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2007| October-December | Volume 44 | Issue 4
March 4, 2008
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Validation of the University of Washington quality of life questionnaires for head and neck cancer patients in India
AK D'cruz, B Yueh, AK Das, JA Mcdowell, DA Chaukar, AW Ernest
October-December 2007, 44(4):147-154
Quality of life (QOL) is a multidimensional construct capturing the subjective wellbeing of patients in physical, emotional, functional and social domains. Available work on post treatment QOL have only been made in western literature and less in Indian literature.
To translate the UWQOL into both Hindi and Marathi and psychometrically validate the translation in HandN cancer patients in Indian population.
Settings and Design :
A prospective study was done at the Tata Memorial Hospital for patients who were treated for H and N cancers.
Materials and Methods :
147 patients were enrolled from January to April 2005. The study was carried out in two phases. Patients were given translated versions of the UWQOL and EORTC QOL questionnaires preoperatively, 15 days postoperatively and then three months postoperatively.
Both the Hindi and Marathi translations had strong internal consistency (Cronbach's alpha=0.7971 and 0.7839). UWQOL composite scores correlated well with the global questions on overall QOL in both the Hindi (r=0.69) and Marathi (r=0.66) translations and also with Tstage. QOL scores were worse three months postoperatively than preoperatively and for patients undergoing surgery that violated the mucosa. A strong correlations was observed (r>0.50) between all similar domains on the UWQOL and EORTC HandN35 except the saliva item on the Marathi translation, where r<0.50, but Pvalues were significant.
The Marathi and Hindi versions of the UWQOL appear to be valid and reliable instruments for assessing the QOL in Indian population and will be a vital tool for achieving greater insight into the short and the long term QOL.
Point of sale tobacco advertisements in India
S Chaudhry, S Chaudhry, K Chaudhry
October-December 2007, 44(4):131-136
The effect of any legislation depends on its implementation. Limited studies indicate that tobacco companies may tend to use such provision for surrogate advertising. The point of sale advertisement provision has been placed in the Indian Tobacco Control legislation. The study was undertaken to assess the Indian scenario in this regard.
To assess if there are any violations related to provision of point of tobacco sale advertisements under India's comprehensive tobacco Control legislation in different parts of India.
Materials and Methods :
Boards over various shops showing advertisements of tobacco products were observed in the cities of Delhi, Mumbai, Kolkata, Trivandrum and Jaipur, between September 2005 and March 2006.
The point of sale advertisements mushroomed after the implementation of 2004 tobacco Control legislation. Tobacco advertisement boards fully satisfying the point of sale provision were practically non-existent. The most common violation of point of sale advertisements was the larger size of the board but with tobacco advertisement equal to the size indicated in the legislation and remaining area often showing a picture. Invariably two boards were placed together to provide the impression of a large single repetitive advertisement. More than two boards was not common. Tobacco advertisement boards were also observed on closed shops/ warehouses, shops not selling tobacco products and on several adjacent shops.
The purpose of the point of sale advertisements seem to be surrogate advertisement of tobacco products, mainly cigarettes.
chemosensitivity profile of oral squamous cell cancer and its correlation with clinical response to chemotherapy
KA Pathak, AS Juvekar, DK Radhakrishnan, MS Deshpande, VR Pai, P Chaturvedi, PS Pai, DA Chaukar, AK D'Cruz, PM Parikh
October-December 2007, 44(4):142-146
Oral cancers represent a disparate group of tumors with diverse clinical behavior and chemosensitivity profile. Currently, it is difficult to predict whether a tumor will respond to chemotherapy and which drug(s) will achieve the maximum clinical response.
chemosensitivity profile of oral cancers and to correlate the
chemosensitivity of oral cancer to clinical response to chemotherapy.
Settings and Design :
Prospective study in a tertiary cancer care center.
Methods and Material :
We prospectively studied the chemosensitivity profile of 57 untreated, advanced, unresectable oral cancers to cisplatin, methotrexate, 5-fluorouracil and their combinations by using histoculture drug response assay (HDRA) and correlated them to the clinical response to chemotherapy.
Statistical Analysis Used :
Biopsy samples were successfully histocultured in 52/57 (91%) cases. Of these 52 evaluable patients, 47 had primary gingivo-buccal cancers and five had tongue / floor of mouth cancers. Based on the assay, 27 (52%) tumors were sensitive to cisplatin, 27 (52%) to methotrexate, 24 (46%) to 5-fluorouracil, 38 (73%) to combination of cisplatin and methotrexate and 36 (69%) to combination of cisplatin and 5-fluorouracil. Of these, 31 patients with good performance status received two cycles of chemotherapy using one or more of these test drugs. There was a significant correlation (p=0.03) between the
chemosensitivity and the clinical response. Negative predictive value of the test was 80%, positive predictive value-69%, sensitivity-79% and specificity -71%. The overall accuracy of the assay was 74%.
We found HDRA to be a fairly good predictor of chemo-response of oral cancer.
Penile metastasis from rectal carcinoma
KM Murhekar, U Majhi, V Mahajan, B Satheesan
October-December 2007, 44(4):155-156
Penile metastases are infrequent and often originate from genitor-urinary organs including bladder and prostate. In the present communication, we report an unusual case of penile metastasis from rectal adenocarcinoma. Though uncommon, this presentation is not unknown. A review of literature of penile metastases in colorectal cancers is also summarized here.
Activity and toxicity of 2-CDA in Langerhans cell histiocytosis: A single institutional experience
G Biswas, A Khadwal, B Arora, R Bhagwat, SD Banavali, CN Nair, SK Pai, PA Kurkure, PM Parikh
October-December 2007, 44(4):137-141
Langerhans cell histiocytosis (LCH) is a rare disorder characterized by clonal proliferation of immature and abnormal bone marrow derived langerhans cells. Treatment is usually multimodal. Potent anti-monocyte as well as immunomodulatory activity of 2-CDA and its proven efficacy in many lymphoproliferative disorders has made 2-CDA a rational choice in treatment of LCH.
evaluate the efficacy and toxicity profile of 2-CDA in children with relapsed or refractory LCH.
Setting and Design :
This is a pilot study and we present the initial data of the first seven patients treated at our institution.
Materials and Methods :
Seven patients of relapsed and refractory LCH were enrolled from July 2000 to June 2004. The cohort of seven patients included six males and one female with a median age at initiation of cladribine
was 2.25 years (range, 1.67 to 7.0 years). Three patients had received one prior chemotherapy regimen while the rest were heavily pretreated. Cladribine was administered over two hours IV daily for five days and repeated every four weeks.
After a median of six courses of cladribine (range, 2 to 9),
two (33%) patients achieved PR and two (33%) patients have SD on imaging but are clinically better. None experienced grade 3 or 4 hematologic toxicity. At a median follow-up of 19 months (range, 8 to 52 months), five patients remain alive and one patient has
Our study shows that single agent 2-CDA is active and well-tolerated in children with relapsed or refractory LCH.
Indian needs stricter implementation.....
October-December 2007, 44(4):129-130
Radiotherapy-induced depigmentation in a patient with breast cancer
Anusheel Munshi, Sandeep Jain, Ashwini Budrukkar, Rakesh Jalali, Rajiv Sarin
October-December 2007, 44(4):157-158
Vitiligo is a common dermatological disorder. A middle-aged woman with preexisting vitiligo was diagnosed with breast carcinoma. After surgery and chemotherapy she received regional radiotherapy. Six months after the completion of radiotherapy she developed depigmentation in the irradiated area. This article discusses the etiology for this phenomenon and the literature in this regard.
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