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This study aimed to evaluate the effect of postoperative radiotherapy (PORT) in patients with pIIIA-N2 non-small cell lung cancer after complete resection and adjuvant chemotherapy.Electronic databases (PubMed, Web of Science databases, Embase, and the Cochrane Central Register of Controlled Trials) were systematically searched to extract randomized control trials comparing PORT with observation in pIIIA-N2 non-small cell lung cancer patients until October 2021. Main outcomes were disease-free survival (DFS), overall survival (OS), and local recurrence.Three-phase 3 randomized control trials involving 902 patients were included: 455 patients in the PORT group and 447 patients in the observation group. The methodological quality of the 3 randomized control trials were high quality. The pooled analysis revealed that PORT decreased local recurrence rate (odds ratio = 0.56, 95% confidence interval [CI]: 0.40-0.76). However, PORT did not improve median DFS (hazard ratio = 0.84, 95% CI: 0.71-1.00) and OS (hazard ratio = 1.02, 95% CI: 0.68-1.52).PORT decreased the incidence of local recurrence. However, PORT did not improve DFS and OS.

Objective This study aimed to explore the effect of silencing hTERT on the CSC-like characteristics and radioresistance of CNE-2R cells. Results Silencing hTERT suppressed CNE-2R cell proliferation and increased the cell apoptosis rate and radiosensitivity in vitro. Moreover, it could also inhibit the growth of xenografts and increase the apoptosis index and radiosensitivity in vivo. Further study discovered that after silencing hTERT, telomerase activity in CNE-2R cells was markedly suppressed, along with remarkably down-regulated stem cell-related protein levels both in vitro and in vivo. Conclusion Silencing hTERT can suppress the CSC-like characteristics of CNE-2R cells to enhance their radiosensitivity, revealing that hTERT may become a potential target for treating radioresistant NPC. Methods An RNAi lentiviral vector specific to the hTERT gene was constructed to infect CNE-2R cells, the hTERT silencing effect was verified through qPCR and Western blot assays, and telomerase activity was detected by PCR-ELISA. Moreover, radiosensitivity in vitro was detected through colony formation assays, CCK-8 assays and flow cytometry. Tumor growth and radioresistance were also evaluated using xenograft models, while the apoptosis index in xenografts was measured through TUNEL assay. Levels of stem cell-related proteins were determined in vitro and in vivo.

OBJECTIVES To validate stage nodal (N)3 of the 8th edition American Joint Committee on Cancer (AJCC) staging system for nasopharyngeal carcinoma (NPC). METHODS This retrospective cohort study extracted NPC patients from the Surveillance, Epidemiology, and End Results database between 2004 and 2016. Pathologically confirmed patients with complete data of level IV, N3a, and N3b lymph node metastasis were investigated. The included patients were divided into level IV, N3a, and N3b groups. Five-year overall survival (OS) and cancer-specific survival (CSS) were compared among the three groups. RESULTS A total of 693 patients were included: 285 (41.13%) patients in the level IV group, 124 (17.89%) patients in the N3a group, and 284 (40.98%) patients in the N3b group. The 5-year OS (57.1%, 55.0%, and 55.2%) and CSS (64.4%, 63.5%, and 64.4%) were not different among the level IV, N3a, and N3b groups. Multivariate regression analysis revealed that N stage was not an independent prognostic factor for OS (hazard ratio [HR] = 1.03, 95% confidence interval [CI]: 0.91-1.17; P = .65) or CSS (HR = 1.03, 95% CI: 0.89-1.19; P = .70). CONCLUSION Stage N3 of the 8th edition AJCC staging system for NPC is reasonable. LEVEL OF EVIDENCE III Laryngoscope, 131:535-540, 2021.

Purpose. To compare the efficacy of EGFR-TKIs combined with antiangiogenic agents between non-small cell lung cancer patients with exon 19 deletion and patients with exon 21 Leu858 Arg mutation. Methods. Electronic databases (PubMed, Embase, and the Cochrane Central Register of Controlled Trials) were systematically searched for studies published until March 2022. Randomized control trials comparing the survival of EGFR-TKIs plus antiangiogenic agents with EGFR-TKI were extracted. The primary endpoint was progression-free survival (PFS). Results. Five randomized control trials involving 1533 patients were as follows: 818 patients had exon 19 deletion, and 715 patients with exon 21 Leu858 Arg mutation. The methodological quality of the 5 randomized control trials was high. EGFR-TKIs plus antiangiogenic agents improved PFS in patients with exon 19 deletion (hazard ratio [HR] = 0.62, 95% confidence interval [CI]: 0.51–0.75) and exon 21 Leu858 Arg mutation (HR = 0.61, 95% CI: 0.50–0.75). PFS did not differ between the exon 19 deletion and exon 21 Leu858 Arg mutation groups (Z = 0.07, P = 0.94 ). Conclusions. PFS was comparable between patients receiving EGFR-TKIs combined with antiangiogenic agents with exon 19 deletion and those with exon 21 Leu858 Arg mutation.

Background and aim Nasopharyngeal carcinoma (NPC) is one of the most common cancers in Southern China, Southeast Asia. Radiotherapy is the main treatment for NPC. Still, about 20% of patients with NPC have a recurrence. No effective serum biomarkers are available for recurrent nasopharyngeal carcinoma (rNPC) to date. This study aimed to explore whether amyloid beta (A4) precursor protein (APP) might serve as a valuable diagnostic and prognostic biomarker for patients with rNPC. Methods In a previous study, a tandem mass tag-based proteomic test was performed, which screened 59 differentially expressed proteins (DEPs) between nonrecurrent nasopharyngeal carcinoma (nrNPC) and rNPC. In this study, a protein-protein interaction was conducted to screen the key proteins among the 59 DEPs. APP was validated and evaluated by enzyme-linked immunosorbent assay in 70 serum samples [recurrence (n = 35) and no-recurrence (n = 35)]. Also, the receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of APP. Results The area under the ROC curve was 0.666 (95% CI: 0.514-0.818, P = 0.044). The best cutoff point of the relative expression levels for APP was 1.23 (concentration = 16.95 ng/mL), at which the sensitivity was 55.2% and the specificity was 90.9%. Conclusion The findings indicated that APP might be a valuable diagnostic and prognostic biomarker for patients with rNPC.

Cervical squamous cell carcinoma (CSCC) is one of the most commonly occurring gynecological malignancies. Because CSCC is a biologically heterogeneous disease, its prognosis varies. Therefore, identifying prognostic biomarkers that reflect its biological heterogeneity could lead to better interventions for patients with a poor prognosis. This study used the ESTIMATE algorithm to identify immune related prognostic genes within the tumor microenvironment of CSCC. The results revealed that high immune scores were associated with better overall survival (P = 0.029). Differential expression analysis revealed 384 intersection genes influencing both the immune and stromal scores. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses showed the 384 intersection genes to be mainly enriched for T cell activation, the region of the membrane, carbohydrate binding, and cytokine-cytokine receptor interaction. Among them, 149 immune genes were predictive of overall survival in CSCC. These findings provide a more comprehensive understanding of immune genes within the tumor microenvironment as well as a list of immune genes prognostic in CSCC.

Purpose To assess the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in stage II nasopharyngeal carcinoma (NPC). Methods Stage II (2010 UICC/AJCC staging system) NPC patients treated between January 2007 and December 2014 were retrospectively analyzed. The NLR was calculated from peripheral blood cell counts before treatment. The optimal cut-off value of NLR was determined by receiver operating characteristic curve analysis. Survival rates were compared according to the NLR value. Multivariable Cox regression analyses were performed to assess the association between the NLR and overall survival (OS), locoregional-free survival (LRFS), and distant metastasis-free survival (DMFS). Results Two hundred and fifty-one stage II NPC patients were included in this study. The NLR was correlated with T stage (r=0.158, p=0.012). An NLR ≥2.92 was associated with poor 5-year OS (84.3% vs 97.4%, p=0.001) and LRFS (91.4% vs 98.4%, p=0.003). An NLR ≥2.82 was associated with poor 5-year DMFS (92.6% vs 98.2%, p=0.033). The multivariate Cox regression analysis showed that an NLR ≥2.92 was an independent prognostic biomarker in stage II NPC. Conclusion The NLR is an independent prognostic factor in stage II NPC.

Purposes To evaluate retropharyngeal lymph node metastasis on N stage of nasopharyngeal carcinoma (NPC). Methods NPC patients were extracted from the Surveillance, Epidemiology, and End Results database between 2004 and 2016. Pathologically confirmed patients with complete data of retropharyngeal lymph node metastasis were investigated. The included patients were divided into N1a and N1b groups. Overall survival (OS) and cancer-specific survival (CSS) were assessed using the Kaplan–Meier method and propensity score matching (PSM) analyses. Results This retrospective cohort study examined 759 patients: 70 who were stage N1a and 689 who were stage N1b. Before PSM, N1a group was associated with similar 5-year OS (77.7% vs. 72.4%; P = 0.15) and CSS (85.6% vs. 79.9%; P = 0.09) compared to N1b group. After PSM, a similar OS (75.0% vs. 60.7%; P = 0.12) was found between the radiotherapy and chemoradiotherapy groups. However, N1a group showed a better 5-year CSS (83.8% vs. 71.1%; P = 0.04) compared to N1b group. Stage N1b was an independent risk prognostic factor for CSS (hazard ratio = 2.54, 95% confidence interval: 1.02–6.34; P = 0.04). Conclusions OS was not different between N1a and N1b groups. Retropharyngeal lymph node metastasis defined as stage N1 of the 8th edition American Joint Committee on Cancer staging system is reasonable.

To investigate the follow-up strategy of stage II NPC based on event dynamics.Stage II NPC patients were retrospectively assessed from January 2007 to December 2014 at Guangxi Medical University Cancer Hospital. Event dynamics for patterns of recurrence and metastasis were calculated based on the hazard rates.A total of 251 patients were included. After treatment, 10 (4.0%) patients developed recurrence and 6 (2.4%) patients developed metastasis. The hazard rate curve of recurrence showed a bimodal recurrence pattern. The maximum hazard rates were 0.048 and 0.072 at the intervals of 36-42 and 90-96 months, respectively. The maximum hazard rate was 0.036 at the interval of 48-54 months in the hazard rate curve of metastasis.Follow-up strategies of stage II NPC should be performed based on currently recommended guidelines. In the future, it should be modified to meet the needs of individual patients.

PURPOSE To identify whether chemoradiotherapy improves survival in patients with stage T3-4N0M0 nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS The data of patients with stage T3-4N0M0 NPC were extracted from the Surveillance, Epidemiology, and End Results database between 2004 and 2016. The patients were divided into radiotherapy and chemoradiotherapy groups. Overall survival (OS) and cancer-specific survival (CSS) were assessed using the Kaplan-Meier method and propensity score matching (PSM) analyses. RESULTS We examined 496 patients: 88 who received radiotherapy and 408 who received chemoradiotherapy. Before PSM, chemoradiotherapy was associated with a better 5-year OS (52.58% vs. 38.13%; P = .005) and similar CSS (63.62% vs. 59.26%; P = .196) compared to those associated with radiotherapy. However, chemoradiotherapy was not an independent prognostic factor for OS [hazard ratio (HR)=0.95, 95% confidence interval (CI): 0.68-1.32; P = .760] or CSS (HR = 1.02, 95% CI: 0.66-1.56; P = .935). After PSM, similar OS (45.15% vs. 42.78%; P = .626) and CSS (58.22% vs. 60.37%; P = .730) were found between the radiotherapy and chemoradiotherapy groups. CONCLUSION Radiotherapy and chemoradiotherapy are associated with similar OS and CSS in patients with stage T3-4N0M0 NPC.

Background: The value of maximal lymph nodal diameter in staging system of nasopharyngeal carcinoma (NPC) is not well established.Methods: NPC patients were extracted from SEER database between 2004 and 2016. Overall survival (OS) and cancer-specific survival (CSS) were compared among three groups based on the maximal lymph nodal diameter: ≤3.0 cm, >3.0-6.0 cm, and >6.0 cm. Included patients were randomly divided into training set and validated set with 1:1 ratio. In training set, X-tile plots were created by dividing maximal lymph nodal diameter into three populations. All possible divisions of the maximal lymph nodal diameter were assessed. Two cut-off values were calculated by the X-tile plots in training set. The two cut-off values were evaluated in validated set.Results: The 10-year OS and CSS were different between the three groups. Multivariate regression analysis revealed that maximal lymph nodal diameter >6.0 cm was an independent risk prognostic factor for OS (hazard ratio [HR]=1.91, 95% confidence interval [CI]: 1.51-2.43; PP5.0 cm was a risk prognostic factor for OS and CSS.Conclusions: The maximal lymph nodal diameter of 5.0 cm may be a reasonable cut-off value for N stage.

Recent studies suggested that RNA binding proteins (RBPs) were related to the tumorigenesis and progression of glioma. This study was conducted to identify prognostic RBPs of glioblastoma (GBM) and construct an RBP signature to predict the prognosis of GBM.Univariate Cox regression analysis was carried out to identify the RBPs associated with overall survival of GBM in the The Cancer Genome Atlas (TCGA), GSE16011, and Repository for Molecular Brain Neoplasia data (Rembrandt) datasets, respectively. Overlapping RBPs from the TCGA, GSE16011, and Rembrandt datasets were selected. The biological role of prognostic RBPs was assessed by Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, and protein-protein interaction analyses. Least absolute shrinkage and selection operator regression analysis and multivariate Cox regression analysis were used to construct an RBP-related risk signature. The prognostic value of RBP signature was measured by Kaplan-Meier method and time-dependent receiver operating characteristic curve. A nomogram based on independent prognostic factors was established to predict survival for GBM. The CGGA cohort was used as the validation cohort for external validation.This study identified 27 RBPs associated with the prognosis of GBM and constructed a 6-RPBs signature. Kaplan-Meier curves suggested that high-risk score was associated with a poor prognosis. Area under the curve of 1-, 3-, and 5-year overall survival was 0.618, 0.728, and 0.833 for TCGA cohort, 0.655, 0.909, and 0.911 for GSE16011 cohort, and 0.665, 0.792, and 0.781 for Rembrandt cohort, respectively. A nomogram with 4 parameters (age, chemotherapy, O6-methylguanine-DNA methyltransferase promoter status, and risk score) was constructed. The calibration curve showed that the nomogram prediction was in good agreement with the actual observation.The 6-RBPs signature could effectively predict the prognosis of GBM, and our findings supplemented the prognostic index of GBM to a certain extent.

// Yanming Jiang 1 , Song Qu 1 , Xinbin Pan 1 , Shiting Huang 1 and Xiaodong Zhu 1 1 Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China Correspondence to: Xiaodong Zhu, email: zhuxiaodonggxmu@163.com Keywords: nasopharyngeal carcinoma, NLR, PLR, prognosis Received: January 28, 2017 Accepted: August 30, 2017 Published: January 11, 2018 ABSTRACT Background: Inflammatory response markers plays an important role in tumor progression. The aim of this analysis was to evaluate whether the neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) could predict the prognosis of nasopharyngeal carcinoma(NPC). Materials and Methods: 247 patients who underwent Intensity Modulated Radiation Therapy( IMRT )were enrolled from January 2012 and December 2012. NLR, and PLR were calculated from peripheral blood cell counts taken at pre-treatment. Optimal cutoff values of NLR and PLR were determined on the basis of receiver operating characteristic curve analysis. Overall survival (OS), progression-free survival(PFS), distant metastasis-free survival (DMFS) and loco-regional recurrence-free survival ( LRFS) rates were compared according to NLR and PLR level respectively. Multivariate analysis was performed to assess the prognostic value of NLR and PLR. Results: The 5-year estimated OS, PFS, LRFS and DFS were 87.2, 77.8, 96.9, and 86.2%, respectively. Our results shows that the NLR was significantly associated with T-stage ( P < 0.05), N-stage ( P < 0.05) and tumor stage( P < 0.05). PLR was significantly associated with T-stage ( P < 0.05) and tumor stage( P < 0.05). NLR was an independent prognostic indicator for OS (HR: 3.259, P = 0.004), PFS (HR:7.093, P < 0.001), DMFS (HR: 6.576, P = 0.003), except for PLR. In subgroup analysis, adjuvant chemotherapy had no significantly improved survival for patients with high NLR. Conclusions: NLR is a strong prognostic factor for NPC patients. NLR might not be a useful indicator for selection of treatment strategies for loco-regionally advanced NPC.

// Xin-Bin Pan 1 , Shi-Ting Huang 1 , Kai-Hua Chen 1 and Xiao-Dong Zhu 1 1 Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China Correspondence to: Xiao-Dong Zhu, email: zhuxiaodonggx@163.com Keywords: nasopharyngeal carcinoma, chemotherapy, survival, stage II Received: August 07, 2017 Accepted: September 21, 2017 Published: October 11, 2017 ABSTRACT Although common, the use of chemotherapy for stage II nasopharyngeal carcinoma (NPC) is controversial due to its undefined clinical benefits. We therefore conducted a retrospective cohort study to investigate whether chemotherapy confers survival gains to stage II NPC patients. A total of 251 stage II (2010 UICC/AJCC staging system) NPC patients treated between January 2007 and December 2014 were retrospectively analyzed. Patients were matched using the propensity-score matching method. The primary endpoint was overall survival (OS). Secondary endpoints were locoregional-free survival (LRFS) and distant metastasis-free survival (DMFS). Our analyses revealed no significant differences in OS, LRFS, or DMFS for stage II NPC patients treated with radiotherapy (RT) alone, concurrent chemoradiotherapy (CCRT), or CCRT + adjuvant chemotherapy (AC). T2N1 (OR = 6.690; 95% CI, 3.091–14.481) and T1N1 (OR = 5.857; 95% CI, 2.278–15.061) patients were more likely to receive CCRT than T2N0 patients. Similarly, both T2N1 (OR = 10.513; 95% CI, 3.439–32.137) and T1N1 (OR = 7.321; 95% CI, 1.978–27.098) patients were more likely to receive CCRT + AC than T2N0 patients. The present matched survival analysis suggests potential overuse of chemotherapy in stage II NPC, as the addition of chemotherapy did not provide a survival benefit in this group of patients.

It is unclear whether hemorrhage of brain metastasis is a poor prognostic factor in patients with hepatocellular carcinoma. We conducted a retrospective cohort study to compare overall survival between hemorrhage and no-hemorrhage groups of hepatocellular carcinoma patients with brain metastasis. Hepatocellular carcinoma patients with brain metastasis treated between June 2000 and June 2016 at the Cancer Hospital of Guangxi Medical University were retrospectively reviewed. Clinical characteristics and overall survival were compared between patients with (n = 11) and without (n = 25) hemorrhage of brain metastasis. Univariate and multivariate survival analyses showed hemorrhage to be a poor prognostic factor (hazard ratio = 5.812, 95% confidence interval: 1.399-24.142, p = 0.015). Patients with hemorrhage had a shorter median survival than those without hemorrhage (4 weeks vs 8 weeks, p = 0.001). These results suggest hemorrhage of brain metastasis is a poor prognostic factor in patients with hepatocellular carcinoma patients.

// Xin-Bin Pan 1 , Shi-Ting Huang 1 , Kai-Hua Chen 1 , Yan-Ming Jiang 1 , Jia-Lin Ma 1 , Song Qu 1 , Ling Li 1 , Long Chen 1 and Xiao-Dong Zhu 1 1 Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China Correspondence to: Xiao-Dong Zhu, email: zhuxiaodonggx@163.com Keywords: nasopharyngeal carcinoma, quality of life, intensity-modulated radiotherapy, two-dimensional conventional radiotherapy Received: January 02, 2017 Accepted: April 03, 2017 Published: May 03, 2017 ABSTRACT Two-dimensional conventional radiotherapy (2D-CRT) and intensity-modulated radiotherapy (IMRT) are effective for control of nasopharyngeal carcinoma (NPC). The purpose of this study was to compare the quality of life (QoL) of stage II NPC patients treated with 2D-CRT versus IMRT. We conducted a cross-sectional study of 106 patients with stage II NPC treated with 2D-CRT (n = 47) versus IMRT (n = 59) between June 2008 and June 2013. For all subjects, disease-free survival was more than 3 years. QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questions and the Head and Neck 35 (EORTC QLQ-H&N35) questions. Patients receiving IMRT with or without concurrent chemotherapy had better outcomes in head and neck related symptoms and general aspects of QoL than those receiving 2D-CRT with or without concurrent chemotherapy. Thus, IMRT improves the QoL of patients with stage II NPC as compared to 2D-CRT.

We compared treatment outcomes in patients with stage II nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT) or two-dimensional conventional radiotherapy (2D-CRT). Stage II (2010 UICC/AJCC staging system) NPC patients treated with IMRT (n = 178) or 2D-CRT (n = 73) between January 2007 and December 2014 were retrospectively analyzed. Patients were matched using the propensity score-matching method. The primary endpoint was overall survival (OS). Secondary endpoints were local relapse-free survival (LRFS), regional relapse-free survival (RRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS). Acute and late toxicity reactions to IMRT and 2D-CRT were also compared. In an unmatched cohort of 251 patients, no significant survival differences were found between those receiving IMRT and those receiving 2D-CRT (5-year OS, 95.67% vs 94.44%, P = 0.0556; LRFS, 97.34% vs 98.59%, P = 0.6656; RRFS, 99.26% vs 100%, P = 0.6785; DMFS, 96.5% vs 98.63%, P = 0.7910; DFS, 92.2% vs 97.24%, P = 0.8719). In the propensity-matched cohort of 146 patients, 5-year OS (97.06% vs 94.44%, P = 0.1325), LRFS (96.75% vs 98.59%, P = 0.8869), RRFS (100% vs 100%, P = 1.0000), DMFS (98.63% vs 98.63%, P = 0.4225), and DFS (95.37% vs 97.24%, P = 0.5634) were similar between patients treated with IMRT or 2D-CRT. However, IMRT correlated with fewer acute and late toxicity reactions. Thus although IMRT provides no survival advantage, it has a lower incidence of toxicity than 2D-CRT in stage II NPC patients.

Xerostomia is a common radiation-induced late complication after radiotherapy. Identifying predictive factors for xerostomia will lead to better treatments and improve the quality of life. This study was conducted to establish an effective predictive nomogram for xerostomia by assessing stage I-IVb (AJCC 7th edition) NPC patients between September 2015 and March 2016. Xerostomia was evaluated via the RTOG/EORTC system. The primary endpoint was grade 2-3 xerostomia 1 year after treatment. The predictive factors for xerostomia were analysed using logistic regression analysis. A nomogram was constructed based on combining the predictors and clinical variables. In total, 102 patients with grade 0-1 xerostomia and 93 patients with grade 2-3 xerostomia were included. The independent predictive factors for xerostomia were V25, V30, V35, and V45 of the ipsilateral parotid gland and mean dose of the contralateral parotid gland. The calibration plot for the probability of xerostomia showed good agreement between prediction by the nomogram and actual observation. The concordance index of the nomogram for predicting xerostomia was 0.796 (95% CI: 0.735-0.857, P

To identify predictors for improvement of xerostomia in patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). Patients diagnosed with stage I-IVb NPC (according to the 7th edition of the American Joint Committee on Cancer) between September 2015 and March 2016 were retrospectively analyzed. All the patients received IMRT. Predictors for improvement of xerostomia were analyzed using logistic regression analysis. Receiver operating characteristic curve analysis was used to identify the most appropriate cut-off values for predicting factors. This study included 195 patients: xerostomia improved in 109 patients and xerostomia remained unchanged in 86 patients. Volume of the parotid gland ≤52.2 cm3 was a risk factor for xerostomia improvement (odds ratio [OR] = 3.506, 95% confidence interval [CI]: 1.932–6.362, P = .001). The mean dose of

Purpose Chemotherapy use remains controversial for stage II nasopharyngeal carcinoma (NPC). This retrospective study was conducted to identify whether chemoradiotherapy was associated with better survival compared to radiotherapy. Materials and methods The Surveillance, Epidemiology, and End Results (SEER) database was queried for stage II NPC patients between 2004 and 2015. Patients were divided into radiotherapy and chemoradiotherapy groups. Overall survival (OS) and cancer-specific survival (CSS) were examined using the Kaplan-Meier method, Cox proportional hazards models, and propensity score matching analyses. Results This study examined 908 patients, including 102 receiving radiotherapy and 806 receiving chemoradiotherapy. Chemoradiotherapy was associated with 5-year OS (78.01% vs. 75.12%; p = 0.22) and CSS (78.92% vs. 78.26%; p = 0.40) rates comparable to those of radiotherapy. Propensity score matching analyses demonstrated similar OS (HR: 0.63, 95% CI: 0.36–-1.10; p = 0.10) and CSS (HR: 0.77, 95% CI: 0.41–1.48; p = 0.44) rates with radiotherapy. Age >60 years and non-Asian patients were associated with worse survival. Conclusion This study revealed that chemoradiotherapy showed similar survivals to stage II NPC patients compared with radiotherapy. Due to the limitations of SEER database, further studies should be performed to verify the results.

The TNM staging system of NPC is the most important model for survival prediction. However, this model does not consider the biological variability of the tumor itself. This study aimed to develop a nomogram for predicting the overall survival of loco-regionally advanced nasopharyngeal carcinoma. 487 Patients with confimed nasopharyngeal carcinoma who underwent IMRT and chemotherapy were included in this study. We established prognostic nomogram for overall survival (OS) based on the Cox proportional hazards model. The predictive accuracy and discriminative ability were measured using the concordance index (C-index) and calibration curve. Nomogram was validated externally by assessing discrimination and calibration using an independent data set. Continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to analyze whether nomogram improve the prediction of survival than TNM stage system. Recursive partitioning analysis (RPA) was performed to stratifying risk of patients. Age, T-stage, N-stage, NLR, LDH were included in the nomogram for OS. The C-index of the nomogram for OS were 0.726 (95% CI, 0.690 to 0.762); The calibration curve showed the nomogram was able to predict 5-year OS accurately. The nomogram had a higher C-index than the TNM stage system (0.726 VS 0.632, P-value

Purpose: To develop a multi-RNA-based model to provide survival risk prediction for colon cancer by constructing a competing endogenous RNAs (ceRNAs) network. Methods: The prognostic information and expression of the lncRNAs, miRNAs, and mRNAs in colon cancer specimens from The Cancer Genome Atlas (TCGA) were assessed. Constructing prognostic models used the differentially expressed RNAs. Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses and Gene Ontology were used to identify the functional role of the ceRNA network in the prognosis of colon cancer. Results: Five lncRNAs (AC007384.1, AC002511.1, AC012640.1, C17orf82, and AP001619.1), 8 miRNAs (hsa-mir-141, hsa-mir-150, hsa-mir-375, hsa-mir-96, hsa-mir-107, hsa-mir-106a, hsa-mir-200a, and hsa-mir-1271), and 5 mRNAs (BDNF, KLF4, SESN2, SMOC1, and TRIB3) were highly correlated with tumor status and tumor stage. Three prognostic models based on the 5 lncRNAs, 8 miRNAs, and 5 mRNAs were constructed. The prognostic ability was 0.850 for the lncRNA-based model, 0.811 for the miRNA-based model, and 0.770 for the mRNA-based model. Patients with high-risk scores revealed worse overall survival. The KEGG pathways were significantly enriched in the "neuroactive ligand-receptor interaction." Conclusion: This study identified several potential prognostic biomarkers to construct a multi-RNA-based prognostic model for colon cancer.

To assess the maximal lymph nodal diameter on the 8th edition American Joint Committee on Cancer staging system of nasopharyngeal carcinoma (NPC). This study extracted NPC patients between 2004 and 2016 in the Surveillance, Epidemiology, and End Results database. Included patients were divided into 3 groups: ≤3 cm, >3–6 cm, and >6 cm based on the maximal lymph nodal diameter. Cumulative survival curves of 5-year overall survival (OS) and cancer-specific survival (CSS) were calculated using the Kaplan-Meier method between the 3 groups. The 5-year OS (64.0% vs 59.3%, P = .240) and CSS (71.8% vs 67.0%, P = .242) of ≤3 cm and >3–6 cm groups were not different. In contrast, the 5-year OS and CSS were different between >6 cm and ≤3 cm groups, and between >6 cm and >3–6 cm groups. The stratified hazard ratio of OS and CSS was 1.75 (95% confidence interval: 1.25–2.45; P = .001) and 1.77 (95% confidence interval: 1.20–2.60; P = .004) for the >6 cm group in the multivariate regression analysis. It is reasonable that the maximal lymph nodal diameter with >6 cm is classified as stage N3 of the 8th edition American Joint Committee on Cancer staging system for NPC.

To identify prognostic tumor-infiltrating immune cells of endometrial adenocarcinoma. The gene expression profiles of endometrial adenocarcinoma were downloaded from the Cancer Genome Atlas (TCGA). The abundance of tumor-infiltrating immune cells in endometrial adenocarcinoma samples was calculated by CIBERSORT algorithm. Kaplan–Meier analysis was used to identify prognostic tumor-infiltrating immune cells. This study identified 22 kinds of tumor-infiltrating immune cells. Macrophages M0 and CD8 T cells were prognostic factors of endometrial adenocarcinoma. The abundance of macrophages M0 (P = .038) was significantly correlated with better prognosis of endometrial adenocarcinoma. In contrast, the abundance of CD8 T cells (P = .049) was associated with poor prognosis of endometrial adenocarcinoma. Tumor-infiltrati macrophages M0 and CD8 T cells were prognostic factors of endometrial adenocarcinoma.

// Xin-Bin Pan 1 , Shi-Ting Huang 1 , Kai-Hua Chen 1 , Yan-Ming Jiang 1 , Jia-Lin Ma 1 , Song Qu 1 , Ling Li 1 , Long Chen 1 , Xiao-Dong Zhu 1 1 Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China Correspondence to: Xiao-Dong Zhu, email: zhuxiaodonggx@163.com Keywords: nasopharyngeal carcinoma, quality of life, radiotherapy, concurrent chemoradiotherapy Received: September 20, 2016 Accepted: December 28, 2016 Published: February 01, 2017 ABSTRACT The purpose of this study was to compare the quality of life (QoL) of stage II nasopharyngeal carcinoma (NPC) patients treated with radiotherapy (RT) versus concurrent chemoradiotherapy (CCRT). In a cross-sectional study, these patients were treated with RT (n = 55) or CCRT (n = 51) between June 2008 and June 2013. For all subjects, disease-free survival was more than 3 years. QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questions and the Head and Neck 35 (EORTC QLQ-H&N35) questions. RT had better outcomes than CCRT for global QoL, functional scales, symptom scales of fatigue and insomnia, financial problems, and weight gain. Survivors receiving 1 cycle of concurrent chemotherapy had worse QoL outcomes than survivors receiving 2 cycles of concurrent chemotherapy. Patients receiving 3 cycles of concurrent chemotherapy had the best QoL outcomes. Thus, CCRT adversely affects the QoL of patients with stage II NPC as compared to radiotherapy.

// Qiulu Zhong 1 , Xiaodong Zhu 1 , Ling Li 1 , Song Qu 1 , Zhongguo Liang 1 , Fanyan Zeng 1 and Xinbin Pan 1 1 Department of Radiation Oncology, The Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China Correspondence to: Xiaodong Zhu, email: // Keywords : nasopharyngeal carcinoma; intensity-modulated radiotherapy; concurrent chemoradiotherapy; concurrent chemoradiotherapy plus adjuvant chemotherapy Received : August 15, 2016 Accepted : December 07, 2016 Published : January 23, 2017 Abstract Purpose: To evaluate the efficacy of IMRT combined with concurrent chemotherapy followed by adjuvant chemotherapy compared with IMRT combined with concurrent chemotherapy alone in patients with nasopharyngeal carcinoma. Methods: From January 2007 to December 2014, we collected 797 staged II-IVb [UICC = Union for International Cancer Control criteria (7th edition)] NPC patients for analysis. After 1:1 matching ,we selected 261 cases as the CCRT group, another 261 patients as the CCRT+AC group. Using Kaplan-Meier to calculate the overall survival (OS), locoregional failure-free survival(LFFS), distant metastasis failure-free survival(DMFS). The log-rank test and Cox-proportional hazards model to evaluate the prognostic factors. Results: After matching, there were 261 patients in each group. In CCRT+AC group, The 1-,2- and 3- year os rates were a little higher than in CCRT group(99.6% vs 97.9%,97.4% vs 96.2%,93.8% vs 86.9%, P = 0.150). There were no significant difference in 1-,2-,3- year OS, LFFS, DMFS between the two groups. In subgroup analysis, a little higher OS rate in CCRT+AC group for staged III, IV and T4(III:100% vs 100%, 97.6% vs 95.8%, 94.0% vs 84.0%; IV: 99.1% vs 95.4%, 96.3% vs 95.4%, 90.5% vs 79.4%, P = 0.047;T4:99.1% vs 95.2%, 97.1% vs 95.2%, 90.9% vs 78.2%, P = 0.055). No significant difference were observed in OS, LFFS,DMFS between the groups. Conclusion: IMRT combined with concurrent chemotherapy followed by adjuvant chemotherapy might improved 1-,2-,3- year of OS. Whether or not add adjuvant chemotherapy it had similar LFFS rate and DMFS rate in patients with nasopharyngeal carcinoma. Locally advanced NPC patients (III, IV and T4)might benefit from the adjuvant chemotherapy.

// Xin-Bin Pan 1 , Shi-Ting Huang 1 , Yan-Ming Jiang 1 , Jia-Lin Ma 1 , Xiao-Dong Zhu 1 1 Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China Correspondence to: Xiao-Dong Zhu, email: zhuxiaodonggx@163.com Keywords: breast cancer, breast-conserving therapy, partial breast irradiation, whole breast irradiation, secondary malignancies Received: August 26, 2016 Accepted: September 26, 2016 Published: October 04, 2016 ABSTRACT Secondary malignancies are a common complication for patients receiving radiotherapy. Here, we compared rates of secondary malignancies after partial breast irradiation (PBI) and whole breast irradiation (WBI). The MEDLINE, EMBASE, and the Cochrane Library databases were systematically searched to identify relevant randomized clinical trials comparing PBI with WBI in breast cancer patients treated with breast-conserving therapy. Four studies including 2,185 patients were selected. Compared to WBI, the pooled odds ratios (OR) for contralateral breast cancer were 0.86 (95% confidence interval (CI) 0.31–2.42; p = 0.78) after 5 years and 1.15 (95% CI 0.43-3.09; p = 0.78) after 10 years for PBI. The pooled ORs for secondary non-breast cancer were 0.91 (95% CI 0.49-1.67; p = 0.77) after 5 years and 1.20 (95% CI 0.39-3.66; p = 0.75) after 10 years for PBI compared to WBI. These results demonstrate that the risk of secondary malignancies is similar for PBI and WBI after breast-conserving radiotherapy.

Background Ovarian cancer is a highly fatal gynecological malignancy and new, more effective treatments are needed. Immunotherapy is gaining attention from researchers worldwide, although it has not proven to be consistently effective in the treatment of ovarian cancer. We studied the immune landscape of ovarian cancer patients to improve the efficacy of immunotherapy as a treatment option. Methods We obtained expression profiles, somatic mutation data, and clinical information from The Cancer Genome Atlas. Ovarian cancer was classified based on 29 immune-associated gene sets, which represented different immune cell types, functions, and pathways. Single-sample gene set enrichment (ssGSEA) was used to quantify the activity or enrichment levels of the gene sets in ovarian cancer, and the unsupervised machine learning method was used sort the classifications. Our classifications were validated using Gene Expression Omnibus datasets. Results We divided ovarian cancer into three subtypes according to the ssGSEA score: subtype 1 (low immunity), subtype 2 (median immunity), and subtype 3 (high immunity). Most tumor-infiltrating immune cells and immune checkpoint molecules were upgraded in subtype 3 compared with those in the other subtypes. The tumor mutation burden (TMB) was not significantly different among the three subtypes. However, patients with BRCA1 mutations were consistently detected in subtype 3. Furthermore, most immune signature pathways were hyperactivated in subtype 3, including T and B cell receptor signaling pathways, PD-L1 expression and PD-1 checkpoint pathway the NF-κB signaling pathway, Th17 cell differentiation and interleukin-17 signaling pathways, and the TNF signaling pathway. Conclusion Ovarian cancer subtypes that are based on immune biosignatures may contribute to the development of novel therapeutic treatment strategies for ovarian cancer.

BACKGROUND To compare the effects of chemotherapy dose escalation on survival and prognosis of nasopharyngeal carcinoma (NPC) patients who developed bone-only metastasis. MATERIAL AND METHODS Between October 2000 to March 2017, 58 NPC patients with initial bone-only metastasis were retrospectively analyzed. Patients who received

BACKGROUND The first-line therapy for early-stage hepatocellular carcinoma (HCC) is unclear. This study was conducted to assess and compare survival after surgery vs. after radiofrequency ablation (RFA) for early-stage HCC. MATERIAL AND METHODS Data from HCC patients with a single tumor measuring 31-50 mm were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015. Overall survival (OS) and cancer-specific survival (CSS) were assessed and compared between surgery and RFA treatment. Propensity score matching was performed. Multiple imputations were used to create 5 sets of complete data. Fine and Gray competing risk multivariate regression models were used to control biases. RESULTS This study included 839 patients: 339 (40.41%) received RFA and 500 (59.59%) underwent surgery. Surgery improved the 5-year OS (63.95% vs. 37.13%, p

Background Extranodal natural killer/T-cell lymphoma (ENKTL) is a rare lymphoid malignancy with diverse clinical features and prognoses. The aims of this study were to explore the pretreatment prognostic factors of ENKTL and develop a new individual prognostic model. Patients and Methods We retrospectively enrolled 81 ENKTL patients with newly diagnosed disease between June 2006 and August 2017 at the Affiliated Cancer Hospital of Guangxi Medical University. Survival analysis was used to assess the prognostic value of various factors. A nomogram was developed to predict overall survival (OS) based on the Cox proportional hazards model. Results The median survival time of the patients was 48 months, and the 5-year OS rate was 47.5%. Cox regression analysis showed that the prognostic factors of OS for ENKTL patients included Eastern Cooperative Oncology Group performance status, Ann Arbor stage, pretreatment albumin-to-globulin ratio, and platelet count. A prognostic nomogram was developed to predict the OS rate for ENKTL patients based on these factors. The calibration curve showed that the nomogram was able to predict OS accurately. The concordance index of the nomogram for OS prediction was 0.807. Conclusion Our proposed nomogram based on Eastern Cooperative Oncology Group performance status, Ann Arbor stage, albumin-to-globulin ratio, and platelet count provides an individualized risk estimate of OS in patients with ENKTL.

Background: The aim of this study was to compare the efficacy of breast conservation surgery (BCS) followed by radiotherapy (RT) in triple negative breast cancer (TNBC) versus non-TNBC. Methods: We searched the MEDLINE and EMBASE databases from inception through March 31, 2014, using search terms related to TNBC, BCS, and RT. Studies comparing the efficacy of BCS followed by RT in TNBC versus non-TNBC were reviewed. Results: 5 studies including 2,922 non-TNBC and 510 TNBC cases were selected. The overall quality of included studies was deemed moderate to high. Compared with non-TNBC, the pooled relative risk of 5-year local relapse-free survival was 1.315 (95% confidence interval (CI) 0.967-1.789; p = 0.008) for TNBC, and that of 5-year overall survival, regional relapse-free survival, and distant metastasis-free survival was 1.929 (95% CI 1.392-2.674; p = 0.000), 3.052 (95% CI 1.629-5.715; p = 0.000), and 2.407 (95% CI 1.910-3.034; p = 0.000), respectively. Conclusion: The local control rate of TNBC treated with BCS plus RT is similar to that of non-TNBC.

Xueling Chen,1 Xiaodong Zhu,1–3 Zhongguo Liang,1 Ling Li,1–3 Song Qu,1–3 Kaihua Chen,1 Xinbin Pan1 1Department of Radiation Oncology, Affiliated Tumor Hospital, Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, 2Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, 3Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China Purpose: Whether neoadjuvant chemotherapy (NCT) followed by concurrent chemoradiotherapy (CCRT) could improve survival in nasopharyngeal carcinoma (NPC) remains controversial especially in the era of intensity-modulated radiation therapy (IMRT), and we explored the role of NCT for NPC patients.Patients and methods: A retrospective review was conducted of 255 NPC patients treated with NCT+CCRT (n=67) or CCRT alone (n=188) based on IMRT between December 2006 and December 2012. To control the imbalance, a 1:2 match was performed using propensity score matching (PSM) method based on patient’s heterogeneity and regimens of concurrent ­chemotherapy (CCT). The long-term treatment outcomes and toxicity between NCT group (n=67) and concurrent chemoradiotherapy (CRT) group (n=134) after PSM were compared.Results: The 5-year overall survival (OS), progression-free survival (PFS), recurrence-free survival (RFS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS) and distant failure-free survival (DFFS) were 78.8%, 69.1%, 90.0%, 90.0%, 100% and 78.3% for NCT group, while 79.5%, 75.7%, 92.7%, 94.2%, 96.1% and 82.7% for CRT group (P=0.305, 0.448, 0.790, 0.512, 0.104 and 0.671). It indicated that the treatment method (NCT+CCRT vs CCRT) was not the independent prognostic factor for the survival in NPC patients, and only patients who had completed at least two cycles of CCT got better OS, RFS and DFFS (P=0.009, 0.016 and 0.043), whether to receive NCT or not. No difference in the incidences of any acute and most late toxicity between the two groups was shown.Conclusion: Our study did not show the exact advantage of NCT followed by CCRT compared with CCRT alone or higher incidences of toxicity in NCT group. It suggests that NCT might not be necessary if two or more cycles of CCT are finished well in the era of IMRT, and when NCT is finished well, less than two cycles of CCT with IMRT could be enough. However, in the era of IMRT, the role of NCT still needs to be further explored. Keywords: propensity score matching, PSM, nasopharyngeal carcinoma, concurrent chemotherapy, IMRT