Frequency and severity of acute toxicity of pelvic radiotherapy for gynecological cancer

Objective: To determine the frequency and severity of acute toxicity of pelvic radiotherapy for gynecological cancer

Study Design: A case series

Place and Duration of Study: Department of Oncology, The Aga Khan University Hospital, Karachi, from March 2011 to June 2012

Methodology: A total of 99 patients with histologically proven uterine and cervical cancer, receiving radiation therapy, were enrolled into the study after informed consent on justification of inclusion and exclusion criteria. Patients were evaluated for the frequency and severity of pelvic radiotherapy's side effects according to toxicity criteria based on RTOG/EORTC and CTC version 2 criteria at the start, during and at the end of treatment. The data was analyzed by using SPSS version 16

Results: Out of the 99 enrolled patients, 58 [58.6%] had uterine and 41 [41.4%] had cervical cancer. Mean age was 54.54 +/- 10.29 years. Thirty-five [35.4%] patients received chemotherapy with RT. Mean RT dose was 60.72 +/- 7.15 Gy. The most common gastrointestinal adverse effect was diarrhea in 64 [64.6%] followed by proctitis in 55 [55.5%], nausea in 33 [33.3%] and vomiting in 16 [16.2%] patients. Grade [G] 1 was the most frequently observed severity. The most common hematological toxicity was anemia in 37.8% [n=31/82] [[G1=18 [21.9%], G2=11 [13.4%], G3=2 [2.4%]] followed by thrombocytopenia in 22.8% [21/92] [[G1=16 [17.3%], G2=2 [2.1%], G3=3 [3.2%]] and neutropenia in 21 [21.2%] [[G1=12 [12.1%], G2=5 [5%], G3=3 [3%], G4=1 [1%]]. Urinary toxicity was observed in 49 [49.5%] patients. On stratification, chemotherapy and higher RT dose were strong predictor of increased hematological and upper gastrointestinal toxicity [p < 0.05] and age > 60 years for diarrhea [p < 0.05]

Conclusion: The frequency and severity of acute toxicity of pelvic radiotherapy in women with gynecologic cancers was found intermediate to high

Treatment updates regarding anaplastic oligodendroglioma and anaplastic oligoastrocytoma

Anaplastic Oligodendroglioma / Anaplastic Oligoastrocytoma [AO/AOA] is a WHO Grade-III primary brain tumor. These tumors comprise about 5 - 10% of all gliomas, which make them the third most common primary brain tumors after glioblastoma multiforme and astrocytomas. For many years standard of treatment remained Maximum Safe Resection [MSR] followed by Radiotherapy [RT]. These tumors have also been known to be sensitive to alkylator-based chemotherapy particularly the subset having 1p/19q co-deletion signature. There is robust data showing that these tumors are responsive to chemotherapy in recurrent or progressive setting. Recently, up front chemotherapy has been added to standard post-surgery RT. It has been found that subset of AO/AOA having 1p/19q co-deletion responded very well to the addition of chemotherapy. This substantial benefit in terms of median Overall Survival [OS] and median Progression Free Survival [PFS] have intrigued the personalized treatment of AO/AOA on the basis of molecular signature markers

Imatinib-related bone marrow aplasia after complete cytogenetic response in chronic myeloid leukemia

Imatinib mesylate is a BCR-ABL tyrosine kinase inhibitor used in the management of chronic myeloid leukemia. It is a safe and well-tolerated agent with a few manageable side effects. We are reporting a case of imatinib-related fatal bone marrow aplasia after complete cytogenetic response

Non-secretory myeloma: a rare variant of multiple myeloma

The spectrum of plasma cell neoplasm represents indolent conditions like Monoclonal Gammopathy of Undetermined Significance [MGUS] to more aggressive multiple myeloma and plasma cell leukemia. Non-secretory myeloma comprises less than 01% of this spectrum where serum protein electrophoresis and quantitative immunoglobulins remain essentially normal. We are presenting a case report of this rare variant involving the sternum of an adult male