Cisplatin and paclitaxel both can cause peripheral neurotoxicity as an adverse effect; however, central nervous system neurotoxicity in the form of seizures is rare. We report a case of a 36-year-old female patient of metastatic carcinoma cervix, who developed seizure shortly after cisplatin infusion. Her laboratory investigations were within normal limits. Computed tomography scan and magnetic resonance imaging of the brain did not reveal brain primary metastasis or meningeal carcinomatosis. She had no complaints of fever, no signs and symptoms of infection, and no history of seizure nor was she on any medication predisposing to such an event. Excluding several causes, seizure was thought to be most likely related to the chemotherapy and cisplatin was the more likely agent in view of observed temporal relationship with the adverse event.
Background: Brachytherapy is an integral component of the definitive treatment of locally advanced cancer cervix. Cervical Brachytherapy has evolved from the time when dose prescription was largely empirical, to the image based conformal brachytherapy advocated by Groupe Europeen de Curie Therapie-European society for therapeutic radiology and oncology (GEC-ESTRO) and American brachytherapy society (ABS).
Intestinal-type sinonasal adenocarcinoma accounts for about 3% of cancers of the upper aero-digestive tract. It is commonly seen in men in the age group of 55-60 years. We present the case of a 60-year-old woman having extensive disease in the right half of the nasal cavity extending to the dura of the anterior cranial fossa, and the right orbital contents. The patient was given induction chemotherapy to make the condition surgically amenable, but the regression was modest, and hence she has been put on concurrent chemo-radiotherapy.
doses to the organs at risk. Among the three treatment plans generated, the hybrid IGBT was able to achieve the lowest dose for the rectum 65.24 Gy, bladder 72.13 Gy and sigmoid 54.52 Gy. Intracavitary image-guided brachytherapy alone may achieve similar HR-CTV doses as with the hybrid IGBT but it could only be achieved with accompanying higher doses to the organs at risk. At 6 months follow-up, patient was noted with smooth cervix, free bilateral parametria and with no evidence of disease. Conclusions: Our pilot case study showed that hybrid image-guided brachytherapy for locally advanced cervical cancer may improve dose coverage to the HR-CTV, reduce dose to organs at risk and offer good local control of the disease. Further case series is recommended to improve on the application of the technique in the local setting and document treatment outcomes.
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