Achievements at BA Cancer center, Navsari
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Achievements at BA Cancer center, Navsari

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In this presentation we have tried to show how we are working at our centre. we are also showing out data collected at our centre in last one year.

In this presentation we have tried to show how we are working at our centre. we are also showing out data collected at our centre in last one year.

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Achievements at BA Cancer center, Navsari Achievements at BA Cancer center, Navsari Presentation Transcript

  • Dr S.S. Solanki MD (Radiation Oncology ) Consultant , Radiation Oncology “BA” Lilaben Chimanlal Parikh Cancer Centre, Navsari , Gujrat
  • Topic for this presentation Facilities at Ba cancer Centre Self developed “Electronic Medical Record System” How we practice Radiation therapy- Immobilization, planning and plan execution. Systematic review of Patients treated in year 2011.
  • Facilities to offer At PresentDiagnostic- CT Scan, X Ray facility, USGLaboratory- Simple lab testTherapeutic- Radiation Oncology including External Beam Radiotherapy (IMRT and 3D CRT) and Brachytherapy. Future ProposalChemotherapy unit, Surgical unit, Image Guided Radiotherapy.
  • CT scan Simens’ Somatom Sprit Dual slice
  • Data of CT Scans Chart Title Total RT scans - 486 120 Total CT Diag. - 481 100 Total Brachy - 57 80 Total no of scans- 845 60 40 20 0 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12RT Scan 19 31 36 34 23 23 42 34 36 33 35 30 32 21 20 37Daignostic Scan 36 32 64 70 35 24 30 28 35 25 29 18 19 16 7 13Brachy Scan 0 0 0 5 5 2 7 3 9 2 7 3 2 4 6 2Total Monthly Scan 55 63 100 109 63 49 79 65 80 60 71 51 53 41 33 52
  • Siemens Digital X ray unitX ray
  • Ultrasonography unit
  • Data for X-ray and USG Chart Title 70 Total X-Rays - 381 Total USG - 210 60 50No. of scans 40 30 20 10 0 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 X-Ray 12 24 39 65 20 19 16 32 21 26 23 22 16 17 19 10 Sonogrphy 4 12 18 32 11 13 12 12 25 11 12 9 12 5 15 7
  • Laboratory services
  • No. of Pathological test done 200 180 160 140 120 Average 100 80 60 40 Total Pathological test done- 1696, 20 Avg Pathological test -106 per mth 0 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 nav-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 No of PathoTest 10 61 74 98 138 114 93 184 124 117 151 109 112 104 122 85
  • Therapeutic Units External Beam Radiotherapy. Linear Accelerator from Varian Medical System (Clinac iX)Total no patients treated till date –396No of Patients on Radiotherapy -35Total patients in planning process –16 Total =447 Brachytherapy Unit (Nucleotron’s Microselectron)Total no. of patients treated- 32Total no. of session of Brachy- 92
  • External Beam Radiation Therapy unit Head Gantry Couch
  • Bending magnate Tungsten target Electron gunBeam flattening device Ion chamber Asymmetrical jaws Multileaf collimator Electron Acceleration tube
  • Blue phantom –for measuring Beam parameters
  • Nucelotrons’ Microselectron Brachytherapy Unit
  • Brachytherapy instruments Central Vaginal SourceIntracavitary Applicators
  • Data from Brachytherapy No. of No ofBrachytherapy Patients fraction CVS 23 66 ICRT 7 22 Intraluminal Rectum 1 2 Esophageal 1 2 Total 32 92
  • Electronic Medical Record self developed excel sheets.
  • Electronic Medical Record
  • Electronic Medical Record
  • Electronic Medical Record
  • Case Sheet- Page 1 page 569 "BA" Smt L. C. Parikh Cancer Centre, Navsari, Gujarat-396445 Date 25/04/2012 Reg.No. LCA1049 RT No. Patients Name Anarsingh Ratiramsingh Tevatia Father/Husbands Name Ratiramsingh Tevatia Age & Sex 76 Years Male Birth Date. Address Opp. Police head Quarter AbramaVAlsad Religion Hindu Marital Status Married Citizenship Indian Birth Country Mobile self 9820134043 Passport No. First Name of Contact(Mobile) 9724902926 contact/Relationship E-mail ID. Reffered From Dr. Parimal Lad Original Complaints :- Pt is K/ case of CA Past History :- No H/O HTN, DM rectum Post op , new developed brain mets First O/E - DR Parimal Lad - 24/03/2012, P/A - growth in rectum lower Examination with margine in 3.5 - 4cm from anal verge, post wall margin high Dig. Previous CT Abdomen ( 17/03/2011) - 6-7cm of lower rectum shows Investigations diffusecircumferential heterogeneous thickening max thickening - 17 done (Imaging) mm, paracolic infiltration with multipale Nodes. Biopsy with Date Bx - 21/803/2011 => well diff adenocarcinoma ICM Codes (description) Previous Sx - 26/03/2011 => Dr. Parimal Lad - abdomino perineal resection. Treatment Per op - circumferential growth of lower rectum 3-5cm from anal Recived. verge. Extending 5cm, adviced adjuvant EBRT + chemo. Pt had not taken. In Apr 2012 C/O. severe headache walking difficulty, left side weakness, MRI Brain - 11/04/2012 - multiple lung mets, tru cut biopsy from lung - 21/04/2012 - metastatic adenocarcinoma.Actual File EMR Sheet
  • Case Sheet page 2 Histopatho Report well diff adenocarcinoma recutam with date :- Site tumor involve full thickness of wall to external fat 31/03/2011 Desai lab Tumor Surat Size Margin Status cut margine free Invasion LVI - 1 Nodal Examined 7/10 Level Involvem Largest ent (cm) ECE Comment s Post Present status treatment days Present Complaints Present Examination :- GC stable pallor - ve, No neurological deficiency, P/A soft colostomy by on left side abdomen. Final Diagnosis Ca rectum with brain mets T3N2M0post op Stage IV RT Decision palliative EBRT Plan Dose/Site 30 Gy / 10 # Planning Technique Conv Time Period 2 weeks Indications for Radiation Therapy Brain metastasis Expected Reaction Alopacia Comments Advices :- to be taken for EBRT. CT Scan for RT planning(27/04/2012) --> 3.6x2.2cm lesion in right high frontal region with surrounding edema,. 1.7x1.6 cm nodular lesion in right temporal region . S/O - metastasis. Consent For RT Taken/Not Taken Dr Surendra Singh Solanki MD Consultant, Radiation OncologyActual File EMR Sheet
  • Files on Desktop for RecordFiles on Desktop for Record Daily Backup of files into hospital’s Gmail Account
  • OPD 2 All patients recordOPD 2 All patients record
  • RT list- Patient enrolledRT list- Patient enrolled
  • Pt seen in OPD and RT enrolled Avg new pts per month = 35.87 Range(64-21) Total 598 Chart Title 70 Avg new pts enrolled = 26.68 Range(37-18) Total 447 60No of Patients 50 40 30 20 10 0 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12May-12 Mar- May- Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Apr-12 12 12 New Pt Seen in OPD 64 47 40 35 24 27 55 45 38 36 28 25 33 21 23 33 24 CT scan done for EBRT 19 29 34 30 18 22 37 31 32 30 24 19 29 20 19 34 20
  • 1st Step - Radiation planning1st Step - Radiation planning  CT scan + immobilization  CT scan + immobilization
  • Good Immobilization Practice Immobilization is a team effort involving Radiation technologist, CT technician, Nursing staff, ward boys Supervised by medical physicist and radiation oncologist.
  • Good Immobilization Practice Multiple hand support Siemens’ Somatom SpiritLAP LASERs All in one Base plate
  • Good Immobilization Practice Proper laser Alignment Blue marking- CT marks Red marking- treat marks at LA Indexed Carbon Couch
  • Good Immobilization PracticeSelf Designed Vac-Lok Support (by Amol) Vac-Lok for Pelvis and abdomen cases
  • 2nd Step- CT images in TPS Treatment planning system
  • 3rd step Precise Target marking and field Placement. Conventional Radiotherapy - square or rectangle fields 2 or 3 fields 3Dimentional Conformal Radiotherapy- MLC based Multiple Fields to conform target IMRT- Intensity modulate during movement of MLCs with 7-9 fields optimize the doses to target
  • Conventional Radiotherapy
  • Three Dimensional Conformal Radiotherapy
  • Pain in wrist due to excessive contouring
  • Pen Tablet- a good solution Smooth working Faster speed in marking
  • Intensity Modulated Radiotherapy
  • 95 % ofPTV toreceive 100 %of dose
  • Page 32 "BA" Smt L. C. Parikh Cancer Centre, Navsari, Gujarat-396445Date of Reg. 01-12-2011Reg.No. LCA694 RT No. RT2011309Patients Name Nitinbhai Bhagubhai Patel Age/Sex 50 / MDiagnosis Ca tongue T4N2MOTreatment period From 14-12-2011To 25-01-2012DaysEBRT IMRT SIB/Phase treatmentPTVs Prescription Vol D95% D98% D2%PTV1 6600cGy/30# 213 cc 6428 6366 6806PTV2 6000cGy/30# 600.55 cc 5933 5841 6620PTV3 5400cGy/30# 333 cc 5038 4935 5746OAR Dose Prescription Dose tye Dose Achive approval commentSpinal Cord <4500 Dmax 3828Spinal Cord PRV <5000 Dmax 4409Brain stem <5400 Dmax 4047Brain stem PRV <6000 Dmax 4603Parotid Lt <3000 Dmean 5138Parotid Rt <3000 Dmean 4808Larynx <4500 Dmean 5804DARS <4500 DmeanTrachea <4000 Dmean 4539Esophagus <4000 Dmean 3910Oral Cavity <4000 DmeanLips <4000 Dmean 3827Buccal Mucosa <4000 DmeanMandible <6600 Dmax 6776Middle ear Lt <3000 Dmean 2517Middle Ear Rt <3000 Dmean 2995Eye Lt <4000 Dmax 244Eye Rt <4000 Dmax 464eye Lens Lt <600 Dmax 228Eye Lens Rt <600 Dmax 227Optic chiasma <5400 Dmax 356Brain <2000 Dmean 515Optic Nerve Lt <5000 Dmax 358Optic Nerve Rt <5000 Dmax 351Parotid Sup Lt <2600 Dmean 3584Parotid Sup Rt <2600 Dmean 2602
  • First Day –Set up Verification Marking on Orfit CT scan by blue pen= Set up origin in 3 D coordinates(x=0,y=0,z=0) Field centre = Isocentre (new point in CT scan images) The shift from set up origin to isocentre is called isocentre shift. After that shift we mark new point with red ink
  • Fiducial FiducialUser origin X=0, Y=0, Z=0
  • Digitally Reconstructed Y= -7.9 RadiographZ= 0.88 X= 0.18
  • Shift y axis Blue ink marking Shift Z axisRed ink marking
  • EPID matching
  • Treatment Console Machine Machine Patients data Computer PlannerInside room camera
  • Setup Verification With EPID X rays passingElectronic PortalImaging Device
  • Digitally reconstructed RadiographFusion of both images EPID image
  • Quality Assurance of IMRT plan Im’RT MatriXX is unique solution to show us what ever is planned at TPS is in reality executed by Linac
  • QA-IMRT by Im’RT MatriXX
  • Todays fraction/ Total fraction
  • Daily Patients on Linear Accelerator
  • Average No. of Patients on LA 30 0 35 40 45 5 50 10 20 15 25 Jan-11Feb-11Mar-11Apr-11May-11Jun-11 Jul-11Aug-11Sep-11Oct-11Nov-11Dec-11Jan-12Feb-12Mar-12Apr-12 Conv IMRT 3DCRT Diff. RT Practices + Avg Pt on LA Palliative Average pT
  • Average Patients on Linac Avg Patient per month Average No. of Patients on LA 50 40 30 20 10 0 Aug-11 Jan-12 Jul-11 Feb-12 Jan-11 Feb-11 Jun-11 Dec-11 Oct-11 Apr-12 Apr-11 Sep-11 Nov-11 Mar-12 May-12 Mar-11 May-11 Jan- Feb Mar Apr May Jun- Jul- Aug Sep Oct Nov Dec Jan- Feb Mar Apr May 11 -11 -11 -11 -11 11 11 -11 -11 -11 -11 -11 12 -12 -12 -12 -12Avg Patient per month 4.6 22. 37. 36. 36. 36. 32. 44. 39. 44. 40. 34. 28. 31. 31. 28. 36
  • Side Effect analysis During weekly review patients in quantify for side effects of radiation therapy and its recording. 27 side effects are being investigated Also taking their picture of radiation side effects esp skin
  • Side effect sheet "BA" Smt L. C. Parikh Cancer Centre, Navsari, Gujarat-396445Date 06-01-2012Reg.No. LCA772 RT No. RT2012374Patients Name Mohammadmustafa Mohammadkasim KhanFather/Husbands Name Mohammadkasim KhanReligion Muslim EBRT From 06-03-2012ToCitizenship Indian DoseRegion Face & Neck Diagnosis Ca left PFS T3N2M0Adv.effects wk1(1-5#) wk2(6-10#) wk3(11-15#) wk4(16-20#) wk5(21-25#) wk6(26-30#)Dates 7#15/03/2012 11#21/03/2012 16#28/03/2012 25#11/04/2012 29#18/04/2012Malaise Gr- Gr-II Gr-I Gr-I Gr-I Gr-IFever Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Headache Gr- Gr-0 Gr-I Gr-I Gr-I Gr-0Infection Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Pain Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Cough Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Skin reac. Gr- Gr-0 Gr-0 Gr-0 Gr-I Gr-0Acne. rashes Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-IPruritis Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Sl Gl changes Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Taste alter. Gr- Gr-I Gr-I Gr-I Gr-I Gr-0Mucositis Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-IDysphagia Gr- Gr-0 Gr-II Gr-II Gr-III Gr-IIINausea Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0vomiting Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Constipation Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Diarrhea Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Anorexia Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Dyspepsia Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0weight loss Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Dehydration Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Haematuria Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0freq. of urine Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Hemoglobin Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0WBC Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0ANC Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0Platelets Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0 Grading acc to CTCAE ver 4.0
  • Side effect Pictures
  • Tejus Beauty Cream Excellent healing in Skin reaction24th # EBRT 30th # EBRT
  • S.S. Solanki1 , M. Loganathan1, R. Swathika’ 1 ,Amol Palaskar1 , Boniface Chettri1 , Jyoti Pokale 1 , P.B. Lad2 1Department of Radiation Oncology, 2Department of Onco-Surgery, “BA” Lilaben Chimanlal Parikh Cancer Centre, Navsari , Guj
  • Introduction Computerization of medical record of patients is one of the key to access the information in least time. To keep patient’s data at par with good institutes, we use our own self developed Electronic Medical Record System in form of Microsoft’s Excel sheets in our day to day activities. This study is being conducted to show how the medical data is recorded and analyzed at our centre for the year 2011.
  • Objectives To find number of patients treated for curative and palliative intent. To find how many patients completed radiation therapy for their prescribed doses. To find present status of patients in terms of alive and lost to follow up through record search and phone calls. To find overall survival in months for Radiotherapy in year 2011.
  • Material and Methods:In the year 2011, a total of 325 patients were enrolled for Radiotherapy. All information about patients details were first written on case sheet then typed on Microsoft’s excel sheet specially prepared for medical records. (Fig 1& 2- excel sheet for data). Treatment decisions were taken to treat patient for radiation therapy on clinical grounds for curative intent (radical, post op or Adjuvant EBRT) or for palliative intent( bone metastasis, brain metastasis, or haemostatic EBRT). All Patients were immobilized with Thermoplastic Cast (ORFIT Industries) and CT scans done (Siemens Emotion Sprit) for planning purpose on flat indexed Carbon Couch (Civco) with help of All in one Base plate (POCL). (Fig 3)
  • Material and Methods: Patients were planned on Eclipse treatment planning system (version 8.9) (Fig. 4) All patients were treated on Varian’s Clinac iX Linear Accelerator daily for 5 days a week. (Fig.5) Weekly OPD review for side effect analysis and adequate treatment was offered for their problems. (Fig 6.)All Patients were given treatment summary after their completion of EBRT from the record.Patients are advised to come on follow up every 2-4 monthly in first year.
  • Material and Methods:To find present status of patients , they were called on mobilein the month of March and Apr 2012 and their status regardingalive with disease free or with disease progression was noted.The analysis was done only for those patients who havecompleted radiotherapy as per prescribed doses.The data was analyzed for treatment completion, overallsurvival and average survival in alive.For Overall survival months were found between date ofevaluation to date of registration.
  • Results-Major groupsTable 1. EBRT Data Survival Figures Incomp Complete Complet Alive Median No RT Alive Alive Lost toMajor Groups Enrolled lete d ed (dis. survival started ( with dis.) (Total) Follow up EBRT EBRT EBRT Free) (months) 288 8.35 (1.36-Curative intent- 6 25 257 257 177 25 202 55 (88.61%) 14.63) 37 7.90 (3.60-Palliative intent 1 1 35 35 0 12 12 23 (11.38%) 13.90) 325 7 26 292 292 177 214 8.32 (1.36- 78 Total 37 (12.67%) (100%) (2.1%) (8%) (89.8%) (100%) (60.6%) (73.28%) 14.63) (26.7%)
  • Results- Curative Group Table 2. EBRT Data Survival Figures Curative Alive Alive Median No RT Incomplete Completed Complete Alive Lost tointent-Major Enrolled (dis. ( with survival started EBRT EBRT d EBRT (Total) Follow up Groups Free) dis.) (months) 14 9.80 (5.90 - CNS Tumors 0 0 14 14 7 4 11 3 (4.86%) 14.13)Head and Neck 8.16 (3.10 - 171 (59.37%) 0 18 153 153 103 10 113 40 Tumors 14.63) Thoracic 11 7.88 (4.36 - 0 2 9 9 5 1 6 3 Tumors (3.81%) 10.53) 28 7.69 (1.36 -Breast Tumors 2 0 26 26 25 1 26 0 (9.72%) 14.60) 6 7.61 (5.83 - GI Tumors 0 2 4 4 4 0 4 0 (2.08%) 11.00)Urinary Tract 3 0 0 3 3 1 0 1 12.03 1 Tumors (1.04%) Male G.U. 3 4.86 (1.73 - 0 0 3 3 2 0 2 1 Tumors (1.04%) 8.00)Gynecological 38 9.67 (2.93 - 3 1 34 34 20 8 28 6 Tumors (13.19%) 14.6)Hematological 10 7.29 (3.73 - 0 2 8 8 7 1 8 0and Lymphoma (3.47%) 11.36)Sarcomas-Bone 2 10.56 (8.60 - 0 0 2 2 2 0 2 0and Soft Tissue (0.69%) 12.53) Pediatric 2 1 0 1 1 1 0 1 6.33 0 Tumors (0.69%) 288 6 25 257 257( 177 25 202 8.34 (1.36- 55 Total (100%) (2.08%) (8.68%) (89.23%) 100%) (68.87%) (9.72%) (78.59%) 14.63) (21.2%)
  • Results-Palliative GroupTable 3. EBRT Data Survival FiguresPalliative Incompl Complete Alive Median intent - No RT Complete Alive Alive Lost to Enrolled ete d (dis. survival Major started d EBRT ( with dis.) (Total) Follow up EBRT EBRT Free) (months) GroupsMetastasis- 27 8.38 (3.60- 1 1 25 25 0 9 9 14 Bone (72.97%) 13.90)Metastasis- 7 0 0 7 7 0 1 1 6.8 5 Brain (18.91%)Metastasis- 2 6.33 (5.70- 0 0 2 2 0 2 2 0Soft tissue (5.40%) 6.96)Hemostatic 1 0 0 1 1 0 0 0 0 0 EBRT (2.70%) 37 1 1 35 35 12 12 6.74(3.60- 23 Total 0 (100%) (2.70%) (2.70%) (94.59%) (100%) (34.28%) (34.28%) 12.70) (65.71%)
  • Results- CNS tumors Table 4 EBRT Data Survival Figures Alive Alive Median No RT Incomplete Completed Completed Alive Lost to CNS Tumors Enrolled (dis. ( with survival started EBRT EBRT EBRT (Total) Follow up Free) dis.) (months) 2 11.31 Ependymoma 0 0 2 2 2 0 2 0 (14.28%) (10.03-12.6)Astrocytoma Gr 1 0 0 1 1 0 0 0 0 1 II (7.14%)Astrocytoma Gr 2 0 0 2 2 1 0 1 7.63 1 III (14.28%)Oligodendroglio 2 13.26 0 0 2 2 2 0 2 0 ma (14.28%) (12.40- 14.13)Glioblastoma Gr 3 8.03 0 0 3 3 0 2 2 1 IV (21.42%) (6.43-9.63) 1CNS Lymphoma 0 0 1 1 0 1 1 12.8 0 (7.14%) Pitutary 3 7.51 0 0 3 3 2 1 3 0 Adenoma (21.42%) (5.90-8.60) 14 14 14 7 4 11 9.80 3 Total 0 0 (100%) (100%) (100%) (50%) (28.5%) (78.57%) (5.90 -14.13) (21.42%)
  • Table 5 EBRT Data Survival Figures MedianHead and Neck No RT Incomp. Complete Complete Alive(Ds. Alive Alive Lost to Enroll. survival Tumors started EBRT EBRT EBRT Free) (with Dis) (Total) Follow up (months) 7.85 Tongue 47 (27.48%) 0 5 42 42 29 1 30 12 3.10-13.66) 8.21Buccal Mucosa 41 (23.97%) 0 3 38 38 31 1 32 6 (3.1-13.96) Retromolar 7.04 12 (7.01%) 0 0 12 12 7 1 8 4 Triagon (4.86- 9.8) 8.27 Alveolus 23 (13.45%) 0 4 19 19 11 3 14 5 (5.0- 14.63) 1 Hard Palate 0 0 1 1 1 0 1 8.16 0 (0.58%) 2 Nasopharynx 0 0 2 2 1 0 1 11.56 1 (1.16%) 8.36 Oropharynx 14 (8.18%) 0 4 10 10 5 1 6 4 (3.4-10.96) 8.48 Larynx 12 (7.01%) 0 1 11 11 6 2 8 3 (4.6- 11.70) 6 5.5Hypopharynx 0 0 6 6 5 0 5 1 (3.50%) (3.53- 9.10) 3 MUO 0 0 3 3 0 0 0 0 3 (1.75%)Parotid + min. 5 12.56 0 1 4 4 4 0 4 0salivary glands (2.92%) (8.43- 14.6) 2Paranasal Sinus 0 0 2 2 0 1 1 11.53 1 (1.16%) 2 6.01Orbit + eye lid 0 0 2 2 2 0 2 0 (1.16%) (3.93-12.) 1Thyroid cancer 0 0 1 1 1 0 1 12.33 0 (0.58%) 171 18 153 153 103 10 113 8.16 40 Total 0 (100%) (10.5%) (89.47%) (100%) (67.32%) (6.53%) (73.8%) (3.10 - 14.63) (23.23%)
  • Results- Thoracic tumors Table 6 EBRT Data Survival Figures Median Thoracic No RT Incomp. Complete Complete Alive(Ds. Alive (with Lost to Enroll. Alive (Total) survival tumors started EBRT EBRT EBRT Free) Dis) Follow up (months) Lung 3 6.04 (4.36- 0 0 3 3 3 0 3 0Carcinoma (27.27%) 7.83)Esophageal 9.73 (8.70- 8 (72.72%) 0 2 6 6 2 1 3 3 Cancer 10.53) 11 9( 9 6 7.88 (4.36 - 3 Total 0 2 (18.1%) 5 (55.5% 1 (11.11%) (100%) 81.8%) (100%) (66.6%) 10.53) (33.3%) Results- Breast tumors Table7 EBRT Data Survival Figures Median Breast No RT Incomp. Complete Complete Alive(Ds. Alive Lost to Enroll. Alive (Total) survival Tumors started EBRT EBRT EBRT Free) (with Dis) Follow up (months) Breast 27 7.60 (1.36-Tumors- Post 2 0 25 25 24 1 25 0 (96.42%) 14.60) MRM Breast 1Tumors- Post 0 0 1 1 1 0 1 9.96 0 (3.57%) BCS 28 2 26 26 25 1 26 7.69 (1.36 - Total 0 0 (100%) (7.14%) (92.85%) (100%) (96.15%) (3.84%) (100%) 14.60)
  • Results- GI Tract tumors Table 8 EBRT Data Survival Figures Gastro- Median No RT Incomp. Complete Complete Alive(Ds. Alive (with Lost toIntestinal Enroll. Alive (Total) survival started EBRT EBRT EBRT Free) Dis) Follow up Tumors (months) 1 Stomach 0 0 1 1 1 0 1 11 0 (16.66%) 1Pancrease 0 1 0 0 0 0 0 0 0 (16.66%) 1 Colon 0 1 0 0 0 0 0 0 0 (16.66%) 2 6.21 Rectum 0 0 2 2 2 0 2 0 (33.33%) (5.83-6.60) 1Anal Canal 0 0 1 1 1 0 1 7.03 0 (16.66%) 6 2 4 4 4 4 7.61 Total 0 0 0 (100%) (33.33%) (66.66%) (100%) (100%) (100%) (5.83 - 11.00) Results- Urinary Tract tumors Table 9 EBRT Data Survival Figures MedianUrinary Tract No RT Incomp. Complete Complete Alive(Ds. Alive (with Alive Lost to Enroll. survival Tumors started EBRT EBRT EBRT Free) Dis) (Total) Follow up (months) 1 Ureter 0 0 1 1 1 0 1 12.03 0 (33.33% 2 Bladder 0 0 2 2 0 0 0 0 2 (66.66% 3 3 3 1 1 2 Total 0 0 0 12.03 (100%) (100%) (100%) (33.33%) (33.33%) (33.33%)
  • Results- Male Genito-urinary tumors Table 10 EBRT Data Survival Figures Male MedianGenitouri No RT Incomp. Complete Complet Alive(Ds. Alive Alive Lost to Enroll. survival nary started EBRT EBRT e EBRT Free) (with Dis) (Total) Follow up (months) Tumors 1 Penis 0 0 1 1 1 0 1 8 0 (33.33% 2 Prostate 0 0 2 2 1 0 1 1.73 1 (66.66% 3 3 3 2 2 4.86 (1.73 - 1 Total 0 0 0 (100%) (100%) (100%) (66.66%) (66.66% 8.00) (33.33% Results- Gynecological tumors Table 11 EBRT Data Survival Figures MedianGynecologic No RT Incomp. Complete Complete Alive(Ds. Alive (with Alive Lost to Enroll. survival al tumors started EBRT EBRT EBRT Free) Dis) (Total) Follow up (months)Endometrium 1 (2.63%) 0 0 1 1 1 0 1 10 0 32 9.12 (2.93 - Cervix 3 1 28 28 15 8 23 3 (84.21%) 14.30% 14.11(13.63-Vaginal Vault 2 (5.26%) 0 0 2 2 2 0 2 0 14.6) Vagina 2 (5.26%) 0 0 2 2 1 0 1 8.7 1 Sarcoma 1 (2.63%) 0 0 1 1 1 0 1 13.86 0 34 34 8 28 9.67 (2.93 - Total 38 (100%) 3 (7.89%) 1 (2.63%) 20 (58.82%) 4 (11.76%) (89.47%) (100%) (23.52%) (82.35%) 14.6)
  • Results- Hematological and Lymphoma Table 12 EBRT Data Survival Figures MedianHematological No RT Incomp. Complete Complete Alive(Ds. Alive (with Alive Lost to Enroll. survivaland Lymphoma started EBRT EBRT EBRT Free) Dis) (Total) Follow up (months) Hodgkins 4 5.41 (3.73- 0 0 4 4 3 1 4 0 Lymphoma (40%) 7.03)Non Hodgkins 9.5(8.43- 5 (50%) 0 2 3 3 3 0 3 0 Lymphoma 11.36) 1 ALL-PCI 0 0 1 1 1 0 1 8.2 0 (10%) 10 2 8 8 1 8 7.29 (3.73 - Total 0 7 (87.5%) 0 (100% (20%) (80%) (100%) (12.5%) (100%) 11.36)
  • Results- Soft Tissue Sarcoma Table 13 EBRT Data Survival FiguresSarcomas- Median No RT Incomp. Complete Complete Alive(Ds. Alive (with Alive Lost to Bone and Enroll. survival started EBRT EBRT EBRT Free) Dis) (Total) Follow upSoft Tissue (months)Soft tissue 2 10.56 (8.6- 0 0 2 2 2 0 2 0 sarcoma (100%) 12.53) 2 2 2 2 10.56 (8.6- Total 0 0 2 (100%) 0 0 (100%) (100%) (100%) (100%) 12.53) Results- Pediatric tumors Table 14 EBRT Data Survival Figures Median Pediatric No RT Incomp. Complete Complete Alive(Ds. Alive (with Alive Lost to Enroll. survival Tumors started EBRT EBRT EBRT Free) Dis) (Total) Follow up (months) Ewing 1 0 0 1 1 1 0 1 6.33 0 sarcoma (50%) CNS- 1 pediatric 1 0 0 0 0 0 0 0 0 (50%) tumor 2 1 1 1 1 Total 0 1 (100%) 0 6.33 0 (100%) (50%) (50%) (100%) (100%)
  • ConclusionsIn one year of Radiation practice at Ba Cancer Centre wehave tried our level best to ensure good radiation practice forour patients. Overall 292/325 (89.8% ) of patients were able to completetheir radiotherapy as per prescribed doses.From curative intent group 214/325 (78.3%) patients are stillalive.Median survival of all alive Patients were 8.32 months (range1.36-14.63)
  • Charges at present Ba Cancer Centre Any Pvt centreConventional 26,000/- 50,000/- toRadiotherapy 80,000/-3D Conformal 31,000/- 75,000/-toRadiotherapy 1,00,000/- Intensity 51,000/- 1,15,000/- to Modulated 1,50,000/-Radiotherapy Palliative 10,000/-,15,000/- 30,000/-,45,000/-Radiotherapy
  • Take home message Option of a Good Radiation therapy centre is opened for the people of Surat and nearby areas in form of Ba Cancer Centre, Navsari Electronic Medical Record System makes this centre working smoothly. We offer world class Immobilization, radiation Planning and Delivery methods. Economically less burden to patients