Esophageal cancer is the seventh most common cancer constituting 3.2% of all cancer cases and sixth most common cause of mortality constituting 5.3% cases worldwide in 2018. Most common presenting symptom is dysphagia which is seen in 80–90% of patients. Most patients present in locally advanced stage and because of extensive local disease palliative radiotherapy plays a significant role. Aim and objectivesAim of the study was to compare two palliative radiotherapy schedules- 30 Gy in 10 fractions over 2- weeks versus 20 Gy in 5 fractions over 1-week in locally advanced carcinoma esophagus. Objectives were to compare above schedules based upon symptomatic relief and tolerability by the patient. Material and methodsThe study was a randomized control study done from July 2017 - December 2018 on 60 previously untreated, histo-pathologically proven patients of squamous cell carcinoma esophagus (locally advanced) reporting in the Department of Radiation oncology, Pandit B. D. Sharma PGIMS, Rohtak, where palliative radiotherapy was indicated as the treatment. Patients were divided into two groups of 30 patients each; Study group received- 30 Gy in 10 fractions over 2-weeks and Control group received 20 Gy in 5 fractions over 1- week. The symptomatic relief was assessed according to dysphagia score at 1- month after completion of radiation treatment. A reduction of at least 1 point in dysphagia score was depicted as improvement of dysphagia. Observations and resultDysphagia was the most common presenting symptom seen in all the patients followed by chest pain and weight loss. 80% patients in study group and 76.6% patients in control group showed improvement in dysphagia. 25% patients in study group and 43.4% in control group developed recurrent dysphagia. The mean duration of development of recurrent dysphagia in study group was 2.5 months and 5.6 months in control group. It was concluded that both the radiotherapy schedules were comparable in providing symptomatic relief; both radiotherapy schedules were tolerable by the patients.
Sebaceous gland carcinoma of ocular adnexa is a highly malignant but relatively rare condition. It has an aggressive course with tendency for local invasion and systemic metastasis resulting in poor outcome and increased mortality. Here, we describe the clinical course of recurrent sebaceous gland carcinoma of the upper eyelid in a 55 year old female patient who presented with complaint of growth over right upper eyelid from 10 years.
Introduction: Head and neck cancers include malignant neoplasms that develop in the oral cavity, nasal cavity, paranasal sinuses, pharynx, larynx and salivary glands. Out of the newly diagnosed patients of head and neck carcinoma in India, most of the patients present in locally advanced stage. Because of extensive local disease and associated co-morbidities and compromised KPS, palliative radiation therapy is preferred treatment for these patients. Material and methods: The study was conducted on 60 previously untreated, histo-pathologically proven patients of locally advanced head and neck cancer who were randomized in two equal groups by draw of lots. Study group received radiation dose of 30 Gy/ 10 fractions / 2 weeks followed by repeat dose of 30 Gy/ 10 fractions / 2 weeks (Total dose 60 Gy in 20 fractions delivered with a gap of 4 weeks). Control group received radiation dose of 20 Gy/ 5 fractions/ 5 days followed by repeat dose of 20 Gy/ 5 fractions/ 5 days followed by repeat dose of 20 Gy/ 5 fractions/ 5 days (Total dose 60 Gy in 3 sessions with a gap of 3 weeks each). Objectives were to compare efficacy of above schedules based on symptomatic relief and overall tumor response and to compare the toxicities of the above schedules. Results and Conclusion: To expedite the treatment time in tertiary care centres, control group (20 Gy / 5 fractions / 1 week; 3 weekly X 3) was better than the study group (30 Gy / 10 fractions / 2 weeks; 4 weekly X 2) as it had comparable local control and toxicity (acute mucosal reactions being slightly higher in the study group) with the added advantage of only 15 total fractions (machine days) in control group rather than 20 total fractions (machine days) in study group. This reduced the patient visits to the hospital by one week (i.e. 5 fractions) with comparable local control and toxicity.
BACKGROUND Majority of Head and Neck Squamous Cell Cancer patients in India present in advanced stages. They are not candidates for multimodality treatment due to locoregionally advanced disease, poor performance status or distant metastasis. Hypo-fractionated regimens have been used for palliation of locally advanced head and neck cancers. Here we aim to compare two different schedules of palliative radiotherapy to evaluate and compare their feasibility, efficacy, tolerability, local control and side effects. METHODS This is a prospective, randomized study, conducted among 60 untreated patients of head and neck squamous cell carcinoma where palliative radiotherapy was indicated. These patients were divided in to two groups of 30 patients each by computer generated randomization. In Group 1, 14.8 Gy/ 4 fractions/ 2 days (2 fraction per day 6 hours apart for 2 consecutive days) repeated for 2 more cycles each with an interval of 3 weeks. In Group 2, 32 Gy/ 8 fractions/ 2 days (2 fraction per day 6 hours apart twice weekly (Wednesday and Saturday) for 4 consecutive weeks). RESULTS Group 1 had slightly better locoregional control but the difference was statistically insignificant. Group 1 had more grade 1 skin and mucosal reaction than group 2. Group 2 had more grade 2 skin and mucosal reaction than group 1. Symptomatic relief (subjective regression) was better in group 1 than group 2. CONCLUSIONS Both quad shot and twice weekly palliative radiotherapy for locally advanced head and neck cancer are comparable in term of efficacy, toxicity and feasibility.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.