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Yoon S, Ploss A, Hutzel M, Webb R, Hatfield A, Lee JY, Munshi A, Radney A, McClellan J. Parenting attitudes and behaviors among parents involved with the child welfare system and affected by substance use disorders. Child Abuse Negl 2024; 149:106657. [PMID: 38262180 DOI: 10.1016/j.chiabu.2024.106657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/13/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Co-occurring parental substance use and child maltreatment is a serious concern in the U.S child welfare system. OBJECTIVE The aim of the study was to examine parenting attitudes and practices among parents who participated in Ohio START (Sobriety, Treatment, And Reducing Trauma), a statewide initiative that provides support to families affected by co-occurring parental substance use and child maltreatment. PARTICIPANTS AND SETTING Study 1 involved quantitative data collected from 73 enrolled parents through pre-test and post-test telephone surveys. Study 2 (parent interviews) involved qualitative data collected through in-depth interviews with 34 enrolled parents. METHODS The paired-sample t-test and the McNemar test were conducted in Study 1 and thematic analysis was conducted in Study 2. RESULTS Quantitative analysis indicated significant improvements in parental expectations of children (t = -3.42, p = .001, Cohen's d = -0.40), parent-child family roles (t = -5.74, p < .001, Cohen's d = -0.67), and children's power and independence (t = -3.42, p = .001, Cohen's d = -0.40). Qualitative analysis revealed six themes related to changes in parenting after participation in Ohio START: (1) Being present for children, (2) Engaging in activities with children, (3) Enjoyment in providing care to children, (4) Maintaining employment for financial stability, (5) Better emotion regulation and stress management, and (6) a sense of pride. CONCLUSIONS Our findings demonstrate positive changes in parenting attitudes and practices among parents who participated in Ohio START and provide further support for the potential merits of this model and its continued expansion throughout Ohio.
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Affiliation(s)
- Susan Yoon
- College of Social Work, The Ohio State University, Columbus, OH, USA; Department of Social Welfare, College of Social Sciences, Ewha Womans University, Seoul, South Korea.
| | - Alexa Ploss
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Margaret Hutzel
- Voinovich School of Leadership and Public Service, Ohio University, Athens, OH, USA
| | - Robin Webb
- Voinovich School of Leadership and Public Service, Ohio University, Athens, OH, USA
| | - Ally Hatfield
- Voinovich School of Leadership and Public Service, Ohio University, Athens, OH, USA
| | - Joyce Y Lee
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Additti Munshi
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Angelise Radney
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Jen McClellan
- Public Children Services Association of Ohio (PCSAO), Columbus, OH, USA
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Quinn CR, Johnson S, Jones K, Parekh R, Munshi A, Boyd DT. Social Work and the Next Frontier of Racial Justice: Using COVID-19 as a Vehicle for Healing. Soc Work Public Health 2022; 37:703-718. [PMID: 35656717 DOI: 10.1080/19371918.2022.2084197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has put the United States and the world into a state of uncertainty. Before the onset of the coronavirus, awareness of health disparities across cities in the United States was questionable at best. As the world continues to grapple with the fallout of the pandemic and the response to it, several states and developed and developing countries created and implemented response efforts that were used as a guide, which social workers are most qualified to address but have not been a focus on a national nor international stage. This commentary focuses on two American states - Texas and Ohio as well as other global countries, and their responses that gained worldwide attention related to healthcare accessibility, service provision, and the role social workers should play moving forward and beyond the pandemic.
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Affiliation(s)
- Camille R Quinn
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
| | - Shavonda Johnson
- Ohio Department of Rehabilitation and Correction, Columbus, Ohio, USA
| | - Kristian Jones
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Ravi Parekh
- College of Human Ecology, University of Texas at Austin, Austin, Texas, USA
| | - Additti Munshi
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
| | - Donte T Boyd
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
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Sarkar B, Shahid T, Biswal S, Appunu K, Bhattacharya J, Ghosh T, De A, George K, Mandal S, Roy Chowdhury S, Ganesh T, Munshi A, Mukherjee M, Das A, Soren P, Arjunan M, Chatterjee P, Biswas L, Pradhan A. A Comparative Dose-Escalation Analysis for the Head and Neck Reirradiation Patients with and without Appropriate DICOM Based Dose-Volume Information of Primary Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sarkar B, Munshi A, Ganesh T, Rastogi K, Bansal K, Manikandan A, Mohanti BK, Pradhan A. Personal, Social, Economic and Professional Challenges Faced by Female Radiation Oncologists in South Asia. Clin Oncol (R Coll Radiol) 2021; 34:e81-e82. [PMID: 34810070 DOI: 10.1016/j.clon.2021.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/20/2021] [Accepted: 11/02/2021] [Indexed: 11/03/2022]
Affiliation(s)
- B Sarkar
- Department of Radiotherapy, Apollo Multispeciality Hospitals, Kolkata, India; Department of Physics, GLA University, Mathura, India.
| | - A Munshi
- Department of Radiotherapy, Manipal Hospitals, Dwarka, New Delhi, India
| | - T Ganesh
- Department of Radiotherapy, Manipal Hospitals, Dwarka, New Delhi, India
| | - K Rastogi
- Department of Radiotherapy, Manipal Hospitals, Dwarka, New Delhi, India
| | - K Bansal
- Department of Radiotherapy, Manipal Hospitals, Dwarka, New Delhi, India
| | - A Manikandan
- Department of Medical Physics, Apollo Proton Cancer Center, Chennai, India
| | - B K Mohanti
- Department of Radiotherapy, Manipal Hospitals, Dwarka, New Delhi, India
| | - A Pradhan
- Department of Mathematics, GLA University, Mathura, India
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Sarkar B, Munshi A, Shahid T, Sengupta S, Bhaskar R, Ganesh T, Paul A, Bhattacharjee B, Pun R, Imbulgoda N, Biswal S, Rastogi K, Bansal K, Baba A, Yasmin T, Bhattacharya J, Ghosh T, De A, Chatterjee P, Pradhan A. Growth Characteristics of Woman Radiation Oncologists in South Asia: Assessment of Gender Neutrality and Leadership Position. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mehta V, Chander H, Munshi A. Complex roles of discoidin domain receptor tyrosine kinases in cancer. Clin Transl Oncol 2021; 23:1497-1510. [PMID: 33634432 DOI: 10.1007/s12094-021-02552-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/07/2021] [Indexed: 12/15/2022]
Abstract
Discoidin domain receptors, DDR1 and DDR2 are members of the receptor tyrosine kinase (RTK) family that serves as a non-integrin collagen receptor and were initially identified as critical regulators of embryonic development and cellular homeostasis. In recent years, numerous studies have focused on the role of these receptors in disease development, in particular, cancer where they have been reported to augment ECM remodeling, invasion, drug resistance to facilitate tumor progression and metastasis. Interestingly, accumulating evidence also suggests that DDRs promote apoptosis and suppress tumor progression in various human cancers due to which their functions in cancer remain ill-defined and presents a case of an interesting therapeutic target. The present review has discussed the role of DDRs in tumorigenesis and the metastasis.
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Affiliation(s)
- V Mehta
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151001, India.
| | - H Chander
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151001, India.,National Institute of Biologicals, Sector 62, Noida-201309, India
| | - A Munshi
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151001, India
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Munshi A. Ablative radiosurgery for cardiac arrhythmias - A systematic review. Cancer Radiother 2021; 25:373-379. [PMID: 33589330 DOI: 10.1016/j.canrad.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
Stereotactic body radiotherapy (SBRT) is a high precision technique that is commonly used for malignant lesions in lung, liver, pancreas and spine. Recent reports suggest promise in use of SBRT as a tool in atrial and ventricular cardiac arrhythmias. The present systematic review deals with the use of SBRT technology for this novel indication. A PubMed search was done for articles published between 1990 and 2020. All original articles, case reports, case series of treated patients were included in the analyses. Out of the 55 articles in PubMed search, our search found 1 phase I/II clinical case series, 3 clinical case reports, 3 animal studies and 4 dosimetric studies related to cardiac SBRT for arrythmias. All studies used a uniform cardiac dose of 25Gy. The available preclinical, dosimetric and clinical studies have suggested that SBRT for cardiac arrhythmias could become a potential alternative in suitable patients. Cardiac and radiation oncology community await further data and experience in this modality, including safety and outcomes.
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Affiliation(s)
- A Munshi
- Department of Radiation Oncology, Manipal Hospitals, Dwarka, New Delhi, India.
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Rohatgi N, Munshi A, Bajpai P, Singh M, Sahai S, Ahmad M, Singh K, Singh H, Parikh PM, Aggarwal S. Practical consensus recommendations on Her2 +ve breast cancer with solitary brain mets. South Asian J Cancer 2020; 7:118-122. [PMID: 29721477 PMCID: PMC5909288 DOI: 10.4103/sajc.sajc_116_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Breast cancer is a common cause of brain metastases, with metastases occurring in at least 10-16% of patients. Longer survival of patients with metastatic breast cancer and the use of better imaging techniques are associated with an increased incidence of brain metastases. Current therapies include surgery, whole-brain radiation therapy, stereotactic radiosurgery, chemotherapy and targeted therapies. However, the timing and appropriate use of these therapies is controversial and careful patient selection by using available prognostic tools is extremely important. Expert oncologist discussed on the mode of treatment to extend the OS and improve the quality of life ofHER2-positivebreast cancer patients with Solitary brain metastases. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.
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Affiliation(s)
- Nitesh Rohatgi
- Department of Medical Oncology, Max Hospital, New Delhi, India
| | - A Munshi
- Department of Radiation Oncology, Fortis Hospital, Gurugram, Haryana, India
| | - P Bajpai
- Department of Medical Oncology, Manipal Super Specialty Hospital, New Delhi, India
| | - M Singh
- Department of Medical Oncology, Mahavir Cancer Sansthan, Patna, Bihar, India
| | - S Sahai
- Department of Radiation Oncology, Fortis Hospital, Gurugram, Haryana, India
| | - M Ahmad
- Department of Radiation Oncology, Jolly Grant Himalayan Institute, Dehradoon, Uttarakhand, India
| | - K Singh
- Department of Radiation Oncology, MAMS, New Delhi, India
| | - H Singh
- Department of Radiaton Oncology, Action Balajee Cancer Center, New Delhi, India
| | - Purvish M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
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9
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Rastogi K, Sarkar B, Munshi A, Ganesh T, Bansal K, Pandey V, Mohanti B. Analysis of Medical Tourism of Cancer patients in Asia-Africa-Oceania region and Financial Toxicity due to Migration. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10
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Sarkar B, Munshi A, Shahid T, Ganesh T, Mohanti B, Bansal K, Rastogi K, Chaudhari B, Manikandan A, Biswal S, Bhattacharya J, Ghosh T, De A, Roy Chowdhury S, Mandal S, George K, Mukherjee M, Gazi M, Chauhan R, Chatterjee P. Challenges Faced by Woman Radiation Oncologists (WRO) in South Asia. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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11
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Shahid T, Sarkar B, Mukherjee M, Bhattacharya J, Ghosh T, De A, Munshi A, Ganesh T. Assessment of Unplanned Treatment Interruptions During Modern Day Radiotherapy in a Large Patient Database. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Sarkar B, Rastogi K, Munshi A, Ganesh T, Bansal K, Tiwari S, Tyagi B, Mohanti B. Audit of Financial, Social and Logistic Concerns of Overseas Cancer Patients Treated at Tertiary Care Centers in New Delhi. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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13
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Munshi A, Banjoko O, Neri J. SPONTANEOUS CORONARY ARTERY DISSECTION IN A POSTPARTUM PATIENT WITH SEQUENTIAL VESSEL INVOLVEMENT. Chest 2019. [DOI: 10.1016/j.chest.2019.02.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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Munshi A, Sarkar B, Roy S, Ganesh T, Mohanti B. Dose fall-off patterns with volumetric modulated arc therapy and three-dimensional conformal radiotherapy including the “organ at risk” effect. Experience of linear accelerator-based frameless radiosurgery from a single institution. Cancer Radiother 2019; 23:138-146. [DOI: 10.1016/j.canrad.2018.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/22/2018] [Accepted: 10/02/2018] [Indexed: 12/31/2022]
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15
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Lavoie J, Rigg E, Munshi A, Mehic J, Muradia G, Rosu-Myles M. Characterization of leukemia-derived extracellular vesicles and subsequent effects on mesenchymal stem cell phenotype. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Sarkar B, Ganesh T, Manikandan A, Munshi A, Mohanti B. EP-1922: Standardisation of VMAT frameless SRS/SRT planning using ensemble mapped knowledge based planning. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32231-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Mathew AS, Agarwal JP, Munshi A, Laskar SG, Pramesh CS, Karimundackal G, Jiwnani S, Prabhash K, Noronha V, Joshi A, Rangarajan V, Purandare NC, Jambhekar N, Tandon S, Mahajan A, Kumar R, Deodhar J. A prospective study of telephonic contact and subsequent physical follow-up of radically treated lung cancer patients. Indian J Cancer 2017; 54:241-252. [PMID: 29199699 DOI: 10.4103/0019-509x.219599] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND We tested the hypothesis that telephonic follow-up (FU) may offer a convenient and equivalent alternative to physical FU of radically treated lung cancer patients. DESIGN Prospective study carried out at a tertiary referral cancer care institute, Mumbai. MATERIALS AND METHODS Two hundred consecutive lung cancer patients treated with curative intent were followed up regularly with telephonic interviews paired with their routine physical FU visits. Patient satisfaction with the telephonic call and the physical visit, the anxiety level of the patient after meeting the physician and the economic burden of the visit to the patient were noted in a descriptive manner. Kappa statistics was used to assess concurrence between the telephonic and physical impression of disease status. RESULTS With a median FU duration of 21.5 months, the median satisfaction scores for telephonic and physical FU were 8 and 9, respectively. The prevalence and bias adjusted kappa (PABAK) score of the entire cohort of patients was 0.64 (95% confidence interval [CI] =0.58-0.70). Data analyzed up to first disease progression/relapse on FU had a PABAK score of 0.71 (95% CI = 0.64-0.77) indicating substantial agreement. Patients with disease controlled at the FU had a significant PABAK score of 0.88 (95% CI = 0.80-0.94) indicating excellent concurrence. On average, each patient spent Rs. 5117.10 on travel and Rs. 3079.06 on lodging per FU visit. CONCLUSION Telephonic FU is substantially accurate in assessing disease status until the first relapse. In a resource-constrained country like India, it is worthwhile to further explore the benefits of such an alternative strategy.
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Affiliation(s)
- A S Mathew
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - J P Agarwal
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - A Munshi
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - S G Laskar
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - C S Pramesh
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - G Karimundackal
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - S Jiwnani
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - A Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - V Rangarajan
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - N C Purandare
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - N Jambhekar
- Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - S Tandon
- Department of Pulmonary Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - A Mahajan
- Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - R Kumar
- Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - J Deodhar
- Department of Clinical Psychology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Sarkar B, Munshi A, Manikandan A, Roy S, Ganesh T, Mohanti BK, Pradhan A. A low gradient junction technique of craniospinal irradiation using volumetric-modulated arc therapy and its advantages over the conventional therapy. Cancer Radiother 2017; 22:62-72. [PMID: 29195796 DOI: 10.1016/j.canrad.2017.07.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 06/27/2017] [Accepted: 07/05/2017] [Indexed: 12/16/2022]
Abstract
A technique using volumetric-modulated arc therapy (VMAT) fields for craniospinal irradiation with low dose gradients at the field junction was tested for its sensitivity to positional inaccuracy. It was compared against the conventional three-dimensional (3D) conformal radiotherapy in terms of dose uniformity at the junction. Treatment plans generated for ten patients who received craniospinal irradiation (35Gy in 21 fractions) by VMAT technique at our centre were included in this study. For these patients, 3D conformal radiotherapy plans were also generated in addition to the VMAT treatment plans. Intentional shifting of the cranial field in the superior and then in the inferior directions was done, creating a gap or overlap between the fields. Consequent changes in dose distributions in these two plans to positional inaccuracies were studied. The 3D conformal radiotherapy plans showed large dose variations at the junction due to positional shifts as compared to the VMAT plans. With a 5mm superior shift of the cranial field isocentre creating a gap between the cranial and spinal fields, the magnitudes of under-dosing were 13.9±3.6Gy and 4.8±2.0Gy for 3D conformal radiotherapy and VMAT respectively. When the cranial field was moved by 5mm inferiorly creating an overlap between the fields, overdose to the effects of 10.3±4.0Gy and 4.9±1.3Gy were observed for the 3D conformal radiotherapy plans and VMAT plans respectively. The VMAT technique is insensitive to longitudinal setup errors (1-3mm) in patients because of the existence of low dose gradients at the junction between fields. This is unlike the 3D conformal radiotherapy plans which have steep dose gradients at the field edges and thus are highly sensitive to setup errors. Such an advantage for VMAT circumvents the need for dose feathering often practiced with the 3D conformal radiotherapy technique and makes the technique simpler to follow.
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Affiliation(s)
- B Sarkar
- Radiation oncology, Fortis Memorial Research Institute, 122002 Gurgaon, Haryana, India; Department of Physics, GLA University, Mathura, Uttar Pradesh, India.
| | - A Munshi
- Radiation oncology, Fortis Memorial Research Institute, 122002 Gurgaon, Haryana, India
| | - A Manikandan
- Radiation oncology, NRI Medical College and General Hospital, Guntur, Andhra Pradesh, India
| | - S Roy
- Radiation oncology, Fortis Memorial Research Institute, 122002 Gurgaon, Haryana, India
| | - T Ganesh
- Radiation oncology, Fortis Memorial Research Institute, 122002 Gurgaon, Haryana, India
| | - B K Mohanti
- Radiation oncology, Fortis Memorial Research Institute, 122002 Gurgaon, Haryana, India
| | - A Pradhan
- Department of mathematics, GLA University, Mathura, Uttar Pradesh, India
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Herman T, Andrade D, Mehta M, Griffith J, Jin H, Ahmad S, Algan O, Munshi A. Targeted Inhibition of Rad51 Renders Non–small Cell Lung Cancer Cells More Sensitive to Proton Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Munshi A, Sarkar B, Roy S, Ganesh T, Mohanti B. PV-0135: Short tangential arcs in VMAT based breast and chest wall radiotherapy planning. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30578-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Sarkar B, Manikandan A, Nandy M, Munshi A, Sayan P, Sujatha N. Influence of monte carlo variance with fluence smoothing in VMAT treatment planning with Monaco TPS. Indian J Cancer 2017; 53:158-61. [PMID: 27146769 DOI: 10.4103/0019-509x.180820] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The study aimed to investigate the interplay between Monte Carlo Variance (MCV) and fluence smoothing factor (FSF) in volumetric modulated arc therapy treatment planning by using a sample set of complex treatment planning cases and a X-ray Voxel Monte Carlo-based treatment planning system equipped with tools to tune fluence smoothness as well as MCV. MATERIALS AND METHODS The dosimetric (dose to tumor volume, and organ at risk) and physical characteristic (treatment time, number of segments, and so on) of a set 45 treatment plans for all combinations of 1%, 3%, 5% MCV and 1, 3, 5 FSF were evaluated for five carcinoma esophagus cases under the study. RESULT Increase in FSF reduce the treatment time. Variation of MCV and FSF gives a highest planning target volume (PTV), heart and lung dose variation of 3.6%, 12.8% and 4.3%, respectively. The heart dose variation was highest among all organs at risk. Highest variation of spinal cord dose was 0.6 Gy. CONCLUSION Variation of MCV and FSF influences the organ at risk (OAR) doses significantly but not PTV coverage and dose homogeneity. Variation in FSF causes difference in dosimetric and physical parameters for the treatment plans but variation of MCV does not. MCV 3% or less do not improve the plan quality significantly (physical and clinical) compared with MCV greater than 3%. The use of MCV between 3% and 5% gives similar results as 1% with lesser calculation time. Minimally detected differences in plan quality suggest that the optimum FSF can be set between 3 and 5.
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Affiliation(s)
- B Sarkar
- Department of Radiation Oncology, AMRI Hospitals, Kolkata, India
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Agarwal JP, Hotwani C, Prabhash K, Munshi A, Misra S, Mathew A, Kalyani N, Noronha V, Laskar SG, Joshi A, Purandare N, Tandon S, Sharma V. Optimizing treatment and analysis of prognostic factors for locally advanced nonsmall cell lung cancer in resource-limited population. Indian J Cancer 2017; 53:96-101. [PMID: 27146753 DOI: 10.4103/0019-509x.180810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Lung cancer most commonly presents in advanced stages in developing countries, where combined modality treatment using chemo-radiotherapy (CTRT) is the standard of care. MATERIALS AND METHODS A retrospective audit of patients of nonsmall cell lung cancer (NSCLC) treated at a single Institute from January 2008 to December 2012 was conducted. Various prognostic factors affecting disease-free survival (DFS) and overall survival (OS) were studied by univariate and multivariate analysis. All patients were meticulously followed-up clinically and telephonic contacts. RESULTS Overall 171 patients of NSCLC were treated with definitive CTRT using concurrent chemotherapy in 66% patients and sequential therapy in 28% patients. The actuarial 2 years DFS was 17.5% and 2 years OS was 61.5%. Complete response to treatment resulted in significantly better DFS and OS. Definitive CTRT was very well-tolerated in these patients with good compliance. CONCLUSION Definitive CTRT, sequence being individualized depending on performance status and disease stage at presentation, is a feasible and effective treatment modality for locally advanced NSCLC patients in the developing world. Response to treatment is an important prognostic factor for treatment outcomes.
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Affiliation(s)
- J P Agarwal
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Agarwal JP, Hotwani C, Prabhash K, Munshi A, Joshi A, Misra S, Kumar D, Das S, Laskar SG. Palliative thoracic radiotherapy in advanced lung cancer: A single institution experience. Indian J Cancer 2017; 54:262-266. [DOI: 10.4103/0019-509x.219587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sarkar B, Manikandan A, Jassal K, Ganesh T, Munshi A, Mohanti B, Pradhan A. SU-F-J-126: Influence of Six Dimensional Motions in Frameless Stereotactic Dosimetry Incorporating Rotational Shifts as Equivalent Translational Shifts: A Feasibility Study for Elekta-BrainLAB Stereotactic System. Med Phys 2016. [DOI: 10.1118/1.4956034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Giri U, Ganesh T, Saini V, Munshi A, Sarkar B, Mohanti B. SU-F-J-47: Inherent Uncertainty in the Positional Shifts Determined by a Volumetric Cone Beam Imaging System. Med Phys 2016. [DOI: 10.1118/1.4955955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ganesh T, Sarkar B, Munshi A, Mohanti B. SU-F-T-429: Craniospinal Irradiation by VMAT Technique: Impact of FFF Beam and High Resolution MLC On Plan Quality. Med Phys 2016. [DOI: 10.1118/1.4956614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kaur H, Kumar S, Sarkar B, Ganesh T, Giri U, Jassal K, Rathinamuthu S, Gulia G, Gopal V, Mohanti B, Munshi A. SU-F-T-327: Total Body Irradiation In-Vivo Dose Measurements Using Optically Stimulated Luminescence (OSL) NanoDots and Farmer Type Ion Chamber. Med Phys 2016. [DOI: 10.1118/1.4956512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Giri U, Sarkar B, Kaur H, Ganesh T, Munshi A, Mohanti B. SU-F-T-414: Mathematical Formulation of Gantry Starting Angle for Right Medial Tangential Arc in Left Intact Partial Breast Irradiation Using Volumetric Modulated Arc Therapy (VMAT). Med Phys 2016. [DOI: 10.1118/1.4956599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Giri U, Sarkar B, Munshi A, Kaur H, Jassal K, Rathinamuthu S, Kumar S, Ganesh T, Mohanti B. SU-F-T-422: Detection of Optimal Tangential Partial Arc Span for VMAT Planning in IntactLeft-Breast Treatment. Med Phys 2016. [DOI: 10.1118/1.4956607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Jassal K, Sarkar B, Ganesh T, Kaur H, Giri U, Mohanti B, Munshi A. SU-F-T-343: Dosimetric Investigation for Fluence Smoothing On VMAT Plans in Monaco for Head - Neck Cancers. Med Phys 2016. [DOI: 10.1118/1.4956528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kumar S, Sarkar B, Kaur H, Rathinamuthu S, Giri U, Jassal K, Ganesh T, Munshi A, Mohanti B, Krishnankutty S, Sathiya J. SU-F-P-50: Performance Evaluation of Optically Stimulated Luminescence (OSL) NanoDots in Therapy and Imaging In-Vivo Dose Measurement During Patient Treatment. Med Phys 2016. [DOI: 10.1118/1.4955757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Rathod S, Munshi A, Agarwal JP. Practice of stereotactic body radiotherapy in a developing country: Perception, aspiration, and limitation - A survey. Indian J Cancer 2016; 53:135-7. [PMID: 27146763 DOI: 10.4103/0019-509x.180864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Stereotactic body radiotherapy (SBRT) is an effective and established modern technology now used more commonly. Radiation oncology personnel's (ROP) opinion toward SBRT in the developing countries like India is unknown. SUBJECTS AND METHODS A 30 question survey evaluating ROP's profile, technological details, and SBRT's perceptive were seeked. Tata Memorial Center - ROP's email database was used. RESULTS Survey questionnaire was emailed to 500 ROP's and 224 ROP's were contactable. Majority of the responders were from corporate hospitals and half of responders had experience of 5 or more years of experience in radiation oncology. SBRT was practiced by 70% of responders and the majority had adopted SBRT in 2010 or later. Quick turn around time, high dose delivery and competitive market forces were major factors to adopt SBRT. Lung was the most common site practiced followed by prostate, spine, and liver. All SBRT users were keen to increase SBRT in practice and the majority of non-responders were planning to adapt SBRT in the recent future. Almost half of SBRT users were willing to share data and expertise for training others. Lack of infrastructure was the prime reason for not practicing SBRT. ROP's perceived physics, radiobiology as the biggest challenge in SBRT. International collaboration may be helpful. CONCLUSION Use of SBRT is expected to increase in India. Limited experience with lack of infrastructure in public funded centers is a major limitation. Unmet need of infrastructure, training and guidelines is enormous and formulation of Indian SBRT consortium will help reforming at all levels.
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Affiliation(s)
| | | | - J P Agarwal
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, India
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Munshi A, Sarkar B, Roy S, Ganesh T, Mohanti B. EP-1667: Dose fall off patterns and the OAR effect - experience of Linac based frameless radiosurgery. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32918-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sarkar B, Pradhan A, Munshi A, Roy S, Ganesh T, Mohanti B. EP-1685: Influence of flat, flattening filter free beam model and different MLC’s on VMAT based SRS/SRT. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32936-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sarkar B, Pradhan A, Munshi A. Do technological advances in linear accelerators improve dosimetric outcomes in stereotaxy? A head-on comparison of seven linear accelerators using volumetric modulated arc therapy-based stereotactic planning. Indian J Cancer 2016; 53:166-73. [DOI: 10.4103/0019-509x.180815] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mathew A, Agarwal J, Munshi A, Laskar S, Pramesh C, Prabhash K, Karimundackal G, Noronha V, Tandon S, Jambhekar N, Dikshit R. A Prospective Study of Telephonic Contact and Subsequent Physical Follow-up of Radically Treated Lung Cancer Patients. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Batchelder A, Hunter J, Cairns V, Sandford R, Munshi A, Naylor A. Dual Antiplatelet Therapy Prior to Expedited Carotid Surgery Reduces Recurrent Events Prior to Surgery without Significantly Increasing Peri-operative Bleeding Complications. Eur J Vasc Endovasc Surg 2015; 50:412-9. [DOI: 10.1016/j.ejvs.2015.07.019] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 07/05/2015] [Indexed: 11/28/2022]
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Jassal K, Sarkar B, Mohanti B, Roy S, Ganesh T, Munshi A, Chougule A, Sachdev K. SU-E-T-77: A Statistical Approach to Manage Quality for Pre-Treatment Verification in IMRT/VMAT. Med Phys 2015. [DOI: 10.1118/1.4924438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Sarkar B, Roy S, Munshi A, Pradhan A. SU-E-T-583: Operated Left Breast and Chest Wall Radiotherapy: A Dosimetric Comparison Between 3DCRT,IMRT and VMAT. Med Phys 2015. [DOI: 10.1118/1.4924945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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40
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Biplab S, Soumya R, Paul S, Jassal K, Munshi A, Giri U, Kumar V, Roy S, Ganesh T, Mohanti B. SU-E-T-190: First Integration of Steriotactic Radiotherapy Planning System Iplan with Elekta Linear Accelerator. Med Phys 2014. [DOI: 10.1118/1.4888520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ganesh T, Paul S, Munshi A, Sarkar B, Krishnankutty S, Sathya J, George S, Jassal K, Roy S, Mohanti B. SU-E-J-39: Comparison of PTV Margins Determined by In-Room Stereoscopic Image Guidance and by On-Board Cone Beam Computed Tomography Technique for Brain Radiotherapy Patients. Med Phys 2014. [DOI: 10.1118/1.4888091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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42
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Sarkar B, Roy S, Paul S, Munshi A, Roy S, Jassal K, Ganesh T, Mohanti BK. SU-E-T-226: Junction Free Craniospinal Irradiation in Linear Accelerator Using Volumetric Modulated Arc Therapy : A Novel Technique Using Dose Tapering. Med Phys 2014. [DOI: 10.1118/1.4888556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kundu S, Mathew A, Munshi A, Prabhash K, Pramesh CS, Agarwal JP. Stereotactic body radiotherapy in early stage non-small cell lung cancer: first experience from an Indian Centre. Indian J Cancer 2014; 50:227-32. [PMID: 24061463 DOI: 10.4103/0019-509x.118739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Surgery is the standard of care for early stage (T1-2, N0, M0) non-small cell lung cancer. A considerable number of these patients are ineligible for surgery due to age and comorbidities. Hypo fractionated high-dose stereotactic body radiotherapy (SBRT) is being performed for these group of patients. There is paucity of literature regarding this novel technique from the Indian subcontinent. AIMS AND OBJECTIVES We hereby report the dosimetry, response and outcome of our small cohort of early stage non-small cell lung cancer patients treated with SBRT. MATERIALS AND METHODS Between December 2007 and December 2010, 8 patients of early stage (T1-2N0M0) underwent SBRT at our centre. All the patients had undergone whole body PET-CT scan, MRI brain and pulmonary function test (PFT with DLCO). The SBRT schedules included 48 Gy in 6 fractions for peripherally located and 48 Gy in 8 fractions for centrally located tumors. Response and toxicity were assessed in 3 monthly follow up visits. RESULTS The median duration of follow up was 18 months (range 8-44 months). The median age of the patients was 70 years (range 63-82 years) and the median tumor diameter was 4 cm (range 2.8-5.0 cm). The mean PTV volume was 165 cc(range 127.3- 193.9 cc). The mean dose to the PTV was 99.5% (range 97.7- 102.1%). After 3 months, 7 patients had complete metabolic response and 1 patient had partial metabolic response. Overall survival at 1.5 years was 87.5%. One patient had grade 2 pneumonitis. No toxicities of grade 3 or higher were identified. CONCLUSION SBRT for early stage NSCLC resulted in excellent local control with minimal toxicity and can be considered as a treatment option in properly selected patients.
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Affiliation(s)
- S Kundu
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Paul S, Sarkar B, Ganesh T, Munshi A, Kumar R, Mohanti B. EP-1641: PTV margin calculation and time dependency monitoring of intrafraction isocenter movement in lung SBRT by ExacTrac. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31759-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Parikh PM, Gupta S, Dawood S, Rugo H, Bhattacharyya GS, Agarwal A, Chacko R, Sahoo TP, Babu G, Agarwal S, Munshi A, Goswami C, Smruti BK, Bondarde S, Desai C, Rajappa S, Somani N, Singh M, Nimmagadda R, Pavitran K, Mehta A, Parmar V, Desai S, Nair R, Doval D. ICON 2013: Practical consensus recommendations for hormone receptor-positive Her2-negative advanced or metastatic breastcancer. Indian J Cancer 2014; 51:73-9. [DOI: 10.4103/0019-509x.134650] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Srivastava R, Sharma PK, Sharma P, Munshi A, Chomal M, Laishram S, Saini G. SU-E-J-217: To Determine the Gross Tumor Volume with CT Scan in End Expiration, Inspiration and All Phases of Respiration in Carcinoma Lung Patients. Med Phys 2013. [DOI: 10.1118/1.4814429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Hotwani C, Munshi A, Dangwal D, Ghosh Laskar S, Prabhash K, Joshi A, Agrawal J. EP-1033: Retrospective audit of patients of advanced lung cancer treated with palliative radiotherapy. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33339-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Noronha V, Dikshit R, Raut N, Joshi A, Pramesh CS, George K, Agarwal JP, Munshi A, Prabhash K. Epidemiology of lung cancer in India: focus on the differences between non-smokers and smokers: a single-centre experience. Indian J Cancer 2012; 49:74-81. [PMID: 22842172 DOI: 10.4103/0019-509x.98925] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
CONTEXT Lung cancer has varied epidemiology depending on the geographic region. Globally, there have been important changes in incidence trends amongst men and women, histology, and incidence in non-smokers. Indian epidemiological data on lung cancer is scarce. AIMS We set out to study the epidemiological patterns and clinical profile of lung cancer in India. MATERIALS AND METHODS We interviewed patients discussed in the thoracic oncology multidisciplinary meetings between 2008 and 2009. Demographic data, smoking history, place of residence, histology, stage at presentation, and treatment details were collected. Data was entered and analyzed in SPSS. RESULTS There were 489 patients, with a median age of 56 years, of which 255 (52%) were non-smokers and 234 (48%) were smokers. One hundred and thirty-three patients had consumed smokeless tobacco. The male-to-female ratio was 3.5:1. Sixty-nine patients (14.1%) were incorrectly diagnosed and treated with anti-tuberculosis treatment, which delayed the diagnosis of lung cancer by four months. Eight percent of patients had small-cell carcinoma; of the 92% patients with non-small-cell carcinoma (NSCLC), the most common histology was adenocarcinoma (43.8%), followed by squamous cell (26.2%), large cell (2.1%) and other (8.3%). Eighteen percent of patients were diagnosed by cytology, therefore were diagnosed as NSCLC, without further histologic subtyping. Most patients (43%) were in Stage III at presentation. Lung followed by bone were the common sites of metastases. The majority of the patients (49%) received palliative chemotherapy. Among definitive therapy, concurrent chemo-radiation (13%) was offered more frequently than surgery (6%). CONCLUSION Considerably higher numbers of Indian patients with lung cancer are non-smokers, compared to the West. The global trend of rise in adenocarcinoma is paralleled in India. Non-tobacco-related risk factors need further investigation.
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Affiliation(s)
- V Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India
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Almoallim H, Aldahlawi S, Alqahtani E, Alqurashi S, Munshi A. Difficulties facing first-year medical students at Umm Alqura University in Saudi Arabia. East Mediterr Health J 2012; 16:1272-7. [PMID: 24988403 DOI: 10.26719/2010.16.12.1272] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 06/17/2009] [Indexed: 11/09/2022]
Abstract
This study investigated medical students' study habits and perceptions of learning difficulties during their first year of study. A specially-designed questionnaire was answered by 165 second-year medical and medical science students at Umm Alqura University in Saudi Arabia. Out of the 7 difficulties listed in the questionnaire, students ranked peer competition first, followed by poor English language skills. Male students ranked peer competition as the top difficulty whereas females ranked it fourth. A majority of students were dissatisfied with the passive, lecture-based method of teaching and wanted the English language curriculum to be improved by more emphasis on conversation skills. Early introduction of the concept of active learning and effective studying habits is needed.
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Affiliation(s)
- H Almoallim
- Department of Medicine, Medical College, Umm Alqura University, Saudi Arabia; Department of Medicine, King Faisal Specialist Hospital, Jedda, Saudi Arabia
| | - S Aldahlawi
- Department of Dentistry, International Medical Center, Jedda, Saudi Arabia
| | - E Alqahtani
- Department of Radiology, National Guard Hospital. Jedda, Saudi Arabia
| | - S Alqurashi
- Department of Internal Medicine, Al-Hada Armed Forces Hospital, Taif, Saudi Arabia
| | - A Munshi
- Department of Family Medicine, National Guard Hospital. Jedda, Saudi Arabia
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