Short-term efficacy of camrelizumab combined with induction chemotherapy followed by concurrent chemoradiotherapy for patients with locally advanced nasopharyngeal carcinoma / 中华放射医学与防护杂志

Objective:To investigate the clinical effect and safety of camrelizumab combined with induction chemotherapy followed by concurrent chemoradiotherapy for patients with locally advanced nasopharyngeal carcinoma (NPC).Methods:A total of 24 patients with stage Ⅲ-IV A NPC were recruited prospectively to receive two cycles of camrelizumab combined with induction chemotherapy (docetaxel 75 mg/m 2+ cisplatin 25 mg/m 2 for three consecutive days) followed by concurrent chemoradiotherapy (prescription doses: 6 996 cGy in 33 fractions for PGTV and PGTV nd, 6 006 cGy in 33 fractions for PTV 1, 5 096 cGy in 28 fractions for PTV 2, and concurrent cisplatin chemotherapy with a dose of 75 mg/m 2). The short-term efficacy and adverse reactions were evaluated. Results:After induction therapy, nasopharyngeal lesions showed an objective response rate (ORR) of 91.6%, including 45.8% of complete response (CR) and 45.8% of partial response (PR); cervical lymph nodes showed an ORR of 95.8% (CR: 4.2%; PR: 91.6%). Seventeen patients accepted a reexamination under a nasopharyngoscope, and the biting biopsy result indicated that 13 patients among them had complete pathologic response. After concurrent chemoradiotherapy, nasopharyngeal lesions and cervical lymph nodes showed CR rates of 83.3% and 91.7% and PR rates of 16.7% and 8.3%, respectively. After the induction therapy, 13 patients with stage IV A NPC had ORR (PR) rates of 92.4% and 92.4%, respectively, at nasopharyngeal lesions and cervical lymph nodes. After concurrent chemoradiotherapy, the patients with stage IV A NPC had CR rates of 84.6% and 92.3% and PR rates of 15.4% and 7.7%, respectively, at nasopharyngeal lesions and cervical lymph nodes. Major adverse reactions include leukopenia, granulopenia, anemia, radioactive acute oropharyngeal mucositis and dermatitis, digestive tract reaction, fatigue, hypothyroidism, aminotransferase elevation, and reactive capillary hyperplasia. Conclusions:Camrelizumab combined with induction chemotherapy followed by concurrent chemoradiotherapy can achieve high short-term efficacy for patients with locally advanced nasopharyngeal carcinoma, without increasing the incidence of adverse reactions. Its long-term efficacy deserves further research.

Comparison of clinical characteristics and factors affecting prognosis vision of idiopathic and myopic macular hole / 中华眼底病杂志

Objective:To compare the clinical characteristics and analyze the factors affecting vision prognosis of idiopathic macular hole (IMH) or myopic macular hole (MMH).Methods:A cross-sectional study. From October 2012 to October 2020, 336 patients with 346 eyes of IMH and MMH who were diagnosed in Shanxi Provincial Eye Hospital with continuous follow-up data after surgery were included. There were 346 eyes (336 cases), including IMH with 247 cases (255 eyes) and MMH with 89 cases (91 eyes), which were divided into IMH group and MMH group. Best corrected visual acuity (BCVA) and optical coherence tomography were performed in all eyes. The BCVA examination used the standard logarithmic visual acuity chart, which was converted into logarithmic minimum angle of resolution (logMAR) visual acuity. The age of outset in IMH and MMH was 64.8±6.6 and 59.2±8.1 years, the logMAR BCVA was 1.11±0.50 and 1.80±0.78, respectively. There were significant differences in age ( Wald=34.507) and logMAR BCVA ( Z=-7.703) between two groups ( P<0.05). All eyes were performed inner limiting membrane (ILM) peeling or partial inverted ILM covering hole operation. After the operation, the vitreous cavity was filled with air, C 3F 8 and silicone oil, including 73, 102, 83 eyes in IMH group and 9, 10, 72 eyes in MMH group, respectively. Follow-up time after surgery was more than 2 months. The optimal BCVA and macular hole closure of the two groups were observed. If the quantitative data conformed to the normal distribution, the generalized estimating equation was used, otherwise, the Mann-Whitney U test or Kruskal-wallis test was used, the χ 2 test was used for the comparison of categorical variables. Generalized estimating equation logistic regression analyzed the influencing factors of optimal BCVA after surgery and visual acuity success. Results:In IMH and MMH, the optimal logMAR BCVA were 0.71±0.36, 1.10±0.51 respectively, and 147 (57.6%, 147/255) eyes, 63 (69.2%, 63/91) eyes achieved visual success respectively. There was a significant difference in the optimal logMAR BCVA ( Z=-6.803, P<0.005), but no difference in visual success rate ( χ2=3.772) between the two groups. The visual success rate of IMH at the same baseline BCVA level was higher than that of MMH, and the difference was statistically significant ( χ2=14.500, P=0.001). Logistic regression analysis showed that the influencing factors predicting poor optimal visual acuity after surgery were: IMH, baseline BCVA [odds ratio ( OR)=2.941, 95% confidence interval ( CI) 1.341-6.447, P<0.05], MH diameter ( OR=1.003, 95% CI 1.001-1.005, P<0.05), silicon oil filling ( OR=3.481, 95% CI 1.594-7.605, P<0.05); MMH, baseline BCVA ( OR=2.549, 95% CI 1.344-4.834, P<0.05), C 3F 8 filling ( OR=18.131, 95% CI 1.505-218.365, P<0.05) and silicon oil filling ( OR=7.796, 95% CI 0.997-60.944, P<0.05). The factors leading to a lower likelihood of achieving visual success: IMH, baseline BCVA ( OR=213.329, 95% CI 46.123-986.694, P<0.05), MH diameter ( OR=0.995, 95% CI 0.992-0.997, P<0.05), silicon oil filling ( OR=0.326, 95% CI 0.115-0.926, P<0.05) and duration ( OR=1.036, 95% CI 1.005-1.067, P<0.05); MMH, baseline BCVA ( OR=13.316, 95% CI 2.513-70.565, P<0.05) and duration ( OR=1.022, 95% CI 1.001-1.044, P<0.05). Conclusions:MMH was earlier than IMH in age of outset. Baseline vision significantly affected vision prognosis in IMH and MMH. Silicone oil should be avoided as much as possible under the premise of hole closure.

Radiation oncology residency training programs in China: investigation and comparison with western programs / 中华放射肿瘤学杂志

Objective:To summarize the experience of radiation oncology residency training programs in western coutries, and provide evidence to improve the present Phase-I Radiation Oncology Residency Training Programs in China.Methods:An electronic questionnaire-based survey was conducted among residents and staffs in 6 top cancer centers in China and 5 centers from Europe and North America to collect their feedback regarding the description and comparison of different programs.Results:A total of 70 responses and 4 papers explaining relevant training programs from 26 residents and 23 teachers in Chinese hopsitals and 20 residents and 1 teacher from Europe and North America were received. The Radiation Oncology Residency Training Programs in China were designed into 2 phases, and the results in the current study were involved with the first phase. Program designs were similar in the following aspects: goal, clinical practice-based training, rotation curriculum, interim and final assessment. However, the total timeframe in the investigated Chinese Phase-I programs was shorter than that in western hospitals (2 to 3 years vs. 4 to 5 years). Chinese programs covered major common diseases, whereas rotation design was performed based on each individual disease in western programs. In Chinese programs, the working hours were mainly 40-60 h every week. Although the working hours were commensurate with local workforce regulations, the residents from MSK program had an outstanding longer working time of 60-80 h every week and treated more patients compared with other programs. Conclusions:The investigated Phase-I Radiation Oncology Residency Training Programs in 6 top cancer centers in China share common features in goals, training modes and assessments with western programs. However, our programs have shorter timeframe and less detailed requirements in individual disease than the western programs.

Clinical features and prognosis analysis of 15 cases of extra-nodal nasal-type natural killer/T-cell lymphoma originated from the larynx / 中华放射肿瘤学杂志

Objective To analyze the clinical features and prognosis of extra-nodal nasal NK/T cell lymphoma originated from the larynx. Methods Clinical data of 15 cases of extra-nodal nasal NK/T-cell lymphoma originated from the larynx were retrospectively analyzed. The overall survival ( OS ) and progression-free survival ( PFS) were calculated by Kaplan-Meier survival analysis. The effect of different clinical factors on the clinical prognosis was assessed by univariate analysis. Results Among 15 patients,13 cases were male and 2 female. The median age of onset was 40 years. In 8 cases,the lesions were confined to the larynx,and only 4 cases suffered from cervical lymph node involvement. According to Ann Abor staging, 11 cases were classified as grade I,3 as gradeⅡand 1 as gradeⅢ.The median OS was 28. 0 months and the 5-year OS was 32. 0％.The median PFS was 24. 7 months and the 5-year PFS was 33. 3％.Among 14 patients with stage Ⅰ/Ⅱ,the clinical prognosis of patients receiving combined chemo-radiotherapy was significantly better than those of their counterparts undergoing radiotherapy or chemotherapy alone ( median OS:37. 2 vs. 11. 2 vs.3. 7 months,P=0. 004) . Conclusion Extra-nodal nasal NK/T cell lymphoma originated from the larynx is extremely rare, predominantly in middle-aged male patients. The general condition is relatively favorable. Patients present with multiple lesions in the early stage and relatively poor prognosis. The clinical efficacy of chemotherapy combined with radiotherapy is probably higher compared with that of radiotherapy or chemotherapy alone.

Treatment outcomes of different induction chemotherapy regimens combined with in-tensity-modulated radiotherapy in nasopharyngeal carcinoma / 中国肿瘤临床

Objective:The role of induction chemotherapy(IC)and preferred regimens is not very clear in non-endemic nasopharyn-geal carcinoma(NPC)in northern China.Methods:A total of 170 pathologically proven locoregional advanced NPCs between January 2012 and December 2014 were included in this analysis.One hundred and twenty-six were men and 44 patients were women.Accord-ing to the American Joint Committee on Cancer(AJCC)7th stage system,48 patients were T1-2 and 77 patients were T3-4;48 patients were N0-1 and 122 patients were N2-3;27 patients were stageⅡ,105 patients were stageⅢ,and 38 patients were stage IVa-b.Re-sults:The median follow-up time was 34 months.The 3-year overall survival(OS),locoregional failure-free survival(LRFS),distant me-tastasis-free survival(DMFS),and disease-free survival(DFS)were 82.8%,91.5%,76.7%,and 69.1%,respectively.Multivariate analyses showed that IC with TPF(docetaxel,carboplatin,and fluorouracil)or TP(docetaxel and cisplatin)presented superior DFS and DMFS compared with PF(cisplatin+5-FU)[DFS-hazard ratio(HR):1.820,95% confidence interval(CI):1.013-3.271,P=0.045;DMFS-HR:2.240, 95% CI:1.017-4.090,P=0.045].Conclusions:The IC regimens appeared to affect patients' outcomes,and TP-containing IC regimens conferred better DFS and DMFS than PF regimens.

Understanding of radiation enteritis and its possible pathogenic mechanism / 中华放射肿瘤学杂志

Radiation enteritis significantly affects the quality of life in the patients receiving radiotherapy due to pelvic tumor.As an intestinal inflammation related to radiotherapy, radiation enteritis is an inflammation of the mucous membrane in nature based on some basic research.Studies demonstrate that programmed necroptosis might play a role in the development of inflammatory bowel disease;therefore, as a subtype of inflammatory bowel disease, programmed necroptosis also might play a role in the development and progression of radiation enteritis.This paper aims to review the studies about the nature and pathogenic mechanism in order to contribute to the treatment of radiation enteritis and improve patients'' quality of life.

Changes of fundus autofluorescence in polypoidal choroidal vasculopathy before and after intravitreal ranibizumab injections / 中华眼底病杂志

Objective To observe the characteristics offundus autofluorescence (FAF) in patients with polypoidal choroidal vasculopathy (PCV) before and after intravitreal ranibizumab injections.Methods A retrospective case series.Seventeen patients (17 eyes) including 11 males and 6 females were enrolled in this study.Best corrected visual acuity (BCVA),FAF and indocyanine green angiography examination were performed on all eyes.The eyes were divided into hypo-autofluorescence group (8 eyes) and mixed autofluorescence group (9 eyes) according to the fluorescence degree.There was no differences of BCVA between two groups (t=2.403,P=0.072).A11 eyes received monthly intravitreal ranibizumab injections for 3 months followed by an as-needed reinjection schedule.All eyes were followed up for 12 months.FAF was performed at the 3rd,6th and 12th month after first treatment.The changes of FAF characteristics and BCVA before and after treatment were observed.Results Before the treatment,the PCV lesions showed two distinct FAF patterns:the confluent hypo-autofluorescence at the polypoidal lesions and the granular hypo-autofluorescence at branching choroidal vascular networks (BVN).During the treatment,the abnormal FAF area of the whole lesions in all eyes reduced and gradually returned to normal.At the 3rd month after treatment,the central hypo-autofluorescence of polyps was surrounded by a hyper-autofluorescence ring,and with time,the ring was weakened or eliminated.However,all the hypo-autofluorescence findings in BVN at baseline were unchanged during the follow-up period.There was no significant differences in BCVA between hypo-autofluorescence group and hyper-autofluorescence group at different follow-up times (t=2.674,2.862,2.250;P=0.058,0.052,0.081).At final follow-up,5 eyes (62.5％) in hypo-autofluorescence group and 3 eyes (33.3％)in hyper-autofluorescence group had increased BCVA,the different was not significant (P=0.347).Conclusions Before the treatment,there were the central hypo-autofluorescence of polyps and circumferential hypo-autofluorescence ring or confluent hypo-autofluorescence.After the treatment,the autofluorescence of polyps increased and then gradually returned to normal.

Evaluation of an algorithm-based automatic treatment planning module for volumetric-modulated arc therapy planning in nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective To evaluate the performance of progressive optimization algorithm-based Auto-Planning module in automated volumetric-modulated arc therapy(VMAT)planning for nasopharyngeal carcinoma. Methods Thirteen treated VMAT plans of nasopharyngeal carcinoma were re-planed with Auto-Planning module. Only one cycle of automated optimization of the Auto-Planning module was performed for each plan without any manual intervention. The dosimetric parameters of the automated treatment plans were compared with those of the manual plans. Paired t-test was used for statistical analysis. The time required for automated planning using the Auto-Planning module was also measured. Results All plans generated with the Auto-Planning module met the routine dosimetric requirements and were acceptable for clinical use. The homogeneity index of targets was superior in the automated plans than in manual plans(P= 0.000).In addition,the automated plans had significantly improved protection for some organs at risk than the manual plans. The mean dose to the left and right parotids were reduced by 7.75 Gy(P=0.000)and 5.79 Gy(P=0.000)in the automated plans,respectively. Furthermore,the V60(0.58% vs. 3.12%,P=0.000)and Dmean(34.11 Gy vs. 40.78 Gy,P= 0.000)of the mandible were also significantly lower with Auto-Planning than with manual planning. Conclusions Auto-Planning module can improve the overall quality and consistency of treatment plans,and reduce the workload and time of treatment planning,resulting in substantially enhanced treatment planning efficiency.

Treatment advances in early-stage primary systemic anaplastic large cell lymphoma / 肿瘤研究与临床

Primary systemic anaplastic large cell lymphoma (ALCL) is a subtype of rare and heterogeneous clinical entity, extremely rare in early stage of disease. There is no standard treatment yet. Based on retrospective studies, systematic chemotherapy followed by involved field radiation after chemotherapy is the mainstay of treatment. The role of radiotherapy in the treatment of early stage ALCL remains unclear due to lack of prospective studies. So do the optimal chemotherapy regimens and hematopoietic stem cell transplantation. The paper will review these issues.

Clinical decision on a patient with ALK+diffuse large B cell lymphoma / 中国肿瘤临床

Anaplastic lymphoma kinase (ALK)-positive diffuse large B-cell lymphoma (DLBCL) is a rare and distinct variant of DLBCL. It is classified as a unique subtype of DLBCL in the 2008 WHO classification of lymphomas. No standard and effective therapeutic regi-men is available for ALK+DLBCL because it shows a more aggressive clinical course and frequent relapse. Therefore, a standardized and individualized treatment is needed to benefit more patients diagnosed with ALK+DLBCL through a multiple disciplinary team. This arti-cle presents a case of an ALK+DLBCL patient who relapsed after transplantation and was successfully treated with the ALK kinase inhibi-tor Crizotinib.

Study on serum concentrations of homocysteine and relation factors in the patients with manic episodes of bipolar Ⅰ disorder / 中华行为医学与脑科学杂志

Objective To explore the association between serum levels of homocysteine (Hcy) and relation factors in the patients with manic episodes of bipolar Ⅰ disorder(BD).Methods The case-control study was used for this study.A total of 73 inpatients with manic episodes of BD(patient group) and 39 healthy individuals (control group) were enrolled.Diagnosis was made according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM-Ⅳ) criteria.Serum levels of Hcy was measured by enzymatic cycling assay.Young Mania Rating Scale(YMRS) were used to assess the severity of clinical symptoms of patients.Results There was a statistical difference in serum Hcy levels between patient group ((16.89± 14.67)μmol/L) and control group ((10.61±6.46) μmol/L) (P＜0.01),and serum Hcy levels was higher in men((20.42± 16.52) μmol/L) than that in women((10.87±8.02) μmol/L) in patients group(P＜0.05).The prevalence rate of high Hcy was 35.6％ in the patient group and 13.5％ in the control group(P＜0.05).Correlation analysis showed body mass index(BMI) had positive correlation with serum levels of Hcy (r=0.317,P＜0.05).Stepwise multiple regression analysis showed male,BMI were associated with serum levels of Hcy among the patients (all P＜ 0.05).Conclusion Serum Hcy levels in the patients with manic episodes of bipolar Ⅰ disorder increase,and it is associated with gender and BMI.

Clinical value of drug sensitivity test of ovarian tumor cells in vitro / 中国生化药物杂志

Objective To evaluate the clinical value of tumor chemosensitivity test in the guidance of the advanced epithelial ovarian carcinoma patients treated with chemotherapy.Methods Women with ovarian cancer were enrolled and fresh tissue samples were collected for chemoresponse testing.Oncologists chose a drug for each patient according to the patient’ s condition by double blind method.Each treatment was classified by the assay as: sensitivity (S); moderate sensitivity (I);resistant (R).Progression-free survival (PFS) and overall survival (OS) were detection.The relationship between treatment response and PFS or OS was analysis.Results 262 patients were enrolled.The PFS and OS were significantly improved in sensitivity patients (S) after chemotherapy,but no significant difference were found in I and R groups.In I+R groups (HR=0.66,P=0.008) , median PFS was 8.9 months, OS was 5.8 months.Chemotherapy response test results was consistent with clinical results cisplatin sensitive and resistant ( HR:0.72 vs.0.66).Multi factor regression analysis showed that tumor chemosensitivity test was independent prognostic factors (HR =0.66, P =0.021).The average OS extended for 14 months (37.6 months for the S group vs.group I +R 23.8 months,HR =0.62, P =0.011).Conclusion Tumor chemosensitivity assay is correlated with the clinical effects and might play an important role in guiding the recurrent epithelial ovarian cancer patients with individualized chemotherapy.

Molecular identification and sequence analysis of broad bean wilt virus 2 isolates from atractylodes macrocephala Koidz / 病毒学报

To identity the pathogen that causes the mosaic and yellowing symptoms on Atractylodes macrocephala Koidz in Jiangxian, Shanxi province, biological inoculation, sequence-independent amplification (SIA),RT-PCR and other identification methods were used. The results showed that the chlorotic and necrosis symptoms occurred in the indicator plant Chenopodium quinoa after it was infected with the pathogen,and the same symptoms appeared after the reinoculation of healthy Atractylodes macrocephala Koidz; this reflected that the disease was likely to be caused by a virus. The results of SIA and sequencing showed that Broad bean wilt virus 2 (BBWV2) was present in severely mosaic Atractylodes macrocephala Koidz leaves. To further characterize the BBWV2 isolate from Atractylodes macrocephala (BBWV2-Am), the polyprotein partial gene encoded by BBWV2-Am RNA2 was cloned and sequenced. Sequence alignments showed that the nucleotide sequence identity of BBWV2-Am SCP and LCP genes ranged from 79.3% to 87.2% and from 80.1% to 89.2% compared to other BBWV2 strains,respectively; the deduced amino acid sequence similarities of the two gene products ranged from 91.2% to 95.7% and from 89.44 to 95.5%, respectively,compared to those of other BBWV2 strains. Phylogenetic comparisons showed that BBWV2-Am was most likely to be related to BBWV2-Rg,but formed an independent branch. This is the first report of BBWV2 in Atractylodes macrocephala Koidz.

Clinical treatment of primary cutaneous anaplastic large cell lym-phoma / 中国肿瘤临床

Objective: To explore the clinical presentation and therapy of primary cutaneous anaplastic large cell lymphoma (PCALCL). Methods:We reviewed and analyzed six cases of PCALCL who were treated at our hospital from January 2009 to Decem-ber 2012. Results:The subjects were three males and three females with a median age of 54 years old (range:38 years to 60 years). Three patients had a single subcutaneous nodule and three had multiple nodules. The subcutaneous lesions appeared red, solid, and sta-ble nodules. Some patients developed pruritus around the lesions, or developed more nodules, which coalesced with other nodules. Some of the lesions exhibited partial spontaneous regression and new nodules appeared at the same site or at different sites. Finally, the lesions changed color from red to brown. The surfaces of some lesions developed ulcerations. Only 1 case had superficial lymph node metastasis. Three cases with single lesions received surgical excision plus radiotherapy, chemotherapy, or radiochemotherapy;all three cases survived and achieved complete remission. The three cases with multiple lesions mainly received systemic chemotherapy, with two of the cases recurring and one surviving with complete remission. The median follow-up was 24 months (range: 11 months to 35 months), with a progression free survival of 66.7%and an overall survival of 100%. Conclusion:Surgical excision or radiotherapy provides satisfactory control in patients with single lesions. Chemotherapy may be prescribed to patients with multiple lesions or with extracutaneous metastasis.

Comparison of clinical characteristics and prognoses between primary Waldeyer's ring diffuse large B-cell lymphoma and extranodal nasal-type NK/T-cell lymphoma / 中华放射肿瘤学杂志

ObjectiveThis study aimed to compare the clinical characteristics and prognoses of primary Waldeyer's ring diffuse large B-cell lymphoma (DLBCL) and extranodal nasal-type NK/T-cell lymphoma ( ENKTCL).MethodsFrom 2000 to 2008,122 patients with primary Waldeyer's ring DLBCL and 44 patients with primary Waldeyer' s ring ENKTCL consecutively diagnosed were retrospectively compared.Patients with DLBCL usually received 4-6 cycles of CHOP-based chemotherapy followed by involved-field radiotherapy.Patients with early stage ENKTCL usually received extended-field radiotherapy with or without subsequent chemotherapy,or short courses ( 1 - 3 cycles ) of chemotherapy followed by radiotherapy.Kaplan-Meier method was used for survival analysis.Logrank method was used for univariate analysis.ResultsThe follow-up rate was 82％.The number of patients followed 5 years were 32 and 15 in DLBCL and ENKTCL.DLBCL mainly presented with stage Ⅱ tonsillar disease with regional lymph node involvement.ENKTCL occurred predominately in young males,as nasopharyngeal stage I disease with B symptoms and involving adjacent structures.The 5-year overall survival (OS) and progression-free survival (PFS) rates were 74％ and 67％ in DLBCL,and 68％ and 59％ in ENKTCL (x2=0.53,1.06,P=0.468,0.303),respectively.In stage Ⅰ and Ⅱ diseases,the 5-year OS and PFS rates were 79％ and 76％ for DLBCL compared to 72％ and 62％ for ENKTCL (x2 =1.20,2.46,P=0.273,0.117).On univariate analysis,age ＞ 60 years,elevated lactate dehydrogenase,eastern cooperative oncology group performance status ＞ 1,international prognosis index ( IPI ) score ≥ 1,stage Ⅲ/Ⅳ diseases and bulky disease were associated with unfavorable survival for DLBCL (x2=9.40,12.72,6.15,10.36,12.48,5.53,P=0.002,0.000,0.013,0.001,0.000,0.019),and only age＞60 years and IPI score ≥ 1 were associated with poor survival for ENKTCL (x2 =3.98,8.41,P =0.046,0.004).ConclusionsThese results indicate that remarkable clinical disparities exist between DLBCL and ENKTCL in Waldeyer's ring. Different treatment strategies for each can result in similarly favorable prognoses.

Primary mucosa-associated lymphoid tissue lymphoma of Waldeyer's ring:clinical characteristics and long-term outcome / 中华放射肿瘤学杂志

Objective To investigate the clinical characteristics and long-term outcome of patients with mucosa-associated lymphoid tissue ( MALT) lymphoma of Waldeyer's ring. Methods Ten patients were retrospectively analyzed. Seven patients had stage ⅠE and 3 patients had stage ⅡE disease. All patients received radiation therapy with a median dose of 40 Gy, and 7 patients also received 1 t0 4 cycles of CHOP-based chemotherapy before radiation. Results The ratio of male to　female was 1∶9. The median age was 58 years. No patient had B symptoms. One patient had elevated LDH level. The complete response rate after treatment was 100％. With median follow-up periods of 90 months, 1 patient died from rectal cancer. One patient developed brain metastasis and was salvaged by radiotherapy. The 5-year overall survival, cancer specific survival and progression-free survival rates were 90％ , 100％ and 80％ , respectively. Conclusions The clinical characteristics of Waldeyer's ring MALT lymphoma were similar to that of nongastric MALT lymphoma. For patients with Waldeyer's ring MALT lymphoma, primary radiotherapy can result in excellent long-term survival.

Clinical analysis on primary salivary gland type nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective To analyze the clinical characteristics , therapeutic outcomes , and prognostic factors of primary salivary gland type nasopharyngeal carcinoma ( SNPC) . Methods The medical records of 54 patients with SNPC at single institution between 1963 and 2006 were reviewed, 2 patients received surgery alone, 30 patients received radiotherapy alone and 22 patients received combined modality therapy consisting of surgery (S) and radiotherapy ( RT) ( S + RT in 15 and RT + S in 7). Of them, 8 patients received chemotherapy , including post-operative adjuvant chemotherapy in 1 patient, palliative chemotherapy in 6 patients and concurrent chemotherapy in 1 patient. 36 patients had adenoid cystic carcinoma ( ACC) ,11 mucoepidermoid carcinoma ( MEC) , and 7 primary traditional adenocarcinoma ( AC) . The Kaplan-Meier method was used to calculate the overall sunival ( OS) , locoregional failure-free survival ( LRFFS) , and distant failure-free survival ( DFFS) rates. Univariate analyses were performed using the Log-rank method.Comparisons of variables between cases were performed using Pearson chi-square test. Results The follow-up was 89％ . The 2-, and 5-year overall survival rates, loco-regional failure free survival rates and distant failure free survival rates were 85％ and 61％ , 74％ and 55％ , 92％ and 70％, respectively. Among the 35 patients with treatment failure, 26 patients had locoregional failure (1 in primary site and cervical lymph node ,23 in primary site and 2 in cervical lymph node) ,and 13 had distant metastasis. The lung was the most common site of metastasis ( n =10) , followed by liver (n = 3), bone ( n = 2) , brain ( n = 1) , and subcutaneous tissue ( n = 1) . Univariate analyses indicated that histological subtypes correlated with overall survival ( X2 = 15. 29, P = 0. 000) and cervial lymph node metastases correlated with distant failure-free survival ( X2 =9. 08 ,P = 0. 003) . Conclusions Primary salivary gland type nasopharyngeal carcinoma is a locally aggressive disease with a long course. The optimal treatment policy for patients with SNPC may be surgery plus radiotherapy.

Advances in primary systemic anaplastic large cell lymphoma / 白血病·淋巴瘤

Primary systemic anaplastic large cell lymphoma is a subtype of rare and heterogeneous clinical entity.There is no standard treatment as yet.Based on retrospective studies,systematic chemotherapy is the main treatment while combining field radiation with chemotherapy is always used for diseases at early stage. Recently, there are some improvement were made on this kind of disease in the pathology and pathogenesis because of the advancement in molecular biology. This review focuses on the pathogenesis,pathology,treatment and prognosis of primary systemic anaplastic large cell lymphoma.

Nasopharyngeal mucoepidermoid carcinoma:A report of eleven cases / 中华放射肿瘤学杂志

Objective To evaluate the treatment results of the patients with nasopharyngeal mucoe-pidermoid carcinoma (MEC), and explore an appropriate treatment method. Methods Eleven patients with pathologically confirmed nasopharyngeal MEC were included in this study. The number of patients with pathologically well-, medium-and poorly-differentiated tumor were 1, 2 and 7, respectively. Radiotherapy (RT) alone and surgery (S) alone were given to 1 patient each. Combined modality treatment was RT + S in 6 patients and S + RT in 3 patients. Results After a median follow-up of 41.5 months (range, 8 to 153 months), one patient died of heart disease and one was lost follow-up. The remaining 9 patients were alive, including 6 with disease-free and 3 with residual tumors. None of them had cervical lymphatic spread or dis-tant metastasis. Conclusions Nasopharyngeal MEC progresses slowly and has good prognosis, which should be followed up for a long time. Primary surgery followed by radiotherapy is recommended.

Dose distribution variation of target volumes in nasopharyngeal carcinoma treated with intensity modulated radiotherapy / 中华放射肿瘤学杂志

Objective To analyze the dose distributions of changing target volumes during intensity modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). Methods Twenty-one NPC patients received definitive IMRT. A total of 126 computed tomography (CT) planning images were acquired, including the first CT scan for the primary plan and a series of scans taken weekly from the start of treatment to the fifth week. The images were registered to the planning images. Target volumes (GTV_(nx), CTV_1 ,CTV_2 ,PTV, and PTV_2) and normal structures (the parotid, brain stem and spinal cord) were re-contoured on the fusion CT images. Results The D_(mean) D_(95), D_(90), D_(10), D_5 and V_(100) of GTV_(nx) were 15.44 -15.60 Gy (F=0.07,P=0.996),14.66 -14.92 Gy (F=0. 11,P=0.990),14.81 -15.06 Gy (F= 0. 12,P=0.988),15.88 -16.29 Gy (F =0.28,P=0.924),16.00 -16.38 Gy (F=0.25,P =0. 940) and 98. 1% -99. 5 % (F = 0. 08, P = 0. 995), CTV_1 with 14. 75 -14. 98 Gy (F = 0. 07,P = 0. 997), 13.39 -13.73 Gy (F=0.20,P=0.964),13.74 -13.96 Gy (F=0.08,P=0.995), 15.65 -15.90 Gy (F= 0.09,P=0.994),15.91 -16.05 Gy (F=0. 10,P=0.992), 98.2% -99.5% (F=0.02,P= 1.000), and CTV_2 with 13.34 -13.64 Gy (F=0. 18,P=0.970),12.71 -13. 18 Gy (F=0.32,P=0.898), 12.89 -13.28Gy(F=0.23,P=0. 949) ,13.79 -14.03Gy(F=0. 12,P=0. 987) ,13.92 -14. 16 Gy (F=0. 12,P=0.987), 94.4% -99.6% (F=0.25,P=0.937), respectively. Conclusions No significantly different dose distributions exists with the changes of the target volumes, even on the largest variations of external contours. The primary plan could ensure adequate doses to the changing target volumes. The replanning is unnecessary in terms of the change of target volumes during radiotherapy.