Oral cavity cancer (OCC) patients undergoing flap reconstruction during surgery present unique anatomical challenges during postoperative radiation therapy (PORT). Variations in body contour and internal anatomy can affect dose distribution and necessitate adaptive radiotherapy (ART). However, limited data is available regarding the frequency, timing, and causes of re-planning.

To evaluate anatomical surface contour variations and the need for adaptive re-planning in OCC patients with flap reconstruction (OCCwFR) receiving PORT using co-registration of planning CT and cone-beam CT (CBCT).

This prospective observational study included adult OCCwFR patients treated with curative-intent PORT. Daily portal imaging and weekly CBCTs were analyzed. Variations greater than 1 cm across three or more consecutive CBCTs were considered significant. Changes were categorized as progression, regression, internal target motion, or setup error. Factors associated with adaptive re-planning were recorded.

Among 111 patients, 39 (35%) required re-planning. Regression was the predominant change (92%), mainly due to weight loss (80%), followed by edema resolution and tumor response. Re-planning occurred mostly around the 20th fraction. Progression-related changes were rare (5%) and occurred earlier (3rd week). No association was found between flap type and re-planning (p= 0.21). Weight loss strongly correlated with re-planning (χ²= 45.5, p< 0.0001) and mean volume reduction of 50 cc.

Anatomical changes during PORT in OCCwFR patients are frequent, predominantly due to weight loss. Mid-treatment ART around the 5th week and proactive nutritional support are essential to maintain dosimetric accuracy and treatment efficacy.

Retinoblastoma is a malignant ocular tumor in children. Patient characteristics differ between low- and middle-income countries and high-income countries. This study analyzes the clinical presentation and survival rates of patients with retinoblastoma at the National Eye Center (NEC) in Indonesia, a middle-income country.

Clinical data of all children diagnosed with retinoblastoma at NEC between 2012 and 2021 were retrospectively analyzed.

In 10 years, 395 patients with retinoblastoma were diagnosed and treated at NEC. The number of diagnoses increased from 2012 to 2019, but declined during the COVID-19 pandemic. Most patients were diagnosed under 5 years of age. The most common sign was leukocoria (77.5%), followed by proptosis (14.0%). Proptosis was even more common in children from remote areas of Indonesia (20.0%). At NEC, 73.4% had unilateral and 26.6% bilateral retinoblastoma. Patients with bilateral retinoblastoma were statistically noticeably younger at diagnosis than unilateral retinoblastoma (unilateral: 27 months; bilateral 21 months; p<0.001). In patients diagnosed between 2017 and 2021, overt extraocular retinoblastoma (IRSS III and IV) was detected in 16.1% while only 5.4% of patients presented with IRSS 0/I at diagnosis. The 3-year overall survival rate for patients diagnosed between 2017 and 2021 was 53.5% (95%-CI: [43.1%, 66.4%]).

In Indonesia extraocular disease at diagnosis is common contributing to low survival rates. To address this, early detection programs, standardized referral pathways, and treatment guidelines have been implemented. These efforts aim to improve survival outcomes and bring them closer in line with those of other middle-income countries.

Human papillomavirus (HPV) is the primary cause of cervical cancer, a global health crisis. Indonesia is placed as having the highest cervical cancer incidence and fatality in Southeast Asia. Currently, under the National Cervical Cancer Elimination (NCCE) plan, Indonesia has extended HPV DNA-based screening from 30-50 to 30-69 years old. However, various factors can lead to inadequate virus clearance in younger populations, and Indonesia has not yet had a large-scale analysis of age-specific HPV infection reports, leaving the ideal screening age uncertain. Therefore, this study aims to investigate age-specific HPV prevalence in Indonesia to inform the optimal age range for cervical cancer screening.

In this retrospective cross-sectional study, 75,719 subjects' data were utilized from all metropolitan regions in Indonesia from 2012-2020, who were tested with HPV DNA using PCR (SPF10-DEIA-LiPA25) and hybridization. The data were then analyzed by age and HPV genotype using IBM SPSS 27.0.

12.62% of 75,719 women aged 13-75 are HPV-positive. Women aged 30-39 (39.56%) and 40-49 (21.1%) had the highest infection rates, followed by 25-29 (18.9%) and those below 25 years (8.8%). This contrasts with the infection rates of women aged 60-65 (1.5%) and 66-69 (0.6%). Across all age categories, HPV52, HPV16, and HPV58 were the most prevalent high-risk genotypes, with substantial variations in infection rates (p <0.001). High-risk HPV outnumbered low-risk HPV in all age categories.

HPV-positive prevalence in the younger population, particularly among those aged 25-29, is frequent in Indonesia. After age 65, HPV-positive cases drop significantly. Several variables contribute to this. This study recommends adjusting cervical cancer screening to Indonesian women aged 25-65.

To evaluate the gynecologic and reproductive changes in women of reproductive age diagnosed with leukemia, with an emphasis on menstrual disturbances, vaginal microbiota alterations, and cytological abnormalities.

A cross-sectional observational study was conducted involving 100 female patients aged 16 - 46 years with confirmed diagnoses of acute or chronic leukemia. Clinical and gynecological examinations were performed, including cytological assessment (Pap smear), vaginal microbiological analysis, and pelvic ultrasound. Statistical analysis was performed using descriptive methods and Student t-test.

Hyperpolymenorrhea was observed in 62% of participants, while 21% reported secondary amenorrhea. Vaginal microbiological analysis revealed Grade III-IV dysbiosis in 77.7% of patients, with dominant growth of Candida spp., Staphylococcus aureus, and E. coli. Cytological abnormalities were detected in 50% of cases, including ASCUS (40%) and LSIL (5%). In 28% of cases, leukemic blast cells were identified in cervical smears. Ultrasound findings included enlarged ovaries and uteri in 35% of patients, with evidence of solid infiltrative changes in the external genitalia and mammary glands in isolated cases.

Leukemia in women of reproductive age is frequently associated with menstrual disorders, significant disturbances in vaginal microbiota, and cytological abnormalities, including evidence of leukemic infiltration. Early gynecological screening in such patients is essential to ensure the timely management of reproductive health complications.

Cholangiocarcinoma (CCA) is an aggressive malignancy of the biliary tract with poor prognosis and limited early diagnostic tools. Microbial dysbiosis has been implicated in carcinogenesis, yet microbial signatures across disease stages and anatomical sites in CCA remain poorly defined. This study aimed to characterize the microbial diversity in bile and tumor tissue of CCA patients and evaluate association with disease stage.

Microbiome profiles were analyzed from 36 subjects using 16Sr RNA gene sequencing data from the Sequence Read Archive (SRA). Alpha diversity (Chao1 index) and beta diversity (Bray-Curtis dissimilarity) were assessed across bile and intratumoral samples. Linear discriminant analysis effect size (LEfSe) was employed to identify stage-specific microbial taxa.

Alpha diversity did not differ significantly between disease stages (ANOVA, F = 0.385, p = 0.816), suggesting stable microbial richness throughout progression. However, beta diversity analysis (PERMANOVA, R² = 0.279, p = 0.013) revealed distinct clustering by sample type and tumor stage. LEfSe identified enrichment of Fusobacterium, Escherichia-Shigella, and Enterococcus in advanced-stage tumor samples, while Lactobacillus and Streptococcus were more abundant in early-stage bile samples.

This study demonstrates distinct microbial composition patterns across disease stages and anatomical sites in CCA. Enrichment of specific pathogenic taxa in advanced stages supports a role for microbiome alterations in CCA pathogenesis. Microbial markers may serve as potential tools for staging and prognosis, warranting further functional and prospective validation studies.

Exosomes, extracellular vesicles (EVs) 30-150 nm in diameter, are known to mediate intercellular communication by transferring bioactive molecules that can reprogram recipient cell phenotypes. Our analysis of 5-year survival data from breast cancer patients (BCPs) revealed that the poorest outcomes were exclusively associated with conserved signature of three ribosomal proteins (RPs) - MRPL52, RPL28, and RPL40 (UBA52) - that were completely absent in healthy females (HFs) and better-prognosis cases. Strikingly, all patients with this exosomal RP profile succumbed to metastatic relapse within the observation period.

While RPs are known components of tumor-derived exosomes, their absence in EVs from normal cells suggests cancer-specific sorting mechanisms. To investigate this, we characterized exosomal RP cargo from three breast cancer cell lines (MCF-7, BT-474, BT-549), finding cell-type-specific RP patterns that differed from the clinical BC signature. Transfection of BT-549 cells with FLAG-tagged RPS3 (an aggressive cancer-associated RP) induced dramatic changes in exosomal RP composition, including the appearance of RPL28 - matching our clinical findings.

Bioinformatic analysis revealed that the RPs identified in BCP blood exosomes (MRPL52, RPL28, RPL40, RPS6) are associated with poor prognosis across multiple cancers and participate in key oncogenic pathways.

The concordance between our clinical and experimental data suggests that: (a) specific RPs are selectively packaged into exosomes under stress conditions; (b) this process may contribute to BC aggressiveness; (c) exosomal RP profiling could serve as a novel prognostic approach. These findings illuminate previously unrecognized roles of ribosomal components in cancer progression through EV-mediated communication.

S100A9, a calcium-binding protein involved in inflammation and tumor progression, has been identified as a potential biomarker for Opisthorchis viverrini related cholangiocarcinoma (CCA) diagnosis. However, its role in O. viverrini infection remains unclear.

ELISA was used to investigate the plasma S100A9 level among healthy individuals, O. viverrini-infected patients, and CCA patients to evaluate its potential as a diagnostic biomarker. The highest S100A9 levels were observed in CCA patients, while the lowest levels occurred in O. viverrini-infected individuals.

One-way ANOVA followed by post-hoc analysis revealed a significant difference between the O. viverrini infected and CCA groups, but not between the CCA and healthy groups or between the healthy and O. viverrini infected groups. S100A9 had high specificity (97.50%) but low sensitivity (21.88%) for distinguishing CCA from O. viverrini infected and healthy groups, suggesting limited utility as a standalone screening tool but potential value in diagnostic contexts. Although limited by diagnostic performance (AUC = 0.5580), the consistent upregulation trend in CCA aligns with previous studies. Combining S100A9 with other biomarkers may enhance diagnostic accuracy for O. viverrini-related CCA.

S100A9 was elevated in CCA but not in O. viverrini infection, highlighting its potential as a differential diagnostic marker.

Chronic myeloid leukemia (CML) is driven by the BCR-ABL1 fusion gene. Molecular monitoring of this transcript is essential for patient management. However, the high cost of imported assays limits access to regular monitoring in Morocco.

We developed and validated a cost-effective one-step multiplex RT-qPCR assay that simultaneously detects BCR-ABL1 and ABL1 transcripts in peripheral blood mononuclear cells. Samples from 63 Moroccan CML patients were analyzed and compared with the GeneXpert system.

The assay showed efficiencies above 95% and R2 ≥ 0.99 for both targets. BCR-ABL1/ABL1 ratios correlated strongly with GeneXpert (r = 0.93, p < 0.001) and showed 86% overall agreement.

This locally developed assay is a reliable and affordable alternative for routine BCR-ABL1 detection and monitoring, improving access to molecular testing in resource-limited settings.

Cancer poses a formidable health crisis and major public health challenge in Bangladesh, while globally it remains among the leading causes of morbidity and mortality across all ages. This study aimed to explore the age- and sex-specific incidence, mortality, and prevalence of cancers in Bangladesh.

This study was based on secondary, modeled data obtained from the Global Cancer Observatory (GCO), GLOBOCAN 2022 database developed by the International Agency for Research on Cancer under the World Health Organization, with supplementary estimates retrieved from the Global Burden of Disease (GBD) Study.

In 2022, Bangladesh recorded 167,256 new cancer cases and 116,598 cancer-related deaths, with higher age-standardized incidence and mortality rates observed in males. The leading cancers by incidence (per 100,000) were esophagus (16.0), breast (15.2), cervix uteri (11.3), lip and oral cavity (10.3), and lung cancers (8.8). Notably, Bangladesh ranked first globally for esophageal cancer incidence (16.0) and mortality (15.3). Prevalence was the highest for breast and oral cavity cancers. Age-specific patterns revealed that leukemia and non-Hodgkin lymphoma (NHL) were predominant in children, while breast, cervix, esophageal, and lung cancers became more common in adults and the elderly. Forecasts suggest that by 2050, new cancer cases will rise to 348,000 and deaths to 252,000, nearly doubling the current burden.

Significant increases are expected for trachea, bronchus, lung, and gallbladder cancers. Esophageal cancer is projected to remain the leading cause of cancer-related deaths, while leukemia, breast, cervix, and gallbladder cancers will continue to exert substantial impacts across different age groups. These trends underscore the urgent need for targeted prevention, early detection, and comprehensive cancer control strategies in Bangladesh.

Cervical cancer is the second most prevalent cancer among women in developing nations, including India. This study aims to assess the knowledge, attitude, and practice (KAP)  regarding cervical cancer screening, risk factors, and prevention strategies, along with the  barriers to participation in screening activities, among married tribal women in  Sirohi district, Rajasthan, to identify areas for improvement in this essential aspect of women's health.

A cross-sectional, community-based study was conducted among 170 married tribal women recruited from the Tribal Sub-Plan (TSP) zone in Sirohi district, Rajasthan. A  standardised, fixed-response questionnaire was used to obtain data on participants' KAP regarding cervical cancer screening.

The mean age of the study population was 32.81 ± 10.5 years. Out of 170, 28 (16.5%) women had heard of cervical cancer, and 20 (11.8%) women were aware of cervical cancer screening. Only 19.4% of women agreed to undergo screening for cervical cancer. A significant proportion, 86.5% of participants, had poor knowledge, 84.1% had a negative attitude, and only 0.6% demonstrated good practices regarding cervical cancer screening. Knowledge scores were significantly associated with age group, education, socioeconomic class, and number of children (p < 0.05). Attitude scores were significantly associated with age, contraceptive method used, and tobacco use. Practice scores were significantly associated with education and menstrual cycle characteristics (p < 0.05). Identified barriers to screening included lack of awareness, financial constraints, anxiety about vaginal examinations, feelings of embarrassment, and communication difficulties.

The study findings indicate a critical deficiency in knowledge, attitude, and practice as well as low willingness to participate in cervical cancer screening among tribal women. Educational interventions  through culturally sensitive awareness programs should be conducted in the local tribal language to enhance preventive healthcare in the tribal population.