Primary Non-Hodgkin's Lymphoma ofWaldeyer's Ring-A Retrospective Analysis

Tweny -five newly diagnosed cases of primary Waldeye!'s Ring (WR) Non-Hodgkin's lymphoma (NHL) registered from 1989-99 were analysed. These comprised 5% of tota! NHL cases. The most common site was tonsil (44%). followed by nasopharynx (20%), base of tongue (20%). nasal cavity (12%) and palate (4%). All the patients were staged thoroughly according to Ann Arbor staging system and -40% patients were stage I. 36% patients stage II. 4% stage IIl and 20% stage IV. Eighty-eight per cent patients were high grade at presentation and 12% were intermediate grade. Three patients absconded without treatment. Patients were treated with radiotherapy alone (4/22 patients). chemotherapy with CHOP regimen alone (9/22 patients) or a combination of both (9/22 patients). On comparison. complete response was recorded in 4/4 patients treated with radiotherapy alone. 5/9 patients treated with chemotherapy alone and 7/9 patients treated with combination of radiation and chemotherapy (p>O.05). The range of Follow up period was 1-10 years with median 20 months. Overall 16/22 evaluable patients were with no evidence of disease on last follow up and the primary site was the most common site of first failure. A combined modality treatment except for stage Ia seems to be the treatment of choice for this relatively (Uncommon entity of Primary Waldeyer's Rjng NHL.

Plasmacytoma of the Mandible

We describe a patient with an extramedullary plasmacytoma (EMP) of the mandible. which presented a diagnostic and therapeutic challenge on several levels. We discuss herein the clinical presentation surgery and the role of radiotherapy in this rare case.

Comparative Evaluation of Concurrent Chemotherapy & Hyperfractionated radiotherapy Versus Conventional Radiotherapy alone in the Treatment of Locally Advanced Carcinoma Cervix-A Prospective Randomised Study

The aim of this study was to determine whether the addition of concurrent cisplalin and hyperfractionation in external pelvic radiotherapy improves local control and survival in patients with locally advanced carcinoma cervix as compared to treatment with conventional radiptjerapy alone. The morbidity of two treatment protocols was also compared. Sixty patients of newly diagnosed squamous cell carcinoma cervix, FIGO stage 118 and III were randomised into the following two treatment protocols: Group A (study group): Cisplatin30 mg/m2 weekly x 5 courses and external beam pelvic radiotherapy 50 Gy/33#4.5 weeks with hyperfractionation in first and following weeks. Group B (control group) : External beam pelvic radiotherapy 46 Gy/23#/4.5 weeks. Patients in both the group were then treated with intracavitary brachytherapy by LDR/MDR Selectron and a dose of 28 Gy was delivered to point A. The patients who were not suitable for intracavitary treatment were treated by supplementary external beam pelvic radiotherapy 20 Gy/ 10#/2" ceks. The actuarial local control at 4 years was 60% in group A and 42% in Group 8 9p<0.05). The a Cluarial disease free survival at 4 years was 52% in Group A and 35% in Group 8 (p<0.05). Only grade I acute and delayed haematological toxicity and grade I nausea and vomiting as acute toxicity "ere significantl) higher for Group A patients as compared to Group 8. Concomitant chemotherapy with hyperfraclionated radiotherapy is well tolerated and seems to offer potential benefit for imprOl ing the locoregional control in locally advanced carcinoma of cervix.