A case report of all-trans retinoic acid-induced pseudotumor cerebri in an adult patient of acute promyelocytic leukemia

All-trans retinoic acid (ATRA), a derivative of vitamin A, is the first line drug for acute promyelocytic leukemia (APL). At the same time, ATRA is also associated with various side effects, including some life threatening conditions. We describe a case of ATRA-induced pseudotumor cerebri in an adult patient of APL

Sudden hearing loss in a patient of Hodgkin’s lymphoma following vinblastine chemotherapy: a rare case report and review of the literature

Ototoxicity is a well-known complication of certain chemotherapeutic agents. There have been few reports of ototoxicity following administration of vincristine. However, vinblastine has seldom been implicated causing ototoxicity. We report a case of sudden bilateral hearing loss in a 32-year-old male patient of classical Hodgkin’s lymphoma following standard adriamycin, bleomycin, vinblastine, dacarbazine chemotherapy

A comparative study of weekly versus daily schedule of hypofractionated palliative radiotherapy with concurrent chemotherapy in the treatment of locally advanced head and neck cancer

Background:Most head and neck cancer cases and deaths are due to both individual predispositions linked to certain genetic characteristics, and exposure to carcinogens caused by lifestyle behaviors. We compared weekly versus daily schedule of hypofractionated palliative radiotherapy with concurrent chemotherapy in the treatment of locally advanced head and neck cancer.Materials & Methods:Fifty patients, randomly selected were divided in to two groups of 25 patients each. Group A: - These patients received injection Cisplatin 40 mg/m 2 given intravenously 2 hrs infusion six hour before radiation and repeated weekly for 6 cycles. Group B: - This group consisted of randomly selected, previously untreated 25 patient of squamous cell carcinoma of head and neck. Thesepatients received injection Cisplatin 40mg/m 2 given intravenously 2 hrs infusion six hour before radiation and repeated weekly for 3 cycles. Results: Incidence of well differentiated histology was 20% in both arm, poor differentiated was 8 % and 4% respectively in arm-A and Arm-B, undifferentiated was 52% and 44% respectively in arm-A and arm-B. It was observed that moderately differentiated squamous cell carcinoma was the commonest in both arm-A and arm-B i.e. 13(52%) in arm-A and 11(44%) in arm-B. The P value was insignificant in each group. Among the arm-A and arm-B the complete response is 20% and 36% (χ2 = 4.571, p=0.032), the partial response is 52% and 44% (χ2 = 0.667, p=O.414). Stable disease in the arm-A and in arm-B was 12% and 8% (χ2 = 0.800, p=O.371) respectively and progressive disease was 16% and 12% respectively (χ2 = 0.571 p=O.449).Conclusion: Hypofractionated radiotherapy with either 600cGy per fraction given weekly or 300cGy per fraction given daily along with concurrent chemotherapy are feasible options for palliation in advanced head and neck cancers. 300cGy given daily schedule is associated with slightly higher acute reactions but increases the chances of complete response. The 300cGy daily arm patients completed treatment in 3 weeks as against 6 weeks for 600cGy weekly arm. 600cGy weekly radiotherapy given on Saturday is a feasible alternative to daily 300cGy schedule with lesser burden to the busy radiotherapy department

Scattered radiation to gonads: Role of testicular shielding for para-aortic and homolateral illiac nodal radiotherapy

AbstractBackgroundScattered radiation to organs at risk deserves great attention during radiotherapy especially when the concern is about fertility. Minimizing the delivery of scattered radiation to the gonads while treating abdominal nodes or pelvic fields in male patients requires adequate shielding of the testes to preserve testicular functions. We constructed a testicular shield with cerrobend for the purpose of treatment of seminoma of testis stage I and IIA disease.Materials & methodsAn outer shell of coconut of required dimensions was taken as a base over which cerrobend was poured to obtain two semi-spherical half testicular shields. Five patients of seminoma early stage (stage I and IIA) were treated with this testicular shield.ResultsThe estimated total dose received by the testis by scatter radiation after completion of the treatment was 0.115Gy (0.28%) of total mid-plane dose of 40Gy delivered by inverted Y field. At a distance of 8cm from the inferior field border the 2cm thick cerrobend testicular shield provided a shielding factor of 3.2/0.3=10.33.ConclusionsWith proper testicular shielding, doses as low as 0.28% of the prescribed dose can be achieved. This low dose is believed to maintain the fertility of the patient