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.

Common causes and trends of hepatocellular carcinoma at regional cancer centre Raipur, India

Background: Hepatocellular Carcinoma (HCC) is the most common primary malignancy of the liver and is the third most common cause of cancer related deaths in Asia-pacific region. Representative data on epidemiology of HCC in India is scanty and mostly from urban areas. It is more common in males then female. Hepatitis, alcohol consumption, aflatoxin and other hepatotoxins in diet are common causes. Authors did a study for the common causes and trends of the HCC registered at authors’ centre between January 2013 to November 2018.Methods: Authors analyzed their hospital data for the patient registered with the diagnosis of hepatocellular carcinoma at their centre during the study period for age, sex, number and causes.Results: Out of 23,766 patients registered for cancer in study period, 132 (0.55%) patients were of HCC, of which 89 (66.4%) were males and 43 (32.6%) were females, with ratio of 2:1. Commonest age group was between 50-59 years 46 (34.6%) followed by 40-49years 26 (19.5%). No patients were below 20 years of age. Among the commonest causes were alcohol consumption in 71 (53.4%), hepatitis B in 37 (27.8%), hepatitis C in 10 (7.5%), HIV in 4 (3%) and unknown in 11 (8.3%). There is rising trend in males and declining trend in females.Conclusions: Incidence of hepatocellular carcinoma is low among all cancer but has high mortality rate. Alcohol consumption and hepatitis were the commonest cause. It is common above 40 years specially in males