HPV positive oropharyngeal cancer and treatment deintensification: How pertinent is it?

In recent years there has been change in trends in the incidence of head and neck squamous cell carcinoma (HNSCC) with oropharyngeal carcinoma (OPC) showing an increased incidence, attributable specifically to infection by human papillomavirus (HPV). At the same time there is change in demographic characteristics and prognosis of this subset of HNSCC. Considering the better prognosis, researchers are trying to reduce the acute and long-term toxicities by alteration of various components of treatment protocols. Although treatment deintensification is an option for this group of patients, there is no standard protocol available and should be tried only in the protocol setting

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Not AvailableFingerling rearing of pengba, Osteobrama belangeri, was conducted at varied densi-ties for 90 days in 12 outdoor concrete tanks (10 m × 5 m × 1 m). The tanks, grouped into four triplicated treatments, were stocked with fry at 20, 30, 40 and 50 fry m-3; and designated as control, T-1, T-2 and T-3 respectively. Tanks were filled up to 90 cm depth. Evaporation loss compensated fortnightly. Fish sampling and monitoring of water quality parameters done at fortnight intervals. Survival varied between 71.5% and 84.0% in treatments. Both survival and total length significantly reduced with increasing densities from control to T-2 (p .05). Similarly, significant reductions in final body weight and specific growth rate were observed with increased densities and these values further reduced in T-3 than T-2 (p < .05). Such results corroborated the inverse relationship between stocking density and growth. Gross biomass yields in two higher densities (T-2 and T-3), despite their lower survivals, were significantly higher than the two lower densities. The numbers of fingerlings harvested were 35, 74 and 112% higher than the control in T-1, T-2 and T-3 respectively. The lowest size obtained even at the highest density (T-3) was of 7.0 ± 1.0 cm and 3.99 ± 0.17 g, which can be considered as ideal grow-out stocking size of pengba. Therefore, the study showed feasibility of stocking up to 50 fry m-3 for rearing from fry to fingerling stage. However, the other lower densities may be used in case of requirement of larger fingerlings.Not Availabl

In vitro antibacterial activity of crude extracts of 9 selected medicinal plants against UTI causing MDR bacteria

Urinary tract infection (UTI) has become a more grievous problem today, due to multidrug resistance of infecting Gram-positive (GP) and Gram-negative (GN) bacteria, sometimes even with multiple infections. This study examines effectivity of 9 tropical flowering plants (Anogeissus acuminata, Azadirachta indica, Bauhinia variegata, Boerhaavia diffusa, Punica granatum, Soymida febrifuga, Terminalia chebula, Tinospora cordifolia and Tribulus terrestris) for possible use as source of antimicrobials for multidrug resistant (MDR) bacteria, along with main-stream antibiotics. Pathogenic bacteria were isolated from urine samples of patients attending and admitted in the hospital. Antibiograms of 11 isolated bacteria (GPs, Enterococcus faecalis and Staphylococcus aureus; and GNs, Acinetobacter baumannii, Citrobacter freundii, Enterobacter aerogenes, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris and Pseudomonas aeruginosa) were ascertained by the disc-diffusion method, and antibacterial effectivity of plant extracts was monitored by the agar-well diffusion method. Isolated bacteria were floridly MDR to most antibiotics of the day. Methanol extracts of 9 plants were used, and extracts of 3 plants, A. acuminata, P. granatum and S. febrifuga at least caused 25–29 mm as the maximum size of zone of inhibition on bacterial lawns. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of methanol extracts of 9 plants were recorded. The methanol extract of A. acuminata had 0.29 mg/ml as the lowest MIC value and 0.67 mg/ml as the lowest MBC value, against MDR S. aureus, signifying effectivity; but, it had the highest MIC value of 3.41 mg/ml. and the highest MBC value of 4.27 mg/ml for most other MDR bacteria including E. coli. Qualitative phytochemical analysis was done for these 9 plants and information on leading phytochemicals was presented retrieved from PubChem database. Thus, three effective-most plants in controlling MDR-UTI bacteria in vitro were A. acuminata, P. granatum and S. febrifuga, which can be promoted as complementary medicine

Human papillomavirus in head and neck cancer in India: Current status and consensus recommendations

Human papillomavirus (HPV) associated head and neck squamous cell cancers (HNSCC) have become increasingly common in the West, but the same cannot be said about India. These cancers have a different biology and confer a better prognosis, however, its current role in the management of patients in India is not clearly defined. At the 35th Indian Cooperative Oncology Network conference held in September 2016, a panel of radiation, surgical and medical oncologists, pathologists, and basic scientists from across the country having experience in clinical research with respect to HPV in HNSCC reviewed the available literature from India. All the ideas and facts were thereafter collated in this report. Various topics of controversy in dealing with the diagnosis and management of HPV-associated HNSCC have been highlighted in this report in context to the Indian scenario. Furthermore, the prevalence of the same and its association with tobacco and high-risk sexual behavior has been touched on. Conclusively, a set of recommendations has been proposed by the panel to guide the practicing oncologists of the country while dealing with HPV-associated HNSCC

Results of Phase III Randomized Trial for Use of Docetaxel as a Radiosensitizer in Patients With Head and Neck Cancer, Unsuitable for Cisplatin-Based Chemoradiation

PURPOSE There is a lack of published literature on systemic therapeutic options in cisplatin-ineligible patients with locally advanced head and neck squamous cell carcinoma (LAHNSCC) undergoing chemoradiation. Docetaxel was assessed as a radiosensitizer in this situation.METHODS This was a randomized phase II/III study. Adult patients (age a-18 years) with LAHNSCC planned for chemoradiation and an Eastern Cooperative Oncology Group performance status of 0-2 and who were cisplatin-ineligible were randomly assigned in 1:1 to either radiation alone or radiation with concurrent docetaxel 15 mg/m2 once weekly for a maximum of seven cycles. The primary end point was 2-year disease-free survival (DFS).RESULTS The study recruited 356 patients between July 2017 and May 2021. The 2-year DFS was 30.3% (95% CI, 23.6 to 37.4) versus 42% (95% CI, 34.6 to 49.2) in the RT and Docetaxel-RT arms, respectively (hazard ratio, 0.673; 95% CI, 0.521 to 0.868; P value =.002). The corresponding median overall survival (OS) was 15.3 months (95% CI, 13.1 to 22.0) and 25.5 months (95% CI, 17.6 to 32.5), respectively (log-rank P value =.035). The 2-year OS was 41.7% (95% CI, 34.1 to 49.1) versus 50.8% (95% CI, 43.1 to 58.1) in the RT and Docetaxel-RT arms, respectively (hazard ratio, 0.747; 95% CI, 0.569 to 0.980; P value =.035). There was a higher incidence of grade 3 or above mucositis (22.2% v 49.7%; P &lt;.001), odynophagia (33.5% v 52.5%; P &lt;.001), and dysphagia (33% v 49.7%; P =.002) with the addition of docetaxel.CONCLUSION The addition of docetaxel to radiation improved DFS and OS in cisplatin-ineligible patients with LAHNSCC.</p

Results of Phase III Randomized Trial for Use of Docetaxel as a Radiosensitizer in Patients With Head and Neck Cancer, Unsuitable for Cisplatin-Based Chemoradiation

PURPOSE There is a lack of published literature on systemic therapeutic options in cisplatin-ineligible patients with locally advanced head and neck squamous cell carcinoma (LAHNSCC) undergoing chemoradiation. Docetaxel was assessed as a radiosensitizer in this situation.METHODS This was a randomized phase II/III study. Adult patients (age a-18 years) with LAHNSCC planned for chemoradiation and an Eastern Cooperative Oncology Group performance status of 0-2 and who were cisplatin-ineligible were randomly assigned in 1:1 to either radiation alone or radiation with concurrent docetaxel 15 mg/m2 once weekly for a maximum of seven cycles. The primary end point was 2-year disease-free survival (DFS).RESULTS The study recruited 356 patients between July 2017 and May 2021. The 2-year DFS was 30.3% (95% CI, 23.6 to 37.4) versus 42% (95% CI, 34.6 to 49.2) in the RT and Docetaxel-RT arms, respectively (hazard ratio, 0.673; 95% CI, 0.521 to 0.868; P value =.002). The corresponding median overall survival (OS) was 15.3 months (95% CI, 13.1 to 22.0) and 25.5 months (95% CI, 17.6 to 32.5), respectively (log-rank P value =.035). The 2-year OS was 41.7% (95% CI, 34.1 to 49.1) versus 50.8% (95% CI, 43.1 to 58.1) in the RT and Docetaxel-RT arms, respectively (hazard ratio, 0.747; 95% CI, 0.569 to 0.980; P value =.035). There was a higher incidence of grade 3 or above mucositis (22.2% v 49.7%; P &lt;.001), odynophagia (33.5% v 52.5%; P &lt;.001), and dysphagia (33% v 49.7%; P =.002) with the addition of docetaxel.CONCLUSION The addition of docetaxel to radiation improved DFS and OS in cisplatin-ineligible patients with LAHNSCC.</p