Real World Presentation and Treatment Outcomes with a Predominant Induction Chemotherapy Based Approach in Nasopharyngeal Carcinoma: A Sixteen Year Report from a Teaching Hospital in India.

Introduction: Nasopharyngeal carcinoma (NPC) is a rare malignancy in India except in north-eastern states. We present our institutional experience of 16 years highlighting management, outcomes, responses and toxicities.

Materials And Methods: NPC patients registered at our center during the period of 2000-2015.

Analysis of the efficacy of the pectoralis major myocutaneous flap in reconstructive head and neck surgery.

Introduction: Although free flaps have been used predominantly in past decades for the soft tissue reconstruction of head and neck malignancies, Pectoralis major myocutaneous flap (PMMF) is still a reliable workhorse for patients with co-existing co-morbidities or low economic status where free flaps are not feasible.

Patients And Methods: It was a retrospective study done on 36 patients of head and neck malignancies over the period of 5 years in which PMMF was used as a method of reconstruction in our hospital. Patients were followed up for a period of one year and outcome of PMMF was evaluated.

Analysis of the efficacy of the pectoralis major myocutaneous flap in reconstructive head and neck surgery.

Introduction: Although free flaps have been used predominantly in past decades for the soft tissue reconstruction of head and neck malignancies, Pectoralis major myocutaneous flap (PMMF) is still a reliable workhorse for patients with co-existing co-morbidities or low economic status where free flaps are not feasible.

Patients And Methods: It was a retrospective study done on 36 patients of head and neck malignancies over the period of 5 years in which PMMF was used as a method of reconstruction in our hospital. Patients were followed up for a period of one year and outcome of PMMF was evaluated.

Deranged Pulmonary Function Tests in Allergic Rhinitis in North Indian Patients.

Introduction: Significant associations between allergic rhinitis and bronchial asthma have been established and as a result of bronchial hyper-responsiveness, patients can have deranged pulmonary function tests. We aim to compare previous such studies with the result of our study done in India wherein we identify among allergic rhinitis patients who despite not having overt asthmatic symptoms, have pulmonary function derangements, quite possibly at a subclinical disease level.

Materials And Methods: We studied 74 patients of allergic rhinitis and after meticulous clinical work up, they underwent blood tests including hemogram, absolute eosinophil count, and total serum IgE followed by pulmonary function tests.

Postoperative radiotherapy dose requirement in standard combined-modality practice for head and neck squamous cell carcinoma: Analysis of salient surgical and radiotherapy parameters in 2 cohorts.

Background: This study compared 2 sequential cohorts to identify the postoperative radiotherapy (PORT) dose requirement for head and neck squamous cell carcinoma (HNSCC).

Methods: Two distinct PORT dose regimens were prescribed over 11 years; group 1 received 56 Gy or less, and group 2 received 60 Gy or more. The 2D and 3D techniques were used.

Sinonasal tuberculosis: Report of three atypical cases.

Primary sinonasal/nasal tuberculosis is rare amongst the commonly seen cases of extrapulmonary tuberculosis. We report three cases, two of primary sinonasal tuberculosis and one case of nasal tuberculosis in otherwise healthy patients. The diagnosis was based on radiological and histopathological findings.

Institutional experience of interstitial brachytherapy for head and neck cancer with a comparison of high- and low dose rate practice.

Aims: To describe our institutional experience with high dose rate (HDR) interstitial brachytherapy (IBT) compared with previously reported results on the low dose rate (LDR) practice for head and neck cancer.

Materials And Methods: Eighty-four patients with oral cavity (n=70) or oropharyngeal cancer (n=14) were treated with 192Ir HDR-IBT. Seventy-eight patients had stage I or II tumour.

The first and second echelon sentinel lymph node evaluation in oral cancer.

Sentinel lymph node biopsy shows promise as a minimally invasive technique that samples the first echelon (station) of nodes to predict the need for more extensive neck dissection. This paper discusses the accuracy and feasibility of sentinel node and "station II node" biopsy for predicting the status of neck in 20 patients of oral cancer. We identified sentinel node in these patients.

Oncogenic osteomalacia from nasal cavity giant cell tumor.

Background: Oncogenic osteomalacia is a rare paraneoplastic syndrome characterized by osteomalacia, which occurs as a result of excess renal phosphate excretion caused by fibroblast growth factor-23 secreted by mesenchymal tumors. This entity is rare in head and neck cancers. We report a rare case of oncogenic osteomalacia in a patient with an anterior skull base giant cell tumor.

Adjuvant therapy with flutamide for presurgical volume reduction in juvenile nasopharyngeal angiofibroma.

Background: Although 2 studies totaling 11 cases have indicated some benefit of anti-androgen treatment with flutamide on juvenile nasopharyngeal angiofibroma (JNA), it is not part of contemporary practice.

Methods: Our approach was through a prospective, single-arm, before-and-after study, in which 20 patients with advanced JNA (Radkowski stage IIB-IIIB) were administered flutamide (per oral: 10 mg kg(-1) day(-1) × 6 weeks) prior to surgical excision. Pretherapy and posttherapy tumor volume measurements were established by MRI.

Lactobacillus brevis CD2 lozenges reduce radiation- and chemotherapy-induced mucositis in patients with head and neck cancer: a randomized double-blind placebo-controlled study.

Background: Oral mucositis is a frequent and serious complication in patients receiving chemo-radiotherapy for head and neck squamous cell carcinoma. This study evaluated the effects of administering Lactobacillus brevis CD2 lozenges on the incidence and severity of mucositis and tolerance to chemo-radiotherapy.

Methods: Two hundred patients suitable for chemo-radiotherapy were enrolled in a randomised, double-blind study to receive daily treatment with lozenges containing either L.

Malacoplakia of the vallecula masquerading as a malignancy.

Malacoplakia is an unusual chronic granulomatous inflammation that commonly occurs in the urinary tract. It is rarely encountered in the head and neck region, and only a handful of such cases have been described. We report a case of malacoplakia in a 50-year-old woman who presented with a mass in the vallecula that was clinically suspected of being malignant.

Vascular hamartoma of the paranasal sinuses: report of 3 rare cases and a short review of the literature.

The paranasal sinuses are an extremely unusual location for a vascular hamartoma. As far as we know, only 1 such case has been previously reported in the English-language literature. We report 3 new cases of vascular hamartoma of the paranasal sinuses, which occurred in a 20-year-old woman and in 2 men aged 36 and 45 years.

Discovery and verification of head-and-neck cancer biomarkers by differential protein expression analysis using iTRAQ labeling, multidimensional liquid chromatography, and tandem mass spectrometry.

Multidimensional LC-MS/MS has been used for the analysis of biological samples labeled with isobaric mass tags for relative and absolute quantitation (iTRAQ) to identify proteins that are differentially expressed in human head-and-neck squamous cell carcinomas (HNSCCs) in relation to non-cancerous head-and-neck tissues (controls) for cancer biomarker discovery. Fifteen individual samples (cancer and non-cancerous tissues) were compared against a pooled non-cancerous control (prepared by pooling equal amounts of proteins from six non-cancerous tissues) in five sets by on-line and off-line separation. We identified 811 non-redundant proteins in HNSCCs, including structural proteins, signaling components, enzymes, receptors, transcription factors, and chaperones.

Over-expression of 14-3-3zeta is an early event in oral cancer.

Background: The functional and clinical significance of 14-3-3 proteins in human cancers remain largely undetermined. Earlier, we have reported differential expression of 14-3-3zeta mRNA in oral squamous cell carcinoma (OSCC) by differential display.

Methods: The clinical relevance of 14-3-3zeta protein in oral tumorigenesis was determined by immunohistochemistry in paraffin embedded sections of oral pre-malignant lesions (OPLs), OSCCs and histologically normal oral tissues and corroborated by Western Blotting.

Management protocols of Allergic Fungal Sinusitis.

Controversy surrounds the appropriate surgical approach and the appropriate medical therapy for Allergic Fungal Sinusitis. The present prospective study aims to assess the impact of these factors on the treatment outcome of Allergic Fungal Sinusitis. In the present study 34 cases with AFS were randomized into one of 3 methods of post operative therapy i.

Clinical significance of altered expression of retinoid receptors in oral precancerous and cancerous lesions: relationship with cell cycle regulators.

Alterations in expression of retinoid receptors are implicated in human cancers. We hypothesized that altered expression of retinoic acid receptors (RARalpha,beta,gamma) and retinoid X receptor RXRalpha and their relationship with cell cycle regulators (p53, p16, p21) is associated with development, progression and prognosis of oral cancer. Immunohistochemical analysis of RAR alpha, beta, gamma and RXRalpha proteins was carried out on serial sections from 244 oral squamous cell carcinomas (OSCCs), 102 potentially malignant lesions (65 hyperplasias, 37 dysplasias), 83 matched histologically normal oral tissues and 29 normal mucosa from non-exposed individuals without oral lesions and correlated with expression of cell cycle regulators p53, p16 and p21 as well as with clinicopathological parameters.

Assessment of risk factors in laryngeal cancer in India: a case-control study.

Cancer of the larynx is fourteenth most common cancer in the world. Limited data are available from India on associations with risk factors and hence the present hospital based matched case-control study was conducted. Three hundred and five laryngeal cancer patients and an equal number of healthy controls matched for their age within 2 years, sex and place of residence constituted the study population.

Alterations of rb pathway components are frequent events in patients with oral epithelial dysplasia and predict clinical outcome in patients with squamous cell carcinoma.

Objective: This study was designed to test the hypothesis that alterations in expression of G1/S modulators cyclin D1, p16 and pRb occur in patients with oral epithelial dysplasia, considered to be at increased risk for malignant transformation. In addition, the analysis of expression of all three markers in the same set of oral cancer patients would provide a unique opportunity to determine whether these alterations have cooperative or synergistic effects on oral cancer development and prognosis.

Patients And Methods: A prospective study was undertaken to carry out immunohistochemical analysis of cyclin D1, p16 and pRb proteins in serial paraffin-embedded tissue sections of 220 oral squamous cell carcinomas (OSCCs), 90 potentially malignant lesions (52 oral hyperplastic lesions, 38 dysplasias) and 81 matched histologically normal oral tissues and correlated them with clinicopathological parameters.

Stromelysin 3, Ets-1, and vascular endothelial growth factor expression in oral precancerous and cancerous lesions: correlation with microvessel density, progression, and prognosis.

Purpose: Identification of molecular changes characteristic of development and progression of oral cancer are of paramount importance for effective intervention. Stromelysin 3 (MMP11) is a unique matrix metalloproteinase shown to have dual function during cancer progression. The transcription factor Ets-1 and vascular endothelial growth factor (VEGF) are important proangiogenic factors in cancer.

Combined evaluation of expression of telomerase, survivin, and anti-apoptotic Bcl-2 family members in relation to loss of differentiation and apoptosis in human head and neck cancers.

Background: Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers, and it accounts for 5% of all adult cancers worldwide. Loss of growth control and a marked resistance to apoptosis are considered major mechanisms driving tumor progression. Little is known about the distribution of inhibitors of apoptosis in HNSCC or how they correlate with other biomarkers of malignancy, such as telomerase, an enzyme that plays a critical role in cellular immortalization.

Short course palliative radiotherapy of 20 Gy in 5 fractions for advanced and incurable head and neck cancer: AIIMS study.

Background And Purpose: A proportion of advanced stage head and neck cancer patients are incurable and have a limited life expectancy of 100 days or less. The study aimed to offer a short course of palliative radiotherapy (PRT) and evaluate the symptom relief, disease response and duration of survival.

Patients And Methods: Between 1995 and 2001, 505 patients of stage IV squamous cell carcinoma received uniform dose of 20 Gy in 5 fractions over 1 week along with symptom relief drugs.

Weight loss during radiotherapy for head and neck malignancies: what factors impact it?

Radiotherapy (RT) is an important treatment modality in head and neck cancers. Loss of weight during RT due to various factors is a matter of concern. This study was conducted to see the pattern of weight loss and the causative factors involved.

Allergic fungal sinusitis: expanding the clinicopathologic spectrum.

Objective: We sought to determine whether histologic tissue invasion occurs in allergic fungal sinusitis (AFS) and, if so, to identify clinical indicators for the same. Study design and setting We conducted a retrospective case record review of all 28 AFS cases identified by histology over a 32-month period at a tertiary care referral center. All histologic specimens were reevaluated for features of invasive pathology, and case records were correlated for clinical, radiologic, or laboratory parameters associated with such invasion.

Solitary malignant schwannoma of the nasal cavity and paranasal sinuses: report of two rare cases.

Malignant schwannomas of the paranasal sinuses are extremely uncommon tumors, as only 18 well-documented cases have been previously published in the English-language literature. We report two new cases of solitary malignant schwannoma--one in a 23-year-old man and the other in a 45-year-old woman. Neither was associated with von Recklinghausen's disease.