ABSTRACT
Objective: to evaluate the efficacy of cisplatin-based concurrent chemoradiation in squamous cell carcinoma of cervix and the frequency of acute toxicity
Study Design: case series
Place and Duration of Study: department of Clinical Oncology, Karachi Institute of Radiotherapy and Nuclear Medicine [KIRAN], Karachi, from September 2010 to September 2011
Methodology: eighty patients with histologically proven squamous cell carcinoma of cervix were included. Patients were treated with concurrent chemoradiation. External beam radiation was delivered with 50 Gy whole pelvis along with 40 mg/m2 weekly cisplatin followed by brachytherapy three insertions of 6.5 Gy each, one week apart. Response to treatment was assessed using response evaluation criteria in solid tumours [RECIST] criteria at 4 weeks after treatment. Acute toxicity of chemoradiation was assessed using common toxicity criteria
Results: out of the 80 patients, 8 patients were lost to follow-up. Remaining 72 patients aged 28 - 65 years with mean age of 48.03 +/- 8.9 years. Forty-eight patients [66%] were in stage II-B, 5 [7%] were in stage III-A, 7 [10%] were in stage III-B, and 12 [17%] were in stage IV-A. Overall response to treatment was 92%, in which 39 [54%] had complete response, and 27 [38%] had partial response while 6 [8%] show progressive disease. About 70% patients had diarrhea, 61.2% patients developed vomiting, 45.8% patients had dermatitis, 43% patients had vaginal mucositis, 40.3% had anemia, 13.9% patients had neutropenia, 27.8% patients had dysuria, and 22.2% patients had proctitis
Conclusion: cisplatin-based concurrent chemoradiation is an effective treatment in locally advanced stage of cervical cancer with manageable toxicity
ABSTRACT
We evaluated the treatment outcome and associated prognostic factors for patients with nonseminomatous testicular germ cell tumours [NSGCT], who were treated in our hospital during last 15 years. Data was retrospectively analyzed for the 1995 through 2010 period. One hundred and twenty patients with NSGCT were identified. Descriptive Data was analyzed for the age, risk factors, site, histology, stage, chemotherapy regimen, retroperitoneal lymph node dissection [RPLND] and radiological response. The disease free survival [DFS] and overall survival [OS] were determined by Kaplan and Meier method and statistical inferences with the log-rank test. Cox proportional hazards Model was used to find different prognostic factors. Mean age of patients was 29.65 years [16-45]. Pain and swelling of testis was commonest presentation [30%]. Right sided were predominant [63.3%]. Predominant stage was IIIC [55%] and commonest histology was mixed [embryonal cell carcinoma+yolk sac tumor+teratoma] in 45% cases. Majority of patients were poor risk according to International Germ Cell Cancer Consensus Classification [IGCCC], 41.7%. Bleomycin, etoposide and cisplatinum [BEP] chemotherapy was mostly as a first line treatment [87.5%]. Postchemotherapy RPLND was performed in 31 patients [25.8%]. Histology among residuals was fibrosis [48.4%], viable tumors [35.5%] and mature teratoma [16.1%]. Median DFS and OS were 9 and 9.1 years respectively. Stage, IGCCC, RPLND were found important prognostic factors [p < 0.001]. Better outcome with lower disease burden and lower IGCCC and multidiscplinary approach warrants public awareness should be carried out for the testicular self-examination to reduce the time from the beginning of symptoms to time of seeking treatment