Abstract
Introduction
About a hundred years ago, lung cancer was a reportable disease, and it is now the commonest cause of death from cancer in both men and women in the developed world, and before long, will reach that level in the developing world as well.Lung cancer has been the most common cancer in the world for several decades. There were estimated to be 1.8 million new cases in 2015 (12.9% of the total), 58% of which occurred in the less developed regions. In India, the estimated number of new cases of lung carcinoma in 2012 were 70,275(6.9% of the total).2Majority of the patients who were recruited in the present study were bidi smokers, which poses a 6-fold higher risk of lung cancer as compared to cigarette.9 The incidence of lung cancer increases with larger amounts of bidis smoked per day, with longer duration of bidi smoking and with starting to smoke bidis from a younger age.10 Hookah smokers have an increased risk of developing lung cancer as compared to non-smokers and also pose a threat to non-smokers in their households by exposing them to second/third hand smoke.11In developing countries like India, most of the patients present with locally advanced as well as metastatic disease, which could be due to lack of awareness, economic constraints and asymptomatic early stages of the disease. Locally advanced stages, along with poor general condition of the patient presents a unique kind of challenge about its management as in majority of the cases the patients are unfit for any sort of radical treatment. Therefore, there is a need for tailoring out treatment for such patients which can give them symptomatic relief and improve their quality of life.The palliative treatment approaches traditionally include palliative radiotherapy, palliative intravenous or oral chemotherapy, or both. More recently, the availability oral tyrosine kinase inhibitors (such as Gefitinib and Crizotinib) has revolutionized the treatment of Non-small cell lung cancer. Though very effective, these targeted therapies are applicable only in certain mutational variants of adenocarcinoma.21 Also being expensive, targeted therapies are often not afforded by a large proportion of patients.22 As there are no effective targeted therapies for squamous cell carcinoma23, therefore metronomic Cyclophosphamide is a suitable and effective alternative in such situations.
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Corresponding Author
Dr Joydeep Singh Vasant
3rd Year Post Graduate Student, Department of Radiotherapy, PGIMS, Rohtak, India
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.62
