Trends and future burden of tobacco-related cancers incidence in Delhi urban areas: 1988�12

Introduction: Tobacco products are the major contributors for various cancers and other diseases. In India, tobacco-related cancers (TRCs) contribute nearly half of the total cancers in males and one-fifth in females. Objective: The objective of the study is to investigate 25-year trends and projection of TRCs for 2018�22. Methods: Joinpoint analysis was performed to assess the trends of TRCs on world age-adjusted rates. Age-period-cohort model with power link function was performed to project the future incidence burden of TRCs in urban Delhi. Results: During the 25 years, a total of 67,129 TRCs (53,125 males and 14,004 females) were registered which was 25.4% of total cancer cases registered. Males contributed 39.1% and females 10.8% of total cases. In males, TRCs declined significantly from 1988 to 2003 with estimated annual percentage change (EAPC) = ?0.91% and thereafter increasing trend was observed with EAPC = 3.42%, while in females, the EAPC values were 2.2% and 3.54% respectively for the same period. The total burden of TRCs will be doubled in 2018�22 with around 46% change due to cancer risk and around 54% due to population age and size in both the genders. The average annual count in males will be 7310 in 2018�22 as compared to 3571 in 2008�12 while in females this count will be increased to 2066 from 955 based on recent slope. Conclusion: The incidence of TRCs is increasing due to increase in population age, size, and factors other than population. TRCs are the preventable cancers, and load of these cancers can be controlled with strictly adhering the policy and acts.

Micronuclei evaluation of reduction in neoadjuvant chemotherapy related acute toxicity in locally advanced lung cancer: an indian experience.

BACKGROUND: Lung cancer is the most common cancer in the world accounting for 17.6% cancers worldwide. The AAR i n I ndian population varies f r om 0.98-15.55. The aim of t he present study was to analyze areduction in neoadjuvant chemotherapy related acute toxicity in locally advanced lung cancer (stage IIIA and III B) using Wobe Mugos E and its evaluation using micronuclei as a cytogenetic marker. Micronuclei, which are cytoplasmic fragments of DNA, have been used as a biological dosimeter to assess DNA damage. MATERIAL AND METHODS: Fourty patients of locally advanced NSCLC were randomized into two study groups between 2001-2003. One group received neoadjuvant chemotherapy using Cisplatin and Etoposide. The other group received neoadjuvant chemotherapy using Cisplatin and Etoposide along with Wobe Mugos E which is a proteolytic enzyme preparation. A study of micronuclei frequency was done pre and post chemotherapy in both groups. RESULTS: Thirty eight patients were available for final evaluation. Anemia was the most common hematological toxicity observed. Nausea and vomiting were the most common non -hematological toxicity seen. Wobe Mugos E was found to reduce the incidence of leucopenia (p = 0.005), nausea (p=0.004), vomiting (p= 0.003), sensory neuropathy (p = 0.032) and treatment related depression (p= 0.005). A reduction in micronuclei was seen in patients in patients on Wobe Mugos E. (p =0.01). CONCLUSION: Neo-adjuvant chemotherapy related acute toxicity is a major problem in patients with advanced lung cancer. A reduction in micronuclei frequency shows Wobe Mugos E to be effective in reducing chemotherapy related acute toxicity.

Effect of amifostine on toxicities associated with salvage combination chemotherapy.

PURPOSE: To determine the effect of amifostine on the safety and efficacy of chemotherapy in heavily pretreated patients and to study the side effects of amifostine delivered to patients receiving chemotherapy at a dose of 740 mg/m2. MATERIAL AND METHODS: Thirty-two patients of histologically proven (recurrent) malignancy who had previously received > or = 6 cycles of chemotherapy and developed grade II or grade III toxicities during treatment with salvage chemotherapy were eligible. These patients were given Injection Amifostine 740 mg/m2 as a 15 min. i.v. infusion 30 min. prior to combination chemotherapy. RESULTS: A total of 85 cycles were administered with amifostine and 46 cycles without amifostine. The side effects during amifostine infusion were hypotension (9.6% cycles), vomiting (20% cycles), somnolence (33% cycles), sneezing (8% cycles), and flushing (19% cycles). The chemotherapy toxicities were reduced from 47.7% to 30.6% for grade II and from 28% to 9.4% for grade III in case of gastrointestinal toxicity. Similarly there was improvement in the mean hemoglobin level from 8.2 gm% to 10.01 gm%, mean total leucocyte count from 2,280/mm3 to 3,600/mm3. CONCLUSION: Amifostine has an excellent safety profile and is well tolerated by the patients. Pretreatment with Amifostine resulted in fewer treatment related delays and dose reduction resulting in better tolerance to salvage chemotherapy.