Category: Statistics

J Cancer Res Ther. 2021 Jan-Mar;17(1):174-179. doi: 10.4103/jcrt.JCRT_817_19.

ABSTRACT

CONTEXT: Sigmoid colon, due to its close proximity to central tandem in intracavitary brachytherapy (BT), is at risk of receiving high dose, the clinical significance of which is not documented.

AIM: This study was designed to assess the dose received by sigmoid colon following radical treatment and to correlate clinically with the sigmoid mucosal changes seen on sigmoidoscopy.

SETTINGS AND DESIGN: This is a prospective study.

SUBJECTS AND METHODS: Thirty histologically proven carcinoma cervix patients treated with radical radiotherapy were accrued. A baseline sigmoidoscopy was done and repeated at 6 months following completion of BT. The dose-volume parameters (DVP) were used to calculate the dose received by the sigmoid colon and correlate with symptoms along with the sigmoid mucosal changes.

STATISTICS: The following were the statistical methods used: frequency; percentages; and descriptive statistics such as mean ± standard deviation, Chi-square test, Kolmogorov-Smirnov test, and independent sample t-test. P < 0.05 was considered statistically significant.

RESULTS: The dose of the sigmoid colon in patients with a sigmoidoscopy score of ≥2 was significantly high compared to that of patients with a score of <2 for DVP such as D0.1cc, D1cc, D2cc, D5cc, and mean dose, whereas max dose was not significantly high.

CONCLUSIONS: The dose received by the sigmoid colon is directly proportional to the mucosal changes and hence possibly a higher morbidity. Tighter dose-volume constraints, better optimization techniques, and close follow-up sigmoidoscopy will help in the prevention and early treatment of long-term morbidity.

PMID:33723151 | DOI:10.4103/jcrt.JCRT_817_19

J Cancer Res Ther. 2021 Jan-Mar;17(1):186-190. doi: 10.4103/jcrt.JCRT_9_19.

ABSTRACT

CONTEXT: Vulvar carcinoma accounts for 3%-5% of gynecologic malignancies. The past three decades has observed changes in the trends of clinical characteristics and treatment modalities used in managing this disease.

AIMS: The aim of the present study is to analyze the clinic-pathological characteristics and survival of women with squamous cell carcinoma vulva who underwent primary surgical management.

SETTINGS AND DESIGN: This was a retrospective observational study.

SUBJECTS AND METHODS: Case records of 30 consecutive patients with squamous cell carcinoma of vulva during the period of 2010-2016 were retrospectively reviewed and their clinical profile, treatment details, complications, and survival were analyzed.

STATISTICAL ANALYSIS USED: Kaplan-Meier survival analysis, followed by logrank test, was used for survival outcome, and Cox proportional hazard model was used to assess significant risk factors.

RESULTS: The mean age of patients was 58 ± 12.9 years. The most common symptom was growth over vulva (73.3%), itching (63.3%), and nonhealing vulval ulcer (26.6%). The most common site for disease was labia majora. The surgical treatments ranged from wide local excision to radical vulvectomy. Postoperative adjuvant therapy was required for 16 patients. The median (95% confidence interval [CI]) overall survival was 27 (21.7-32.2) months. Five-year survival probability for early-stage disease (I + II) was 49% (95% CI: 12.9, 78.4) and for advanced disease (III + IV) was 24.8% (95% CI: 4.8, 42.6). Lymph node-positive status was found to have a significant impact on survival (hazard ratio of 4.9 [95% CI: 1.15-21.02, P = 0.02]).

CONCLUSIONS: Despite advances in detection and management modalities, the survival for vulval malignancies has not improved.

PMID:33723153 | DOI:10.4103/jcrt.JCRT_9_19

J Cancer Res Ther. 2021 Jan-Mar;17(1):69-74. doi: 10.4103/jcrt.JCRT_217_19.

ABSTRACT

BACKGROUND: Malignant pleural mesothelioma (MPM) is a pleural tumor with high mortality rate and short-term survival expectancy after diagnosis. Assessment of the response to chemotherapy, which is the first choice in treatment of MPM, is important for the transition to alternative chemotherapy protocols and immunotherapy. There is no clarity in the response to chemotherapy treatment.

OBJECTIVE: Our study aims to compare the assessment of chemotherapy response using the Modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria and volumetric measurements and to correlate with median survival.

MATERIALS AND METHODS: Thirty-two patients (16 females and 16 males) were included in the study, and their ages ranged from 28 to 78 years. Chemotherapy response was determined by both mRECIST and volumetric approach. Tumor volume was measured by linear interpolation and semi-automatic segmentation. Log-rank multiple cutoff analysis was used to determine appropriate cutoff values of volumetric response criteria.

RESULTS: According to both mRECIST and volumetric approach, median survival times in partial response, stable disease, and progressive disease groups were 24, 15, and 9 months, respectively. The survival times of the three groups were different (logrank: 17.76; P < 0.001) by mRECIST. The survival of the progressive disease group was shorter than that of the other groups (logrank: 18.91; P < 0.001) by volumetric approach.

CONCLUSIONS: In the assessment of chemotherapy response, even though classifications obtained according to the mRECIST criteria and volumetric measurements are statistically compatible, we think that the measurement of the volumetric values will increase the standardization. In our study, threshold values for volumetric measurements were determined; however, these values should be supported by large-scale multicenter studies.

PMID:33723135 | DOI:10.4103/jcrt.JCRT_217_19

J Cancer Res Ther. 2021 Jan-Mar;17(1):99-105. doi: 10.4103/jcrt.JCRT_32_19.

ABSTRACT

CONTEXT: Radiotherapy may have side effects on the brain, such as radiation necrosis, cognitive impairment, and a high chance of tumor recurrence, which has been considered the most common cause of treatment failure.

AIMS: Using intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques, we aimed to test the potential outcome of sparing the contralateral hippocampus (CLH) in radiotherapy for brain tumors by comparing dosimetric parameters.

SETTINGS AND DESIGN: A prospective clinical comparative study.

SUBJECTS AND METHODS: Using IMRT and VMAT, sparing CLH in radiotherapy of brain tumors was tested in ten patients, and various dosimetric parameters were compared. The treatment plans were accepted only if they met the set of planning objectives defined in the protocol.

RESULTS: The dose delivered to 95% of the CLH volume (CLH D95), and the mean (CLH Dmean) and max (CLH Dmax) doses were found to be significantly highest in the standard IMRT (P = 0.002, <0.001, and < 0.001, respectively). The lowest CLH D95, CLH Dmean and CLH Dmax for the hippocampus were detected in sparing VMAT planning than in the other plans (P < 0.05). None of the post hoc comparisons for CLH D95 was different among any of the plans, whereas the mean dose to CLH was statistically different among all paired comparisons (P < 0.008). The maximum dose to CLH was also statistically different among all paired plans (P < 0.008), except the dose difference between standard VMAT and IMRT plans.

CONCLUSIONS: Although VMAT planning is troublesome and time-consuming, the advantage of sparing the hippocampus is beneficial, preserving the hippocampus and cognitive functions during radiotherapy.

PMID:33723139 | DOI:10.4103/jcrt.JCRT_32_19

J Cancer Res Ther. 2021 Jan-Mar;17(1):106-113. doi: 10.4103/jcrt.JCRT_854_19.

ABSTRACT

CONTEXT: Malignant peripheral nerve sheath tumor (MPNST) is a rare and aggressive soft-tissue sarcoma.

AIMS: The aim of this study was to analyze various prognostic factors and treatment outcome of patients with MPNST.

SETTINGS AND DESIGN: This was a retrospective study.

SUBJECTS AND METHODS: Ninety-two patients, who presented with MPNST at a tertiary care cancer center from 2011 to 2018, were included in this study. The median follow-up of all living patients was 33 months. Neurofibromatosis 1 (NF1) was seen in 12 (13%) patients. Sixty (65.2%) patients received curative-intent treatment.

STATISTICAL ANALYSIS USED: Kaplan-Meier method was used for survival analysis. Log-rank test was used for univariate analysis, and multivariate analysis was done by Cox proportional hazard ratio method.

RESULTS: The 5-year overall survival (OS) of all patients was 47.2% and the 5-year disease-free survival (DFS) of operated patients was 41.5%. On univariate analysis, association with NF1 (P = 0.009), grade (P = 0.017), and margin status (P = 0.002) had a significant effect on DFS, whereas association with NF1 (P = 0.025), metastatic disease on presentation (P < 0.0001), palliative intent of treatment (P < 0.0001), grade (P = 0.049), and margin status (P = 0.036) had a significant effect on OS. On multivariate analysis for patients who were treated with curative-intent treatment, grade (P = 0.015), and margin status (P = 0.028) had a significant effect on DFS, whereas association with NF1 (P = 0.00026) and location of tumor (P = 0.040) had a significant effect on OS.

CONCLUSIONS: The presence of distant metastasis, palliative intent of treatment, association with NF1, location of the tumor in the head and neck, high tumor grade, and positive margin status were the risk factors associated with poor survival for the patients with MPNST. Wide local excision with negative resection margin is the highly recommended treatment.

PMID:33723140 | DOI:10.4103/jcrt.JCRT_854_19

J Cancer Res Ther. 2021 Jan-Mar;17(1):62-68. doi: 10.4103/jcrt.JCRT_915_17.

ABSTRACT

OBJECTIVE: The main objective of the study was to evaluate the cytotoxicity of selected essential oils on human skin, gastric, and brain cancer cell lines using microculture tetrazolium test.

MATERIALS AND METHODS: Phytochemical analysis, as well as acute oral toxicity tests, was carried out in female albino mice with cardamom oil, lemon oil, and jasmine oil according to the Organization for Economic Co-operation and Development guidelines 425. Anticancer activities of the above test drugs were performed using human cancer cell lines. The studies were carried out at Skanda Life Sciences Pvt. Ltd., Bengaluru.

RESULTS: Phytochemical analysis has shown the presence of carbohydrates and flavonoids in cardamom oil. While lemon oil has shown the presence of carbohydrates, flavonoids, steroids, terpenoids, and tannins, jasmine oil has shown the presence of carbohydrates, alkaloids, flavonoids, steroids, terpenoids, and glycosides. Toxicity studies showed that cardamom oil, lemon oil, and jasmine oil were all found to be safe up to 2000 mg/kg body weight. Results have shown that lemon oil exhibited the strongest cytotoxicity toward three human cancer cell lines, namely skin cancer (A431), gastric cancer (MKN-45), and brain cancer (U-87 MG) cell lines, with higher IC₅₀ values of 62.82 μg/ml, 220.9 μg/ml, and 440.1 μg/ml compared to standard. Jasmine oil exhibited the strongest cytotoxicity toward skin cancer and brain cancer cell lines, whereas cardamom oil has shown stronger cytotoxicity only toward skin cancer cell line but did not show any level of inhibition of growth of brain and gastric cancer cells.

CONCLUSION: Our study reveals that lemon oil, jasmine oil, and cardamom oil possess potent antitumor activity compared to standard. At different concentrations, lemon oil has shown statistically significant (***P < 0.0001) anticancer activity toward all the three human cancer cell lines. While jasmine oil has shown statistically significant (***P < 0.0001) anticancer activity toward skin and brain cancer cell line, cardamom oil has also shown statistically significant (***P < 0.0001) anticancer activity but only toward skin cancer cell line.

PMID:33723134 | DOI:10.4103/jcrt.JCRT_915_17

Niger J Clin Pract. 2021 Mar;24(3):393-399. doi: 10.4103/njcp.njcp_280_18.

ABSTRACT

BACKGROUND: Self-efficacy is defined as the ability of an individual to perform an action successfully or her/his perception of being able to control events. The self-efficacy perception of diabetes management may affect well-being of the patient.

AIMS: This study aimed to examine the relationships between self-efficacy of diabetes management and well-being in patients with type 2 diabetes.

SUBJECTS AND METHODS: The study used a descriptive correlational design. Sample of the study included 200 patients with type 2 diabetes. Sociodemographic and disease-related questionnaire form “Self-Efficacy Scale for Diabetes Management” and “Well-Being Questionnaire” have been used as data collection tools. Multiple linear regression analysis was performed to explore the predictors of well-being in patients with type 2 diabetes.

RESULTS: Self-efficacy level, age, level of compliance with treatment, and state of doing exercise were found to be statistically significant predictors of well-being in type 2 diabetic patients. Self-efficacy level for diabetes management was found to be the strongest predictor of well-being in patients with type 2 diabetes.

CONCLUSION: Self-efficacy level of diabetes management is a factor that affects well-being in type 2 diabetes patients and it should be considered during interventions for improving the well-being of patients.

PMID:33723114 | DOI:10.4103/njcp.njcp_280_18

Niger J Clin Pract. 2021 Mar;24(3):418-424. doi: 10.4103/njcp.njcp_250_20.

ABSTRACT

OBJECTIVES: The aim of this study was to compare the formation of dentinal crack after root canal preparation performed with different heat treated single-file systems.

MATERIALS AND METHODS: Forty mandibular premolar teeth were randomly divided into four groups according to the file system to be used during the preparation (n = 10): Group 1: Reciproc Blue; group 2: One Curve; group 3: HyFlex EDM; group 4: (control group) hand files. During the cleaning and shaping, irrigation was performed with a total of 10 ml of 5.25% sodium hypochlorite and 2 mL of distilled water. Then sections were taken from the roots (3, 6 and 9 mm). Sections were examined on a stereomicroscope to determine the presence of cracks. Chi-square test was used for data analysis.

RESULTS: There was a significant difference between the groups in dentinal crack frequency (P <.05). HyFlex EDM (13.3%) caused less dentinal crack than One Curve (26.7%) and Reciproc Blue (30%). No cracks were observed in the control group. When 3, 6, and 9 mm were evaluated within themselves, dentinal crack formation did not differ according to the groups (P > 0.05). A statistically higher mean value was obtained in the control group compared to the other groups in terms of working time (P < 0.001).

CONCLUSIONS: All the files used during root canal preparation formed dentin crack. Hy-Flex EDM caused less dentinal cracks than other file systems. The flexibility of nickel-titanium instruments because of heat treatment seems to have a significant influence on dentinal crack formation.

PMID:33723118 | DOI:10.4103/njcp.njcp_250_20

Niger J Clin Pract. 2021 Mar;24(3):425-434. doi: 10.4103/njcp.njcp_112_20.

ABSTRACT

OBJECTIVE: This study aimed to compare the clinical efficacy and survival rates of the hall technique (HT), and conventional restoration (CR) for the management of occlusoproximal carious lesions in primary molars.

MATERIALS AND METHODS: This clinical study observed 35 children (aged 4-8 years). Exclusion criteria included symptoms of pulpal or periradicular pathology or systemic conditions requiring special dental considerations. For each child, at least one tooth was treated with HT and one with CR. The primary outcome measures were minor and major clinical failure rates. Plaque and gingival scores of the teeth were also evaluated. Friedman test and Wilcoxon signed ranks test were used to compare the plaque and gingival index scores for each arm. Chi-square tests were used for comparisons of clinical outcomes, plaque-gingival index, and distribution of ICDAS categories among treatment arms (P < 0.05).

RESULTS: Thirty-three of 35 (94.2%) participants returned for 1-year follow-up. HT showed statistically significantly higher treatment survival rate and fewer minor failures than CR (P = 0.040). The rate of major failures was minimal (2 of 84 teeth) and did not differ between treatments (P = 0.092). In both treatment groups, the gingival score and plaque score were significantly decreased at the 1-year follow-up (P < 0.05).

CONCLUSION: HT was a more successful method for managing caries in primary molars than CR, both for symptoms of pulpal disease and longevity of the restorations. HT is a simplified method of managing carious primary molars using SSCs cemented with no local anesthesia, caries removal, or tooth preparation.

PMID:33723119 | DOI:10.4103/njcp.njcp_112_20

Zhonghua Yan Ke Za Zhi. 2021 Mar 11;57(3):223-227. doi: 10.3760/cma.j.cn112142-20200317-00195.

ABSTRACT

Objective: To observe the changes of four pulley locations of extraocular rectus muscles and rectus muscle volumes, as well as superior and inferior part ratio of horizontal rectus muscles, in concomitant exotropia with small-angle vertical deviation in primary gaze. Methods: Cross-sectional study. Data was collected from January 2018 to December 2019 in Tianjin Eye Hospital. The pulley position changes and volumes of four extraocular rectus muscles in the coronal position of patients who had concomitant exotropia without vertical deviation (group A) or with small-angle vertical deviation in primary gaze (<5 prism diopter; group B) and normal controls (group C) were observed using MRI, and the changes of the volume ratio of the superior and inferior parts of the horizontal rectus muscle were calculated. One way analysis of variance and Kruskal-Wallis test were used for statistical analysis. Results: There were 19 patients (38 eyes; 10 males, 9 females) aged (30±7) years in group A, ten patients (20 eyes; 4 males, 6 females) aged (27±6) years in group B, and 20 healthy volunteers (40 eyes) in group C. Age and gender distribution were matched among the three groups (all P>0.05). Among the three groups, the pulley locations of the four extraocular rectus muscles were not significantly different (all P>0.05). The medial rectus muscle volume in groups A [(358.6±44.9) mm³; t=6.405, P<0.01] and B [(334.7±35.6) mm³; t=6.025, P<0.01] was significantly smaller than group C [(437.5±49.3) mm³]. There was no statistically significant difference in the superior and inferior muscle volume ratio of the lateral rectus in three groups (all P>0.05), while the ratio in group B was more dispersive. Conclusions: The pulley location changes of four extraocular rectus muscles of patients with concomitant exotropia and small-angle vertical deviation in primary gaze are not significant, but the medial rectus volume in patients who had concomitant exotropia with vertical deviation or not is significantly smaller. The dispersive superior and inferior muscle volume ratio of the horizontal rectus muscles may be related to the small angle of vertical deviation in clinical examinations. (Chin J Ophthalmol, 2021, 57: 223-227).

PMID:33721962 | DOI:10.3760/cma.j.cn112142-20200317-00195