Prognostic importance of expression of mini-chromosome maintenance proteins (MCMs) in patients with nasopharyngeal cancer treated with curative radiotherapy

Abstract Objective: The prognostic importance of minichromosome maintenance complex expression in nasopharyngeal cancer is still unknown. We aimed to find whether minichromosome maintenance complex 2-7 expression may potentially be used to predict the prognosis of nasopharyngeal cancer patients treated with definitive radiotherapy. Methods: Between April 2007 and July 2020, patients with nasopharyngeal cancer treated with radiotherapy were identified. Immunohistochemical analysis was performed on formalin-fixed paraffin-embedded tissues of cases. A single pathologist analyzed the histologic specimens of all patients. Results: Totally, 67 patients were included. The median followup was 75.3 months. Higher tumor (T) stage was correlated with minichromosome maintenance complex 2 overexpression. Minichromosome maintenance complex s expression was also associated with histopathologic subgroups. According to univariate analysis, AJCC stage, histopathological subgroups, tumor response after treatment, minichromosome maintenance complex 2, 3, 5, 6 and 7 expression were the prognostic factors that predict overall survival. According to multivariate analysis minichromosome maintenance complex 7 expression was the only prognostic marker for both progression-free survival and overall survival. Conclusion: The overexpression of minichromosome maintenance complex 2, 3, 5, 6 and 7 indicated bad prognosis. Minichromosome maintenance complex 7 was an independent prognostic factor for survival outcomes in nasopharyngeal cancer and may be a potential therapeutic target for treatment.

The impact of multimodality integrated positron emission tomography-computed tomography on improving the staging and management of head and neck malignancy: a cross- sectional study

ABSTRACT BACKGROUND: Clinical assessment of head and neck cancers is highly challenging owing to the complexity of regional anatomy and wide range of lesions. The diagnostic evaluation includes detailed physical examination, biopsy and imaging modalities for disease extent and staging. Appropriate imaging is done to enable determination of precise tumor extent and involvement of lymph nodes, and detection of distant metastases and second primary tumors. OBJECTIVE: To evaluate the initial staging discrepancy between conventional contrasted computed tomography (CT) and 18F-fluorodeoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) and its impact on management plans for head and neck malignancies. DESIGN AND SETTING: Prospective cross-sectional study in two tertiary-level hospitals. METHODS: This study included 30 patients with primary head and neck malignant tumors who underwent contrasted computed tomography and whole-body 18F-FDG PET/CT assessments. The staging and treatment plans were compared with the incremental information obtained after 18F-FDG PET/CT. RESULTS: 18F-FDG PET/CT was found to raise the stage in 33.3% of the cases and the treatment intent was altered in 43.3% of them, while there was no management change in the remaining 56.7%. 18F-FDG PET/CT had higher sensitivity (96% versus 89.2%) and accuracy (93% versus 86.7%) than conventional contrast-enhanced computed tomography. CONCLUSION: Our study demonstrated that 18F-FDG PET/CT had higher sensitivity and accuracy for detecting head and neck malignancy, in comparison with conventional contrast-enhanced computed tomography. 18F-FDG PET/CT improved the initial staging and substantially impacted the management strategy for head and neck malignancies.

Prognostic factors in metastatic nasopharyngeal carcinoma / Fatores prognósticos no carcinoma nasofaríngeo metastático

Abstract Introduction: Nasopharyngeal carcinoma has the highest metastatic potential of all head and neck cancers. The survival time of patients with nasopharyngeal carcinoma has improved significantly in the last decades due to the use of combination of chemotherapy and radiotherapy, as well as advances in radiotherapy techniques. However, appropriately 30% of patients with nasopharyngeal carcinoma suffer a poor prognosis, mainly due to distant metastasis. Objective: The study aimed to identify the survival and prognostic factors in metastatic nasopharyngeal carcinoma. Methods: A retrospective analysis was conducted in patients treated for synchronous metastatic nasopharyngeal carcinoma or metachronous metastatic nasopharyngeal carcinoma for 14years (2003-2016). Overall survival was analyzed using the Kaplan-Meier method and compared using the log-rank test for the whole population and both groups of patients. Multivariate analysis was performed using the Cox model; p-values < 0.05 were considered to indicate statistical significance. Results: One hundred and twelve patients with metastatic nasopharyngeal carcinoma were included (51 patients with metastatic nasopharyngeal carcinoma, and 61 patients with metachronous metastatic nasopharyngeal carcinoma). In the whole population, the median overall survival was 10 months (1-156 months). In the multivariate analysis, female gender, poor performance status (WHO > 1) and metachronous metastasis were independent prognostic factors. In the metastatic nasopharyngeal carcinoma patients, the median overall survival was 13 months (1-156 months). In multivariate analysis, independent prognostic factors were non-oligometastatic disease, severe (G3-G4) chemotherapy toxicity and the lack of nasopharyngeal and metastatic site irradiation. In the metachronous metastatic nasopharyngeal carcinoma patients, the median overall survival was 7 months (1-41 months). In multivariate analysis, the poor performance status (WHO > 1) was an independent metastatic nasopharyngeal carcinoma prognostic factor. Conclusion: Oligometastatic patients with synchronous metastatic nasopharyngeal carcinoma had better survival. The locoregional treatment of primitive nasopharyngeal carcinoma improved survival in patients with metastatic nasopharyngeal carcinoma who responded to induction chemotherapy. Local irradiation of metastatic sites improved survival of metastatic nasopharyngeal carcinoma patients. Grade 3 or 4 chemotherapy toxicity altered survival among patients with synchronous metastatic nasopharyngeal carcinoma.

Resumo Introdução: O carcinoma nasofaríngeo tem o maior potencial metastático de todos os tipos de câncer de cabeça e pescoço. O tempo de sobrevida dos pacientes com carcinoma nasofaríngeo melhorou significativamente nas últimas décadas devido ao uso combinado de quimioterapia e radioterapia e os avanços nas técnicas de radioterapia. No entanto, aproximadamente 30% dos pacientes com carcinoma nasofaríngeo têm um prognóstico ruim, principalmente devido a metástases a distância. Objetivo: Identificar a sobrevida e os fatores prognósticos no carcinoma nasofaríngeo metastático. Método: Foi feita uma análise retrospectiva de pacientes tratados por carcinoma nasofaríngeo metastático sincrônico ou carcinoma nasofaríngeo metastático metacrônico por 14 anos (2003-2016). A sobrevida global foi analisada pelo método de Kaplan-Meier e comparada pelo teste de log-rank para toda a população e ambos os grupos de pacientes. A análise multivariada foi feita com o modelo de Cox; valores de p < 0,05 foram considerados como significância estatística. Resultados: Foram incluídos 112 pacientes com carcinoma nasofaríngeo metastático (51 com carcinoma nasofaríngeo metastático sincrônico e 61 com carcinoma nasofaríngeo metastático metacrônico). Em toda a população, a mediana da sobrevida global foi de 10 meses (1-156 meses). Na análise multivariada, sexo feminino, baixo status de desempenho (OMS > 1) e metástase metacrônica foram fatores prognósticos independentes. Nos pacientes com carcinoma nasofaríngeo metastático sincrônico, a mediana da sobrevida global foi de 13 meses (1-156 meses). Na análise multivariada, os fatores prognósticos independentes foram doença não oli-gometastática, toxicidade grave à quimioterapia (G3 - G4) e falta de irradiação nasofaríngea e do sítio metastático. Nos pacientes com carcinoma nasofaríngeo metastático metacrônico, a mediana da sobrevida global foi de 7 meses (1-41 meses). Na análise multivariada, o baixo status de desempenho (OMS > 1) foi um fator prognóstico independente. Conclusão: Pacientes oligometastáticos com carcinoma nasofaríngeo metastático sincrônico tiveram melhor sobrevida. O tratamento locorregional do carcinoma nasofaríngeo primário melhorou a sobrevida em pacientes com carcinoma nasofaríngeo metastático sincrônico que responderam à quimioterapia de indução. A irradiação local dos locais metastáticos melhorou a sobrevida dos pacientes com carcinoma nasofaríngeo metastático. A toxicidade de quimioterapia de grau 3 ou 4 alterou a sobrevida entre pacientes com carcinoma nasofaríngeo metastático sincrônico.

Preclinical evaluation and pilot clinical study of 18FAlF-labeled FAPI-tracer for PET imaging of cancer associated fibroblasts

In recent years, fibroblast activation protein (FAP) has emerged as an attractive target for the diagnosis and radiotherapy of cancers using FAP-specific radioligands. Herein, we aimed to design a novel 18F-labeled FAP tracer ([18F]AlF-P-FAPI) for FAP imaging and evaluated its potential for clinical application. The [18F]AlF-P-FAPI novel tracer was prepared in an automated manner within 42 min with a non-decay corrected radiochemical yield of 32 ± 6% (n = 8). Among A549-FAP cells, [18F]AlF-P-FAPI demonstrated specific uptake, rapid internalization, and low cellular efflux. Compared to the patent tracer [18F]FAPI-42, [18F]AlF-P-FAPI exhibited lower levels of cellular efflux in the A549-FAP cells and higher stability in vivo. Micro-PET imaging in the A549-FAP tumor model indicated higher specific tumor uptake of [18F]AlF-P-FAPI (7.0 ± 1.0% ID/g) compared to patent tracers [18F]FAPI-42 (3.2 ± 0.6% ID/g) and [68Ga]Ga-FAPI-04 (2.7 ± 0.5% ID/g). Furthermore, in an initial diagnostic application in a patient with nasopharyngeal cancer, [18F]AlF-P-FAPI and [18F]FDG PET/CT showed comparable results for both primary tumors and lymph node metastases. These results suggest that [18F]AlF-P-FAPI can be conveniently prepared, with promising characteristics in the preclinical evaluation. The feasibility of FAP imaging was demonstrated using PET studies.

Complete response to radiation therapy for nasopharyngeal sarcomatoid carcinoma

Nasopharyngeal sarcomatoid carcinoma (SaCa) is extremely rare, and concurrent chemoradiation is the standard treatment for squamous cell-based nasopharyngeal cancer (NPC). This case report gives the first explanation of a nasopharyngeal SaCa patient treated with volumetric modulated arc therapy (VMAT) with simultaneous integrated boost (SIB), which is an excellent treatment modality that leads to complete response for locally advanced NPC. A 70-year-old male presented with nasal obstruction, epistaxis, and right neck node enlargements. Examination revealed an extensive tumor of nasopharyngeal tumor extending into the nasal cavity and right parapharyngeal space with bilateral lymphadenopathy on positron emission tomography (PET)–computed tomography images of focal hypermetabolic bone lesion in C4 body (stage T3N2M1). An excisional biopsy of nasopharyngeal wall mass showed a SaCa. He received concurrent chemoradiation which was VMAT and systemic chemotherapy (cisplatin 60 mg). A dose of 70 Gy was delivered to the planning target volume (PTV70) (gross tumor volume plus margin 3–5 mm) and PTV59.4(a wider margin around high-risk clinical target volume, including the clivus and neck nodes) all given in 33 fractions. Radiological examination such as magnetic resonance imaging (MRI) and PET images at the completion of external beam therapy revealed questionable residual disease. Follow-up MRI scans 4 weeks after radiotherapy revealed a complete tumor response. VMAT with SIB can be an effective treatment option for SaCa of the advanced nasopharynx.

Synchronous papillary thyroid carcinoma with metastatic nasopharyngeal carcinoma issues regarding its diagnosis and management

@#A 46-year old female presented with a one-year history of a right lateral neck mass which gradually increased in size and subsequently involved bilateral cervical nodes. Diagnosed as Papillary Thyroid Carcinoma Stage I (T1N2M0), she underwent Total Thyroidectomy, Central Neck Dissection, Modified Radical Neck Dissection, Type I, right and Modified Radical Neck Dissection Type III, left. Histopathology revealed papillary thyroid carcinoma with no lymphovascular and capsular invasion, and metastatic undifferentiated carcinoma in 15 out of 16 lymph nodes, probably nasopharyngeal in origin. Work up uncovered an erythematous, friable nasopharyngeal mass. Its histopathology was nasopharyngeal cancer, a second primary malignancy. The malignancies were treated as separate entities. The patient underwent chemoradiotherapy first for the nasopharyngeal cancer. Radioactive Iodine for the thyroid malignancy was given six months after completion of radiotherapy. Double primary malignancies deserve aggressive treatment. The sequence of therapy should be based on the severity of the malignancy.

Mechanisms of inhibition of invasion and metastasis of nasopharyngeal carcinoma cells by neferine through its influence on microRNAs / 药学学报

This study was designed to investigate the inhibitory effect and mechanism of neferine (Nef) on invasion and metastasis of nasopharyngeal carcinoma cells (NPC). The viability of CNE-1 and 5-8F cells was detected by CCK-8 assay after treatment with different concentrations of Nef. The effects of Nef on cell migration and invasion were detected by the scratch test and Transwell assay. Western blot analysis was used to detect the effects of Nef on levels of epithelial-mesenchymal transition (EMT)-associated proteins and transcription factors. The differentially expressed gene profiles between control group and Nef group were analyzed by microRNA microarray, combined with bioinformation analysis. It was observed that 30 μmol·L-1 Nef had no significant effect on the viability of CNE-1 and 5-8F cells. Western blot assay showed that the expression level of neurotroponin cadherin (N-cadherin) and vimentin decreased after treatment with Nef, while the expression of epithelial cadherin (E-cadherin) increased. The expression of transcription factors including Twist, Snail, and Slug exhibited no significant difference. Results of the microRNA microarray suggest that 10 microRNAs showed significant differences when compared with the control group. Bioinformatics analysis showed that hsa-let-7c-5p and hsa-microRNA-423-5p targeted the same downstream genes: small integral membrane protein 3 (SMIM3) and nerve growth factor (NGF). Overexpression of hsa-let-7c-5p and hsa-miR-423-5p promoted the invasion and migration ability of 5-8F cells and decreased the expression of SMIM3 and NGF. The results from this study suggest that Nef may inhibit the invasion and metastasis of NPC cells by inhibiting the expression of hsa-let-7c-5p and hsa-miR-423-5p followed by the upregulation of SMIM3 and NGF; thus, regulating the expression of EMT-associated proteins. Our data have provided experimental evidence for the inhibition of tumor invasion and metastasis by Nef.

Nasopharyngeal Cancer : Geographic Variation and Risk Factors

@#Introduction: Nasopharyngeal cancer is known to be a rare malignancy that effects the head and neck region involving the nasopharynx. It has a 0.8% occurrence rate among all types of cancer and has many risk factors ranging from viral infections to dietary intake habits. This study aims in determining the geographical variations across the world and its associated risk factors with nasopharyngeal cancer. Methods: The study was initiated by extracting relevant literature articles from electronic databases such as PubMed, Science Direct and SEER from 2008-2018. Search strategy also included key terms; nasopharyngeal cancer, nasopharyngeal carcinoma, prevalence, risk factors, geographic variation, distribution, incidences, epidemiology and mortality. Results: Nasopharyngeal cancer is most common in Asia and China had the most number of new cases diagnosed in 2018. The standard incidence rate of nasopharyngeal cancer globally in 2018 was 1.5 per 100,000. The standardized mortality rate for nasopharyngeal cancer globally in 2018 was 0.84 per 100,000. The 5 identified countries with the highest mortality rates were China, Indonesia, Vietnam, India and Philippines accordingly. Among the risk factors attributing to the incidences of nasopharyngeal cancer are Epstein Barr Virus (EBV) infection, salted and preserved food consumption and tobacco smoking. Conclusion: Nasopharyngeal cancer is strongly associated with the variation of geographical regions therefore adequate knowledge, early detection, immediate administration of treatment and rapid detection is vital in reducing the global incidence burden.

Effect of triptolide on the expression and function of P-gp in nasopharyngeal cancer cells / 药学学报

This study is designed to investigate the effect of triptolide on the function and expression of P-glycoprotein (P-gp) in HNE1 nasopharyngeal cancer cells. MTT assay was used to test cell viability. Intracellular doxorubicin content was evaluated with flow cytometry. Rhodamine 123 (Rh) was used to detect the excretion function of P-gp. The expression of P-gp was analyzed by Western blot. ATP levels were evaluated. JC-1 staining was used to determining mitochondrial membrane potential (MMP). Triptolide, doxorubicin and the combination treatment all had the inhibitory effect to HNE1 cells, and the combination treatment had the best effect. Triptolide increased intracellular concentration of doxorubicin and Rh (P P P < 0.05). JC-1 staining showed that triptolide mediated the down-regulation of MMP in HNE1 cells. Triptolide could increase intracellular drug content and enhance cytotoxicity of chemotherapeutics by inhibition of the expression and the excretion function of P-gp.

Effects of lncRNA PVT1 silencing on C666-1 cell proliferation,migration and invasion / 实用医学杂志

Objective To explore the effects of down-regulated PVT1 on the proliferation,migration and invasion of nasopharyngeal cancer(NPC)C666-1 cells. Methods Expression of PVT1 in NPC cell lines was de-tected by real-time RT-PCR. The effects of PVT1 silencing on cell proliferation were detected using MTT assay. Transwell assay was performed to assess the effect of down-regulated PVT1 on C666-1 cells migration and invasion. Protein level of N-cadherin,Vimentin and E-cadherin were determined by qRT-PCR and Western blot. Results Expression of PVT1 was significantly increased in seven NPC cell lines. Expression of PVT1 was reduced compared to the control group after the siPVT1 transfection. C666-1 cell proliferation was inhibited as compared with siNC group after transfection. The number of migration and invasion cells were significantly reduced while down-regulat-ed PVT1 expression. E-cadherin expression was upregulated while N-cadherin and Vimentinafter was downregulat-ed after PVT1 silencing. Conclusions Downregulation of PVT1 in C666-1 cells via siPVT1 transfection can inhib-it cell growth,migration and invasion,as well as reverse epithelial-mesenchymal transition. PVT1 may serve as a biomarker or even a therapeutic target for NPC.

The Changes of the Volume and the CT Number of Parotid Gland to Replan during Radiotherapy for Nasopharyngeal Cancer / 昆明医科大学学报

Objective This study is aimed to compare the CT number and volume of the parotid of the NPC patients between the first CT scan and the rescanning after 20 fractions.Method 14 NPC patients who had been treated were selected for analysis. Each patient was rescanned after the treatment of 20 fractions as the same protocol of the first CT sim for replanning. The CT number and volume change of the Parotid were compared and the CT number and volume change of the brain stem were also evaluated as a reference data. The results were analyzed with SPPS19, The results were analyzed with SPPS19 for t test. Results Mean right parotid CT number of the 14 patients for pre treatment and re-plan(after 20 fractions) was 6.4 and-0.5 ( =0.02) separately, the mean stand deviation was 26.5 and 35.6 ( = 0.04) separately、the mean volume was 24.6 cm3 and 16.1 cm 3 ( = 0.002) separately. Mean left parotid CT number of the 14 patients for pre treatment and re-plan was 4.4 and-1.8 ( =0.024) separately, the mean stand deviation is 29.7 and 35.5 ( =0.026) separately、the mean volume was 24.1 cm3 and 16.7 cm3 ( =0.001) separately. The Mean brain stem CT number of the 14 patients for pre-treatment and re-plan was 28.7 cm3 and 28.9 cm3 ( =0.887) separately. Conclusion After the treatment of 20 fractions , the volume of the parotid was significantly shrinked, the CT number was significantly decreased and the SD of CT number was significantly increased. The volume, CT number and SD of the Brain stem did not have significant changes. The change of the CT number could be a new observed data for the adaptive plan during the treatment as the tumor response.

Effect of miRNA-143 on proliferation, migration and invasion of CNE-2Z cells of human nasopharyngeal cancer / 安徽医科大学学报

Objective To detect the effects of miR-143 on proliferation, migration and invasion of human nasopharyngeal cancer CNE-2Z cells.Methods The expression of miR-143 in NP69 cells, CNE-1 cells and CNE-2Z cells were detected by using real-time PCR.The overexpression of miR-143 in CNE-2Z cells was constructed through infecting lentivrius, and the level of miR-143 was determined by using real-time PCR.Cell viability was detected by using a CCK-8 kit according to the manufacturer's instruction at indicated time points.The effectiveness of overex-pression of miR-143 on migration and invasion of CNE-2Z cells were detected by using Transwell cell migration and invasion assay.Results The expression level of miR-143 in CNE-2Z was significantly lower than those in NP69 and CNE-1 (P<0.01).The miR-143 over-expressed CNE-2Z cell was successfully established.The cell viability in CNE-2Z/ miR-143 group was significantly decreased compared with CNE-2Z and CNE-2Z/miR-NC (P<0.01).Overexpression of miR-143 inhibited cell migration and invasion of CNE-2Z cells significantly(P<0.01).Conclusion miR-143 might inhibit cell proliferation, migration and invasion in human nasopharyngeal cancer CNE-2Z cells, indicating its important role in diagnosis, treatment and prognosis of nasopharyngeal cancer.

Tolfenamic Acid Inhibits the Proliferation, Migration, and Invasion of Nasopharyngeal Carcinoma: Involvement of p38-Mediated Down-Regulation of Slug

PURPOSE: Tolfenamic acid (TA), a non-steroidal anti-inflammatory drug, is known to exhibit antitumor effects in various cancers apart from nasopharyngeal cancer (NPC). NPC exhibits high invasiveness, as well as metastatic potential, and patients continue to suffer from residual, recurrent, or metastatic disease even after chemoradiation therapy. Therefore, new treatment strategies are needed for NPC. In this study, we investigated the efficacy and molecular mechanisms of TA in NPC treatment. MATERIALS AND METHODS: TA-induced cell death was detected by cell viability assay in the NPC cell lines, HNE1 and HONE1. Wound healing assay, invasion assay, and Western blot analysis were used to evaluate the antitumor effects of TA in NPC cell lines. RESULTS: Treatment with TA suppressed the migration and invasion of HNE1 and HONE1 cells. Hepatocyte growth factor enhanced the proliferation, migration, and invasion abilities of NPC cells. This enhancement was successfully inhibited by TA treatment. Treatment with TA increased phosphorylation of p38, and the inhibition of p38 with SB203580 reversed the cytotoxic, anti-invasive, and anti-migratory effects of TA treatment in NPC cell lines. Moreover, inhibition of p38 also reversed the decrease in expression of Slug that was induced by TA treatment. CONCLUSION: In conclusion, the activation of p38 plays a role in mediating TA-induced cytotoxicity and inhibition of invasion and migration via down-regulation of Slug.

Bioinformatics screening of up-regulated protein kinases and their inhibitors in nasopharyngeal cancer / 局解手术学杂志

Objective To screening up-regulated protein kinases and their inhibitors in order to provide new targets for molecular thera-py of nasopharyngeal cancer.Methods GEO database and SAM software were employed to screen the up-regulated protein kinase gene in nasopharyngeal cancer.Based on DAVID database,the regulating functions of kinases were identified.The inhibitors of up-regulated kinase genes were identified by Selleckchem database.Literature mining was used to screen the potential anti-cancer drugs.Results Totally 2360 differentially expressed genes including 21 up-regulated protein kinases (CHEK1,CHEK2,PRKDC,AURKA,VRK2,STK17A,MELK,NU-AK1,TRPM7,MASTL,AXL,BUB1,BUB1B,CDK4,TTK,CDC7,CASK,AKT3,TBK1 and PBK)were identified in the whole genome profi-ling (Fold Change≥2,P <0.05).The results of function analysis showed the up-regulated genes were enriched in 10 function terms such as‘protein amino acid phosphorylation’‘phosphorylation’‘phosphate metabolic process’‘mitotic cell cycle’‘cell cycle phase’‘regulation of cell cycle’,and so on.The Selleckchem database analysis showed there were 9 up-regulated protein kinases equipped with 51 inhibitors which were proved already.The results of literature mining showed that 18 inhibitors of them had a few studies (less than 10 literatures)in cancer terms,and there was a potential to become new drugs to treat nasopharyngeal cancer.Conclusion A total of 21 up-regulated protein kinases were identified,and they might promote the nasopharyngeal carcinoma by regulating functions such as the cell-cycle control pathway.Their ki-nase inhibitors may have a potential role in anti-cancer treatment,which provided a new target point for molecular therapy of nasopharyngeal cancer.

Evaluation of salivary function by sialoscintigraphy in locally advanced nasopharyngeal cancer patients after intensity modulated radiotherapy.

PURPOSE: This study aimed to evaluate the salivary gland function changes by sialoscintigraphy in locally advanced nasopharyngeal cancer (NPC) after intensity modulated radiotherapy (IMRT). MATERIALS AND METHODS: Salivary function was assessed by sialoscintigraphy. Quantitative sialoscintigraphy was performed in 24 NPC patients prior to and after IMRT. Results were categorized in four groups according to the duration of treatment. The sialoscintigraphy parameters were examined. RESULTS: Sialoscintigraphy showed a significant difference in the secretion of each interval groups. The parameters of scintigraphy, except maximum accumulation (MA) of submandibular glands, decreased first after radiotherapy, and then recovered. However, the MA of submandibular glands was continuously downhill after radiation. CONCLUSIONS: The sialoscintigraphy parameters of each gland changed with the different radiation dose and follow‑up intervals. The salivary function was influenced after radiotherapy in locally advanced NPC, especially, in the submandibular gland. Strategies to improve the salivary function should be assessed.

Herpes Simplex Encephalitis after Concurrent Chemoradiotherapy in Nasopharyngeal Cancer: A Case Report / 대한내과학회지

Herpes simplex encephalitis (HSE) is a rare viral encephalitis in adults. A high (70%) mortality rate with serious complications has been reported even after active, appropriate management. The association between HSE and immune suppression is unclear, but there are case reports of cancer patients in which HSE concomitantly developed after whole brain radiation or high-dose steroid treatment. The clinical manifestations and laboratory findings of these patients are atypical compared to the general population. Although brain magnetic resonance images reveal typical HSE findings, cerebrospinal fluid (CSF) analysis might be normal in cancer patients. We report a case of HSE in a 48-year-old male diagnosed with nasopharyngeal cancer and treated with concurrent chemoradiation. This patient had a normal cell count in CSF, but HSE was finally diagnosed from positive polymerase chain reaction test results. After administration of acyclovir and systemic steroid treatment, the patient had a good clinical course with few neurologic sequelae.

Met inactivation by S-allylcysteine suppresses the migration and invasion of nasopharyngeal cancer cells induced by hepatocyte growth factor

PURPOSE: Past studies have reported that S-allylcysteine (SAC) inhibits the migration and invasion of cancer cells through the restoration of E-cadherin, the reduction of matrix metalloproteinase (MMP) and Slug protein expression, and inhibition of the production of reactive oxygen species (ROS). Furthermore, evidence is emerging that shows that ROS induced by radiation could increase Met activation. Following on these reports of SAC and Met, we investigated whether SAC could suppress Met activation. MATERIALS AND METHODS: Wound healing, invasion, 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium (MTT), soft agar colony forming, western blotting, and gelatin zymography assays were performed in the human nasopharyngeal cancer cell lines HNE1 and HONE1 treated with SAC (0, 10, 20, or 40 mM) and hepatocyte growth factor (HGF). RESULTS: This study showed that SAC could suppress the migration and invasion of HNE1 and HONE1 cell lines by inhibiting p-Met. An increase of migration and invasion induced by HGF and its decrease in a dose dependent manner by SAC in wound healing and invasion assays was observed. The reduction of p-Met by SAC was positively correlated with p-focal adhesion kinase (p-FAK) and p-extracellular related kinase (p-ERK in both cell lines). SAC reduced Slug, MMP2, and MMP9 involved in migration and invasion with the inhibition of Met-FAK signaling. CONCLUSION: These results suggest that SAC inhibited not only Met activation but also the downstream FAK, Slug, and MMP expression. Finally, SAC may be a potent anticancer compound for nasopharyngeal cancer treated with radiotherapy.

Influence of Chinese Herbal Medicine on Survival Rate of Nasopharyngeal Cancer Patients After Chemoradiotherapy / 广州中医药大学学报

Objective A retrospective study was carried out to investigate the survival rate of nasopharyngeal cancer patients after the combined treatment of chemoradiotherapy and Chinese herbal medicine. Methods Based on the will of the patients, 230 cases were divided into treatment group (N=107) and control group (N=123). Both groups received chemoradiotherapy, and the treatment group was additionally given oral use of Chinese herbal medicine over 180 doses per year, and the treatment lasted over 2 years. The survival rate was calculated by Kaplan-Meier estimator, and the Kaplan-Meier plot for the two groups was compared. Results (1) In the treatment group, the one-year, 3-year and 5-year survival rate was 99.1%, 86.4%, 72.5%, and was 95.9%, 73.5%, 58.3% respectively in the control group. The Kaplan-Meier plot showed that significant difference of patient survival was presented in the two groups ( P<0.01) . ( 2) The results of hierarchical group analysis of 230 nasopharyngeal cancer patients showed higher survival rate can be achieved in the T3-4 and N0 poorly-differentiated squamous carcinoma patients aged 50 years or more at the stage Ⅲ-Ⅳ in the treatment group than that in the control group, and the statistical differences were significant ( P<0.05 or P<0.01). Conclusion Chemoradiotherapy combined with Chinese herbal medicine can increase the survival rate, and prolong life span of the nasopharyngeal carcinoma patinets, in particular for the T3-4 and N0 poorly-differentiated squamous carcinoma patients aged 50 years or more at the stageⅢ-Ⅳ.

Dosimetric comparison between volumetric modulated arc therapy with RapidArc and fixed-field intensity modulation radiation ther-apy for nasopharyngeal carcinoma / 中国肿瘤临床

Objective:To compare the dosimetric differences between volumetric modulated arc radiotherapy with RapidArc and fixed-field intensity modulation radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC), and identify the techniques from which patients of different T stages can gain the maximum benefit. Methods:Sixty non-metastatic patients with NPC were randomly selected. According to the T staging of 2008 Chinese Classification, T1-T2 stage cases were observed in 20 of the 60 patients, whereas T3 and T4 stage cases were seen with 20 patients each. RapidArc and IMRT treatment plans were managed by the Eclipse treatment planning sys-tem of Varian Co., US. The dosimetry of the target volume coverage, organs at risk (OARs), monitor unit (MU) per second, and deliv-ery time were evaluated. Results:Both techniques reached the requirement of clinical treatment. The coverages of planning target vol-ume, conformity index, and homogeneity index were similar. However, the stratified analysis of T staging indicated that RapidArc plans led to an increased dose to the tumor target (P<0.05) and an improved homogeneity index (P=0.059) in the T4 stage cases. RapidArc al-lowed a statistical dose reduction to the OARs, including optic nerves, lens, temporal lobe, V20 of the parotids, larynx, and temporo-mandibular joint (P<0.05). In the T-stage stratified analysis, the D1%and Dmax of brain stem in T1-T3 stages were similar but statistical-ly low in T4 stage in the RapidArc group (P<0.05). Compared with those in IMRT group, the MUs and the delivery time in RapidArc group were reduced by 65%and 63%, respectively. Conclusion:Both RapidArc and IMRT attained the clinical requirement for NPC. RapidArc technique showed improvements in the OARs and reduction in MUs and delivery time. The target volume coverages were similar for T1-T3 stage. However, RapidArc delivered an increased dose to the tumor target in T4 stage cases, and the dose to OARs was reduced.

Zhongshan nasopharyngeal carcinoma (NPC) mortality in 1970-2010 / 中国癌症杂志

Background and purpose:Zhongshan City is one of the areas with the highest NPC incidence worldwide and nationwide. Although its incidence rate had been analyzed thoroughly, but its mortality rate was not studied further until now. This study was to explore NPC mortality status in Zhongshan City from 1970 to 2010, and to provide scientiifc information for its control and prevention.Methods:NPC death data in Zhongshan City from 1970 to 2010 came from Zhongshan Cancer Registry Ofifce. Such indices as its death number, crude rate, age standardized rate (ASR) and truncated rate etc were calculated and analyzed. Results:There were 5 267 NPC death cases in Zhongshan City from 1970 to 2010, its crude world ASR and truncated rates were 11.03/105, 12.34/105 and 29.31/105 respectively. Its world ASRs increased before 1999 but no statistical signiifcance (P=0.64) and decreased thereafter with obvious statistical signiifcance (P=0.001). But overall, there were a decreasing trend for its ASRs (P=0.001) from 1970 to 2010 in Zhongshan City. Moreover, NPC mortality rate in male was remarkably higher than in female, the death peak age was 55-59 age group, and the different age groups were with different trends fro 1970 to 2010. Conclusion:Although with declining trend from 1970 to 2010, NPC mortality rate in Zhongshan City was at high level worldwide. It suggested that NPC control and prevention should be enhanced.