To evaluate the clinical effect and prognostic factors of nasopharyngeal carcinoma in 44 children and adolescents.From June 1987 to December 2003,44 children and adolescents with nasopharyngeal carcinoma were treated by radiotherapy, and some patients also received chemotherapy. Kaplan-Meier method was used for the survival rate and univariate analysis, and Cox proportional hazard model was used in multivariate analysis.The 3.5 year survival rate was 84.2% and 62.3%.In the univariate analysis, clinical stage, lymph node (N) stage, radiotherapy dose and chemotherapy were significant prognostic factors of survival.In the multivariate analysis, N stage and chemotherapy were the prognostic factors in the survival rate.Most nasopharyngeal carcinomas belong to the advanced degree. These patients are sensitive to radiotherapy and chemotherapy. Combined modality therapy can improve the clinical effect of nasopharyngeal carcinoma in children and adolescents.
To explore the association of Ezrin and E-cadherin expression with the invasion, metastasis and prognois of nasopharyngeal carcinoma.Imunohistochemical SP staining was used to detect the expression of Ezrin and E-cadherin in 42 nasopharyngeal carcinoma and 10 chronic nasopharyngitis specimens.Ezrin protein expression in the nasopharyngeal carcinoma tissues was significantly higher than that in the chronic nasopharyngitis tissues (P<0.05). E-cadherin expression in the nasopharyngeal carcinoma tissues was significantly lower than that in the chronic nasopharyngitis tissues (P<0.05). Expressions of both Ezrin and E-cadherin of nasopharyngeal carcinoma were closely associated with T staging,the cervical lymph node metastases and clinical staging (P<0.05). A negative correlation was found between Ezrin and E-cadherin expression in the nasopharyngeal carcinoma tissues (r=-0.450, P<0.05). Survival analysis showed that the abnormal expression of Ezrin and E-cadhrin, clinical staging and the cervical lymph node metastases were associated with the survival rate of patients with nasopharyngeal carcinoma.A negative correlation is found between Ezrin and E-cadherin expression in the nasopharyngeal carcinoma tissues. Ezrin and E-cadherin are closely related to clinical staging and the cervical lymph node metastases of nasopharyngeal carcinoma,suggesting that they may be important tumor markers for nasopharyngeal carcinoma. Combined detection of the expressions of Ezrin and E-cadherin is helpful for clinical doctors to determine the prognosis of patients with nasopharyngeal carcinoma.
As many countries face an ageing population, the number of older patients with glioblastoma (GB) is increasing. Thus, there is an urgent need for prognostic models to aid in treatment decision-making and life planning. A total of 98 patients with isocitrate dehydrogenase (IDH)-wild-type GB aged ≥65 years were analysed from January 2012 to January 2020. Independent prognostic factors were identified by prognostic analysis. Using the independent prognostic factors for overall survival (OS), a nomogram was constructed by R software to predict the prognosis of older patients with IDH-wild-type GB. The concordance index (C-index) and receiver operating characteristic (ROC) curve were used to assess model discrimination, and the calibration curve was used to assess model calibration. Prognostic analysis showed that the extent of resection (EOR), adjusted Charlson comorbidity index (ACCI), O6-methylguanine-DNA methyltransferase (MGMT) methylation status, postoperative radiotherapy, and postoperative temozolomide (TMZ) chemotherapy were independent prognostic factors for OS. MGMT methylation status and subventricular zone (SVZ) involvement were independent prognostic factors for progression-free survival (PFS). A nomogram was constructed based on EOR, ACCI, MGMT methylation status, postoperative radiotherapy and postoperative TMZ chemotherapy to predict the 6-month, 12-month and 18-month OS of older patients with IDH-wild-type GB. The C-index of the nomogram was 0.72, and the ROC curves showed that the areas under the curve (AUCs) at 6, 12 and 18 months were 0.874, 0.739 and 0.779, respectively. The calibration plots showed that the nomogram was in good agreement with the actual observations in predicting the OS of older patients with IDH-wild-type GB. Older patients with IDH-wild-type GB can benefit from gross total resection (GTR), postoperative radiotherapy and postoperative TMZ chemotherapy. A high ACCI score and MGMT nonmethylation are poor prognostic factors. We constructed a nomogram including the ACCI to facilitate clinical decision-making and follow-up interval selection.
Abstract: The study aimed to investigate the difference of setup errors on different registration in the treatment of nasopharyngeal carcinoma based on weekly cone-beam computed tomography (CBCT). Thirty nasopharyngeal cancer patients scheduled to undergo intensity-modulated radiotherapy (IMRT) were prospectively enrolled in the study. Each patient had a weekly CBCT before radiation therapy. In the entire study, 201 CBCT scans were obtained. The scans were registered to the planning CT to determine the difference of setup errors on different registration sites. Different registration sites were represented by bony landmarks. Nasal septum and pterygoid process represent head, cervical vertebrae 1–3 represent upper neck, and cervical vertebrae 4–6 represent lower neck. Patient positioning errors were recorded in the right–left (RL), superior–inferior (SI), and anterior–posterior (AP) directions over the course of radiotherapy. Planning target volume margins were calculated from the systematic and random errors. In this study, we can make a conclusion that there are setup errors in RL, SI, and AP directions of nasopharyngeal carcinoma patients undergoing IMRT. In addition, the head and neck setup error has the difference, with statistical significance, while patient setup error of neck is greater than that of head during the course of radiotherapy. In our institution, we recommend a planning target volume margin of 3.0 mm in RL direction, 1.3 mm in SI direction, and 2.6 mm in AP direction for nasopharyngeal cancer patients undergoing IMRT with weekly CBCT scans. Keywords: cone-beam computed tomography, setup error, PTV margins, nasopharyngeal carcinoma, intensity-modulated radiation therapy
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