PMID- 20479545
OWN - NLM
STAT- MEDLINE
DCOM- 20100813
LR  - 20151119
IS  - 1998-4138 (Electronic)
IS  - 1998-4138 (Linking)
VI  - 6
IP  - 1
DP  - 2010 Jan-Mar
TI  - Non-Hodgkin's lymphoma: is India ready to incorporate recent advances in day to 
      day practice?
PG  - 36-40
LID - 10.4103/0973-1482.63571 [doi]
AB  - BACKGROUND: Non Hodgkin's Lymphoma (NHL) cure rates are increasing and 
      morbidities are decreasing, with more active pharmacological agents and 
      technological advancements. In spite of this, India is still battling with the 
      prejudices of an economically and educationally impoverished patient base. 
      METHODS AND RESULTS: We analyzed NHL cases from 2000 to 2006 using data from case 
      sheets. Of 303 cases, only 100 patients had complete workup and received some 
      form of treatment. For 203 patients, reasons for non-compliance were: financial 
      constraint (119), distance from center (38), inability of physician to provide 
      guarantees of cure (13), poor prognosis/fear of recurrence (28)), preferences for 
      alternate medicine (5). Most common investigations that could not be afforded for 
      staging were whole body CT scans and bone marrow aspiration and biopsy. Thirteen 
      patients were in stage III and 53 in Stage IV. The most common regimen was CHOP 
      (Cyclophosphamide, Adriamycin, Vincristine, Prednisolone). Forty-five patients 
      did not complete six courses of CHOP and 35 patients had significant delay. 
      Reasons for delay were intermittent availability of cash (35), intolerable 
      toxicities (30), absence of supportive care (21), given-up attitudes (17). 
      Eighty-three patients suffered Grade III/IV debilitating toxicities. Overall 
      survival at five years was 50%. CONCLUSIONS: NHL in India is no different from 
      the developed world. However, there are disparities in survivorship and outcomes, 
      due to un-affordability and attitudes of the patients. Therefore, we suggest the 
      development of Community Health Insurance Schemes (CHIs), with the hospital as 
      the nodal center to address the above mentioned issues.
FAU - Vallabhajosyula, Saraschandra
AU  - Vallabhajosyula S
AD  - Department of Radiotherapy, Shirdi Sai Baba Cancer Hospital, Kasturba Medical 
      College, Manipal - 576 104, Udupi District, Karnataka, India.
FAU - Baijal, Gunjan
AU  - Baijal G
FAU - Vadhiraja, B M
AU  - Vadhiraja BM
FAU - Fernandes, Donald J
AU  - Fernandes DJ
FAU - Vidyasagar, M S
AU  - Vidyasagar MS
LA  - eng
PT  - Journal Article
PL  - India
TA  - J Cancer Res Ther
JT  - Journal of cancer research and therapeutics
JID - 101249598
RN  - 35S93Y190K (Procarbazine)
RN  - 3Z8479ZZ5X (Epirubicin)
RN  - 5J49Q6B70F (Vincristine)
RN  - 6PLQ3CP4P3 (Etoposide)
RN  - 80168379AG (Doxorubicin)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - Q573I9DVLP (Leucovorin)
RN  - UM20QQM95Y (Ifosfamide)
RN  - VB0R961HZT (Prednisone)
RN  - YL5FZ2Y5U1 (Methotrexate)
RN  - CEOP protocol 1
RN  - CHOP protocol
RN  - IMVP-16 protocol
RN  - Pro-MACE-C-MOPP protocol
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/economics/therapeutic use
MH  - Cyclophosphamide/economics/therapeutic use
MH  - Developing Countries
MH  - Doxorubicin/economics/therapeutic use
MH  - Epirubicin
MH  - Etoposide
MH  - *Health Knowledge, Attitudes, Practice
MH  - *Healthcare Disparities/economics/statistics & numerical data
MH  - Humans
MH  - Ifosfamide
MH  - India
MH  - Leucovorin
MH  - Lymphoma, Non-Hodgkin/diagnosis/*drug therapy/economics
MH  - Methotrexate
MH  - Patient Compliance/*statistics & numerical data
MH  - Prednisone/economics/therapeutic use
MH  - Procarbazine
MH  - Vincristine/economics/therapeutic use
EDAT- 2010/05/19 06:00
MHDA- 2010/08/14 06:00
CRDT- 2010/05/19 06:00
PHST- 2010/05/19 06:00 [entrez]
PHST- 2010/05/19 06:00 [pubmed]
PHST- 2010/08/14 06:00 [medline]
AID - JCanResTher_2010_6_1_36_63571 [pii]
AID - 10.4103/0973-1482.63571 [doi]
PST - ppublish
SO  - J Cancer Res Ther. 2010 Jan-Mar;6(1):36-40. doi: 10.4103/0973-1482.63571.