Objective To explore the spread patterns of retropharyngeal lymph node (RLN) metastasis of nasopharyngeal carcinoma. Methods From July 2003 to March 2005, three hundred and three patients with nasopharyngeal carcinoma in initial treatment were enrolled in this study. All patients underwent magnetic resonance imaging (MRI) before treatment, meanwhile measured the minimal and maximal axial diameters, the longitudinal diameter and the central and craniocaudad locations of each positive RLN. Results A total number of 264 positive RLN were found in 177 patients. The minimal and maximal axial diameters and longitudinal diameter of positive RLN were 9.9, 12.9 and 22.4 mm, respectively. Ipsilateral metastatic RLN were noted as follows: two nodes in 21 patients, three nodes in 3 patients and four nodes in 1 patient. According to the longitudinal central location of 263 positive lateral RLN, the numbers of nodes at occipital bone, C1, C1/C2, C2, C2/C3 and C3 were 27, 166, 40, 23, 5 and 2, respectively; the mean minimal axial diameters of nodes were 6.8, 9.9, 12.5, 10.4, 9.3 and 8.0 mm, respectively. Conclusion Multiple metastatic ipsilateral RLN are not common in NPC. The rate of RLN metastasis shows the trend of decreasing from vertebral C1 to C3.The maximal diameters of RLN are in the C1/C2 intervertebral space, and reveal a decreasing frequency along the craniocaudal directions of occipital and vertebral C1.

Objective To compare the short-term effects and toxicity of one cycle of TPF regimen induction chemotherapy with that of two cycles of PF regimen induction chemotherapy in the N advanced local nasopharyngeal carcinoma (NPC). Methods A total of 47 patients initially treated with N advanced local NPC without distant metastasis from Jan 2007 to Dec 2008 were enrolled in this study. The TPF chemotherapy regimen was administered as follows: TAX 60 mg/m2, i.v. infusion on day 1st, cisplatin 80 mg/m2, i.v. infusion on day 1st and 5-Fu 800 mg/m2, bolus infusion in 96 hours on day lst-4th. The PF chemotherapy regimen was as follows: cisplatin 100 mg/m2, i.v. infusion on day 1 and 5-Fu 1000 mg/m2, bolus infusion in 96 hours on day lst-4th. Twenty-six patients received one cycle of TPF regimen and 21 patients received two cycles of PF regimen, with 21 days each cycle and a total of 3 courses in each group, then chemoradiotherapy with cisplatin 30 mg/m2 (weekly) was followed. Results The short-term efficacy was no significant difference between two groups, after one cycle TPF chemotherapy, the CR+PR rates of primary site and lymph nodes were 57.7 % and 69.2 %, respectively, while after two cycles PF chemotherapy in control group, those were 66.7 % and 71.4 %, respectively (P>0.05). In 3 months after treatment, the CR rates of primary site and lymph nodes in TPF group were 92.3 % and 88.7 %, respectively, while those in control group were 100.0 % and 90.5 %, respectively (P>0.05). The main adverse reactions were Grade Ⅲ-Ⅳ neutropenia and alopecia in TPF group. Conclusion Short-term effects of induction chemotherapy with one cycle of TPF regimen in the N advanced local NPC is satisfied, and the main toxicity is neutropenia.

Objective To investigate the prognostic value of maximum diameter in axial plane of primary tumor (MDAPPT) on MRI in nasopharyngeal carcinoma (NPC).Methods From 2005 to 2007,333 patients with newly diagnosed and biopsy-proven NPC without distant metastasis,who underwent MRI scans of the nasopharynx and neck,were included in our study.MDAPPT was measured on MRI.The univariate analysis with the log-rank test and multivariate analysis with the Cox proportional hazards model were used to analyze the relationship between MDAPPT and prognosis.Results The median values of MDAPPT in patients with T1,T2,T3,and T4 NPC were 21.2,30.0,38.0,and 52.3 mm,respectively.For all patients with a MDAPPT of ≤30 mm,＞ 30-50 mm,and ＞ 50 mm,the 5-year overall survival (OS) rates were 81.3％,70.1％,and 51.5％,respectively (P =0.000) ; the 5-year progression-free survival (PFS) rates were 81.3％,70.0％,and 48.9％,respectively (P =0.000) ;the 5-year distant metastasisfree survival (DMFS) rates were 85.5 ％,86.5 ％,and 67.2 ％,respectively (P =0.000) ; the 5-year local relapse-free survival (LRFS) rates were 97.7％,91.5％,and 83.3％,respectively (P =0.013).The multivariate analysis showed that MDAPPT was a prognostic factor for PFS and DMFS.For the T3-T4 patients with a MDAPPT of ≤50 mm and ＞50 mm,the 5-year OS rates were 69.4％ and 52.2％ (P =0.004),the 5-year PFS rates were 68.0％ and 49.6％ (P =0.001),and the 5-year DMFS rates were 84.0％ and 66.8％ (P=0.001).In the patients with a MDAPPT ≤30 mm,the 5-year LRFS rates for those with T1,T2,T3,and T4 NPC were 10 0 ％,9 5.8 ％,9 6.3 ％,and 10 0 ％,respectively (P =0.6 4 3).Conclusions MDAPPT is a prognostic factor for PFS and DMFS in NPC,and it is an important prognostic factor in patients with T3-T4 NPC.In the NPC patients with a small MDAPPT,local control rate varies little in different T stages.

Objective To evaluate the prognostic impact of MRI-detected prevertebral space involvement in nasopharyngeal carcinoma (NPC) treated with radiotherapy and chemotherapy.Methods A retrospective analysis was performed on the clinical data of 333 patients who had newly diagnosed biopsyproven NPC without distant metastasis from 2005 to 2007.All patients underwent MRI scans of the nasopharynx and neck and were treated with two-and three-dimensional radiotherapy without or without chemotherapy.The Kaplan-Meier method was used to calculate overall survival (OS),distant metastasis-free survival (DMFS),and locoregional relapse-free survival (LRFS),and the log-rank test was used for survival difference analysis;the Cox proportional hazards regression analysis was used to assess the prognostic value of prevertebral space involvement.Results The follow-up rate was 95.2％.Prevertebral space involvement was seen in 139(41.7％) of these patients.The patients with prevertebral space involvement had significantly higher T stage and clinical stage than those without prevertebral space involvement (x2 =90.41,P =0.000;x2 =54.03,P =0.000).The 5-year OS,DMFS,and LRFS for NPC patients with and without prevertebral space involvement were 58.8％ vs.77.5％ (x2 =11.95,P =0.000),77.8％ vs.85.0％(x2=2.56,P=0.110),and 88.3％ vs.91.8％ (x2=1.51,P=0.220),respectively.After adjusting for N stage,a significant difference was still seen between the two groups with regard to 5-year OS (x2 =9.93,P =0.002).The multivariate analysis showed that prevertebral space involvement was not the independent prognostic factor for OS,DMFS,and LRFS (x2 =0.43,P =0.512 ; x2 =0.08,P =0.783 ; x2 =0.00,P =0.971).Conclusions The frequency of prevertebral space involvement is very high in NPC.The OS for the patients with prevertebral space involvement is significantly lower than those without prevertebral space involvement.But prevertebral space involvement is not the independent prognostic factor in NPC patients.

OBJECTIVE: To investigate the correlation of cyclin D1 (CCND1) G870A single nucleotide polymorphism (SNP) with radiotherapy response in patients with high risk human papillomavirus (HR-HPV) related cervical cancer.
 METHODS: A total of 273 patients with cervical cancer, who were confirmed by histopathology and hybrid capture 2 (HC-2) assay and treated by radiotherapy, were enrolled for this study. The correlation of CCND1 G870A polymorphism with tumor response in patients was assessed.
 RESULTS: Compared with patients with AA genotype, the patients with GG genotype and AA genotype showed lower sensitivity to radio-therapy treatment (adjusted ORGA=2.69, 95% CI 1.28-5.67 and adjusted ORGG=3.28, 95% CI 1.47-7.29, respectively), an increase in risks of recurrence/metastasis (adjusted ORGA=2.52, 95% CI 1.12-5.63 and adjusted ORGG=3.95, 95% CI 1.68-9.26, respectively), and shorter recurrence/metastasis-free survival (PGA=0.010 and PGG=0.045).
 CONCLUSION G870A polymorphism is a frequent variation that could be used for evaluate the radio-sensitivity and prognosis for patients with HR-HPV related cervical cancer.
Cyclin D1 ; genetics ; Female ; Genotype ; Humans ; Papillomaviridae ; Polymorphism, Single Nucleotide ; Prognosis ; Uterine Cervical Neoplasms ; genetics ; radiotherapy ; virology