Biological tailoring of adjuvant radiotherapy in head and neck and oral malignancies – The potential role of p53 and eIF4E as predictive parameters

BACKGROUND: Recent advances in radiation technology has allowed to significantly reduce toxicity and improve the efficacy of radical radiotherapy in head and neck and oral squamous cell cancers. Insights into molecular biology of carcinogenesis has opened a window for identifying aggressive clinical situations that may benefit with larger clinical target volume (CTV ) margin, broader levels of nodal coverage, or alternative radiation sensitizers. AIM: To evaluate the potential role of eukaryotic translation initiation factor 4E (elF4E) and p53 as predictive biomarkers in resected margins of head and neck and oral cancers. MATERIAL AND METHODS: Forty patients with oral cancers and 26 patients with head and neck cancers were evaluated for p53 and eIF4E in their negative surgical margins, for pattern of distribution and outcome. RESULTS: In oral cancers, 27 patients (67.5%) were positive for p53 and 10 (25%) for eIF4E in surgically negative margins. For head and neck cancer, the values were 13 (50%) for p53 and 9 (34.6%) for eIF4E. Twelve patients with oral cancers and 8 patients with head and neck cancers had local failure or death. The association with these biomarkers did not achieve statistical significance. However, adjuvant radiotherapy had a significant protective value. It improved median survival from 15 to 21 months in patients positive for p53 (P = 0.018) and from 12 to 20 months (P = 0.03) in those with eIF4E. There was no predictive association of subsite, tumor size, or nodal status. CONCLUSION: The overexpression of p53 and eIF4E in pathologically negative margins may represent a subset of patients who would benefit from early initiation of adjuvant radiation and tailored intensity-modulated radiotherapy (IMRT).

Herbal oral care: an old concept or a new model.

dental health. The commonly used Ayurvedic medications for oral and dental health can be classified based on their properties as PLANTS WITH ANTIMICROBIAL PROPERTY Aloe, betel pepper (Piper betel), black pepper (Piper nigrum), clove (Syzygium aromaticum), coriander, (Coriandrum sativum), eucalyptus (Eucalyptus globules), garlic (Allium sativum), turmeric (Curcuma longa), green tea (Camellia sinensis), Onion (Allium cepa), papaya (Carica papaya), potato (Solanum tuberosum) are few Indian plants species which contain antimicrobial activities.3 PLANTS WITH ANTIOXIDANT PROPERTY Spinach, pepper, black tea, broccoli, green tea, carrot, potato tomato, blackberry, grape, olive, pineapple, ABSTRACT Ayurveda, the oldest medical science originating from Indian subcontinent, has been practiced since the 12th century BC. Its objective is to accomplish physical, mental, social and spiritual well- being by adopting preventive, health promoting and holistic approach towards life. Ayurveda is the science that developed as humans evolved and has stood the test of time. Oral diseases are major health problems worldwide and are not limited to dental caries and periodontal diseases but to various autoimmune conditions. Oral health influences the general quality of life and poor oral health is linked to chronic conditions and systemic diseases. Recently there is renewed interest in use of various Ayurvedic drugs for oral and dental healthyurvedic drugs for oral and dental health.

Anxiolytic effect of chronic administration of ursolic acid in rats.

Anxiety is a cardinal symptom of many psychiatric disorders and an almost inevitable component of many medical and surgical conditions. Indeed it is a universal human emotion, closely allied with appropriate fear presumably serving pyschobiologically adaptive purposes. Anxiety is a normal emotional behaviour. When it is severe and/or chronic, however, it becomes pathological and can precipitate or aggravate cardiovascular and psychiatric disorders. Although many drugs are available in allopathic medicine to treat anxiety disorders, they produce various systemic side effects. Ursolic acid has been identified as the active principle of Ocimum sanctum. From our laboratory we have established the antianxiety, anticateleptic and antidepressant activity of ethanolic extract of leaves of Ocimum sanctum. In the present study, we have attempted to evaluate the anxiolytic- activity of ursolic acid in rats by employing, elevated plus maze and bright and dark arena. The rats were divided into five groups, each group containing six animals. The effects of the test drug ursolic acid (at 0.05, 0.1 and 0.2 mg/kg doses), the standard anxiolytic, diazepam (1.0 mg/kg) and control group 14% dimethyl sulfoxide (10ml/kg) were assessed after repeated doses administration for ten days. The results suggest that, ursolic acid exhibited anxiolytic like activity comparable to diazepam.

Effect of acorus calamus on electrical and chemical induced seizures in mice.

Acorus calamus Linn. (Family: Araceae) is an aromatic semi-aquatic perennial marshy herb. Experimental studies have indicated the efficacy of this plant against various types of epileptic seizures, but the results vary with the models and the type of extract used. These conflicting reports and the unavailability of the data regarding the effects of aqueous extract of Acorus calamus (AEAC) prompted us to evaluate the efficacy of AEAC on electrical and chemical induced seizures in albino mice. Either normal saline or sodium valproate or AEAC was given sixty minutes prior to the experiment in acute study, whereas in chronic study, they were given twice daily for ten days and the last dose was given one hour prior to the exposure of the animal either to maximal electrical shock (MES) or pentylenetetrazole (PTZ) administration. On acute administration, AEAC dose dependently reduced the duration of tonic hind limb extension in MES induced seizure which was comparable to that produced by sodium valproate. Whereas, in PTZ induced seizures, the test drug decreased the latency and increased the duration of seizures as well as mortality. On repeated administration (chronic study) the test drug significantly reduced the duration of tonic hind limb extension and also the clonus phase of MES induced seizures. However, in PTZ induced seizures, results were similar to that obtained in acute study. Results indicates that AEAC has protective effect against MES, but not against PTZ induced seizures.

Antidepressant activity of aqueous extract of fruits of emblica officinalis in mice.

Depression is a widespread psychiatric disorder affecting around 5% of the population. Furthermore, it is difficult to predict which patient will respond to any given treatment. In the traditional systems of medicine, many plants and formulations have been used to treat depression for thousands of years. Emblica officinalis (EO) contains tannic acid as its main ingredient and this compound has been shown to have non-selective mono-amine oxidase activity. Therefore, the present study was undertaken to evaluate the antidepressant potential of acute and chronic administration of EO in forced swim test (FST) and tail suspension test (TST). Inbred adult male Swiss Albino mice weighing 25-30g were used in the study. Standard drug (imipramine) and test drug (EO) were suspended in 1% gum acacia. The vehicle (10ml/kg, p.o), imipramine (10mg/kg, p.o) and EO (0.8mg/kg, 2mg/kg, 4mg/kg, p.o. respectively) were administered 1hour prior to acute study. In chronic study, all drugs were given for 10 days and the last dose was given 1hour before the experiment. Duration of immobility was noted in both the models. In our study, both imipramine and EO significantly reduced the duration of immobility in both experimental models as compared to the animals in the control group. The antidepressant activity of EO was comparable to that of standard drug imipramine. The results of the present study indicate the potential for use of EO as an adjuvant in the treatment of depression.

Follicular dendritic cell tumour--a case report.

Follicular dendritic cell tumors are rare entities, which are however being increasingly recognised. One such tumor in the parapharyngeal region, diagnostically challenging, and with an unusual histological feature is reported, with a short review of the literature.