Asian Pacific Journal of Cancer Care

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EISSN : 2588-3682
Published by: EpiSmart Science Vector Ltd (10.31557)
Total articles ≅ 252
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Ymty Wijeratne, Hdkc Hapuachchige, S Kannangara
Asian Pacific Journal of Cancer Care, Volume 7, pp 409-413;

Vaginal melanomas are extremely rare gynaecological malignancy with aggressive behavior resulting in poor outcome. The aetiology is not well understood so far. There is no standardized treatment owing to the extreme rarity of the disease, however surgical excision with adjuvant radiotherapy has been the widely practiced treatment. The role of lymphadenectomy is controversial. The six cases reported between November 2015 to November 2021 at the National cancer institute Sri Lanka were treated primarily by surgical excision including hysterocolpectomy, colpectomy, and wide local excision. Pelvic lymphadenectomy was not done in most cases. Only one patient has received adjuvant radiotherapy. Only one patient died during the follow-up and 2 had recurrences.
, Ashwin Thovarayi, Pritanjali Singh, Rakesh Ranjan, Rohit Saini, Arkaprava Sinha, Arijit Saha
Asian Pacific Journal of Cancer Care, Volume 7, pp 431-433;

Globally, head and neck cancer is estimated to occur in more than 700,000 patients a year and cause 400,000 deaths and second most common cancer in India among both sexes and all ages. Even after optimal treatment for primary cancer, there are cases where second primary cancers develop around the previously treated areas. This occurrence is explained by the concept of field cancerization, which refers to a term where a carcinogen such as tobacco when chewed, exposes the mucosa to the carcinogen starting from the oral cavity to the upper aerodigestive tract. Combinations of two primary malignancies are seen in around 3% to 5% of patients, combinations of three cancers in about 0.5%, and combinations of four malignant tumors in about 0.3% of patients with a previous history of cancer. Early diagnosis and detection of these cancers are necessary for optimal treatment as with each occurrence the tolerability and the response rates gets poorer.
Sherin James, , Vipin Gopinath, Sangeetha K Nayanar
Asian Pacific Journal of Cancer Care, Volume 7, pp 415-419;

Introduction: Collision tumours (CT) of the thyroid refer to the coexistence of two or more independent, histologically distinct malignant tumours. Though the presence of multifocal differentiated thyroid carcinomas is common, it is extremely rare for the thyroid to harbour more than one type of malignancy simultaneously. Methods: An extensive literature search of PubMed databases identified very few cases indicating the tumour rarity. To the best of our knowledge, this is the first documentation of a case series including various combinations of CT in the thyroid. Our main aim is to explore the phenotypic characteristics of CT in the thyroid with an aim of revealing unique features associated with this rare entity. Results: Of a total of 138 thyroid cancers treated during the eight-year period, five (3.62%) were diagnosed as CT. All were females with a median age of 50 years. Papillary Thyroid Carcinoma (PTC) was the major component (80%) in collision with medullary (MC), follicular, and hurthle cell carcinomas. Both cases with papillary microcarcinoma showed vascular emboli and patients with a combination of MC and PTC had nodal metastasis. 80% of patients had a survival of more than 2.5 years and are alive without disease at present. Our study showed features like female predominance and PTC as the most common component with good overall survival. Metastatic and survival rates were consistent with matched singleton pathology. Conclusion: Insight into the genomic and proteomic pathways of this entity is the need of the hour.
, Madhu Narayan, Krishnan Rajkumar, V Vasanthi
Asian Pacific Journal of Cancer Care, Volume 7, pp 357-362;

Introduction: Intermediate filament and its prime role in the cytoskeleton involved in maintaining cell morphology, and is mainly observed in epithelial cells called as Cytokeratin. CKAE1/AE3 is a combination of two different clones of anti-CK monoclonal antibodies, a single reagent can be obtained with broad spectrum reactivity to high molecular weight and low molecular weight CK which can be used in different types of cancers or lesions. Aim: To compare the expression of the CK-AE1/AE3 in oral squamous cell carcinoma (OSCC) and potentially malignant oral disorders (PMOD) through immunohistochemical method through a systematic review process. Materials and Methods: Articles or original studies related to the use of IHC marker AE1/AE3 in OSCC, malignant tumors and PMODs were selected for systematic review process. PUBMED and GOOGLE SCHOLAR were the search engines used for collection of articles. Keywords used were PAN CK [AE1/AE3], SCC, OSCC, PMOD. Articles included based on PRISMA guidelines. Results: A total article based on search strategy identified 492 suitable abstracts; 474 did not meet the eligibility criteria. Full text articles were obtained for 18 articles. Six articles were excluded from the study for various reasons like case reports, reviews and letters to editors and any article published in languages other than English were also excluded. Finally, after considering all the inclusion and exclusion criteria, a total of 12 articles were included in the study. Considering all these articles, comparing the expression of pan-cytokeratin [ae1/ae3] in oral squamous cell carcinoma and potential malignant oral disorders.
Asian Pacific Journal of Cancer Care, Volume 7, pp 285-293;

Introduction: Chemotherapy-induced severe neutropenia requires dose reduction, delay in treatment, or discontinuation, and induces neutropenic complications resulting in poor outcomes and increased healthcare costs. This study aims to identify the risk factors for chemotherapy-induced severe neutropenia and outcome in advanced-stage NSCLC. Method: From July 2014-January 2019, advanced-stage NSCLC who received chemotherapy were retrospectively analyzed. Demographic and risk factors data were collected from the electronic medical record system. Univariate and multivariate logistic regression analyses were performed to identify risk factors for severe neutropenia. Survival curves were estimated using the Kaplan–Meier method. Results: Among 259 patients, 37 (14.28%) and 3 patients (1.2%) developed severe neutropenia and febrile neutropenia respectively. In multivariate analysis, restriction of protein diet (OR 9.54; 95%CI 2.44-37.24; P=0.001), concomitant use herbal medicine (OR 8.66; 95% CI 1.04-72.07; P=0.045), high BMI (OR3.1; 95% CI 1.07-8.99; P=0.04), renal disease (OR 3.9; 95% CI 1.7-8.91; P=0.001), number of cycle chemotherapy > 4 (OR 3.97; 95% CI 1.11-14.18; P=0.03) were significant predictors of Chemotherapy-induced severe neutropenia. No difference in response rate, progression-free survival and overall survival among groups (RR 18.9% vs 26.7%; median PFS; 9.6 vs 8.2 months, P=0.32 and median OS 13.8 vs 16.7 months, P=0.79 in severe and non-severe neutropenia respectively).Conclusions: The present study indicates that protein-restricted diet, concomitant use of herbal medicine, BMI ≥ 25 kg/m2, renal disease, and more than 4 cycles of chemotherapy are significant risk factors for chemotherapy-induced severe neutropenia. Therefore, patients with these risk factors should be more carefully monitored.
Selvaluxmy Ganesarajah, Vasanth Cristopher Jayapaul, , Vengada Krishnan
Asian Pacific Journal of Cancer Care, Volume 7, pp 279-284;

Background: The incidence of renal failure in carcinoma cervix ranges from 14% to 44·2%. The interventional strategies like ureteric stenting and percutaneous nephrostomy can be considered to improve renal function. The primary objective of our study is to analyze the impact of hydroureteronephrosis [HUN] in the outcome of cervical cancer patients treated with radical radiation. The secondary objective is to analyze the role of ureteric stenting to protect the renal function while proceeding with radical radiation. Methods: In this retrospective study, all patients with stage IIIB cervical cancer treated with radical radiation therapy at our institution from January 2010 to December 2019 were included. Results: Among the total 483 stage IIIB patients, 146 patients [30·22%] had hydronephrosis.Thirty eight [26·02%] out of 146 patients with HUN underwent ureteric stenting. The five year overall survival [OS] was 61·4 ± 0·04 % and on subset analysis, overallsurvival was 65·7 ± 0·05 % for patients without HUN and 50·6 ± 0·06 % for patientswith HUN. [P value 1·1 mg/dL have benefitted more from stenting. In this high risk subgroup, the one year overall survival was 65·2 ± 0·11 % and 42·4 ±0·13 % for patients with and without stenting. [p value 0·07]. No major stent related morbidity occurred. Conclusions: Hydronephrosis in cervical cancer patients indicates bad prognosis which results in decreased survival. The presence of hydronephrosis should be redesignated as a separate substage, IIIB2 in future FIGO updates, for better prognostication and treatment recommendations. The relief of obstructive uropathy should be sought out inpatients with serum creatinine levels > 1·1 mg/dL or bilateral hydronephrosis before theinitiation of oncological treatment.
, Saloni Chawla, Achyut Koirala, Uddhav Dhakal, Ramanand Shah
Asian Pacific Journal of Cancer Care, Volume 7, pp 273-278;

The majority of cancer patients will require radiotherapy at some time during their illness, either for curative or palliative purposes, making it an important part of a multidisciplinary cancer treatment approach. External beam radiotherapy and brachytherapy are two methods of administering radiation to the tumor location. Cobalt tele source, Linear accelerator, and Tomotherapy are examples of external beam radiotherapy equipment; similarly, after loading brachytherapy unit is an example of brachytherapy equipment. Because these units generate radiation, a specific site design is required to guarantee that radiation leakage is kept to a minimum. Linear accelerator and Brachytherapy devices are housed in specialized chambers known as “Bunkers.” The engineering of these bunkers is still a difficulty. The layout of the radiation department is designed in such a way that it will smooth the day-to-day operations and maximize the efficiency of the working crew. The general considerations, location, and layout of different rooms built for the LINAC and brachytherapy unit at CMC, Bharatpur, Nepal are discussed in this study.
Sharathbabu N Manjunath, , Malay S. Sarkar, Satinder S. Kaushal
Asian Pacific Journal of Cancer Care, Volume 7, pp 239-246;

Background: Primary lung cancers in India were reported to be rare in earlier studies. But the trend is changing and there is increased incidence of lung cancers. Aims and Objectives: This present descriptive observational study was conducted to report the risk factor profile of the lung cancer patients from the Himalayan state of the Indian population. Materials and Methods: This descriptive epidemiological study was conducted from a single centre, in a prospective observational design, among the patients who were diagnosed as carcinoma lung histologically or cytologically over a period of one year in a tertiary care referral centre in the Himalayan state of the Northern India. The patients data was collected in detailed manner pertaining to age, sex, residence and occupation, questionnaires regarding risk factors like smoking history, Environmental tobacco smoke exposure, Indoor pollution, Alcohol history, HIV infection, Structural lung disease, Religion and Geography. Results: One hundred and one consecutive patients of primary lung cancer were recruited in the study which was confirmed either cytologically or histopathologically. Out of 101 patients, 79 (78.2%) were males and 22 (21.8%) were females, mean age was 62.65 years, 97 (96%) patients had rural background and 4 (4%) patients had urban background, 96 (95.04%) patients were active smokers, 3 (2.9%) were passive smokers and non smokers were 2 (1.9%), 25 (24.8%) were vegetarians and 76 (75.2%) were non vegetarians. 36 patients (35.6%) were from altitude of 0-1000 meters, 41 patients (40.6%) were from altitude of 1001-2000 meters, 21.8% were from altitude of 2001-3000 meters and 2% were from altitude of 3001-4000 meters. Adenocarcinoma was the most common type at all altitudes. Conclusions: Awareness about carcinoma lung in the Himalayan state especially in rural population is still lacking and are presenting at an advanced stage, which largely impact on survival of the patients. This study provides the data pertaining to risk factor profile of the lung cancer patients from the Himalayan state and can be utilised for future comparison with other Indian studies, to educate the community and to spread the awareness of the prevailing lung cancer risk factors.
, Fadekemi O. Gabriel-Raji, Salimat A. Yusuf-Awesu, Rukayat O. Salawu-Giwa, Oluwaseun E. Familusi
Asian Pacific Journal of Cancer Care, Volume 7, pp 219-230;

Background: The burden of HPV infection and its diseases is very high in Sub-Saharan Africa and unfortunately many vulnerable women in this region have little or no knowledge about the infection and its diseases. Bearing in mind the vital role knowledge plays in disease prevention and control, our study aimed to assess women’s knowledge about relevant aspects of human papillomavirus (HPV) infection & its related diseases and to predict the factors that influence their knowledge. Material and methods: A cross-sectional study conducted among 500 women attending a tertiary health institution in Nigeria using a self-administered structured questionnaire to assess knowledge about HPV infection, its related diseases and associated risk factors. Knowledge scores were derived, participants were categorized into having either good or poor knowledge and factors associated with good knowledge were assessed. Data was analyzed was using Statistical Package for Social Sciences version 23.0. Results: The knowledge of HPV infection & its diseases was poor with only 26.3% (123/468) of participants having good level of knowledge. Worse still, only 21.4% believed that they were at risk of acquiring the infection. Tertiary education (AOR=2.40, CI=1.30-4.44, P=0.005), low parity (AOR=4.22, CI=1.40-12.66, P=0.011), and having electronic media (AOR=6.06, CI=2.86-12.9, P<0.001), print media (AOR=4.00, CI=1.21-13.16, P=0.023), healthcare professionals (HCP) (AOR=6.30, CI=3.56-11.11, P<0.001) and organized program (AOR=13.16, CI=5.08-34.48, P<0.001) as primary sources of information significantly predicted good knowledge of HPV infection & its related diseases. Conclusion: Knowledge of HPV infection and its related diseases is very low among Nigerian women in our study. Tertiary education, low parity and having electronic media, print media, HCP and organized health programs as primary sources of information significantly predicted of good knowledge. Health education through these information channels may help to bridge the gap in knowledge and improve public knowledge about HPV and its related diseases.
Geetha Muttath, Greeshma Keloth Erakkotan, Anjana Jayaraj, Suja Cheruliyil Ayyappan, Arun Kumar. E.S, Vinin Narayanan, Joneetha Jones, Arun. P. Narendran, Nabeel Yahiya, Akhil. P. Suresh, et al.
Asian Pacific Journal of Cancer Care, Volume 7, pp 207-211;

Introduction: Lung is a major organ at risk during Post Mastectomy RadioTherapy (PMRT), because of the risk of Radiation Pneumonitis (RP). In countries like India 2D RT is widely used due to limited access to advanced technologies. We estimated the lung dose volumetrically in breast cancer patients treated with 2D tangential techniques, the incidence of acute RP and its association with lung dose. Methodology: Retrospective study of patients who underwent PMRT was done. The images with structure sets of cases planned using 2D technique were transferred to TPS and 3 D plans were generated. CLD, MLD, LL were measured from the 2D plan in the CT simulator. LDmean and V20 were measured from from DVH, in the TPS. Correlation between V20 and LDmean was done with CLD, MLD and LL. The incidence of radiation pneumonitis and its association with lung dose also was studied. Result: Total 50 patients were analyzed of which 3 patients had radiation pneumonitis. The mean CLD was 2.28 cm ± 0.54cm, MLD was 2.32 ± 0.6cm and LL was 12.52 ±2cm. V20 for two fields (MT+LT) was 17.04 ± 5.6 Gy and for three field (MT,LT and SCF) was 28.75 ± 8.6 Gy. Positive correlation was found between for V20 & LDmean and CLD, MLD & LL (p<0.05) 6% of patients developed Radiation pneumonitis but did not have association with V20 or MLD. Conclusion: Radiation pneumonitis is major concern after chest wall irradiation and the incidence is expected to be high with conventional technique where the volume is not accurately measured. It is still an option in countries like India with resource constraints by planning cautiously with the indicators of irradiated lung, like CLD and MLD within limits thus minimizing the incidence of radiation induced lung injury.
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