OBJECTIVETo analyze the prognostic factors affecting long-term result in pediatric or adolescent nasopharyngeal carcinoma.

METHODSFrom January 1984 to December 1998, 117 cases of pediatric and adolescent nasopharyngeal carcinoma proven by pathology were treated by radiotherapy and/or chemotherapy. Their data were retrospectively analyzed. Of the 117 patients, 35 received chemotherapy before radiotherapy, 36 were treated with continuous radiotherapy and the other 81 with split-course radiotherapy. A dose of 56 - 80 Gy/6 - 13 weeks (66.32 +/- 4.72 Gy) was given in the nasopharynx and 47 - 73 Gy/5 - 13 weeks (57.90 +/- 5.80 Gy) in the neck. The survival rates were assessed by Kaplan-Meier analysis and the survival curves compared by Log-rank test. The multivariate analysis was conducted by Cox model.

RESULTSThe 1-, 3- and 5-year overall survival rate was 86.3%, 66.6% and 56.4%, respectively; and disease-free survival rate at 1, 3 and 5 years was 71.8%, 53.9% and 50.4%, respectively. A monovariate analysis showed that the age (P = 0.0015), mode of biopsy (P = 0.0234), N stage (P = 0.0001), mode of irradiation (P = 0.0027), chemotherapy (P = 0.0056) and short-term result (P = 0.0000) were the significant prognostic factors. The multivariate analysis demonstrated that the age (P = 0.027), N stage (P = 0.048), mode of irradiation (P = 0.009) and short-term result (P = 0.000) were the factors influencing prognosis of nasopharyngeal carcinoma in childhood and adolescence. Radiation-induced brain injuries were observed in 17 patients including brain stem injury in 1 (0.9%), temporal brain lobes in 3 (2.6%) and cranial nerves in 13 (11.1%).

CONCLUSIONThe mode of irradiation, N stage and short-term result are the significantly influencing factors of prognosis in pediatric and adolescent nasopharyngeal carcinoma. Radiation-induced brain injuries during radiotherapy should not be overlooked.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; mortality ; pathology ; radiotherapy ; Child ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Nasopharyngeal Neoplasms ; drug therapy ; mortality ; pathology ; radiotherapy ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Radiation Injuries ; etiology ; Radiotherapy, High-Energy ; adverse effects ; Retrospective Studies ; Survival Rate

BACKGROUNDBrain metastasis is one of the most important causes of treatment failure in patients with small cell lung cancer (SCLC). This study was conducted to evaluate the effects of prophylactic cranial irradiation (PCI) on survival and brain metastases for patients with limited stage small cell lung cancer in complete remission.

METHODSFifty one patients with limited stage SCLC in complete remission after chemoradiotherapy were randomly divided into PCI group (n = 26) and control group (n = 25). Patients in the PCI group received PCI at a dose of 25.2 to 30.6 Gy in 1.8 to 2.0 Gy per fraction. The Kaplan-Meier method and Log rank test were used to analyse and compare survival rates, and chi(2) test was used to compare the incidences of cranial metastases in two groups.

RESULTSThere was no significant difference in clinical characteristics of patients such as age, sex, effect of treatment before PCI between the two groups. The incidence of brain metastases was 3.8% in the PCI group in contrast to 32.0% in the control group (chi(2) = 5.15, P = 0.02). The 1, 3, 5-year survival rates were 84.6%, 42.3%, 34.6% respectively in the PCI group and 72.0%, 32.0%, 24.0% respectively in the control group, with no difference between the two groups (chi(2) = 2.25, P = 0.13). No serious sequelae were observed in patients receiving PCI.

CONCLUSIONFor patients with limited stage SCLC responding completely to chemotherapy plus radiotherapy, PCI can decrease the incidence of brain metastases and improve survival rate.

Adult ; Aged ; Brain Neoplasms ; prevention & control ; secondary ; Carcinoma, Small Cell ; therapy ; Combined Modality Therapy ; Cranial Irradiation ; Female ; Humans ; Lung Neoplasms ; therapy ; Male ; Middle Aged

AIMTo determine the effects of azide methyl anthraquinone derivative (AMAD) on growth inhibition and inducing apoptosis of multidrug resistant (MDR) KBv200 cells and parental drug-sensitive KB cells.

METHODSCytotoxicity was determined by tetrazolium (MTF) assay. Reactive oxygen species (ROS) levels and mitochondrial membrane potential (deltapsi(m)) in cells were labeled with DCFH-DA and DiOC6 and tested by flow cytometry. Annexin V stain and DNA ladder were used to examine the apoptosis of KB and KBv200 cells induced by AMAD.

RESULTSAMAD was shown to inhibit the growth of KB and KBv200 cells significantly in a concentration-dependent manner, with mean IC50 of 0.36 and 0.45 micromol x L(-1), respectively. The generation of ROS increased obviously after the cells were treated with AMAD for 12 h, up to the peak in 24 h, meanwhile the levels of deltapsi(m) were time-dependently decreased. DNA fragmentation appeared on the agarose gel. Annexin V stain showed AMAD induced apoptosis of KB and KBv200 cells also in a concentration-dependent manner.

CONCLUSIONAMAD showed inhibitory effect on both MDR KBv200 cells and parental drug-sensitive KB cells. The mechanism of action was associated with the increase of the cellular ROS level and the decrease of the mitochondrial membrane potential induced by AMAD, which result in cell apoptosis.

Anthraquinones ; administration & dosage ; chemistry ; pharmacology ; Antineoplastic Agents ; administration & dosage ; chemistry ; pharmacology ; Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Humans ; KB Cells ; Mitochondria ; physiology ; Molecular Structure ; Mouth Floor ; Mouth Neoplasms ; pathology ; Reactive Oxygen Species ; metabolism ; Vincristine ; pharmacology

BACKGROUND AND OBJECTIVECancer is one of the most primary causes of death for children. The study was to analyze the cancer incidence and mortality of children in urban districts of Guangzhou between 2000 and 2004, to explore the incidence regularity of pediatric cancers and to provide a reference for prevention and treatment of pediatric cancers.

METHODSThe data of cancer incidence and mortality of children during 2000-2004 were collected from Guangzhou Population-based Cancer Registry, and were calculated and analyzed.

RESULTSThe cancer incidence of children between 2000 and 2004 in Guangzhou was 17.91 per 100,000 (18.92 per 100,000 in males, 16.70 per 100,000 in females); the cancer mortality was 4.73 per 100,000 (4.65 per 100,000 in males, 4.83 per 100,000 in females). The incidence of lymphoid leukemia ranked first followed by cancer of central nervous system and non-Hodgkin's lymphoma. Cancer incidence was 77.52 per 100 000 in children of less than one year old, 21.49 per 100,000 in 1-4 years, 9.66 per 100,000 in 5-9 years and 17.11 per 100 000 in 10-14 years, with significant difference among the four groups (Chi(2) = 307.602, P < 0.001).

CONCLUSIONLymphoid leukemia, cancer of central nervous system and non-Hodgkin's lymphoma are the most common cancers in children. The children of 0-4 years old are the population with high cancer incidence.

Adolescent ; Central Nervous System Neoplasms ; epidemiology ; mortality ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Leukemia, Lymphoid ; epidemiology ; mortality ; Lymphoma, Non-Hodgkin ; epidemiology ; mortality ; Male ; Neoplasms ; epidemiology ; mortality

OBJECTIVETo compare the efficacy and side effects of nedaplatin plus 5-fluorouracil (5-Fu) and cisplatin plus 5-Fu for treatment of stage III-IVa nasopharyngeal carcinoma (NPC).

METHODSA total of 100 patients with NPC proved by histopathology were divided into nedaplatin plus 5-Fu group (NF group) and cisplatin plus 5-Fu group (PF group), 50 cases in each group. NF group: nedaplatin 30 mg/m(2), d1-d3, 5-Fu 500 mg/m(2) d1-d5, repeated every 3 weeks for 2 cycles. PF group: cisplatin 30 mg/m(2) d1-d3, 5-Fu 500 mg/m(2) d1-d5, repeated every 3 weeks for 2 cycles. χ(2) test was used to compare the efficacy and side-effects of the two groups.

RESULTSAll the 100 cases were evaluable and their clinical data in the two groups were comparable. Six patients with complete response were observed, 3 cases in NF group and 3 in PF group. The overall response rates were 86.0% in NF group and 84.0% in PF group, with no significant difference (χ(2) = 0.078, P = 0.779). The rates of leukocytopenia, thrombocytopenia, impairment of hepatic and renal function were similar whereas more patients in the PF group than in the NF group suffered from nausea and vomiting (88.0% vs. 56.0%, P = 0.000).

CONCLUSIONSNedaplatin plus 5-Fu is an effective treatment regimen for NPC. When compared with PF regimen, the response rate is similar. However, NF regimen shows a significant superiority in reducing nausea and vomiting.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Cisplatin ; adverse effects ; therapeutic use ; Female ; Fluorouracil ; administration & dosage ; adverse effects ; therapeutic use ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; drug therapy ; pathology ; Nausea ; chemically induced ; Neoplasm Staging ; Organoplatinum Compounds ; administration & dosage ; adverse effects ; Remission Induction ; Vomiting ; chemically induced

PURPOSE: Little is known about combination of the circulating Epstein-Barr viral (EBV) DNA and tumor volume in prognosis of stage II nasopharyngeal carcinoma (NPC) patients in the intensity modulated radiotherapy (IMRT) era. We conducted this cohort study to evaluate the prognostic values of combining these two factors. MATERIALS AND METHODS: By Kaplan-Meier, we compare the differences of survival curves between 385 patients with different EBV DNA or tumor volume levels, or with the combination of two biomarkers mentioned above. RESULTS: Gross tumor volume of cervical lymph nodes (GTVnd, p < 0.001) and total tumor volume (GTVtotal, p < 0.001) were both closely related to pretreatment EBV DNA, while gross tumor volume of nasopharynx (GTVnx, p=0.047) was weakly related to EBV DNA. EBV DNA was significantly correlated with progress-free survival (PFS, p=0.005), locoregional-free survival (LRFS, p=0.039), and distant metastasis-free survival (DMFS, p=0.017), while GTVtotal, regardless of GTVnx and GTVnd, had a significant correlation with PFS and LRFS. The p-values of GTVtotal for PFS and LRFS were 0.008 and 0.001, respectively. According to GTVtotal and pretreatment EBV DNA level, patients were divided into a low-risk group (EBV DNA 0 copy/mL, GTVtotal < 30 cm³; EBV DNA 0 copy/mL, GTVtotal ≥ 30 cm³; or EBV DNA > 0 copy/mL, GTVtotal < 30 cm³) and a high-risk group (EBV DNA > 0 copy/mL, GTVtotal ≥ 30 cm³). When patients in the low-risk group were compared with those in the high-risk group, 3-year PFS (p=0.003), LRFS (p=0.010), and DMFS (p=0.031) rates were statistically significant. CONCLUSION: Pretreatment plasma EBV DNA and tumor volume were both closely correlated with prognosis of stage II NPC patients in the IMRT era. Combination of EBV DNA and tumor volume can refine prognosis and indicate for clinical therapy.
Biomarkers ; Cohort Studies* ; DNA* ; Herpesvirus 4, Human* ; Humans ; Lymph Nodes ; Nasopharynx ; Plasma ; Prognosis ; Radiotherapy* ; Tumor Burden*

PURPOSE: The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC. MATERIALS AND METHODS: In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary end-point was progress-free survival (PFS). RESULTS: The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the high-SAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors. CONCLUSION: The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.
C-Reactive Protein* ; DNA* ; Herpesvirus 4, Human* ; Humans ; Observational Study ; Prognosis ; Prospective Studies* ; Serum Amyloid A Protein* ; Survival Analysis

We report a complete genomic sequence of rare isolates (minor genotype) of the SARS-CoV from SARS patients in Guangdong, China, where the first few cases emerged. The most striking discovery from the isolate is an extra 29-nucleotide sequence located at the nucleotide positions between 27,863 and 27,864 (referred to the complete sequence of BJ01) within an overlapped region composed of BGI-PUP5 (BGI-postulated uncharacterized protein 5) and BGI-PUP6 upstream of the N (nucleocapsid) protein. The discovery of this minor genotype, GD-Ins29, suggests a significant genetic event and differentiates it from the previously reported genotype, the dominant form among all sequenced SARS-CoV isolates. A 17-nt segment of this extra sequence is identical to a segment of the same size in two human mRNA sequences that may interfere with viral replication and transcription in the cytosol of the infected cells. It provides a new avenue for the exploration of the virus-host interaction in viral evolution, host pathogenesis, and vaccine development.
Base Sequence ; China ; Cluster Analysis ; Gene Components ; Genetic Variation ; Genome, Viral ; Genotype ; Molecular Sequence Data ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction ; SARS Virus ; genetics ; Sequence Analysis, DNA ; Severe Acute Respiratory Syndrome ; genetics