BACKGROUND:We sought to provide clinicians with important insights into the best treatment plans for locally advanced head and neck squamous cell carcinoma (LA-HNSCC) by examining the treatment trends and outcomes of the disease. METHODS:Data pertaining to 158 patients with stage III to IVB LA-HNSCC who received treatment at our hospital from October 2019 to October 2021 were examined in this study. The clinical results of various treatment approaches were compared among the patients. RESULTS:Of the 158 patients, 42 (26.6%) received definitive concurrent chemoradiotherapy (CCRT), 41 (36%) received induction chemotherapy (IC), and 95 (60.1%) underwent surgery. The 1-, 2-, and 3-year survival rates were 84.8%, 70.7%, and 59.3%, respectively, with a median follow-up of 36 months. No discernible difference in overall survival was observed between the CCRT and surgical groups (P = 0.397). CONCLUSIONS:The decision regarding definitive CCRT, IC followed by definitive CCRT, surgery followed by adjuvant CCRT, or radiotherapy for patients with LA-HNSCC should be made in consultation with the multidisciplinary team. Furthermore, the decision should take into account the patient's overall health and the diagnosis, stage, developmental tendency, preferences, and prognosis of the disease. The most suitable overall treatment strategy for the patient must be formulated.

AIM:This study is formulated to reveal the variables affecting the radio-sensitivity in lung adenocarcinoma (LUAD). BACKGROUND:LUAD patients show varied radiotherapy responses. While epidermal growth factor receptor (EGFR) mutations are often used to predict sensitivity, their reliability is debated, underscoring the need for better biomarkers. OBJECTIVE:The aim of this study was to identify key functional proteins that regulate the sensitivity of LUAD to radiotherapy and to assess the potential value of exosomal LAMC1 as a clinical predictive marker. METHODS:In this study, 103 LUAD patients receiving concurrent radiotherapy were included to assess the relationship between EGFR mutation and survival. Intrinsic radio-sensitivity and different radio-sensitivities in 14 LUAD cell lines with/out EGFR mutation were examined based on the surviving fraction at 2 Gy (SF2). Data-independent acquisition (DIA) and Liquid chromatography-tandem mass spectrometry (LC-MS/MS)- based proteomics were used to investigate the proteomics of the LUAD cell lines. Subsequently, GO/KEGG enrichment analysis was combined with protein-protein interaction (PPI) network screening for key proteins. Nano-flow cytometry was employed to validate changes in radiosensitivity-associated protein expression within exosomes, while siRNA-mediated knockdown was performed to assess the functional impact of specific proteins on LUAD cells. RESULTS:EGFR mutations were not significantly associated with progression-free survival (PFS)/overall survival (OS). 14 LUAD cell lines displayed intrinsic variations in SF2, and no difference between the EGFR mutation and wild-type groups was reported. 5425 proteins were identified via DIA in 14 LUAD cell lines. After bio-informatics analysis, LAMC1, ITGB4, ITGA6, and CD44 were the most representative core differential proteins for the radio-sensitivity in LUAD cells. Notably, LAMC1 was confirmed as a radiation-resistant protein. Following radiotherapy, LUAD cells secreted exosomes with reduced LAMC1 levels. Moreover, LAMC1 knockdown significantly affected cellular proliferation and apoptosis following the irradiation. CONCLUSION:LAMC1 serves as a critical functional determinant of radiotherapy resistance in LUAD. Its dynamic changes in exosomes demonstrate potential for predicting radiotherapy response, suggesting clinical utility for radiosensitivity assessment and personalized radiotherapy guidance.

目的 螺旋断层放疗在保护多病灶、大肿瘤周围的正常组织和器官,降低放疗的毒性反应方面有较大优势.本研究主要分析肺寡转移瘤患者应用螺旋断层调强大分割放射治疗的近期疗效和影响预后的危险因素.方法 回顾性分析2018年1月1日-2021年6月30日就诊于蚌埠医学院第一附属医院肿瘤放疗科的45例完成螺旋断层大分割放疗的肺寡转移瘤患者资料.采用Kaplan-Meier方法计算总生存(OS)、局部控制(LC)和无进展生存(PFS),运用Cox比例风险模型明确患者预后的独立影响因素.治疗相关毒性采用美国国家癌症研究所常见不良事件评价标准(CTCAE)5.0版本评价.结果 截至2021年9月30日,全组患者均完成放疗计划,随访时间为16.0(12.3,24.2)个月,生物等效剂量为76.8(72.8,90.0)Gy.1年与2年OS率分别为94.8％、58.1％;1年与2年LC率分别为83.8％、74.1％;1年与2年PFS率分别为57.8％、43.3％.单因素分析显示Karnofsky功能状态评分(KPS)＞80分与高LC率有关(P=0.043).多因素分析显示确诊肺转移前有无远处淋巴结转移患者OS比较差异有统计学意义(P=0.041,HR=3.014,95％CI:1.043～8.706);是否使用四维计算机断层扫描术定位患者PFS比较差异有统计学意义(P=0.035,HR=2.693,95％CI=1.072～6.761).无治疗相关性死亡及≥3级的放射性肺炎发生.结论 螺旋断层调强大分割放射治疗技术在肺寡转移瘤的治疗上是安全有效的,并且KPS＞80分、确诊肺转移前无远处淋巴结转移的患者有较长的生存时间.

目的:探讨发泡胶个体化体位固定技术在颈段及胸上段食管癌调强放射治疗中的应用价值.方法:选取在医院肿瘤放疗中心接受调强放射治疗(IMRT)的80例颈段及胸上段食管癌患者,按不同体位固定方式将患者分为发泡胶组和头枕组,每组40例.发泡胶组采用个体化发泡胶联合头颈肩热塑膜固定体位,头枕组采用标准聚氨酯头枕联合头颈肩热塑膜固定体位.采集每例患者放射治疗前3次和治疗后每周1次的锥形束CT(CBCT)图像,并与计划CT图像进行配准后分别记录在左右、上下及前后方向上的重复摆位误差值,并根据3个方向的误差值计算出三维摆位误差.采用问卷调查形式评估患者对固定装置及技师操作的主观治疗舒适满意度.结果:发泡胶组和头枕组摆位误差左右方向分别为(0.76±0.97)mm和(1.78±1.33)mm;上下方向分别为(0.82±1.02)mm和(2.29±1.45)mm;三维摆位误差分别为(2.97±1.13)mm和(4.34±1.65)mm,差异均有统计学意义(t=8.78,t=11.89,t=1.74;P<0.05);前后方向分别为(0.97±0.82)mm和(1.10±0.97)mm;两者比较差异无统计学意义.发泡胶组和头枕组≥5 mm的三维摆位误差累积频率分别为11.9％和24.4％,其差异有统计学意义(x2=16.73,P<0.05);发泡胶组和头枕组患者的主观舒适满意度分别为87.5％和57.5％,其差异有统计学意义(x2=9.03,P<0.05);结论:发泡胶个体化体位固定技术在颈段及胸上段食管癌IMRT中,能够减少患者的摆位误差,提高患者摆位精度和舒适度,具有临床应用价值.

Lung cancer is the most common cause of cancer-related deaths. Moreover, exploring efficient tumor-killing drugs is urgently needed. In our study, several derivative compounds of myricetin were synthesized and tested. Experiments on non-small cell lung cancer (NSCLC) showed that S4-2-2 (5,7-dimethoxy-3-(4-(methyl(1-(naphthalen-2-ylsulfonyl)piperidin-4-yl)amino)butoxy)-2-(3,4,5-trimethoxyphenyl)-4H-chromen-4-one) had the strongest effect on A549 cell inhibition across all compounds. Furthermore, S4-2-2-treated A549 cells were also suppressed when transplanted into immunodeficient mice. Particularly, we found that the migration and invasiveness of A549 cells became suppressed upon treatment with S4-2-2. Furthermore, the compound significantly induced cell apoptosis, but did not affect the cell cycle of A549 cells. Finally, we revealed that S4-2-2 inhibited the biological function of NSCLC cells by regulating the protein process in the endoplasmic reticulum, and then by inducing the expression of apoptosis-related proteins. Taken together, S4-2-2 was shown to act as a potential molecular inhibitor of A549 cells.

Objective:To evaluate the efficacy and safety of apatinib in combination with chemoradiotherapy for head and neck squamous cell carcinoma (HNSCC).Methods:37 patients orally received apatinib at 250 mg/d during concurrent chemoradiotherapy until completion of radiotherapy, complete remission assessed by imaging examination, the onset of unacceptable toxicity or death. Baseline characteristics, objective response rates (ORR) and adverse events were assessed in all enrolled patients with complete baseline and safety data. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method. Prognostic factors were statistically identified using Cox regression models.Results:The ORR was 85%(95% CI: 72%-98%). The median PFS was 17.9 months and the 2-year OS rate was 62%(95% CI: 48%-80%). Ineffective short-term efficacy ( HR=0.035, 995% CI: 0.02-0.652, P=0.025) was an independent risk factor for poor OS. In addition, ineffective short-term efficacy ( HR=0.104, 95% CI: 0.017-0.633, P=0.014) and lymphocytopenia ( HR=17.539, 95% CI: 2.040-150.779, P=0.009) were independent risk factors for poor PFS. Common adverse events (>60%) included lymphocytopenia (76%), leukopenia (68%) and irradiation-induced mucosal injury (65%). The most common treatment-associated grade 3 adverse event was lymphopenia (49%). Conclusions:Apatinib combined with chemoradiotherapy yield significant anti-tumor activity for HNSCC with controllable toxicity. For patients with advanced HNSCC, short-term efficacy and lymphocytopenia may be potential predictors for clinical efficacy of apatinib combined with chemoradiotherapy.

临床教学是现代医学培训的重要环节,对于提升学生对理论知识的理解和实践能力具有重要意义.放射肿瘤学理论知识复杂,临床表现特点丰富,必须引起医学培训教师的重视.要想合理化进行放射肿瘤学的临床教学,教师必须正确认识现阶段临床教学中亟须解决的问题并进行合理化改善,才能推进医学教育的不断进步,推进放射肿瘤学的不断发展,最终帮助患者减轻痛苦,延续生命.

Standard treatments for patients with metastatic non-small cell lung cancer (NSCLC) include palliative chemotherapy and radiotherapy, but with limited survival rates. With the development of improved immunotherapy and targeted therapy, NSCLC prognoses have significantly improved. In recent years, the concept of oligometastatic disease has been developed, with randomized trial data showing survival benefits from local ablation therapy (LAT) in patients with oligometastatic NSCLC (OM-NSCLC). LAT includes surgery, stereotactic ablation body radiation therapy, or thermal ablation, and is becoming an important treatment component for OM-NSCLC. However, controversy remains on specific management strategies for the condition. In this review, we gathered current randomized trial data to analyze prognostic factors affecting patient survival, and explored ideal treatment conditions for patients with OM-NSCLC with respect to long-term survival.

目的 探讨发泡胶联合热塑膜在头颈部肿瘤放疗中的应用效果.方法 选取2019年1-12月该院收治的86例接受放疗的头颈部肿瘤患者为研究对象,按照固定模具方法分成观察组和对照组,每组43例.对照组采用颈部固定标准套枕加头颈肩板作为底座,观察组采用发泡胶泡沫垫加头颈肩板作为底座.TOMO机载MV级图像引导系统对摆位误差进行验证,比较两组患者头颈部上下、头脚、左右的摆位误差值情况.结果 观察组患者上下、头脚、左右的摆位误差值均明显小于对照组,差异有统计学意义(P<0.05).两组患者颈部摆位误差基本随放疗次数的增加而加大,观察组放疗过程中颈部上下、头脚、左右摆位误差均明显小于对照组,差异有统计学意义(P<0.05).结论 发泡胶联合热塑膜应用于头颈部肿瘤放疗中可明显提高摆位精度和重复性.

目的 分析放疗前外周血中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞计数比(PLR)对局部晚期下咽鳞状细胞癌患者的预后评估价值.方法 回顾性分析2017年2月-2018年12月蚌埠医学院第一附属医院放疗科收治的27例接受单纯放疗、序贯放化疗或同步放化疗下咽癌患者的临床以及随访资料.通过建立受试者工作特征曲线,获得最佳界值,根据界值将患者分为高NLR组、低NLR组以及高PLR组、低PLR组,分析患者放疗前外周血NLR和PLR与临床病理特征及预后的相关性,通过Kaplan-Meier法绘制患者的生存曲线,log rank法比较患者的预后,通过Cox比例风险回归模型进行多因素分析.结果 27例患者中,有10例患者生存,中位随访时间为34个月,中位生存时间为21个月.放疗前NLR的最佳界值为2.30,PLR的最佳界值为131.46.放疗前高NLR组和低NLR组患者的2年总生存率分别为18.8％和45.5％(P =0.006).放疗前高PLR组和低PLR组患者的2年总生存率分别为18.8％和45.5％ (P =0.040).Log rank单因素分析显示肿瘤临床分期、治疗方式、放疗前NLR和放疗前PLR与患者的总生存有关(均P＜0.05).多因素分析结果显示,肿瘤临床分期和治疗方式为影响患者总生存的独立因素.结论 放疗前NLR、PLR升高对于接受放疗的下咽癌患者可能是预后不良的影响因素,但仍需进一步深入研究.

目的 探讨杨梅素衍生物对人非小细胞肺癌A549细胞增殖及凋亡的影响和放射增敏作用.方法 将修饰后的杨梅素溶解在DMSO中,A549细胞被分成DMSO对照组和杨梅素衍生物组,MTT及Ki67实验检测A549细胞的增殖能力,Tran-swell检测A549细胞的侵袭能力,流式细胞术检测A549细胞的凋亡,Western blot法检测A549细胞中Bax、Bcl-2、P53、cleavedCaspase-3的表达情况.集落形成实验检测杨梅素衍生物对A549细胞的放射增敏作用.结果 与对照组比较,杨梅素衍生物组A549细胞活力降低(P<0.001),A549细胞的增殖指数下降(P<0.01),同时A549细胞的侵袭能力减弱(P<0.001),细胞凋亡比例增加(P<0.05).Western blot结果显示杨梅素衍生物处理后A549细胞中Bax/Bcl-2的比值增大,P53表达减少,cleaved Caspase-3表达增强(P<0.001).集落形成实验显示杨梅素衍生物的放射增敏参数SER为1.31.结论 杨梅素衍生物可通过诱导细胞凋亡相关蛋白的表达,降低A549细胞的增殖及侵袭能力,同时可作为放射增敏剂提高放疗疗效.

Background : With continued improvement in radiotherapy technology, hypofractionated radiotherapy has helped achieve good results in the local control and toxicity of pulmonary oligometastases. This study aimed to investigate the efficacy of radiotherapy and the prognostic factors that affect survival in patients with pulmonary oligometastases who undergo helical tomotherapy (TOMO) hypofractionated radiotherapy. Methods : Ninety pulmonary oligometastases in 40 patients (26 males, 14 females; median age 57 years) were retrospectively investigated and treated with hypofractionated radiotherapy in the Department of Oncology and Radiotherapy of the First Affiliated Hospital of Bengbu Medical College during 2018-2020. Their Karnofsky performance status (KPS) was ≥70 points. The primary endpoints were overall survival (OS), local control (LC), and progression-free survival (PFS), and we determine the related influencing factors. Results : The median gross tumor volume (GTV) and planning target volume (PTV) were 9.7 cm³ (range 1.1–287.0 cm³) and 56.9 cm³ (range 16.3–494.2 cm³), respectively, the median biological effective dose, α/β=10 (BED10), was 76.8 Gy (range 56-96 Gy), and four-dimensional computed tomography positioning was applied to 52.5% of the patients. All patients completed the treatment plan during a median follow-up of 16.1 months (range 4.9–33.3 months). The 1- and 2-year OS rates were 90.3% and 55.2%, respectively. The 1- and 2-year LC rates were 80.8% and 64.7%, respectively. The 1- and 2-year PFS rates were 47.3% and 28.4%, respectively. Univariate analysis revealed that colorectal primary (p=0.004), age >57 years (p=0.037), and number of organ metastases ≥2 (p=0.046) were associated with OS, whereas disease-free interval (DFI) ≤17.4 months (p=0.032), number of lung metastases≥2 (p=0.049), and PTV >56.9 cm³ (p=0.041) were associated with LC; and number of metastatic organs ≥2 (p=0.015) was independently associated with PFS. In multivariate analysis, colorectal cancer (p=0.010) and age >57 years (p=0.009) were significantly associated with OS. No > grade 3 toxic reaction. Conclusions : The median OS, LC, and PFS rates of TOMO hypofractionated radiotherapy for pulmonary oligometastases were 24.9, 25.9, and 11.8 months, respectively, showing that good survival rates and low toxicity could still be achieved using the medium dose.

头颈部鳞状细胞癌是全球第六大常见恶性肿瘤,在我国发病率为135.1/10万.头颈部解剖复杂,临床表现多样,早期诊断困难,因此,早诊断早治疗研究探索空间较大.类器官(Organoid)是一种体外3D培养技术,与对应的器官拥有类似的空间组织及生物学功能,是一种较好的肿瘤研究模型.因此,头颈部鳞状细胞癌类器官逐渐受到重视,有望广泛应用于头颈部鳞状细胞癌的研究.本文综述重点讨论类器官技术的研究进展及其在头颈部鳞状细胞癌研究中的应用情况.

Background: To investigate the biological basis of radiosensitivity difference in lung adenocarcinoma cells, EGFR mutant or a wide variety of signal pathways？ Methods: There were fourteen lung adenocarcinoma cell lines used to carry out experiments in this study. The SF2 experimental test data of fourteen cell lines used in this study are from the previous work we did. EGFR mutation in each cell line detected by Next-Generation Sequencing. Statistical difference in SF2 about fourteen cells used the Kruskal-Wallis test. Correlation between EGFR mutant or not and SF2 analyzed by Student’s t-test. The proteomes of the 14 lung adenocarcinoma organisms were identified by DIA in LC-MS/MS proteomic technology. P < 0.05 showed statistical significance. R language software was used to perform the bioinformatics analysis. Results: The SF2(Surviving fractional 2Gy ) median value is 0.351(0.122-0.825). The number of cell lines in the EGFR mutatant-type is five, wild-type is nine. We obtained a mean coverage of 5425 proteins from fourteen lung adenocarcinoma cell lines. There are thirty-nine different expression proteins in total. Significant differences of SF2 was found among fourteen cell lines (P=0.004 < 0.05). showed that there is no correlation between the EGFR mutant-type group and the EGFR wild-type group（P=0.822> 0.05）. The R language analyzed based on proteomic explored that there were thirty-nine DEPs(differently expresse proteins) and four KEGG pathways: ECM-receptor interaction, Focal adhesion, Hematopoietic cell lineage, and Prion diseases. LAMC1, ITGB4/ITGA6, and CD44 participated in multiple signaling pathways. PPI examined that LAMC1, ITGB4/ITGA6, CD44, FLNB, CD59, PRNP interacted more concentratedly. Conclusion: The inherent radiosensitivity of lung adenocarcinoma cell lines is not determined by the status of EGFR mutant, maybe by other signal pathways such as LAMC1, ITGB4/ITGA6, CD44, and PRNP.

针对当前计算机网络实验教学中存在的问题,为适应新工科建设背景下物联网工程专业人才的培养,提出了实验教学改革措施.主要从虚拟仿真实验平台建设、创新实验内容、教学模式改革、实验教学评价等方面对计算机网络实验教学进行探索与实践.实践表明,新的实验教学模式和评价体制更能激发学生的兴趣,更有利于学生实践创新能力的培养.

目的:分析在临床见习本科生肿瘤放射治疗学教学中应用PBL结合CBL教学法的效果.方法:选取2015级临床医学本科生46名,随机分为传统教学组23名和PBL+CBL教学组23人,比较教学满意度及出科考试成绩.结果:传统教学组在提高自学能力、提高临床实践能力和培养临思维能力方面的满意度,显著低于PBL+CBL教学组的满意度,两组相比,差异具有统计学意义(P<0.05).在出科考试中,传统教学组学生成绩为(75.15±4.32),P B L+C B L教学组成绩为(83.35±3.68),两组出科考试成绩相比,差异具有统计学意义(P<0.05).结论:在临床医学本科生肿瘤放射治疗学临床见习带教中应用PBL+CBL相结合的教学模式,极大地调动了学生的学习主动性,激发学习热情,提高了学生分析问题、解决问题的能力,起到较好的教学效果.

Objective:To compare the survival rate and adverse reactions of patients with advanced hypopharyngeal squamous cell carcinoma undergoing surgery combined with chemoradiotherapy, and to analyze the prognostic factors of patients.Methods:The clinicopathologic data of 78 patients with advanced hypopharyngeal squamous cell carcinoma admitted to the Department of Radiation Oncology of the First Affiliated Hospital of Bengbu Medical University from August 2013 to December 2018 were retrospectively analyzed. The patients were divided into surgery combined with chemoradiotherapy group ( n=27) and chemoradiotherapy group ( n=51) according to different treatment methods. The median follow-up time was 46 months (20-84 months). The main observation indicators were overall survival (OS), progression-free survival (PFS) and local control rate (LCR). Cox regression model was used to analyze the prognostic factors. Results:Until July 31, 2020, 51 of the 78 patients with advanced hypopharyngeal squamous cell carcinoma died, including 6 cases of local recurrence, 11 cases of distant metastasis, and 34 cases of other causes (15 cases of hemorrhage, 15 cases of cachexia, and 4 cases of other diseases). In the surgery combined with chemoradiotherapy group, 12 patients died, accounting for 44.44%. In the chemoradiotherapy group, 39 patients died, accounting for 76.47%. The 1-, 3- and 5-year OS rates of 78 patients were 57.7%, 36.3% and 27.2% respectively, the 1-, 2- and 3-year PFS rates were 49.5%, 38.7% and 32.6% respectively, and the 1-, 2- and 3-year LCR were 53.4%, 40.0% and 34.2% respectively. The 1-, 3- and 5-year OS rates in the surgery combined with chemoradiotherapy group were 74.1%, 50.1% and 44.6%, and those in the chemoradiotherapy group were 49.0%, 29.3% and 12.8%, with a statistically significant difference ( χ2=5.142, P=0.023). The 1-, 2- and 3-year PFS rates in the surgery combined with chemoradiotherapy group were 62.1%, 54.3% and 44.4%, and those in the chemoradiotherapy group were 43.1%, 30.6% and 26.7%, with no statistically significant difference ( χ2=3.222, P=0.073). The 1-, 2- and 3-year LCR of the surgery combined with chemoradiotherapy group were 69.8%, 54.3% and 44.4%, and those in the chemoradiotherapy group were 45.1%, 32.9% and 29.6%, with no statistically significant difference ( χ2=3.576, P=0.059). The results of univariate analysis showed that tumor T stage ( χ2=7.140, P=0.008), N stage ( χ2=4.493, P=0.034) and treatment method ( χ2=5.142, P=0.023) were all independent influencing factors of the OS of patient with advanced hypopharyngeal squamous cell carcinoma; T stage ( χ2=5.807, P=0.016) and N stage ( χ2=6.587, P=0.010) were both independent influencing factors of PFS. The results of multivariate analysis showed that tumor T stage ( HR=2.121, 95% CI: 1.142-3.938, P=0.017), N stage ( HR=2.088, 95% CI: 1.144-3.811, P=0.016) and treatment method ( HR=0.430, 95% CI: 0.226-0.815, P=0.010) were all independent prognostic factors of the OS of patients with advanced hypopharyngeal squamous cell carcinoma; T stage ( HR=1.884, 95% CI: 1.011-3.510, P=0.046) and N stage ( HR=1.904, 95% CI: 1.058-3.429, P=0.032) were both independent prognostic factors of PFS. During the treatment period, there were statistically significant differences in the incidences of radioactive pharyngitis [7.41% (2/27) vs. 39.22% (20/51), χ2=8.821, P=0.003] and radioactive dermatitis [3.70% (1/27) vs. 29.41% (15/51), χ2=7.156, P=0.007] between the surgery combined with chemoradiotherapy group and the chemoradiotherapy group. However, there were no statistically significant differences in the incidences of radioactive oral mucositis [11.11% (3/27) vs. 17.65% (9/51), χ2=0.186, P=0.666], bone marrow suppression [37.04% (10/27) vs. 50.98% (26/51), χ2=1.381, P=0.240], pharynx infection [11.11% (3/27) vs. 5.88% (3/51), χ2=0.143, P=0.706] and tracheal fistula [7.41% (2/27) vs. 0 (0/51), P=0.117] between the two groups. Conclusion:The 1-, 3- and 5-year OS rates in the surgery combined with chemoradiotherapy group are higher than those in the chemoradiotherapy group, and the incidences of adverse reactions are low. T stage, N stage and treatment method are independent prognostic factors for OS of advanced hypopharyngeal squamous cell carcinoma patients, while T stage and N stage are independent prognostic factors for PFS.

目的:分析根治性放射治疗对局部晚期下咽癌的临床疗效,并对其影响预后的相关因素进行评价.方法:回顾性分析2016年10月至2018年12月25例局部晚期下咽癌病人的临床资料,通过Kaplan-Meier法计算总生存时间,应用Cox比例风险回归模型进行单因素和多因素分析.结果:近期有效率为100％.中位生存时间为17个月,2年生存率为32.0％.通过单因素分析,结果显示N分期、临床分期、近期疗效、是否同步化疗与生存预后有关(P<0.01).多因素分析结果表明,临床分期和是否同步化疗是下咽癌病人预后的独立影响因素(P<0.01和P<0.05).结论:根治性放射治疗局部晚期下咽癌近期疗效确切,临床分期和是否同步化疗是影响其预后的独立危险因素.

本文在分析MOOC平台和SPOC平台教学现状的基础上,采用理论与实践相结合、线上与线下相结合的理念,将MNSS与目前的爱慕课、雨课堂、超星泛雅等在线MOOC平台及各个学校自建的SPOC平台相结合,形成完备的"MOOC+MOOP+SPOC"大规模混合教学平台.应用该模式有利于学生进行碎片化学习,有效促进学生实践课程的学习,提高学生的实践动手能力.