Disease characteristics and treatment outcome of testicular germ cell tumors treated with platinum-based regimens

Objective: To determine the disease characteristics of testicular germ cell tumor, biochemical/radiological response to chemotherapy and common toxicity profile. Study Design: Case series. Place and Duration of Study: Institute of Nuclear Medicine and Oncology [INMOL], Lahore, from January 2010 to December 2013

Methodology: Fifty-one patients with histologically proven testicular germ cell tumor, who fulfilled the pre-defined eligibility criteria, were selected. Presenting symptoms and disease stage were studied. Patients were staged according to the AJCC 2010 staging criteria and prognosis was classified according to the IGCCCG Classification of Metastatic Germ Cell Cancer. Initial chemotherapy treatment was based upon the International Germ Cell Consensus Classification, 1997. Patients were also evaluated for chemotherapy-induced toxicity based on Common Toxicology Criteria version 4. SPSS version 16.0 was used for statistical analysis

Results: Main presenting symptoms included testicular pain [37.3%], testicular swelling [25.5%], and abdominopelvic pain [11.8%]. Most of the patients had mixed germ cell histology [p<0.001] and presented with advanced disease stage. Out of 51 patients, 41 [80.3%] achieved complete clinical remission after first line chemotherapy. All patients having complete response achieved 2-year survival and 37 [90.2%] had no evidence of recurrent disease. Four patients with recurrent disease achieved complete remission with second line chemotherapy. Five [9.8%] had partial response after first line chemotherapy while 2 [3.9%] progressed on treatment. All patients developed alopecia, 21 [41.1%] experienced other toxicities which were managed symptomatically and with minor dose modifications

Conclusion: Many patients with germ cell tumors presented with pain, and in an advanced stage, with mixed histology. Overall response rate was 90.2% with platinum-based chemotherapy

Efficacy and toxicity of concurrent chemoradiation in inoperable oral carcinoma in pakistani population

Objective: To evaluate the efficacy of concurrent Chemoradiation in patients with locally advanced inoperable squamous cell carcinoma of oral cavity in terms of local control and toxicity

Study Design: Case series

Place and Duration of Study: Institute of Nuclear Medicine and Oncology [INMOL], Lahore, from January 2008 to December 2013

Methodology: Sixty-nine patients with locally advanced inoperable oral cavity cancer, registered in INMOL hospital from January 2008 to December 2013 who fulfilled a pre-defined eligibility criteria, were enrolled in the study

Concurrent Chemoradiation protocol consisted of conventional fractionation delivering 70 Gy with weekly Cisplatin [50 mg/m[2]] during the course of radiation

Tumor response was calculated by RECIST criteria version 1.1 along with the median overall survival and disease-free survival. Acute treatment related toxicities were graded as [G]

Results: Thirty-six [52.17%] patients showed complete response; while 19 [27.54%], 8 [11.59%] and 6 [8.7%] were observed with partial response, stable and progressive disease, respectively. Treatment response was significant [p<0.001] in terms of responders vs. nonresponders to treatment. Median overall survival was 18.00 months; whereas, median disease-free survival remained 14.00 months. Main toxicities included mucositis [G3 and G4, 71%], xerostomia [G2 and G3, 82.5%], vomiting [G3 and G4, 51%], myelosuppression [G3 and G4, 26.2%], dermatitis [G3 and G4, 49.2%], and fatigue [G3 and G4, 57.9%]

Conclusion: Platinum based CCRT remained effective for inoperable oral cancer patients

Effect of an anti-thyroid drug, 2,8-Dimercapto-6-hydroxy purine on reproduction in male rats

This histomorphological study is designed to evaluate the peripheral action of 2,8-Dimercapto-6-hydroxypurine [an antithyroid drug] on male reproductive system. The drug was administered as i.p. injection for 21 days to investigate its role on morphology of intratesticular cells and plasma testosterone level. Adult male rats [n=12], divided into three groups i.e. control, dimethylsulphoxide [DMSO] and 2,8-Dimercapto-6-hydroxypurine treated groups and treated with saline, DMSO and 2,8-Dimercapto-6-hydroxypurine for 21 consecutive days respectively. Blood samples were collected at day 1, 7, 14 and 21 and analyzed by using EIA systems. All the animals were scarified on 22nd day and testicular tissues were studied by histomorphpological assesment. 2,8-Dimercapto-6-hydroxypurine caused a significant decrease [P<0.0001] in mean testicular cell population, testicular cell diameter and resulted in arrested spermatogenesis. A significant decrease [P<0.0001] was observed in mean Sertoli and Leydig cell population and diameter in treated group. Similarly a significant decrease was observed in plasma testosterone levels at days 1, 7 and 14 [P<0.05] and further decrease by day 21 [P<0.01] of drug treatment. The present study suggests that 2,8-Dimercapto-6-hydroxypurine is a negative modulator of reproductive system as it suppressed the plasma testosterone level and proliferation of different testicular cell types in adult male rats