Dr. Vivek Tiwari, MD  - Gandhi Medical College - Astt. Professor

Dr. Vivek Tiwari

MD

Gandhi Medical College

Astt. Professor

Bhopal, M.P. | India

Main Specialties: Oncology

Additional Specialties: Oncology

Dr. Vivek Tiwari, MD  - Gandhi Medical College - Astt. Professor

Dr. Vivek Tiwari

MD
Introduction

Primary Affiliation: Gandhi Medical College - Bhopal, M.P. , India

Specialties:

Additional Specialties:

Metrics

24

Publications

1644

Profile Views

84

Reads

3

PubMed Central Citations

Top co-authors
Piyush Shukla
Piyush Shukla

1 University Station A5300

3
Sandeep Goel
Sandeep Goel

Kyoto University

3
Kamal Verma
Kamal Verma

National Neuroscience Institute

3
Gourav Gupta
Gourav Gupta

Post Graduate Institute of Medical Education and Research

2
Soumyajit Roy
Soumyajit Roy

Debye Institute

1
Bidhu K Mohanti
Bidhu K Mohanti

All India Institute of Medical Sciences

1
Hameed Uzzafar Ghori
Hameed Uzzafar Ghori

Gandhi Medical College

1
Om Prakash Singh
Om Prakash Singh

Infectious Disease Research Laboratory

1
Suresh Yadav
Suresh Yadav

Gandhi Medical College Bhopal

1

Publications

24Publications

84Reads

3PubMed Central Citations

Squamous Cell Carcinoma of the Buccal mucosa: A Single Institute Retrospective Analysis of Nodal Involvement and Survival.

Gulf J Oncolog. 2017 September;1(25):46-50.

Gulf journal of Oncology

Background: The magnitude of head and neck (H&N) cancers in the Indian subcontinent is very high. Neck nodal involvement is indicative of higher stage and subsequent adverse prognosis when compared with node negative disease. The frequency of such spread is greater than 20% for most H& N squamous cell carcinomas (SCC). The purpose of this study was to analyze the pattern of nodal metastasis in patients presenting with SCC of buccal mucosa (BM) and correlate it with survival. Patients and methods: Ninety-nine cases of carcinoma BM who received post op radiotherapy were analyzed retrospectively. Medical records were reviewed and data collected from the hospital case files. Patients were analyzed for age and sex distribution, tumor staging, metastasis and overall survival. Results: The majority of cases were T4 lesions (n=40, 40.40%), followed by T2 lesions (n=35, 35.35%). T3 lesions constituted for 19.19% cases (n=19) while there were five cases (5.05%) of T1 lesions. 62 patients (62.62%) had positive neck nodes, with/without adverse pathologic features mandating post-operative radiotherapy, while 37 patients (37.37%) did not have any neck nodal involvement. The mean overall survival of the node negative patients (n=37) was 14.51 months (range 02-61 months) and was significantly more (p=0.03) than that of the node positive patients [10.82 months (range 01-35 months)]. A statistically significant difference in survival was also seen between the node negative patients and patients with >3 positive neck nodes (p=0.04). Conclusion: Neck nodal involvement in cases of carcinoma BM is an adverse prognostic indicator. The number of pathological positive neck nodes can be used as a predictor of treatment outcome.

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October 2017
14 Reads

Malignant Phyllodes Tumor of the Breast with Isolated Brain Metastasis: A Case Report of an Intriguing Aggressive Subtype

Clin Cancer Investig J 2017;6:167-70.

Clinical Cancer Investigation Journal

Phyllodes tumors are rare breast tumor types and comprise 0.3%–1.0% of all breast tumors. They usually manifest in 35–55‑year age group and are classified into benign, borderline, and malignant types based on the histopathological features. Certain cases of malignant tumors behave in an aggressive manner with an unpredictable and often dismal outcome. The present case report addresses such a scenario in a very young female who showed a rapid appearance of brain metastatic disease. We describe this case and present a brief literature review.

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October 2017
13 Reads

Comparison of Toxicities Associated with Concomitant Boost and Conventional Fractionated Radiotherapy Regimen in Oral and Oropharyngeal Cancers

Journal of Clinical and Diagnostic Research [serial online] 2017 October [cited: 2017 Oct 4 ]; 11:XC

Journal of Clinical and Diagnostic Research

Introduction: The prevalence of Head and Neck Cancers (HNC) is very high in the Indian subcontinent. Radiotherapy is an essential modality in the management of HNC. Aim: The aim of the present study was to compare toxicities of two radiotherapy fractionation regimen (conventional fractionation and concomitant boost technique) for the management of HNC. Materials and Methods: A total of 60 patients (n=30 in each arm) were assigned to receive either conventional fractionation or concomitant boost radiotherapy. Toxicities were analysed weekly during the treatment, and one and three month after treatment completion. The radiation therapy oncology group acute radiation morbidity scoring system was used to document the severity. Toxicities assessed were mucositis, skin reactions, dysphagia and xerostomia. Statistical analysis was done by the online graph pad software using Chi-square test. A value of p<0.05 was considered significant. Results: Overall mean age of the patients was 47.35 years (range 23-70 years). There was a male preponderance in both groups (Group A=73.33%, Group B= 76.6%). Most common primary sub site in Group A was tongue (33.3%) and in Group B was buccal mucosa (50%). On statistical analysis of toxicity comparison during and post treatment completion, no significant difference in toxicity was found between the two arms in terms of mucositis (p=1), skin reactions (p=0.6404), dysphagia (p=0.7906) and xerostomia (p=0.1066). Conclusion: The concomitant boost technique resulted in no statistically significant difference in toxicity as compared to the conventional fractionation with the added advantage of reduced overall treatment time. This may be a favourable schedule for high volume centers

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October 2017
16 Reads

Carcinoma buccal mucosa in a treated case of carcinoma cervix: A rare presentation

Clin Cancer Investig J 2016;5:330-2.

Clinical Cancer Investigation Journal

Second malignancy in an adequately treated cancer is a rare occurrence. Second cancer arising beyond the treated region and its draining lymphatic is even more sporadic. We report a treated case of carcinoma cervix with a metachronous presentation of carcinoma buccal mucosa and provide a brief literature review.

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July 2016
14 Reads

Nab‑paclitaxel as induction chemotherapy in external auditory canal carcinoma: Case report and review of literature

Clin Cancer Investig J 2016;5:76-8.

Clinical Cancer Investigation Journal

Squamous cell carcinoma of the external auditory canal, middle ear, and temporal bone is a rare and unusual malignancy. The rare occurrence of the disease makes the formulation of uniform treatment guidelines and appropriate management challenging. The role of chemotherapy in this disease is not clearly defined in literature. We describe a clinical case of a patient with this rare malignancy and an excellent response achieved with nanoparticle ‑ albumin‑bound paclitaxel and present a comprehensive review of literature.

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January 2016
12 Reads

Addressing the status of radiotherapy facilities in Bhopal: World leader in mouth cancers

Clin Cancer Investig J 2015;4:777-8

Clinical Cancer Investigation Journal

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November 2015
13 Reads

Identifying the Factors Causing Delayed Presentation of Cancer Patients to a Government Medical College of Central India.

J Clin Diagn Res 2015 Sep 1;9(9):XC09-XC12. Epub 2015 Sep 1.

Scientific Officer, Department of Radiation Oncology, Gandhi Medical College , Bhopal, India .

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September 2015
13 Reads

Spinal metastasis of breast cancer presenting after 25 years: An extremely rare presentation

Gulf J Oncolog.2015 Sep;1(19):24-7.

Gulf J Oncology

Breast cancer is the most frequently diagnosed cancer in females of the developed world and is gradually becoming the leading cause in the developing world as well. The innate biology of breast cancer is marked by varied presentations, characteristics, response, recurrence and metastatic phenomenon. Even an early stage breast cancer has the potential to recur and/or metastasize after extremely long duration and this possibility should be borne in the clinician’s mind.

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September 2015
12 Reads

IDENTIFYING THE FACTORS CAUSING DELAYED PRESENTATION OF CANCER PATIENTS TO A GOVERNMENT MEDICAL COLLEGE OF CENTRAL INDIA

J Clin Diagn Res.2015 Sep;9(9):XC 09-12.DOI: 10.7860/JCDR/2015/15104.6512

Journal of clinical and diagnostic research

Background: The incidence of cancer is increasing throughout the world. One of the prime aims of its management is early diagnosis and therapeutic intervention. Factors causing delay to either of these goals should be identified and rectified. Aim: To identify the factors causing delayed initial diagnosis and subsequent management in patients presenting to the Oncology department. Materials and Methods: Three hundred proven cancer patients were prospectively evaluated for the pattern of presentation to the outpatient Department of Radiation Oncology of a Government Medical College (MC) in Central India. Results: The mean age of presentation was 51.05 years (range 7 months-77 years). The number of male patients was 168 while females were 132. The duration of symptoms ranged from 20 days to 3 years. The number of patients with little/no education presented mainly in advanced stages as compared to their educated counterpart and this difference was statistically significant (p<0.001). The number of patients presenting directly to the department was 108, those diagnosed outside and referred to us was 84 while those diagnosed and received some form of oncologic treatment outside and referred thereafter was 108. The difference in the primary delay between patients presenting directly to the MC versus those diagnosed outside was significant (p=0.0126). The mean duration of starting definitive treatment after presentation to the outpatient was 4.68 days (range 0-22 days) and was very significantly (p<0.001) less than the secondary delays caused to the other two subsets of patients. Conclusion: Factors causing delayed presentation are both patient and system related. It is imperative to educate the common people regarding the early signs and symptoms of cancer. At the same time, the system needs to overhaul its efficiency to avoid secondary delays that adversely affect the treatment outcome. An upgradation of the existing oncology facilities in the public sector can achieve this target efficiently.

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September 2015
22 Reads

Nab Paclitaxel and Carboplatin as Induction Chemotherapy in Head Neck Cancer Patients: Efficacy and Tolerability

IOSR-JDMS Aug;14;8:57-60.

IOSR Journal of Dental and Medical Sciences

Background: The objective of this study was to compare the efficacy and tolerability of nab paclitaxel (NP) and carboplatin based induction chemotherapy (IC) for advanced head neck squamous cell carcinoma patients. Methods: 32 patients with advanced head and neck cancer who underwent three cycles IC with NP and carboplatin were retrospectively analysed for the response and tolerability. Results: 28 patients completed the planned course of IC. The number of patients achieving complete response; partial response; stable disease;progressive disease at the primary and neck nodal site were 10/16/2/0 and 7/8/0/1 respectively. The most common adverse effects encountered were fatigue (71%), peripheral sensory neuropathy (53.57%) , Gastrointestinal( 32.14%) and anemia (17.85%). Conclusion: NP- Carboplatin based IC showed response comparable to the literature and with fewer adverse effects. This regimen can be beneficial in high volume centres.

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August 2015
13 Reads

Simultaneous integrated boost with intensity modulated radiation therapy in brain oligometastases: A feasible technique for developing countries.

South Asian J Cancer 2015 Jan-Mar;4(1):11-4

Department of Radiation Oncology, Artemis Health Institute, Gurgaon, Haryana, India.

View Article
April 2015
15 Reads

Assessment of treatment tolerance and response of elderly head and neck cancer patients: A single institution retrospective study

Clin Cancer Investig J [Epub ahead of print] [cited 2015 Apr 3].

Clinical Cancer Investigation Journal

Background: Head and neck (H and N) cancers are the leading cancer in elderly Indian population especially in Central India. Poor socioeconomic (SE) factors, lack of knowledge, and that of proper facilities is responsible for delayed presentation in advanced stages of the disease. Management of such patients is challenging for an oncologist. Aim: The present study evaluated the pattern of tolerance and response to treatment in elderly (>65 years) H and N cancer patients. Materials and Methods: Medical records of elderly H and N cancer patients presenting from January to December 2014 to the Department of Radiotherapy, Gandhi Medical College, Bhopal were reviewed, and data were collected from the departmental case files. Results: A total 112 patients were selected for this study. The mean age of presentation was 70 years. There was a marked male preponderance, with male to female ratio of 5.22:1. 102 patients presented in advanced stages (stage III and IV). The mean duration of symptoms was 6.5 months. Records of 99 patients were available and further analyzed. 59 patients were advised three courses of induction chemotherapy (CT) out of which 44 patients completed the treatment. 28 of these patients showed a positive response to the treatment while 16 showed no response (NR)/progression. Similarly, 24 patients were advised concurrent chemoradiotherapy out of which 17 patients completed the treatment. 13 of these patients showed a positive response while 04 showed NR/progression. On subgroup analysis, the difference between tolerance, response and overall treatment time between the two arms was not statistically significant. Conclusions: Treating elderly H and N cancer patients is a major therapeutic challenge for a clinician because of its poor prognosis, aggressive clinical behavior, associated co-morbidities, and SE factors. However, it is possible to achieve a quality outcome in select patients with basic CT and radiation.

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April 2015
11 Reads

Unusual presentation of metastatic gall bladder cancer.

J Cancer Res Ther 2014 Apr-Jun;10(2):397-8

Department of Radiation Oncology, Institute Rotary Cancer Hospital, AIIMS, New Delhi, India.

View Article
March 2015
8 Reads

Is multiparity a protective mechanism in Iraqi females with breast cancer? Need for detailed analysis

Clin Cancer Investig J 2015;4:292-3

Clinical Cancer Investigation Journal

View Article
March 2015
12 Reads

Orbital sebaceous gland carcinoma: A brief communication

Clin Cancer Investig J [Epub ahead of print]

Clinical Cancer Investigation Journal

Sebaceous gland carcinoma commonly arises in the periocular area and is an uncommon condition. Its orbital origin is even rare with isolated reports in literature search. Its early diagnosis is frequently missed owing to the subtle presentation that mimics various benign conditions. Surgery with wide resection margin is considered the standard of care. Irradiation is frequently indicated and administered as an adjuvant regimen following surgical resection. The role of chemotherapy in this disease remains investigational and is usually employed in recurrent settings.

View Article
January 2015
16 Reads

Simultaneous integrated boost with intensity modulated radiation therapy in brain oligometastases: A feasible technique for developing countries

South Asian J Cancer 2015;4:11-4.

South Asian J Cancer

Introduction: To analyze the pattern of brain metastasis (BM), and to use intensity modulated radiation therapy (IMRT) for target dose escalation in cases with ≤3 metastatic lesions (oligometastases). Materials and Methods: Thirty‑two consecutive cases of BM treated during September 2009 to August 2012 were analyzed retrospectively. Results: The study comprised 13 males (40.62%) and 19 females (59.37%). Thirteen (40%) patients presented with disseminated intracranial metastases, while 19 (60%) had ≤3 foci. In 25 cases (78%), the primary was located either in the breast (14 cases) or lung (11 cases).The 13 patients with disseminated intracranial metastases received whole brain radiation therapy to a dose of 30 Gy/10-12 daily fractions (Group A) while the 19 cases with ≤3 lesions received an additional dose of 6-10 Gy to gross lesions using a simultaneous integrated boost (SIB) with IMRT thus receiving a total dose of 36-40 Gy/12-15 fractions (Group B). Overall survival (OS) for the breast primary was 6.3 and lung primary was 5.3 months, respectively. The mean OS for breast cases in Group B was higher (9.5 months) as compared to Group A cases (1.9 months) and was statistically significant (P = 0.0056). Similarly, primary lung cancer cases in Group B showed a mean OS of 8.75 months versus 2.6 months for Group A cases (P = 0.213). Conclusions: IMRT is a safe and effective technique in cases with oligometastases for dose escalation in the form of SIB.

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January 2015
11 Reads

Paranasal sinus and retro-orbital metastasis in a case of breast carcinoma: a clinicoradiological review.

BMJ Case Rep 2014 Apr 17;2014. Epub 2014 Apr 17.

Department of Radiation Oncology, Artemis Health Institute, Gurgaon, Haryana, India.

View Article
April 2014
13 Reads
2 PubMed Central Citations(source)

Changing trends of breast cancer awareness in young females of north India: A pilot study from a rural cancer hospital

Int J Med Public Health 2014;4:62-5

International Journal of Medicine and Public Health

Aim: To assess the spectrum of presentation of young (18-35 years) females to a rural cancer hospital and to correlate it with the level of education. Materials and Methods: Ninety cases of the selected age group were prospectively studied for the manner of presentation and level of education. Results: Majority patients (57.77%) presented with breast related symptoms. 81.1% of the patients were educated at least up to secondary school education. Conclusions: Owing to the improved education levels and awareness, the young rural females are more informed about breast related symptoms and are seeking proper care for the same. A robust rural cancer registry system may document this changing scenario that may well contrast with the traditional beliefs and learning of cancer epidemiology.

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February 2014
17 Reads

Serum zinc as a prognostic indicator in locally advanced cancer cervix patients receiving chemo-irradiation: A pilot study.

South Asian J Cancer 2014 Jan;3(1):43-7

Department of Radiation Oncology, RGCI and RC, New Delhi, India.

View Article
January 2014
11 Reads

Application of PET-MRI in pseudo progression versus true progression in High Grade Gliomas: A new avenue!

J Neurosci Rural Pract 2014 Jan;5(1):94-8

Department of Radiation Oncology, Artemis Health Institute, Sector 51, Gurgaon, Haryana, India.

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January 2014
11 Reads

Taxane induced pneumonitis in a case of carcinoma esophagus treated with chemo-radiation: Case report and review of literature

Clin Cancer Investig J 2014;3:119-22

Clinical Cancer Investigation Journal

Taxanes are the preferred chemotherapy (CT) modality in treatment of carcinoma esophagus. Taxane use is associated with toxicities such as myelosuppression, neuropathy and musculoskeletal effects. Pneumonitis arising with the use of taxanes is a relatively rare and less explored entity. The present case report addresses this phenomenon in a patient who received Neoadjuvant and concurrent treatment with taxane and presented with symptoms and signs of pneumonitis. Patient initially presented with flu like symptoms and dyspnea that was unresponsive to antibiotic treatment. She presented 12 days after, the completion of concurrent CT-Radiotherapy. Despite all the measures, she ultimately succumbed to the pneumonitis. In any such case of development of pneumonitis/interstitial lung disease/fibrosis related symptoms and signs in relation to CT-RT, taxane induced pneumonitis should be kept in the differential diagnosis. Clinicians should be aware of this entity to appropriately manage such a rare and life-threatening occurrence.

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January 2014
11 Reads

Palliative care in a rural Indian setup: An oncologist's experience

Authors:
Vivek Tiwari

Tiwari V. Palliative care in a rural Indian setup: An oncologist's experience. Clin Cancer Investig

Clinical Cancer Investigation Journal

View Article
June 2013
14 Reads

Feasibility of capecitabine immunotherapy in a taxane-refractory metastatic breast cancer patient: A rural cancer hospital experience

Oncol. Gastroenterol. Hepatol. Reports ;2; 2; 2013:23-26.

Oncology, Gastroenterology and Hepatology reports

To manage a metastatic cancer patient in a rural setting is a daunting task owing to the lack of resources and infrastructure. Intravenous chemotherapy (CT), with its debilitating side effects, often causes a decrease in the quality of life (QOL) of the patient. When the treatment is of palliative intent, efforts should be made to provide maximum symptom relief to the patient, striking a balance between the patient's wishes and a sound scientific rationale. We describe our experience with a patient with extensively metastatic breast cancer treated in our rural center with single-agent oral capecitabine, without development of any severe toxicity and with a significant improvement in disease process and patient's performance status (PS)

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May 2013
13 Reads

The scenario of presentation of young females in a rural cancer hospital of North India: An initial experience.

South Asian J Cancer 2012 Oct;1(2):63-5

Rajiv Gandhi Cancer Hospital and RC, Delhi, India.

View Article
October 2012
13 Reads
1 PubMed Central Citation(source)
Top co-authors
Piyush Shukla
Piyush Shukla

1 University Station A5300

3
Sandeep Goel
Sandeep Goel

Kyoto University

3
Kamal Verma
Kamal Verma

National Neuroscience Institute

3
Gourav Gupta
Gourav Gupta

Post Graduate Institute of Medical Education and Research

2
Soumyajit Roy
Soumyajit Roy

Debye Institute

1
Bidhu K Mohanti
Bidhu K Mohanti

All India Institute of Medical Sciences

1
Hameed Uzzafar Ghori
Hameed Uzzafar Ghori

Gandhi Medical College

1
Om Prakash Singh
Om Prakash Singh

Infectious Disease Research Laboratory

1
Suresh Yadav
Suresh Yadav

Gandhi Medical College Bhopal

1