Clinical efficacy and safety of hypofractionated three-dimensional conformal radiotherapy in the treatment of recurrent nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective To evaluate the clinical efficacy and safety of the hypofractionated three-dimensional conformal radiotherapy in the treatment of recurrent nasopharyngeal carcinoma.Methods Clinical data of 153 patients with recurrent nasopharyngeal carcinoma admitted to our hospital from 2008 to 2013 undergoing hypofractionated three-dimensional conformal radiotherapy (3 Gy for each time,5 times a week,a total dose of 51-60 Gy,17-20 times/4 weeks) were retrospectively analyzed.The short-and long-term radiation-induced injury,Karnofsky performance score (KPS),short-and long-term clinical efficacy were evaluated.Results For the short-term radiation-induced injury,the incidence of oral mucosa and fatigue significantly differed before and after treatment (both P＜0.05).Regarding the long-term radiation-induced injury,the incidence of dry mouth (95.4％) and deafness (51.0％),difficulty in opening mouth (79.1％),maxillofacial fibrosis (33.3％) and radiation-induced encephalopathy (15.0％) significantly differed before and following treatment (all P＜ 0.05).The actual long-term radiation-induced injury included dry mouth (91.5％),deafness (50.9％),difficulty in opening mouth (76.5％),maxillofacial fibrosis (32.0％) and radiation-induced encephalopathy (14.4％).The number of patients with changes in the KPS scores significantly differed between the end of treatment and 3 months after treatment (P＜0.05).The local control rates were 29.4％,68.6％,79.1％,83.7％ and 86.9％ at 1-,3-,6-,9-and 12-month after corresponding treatment,respectively.The local control rate significantly differed between 1 and 3 months,and between 3 and 6 months after treatment (both P＜0.05).The 1-,2-,3-,4-and 5-year survival rates were calculated as 96.1％,80.4％,68.5％,57.9％ and 51.1％,respectively.Conclusions Hypofractionated three-dimensional conformal radiotherapy is an efficacious and safe treatment of recurrent nasopharyngeal nasopharyngeal carcinoma,which yields relatively high short-and long-term clinical efficacy,high local control rate and well tolerance by the patients.

Palonosetron combined with dexamethasone prevents nasopharyngeal carcinoma radiotherapy cisplatin-induced nausea and vomiting / 中国基层医药

Objective@#To investigate the efficacy and adverse reactions of palonosetron and dexamethasone in preventing cisplatin-induced nausea and vomiting.@*Methods@#From September 2015 to August 2017, a total of 217 nasopharyngeal carcinoma patients in the 163rd Hospital of PLA were randomly divided into two groups according to the digital table.The control group (n=108) was given palonosetron when used cisplatin treatment, the study group(n=109) was given palonosetron combined with dexamethasone.The clinical efficacy and adverse reactions in the two groups were observed.@*Results@#After treatment of 1-6 weeks, the incidence rates of headache, dizziness and fatigue in the study group were 7.2%, 2.9% and 3.4% respectively, which were significantly lower than those in the control group(12.7%, 6.0% and 6.3%), the differences between the two groups were statistically significant(χ2=10.902, 7.412, 6.207, all P<0.05). The prevention rate of nausea and vomiting in the control group was 75.5%, which in the study group was 80.9%, and at delay period, the prevention rate of nausea and vomiting in the control group was 85.5%, which in the study group was 91.0%, the differences between the two groups were statistically significant(χ2=5.615, 9.442, all P<0.05).@*Conclusion@#Palonosetron and dexamethasone are effective in the treatment of nasopharyngeal carcinoma with cisplatin-induced nausea and vomiting, and can reduce the side effects of palonosetron.

Contrastive study on the treatment of locally recurrent nasopharyngeal carcinoma with large segmentation gamma knife and large segmentation conformal retransmission radiotherapy / 中国医师进修杂志

Objective To compare the efficacy and adverse reactions of large segmentation gamma knife and large segmentation conformal retransmission radiotherapy for locally recurrent nasopharyngeal carcinoma. Methods One hundred and twenty- one patients with locally recurrent nasopharyngeal carcinoma from January 2009 to June 2012 were selected. The patients were divided into large segmentation conformal retransmission radiotherapy group (control group, 61 cases) and large segmentation gamma knife retransmission radiotherapy group (study group, 60 cases) according to the propensity score matching method. The radiation injury, quality of life, short-term efficacy and long-term efficacy were observed. Results In the recent radiation injury, the incidences of maxillofacial skin reaction and fatigue in study group were significantly higher than those in control group: 28.3％ (17/60) vs. 13.1％ (8/61) and 48.3％ (29/60) vs. 29.5％ (18/61), and there were statistical differences (P<0.05);there were no statistical differences in the incidences of dry mouth and oral mucosal injury between 2 groups (P>0.05). In the long-term radiation injury, the incidences of deafness and difficulty in opening mouth in study group were significantly lower than those in control group: 33.3％ (20/60) vs. 52.5％(32/61) and 58.3％ (35/60) vs. 73.8％ (45/61), the incidence of maxillofacial muscle fibrosis in control group was significantly higher than that in control group: 43.3％ (26/60) vs. 26.2％ (16/61), and there were statistical differences (P<0.05); there were no statistical differences in the incidences of dry mouth and radiation encephalopathy between 2 groups (P>0.05). In the actual long- term radiation injury, the incidences of dry mouth, deafness and difficulty in opening mouth in study group were significantly lower than those in control group: 66.7％ (40/60) vs. 86.9％ (53/61), 31.7％ (19/60) vs. 50.8％ (31/61) and 43.3％ (26/60) vs. 67.2％ (41/61), the incidence of maxillofacial muscle fibrosis in study group was significantly higher than that in control group: 41.7％ (25/60) vs. 23.0％ (14/61), and there were statistical differences (P<0.01 or <0.05); there was no statistical difference in the incidence of radiation encephalopathy between 2 groups (P>0.05). There were no significant differences in Karnofsky performance scale (KPS) score and body weight change before treatment and at the end of treatment, and at the end of treatment and 3 months after treatment between 2 groups (P > 0.05). For the short-term efficacy, the local control rates of 3, 6, 9 and 12 months after treatment in study group were significantly higher than those in control group: 75.0％ (45/60) vs. 54.1％ (33/61), 86.7％ (52/60) vs. 62.3％ (38/61), 90.0％ (54/60) vs. 67.2％ (41/61) and 91.7％ (55/60) vs. 68.9％ (42/61), and there were statistical differences (P<0.05). For long-term efficacy, there was no significant difference in the survival rates of 1, 2, 3, 4 and 5-year between 2 groups (P > 0.05). Conclusions Large-segment gamma knife and large-segment conformal reconstitution radiotherapy are effective for the short-term curative effect and long-term curative effect of locally recurrent nasopharyngeal carcinoma. They can reduce radiation damage and have better safety. Large segmentation gamma knife reconstitution radiotherapy is more advantageous in reducing the long- term radiation injury and improving the local control than large segmentation conformal retransmission radiotherapy.

Clinical analysis of ubenimex combined with radiotherapy for early nasopharyngeal carcinoma / 肿瘤研究与临床

Objective To observe the efficacy and adverse reactions of ubenimex combined with radiotherapy for the treatment of early nasopharyngeal carcinoma. Methods A total of 129 patients with early nasopharyngeal carcinoma who were admitted to the 163th Hospital of PLA, the Second Affiliated Hospital of Hunan Normal University from October 2013 to September 2016 were retrospectively analyzed. Three-dimensional conformal radiotherapy was used in the control group and ubenimex combined with three-dimensional conformal radiotherapy was taken in the study group. Radiation injury response, quality of life and therapeutic effects of patients in both groups were observed respectively. Results The fatigue incidence of the study group was lower than that of the control group (57.8 % vs. 75.4 %, χ2= 4.481, P= 0.034). Karnofsky score (χ2=6.345, P=0.042; χ2=6.382, P=0.041, respectively) and weight change (χ2=6.014, P= 0.049; χ2= 6.351, P= 0.042, respectively) had statistical differences in both groups in the end of radiotherapy and 3 months after radiotherapy. 1-year non-distant metastasis survival rate (92.2 %, 59/64) in the study group was significantly higher than that in the control group (80.0 %, 52/65) (χ2=3.989, P=0.046). Conclusion Ubenimex combined with radiotherapy for early nasopharyngeal carcinoma can improve the patients' quality of life, reduce the radiation injury response and increase the metastasis-free survival rate.

Prevalence Survey of Pre-excitation and Wolff-Parkinson-White Syndrome in Adolescents in Beijing Area / 中国循环杂志

Objective:To study the prevalence of pre-excitation and Wolff-Parkinson-White (WPW) syndrome in adolescents in Beijing area. Methods: A total of 19 484 adolescents at the age of (15-20) years from Xicheng district of Beijing and the freshmen from Peking University were enrolled for our survey; 12-lead electrocardiography (ECG) screening was conducted and the diagnosis, classification of pre-excitation, WPW syndrome were recorded. The follow-up study was performed in relevant patients. Results: There were 19 389 qualiifed ECG obtained, among them, 30 (0.15%) patients with ventricular pre-excitation and WPW syndrome identiifed including 17 male (0.17%) and 13 (0.13%) female, the prevalence between male and female was similar (χ2=0.495,P>0.05). There were 6/19389 (0.03%) patients with palpitation and 2 (0.01%) documented by super-ventricular tachycardia. There were 16/30 (53.33%) patients with type A and 14(46.7%) with type B ventricular pre-excitation, the prevalence between male and female was similar (χ2=4.693,P>0.05). The patients were followed-up at the mean of 2.5 (1.5-3) years and no malignant arrhythmia events occurred. Conclusion: In this cohort survey, prevalence of pre-excitation and WPW syndrome is about 0.15% in adolescents from (15-20) years in Beijing area; the prevalence is similar between male and female subjects.

Expression and clinical significance of inducible nitric oxide synthase and β-catenin in nasopharyngeal carcinoma tissue / 中国癌症杂志

Background and purpose: There have been no reports on the clinical and biological significance of the co-expression of inducible nitric oxide synthase (iNOS) and β-catenin (β-cat) in has.pharyngeal carcinoma(NPC). This study was aimed to investigate the expression of iNOS and β-cat in NPC, to analyze their interrelation, and to explore their roles in the carcinogenesis, development, invasion, and metastasis of NPC. Methods: The expression of iNOS and β-cat was examined in 50 poorly differentiated NPC and 15 normal nasopharyngeal epithelium tissue by immunohistochemical staining (SP method). None of the patients had received radiotherapy and chemotherapy. The results of immunostaining were observed by two pathologists independently, using double blind scoring method. iNOS and β-cat expression were categorized by the extent and intensity of staining using a semiquantitative method. Results: No iNOS expression was observed in 15 normal nasopharyngeal epithelium, but β-cat expression was located in cytomembrane in normal samples. The positive rate of iNOS protein expression was 74.0% (37/50) in NPC tissues. The expression of iNOS was statistically different among the NPC group and normal nasopharyngeal epithelium group, T_(1-2) group and T_(3-4) group, metastatic lymph nodes group and no metastatic lymph nodes group. There was a great quantity of β-cat expression in cytoplasm, little or no β-cat expression in cytomembrane and nucleus in NPC tumorous tissues. Statistical analysis indicated that strong positive expression of β-cat in cytoplasm was significantly higher in NPC than those of normal nasopharyngeal epithelium. The positive expression of β-cat was significantly correlated with clinical stage, invasion and lymph gland metastasis. Neither iNOS nor β-cat was significantly different between different ages and genders. There was a positive relationship between iNOS and β-cat expression in NPC tissues (r=0.394, P=0.005). Conclusion: The positive expressions of iNOS and β-cat in cytoplasm were significantly correlated with clinical stage, invasion and metastasis, and were not significantly different in terms of ages and genders of the patients. There was a positive relationship between the expression of iNOS and β-cat in NPC tissues. Co-overexpression of iNOS and β-cat may play an important role in carcinogenesis, development, invasion, and metastasis of NPC.

Quality control of three-dimensional conformal radiotherapy for non-small cell lung cancer / 医疗卫生装备

Objective To explore quality control methods for clinical three-dimensional conformal radiation therapy(3DCRT) for non-small cell lung cancer.Methods 91 patients with non-small cell lung cancer accepted Whole Body Gamma radiation.The feasible methods on the aspects of quality control for 3DCRT were explored.Results Among those cases,the rate of CR was 34.1%;PR 61.5%;NC 4.4%;and PD 6.1%.Conclusion Those methods of quality control for 3DCRT were practicable and effective.

Clinical analysis of whole body gamma knife conformal radiotherapy for 169 patients with non-small cell lung cancer / 解放军医学杂志

Objective To evaluate the therapeutic effects and complications of whole body gamma knife conformal radiotherapy for patients with non-small cell lung cancer(NSCLC).Methods 169 patients with NSCLC received whole body gamma knife conformal radiotherapy.Total dose,fractions,and radiation time were determined based on disease course,tumor location,tumor features and tumor volume,etc.Small target volume(tumor size less than 3cm in diameter) received 5-10Gy each time,40-50Gy in 4-10 fractions;moderate target volume(tumor size 3cm-5cm in diameter) received 4-8Gy each time,48-56Gy in 4-16 fractions;and big target volume(tumor size more than 5cm in diameter) received 3-4Gy per time,40Gy in 10-14 fractions and followed by 10-30Gy using reduced fields.Results Of 269 tumors in 169 patients,complete response(CR) rate,partial response(PR) rate,and rate of no change(NC) were 41.6%(112/269),44.6%(120/269) and 13.8%(37/269),respectively.Overall response rate(CR+PR) was 86.2%(232/269),with 1-year local control rate of 92.3%.1-year and 2-year survival rate was 75.1% and 46.2%,respectively,with median survival time of 19 months.The incidence of Grade 1,2 and Grade 3 radiation pneumonia was 15.4% and 3.1%,respectively.Conclusions With minor adverse effects,whole body gamma knife conformal radiotherapy may have short-term therapeutic effects for NSCLC patients with amelioration of disease symptoms,obvious elevation of tumor local control rate,a raise of the survival rate,and improvement of life quality.

Analysis of multiple factors in local recurrence following body gamma knife radiotherapy for patients with non-small cell lung cancer / 解放军医学杂志

Objective To analyze the factors contributing to local recurrence following body gamma knife radiotherapy in patients with non-small cell lung cancer(NSCLC),and to explore a standard therapeutic scheme under the circumstance.Methods 332 patients with NSCLC received body gamma knife therapy and subsequent regular follow-up.Dose per fraction and total dosage used were dependent on disease condition,tumor location,tumor features and tumor size,etc.On the basis of patients' conditions and adverse effects,biological effective dose(BED) was 56-90Gy calculated with LQ model.Univariate analyses were performed including sex,age,Karnofsky performance score,clinical stage,pathological type,tumor differentiation degree,tumor size,tumor location,target volume delineation,dose per fraction,BED and chemotherapy scheme,etc.with X2 or t test.By selecting significant clinical factors in univariate analysis,multivariate analyses were performed with COX regression model.Results Of the 332 patients,local recurrence occurred in 22 cases during regular follow-up period,with average recurrence time of 10 months,and the local recurrence rate was 6.63%.The results of multivariate analysis showed that low BED,low Karnofsky score,old age,too small delineation for target volume range and central type of lung cancer were the factors related to local recurrence.Conclusions Low BED in body gamma knife radiotherapy is the significant factor of local recurrence for patients with NSCLC.BED in body gamma knife radiotherapy should be more than 80Gy for NSCLC patients who receive the radical treatment.