ABSTRACT
OBJECTIVE: To study the efficacy of neo-adjuvant chemotherapy followed by radiotherapy in advanced head and neck cancer. STUDY DESIGN: Randomised, prospective study. SETTING: Tertiary academic referral center. PATIENTS: One hundred and eighty patients of advanced head and neck squamous cell carcinoma. INTERVENTION: PATIENTS were randomized into two arms. The study arm (CT-RT arm) received 3 cycles of anterior chemotherapy with Inj. Cisplatin 100 mg/m(2) on D(1) and Inj 5F.U. 700 mg/m(2) on D(1)-D(4) at an interval of 21 days, followed by external radiation. The control arm (RT arm) received external radiotherapy only. The dose of Radiotherapy was 64 to 68 Gy in conventional fractionation. RESULTS: PATIENTS of CT-RT showed better tumour control locally than patients who received only RT. Toxicities were commoner in CT-RT arm but they were manageable. 5 year survival is higher in the CT-RT arm (21% vs 16%; p value> 0.05). CONCLUSION: Anterior chemotherapy with Cisplatin and 5F.U. is associated with good clinical response which is translated into increased survival along with acceptable toxicities.
ABSTRACT
Clinicopathological features of 26 cases of bronchogenic carcinoma in patients below the age of 40 years have been studied and compared with 271 cases of bronchogenic carcinoma occurring in elderly patients. There was female preponderance (19.23%) in the younger study group compared to the elderly group (6.6%) and increased incidence of smokers in the younger group (57.6% versus 79.3%) and had achieved statistical significance (p < 0.001). Majority (20 out of 26) had a rural background. All the patients were symptomatic at the time of diagnosis and all the 26 cases except one belonged to advanced stage. The incidence of squamous cell carcinoma was almost same for both the age groups. Eighteen of the 26 cases had received antituberculosis chemotherapy by general practitioners before referral to the specialists. Twenty patients were treated initially by palliative radiotherapy and then by chemotherapy.
Subject(s)
Carcinoma, Bronchogenic , Lung Neoplasms , Adult , Age Factors , Carcinoma, Bronchogenic/diagnosis , Female , Humans , Lung Neoplasms/diagnosis , Male , SmokingABSTRACT
Case records of 50 patients of superior vena caval obstruction in young adults treated and followed-up at Radiotherapy Department, Medical College Hospitals, Calcutta have been looked into. Twenty-eight out of these 50 patients had disease confined to mediastinum only during presentation. In consideration of the fact that the optimum management of superior vena caval obstruction depends upon a balance between just adequate pretreatment investigation and early institution of treatment, the various difficulties in the management discussed. With the existing infrastructural facilities, the institutional policy for the management of superior vena caval obstruction in young adults whose disease is confined to mediastinum only, during presentation, is described.
