Prediction of outcomes in patients with local recurrent nasopharyngeal carcinoma: development and validation of a four-factor prognostic model integrating baseline characteristics and [18F]FDG PET/CT parameters.

OBJECTIVES: To investigate the prognostic value of [18F]FDG PET/CT parameters in local recurrent nasopharyngeal carcinoma (lrNPC) and establish a prognostic tool for lrNPC patients based on these [18F]FDG PET/CT parameters. METHODS: A total of 358 lrNPC patients seen from 2010 to 2019 at Sun Yat-sen University Cancer Center with complete baseline characteristics and [18F]FDG PET/CT data were retrospectively analyzed. Maximal standardized uptake value (SUVmax), SUVmean, SUVpeak, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneity index (HI) for recurrent nasopharynx tumors were included. Cox regression analysis was performed to select candidate variables. Subsequently, a nomogram for predicting overall survival (OS) for lrNPC patients was developed and internally validated. RESULTS: Multivariate Cox analysis results suggested that age ≥ 47 years (hazard ratio (HR), 1.62 (1.18-2.24); p = 0.003)，with smoking history (HR, 1.41 (1.01-1.98); p = 0.046), recurrent T stage {[rT3 vs rT1/2: HR, 1.81 (1.04-3.12); p = 0.037]; [rT4 vs rT1/2: HR, 2.46 (1.32-4.60); p = 0.005]}, and TLG {[37.1-184.3 vs ≤ 37.1: HR, 2.26 (1.49-3.42); p < 0.001]; [>184.3 vs ≤ 37.1: HR, 4.31 (2.50-7.43); p < 0.001]) were independent predictors of OS. A 4-factor nomogram was generated to stratify patients into 3 risk groups. This novel model showed good discrimination with a high C-index (0.752, 95%CI: 0.714-0.790). In addition, the calibration curves showed good agreement between the predicted probabilities and actual observations and decision curve analysis (DCA) suggested that the nomogram was useful for clinical decision-making. CONCLUSIONS: Our study confirmed that [18F]FDG PET/CT parameters were valuable in predicting OS and PFS for lrNPC patients. The 4-factor prognostic model combing baseline patient characteristics with [18F]FDG PET/CT parameters for lrNPC patients had good discrimination, agreement, and clinical application potential. KEY POINTS: • [18F]FDG PET/CT parameters were valuable in predicting OS and PFS for lrNPC patients. • The novel 4-factor nomogram for lrNPC patients had good discrimination, agreement, and potential for clinical application.

Clinical Study on Liver-soothing,Essence-tonifying and Spleen-strengthening Herbal Medicine for Ametropic Amblyopia in Children / 广州中医药大学学报

Objective To observe the effect of liver-soothing and spleen-strengthening,essence-tonifying and eyesight-improving herbal medicine for ametropic amblyopia(AA) in children.Methods AA children were randomized into 2 groups.The two groups received treatment of optometry and sight-enhancing device based on microcomputer.Meanwhile,group A(52 affected eyes in 29 patients) received oral use of Ximing Decoction with liver-soothing and spleen-strengthening,essence-tonifying and eyesight-improving actions,which is mainly composed of Radix Curcumae,Radix Pseudostellariae,Radix Panacis Quinquefolii,Fructus Aurantii Immaturus,Herba Agastaches,Flos Buddlejae,Nux Prinsepiae,Fructus Setariae Germinatus,Radix Ophiopogonis,Fructus Crataegi and Massa Medicata Fermentata.Group B(46 affected eyes in 28 patients) received oral use of levodopa additionally.Seven days constituted one treatment course.The treatment lasted 8 courses.Before and after treatment,corrected visual acuity(CVA) was observed.Results In group A,CVA of 13 eyes were improved,AA of 33 eyes cured,6 eyes ineffective,and the total effective rate was 88.46%.In group B,CVA of 10 eyes were improved,AA of 12 eyes cured,24 eyes ineffective,and the total effective rate was 47.83%.The effect in group A was superior to that in group B(P