We noted CD66 expression associated with clusters of cells which are spindle shaped, SMA+ve, podoplanin+ve, phalloidin high, fibronectin high, plakoglobin low, ki67-ve and CK10+ve at the migratory phase along with features of partial EMT. Further, TGFβ1 a well known regulator of EMT, positively correlated with CD66 expression. The additional CD49f+ve subset at the leading invading front of migration was SMA-ve, phalloidin low, fibronectin low, plakoglobin high, Ki67+ve and CK14+ve. These data are consistent with a role for CD66 cells in metastatic invasion with a collective cell migration process co-opting the CD49f subset. Our retrospective analysis of a cohort is consistent with a role for CD66 in metastasis. However, the broad analysis of CD66, CD49f and TGFβ1 expression with patterns of overall survival points to a possible protective effect particularly for local recurrences. Hence, future studies focussing on potential heterogeneity within the CD66 subset along with the possible role of isoforms and intra-cellular roles would be essential.

Introduction: The chemotherapy schedules with cytotoxic dose or weekly regimes are still challenging, weighing the benefits versus toxicities. This prospective randomized study is an attempt to assess the efficacy of two schedules of cisplatin in management of locally advanced HNSCC. Objectives: The objectives of this study was to evaluate tolerance, tumour response and toxicities of concurrent chemoradiation with cisplatin in weekly and three weekly regimes. Methods: Locally advanced oropharyngeal squamous cell carcinoma patients fit for concurrent chemoradiation with cisplatin 40 mg/m2 (weekly) and 100 mg/m2 (3 weekly) were randomized to Arm A and B concurrently with radiotherapy of 70Gy/35frs/7 weeks. Statistical Analysis: Chi-square/ Fisher Exact test has been used to find the significance of study parameters on categorical scale between the groups. The statistical software SPSS 15.0 was used. Results: Between December 2010 and January 2013, 60 patients were enrolled. The median cycles of cisplatin in Arm-A was 5 and 2 in Arm-B. The complete response of 80.9% vs 75% and partial response of 14.3% vs 12.5% was observed in both arms respectively. There was no statistical difference in acute radiation and hematological toxicities between the two groups. With median follow up of 28 months, the 2 and 5 years overall survival was 55% and 58%; 41.6% and 32.3% in arms A and B respectively. Conclusion: In our study of locally advanced oropharyngeal carcinoma treated with radical radiotherapy comparing concurrent chemotherapy with cisplatin weekly vs 3 weekly had no significant difference in overall response, complete response and acute toxicities.

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The rate of the tumor regression can predict the overall outcome in patients with buccal cancers treated with radiation. Completion of the planned course of radiation in patients who do not show a substantial reduction in size by 4.5 weeks of conventional radiation does not improve the results.

Introduction: Nasopharyngeal carcinoma is very uncommon in the southern part of India, the age-adjusted incidence rate is less than 1 per 1,00,000 population. This study is undertaken to evaluate the outcome of nasopharyngeal carcinoma and its correlation with Primary tumor volume. Material and methods: Total of 50 non-metastatic nasopharyngeal carcinoma patients treated with concurrent chemo radiation between January 2013 and December 2015 were included in the study. All patients were treated via IMRT with dose of 66-70Gy, along with concurrent chemotherapy. Initial tumour volume was measured from CT based contouring and mean dose delivered was calculated. All patients were followed up for survival, relapse and metastasis. Results: The median follow up for the group was 24 months. The median Gross tumor volume of primary disease and nodal disease was 61.6 cubic centimetres and 35.4 cubic centimeters respectively. The 2 year Disease free survival and Overall survival for the entire group was 64% and 68% respectively. There was significant difference (p-0.018) between disease free survival of low volume disease group (LVD) which was 78 % as compared to high volume disease (HVD) group 52% at 24 months, similarly Overall survival was also significantly better (p-0.015) in LVD group as compared to HVD group 80% vs 55% at 24 months. Among the treatment related factors adjuvant chemotherapy significantly improved the outcome in HVD group but no difference was seen in LVD group. Conclusion: Our patients had large volume primary disease, the OS and DFS was significantly better in LVD patients, adjuvant chemotherapy after concurrent chemoradiotherapy had no additional benefit for LVD patients but improved DFS and MFS in HVD Patients.