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2006| January-March | Volume 43 | Issue 1
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Squamous cell carcinoma of the maxillary sinus: A Tata Memorial Hospital experience
Sajid S Qureshi, Devendra A Chaukar, Sanjay D Talole, Anil K Dcruz
January-March 2006, 43(1):26-29
The optimal treatment of maxillary sinus carcinoma remains to be defined and there is a paucity of Indian studies on the subject.
To present experience of management of squamous cell carcinoma of the maxillary sinus treated with curative intent at a single institution.
Settings and Design:
Retrospective study of patients with squamous cell carcinoma of the maxillary sinus who presented between 1994 to 1999.
materials and Methods:
The records of 73 patients with squamous cell carcinoma of the maxillary sinus were analyzed. Sixty-two patients were evaluable. Forty patients (65%) were treated with surgery followed by postoperative radiotherapy, five patients (8%) were treated with radiotherapy alone, five patients (8%) were treated with surgery alone; 12 patients (19%) received chemotherapy. Statistical analysis used: Statistical analysis was done using Kaplan-Meier method.
The majority of patients presented with locally advanced disease (52, 84%); nodal involvement was observed in five patients (8%). The most common site of recurrence was at the primary site, which was observed in 28 patients (45%) and regional failures occurred in 10 (16%). The 3 and 5-year overall survival was 38% and 35% and the disease free survival was 29% and 26% respectively. The 5-year overall survival after surgery and postoperative radiotherapy was 42%.
The majority of patients present with advanced disease resulting in poor outcomes to conventional treatment modalities. Locoregional tumor progression remains a significant pattern of failure. New approaches such as neoadjuvant or concomitant chemoradiotherapy with aggressive surgery need to be considered and evaluated in prospective studies.
Mitochondrial DNA 4977 BP deletion mutations in lung carcinoma
Ji Gang Dai, Ying Bin Xiao, Jia Xin Min, Guo Qiang Zhang, Ke Yao, Ren Jie Zhou
January-March 2006, 43(1):20-25
The most common and also the most often assayed mtDNA deletion mutation, °mtDNA
has been demonstrated in various types of human cancer. However, knowledge about °mtDNA
in lung carcinoma is poor.
To study the 4977 bp deletions of mitochondrial DNA (°mtDNA
) in lung cancer, adjacent histologically normal and normal lung tissue and its potential roles in the development of cancer.
MATERIALS AND METHODS:
Thirty-seven matched lung cancer/adjacent histologically normal and 20 histologically normal lung tissue samples in subjects without lung cancer were analyzed by PCR technique.
deletions were detected in 54.1% (20/37) of lung cancers, 59.5% (22/37) of adjacent normal and 30.0% (6/20) of normal lung tissue samples. No significant difference was found in the frequency of °mtDNA
deletions between the tumor and adjacent normal lung tissues (
value = 0.815). Moreover, no significant difference was found in the frequency of °mtDNA
deletions between the tumor and histologically normal lung tissues in subjects without lung cancer (
value = 0.101). However, the correlation between °mtDNA
deletion and age and smoking factors was present in our data.
Fisher's exact test was used to assess the difference in different groups by the Scientific Package for Social Sciences (SPSS), version 10.0, Statistical analysis software.
Mitochondrial DNA 4977 bp deletion, which is not specific to lung cancer, may reflect the environmental and aging process influences operative during tumor progression.
Primary gastrointestinal Non Hodgkin's lymphoma chemotherapy alone an effective treatment modality: Experience from a single centre in India
Vinod Raina, Atul Sharma, Amish Vora, NK Shukla, SVS Deo, R Dawar
January-March 2006, 43(1):30-35
Gastrointestinal tract (GI) is the most frequently involved extra nodal site in non-Hodgkin's lymphoma (NHL). Surgery, radiotherapy and chemotherapy (CT) have been used mostly in various combinations, but lately chemotherapy alone has emerged as an effective option. The purpose of this study is to evaluate efficacy of CT alone in treatment of primary GI-NHL and to compare the results with combined CT + surgery.
Setting and design:
Retrospective analysis of case records of GI NHL patients.
Materials and Methods:
Over a 15-year period (1986-2000), 77 new cases of primary GI-NHL were registered at our center. GI-NHL was defined according to standard criteria. All patients received chemotherapy.
The median age was 32 years (Range 9-80). Endoscopy / CT guided biopsies were performed in 42% (32) of patients for the purpose of diagnosis. Laparotomy was done in 58% (45) of patients to establish a diagnosis or as primary or debulking treatment. Stomach and intestines were involved in 47% (36) and 53% (41) patients respectively. Early stage disease was present in 37% (29). Seventy eight percent of tumors were intermediate to high grade, 43% (33) received only CT while 57% (44) received CT + surgery. Five years EFS and OS were: 72% and 65% for all patients; 72% and 67% for CT only group; 60% and 64% for CT + surgery group (
=0.05). Four patients died of neutropenic infection.
Organ-preservation strategy using chemotherapy alone (CT) can be successfully employed in a significant number of patients with primary GI-NHL.
Coping preferences of head and neck cancer patients - Indian context
E Vidhubala, Latha , R Ravikannan, CS Mani, M Karthikesh
January-March 2006, 43(1):6-11
Cancer is a major health-related stress and demands adequate coping. Patients with head and neck carcinoma (HNC) often face exhaustive and debilitating treatment as well as physical and functional residual effects such as disfigurement, compromised speech, dry mouth and difficulty in swallowing. Understanding how patients cope with these challenges is important in comprehensive care of patients with HNC.
To assess and evaluate the coping preferences of head and neck cancer patients.
Materials and Methods:
Towards this goal, a prospective study was conducted at the Cancer Institute (WIA), Chennai. 176 HNC patients participated in the study. The age group ranged from 19 to 87 years. The questionnaire used for assessing coping preferences was Jalowiec coping preference scale containing 40 items, with responses ranging on a 5-point scale. The variables chosen were treatment, site, education, survival, age and gender.
Statistical analysis used:
SPSS 9.0 version was used for both descriptive and multivariate analysis.
No significant difference was observed in the preference of Emotion-Oriented Coping (EOC) in relation to age, treatment, site, education and survival. Treatment, site, education and gender showed significant differences in the preference of Problem-Oriented Coping (POC). There was, however, no difference in the preference of POC among the patients with different survival periods and age.
In conclusion, HNC patients adapt both EOC and POC during the course of the illness. Literates, males and patients subjected to different modalities of treatment preferred more of POC compared to other groups.
Comparison of uroprotective efficacy of mesna and amifostine in Cyclophosphamide- induced hemorrhagic cystitis in rats
Ozkan Kanat, E Kurt, U Yalcinkaya, T Evrensel, O Manavoglu
January-March 2006, 43(1):12-15
Hemorrhagic cystitis (HC) is a dose limiting side effect of cyclophosphamide (CYP).
In this study, we aimed to investigate the role of amifostine in the protection of CYP-induced HC and compare its efficacy with mesna.
SETTING AND DESIGN:
This animal study was conducted in the Experimental Animals Breeding and Research Center of the Medical Faculty of Uludag University.
MATERIALS AND METHODS:
Male Wistar rats (150-200 g; 10 rats per group) were randomly assigned to four groups. Group I (control group) received no drugs, group II received CYP (200 mg/kg, i.p.) alone, group III received amifostine (200 mg/kg, i.p.) and CYP, and group IV received CYP and mesna (40 mg/kg, i.p.) immediately and 4 and 8 h after administration of CYP. Bladders of animals were assessed macroscopically and histologically 24 h later. Gross assessment for presence of edema and hemorrhage and histological evaluation of damage to the bladder were scored according to Gray's criteria.
STATISTICAL ANALYSIS USED:
For macroscopic and microscopic data, we used statistical evaluation by Kruskal-Wallis nonparametric analysis of variance followed by the Mann-Whitney U-test.
All the animals in group II had evidence of HC. Significant histological damage and macroscopic changes were present in this group compared to control group (
<0.001). The median scores for bladder damage in group III and IV were significantly lower compared to group II (
<0.001). When the median scores for bladder damage of group I, III, and IV were compared, there was no significant difference among these groups.
This study demonstrated the efficacy of amifostine in prevention of cyclophosphamide-induced hemorrhagic cystitis.
Inflammatory variant of a well-differentiated retroperitoneal liposarcoma: Case report of a rare giant variety
Prateek K Mehrotra, CS Ramachandran, Deep Goel, Vijay Arora
January-March 2006, 43(1):36-38
Inflammatory liposarcoma is a rare variant of a well-differentiated liposarcoma (WDLPS). We present a case of a 37 years old male who had a giant variety of this inflammatory WDLPS. CT scan revealed a large abdomino-pelvic mass abutting the left kidney and pushing the IVC, Aorta and the left ureter across the midline. CT guided FNAC did not reveal any malignant cells. A large 9-kg fibro-fatty mass, which appeared irregular, congested and bosillated was excised. Microscopic picture revealed foci of fibrosis with mature adipose tissue. Lymphocyte and plasma cell infiltrate was abundant along with multi-nucleate giant cells and few lipoblasts. There are no case reports of a giant inflammatory variant of WD-LPS in world literature and this is the first of its kind from the Indian sub-continent. We present a case report of this rare giant variant of inflammatory WDLPS and discuss the review of literature.
Infantile rhabdomyofibrosarcoma: A distinct variant or a missing link between fibrosarcoma and rhabdomyosarcoma?
Satish I Rao, Shantveer G Uppin, KS Ratnakar, C Sundaram, Rajappa P Senthil
January-March 2006, 43(1):39-42
Infantile rhabdomyofibrosarcoma (IRMFS) is a rare soft tissue tumour affecting infants and young children. It occupies an intermediate position between infantile fibrosarcoma and spindle cell rhabdomyosarcoma in its clinical presentation, behaviour, morphology, immunohistochemical and ultrastructural features. This case is reported here to reiterate its occurence as tumour with distinct morphological immunohistochemical and clinical behavioral patterns.
Phase II study of cisplatin, etoposide and paclitaxel in locally advanced or metastatic adenocarcinoma of gastric/gastroesophageal junction
Atul Sharma, V Raina, N Lokeshwar, SVS Deo, NK Shukla, BK Mohanti
January-March 2006, 43(1):16-19
Unresectable and metastatic gastric cancers carry a poor and dismal prognosis. Several phase II studies have identified effective anticancer drugs
To evaluate safety and efficacy of low-dose cisplatin, etoposide and paclitaxel (CEP) based combination chemotherapy in locally advanced or metastatic adenocarcinoma of gastric/gastroesophageal junction.
Setting and design:
Prospective single-arm phase II study.
materials and Methods:
Thirty-three patients were enrolled onto this study, out of which, all but one received cisplatin 15 mg/m
, etoposide 40 mg/m
and paclitaxel 50 mg/m
, given on day 1 and 4 every week for three weeks in a 28-day cycle. Survival analysis was done using SPSS program.
Median age of group was 56 years. Twenty-five were males. Twenty-nine had metastatic/inoperable disease and four patients had recurrent disease. Liver was the commonest metastatic site seen in 15 patients. With a median of 2 cycles per patient, a total of 76 cycles was administered. Grade III or IV toxicity were seen in 11 (35%) patients; diarrhea, 5 patients; vomiting, 3 patients; and neutropenia, 7 patients, 5 of whom also had fever). One patient died of neutropenic fever. Best responses, seen in 32 evaluable patients, were 2 CR (6.1%), 21 PR (63%) and 3 SD (9.2%). Four patients were considered operable after chemotherapy. With median follow-up of 11 months in surviving patients, median OS was 10 months and PFS was 8 months. Median OS was 13 months in responders versus 8 months in nonresponders (
=0.04). Seven patients survived >12 months
Combination of low-dose CEP shows good clinical response and an acceptable toxicity profile in advanced or metastatic adenocarcinoma of gastric/gastroesophageal cancers. Whether addition of 5 FU or capecitabine adds to the benefit should be explored. This may be tested with other standard/conventional protocols in a randomized fashion.
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