RESUMO
Objective To prospectively determine the dosimetric and clinical factors for predicting the risk of acute radiation oral mucositis ( ROM ) in patients receiving intensity?modulated radiotherapy ( IMRT) with concurrent chemotherapy for local advanced nasopharyngeal carcinoma. Methods Ninety?two patients who were treated with IMRT with concurrent chemotherapy from 2015 to 2016 for local advanced nasopharyngeal carcinoma were included in this study, and their acute ROM was scored according to the RTOG criteria. Grade≥3 ROM was used as a surrogate marker for severe mucositis, which was defined as a toxicity endpoint. The clinical data were reviewed, and the dose?volume histograms ( DVHs) of the patients were exported from the IMRT planning system. Optimal thresholds for predicting the incidence of severe ROM were evaluated by the area under the receiver operating characteristic ( ROC) curve ( AUC) . Results The incidence of severe ROM was 21%(19/92). Weight loss and V30 of the oral mucosa were determined as the independent predictors for severe ROM ( P=0017 and 0003, respectively) . The optimal cut?off point and AUC of V30 of the oral mucosa as a predictor for severe ROM were 7316%( 0842 sensitivity and 0671 specificity) and 0753( P=0001) , respectively. Conclusion Weight loss and V30 of the oral mucosa are predictors for severe ROM.
RESUMO
Objective To evaluate the efficacy of the coated metallic stent insertion in patients with complexity esophageal stricture and(or) fistula caused by carcinoma. Metheds 51 cases with complexity esophageal stricture and (or) fistula caused by carcinoma had undergone the treatment in our hospital. Different methods were used with different patients.Patients were evaluated for symptomatic dysphagia improvement 1-month and 12-month after treament. Results It were succeeded in placement of stents in all cases. All of them nearly complete symptomatic dysphagia relief or significant improvement .The diameter of the stricture increased from(4.05?1.34) mm to (13.03?3.99) mm (P