Research Article
Comparison of Outcome and Toxicities of Concurrent Chemo-radiation Versus Sequential Chemo-radiation in Inoperable Locally Advanced Non-small Cell Lung Cancer
Issue:
Volume 11, Issue 1, March 2026
Pages:
1-14
Received:
21 November 2025
Accepted:
9 December 2025
Published:
7 January 2026
Abstract: Concurrent chemoradiotherapy (CCRT) is the standard of care for inoperable locally advanced non-small cell lung cancer (LA-NSCLC), but its associated toxicities pose a significant challenge, particularly in resource-limited settings, and sequential chemoradiotherapy (SCRT) may offer a more feasible alternative, though with potentially inferior efficacy. This quasi-experimental study, conducted from January 2022 to June 2023, aimed to compare the treatment outcomes and toxicity profiles of CCRT versus SCRT in a real-world Bangladeshi cohort by enrolling 66 patients with LA-NSCLC (Stage IIIA-IIIC) allocated to Arm A (CCRT; n=33), receiving weekly paclitaxel (45 mg/m²) and carboplatin (AUC 2) with concurrent radiotherapy (50 Gy/25 fractions), or Arm B (SCRT; n=33), receiving three cycles of induction paclitaxel (175 mg/m²) and carboplatin (AUC 6) followed by the same radiotherapy regimen, with treatment response assessed using RECIST 1.1 and toxicities graded per CTCAE v5.0. The study population was predominantly male (77.3%), with a mean age of 55.9 years, and had a high prevalence of squamous cell carcinoma (57.6%), and at the 12-week follow-up, the CCRT arm demonstrated a higher complete response rate compared to the SCRT arm (51.5% vs. 33.3%, p=0.535) and a higher overall response rate (84.8% vs. 72.7%, p>0.05), though these differences were not statistically significant, but CCRT was associated with a higher incidence of acute toxicities, notably Grade 2-3 esophagitis (30.3% vs. 15.2%) and Grade 2-3 leucopenia (21.3% vs. 12.1%), while all other hematological and non-hematological toxicities were comparable between the arms and not statistically significant. In conclusion, while CCRT showed a clinically meaningful improvement in treatment response rates, it was associated with increased, though manageable, acute toxicities, and the lack of statistical significance in efficacy, combined with the higher toxicity burden, suggests that SCRT remains a viable and potentially more tolerable treatment option for selected patients in resource-constrained environments where supportive care capabilities are limited.
Abstract: Concurrent chemoradiotherapy (CCRT) is the standard of care for inoperable locally advanced non-small cell lung cancer (LA-NSCLC), but its associated toxicities pose a significant challenge, particularly in resource-limited settings, and sequential chemoradiotherapy (SCRT) may offer a more feasible alternative, though with potentially inferior effi...
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Case Report
A Pediatric Case of Embryonal Rhabdomyosarcoma of the Bladder: A Case Report and Literature Review
Faye Samba Thiapato*
,
Fall Mbene,
Diop Rama Fatou Bintou,
Kikalulu Kiambote Hamidou,
Sarr El Hadji Souleymane,
Seck Aita,
Dembele Mamadou,
Diatta Marie Noel,
Ndiaye Abdoulaye
Issue:
Volume 11, Issue 1, March 2026
Pages:
15-21
Received:
19 December 2025
Accepted:
4 January 2026
Published:
23 January 2026
DOI:
10.11648/j.ijcocr.20261101.12
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Abstract: Rhabdomyosarcomas (RMS) are malignant tumors derived embryonically from the mesenchymal tissue that form from the skeletal muscles. It is the most common soft tissue sarcoma in pediatrics. The embryonal mesenchymal subtype is the most common and is often diagnosed in the first decade of life. Treatment of RMS is multimodal including systemic chemotherapy, surgery and radiotherapy. In sub-Saharan Africa, data in pediatric cancers, and on RMS in particular, are rare and limited generaly to case reports. This case aims to report a bladder embryonal rhabdomyosarcoma in a 19-month-old child boy who is diagnosed post mortem. It was referred to the pediatric emergency department for sudden painful complete inability to urinate. On clinical examination, an acute urine retention was diagnosed and transurethral catherisation was established with resultant drainnage of hematic urine. Hemodynamic parameters were unstable, with oxygen saturation at 91%. A painless well-fixed mass of solid appearance was palpable at the hypogastric. Laboratory exams showed an impaired renal function with metabolic acidosis. Urine culture and sensitivity testing revealed a urinary tract infection that isolated klebsiella pneumonia. Emergency ultrasonography of the urinary tract, showed a large, heterogeneous, multilobulated intravesical vegetative mass measuring 60.85 x 35.34 x 42.2mm, responsible of a bilateral stage VI ureterohydronephrosis. Abdominal-pelvic MRI showed a vegetative postero-basal tissue mass invading the entire bladder trigone and classified T3bN0Mx. Bilateral nephrostomy was performed the following day with a medical resuscitation, and antibiotherapy adapted to renal function, was installed. A cystoscopy was performed under general anaesthesia showed a large bladder mass filling almost the entire bladder lumen. The biopsy was done using a monopolar resector. The post-operative event was marked by a cardiorespiratory arrest with failure of all reanimation maneuvers occurred. The histological results the biopsy showed a sarcomatous proliferation of small round or spindle-shaped fusiformed cells with hyperchromatic nuclei and little cytoplasm. Mitotic activity was high. Immunohistochemical analysis showed desmin and myoginin, confirming the diagnosis of embryonal-type rhabdomyosarcoma classified as TNM stage II and ISRG IV.
Abstract: Rhabdomyosarcomas (RMS) are malignant tumors derived embryonically from the mesenchymal tissue that form from the skeletal muscles. It is the most common soft tissue sarcoma in pediatrics. The embryonal mesenchymal subtype is the most common and is often diagnosed in the first decade of life. Treatment of RMS is multimodal including systemic chemot...
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