Supercilliary madarosis in an Indian male with Chronic Myelogenous Leukemia Treated with Dasatinib - A case report.

Dasatinib, a second generation multi-target tyrosine kinase inhibitor (TKI) is active against many imatinib-resistant BCR-ABL mutant forms, Src, and c-Kit tyrosine kinases. While skin hypopigmentation is a well recognized adverse effect of first generation TKIs; it has rarely been reported with dasatinib. We report a rare case of diffuse cutaneous hypopigmentation and bilateral supercilliary madarosis induced by dasatinib. A 51 year-old Indian male with no co-morbidities and with history of chronic myelogenous leukaemia with complex variant of Philadelphia translocation and E 225 V mutation in P loop domain of bcr-abl transcript who was initiated on imatinib followed by dasatinib as a part of treatment. After 5 months of treatment with dasatinib, he developed supercilliary madarosis bilaterally. Cutaneous side effects may adversely affect patient’s quality of life and, therefore, require prompt attention to prevent long-term complications or suboptimal outcomes due to poor compliance.

Assessment of free radical-mediated damage in head and neck squamous cell carcinoma patients and after treatment with radiotherapy.

Reactive oxygen species (ROS) produced as a part of cellular metabolism can interact with biological macromolecules such as DNA, proteins and lipids and interfere with their normal functions, leading to the loss of cellular viability. ROS have been implicated in many pathophysiological conditions including cancer. In the present study, the damage caused by ROS and the effect of radiation in head and neck squamous cell carcinoma (HNSCC) patients were assessed in the erythrocytes by analyzing the superoxide dismutase (SOD) and catalase (CAT) activities, and levels of total thiols (T-SH) and malondialdehyde (MDA, a marker for lipid peroxidation). Blood samples were collected before the start of treatment and after the completion of radiotherapy. Both SOD and CAT activities were decreased in untreated patients, but elevated in patients after treatment. The T-SH levels were also depleted in untreated HNSCC patients, but elevated non-significantly after radiation therapy (p>0.05). The levels of MDA showed a significant increase in both untreated patients and after radiation therapy when compared with normal subjects (p<0.05). Thus, the present study indicated that the free radical-mediated damage was aggravated in untreated HNSCC patients, but the levels of antioxidants returned to baseline or nearly so after the treatment with radiation therapy.

Palliative treatment of advanced non small cell lung cancer with weekly fraction radiotherapy.

Various hypofractionated radiotherapy schedules of radiotherapy have been tried in patients of advanced NSCLC with no conclusive superiority of either a more protracted low dose per fraction schedule or a rapid course of large fraction size. Present study evaluates the role of weekly high dose radiotherapy for the palliation of various intrathoracic symptoms like cough, chest pain, hemoptysis, dyspnoea. A total of 47 patients of advanced non-small cell lung cancer were treated with four weekly fraction of 5 Gy to a total dose of 20 Gy. Mean age at presentation was 53 years. Majority of patients had stage III disease. Pain relief was seen in 77% (23/30) patients with complete relief in 57%; haemoptysis was completely relieved in 77% patients (17/22); and cough was relieved in 68% (19/28) patients. Complete relief from dyspnoea was seen in only 5/12 (42%) patients whereas 2/12 (17%) patients had partial response. The present regime of 20 Gy in four weekly fractions was well tolerated by the patients without any identifiable acute toxicity and was simple and convenient to the patients, who traverse a long distance for radiotherapy in India. To conclude, weekly schedule af EBRT provide effective palliation of various intrathoracic symptoms in the patients with advanced NSCLC.