ABSTRACT
To compare the results of sequential with concurrent chemo radiotherapy in locally advanced squamous cell carcinoma of esophagus in terms of loco regional control, toxicity profile and overall survival,65 patients were enrolled between Jan 2008 and Dec. 2010, of which 37 were male and 28 female. Patients had histologically confirmed squamous cell carcinoma with locally advanced disease with no prior treatment in the form of chemotherapy, radiotherapy or surgery. Patients were divided into two groups and were comparable in terms of patient characteristics. In Group-I, 35 were given sequentially paclitaxel 175mg/ m2, cisplatin 75mg/m2 on day 1 of every 21 days for 3 cycles followed by external beam Radiotherapy followed by 3 more cycles of same chemotherapy. In Group-II, 30 patients were given two cycles of Induction chemotherapy same drugs and dosage as in Group-I and was followed by EBRT concurrent with paclitaxel 30mg/m2 given on day 1 of every week during radiation therapy treatment. The overall objective response rate at the end of treatment was superior 93.33% in Group-II as compared to 74.28% in Group-I. Thrombocytopenia was 73.33% and 17.14% in Group-II and Group-I respectively. Similarly, mucosites was higher 56.66% in Group-II as compared to 22.85% in Group-I. At 2 years of follow up, there was no statistically significant difference seen in overall and disease free survival.
ABSTRACT
The socio-demographic, behavioral and anthropometric correlates of C-reactive protein levels were examined in a representative young adult Brazilian population. The 1982 Pelotas Birth Cohort Study (Brazil) recruited over 99 percent of births in the city of Pelotas that year (N = 5914). Individuals belonging to the cohort have been prospectively followed up. In 2004-2005, 77.4 percent of the cohort was traced, members were interviewed and 3827 individuals donated blood. Analyses of the outcome were based on a conceptual model that differentiated confounders from potential mediators. The following independent variables were studied in relation to levels of C-reactive protein in sex-stratified analyses: skin color, age, family income, education, parity, body mass index, waist circumference, smoking, fat/fiber/alcohol intake, physical activity, and minor psychiatric disorder. Geometric mean (95 percent confidence interval) C-reactive protein levels for the 1919 males and 1908 females were 0.89 (0.84-0.94) and 1.96 mg/L (1.85-2.09), respectively. Pregnant women and those using oral contraceptive therapies presented the highest C-reactive protein levels and all sub-groups of women had higher levels than men (P < 0.001). Significant associations between C-reactive protein levels were observed with age, socioeconomic indicators, obesity status, smoking, fat and alcohol intake, and minor psychiatric disorder. Associations were stronger at higher levels of C-reactive protein and some associations were sex-specific. We conclude that both distal (socio-demographic) and proximal (anthropometric and behavioral) factors exert strong effects on C-reactive protein levels and that the former are mediated to some degree by the latter.