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Table of Contents
LETTER TO EDITOR
Year : 2020  |  Volume : 3  |  Issue : 3  |  Page : 653

Authors' reply to Kies and Katna et al.


Department of Medical Oncology, Tata Memorial Centre, HBNI, Mumbai, Maharashtra, India

Date of Submission07-Jul-2020
Date of Decision10-Jul-2020
Date of Acceptance16-Jul-2020
Date of Web Publication19-Sep-2020

Correspondence Address:
Kumar Prabhash
Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_235_20

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How to cite this article:
Patil VM, Noronha V, Joshi A, Dhumal S, Menon N, Prabhash K. Authors' reply to Kies and Katna et al. Cancer Res Stat Treat 2020;3:653

How to cite this URL:
Patil VM, Noronha V, Joshi A, Dhumal S, Menon N, Prabhash K. Authors' reply to Kies and Katna et al. Cancer Res Stat Treat [serial online] 2020 [cited 2020 Oct 21];3:653. Available from: https://www.crstonline.com/text.asp?2020/3/3/653/295491



We thank Kies[1] and Katna et al.[2] for their interest in our study[3] and the accompanying editorial.[4] We agree with the comments made by Dr. Kies. A prospective Phase II study with an innovative design and Bayesian statistics[5] is required. However, a long duration of follow-up is necessary, especially for esthesioneuroblastoma. Further, as pointed out by Dr. Kies, the treatment advances might make the approach outdated. Hence, there is a need to develop biomarkers and reliable short-term endpoints which could be used to address these concerns.

To answer Katna et al.'s query regarding the long-term survival outcomes in patients who underwent surgical resection with appropriate adjuvant treatment as compared to patients who received no surgery, we would like to mention that the required analysis was performed and presented in [Figure 3] and [Figure 5] of the article.[3] The factor “operability” used in the figures divides the patients into two groups based on whether or not they were surgically operated. As depicted, there was no statistically significant difference in the outcomes between these two groups. We agree that the metabolic complications reported by us are higher than those reported in germ cell tumors. However, there is a biological reason for this. All the patients received neoadjuvant chemotherapy, and except three, all had received radiation.[6] The radiation portals in sinonasal tumors encompass the pituitary gland and, to a variable extent, the hypothalamus. Radiation to the pituitary gland and hypothalamus can predispose the patients to the development of a metabolic syndrome due to endocrine insufficiency.[7],[8]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kies M. Does induction chemotherapy advance the multimodal treatment of locally advanced esthesioneuroblastoma and sinonasal tumor with neuroendocrine differentiation? Cancer Res Stat Treat 2020;3;650-1.  Back to cited text no. 1
    
2.
Katna R, Kalyani N, Bhosale B. Changing treatment paradigms in advanced sinonasal neuroendocrine cancers. Cancer Res Stat Treat 2020;3:651-2.  Back to cited text no. 2
  [Full text]  
3.
Patil VM, Noronha V, Joshi A, Talreja V, Dhumal S, Menon N, et al. Long-term outcomes of locally advanced and borderline resectable esthesioneuroblastoma and sinonasal tumor with neuroendocrine differentiation treated with neoadjuvant chemotherapy. Cancer Res Stat Treat 2020;3:201-6.  Back to cited text no. 3
  [Full text]  
4.
Limaye S, Shreenivas A. Who knows the nose? – The tale of esthesioneuroblastoma and sinonasal neuroendocrine carcinoma. Cancer Res Stat Treat 2020;3:293-5.  Back to cited text no. 4
  [Full text]  
5.
Bhattacharjee A, Vishwakarma GK, Banerjee S. A Bayesian approach for dynamic treatment regimes in the presence of competing risk analysis. Cancer Res Stat Treat 2018;1:51-7.  Back to cited text no. 5
  [Full text]  
6.
Patil VM, Joshi A, Noronha V, Sharma V, Zanwar S, Dhumal S, et al. Neoadjuvant chemotherapy in locally advanced and borderline resectable nonsquamous sinonasal tumors (esthesioneuroblastoma and sinonasal tumor with neuroendocrine differentiation). Int J Surg Oncol 2016;2016:6923730.  Back to cited text no. 6
    
7.
Sklar CA, Antal Z, Chemaitilly W, Cohen LE, Follin C, Meacham LR, et al. Hypothalamic-pituitary and growth disorders in survivors of childhood cancer: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2018;103:2761-84.  Back to cited text no. 7
    
8.
Cooksey R, Wu SY, Klesse L, Oden JD, Bland RE, Hodges JC, et al. Metabolic syndrome is a sequela of radiation exposure in hypothalamic obesity among survivors of childhood brain tumors. J Investig Med 2019;67:295-302.  Back to cited text no. 8
    




 

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