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Role of MRI in newly diagnosed breast cancer patients undergoing neo-adjuvant systemic therapy. P156. [Extracted from the article]

The potential impact of chest wall perforator flaps in avoiding mastectomy. P138. [Extracted from the article]

Retrospective audit of implant salvage using peri-prosthetic irrigation system and conventional wash out in immediate breast reconstruction. P054. [Extracted from the article]

Liquid biopsy is a new technique for cancer detection. Evaluation of circulating cell-free DNA (ccfDNA) through liquid biopsy is a minimally invasive and cost-effective method that may serve as a potential biomarker for early detection, treatment monitoring, status of residual disease, and distant tumor metastasis in cervical cancer patients. We evaluated plasma ccfDNA levels in patients of cervical cancer undergoing chemo-radiation and correlated their levels with treatment response and short-term clinical outcome. This prospective, single arm, open–label, observational pilot study included patients of cervical cancer, being radically treated with three-dimensional conformal radiotherapy or intensity modulated radiotherapy to a dose of 46Gy/23 fractions over 4.5weeks followed by high dose rate (HDR) brachytherapy to deliver EQD2 of >80Gy. Concurrent weekly cisplatin 40mg/m2 was administered weekly throughout the course of external radiotherapy. Peripheral blood samples were collected in EDTA tubes before starting treatment and at 6months after completion of treatment. On the same day, tubes were centrifuged at 800g for 10 minutes. The supernatant was transferred to 10ml tubes and centrifuged at 1600g for 10 minutes to remove debris. Plasma supernatants were transferred in 1mL aliquots and stored at -80°C. Total genomic DNA of plasma aliquots were extracted using the commercially available Circulating Nucleic Acid Kits. Categorical variables were tested using the chi-square test. Univariate analysis was done to analyze the factors affecting ccfDNA levels and if found significant, multivariate analysis was used. Of 22 patients of histologically confirmed cervical cancer, 11 (50%) were of stage II disease followed by 7 (31.8%) with stage III disease. The median age was 53.5 years (range 39-70 years). The baseline mean ccfDNA levels was 69.68±58.335 ng/μL which was significantly reduced post-treatment to 0.452±0.199 ng/μL (p<0.001). The stage of the disease significantly affected the baseline ccfDNA levels (p=0.029). Positive pelvic and para-aortic lymph nodes showed a trend towards higher baseline ccfDNA levels (p=0.068 and 0.38 respectively). Patients with progressive disease had a trend towards higher post-treatment ccfDNA levels (p=0.19). Our study revealed the role of ccfDNA as a potential biomarker in cervical cancer, which, however requires further longitudinal studies for confirmation. [ABSTRACT FROM AUTHOR]

This prospective study compares the effectiveness of hypo fractionated two-week short course radiotherapy versus monthly single fraction radiotherapy, as palliative radiotherapy in advanced gynecologic cancers. The primary end point was subjective response in symptoms and secondary end points were the impact on quality of life, objective response rate and treatment related toxicity. Fifty patients with advanced or metastatic cancer of the cervix, endometrium, vulva and vagina with significant pelvic symptoms and unfit for curative treatment were enrolled in the study. Palliative radiotherapy was planned using conventional fluoroscopic simulator with standard pelvic radiation portals. Radiotherapy was delivered using a Co-60 unit or Linear Accelerator with 6MV photons. Patients randomized to two-week radiotherapy arm received a dose of 30Gy in 10 fractions over two weeks and those in the single fraction arm received 8 Gy single fraction, up to 3 fractions at monthly interval. The decision of second and third fraction was based on symptom relief and tumor response. Disease symptoms and Quality of life were assessed using the ESAS-r and FACT questionnaires respectively. Toxicity was assessed using the CTCAE (version 5) and WHO subjective treatment response assessment was done. Of the 25 patients recruited in each arm, all patients completed treatment in the 30Gy/10 fractions arm. In the single fraction arm, 6 (24%) had good symptom control after one fraction, and 8 (32%) required 2 fractions and 11 patients (44%) required three fractions. The median follow- up period was 7.5 months. Compared to baseline, there was a significant improvement in the symptom scores at 1, 3 and 6 months in both the arms. There was no significant difference in the symptom scores between the two treatment arms. The overall symptomatic response rates in the 30Gy/10# and SFRT arm were more than 80%for pelvic pain, 96% for vaginal bleeding and more than 80%for vaginal discharge. When compared with baseline, Quality of life scores at 1, 3 and 6 months showed significant improvement in all domains in both the arms. The emotional and physical well-being scores at 3 months were significantly better (p=0.02 and 0.04) in the 30Gy/10# arm compared to the SFRT arm. There was no difference in the treatment toxicities between both the arms. At last follow-up, 50% had stable disease, 26% had progressive disease and 24% had partial response to treatment. There was no difference in the response rates between both the arms Palliative Pelvic Radiation provides significant symptomatic relief and improves the Quality of life of patients with Advanced Gynecologic cancers. Single fraction palliative radiation is comparable to two-week hypo-fractionated radiotherapy with comparable symptom control, toxicities, and improvement in quality of life. The improved emotional and physical wellbeing scores in the two-week radiotherapy arm could be due to the psychological effect of a longer treatment. [ABSTRACT FROM AUTHOR]