BackgroundHead and neck cancer (HNC) is the seventh most common type of cancer in the world and constitute 5% of the entire cancers worldwide. The global burden of HNC accounts for 650,000 new cases and 350,000 deaths worldwide every year and a major proportion of regional malignancies in India. More than 70% of squamous cell carcinoma of the head and neck are estimated to be avoidable by lifestyle changes, particularly by effective reduction of exposure to well-known risk factors such as tobacco smoking and alcohol drinking.MethodsA retrospective analysis of 12 years (2001 - 2012) of HNC patients attending RCC, PGIMS Rohtak was done. Total numbers of cancer patients seen were 26,295 and out of these 9,950 patients were of HNCs, which were retrospectively analyzed for their associated risk factors in different HNC subtypes. Most of the patients, i.e. 92.3%, were presented as locally advanced HNC (stages III and IV).ResultsIt has been observed that smoking and alcohol are the strongest independent risk factors responsible for increased risk of HNC and are further having synergetic correlations.ConclusionThe present study confirms the principal role of alcohol consumption and smoking in HNC carcinogenesis, as well as the differential associations with HNC subtypes, and a significant, positive, multiplicative interaction with different risk factors.

No abstract

INTRODUCTION Head and neck cancer (HNC) is the seventh most common cancer in the world. After smoking, alcohol consumption is a strong associated risk factor for HNC. Alcohol consumption has negative impact on health and social consequences. The existing literature shows that alcohol consumption along with smoking is an important risk factor for HNC. MATERIAL AND METHODS In this retrospective analysis of 12-years from 2001 to 2012, total 9,950 patients of histopathologically proven head and neck cancers, were included in the study. The patients were analyzed for their association with alcohol as an associated risk factor along with smoking in different HNC subtypes. RESULTS Male to female ratio was 7:1 and median age of presentation was 54-years. 59% patients were alcoholics (alcoholics only+ smokers as well as alcoholics), out of which 6% were alcoholics only and the strength of association differed between different HNC subtypes; maximum for oropharyngeal group (35%), and 7.6%, 5% and 10% for oral cavity, hypopharynx and larynx respectively. Further evaluation has shown that total smokers (smokers only+ smokers as well as alcoholics) were 89%, out of which 36% were smokers only. At last follow-up, no evidence of disease (NED) was seen in 15% patients among total alcoholics and in 20% patients among non-alcoholics. CONCLUSION The present retrospective study of HNC patients at a tertiary care centre over a period of twelve years concluded the strong association of alcohol consumption with HNC and its different subtypes. Alcohol problems have an enormous toll on lives and communities of the developing nations particularly in the populous regions of the world (e.g. in China and India). There is a need to raise awareness among the population about the negative implications of alcohol consumption and to minimize them.

Gastrointestinal stromal tumors (GISTs) are malignant and rare form of soft tissue sarcoma of the digestive tract. The incidence of gastrointestinal stromal tumors is very low Kramer et al. 2005 Jejunal GISTs are extremely rare. Here we present a rare case of jejunal GIST with unusually large size at presentation. The patient presented with severe abdomen pain, exophytic growth, and dimorphic anemia. Surgical resection of the tumor was carried out, and operative findings revealed a 15 × 10 cm growth, arising from serosal surface of jejunum, at the antimesenteric surface. Diagnosis in this case was made by subjecting the resected specimen to immunohistochemical analysis. In view of large size of the resected tumor, and high-risk histopathological features, imatinib mesylate 400 mg once daily was given as adjuvant chemotherapy. Patient is asymptomatic without any evidence of tumor recurrence after six months of postoperative followup. Imatinib as such is recommended in metastatic, residual or recurrent cases of GISTs or which are surgically not removable; however, recent recommendations suggests the use of imatinib mesylate after radical surgery in high-risk cases, because it has shown a significant decrease in the recurrence rate, and the Food and Drug Administration (FDA) has also approved the use of imatinib as adjuvant therapy after complete resection of localized, primary GIST.

BackgroundThe aim of the study was to evaluate and compare the efficacy, tolerability and toxicity of three palliative radiotherapy (RT) schedules in locally advanced head and neck carcinoma (LAHNC), i.e. Quad Shot schedule, Christie schedule and conventional palliative schedule.MethodsThe patients were randomly divided into three groups of 30 each. Group I patients were planned for 14.8 Gy in 4 fractions over 2 days, repeated three weekly for two more cycles. Group II patients were planned for 50 Gy in 16 fractions over 3.1 weeks. Group III patients were planned for 20 Gy in 5 fractions over 5 days, repeated after an interval of 3 weeks. The quality of life was assessed before and after RT using University of Washington Quality of Life questionnaire version 4.ResultsLocal control rates were 84%, 76%, and 76% for groups I, II and III, respectively. Disease status at 6-month follow-up was no evidence of disease (20%, 28%, and 16%), residual disease (72%, 48%, and 76%), and recurrent disease (8%, 24%, and 8%) in groups I, II and III, respectively. Grade III acute skin reactions were 28%, 44%, and 16% in groups I, II and III, respectively. Grade III acute mucosal reactions were 36%, 56%, and 24% in group I, II and III, respectively. Quality of life improved in all groups after RT.ConclusionQuad Shot schedule may be used in LAHNC with better local control and acceptable toxicity as compared to conventional palliative RT schedule in Indian setting.