RESUMEN
To report the outcomes of patients with head and neck squamous cell cancers (HNSCC) who received radiotherapy as a part of their first line treatment. All patients treated with radiotherapy for HNSCC between 2013 and 2017 were retrospectively identified from the department records. Patients with follow-up of less than 3 months following primary treatment were excluded. The demographic, disease and outcome details were retrieved from the patients' hospital records. The disease free survival (DFS) was estimated with Kaplan-Meier analysis, and effect of different variables on DFS were compared using log-rank test. The late toxicities of treatment were also recorded and reported. A total of 311 patients were found to be eligible. Most patients were males (82%), and oral cavity cancers predominated (45.3%). 237 patients (76.2%) had locally advanced disease at presentation. Radiotherapy was used as definitive treatment for 152 patients (48.9%). At a median follow up of 14.8 months (range: 3-85.2 months), the estimated Disease-Free Survival (DFS) was 52.7 months (95%CI: 37.7-67.7 months). Locally advanced disease correlated with a significantly lower median DFS (61.2 vs. 32.8 months; p = 0.01), but other factors, including gender, use of concurrent chemotherapy and adjuvant vs definitive radiotherapy appeared to have no statistical association with DFS. 181 (58.2%) patients had chronic RT-related toxicities at last follow-up, but most were generally mild, most frequently subcutaneous fibrosis (48.6%, which occurred significantly more frequently in patients receiving adjuvant RT following surgery- 40.8% versus 57.2%; p = 0.03) and xerostomia (32.4%). Radiation induced osteoradionecrosis was rare, occurring in only three (1%).Most HNSCC patients present with locally advanced disease, where disease control remains poor. Though there is substantial toxicity following treatment, the risk of severe toxicities with modern radiotherapy is low.
RESUMEN
The commonest procedure for adult diaphyseal femoral fractures is intramedullary nailing. A thorough preoperative examination of facture pattern and its morphology are necessary. Previous studies are non-homogenous and with conflicting results. So the study was planned to find out, any relation between femur and forearm plus little finger length and its association with height/ arm span and upper segment/lower segment ratios in an individual, with its statistical validity. The study was carried on 75 male and 75 female students of more than 18 years of age, studying at AIIMS Rishikesh after taking their informed consent and ethical approval. The forearm plus hand length and the length offemur were measured as per protocol, by simple measuring tape. The mean forearm plus hand length and the length of femur were 42.85 (SD, ±1.87) and 45.88 (SD, ±2.95) cm, respectively with the mean difference between these 2 measurements of -3.03 (95% CI, -3.83 to -2.22) cm, in male and 39.56(SD, ±1.68), 40.96 (SD, ± 2.75) cm and -1.400 (95% CI, -1.917 to -0.883) cm in female volunteers. The Pearson correlation co efficient and p value 0.575, 0.0001 and 0.585, 0.0001 in male and female respectively. There was no significant variation with height, upper segment and lower segment ratios. So we conclude that there is extremely significant correlation between the forearm plus hand length and the length of femur of the individuals. The forearm plus hand length represents the maximum length of the nail to be used in femur. The length of the femur nail can be definitely predicted by the forearm plus hand length in both sexes but it has to be different in both, for the same femoral fracture and there is no significant variation in the femur length with height, upper segment and lower segment variation in the same individ
