Objective:The objective of this study is comparision of local and distant control rates with high-dose versus standard-dose radiotherapy along with concurrent chemotherapy in esophageal cancer – a prospective randomized study.Materials and Methods:Histologically proven Stage I–III patients with carcinoma esophagus were randomized into two groups. One group has been treated with standard-dose radiotherapy, i.e., a total dose of 50.4 Gy (1.8 Gy/day, 28#, 5 days/week). The other group (study arm) has received high-dose radiotherapy, i.e. a total dose of 64.8 Gy (1.8 Gy/day, 36#, 5 days/week). Both groups have received 2 cycles of 3 weekly concurrent chemotherapy (cisplatin 75 mg/m[2] on day 1 and 5-fluorouracil 750 mg/m[2] continuous intravenous infusion over 24 h on day 1–4). Follow-up response evaluation was done by both endoscopy and computed tomography scan after 6–8 weeks and after 2 months thereafter.Results:Out of a total of 28 patients, 68% showed a complete response, 14% showed partial response, and 18% patients developed progressive disease at first and subsequent follow up (median follow-up of 21 months). Among the complete response patients, rates were higher in high-dose group compared to standard-dose radiotherapy group (71% vs. 64%, P = 0.38). Treatment-related toxicities were acceptable in both groups.Conclusion:High-dose radiotherapy with concurrent chemotherapy seems to be more effective with acceptable toxicity in our study. However, further follow-up and large sample size may be required to validate the current study conclusion.
Mantle cell lymphoma is a rare type of B cell non-Hodgkin's lymphoma (NHL) comprising only 3%–6% of all NHL. It is aggressive and prone to relapse. Around 15%–30% of the patients present with gastrointestinal tract involvement. Solitary rectal mantle cell lymphoma is rare and there are very few reports of the same. Till date, there is no report of a solitary rectal relapse of mantle cell lymphoma occurring after second remission. We report a relapse of solitary rectal mantle cell lymphoma presenting with rectal bleeding after second remission in primary gastric mantle cell lymphoma.
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