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

Development and bioevaluation of [99m] Tc[CO][3]-labeled [1-azido-1- deoxy-beta -D-glucopyranoside] complex as a potential tumor-seeking agent

The 1,2,3-triazole-containing [1-azido-1-deoxy-beta -D-glucopyranoside] complex was synthesized using click chemistry approach and evaluated its potential as a tumor-seeking agent. In the present study, [99m] Tc-tricarbonyl labeled [1-azido-1-deoxy-beta -D-glucopyranoside] radiotracer [[99m] Tc[CO][3]-BM], [where BM stands for biomolecule, e.g., [1- azido-1-deoxy-beta -D- glucopyranoside]] was synthesized via click chemistry approach and then labeled with technetium- 99m through isolink kit. Radio labeled drug was tested for radiochemical purity and in vitro stability by chromatographic techniques. Normal distribution and tumoral uptake were studied in Swiss Webster mice. Radiochemical purity results show 97.9 +/- 1.5% labeling and its in vitro stability were studied at room temperature up to 5h. The radio labeled drug exhibited 73.6 +/- 1.1% binding with blood proteins. Normal distribution of drug shows prominent uptake in brain while in case of tumor-bearing mice, the uptake was maximum in tumor tissue and negligible amount was shown in brain. The biodistribution was further compared with 2-fluoro-2-deoxy glucose [[18]F-FDG], which was used as a positive control. The data indicate that [99m] Tc-tricarbonyl labeled [1-azido-1-deoxy-beta -D- glucopyranoside] radiotracer might be a feasible candidate with reasonable potential for tumor diagnosis

Development of [99m]Tc-5-fluorouracil as a potential tumor diagnostic agent

5-Fluorouracil is a well know drug for chemotherapy of various types of cancer. In the present study, we radiolabeled 5-fluorouracil with 99mTc for a diagnostic study of cancer. After successful labeling of the drug we performed an animal study to evaluate the potential of this radiopharmaceutical as a tumor diagnostic agent. The results showed 98.1 +/- 1.2 % labeling efficacy of 5-fluorouracil with [99m]Tc. The in vitro stability of the radiolabeled drug at room temperature at 4 hr of post-labeling was >96.5 +/- 0.4 %. The binding of the radiolabeled drug with plasma proteins was 66.6 +/- 3%. Partition coefficient results showed that this drug is hydrophilic in nature. Biodistribution study in rabbit models displayed faint uptake in liver. Both kidney and bladder were prominent as excretory route of the labeled drug. Bioevaluation was performed in Swiss Webster mice having naturally developed tumor. Mice were dissected, uptake of drug in various organs was studied and results showed prominent uptake in liver and tumor. Tumor was further investigated by histopathological study

Synthesis, characterization and bioevaluation of technetium-99m labeled N-[2-Hydroxybenzyl]-2-amino-2-deoxy-D-glucose as a tumor imaging agent

N-[2-Hydroxybenzyl]-2-amino-2-deoxy-D-glucose [NHADG] was synthesized by conjugation of salicylaldehyde to glucosamine. The obtained compound was well characterized via different analytical techniques. Labeling of the synthesized compound with technetium-99m [[99m]Tc] in pertechnetate form [[99m]TcO4[-]] was carried out via chelation reaction in the presence of stannous chloride dihydrate. Maximum radiochemical yield of [99m]Tc-NHADG complex [99%] was obtained by using 1 mg NHADG, 200 micro g SnCl[2].2H[2]O, at pH 9.5 and reaction time of 15 min. The radiochemical purity of the [99m]Tc-NHADG complex was measured by Instant Thin Layer Chromatography [ITLC] and Paper Chromatography [PC], without any notable decomposition at room temperature over a period of 4h. The biological evaluation results show that the [99m]Tc labeled NHADG conjugate is able to specifically target mammary carcinoma in mice models, thus highlighting its potential as an effective [99m]Tc labeled glucose-derived agent for tumor imaging

In house development of [99m]Tc-Rhenium sulfide colloidal nanoparticles for sentinel lymph node detection

In this study, rhenium sulfide colloidal nanoparticles were developed as radiopharmaceutical for sentinel lymph node detection. We directly used rhenium sulfide as a starting material for the preparation of colloidal nanoparticles. UV-visible spectrophotometry was used for characterization of in house developed colloidal particles. The size distribution of radioactive particles was studied by using membrane filtration method. The percentage of radiolabeled colloidal nanoparticles was determined by paper chromatography [PC]. The study also includes in vitro stability, protein binding in human blood and bioevaluation in a rabbit model. The results indicate that 77.27 +/- 3.26 % particles of size less than 20nm [suitable for lymphoscintigraphy] were radiolabeled. [99m]Tc labeled rhenium sulfide labeling efficacy with the radiometal is 98.5 +/- 0.5%, which remains considerably stable beyond 5h at room temperature. Furthermore, it was observed that 70.2 +/- 1.3 % radiolabeled colloid complex showed binding with the blood protein. Bioevaluation results show the remarkable achievement of our radiopharmaceutical. The in house prepared [99m]Tc labeled rhenium sulfide colloidal nanoparticles reached the sentinel node within 15 min of post injection. These results indicate that [99m]Tc labeled rhenium sulfide colloid nanoparticles kit produced by a novel procedure seems of significant potential as a feasible candidate for further development to be used in clinical practice

Synthesis, characterization and biodistribution of novel amine thiophene [99m]Tc labeled complex

[99m]Tc-labeled amine thiophene ligand might be a potential candidate for brain imaging. The purpose was to investigate the uptake of a radiolabeled drug in the brain. In this study, a tetradentate amine-thiophene-dione ligand was synthesized by the reaction of thiophene-2-carboxaldehyde with ethane-1,2-diamine and reducing with NaBH4. The ligand system was characterized by elemental analysis, FTIR and [1]H NMR. Radiolabeling of the complex with [99m]Tc was performed by reducing with stannous ions. The radiochemical purity of the radiolabeled drug was determined by paper chromatography [PC] and instant thin layer chromatography [ITLC]. Bioevaluation of the [99m]Tc complex was studied in rabbits. The yield of the final product was 4.42 g [60%] and the characterization data confirmed the synthesis of the final product. The efficacy of radiolabeling was >98%. A significant uptake was observed in the brain which retained significantly up to 4h. The data indicate that the proposed system may be suitable for brain imaging in future clinical applications

Shear bond strength of conventional glass ionomer cement to mechanically treated versus chemo-mechanically treated dentin

To determine the effect of a chemo mechanical caries removal [CMCR] gel Carisolv[TM] on shear bond strength [SBS] of conventional glass ionomer cement bonded to human permanent dentin. One conventional glass ionomer cement [Fuji IX, GC Co, Tokyo Japan] was used. Sixty four teeth were sectioned occlusally; exposed coronal dentin was polished with silicon papers. Teeth in the control groups [C] were directly bonded to respective glass ionomer cements [GIC]. For test groups [T] the polished dentin surface was pre-treated with Carisolv [TM] [Singlemix Uncoloured Gel, Medi Team, Sweden] prior to bonding. Bonded specimens were stored for 24 hours and stressed to failure in the shear mode. SBS of Fuji IX, test group [4.97 +/- 0.82 MPa] was significantly higher [P = .001] than its control group [3.98 +/- 0.67MPa]. Carisolv[TM] pre-treatment significantly increased the shear bond strength of conventional glass ionomer cement to dentin

Detecting the apical constriction in curved mandibular molar roots-preflared versus nonflared canals

Bckground: Achieving and maintaining correct working length is critical to success in endodontic therapy. This involves placing the file in to the canal to feel the apical constriction, preparing the canal upto that extent and then filling the entire canal upto the apical constriction with gutta percha points. Detection of the apical constriction is affected if the coronal part of the canal is narrow or obstructed due to dentine deposition. This usually happens in curved canals and gives the operator a false feeling of the apical constriction. The aim of this study was to compare the effect on tactile detection of apical constriction in mandibular molars with curved roots, between the preflared and non-flared root canals. This study was carried out at Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from February to April 2002. Seventy patients coming for the endodontic treatment of their mandibular first molars were selected. The study included only mandibular molars with curved mesial canals. The total no of patients were divided equally into the preflared and non-flared groups. In both groups a No. 15 K file was used to detect or feel the apical constriction but in the preflared group the coronal portion of the canal was flared/prepared using Hedstrom files [No. 25'55] and Gates Glidden Drills No. 02 to No. 05 before inserting the No. 15 file. The tooth was radiographed at this moment and the distance between the tip of the file and the radiographic apex was measured. The location of the tip was classified as: a] Within 1 mm of the radiographic apex, b] Under extended, more than 1 mm of radiographic apex, and c] Over extended, beyond the radiographic apex. In the non-flared group 31.4% belonged to group 'a', 40% to group 'b', and 28.57% to group 'c'. In the flared group 80% belonged to group 'a', 5.7% to group 'b', and 14.28% to group 'c'. Conclusions: Results of this study suggest that preflaring greatly improves the tactile sense to feel the apical constriction in curved canals