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Background: To assess the safety and efficacy of a combination therapy consisting of hepatic arterial infusion chemotherapy (HAIC) of Oxaliplatin, Fluorouracil, and Leucovorin (FOLFOX), tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICI) (TRIPLET) for patients with advanced hepatocellular carcinoma (HCC) in BCLC Stage C. Methods: This retrospective study was approved by the ethical review committee, and informed consent was obtained from all patients. 22 patients with initial presentation or recurrent HCC in BCLC Stage C received HAIC plus TKI plus ICI (TRIPLET) treatment from April 1, 2019, to April 30, 2020. The primary endpoint was objective response. The second endpoint were survival outcomes and safety. Findings: The best overall response was 59.1% per RECIST 1.1 and 81.8% per mRECIST. The median duration of response was 9.83 months per mRECIST. The DCR was 100% per both RECIST and mRECIST. Complete response (CR) was achieved in 7 patients (31.8%) per mRECIST. The median overall progression free survival (PFS) time in the cohort was 11.17 months (95% CI 5.87 - 16.46) per mRECIST. The estimated 6- and 12-month overall PFS rates were 82.7% and 42.7%, respectively. The estimated 6- and 12-month OS rates were 93.8% and 93.8%, respectively. Grade 3 adverse events occurred in 15 patients (68.2%) and were all reversible. Grade 4 adverse events occurred in 4 patients (18.2%) all with transient bone marrow suppression. Conclusion: HAIC plus TKI plus ICI (TRIPLET) has promising survival benefits in the management of advanced hepatocellular carcinoma in BCLC Stage C with tolerable safety. Funding Statement: This work was supported by the Guangzhou Science and Technology Program, civic technology research plan (No. 201903010037). Declaration of Interests: The authors declare that they have no conflict of interest. Ethics Approval Statement: The informed consent was obtained from all patients. All patients were followed up under the hospital ethics committee approval of SYSUCC (B2020-243-01). The principles of the Declaration of Helsinki were followed.

Objective We previously reported the five-year results of a randomised trial that compared induction chemotherapy plus concurrent chemoradiotherapy (IC + CCRT) with induction chemotherapy plus radiotherapy (IC + RT) in patients with locoregionally advanced nasopharyngeal carcinoma (NPC). The aim of this study was to report the ten-year results and to explore potential prognostic factors. Methods From August 2002 to April 2005, 408 patients with locoregionally advanced NPC were randomly assigned to receive either IC (carboplatin and floxuridine) + CCRT (carboplatin) or IC + RT. The survival rates were analysed using the Kaplan–Meier method and compared using the log-rank test. Multivariable analysis was performed to identify valuable prognostic factors. Results The ten-year overall survival, failure-free survival, locoregional failure-free survival and distant failure-free survival rates for the entire patient cohort were 49.5%, 48.0%, 80.8% and 66.9%, respectively. No significant survival differences were found between the IC + CCRT and IC + RT arms. By 3 years from the date of randomisation, 62.5% of the relapses had been detected; no recurrence occurred after 8 years. Within 3 years after randomisation, 77.0% of the metastases were detected; 0.8% was identified after 8 years. Age, Union for International Cancer Control (UICC) N-stage, serum lactate dehydrogenase (LDH) and body mass index (BMI) were independent prognostic factors that predicted death. Smoking status and total radiotherapy dose were independent prognostic factors that predicted locoregional recurrence. UICC N-stage, LDH and BMI were independent prognostic factors that predicted distant metastasis. Conclusions Concurrent carboplatin chemotherapy did not significantly improve the long-term survival after inductive carboplatin and floxuridine chemotherapy in locoregionally advanced nasopharyngeal carcinoma. In addition to patient and tumour characteristics, LDH, BMI and smoking status were important baseline prognostic factors for tumour recurrence or distant metastasis; these are worthy of further prognostic investigation in future studies.

To evaluate patterns of skull base invasion and its possible impact on tumor (T)-staging in nasopharyngeal carcinoma (NPC) using magnetic resonance imaging (MRI).838 consecutive newly diagnosed by biopsy proven and untreated patients with NPC underwent MRI. The skull-base invasion of NPC was classified according to their incidence from proximal sites to more distant sites surrounding the nasopharynx as: high (≥35%), medium (≥5-35%), and low (5%) groups. A retrospective analysis of data consisting of a 5-year follow-up was carried out. The skull base invasion was related to their tumor (T) staging and prognosis at the 5-year follow-up after treatment with definitive radiation therapy. In addition, a survival health-related quality of life (QOL), overall survival (OS), local relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) were also assessed among the three groups.The total incidence of skull-base invasion was 65.51% (549/838). The differences in T-stage distribution, and the total survival health-related QOL, among the three groups were statistically significant (χ(2)=160.45, p0.005; χ(2)=38.43, p0.005, respectively). The differences between any two of the three groups were also significant, except when the medium grade was compared to the low grade. Significant differences were observed with regard to 5-year OS (83.2%, 74.7%, 59.2%, p=0.000) and DMFS (95.0%, 88.0%, 88.0%, p=0.016); no significant difference was observed in LRFS (95.3%, 95.6%, 91.23%, p=0.450).The results indicate that medium and low group displayed similar findings of skull base invasion, and survival status. We, therefore, propose that patients in these two groups be grouped under T4 in the TNM classification that might have a bearing in implementing optimum treatment.

Purpose The aim of this retrospective study was to evaluate technical efficacy and the impact of CT-guided pulmonary radiofrequency ablation (RFA) on survival in patients with pulmonary metastases from nasopharyngeal carcinoma (NPC). Materials and methods Between 2000 and 2009, 480 patients were pathologically or clinically confirmed pulmonary metastases from NPC. And ten included patients of them had a total of 23 pulmonary metastases treated with percutaneous RFA under the real-time CT fluoroscopy. Safety, local tumor progression, and survival were evaluated in our institutions. Matched-pair survival was compared using Kaplan–Meier analysis. Results A total of 25 ablations were performed to 23 pulmonary metastases in 13 RFA sessions. Pneumothorax requiring chest tube placement developed in 3 of 13 (23.1%) RFA sessions. The median metastatic overall survival was 36.1 months for all the 480 NPC patients with pulmonary metastases. Furthermore, matched-pair analysis demonstrated patients with RFA treatment had a greater metastatic overall survival than patients without RFA treatment (77.1 months vs 32.4 months, log-rank test, p = 0.009). There were no statistically significant differences in the survival probability of patients with RFA treatment ( n = 10) and surgical resection of pulmonary metastases ( n = 27) (log-rank test, p = 0.75). Conclusion CT-guided pulmonary RFA is safe and offers a treatment alternative for local tumor control, providing promising survival in selected patients with pulmonary metastases from NPC.

Gastric carcinoma is one of the most common malignancies in Asia. Although the allelic deletion of 7q has been reportedly associated with primary gastric carcinoma tumorigenesis, no predisposing genes in this region have been identified so far. Here, we report the results of genotype and loss of heterozygosity (LOH) analysis on 7q in this tumor. A panel of nine microsatellite markers distributed over the whole chromosome 7q was used for genotyping primary gastric carcinomas. Of 72 primary tumors LOH of D7S486 occurred in 24.0% (12/50) of cases. Fine mapping with 12 additional markers flanking D7S486 resulted in LOH of 30.36% (17/56) and defined one minimal deleted region in primary gastric carcinomas, a 90-kilobase region bounded by D7S2543 and D7S486 at 7q31.2. The allelic deletion correlates statistically with clinicopathologic variables. Our data suggest a possible link between putative tumor suppressor genes and gastric carcinoma in the 7q31 region.