Relationship between molecular markers and treatment response in a retrospective cohort of Indian patients with primary carcinoma of the larynx.

p53 Mutations and over expression have been shown to predict treatment response in head and neck cancer patients. Failure of organ sparing therapy has been attributed to cisplatin and radiotherapy resistance in carcinoma of the larynx patients. In this study, we evaluate the relationships between p53 over expression/mutations, bcl(2) expression and ploidy status in a retrospective cohort of responder and non-responder carcinoma of the larynx patients. Tissue samples from 22 patients with histopathologically confirmed carcinoma of the larynx and matched for age, stage, node status and treatment regimen, were analysed from our tissue biorepository. Differences in the above molecular markers were analysed between the responders and non-responders to conventional treatment. p53 and bcl(2) over expression was checked by IHC and p53 mutation by PCR and direct sequencing. DNA ploidy and S-phase fractions were also analysed. Chi square analysis was used to identify changes in proportions of these markers in responders and non-responders and likelihood ratio test was done to determine the best predictor biological marker for treatment response. Bivariate relationships were determined between these variables using Spearman's rank correlation. Node negativity at time of diagnosis (p=0.05), p53 mutation (p=0.02) and bcl(2) negativity (p=0.05) are some of the factors that are known to influence treatment response in our study. p53 over expression, S-phase fractions and ploidy status did not seem to influence treatment response. There was a significant inverse correlation between stage of cancer (p=0.03) and node positivity (p=0.06) with bcl(2) positivity. There was an inverse correlation between mutation category to treatment response (p=0.01). The results suggest p53 mutations to be a promising marker in predicting treatment response in carcinoma of the larynx patients.

Effects of an integrated yoga programme on chemotherapy-induced nausea and emesis in breast cancer patients.

This study examined the effect of an integrated yoga programme on chemotherapy-related nausea and emesis in early operable breast cancer outpatients. Sixty-two subjects were randomly allocated to receive yoga (n = 28) or supportive therapy intervention (n = 34) during the course of their chemotherapy. Both groups had similar socio-demographic and medical characteristics. Intervention consisted of both supervised and home practice of yoga sessions lasting for 60 min daily, while the control group received supportive therapy and coping preparation during their hospital visits over a complete course of chemotherapy. The primary outcome measure was the Morrow Assessment of Nausea and Emesis (MANE) assessed after the fourth cycle of chemotherapy. Secondary outcomes included measures for anxiety, depression, quality of life, distressful symptoms and treatment-related toxicity assessed before and during the course of chemotherapy. Following yoga, there was a significant decrease in post-chemotherapy-induced nausea frequency (P = 0.01) and nausea intensity (P = 0.01), and intensity of anticipatory nausea (P = 0.01) and anticipatory vomiting (P = 0.05) as compared with the control group. There was a significant positive correlation between MANE scores and anxiety, depression and distressful symptoms. In conclusion, the results suggest a possible use for stress reduction interventions such as yoga in complementing conventional antiemetics to manage chemotherapy-related nausea and emesis.