Dr. Mohammad Jahan Shams is a Consultant of Clinical Oncology, Department of Clinical Oncology,Bangabandhu Sheikh Mujib Medical University, Dhaka,Bangladesh. Dr. Mohammad Jahan Shams is a member of BSRO (Bangladesh Society of Radiation Oncology) since 2022, with different medical professionals, scientists, professors, nurses and others to provide relevant and accurate information on the prevention, early diagnosis, treatment, and palliation of cancer. Address: Dhaka, Bangladesh 🇧🇩
Bangabandhu Sheikh Mujib Medical University Journal, Jan 16, 2023
Chemotherapy is the primary therapeutic choice for advanced gastric cancer. The goal of this stud... more Chemotherapy is the primary therapeutic choice for advanced gastric cancer. The goal of this study was to assess the effectiveness and toxicity of the cisplatin-capecitabine regimen versus the oxaliplatin-capecitabine regimen in treating advanced gastric cancer. Between February 2021 and March 2022, this quasi-experimental study was conducted on 64 advanced gastric cancer patients. Purposive sampling was used to include those who met the inclusion criteria and distributed them evenly between the two arms. Arm A got an injection of cisplatin (80 mg/m2 on day 1) with oral capecitabine (1000 mg/m2 b.i.d. on days 1–14), whereas arm B received an injection of oxaliplatin (130 mg/m2 on day 1) plus oral capecitabine (1000 mg/m2 b.i.d. on days 1–14), every 3 weeks for 6 cycles. A final check-up was done at 12 weeks after the treatment. In arm A, 18 (56.2%) patients exhibited partial response compared to 15 (46.9%) in arm B. Stable diseases were also reported in both arms (18.8% in arm A and 21.9% in arm B). There were 8 (25.0%) cases of progressive disease in arm A and 10 (31.2%) cases in Arm B. The median progression-free survival in arms A (5.6 months) was almost similar to arm B (5.9 months). The most prevalent toxicities in both arms were vomiting, diarrhea, anemia, neutropenia, oral mucositis, paresthesia, handfoot syndrome, and renal toxicity. There were no statistically significant variations in outcomes between the two arms. In conclusion, the cisplatincapecitabine regimen is as effective as the oxaliplatin-capecitabine regimen in advanced gastric cancer. BSMMU J 2022; 15(3): 180-185
EUROPEAN JOURNAL OF PHARMACEUTICAL AND MEDICAL RESEARCH, Sep 1, 2024
Background: Combined modality of treatment i.e., platinum-based doublet chemotherapy with concurr... more Background: Combined modality of treatment i.e., platinum-based doublet chemotherapy with concurrent radiotherapy is the standard treatment for locally advanced non-small cell lung cancer (NSCLC). However, the optimal chemotherapy regimen to use with radiotherapy is still not established. Aim of this study was to compare the acute toxicities between cisplatin-etoposide (EP) and paclitaxel-carboplatin (PC) along with thoracic radiotherapy in unresectable locally advanced NSCLC. Materials and Methods: A Quasi-experimental study was conducted from October 2020 to September 2021 at Bangabandhu Sheikh Mujib Medical University (BSMMU) and National Institute of Cancer Research and Hospital (NICR&H), Dhaka. Patients with unresectable, locally advanced NSCLC who met the inclusion criteria were enrolled and distributed equally into two arms. Patients received thoracic radiotherapy with 60Gy in 2Gy daily fractions, 5 fractions a week, for 6 weeks with either Injection Cisplatin 50 mg/m2 administered on days 1, 8, 29, and 36, and Injection Etoposide 50 mg/m2/day on days 1–5 and 29–33 (Arm A), or Injection Carboplatin (AUC-2) and Injection Paclitaxel (45 mg/m2) administered on day 1, weekly, over a 6-week period (Arm B). All the patients were evaluated before, during, and after the completion of the treatment. Follow ups were done at 6 weeks, 12 weeks and 24 weeks following the completion of treatment using history, clinical examination and investigations. Results: most commonly observed toxicities were nausea, esophagitis and radiation pneumonitis. Although grade 1 esophagitis was more in arm B (56.76% vs 35.14%), grade 2 and 3 esophagitis were more in arm A (40.54% vs 16.21%; and 13.51% vs 5.41% respectively; p 0.043). Grade 1 pneumonitis was same (16 or 43.24%) in both arms. However, Grade 2 and 3 radiation pneumonitis were significantly more in Arm B (40.54% vs 16.22% and 5.41% vs 2.7 % respectively; p 0.004). Observed differences in nausea, vomiting, dermatitis, neurotoxicity, and hematological toxicities were not found to be statistically significant. Conclusion: This study suggests that the toxicities of cisplatin-etoposide regimen is comparable to paclitaxel-carboplatin regimen when given with concurrent radiotherapy in unresectable locally advanced non-small cell lung cancer.
Background: Gastric carcinoma is one of the commonest cancers in Bangladesh. The goal of this stu... more Background: Gastric carcinoma is one of the commonest cancers in Bangladesh. The goal of this study was to assess at the clinico-epidemiological characteristics of individuals with gastric cancer. Methods: This descriptive, cross- sectional study was conducted from November 2021 to October 2022, 120 patients with gastric cancer were included at Bangabandhu Sheikh Mujib Medical University (BSMMU), Department of Clinical Oncology. A pre-made questionnaire was used to collect data from patients during face-to-face interviews. Results: The mean age of the patients was 53.0 (±11.496) years, most of the patients (46.6%) were 51 – 60 years of age, 75.0 % of enrolled patients were male, 35.0 % of patients were service holder. The bulk of the cases had H. pylori infection (73.3%). The most common histological type among the patients was adenocarcinoma (95%). In terms of primary tumor location, the gastric antrum (50.0%) was the most prevalent subsite. Most of the patients were diagnosed as locally advanced stage. Conclusions: In conclusion, gastric cancer occurs mainly in middle aged males and associated with H. pylori infection. Adenocarcinoma is the most frequent histological form, with the gastric antrum as the main location of tumors and advanced stage.
Bangabandhu Sheikh Mujib Medical University Journal, Feb 22, 2022
Molecular factors play an important role in the management and treatment outcome of breast cancer... more Molecular factors play an important role in the management and treatment outcome of breast cancer. Molecular subtyping has been developed depending upon estrogen and progesterone receptors, human epidermal growth factor receptor-2 and ki76 level. This cross-sectional study was done to assess the molecular subtypes of locally advanced breast cancer and its associated risk factors. Total 94 patients with locally advanced breast cancer were included in the study. The mean age was 42.6 years with a standard deviation of 9.56. In total, 91.5 percent of respondents had menarche at or after the age of 12, and 26.6 % had used hormonal contra- ception in the past. Tobacco users and positive family history were found in 21.2% and 5.35% of the cases. Among the patients, 3.4 % of cases had their first childbirth after the age of 30 and 95.5% of patients feed their babies from their both breasts. Among 94 cases 5 did not have any child. Estrogen receptor was found positive in 35% of cases, proge...
International Journal of Research in Medical Sciences, 2023
Background: The outcome of treatment for advanced gastric carcinoma can vary depending on a numbe... more Background: The outcome of treatment for advanced gastric carcinoma can vary depending on a number of factors, including the stage and aggressiveness of the cancer, the patient's overall health, and their response to treatment. In general, the prognosis is poor, with a median overall survival of less than one year. Quality of life (QOL) is an important consideration for patients with advanced gastric carcinoma, as they may experience a range of symptoms such as pain, fatigue, and difficulty eating. This study aimed to evaluate the post-treatment outcomes and QOL in patients with inoperable advanced gastric carcinoma after treatment with cisplatin-capecitabine and with oxaliplatincapecitabine. Methods: This Quasi-experimental study was conducted at the department of oncology, Bangabandhu Sheikh Mujib medical university, Dhaka, Bangladesh. The study duration was 1 year, from February 2021 to March 2022. During this period, a total of 64 cases of advanced gastric cancer were divided in two equal groups, arm A who had received cisplatin capecitabine, and arm B who received oxaliplatin capecitabine. Result: The mean age at diagnosis was 55.85 and 56.76 respectively. The majority of the patients, 43.8% in arm A and 50% in arm B, ranged in age from 61 to 70. The gender distribution was similar, 78% and 69% of patients in arm A and B respectively were male. Both groups had the majority of patients receiving an ECOG performance rating of 2, with 68.8% in arm A and 59.4% in arm B, and the liver being the most common metastatic site for 56.3% in arm A and 50.0% in arm B. The most frequent risk factor was Helicobacter pylori infection, observed in 68.8% of arm A and 78.1% of arm B. The most common primary tumor site was the antrum, with 50% and 53.1% patients in arm A and B respectively had the primary tumor in the antrum of the stomach. Conclusions: In inoperable advanced gastric cancer, the cisplatin-capecitabine regimen is equally effective as oxaliplatin-capecitabine in terms of disease outcome. Furthermore, the cisplatin-capecitabine regimen is less costly than the combination of oxaliplatin-capecitabine, and provides almost similar QOL. As a result, the cisplatincapecitabine regimen could be utilized as an alternate choice in patients who are unable to afford an oxaliplatin-based regimen.
International Journal of Advances in Medicine, 2024
Background: Enteric fever remains a significant public health challenge, particularly in developi... more Background: Enteric fever remains a significant public health challenge, particularly in developing countries. Understanding the knowledge, attitudes, and practices of general practitioners regarding enteric fever is crucial for effective disease management and control. This study aims to assess these aspects among general practitioners, providing insights into current practices and identifying areas for improvement. Methods: This cross-sectional survey was conducted with 200 general practitioners. The questionnaire covered various aspects, including baseline characteristics, knowledge about enteric fever causative agents and symptoms, diagnostic practices, antibiotic preferences, and general attitudes towards management and prevention. Data were analyzed to determine the prevalence of specific knowledge and practices. Results: Majority of practitioners (74%) were residents, predominantly working indoors (61.5%). All respondents correctly identified Salmonella typhi and para typhi as causative agents and fever as a primary symptom. However, there was variability in recognizing other symptoms and diagnostic methods. Ceftriaxon was the most preferred antibiotic (67%), and blood culture correctly identified as gold standard for diagnosis by 71% of respondents. Attitudes and practices varied, with significant number not adhering to recommended diagnostic and treatment protocols. Conclusions: The study reveals a solid foundation of basic knowledge about enteric fever among general practitioners but also highlights significant gaps in the understanding of clinical symptoms, diagnostic practices, and treatment protocols. These findings underscore the need for enhanced educational initiatives and standardized guidelines to improve the management of enteric fever.
Breast cancer patients may experience multiple symptoms due to the disease itself, treatment or c... more Breast cancer patients may experience multiple symptoms due to the disease itself, treatment or combination of both. The aim of the present study was to identify group of symptoms experienced by the patients with breast cancer using cluster analysis. We examined symptom profiles of 120 patients with breast cancer who attended a hospital palliative care centre in a tertiary institution. Following symptoms were analyzed: pain, nausea, loss of appetite, constipation, weakness, cough, breathlessness, sleeplessness, lymphedema, sadness, anxiety and depression. Hierarchical cluster analysis was used to identify the natural groupings within the set. We could identify three clusters. Cluster 1 was characterized by pain, depression, anxiety, weakness, sleeplessness and loss of appetite. Cluster 2 comprised of cough, breathlessness, nausea and constipation. Cluster 3 consisted of two symptoms lymphedema and sadness. The results revealed that the patients with breast cancer experienced symptoms that are multiple and clustered together. Neuro-psychiatric symptoms and weakness formed a significant strong relationship. Knowledge obtained from this study can be beneficial for better understanding, assessment and management of symptom clusters in women with breast cancer. It may also help patients to plan ahead for them to seek management of concurrent symptoms to improve their quality of life. Bangladesh Med J. 2016 Jan; 45 (1): 25-30
Bangabandhu Sheikh Mujib Medical University Journal, Feb 22, 2022
Molecular factors play an important role in the management and treatment outcome of breast cancer... more Molecular factors play an important role in the management and treatment outcome of breast cancer. Molecular subtyping has been developed depending upon estrogen and progesterone receptors, human epidermal growth factor receptor-2 and ki76 level. This cross-sectional study was done to assess the molecular subtypes of locally advanced breast cancer and its associated risk factors. Total 94 patients with locally advanced breast cancer were included in the study. The mean age was 42.6 years with a standard deviation of 9.56. In total, 91.5 percent of respondents had menarche at or after the age of 12, and 26.6 % had used hormonal contra- ception in the past. Tobacco users and positive family history were found in 21.2% and 5.35% of the cases. Among the patients, 3.4 % of cases had their first childbirth after the age of 30 and 95.5% of patients feed their babies from their both breasts. Among 94 cases 5 did not have any child. Estrogen receptor was found positive in 35% of cases, progesterone receptor-positive patient was 33% and HER-2 was found positive in 39.4% of cases. Ki-67 level was found high in 66% of cases. Among the 94 cases, the Luminal A subtype was found in 18% and the Lumi- nal B subtype was found in 27.7% cases. The human epidermal growth factor receptor-2 subtype was found relatively less frequent than Luminal type B (24.5% vs. 27.7%). Triple-neg- ative breast cancer was most commonly diagnosed among the patients (almost 30%). The increased number of triple-negative variants signifies poor prognostic outcomes. The risk factor of breast cancer did not show any statistical correlation with molecular subtypes. BSMMU J 2021; 14(3): 57-61
Bangabandhu Sheikh Mujib Medical University (BSMMU) Journal, 2021
Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women. This ... more Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women. This cross sectional study was done to assess the presenting features of locally advanced breast cancer. The mean age was 42.6 years with standard deviation 9.56, 86% were house wife, 53.5% were illiterate, 16% were postmenopausal and 75.8% had BMI of 20Kg/m2. Ninety one point five percent had menarche at or above 12 years of age and 26.6 % had history of using hormonal contraceptives. Tobacco user and positive family history were found in 21.2% and 5.35% of the cases. 84% were presented with only lump and 16% with both lump and ulceration. Right breast was involved in 51.1%. About 37% cases presented on 3rd month of their symptoms. Around 71.2% patients presented with lump >5cm in diameter, axillary lymph nodes were palpable in 81% and fixed in 31% of patients. Around Sixty three percent of patients were in stage IIIA. Still a large fraction of patients present with advanced stage with varied presentation, sometimes surgeons face difficulties to offer the treatment. Proper awareness, early presentation and early detection give them the opportunity to receive the best treatment. BSMMU J 2021; 14(4): 148-151
Scholars Journal of Applied Medical Sciences, Jul 14, 2020
Back ground: Biliary tract cancers refer to as group of cancers that arise from epithelial lining... more Back ground: Biliary tract cancers refer to as group of cancers that arise from epithelial lining of the gall bladder and bile ducts peri-hilar and extra hepatic biliary tree and peri-ampullary tumors. Though biliary tract cancer is a rare entity.
Objective: In this study our main goal is to evaluate the sociodemographic status of biliary tract carcinoma patients.
Method: This cross-sectional study was conducted in Department of Oncology Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College and National Institute of Cancer Research and Hospital, Dhaka from January 2018 to June 2019. 78patients with advanced biliary tract carcinoma (Stage IV), attending the out-Patient department were selected as sample where 39 patients received - Oral Capecitabine plus injectable Cisplatin (Arm-A) and 39 patients received injection Gemcitabine plus Cisplatin (Arm-B). Purposive sampling was done and data were analyzed by SSPS 21.
Results: In this study, the majority of the patients were in the 50 to 59 years age groups in both the arms, range from 37 -70 years. Most of the patients were in the group 2 in both the arms. It was 51.29% and 56.41% in arm A & B respectively. 53.85% and 43.59% patients from Arm A and B had the primary tumor in the Gall Bladder respectively. 35.89% and 43.58% patients from Arm A and B respectively had the primary tumor in the Cholangiocarcinoma (CCA). On the other hand, 10.26% and 12.83% patients from Arm A and B had the primary tumor in the Periampullary Carcinoma respectively. Most of the patients (66.66% in Arm A and 66.66% in Arm B) had liver metastasis.
Conclusion: In conclusion we can say that, this study demonstrated that, biliary tract cancers are a highly aggressive human malignancy that is difficult to diagnose. Most of the cases site of metastasis increase gradually which compare from similar studies in the literature.
Background: Gastric carcinoma is one of the commonest cancers in Bangladesh. The goal of this stu... more Background: Gastric carcinoma is one of the commonest cancers in Bangladesh. The goal of this study was to assess at the clinico-epidemiological characteristics of individuals with gastric cancer.
Methods: This descriptive, cross- sectional study was conducted from November 2021 to October 2022, 120 patients with gastric cancer were included at Bangabandhu Sheikh Mujib Medical University (BSMMU), Department of Clinical Oncology. A pre-made questionnaire was used to collect data from patients during face-to-face interviews.
Results: The mean age of the patients was 53.0 (±11.496) years, most of the patients (46.6%) were 51 – 60 years of age, 75.0 % of enrolled patients were male, 35.0 % of patients were service holder. The bulk of the cases had H. pylori infection (73.3%). The most common histological type among the patients was adenocarcinoma (95%). In terms of primary tumor location, the gastric antrum (50.0%) was the most prevalent subsite. Most of the patients were diagnosed as locally advanced stage.
Conclusions: In conclusion, gastric cancer occurs mainly in middle aged males and associated with H. pylori infection. Adenocarcinoma is the most frequent histological form, with the gastric antrum as the main location of tumors and advanced stage.
Journal Of Medical Science And Clinical Research , Jan 1, 2023
Introduction: In general head and neck cancer may be treated with single modality of treatment fo... more Introduction: In general head and neck cancer may be treated with single modality of treatment for early-stage disease but may require multimodality treatment protocol for advanced disease. concurrent chemoradiation is the current standard protocol for patients with locally advanced squamous cell carcinoma of head neck. Carcinoma of head and neck is common clinical entity approximately 4.8% of the total new- cancer cases. In Bangladesh, according to cancer Registry Report NICRH (20015-2017), approximately 2901(10.6%) patients ire registered with head and neck cancer.
Study Design and Objective: This prospective observational study is to compare the treatment response and acute toxicities with the treatment of low dose weekly Carboplatin(AUC:2) with radiation versus weekly Cisplatin with radiation therapy for histologically proven advanced squamous cell carcinoma of head neck.
Methods: All the patients were divided in two groups. Arm-A 30 number patients received injection Carboplatin (AUC:2), i/v 30 minutes infusion weekly for 6 weeks and Arm- B 30 number patients received injection Cisplatin 30mg/m2, i/v 2 hrs. infusion weekly for 6 weeks. All patients received 66 Gray (Gy) radiation at the rate of 2Gy/day 5# in a week for 6.5 weeks.
Results: In this study ninety percent (90%) patients were smoker. The most common presenting features were cervical lymphadenopathy (Arm A 100% vs. Arm B 100%), pain (Arm A 73.33% vs. Arm B 66.67%), sore throat (Arm A 36.67% vs. Arm B 36.66%), hoarseness of voice (Arm A 36.67% vs. Arm B 36.66%) etc. Complete response of patients treated with concurrent chemoradiation with inj. Carboplatin was 63.33% in comparison to 53.33% complete response achieved in patients treated with concurrent chemoradiation with inj. Cisplatin. This difference was statistically not much more significant. Common toxicities related to treatment were mucositis, skin reaction, vomiting, nausea, weight loss, anemia, leucopenia, thrombocytopenia and diarrhea. The toxicities in Arm-A were more than that of Arm-B, but were manageable.
Conclusion: In this study the clinical response and toxicities produced by weekly low dose carboplatin with radiation in locally advanced squamous cell carcinoma of head and neck cancer were comparable to those of weekly Cisplatin schedule with radiation showed no additional efficacy. So, concurrent chemoradiotherapy with weekly Carboplatin (AUC:2) is suitable when Cisplatin is contraindicated for the patients with renal impairment.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), Dec 22, 2022
Introduction: Locally advanced head and neck carcinomas constitute a substantial proportion of ca... more Introduction: Locally advanced head and neck carcinomas constitute a substantial proportion of cancer patients in Bangladesh. The common practice is to treat the condition by conventional fractionation (2 gray/fraction, total dose 66 gray). Hypo-fractionated radiotherapy (2.75 gray/fraction, total 55 gray) might be able to produce a similar response in a shorter time. Aim of the study: The aim of the study was to determine tumor response and toxicities in hypo-fractionated radiotherapy.
Methods: This Quasi-Experimental study was conducted at the Department of Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, and the Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh. The study duration was 1.5 years, from July 2018 to December 2019. During this period, a total of 74 patients with inoperable locally advanced squamous cell carcinoma of the head and neck, and equally distributed in two groups, Arm-A and Arm-B. Arm-A received conventionally fractionated chemo-radiotherapy and Arm-B received hypo-fractionated radiotherapy
Result: The mean age of Arm-A and B patients were 53.27 (±11.23) & 51.03 (±9.48) years, respectively. Among 74 patients, 46 patients were smokers. 33.68 % of patients were in stage III and 66.22% of patients were in stage IV. In Arm-A 10 patients (27.03%) showed a complete response and in Arm-B, a complete response was observed in 7 patients (18.93%). Partial response was 19 (51.35%) and 18 (48.64%) in Arm-A and B, respectively. There were 4 (10.81%) progressive disease cases in Arm-A and 5 (13.51%) in Arm-B. Significant differences in frequencies of acute grade 2 skin toxicity, mucositis, were found, with higher frequencies. Grade 2 oral mucositis was seen in 26 (70.27%) and 14 ( 37.83%) patients of Arm-A and B, respectively which was statistically significant. Other toxicities had no significant differences between Arm-A and B. in Arm-B.
Conclusion: Hypo-fractionated radiotherapy can achieve a similar tumor response to conventionally fractionated radiotherapy in HNSCC, although with some increase of manageable toxicity.
International Journal for Multidisciplinary Research (IJFMR), Jul 24, 2023
Introduction: Radiotherapy is an essential modality of treatment after mastectomy. However, toxic... more Introduction: Radiotherapy is an essential modality of treatment after mastectomy. However, toxicities of post-mastectomy radiotherapy are still not well established. This study was aimed at comparing the acute skin toxicitiesand doses to the organs at risk between conventional and advanced conformal radiotherapy in post-mastectomy breast cancer patients. Materials and Method: A quasi-experimental study was conducted on60 breast cancer patients after mastectomy from March 2021 to February 2022. Participants were distributed equally into two arms. Arm-A received radiotherapy in conventional conformal technique (3DCRT) andarm-B in advanced conformal techniques (IMRT or VMAT). Patients were evaluated before, during, and after the completion of the treatment. Results: Among the 60 participants, 43% developed skin toxicities of which 18.3% were grade 2 or higher. IMRT and VMAT in comparison to 3DCRT had significantly lower mean dose and maximum dose for heart (4.92 Gy vs.7.74 Gy, p 0.005 ;30.95 Gy vs.45.40 Gy, p 0.0003) and ipsilateral lung (11.93 Gy vs.17.6 Gy, p 0.0001 ; 37.92 Gy vs.57.77 Gy, p 0.0001).V 5 significantly increased for both. Maximum dose for opposite lung increased significantly (14.14 Gy vs. 7.05 Gy, p 0.001).Mean dose to esophagus was similar in both arms. In case of the spinal cord, mean dose increased in arm-B (3.64 Gy vs. 2.17 Gy, p 0.0004) while maximum dose decreased (15.83 Gy vs. 22.85 Gy, p 0.021).Conclusion: For post-mastectomy patients, advanced conformal radiotherapy techniques are better for minimizing higher dose parameters of organs at risk. Low dose parameters are better in conventional technique. Neither is superior to prevent radiation induced acute skin toxicities.
International Journal of Research in Medical Sciences, Apr 15, 2024
Breast cancer is the fourth leading cause of cancer death worldwide, and the leading cause of can... more Breast cancer is the fourth leading cause of cancer death worldwide, and the leading cause of cancer death among women. 1 Breast cancer prevalence has increased globally, including in Asian countries, over the last few decades. 2 It accounts for 25% of cancer cases and 15% of cancer deaths in women, although there is a 4-fold variation in mortality rates and over 10-fold variation in incidence rates between high-incidence areas such as the United States and Western Europe and low incidence areas such as Africa and Asia. 3 According to Globocan 2020, the worldwide annual age-standardized incidence rate of breast cancer was 47.8/100,000 and around 45% of new the cases occurred in Asia. 4 More than 2.2 million new cases of breast cancer were diagnosed worldwide in 2020, accounting for 11.7% of all new cancer cases, with nearly 0.7 million deaths (6.9% of all cancer deaths). The age-standardized mortality rate was 13.6/100,000 worldwide. 4 Unfortunately, there are no comprehensive statistics on breast cancer incidence and mortality data in Bangladesh.
Bangabandhu Sheikh Mujib Medical University Journal, Jan 16, 2023
Chemotherapy is the primary therapeutic choice for advanced gastric cancer. The goal of this stud... more Chemotherapy is the primary therapeutic choice for advanced gastric cancer. The goal of this study was to assess the effectiveness and toxicity of the cisplatin-capecitabine regimen versus the oxaliplatin-capecitabine regimen in treating advanced gastric cancer. Between February 2021 and March 2022, this quasi-experimental study was conducted on 64 advanced gastric cancer patients. Purposive sampling was used to include those who met the inclusion criteria and distributed them evenly between the two arms. Arm A got an injection of cisplatin (80 mg/m2 on day 1) with oral capecitabine (1000 mg/m2 b.i.d. on days 1–14), whereas arm B received an injection of oxaliplatin (130 mg/m2 on day 1) plus oral capecitabine (1000 mg/m2 b.i.d. on days 1–14), every 3 weeks for 6 cycles. A final check-up was done at 12 weeks after the treatment. In arm A, 18 (56.2%) patients exhibited partial response compared to 15 (46.9%) in arm B. Stable diseases were also reported in both arms (18.8% in arm A and 21.9% in arm B). There were 8 (25.0%) cases of progressive disease in arm A and 10 (31.2%) cases in Arm B. The median progression-free survival in arms A (5.6 months) was almost similar to arm B (5.9 months). The most prevalent toxicities in both arms were vomiting, diarrhea, anemia, neutropenia, oral mucositis, paresthesia, handfoot syndrome, and renal toxicity. There were no statistically significant variations in outcomes between the two arms. In conclusion, the cisplatincapecitabine regimen is as effective as the oxaliplatin-capecitabine regimen in advanced gastric cancer. BSMMU J 2022; 15(3): 180-185
EUROPEAN JOURNAL OF PHARMACEUTICAL AND MEDICAL RESEARCH, Sep 1, 2024
Background: Combined modality of treatment i.e., platinum-based doublet chemotherapy with concurr... more Background: Combined modality of treatment i.e., platinum-based doublet chemotherapy with concurrent radiotherapy is the standard treatment for locally advanced non-small cell lung cancer (NSCLC). However, the optimal chemotherapy regimen to use with radiotherapy is still not established. Aim of this study was to compare the acute toxicities between cisplatin-etoposide (EP) and paclitaxel-carboplatin (PC) along with thoracic radiotherapy in unresectable locally advanced NSCLC. Materials and Methods: A Quasi-experimental study was conducted from October 2020 to September 2021 at Bangabandhu Sheikh Mujib Medical University (BSMMU) and National Institute of Cancer Research and Hospital (NICR&H), Dhaka. Patients with unresectable, locally advanced NSCLC who met the inclusion criteria were enrolled and distributed equally into two arms. Patients received thoracic radiotherapy with 60Gy in 2Gy daily fractions, 5 fractions a week, for 6 weeks with either Injection Cisplatin 50 mg/m2 administered on days 1, 8, 29, and 36, and Injection Etoposide 50 mg/m2/day on days 1–5 and 29–33 (Arm A), or Injection Carboplatin (AUC-2) and Injection Paclitaxel (45 mg/m2) administered on day 1, weekly, over a 6-week period (Arm B). All the patients were evaluated before, during, and after the completion of the treatment. Follow ups were done at 6 weeks, 12 weeks and 24 weeks following the completion of treatment using history, clinical examination and investigations. Results: most commonly observed toxicities were nausea, esophagitis and radiation pneumonitis. Although grade 1 esophagitis was more in arm B (56.76% vs 35.14%), grade 2 and 3 esophagitis were more in arm A (40.54% vs 16.21%; and 13.51% vs 5.41% respectively; p 0.043). Grade 1 pneumonitis was same (16 or 43.24%) in both arms. However, Grade 2 and 3 radiation pneumonitis were significantly more in Arm B (40.54% vs 16.22% and 5.41% vs 2.7 % respectively; p 0.004). Observed differences in nausea, vomiting, dermatitis, neurotoxicity, and hematological toxicities were not found to be statistically significant. Conclusion: This study suggests that the toxicities of cisplatin-etoposide regimen is comparable to paclitaxel-carboplatin regimen when given with concurrent radiotherapy in unresectable locally advanced non-small cell lung cancer.
Background: Gastric carcinoma is one of the commonest cancers in Bangladesh. The goal of this stu... more Background: Gastric carcinoma is one of the commonest cancers in Bangladesh. The goal of this study was to assess at the clinico-epidemiological characteristics of individuals with gastric cancer. Methods: This descriptive, cross- sectional study was conducted from November 2021 to October 2022, 120 patients with gastric cancer were included at Bangabandhu Sheikh Mujib Medical University (BSMMU), Department of Clinical Oncology. A pre-made questionnaire was used to collect data from patients during face-to-face interviews. Results: The mean age of the patients was 53.0 (±11.496) years, most of the patients (46.6%) were 51 – 60 years of age, 75.0 % of enrolled patients were male, 35.0 % of patients were service holder. The bulk of the cases had H. pylori infection (73.3%). The most common histological type among the patients was adenocarcinoma (95%). In terms of primary tumor location, the gastric antrum (50.0%) was the most prevalent subsite. Most of the patients were diagnosed as locally advanced stage. Conclusions: In conclusion, gastric cancer occurs mainly in middle aged males and associated with H. pylori infection. Adenocarcinoma is the most frequent histological form, with the gastric antrum as the main location of tumors and advanced stage.
Bangabandhu Sheikh Mujib Medical University Journal, Feb 22, 2022
Molecular factors play an important role in the management and treatment outcome of breast cancer... more Molecular factors play an important role in the management and treatment outcome of breast cancer. Molecular subtyping has been developed depending upon estrogen and progesterone receptors, human epidermal growth factor receptor-2 and ki76 level. This cross-sectional study was done to assess the molecular subtypes of locally advanced breast cancer and its associated risk factors. Total 94 patients with locally advanced breast cancer were included in the study. The mean age was 42.6 years with a standard deviation of 9.56. In total, 91.5 percent of respondents had menarche at or after the age of 12, and 26.6 % had used hormonal contra- ception in the past. Tobacco users and positive family history were found in 21.2% and 5.35% of the cases. Among the patients, 3.4 % of cases had their first childbirth after the age of 30 and 95.5% of patients feed their babies from their both breasts. Among 94 cases 5 did not have any child. Estrogen receptor was found positive in 35% of cases, proge...
International Journal of Research in Medical Sciences, 2023
Background: The outcome of treatment for advanced gastric carcinoma can vary depending on a numbe... more Background: The outcome of treatment for advanced gastric carcinoma can vary depending on a number of factors, including the stage and aggressiveness of the cancer, the patient's overall health, and their response to treatment. In general, the prognosis is poor, with a median overall survival of less than one year. Quality of life (QOL) is an important consideration for patients with advanced gastric carcinoma, as they may experience a range of symptoms such as pain, fatigue, and difficulty eating. This study aimed to evaluate the post-treatment outcomes and QOL in patients with inoperable advanced gastric carcinoma after treatment with cisplatin-capecitabine and with oxaliplatincapecitabine. Methods: This Quasi-experimental study was conducted at the department of oncology, Bangabandhu Sheikh Mujib medical university, Dhaka, Bangladesh. The study duration was 1 year, from February 2021 to March 2022. During this period, a total of 64 cases of advanced gastric cancer were divided in two equal groups, arm A who had received cisplatin capecitabine, and arm B who received oxaliplatin capecitabine. Result: The mean age at diagnosis was 55.85 and 56.76 respectively. The majority of the patients, 43.8% in arm A and 50% in arm B, ranged in age from 61 to 70. The gender distribution was similar, 78% and 69% of patients in arm A and B respectively were male. Both groups had the majority of patients receiving an ECOG performance rating of 2, with 68.8% in arm A and 59.4% in arm B, and the liver being the most common metastatic site for 56.3% in arm A and 50.0% in arm B. The most frequent risk factor was Helicobacter pylori infection, observed in 68.8% of arm A and 78.1% of arm B. The most common primary tumor site was the antrum, with 50% and 53.1% patients in arm A and B respectively had the primary tumor in the antrum of the stomach. Conclusions: In inoperable advanced gastric cancer, the cisplatin-capecitabine regimen is equally effective as oxaliplatin-capecitabine in terms of disease outcome. Furthermore, the cisplatin-capecitabine regimen is less costly than the combination of oxaliplatin-capecitabine, and provides almost similar QOL. As a result, the cisplatincapecitabine regimen could be utilized as an alternate choice in patients who are unable to afford an oxaliplatin-based regimen.
International Journal of Advances in Medicine, 2024
Background: Enteric fever remains a significant public health challenge, particularly in developi... more Background: Enteric fever remains a significant public health challenge, particularly in developing countries. Understanding the knowledge, attitudes, and practices of general practitioners regarding enteric fever is crucial for effective disease management and control. This study aims to assess these aspects among general practitioners, providing insights into current practices and identifying areas for improvement. Methods: This cross-sectional survey was conducted with 200 general practitioners. The questionnaire covered various aspects, including baseline characteristics, knowledge about enteric fever causative agents and symptoms, diagnostic practices, antibiotic preferences, and general attitudes towards management and prevention. Data were analyzed to determine the prevalence of specific knowledge and practices. Results: Majority of practitioners (74%) were residents, predominantly working indoors (61.5%). All respondents correctly identified Salmonella typhi and para typhi as causative agents and fever as a primary symptom. However, there was variability in recognizing other symptoms and diagnostic methods. Ceftriaxon was the most preferred antibiotic (67%), and blood culture correctly identified as gold standard for diagnosis by 71% of respondents. Attitudes and practices varied, with significant number not adhering to recommended diagnostic and treatment protocols. Conclusions: The study reveals a solid foundation of basic knowledge about enteric fever among general practitioners but also highlights significant gaps in the understanding of clinical symptoms, diagnostic practices, and treatment protocols. These findings underscore the need for enhanced educational initiatives and standardized guidelines to improve the management of enteric fever.
Breast cancer patients may experience multiple symptoms due to the disease itself, treatment or c... more Breast cancer patients may experience multiple symptoms due to the disease itself, treatment or combination of both. The aim of the present study was to identify group of symptoms experienced by the patients with breast cancer using cluster analysis. We examined symptom profiles of 120 patients with breast cancer who attended a hospital palliative care centre in a tertiary institution. Following symptoms were analyzed: pain, nausea, loss of appetite, constipation, weakness, cough, breathlessness, sleeplessness, lymphedema, sadness, anxiety and depression. Hierarchical cluster analysis was used to identify the natural groupings within the set. We could identify three clusters. Cluster 1 was characterized by pain, depression, anxiety, weakness, sleeplessness and loss of appetite. Cluster 2 comprised of cough, breathlessness, nausea and constipation. Cluster 3 consisted of two symptoms lymphedema and sadness. The results revealed that the patients with breast cancer experienced symptoms that are multiple and clustered together. Neuro-psychiatric symptoms and weakness formed a significant strong relationship. Knowledge obtained from this study can be beneficial for better understanding, assessment and management of symptom clusters in women with breast cancer. It may also help patients to plan ahead for them to seek management of concurrent symptoms to improve their quality of life. Bangladesh Med J. 2016 Jan; 45 (1): 25-30
Bangabandhu Sheikh Mujib Medical University Journal, Feb 22, 2022
Molecular factors play an important role in the management and treatment outcome of breast cancer... more Molecular factors play an important role in the management and treatment outcome of breast cancer. Molecular subtyping has been developed depending upon estrogen and progesterone receptors, human epidermal growth factor receptor-2 and ki76 level. This cross-sectional study was done to assess the molecular subtypes of locally advanced breast cancer and its associated risk factors. Total 94 patients with locally advanced breast cancer were included in the study. The mean age was 42.6 years with a standard deviation of 9.56. In total, 91.5 percent of respondents had menarche at or after the age of 12, and 26.6 % had used hormonal contra- ception in the past. Tobacco users and positive family history were found in 21.2% and 5.35% of the cases. Among the patients, 3.4 % of cases had their first childbirth after the age of 30 and 95.5% of patients feed their babies from their both breasts. Among 94 cases 5 did not have any child. Estrogen receptor was found positive in 35% of cases, progesterone receptor-positive patient was 33% and HER-2 was found positive in 39.4% of cases. Ki-67 level was found high in 66% of cases. Among the 94 cases, the Luminal A subtype was found in 18% and the Lumi- nal B subtype was found in 27.7% cases. The human epidermal growth factor receptor-2 subtype was found relatively less frequent than Luminal type B (24.5% vs. 27.7%). Triple-neg- ative breast cancer was most commonly diagnosed among the patients (almost 30%). The increased number of triple-negative variants signifies poor prognostic outcomes. The risk factor of breast cancer did not show any statistical correlation with molecular subtypes. BSMMU J 2021; 14(3): 57-61
Bangabandhu Sheikh Mujib Medical University (BSMMU) Journal, 2021
Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women. This ... more Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women. This cross sectional study was done to assess the presenting features of locally advanced breast cancer. The mean age was 42.6 years with standard deviation 9.56, 86% were house wife, 53.5% were illiterate, 16% were postmenopausal and 75.8% had BMI of 20Kg/m2. Ninety one point five percent had menarche at or above 12 years of age and 26.6 % had history of using hormonal contraceptives. Tobacco user and positive family history were found in 21.2% and 5.35% of the cases. 84% were presented with only lump and 16% with both lump and ulceration. Right breast was involved in 51.1%. About 37% cases presented on 3rd month of their symptoms. Around 71.2% patients presented with lump >5cm in diameter, axillary lymph nodes were palpable in 81% and fixed in 31% of patients. Around Sixty three percent of patients were in stage IIIA. Still a large fraction of patients present with advanced stage with varied presentation, sometimes surgeons face difficulties to offer the treatment. Proper awareness, early presentation and early detection give them the opportunity to receive the best treatment. BSMMU J 2021; 14(4): 148-151
Scholars Journal of Applied Medical Sciences, Jul 14, 2020
Back ground: Biliary tract cancers refer to as group of cancers that arise from epithelial lining... more Back ground: Biliary tract cancers refer to as group of cancers that arise from epithelial lining of the gall bladder and bile ducts peri-hilar and extra hepatic biliary tree and peri-ampullary tumors. Though biliary tract cancer is a rare entity.
Objective: In this study our main goal is to evaluate the sociodemographic status of biliary tract carcinoma patients.
Method: This cross-sectional study was conducted in Department of Oncology Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College and National Institute of Cancer Research and Hospital, Dhaka from January 2018 to June 2019. 78patients with advanced biliary tract carcinoma (Stage IV), attending the out-Patient department were selected as sample where 39 patients received - Oral Capecitabine plus injectable Cisplatin (Arm-A) and 39 patients received injection Gemcitabine plus Cisplatin (Arm-B). Purposive sampling was done and data were analyzed by SSPS 21.
Results: In this study, the majority of the patients were in the 50 to 59 years age groups in both the arms, range from 37 -70 years. Most of the patients were in the group 2 in both the arms. It was 51.29% and 56.41% in arm A & B respectively. 53.85% and 43.59% patients from Arm A and B had the primary tumor in the Gall Bladder respectively. 35.89% and 43.58% patients from Arm A and B respectively had the primary tumor in the Cholangiocarcinoma (CCA). On the other hand, 10.26% and 12.83% patients from Arm A and B had the primary tumor in the Periampullary Carcinoma respectively. Most of the patients (66.66% in Arm A and 66.66% in Arm B) had liver metastasis.
Conclusion: In conclusion we can say that, this study demonstrated that, biliary tract cancers are a highly aggressive human malignancy that is difficult to diagnose. Most of the cases site of metastasis increase gradually which compare from similar studies in the literature.
Background: Gastric carcinoma is one of the commonest cancers in Bangladesh. The goal of this stu... more Background: Gastric carcinoma is one of the commonest cancers in Bangladesh. The goal of this study was to assess at the clinico-epidemiological characteristics of individuals with gastric cancer.
Methods: This descriptive, cross- sectional study was conducted from November 2021 to October 2022, 120 patients with gastric cancer were included at Bangabandhu Sheikh Mujib Medical University (BSMMU), Department of Clinical Oncology. A pre-made questionnaire was used to collect data from patients during face-to-face interviews.
Results: The mean age of the patients was 53.0 (±11.496) years, most of the patients (46.6%) were 51 – 60 years of age, 75.0 % of enrolled patients were male, 35.0 % of patients were service holder. The bulk of the cases had H. pylori infection (73.3%). The most common histological type among the patients was adenocarcinoma (95%). In terms of primary tumor location, the gastric antrum (50.0%) was the most prevalent subsite. Most of the patients were diagnosed as locally advanced stage.
Conclusions: In conclusion, gastric cancer occurs mainly in middle aged males and associated with H. pylori infection. Adenocarcinoma is the most frequent histological form, with the gastric antrum as the main location of tumors and advanced stage.
Journal Of Medical Science And Clinical Research , Jan 1, 2023
Introduction: In general head and neck cancer may be treated with single modality of treatment fo... more Introduction: In general head and neck cancer may be treated with single modality of treatment for early-stage disease but may require multimodality treatment protocol for advanced disease. concurrent chemoradiation is the current standard protocol for patients with locally advanced squamous cell carcinoma of head neck. Carcinoma of head and neck is common clinical entity approximately 4.8% of the total new- cancer cases. In Bangladesh, according to cancer Registry Report NICRH (20015-2017), approximately 2901(10.6%) patients ire registered with head and neck cancer.
Study Design and Objective: This prospective observational study is to compare the treatment response and acute toxicities with the treatment of low dose weekly Carboplatin(AUC:2) with radiation versus weekly Cisplatin with radiation therapy for histologically proven advanced squamous cell carcinoma of head neck.
Methods: All the patients were divided in two groups. Arm-A 30 number patients received injection Carboplatin (AUC:2), i/v 30 minutes infusion weekly for 6 weeks and Arm- B 30 number patients received injection Cisplatin 30mg/m2, i/v 2 hrs. infusion weekly for 6 weeks. All patients received 66 Gray (Gy) radiation at the rate of 2Gy/day 5# in a week for 6.5 weeks.
Results: In this study ninety percent (90%) patients were smoker. The most common presenting features were cervical lymphadenopathy (Arm A 100% vs. Arm B 100%), pain (Arm A 73.33% vs. Arm B 66.67%), sore throat (Arm A 36.67% vs. Arm B 36.66%), hoarseness of voice (Arm A 36.67% vs. Arm B 36.66%) etc. Complete response of patients treated with concurrent chemoradiation with inj. Carboplatin was 63.33% in comparison to 53.33% complete response achieved in patients treated with concurrent chemoradiation with inj. Cisplatin. This difference was statistically not much more significant. Common toxicities related to treatment were mucositis, skin reaction, vomiting, nausea, weight loss, anemia, leucopenia, thrombocytopenia and diarrhea. The toxicities in Arm-A were more than that of Arm-B, but were manageable.
Conclusion: In this study the clinical response and toxicities produced by weekly low dose carboplatin with radiation in locally advanced squamous cell carcinoma of head and neck cancer were comparable to those of weekly Cisplatin schedule with radiation showed no additional efficacy. So, concurrent chemoradiotherapy with weekly Carboplatin (AUC:2) is suitable when Cisplatin is contraindicated for the patients with renal impairment.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), Dec 22, 2022
Introduction: Locally advanced head and neck carcinomas constitute a substantial proportion of ca... more Introduction: Locally advanced head and neck carcinomas constitute a substantial proportion of cancer patients in Bangladesh. The common practice is to treat the condition by conventional fractionation (2 gray/fraction, total dose 66 gray). Hypo-fractionated radiotherapy (2.75 gray/fraction, total 55 gray) might be able to produce a similar response in a shorter time. Aim of the study: The aim of the study was to determine tumor response and toxicities in hypo-fractionated radiotherapy.
Methods: This Quasi-Experimental study was conducted at the Department of Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, and the Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh. The study duration was 1.5 years, from July 2018 to December 2019. During this period, a total of 74 patients with inoperable locally advanced squamous cell carcinoma of the head and neck, and equally distributed in two groups, Arm-A and Arm-B. Arm-A received conventionally fractionated chemo-radiotherapy and Arm-B received hypo-fractionated radiotherapy
Result: The mean age of Arm-A and B patients were 53.27 (±11.23) & 51.03 (±9.48) years, respectively. Among 74 patients, 46 patients were smokers. 33.68 % of patients were in stage III and 66.22% of patients were in stage IV. In Arm-A 10 patients (27.03%) showed a complete response and in Arm-B, a complete response was observed in 7 patients (18.93%). Partial response was 19 (51.35%) and 18 (48.64%) in Arm-A and B, respectively. There were 4 (10.81%) progressive disease cases in Arm-A and 5 (13.51%) in Arm-B. Significant differences in frequencies of acute grade 2 skin toxicity, mucositis, were found, with higher frequencies. Grade 2 oral mucositis was seen in 26 (70.27%) and 14 ( 37.83%) patients of Arm-A and B, respectively which was statistically significant. Other toxicities had no significant differences between Arm-A and B. in Arm-B.
Conclusion: Hypo-fractionated radiotherapy can achieve a similar tumor response to conventionally fractionated radiotherapy in HNSCC, although with some increase of manageable toxicity.
International Journal for Multidisciplinary Research (IJFMR), Jul 24, 2023
Introduction: Radiotherapy is an essential modality of treatment after mastectomy. However, toxic... more Introduction: Radiotherapy is an essential modality of treatment after mastectomy. However, toxicities of post-mastectomy radiotherapy are still not well established. This study was aimed at comparing the acute skin toxicitiesand doses to the organs at risk between conventional and advanced conformal radiotherapy in post-mastectomy breast cancer patients. Materials and Method: A quasi-experimental study was conducted on60 breast cancer patients after mastectomy from March 2021 to February 2022. Participants were distributed equally into two arms. Arm-A received radiotherapy in conventional conformal technique (3DCRT) andarm-B in advanced conformal techniques (IMRT or VMAT). Patients were evaluated before, during, and after the completion of the treatment. Results: Among the 60 participants, 43% developed skin toxicities of which 18.3% were grade 2 or higher. IMRT and VMAT in comparison to 3DCRT had significantly lower mean dose and maximum dose for heart (4.92 Gy vs.7.74 Gy, p 0.005 ;30.95 Gy vs.45.40 Gy, p 0.0003) and ipsilateral lung (11.93 Gy vs.17.6 Gy, p 0.0001 ; 37.92 Gy vs.57.77 Gy, p 0.0001).V 5 significantly increased for both. Maximum dose for opposite lung increased significantly (14.14 Gy vs. 7.05 Gy, p 0.001).Mean dose to esophagus was similar in both arms. In case of the spinal cord, mean dose increased in arm-B (3.64 Gy vs. 2.17 Gy, p 0.0004) while maximum dose decreased (15.83 Gy vs. 22.85 Gy, p 0.021).Conclusion: For post-mastectomy patients, advanced conformal radiotherapy techniques are better for minimizing higher dose parameters of organs at risk. Low dose parameters are better in conventional technique. Neither is superior to prevent radiation induced acute skin toxicities.
International Journal of Research in Medical Sciences, Apr 15, 2024
Breast cancer is the fourth leading cause of cancer death worldwide, and the leading cause of can... more Breast cancer is the fourth leading cause of cancer death worldwide, and the leading cause of cancer death among women. 1 Breast cancer prevalence has increased globally, including in Asian countries, over the last few decades. 2 It accounts for 25% of cancer cases and 15% of cancer deaths in women, although there is a 4-fold variation in mortality rates and over 10-fold variation in incidence rates between high-incidence areas such as the United States and Western Europe and low incidence areas such as Africa and Asia. 3 According to Globocan 2020, the worldwide annual age-standardized incidence rate of breast cancer was 47.8/100,000 and around 45% of new the cases occurred in Asia. 4 More than 2.2 million new cases of breast cancer were diagnosed worldwide in 2020, accounting for 11.7% of all new cancer cases, with nearly 0.7 million deaths (6.9% of all cancer deaths). The age-standardized mortality rate was 13.6/100,000 worldwide. 4 Unfortunately, there are no comprehensive statistics on breast cancer incidence and mortality data in Bangladesh.
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Papers by Dr. Mohammad Jahan Shams
Objective: In this study our main goal is to evaluate the sociodemographic status of biliary tract carcinoma patients.
Method: This cross-sectional study was conducted in Department of Oncology Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College and National Institute of Cancer Research and Hospital, Dhaka from January 2018 to June 2019. 78patients with advanced biliary tract carcinoma (Stage IV), attending the out-Patient department were selected as sample where 39 patients received - Oral Capecitabine plus injectable Cisplatin (Arm-A) and 39 patients received injection Gemcitabine plus Cisplatin (Arm-B). Purposive sampling was done and data were analyzed by SSPS 21.
Results: In this study, the majority of the patients were in the 50 to 59 years age groups in both the arms, range from 37 -70 years. Most of the patients were in the group 2 in both the arms. It was 51.29% and 56.41% in arm A & B respectively. 53.85% and 43.59% patients from Arm A and B had the primary tumor in the Gall Bladder respectively. 35.89% and 43.58% patients from Arm A and B respectively had the primary tumor in the Cholangiocarcinoma (CCA). On the other hand, 10.26% and 12.83% patients from Arm A and B had the primary tumor in the Periampullary Carcinoma respectively. Most of the patients (66.66% in Arm A and 66.66% in Arm B) had liver metastasis.
Conclusion: In conclusion we can say that, this study demonstrated that, biliary tract cancers are a highly aggressive human malignancy that is difficult to diagnose. Most of the cases site of metastasis increase gradually which compare from similar studies in the literature.
Methods: This descriptive, cross- sectional study was conducted from November 2021 to October 2022, 120 patients with gastric cancer were included at Bangabandhu Sheikh Mujib Medical University (BSMMU), Department of Clinical Oncology. A pre-made questionnaire was used to collect data from patients during face-to-face interviews.
Results: The mean age of the patients was 53.0 (±11.496) years, most of the patients (46.6%) were 51 – 60 years of age, 75.0 % of enrolled patients were male, 35.0 % of patients were service holder. The bulk of the cases had H. pylori infection (73.3%). The most common histological type among the patients was adenocarcinoma (95%). In terms of primary tumor location, the gastric antrum (50.0%) was the most prevalent subsite. Most of the patients were diagnosed as locally advanced stage.
Conclusions: In conclusion, gastric cancer occurs mainly in middle aged males and associated with H. pylori infection. Adenocarcinoma is the most frequent histological form, with the gastric antrum as the main location of tumors and advanced stage.
Study Design and Objective: This prospective observational study is to compare the treatment response and acute toxicities with the treatment of low dose weekly Carboplatin(AUC:2) with radiation versus weekly Cisplatin with radiation therapy for histologically proven advanced squamous cell carcinoma of head neck.
Methods: All the patients were divided in two groups. Arm-A 30 number patients received injection Carboplatin (AUC:2), i/v 30 minutes infusion weekly for 6 weeks and Arm- B 30 number patients received injection Cisplatin 30mg/m2, i/v 2 hrs. infusion weekly for 6 weeks. All patients received 66 Gray (Gy) radiation at the rate of 2Gy/day 5# in a week for 6.5 weeks.
Results: In this study ninety percent (90%) patients were smoker. The most common presenting features were cervical lymphadenopathy (Arm A 100% vs. Arm B 100%), pain (Arm A 73.33% vs. Arm B 66.67%), sore throat (Arm A 36.67% vs. Arm B 36.66%), hoarseness of voice (Arm A 36.67% vs. Arm B 36.66%) etc. Complete response of patients treated with concurrent chemoradiation with inj. Carboplatin was 63.33% in comparison to 53.33% complete response achieved in patients treated with concurrent chemoradiation with inj. Cisplatin. This difference was statistically not much more significant. Common toxicities related to treatment were mucositis, skin reaction, vomiting, nausea, weight loss, anemia, leucopenia, thrombocytopenia and diarrhea. The toxicities in Arm-A were more than that of Arm-B, but were manageable.
Conclusion: In this study the clinical response and toxicities produced by weekly low dose carboplatin with radiation in locally advanced squamous cell carcinoma of head and neck cancer were comparable to those of weekly Cisplatin schedule with radiation showed no additional efficacy. So, concurrent chemoradiotherapy with weekly Carboplatin (AUC:2) is suitable when Cisplatin is contraindicated for the patients with renal impairment.
Aim of the study: The aim of the study was to determine tumor response and toxicities in hypo-fractionated radiotherapy.
Methods: This Quasi-Experimental study was conducted at the Department of Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, and the Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh. The study duration was 1.5 years, from July 2018 to December 2019. During this period, a total of 74 patients with inoperable locally advanced squamous cell carcinoma of the head and neck, and equally distributed in two groups, Arm-A and Arm-B. Arm-A received conventionally fractionated chemo-radiotherapy and Arm-B received hypo-fractionated radiotherapy
Result: The mean age of Arm-A and B patients were 53.27 (±11.23) & 51.03 (±9.48) years, respectively. Among 74 patients, 46 patients were smokers. 33.68 % of patients were in stage III and 66.22% of patients were in stage IV. In Arm-A 10 patients (27.03%) showed a complete response and in Arm-B, a complete response was observed in 7 patients (18.93%). Partial response was 19 (51.35%) and 18 (48.64%) in Arm-A and B, respectively. There were 4 (10.81%) progressive disease cases in Arm-A and 5 (13.51%) in Arm-B. Significant differences in frequencies of acute grade 2 skin toxicity, mucositis, were found, with higher frequencies. Grade 2 oral mucositis was seen in 26 (70.27%) and 14 ( 37.83%) patients of Arm-A and B, respectively which was statistically significant. Other toxicities had no significant differences between Arm-A and B. in Arm-B.
Conclusion: Hypo-fractionated radiotherapy can achieve a similar tumor response to conventionally fractionated radiotherapy in HNSCC, although with some increase of manageable toxicity.
Objective: In this study our main goal is to evaluate the sociodemographic status of biliary tract carcinoma patients.
Method: This cross-sectional study was conducted in Department of Oncology Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College and National Institute of Cancer Research and Hospital, Dhaka from January 2018 to June 2019. 78patients with advanced biliary tract carcinoma (Stage IV), attending the out-Patient department were selected as sample where 39 patients received - Oral Capecitabine plus injectable Cisplatin (Arm-A) and 39 patients received injection Gemcitabine plus Cisplatin (Arm-B). Purposive sampling was done and data were analyzed by SSPS 21.
Results: In this study, the majority of the patients were in the 50 to 59 years age groups in both the arms, range from 37 -70 years. Most of the patients were in the group 2 in both the arms. It was 51.29% and 56.41% in arm A & B respectively. 53.85% and 43.59% patients from Arm A and B had the primary tumor in the Gall Bladder respectively. 35.89% and 43.58% patients from Arm A and B respectively had the primary tumor in the Cholangiocarcinoma (CCA). On the other hand, 10.26% and 12.83% patients from Arm A and B had the primary tumor in the Periampullary Carcinoma respectively. Most of the patients (66.66% in Arm A and 66.66% in Arm B) had liver metastasis.
Conclusion: In conclusion we can say that, this study demonstrated that, biliary tract cancers are a highly aggressive human malignancy that is difficult to diagnose. Most of the cases site of metastasis increase gradually which compare from similar studies in the literature.
Methods: This descriptive, cross- sectional study was conducted from November 2021 to October 2022, 120 patients with gastric cancer were included at Bangabandhu Sheikh Mujib Medical University (BSMMU), Department of Clinical Oncology. A pre-made questionnaire was used to collect data from patients during face-to-face interviews.
Results: The mean age of the patients was 53.0 (±11.496) years, most of the patients (46.6%) were 51 – 60 years of age, 75.0 % of enrolled patients were male, 35.0 % of patients were service holder. The bulk of the cases had H. pylori infection (73.3%). The most common histological type among the patients was adenocarcinoma (95%). In terms of primary tumor location, the gastric antrum (50.0%) was the most prevalent subsite. Most of the patients were diagnosed as locally advanced stage.
Conclusions: In conclusion, gastric cancer occurs mainly in middle aged males and associated with H. pylori infection. Adenocarcinoma is the most frequent histological form, with the gastric antrum as the main location of tumors and advanced stage.
Study Design and Objective: This prospective observational study is to compare the treatment response and acute toxicities with the treatment of low dose weekly Carboplatin(AUC:2) with radiation versus weekly Cisplatin with radiation therapy for histologically proven advanced squamous cell carcinoma of head neck.
Methods: All the patients were divided in two groups. Arm-A 30 number patients received injection Carboplatin (AUC:2), i/v 30 minutes infusion weekly for 6 weeks and Arm- B 30 number patients received injection Cisplatin 30mg/m2, i/v 2 hrs. infusion weekly for 6 weeks. All patients received 66 Gray (Gy) radiation at the rate of 2Gy/day 5# in a week for 6.5 weeks.
Results: In this study ninety percent (90%) patients were smoker. The most common presenting features were cervical lymphadenopathy (Arm A 100% vs. Arm B 100%), pain (Arm A 73.33% vs. Arm B 66.67%), sore throat (Arm A 36.67% vs. Arm B 36.66%), hoarseness of voice (Arm A 36.67% vs. Arm B 36.66%) etc. Complete response of patients treated with concurrent chemoradiation with inj. Carboplatin was 63.33% in comparison to 53.33% complete response achieved in patients treated with concurrent chemoradiation with inj. Cisplatin. This difference was statistically not much more significant. Common toxicities related to treatment were mucositis, skin reaction, vomiting, nausea, weight loss, anemia, leucopenia, thrombocytopenia and diarrhea. The toxicities in Arm-A were more than that of Arm-B, but were manageable.
Conclusion: In this study the clinical response and toxicities produced by weekly low dose carboplatin with radiation in locally advanced squamous cell carcinoma of head and neck cancer were comparable to those of weekly Cisplatin schedule with radiation showed no additional efficacy. So, concurrent chemoradiotherapy with weekly Carboplatin (AUC:2) is suitable when Cisplatin is contraindicated for the patients with renal impairment.
Aim of the study: The aim of the study was to determine tumor response and toxicities in hypo-fractionated radiotherapy.
Methods: This Quasi-Experimental study was conducted at the Department of Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, and the Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh. The study duration was 1.5 years, from July 2018 to December 2019. During this period, a total of 74 patients with inoperable locally advanced squamous cell carcinoma of the head and neck, and equally distributed in two groups, Arm-A and Arm-B. Arm-A received conventionally fractionated chemo-radiotherapy and Arm-B received hypo-fractionated radiotherapy
Result: The mean age of Arm-A and B patients were 53.27 (±11.23) & 51.03 (±9.48) years, respectively. Among 74 patients, 46 patients were smokers. 33.68 % of patients were in stage III and 66.22% of patients were in stage IV. In Arm-A 10 patients (27.03%) showed a complete response and in Arm-B, a complete response was observed in 7 patients (18.93%). Partial response was 19 (51.35%) and 18 (48.64%) in Arm-A and B, respectively. There were 4 (10.81%) progressive disease cases in Arm-A and 5 (13.51%) in Arm-B. Significant differences in frequencies of acute grade 2 skin toxicity, mucositis, were found, with higher frequencies. Grade 2 oral mucositis was seen in 26 (70.27%) and 14 ( 37.83%) patients of Arm-A and B, respectively which was statistically significant. Other toxicities had no significant differences between Arm-A and B. in Arm-B.
Conclusion: Hypo-fractionated radiotherapy can achieve a similar tumor response to conventionally fractionated radiotherapy in HNSCC, although with some increase of manageable toxicity.