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Introduction: Radiation-induced lung toxicity (RILT) is a major concern in patients who receive radiation to thorax. The purpose of the study was to evaluate the changes of pulmonary function tests (PFTs) in lung carcinoma patients treated with three-dimensional conformal radiation therapy (3-D CRT) and relation RILT with dosimetric and nondosimetric factors. Methods: This was a prospective observational study which included 65 patients of lung carcinoma treated with 3-D CRT. PFTs were assessed before the radiotherapy and at third and sixth month post-radiation therapy. Radiation pneumonitis (RP) was graded according to National Cancer Institute Common Toxicity Criteria (CTCAE) version 4.0. Results: Majority of patients already had poor lung function before commencing the radiotherapy. There was a modest decrease in pulmonary function after radiation therapy with (3-D CRT). Postradiotherapy, at third month, eight patients (12%) and at the sixth month, 16 patients (25%) were observed with Grade II RP. At the third month, the nondosimetric factors, age >65 years (P = 0.027) and pretreatment Diffusion capacity of the Lung for Carbon monoxide (DLCO) 60% (P = 0.03) were significantly related to grade ≥ II Radiation pneumonitis (RP). Among dosimetric factors, mean lung dose ≥20 Gy (P = 0.001) and volume receving 20Gy ≥35% (P = 0.05) were significantly related to grade ≥ II RP. These factors were also related to grade ≥ II RP at the sixth month with a significant P value. Conclusion: There is a progressive decrease in pulmonary function after (3-D CRT) in lung carcinoma patients. The study suggested that the baseline PFT may be utilized for the identification of high-risk patients for RILT before starting the radiotherapy in lung carcinoma. [ABSTRACT FROM AUTHOR]

Introduction: Age-related deficits such as malnutrition, functional reliance, and cognitive decline also occur in older women, as they are typically weaker and have many co-morbid conditions like diabetes or cardiac illness. These prognostic factors might predict overall survival and progression-free survival. Aim: To analyse the management outcomes of elderly patients with cervical carcinoma treated with radiotherapy and brachytherapy. Materials and Methods: A retrospective observational study was conducted in the Department of Radiation Oncology at Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India. Medical records were collected from 876 patients with cervical cancer who had been treated with radiotherapy or combined radiotherapy and chemotherapy from January 2009 to December 2021. A total of 876 patients presented with cervical cancer in the Outpatient Department (OPD), and 20 patients meeting the inclusion criteria were selected. Patients diagnosed with cervical cancer, Federation International Federation of Gynaecology and Obstetrics (FIGO) stage IB to IVA, aged equal to or greater than 80 years old, and Eastern Cooperative Oncology Group (ECOG) performance status I to III were considered for inclusion. Categorical variables were expressed as counts and percentages. The following clinicopathological characteristics of the study population were examined: FIGO staging, including stage IB to stage IVA, histopathological features of adenocarcinoma, squamous carcinoma, or adenosquamous carcinoma, doses of radiotherapy and brachytherapy, overall survival, disease-free survival, and the patient's current status (alive or dead) was determined. If death occurred, the cause of death was determined. The Kaplan-Meier approach was used to analyse overall survival and disease-free survival in the study population using XLSTAT statistical software. Results: The study population was age standardised, with 18 patients (90%) falling between the ages of 80 and 85, and 2 patients (10%) falling between the ages of 86 and 90. A total of 12 patients (60%) belonged to ECOG PS II. A total of 19 (95%) patients had histologically confirmed squamous cell carcinoma. 75% of the population was in a locally advanced stage (stage III-IVA). The overall survival (in months) was 65.58 months, which was statistically significant (p<0.0083). Similarly, the average disease-free interval was 38.73 months, which was also significant (p<0.0062). Conclusion: According to the findings of the study, age may not be an independent risk factor for determining the outcome of cervical cancer patients in the Indian scenario. Even though elderly females may present with multiple co-morbidities, the standard treatment protocol must be radical. [ABSTRACT FROM AUTHOR]

Introduction: High Dose Rate (HDR) brachytherapy plays an important role in the treatment of lung carcinoma. The treatment of lung carcinoma with Endobronchial Brachytherapy Treatment (EBBT) is delivered with three fractions and the effect of EBBT on the Target Volume (TV) after delivering the three fractions in the lung carcinoma needs to be assessed. The TV is covered with the prescribed dose and Organs At Risk (OARs) doses are evaluated. Aim: To assess the doses to OAR nearby the tumour and analyse the effect of the TV, tumour location, and site on the doses to OARs in EBBT in lung carcinoma. Materials and Methods: A cross-sectional study was conducted in the Department of Radiation Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University Dehradun, Uttarakhand, India, from January 2018 to December 2020. Thirty patients with lung carcinoma were included in dosimetric and volumetric assessments. A flexible lumencare catheter was inserted into the bronchial lesion. Computed Tomography (CT) scan was acquired and exported to Treatment Planning System (TPS) through Digital Imaging and Communications in Medicine (DICOM) networking system. An optimised treatment plan was generated. The TV and OARs were delineated on the CT scan of the patient. A total of three EBBT sessions were given with a 7 Gy dose per fraction and prescribed the dose at 1.0 cm from the center of the catheter. Doses to OARs and the effects of TV on doses to OARs were evaluated with the help of "Dose Volume Histogram (DVH) tool" in the TPS. Thirty patients, with varying TV and site, were grouped as left lung and right lung tumour lesions and also grouped as TV <22 cc and TV >22 cc for the analysis purpose in this study. The data was entered in Microsoft Office Excel 2007 and analysed in Statistical Package for the Social Sciences (SPSS) version 22.0 statistical analysis software (IBM Corp., Armonk, N.Y., USA) tool. Results: The mean doses to OARs in 1st, 2nd and 3rd EBBT sessions were within their tolerance limit. The mean dose difference between left and right lung tumour site were analysed and found mainly the mean dose to oesophagus and maximum dose to oesophagus, contralateral lung, left coronary artery and descending aorta were significantly higher in left lung compared to right lung with p-value 0.015, 0.027, 0.001, 0.007 and 0.001, respectively. The maximum dose to the contralateral lung and spinal cord were significantly higher in middle-lower bronchial lesion with p-value 0.024 and 0.023, respectively. The mean dose difference between left and right lung tumour volume for TV <22 cc and TV>22 cc was analysed and found mainly for the group TV>22 cc the mean dose to oesophagus and maximum dose to oesophagus, Heart, contralateral lung, left coronary artery and descending aorta were significantly higher in the left lung compared to right lung with p-value 0.002, 0.008, 0.027, 0.003, 0.006 and 0.001, respectively whereas in the TV<22 cc group only the contralateral lung max dose was significantly higher in left lung compared to right lung with p-value 0.046. Conclusion: The OARs doses were increased significantly in left lung compared to right lung carcinoma. The TV was large in the middle-lower bronchial region, therefore, the doses were found higher, and TV in the lower bronchial region is less so the dose was less. [ABSTRACT FROM AUTHOR]