ABSTRACT
To examine risk factors for shoulder injuries with or without history of the injuries using the stratification analysis for collegiate rugby players. 71 elite rugby players from one university rugby club joined in the preseason medical screening related to their shoulder joints, including basic demographics, history of injuries, and physical findings at that time. Subsequently, the occurrence of shoulder injuries was recorded during four playing seasons. Analysis was stratified with or without history of the injuries; player without the past history of injury, 47 players; player with the past history of injury, 24 players. As a result of all players with the past history, 13 players sustained the shoulder injuries. Internal rotational range of motion [IR ROM] (OR, 1.5; 95%CI, 1.13-1.96; p=0.004), external rotational range of motion [ER ROM] (OR, 1.9; 95%CI, 1.21-2.87; p=0.005), horizontal flexion range of motion [HF ROM] (OR, 1.3; 95%CI, 1.03-1.64; p=0.025), IR muscle strength (OR, 0.4; 95%CI, 0.20-0.65; p=0.001) and rugby experience (OR, 1.2; 95%CI, 1.02-1.46; p=0.032) were associated with the shoulder injuries. On the other hand, 10 players sustained injuries of the players without the past history of injury. IR muscle strength (OR, 0.3; 95%CI, 0.11-0.72; p=0.008) and rugby experience (OR, 1.4; 95%CI, 1.11-1.66; p=0.003) were associated with the shoulder injuries. This study clearly showed that IR, ER, HF ROM, IR muscle strength and rugby experience were important initial risk factors for shoulder injuries. Moreover, IR muscle strength and rugby experience were important recurrence risk factors for shoulder injuries.
ABSTRACT
Objective To investigate the long-term outcomes of patients with nasopharyngeal carcinoma (NPC) in different stages treated by intensity-modulated radiotherapy (IMRT) and explore their treatment strategies.Methods A retrospective analysis was performed on the clinical data of 868 NPC patients without distant metastasis who received radical IMRT from May 2001 to October 2008.These patients were divided into early N0 (T1-2N0) group (n =137),early N1 (T1-2N1) group (n =129),locally advanced (T3-4N0-1) group (n =322),regionally advanced (T1-2 N2-3) group (n=107),and locoregionally advanced (T3-4 N2-3) group (n =173).There groups were compared in terms of treatment outcome and treatment strategy.Results The follow-up rate was 91.4％,and 314 patients completed 5-years follow-up.The 5-year overall survival rate,local recurrence-free rate,and distant metastasis-free rate (DMFR) were 83.5％,91.8％,and 84.6％,respectively.The early N0 group had the best treatment outcome,with a 5-year disease-specific survival (DSS) rate up to 99.1％.Each group had a similar outcome after receiving either IMRT alone or IMRT combined with chemotherapy.The locally advanced group and regionally advanced group had similar failure patterns and treatment outcomes.The locoregionally advanced group had the worst treatment outcome,with a 5-year DMFR of 67.2％ and a DSS of 68.0％.The regionally advanced group and locoregionally advanced group had a similar treatment outcome after receiving IMRT alone,induction chemotherapy plus IMRT,or concurrent chemotherapy and IMRT.Conclusions Patients with NPC in different stages have different survival outcomes.It is recommended that different treatment strategies should be adopted according to the T and N stages of NPC.IMRT alone can produce satisfactory results in patients with T1-2N0 NPC,but a more effective medication should be added to IMRT in patients with advanced NPC,particularly those with T3-4N2-3 NPC who have a relatively low DMFR.