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Abstract Background Extraskeletal Ewings sarcoma are rare tumors for which there is no consensus on optimal management. Methods A retrospective review of the clinical features, treatment and outcome of patients with extraskeletal Ewings sarcoma who reported to a single institution between January 1992 – December 2003 is reported. Results A total of 19 patients with extraskeletal Ewings sarcoma were identified. Of these, 4 patients had metastatic disease at presentation and 15 patients with non-metastatic disease received combined modality treatment with primary combination chemotherapy followed by local treatment with radiotherapy or surgery. Disease free survival and overall survival for patients with non metastatic disease after combined modality treatment were 60% and 30% respectively. The significant predictors for prolonged disease free survival and overall survival were high haemoglobin(p = 0.002), low lactate dehydrogenase (p = 0.028), chemotherapy with Vincristine, Adriamycin, Cyclophosphamide, Ifosfamide and Etoposide regime (p = 0.008) and complete response to chemotherapy (p = 0.001). Conclusion Aggressive combination chemotherapy followed by complete surgery or radiotherapy to a dose of more than 50 Gy is essential to confer optimal outcome for patients with extraskeletal ewings sarcoma.

Context: Radiotherapy is the cornerstone of treatment in nasopharyngeal cancer (NPC); the addition of chemotherapy has shown improved results. Aims: To compare the results of concurrent chemoradiation with that of radiotherapy alone in NPC. Materials and Methods: One hundred and ninety consecutive NPC patients, without distant metastasis, who reported to the institute from January 1992 to December 2001, received external-beam radiation to 66 Gy in 33 fractions. Seventy-five of these patients received concurrent chemotherapy with cisplatin and 5-fluorouracil (5-FU) for four cycles. We compared the results of treatment in these two groups. Results: The 5-year disease-free survival rates were 40% and 60%, respectively, for patients who had radiotherapy alone and those who had chemoradiation (P = 0.002), while the median survival was 45 months and 60 months, respectively (P = 0.0028). Conclusion: A significant improvement in local control and survival was observed by the addition of concurrent chemotherapy with cisplatin and 5-FU to radical radiation in this nonrandomized study on patients with NPC. [ABSTRACT FROM AUTHOR]

Mr. P.S 47 year old male hailing from a middle class family of Thiruvullur district of Tamil Nadu, was apparently normal until 04th October, 2014 and was admitted to Kumaran Hospital, Chennai on 04th October, 2014 with chief complaints of breathlessness and general weakness. On 06th October, 2014 morning patient developed respiratory problems and shifted to ICU for further care and later a Tracheotomy was done to ease the breathing and to safe guard life of the patient. Later during the ICU stay, the ICU in-charge doctors and nurses found some changes in the behavior of the patient and the patient referred to Psychiatrist and Psycho-oncologist, psychiatrist diagnosed the problem as acute confusion stage with low Potassium and Sodium level. After two days of medical management psychooncologist met the patient and the patient reported high levels of anxiety and negative automatic thought associated with uncertainty in diagnosis, returning to normal speech and life, death anxiety, about family's future. During this time level of anxiety on HADS was 19. At this stage psycho-oncologist started thought distraction and imagery in the beginning and a week later thought diary also started to deal with anxiety associated with uncertainty about the diagnosis of the disease and negative automatic thought. After 3 weeks of continues and vigorous training the patient reported that the intensity and rate of negative automatic thought was decreased significantly and the score (TOTAL SCORE = 12) in HADS showed that there is a significant reduction in the level of anxiety. [ABSTRACT FROM AUTHOR]