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Ameloblastoma is a relatively common benign tumor that occurs in the dental epithelial tissues, which is characterized with local infiltration and growth, high-risk recurrence and metastasis, etc. At present, radical osteotomy is the main treatment of ameloblastoma, whereas it yields high recurrence rate and causes multiple postoperative complications such as facial and functional deformities, etc. For inoperable patients, non-surgical interventions, such as radiotherapy, chemotherapy and molecule-targeted therapy, are urgently needed to improve prognosis and retain organs. This article summarizes the current status and research progresses on non-surgical treatment of ameloblastoma, aiming to provide evidence for individualized treatment of ameloblastoma.
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Objective:Ameloblastoma (AM) is a rare tumor derived from dental epithelial tissues, which is prone to recurrence and infiltration. This study aims to identify the prognostic factors of AM.Methods:207 ameloblastoma patients were screened from the SEER database. A Cox regression model and nomogram were constructed to evaluate the factors on the overall survival. Clinical data of 61 patients admitted to Hunan Cancer Hospital were retrospectively analyzed. The independent factors of recurrence rate were analyzed by the Cox regression model.Results:The results on the SEER database showed that age, tumor size, type of surgery, radiotherapy were important prognostic factors of the overall survival. The nomogram was constructed and the C-index was equaled to 0.821, indicating this model was moderately accurate. The receiver operating characteristic (ROC) curve demonstrated that the area under the ROC curve (AUC) at 1, 3, 5, and 10 years were 0.852, 0.869, 0.856, and 0.879, indicating this model had relatively high sensitivity and specificity. Kaplan- Meier survival analysis suggested that overall survival in the high-risk group was significantly lower than that in the low-risk group ( P<0.001). Based on retrospective analysis, clinical symptoms and type of surgery were the independent factors of the local recurrence rate. Kaplan- Meier survival analysis found the recurrence rate of facial swelling and pain was lower compared to those of other symptoms. Compared with the palliative surgery, radical surgery could decrease the recurrence rate. Conclusions:Age, tumor size, type of surgery, and radiotherapy may be important factors of the overall survival. Type of surgery and clinical symptoms are probably the independent factors of the recurrence rate.
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OBJECTIVES@#To evaluate the application value of CT-based radiomics features for the ascending and descending types of nasopharyngeal carcinoma (NPC).@*METHODS@#A total of 217 NPC patients (48 ascending type and 169 descending type), who obtained CT images before radiotherapy in Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University from February 2015 to October 2017, were analyzed retrospectively. All patients were randomly divided into a training set (=153) and a test set (=64). Gross tumor volume in the nasopharynx (GTVnx) was selected as regions of interest (ROI) and was analyzed by radiomics. A total of 1 300 radiomics features were extracted via IBEX. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to choose the significant features. Support vector machine (SVM) and random forest (RF) classifiers were built and verified.@*RESULTS@#Six features were selected by the LASSO from 1 300 radiomics features. Compared with SVM classifier, RF classifier showed better classification performance. The area under curve (AUC) of the receiver operating characteristic (ROC) curve, accuracy, sensitivity, and specificity were 0.989, 0.941, 1.000, and 0.924, respectively for the training set; 0.994, 0.937, 1.000, and 0.924, respectively for the validation set.@*CONCLUSIONS@#CT-based radiomics features possess great potential in differentiating ascending and descending NPC. It provides a certain basis for accurate medical treatment of NPC, and may affect the treatment strategy of NPC in the future.
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Humans , Nasopharyngeal Carcinoma , Nasopharyngeal Neoplasms , ROC Curve , Retrospective Studies , Sensitivity and SpecificityABSTRACT
Objective To explore the expression of Metastasis-associated in colon cancer-1 (MACC1) in patients with nasopharyngeal carcinoma (NPC), and its relationship with clinical pathologic characteristics and prognosis Methods The expression of MACC1 was detected in 130 cases of NPC and the relationship among the MACC1 expressions, clinical pathologic characteristics and prognosis of NPC was analyzed. Results Positive expression rate of MACC1was 68.5% in the NPC and MACC1 expression was associated with advanced T stages, lymph node metastasis and advanced clinical stages of NPC (P < 0.05). The results of Kaplan-Meier survival analysis showed that the five year overall survival rate in patients with positive expressions of MACC1 (45.9%) was significantly lower than that of those with negative expressions (73.7%) and the difference was statistically significant (P < 0.05), Cox multi-factor analysis results showed that MACC1 expression was an independent prognostic factor for NPC (P = 0.004). Conclusion MACC1 abnormal expression is closely related to the invasion and metastasis of NPC and it is expected to become a new target for gene therapy of NPC.
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Objective To determine the relation between the incidence of radiation pneumonitis(RP) and available parameters from a dose-volume histogram(DVH) in patients with non-small cell lung cancer(NSCLC) who underwent three-dimensional conformal radiotherapy treatment.Methods Between January 1998 and December 2005 our hospital,62 patients with NSCLC were treated using three-dimensional conformal radiotherapy(3D CRT).All patients were treated 5 days per week with daily fractionation of 2 Gy to total dose of 60~70 Gy.All patients were available for analysis for symptomatic RP.Radiation pneumonitis was graded according to the RTOG/EORTC morbidity scoring classification.Logistic regression analysis was performed to test the association between RP and the following DVH parameters: mean lung dose(MLD),volume of lung receiving 20 Gy(V20) and 30 Gy(V30) and normal tissue complication probability(NTCP).Additionally,correlation of the following clinical factors such as: age,sex,tumor site,performance status(KPS),and additional therapy(chemotherapy) with incidence of the RP were performed.Results Thirty out of 62 patients(48%) developed RP grade 0 or 1(0 grade:12%,1 grade:36%) and 32(52%) grade 2 or 3(2 grade:47%,3 grade:5%).In the logistic regression analysis,all DVH parameters were associated with RP(p in range from 0.004 to 0.007).The strongest association was observed for NTCP and V30(P=0.004).Conclusion NTCP and V30 parameters were the best predictors of symptomatic radiation pneumonitis for patients after three-dimensional conformal radiotherapy of non-small cell lung cancer.