Indication of lower neck irradiation in nasopharyngeal carcinoma without nodal metastasis: the potential impact of tumor volume / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Elective radiation of lower neck is controversial for nasopharyngeal carcinoma (NPC) without lymph node metastasis (N0 disease). Tumor volume is an important prognostic indicator. The objective of this study is to explore the potential impact of tumor volume on the indication of the lower neck irradiation for N0-NPC, by a qualitative evaluation of the relationship between tumor volume and nodal metastasis.</p><p><b>METHODS</b>Magnetic resonance (MR) images of 99 consecutive patients with NPC who underwent treatment were retrospectively reviewed. Primary tumor volumes of NPC were semi-automatically measured, nodal metastases were N-classified and neck level involvements were examined. Distributions of tumor volumes among N-category-based groups and distributions of N-categories among tumor volume-based groups were analyzed, respectively.</p><p><b>RESULTS</b>The numbers of patients with N0 to N3 disease were 12, 39, 32, and 16, respectively. The volumes of primary tumor were from 3.3 to 89.6 ml, with a median of 17.1 ml. For patients with nodal metastasis, tumor volume did not increase significantly with the advancing of N-category (P > 0.05). No significant difference was found for the distribution of N1, N2, and N3 categories among tumor volume-based groups (P > 0.05). Nevertheless patients with nodal metastasis had significantly larger tumor volumes than those without metastasis (P < 0.05). Patients with larger tumor volumes were associated with an increased incidence of nodal metastasis.</p><p><b>CONCLUSIONS</b>Certain positive correlations existed between tumor volume and the presence of nodal metastasis. The tumor volume (>10 ml) is a potential indicator for the lower neck irradiation for N0-NPC.</p>

A survey of local preclinical and clinical medical students' attitudes towards radiology

<p><b>INTRODUCTION</b>This study compares the attitudes between preclinical and clinical medical students towards radiology, following the introduction of a new radiology curriculum for 1st year students.</p><p><b>MATERIALS AND METHODS</b>Revision of the 1st year medical school curriculum for the academic year of 2008/9 with the inclusion of 13 one-hour formal radiology lectures integrated with each body system was done in an undergraduate Southeast Asian medical school. In the old curriculum, 1st and 2nd year medical students are not exposed to radiology. They received limited radiology teaching in their 3rd and 5th years with 2 one-hour lectures as part of their medicine and surgery rotations. In the 4th year, they have a one week non-examinable posting in radiology. A survey was administered to preclinical (new curriculum) and clinical (old curriculum) students. Survey responses were tabulated and attitudes between preclinical and clinical students were compared.</p><p><b>RESULTS</b>More than half of the preclinical students (155 out of 270 students, 59%) and 90 out of 720 clinical students (12.5%) responded. Students exposed to the new curriculum had attended one or two dedicated radiology lectures and were considering radiology as a clinical elective. Both groups of students did not feel familiar with radiology as with other specialties, were not considering radiology as a career, but felt that radiology was interesting and important to the overall practice of medicine.</p><p><b>CONCLUSIONS</b>Exposure of 1st year students to radiology increases their interest in the subject. Further intervention, fi ne-tuning of the curriculum and follow-up surveys will be carried out to see if this interest persists throughout their clinical years.</p>