Search

Background and Objectives: Metronomic chemotherapy is a treatment regimen which involves the administration of low-dose chemotherapy frequently with shorter drug-free intervals. In India, a majority of the patients diagnosed with cancer present to the health-care providers at an advanced stage. Moreover, they are often from the lower socioeconomic strata with limited access to health care. Metronomic chemotherapy is a convenient, minimally toxic, and economically viable treatment option whose potential should be explored. Materials and Methods: We retrospectively reviewed the data of 100 patients diagnosed with cancer who received metronomic chemotherapy in a tertiary cancer care center. The records of all the patients who visited the cancer care center between September 2015 and February 2017 were reviewed. Data on age, sex, address, diagnosis with staging, sequence of prior treatment received, and duration of metronomic chemotherapy, reasons for discontinuing metronomic chemotherapy, response, toxicity profile, and outcome were collected and analyzed. The statistical analysis was performed using SPSS statistics software, version 23.0. The survival analysis was done using the Kaplan–Meier survival analysis. Results: The mean age of patients was 53.75 years (32–92 years). About 60% were in Stage 4. With therapy, 79% improved, 16% deteriorated, and 5% were stable in their symptom profile. The mean disease progression-free survival was 232 days, while the overall survival was 310 days. Interpretation and Conclusion: Metronomic therapy is a feasible option in the palliative care setting. It does not require stringent monitoring, as it has a well-tolerated side effect profile when compared to conventional chemotherapy. Its utility in patients being treated with curative intent and the criteria for response assessment with low-cost imaging has to be explored. [ABSTRACT FROM AUTHOR]

A young male patient was diagnosed to have laryngeal papillomas at the age of 3 years for which he underwent permanent tracheostomy and also multiple surgical and laser excision procedures. Then, later in life, the patient had progressive breathlessness and dysphagia. On examination, he had supraclavicular lymphadenopathy showing squamous carcinoma pathology. Since laryngeal papillomas have a high propensity to transform into laryngeal squamous cell carcinoma, he was first evaluated for laryngeal carcinoma which was negative. Esophagoscopy showed a growth in the esophagus, the biopsy of which was positive for squamous malignant cells. Patient was then started on palliative chemotherapy with combination of paclitaxel and carboplatin, and at progression with weekly nanoxel with stable disease. This is a rare case of childhood laryngeal papillomatosis progressing to metastatic esophageal carcinoma. This case has been presented to highlight the fact that patients with laryngeal papillomas are not only at high risk of progressing to laryngeal carcinoma but can also have other malignancies of the upper aerodigestive tract and lung. Most of them have been correlated to human papilloma virus (HPV), but in our patient HPV DNA was negative. [ABSTRACT FROM AUTHOR]

The Immune Reconstitution Inflammatory Syndrome (IRIS) is an exaggerated pathological inflammatory reaction which occurs after the initiation of the antiretroviral therapy, due to the exuberant immune responses to the occult or the apparent opportunistic infections. The hallmark of the syndrome is the paradoxical worsening of an existing infection or a disease process or the appearance of a new infection or a disease process soon after the initiation of the antiretroviral therapy. The most common forms of IRIS occur in association with tuberculosis and chronic viral and invasive fungal infections. Multiple IRIS in a patient is extremely rare. Our patient had multiple manifestations of IRIS, in the form of cryptococcal meningitis, toxoplasmosis and Cytomegalovirus (CMV) retinitis after the initiation of highly active antiretroviral therapy. [ABSTRACT FROM AUTHOR]

Background: Anticancer therapies causes decreased respiratory function, quality of life and functional capacity in head and neck cancer patients. Patients receiving these cancer therapies suffer from fatigue which causes decrease in functional capacity and quality of life. The objective of this present study was to determine and compare the effect of exercise training on fatigue, functional capacity and quality of life in head and neck cancer patients receiving various anticancer therapies., Method: A total of 45 subjects were included based on inclusion and exclusion criteria. 6-minute walk test, brief fatigue inventory (BFI) and functional assessment of cancer therapy- general (FACT-G) was used to measure the functional capacity, fatigue and quality of life respectively at baseline and post intervention. Participants received exercise intervention for six weeks (three days a week) for 40 min. Exercise intervention is delivered by a qualified physiotherapist from the Department of Physiotherapy., Results: The result of this study shows that there was highly significant improvement in six-minute walk distance pre and post intervention in chemotherapy (33.75+21.55, p=0.000), radiation therapy (39.69+25.46, p=0.000) and chemoradiotherapy (32.06+16.49, p=0.000) within the group. Similarly, significant improvement was also seen in quality of life within the groups, chemotherapy (2.92+2.43, p=0.002), radiation therapy (6.06+3.13, p=0.000) and chemo radiotherapy (5.65+6.93, p=0.004). There was significant reduction in fatigue in chemotherapy (6.92+11.07, p=0.045), radiation   therapy (12.38+7.28, p=0.000)   and   chemo   radiotherapy (11.47+8.89, p=0.000). No significant improvement was noted between the groups for six- minute walk distance (p=0.784), quality of life (p= 0.058) and reduction in fatigue (p=0.065)., Conclusion: This study concluded that exercise training is effective in improving functional capacity, quality of life and reducing fatigue in head and neck cancer patients receiving various anticancer therapies.