The Effect of Induction Chemotherapy Using Docetaxel and Platinum in Treatment Methods of Nasopharyngeal Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to determine the efficacy of induction chemotherapy with docetaxel and platinum in patients with nasopharyngeal carcinoma. SUBJECTS AND METHOD: The medical records of 52 patients, who were diagnosed with NPC at our department from January 1995 to December 2005, were reviewed and retrospectively analyzed. Patients were divided into three groups according to treatment methods. Twenty-eight cases treated with induction chemotherapy consisted of docetaxel, platinum and RT, 17 cases treated with induction chemotherapy consisted of 5-FU, platinum and RT, and 7 cases were treated with RT only. A total of 114 chemotherapy cycles were administered to patients and most received 2 cycles. RESULTS: The T stage distribution at the time of diagnosis was 48%, 14%, 15%, and 23% for T1, T2, T3 and T4, respectively. According to the WHO classification, the type I included 11 cases, type II 2cases, and type III 39 cases. The overall 5-year survival rate was 60.6%. According to the treatment modality, only the RT group was 42.9%. In the chemoradiotherapy group, the 5-year survival rates of 5-FU and platinum combination group and docetaxel and platinum combination group were 47.1% and 78.8%, respectively. There was significant difference in survival (p=0.037). There was no difference in sex, age, and N stage with regards to the 5-year survival rate. CONCLUSION: Although no valid conclusions could be drawn because of the small number of patients examined in the present study, we found that induction chemotherapy consists of docetaxel and that platinum may improve the outcome of patients with NPC.

The Utility of Serum PTH Assessment 1 Hour after Total Thyroidectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hypocalcemia is the most frequent complication following total thyroidectomy. This prospective study examines the predictive value of parathyroid hormone (PTH) levels measured 1 hour after surgery. MATERIALS AND METHOD: Twenty-four patients underwent total or near-total thyroidectomy for benign or malignant thyroid tumor in one year. Serum calcium and PTH levels were measured preoperatively and at 1 hour after surgery. RESULTS: All patients were classified into three groups according to hypocalcemic symptoms and postoperative serum calcium levels. A total of 6 (25%) patients were found with hypocalcemia, as demonstrated by clinical and laboratory findings. PTH levels at 1 hour were below normal level (100%) for 6 of the 6 symptomatic hypocalcemia patients, 5 (45%) of the 11 biochemical hypocalcemia patients, and in 1 (14%) of 7 normocalcemic patients (p=0.002). The sensitivity and specificity of postoperative 1 hour PTH assessment to predict symptomatic hypocalcemia were 100% and 66%. The positive and negative predictive rate of postoperative 1 hour PTH assessment to predict symptomatic hypocalcemia were 50% and 100%. CONCLUSION: Parathyroid gland insufficiency is the main determinant of transient hypocalcemia after bilateral thyroid surgery. Low PTH level at 1 hour after surgery is therefore a feasible predictor of postoperative symptomatic hypocalcemia and permanent hypoparathyroidism.