INTRODUCTIONHead and neck cancers constitute 5% of all cancers worldwide and in the Indian population, it accounts above 50% of all malignant tumours. Most of the patients present with locally or locoregionally advanced disease. As a result of their location, these tumors can cause varying degree of functional and cosmetic deformity that are often exacerbated by cancer treatment.Larynx preservation trial 1991, 1 the non-surgical organ preservation through the radiation and chemotherapy entered the main stream. Since then the most significant advances in the treatment of head and neck tumours have been the development of altered fractionation schedules ABSTRACT Background: Objective of current study was to observe the local control, progression free survival and organ preservation for locally advanced head and neck cancer by using induction Chemotherapy followed by concurrent chemoradiotherapy. Methods: 102 patients enrolled in this study with stage III-IVB of head & neck cancer. Patients were assessed and treated by faculty of the department as per NCCN guidelines. Group A patients received three courses of cisplatin (100mg/m 2 ) and paclitaxel (175mg/m 2 ) at every 21 days interval followed by concurrent chemoradiothearpy with cisplatin 30mg/m 2 on weekly basis while group B received only concurrent chemoradiothearpy. Radiotherapy consisted of total dose up to 66-70 Gy. by conventional fractionation schedule. Results: From August 2011 to July 2013, total 102 patients have completed 14 months of follow up after completing definitive treatment group A : 48 and group B: 54 patients. Response evaluation was done after one and half months of completion of chemoradiotherapy in both arms. Complete response rate was 60.42% and 38.88 % in study and control arm respectively while partial response was 72.92% and 55.56%. Most common grade III or IV toxicity was mucositis in group A and skin reaction in control arm. At a median follow-up 13 months the median progression free survival in group A was 11.5 months and 9 months in group B. Conclusion: Response to induction chemotherapy was useful as predictive factor for ultimate outcome and progression free survival. But our study shows statistically significant improvement in complete response rate in group A as compared to group B (p<0.05). Our induction chemotherapy with two-drug regimen followed by concurrent chemoradiotherapy was well tolerated with manageable toxicity and good locoregional control.
Breast Cancer is the most prevalent cancer of women worldwide. Worldwide breast cancer incidence accounts for approximately 25% of all cancers diagnosed in women and almost 15% of all cancer deaths. It is one of the most common malignancies in the Western world and has the highest incidence in North America. The estimated incidence of cancer in India is 1.2 million cases and prevalence is about two million cases. About 25% increases is expected by the year 2015. 1 There is an increasing trend in rates of breast cancer in the urban population of the country (Yeole & Kurkute. 2003); 2 (Satyanarayana and Asthana, 2008). 3 The breast cancer risk varies with age groups; for example, the risk from birth to 39 years is 1:229 (0.44%),
Head and neck cancers are not curable yet but survival and local control has been increased due to concurrent treatment approach. Study was conducted to assess the role of concurrent Gemcitabine (2'2' Difluro Deoxycytidine) along with radiotherapy in treatment of Head and Neck cancers and to assess local control as well as disease free survival achieved due to chemoradiation. 100 patients were enrolled in this study, 50 patients received Radiotherapy (Group A- Control group) alone and 50 patients received Concurrent Chemoradiotherapy (Group B- Study group). Patients in study group received Gemcitabine 200mg/m2 on weekly basis for 5-7 cycles over 30 mins. Radiation delivered after 2 hours of IV infusion. Conventional radiotherapy was given in dose ranging from 66-70Gy in 33-37# for 6-7weeks. In this study, Grade 3 mucositis and Grade 2 pharyngeal toxicity were common i.e, 56% and 54% respectively in study group and 30% and 38% respectively in control group. Hematological toxicity i.e., Grade 1 leucopenia was seen in 28%. Even though the toxicities were high in study group compare to control group but they were tolerable and acceptable. The response was better in concurrent group than radiotherapy alone (Control group) CR 52% vs 40%, PR 34% vs 36% and SD 14% vs 24%. Concurrent use of gemcitabine and radiotherapy is a effective modality in treatment of head and neck cancers with acceptable toxicity. Improved local control shows that Gemcitabine acts as a sensitizers and has synergistic action along with radiotherapy. [Int J Res Med Sci 2013; 1(4.000): 392-396
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