

Results : Correlation of ERD with probability of myelitis was statistically significant for four groups on the basis of dose per fraction of <1.80, 1.80-2.25 , >2.25 Gy/fr and combined data (p<0.001). The ERD limit for 5% complication rate of 130 Gy was observed in the three groups indicating the validity of ERD over a range of dose per fractions inclusive of above and below conventional dose per fraction.

Conclusion : ERD is applicable for lesser than conventional, conventional and higher than conventional dose per fractions. Deciding spinal cord tolerance on the basis of ERD for designing innovative non-conventional fractionation schemes could be a better approach.

Key Words : ERD, Fractionation, Radiation Dose, Radiation Myelitis, Spinal Cord.

93. Sanjay S.Supe, R. Ravichandran, S.V. Kumaraswamy

Radiological Protection in Dental Radiology

JIDA 2000; 71:240-244

Introduction : The use of ionizing radiation in dentistry, like that in general medicine, was initiated soon after the discovery of X-rays by Roentgen in 1895. A rapid growth in the application of this new tool by dentists can be dated from 1913, the year of Coolidge’s invention of the hot-cathode X-ray tube. By the decade following 1930, X-rays had come into general use in dentistry. Today, particularly in the more highly developed countries of the world, a complete radiographic survey of the mouth is considered an essential adjunct to diagnosis, and indeed, failure to examine a dental structure radiographically prior to diagnosis and treatment has in certain places been considered an act of malpractice. This vast increase in the use of X-rays by the dental profession calls for the development of guidelines, the purpose of which is to protect the dentist and the public by offering suggestions for minimizing exposure of the individual and the population as a whole.

94. S.S. Supe, V. Vishwanathan, V. Bhaskar, K. Swamy, R. Ravichandran, V. Kannan, and C, Ramesh

Effect of Overall Treatment time on Overall and Disease Free Survival in the Post-Operative Radiotherapy of Carcinoma of the Breast.

Journal of Medical Physics, 1997; 22:77-78

95. A.C. Sasikala, E.R. Radhakrishnan, P. Nageshwara Rao, S. Devaru, U. Jayashree, S.S. Supe, R.Ravichanran

Assessment of patient radioactive body burden of I-131 in the management of thyroid cancer.

IJNM 1996; 11:3, 151-156

Therapeutic doses of upto 7.4 GBq (200 mCi) and cumulated activities upto 25.9 GBq (700 mCi) of I-131 are used in the treatment of cancer thyroid. Though ablation is not associated with life threatening complications, risk factors for induction of carcinoma in the patients treated with I-131 need to be assessed. In the present study we have measured effective half life of I-131 in whole body using a 350 cc ion chamber calibrated with an IAEA neck phantom. 23 patients (with 12 remnant thyroid) were administered activities ranging from 1.67 - 7.96 GBq (45 - 215 mCi). A mean T1/2 eff or 11.2 h was estimated for the first phase of clearance. From the scans, the mean mass of thyroid was 18.5+ 14.0 gm. The mean committed dose equivalents for thyroid using ICRP 30 (1979) and Best (1981) are 4291 Sv and 2379 Sv respectively. The mean dose to thyroid is 1760 by mean dose to whole body is 0.18 Gy.

96. V.K. Sathya Narayanan, R. Ravichandran, E.E. Prasad, K. Subbarangaiah.

Method for Brachytherapy Source Standardisation Using Air-Kerma Measurements.

Journal of Medical Physics, 1997; 22:112-113

97. Shenoy. A.M.,

Rehabilitation in Head & Neck Cancer Patients

KMJ, 1996, 66:43-46

98. Shenoy. A.M., P.K. Plinkert, N. Nanjundappa, S. Premalata, G.R. Arunodhay

Functional utility and oncologic safety of near-total laryngectomy with tracheopharyngeal speech shunt in a Third World oncologic center

The Arch Otorhinolaryngol 1997, 254:128-132

Abstract : This prospective study analyzes the feasibility, oncologic safety and functional utility of Pearson’s near total laryngectomy with tracheopharyngeal shunt (NTL-TPSS). The procedure was found to give gratifying locoregional control in 30 consecutive advanced T3 and selected T4 tumors involving the larynx (n=11) and hypopharynx (n=19) and managed at Kidwai Memorial Institute of Oncology, Bangalore, India. The oncologic "safety" of the technique was established in following examinations, ranging from 18 to 44 months (median, 22.2 months). A locoregional control rate of 74% was obtained. Lung-powered "shunt" speech was acquired with ease in periods ranging from 7 days in speakers deemed "excellent" (15/99) to 20 days in those deemed "satisfactory" (8/29). Except for a single case experiencing temporary aspiration of liquids. patients did not have any swallowing difficulties following removal of nasogastric tubes. The period of hospitalization averaged 22.6 days. The complication rate was 33%, with one patient death (3.3%) occurring. The dynamics of the "TPSS were analyzed in selected "speakers" and "non-speakers". using transcutaneous needle electromyography. Analysis of data supports the possibility of dynamic speech modulation. However, the favored anatomic location and design renders the shunts aspiration-proof rather than demonstrating any active sphincteric action.

99. Shenoy A.M., A. Nanjundappa, Pradeep Kumar, Rekha V. Kumar, B.K.M. Reddy, V. Kannan, N. Anantha

Interjugular neck dissection and post-operative irradiation for neck control in advanced glottic cancers - are we justified?

The Journal of Laryngology and Otology, 1994;108:1, 26-29

Abstract : At the Kidwai Memorial Institute of Oncology, advanced laryngeal cancers are subjected routinely to primary surgery and/or post-operative radiotherapy (RT). The surgery consists of wide field laryngectomy which entails total laryngectomy, ipsilateral/bilateral thyroid lobectomy, bilateral paratracheal clearance, and bilateral clearance of levels 2, 3 and 4 lymphatics. Post-operative RT is indicated in event of the following histo-pathological (HPE) situations to consolidate local regional control : (1) T4 primary; 2) Significant subglottic extension; and (3) jugular / paratracheal metastatic deposits. This prospective study highlights the therapeutic efficacy of this protocol at our centre in 45 consecutive T4/T3 glottic cancers and specifically evaluates the role of interjugular dissection and/or post-operative RT in prevention of regional recurrence. Fifty-two per cent of primary lesions needed a post-surgical upstaging as against 14 per cent of the neck lesions. Accordingly 91 percent of the cases (41/45) qualified for post-operative RT and 82 per cent (37/41) complied with the prescribed schedule. Recurrent disease in the lateral neck was noted in 2/37 who received the prescribed schedule and 1/4 non-complaint cases; while a recurrent central neck disease was noted in 1/37 and 1/4 of these cases respectively. All cases were followed-up for a period of two years and 66 per cent of the evaluable cases for a period of five years. This study confirms conclusively that our treatment schedule yields extremely gratifying two-year local-regional control rates of 89 per cent which translates into a two and five-year actuarial survival rate of 92 and 70 per cent respectively.

Key words : Laryngeal neoplasms; Neck dissection; Radiotherapy.

100. A.M. Shenoy, M.S.(ENT), Honey Ashok, M.S. (ENT), Mrs. Premalata. B.S., M.Sc., A.V. Srihari Prasad, M.S., (ENT), K. Nanjundappa. M.S., (ENT) Satish Kumar, M.S. (ENT)

Surgical speech restoration by tracheo-oesophageal puncture-kidwai experience

Indian Journal of Cancer, 2000; 37:1, 27-31

Summary : This paper addresses our experience with primary (15 patients) and secondary (8 patients) tracheo-oesophageal puncture (TEP) in the laryngectomee. Despite a success rate of 93.3 percent in the primary TEP and 62.5 percent in secondary TEP, in a follow-up period of one month to eight years, prosthesis related problems like maintenance and recurring expenses emerged as significant deterrent factors in adopting prosthetic speech rehabilitation.

Successful oesophageal speech training, increased practice of Pearson's near total laryngectomy, prior tracheostomy and advanced disease mandating post-operative radiotherapy in majority of patients are some of the factors in addition to prosthesis after-care maintenance that makes TEP a less practiced option at our center.

101. A.M. Shenoy, Harindra M.N., Premalatha B.S., S. Subbaiah, D. Sridhar Reddy, Sri Hari Prasad. A.V., Ravi. S.

Functional laryngeal surgery - critical determinants of successful rehabilitation

Indian Journal of Otolaryngology and Head and Neck Surgery, 2000;4, 341-346

Abstract : This study addresses the functioned outcome and rehabilitative process in 30 partial laryngectomies carried out for laryngeal (22) and hypo/propharyngeal (8) cancers at the department of H/N Surgery. The Kidwai Memoria Institute of Oncology, Bangalore, Indian from 1985-1995. Special emphasis is directed towards post-surgical convalescence after various partial laryngectomy techniques which include 6 vertical laryngectomies (V L / VPL), 17 supraglottic laryngectomies (S G L), and 7 supracricoid laryngectomies with Cricohyoidepexy (CHP). Rehabilitative success was measured with respect to the ease of decannulation, resumption of normal deglutition and speech analysis - both objectively using standard speech analytical equipment in a speech laboratory and subjectively using the services of blinded judges to score recorded speech of patients. The speech analysis indicate that post SGL speech was the superior most followed by V.L. and C H P in that order. Aspiration was deemed as minimal and inconsequential after VL/VPL followed by CHP : and SGL in the order of severity; the extended modifications to resect the arytenoid and / or base of tongue and / or piriform fossa faring worse than classic standard technique.

Key words : Functional Laryngeal Surgery Rehabilitation.

102. A.M. Shenoy, M.S., F.R.C.S. (Rd.), S. Sathis Kumar, M.S., Nanjundappa, M.S., Srihari Prasad, M.S., B.S. Premalatha, M.Sc., Ph.D.,

Supracricoid laryngectomy with cricohyoidopexy - A clinico oncological & functional experience

Indian Journal of Cancer, 2000; 37:2, 67-73

Summary : Supracricoid laryngectomy with Cricohyoidopexy (CHP) is a procedure that is commonly practiced in France & Canada. Eight such procedures were carried out at Kidwai Memorial Institute of Oncology Bangalore during the period from 1991 through 1996. Four Glottic, 3 transglottic & one supraglottic cancers were subjected to this procedure. The study comprised of 7 males & 1 female. The average age was 52 years. Two procedures were done as salvage procedures for radiotherapy (RT) failures. The patients have a follow-up ranging from one year to six years, except for one who dies soon after discharge from hospital secondary to myocardial infarction. Median follow up was four years. The three year acturial disease free survival was 83%. Six out of 8 (75%) were decannulated, and physiologic deglutition without apsiration was established in all patients. Hospital stay ranged from 11 to 62 days averaging 29 days. The speech was analyzed together with other partial laryngectomies and was found to be qualitatively worse than speech after other partial laryngectomy procedures. In addition speech intensity levels after CHP were lower than in other partial laryngectomy procedures. In addition speech intensity levels after CHP were lower than in other partial laryngectomy procedures. The speech however allowed normal social interaction. This procedure certainly has distinct oncological advantage in encompassing circumferential horse-shoe lesions with minimal subglottic extension which in the past would have received total laryngectomy and needs to be included in the repertoire of speech restorative surgery in laryngeal cancers.

103. A. Sreedharan, R.S. Jayshree, Anita Desai, Hema Sridhar, A. Chandramuki & V. Ravi

Assessment of suitability & ease of performance of seven commercial assay systems for the detection of antibodies to HIV-1

Indian J. Med. Res. 1995; 101-179-182

In this study, we have evaluated the suitability and ease of performance of seven HIV assays namely : Vironostika anti-HIV Uni-Form; Vironostika HIV MIXT; Elavia MIXT; Genelavia MIXT; Serodia HIV; Immunocomb Bi-spot; and Test pack HIV-1 and 2 Abbott, for use in Indian laboratories. A panel of 41 blind coded Western blot confirmed sera were used for this purpose. Rapid assays like immunocomb Bi-Spot. Serodia HIV and Test pack HIV-1/HIV-2 Abbott were found to be more suitable and easy to perform as compared to the ELISAs. Sensitivity of all the assays was excellent (100%). Specificity of Serodia HIV, Immunocomb Bi-spot, Test pack HIV-1 and 2 Abbott and Elavia MIXT were excellent (100%), while that of Vironostika MIXT and Vironostika anti-HIV Uni-Form was poor. Positive predictive value of the assays ranged from 64.5 to 100 per cent. Negative predictive value of six of the assays was 100 per cent and that of Vironostika anti-HIV Uni-Form was very poor.

104. A. Sreedharan, R.S Jayshree, and Hema Sridhar

Cryptosporidiosis Among Cancer Patients : An Observation

J. Diarrhoeal Dis. Res. 1996; 14:3, 211-213

Abstract : The incidence of cryptosporidiosis was studied in 560 cancer patients presenting with symptoms of diarrhoea. Cryptosporidium oocysts were detected in the stool specimens by modified acid fast staining. Blood was examined for HIV antibodies from patients whose stool specimens were positive for Cryptosporidium oocysts. Oocysts were detected in 7 of the 560 (1.3%) patients who were receiving chemotherapy and had diarrhoea; in five of them the symptoms were acute, while two patients had chronic diarrhoea; in five of them the symptoms were acute, while two patients had chronic diarrhoea. Of these seven patients, five had cancer of haemopoetic system, one had cancer of cervix and one had uterine sarcoma. None of the patients positive for oocysts were positive for HIV antibodies, ruling out the possibility of an opportunistic infection due to HIV infection.

Key words : Diarrhoea, Acute; Cancer; Cryptosporidium; Cryptosporidiosis.

105. T.S. Sundareshan and M. Augustus

Expression of Fragile Sites in Patients with Retinoblastoma, their Parents, and Unaffected Siblings : A Study of Ten Families

Cancer Genet Cytogenet, 1994; 78:72-77

Abstract : The expression of fragile sites (FS) in the blood lymphocytes of 54 individuals, including 11 retinoblastoma (Rb) patients, their clinically healthy family members, and corresponding age and sex-matched controls is presented. 5-fluorodeoxyuridine (5-FdU and caffeine were used for FS induction. Enhanced expression of fra (13) (q13.2) was observed in the patient group as compared with controls. One of the patients had a constitutional del(13)(q14.2q21.2). In this individual, only the nondeleted homologue expressed the fra(13)(q13.2). Expression of fra(13)(q13.2) in two of the patients unaffected younger siblings of different families showed statistically significant values. The possible relation between enhanced expression of FS and the inheritance of a genetic predisposition to Rb requires further examination.

106. T.S. Sundareshan and M. Augustus

Expression of Common Fragile Sites in Lymphocytes of Wilms’ Tumor in Patients, Their Parents, and Siblings

Cancer Genet Cytogenet 1995; 84:51-55

Abstract : Fragile site expression in blood lymphocytes of 56 individuals, including 11 Wilms’ tumor patients, family members, and controls, was studied by 5-fluorodeoxyuridine induction with caffeine enhancement. Significantly elevated expression of fra(11)(p13) was observed in the patient group, compared with controls. One patient clinically diagnosed with the Wilms’ tumor, aniridia, and genitourinary and retardation (WAGR) syndrome revealed constitutional deletion of 11p13. Expression of fra(11)(p13) in this individual was observed only on the nondeleted homology. Among the family members studied, only one sibling showed elevated expression of fra(11)(p13).

107. T.S. Sundareshan and M. Augustus

Cytogenetics on Non-Small Cell Lung Cancer : Simple Technique For Obtaining High Quality Chromosomes by Fine Needle Aspirate Cultures

Cancer Genet Cytogenet 1996; 91:53-60

Abstract : Cytogenetic analysis of six non-small cell lung carcinomas (NSCLC) was carried out on overnight cultures of tumor material obtained from transthoracic fine needle aspirates to determine karyotype changes involved in the early stages of the disease. Multiple chromosome alterations were characterized. Numerical abnormalities included additional copies of chromosomes 3, 7, 8, 16, 17 and loss of chromosomes 1, 2, 6, 9, 12, 20, 21 and 22. Structural alterations included deletion or derivative chromosome 3 (band p14 or p21) in 5 patients. Clustering of other break points including 16q21, 17p13, 11p15, 15p12, 8p23, 4q27, 9p21, 12p13, 14p12, and i(Xq) was observed in the descending order of their involvement. These abnormalities may be indicative of critical molecular events in the etiology of NSCLC. *Elsevie Science Inc., 1996.

108. T.S. Sundareshan and M. Augusts

Normal Expression of fra(3)(p14.2) in Lymphocytes of Lung Cancer Patients

Cancer Genetics Cytogenetics 1996; 89:82-84

Abstract : Fragile site (FS) analysis was performed in 10 bronchogenic carcinoma families (non small cell type) each represented by the patient and one adult offspring. Twenty age and sex matched controls were evaluated simultaneously for FS expression. The question whether increased fragility at band 3p14 exists in lung cancer patients or their offspring was examined. The expression level was found to be similar among patients, offspring, and controls.

109. A.M. Udayakumar, M. Krishna Bhargava

Chromosomal Aberrations in Peripheral Blood Lymphocytes of Breast Cancer Patients Prior to any Therapy

Ann Génét, 1994; 37:4, 192-195

Summary : In a study comprised of 53 breast cancer patients, chosen for determining the cytogenetic damage to peripheral blood lymphocytes (PBL) due to cancer therapy, eleven patients revealed chromosomal abnormalities in 3.18% of cells prior to any such therapy. Age matched controls showed 0.18% abnormal cells. Statistical analysis of the abnormal cells in patients prior to therapy and normal controls revealed significant values at 1% level (p<0.01). The factors causing <<chromosome instability>> causing chromosome breakage or whether any clastogenic metabolites produced by the tumor itself is triggering neoplastic transformation are discussed.

Keywords : Breast Cancer - Chromosomal anomalies - (Thermosomal breaks) - Chromosomal instability.

110. A.M. Udayakakumar and M. Krishna Bhargava

Chromosomal Abnormalities in the Lymphocytes of a Male Patient with Breast Cancer

Cancer Genet Cytogenet 1994; 78:99-101

Abstract : Blood lymphocyte cultures of a male with carcinoma of the breast revealed both numerical (hypodiploidy any hyperdiploidy) and structural abnormalities. Only few cases of male breast cancer have been cytogenetically characterized. Earlier studies revealed normal karyotypes in peripheral blood cultures of male breast cancer patients and abnormalities only in the tumor tissue. The present report describes 16.6% abnormal metaphases detected in the peripheral blood lymphocytes. Numerical abnormalities were loss of chromosome 9 and 19 and gain of chromosome 7. Structural abnormalities were a cell with marker, del (11) (q22-23) and dic(7:19)(q36;p13). These abnormalities are compared with male and female tumor karyotypes reported in the literature.

111. A.M. Udayakumar and M. Krishna Bhargava

Double Minutes and Premature Chromosome Condensation in Blood Lumphocytes of Four Breast Cancer Patients

Cancer Research 1995; 15:1577-1580

Abstract : Double minutes (dmin) and premature chromosome condensation (PCC) were observed in the peripheral blood lymphocytes (PBL) of four breast cancer patients using GTG banding. Among 53 breast cancer patients studied, four cases revealed dmin of which one case had PCC along with dmin PCC might be an indicator of the spontaneous proliferative potential of tumor cells manifested in lymphocytes as a rare phenomenon. The presence of dmin represents amplified genes (well documented in different types of tumors), but their presence in PBL has rarely been reported in the literature. These findings in PBL might indicate the defective genetic/molecular mechanisms expressed generally in tumor tissue are also manifested in a similar manner in the circulating lymphocytes of patients at a lower frequency.

Key words : Breast cancer, chemotherapy, double minutes, gene amplification, premature chromosome condensation.

112. A.M. Udayakumar and T.S. Sundareshan

Tetrasomy 21 as a Sole Abnormality in Erythroleukemia

Cancer Genet Cytogenet, 1995; 85:85-87

Abstract : A 13-year-old girl presented with swelling in the neck, fever, bleeding of the gums, and hepatosplenomegaly. Bone marrow morphology was suggestive of erythroleukemia (AML-M6). Chromosome analysis of the marrow revealed 48, XX, +21, +21 as the sole clonal abnormality.

113. A.M. Udayakumar, M. Krishna Bhargava

Persistence of chromosomal aberrations in blood lymphocytes 11 years after cessation of CMF therapy in a breast cancer patient.

Cancer Letters, 1996; 107:1-3

Abstract : Chromosomal aberrations were examined in a breast cancer patient 11 years after cessation of cyclophosphamide methotrexate 5-fluorouacil (CMF) therapy. This indicates that they may well be derived from a population of genetically damaged progenitor cells, from which abnormal and possibly malignant cell clones may have been generated, and a fraction of these randomly occurring chromosome rearrangements appear to be ‘stable’.

Keywords : Breast cancer; Chromosomal aberrations; CMF therapy; Cyclophosphamide; Methotrexate; 5-Fluorouacil

114. Vasanti R. Rao, Girija Ramaswamy and Elizabeth Zacharraiah

Serum Concentration of Trace Elements in Patients with Lymphoid Malignancy

Indian Journal of Clinical Biochemistry, 1996; 11:1, 32-36

Abstract : The role of trace elements especially copper, zinc in carcinogenesis and in relation to disease activity have been studied. Pretreatment levels of serum copper and zinc were found to be altered in patients with Non Hodgkin’s lymphoma (NHL) and Hodgkin’s disease (HD) when compared to the control group. Serum copper concentration significantly increased with the stage of the disease and was useful to predict relapse and response to therapy, Serum concentration of zinc could be significantly correlated with the stage of the disease, in response to therapy and in predicting relapse. Superoxide dismutase could not be correlated with the stage of the disease.

Key words : Copper, Zinc, Superoxide dismutase, Lymphomas.

115. Vasanti R. Rao, Ph.D., Lakshmi Krishnamoorthy, Ph.D., S.V. umaraswamy, M.D.S., and Girija Ramaswamy, Ph.D.

Circulating Levels in Serum of Total Sialic Acid, Lipid-Associated Sialic Acid, and Fucose in Precancerous Lesion and Cancer of the Oral Cavity.

Cancer Detection and Prevention, 1998; 22:3, 237-240

Abstract : Total sialic acid (TSA), lipid-associated sialic acid (LASA), and fucose were estimated in sera of 35 patients with precancerous lesion of the oral cavity, 68 patients with cancer of the oral cavity, and 25 age and sex matched non-chewers of both tobacco and betal nut and nonsmokers as controls. Significant elevation in the serum levels of TSA and LASA were observed in patients with the precancerous and cancer lesions when compared with the controls. Serum TSA levels were elevated significantly in patients with cancer when compared with those with precancerous lesions. Circulating TSA and LASA levels were found to reflect tumor burden and correlated well with stage of the disease. However, serum fucose levels did not show an increase corresponding to stage of the disease. The results suggests that combined evaluation of these markers may be useful in predicting early malignant change and also in assessing the spread and invasiveness of the disease in cancer of the oral cavity.

Key Words : glycoconjugates, glycolipids, precancerous lesions.

116. K.V. Veerendra Kumar, B. Krishnamurthy Reddy, P.S. Prabhakaran,
M. Vijaykumar and K. Mani.

Role of Adjuvant Radiotherapy in Soft Tissue Sarcoma;-A Retrospective Analysis from Regional Cancer Centre

Indian Journal of Surgery, 1997, 59:353-356

Abstract : A retrospective analysis of soft tissue sarcoma registered at Kidwai Memorial Institute of Oncology between Jan. 1988 to Dec. 1992, was done to identify the role of adjuvant radiotherapy. For this study, 137 evaluable patients considered. Of these 89 patients had surgery alone and the remaining 48 (35%) patients had surgery plus postoperative adjuvant radiotherapy. Local failure rate of 34.8% and 18.8% among the only surgery group and the surgery plus RT group respectively. When the tumour grade was taken into consideration local failure rate of 6.7% in low grade and 24.2% in high grade tumours for the Surgery + RT group, where as 24% in low grade and 39.1% in high grade local failure found in the other surgery group. Similarly very high difference of local failure noticed in margin positive and margin negative group. This analysis clearly indicates that the tumour grade and surgical margin plays an important prognostic factors along with the surgery plus adjuvant RT as the choice of treatment.

Key words : Soft tissue sarcoma, Adjuvant Radiotherapy, Surgery.

117. M. Vijaykumar

Surgery in the Management of Cancer

KMJ 1996; 66:18-20

Introduction : Surgery is the oldest form of treatment for Cancer. It was considered as the only modality for treating solid tumours till recently. Presently it is considered as a part of multidisciplinary approach in the treatment of Cancer along with Radiotherapy, Chemotherapy etc. Interestingly in the management of Cancer, surgery plays more than one role. It is useful in diagnosis, in staging and in the treatment of solid tumours. Apart from the utility of Cancer Surgery, one should also know about its safety, its effect of immunity and the making of a Cancer Surgeon.

118. N. Vishwanathan, N. Bhaskar, Sanjay S. Supe, Kumara Swamy, R. Ravichandran, V. Kannan, C. Ramesh

Role of Electron Beam Treatment in Postoperative Management of Carcinoma of the Breast

Indian Journal of Cancer, 1998; 35:1, 1-9

Summary : The aim of post operative radiotherapy to chest wall and drainage areas in advanced breast cancer is to sterilize the possible microscopic disease. Fifty cases of post surgical breast cancers were evaluated in a prospective study of chest wall radiation therapy by electrons. Fifty women of histologically proved post operative invasive breast cancers underwent simple mastectomy with axillary dissection followed by post-operative radiotherapy (Electron) to chest wall + /- drainage area. The chest wall and IMC was treated by a direct electron beam (9/12) MeV and 12MeV at fixed angle. 6MV X-ray beam was used to treat axillary apex and supraclavicular area. In some cases, supplement RT was given by 6MV X-rays through small posterior axillary portal. The energy of electron beam was 8 MeV or 12MeV depending on the thickness of treated area. The supraclavicular and axillary lymphatic regions were treated, by direct custom shaped anterior portal. The dose delivered was 50 Gy over 5 weeks at 2 Gy per fraction. Adjuvant chemotherapy was given to patients who were pre-menopausal with histologically proved axillary node involvement as Cyclophosphamide, Methotrexate and 5-Flurouracil (CMF) after radiotherapy. Post menopausal patients received adjuvant tamoxifen 10 mg. bid.

The overall time varied from 26 to 87 days with a median of 41.5 days (SD 11.7). The followup period varied from 4-32 months with a mean of 22 months (SD 6.4) All the fifty patients developed dense pigmentation towards the end of radiation therapy, along with patchy dry desquamation. Moist desquamation occurred in 6 patients. The median OTT in the patients who developed moist desquamation was 34.5 days. The moist reaction healed over 10-15 days after completion of radiotherapy. Lung Fibrosis (Apical lobe) occured in four patients., The fibrosis was evident at a median of 12 months of follow up. Lymphoedema of the ipsilatral arm occured in six patients. None of 50 patients developed late sequalae like Cardiac effects, Rib fracture, Branchial Plexopathy, Shoulder joint impairment and Soft tissue effects. Local control in this study was 96% (48 patients). The two year actuarial overall survival was 80%. In early stages survival was significantly better compared to late stages. The actuarial two year DFS was 72%. In early stages DFS was significantly better compared to late stages.






( Vol. 2 : 1994-2000 )




The Kidwai Memorial Institute of Oncology is a comprehensive centre for Cancer Research and Treatment, located on Dr. M.H. Marigowda Road, Bangalore, Karnataka. It is one of the fourteen Regional Cancer Centres in the country. The Institute was established in the year 1973 and became autonomous on 8 January 1980. After attaining autonomy, the Institute has developed rapidly in all spheres. In addition to the rendering of treatment services to the cancer afflicted from all over the state and the adjoining areas of neighbouring states, due importance has been given to cancer research, basic as well as clinical, and a number of publications are emerging from the different disciplines of the Institute.

This is an attempt to throw light on the contributions made by staff on oncology and allied sciences. It contains the abstracts of all papers published in the last 7 years i.e., 1994 to 2000. Efforts have been made to make it as comprehensive as possible. Papers have been arranged according to the alphabetical order of the first author. The booklet is provided with an alphabetical author index at the end. The numbers against the name of the author refer to article numbers of papers. Most of these publications are available for ready reference in the KIMIO Library & Information Centre.


M. Nagaraj Dr. P.S. Prabhakaran

Librarian Director


Compiled by : Dr. Rekha V. Kumar & Mrs. Varalakshmamma








Sl. No. Author Name Article No.

1. Anantha. N. 1

2. Anil K. Sharma 2

3. Anna Abraham 3, 4, 5, 6, 7

4. Anusridhar 8

5. Bafna. U.D. 9, 10

6. Balu. S. 11

7. Bapsy. P.P. 12

8. Beliappa M.S. 13

9. Clementina Rama Rao 14, 15, 16

10. D.C. Doval 17, 18, 19, 23

11. Elizabeth Vallikad 24

12. Girija Ramaswamy 25, 26, 27

13. Govinda Babu. K. 28 - 32

14. Hazarika. D. 33 - 35

15. Hema Sridhar 36 - 37

16. Hema. V. 38 - 41

17. Jayashree. R.S. 42 - 47

18. Krishnamurthy. M. 48

19. Krishnamurthy Reddy. R. 49

20. Kumara Swamy 50 - 51

21. K.C. Lakshmaiah 52, 53

22. Lakshmi Devi. V. 54 - 55

23. Lakshmi Krishnamoorthy 56

24. Lakshminarasimhan 57

25. Mallana Gowda. T. 58

26. Mohanti. B.K. 59

27. Nageshwara Rao. P. 60

28. Nandakumar. A. 61

29. Poonam Patil 65

30. Prasannakumari 62

31. Premalatha. B.S. 63, 64

32. Rani. S. Acharya 66

33. Ravichandran. R. 67 - 69

34. Ravikumar. R. 70 - 72

35. Ravikumar. M. 73 - 81

36. Rekha. V. Kumar 82 - 85

37. Sanjay S. Supe 86 - 94

38. Sasikala. A.C. 95

39. Sathya Narayana. V. 96

40. Shenoy. A.M. 97 - 102

41. Sreedharan. A. 103-104

42. Sundareshan. T.S. 105 - 108

43. Udyakumar. A.M. 109 - 113

44. Vasanthi R. Rao 114 - 115

45. Veerendra Kumar. K.V. 116

46. Vijayakumar. M. 117

47. Vishwanathan. N. 118