BACKGROUND:Pulmonary rehabilitation (PR) is a cornerstone of chronic obstructive pulmonary disease (COPD) management, but exercise intolerance often limits its effectiveness. Non-invasive positive pressure ventilation (NPPV) during PR may enhance training tolerance and outcomes, yet the overall evidence remains uncertain. OBJECTIVES:To evaluate the effects of adding NPPV to PR on exercise capacity, dyspnea, and respiratory muscle strength in patients with COPD. DESIGN:Systematic review and meta-analysis of randomized controlled trials (RCTs). DATA SOURCES AND METHODS:We searched PubMed, Web of Science, Embase, the Cochrane Library, and CINAHL from inception to December 2024 for RCTs evaluating NPPV combined with PR in patients with COPD. Two reviewers independently assessed risk of bias using the Cochrane Risk of Bias Assessment Tool for Randomized Trials (RoB 2), extracted data, and performed analyses using RevMan 5.3. RESULTS:A total of 17 RCTs (489 participants; predominantly GOLD stage III-IV) were included. NPPV + PR significantly improved 6-minute walk distance (MD = 29.1 m, 95% CI: 3.6-54.6), incremental shuttle walk test distance (MD = 21.8 m, 95% CI: 5.0-38.7), peak oxygen uptake (SMD = 0.53, 95% CI: 0.23-0.83), maximal inspiratory pressure (Pimax; MD = 5.8 cmH2O, 95% CI: 1.0-10.7), and maximal expiratory pressure (Pemax; MD = 14.9 cmH2O, 95% CI:4.1-25.7). Significant reductions were observed in blood lactate levels (MD = -0.49 mmol/L, 95% CI:-0.79 to -0.19), BORG dyspnea score (MD = -1.1, 95% CI: -1.7 to -0.6), and mMRC scale (MD = -0.3, 95% CI: -0.5 to -0.1). No significant effect was found on quality of life. CONCLUSION:Adding NPPV to exercise-based PR provides clinically meaningful improvements in exercise capacity, dyspnea, and respiratory muscle strength in patients with COPD who have significant exercise limitation. NPPV may be a valuable adjunct to optimize PR outcomes in this population. TRIAL REGISTRATION:This review was prospectively registered in PROSPERO (CRD42023486598).

BACKGROUND:Outcomes for locally advanced nasopharyngeal carcinoma (LANPC) remain suboptimal despite comprehensive therapy. Preclinical studies demonstrated that low-dose fractionated radiotherapy (LDFRT) could potentiate chemotherapy, warranting further investigation. METHODS:This open-label, randomized phase 2 trial enrolled LANPC patients with advanced nodal stage (N2-N3 with necrosis, extranodal extension, or short axis ≥ 3 cm). Eligible patients were randomized to the LDFRT or control group. All patients received three cycles of induction chemotherapy (IC) followed by concurrent chemoradiotherapy. The LDFRT group received 50 cGy radiation twice daily for 2 days targeting positive lymph nodes during each cycle of IC. The primary endpoint was the overall (nasopharynx and lymph nodes) objective response rate (ORR) after IC, with the secondary endpoints including 2-year survival outcomes and safety. RESULTS:Eighty-two patients (41 per group) were included in the intention-to-treat analysis. After IC, the LDFRT group demonstrated a significantly higher overall ORR (100% vs. 85.4%, p = 0.03) and numerically higher CR rate (14.6% vs. 2.4%, p = 0.11). The LDFRT group achieved greater median lymph node and total tumor volume regression compared to the control group (90.1% vs 53.91%; 77.1% vs 55.1%, respectively; p < 0.001). After a median follow-up of 26.2 months, the 2-year progression-free survival (PFS) and distant metastasis-free survival (DMFS) showed trends favored LDFRT (87.6% vs. 71.9%, p = 0.17; 90.1% vs. 77.1%, p = 0.23, respectively). Acute toxicities were comparable between groups. CONCLUSIONS:In high-risk LANPC, LDFRT with IC improved ORR and tumor volume reduction, and was associated with a potential benefit in PFS and DMFS.

12125 Background: To explore the early intervention timing of recombinant human thrombopoietin (rhTPO) for cancer treatment-induced thrombocytopenia (CTIT) in cervical squamous cell carcinoma (CSCC) patients during concurrent chemoradiotherapy. Methods: Patients with stage I-IVa CSCC who developed CTIT during radical concurrent chemoradiotherapy were prospectively enrolled in our study. rhTPO intervention was used at the first presentation of G1 or G2 CTIT during concurrent chemotherapy respectively. The key indexes, including nadir platelet count, platelet recovery time, platelet transfusion and incidence of G3-5 CTIT were recorded in two groups. χ² test was used for the effective analysis, and univariate and multivariate analyses logistic regression analysis was used to predict the potential factors for the G3-5 CTIT. Results: From February 2021 to June 2024, 204 CSCC patients who developed CTIT during radical chemoradiotherapy at Sichuan Cancer Hospital were prospectively enrolled. 75 patients who occurred G1 and G2 CTIT at the first presentation during concurrent chemoradiotherapy received rhTPO intervention. They were included in the intent-to-treat (ITT) population analysis. According to the timing of the rhTPO intervention, the patients were divided into G1 group (100×10 9 /L>PLT>75×10 9 /L) and G2 group (75×10 9 /L>PLT>50×10 9 /L). For effective analysis, the nadir platelet count in G1 group was greater than that in G2 group (67 × 10 9 /L vs. 54 × 10 9 /L, p = 0.000), and the platelet recovery time in G1 group was shorter than that in G2 group (8 days vs. 14 days, p = 0.003). Moreover, patients in G1 group had a significantly lower incidence of G3-5 CTIT than that in G2 group (14.3% vs. 35%, p = 0.04). In two groups, only 1 patient in G2 group received 4 apheresis platelet units transfusion. Univariate and multivariate analysis showed the early intervention of the rhTPO was a substantial factor for decreasing the incidence of G3-5 CTIT. The sensitivity was 0.67 and the specificity was 0.74. Conclusions: For CSCC patients received with radical concurrent chemoradiotherapy, the early intervention of rhTPO was a substantial factor for decreasing the incidence of G3-5 CTIT. It could significantly improve the nadir platelet count, shorten the platelet recovery time, and reduce the incidence of G3-5 CTIT, thereby ensuring the uninterrupted continuation of treatment. Platelet recovery time and the degree of CTIT. Data Baseline platelet count(×10 9 /L) Days with platelet count recover ≥100×10 9 (Days) Minimal mean platelet count（×10 9 /L） Incidence of G3-5 CTIT(%) G1 group 172±64.92 8±5.86 67±15.81 14.3 G2 group 166±78.43 14±9.59 54±14.37 35 P value 0.76 0.003* 0.000* 0.04* *Statistically significant.

BackgroundAntibiotic-resistant bacterial infections remain a major global health threat, particularly in hospital settings. Standard antimicrobial susceptibility testing provides essential clinical information, but it does not fully capture pathogen metabolic adaptation under host-like conditions. Integrating isolate whole-genome sequencing with metabolomics may help prioritize condition-associated metabolic signatures linked to bacterial physiology and antibiotic response.MethodsWe performed a secondary integrative re-analysis of publicly available isolate whole-genome sequencing and matched metabolomics datasets from Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pyogenes cultured under RPMI and human serum conditions. Genome assemblies were assessed by quality metrics, fastANI, functional annotation, antimicrobial resistance gene screening, virulence-factor analysis, and KEGG profiling. Metabolomics data were analyzed using PCA, OPLS-DA, KEGG enrichment, and ROC analysis for exploratory feature prioritization. Candidate metabolites were further evaluated in Klebsiella quasipneumoniae ATCC 700603 cultured under RPMI or heat-inactivated human serum conditions.ResultsMetabolomic profiles showed condition-associated separation between RPMI and serum samples, with the most consistent serum-associated signature observed in Klebsiella. KEGG enrichment prioritized amino acid metabolism, particularly valine, leucine and isoleucine biosynthesis and alanine, aspartate and glutamate metabolism. l-aspartic acid, l-isoleucine, l-leucine, and l-valine showed strong within-dataset discriminatory performance in Klebsiella. Experimental validation showed that serum exposure reduced Klebsiella growth and viable bacterial burden, increased cell-associated levels of these amino acids, and elevated meropenem and ciprofloxacin MIC-like inhibitory endpoints under serum-conditioned assay conditions.ConclusionThis integrative re-analysis identified serum-associated amino acid remodeling as a prominent feature of host-like adaptation in Klebsiella. These findings provide candidate metabolic signatures for future mechanistic validation and suggest that serum exposure is associated with growth restriction and reduced antibiotic susceptibility under host-like conditions.

BACKGROUND:Asthma affects an estimated 260 million people worldwide. Adherence to inhaled corticosteroids ranges from 22% to 63% and accounts for about 24% of exacerbations. Feedback-enhanced electronic monitoring couples electronic recording of inhaler use with active feedback, unlike passive monitoring. Randomized trial evidence for this approach has not been synthesized. OBJECTIVE:To evaluate the effect of feedback-enhanced electronic monitoring on medication adherence, exacerbations, disease control, health-related quality of life, safety and acceptability in people with asthma. DESIGN:Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES:PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, Web of Science and Scopus were searched from inception to October 2025 without language restriction, supplemented by reference lists and trial registries. REVIEW METHODS:Trials comparing electronic monitoring combined with at least one feedback modality against standard care were eligible. Two reviewers independently screened records, extracted data and appraised risk of bias with the Cochrane risk of bias tool for randomized trials, version 2. Random-effects meta-analyses were performed and certainty of evidence was rated with the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS:Twenty-eight trials with 4410 participants were included. Feedback-enhanced electronic monitoring improved adherence relative to standard care (mean difference 18.43%, 95% confidence interval 13.02 to 23.84; 21 trials, 2567 participants; moderate certainty), with consistent benefit in children (22.21%), adults (14.23%) and mixed populations (23.18%). Exacerbation rates fell (mean difference -2.65, 95% confidence interval -4.39 to -0.91; 10 trials, 1569 participants; low certainty) and the proportion with well-controlled asthma rose (mean difference 6.67%, 95% confidence interval 4.47 to 8.86; 5 trials, 1709 participants; low certainty). Quality of life improved (Mini Asthma Quality of Life Questionnaire mean difference 0.26, 95% confidence interval 0.13 to 0.40; 5 trials, 787 participants; moderate certainty), whereas the change in Asthma Control Test score did not reach statistical significance (mean difference 0.53, 95% confidence interval -0.24 to 1.31; 9 trials). Adverse events were comparable and acceptability was high (System Usability Scale 69.4 to 80.1). CONCLUSIONS:Feedback-enhanced electronic monitoring improves inhaler adherence in asthma across age groups, and this is accompanied by fewer exacerbations, a higher proportion of patients reaching disease control and better quality of life. The benefit appears to arise from converting passive monitoring into active behavior change. Device durability, user training, integration with health services and digital equity require attention at implementation. SOCIAL MEDIA ABSTRACT:Adding feedback to electronic inhaler monitoring raises asthma medication adherence by 18% and improves control and quality of life.

Introduction Asthma and chronic obstructive pulmonary disease (COPD) collectively affect an estimated 475 million individuals worldwide, yet only 31% of patients achieve correct inhaler technique, a proportion that has not meaningfully improved over four decades of clinical practice. Critical technique errors are independently associated with poor disease control, increased exacerbation risk and greater healthcare utilisation. Although multiple educational modalities exist, no systematic review has applied network meta-analysis (NMA) to simultaneously compare and rank all six principal training approaches. This protocol describes a systematic review and NMA to generate comparative effectiveness evidence for inhaler technique training modality selection in adults with asthma or COPD.Methods and analysis A Bayesian random-effects NMA will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA-P) 2015, PRISMA-NMA and PRISMA 2020, with prospective PROSPERO registration (systematic search: June 2026; completion anticipated: February 2027). Seven databases will be searched from inception to June 2026 without language restriction: PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science Core Collection, CINAHL, CNKI and Wanfang Data, supplemented by clinical trial registry searches. Eligible randomised controlled trials will enrol adults aged 18 years or older with confirmed asthma (Global Initiative for Asthma (GINA) criteria) or COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria). Six intervention nodes defined a priori using the Template for Intervention Description and Replication (TIDieR) framework will be compared against usual care and each other: face-to-face physical demonstration, video and digital training, teach-to-goal training, pharmacist-led training, nurse or clinician-led training and sensor-assisted technique feedback training. Primary analyses comprise two disease-specific NMAs (asthma: Asthma Control Test; COPD: COPD Assessment Test) with a pooled exploratory NMA as secondary analysis, a prespecified sparsity contingency and Bayesian meta-regression for transitivity (four covariates in disease-specific NMAs: device category, baseline severity, number of training sessions and participant age; disease type is added as a fifth in the pooled NMA). Risk of bias will be assessed using the Cochrane Risk of Bias 2; certainty of evidence will be evaluated using the Confidence in Network Meta-Analysis framework.Ethics and dissemination Formal ethical approval is not required. Findings will be published in a peer-reviewed respiratory or evidence synthesis journal, presented at ERS and ATS annual congresses and communicated to GINA, GOLD and NICE guideline development groups.PROSPERO registration number CRD420261347918.

Introduction Chronic obstructive pulmonary disease (COPD) affects approximately 480 million individuals globally and is projected to reach 600 million by 2050, representing a substantial burden on healthcare systems and patient quality of life. Pulmonary rehabilitation is a cornerstone intervention for COPD management, delivering clinically meaningful improvements in exercise capacity, health-related quality of life and dyspnoea. Despite strong guideline recommendations and established efficacy, only 2%–4% of eligible patients with COPD access traditional centre-based pulmonary rehabilitation due to geographical barriers, transportation difficulties, scheduling conflicts and limited healthcare resources. Digital health technologies offer promising alternatives to overcome these access barriers while potentially maintaining therapeutic benefits. Various digital delivery models have emerged, including video-based telerehabilitation, virtual reality platforms, mobile health applications and web-based programmes. However, their comparative effectiveness remains unclear, limiting evidence-based clinical decision making. This systematic review and network meta-analysis will aim to compare and rank the effectiveness and safety of different digital health delivery models for pulmonary rehabilitation in patients with COPD, providing evidence to inform optimal intervention selection in clinical practice.Methods and analysis We will conduct a systematic review and Bayesian network meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Network Meta-Analyses guidelines. Comprehensive searches will be performed across five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL) from inception to January 2026, without language restrictions. Eligible studies will include randomised controlled trials comparing digital health delivery models for pulmonary rehabilitation in adults with COPD. Digital health interventions will be categorised into four distinct delivery models: video-based telerehabilitation, virtual reality rehabilitation, mobile health rehabilitation and web-based platform rehabilitation. Interventions combining multiple modalities will be categorised according to the predominant component based on intervention frequency, duration and primary therapeutic mechanism. Two independent reviewers will perform study selection, data extraction and risk of bias assessment using the Cochrane Risk of Bias 2 tool. The primary outcome will be change in 6 min walk distance. Key secondary outcomes will include disease-specific quality of life measures, dyspnoea severity, hospitalisation rates, exacerbation frequency, intervention adherence and adverse events. A Bayesian random-effects network meta-analysis will be conducted, calculating mean differences or ORs with 95% credible intervals. Treatment rankings will be estimated using surface under the cumulative ranking curve probabilities. Evidence certainty will be assessed using the Confidence in Network Meta-Analysis framework. Planned subgroup analyses will explore potential effect modifiers including disease severity, intervention duration, supervision mode and technological features.Ethics and dissemination As this systematic review will use data from previously published studies, formal ethical approval is not required. Findings will be disseminated through peer-reviewed publication, presentations at relevant scientific conferences and communication to healthcare providers, policymakers and patient advocacy organisations.PROSPERO registration number CRD420251268701.

PURPOSE:Lattice radiation therapy (LRT) is a promising approach for treating bulky tumors; however, current methods do not consider patient-specific tumor heterogeneity. Low apparent diffusion coefficient (ADC) regions, identified via diffusion-weighted magnetic resonance imaging, correspond to areas of high cellular density and radioresistance. Targeted dose escalation in these regions may enhance tumor control. Thus, we propose biologically guided lattice radiation therapy (BG-LRT), which optimizes lattice positioning based on the ADC map. METHODS AND MATERIALS:We retrospectively analyzed 20 patients with bulky tumors (>6 cm) who underwent diffusion-weighted magnetic resonance imaging and simulation computed tomography within 3 days. BG-LRT plans were created by aligning high-dose lattice regions with low-ADC areas and comparing them with hexagonal close-packed-LRT (HCP-LRT). Both techniques prescribed 60 Gy in lattice regions and 20 Gy to the gross tumor volume (GTV) over 5 fractions. The dosimetric evaluation included the peak-valley dose ratio (PVDR) and ablation dose ratio (ADR) within the GTV as well as dose distribution in ADC-defined tumor subregions (R_ADC10 to R_ADC50) and organs at risk (OARs). RESULTS:BG-LRT achieved a higher PVDR (2.7 vs 2.4) and ADR (2.6% vs 1.7%) than HCP-LRT. ADR values across all ADC-defined tumor subregions (R_ADC10 to R_ADC50) were significantly higher for BG-LRT. OAR doses were comparable between methods, with no significant differences in mean dose (Dmean) to the heart, stomach, esophagus, kidneys, liver, and duodenum as well as the maximum doses (Dmax) to the lens, eye, optic nerve, brainstem, and optic chiasm. Planning time, delivery time, monitor units, and gamma pass rates were similar between techniques. CONCLUSIONS:BG-LRT improves PVDR and ADR in the GTV while focusing on dose escalation in biologically relevant tumor regions. This technique maintains low OAR doses and represents a promising step toward personalized LRT treatment planning.

Purpose: Patients with nasopharyngeal carcinoma (NPC) experiencing locoregional recurrence concomitant with distant metastases (rmNPC) after initial treatment represent a unique subgroup with significant management challenges. This study aimed to evaluate overall survival (OS) in rmNPC patients treated with systemic therapies with or without radiotherapy. Methods: This retrospective multicenter study included patients with locally recurrent and metastatic NPC from five hospitals. Kaplan-Meier analyses and log-rank tests were applied to assess survival outcomes based on recurrence and metastasis profiles, as well as treatment modalities. Independent prognostic factors affecting OS were identified using Cox regression models. Results: A total of 52 patients were analyzed, with a median follow-up duration of 68.3 months (range: 7–240 months). The median OS was 23.4 months (range: 11.1–35.6 months), and the 1-, 2-, 3-, 4-, and 5-year OS rates were 61.3

This study aimed to quantify dynamic changes in the Apparent Diffusion Coefficient (ADC) values of the parotid glands during radiotherapy and explore their correlation with early-stage gland dysfunction. Nasopharyngeal carcinoma patients receiving definitive chemoradiotherapy were prospectively enrolled. Magnetic Resonance Diffusion-Weighted Imaging (MR-DWI) was performed at pre-radiotherapy (pre-RT), the 5th, 15th fractions, and end of radiotherapy. ADC values and volumes for ipsilateral (IP) and contralateral parotid glands (CP) were recorded. Salivary function was assessed using scintigraphy (SGS) and the Radiation Therapy Oncology Group (RTOG) xerostomia criteria. A total of 80 eligible patients were analyzed. From pre-radiotherapy(pre-RT) to the end of radiotherapy, Pearson correlation analysis showed that changes in ADC values were positively correlated with the delivered dose (p < 0.01) and reduction in parotid volume (p < 0.01).From pre-RT to the 5th fraction, mean ADC values((ΔADC5) increased significantly by 17.7

Head and neck squamous cell carcinoma (HNSCC) is the most prevalent type of head and neck cancer; however, treatment outcomes and patient prognosis remain suboptimal. Although the survival of patients with HNSCC has improved with the widespread use of anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs) and immune checkpoint inhibitors (ICIs), there remains considerable potential for further improvement. Recent studies suggest that the combination of anti-EGFR monoclonal antibodies and ICIs demonstrates promising efficacy and safety, which has been recommended by international guidelines for patients with recurrent or metastatic disease. Nevertheless, the application of this combination therapy remains in the early stages of exploration, and numerous questions concerning its standardized clinical use remain unanswered, including the mechanisms underlying the synergistic effects of individual agents, therapeutic value across different patient populations, and safety considerations. The Expert Committee of Head and Neck Cancer of the Chinese Society of Clinical Oncology (CSCO) organized an expert panel to develop this expert consensus on the combination of anti-EGFR mAbs and ICIs in the treatment of HNSCC through multiple rounds of discussion based on evidence-based medicine and clinical practice experience. This consensus provides guidance on the mechanisms of treatment with anti-EGFR mAbs plus ICIs, stratified treatment approaches, applications in special populations, and safety management. It is hoped that this consensus will provide clearer and more practical guidance for clinicians, promote the rational application of this combination therapy in clinical practice, and offer more treatment options for patients with HNSCC.

Immunotherapy combined with chemotherapy is currently the first-line treatment for metastatic head and neck squamous cell carcinoma (HNSCC). This study aims to evaluate whether adding metastasis-directed radiotherapy (MDRT) to immunotherapy and chemotherapy could improve the survival rate of patients with metastatic HNSCC. A retrospective analysis was conducted on patients with HNSCC who developed distant metastases after curative treatment. Systemic treatment was determined by the multidisciplinary team, with a programmed cell death-1 (PD-1) inhibitor combined with chemotherapy as the primary approach. The feasibility of radiotherapy was evaluated by clinical and imaging examinations. Stereotactic body radiotherapy (SBRT) was used to deliver different doses according to the number and location of metastatic lesions. Kaplan–Meier method was used to estimate survival, and Cox regression analysis was performed to evaluate the association between clinical factors and survival outcomes. From January 2018 to June 2023, a total of 94 patients with 164 metastatic sites were included for the analysis. The most common primary tumor was the nasopharynx (77.7

Purpose: Radiotherapy-induced oral mucositis is the most common side effect in nasopharyngeal carcinoma (NPC) patients. We aimed to evaluate the efficacy and safety of Rabdosia rubescens drop pills in NPC patients with radiation-induced oral mucositis (RTOM). Methods: The study involved 40 NPC patients who were given Rabdosia rubescens drop pills thrice daily from the start of radiation therapy. The study monitored the incidence and severity of oral mucositis and oral pain. The main outcomes measured were the occurrence rate of oral mucositis, grade 3 oral mucositis, oral pain assessment, and changes in immunological function, body weight, BMI, NRS2002, and albumin levels. Results: In the study, 38 patients completed the treatment. The incidence rates of Grade 0 to 3 oral mucositis were 5.26%, 21.05%, 47.37%, and 26.32% respectively. Pain levels were mild (42.11%), moderate (13.16%), and severe (13.16%). The onset of Grade 1, 2, and 3 oral mucositis occurred at 18, 24, and 30 days respectively. Grade 3 oral mucositis was associated with body weight, BMI, NRS2002 score, and albumin levels. Post-treatment, there was a decrease in CD4 + /CD8 + , CD3 + , and CD4 + immune cells, but an increase in CD8 + cells. Mild to moderate gastrointestinal adverse events were observed in 13.2% of patients. Conclusion: Rabdosia rubescens drop pills administration can reduce the incidence and severity of radiotherapy induced oral mucositis. Our finding suggested a positive impact of Rabdosia rubescens drops pills upon administration to NPC patients.

Currently, there is little evidence supporting the use of early endpoints to assess primary treatment outcomes in nasopharyngeal carcinoma (NPC). We aim to explore the relationship between 24-month progression-free survival (PFS24) and subsequent overall survival (sOS) as well as loss of lifetime (LoL) in NPC patients. sOS is defined as survival from the 24-month point or progression within 24 months leading to mortality. LoL represents the reduction in life expectancy due to NPC, compared to the general population matched by age, sex, and calendar year. The standardized mortality ratio (SMR) is defined as the ratio of observed mortality to expected mortality. The study included 6315 patients from nonendemic and endemic regions of China. Among them, 5301 patients (83.9%) achieved PFS24, with a 5-year sOS of 90.2% and an SMR of 1.0. Over a 10-year period following treatment, the mean LoL was only 0.01 months/year. For most subgroups, patients achieving PFS24 exhibited comparable sOS and LoL with the general population. However, patients failing to achieve PFS24 showed significantly worse outcomes, with 5-year sOS of 21.9%, SMR of 23.7, and LoL of 6.48 months/year. These notable outcome disparities highlight the importance of PFS24 in NPC risk stratification, patient monitoring, and study design.

ObjectiveTo investigate how Chinese residents perceived changes in their protective behaviors in the early stage after the lifting of the dynamic zero-COVID policy, and to explore the associations between the overall perceived change and factors such as demographic and health-related information, COVID-19 related perceptions, negative emotions, and coping styles.MethodsThis cross-sectional study involved 798 Chinese residents who completed an online questionnaire between 16 and 25 December 2022. The questionnaire covered demographic and health-related information, COVID-19 related perceptions, negative emotions, coping styles, and perceived changes in protective behaviors. Multiple linear stepwise regression analysis was used to determine the factors associated with the overall perceived change in protective behaviors.ResultsThe mean score for perceived protective behavioral change among participants was 61.38 (SD = 10.20), which was significantly higher than the hypothesized no-change value of 49 (p < 0.001). The mean scores for each of the 15 behaviors (excluding the two vaccination-related items) were significantly greater than the hypothesized no-change value of 3 (p < 0.001). The mean scores for the two vaccination-related items were significantly greater than the hypothesized no-change value of 2 (p < 0.001). Among all behaviors, avoiding dining out or gathering with friends had the highest mean score (Mean = 4.16), while engaging in regular physical activity had the lowest (Mean = 3.32). Avoiding dining out or gathering with friends had the highest percentage of individuals reporting an increase (71.3%), whereas maintaining a social distance of more than 1 m had the highest percentage of individuals reporting a decrease (17.5%). Regression analysis indicated that age, worry, positive coping, female sex, negative coping, and perceived severity were associated with the overall perceived change in protective behaviors, with worry being the most predictive variable.ConclusionThis study suggested that Chinese residents perceived an increase in their protective behaviors in the early stage after the policy change, with varying magnitudes across behaviors. We identified some potentially modifiable factors associated with perceived protective behavioral change, with worry emerging as the strongest predictor, followed by positive coping, negative coping, and perceived severity. These insights offer valuable information for developing effective communication strategies, psychological support, and comprehensive models in health behavior research.

BACKGROUND:The present meta-analysis aimed to evaluate the efficacy and safety of adding nimotuzumab to radiotherapy (RT) or chemoradiotherapy (CRT). METHODS:Prospective randomized controlled studies at EMBASE, PubMed, and the Cochrane Library from January 1, 2010, to October 1, 2022, were searched. Data on the overall survival (OS), progress-free survival (PFS), disease-free survival (DFS), complete response rate (CRR), objective response rate (ORR), and all grade adverse events were collected from the enrolled publications. OS was the primary measurement indicator. Pooled analysis was performed with relative risks (RRs), hazard risks (HRs), and their corresponding 95% confidence intervals (CIs) in the software Stata SE 16.0. RESULTS:Six randomized controlled studies were included in the analysis of the overall pooled effect. As compared to the control group, the nimotuzumab intervention group exhibited improved OS by 21% (pooled HR=0.79,95% CI: 0.64-0.98, P=0.028), along with PFS up to 31% (HR=0.69, 95% CI: 0.55-0.86, P=0.001) and DFS up to 29% (HR=0.71, 95% CI: 0.56-0.91, P=0.006), increased CRR as 50% (RR=1.50, 95% CI:1.09-2.04; P=0.012), and ORR as 35% (RR=1.35, 95% CI:1.04-1.73; P=0.022). Regarding safety, nimotuzumab in combination with RT or CRT did not increase the incidence of all grade adverse events (pooled-RD=-1.27, 95% CI:-2.78-0.23, P=0.099). CONCLUSION:The present meta-analysis has demonstrated that nimotuzumab, in combination with RT or CRT, could provide survival benefits and increase response rates. Its safety profile has been found to be controllable.