Objective:To investigate the efficacy of re-treatment for cervical lymph node recurrence in nasopharyngeal carcinoma patients after radiotherapy and to explore the prognostic factors.Methods:Eighty-two patients who received therapy due to cervical lymph node recurrence after deftnitive radiotherapy were reviewed.The relevant factors including sex.the interval between radiotherapy and recurrence,rN stage,recurrence site,treatment modalities,and treatment efficacy were analyzed.Subgroup analysis was performed to review the relevant factors including the involvement in the adjacent tissues,the number of positive nodes and surgical range.Kaplan-Meier method,Log-rank test and Cox method were used for statistical analysis.Results:The 1-,3-and 5-year local control rates were 58%,39.0%,and 39.0%,respectively.The 1-,3-and 5-year overall survival rates were 82.9%,47.6%.and 25.0%,respectively.The 1-,3-and 5-year overall survival rates in the radiotherapy-based treatment group were 80.8%,37.1%and 19.1%,respectively.The 1-,3-and 5-year overall survival rates in the surgery-based treatment group were 86.7%,66% and 34.2%,respectively.The efficacy of surgery-based treatment was superior to that of radiotherapy-based treatment.In the multivariate analysis,tumor recurrence site was an independent prognostic factor.Conclusion:Radical neck dissection-based treatment can achieve satisfactory efficacy for cervical lymph node recurrence after radiotherapy in nasopharyngeal carcinoma patients.

Objective To evaluated the treatment results of late course accelerated fractionation radiotherapy for Stage Ⅲ and Ⅳa nasopharyngeal carcinoma. Methods 100 patients with stage Ⅲ and Ⅳa nasopharyngeal carcinoma were randomized into two groups. The late course accelerated hyperfractionated radiotherapy combine chemotherapy group(LCAF+CT group) received the induction chemotherapy for two cycles, followed by conventional fractionation radiotherapy to a dose 40 Gy, than changed into accelerated hyperfractionated radiotherapy to a total dose of 70 Gy, and use two cycles adjuvant chemotherapy, The conventional fractionation radiotherapy combine chemotherapy group(CF+CT group) received the chemotherapy that it similar to the LCAF+CT group, and use the conventional fractionation radiotherapy to a total dose of 70 Gy. Results The 3- and 5-year overall survival rate were 70.0% and 62.0% respectively in LCAF+CT group and 58.0 % and 46.0 % respectively in CF+CT group, had the significant difference (P 0.05). There were the cranial nerves complications in two patients of LCAF+CT group. Conclusions The results from this study show that the 3- and 5-year overall survival rate, the 3- and 5-year disease free survival rate and the 3- and 5-year local-regional free survival rate in LCAF+CT group was significant better than in CF+CT group, but the radiation-induced damage to the cranial nerves was improved in LCAF+CT group.

Circulating microRNAs (miRNAs) is a class of non-coding small RNA molecules.As tumor biomarkers, circulating miRNAs deregulation is associated with the initiation and progression of human cancer.Studies indicate that circulating miRNAs have great potential in the early diagnosis and prognosis of primary or metastatic tumors (colorectal, breast, prostate, hepatocellular and ovarian cancer and other epithelial cancer).

Purpose:To evaluate the treatment results of induction chemotherapy followed by radiotherapy in patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma.Methods:Fifty patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma were treated by induction chemotherapy followed by definitive radiation therapy (CT/RT group). This group was matched with a group of fifty patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma treated with radiotherapy alone (RT group). Results: The 5 year loco regional control was 61.2% for the CT/RT Group and 68.7% for the RT Group; The 5 yera distant metastasis was 15.2% for the CT/RT group and 27.1% for the RT Group; The 5 year distant metastasis for the patients with stage N 2 and N 3 disease was 27.4% for the CT/RT Group and 43.8% for the RT Group respectively; The overall 5 year survival (OS) was 57.8% for the CT/RT group and 51.6% for the RT group( P =0 61); The 5 year OS of N 2 and N 3 patients was 60.6% for the CT/RT group and 26.3% for the RT group( P =0 033);The 5 year OS of T 3 and T 4 patients was 36.8% for the CT/RT group and 41.2% for the RT group ( P =0 80) respectively. There were no significant differences in the incidence of acute mucositis between the two groups during radiotherapy, the side effects in leukopenia, nausea, vomiting were higher in CT/RT group than in RT group. No Grade 3 or higher late complications were observed in both groups. Conclusions:Induction chemotherapy followed by definitive radiation therapy did not improve the 5 year survival and loco regional control for the stage Ⅲ and Ⅳ nasopharyngeal carcinoma, but reduced the distant metastasis for the stage N 2 and N 3 patients; The overall 5 year survival rate for the patients with N 2 and N 3 nasopharyngeal carcinoma was improved by induction chemotherapy followed by radiotherapy. [

Objective To understand the basic situation and the current work status of health education staff in Beibei district of Chongqing city and to explore the community health education pattern in Beibei district to provide reference for rational talent strat -egy and personnel policy adjustment .Methods By using the Investigation Questionnaires of Health Education Personal in Beibei District ,35 health education staffs in Beibei district were performed the investigation .Results Most health education staffs in Bei-bei district are young and middle-aged .The average age was 36 .7 years ;71 .4% of them had undergraduate or college degree .Only 3 individuals were full-time staff and the others were part-time;the health education forms were plentiful with various contents . The health education staffs were insufficient in the professional knowledge and the health education skill .The external factors had influence on the health education work .Conclusion The health education staffs rejuvenation ,lack of the professional staffs and in-adequate depth of the theory and practice of the health education work restrict the deep development of the health education work to some extent .It is suggested that the relevant departments introduce the professional health education talents ,conduct the systematic training for enhancing the professional knowledge and working skills ,and give support in terms of policy and funding .

Objective To understand college students on-site first aid training demand situation in Chongqing ,in order to provide the basis for college students to carry out on-site first aid training .Methods Using stratified random sampling method ,a question-naire survey was conducted on 1 232 students of 6 university in Chongqing .Results 90 .9% of the students hoped that they could master the on-site first-aid knowledge and skills ,students of different genders had significant differences on learning attitude of field first aid knowledge(P<0 .05) .The on-site first-aid knowledge among college students in Chongqing city most wanted to know was thetrauma emergency stop(74 .8% ) ,the most loving way of learning was to the hospital or emergency center study tour(47 .7% ) ,The love of on-site first aid training and learning style were theory teaching+watch video teaching or teacher demon-stration+classroom practice (63 .6% ) ,The operation way of learning the most love was teacher ,all the students into groups of two ,mutual operation practice(65 .9% ) ,and in both gender and specialty had significant differences(P<0 .05) .The survey of col-lege students in Chongqing city training status display results ,43 .5% of the students never received on-site first aid training .In ad-dition ,college students receive on-site first aid training frequencies were low ,48 .6% students in more than 2 years received 1 ses-sions of training .while the rescue confidence survey of college students after the on-site first aid training ,only 13 .1% of the students“completely had the confidence to do” .Conclusion College students in Chongqing have strong desire to learn on-site first aid training ,and there are differences in gender and major on demand ,past state of first aid training is poor ,in urgent need of the relevant departments give attention ,and formulate the on-site first aid training programs to improve college students′competence .

Background and purpose:The application of intensity-modulated radiotherapy (IMRT) has improved the local control rate of nasopharyngeal carcinoma greatly, which changed the predictive value of T classiifca-tions of TNM staging system. This study aimed to validate the predictive effect of T classiifcations in the 7th Union for International Cancer Control (UICC) staging system and discuss the simpliifcation of T classiifcations.Methods:We retrospectively reviewed the clinical data of 641 primary nasopharyngeal carcinoma patients at our center from January 2007 to June 2011. We evaluated the predictive effect of T classiifcations by Kaplan-Meier method and Cox regression model.Results:The 5-year overall survival (OS), local relapse-free survival (LRFS), progression-free survival (PFS) and distant metastasis free survival (DMFS) were 85.4%, 88.5%, 78% and 87.1%, respectively. The 5-year OS of T1, T2, T3 and T4 categories were 91.6%, 85.3%, 90.1% and 76.5%, respectively; LRFS were 93%, 85.3%, 91.5% and 84.4%; PFS were 88.2%, 77.3%, 80.8% and 70.9%; DMFS were 95.1%, 88.9%, 88.2% and 81.3%, respectively. The difference in survival curves between T1, T2 and T3 were not signiifcant (P>0.05). However, several prognostic indexes were signiifcantly different between T4 and T1, T2, T3. We merged the T1, T2 and T3 classiifcations as new T1, and the T4 classiifcation as new T2. The 5-year OS of new T1 and T2 were 89.1% and 76.5% (P=0.001); LRFS were 90.1% and 84.4% (P=0.028); PFS were 81% and 70.9% (P=0.001); DMFS were 90.8% and 81.2% (P=0.002). The survival curves were substantially separated. The simpliifed T classiifcations had obvious advantages when separately analyzed in different N stages.Conclusion:In the era of IMRT, the predictive effect of T classiifcations of the 7th UICC staging system has diminished. The simpliifcation of T classiifcations can ift with the new treatment and provide a better surviv-al prediction.

PURPOSE: The aim of the present study was to evaluate the prognostic value of magnetic resonance imaging (MRI)‒determined lymph nodal necrosis (LNN) in nasopharyngeal carcinoma (NPC) and explore the feasibility of an N-classification system based on the 8th edition of the American Joint Committee on Cancer (AJCC) system. MATERIALS AND METHODS: The MRI scans of 616 patients with newly diagnosed stage T1-4N1-3M0 NPC who were treated with definitive intensity-modulated radiotherapy (IMRT) were reviewed. RESULTS: Multivariate analysis showed that LNN was an independent negative prognostic predictor of distant metastasis free survival (hazard ratio, 1.634; 95% confidence interval, 1.023 to 2.609; p=0.040) and overall survival (hazard ratio, 2.154; 95% confidence interval, 1.282 to 3.620; p=0.004). Patients of classification N1 disease with LNN were reclassified as classification N2, and classification N2 disease with LNN as classification N3 in the proposed N-classification system. Correlation with death and distant failure was significant, and the total difference between N1 and N3 was wider with the proposed system. CONCLUSION: MRI-determined LNN is an independent negative prognostic factor for NPC. The proposed N classification system is powerfully predictive.
Classification ; Humans ; Joints ; Lymph Nodes ; Magnetic Resonance Imaging ; Multivariate Analysis ; Necrosis ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Radiotherapy, Intensity-Modulated

Objective:To preliminarily evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for pulmonary oligometastatic tumors from head and neck carcinoma.Methods:Clinical data of 24 patients with pulmonary oligometastasis from head and neck carcinoma undergoing SBRT in Zhejiang Cancer Hospital from January 2014 to May 2019 were retrospectively analyzed. Survival analysis was performed by Kaplan- Meier method. Results:Among the 24 patients, 12 cases were diagnosed with nasopharyngeal origin and 12 cases of non-nasopharyngeal origin. A total of 34 pulmonary metastatic lesions were treated with SBRT. The median follow-up time was 19.5 months. Thirteen cases developed new lesions after SBRT, and 9 of them occurred within 1 year after SBRT treatment. The actual 1-year local control rate was 95%. The median progression-free survival was 15.2 months, and the 1-and 2-year progression-free survival were 59% and 46%, respectively. The 2-and 3-years overall survival rate at were 71% and 51% fter lung metastasis, respectively. Univariate analysis showed that the patients with primary lesions located in nasopharynx and disease-free interval of more than 1 year had survival advantage. No more than grade 3 radiation-induced injury was observed in the whole cohort after SBRT, and the incidence of mild radiation-induced injury was 13%.Conclusions:SBRT is safe and effective in the treatment of pulmonary oligometastatsis from head and neck carcinoma, and it may be more effective for patients with primary tumors located in nasopharynx.

Objective To investigate whether the mucosal surface volume can be an alternative to the oral cavity volume for predicting grade 3/4 acute oral mucosal toxicity in patients with locally advanced nasopharyngeal carcinoma(LANPC). Methods A total of 92 patients with LANPC who underwent intensity-modulated radiotherapy(IMRT)and concurrent chemotherapy were enrolled in this study. The delineation of the oral mucosa was performed using oral cavity contours(OCC)or mucosal surface contours(MSC). Dosimetric comparisons of toxicity were performed based on the obtained dose-volume histograms(DVHs). The receiver operating characteristic(ROC)curve and logistic regression analysis were used to do statistical analysis of the data obtained from the two different contour methods. Results Both contouring methods showed a significant dose-volume association between oral mucosal exposure and acute oral mucosal toxicity. Logistic regression analysis showed that body weight loss was the independent associated factor for grade 3/4 toxicity in both OCC group and MSC group(P=0.017 and 0.005). And the independent correlation factors for dosimetric parameters in OCC group and MSC group were V30(P=0.003)and V50(P=0.003),respectively. The area under the ROC curve(AUC)of OCC at V30was 0.753(P=0.001)and the AUC of MSC at V50was 0.714(P=0.004). Conclusions DVH analysis of mucosal surface volume can accurately predict grade≥3 oral mucosal toxicity in patients with LANPC who receive IMRT and concurrent chemotherapy. However, OCC is superior to MSC in clinical application.