Ventricular tachycardia(VT) is a wide complex tachyarrhythmia which could be potentially life-threatening. Standard treatment options include catheter ablation, anti-arrhythmic drugs and ICDs (Implantable cardioverter defibrillator). In patients refractory to the above treatments, limited options are available. Stereotactic arrhythmia radio-ablation (STAR) is a novel non-invasive method of ablating the arrhythmogenic substrate using high dose of highly focused radiotherapy. This technique requires a multi-disciplinary team consisting of Cardiologist, Electrophysiologist, Radiation oncologist and Radiologist to integrate pre-treatment imaging and electro-physiological data to generate a target that can be radiated. Studies show excellent control of VT, 6–12 weeks post-treatment with no major toxicities. This article attempts to provide a practical step by step approach to stereotactic arrhythmia radioablation.

Background: Phyllodes tumour(PT) of the breast are rare fibroepithelial tumours that are generally more prone to recurrence. Aims and objective: The study aimed to assess the clinico-pathological features, diagnostic modalities and therapeutic interventions with their outcomes leading to recurrence in Phyllodes tumour of the breast. Materials and Methods: A retrospective cohort and observational study which entailed clinico-pathological data of patients who were previously diagnosed or presented with Phyllodes tumour of the breast between 1996 and 2021 were analysed. Data included- total number of patients diagnosed with Phyllodes tumour of the breast, age, type of tumour on initial presentation or biopsy, side, size, therapeutic interventions carried out- surgery(mastectomy or lumpectomy) and adjuvant radiotherapy, final biopsy type, recurrence, type of recurrence and time to recurrence. Results: We analysed a total of 87 patients who were pathologically proven to have PT and 46 patients(52.87%) were found to have recurrence. All patients were recorded to be in the female gender only with a mean age at diagnosis of 39 years (range 15–70). Age <40 years had the highest incidence of recurrence of 56.82%(n = 25) followed by age>40 years with 48.84%(n = 21). 55.4% patients presented with primary phylloides and 44.6% had recurrent phylloides at presentation. Average time of local recurrence from the time of completion of treatment were 13.8 months whereas for systemic recurrence it were 15.29 months. Surgery(mastectomy/lumpectomy) with regard to local recurrence was the major determinant for recurrence followed by adjuvant radiation. (P <0.05)Conclusion: Patients who received adjuvant radiation had minimal recurrence. Patients who were found to have malignant type of biopsy on initial diagnosis(triple assessment) had more incidence and were prone to systemic recurrence over local recurrence. Surgery again played a determining factor leading to increased rate of local recurrence following lumpectomy over mastectomy.

Introduction: Bronchoscopy is an important diagnostic tool for the diagnosis of lung cancer, and various techniques have documented increase in diagnostic sensitivity. In this study, we have analyzed the role of bronchoscopy in diagnosis of lung cancer with special emphasis on endobronchial needle aspiration cytology (EBNA) in comparison to other conventional diagnostic techniques (CDTs) such as bronchial wash (BW) and forcep biopsy (FB). Materials and Methods: Prospective, observational study screened 1564 cases with suspected lung malignancy on clinical and radiological basis. Bronchoscopy-guided techniques such as EBNA, BW, and FB are used in exophytic endobronchial lesions (EELs) in confirming the diagnosis of lung cancer and to find additive yield over other techniques such as BW and FB. Rapid onsite evaluation (ROSE) analysis of all EBNA samples done in pathology lab allied center. Finally, histopathology proven 917 lung malignancy cases are included in this study. Statistical analysis is done by using chi-test. Results: In this study, 917 diagnosed lung cancer patients between 29 and 85 age group predominant 61.83% (567/917) and smokers by addiction in 52.12% (478/917) cases. Presented with cough in 80.80% (741/917), clubbing in 55.83% (512/917) cases, and mass lesion in chest radiograph in 53.10% (487/917) cases. Anatomical location is documented on the right side of tracheobronchial in 58.66% (538/917) cases during bronchoscopy. Yield of FB and FB plus BW in EEL is 86.69% (795/917) and 90.94% (834/917), respectively. Yield of EBNA, EBNA plus BW, and EBNA plus FB in EEL is 70.22% (644/917), 75.13% (689/917), and 97.16% (891/917), respectively. Overall yield of all bronchoscopy-guided techniques (EBNA + FB + BW) in our study in EEL is 100%. Additional yield of EBNA in EEL over other CDTs (FB plus BW) is 9.06%. Sensitivity of FB and EBNA in diagnosing lung malignancy in EEL is 86.69% and 70.22%, respectively. FB is more sensitive technique than EBNA in EEL (P < 0.00001). Sensitivity of FB plus BW in EEL is 90.94% (834/917). Sensitivity of EBNA plus BW in EEL is 75.13% (689/917). Sensitivity of EBNA plus FB in EEL is 97.16% (891/917) (P < 0.00001). Conclusion: EBNA is underutilized bronchoscopic technique in visible endobronchial lesions (exophytic endobronchial type) in spite of satisfactory diagnostic yield as compared with other CDTs. Although FB is most commonly preferred technique in bronchoscopically visible tumors, the addition of EBNA has improved overall diagnostic yield of bronchoscopy and decreased need for repeat bronchoscopy procedure.

Unscheduled treatment gaps are a recurring problem faced by radiotherapy units worldwide. During the times of a global emergency like the coronavirus pandemic, the problem was further potentiated. This article describes the treatment breaks experienced by our radiotherapy unit during the initial nine months of the pandemic in a tertiary-care academic university hospital. Head and neck cancers are a priority for radiation oncologists and gaps in treatment lead to reduced local control. Sound knowledge of tumor repopulation and timely corrections using the biologically effective dose are essential to mitigate such effects.

Synchronous ovarian and endometrial carcinoma, the name itself creates a huge confusion regarding the diagnosis or treatment strategy. We have reported a case of a 54-year-old female patient, who presented to our department with synchronous ovarian and endometrial carcinoma, and here we have discussed the management strategies, which were undertaken.