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Patients with metastatic breast cancer (MBC) in visceral crisis require systemic chemotherapy. However, a coexisting cardiac failure that contradicts the use of systemic chemotherapy often demands an alternative treatment. Here, we report a case of hormone-receptor-positive MBC with cardiological comorbidities. She was treated with a combination treatment of tablet Ribociclib (600 mg once daily for 21 days followed by 7 days gap) and tablet Letrozole (2.5 mg once daily). The patient had a complete metabolic response in 18-Fluorodeoxyglucose Positron Emission tomography-Computed Tomography (18F-FDG PET/CT), after 6 months of treatment. Combination treatment with Ribociclib and Letrozole is beneficial in postmenopausal females with hormone receptor-positive and human epidermal growth factor receptor 2 neu-negative MBC in visceral crisis who have a contraindication to chemotherapy.

To investigate and evaluate the feasibility of a simple modified Divided Planning Target Volume (DPTV) optimization method in radiation therapy planning of lung cancer patients.A cohort of 15 patients of Non-Small Cell Lung Cancer (13 patients stage III and two patients of stage II) who were previously treated with Concurrent Chemo Radiation Therapy were included in the study. The planning modality was Volumetric Modulated Arc Therapy, and the dose prescription was 60 Gray in 30 fractions. In this study, we attempted to replan by dividing the previous Single Planning Target Volume (SPTV) into a DPTV. All the treatment plans were revised and again optimized for DPTV with required dose constraints as in SPTV. The dosimetric parameters that were achieved for target and normal structures were recorded in both the optimization methods.Dosimetric target coverage (D95%) (p-value = 0.0001), dose homogeneity (p-value =0.0001) and conformity (p-value = 0.044) were improved by the DPTV optimization. The volume of the oesophagus receiving 35 Gy was found to be higher in the DPTV arm (p-value = 0.02) compared to the SPTV arm, but the volume of the oesophagus receiving 50 Gy was found to be similar (p-value = 0.122).In radiation therapy planning of lung cancer, the DPTV optimization method has better dose coverage to the target volume, homogeneity, as well as conformity than the stsndsrd SPTV method. Therefore, the DPTV optimization method can be a simple and efficient alternative to the SPTV method in lung cancer.

Mycosis fungoides (MF) is a low-grade chronic lymphoid proliferative disorder of T-lymphocytes arising out of the skin, having an indolent course caused by abnormal proliferation of CD4+ T-cells. Here we present a case of a 37-year-old male who was diagnosed with mycosis fungoides in 2001 and treated with Total Skin Electron Beam Therapy (TSEBT). The purpose of this autobiographical case report is to give an insight into the eventful journey of the patient living with the disease for the last 20 years. His journey will serve the purpose of both patients and physicians and will add to the literature on the subject.

Introduction Intracavitary brachytherapy (ICBT) is an integral component in the management of locally advanced cervical cancer. Spinal anaesthesia is the preferred mode of pain management during brachytherapy procedures. In high volume, resource constraint settings, it is difficult to provide spinal anaesthesia to all patients. This study attempts dosimetric comparison of high-dose-rate ICBT with spinal anaesthesia to that under conscious sedation to find out whether brachytherapy under conscious sedation is comparable with spinal anaesthesia. Methods Retrospective data of total of 56 cervical cancer patients who received ICBT after completion of external beam radiotherapy (EBRT) were collected. Among these 56 patients, 28 patients received brachytherapy under spinal anaesthesia (SA group) and the rest under conscious sedation (CS group). Brachytherapy dose was 7 Gray per fraction weekly for three weeks. Thus, 84 brachytherapy plans of each group were analysed with respect to doses received by points A, B, P and Organs at Risk. Results The mean doses received by points A, B and P were comparable in SA and CS groups (p-value >0.05). Similarly, the mean doses received by Organs at Risk (rectum, urinary bladder, and sigmoid colon) were also comparable in both the groups (p-value>0.05). Conclusion ICBT under CS is dosimetrically non-inferior to SA, which makes it an alternative option.

Prostate carcinoma is the second most common cancer in men. While bone metastasis is more common in carcinoma prostate, dural metastasis is an uncommon diagnosis. Nowadays, men with castration-resistant prostate cancer (CRPC) have shown increase survival with the introduction of better chemotherapy regimens. Here, we present the case of a heavily pre-treated CRPC patient of age 69-year-old who developed metastasis to dura mater. The patient presented with complaints of increased urinary frequency and urgency with bilateral inguinal lymphadenopathy. The ultrasonography-guided biopsy showed acinar adenocarcinoma of the prostate with a Gleason score of 4 + 4 = 8 and TNM staging of T1N3M1b. He was treated initially with hormonal therapy. Subsequently, he developed castration resistance and was advised docetaxel-based chemotherapy. However, on follow-up, the patient developed dural metastasis. Metastases to dura mater should be considered as a differential diagnosis in advanced CRPC with neurological symptoms.

Gallbladder cancer (GBC) is the commonest malignancy among biliary tract cancers. Locoregional spread in GBC is more common than distant metastasis. The liver and abdominal lymph nodes is the most common site of distant metastasis. Breast metastasis is a rare site of dissemination. GBC is an aggressive tumor and carries a poor prognosis, with a five-year survival rate of less than 10%. Metastasis to the breast from a gallbladder is significantly less and accounts for very few cases. Here, we are reporting a rare case of carcinoma gallbladder metastasis to the breast who survived for 38 months from the diagnosis of GBC and around 25 months after breast metastasis.

Patients with cancer are at a higher risk of infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) than the general population. In India, it has become a significant health problem of utmost importance, and India's Government has issued health advisories. Lockdown brought many unforeseen problems for patients and hospitals, leading to confusion and chaos. The aim of this article is to identify various issues related to our hospital, follow-up, nutrition, treatment and psychosocial issues. Multiple changes were made in the hospital, departmental and treatment policy for cancer patients' convenience and safety. As India is in the peak of COVID-19, these types of modifications and modifications of treatment schedules will be the 'New Normal'.

Managing of radiotherapy department in many cancer centers in India has become very challenging during the COVID-19 pandemic. A radiotherapy center has to deal with multiple problems such as long treatment duration of each patient, high caseload on each radiotherapy machine, a limited number of qualified technical staff available, and equipment maintenance. For the department's smooth running, both the patient and healthcare worker must be safe from contacting COVID-19. A robust and planned strategy is required for prevention, screening, and awareness among all. To access our preparedness and evolve by gaining from other radiotherapy centers, a study was conducted using questionnaires and responses collected from different cancer centers in India.

A rare case of advanced neuroendocrine carcinoma of thigh in a young adult female, diagnosed with the aid of immunohistochemistry and electron microscopic examinations together with a review of the literature are reported. The primary tumor involved the lateral aspect of thigh without bone involvement. Patient showed significant response with adjuvant chemoradiotherapy following incomplete surgery.