The study was undertaken to evaluate physical, psychological and functional aspects in quality of life (QoL) assessment prospectively in biopsy-proven head and neck cancer patients receiving radical radiotherapy. Fifty male patients were assessed using Karnofsky's Performance Status (KPS), Beck's Depression Inventory (BDI) and the Functional Living Index-Cancer (FLIC). Patient questionnaires were completed before radiotherapy, during 3-4 weeks of radiotherapy and 3 months after radiotherapy. Before the start of radiotherapy, KPS was 91 +/- 10.26, FLIC was 129.98 +/- 33.41 and BDI was 7.10 +/- 4.57. This indicated good performance and functional status with lower depression. In weeks 3-4 of radiotherapy, KPS (71.00 +/- 20.12) and FLIC (81.34 +/- 45.23) decreased, while BDI (16.56 +/- 9.01) increased, indicating impairment in QoL. Three months after radiotherapy, KPS (78.37 +/- 23.0), FLIC (119.51 +/- 43.62) and BDI (9.02 +/- 7.81) improved but were not restored to pre-treatment levels. When patients were scheduled for radical radiotherapy, maximum deterioration in QoL was seen in weeks 3-4. This is the time when maximum supportive care and psychologic counselling is required.
Vitamin E acts as antipromoter of carcinogenesis and MDA is a byproduct of lipid peroxidation inherent in carcinogenesis. Reduced serum levels of vitamin E have been found to be associated with higher risk of oral, gastrointestinal and breast cancers. This study was designed to evaluate status of serum vitamin E levels in carcinoma cervix patients receiving radical radiotherapy (RRT). Material and Methods: Fifty patients with biopsy-proven carcinoma of the cervix were divided into two groups. Group I received vitamin E supplement (100 mg orally daily) in addition to RRT. Group II received RRT only. Serum vitamin E and MDA levels were compared in the two groups pre- and post-RRT using Duggans and Beuges methods, respectively. Results and Conclusion: Serum vitamin E levels were statistically lower in 50 patients than in controls. Post-RRT serum vitamin E levels increased in group I (p < 0.02) and group II (p < 0.01) while serum MDA levels decreased in group I (p < 0.01) and group II (p < 0.05) meaning thereby that oxidative stress and consequent lipid peroxidation was reduced with decrease in tumour mass. Mean post-RRT serum vitamin E levels in the two groups was not statistically different. We found that serum vitamin E levels in the patients did not correlate with oral supplementation of vitamin E.
The authors have assessed the role of computerized three-dimensional (3-D) and traditional (TD) radiotherapy planning and inhomogeneity corrections in improving target volume coverage and normal tissue sparing in carcinoma of the tongue. Coverage of target volumes in 3-D versus TD plans revealed t h e following. Volume receiving 95% of dose, clinical target volume (CTV): 1-68% versus 0-24%; gross tumour volume-lymph nodes (GTV-I): 0-80% versus 0-20%; gross tumour volume-primary tumour (GlV-11): 0-65% versus 0-26%. Dose to 95% of target volume CN 77-92% versus 76-87%; GTV-I: 81-90% versus 61-88%; GTV-II: 82-93% versus 68-87%. Minimum dose to 5% of target volume, CTV: 77-93% versus 7481%; GTV-I: 81-90% versus 61-88%; GlV-ll: 76-93% versus 68-87%. Minimum doseto a volume of no less than 5% of the target volume, CTV: 93-98% versus 88-96%; GTV-I: 87-100% versus 88-97%; GW-II: 86-98% versus 88-96%. A new parameter (inhomogeneity difference) was devised to study target volume dose homogeneity and was found to be very useful. Dose t o two-thirds of the parotid glands in 3-D versus TD plans showed a mean of 46 versus 65% for right parotid glands and 44 versus 56% for left parotid glands in all patients. Better tumour dose homogeneity, increased mean tumour dose, avoidance of geographic misses and better parotid sparing was achieved in 3-D plans as compared to TD plans. We could not demonstrate any role for inhomogeneity corrections using currently available computerized dose algorithms.
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