Asian Pacific Journal of Cancer Care

Radiation Recall Dermatitis in Carcinoma Breast: A Decade of Experience from a Tertiary Cancer Center in North West India

Kamlesh Kumar Harsh — 2025-07-14

Aim: This study investigates the occurrence of radiation recall dermatitis (RRD), an acute inflammatory reaction triggered by chemotherapy in previously irradiated areas. RRD manifests in nearly two thirds of cases as skin reactions, ranging from mild erythema to severe desquamation. Our objective was to evaluate the frequency, severity and clinical pattern of RRD in breast cancer patients treated with radiotherapy.

Materials and Methods: Data were retrospectively reviewed for 3462 breast cancer patients who underwent radiation therapy. Follow-ups were conducted weekly during chemotherapy, monthly for the initial 3 months, every 3 monthly up to 1 year, and biannually thereafter. The severity of dermatitis was graded using Radiation Therapy Oncology Group (RTOG) criteria, and supportive skin care was provided as needed. Patients included in the study had pathologically confirmed breast cancer, underwent modified radicle mastectomy, and received chest wall radiotherapy (40.05 Gy in 15 fractions; 2.67 Gy per fraction, 5 fraction per week for 3 weeks).

Results: RDD was reported in 359 patients of 3462 (10.36%) following the administration of chemotherapy. The majority of cases (302 patients, 84.12%) occurred between 3^rd week and the 2^nd month post-chemotherapy. Grade 1 reactions were observed in 258 patients (71.86%), grade 2 in 85 patients (23.67%) and grade 3 in 16 patients (4.45%). Most RRD cases were associated with Adriamycin/doxorubicin, although other agents also agents also contributed. All patients responded favourably to topical steroids, with complete resolution and satisfactory skin appearance by 6 months. The latest reported case of RRD occurred 5 years post-radiotherapy and linked to administration of Paclitaxel and Carboplatin.

Conclusion: This study highlights the frequency, timing and severity of RRD in breast cancer patients treated with radiotherapy and subsequent chemotherapy. While anthracyclines such as Doxorubicin are the most common culprits, other agents, including alkylating agents, antimetabolites and even exposure to UV light are also implicated. The unpredictable interval between radiotherapy and RRD onset, ranging from days to years, underscores the need for ongoing research to better understand this phenomenon.

Clinicopathological Profile and Treatment Outcome of Renal Cell Carcinoma: A Review from a Tertiary Cancer Centre in North East India

Partha S. Roy — 2025-07-14

Background and Objectives: Renal cell carcinoma (RCC) constitutes 4% of adult malignancies and 90% of kidney cancers. While extensively studied in Western populations, data from India particularly Northeast India remain limited. This retrospective study aimed to assess overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) among RCC patients treated at a tertiary cancer centre in Northeast India between January 2020 and December 2022.

Materials and Methods: We retrospectively analyzed 88 RCC patients who received treatment. Clinical parameters, including age, sex, histology, stage, metastatic pattern, treatment, and outcomes, were recorded. Kaplan-Meier analysis was used for survival estimation. Prognostic factors were evaluated using univariate and multivariate analyses.

Results: The majority had clear cell histology (85%), with a median age of 56 years and a male-to-female ratio of 3:1. Metastatic disease was present in 65%, commonly affecting the lungs (67%), bones (44%), liver (32%), and brain (10%). Among those with metastasis, 40% were classified as poor-risk according to IMDC criteria. All non-metastatic patients (n=31) underwent surgery (68% radical, 32% partial nephrectomy). Among metastatic patients (n=57), VEGFR tyrosine kinase inhibitors were commonly used sunitinib (n=22) and pazopanib (n=25); one received nivolumab-based immunotherapy. With a median follow-up of 17 months, metastatic RCC showed poor outcomes, with median PFS and OS of 9 and 12 months, respectively. Non-metastatic RCC had an 18-month OS of 80.5%, with median OS not reached. OS varied by IMDC risk: 30 months (favorable), 12 months (intermediate), and 6 months (poor) (p<0.001). Sunitinib and pazopanib had comparable efficacy overall, though sunitinib had superior OS in favorable-risk patients (51 vs. 28 months, p<0.0001).

Conclusions: RCC patients in Northeast India often present younger and with advanced disease. VEGFR-TKIs remain standard in limited access to immunotherapy. Enhanced early detection and access to immunotherapy are vital to improve outcomes.

Life After Treatment:A Comparative Study of Quality of life among Cervical and Female Oral Cavity Cancer Survivors

K Rakshitha Gowda — 2025-07-14

Background: Cervical cancer is one of the most prevalent gynecological malignancies, while oral cavity cancer is the leading head and neck cancer. Advances in treatment have improved survival rates, but the long-term side effects significantly impact survivors’ quality of life (QoL). Understanding and comparing these impacts is crucial for post-treatment care.

Objective: This study aims to assess and compare the QoL of cervical and female oral cavity cancer survivors, identifying the most affected dimensions of their well-being.

Methods: A cross-sectional study was conducted at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, involving 72 female cancer survivors (36 cervical, 36 oral cavity). QoL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, along with disease-specific modules (Cx24 for cervical cancer, OH-14 and H&N-35 for oral cavity cancer). Statistical analysis included independent sample t-tests, Chi-square tests, correlation analysis, and ANOVA.

Results: Oral cavity cancer survivors exhibited significantly lower physical functioning (85.97 vs. 91.52, p = 0.047), role functioning (p = 0.024), and emotional functioning (p = 0.043) compared to cervical cancer survivors. Fatigue (p = 0.025), pain (p = 0.001), and diarrhea (p < 0.001) were significantly worse in oral cavity cancer survivors. The analysis of disease-specific QoL modules revealed that the oral cavity cancer survivors had more challenges with swallowing, speech, social eating, and pain management, whereas cervical cancer survivors faced significant issues with menopausal symptoms, peripheral neuropathy, and sexual well-being.

Conclusion: Survivors of oral cavity cancer experience a greater decline in QoL compared to cervical cancer survivors, particularly in physical and emotional domains. These findings emphasize the need for tailored post-treatment interventions to address the specific challenges faced by each group, improving long-term survivorship outcomes.

Current Approaches, Challenges, and Future Perspectives in Colorectal Cancer Therapeutics and Integrated Care

Vahid Jafarlou — 2025-07-14

Colorectal cancer (CRC) is one of the most frequently diagnosed malignancies and a key reason for the increase in the number of cancer-related deaths experienced all over the world, making it a serious global health concern. The approach for CRC is multidimensional managing the factors such as the tumor burden, molecular markers, and factors that are specific to the patient. The primary treatment for early-stage CRC is still the surgical removal of the tumor, and the adjuvant chemotherapy is recommended on the basis of the pathological staging, lymph node involvement, and the features that are high-risk. When it comes to mCRC, the treatment’s initial objectives are to extend the patient life and to maintain the quality of life with the help of systemic treatments, localized interventions, and personalized strategies. In this review, we will present the cutting-edge technologies that have emerged and the contention that came up in CRC treatment, including the use of surgical methods, chemotherapy, radiotherapy, targeted therapy (e.g., anti-EGFR, anti-VEGF agents), immunotherapy (particularly for mismatch repair-deficient tumors), and the introduction of gene therapy and novel combinations of drugs which are still at the research stage are also discussed.

Efficacy of a Single-Agent Ts1 (Tegafur, Gimeracil, and Oteracil) in Recurrent Gastric Cancer after Progression from Previous Oxaliplatin, Irinotecan, and Anti-Her2 Targeted Therapy: A Case Report

John Bryle J. Zapanta — 2025-07-14

Background: Gastric cancer ranks fourth globally in cancer-related deaths, with advanced cases having a median survival of less than 12 months. Timely surgery improves survival for localized cancer, but advanced and recurring cases have low survival rates. Treatment options include 5-fluorouracil (5-FU), but TS-1, a modified form of 5-FU, shows promise. Two Japanese trials found TS-1 effective in advanced gastric cancer, with response rates of 44% and 49%, and survival periods of 207 and 250 days. TS-1 has fewer adverse effects than 5-FU. This case report demonstrates TS1’s efficacy as a second-line treatment for recurrent gastric cancer post-previous therapies.

Methods: The case involves a 44-year-old Filipino woman with a 2-month history of upper GI symptoms.

Results: This case initially presented with symptoms of easy fatigability, epigastric pain, and anemia. Gastroscopy revealed gastric adenocarcinoma, leading to radical subtotal gastrectomy and adjuvant chemotherapy with Epirubicin, oxaliplatin, and capecitabine. She achieved a complete response for nine months until a left pelvoabdominal mass was discovered and surgically removed, revealing recurrent metastatic adenocarcinoma. Treatment shifted to docetaxel, irinotecan, and Trastuzumab due to HER2neu positivity, followed by maintenance therapy with Trastuzumab plus capecitabine. In December 2022, the patient experienced epigastric pain, prompting imaging revealing a stomach mass. Despite local therapy with radiation, gastrointestinal metastasis occurred, requiring TS1 as second-line treatment. The patient remained stable for nine months until presenting with jaundice in December 2023. Imaging revealed progressive disease in the stomach, omentum, and pancreas, leading to obstructive jaundice managed with biliary drainage. However, she developed severe pneumonia, intraabdominal infection, acute kidney injury, and electrolyte imbalances, ultimately leading to her demise.

Conclusion: The utilization of TS1 as a second-line treatment for gastric cancer can be effective and shows promising results prolonging patients’ progression free survival and overall survival, it underscores ongoing efforts to tackle refractory cases, emphasizing the imperative for continuous research and innovation in the field.

Primary Leiomyosarcoma of the Ovary: A Case Report of a Rare Ovarian Malignancy

Dixie Jane Bangasan — 2025-07-14

Primary leiomyosarcoma of the ovary is a sporadic ovarian tumor constituting less than 0.1% of ovarian malignancies. This ovarian tumor is noted to have a very poor prognosis and generally affects post-menopausal women with few exceptions involving cases seen in younger women, as in the index case. Due to its rarity, there are no large series of case reports in the literature, and definitive treatment guidelines have not yet been developed. This report presents a reproductive woman with primary ovarian leiomyosarcoma who underwent exploratory laparotomy and total hysterectomy with bilateral salpingo-oophorectomy, received adjuvant chemotherapy postoperatively and later underwent tumor debulking post chemotherapy.

Pulmonary Cystic Metastasis from Epithelioid Sarcoma Leading to Secondary Spontaneous Pneumothorax- A Case Report and Review of Literature

Priyanka Singh — 2025-07-14

Well defined solid nodules are a recognized entity in pulmonary metastasis due to sarcoma, but cystic lung metastasis is seldom reported. A rare case of a 33 year old male presenting with left spontaneous pneumothorax secondary to underlying cystic metastasis from epithelioid sarcoma of left forearm is discussed. The Patient had undergone wide resection of epithelioid sarcoma in the left forearm 5 years back and had received chemotherapy for 2 years. His imaging study 2 years back did not reveal any evidence of metastasis. He presented to emergency department with acute onset left sided chest pain and breathlessness. A chest radiograph revealed spontaneous pneumothorax left side. A chest tube insertion and subsequent pleurodesis was done for the patient. He is on follow up and was restarted with chemotherapy. Oncologists need to be cognizant of this unusual sarcomatous metastasis and maintain high vigilance during the follow up of epithelioid sarcoma.