Background and objectiveEsophageal carcinoma remains a disease associated with high mortality rates among patients even after receiving treatment. Management with surgery alone offers a five-year survival of only 20%. Hence adjuvant and neoadjuvant therapies were instituted to treat this condition along with surgery. Neoadjuvant chemoradiotherapy (NACRT) followed by surgery is currently the standard of care. Neoadjuvant chemotherapy (NACT) is also recommended by some authors as a method of adequate care. There is a scarcity of studies in the literature comparing NACRT with NACT. In light of this, we employed the criteria of pathological response as a primary endpoint to compare the effectiveness of NACT and NACRT in treating esophageal carcinoma. Materials and methodsA total of 50 patients with esophageal cancer having Eastern Cooperative Oncology Group (ECOG) scores 0-2 with cancer stages cT2-T4a, cN0-N1, and cM0 were enrolled. The patients were further classified into two groups of 25 each. While one group received chemotherapy using inj. paclitaxel and carboplatin (NACT group), the other was managed with inj paclitaxel and carboplatin as well as 42 Gy of fractionated irradiation (NACRT group). Six weeks after the last dose of radiation or three weeks after chemotherapy, they were evaluated and offered transthoracic esophagectomy (TTE). ResultsSquamous cell carcinoma was found in 39 (78%) cases and 11 (22%) cases had adenocarcinoma. Pathologically complete or near-complete responses were seen in 42% of patients in the NACRT group and 22% in the NACT group. ConclusionWhile NACT and NACRT are both effective therapies for esophageal cancers, NACRT offers better tumor regression compared to NACT. Given the higher rates of complete or near-complete response in the NACRT group, NACRT is likely to offer higher overall survival rates than NACT.
Background Breast cancer is less common in males than females and accounts for about 1% of all malignancies among males. The data on this patient population remains largely unexploredpartially in India since the lifetime risk of developing this cancer is unusually low. MethodsThis is a prospective observational study of male patients diagnosed with breast cancer during 2014 to 2021 at a tertiary care teaching hospital in India. Management consisted of surgery (Modified Radical Mastectomy) followed by adjuvant chemotherapy and radiotherapy with or without hormonal therapy. Descriptive statistics were used for analysis. ResultsA total of 22 patients with a mean age of 59 (range 36-85) yearswere included. The primary presenting complaint was subareolar swelling in 15(68.1%)patients. The histology revealed invasive ductal carcinoma in 22(100%) cases. Breast cancer hormone receptor status (ER/PR-positive) was seen in 20(90.9%) patients. The median follow-up was 38 months. A total of 20(90.9%) patients received adjuvant chemotherapy, radiotherapy, and hormonal therapy. The local recurrence was noted in 6(27.3%) patients. The lung andbone metastaseswere seen in 2(9.1%)patients,liver metastases in 1(4.5%)patient, andbilateral breast cancer in 1(4.5%) patient. At the last available visit, 10(45.4%) patients were following up, 9(40.9%) lost to follow up and unfortunately, 3(13.7%) patients were deceased. ConclusionsThe prognosis of patients with male breast cancer at our center was good. Although male breast cancer has similarities to those in women, there are distinct differences that need to be studied to improve treatment outcomes.
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