Adult ; Cross-Sectional Studies ; Female ; Humans ; Job Satisfaction ; Nurses ; Ophthalmology ; manpower ; Stress, Psychological ; Surveys and Questionnaires ; Workload ; Young Adult

OBJECTIVETo determine the value of concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma from the mainland of China.

METHODSData were extracted from randomized trials comparing chemotherapy plus radiotherapy with radiotherapy alone in locally advanced nasopharyngeal carcinoma. Actuarial rates of survival and distant metastases were calculated. The followed electronic databases were searched the Chinese Biomedicine database, Pubmed, Medline, Embase and Cochrane library; Data were extracted by tow reviewers and Review manager 4.1 software was applied for statistical analysis.

RESULTSEighteen trials with 1993 patients were include according to the including criterion. The 3-year overall survival rate of the chemoradiotherapy group and the radiotherapy group were 68.47% and 56.38% respectively, and the 5-year overall survival rate of the two groups above were 51.91% and 41.09% respectively, while the distant metastases rate of the chemoradiotherapy group and the radiotherapy group were 26.19% and 38.71% respectively. The result demonstrated that chemoradiotherapy increased overall survival by 12% at 3 years, and 11% at 5 years after treatment. After chemoradiotherapy, the rate of distant metastasis was reduce by 12%.

CONCLUSIONSIn patients with locoregionally advanced nasopharyngeal carcinoma, chemoradiotherapy significantly improves overall survival at 3 years, and 5 years compared with radiotherapy alone.

Antineoplastic Combined Chemotherapy Protocols ; China ; Combined Modality Therapy ; Humans ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; Radiotherapy ; Randomized Controlled Trials as Topic ; Survival Rate

OBJECTIVETo study the clinical characters, management and the prognosis of patients with adenoid cystic carcinoma of the maxillary sinus.

METHODSThe clinical data were analyzed retrospectively for 36 patients with adenoid cystic carcinoma of the maxillary sinus to evaluate the treatment results of different modalities. The contribution of every factors influencing on survival were also analyzed. Survival analysis was performed by life table method, comparison among/between groups was performed using log-rank test, and multivariate analysis was carried out using Cox proportional hazard model.

RESULTSThe 5-year survival rate was 58.33% in all patients, while they were only 75.0% and 42.9% in stage III and stage IV lesions respectively. The 5-year survival rate of 66.7% was obtained in patients who received surgery combined with radiotherapy,71.4% and 12.5% respectively in those treated by surgery and by radiotherapy alone. Multivariate analysis indicated that stage, treatment modality, and the tumour residues in the primary treatment were the predict factors for the prognosis.

CONCLUSIONSAdvanced adenoid cystic carcinoma should be treated by combined surgery and radiotherapy. Stage, treatment approach and short-term therapeutic response are the most important factors affecting the prognosis of the patients with adenoid cystic carcinoma of the maxillary sinus.

Adolescent ; Adult ; Aged ; Carcinoma, Adenoid Cystic ; diagnosis ; mortality ; therapy ; Female ; Humans ; Male ; Maxillary Sinus Neoplasms ; diagnosis ; mortality ; therapy ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Analysis ; Survival Rate ; Young Adult

OBJECTIVETo determine the value of elective neck dissection in patients with clinically stage I (cT1N0M0) squamous cell carcinoma of the tongue.

METHODSThis was a retrospective study of patients with surgical treatment between November 1984 and November 1999. A total of 130 patients were included in the study, all of whom received operation of the primary site, meanwhile, 99 of whom underwent elective neck dissection simultaneously including level I -III or level I -IV neck dissection in 20 patients and level I - V neck dissection in 79 patients. Results Among all these patients, the rate of occult metastasis to the neck were 12. 0%. Local failure rate in patients with only local treatment, level I II, II, III/IV neck dissection and level I - V neck dissection were 25. 8%, 15. 0% and 7. 6% respectively. There were significant difference in regional failure between patients with only local treatment and patients with elective neck dissection (P < 0.05). Also, no significant differences were noted in the survival rate between patients with only local treatment, elective neck dissection (level I -III or level I -IV) and level I -V neck dissection (P > 0.05).

CONCLUSIONSElective neck dissection significantly reduced regional control failure but was not able to reduce distant metastasis or increase the overall survival. A prospective randomized study is worthwhile to further evaluate the benefit of elective neck dissection in the treatment of clinically stage I squamous cell carcinoma of the tongue.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; surgery ; Elective Surgical Procedures ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Neoplasm Staging ; Retrospective Studies ; Tongue Neoplasms ; pathology ; surgery ; Treatment Outcome ; Young Adult

BACKGROUNDIt remains controversial whether patients with Stage II colorectal cancer would benefit from adjuvant chemotherapy after radical resection. The aim of this study was to establish two mathematical models to identify the suitable patients for adjuvant chemotherapy.

METHODSThe current study comprised of two steps. In the first step, 353 patients with Stage II colorectal cancer who underwent surgical procedures at the Third Affiliated Hospital of Sun Yat-sen University between June 2006 and December 2015 were entered and followed up for 6-120 months. Their clinical data were collected and enrolled into the database. We established two mathematical models by univariate and multivariate Cox regression analysis to identify the target patients; in the second step, 230 patients under the same standard between January 2012 and December 2016 were entered and followed up for 3-62 months to verify the two models' validation.

RESULTSIn the first step, totally 340 surgical patients with Stage II colorectal cancer were finally enrolled in this study. Statistical analysis showed that tumor differentiation (TD) (P < 0.001), lymphovascular invasion (LVI) (P < 0.001), uncertain or positive margins (UPM) (P < 0.001), and fewer lymph nodes (LNs) (<12) retrieved (P < 0.001) were correlated with the overall survival (OS) and disease free survival (DFS). We obtained two models: (1) OS risk score = 1.116 × TD + 2.202 × LVI + 3.676 × UPM + 1.438 × LN - 0.493; (2) DFS risk score = 0.789 × TD + 2.074 × LVI + 3.183 × UPM + 1.329 × LN - 0.432. According to the models and cutoff points [(0.07, 1.33) and (-0.04, 1.30), respectively], patients can be divided into three groups: low-risk, moderate-risk, and high-risk. Moreover, the high-risk group patients could benefit from adjuvant chemotherapy. In the second step, totally 221 patients were finally used to verify the models' validation. The results proved that the models were accurate and feasible (P< 0.05).

CONCLUSIONSAccording to the predictive models, patients with Stage II colorectal cancer in the high-risk group are strongly recommended for adjuvant chemotherapy, thus facilitating the individualized and precise treatment.