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- 저자 : ( Pk Julka ) (검색결과 3 건)
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( Manoj Behera ),( Pk Julka ),( Gk Rath ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The standard adjuvant therapy for transmural and/or node +ve rectal cancer is the combination of pelvic radiation with 5FU based chemotherapy, which significantly improves both local control and overall survival. The addition of concurrent chemotherapy to neoadjuvant radiotherapy increases pathological complete response and down staging occurs in about 60% and which may facilitate sphincter preserving surgery in distally located tumors Methods: A total of 50 patients of locally advanced carcinoma rectum were studied from July 2010 to December 2011. Patients with clinical T3 / T4 and N1/N2 cancer of distal rectum were subjected to receive concurrent chemoradiation followed by surgical resection. All the patients were given Tab. Capecitabine@825 mg/m2 twice concurrently with radiation of 45 Gy/25# @ 1.8 Gy for 5 weeks. Surgery was performed 4-6 weeks after completion of chemoradiation. Tumor downstaging and sphincter preservation were the primary endpoints. Acute normal tissue toxicities were taken into account as secondary point. Postoperatively patients with high risk pathological features were treated with adjuvant chemotherapy with FOLFOX regimen. Results: This regimen resulted in overall resectability rate of 75% and a sphincter preservation rate of 40%. The complete pathological response rate was 40%. Diversion colostomy was done in 25% patients who were declared inoperable. Non hematological toxicities viz: diarrhea grade III = 21% and skin reaction grade II =16%; grade III= 5%). Grade II neutropenia (5%) and grade I thrombocytopenia (2%) were the hematological toxicity observed. With a median follow up period of 9 months no loco-regional failure has been seen. Conclusions: Concurrent preoperative chemoradiation for locally advanced carcinoma rectum is associated with improved tumor resectability which results in improved sphincter preservation, local control and is relatively safe, effective and well tolerated.
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Prevention of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients
Shankar, Abhishek,Roy, Shubham,Malik, Abhidha,Julka, PK,Rath, GK Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.15
The supportive care of patients receiving antineoplastic treatment has dramatically improved over the past few years and development of effective measures to prevent nausea and vomiting after chemotherapy serves as one of the most important examples of this progress. A patient who starts cancer treatment with chemotherapy lists chemotherapy-induced nausea and vomiting as among their greatest fears. Inadequately controlled emesis impairs functional activity and quality of life, increases the use of health care resources, and may occasionally compromise adherence to treatment. New insights into the pathophysiology of chemotherapy-induced nausea and vomiting, a better understanding of the risk factors for these effects, and the availability of new antiemetic agents have all contributed to substantial improvements in emetic control. This review focuses on current understanding of chemotherapy-induced nausea and vomiting and the status of pharmacological interventions for their prevention and treatment.
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Evaluation of Delhi Population Based Cancer Registry and Trends of Tobacco Related Cancers
Yadav, Rajesh,Garg, Renu,Manoharan, N,Swasticharan, L,Julka, PK,Rath, GK Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.6
Background: Tobacco use is the single most important preventable risk factor for cancer. Surveillance of tobacco-related cancers (TRC) is critical for monitoring trends and evaluating tobacco control programmes. We analysed the trends of TRC and evaluated the population-based cancer registry (PBCR) in Delhi for simplicity, comparability, validity, timeliness and representativeness. Materials and Methods: We interviewed key informants, observed registry processes and analysed the PBCR dataset for the period 1988-2009 using the 2009 TRC definition of the International Agency for Research on Cancer. We calculated the percentages of morphologically verified cancers, death certificate-only (DCO) cases, missing values of key variables and the time between cancer diagnosis and registration or publication for the year 2009. Results: The number of new cancer cases increased from 5,854 to 15,244 (160%) during 1988-2009. TRC constituted 58% of all cancers among men and 47% among women in 2009. The age-adjusted incidence rates of TRC per 100,000 population increased from 64.2 to 97.3 among men, and from 66.2 to 69.2 among women during 1988-2009. Data on all cancer cases presenting at all major government and private health facilities are actively collected by the PBCR staff using standard paper-based forms. Data abstraction and coding is conducted manually following ICD-10 classifications. Eighty per cent of cases were morphologically verified and 1% were identified by death certificate only. Less than 1% of key variables had missing values. The median time to registration and publishing was 13 and 32 months, respectively. Conclusions: The burden of TRC in Delhi is high and increasing. The Delhi PBCR is well organized and generates high-quality, representative data. However, data could be published earlier if paper-based data are replaced by electronic data abstraction.
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