Micronuclei evaluation of reduction in neoadjuvant chemotherapy related acute toxicity in locally advanced lung cancer: an indian experience.
BACKGROUND
Lung cancer is the most common cancer in the world accounting for 17.6% cancers worldwide. The AAR i n I ndian population varies f r om 0.98-15.55. The aim of t he present study was to analyze areduction in neoadjuvant chemotherapy related acute toxicity in locally advanced lung cancer (stage IIIA and III B) using Wobe Mugos E and its evaluation using micronuclei as a cytogenetic marker. Micronuclei, which are cytoplasmic fragments of DNA, have been used as a biological dosimeter to assess DNA damage.


METHODS
Fourty patients of locally advanced NSCLC were randomized into two study groups between 2001-2003. One group received neoadjuvant chemotherapy using Cisplatin and Etoposide. The other group received neoadjuvant chemotherapy using Cisplatin and Etoposide along with Wobe Mugos E which is a proteolytic enzyme preparation. A study of micronuclei frequency was done pre and post chemotherapy in both groups.


RESULTS
Thirty eight patients were available for final evaluation. Anemia was the most common hematological toxicity observed. Nausea and vomiting were the most common non -hematological toxicity seen. Wobe Mugos E was found to reduce the incidence of leucopenia (p = 0.005), nausea (p=0.004), vomiting (p= 0.003), sensory neuropathy (p = 0.032) and treatment related depression (p= 0.005). A reduction in micronuclei was seen in patients in patients on Wobe Mugos E. (p =0.01).


CONCLUSIONS
Neo-adjuvant chemotherapy related acute toxicity is a major problem in patients with advanced lung cancer. A reduction in micronuclei frequency shows Wobe Mugos E to be effective in reducing chemotherapy related acute toxicity.
Bahl
A
A
Department of Radiotherapy and Oncology AIIMS , New Delhi, India.
Chander
S
S
Julka
P K
PK
Rath
G K
GK
Sharma
D N
DN
Kumar
A
A
Nair
O
O
D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D002918:Chymotrypsin / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007194:India; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D048629:Micronuclei, Chromosome-Defective / Q000139:chemically induced*; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D009367:Neoplasm Staging; D010206:Papain / Q000627:therapeutic use*; D014357:Trypsin / Q000627:therapeutic use*
D004338:Drug Combinations; C009685:chymotrypsin, papain, trypsin drug combination; D002918:Chymotrypsin; D014357:Trypsin; D010206:Papain