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Background: For patients with less chemosensitive neck nodes, poor prognosis after chemoradiotherapy (CRT) could be predicted and neck dissection is needed. Methods: Ninety‐two N2/3 hypopharyngeal carcinoma patients were retrospectively studied. According to response after induction chemotherapy (ICT), patients were treated with neck dissection followed by concurrent CRT (CCRT) (group 1), surgery plus postoperative CRT (group 2), or CCRT for primary and regional sites (group 3). Results: Overall survival and disease‐free survival rates of group 1 were significantly higher than group 2 (p = 0.038, p = 0.031) and group 3 (both p = 0.018). Regional control rate of group 1 was significantly higher than group 3 (p = 0.041). There were no significant differences between groups 1 and 2 regarding local and regional control (p = 0.746, p = 0.302). Conclusions: Neck dissection followed by CCRT is the best choice for patients with responsive primary but nonresponsive nodes. [ABSTRACT FROM AUTHOR]

Introduction: This study investigated the best mode for the application of nimotuzumab (Nimo) in combination with chemoradiotherapy to treat nasopharyngeal carcinoma (NPC).Material and Methods: Data were prospectively collected from 168 patients with NPC from September 2009 to February 2014. One hundred twelve patients received 2-3 cycles of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT), and 56 patients with well-matched propensity scores received IC + CCRT + Nimo. Patients were divided into 3 subgroups according to the application schedule of Nimo: group A, IC + CCRT; group B: IC (combined with Nimo) + CCRT; and group C: IC + CCRT (combined with Nimo). The 5-year overall survival (OS) and progression-free survival (PFS) and adverse events were investigated.Results: With a median follow-up of 61.4 months (range: 1.7-96.5 months), the 5-year OS and PFS for group A vs. groups B + C were 74.8 ±4.1% versus 87.0 ±4.6% (p = 0.043) and 72.7 ±4.3% vs. 83.1 ± 5.1% (p = 0.243), respectively. The 5-year OS of group B was significantly improved over that of group A (93.0 ±4.8% vs. 74.8 ±4.1%, p = 0.038); however, there was no benefit to the 5-year PFS (89.3 ±5.9% vs. 72.7 ±4.3%, p = 0.144). The 5-year OS and PFS for group C were 80.4 ±7.9% and 76.4 ±8.5%, respectively, and there was no statistically significant difference from group A (p = 0.257 and p = 0.611, respectively). No significant increase in toxicities was observed with the addition of Nimo.Conclusions: Nimo administered with chemoradiotherapy is effective for NPC. Nimo concurrent with IC followed by CCRT could be the optimal mode of sequential treatment. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the therapeutic effect of malignant tumor of nasal cavity and sinus that based on modern radiotherapy., Method: Two hundred cases of malignant tumor of nasal cavity and sinus were retrospectively analyzed from 2004 to 2007. All the cases were location by CT simulator system and were treated with three dimensional conformal radiotherapy., Result: Among malignant tumor of nasal cavity and sinus, the incidence for locations was nasal cavity > maxillary sinus > ethmoid sinus > sphenoid sinus; the incidence for the type of pathology was squamous cell carcinoma > adenocarcinoma > olfactory neuroblastoma and olfactory esthesioneuroepithelioma > malignant melanoma > rhabdomyosarcoma; the incidence for general metastasis was rhabdomyosarcoma > malignant melanoma > adenocarcinoma, inverted papilloma and malignant changes > squamous cell carcinoma, olfactory neuroblastoma and olfactory esthesioneuroepithelioma. No severe radiation-related complication were found., Conclusion: Clinical stage, pathological type were the important factors effecting the prognosis of patients with malignant tumor of nasal cavity and sinus. Three dimensional conformal radiotherapy based on CT simulator system could improve therapeutic effect and protect the normal tissue very well.

Objective: To investigate the distribution patterns of microvascular density(MVD) and lymph vessel density (LVD) in nasopharyngeal carcinoma, and to discuss their relationships with tumor recurrence-metastasis and prognosis., Method: One hundred and six patients with pathologically proved nasopharyngeal carcinoma were included in this study. Immunostainings for the vascular endothelial marker CD34 and the lymph vessel marker D2-40 were performed. The microvascular and lymph vessels within the tumor and the peritumoral area were respectively quantified with computer assisted morphometric analysis., Result: Both microvascular and lymph vessels were positive in the specimen of 106 nasopharyngeal carcinoma patients, with MVD and LVD higher in the peritumoral area than in the tumor. Univariate analysis showed that intra-tumor MVD,intra-tumor and peritumor LVD were correlated with nasopharyngeal carcinoma recurrence-metastasis (P < 0.05), while no significant correlation was found between tumor recurrence-metastasis and age, gender, T stage, lymph node stage, clinical stage and peritumor MVD (P > 0.05). Multivariate analysis demonstrated that intra-tumor MVD and peri-tumor LVD were two independent risk factors of nasopharyngeal carcinoma recurrence-metastasis. Higher intra-tumor MVD was associated with adverse prognosis of nasopharyngeal carcinoma (P < 0.05)., Conclusion: High MVD and LVD may be of significance in predicting poor prognosis in patients with nasopharyngeal carcinoma. Intra-tumor and peri-tumor microvessels may play different roles in the tumor recurrence and metastasis. Intra-tumor MVD and peri-tumor LVD should be the therapeutic targets in the nasopharyngeal carcinoma.

Objective: To assess the radio-protective effect of amifostine on the middle ear in animal models by observing the morphological changes of middle ear mucosa., Method: Adult guinea pigs (n=38) were divided into the radiation group, the radiation-amifostine group and the control group. The first two groups were exposed to total 45 Gy of Gamma radiation which was administered to the right ear of each guinea pig with 3.0 Gy/fraction, 5 times per week, using a cobalt-60 machine. And the radiation+amifostine group was pretreated with the radio protector amifostine 100 mg/kg intra-peritoneally 30 min before each fraction of radiation. Sterile saline was administered intra-peritoneally in radiation group before ear irradiation. Two normal guinea pigs given no treatment were chosen as the control. The tympanic bullas were removed and the mucosae was processed for light microscope and scanning electron microscope examination on the 2nd and 30th days post irradiation to observe mucosa thickness, leukocyte and cilia., Result: Light microscope and scanning transmission electron microscope examination showed in radiation groups that the middle ear effusion occurred; the cilia and micro cilia fell off, fused or collapsed; their directions changed; the mucosa became thicker; and leukocytes were also found infiltrating into the mucosa. On the 30th day,the damage was more serious. As comparison, there was no manifest damage of the middle ear mucosa in radiation+amifostine group. The mucosa thickness and the leukocyte quantity of radiation group were obviously higher than that of radiation+amifostine group (P < 0.01)., Conclusion: The middle ear mucosa was found to change over time after irradiation. Amifostine has a protective effect on radiation induced early middle ear injury.