Retrospective study on efficacy and safety of nanoparticle paclitaxel and concurrent radiotherapy in patients with advanced head and neck cancer.

Background: Advanced (Stage III and IV) Squamous Cell Carcinomas of the head and neck (SCCHN) produce severe functional impairment, considerable morbidity, and significant mortality. Over the past 2 decades, organ-sparing efforts using either induction chemotherapy or concurrent chemotherapy and radiotherapy (RT) have become popular and have demonstrated equivalent or superior survival rates compared with surgery and/or RT alone, with a survival rate of approximately 40% at 5 years. Although the addition of chemotherapy to RT enhances toxicity, randomized trials and meta analyses have documented improved survival clearly compared with the results from RT alone. Initially, most combinations included once-daily RT combined with cisplatin either alone or with 5-fluorouracil (5-FU). There was number of toxicities of high grades associated with these drugs, and also difficulty in their administration. We have retrospectively studied nanoparticle paclitaxel with RT on concurrent setting as an alternative. Methods: We have retrospectively studied data of patients of advanced SCCHN treated with nanoparticle paclitaxel along with RT. Nanoparticle paclitaxel was administered at a dose of 80 mg/m2 over one hour infusion once weekly along with RT, 60 Gray (Gy) in 30 fractions, five days per week, over 6 weeks. Results: Total numbers of patient in this study were 28 with median age of 49 years. 78.57% of patient had stage IV disease and 21.43% stage III. Overall response rate was 68% with complete response (CR) in 29% and partial response (PR) in 39%. Conclusions: The use of nanoparticle paclitaxel along with RT is safe, feasible, efficacious and cost effective. Intensive randomized studies with large sample size are required in this direction.

Protective association exhibited by the single nucleotide polymorphism (SNP) rs1052133 in the gene human 8-oxoguanine DNA glycosylase (hOGG1) with the risk of squamous cell carcinomas of the head & neck (SCCHN) among north Indians.

Background & objectives: Imbalances in compactly regulated DNA repair pathways in the form of single nucleotide polymorphisms (SNPs) within vital DNA repair genes may result in insufficient DNA repair and increase in DNA breaks thus rendering the human system vulnerable to the debilitatory effects of grave diseases like cancers. The present study involves investigation of association of the non-synonymous SNP rs1052133 (C8069G/Ser326Cys) located in the exonic region of the gene human 8-oxoguanine DNA glycosylase (hOGG1) with the risk of squamous cell carcinomas of the head and neck (SCCHN). Methods: Case-control based genetic association study was performed among 575 (250 SCCHN cases and 325 normal healthy controls) sub-population cluster-matched (Indo-Europeans linguistic subgroup + Caucasoid morphological subtype) samples from the north Indian States of Uttar Pradesh and Uttarakhand using polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing analysis. Results: Our results demonstrated statistically significant protective association for the heterozygous CG [Odds Ratio (OR) 0.6587, 95% Confidence Interval (CI) 0.4615 to 0.9402, P=0.0238], homozygous mutant GG (OR 0.2570, 95% CI 0.1070 to 0.6175, P=0.0013) and combined mutant CG + GG (OR 0.6057, 95% CI 0.4272 to 0.8586, P=0.0059) genotypes. Interpretation & conclusions: The results indicate that the polymorphism rs1052133 is strongly associated with SCCHN susceptibility and the mutant (G) allele might be a protective factor for SCCHN among north Indian subpopulations.