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BACKGROUND AND AIM: Definitive chemoradiation (dCRT) is the standard treatment for locally advanced inoperable esophageal cancer. The aim of this study is to analyze the effect of dCRT combined with paclitaxel and carboplatin (TC) against cisplatin (CDDP) with radiation. METHODS: The study population included patients with locally advanced inoperable esophageal cancer seeking treatment at our center from March 2013 to December 2017. Case records from 66 patients were extracted. The toxicity profile of patients who received TC or CDDP was reported and analyzed. A Chi-square test and students t-test were used to analyze the categorical, and the continuous variables, respectively. The KaplanMeier method was used to estimate the survival probability. A log-rank test was applied to compare the survival differences between the two groups. RESULTS: The overall survival (OS) did not differ at 3 years between the TC and CDDP (p = 0.286). The median survival duration was 13 months for CDDP and 18 months for TC. The toxicity profile like emesis (93% CDDP vs. 25% TC), neutropenia (79% CDDP vs. 13% TC), thrombocytopenia (10% CDDP vs. 17% TC) and dyselectrolytemia (71% CDDP vs. 8% TC) were compared between the two treatment groups and found to be more in CDDP group. CONCLUSION: The treatment of patients with locally advanced esophageal carcinoma with dCRT and TC showed an improved toxicity profile, but similar OS compared to CDDP. Applying dCRT with TC could be an alternate regimen for locally advanced inoperable esophageal cancer patients. RELEVANCE FOR PATIENTS: Concurrent chemoradiation with TC regimen can be considered as an alternative for cisplatin as it shows equivalent survival and reduced toxicity profile.
RESUMO
BACKGROUND: Nimotuzumab is a monoclonal antibody against epidermal growth factor receptor which can be combined with chemotherapy and radiotherapy for the treatment of locally advanced unresectable squamous cell carcinoma of head-and-neck region and its role has already been established in India. AIM: The aim of this case report is to show the role of nimotuzumab in carcinoma hypopharynx. METHODS: We report a patient with Stage III carcinoma of hypopharynx, who received radiotherapy along with weekly nimotuzumab due to his comorbidities. The patient had tolerated the treatment very well without any major side effects. RESULTS: The patient is on regular follow-up with a complete response (CR) of the disease and with the disease-free interval (DFI) of 7 months. CONCLUSIONS: Nimotuzumab along with radiotherapy can be safely given in the patients with carcinoma hypopharynx, who are ineligible for chemotherapy. RELEVANCE FOR PATIENTS: Nimotuzumab can be added with radiotherapy to the patients with head-and-neck malignancies who are ineligible for chemotherapy to improve the clinical outcome with minimal toxicity.
RESUMO
BACKGROUND AND AIM: Primary spinal cord glioblastoma multiforme (GBM) is a rare clinical condition and is often associated with a dismal prognosis. The standard treatment is maximal safe surgery followed by adjuvant radiotherapy and chemotherapy. Despite such aggressive treatments, the median survival is estimated to be around 15 months in several studies. We report three patients with primary spinal GBM who received treatment in our institute from 2012 to 2019. Among the three, one patient is on long-term follow-up with no evidence of disease, another patient succumbed to the illness and the third patient is having stable disease. RELEVANCE FOR PATIENTS: Although primary spinal GBM is usually associated with a dismal prognosis, our case series shows a subset of patients will have a favorable outcome with the protocol treatment.