Objectives: To evaluate long-term outcomes and late toxicities of nasopharyngeal carcinoma (NPC) patients with T1-2N0-3M0 stage in intensity-modulated radiotherapy (IMRT) era.Materials and Methods: From June 2005 to October 2013, 276 patients confirmed T1-2N0-3M0 NPC treated with IMRT were reviewed, with 143 (51.8%)N0-1 disease and 133 (48.2%)N2-3 disease.Among them, 76.4% received chemotherapy.The prescribed doses given to the primary tumor and lymph nodes were 66Gy in 30 fractions.Results: After a median follow-up of 103 months, the 5-year and 10-year overall survival (OS) were 90.6% and 79.2%.The 5-year and 10-year local control (LC) rate, regional control (RC) rate and distant metastasis free survival (DMFS) were 97.0% and 91.9%, 94.1% and 92.2%, 89.4% and 87.0%, respectively.The 5-year and 10-year OS, RC rate and DMFS of N0-1 compared with those of N2-3 were 98.6% vs. 82.0%and 86.8% vs. 70.9%(P=0.000),99.3% vs. 88.3% and 99.3% vs. 84.1% (P=0.000),97.9% vs. 80.1% and 95.7% vs. 77.5% (P=0.000).The incidence of 3-4 late toxicities were low and mainly xerostomia and hearing deficit.The rates of radiation-induced cranial nerve palsy and temporal necrosis were 2.5% and 2.5%, respectively.Eighteen patients had the second primary tumor, of whom eight were lung cancer, six were head and neck cancer, four were others.Conclusions: Satisfactory locoregional control was achieved in T1-2N0-3M0 NPC treated with IMRT.Distant metastasis was the main failure cause and N2-3 was the main adverse prognostic factor.Second primary tumor occurred 6.5% and negatively impacted OS in NPC.
The purpose of this study is to investigate the current status of clinical target volume (CTV) delineation for primary site of nasopharyngeal cancer (NPC) among five large tertiary cancer centers in China.The simulation CT and MR images of a patient with T3N2M0 NPC were sent to the centers participating. Fourteen experienced physicians contoured the targets independently, and the outlined structures were compared. The consistency and differences among these 14 CTVs are discussed.Two different CTV designs were used in the centers. "One-CTV" design defines one CTV with a dose of 60 Gy, whereas "two-CTV" design has a high-risk CTV with dose of 60 Gy and a medium risk CTV with dose of 54 Gy. We found that the coverage of prophylactic area is very consistent between these two designs. The variances on the coverage of some sites were also significant among physicians, including covering cavernous sinus at un-involved side, posterior space of styloid process, and caudal border on posterior pharyngeal wall.Standardization is the main requirement for personalization of care; our study shows that among the 14 physicians in the five centers the coverage of prophylactic areas is in excellent agreement. Two distinct strategies on CTV design are currently being used, and multiple controversies were found, suggesting further optimization of CTV for primary site of NPC is needed.
Background: Breast cancer (BC) is considered a systemic disease with a primarily locoregional component. The accumulation of basic researches and clinical studies related to cytokine-induced killer (CIK) cells has confirmed their safety and feasibility in treating BC. By searching the PubMed, Embase, CNKI, and Wanfang databases, we conducted a meta-analysis to assess the efficacy and safety of DC/CIK plus chemotherapy regimen (Exp) compared with chemotherapy (Con) alone regimen for breast carcinoma. Studies were pooled, and the relative risk (RR) and its corresponding 95% confidence interval (CI) were calculated. Methods: Eleven relevant articles were included in this meta-analysis. We observed that complete response (CR) (RR = 1.54, 95% CI: 1.09–2.19, Pheterogeneity = .994, I2 = 0%), partial response (PR) (RR = 1.33, 95% CI: 1.11–1.59, Pheterogeneity = .802, I2 = 0%) and overall response rate (ORR) (RR = 1.37, 95% CI: 1.20–1.57, Pheterogeneity = .619, I2 = 0%) in BC patients treatment with DC/CIK plus chemotherapy regimen was improved than that with chemotherapy alone. There was no difference in the incidence of leukopenia, thrombocytopenia, hair loss, nausea/vomiting, hepatic complications, and neurologic complications in BC patient's treatment with DC/CIK plus chemotherapy regimen and with chemotherapy alone. Results: Compared to chemotherapy alone, DC/CIK plus chemotherapy treatment significantly increased CR, PR, and ORR; however, there was no difference between the safeties. Conclusion: DC/CIK plus chemotherapy treatment may be a valuable new option for the treatment of breast carcinoma in women. The present study, therefore, provides valuable information to help physicians make treatment decisions for their patients with BC.
The aim of this joint guideline is to provide evidence-based recommendations to practicing physicians and other healthcare providers on definitive-intent chemoradiotherapy for patients with stage II-IVA nasopharyngeal carcinoma (NPC).The Chinese Society of Clinical Oncology (CSCO) and ASCO convened an expert panel of radiation oncology, medical oncology, surgery, and advocacy representatives. The literature search included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2020. Outcomes of interest included survival, distant and locoregional disease control, and quality of life. Expert panel members used this evidence and informal consensus to develop evidence-based guideline recommendations.The literature search identified 108 relevant studies to inform the evidence base for this guideline. Five overarching clinical questions were addressed, which included subquestions on radiotherapy (RT), chemotherapy sequence, and concurrent, induction, and adjuvant chemotherapy options.Evidence-based recommendations were developed to address aspects of care related to chemotherapy in combination with RT for the definitive-intent treatment of stage II to IVA NPC.Additional information is available at www.asco.org/head-neck-cancer-guidelines.
Myelodysplastic syndromes (MDS) are myeloid neoplasms characterized by ineffective hematopoiesis due to stem cell abnormalities. Monosomy 7q aberrations are a common cytogenetic abnormality in MDS. Specifically, an unbalanced translocation der(1;7)(q10;p10) [der(1;7)] has been identified in MDS patients, which is a monosomy 7q aberration variant like -7/del(7q). However, knowledge of der(1;7)'s features remains limited. Existing studies have compared the clinical and genetic characteristics of der(1;7) to those of -7/del(7q) but yielded inconsistent findings. Accordingly, we conducted meta-analyses comparing der(1;7) to -7/del(7q).
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