ABSTRACT
BACKGROUND AND OBJECTIVE: Radiotherapy is effective in treating nasopharyngeal carcinoma (NPC). This study evaluated the treatment efficacy, toxicity, and prognostic factors of intensity-modulated radiotherapy (IMRT) in the treatment NPC. METHODS: Between September 2003 and September 2006, 305 patients with NPC were treated with IMRT in Fujian Provincial Cancer Hospital. IMRT was delivered as follows: gross tumor volume (GTV) received 66.0-69.8 Gy in 30-33 fractions, high-risk clinical target volume (CTV-1) received 60.0-66.65 Gy, low-risk clinical target volume (CTV-2) and clinical target volume of cervical lymph node regions (CTV-N) received 54.0-55.8 Gy. Patients with stages III or IV disease also received cisplatin-based chemotherapy. All patients were assessed for local-regional control, survival, and toxicity. RESULTS: With a median follow-up of 35 months (range, 5-61 months), there were 16, 8, and 39 patients who had developed local, regional, and distant recurrence, respectively. The 3-year rates of local control, regional control, metastasis-free survival, disease-free survival, and overall survival were 94.3%, 97.7%, 86.1%, 80.3%, and 89.1%, respectively. Multivariate analyses revealed that T-classification had no predictive value for local control and survival, whereas N-classification was a significant prognostic factor for overall survival (P < 0.001), metastasis-free survival (P < 0.001), and disease-free survival (P = 0.003). For stages III-IV disease, concurrent and adjuvant chemotherapy did not influence prognosis. The most severe acute toxicities included Grade III mucositis in 14 patients (4.6%), Grade III skin desquamation in 90 (29.5%), and Grades III-IV leucocytopenia in 20 (6.5%). There were 7% patients with Grade II xerostomia after 2 years of IMRT, no Grades 3 or 4 xerostomia was detected. CONCLUSIONS: IMRT provided favorable locoregional control and survival rates for patients with NPC, even in those with locally advanced disease. The acute and late toxicities were acceptable. N-classification was the main factor of prognosis. Further study is needed on chemotherapy for patients with NPC.
Subject(s)
Nasopharyngeal Neoplasms/radiotherapy , Radiotherapy, Intensity-Modulated/methods , Adolescent , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Child , Cisplatin/administration & dosage , Combined Modality Therapy , Disease-Free Survival , Female , Follow-Up Studies , Humans , Leukopenia/etiology , Lymphatic Metastasis , Male , Middle Aged , Mucositis/etiology , Nasopharyngeal Neoplasms/drug therapy , Nasopharyngeal Neoplasms/pathology , Neoplasm Recurrence, Local , Neoplasm Staging , Radiotherapy Dosage , Radiotherapy, Intensity-Modulated/adverse effects , Retrospective Studies , Survival Rate , Xerostomia/etiology , Young AdultABSTRACT
The surface-enhanced Raman scattering (SERS) spectroscopy and normal Raman spectroscopy of single living human nasopharyngeal carcinoma cells(CNE-1) were tested and analyzed by gold nanoparticles incubation into cells. Six obvious Raman bands (718, 1001, 1123, 1336, 1446 and 1660 cm(-1)) were observed in the normal Raman spectroscopy of living CNE-1 cells. The characteristic Raman bands in the SERS spectra of living cells were tentatively assigned. Colloidal gold particles that were introduced inside cells result in strongly enhanced Raman signals of the native chemical constituents of the cells, and over twenty SERS Raman bands were observed in the SERS spectroscopy of living CNE-1 cells. The Raman lines of 1026, 1097, 1336 and 1585 cm(-1) were assigned to vibrations of the DNA backbone, which confirms that some gold nanoparticles were able to enter the nucleus. The results showed that, based on colloidal gold, the SERS spectroscopy might provide a sensitive and structurally selective detecting method for native chemicals inside a cell, such as DNA and phenylalanine.
