Vijayakumar S

Abstract

Introduction:  The third most frequent type of cancer in the world is cervical cancer. Traditionally cervical cancer treatment is carried by either Radiation therapy alone and/or with chemotherapy. High doses of Radiation therapy can cause gastric enteritis.  Objective:  To study the incidence of radiation enteritis in cervical cancer patients of stage upto IIIA. Materials and Methods:  A total of 94 patients receiving radiation therapy (RT) for cervical cancer treatment were enrolled for the study in our hospital from August 2018 to January 2020. The 94 patients were divided into definitive RT group (64 patients) and Adjuvant RT group (30 patients). The incidences of radiation enteritis were evaluated statistically. Results: In all cervical cancer patients, early radiation enteritis (RE) observed in 68.08%, and late radiation enteritis observed in 21.1%. Patients treated with definitive RT showed more frequent radiation enteritis than in adjuvant RT. In the group treated with definitive RT, the occurrence of early (RE) is more in the Radical radiotherapy group (RRT), whereas late RE appeared more with concurrent chemoradiotherapy (CCRT) group. The late (RE) severe cases (Grade 3,4) observed more with the definitive RT group (only RRT) than in the adjuvant RT group.   Conclusion:  In the Definitive RT group, early and late RE occurrence is more than the Adjuvant RT group. The incidence of enteritis was correlated with the lengthening of total irradiation time. Methods to reduce small bowel intervention in RT and volume of irradiation will further decrease enteritis morbidity.   Keywords: Definitive Radiation therapy, Adjuvant Radiation therapy, Radiation enteritis, chemoradiation

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Abstract

Introduction: Patients suffering from Head and Neck Cancers (HNC), when treated with radiotherapy (RT), often experience Oral mucositis (OMS) side effects. OMS can complicate the treatment and worsen the management of HNC. The Radio-oncologist should find a way to minimize the incidence of OMS during the treatment of HNC. Aim: To study the Radiation-induced OMS in HNC patients and its associated factors. Materials and Methods: This prospective study was performed from October 2018 to September 2019. Total 80 patients of with HNC, who were treated with RT, were enrolled for the study with informed consent. In the study, 40 patients received RT and 40 received concurrent chemo-Radiotherapy (CCRT). Results: Amongst 80 patients included in the study, 72.5% were found to be male. Poor oral hygiene was observed in 77.5% of patients in the study. The tongue cancer (35%) and Cancer of Stage IVa (47.5%) were more prevalent in the patients under study. OMS was observed maximum (60%) in 1 to 4 weeks of treatment. Conclusion: Inflammation response of epithelial mucosa to chemo- radiotherapy cytotoxic effects leads to mucositis, a painful side effect. This study gives proper understanding of Radiation-induced OMS and identifies the predisposing factors for OMS.   Keywords: Oral mucositis, Radiation­induced, Head and Neck Cancer, Radiation Therapy

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Abstract

Introduction: Cancer treatment of the head and neck, the effectiveness of hyperfractionated radiation therapy (HFRT) has been revealed in recent randomized trials, mainly in their local control. As the hypopharynx is situated near the larynx, to achieve greater laryngeal preservation, local control of hypopharyngeal cancers should be achieved; it is very important to enhance the patient’s quality of life. In this study, hyperfractionated radiation therapy results were compared with conventional radiation therapy (CFRT) results. Materials and Methods: Patients with squamous cell cancer of hypopharynx (Stage II to IVA); were submitted with hyperfractionated (n = 34) or conventionally fractionated (n = 22) radiotherapy, with chemotherapy, between July 2018 to January 2020. In conventional radiotherapy, each patient received 2 Gy per fraction with a total dose of 66 Gy at over 6.3 weeks, along with concurrent cisplatin (30 mg/m 2) weekly. In hyperfractionated radiotherapy, each patient received 1.2 Gy per fraction two fractions per day six hours apart with a total dose of 72 Gy at over 6 weeks, along with concurrent cisplatin (30 mg/m 2) weekly. The endpoints were tumor response and toxicities. Results : Complete response rate in the HFRT group was 85.29% and that in the CFRT group was 68.18%. The most prevalent acute toxicities were skin, mucosal and dysphagia related. The acute skin toxicity was significantly higher in CFRT (54.55%) than in HFRT (44.12%). Conclusions : This study suggests that for the treatment of locally advanced hypopharynx cancers, hyperfractionated radiation therapy with simultaneous chemotherapy can be a standard method of treatment and care.   Keywords: Hyperfractionation, Conventional fractionation, Hypopharyngeal carcinoma, chemotherapy Introduction

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