a) Volume Indicators
Diagnosis |
Total |
Total(2015) |
Total(2014) |
---|---|---|---|
Neuroblastoma |
98 |
89 |
77 |
Renal Tumor |
59 (WT 55) |
63 |
54 |
GCT |
48 |
56 |
57 |
Liver tumors |
25 (HB 19) |
34 | 29 |
Retinoblastoma |
52 |
56 | 38 |
STS |
115 |
140 |
115 |
Misc |
95 |
53 |
97 |
No malignancy |
29 |
24 |
19 |
No investigation |
15 |
25 |
27 |
Total |
536 |
541 |
513 |
b) Drop out rate : 2.7 % ( 15 out of 536) (2015- 4.6 %)
c) Time to first JC: 0-3 days
d) Time for decision making : 7-14 days
e) Surgeries performed
|
TMH |
ACTREC |
Total(2016) |
Total(2015) |
---|---|---|---|---|
Major |
158 |
|||
Minor |
65 |
|||
Pediatric vascular access |
50 |
|||
Adult vascular access | 27 | |||
Total | 300 |
f) Radiotherapy given : (EBRT + Brachy = 180)
Treatment |
No of Patients |
|
---|---|---|
RT Intent (Ext. RT) | Radical | 122/169 (72%) |
Palliative | 26/169 (15%) | |
Ketlar | 35/169 (21%) | |
Ext RT | 158/180 (88%) | |
Brachytherapy | 11/180 (06%) | |
Conventional | 81/169 (48%) | |
3D-CRT/ IMRT | 88/169 (52%) | |
Turnaround Time (Appt. Visit to Start) | Mean: 54.8 Days | |
Median: 50.2 Days | ||
Range: 0-147 ays | ||
Did not come for RT after Appt. | 05/169 (03%) | |
Did not complete planned RT | 02/169 (1.2%) | |
Post RT follow up visit in RT OPD | - | |
Referred outside for RT | 156 |
g) After Completion of Therapy (ACT) Clinic for long-term survivors of childhood cancers.
|
2016 |
2015 |
---|---|---|
Follow-up |
794 |
655 |
New registration | 60 | 90 |
Total | 854 | 745 |
h) Paediatric palliative care new registrations – 301 (inclusive of all DMGs seeing paediatric
patients like PHL, BST, etc)
b) Outcome Indicators: Morbidity and mortality
Treatment |
Morbidity |
Mortality |
---|---|---|
Surgery |
30 day – 12.1 % (27/233) |
0.4 % (1/223) |
Chemotherapy | Need for admission for | 1.8% (8/443) |
Febrile neutropenia 7.2% (32/ 443) |
||
Radiotherapy (n=169) |
Acute toxicity Grade I: 30% Grade II: 05% Grade III: 04% |
0 % |
c) Outcome Indicators: survival rates
Cancer |
Event-free |
Overall |
From |
---|---|---|---|
Wilms |
84 |
89 |
90(OS) |
Germ cell tumors (extracranial) |
81 | 93 | Best – 95 OS |
Retinoblastoma | 79 | 81 | 95 OS |
Soft tissue sarcomas (non- rhabdomyosarcoma) |
61 | 77 | 89 OS |
Neuroblastoma ( Low/Intermediate) |
68 | 75 |
54-100 (4 year EFS) |
Neuroblastoma (High risk) | 22 | 40 | 30-50 ( 3year EFS) |
Extraskeletal Ewing’s Sarcoma |
68 | 77 | 69–77 and 58–67 EFS and OS |
Hepatoblastoma | 70 | 88 | 100,83,56 and 46 – stage wise OS |
d) Process Indicator
Compliance to time lines: in patients who have completed entire therapy (a range is given as
multiple tumor types are considered)
Date of registration to start of treatment in 14 days: 85-90%
Getting surgery within expected dates from induction chemotherapy: 65-87%
Completion of entire therapy at expected time for tumor and stage: 93-94%
General OPD - All Days Except Saturdays
Timing - 09:15-17:30 Hours
Location - Main Building, Ground Floor , Room No.88 .
Priviate OPD - All Days Except Saturdays
Timing - 09:15-17:30 Hours
Location - Main Building, Ground Floor , Room No.88.
Meeting |
Days |
Incharge |
---|---|---|
OPD timings |
All working days |
All clinicians |
Surgery days |
Every Monday, |
Dr. Sajid Qureshi |
Patient Discussion Joint meeting |
Every Tuesdays & |
Dr. Sajid Qureshi |
ACT clinic |
Every Tuesday and |
Dr. Maya Prasad |
Pediatric Palliative Care OPD |
Tuesday and Thursday |
Dr. Naveen Salins |
Administrative Meeting |
2nd Wednesday |
Dr. Seema Kembhavi |
Morbidity & Mortality Meeting |
2nd Tuesdays |
Dr. Sajid Qureshi |
Academic Meeting |
Tuesdays
|
Dr. TusharVora |
Social Support Group Meeting |
Every Tuesdays |
Dr. TusharVora |
All meeting were held regularly and had adequate quorum of atleast one pediatric oncologist, pediatric surgeon, pediatric radiation oncologist, pathologist and radiologist. Social Support Group meetings are attended by Medical Social Workers & volunteers.
1.Pilot and Phase II study of immunotherapy with anti-GD2 antibody in high risk
neuroblastoma children.
High risk neuroblastoma in children has an unfavourable outcome in spite of multimodality therapy including high dose chemotherapy with ABMT. Over the last decade significant improvements in outcomes have been documented in high risk neuroblastoma children with the use of anti-GD2 antibody. This antibody is resently not available in India. On collaboration with Memorial Sloan Kettering Cancer Centre, New York, a pilot study is being initiated to start anti-GD2 immunotherapy for high risk neuroblastoma children in TMC. The study is approved by ethics committee, received funding and waiting regulatory approval by the DGCI.
2.AGCT 1531; Reduction in therapy for low and intermediate risk extracranial germ cell
tumors (MaGIC consortium study-Malignant Germ Cell Tumors International Consortium)
This is a collaborative study with the children Oncology group of USA. The study is randomised to compare the efficacy and toxicity of Cisplatin and carboplatin for low and intermediate risk GCTs along with reduction in therapy for the low risk disease. The study protocol is now finalised and is now undergoing regulatory approvals in United States after which a formal MOU will be signed between TMC and COG.
1: Qureshi SS, Bhagat M, Anam J, Vora T.
Aggressive cervical neuroblastoma with a rare paraneoplastic syndrome: A therapeutic dilemma.
J Indian Assoc Pediatr Surg. 2016 Oct-Dec;21(4):181-183. PubMed PMID: 27695211;
PubMed Central PMCID: PMC4980880.
2: Prabhu A, Bhagat M, Ramadwar M, Qureshi SS.
Pancreatoblastoma masquerading as hepatoblastoma: A diagnostic dilemma.
J Indian Assoc Pediatr Surg. 2016 Apr-Jun;21(2):84-6. doi: 10.4103/0971-9261.176969.
PubMed PMID: 27046982; PubMed Central PMCID: PMC4790136.
3: Pareekutty NM, Bhagat M, Vora T, Qureshi SS.
Rhabdomyosarcoma of the breast: Report of two cases with the review of literature.
J Indian Assoc Pediatr Surg.2016 Apr-Jun;21(2):81-3. doi: 10.4103/0971-9261.176964.
PubMed PMID: 27046981;PubMed Central PMCID: PMC4790135.
4: Qureshi SS, Rent EG, Bhagat M, Dsouza P, Kembhavi S, Vora T, Prasad M,
Chinnaswamy G, Ramadwar M, Laskar S, Khanna N, Shah S, Talole S. Chyle leak following surgery for abdominal neuroblastoma.
J Pediatr Surg. 2016 Sep;51(9):1557-60. doi: 10.1016/j.jpedsurg.2015.11.002. PubMed
PMID: 26656616.
5.: Gota V, Chinnaswamy G, Vora T, Rath S, Yadav A, Gurjar M, Veal G, Kurkure P.
Pharmacokinetics and pharmacogenetics of 13-cis retinoic acid in Indian high-risk neuroblastoma patients.
Cancer Chemother Pharmacol. 2016 Oct;78(4):763-8. doi: 10.1007/s00280-016-3126-3. PubMed PMID: 27541143.
6: Gupta S, Aitken JF, Bartels U, Brierley J, Dolendo M, Friedrich P,
Fuentes-Alabi S, Garrido CP, Gatta G, Gospodarowicz M, Gross T, Howard SC, Molyneux E, Moreno F, Pole JD, Pritchard-Jones K, Ramirez O, Ries LA, Rodriguez-Galindo C, Shin HY, Steliarova-Foucher E, Sung L, Supriyadi E, Swaminathan R, Torode J, Vora T, Kutluk T, Frazier AL. Paediatric cancer stage in population-based cancer registries: the Toronto consensus principles and guidelines.
Lancet Oncol. 2016 Apr;17(4):e163-72. doi: 10.1016/S1470-2045(15)00539-2. Review. PubMed PMID: 27300676.
7: Indelicato DJ, Merchant T, Laperriere N, Lassen Y, Vennarini S, Wolden S,
Hartsell W, Pankuch M, Brandal P, Law CC, Taylor R, Laskar S, Okcu MF, Bouffet E, Mandeville H, Björk-Eriksson T, Nilsson K, Nyström H, Constine LS, Story M, Timmermann B, Roberts K, Kortmann RD. Consensus Report From the Stockholm Pediatric Proton Therapy Conference. Int J Radiat Oncol Biol Phys. 2016 Oct 1;96(2):387-92. doi: 10.1016/j.ijrobp.2016.06.2446. PubMed PMID: 27598806.
8: Damani A, Salins N, Ghoshal A, Muckaden M. Specialist Pediatric Palliative
Care Prescribing Practices: A Large 5-year Retrospective Audit. Indian J Palliat Care. 2016 Jul-Sep;22(3):274-81. doi: 10.4103/0973-1075.185033. PubMed PMID: 27559255; PubMed Central PMCID: PMC4973487.
9: Ghoshal A, Salins N, Damani A, Deodhar J, Muckaden M.
Specialist Pediatric Palliative Care Referral Practices in Pediatric Oncology: A Large 5-year
Retrospective Audit. Indian J Palliat Care. 2016 Jul-Sep;22(3):266-73. doi:10.4103/0973-1075.185031. PubMed PMID: 27559254; PubMed Central PMCID:PMC4973486.
10: Salins N, Patra L, Usha Rani MR, Lohitashva SO, Rao R, Ramanjulu R, Vallath
N. Integration of Early Specialist Palliative Care in Cancer Care: Survey of Oncologists, Oncology Nurses, and Patients. Indian J Palliat Care. 2016
Jul-Sep;22(3):258-65. doi: 10.4103/0973-1075.185030. PubMed PMID: 27559253;
PubMed Central PMCID: PMC4973485.
11: Ghoshal A, Salins N, Deodhar J, Damani A, Muckaden MA. Fatigue and Quality of
Life Outcomes of Palliative Care Consultation: A Prospective, Observational Study in a Tertiary Cancer Center. Indian J Palliat Care. 2016 Oct-Dec;22(4):416-426.
PubMed PMID: 27803563; PubMed Central PMCID: PMC5072233.
12: Salins N, Ramanjulu R, Patra L, Deodhar J, Muckaden MA. Integration of Early
Specialist Palliative Care in Cancer Care and Patient Related Outcomes: A Critical Review of Evidence. Indian J Palliat Care. 2016 Jul-Sep;22(3):252-7.
doi: 10.4103/0973-1075.185028. PubMed PMID: 27559252; PubMed Central PMCID: PMC4973484.
13: Salins N, Deodhar J, Muckaden MA. Intensive Care Unit death and factors
influencing family satisfaction of Intensive Care Unit care. Indian J Crit Care Med. 2016 Feb;20(2):97-103. doi: 10.4103/0972-5229.175942. Review. PubMed PMID: 27076710; PubMed Central PMCID: PMC4810940.
14: Dhiliwal S, Salins N, Deodhar J, Rao R, Muckaden MA. Pilot Testing of Triage
Coding System in Home-based Palliative Care Using Edmonton Symptom Assessment Scale. Indian J Palliat Care. 2016 Jan-Mar;22(1):19-24. doi:10.4103/0973-1075.173943. PubMed PMID: 26962276;
PubMed Central PMCID:PMC4768444.
15: Ghoshal A, Salins N, Damani A, Deodhar J, Muckaden MA. Medical Management of
Pediatric Malignant Bowel Obstruction in a Patient with Burkitt's Lymphoma and Ataxia Telangiectasia Using Continuous Ambulatory Drug Delivery System.
J Pain Palliat Care Pharmacother. 2016;30(1):44-8. doi: 10.3109/15360288.2015.1134748.
PubMed PMID: 26862790.
Text book chapters: --
Dr. Sajid Qureshi
1. K.M. Yusuf Memorial Oration – Tamil Nadu & Pondicherry Paediatric Surgeons Annual
Conference, Chennai, Tamil Nadu June 2015.
2. Executive Committee Member- International Society of Pediatric Surgical Oncology.
Dr. G. Chinnaswamy
1. Chair, Solid tumour working group, Paediatric Oncology East and Mediterranean
(POEM)
Dr. Maya Prasad
1. Associate editor, Pediatric Hematology and Oncology Journal
2. Chair of Rare Tumour Working Group, InPOG (collaborative research group of
Paediatric Haematology- Oncology Chapter of Indian Academy of Paediatrics)
Dr. Tushar Vora
1. Chair, Osteosarcoma Working Group, InPOG
Dr. Seema Kembhavi
1. Member, Liver tumor Working group (InPOG)
2. Reviewer Indian Journal of Radiology and Imaging (IJRI)
Dr. Siddhartha Laskar
1. Chair, Sarcoma Working group (InPOG)
Dr. M.Mukaden
1. President Elect of Indian Association of Palliative Care to take over from Feb 2016
Dr. Naveen Salins
1. Editor of Indian Journal of Palliative Care
2. Visiting Associate Professor, Northern Adelaide Palliative Services, Modbury Hospital
3. Secured PhD palliative care position in Lancaster University, UK.
Department Office Number: (+9122) 24177000 / Ext.No.- 4180
Department of Pediatric Solid Tumours,
TATA MEMORIAL HOSPITAL, Dr.E.Borges Road, Parel, Mumbai-400-012
Maharashtra, India
Hospital Fax Number: (+9122) 24146392
Email-id: dmgpae@tmc.gov.in
TATA MEMORIAL HOSPITAL
Dr. E Borges Road, Parel, Mumbai - 400 012 India
Phone: +91-22- 24177000, 24177300, 24161413
Fax: +91-22-24146937
E-mail : msoffice@tmc.gov.in(for patient care and queries)/cash@tmc.gov.in(for accounts related)/fundraising@tmc.gov.in (for donors and donation related)/registrar@tmc.gov.in(for education and training)/hrd@tmc.gov.in(for administrative - HRD matters) This email address is being protected from spambots. You need JavaScript enabled to view it.
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