Deshmukh Vineeta, Chiplunkar Shubhada, Sardeshmukh Sadanand, Patil Tushar, Shinde Jagdish, Gupta Vidya, Gujar Shweta, Sardeshmukh Nilambari, Pathak Shridevi, Chavan Sandeep, Pradhan Trupti, Godbole Jueelee
BSDT's Integrated Cancer Treatment and Research Centre [ICTRC], Pune, India.
Advanced Centre for Treatment, Research and Education in Cancer [ACTREC], Tata Memorial Centre, Navi Mumbai, India.
Complement Med Res. 2024;31(6):577-591. doi: 10.1159/000541254. Epub 2024 Sep 18.
Hypopharyngeal squamous cell carcinoma, stage III has poor prognosis with only 25% chance of 5 years of relative survival in such patients in spite of conventional treatment including radical surgery, radiotherapy, and concurrent chemotherapy.
A chronic tobacco-betel nut chewer 62-year-old male patient had dysphagia with hoarseness of voice diagnosed with stage III, grade II malignant pyriform fossa. The patient underwent 9 cycles of neoadjuvant chemotherapy with Inj Paclitaxel 100 mg and Inj Cisplatin 40 mg. He was then referred to our institute for Radical Radiotherapy with concurrent chemotherapy with adjunct Ayurvedic treatment. A total dose of 70 Gy of radiation with cobalt 60 source was administered to the bilateral face and neck, in 35 fractions. Patient also received 6 cycles of concurrent weekly chemotherapy with Inj Cisplatin 40 mg. He received well-planned adjunct Ayurvedic treatment in the form of oral Ayurvedic medicines (OAM) and detoxifying treatment, Panchakarma. All the measured adverse effects of radiotherapy such as Stomatitis, Xerostomia, Taste Alteration, Dysphagia, and Nausea were observed to be remarkably low during and post radiotherapy in this patient. Karnofsky and Quality of Life (QoL) scores revealed patient's well-being throughout the treatment course. After 5 years, PET CT scan revealed no FDG avid locoregional recurrence or distant organ involvement implying disease-free survival (DFS). Various chemokines, cytokines, and oxidative stress markers were assessed during the course of treatment to observe tumour microenvironment.
The present case of Head & Neck Cancer (HNC), stage III, and grade II belonged to high-grade, high-risk hypopharyngeal cancer with poor prognosis. The patient opted for Ayurvedic treatment besides radiotherapy, which continued thereafter for 5 years. We therefore emphasize that in this case, minimum side effects of radiotherapy, immunomodulation, and reduction in inflammation and oxidative stress along with good quality of life can be attributed to OAM and repeated detoxifying Panchakarma treatment supported with healthy diet and good lifestyle. The highlight of the study is the marked effect on the patient's immune response and reduction in oxidative stress, leading to 5 years and beyond of DFS.
下咽鳞状细胞癌III期患者预后较差，尽管接受了包括根治性手术、放疗和同步化疗在内的传统治疗，此类患者5年相对生存率仅为25%。
一名62岁男性患者，长期咀嚼烟草和槟榔，出现吞咽困难和声音嘶哑，被诊断为III期、II级梨状窝恶性肿瘤。该患者接受了9个周期的新辅助化疗，使用紫杉醇注射液100mg和顺铂注射液40mg。随后他被转诊至我院接受根治性放疗并同步化疗，同时辅以阿育吠陀疗法。使用钴60源对双侧面部和颈部进行了总量70Gy的放疗，分35次进行。患者还接受了6个周期的每周同步化疗，使用顺铂注射液40mg。他接受了精心规划的辅助阿育吠陀疗法，包括口服阿育吠陀药物（OAM）和排毒治疗“五疗法”。在该患者放疗期间及放疗后，观察到所有测量的放疗不良反应，如口腔炎、口干、味觉改变、吞咽困难和恶心，均显著较低。卡诺夫斯基评分和生活质量（QoL）评分显示患者在整个治疗过程中状况良好。5年后，PET-CT扫描显示无FDG摄取的局部区域复发或远处器官受累，意味着无病生存（DFS）。在治疗过程中评估了各种趋化因子、细胞因子和氧化应激标志物，以观察肿瘤微环境。
本病例为头颈癌（HNC）III期、II级，属于高级别、高风险下咽癌，预后较差。患者除放疗外选择了阿育吠陀疗法，并在此后持续了5年。因此，我们强调，在本病例中，放疗的副作用最小、免疫调节、炎症和氧化应激减轻以及良好的生活质量可归因于OAM以及在健康饮食和良好生活方式支持下反复进行的排毒“五疗法”治疗。该研究的亮点是对患者免疫反应的显著影响和氧化应激的减轻，从而实现了5年及更长时间的无病生存。
