European Journal of Medicine

4-10

Authors: Ashok Kumar Chauhan, Tinku Takia, Nupur Bansal, Paramjeet Kaur, Anil Khurana, Yashpal Verma

Background: The purpose of this study was to prospectively evaluate and compare the outcome of accelerated radiotherapy versus conventional chemoradiation in patients of head and neck cancers. Methods: The study was conducted on patients with squamous cell carcinoma of head and neck region. The patients were randomly divided into two groups. Patients were treated with radical external beam radiotherapy (EBRT). Group I was given accelerated radiotherapy with dose of 66 Gy/33 fractions/5.3weeks/6 fractions per week and Group II was given conventional radiotherapy with dose of 66 Gy/33 fractions/6.3weeks/ 5 fractions per week along with cisplatin weekly. The response of primary tumor and lymph node were assessed. Acute radiation reactions were assessed on weekly basis. All the patients were re-examined monthly after the completion of treatment and analysed till six months of follow up. Results: Patients were followed for six months after the completion of treatment. At the end of treatment, grade II & grade III acute skin reactions were seen in 53.3% of the patients in group I and 43.3% of the patients in group II. In group I, 63.3% of the patients experienced severe acute mucosal reactions, in comparison to 46.7% in group II. Overall the complete response was seen in 63.3% (19/30) of the patients in group I and in 73.3% (22/30) of the patients in group II. Conclusion: The arm with conventional treatment with weekly cisplatin has shown slightly better outcomes in terms of disease control and toxicity profile in comparison to the arm with accelerated radiotherapy.

17-28

Authors: Abhishek Soni, Nupur Bansal, Monica Verma, Vivek Kaushal, G K Jadhav, Sapna Manocha

Pure primary NGCO (non-gestational choriocarcinoma of ovary) is a type of ovarian germ cell tumor with elevated human chorionic gonadotrophin (hCG), posing diagnostic challenges in the patients of reproductive age group. Clinically and histopathologically, NGCO is indistinguishable from GCO. The both are differentiated on the basis of DNA polymorphism analysis and presence of mRNA for BMG (β2-microglobulin) in NGCO. Diagnostic criteria set by Saito et al helps to make a diagnosis of NGCO. It is possible to cure NGCO while preserving fertility, which is an important consideration as most are young age group patients. As these are rare tumors, recommendations for treatment of primary nongestational choriocarcinomas are not available. The principles of surgical management of NGCO are similar to the ovarian epithelial tumors. GCO is treated by methotrexate based chemotherapy, but some studies reported that NGCO is resistant to this chemotherapy, and it requires more aggressive combination chemotherapy as later has bad prognosis as compared to GCO. Various chemotherapy regimens are BEP, EMA/CO, EMA/EP, VAC etc. The serial quantitative measurement of urinary or serum β-hCG is essential for diagnosis, monitoring efficacy of the treatment, and follow-up of the patients. Role of radiation therapy is limited as a palliative setting in metastatic NGCO. In this article, we have tried to conclude the diagnostic methods and best possible treatment protocol.