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Background: Recently published prospective clinical trials and two meta-analyses have shown that addition of induction chemotherapy (IC) to concurrent chemoradiation (CRT) could potentially improve outcomes in comparison to CRT alone, in locoregionally advanced nasopharyngeal carcinoma (LANPC). Although it remains unclear which is the best IC regimen to be offered and for how many cycles. Unfortunately, till date, there are no published data from India regarding the outcomes of various commonly used IC regimens before CRT, in LANPC.Materials and Methods: Patients diagnosed with LANPC from January 2012 to December 2017, who received three cycles of IC before definitive CRT were reviewed retrospectively. Patients' profile, toxicity of IC, response rates, failure-free survival, and overall survival (OS) were evaluated.Results: A total 34 patients with LANPC who received IC were reviewed. The median age at diagnosis was 36 years, and the majority were males (67.6%, n = 23). Nineteen patients received IC with paclitaxel plus cisplatin regimen (TP) and the remaining 15 patients received IC with docetaxel/paclitaxel plus cisplatin plus 5-FU regimen (TPF). The overall response rates after three cycles of TP and TPF IC were 68.4% and 80%, respectively, and the corresponding rates were 84.2%and 93.3%, respectively, 2 months after completion of CRT. At a median follow-up of 24 months, 2-year failure-free survival and OS for TP arm were 78.9% and 89.5%, and the corresponding rates for TPF arm were 86.7% and 93.3%, respectively. All Grade III-IV toxicities were numerically higher with triplet IC regimen in comparison to doublet regimen.Conclusion: In this retrospective analysis, there was no significant difference between taxane-based doublet and triplet IC regimens, in terms of survival outcomes, although Grade III-IV toxicities were numerically higher with triplet IC regimen. Clearly, these hypothesis-generating findings should be tested in a prospective randomized setting. [ABSTRACT FROM AUTHOR]

Background: During the treatment of diffuse large B-cell lymphoma (DLBCL) patients, treatment-related toxicities are higher in the initial phase of treatment (First cycle effect). Toxicities can be tumor lysis syndrome, deterioration in performance status, febrile neutropenia, and rarely mortality. Prephase treatment before definitive chemotherapy is used in European countries to alleviate these toxicities. Methods: This was a non-randomized study carried out with the aim to evaluate the role of prephase treatment given prior to definitive chemotherapy in newly diagnosed DLBCL patients. Patients were divided into 2 cohorts "prephase cohort" and "non-prephase cohort." Prephase cohort received prephase treatment consisting of vincristine (1 mg) on -6th day and prednisolone 100 mg daily for 7 days (-6th day to day 0). Prephase treatment was followed by CHOP/R-CHOP chemotherapy on day 1. Non-prephase cohort received chemotherapy without prephase. Both groups were followed up for 30 days post-first cycle chemotherapy. Results: A total of 100 patients with DLBCL (50 in each cohort) were enrolled. There was a significant improvement in performance status of the patients who received prephase. A majority of 92% patients attained ECOG performance status of either 0 or 1 before starting chemotherapy in the prephase cohort. Febrile neutropenia was lower (16%) in the prephase cohort as compared with the non-prephase cohort (34%; P = .037). Conclusion: Prephase treatment prior to definitive chemotherapy (CHOP ± Rituximab) improves the performance status and decreases first cycle effect in DLBCL patients. [ABSTRACT FROM AUTHOR]

Introduction: Bone metastasis is a rare site of metastasis, seen in only 3.7-11% of clinical cases. Isolated bone involvement has been reported very rarely in literature. Moreover, the patients who have bone metastasis at presentation are even rare.Objectives: To discuss the demographic characteristics, carcinoembryonic antigen (CEA) levels, pattern of bone involvement, and their correlation with survival in patients of colorectal cancer that have bone metastasis at the time of presentation.Materials and Methods: Retrospectively, tumor registry was analyzed for the cases of colorectal cancer presenting with bone metastasis between 2008 and 2013. Survival curves were generated by Kaplan-Meier method and analyzed using the log-rank test.Results: Ten such patients were identified (male:female = 7:3) of the total 410 patients. Median age was 41 years (22-50 years). All patients were Conclusions: In this study, the patients of colorectal cancer presenting with bone metastasis were of male sex and younger age. The factors that were associated with reduced survival were extraosseous and liver involvement. [ABSTRACT FROM AUTHOR]

BACKGROUND: Diabetes mellitus (DM) and cancer are common causes of morbidity and mortality. This study was designed to retrospectively study from hospital data the treatment outcome in three common cancers among our diabetic population. METHODOLOGY: Patients with histologically-proven breast, lung, or colorectal cancers were analyzed. Patients were stratified into those with or without diabetes. Duration of diabetes, end-organ damage and glycemic control were recorded from the case records. "Response Evaluation Criteria In Solid Tumors. (RECIST) criteria were used to assess response. Common Toxicity Criteria, version 3.0, was used to assess toxicity. Disease-free and overall survival, as well as toxicity, were calculated for both groups and compared using the Student's t test. RESULTS: A total of 119 diabetic patients who presented to the department of medical oncology over a 6-year period between 2000 and 2005, and who met the inclusion criteria, were analyzed. One control was chosen for each case randomly from the same population. Both groups were matched for baseline characteristics. The mean duration of diabetes was 2.6 years in the present study. Diabetics have significantly lower response rates and poor overall and disease-free survival. The toxicity profile is not different in both the groups. CONCLUSION: Our data supports the concept that DM is associated with an increase in mortality and poor response rates. This mechanism is probably independent of the glycemic control, comorbid conditions, or the treatment modality used for control of diabetics. We did not find any significant increase in the complication rates in our diabetic patients. The possible reason for this clinical paradox could be the relatively good glycemic control: all the diabetics in the present study have near-normal blood sugar levels throughout. [ABSTRACT FROM AUTHOR]

Background: Surgical excision is the mainstay of treatment for oral cavity squamous cell cancers (OSCCs). The median survival of locally advanced unresectable OSCCs (T4b and technically unresectable T4a) with various non-surgical treatment modalities is only 2-12 months. We hypothesized that induction chemotherapy (IC) in this subgroup of patients could improve the overall treatment outcome by reducing the tumor bulk and allowing definitive surgery. Methods: Patients diagnosed with locally advanced unresectable OSCCs (T4b and technically unresectable T4a) from January 2013 and May 2017 at our center, who received 2-3 cycles of IC and then assessed for resectability, were reviewed retrospectively. After IC, patients were reassessed clinico-radiologically and planned for either definitive surgery with adjuvant CTRT or non-surgical treatment including definitive CTRT, palliative RT or best supportive care (BSC). The inclusion criteria were: age ?18 years, pathologically proven OSCC, ECOG PS ?2; and adequate organ functions. Major exclusion criteria were: previous therapy for OSCC, congestive cardiac failure and evidence of metastatic disease. Patients received either TP (paclitaxel 175 mg/m2 on day 1, and cisplatin 75 mg/m2 on day 1) or TPF (paclitaxel 175 mg/m2 /docetaxel 75 mg/m2 on day 1, cisplatin 75 mg/m2 on day 1, and 5?FU 750 mg/m2/d on days 1 to 5) as IC, every 3 weeks along with primary G?CSF prophylaxis. Responses to IC were reported according to RECIST 1.1. Adverse events were classified based on CTCAE v 4.0. Statistical analyses were performed by SPSS version 17. Results: Total 206 patients received either TP (n=180) or TPF (n=26) as IC. The median age was 44 years (range, 35-62); 78.2% were males; ECOG PS 0?1/2, 100%/0%; site of primary tumor buccal mucosa/gingivo-buccal complex/oral tongue, 73.8%/21.4%/4.8%; primary tumor grade I/II/III, 53.4%/38.8%/7.8%. Responses to IC were as follows: partial response in 31 (15%) patients, stable disease in 140 (68%) patients and disease progression in 35 (17%) patients. All grade 3-4 toxicities were higher with TPF than TP regimen: neutropenia (30.8% vs. 12.2%), febrile neutropenia (19.2% vs. 4.4%), mucositis (15.4% vs. 6.1%) and diarrhea (11.5% vs. 2.8%). Post-IC, resectability was achieved in 35 (17%) patients (7 in TPF arm and 28 in TP arm); but 9 of them did not undergo surgery due to logistic reasons. The median survival of patients who underwent definitive surgery followed by adjuvant CTRT (n=26, 12.6%) was 19.4 months (95% CI: 16.4-22.3) and for those treated with non-surgical local therapy (n=180) was 7.6 months (95% CI: 6.2-8.8) (log-rank p = 0.000). Conclusions: This study suggests that IC is effective in converting locally advanced unresectable OSCCs to operable disease in a significant proportion of patients and has the potential to improve survival outcomes in that patient population, in comparison to non-surgical treatment. [ABSTRACT FROM AUTHOR]