RESUMEN
The present study was undertaken to evaluate the efficacy of radiotherapy in palliation of dysphagia in patients with squamous cell carcinoma (SCC) of esophagus and to see the quality of life (QoL) following radiotherapy. This was a prospective clinical study done between September 2006 and May 2008. All consecutive patients with SCC of the esophagus, who are not candidates for definitive treatment, were included in the study. Dysphagia and QoL were assessed using modified Takita's grading and modified questionnaire based on EORTC QLQ 30 respectively. External beam radiotherapy (EBRT) was delivered to all patients using linear accelerator 6 Mv photons. Patients who had good response with EBRT were further subjected to intraluminal brachytherapy (ILBT) at 700 cGy using Iridium-192. The cumulative dose each patient received was 65 Gy. Patients were followed up at 6 weeks from completion of treatment to look for any difference in dysphagia grade and QoL following therapy. Thirty-three patients were included in the study. The mean age among males and females was 60.9 and 49.8 years, respectively. Nineteen patients (57.6 %) received EBRT followed by ILBT; the remaining patients received only EBRT. Seven were lost during follow-up, and seven (21.2 %) died during the study period of 6 weeks. Nineteen (57.6 %) were followed up. On follow-up endoscopy, evidence of residual stricture was observed in 57.9 %, and growth in 36.8 %. Of the patients, 27.8 % had biopsy-confirmed residual disease. The median dysphagia score decreased from 4 to 3 after treatment (p = 0.002) in 17 (89.5 %) patients. The mean QoL score improved from 107.5 to 114.1 at 6-week follow-up. Following radiotherapy, 26.3 % had persistent chest pain, increased cough with expectoration in 15.8 %, and hyperpigmentation of skin in 10.5 %. Radiotherapy gives significant relief of dysphagia and improves QoL in 90 % of patients with SCC of esophagus. However, following radiotherapy, a number of patients will have persistent stricture, ulceration, and residual disease.
RESUMEN
BACKGROUND: This study was aimed at evaluating the role of Helicobacter pylori in erosive gastroduodenitis and the necessity for its eradication. MATERIAL/METHODS: A total of forty-nine consecutive patients who presented with hematemesis and or melena and proved to have erosive gastroduodenitis on endoscopy were included in the study. H. pylori status was determined by urease, histology and serology. The presence of at least two positive tests was considered as positive H. pylori status. The erosion sites were noted and classified according to predominance. Correlation of H. pylori status was done between NSAID users and non-users. RESULTS: 28 males and 21 females comprised the study group. H. pylori positivity was 43% in men and 52% in women (p=0.51); the overall H. pylori positivity rate was 47%. 39 patients had taken NSAIDs and three had taken indigenous drugs, which did not belong to the group of NSAIDs. The H. pylori status of drug users and non-users was 48% and 43% respectively (p=0.57) Erosions were most common in the body of the stomach (61%) compared to the antrum (23%), fundus (10%) and duodenum (6%). CONCLUSIONS: Erosive gastroduodenitis is commonly associated with NSAID intake. The body of the stomach is the most common site of erosions. Only 47% of patients with erosive gastritis have a positive H. pylori status. The H. pylori status between drug users and non-users was not significantly different. Eradication of H. pylori is not indicated in patients with erosive gastroduodenitis.