Immunotherapy in SMARCB1 (INI-1)-deficient sinonasal carcinoma: Two case reports.

BACKGROUND: SMARCB1/INI-1 deficient sinonasal carcinoma (SDSC) is a rare subset of sinonasal undifferentiated carcinoma with a poor prognosis. Here, we present two case reports of SDSC patients. We also review the literature on this tumor. This is the first published report of SDSC treatment with immunotherapy. CASE SUMMARY: Here we present two patient cases of SDSC in which initial consultation and diagnosis were complicated but SDSC was ultimately diagnosed. One patient received a traditional treatment of surgery and adjuvant chemoradiotherapy, while the other patient received additional immunotherapy; the prognoses of these two patients differed. We review previous diagnostic literature reports and SDSC treatments and provide a unique perspective on this rare type of tumor. CONCLUSION: SDSC is a rare, diagnostically challenging carcinoma with a consistently poor prognosis, early distant metastases, and frequent recurrence. Timely diagnosis and intervention are critical for treatment, for which the standard of care is surgery followed by adjuvant chemoradiotherapy, though immunotherapy may be an effective new treatment for SDSC.

Validity and reliability of the simplified Chinese patient-reported outcomes version of the common terminology criteria for adverse events.

BACKGROUND: The psychometric properties of the simplified Chinese version of the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) have not been assessed. Therefore, we aimed to assess its validity, reliability, and responsiveness. PATIENTS AND METHODS: A Chinese version of the PRO-CTCAE and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (QLQ-C30) were distributed to 1580 patients from four cancer hospitals in China. Validity assessments included construct validity, measured by Pearson's correlations and confirmatory factor analysis (CFA), and known-groups validity, measured by t-tests. The assessment of reliability included internal consistency, measured by Cronbach's ɑ, and test-retest reliability, measured by the intraclass correlation (ICC). Responsiveness was assessed by standardized response means (SRMs). RESULTS: Data from 1555 patients who completed the instruments were analyzed. The correlations were high between PRO-CTCAE items and parallel QLQ-C30 symptom scales (r > 0.60, p < 0.001), except for fatigue (severity: r = 0.49). Moreover, CFA showed the PRO-CTCAE structure was a good fit with the data (Root Mean Square Error of Approximation = 0.046). Known-groups validity was also confirmed. Cronbach's ɑ of all item clusters were greater than 0.9 and the median test-retest reliability coefficients of the 38 items were 0.85 (range = 0.71-0.91). In addition, the SRMs of PRO-CTCAE items were greater than 0.8, indicating strong responsiveness. CONCLUSION: The simplified Chinese version of the PRO-CTCAE showed good reliability, validity, and responsiveness.

Promoter Methylation of DNA Repair Genes Predicts Disease-free Survival of Gastric Adenocarcinoma after Adjuvant Radiotherapy.

The relentless debate on postoperative adjuvant radiotherapy in gastric adenocarcinoma (GA) has been lasting for decades. In this study, a new biomarker, named promoter methylation burden of DNA repair genes (RPMB), was established to identify the subgroup of patients who might benefit from adjuvant radiotherapy. Methylation profiles of 397 GA tumor samples were downloaded from The Cancer Genome Atlas (TCGA). RPMB for a patient was defined as the ratio of methylated DNA repair genes to the number of all DNA repair genes. Subgroup analyses in term of overall survival (OS) and disease-free survival (DFS) indicated that most of the subgroups favored the high-RMPB group. Kaplan-Meier analysis showed that overall the patients with high RPMB after R0 resection had a significantly better clinical outcome regarding DFS (hazard ratio [HR] = 0.013, p = 0.042). Additionally, high-RPMB patients, who underwent adjuvant radiotherapy with both ≥T2 tumor and positive lymph nodes, showed superior DFS in comparison with the low-RPMB group (HR = 5.35 × 10-10, n = 26, p = 0.010). RPMB might be considered as a promising biomarker for decision-making with regard to postoperative adjuvant radiotherapy for GA patients.

[Open-top Chamber for in situ Research on Response of Mercury Enrichment in Rice to the Rising Gaseous Elemental Mercury in the Atmosphere].

In situ research was conducted on the response of mercury enrichment in rice organs to elevated gaseous elemental mercury (GEM) with open-top chambers (OTCs) fumigation experiment and soil Hg enriched experiment. The results showed that Hg concentrations in roots were generally correlated with soil Hg concentrations (R = 0.9988, P < 0.05) but insignificantly correlated with air Hg concentrations (P > 0.05), indicating that Hg in rice roots was mainly from soil. Hg concentrations in stems increased linearly (R(B) = 0.9646, R(U) = 0.9831, P < 0.05) with elevated GEM, and Hg concentrations in upper stems were usually higher than those in bottom stems in OTCs experiment. Hg concentrations in bottom stems were generally correlated with soil Hg concentrations (R = 0.9901, P < 0.05) and second-order polynomial (R = 0.9989, P < 0.05) was fitted for Hg concentrations in upper stems to soil Hg concentrations, and Hg concentrations in bottom stems were usually higher than those in upper stems in soil Hg enriched experiment, indicating the combining impact of Hg from air and soil on the accumulation of mercury in stems. Hg concentrations in foliage were significantly correlated (P < 0.05) with air Hg and linearly correlated with soil Hg (R = 0.9983, P = 0.0585), implying that mercury in foliage was mainly from air and some of Hg in root from soil was transferred to foliage through stem. Based on the function in these filed experiments, it was estimated that at least 60%-94% and 56%-77% of mercury in foliage and upper-stem of rice was from the atmosphere respectively, and yet only 8%-56% of mercury in bottom-stem was attributed to air. Therefore, mercury in rice aboveground biomass was mainly from the atmosphere, and these results will provide theoretical basis for the regional atmospheric mercury budgets and the model of mercury cycling.

Progress of oral sequelae during head-neck radiotherapy.

OBJECTIVE: To evaluate xerostomia, mucositis and dental caries during head and neck radiotherapy. METHODS: Twenty patients with nasopharyngeal carcinoma were included. Oral examinations were conducted before radiotherapy, after dosage of 2000 cGy irradiation, immediately after the termination of radiotherapy, and 1 month and 6 months after termination of the radiotherapy. Oral hygiene instruction, effective oral care and dental intervention were performed during the treatment. Salivary flow rate was evaluated by modified Schirmer's test. Xerostomia, mucositis and dental caries status were evaluated based on oral examinations. RESULTS: Salivary flow rate decreased significantly after the first dosage of 2000 cGy, and was aggravated with the increase in irradiation dosage until the termination of radiotherapy. Xerostomia and mucositis were observed in parallel with the reduction of saliva flow rate, and were aggravated with the increase in irradiation dosage. Mucositis began to recover within 1 month after the termination of radiotherapy and fully recovered within 6 months after the termination of the radiotherapy. Six months after the termination of irradiation, new carious lesions were detected in two patients. CONCLUSION: Oral sequelae developed during radiotherapy of the head and neck. Oral health instructions and effective intervention were essential before, during and after the radiotherapy.