ABSTRACT
PURPOSE: The purpose of this study was to subdivide M1 stage nasopharyngeal carcinoma (NPC) patients with bone-only metastases for prognosis prediction while identifying the treatment effect of locoregional radiotherapy (LRRT) and metastasis radiotherapy (MRT) among patients with different risk. MATERIALS AND METHODS: From November 2006 to October 2016, a total of 226 patients with bone-only metastasic NPC were retrospectively enrolled. All patients developed distant lesions before receiving treatment. All potential prognostic factors were considered and the correlation of the M1 subdivisions with overall survival (OS) was determined by Cox regression hazards model. Kaplan–Meier curves were used to appraise survival condition and log-rank testing was used to compare the differences. RESULTS: The median follow-up time was 33.9 months (range, 3 to 126 months). According to multivariate Cox proportional hazard analysis, the number of metastatic lesions and Epstein-Barr virus (EBV) DNA status after palliative chemotherapy (PCT) were independent prognostic factors for OS. Thus, we subdivided patients into three risk groups according to these two factors. Systemic chemotherapy combined with LRRT may benefit patients in low- and intermediate-risk groups but not in the high-risk group. Further aggressive MRT based on systemic chemotherapy showed no survival benefit in any risk group. CONCLUSION: The stratification of NPC patients with bone-only metastasis based on EBV DNA after PCT and the number of metastatic lesions provided promising prognostic value and could aid clinicians in person-specific treatment.
Subject(s)
Humans , Diagnosis , DNA , Drug Therapy , Follow-Up Studies , Herpesvirus 4, Human , Neoplasm Metastasis , Prognosis , Proportional Hazards Models , Radiotherapy , Retrospective StudiesABSTRACT
PURPOSE: The purpose of this study was to investigate the survival trends and patterns of failure in patients with stage II nasopharyngeal carcinoma (NPC) treated with radiotherapy (RT) and chemotherapy over the last 20 years. MATERIALS AND METHODS: Thirty-eight hundred and eight patients diagnosed with stage II NPC between January 1990 and December 2012 were involved in this retrospective cohort study. All patients were treated with RT. According to the main imaging techniques and RT technology, we categorized these patients into four calendar periods: 1990-1996, 1997-2002, 2003-2007, and 2008-2012. Overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), and distant metastasis–free survival (DMFS) were served as the clinical outcome. RESULTS: After a median follow-up period of 84.7 months, we observed increasing trends in survival and disease control. The 3- and 5-year OS rates increased from 87.1% and 78.7% in the first calendar period to 97.4% and 94.5% in the last calendar period, respectively (p<0.001). Additionally, significant increasing trends could be seen in the PFS and LRFS during the four calendar periods. In the subgroup analysis, the LRFS in patients older than 50 years at diagnosis showed greater improvement than younger patients. However, the rate of distant metastasis was stable and relatively low, as the 5-year DMFS ranged from 90.5% to 94.7% among the four calendar periods. CONCLUSION: The survival rates in patients with stage II NPC showed increasing trends from 1990 to 2012. The advance of RT provided excellent locoregional control and enhanced OS.
Subject(s)
Humans , Cohort Studies , Diagnosis , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Neoplasm Metastasis , Prognosis , Radiotherapy , Retrospective Studies , Survival RateABSTRACT
PURPOSE: The purpose of this study was to evaluate the long-term clinical outcome and toxicity of induction chemotherapy (IC) followed by concomitant chemoradiotherapy (CCRT) compared with CCRT alone for the treatment of children and adolescent locoregionally advanced nasopharyngeal carcinoma (LACANPC). MATERIALS AND METHODS: A total of 194 locoregionally advanced nasopharyngeal carcinoma patients youngerthan 21 years who received CCRT with or without IC before were included in the study population. Overall survival (OS) rate, progression-free survival (PFS) rate, locoregional recurrence-free survival (LRFS) rate, and distant metastasis-free survival (DMFS) rate were assessed by the Kaplan-Meier method and a log-rank test. Treatment toxicities were clarified and compared between two groups. RESULTS: One hundred and thiry of 194 patients received IC+CCRT. Patients who were younger and with more advanced TNM stage were more likely to receive IC+CCRT and intensive modulated radiotherapy. The addition of IC before CCRT failed to improve survival significantly. The matched analysis identified 43 well-balanced patients in both two groups. With a median follow-up of 51.5 months, no differences were found between the IC+CCRT group and the CCRT group in 5-year OS (83.7% vs. 74.6%, p=0.153), PFS (79.2% vs. 73.4%, p=0.355), LRFS (97.7% vs. 88.2%, p=0.083), and DMFS (81.6% vs. 81.6%, p=0.860). N3 was an independent prognostic factor predicting poorer OS, PFS, and DMFS. The addition of IC was associated with increased rates of grade 3 to 4 neutropenia. CONCLUSION: This study failed to demonstrate that adding IC before CCRT could provide a significant additional survival benefit for LACANPC patients. Further investigations are warranted.
Subject(s)
Adolescent , Child , Humans , Chemoradiotherapy , Cohort Studies , Disease-Free Survival , Follow-Up Studies , Induction Chemotherapy , Methods , Neutropenia , RadiotherapyABSTRACT
PURPOSE: Little is known about combination of the circulating Epstein-Barr viral (EBV) DNA and tumor volume in prognosis of stage II nasopharyngeal carcinoma (NPC) patients in the intensity modulated radiotherapy (IMRT) era. We conducted this cohort study to evaluate the prognostic values of combining these two factors. MATERIALS AND METHODS: By Kaplan-Meier, we compare the differences of survival curves between 385 patients with different EBV DNA or tumor volume levels, or with the combination of two biomarkers mentioned above. RESULTS: Gross tumor volume of cervical lymph nodes (GTVnd, p 0 copy/mL, GTVtotal 0 copy/mL, GTVtotal ≥ 30 cm³). When patients in the low-risk group were compared with those in the high-risk group, 3-year PFS (p=0.003), LRFS (p=0.010), and DMFS (p=0.031) rates were statistically significant. CONCLUSION: Pretreatment plasma EBV DNA and tumor volume were both closely correlated with prognosis of stage II NPC patients in the IMRT era. Combination of EBV DNA and tumor volume can refine prognosis and indicate for clinical therapy.
Subject(s)
Humans , Biomarkers , Cohort Studies , DNA , Herpesvirus 4, Human , Lymph Nodes , Nasopharynx , Plasma , Prognosis , Radiotherapy , Tumor BurdenABSTRACT
PURPOSE: The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC. MATERIALS AND METHODS: In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary end-point was progress-free survival (PFS). RESULTS: The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the high-SAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors. CONCLUSION: The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.
Subject(s)
Humans , C-Reactive Protein , DNA , Herpesvirus 4, Human , Observational Study , Prognosis , Prospective Studies , Serum Amyloid A Protein , Survival AnalysisABSTRACT
·AIM: To investigate the effect of Ghrelin on oxidative stress induced by high glucose in human retinal pigment epithelium (RPE) cells. ·METHODS: RPE cells were cultured and divided into the negative control group, high sugar group, Ghrelin low dose group ( 10-9mol/L ) and high dose group (10-6mol/L). Cells survival rate were detected by CCK-8 colorimetry, cells oxidative damage were observed by oxygen sensitive fluorescence probe H2DCFDA staning, changes of intracellular reactive oxygen species ( ROS ) were detected by H2DCFDA staining, super oxide dismutase ( SOD) activity and malondialdehyde ( MDA) content were detected by spectrophotometer colorimetry. ·RESULTS: CCK-8 results showed that RPE cells survival rate increased to 54.79%±3.43% and 79.16%±3.29% after treated with 10-9mol/L, 10-6mol/L Ghrelin, the difference was statistically significant compared with high glucose group (41.65%±3.42%)(P<0.05). H2DCFDA fluorescent probe dying showed that Ghrelin reduced ROS generation in RPE cells and decreased oxidative damage cells. Spectrophotometer colorimetric method showed that according to the high sugar group, SOD activity increased and MDA content decreased in Ghrelin group. ·CONCLUSION: Ghrelin could inhibit high glucose - induced oxidative damage in human RPE cells, which has protective effect on the process of the occurrence and development of diabetic retinopathy.
ABSTRACT
AIM:To explore the effect of different concentrations of salidroside on H2 O2 induced oxidative stress damage in human lens epithelium cells ( HLEC) . · METHODS: HLEC were cultured and divided into negative control group: cultured in normal cultivation;oxidative damage group: treated with 100μmol/L H2 O2 for 12h; Salidroside low concentration group: 10μmol/L salidroside treated for 24h and H2 O2 treated for 12h;Salidroside high concentration group: 100μmol/L salidroside treated for 24h and H2 O2 treated for 12h. MTT method was applied to observe the effect of salidroside on HLEC survival rate. Morphological change of each group were observed and recorded under inverted microscope. DCFH-DA fluorescent probe was applied to detect intracellular ROS changes; content of malondialdehyde ( MDA ) , superoxide dismutase ( SOD ) and glutathione peroxidase ( GSH-Px ) in supernatants were detected by pectrophotometer. · RESULTS: Salidroside obviously inhibited H2 O2 -induced HLEC vitality decline, inhibited ROS generation in cells, causing SOD, GSH-Px levels increased and MDA levels decreased. ·CONCLUSION:Salidroside inhibited H2 O2 induced HLEC injury by decreasing the intracellular MDA content levels and increasing SOD, GSH-Px content levels, which conclude that salidroside may have a certain role in the treatment of HLEC damage.
ABSTRACT
OBJECTIVE: To optimize the formulation of pressure indicator based on spreadability, nonadhesion to oral mucosa, and difficulty of removal. METHODS: The formulation components were screened by colligation score, the optimal formulation was designed by orthogonal test, and the heat-resistance, cold-resistance, and stability of the optimal formulation were evaluated. RESULTS: The optimized pressure indicator using lanolin as the main ingredient had good color coverage and suitable viscosity which allowed easy coating of the internal surfaces of dentures and no adherence to the oral mucosa at the same time. And it could be removed easily. The results of orthogonal test showed that the ratio of lanolin and water was the main factor affecting the performance of the pressure indicator. The optimized formulation was stable. CONCLUSION: The optimized pressure indicator has good performance and good clinical response. The preparation process is simple. The property of optimized pressure indicator is stable and the quality can be controlled.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the prevalence and natural outcome of late-life depression in the community and to analyze the risk-prediction models.</p><p><b>METHODS</b>A community in Hang Zhou was selected as a trial. A total of 1 275 persons aged 60 or more in this community were screened by PHQ-9 questionnaire; SCID was used for interviewer to diagnostic interview the people whose PHQ-9 was more than 10 points, 50 % of those whose PHQ-9 was from 5 to 9 points and 5 % of those whose PHQ-9 was less than 5 points, then all those who accepted diagnostically interview were interviewed by PHQ-9 every 3 months in one year, and were diagnostic interviewed by SCID in the last month. Logistic regression analysis was used to explore depressive risk factors in 12 months.</p><p><b>RESULTS</b>There were 141 (11.1%) persons whose PHQ-9 score was more than 10 points, 298 (23.4%) whose PHQ-9 score were 5-9 points, and 836 (65.5%) whose PHQ-9 score were 0 to 4 points in the preliminary survey, 93 were major depressive disorder (MDD). The prevalence of late-life depression was 7.3%. Compared with the PHQ-9 score in one year, 17.6% of those with no depressive symptoms emerged depression; 50% of those who had depressive symptoms declined, 9% developed to significant depressive symptoms, and 41% did not change; 12% of those with significant depressive symptoms were found no depression, 24% reduced, and 64% still had depression. The significant predictors were the accumulation of disease, social support, educational level, daily capacity and baseline of depression.</p><p><b>CONCLUSION</b>The prevalence of late-life depression was high. The rates of recognition, diagnosis and treatment were low. The natural outcome after a year did not relieve apparently. Specialist-community health partnership management model is one of the important ways to prevent and treat late-life depression.</p>