Tata Memorial Hospital

About: Tata Memorial Hospital is a healthcare organization based out in Mumbai, India. It is known for research contribution in the topics: Cancer & Breast cancer. The organization has 3187 authors who have published 4636 publications receiving 109143 citations.

Secondary prevention of cervical cancer: ASCO resource-stratified clinical practice guideline

Abstract: PurposeTo provide resource-stratified, evidence-based recommendations on the secondary prevention of cervical cancer globally.MethodsASCO convened a multidisciplinary, multinational panel of oncology, primary care, epidemiology, health economic, cancer control, public health, and patient advocacy experts to produce recommendations reflecting four resource-tiered settings. A review of existing guidelines, a formal consensus-based process, and a modified ADAPTE process to adapt existing guidelines were conducted. Other experts participated in formal consensus.ResultsSeven existing guidelines were identified and reviewed, and adapted recommendations form the evidence base. Four systematic reviews plus cost-effectiveness analyses provided indirect evidence to inform consensus, which resulted in ≥ 75% agreement.RecommendationsHuman papillomavirus (HPV) DNA testing is recommended in all resource settings; visual inspection with acetic acid may be used in basic settings. Recommended age ranges and frequencies by...

Carcinoma of the esophagus in india

Abstract: It is as yet an unrecognised fact in geographic pathology that cancer of the esophagus has the highest incidence in India. An analysis of patient material reveals that 51% of cases are too advanced for any treatment at their initial presentation. The authors present their views regarding the management of cancers of the upper third, the middle third and the lower third of the esophagus (excluding the cervical esophagus). Cancers of the middle segment are the most common and the most debated as regards management. Results of radiotherapy and surgery are presented and compared. Those in whom radiotherapy failed have been analyzed critically, and the authors believe that there is a group of patients which could have been salvaged by timely excision of their growths. Thus, radiotherapy and surgery should have a complementary role in the overall management. Preliminary ideas on the value of preoperative irradiation are presented. The ideal method of preoperative irradiation and the ideal surgical approach are still matters of debate and uncertainty. The management of advanced esophageal cancers by chemotherapy is mentioned; and although the overall prognosis of a patient with esophageal cancer still remains poor, earlier diagnosis, the advent of supervoltage therapy, careful surgery and cautious chemotherapy at the optimum time may help to bring the ultimate survival rate of esophageal cancer patients close to that of patients with other malignancies.

Exercise for the management of cancer-related fatigue in lung cancer: a systematic review.

Abstract: Cancer-related fatigue is a common, persistent and disabling side-effect of the cancer and its treatments. Exercise, once was contraindicated, is now the key non-pharmacological management for cancer-related fatigue. However, the role of exercise in lung cancer cohort is not clear. A computerised database search was undertaken using keyword search in the CENTRAL, PubMed, EMBASE, CINAHL, SPORTDiscus, AMED and Web of Science. Ten relevant articles were reviewed; the evidence on this cohort was found to be limited, warrants further research. However, the available evidence from other than lung cancer groups shows significant beneficial effects of exercises on cancer-related fatigue. Hence, exercises could possibly be used in the management of cancer-related fatigue in this cohort with due caution until more robust evidences are available.

A Randomized Controlled Trial Evaluating the Role of Honey in Reducing Pain Due to Radiation Induced Mucositis in Head and Neck Cancer Patients.

Abstract: Background: There are various drugs tried for relieving pain associated with radiation-induced mucositis. This paper aims to study role of honey in relieving pain due to radiation induced mucositis in head and neck cancer patients receiving concomitant chemoradiation. Materials and Methods: A randomized controlled trial on 78 subjects (40 in test group and 38 in control group) was undertaken to study the analgesic effect of honey, but the analysis of 69 patients was done as nine patients (four in test and five in control group) were lost to follow-up or left treatment in between the study. All patients were advised to do salt-soda and benzydamine mouth gargles, alternatively every 3 hours. Test group patients additionally received 20 ml honey three times a day during the entire course of radiation treatment and 3 months following radiation therapy (RT). Results: Honey significantly reduced the severity of mucositis associated pain and resulted in lesser treatment gaps and a decrease in overall radiotherapy treatment duration. None of the test group and majority of controls (51.5%) had severe pain score during the 7th week of RT. The same pattern was seen in the post-RT period. Mean pain score was significantly different in both groups during all weeks during and upto 6 weeks post-RT (mean score of 3.08 and 6.54 for test and control respectively at 7th week RT, P Conclusion: Honey being a cheap, palatable, and natural medicament can be used for decreasing pain associated with radiation-induced mucositis in cancer patients.

Outcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis.

Abstract: Background The significance of uncommon EGFR mutations in newly diagnosed advanced non-small-cell lung cancer (NSCLC) patients is incompletely known. We aimed to analyze the demographic profile, outcome, and treatment attributes of these patients. Patients and methods We retrospectively surveyed 5,738 advanced NSCLC patients who underwent EGFR testing in our center from 2013 to 2017 by in-house primer probes on real time PCR platform. Descriptive data were accumulated from electronic medical records. Survival plot was calculated using Kaplan-Meier method and compared between groups using log-rank test. Results Out of 1,260 EGFR mutation-positive patients, 83 (6.58%) had uncommon mutations in isolation or in various combinations. Uncommon mutations were more frequent in men, never-smokers, and adenocarcinomas. Overall, exon 18 G719X, exon 20 insertion, exon 20 T790M, exon 20 S768I, and exon 21 (L858R/L861Q) were present in 9.6%, 19.3%, 12%, 3.6%, and 3.6% patients, respectively. Dual mutation positivity was found in 50.6% patients. On classifying patients as per tyrosine kinase inhibitor (TKI) sensitivity, it was found that majority of the patients had a combination TKI sensitive and insensitive mutations. The median duration of follow-up was 13 months. Five patients were lost to follow-up. Median progression-free survival on first line therapy was 6.7 months (95% CI: 4.8-8.5). Median overall survival (OS) of patients who received TKI during the course of their disease was 20.2 months (95% CI: 11.4-28.9). Median overall survival (mOS) of the entire cohort was 15.8 months (95% CI: 10.1-21.5). Among all uncommon mutations, patients with dual mutations did better, with an mOS time of 22.6 months (95% CI: 8.2-37.0, P=0.005). It was observed that TKI sensitive/TKI insensitive dual mutations had a superior OS of 28.2 months (95% CI: 15.2-41.2, P=0.039) as compared to TKI sensitive and TKI insensitive EGFR mutations. Conclusion Uncommon EGFR mutations constitute a heterogeneous group, hence, it is imperative to understand each subgroup more to define optimal treatment.