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.

ICAR: endoscopic skull‐base surgery

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A COMPARISON OF PROPOFOL VERSUS SEVOFLURANE FOR SUPRAGLOTTIC AIRWAY DEVICE INSERTION

Background: The supraglottic airway device (Thermoplastic Elastomer) has gained wide spread popularity for airway management during surgery. Present study aimed to compare the conditions for supraglottic  airway device (Thermoplastic Elastomer) following induction of anaesthesia with inhalation of Sevoflurane or intravenous induction with Propofol. Material & Method: Present observational study was conducted in the Department of Anaesthesia at Command Hospital (Air Force) Bengaluru after obtaining permission from the Institutional Ethical Committee. A total of 140 patients with consenting candidates who satisfy necessary inclusion/exclusion criteria during the 18 Months period between May 2020 to Nov 2021. Patients were randomized into one of the two groups as Group P: Propofol and Group S: Sevoflurane of twenty five each for induction of anaesthesia. Both groups receive IV Lignocaine (2 ml of 1%) before induction of anaesthesia. The grading condition for insertion between the groups were noted and compared using appropriate statistical tool using SPSS v21 operating on windows 10. Results: In present study total of 140 patients included who were divided into two groups with 70 patients in each group. There was no significant difference in the mean age of patients between propofol group and sevoflurane group. Overall propofol group had the better performance compared to the sevoflurane group. There was higher incidence of repeat administration in the sevoflurane group (2.9%) compared to propofol group (1.4%), which was statistically insignificant Conclusion: The present study found comparable results for supraglottic airway device (Thermoplastic Elastomer) following induction of anaesthesia with inhalation of Sevoflurane or intravenous induction with Propofo