The actual burden of head and neck cancer in India is much greater than reflected through the existing literature and hence can be regarded as a 'tip of iceberg' situation. This has further been evident by the recent reports of 'Net-based Atlas of Cancer in India'. South-east Asia is likely to face sharp increases of over 75% in the number of cancer deaths in 2020 as compared to 2000. Since the percentage increase of Indian population has been nearly twice that of the world in last 15 years there is a likelihood of increase in cancer burden with the same proportion. The distribution of population based cancer registries is grossly uneven with certain important parts of the country being not represented at all and hence the current cancer burden is not reflected by registry data. However, the pathetic situation of health care system in major parts of the country as also emphasized by the World Bank, is not suitable to provide anywhere near accurate data on cancer burden. Head and neck cancer (including thyroid lesions) is third most common malignancy seen in both the sexes across the globe but is the commonest malignancy encountered in Indian males. Also oral cavity cancer is the most prevalent type amongst the males and one of the highest across the globe. This article reviews the latest global and national situation with an especial emphasis on head and neck cancer. Furthermore this review focuses on burden in different sub sites at national and global levels.
Background: Laryngeal malignancy is a common malignancy of the head and neck region. Affected patients usually present with features that are characteristic of certain subsites. The larynx is oncologically divided into three: supraglottis, glottis and subglottis. Studies from Western countries have shown that the glottis is the commonest subsite to harbour laryngeal malignancy. However, the supraglottis has been reported to be the commonest subsite in developing countries, including examples in the Indian subcontinent. To our knowledge, no study has been carried out in western Nepal about the epidemiology of laryngeal cancer to date. The purpose of this study was to analyse the epidemiology of laryngeal cancer in relation to its risk factors, age distribution,and preferred subsites and to see if there is any recent change in the subsite wise distribution of laryngeal malignancy in western Nepal. Materials and Methods: Patients of all ages and both sexes with suspected laryngeal malignancy were enrolled in the initial study. Detailed history taking and clinical examination was performed to find out the involved subsite in relation to the clinical features. Direct laryngoscopy was performed to further confirm the subsite and to take biopsy from the growth under general anesthesia. After confirmation of malignancy from the biopsy report, patients were finally included in the study. Data were analysed and observations were made to find out the distribution of laryngeal malignancy in different subsites. Results: The supraglottic larynx was the commonest subsite to harbor laryngeal malignancy. Smoking and alcohol were found to be the common risk factors. The mean age of the patients was in their sixties. Conclusions: Laryngeal malignancy is common in elderly individuals. Supraglottic laryngeal malignancy is the commonest laryngeal malignancy in people who smoke and drink alcohol in Nepal. Avoidance of alcohol use and smoking will be a milestone to reduce the incidence of laryngeal cancers and associated mortality.
Purpose: We aimed to study the inflammatory parameters of complete blood count in breast cancer cases. Materials and Methods: This retrospective study covered 178 breast cancer patients and 107 age and body mass index matched healthy women. Complete blood count parameters, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and MPV/platelet were analyzed. Results: The leukocyte, neutrophil and neutrophil/lymphocyte ratio were higher in the patient group (p values 0.001, 0.0001 and 0.0001, respectively) while haemoglobin and hematocrit were higher in the control group (p=0.0001 for both). Logistic regression analysis showed that elevated neutrophils and platelet distribution width (PDW) (OR: 0.627, 95%CI: 0.508-0.774, p=0.001 and OR: 1.191 95%CI: 1.057-1.342 p=0.003) were independent variables for predicting breast cancer. The cut-off value for the neutrophil/lymphocyte ratio was 2.56. Conclusions: According to our study results, neutrophil levels as part of complete blood count may be used as an independent predictor of breast cancer risk.
Background: The discovery that microRNA (miRNA) regulates metastasis provide a principal molecular basis for tumor heterogeneity. A characteristic of solid tumors is their heterogenous distribution of blood vessels, with significant hypoxia occurring in regions (centers of tumor) of low blood flow. It is necessary to discover the mechanism of breast cancer metastasis in relation to the fact that there is a differential distribution of crucial microRNA in tumors from centers to edges. Methods: Breast tissues from 48 patients (32 patients with breast cancer) were classified into the high invasive and metastatic group (HIMG), low invasive and metastatic group (LIMG), and normal group. Samples were collected from both the centers and edges of all tumors. The first six specimens were detected by microRNA array, and the second ten specimens were detected by real-time qRT-PCR and Western blot analyses. Correlation analysis was performed between the miRNAs and target proteins. Results: The relative content of miR-20a and miR-20b was lower in the center of the tumor than at the edge in the LIMG, lower at the edge of the tumor than in the center in the HIMG, and lower in breast cancer tissues than in normal tissues. VEGF-A and HIF-1alpha mRNA levels were higher in the HIMG than in the LIMG, and levels were higher in both groups than in the normal group; there was no difference in mRNA levels between the edge and center of the tumor. VEGF-A and HIF-1alpha protein levels were higher in the HIMG than in the LIMG, and protein levels in both groups were higher than in the normal group; there was a significant difference in protein expression between the edge and center of the tumor. Correlation analysis showed that the key miRNAs (miR-20a and miR-20b) negatively correlated with the target proteins (VEGF-A and HIF-1alpha). Conclusions: Our data suggest that miR-20a and miR-20b are differentially distributed in breast cancer, while VEGF-A and HIF-1alpha mRNA had coincident distributions, and VEGF-A and HIF-1alpha proteins had uneven and opposing distributions to the miRNAs. It appears that one of the most important facets underlying metastatic heterogeneity is the differential distribution of miR-20a and miR-20b and their regulation of target proteins.
Clinical studies were carried out 40 cases of patients with stomach cancer treated by "Hangammyunyouk I(抗癌免疫1號方)", from September 1th 1997 to May 1th 1998. The results were summarized as follows; 1. Distribution of those attached by stomach cancer, by sex, showed that Male is more then Female, by age, showed that the number of fifties is majority. 2. Distribution of diagnostic stage, on descending order, stage III, stage IV. 3. Distribution of treatment attached by stomach cancer, in descending order: Chemotherapy and operation, chemotherapy, Radiation therapy and operation. 4. After taken herb medicine, the effects according to the symptoms were as follows; Nausea and Vomiting, Constipation, General body weakness, Average efficacy of symptoms were 68.1%. 5. Analysis of hematology attached by stomach cancer, increasing of WBC(61.5%), Hgb(54.5%), Platelet(62.5%) were observed.
Cihan, Yasemin Benderli;Baykan, Halit;Kavuncuoglu, Erhan;Mutlu, Hasan;Kucukoglu, Mehmet Burhan;Ozyurt, Kemal;Oguz, Arzu
Asian Pacific Journal of Cancer Prevention
/
v.14
no.7
/
pp.4199-4203
/
2013
Background: This investigation focused on possible relationships between skin cancers and ABO/Rh blood groups. Materials and Methods: Between January 2005 and December 2012, medical data of 255 patients with skin cancers who were admitted to Kayseri Training and Research Hospital, Radiation Oncology and Plastic Surgery Outpatient Clinics were retrospectively analyzed. Blood groups of these patients were recorded. The control group consisted of 25701 healthy volunteers who were admitted to Kayseri Training and Research Hospital, Blood Donation Center between January 2010 and December 2011. The distribution of the blood groups of the patients with skin cancers was compared to the distribution of ABO/Rh blood groups of healthy controls. The association of the histopathological subtypes of skin cancer with the blood groups was also investigated. Results: Of the patients, 50.2% had A type, 26.3% had O type, 16.1% had B type, and 7.5% had AB blood group with a positive Rh (+) in 77.3%. Of the controls, 44.3% had A type, 31.5% had 0 type, 16.1% had B type, and 8.1% had AB blood group with a positive Rh (+) in 87.8%. There was a statistically significant difference in the distribution of blood groups and Rh factors (A Rh (-) and 0 Rh positive) between the patients and controls. A total of 36.8% and 20.4% of the patients with basal cell carcinoma (BCC) had A Rh (+) and B Rh (+), respectively, while 39.2% and 27.6% of the controls had A Rh (+) and B Rh (+), respectively. A significant relationship was observed between the patients with BCC and controls in terms of A Rh (-) (p=0.001). Conclusion: Our study results demonstrated that there is a significant relationship between non-melanoma skin cancer and ABO/Rh factors.
We investigated the distribution of HPV genotypes in Uyghur women in Xinjiang region of China, and behavioral factors which could predispose them to HPV infection. In this cross-sectional study, women aged 15-59 years were recruited by cluster sampling method in Yutian region in 2009. Liquid-based cytology samples were analyzed centrally for HPV genotype with a linear array detector. Univariate and multivariate logistic regression analyses were performed to identify behavioral risk factors for HPV infection. A total of 883 Uyghur women were recruited successfully. The prevalence of high-risk HPV and low-risk HPV were 7.25% and 1.58%, respectively; the most common HPVs were HPV16, 51, 31, 39 and 58. We found that age of first sexual intercourse was a strong predictor for HPV infection (odds ratio of 4.01 for ${\leq}15$ years versus ${\geq}25$). Having sexual partners ${\geq}3$ was the second predictor (OR 3.69, 95% CI 2.24-7.16). Cleaning the vagina after sex showed an increased risk of HPV infection (OR 2.72; 95% CI 1.98-5.13); Using the condom showed protective factors for HPV infection (OR 0.36; 95%CI0.12-0.53). HPV16, 51, 31, 39 and 58 were the priority types; the age of first sexual intercourse was identified as a major risk factor for HPV infection. Other notable risks were number of sexual partners and cleaning the vagina after sex. Changing these behavioral risk factors could help to reduce the occurrence of cervical cancer in this population.
Jung, Sang Hoon;Kim, Jinsung;Chung, Yoonsun;Keserci, Bilgin;Pyo, Hongryull;Park, Hee Chul;Park, Won
Radiation Oncology Journal
/
v.38
no.1
/
pp.52-59
/
2020
Purpose: To evaluate and compare the feasibilities of magnetic resonance (MR) image-based planning using synthetic computed tomography (sCT) versus CT (pCT)-based planning in helical tomotherapy for prostate cancer. Materials and Methods: A retrospective evaluation was performed in 16 patients with prostate cancer who had been treated with helical tomotherapy. MR images were acquired using a dedicated therapy sequence; sCT images were generated using magnetic resonance for calculating attenuation (MRCAT). The three-dimensional dose distribution according to sCT was recalculated using a previously optimized plan and was compared with the doses calculated using pCT. Results: The mean planning target volume doses calculated by sCT and pCT differed by 0.65% ± 1.11% (p = 0.03). Three-dimensional gamma analysis at a 2%/2 mm dose difference/distance to agreement yielded a pass rate of 0.976 (range, 0.658 to 0.986). Conclusion: The dose distribution results obtained using tomotherapy from MR-only simulations were in good agreement with the dose distribution results from simulation CT, with mean dose differences of less than 1% for target volume and normal organs in patients with prostate cancer.
Purpose: The ability to access clinical trials for cancer treatment is important. This study investigated whether regional differences exist in oncologic clinical trial protocols conducted in South Korea. Methods: Records of all approved oncologic clinical trials conducted in 2019 were downloaded from the Republic of Korea Ministry of Food and Drug Safety. The study covered Seoul, the capital area, other metropolitan cities, and provincial areas. Descriptive statistics summarized the distribution patterns of clinical trials by region. Results: A total of 202 oncologic clinical trials were conducted in 63 institutions in 2019. Of these protocols, 186 (92%) were available in Seoul, 120 (59%) in the capital area, 64 (32%) in metropolitan cities, and 66 (33%) in provincial areas. More regional differences in protocol availability were observed in domestic trials, investigator-initiated trials, phase 1 and 2 trials, and smaller-scale trials. Conclusion: Most oncologic clinical trials were conducted in medical institutions located in Seoul, with the rest conducted in the capital area, metropolitan cities, and provincial areas. The findings reveal clear differences in protocol availability between Seoul and the other regions. Measures designed to improve geographical access to oncologic clinical trials may be needed given their growing importance in cancer treatment.
Purpose: Patients with head and neck cancer (HNC) who undergo dental procedures during radiotherapy (RT) face an increased risk of developing osteoradionecrosis (ORN). Accordingly, new tools must be developed to extract critical information regarding the dose delivered to the teeth and mandible. This article proposes a novel approach for visualizing 3-dimensional planned dose distributions on panoramic reconstruction computed tomography (pCT) images. Materials and Methods: Four patients with HNC who underwent volumetric modulated arc therapy were included. One patient experienced ORN and required the extraction of teeth after RT. In the study approach, the dental arch curve (DAC) was defined using an open-source platform. Subsequently, pCT images and dose distributions were generated based on the new coordinate system. All teeth and mandibles were delineated on both the original CT and pCT images. To evaluate the consistency of dose metrics, the Mann-Whitney U test and Student t-test were employed. Results: A total of 61 teeth and 4 mandibles were evaluated. The correlation coefficient between the 2 methods was 0.999, and no statistically significant difference was observed (P>0.05). This method facilitated a straightforward and intuitive understanding of the delivered dose. In 1 patient, ORN corresponded to the region of the root and the gum receiving a high dosage (approximately 70 Gy). Conclusion: The proposed method particularly benefits dentists involved in the management of patients with HNC. It enables the visualization of a 3-dimensional dose distribution in the teeth and mandible on pCT, enhancing the understanding of the dose delivered during RT.
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