Bangladesh Oncology Journal

Pattern of Malignancies among the Patients Attending the 44 Department of Radiotherapy, Chittagong Medical College Hospital in the Year 2007

MA Awal

This retrospective study was done in department of radiotherapy Chittagong Medical College Hospital from 1st January 2007 to 31st December 2007.A total of 2958 patients suffering from cancer had attended the radiotherapy out-patient department ,and among them 1527 (51.62%) were male and 1431 (48.38%) female, with a male/female ratio of 1.06:1.

Patients of 6th decades (23.77%) and 7th decade (22.51%) were the main victims followed by 5th decade (20.82%).

Among the male, the leading cancers were lung (19.84%), followed by larynx (9.43%), oral cavity (7.92%), esophagus (7.33%), stomach (6.74%) etc.

Among the female, breast cancer (15.58%) ranked the topmost position, followed by cervix uteri (11.46%), ovary (6.70%), larynx (6.70%), oral cavity (5.66%), esophagus (5.59%).

Among pediatric age group, commonest malignancies were NHL (23.34%), followed by bone tumor (22.22%), retinoblastoma (20.00%).

(Bang. Onc. J. 2009; 4 (2) : 44-50)

Management of Non Small Cell Lung Cancer (NSCL) in Different 51 Clinical Situations

Kazi Manzur Kader

This study was done in the period of January 2007 to December 2007, among the Oncologists working in different hospitals of Dhaka city.

The oncologists were interviewed with a set questionnaires regarding Non Small Cell Lung carcinoma in different clinical stages. The total number of respondent was thirty.

It was found from the study that 50% (15) of oncologist recommended post operative radiotherapy and 40% (12) both chemo and radiotherapy in T₂ N₁ M₀ stage of post pneumonectomy patients. 80% (24) oncologist preferred both chemo-radiotherapy in T₂ N₃ M₀ stage.

Key Words: Non small cell lung carcinoma, attitude and practice of Bangladeshi Oncologist

(Bang. Onc. J. 2009; 4 (2) : 51-53)

Low Risk Group Gestational Trophoblastic Diseases - A Study of 40 Cases

Md Mokhles Uddin

This prospective study was done over 40 patients suffering from low risk gestational trophoblastic diseases (GTD) from January 2002 to December 2008 in the department of Radiotherapy , Dhaka Medical College Hospital and Mitford Hospital. They aged between 18 and 45 years, mean age 26.72 years with peak occurrence (70%) in the 3rd decade (21- 30 Years). Among the 40 cases, one belonged to FIGO score- 1, eight to FIGO score-2, twenty to score-3 and 11 to score- 4. Only eight patient presented with beta-hCG above 100000u/ml.

All the patients were planned for two weekly chemotherapy with methotrexate and leucovorin (methotrexate - 1mg/kg IV/IM on day 1,3,5,7 and oral leucovorin -0.1mg/kg on day 2,4,6,8) and were continued until beta-hCG level comes down to normal range. Then another three cycles of same chemotherapy were given. Two patients dropped during the course of chemotherapy.

Chemotherapy schedule was changed to five drug regimen, EMA-CO schedule (etoposide-100mg/m² on day-1&2, methotrexate-100mg/m² IV bolus and 200mg/m² IV drip day-1, actinomycin-D- 0.5mg/m² IV day-1&2, cyclophosphamide-600mg/m² day-8 and vincristine-1mg/ m² IV day-8) due to increase in beta-hCG titre during chemotherapy with methotrexate and leucovorin. Another patient became pregnant after completion of methotrexate plus leucovorin, delivered a healthy male baby and came to us with recurrence. He was also treated with EMA-CO schedule.

After completion of treatment, they were evaluated monthly for three months, three monthly for two years and then six monthly. Follow up period ranged between two to six years (median -four years). Among the 40 cases included in this study, two patients (5%) dropped during therapy, one (2.5%) expired due to post pregnancy recurrence and remaining 37 (92.5%) are yet in disease free state.

(Bang. Onc. J. 2009; 4(2) : 54-58)

Distribution Pattern of Malignancy in the Oncology Department of 59 Bangabandhu Sheikh Mujib Medical University 2005

MA Bari

This study was carried out in the Department of Oncology of Bangabandhu Sheikh Mujib Medical University from 1st January 2005 to 31st December 2005. A total number of 1107 cancer patients were included, of them 72% were smoker, 500 were male and 607 were female. So the male to female ratio was 1: 1.21. Highest incidence of malignancy was observed in the age of 46 to 60. Top five malignancies in female like- Breast, Cervix, Ovary, Gall Bladder, Stomach. Top five malignancies in male like- Lung, Stomach, Liver, Lymphoma, and Colon.

(Bang. Onc. J. 2009; 4 (2) : 59-62)

Comparison of Response of Chemotherapy by Cisplatin and 5-Fu Versus 63 Cisplatin and Paclitaxel in Recurrent Carcinoma of Uterine Cervix

Rowshon Ara Begum

This quasi-experimental study was done from January, 2008 to December, 2008 at Onclogy Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Radiotherapy Department of Dhaka Medical College Hospital (DMCH), Dhaka and National Institute of Cancer Research and Hospital (NIRCH), Dhaka. Total 60 patients were enrolled. Among them 30 patients received Cisplatin & 5-FU as group A and next 30 patients received Cisplatin & Paclitaxel as group B. The objective of the study was to compare the response of chemotherapy regiment of Cisplatin-5FU (group-A) with Cisplatin-Paclitaxel (group-B) in recurrent cervical cancer. After completion of the treatment, response was assessed in terms of toxicities, improvement of symptoms and clinical tumour regression. Tumour response in terms of symptoms improvement, P/V bleeding, P/V discharge, foul smelling discharge and complain of pain, was found to be high in Group B than Group A and was statistically significant (p < 0.05) at the end of 5th and 6th cycle chemotherapy. About chemotherapy toxicities, the symptoms of nausea and vomiting was high among the Group-B patients, than Group-A patients & the difference was statistically significant (p< 0.05). The proportion of diarrhea episodes was higher in Group-A patient than Group-B and the difference was statistically significant (p<0.05).Alopecia and fever was high among Group B patient than Group A patient and the difference was statistically very highly significant (p<0.001) Tumour response seen by P/V and P/S examinations, it was found that after 3rd follow-up, a statistical significant difference was found (p<0.05) between Group-A & Group-B with proportion of complete regression of tumour was found to be higher among the Group-B patients than Group-A. By Pap's test at 1st follow-up, complete regression of tumour was found higher in group B than group A patients and the mean difference was statistically significant (p < 0.05). In 2nd and 3rd follow-up, patients got complete response in Group B was higher than Group A and but the difference was not statistically significant (p > 0.05). There is a significant success in terms of symptom improvement, tumour regression in palliative treatment for recurrent cervical cancer with Cisplatin-Paclitaxel (group-B) regiment over Cisplatin-5FU (group-A) regimen.

(Bang. Onc. J. 2009; 4 (2) : 63-71)

Role & Responsibilities of Medical Physicist in Radiation Oncology - A Review

Shahida Alam

Bang. Onc. J. 2009; 4 (2) : 72-81

Askin's Tumor

M Sayeed Hossain

Askin's tumor is a malignant small round cell tumor affecting thoracopulmonary region. Because of its neuroectodermal origin it is also known as Primitive neuroectodermal tumor. An 8 year-old female patient was admitted to our hospital with complaints of weight loss and upper abdominal mass. Skyagram of chest P/A view showed a well circumscribed mass in upper zone of the left lung. Diagnosis was made by fine needle aspiration cytology which showed malignant small round cell tumor. Clinical, radiological and cytological findings led to the definite diagnosis of Askin tumor.

Treatment in Askin tumor consists of radical surgery, neoadjuvant or adjuvant chemo-therapy and radiotherapy. Although a long survival is intended by multimodel therapy, prognosis is generally poor. Recently remission rate has improved from 26 % to 65% with aggressive chemotherapy.

Survival has been reported as 8 months after diagnosis. Since our case was inoperable and patient denied radiotherapy so, chemotherapy was planned.

Key words: Askin's Tumor, PNET, Chemotherapy.

(Bang. Onc. J. 2009; 4(2) : 82-85)

Malignant Parotid Tumor in a Four Years Old Boy A Case Report

Meher Zabin

Bang. Onc. J. 2009; 4 (2) : 86-87

Pregnancy with Large Ovarian Tumour A Case Report

Nahreen Akhtar

Ovarian tumour occur at any age group. So pregnancy with ovarian cyst is not very uncommon. But pregnancy with large tumour is uncommon. A 25 years old lady was admitted in BSMMU with 3rd gravida 28 weeks pregnancy with large ovarian tumor with ascites with H/O previous two caesarean section. Ovarian tumour was diagnosed at her 24 weeks pregnancy by ultrasonography. FNAC was done by the advice of her clinician which reveal dysgermenoma. She was referred to BSMMU from cancer Institute, Mohakhali for termination of pregnancy.

Key word: Dysgerminoma.

(Bang. Onc. J. 2009; 4 (2) : 88-89)

Immunoproliferative Small Intestinal Disease - A Case Report

Sultana Afroza

(Bang. Onc. J. 2009; 4 (2) : 90-92)

A 32 Days Old Baby with Nephroblastoma- A Case Report