Prognostic value of MRI in nasopharyngeal carcinoma

The nasopharyngeal carcinoma [NPC] therapeutic outcome depends on the initial tumor staging. We aim to evaluate the role of v1RI in prediction of the tumor response to radiotherapy. Fifty-two NPC patients underwent MRI before and after radiotherapy to the local disease and the nodal involvement. MRI assessment included twenty-five anatomical sites. The MRI assessed the size, site, signal intensity, enhancement pattern and extension of the regional disease. Radiotherapy was carried out using the X-rays of 4-6 MV Linac. Complete remission [CR] rates in the lateral, anterior, inferior, intracranial, orbital, skull base and paranasal sinuses extensions were 77%, 89%, 68%, 15%, 0%, 16% and 31% respectively. The CR rate of the lateral, anterior, inferior extensions collectively [almost TI-2 lesions] was 77% compared with 17.6% for intracranial, orbital, skull base and paranasal sinuses extensions collectively [T3-4 lesions] [p<0.00001]. Among T2 lesions the CR rate was 89% for nasal versus 68% for oropharyngeal extension p=0.04]. In cases with parapharyngeal involvement, the CR rate was 90% in the MRI bulging extensions compared with 62% for the MRT infiltrative extensions [p=0,047]. The partial remission [PR] rate among the lateral, anterior, inferior, intracranial, orbital, skull base and paranasal sinuses extensions were 22%, 11%, 32%, 75%, 100%, 59% and 66% respectively. The intracranial, orbital, skull base and paranasal sinuses extensions of NPC were associated with a significantly lower rate of CR. Nasal extension responded more favorably to radiotherapy than oropharyngeal extension and bulging parapharyngeal extension responded better than infiltrative parapharyngeal extension

Advanced low grade non hodgkin's lymphoma [LGL]; treatment results using cyclophosphamide, fludarabine, and prednisone [CFP]

Fludarabine has been shown to be an effective agent in the treatment of low grade lymphoma; either used alone or in combination with other chemotherapeutic agents. It maintains its efficacy both for newly diagnosed cases as well as for patients with recurrent progressive low grade Non Hodgkin's Lymphoma [RPLGL]. This an open phase II study of CFP chemotherapy regimen conducted in patients with advanced LGL to explore the efficacy of this regimen and its toxicity profile. Between January 1998 and March 2000 41 patients aged 42-69 years [median 54] were enrolled to this multicenter study. All of the 37 evaluable patients, were allocated to receive 6 cycles of cyclophosphamide 300 mg/m[2] intravenously [IV.] day 1-3[DI-3], Fludarabine 25 mg/m[2] I.V.D 1-3 and prednisone 40 mg/m[2] PO, Dl-5. Chemotherapy cycles were repeated every 28 days for 6 cycles. Of the 37 evaluable patients. 20 patients [54%] had recurrent progressive disease [RPLQL], while 17 patients [46%] were newly diagnosed advanced LGL [stage; II bulky. III, and IV]. Clinical response to treatment was evaluated immediately after the completion of the chemotherapy schema, and defined according to categories; complete remission [CR], partial remission [PR]. The overall response rate for the whole group was 86% [32/37 patients]. Eleven patients [3 0%] achieved CR, and 21 patients [56%] achieved PR. Patients with newly diagnosed LGL had better

Early detection of cisplatin ototoxicity using distortion product otoacoustic emission

The distortion product otoacoustic emission [DPOAE] can detect small changes in the cochlear status, due to its high sensitivity and specificity to the outer hair cells. This study was carried out on 25 patients receiving cisplatin [100 mg/m2 in 24 hr infusion every 21 days] for early detection of cisplatin ototoxicity in those patients who had normal hearing threshold by standard audiometric methods of evaluation [PTA, SDT, AR]. This work showed that there was a significant difference of the DOPAE at the high frequencies only, in patients that received only one cycle of cisplatin, compared with the control group. However, there was a significant difference in DOPAE in both the low and high frequencies in patients that received more than one cycle of cisplatin compared to the control group

Adenoid cystic carcinoma [ACC] of the head and neck region: 15 year experience at NEMROCK

ACC is a rare disease. This study throws light at the clinico- epidemiological pattern, results of treatment as well as prognostic factors affecting the long-term complete remission [CR] and survival. From the results obtained, it was concluded that the clinical stage was the single most important factor that affected the long-term CR and survival at 10 years. There was a tendency towards a better long- term CR for patients who had wide surgical excision and/or received postoperative R/T