ABSTRACT
Choriocarinoma, a rare variety of testicular germ cell tumour, is associated with poor prognosis. A stage IV choriocarcinoma treated successfully with combination chemotherapy is being reported.
ABSTRACT
Carcinoma esophagus presents with dysphagia and in 60% of patients, the aim of treatment is palliation. ThIs study was done to evaluate the feasibility and role of planned combined approach using radiotherapy with metallic stent in palliation of malignant dysphagia. Ten patients with histologically proven, locoregionally advanced esophageal carcinoma were selected. All patients underwent external radiotherapy followed by brachytherapy. The self-expanding metallic stent was placed under combined endoscopic and fluoroscopic guidance. A predetermined questionnaire to assess dysphagia, pain, reflux symptoms and quality of life was administered before the procedure, and thereafter at monthly intervals until death or last follow-up. 10/10 patients had grade III dysphagia at presentation. 4/10 patients underwent stent placement prior to any radiotherapy (group A), 4/1 0 patients had stent placement after external radiotherapy (group 8) and 2/1 0 had stent after completion of brachytherapy (group C). There was no difficulty in placing the stent despite the post-radiotherapy ulcerations and stricture in all the patients in group 8 and C. 8/8 patients in groups A and 8 had no difficulty in placing esophageal bougie for brachytherapy. The mean follow-up after stent placement was 9 months (4-24 months). There was complete disappearance of dysphagia in 4/4 patients in group A, 2/4 patients in group Band 0/2 patients in group C. The rest of patients had significant improvement in dysphagia score by atJeast two grades. For dysphagia grade. the mean progression free interval was recorded as 5 months for group A, 3 months for group Band 2 months for group C. Combining radiotherapy and metallic stent is a safe, simple and effective means to palliate malignant dysphagia. This raises an issue whether all patients with advanced carcinoma esophagus should preferably be pre planned for stent placement followed by radiotherapy for best results.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.