Clinico-pathological response of neoadjuvant chemotherapy in advance ocular carcinoma
Rajendra P Maurya, Prashant Bhushan, Virendra P Singh, Mahendra K Singh, Manoj Pandey, Udai P Shahi and Mohan Kumar
World Journal of Surgical Medical and Radiation Oncology 2012, 1:6
Objective: To determine the feasibility, toxicity and clinico-pathological response of anterior chemotherapy in patients of advanced ocular malignancies.
Settings: Departments of Ophthalmology, Surgical Oncology and Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P., India.
Materials and Methods: Twenty six patients of ocular malignancies between 20 to 65 years of age were treated with chemotherapy (CT) (I.V. cis-platinum, methotrexate, bleomycin) in 16 cases and only injection methotrexate in 10 cases prior to radiotherapy and/or surgery. Before starting chemotherapy all patients were evaluated by history, clinical examination, complete hematological, radiological and pathological investigations. Drug toxicity, clinical and histological changes were observed after completion of treatment.
Results: Out of 26 cases, 21 were primary malignant tumors arising from eye and its adnexa and 5 were secondary malignant tumors arising from paranasal sinuses. Majority of cases had squamous cell carcinoma 16/26 (61.54%) followed by basal cell carcinoma 5/26 (19.23%) and Meibomian gland carcinoma 5/26 (19.23%). Overall response of CT was seen in 19/26 (73.08%) cases, while in 5/26 (19.23%) cases there was no response and rest 2/26 (7.69%) had progressive disease. The maximum response 12/26 (46.15%) was observed in patients treated by combination chemotherapy containing cis-platinum. There was mild to moderate drug toxicity, commonest were gastrointestinal (69.23%) and hematological (69.23%).
Conclusion: Chemotherapy is better adjuvant to surgery and radiotherapy in advanced ocular malignancies.