PURPOSE:The efficacy and safety of TPF-induced chemotherapy(IC) combined with concurrent chemoradiotherapy(CCRT) compared to CCRT and sequential PF-adjuvant chemotherapy(AC) lack phase III randomized controlled clinical trials for evaluation, so the comparative efficacy and safety between the two approaches remain unclear. METHODS AND MATERIALS:This randomized clinical phase III trial recruited patients from May 2018 to July 2021,at 4 institutions in China(NCT03574324), 266 patients were enrolled and randomly assigned to either the IC or AC groups. The IC group received TPF followed by CCRT, while the AC group received CCRT followed by PF. We are reporting on the primary outcome of progression-free survival (PFS) and secondary endpoints of overall survival(OS), locoregional relapse-free survival(LRFS), distant metastasis-free survival(DMFS), and toxicity profile. RESULTS:The 3-year PFS was similar between the two groups, with 79 % for the IC group and 74.5 % for the AC group (P = 0.454) at a median follow-up of 39 months. Similar findings were observed, with no significant disparities in OS, LRFS, and DMFS between the two treatment cohorts. Both groups had similar compliance rates for radiotherapy and chemotherapy. However, the IC group experienced fewer grade toxic effects during CCRT, such as nausea/vomiting, swallowing, and dryness (101[77.10 %] vs. 114[89.06 %] patients,40 [30.53 %]vs56 [43.75 %] patients and 58 [44.27 %]vs86 [67.19 %] patients, respectively). However,3-4 grade leukopenia and neutrophilia patients were increased(58 [44.27 %]vs28 [21.88 %] patients and 78 [59.54 %]vs24 [18.75 %]) in the IC group. CONCLUSIONS:In this randomized clinical trial, IC did not improve 3-year PFS for LA-NPC patients and increased hematological toxicity. Still, the advantage of it is that it did reduce the incidence rates of nausea/vomiting, swallowing, and dry mouth during radiotherapy.

e18034 Background: To research whether TPF (Docetaxel plus Fluorouracil plus Cisplatin) chrono-chemotherapy combined with cisplatin concurrent chemoradiotherapy can reduce long-term toxicity without affecting the survival of patients with de novo metastatic nasopharyngeal carcinoma (mNPC) compared with conventional chemotherapy combined with cisplatin concurrent chemoradiotherapy. Methods: A retrospective analysis of the clinical data of 121 de novo mNPC patients who treated with TPF chemotherapy at our hospital from January 1, 2012, to December 31, 2018. Among them, 79 patients were treated with chrono-chemotherapy and 42 patients were treated with conventional chemotherapy. The specific chemotherapy regimen for chrono-chemotherapy group:TPF induction chemotherapy for 2-4 cycles, docetaxel: 75mg/m2, ivgtt, d1; Cisplatin: 75mg/m2, civ, d1-5, 60h (10Am—10Pm); 5-Fluorouracil: 750mg/m2/d, civ, administered by intravenous infusion of electronic chemotherapy automatic injection pump d1-5, 60 hours (10 Pm-10 Am), 21 days/cycle. The evaluation of therapeutic efficacy after induction should involve intensity-modulated radiotherapy for at least patients with stable disease, during which concurrent cisplatin chemotherapy is administered. Two cycles of adjuvant chemotherapy were administered 1 month after radiotherapy with the same regimen as induction chemotherapy. The total chemotherapy cycle was 4-6 cycles. The Kaplan-Meier method and log-rank test were used to estimate overall survival (OS) and progression-free survival (PFS), while the COX proportional hazards model was employed for multivariate analysis. Long-term toxic side effects between the two groups were assessed using the chi-square test or Mann-Whitney U test. Propensity score matching was utilized to address confounding factors. Results: At a median follow-up of 104 months, 69.6% of patients died in the chrono-chemotherapy group and 73.8% in the conventional chemotherapy group, and the median OS and PFS in the chrono-chemotherapy group and conventional chemotherapy group were 40 vs 32 months (P=0.636) and 30 vs 19 months, respectively (P=0. 975), there were no statistically significant differences in OS rates and PFS rates at 3, 5, and 7 years between the two groups before and after matching. The incidence of xerostomia, dysphagia, and trismus in the chrono-chemotherapy group matched for timing was significantly lower than that in the conventional chemotherapy group, with a statistically significant difference. (P<0.05). Conclusions: The TPF chrono-chemotherapy combined with cisplatin concurrent chemoradiotherapy reduces the incidence of toxic side effects while ensuring survival, which can benefit patients.

6100 Background: To investigate whether TPF induction chemotherapy combined with concurrent chemoradiotherapy (CCRT) can provide greater survival benefits compared to CCRT followed by PF adjuvant chemotherapy. Methods: Patients with newly diagnosed locally advanced (Stage III–IVA) nasopharyngeal carcinoma (NPC) treated at the Affiliated Tumor Hospital of Guizhou Medical University, the Second Affiliated Hospital of Guizhou Medical University, the Second Affiliated Hospital of Zunyi Medical University, and Guiyang Hospital of Guizhou Aviation from May 2018 to July 2021 were enrolled. Each group included 133 patients. The experimental group received 3 cycles of TPF induction chemotherapy (docetaxel 75mg/m²,intravenous infusion, Day 1; cisplatin 75mg/m²,continuous intravenous infusion over 5 days,10:00–22:00 daily; fluorouracil 750mg/m²/day, continuous intravenous infusion over 5 days, 22:00–10:00 daily) followed by 2–3 cycles of concurrent chemotherapy (cisplatin 100mg/m², continuous intravenous infusion over 2 days, 10:00–22:00 daily). The control group received PF adjuvant chemotherapy (cisplatin 80mg/m², continuous intravenous infusion over 5 days,10:00–22:00 daily; fluorouracil 800mg/m²/day, continuous intravenous infusion over 5 days, 22:00–10:00 daily) combined with 2–3 cycles of concurrent chemotherapy (same as induction chemotherapy).Both groups underwent intensity-modulated radiotherapy (IMRT),with total doses of 69.96 Gy for T1–T2 primary lesions, 72.6 Gy for T3–T4 lesions, and 69.96 Gy for positive lymph nodes. Data were analyzed using SPSS 26.0.Differences in 5-year PFS, OS, LRFS, DMFS, and adverse events were compared between the two groups. Results: No significant differences were observed between the two groups in age, sex, Karnofsky Performance Status (KPS) score, T stage, N stage, or overall stage ( P > 0.05).At a median follow-up of 58 months, the 5-year PFS in both the intention-to-treat and per-protocol populations was similar between the induction chemotherapy (IC) and adjuvant chemotherapy (AC) groups (66.6% vs 66.0%, P = 0.589; 75.3% vs 69.9%, P =0.471). The 5-year OS, LRFS, and DMFS rates were 73.0% vs 71.3% ( P =0.582), 87.4% vs 90.8% ( P =0.508), and 76.9% vs 72.6% ( P =0.267), respectively, with no significant differences. Conclusions: Both groups had similar 5-year PFS, OS, LRFS, DMFS, and long-term toxicity profiles. Clinical trial information: NCT03574324 . 5-year observation indicators for two groups. Observation indicators IC+CCRT CCRT+AC P value Risk ratio(95% CI) PFS ITT Population 66.6% 66.0% 0.589 0.89（0.58-1.36） PP Population 75.3% 69.9% 0.471 0.85（0.55-1.33） OS 73.0% 71.3% 0.582 0.88（0.55-1.39） LRFS 87.4% 90.8% 0.508 1.30（0.60-2.80） DMFS 76.9% 72.6% 0.267 0.75（0.45-1.25） OS, LRFS, and DMFS were all calculated in the ITT population.

Here we report long-term outcomes of adjuvant metronomic capecitabine in patients with locoregionally advanced nasopharyngeal carcinoma. In this multicenter, open-label, parallel-group, randomized, controlled, phase 3 trial, 406 patients who had completed definitive chemoradiotherapy were randomly assigned (1:1) to receive either adjuvant metronomic capecitabine (650 mg m-2 twice daily for 1 year) or observation. The primary endpoint was failure-free survival; secondary endpoints included overall survival (OS), distant failure-free survival, locoregional failure-free survival, and safety, as reported in this analysis. The trial met its primary endpoint. With a median follow-up of 71.3 months, metronomic capecitabine significantly improved OS (hazard ratio = 0.53, 95% confidence interval, 0.31-0.91, P = 0.019). Grade 3 adverse events occurred in 35 (17%) of 201 patients in the metronomic capecitabine group and 11 (6%) of 200 in the observation group; one (<1%) grade 4 neutropenia was reported. In a post hoc analysis, completion of the 1 year course was associated with improved OS, whereas dose reductions and relative dose intensity showed no association with OS. Patients with a higher post-radiotherapy neutrophil-to-lymphocyte ratio derived greater benefit from metronomic capecitabine. These findings support the long-term therapeutic benefit of adjuvant metronomic capecitabine in locoregionally advanced nasopharyngeal carcinoma. ClinicalTrials.gov identifier: NCT02958111 .

Intracranial neuroendocrine carcinoma (NEC) is a highly uncommon malignancy, accounting for approximately 0.74% of cases. It is characterized by rapid infiltration and poor survival rates. This case report details a 51-year-old woman who presented with headaches. Magnetic resonance imaging (MRI) identified an enhancing lesion in the right temporal lobe, and the diagnosis was confirmed by immunohistochemical (IHC) analysis. The patient underwent surgical resection, followed by chemoradiotherapy for recurrence, and subsequent Gamma Knife radiosurgery combined with bevacizumab. Notably, she has achieved a postoperative survival exceeding four years to date. This report comprehensively describes the clinical presentation, diagnostic workup, multidisciplinary treatment course, and favorable outcome, highlighting the potential for prolonged survival with aggressive, multimodal management.

Objective:To validate the safety and efficacy of chronochemotherapy for locoregionally advanced nasopharyngeal carcinoma(NPC). Methods:Participants for this phase 11 randomized controlled trial were recruited from the Department of Head and Neck Oncology at the Affiliated Cancer Hospital of Guizhou Medical University.Patients enrolled(128 in total,112 in the final analysis)between April 1,2017,and February 28,2018,were randomly divided into the chronochemotherapy and conventional chemotherapy groups.In the chronochemotherapy group,docetaxel was intravenously administered between 3:30 a.m.and 4:30 a.m.on day 1,followed by intravenous administration of cisplatin between 10:00 a.m.and 10:00 p.m.from day 1to day 5.In addition,5-fluorouracil was administered through a continuous intravenous pump between 10:00 p.m.and 10:00 a.m.(2nd day)from day 1 to day 5.In the conventional chemotherapy group,docetaxel(on day 1),cisplatin(on day 2),and 5-fluorouracil(from day 1 to day 5,120 h in total)were administered without time-specific constraints.Both groups underwent intensity-modulated radiation therapy with 6-MV X-rays.The gross target volume(GTV)comprised the nasopharyngeal GTV and cervical lymph node GTV.The primary endpoint was immune function,quantified by measuring den-dritic cell and lymphocyte subsets,whereas the secondary endpoints were therapeutic efficacy and incidence of adverse events.Pearson Chi-square test was applied to compare total events between the groups,Mann-Whitney U test was used to compare the DC subsets and toxicities,and Wilcoxon signed-rank test was used to compare the continuous variables between the two groups. Results:Chronochemotherapy preserved immune function,as evidenced by elevated levels of myeloid dendritic cells(P=0.394)and higher CD4/CD8 ratio(P=0.781).No significant difference in overall response rate,measured as the sum of complete and partial response rates,was observed between the groups(P=0.711).A reduction in the incidence of vomiting(P=0.002),stomatitis(P=0.028),and mucositis(P=0.028)was observed in the chronochemotherapy group.Leukopenia incidence rate was 83.3％and 92.3％in the chro-nochemotherapy and conventional chemotherapy groups,respectively(P=0.232). Conclusions:In patients with locoregionally advanced NPC,the overall response rate of chronochemotherapy is comparable to that of conventional chemotherapy;however,chronochemotherapy shows fewer adverse events.

PurposeThis study aimed to evaluate 5-year outcomes and the late toxicity profile of chrono-chemotherapy with different infusion rates in patients with locally advanced nasopharyngeal carcinoma (NPC).Methods and materialsOur retrospective analysis included 70 patients with locally advanced NPC stages III and IVB (according to the 2010 American Joint Committee on Cancer staging system). Patients were treated with two cycles of induction chemotherapy (IC) before concurrent chemoradiotherapy (CCRT) at Guizhou Cancer Hospital. The IC with docetaxel, cisplatin (DDP) and fluorouracil regimen. Patients were divided into two groups during CCRT. Using a “MELODIE” multi-channel programmed pump, DDP (100 mg/m2) was administered for 12 hours from 10:00 am to 10:00 pm and repeated every 3 weeks for 2-3 cycles. DDP was administered at the peak period of 4:00 pm in the sinusoidal chrono-modulated infusion group (Arm A, n=35). The patients in Arm B received a constant rate of infusion. Both arms received radiotherapy through the same technique and dose fraction. The long-term survival and disease progression were observed.ResultsAfter a median follow-up of 82.8 months, the 5-year progression-free survival rate was 81.3% in Arm A and 79.6% in Arm B (P = 0.85). The 5-year overall survival rate was not significantly different between Arm A and Arm B (79.6% vs 85.3%, P = 0.79). The 5-year distant metastasis-free survival rate was 83.6% in Arm A and 84.6% in Arm B (P = 0.75). The 5-year local recurrence-free survival rate was 88.2% in Arm A and 85.3% in Arm B (P = 0.16). There were no late toxicities of grade 3-4 in either group. Both groups had grade 1-2 late toxicities. Dry mouth was the most common late toxic side effect, followed by hearing loss and difficulty in swallowing. There was no statistically significant difference between Arm A and Arm B in terms of side effects.ConclusionLong-term analysis confirmed that in CCRT, cisplatin administration with sinusoidal chrono-modulated infusion was not superior to the constant infusion rate in terms of long-term toxicity and prognosis.

INTRODUCTION:Metronomic capecitabine used as an adjuvant therapy improves survival in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC). This therapeutic approach may also contribute to improving immune function, consequently enhancing overall therapeutic efficacy. AIM:We aimed to evaluate the effect of metronomic capecitabine as adjuvant therapy on immune function and survival in cases of LA-NPC. SUBJECTS AND METHODS:28 patients with LA-NPC were enrolled in the study and equally assigned to two groups of 14 each: experimental and control group. The experimental group received induction chemotherapy + concurrent chemotherapy + adjuvant chemotherapy as well as oral capecitabine at a dose of 650 mg/m² of body surface area twice daily for 1 year, with the option to discontinue in case of intolerance. The control group did not receive additional chemotherapy or targeted drugs after the induction chemotherapy + concurrent chemoradiotherapy; however, they were followed up regularly. Changes in immune function and survival were compared between the two groups. RESULTS:The median follow-up time was 43.5 months. One year after adjuvant chemotherapy, the experimental group showed higher levels of CD8 + cells, CD28 + CD8 + cells, and activated CD8 + cells compared to the control group (P < 0.05). The CD4/CD8 ratio and proportion of monocyte-derived dendritic cells were also higher in the experimental group than in the control group, but the difference was not statistically significant (P ≥ 0.05). Comparisons of 3-year overall survival, local-regional recurrence-free survival, progression-free survival, and distant metastasis-free survival between the two groups showed percentages of 92.9% vs. 78.6%, 92.9% vs. 92.9%, 78.6% vs. 71.4%, and 85.7% vs. 0.78 0.6% respectively, but these differences were not significant (P > 0 0.05 ). CONCLUSION:Metronomic capecitabine chemotherapy was observed to induce an immunomodulatory effect in LA-NPC. TRIAL REGISTRATION:NCT02958111, date of registration 04-11-2016.

PURPOSE:This prospective clinical trial aims to compare the efficacy and safety of gemcitabine plus cisplatin (GP) versus docetaxel plus cisplatin and fluorouracil (TPF) as induction chemotherapy combined with locoregional radiotherapy in de novo metastatic nasopharyngeal carcinoma (dmNPC). METHODS:146 dmNPC patients were randomly assigned in a 1:1 ratio to receive 4-6 cycles of GP (GP group) or TPF induction chemotherapy (TPF group) followed by locoregional radiotherapy (LRRT). The primary endpoint was overall survival (OS). Secondary endpoints consisted of progression-free survival（PFS）, objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events (AEs). RESULTS:As of data cutoff (May 31, 2024), the median follow-up time was 60.0 months (IQR 40.3-68.1). There is no significant difference in median OS (35.4 vs. 34.8 months, p = 0.2609) and PFS (15.8 vs. 14.3 months, p = 0.2318) between the GP and TPF groups. No significant differences in ORR (65.8 % vs. 71.2 %, p = 0.476) and DCR (79.5 % vs. 82.2 %, p = 0.674) were observed between GP and TPF group too. Furthermore, the 5-year OS was 40.1 % (95 % CI, 29.6 %-54.2 %) in the GP group, compared with 27.2 % (95 % CI, 17.9 %-41.3 %) in the TPF group（HR = 0.79, 95 % CI, 0.53-1.20). However, the TPF group had higher incidences of grade 3-4 AEs such as neutropenia, leukopenia, nausea, and diarrhea. CONCLUSION:The study indicates that 4-6 cycles of TPF induction chemotherapy combined with LRRT achieves a therapeutic effect comparable to the GP regimen with controllable safety.

目的 探讨外周血中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)对局部晚期鼻咽癌(NPC)患者预后评估的临床意义.方法 回顾性分析 200 例完成诱导化疗联合同步放化疗治疗的局部晚期鼻咽癌患者(Ⅲ-Ⅳa期)的临床病理资料及随访记录,收集患者行诱导化疗前的NLR、LMR,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC);判定患者NLR、LMR的最佳临界值;使用Cox风险模型分析确定影响局部晚期鼻咽癌患者5 年总生存率(OS)及无进展生存率(PFS)的独立危险因素;根据NLR、LMR的最佳临界值,将患者分为高风险组(NLR≥3.81 且LMR＜2.03)30 例、中风险组(NLR＜3.81 且LMR＜2.03,或NLR≥3.81 且LMR≥2.03)35 例及低风险组(NLR＜3.81 且LMR≥2.03)135 例,通过Kaplan-Meier分析其对生存的影响,并对3 组的T、N分期比较进行亚组分析.结果 ROC曲线计算结果显示,NLR、LMR对局部晚期鼻咽癌患者5 年OS率的最佳临界值分别为 3.81 和 2.03;多因素 Cox回归分析提示 N 分期(HR =0.425,95％CI为0.185～0.975,P＜0.05)、NLR≥3.81(HR=0.117,95％CI为0.048～0.282,P＜0.05)、LMR＜2.03(HR =0.449,95％CI为0.212～0.952,P＜0.05)是OS独立危险因素,同时N分期(HR =0.288,95％CI为0.141～0.589,P＜0.05)、NLR≥3.81(HR=0.215,95％CI为0.110～0.420,P＜0.05)是PFS的独立危险因素;高风险组、中风险组及低风险组患者的5 年OS率分别为 13.3％、68.6％、94.1％,差异具有统计学意义(χ2 =83.973,P＜0.05),5 年PFS率分别为6.7％、57.1％、84.4％,差异具有统计学意义(χ2 =47.286,P＜0.05),3 组的N分期为N3 的患者数所占比率分别为低风险组 35.6％、中风险组 37.1％、高风险组 80％,差异具有统计学分析意义(P＜0.05).结论 局部晚期鼻咽癌患者治疗前外周血NLR和LMR对患者的 5 年OS及PFS有较好预测价值,且联合NLR和LMR预测的价值可能更大.

To compare the toxicity and clinical efficacy of TL (docetaxel + lobaplatin) induction chemotherapy combined with lobaplatin concurrent chemoradiotherapy and TPF (docetaxel + cisplatin + 5-fluorouracil) induction chemotherapy combined with cisplatin concurrent chemoradiotherapy in the treatment of locally advanced head and neck squamous cell carcinoma. In total, 128 patients with locally advanced head and neck cancer were prospectively enrolled between August 2016 and April 2021. They were randomly divided into trial group and control group, all using chronological dosage mode. The trial group used TL regimen induction chemotherapy combined with lobaplatin concurrent chemoradiotherapy; the control group used TPF regimen induction chemotherapy and cisplatin concurrent chemotherapy. The endpoints were adverse events and survival rates at 1, 3 and 5 years. Median follow-up was 42 months (20–71 months). (1) Adverse events: During induction chemotherapy, compared with TPF group, grade 3–4 leukocytes and neutrophils, diarrhea, 1–2 hyperbilirubinemia, nausea / vomiting, oral mucositis, fatigue, anorexia, hyponatremia were significantly lower in TL group (p<0. 05): 6

Objective:To explore the effect of clinical conventional fractionated dose radiation on the expression levels of immunogenic cell death (ICD) related proteins in patients with nasopharyngeal carcinoma (NPC).Methods:A total of 38 newly-treated NPC patients admitted to the Affiliated Cancer Hospital of Guizhou Medical University from November 2020 to December 2021 were enrolled, all of whom received induction chemotherapy and concurrent chemoradiotherapy, and another 20 healthy volunteers were selected as controls for a prospective study. The contents of ICD related proteins, namely calreticulin (CRT), high mobility group box 1 protein (HMGB-1) and heat shock protein 70 (HSP70) and the proportion of dendritic cell (DC) in the peripheral blood of patients were detected before treatment, after induction chemotherapy and after concurrent chemoradiotherapy, respectively. The correlation between the above indicators, general clinical data and short-term efficacy was analyzed by statistical methods such as t-test and analysis of variance (ANOVA). Results:The levels of HSP70 and HMGB-1 in peripheral blood of NPC patients before treatment were higher than those of healthy controls (both P<0.05). After concurrent chemoradiotherapy, the content of CRT was significantly higher than that before treatment ( P<0.05), whereas the difference before and after induction chemotherapy and the difference before and after concurrent chemoradiotherapy were not significantly correlated with the short-term efficacy of NPC patients. HSP70 level was significantly decreased after concurrent chemoradiotherapy ( P<0.001). There were no significant differences in the content of HMGB-1 after induction chemotherapy and concurrent chemoradiotherapy (both P>0.05). Conclusion:NPC patients receiving TPF regimen (docetaxel+cisplatin+fluorouracil) for induction chemotherapy and sequential cisplatin concurrent chemotherapy may induce ICD in NPC cells, and CRT has potential value in reflecting the clinical efficacy of NPC.

目的 探讨lncRNA NEAT1对垂体瘤细胞侵袭、迁移的作用及机制.方法 qRT-PCR检测lncRNA NEAT1、miR-134和ITGB1表达;Transwell检测侵袭和迁移;双荧光素酶报告基因实验检测miR-134与 lncRNANEAT1、ITGB1 的调控关系;Western blot检测 ITGB1/FAK/PI3K通路相关蛋白表达.结果 敲低lncRNA NEAT1抑制GH3细胞侵袭和迁移(P＜0.05);抑制miR-134可逆转下调lncRNA NEAT1对GH3细胞侵袭、迁移的抑制作用(P＜0.05).miR-134与lncRNA NEAT1和ITGB1存在负靶向调控关系(P＜0.05).上调miR-134抑制GH3细胞侵袭和迁移,抑制ITGB1/FAK/PI3K通路激活(P＜0.05);ITGB1过表达削弱上调miR-134对GH3细胞的影响(P＜0.05).结论 下调lncRNA NEAT1靶向miR-134可能通过抑制ITGB1/FAK/PI3K通路激活抑制垂体瘤细胞侵袭、迁移.

目的 观察思维导图联合互动沟通模式在神经外科临床带教中的应用效果.方法 将2019年9月至2020年9月在贵州医科大学附属医院神经外科实习的40名学生纳入对照组,采取传统带教;将2020年10月至2021年10月在神经外科实习的40名学生纳入观察组,采取思维导图联合互动沟通模式带教.两组学生均带教2周,教学结束后评价教学效果.使用SPSS 25.0软件进行t检验和卡方检验.结果 带教2周后,两组学生的理论知识及实践操作技能考核评分均高于带教前,观察组理论知识(90.38±4.03)分、实践操作技能(93.37±3.48)分高于对照组(85.52±5.26)分、(87.25±4.48)分,两组比较差异有统计学意义(t=4.63、6.83,P＜0.001).两组学生的病例分析评分高于带教前,观察组(86.03±6.07)分高于对照组(79.13±5.57)分,两组比较差异有统计学意义(t=5.30,P＜0.001).两组学生的人际沟通能力、合作能力评分均高于带教前,观察组人际沟通能力(82.53±4.74)分、合作能力(169.73±7.55)分高于对照组(77.93±4.45)分、(158.42±8.01)分,两组比较差异有统计学意义(t= 4.48、6.49,P＜0.001).结论 思维导图联合互动沟通模式带教能够有效提高神经外科实习学生的临床基础知识及临床实践能力,提升学生的沟通及合作能力.

Objective:To explore the effects of Onodera′s prognostic nutritional index (PNI) on the prognosis of locally advanced oropharyngeal squamous cell carcinoma (LA-OPSCC) after induction chemotherapy followed by sequential chemoradiotherapy.Methods:A retrospective analysis was conducted on the clinical data of 52 LA-OPSCC patients receiving induction chemotherapy followed by sequential chemoradiotherapy in The Affiliated Cancer Hospital of Guizhou Medical University during 2014-2018. The PNI values of all the patients at different treatment phases were statistically analyzed, and the ROC curve was employed to determine the optimal critical value of PNI. The patients in this study were divided into a well-nourished group ( n = 27) and a poorly-nourished group ( n = 25). The Kaplan-Meier method was used for survival analysis. The Cox proportional hazards model was utilized to analyze the relationships between different nutritional status and prognosis. Clinical features and adverse reactions were compared between the two groups. Results:The PNI values decreased significantly after radiotherapy, with an optimal critical value of 42.4. The 5-year overall survival (OS) and progression-free survival (PFS) of the well-nourished group (PNI ≥ 42.4) were 62.6% and 60.9%, respectively, which were significantly higher than those (30.1% and 29.7%) of the poorly-nourished group (PNI < 42.4, χ2 = 11.12, 5.74, P < 0.05). The multivariate analysis showed that PNI was an independent prognostic factor for the OS after radiotherapy ( HR = 2.752, 95% CI: 1.095-6.917, P = 0.031). The LA-OPSCC patients aged over 60 years or those who did not respond to induction chemotherapy accounted for a higher proportion of malnutrition after chemoradiotherapy ( χ2 = 4.89, 5.05, P < 0.05). Conclusions:PNI after radiotherapy can be used as a prognostic factor in the evaluation of LA-OPSCC patients receiving induction chemotherapy followed by sequential chemoradiotherapy. The LA-OPSCC patients aged over 60 years or those who do not respond to induction chemotherapy should receive more nutritional support during the chemoradiotherapy.

This study was implemented for the evaluation on the circulating endothelial cells’ (CECs) clinical significance in the locally advanced nasopharyngeal carcinoma treatment with endostatin-combined chemoradiotherapy. This study enrolled 47 patients with locally advanced nasopharyngeal carcinoma who were hospitalized from May 9, 2012 to March 10, 2013. These patients were split up into the observation group (25 patients) and control group (22 patients). Patients in the observation group received the endostatin combined with induction chemotherapy and subsequently with concurrent chemoradiotherapy with endostatin. Patients in the control group were treated with inductive chemotherapy followed by concurrent chemoradiotherapy. CECs in peripheral blood were conducted separately before or after inductive chemotherapy and additionally in the end of concurrent chemoradiotherapy. The CEC values of the observation group showed significant statistical differences (p<0.05) before or after different therapies, whereas those data in the control group were not statistically different. And, the mostly importantly, the CEC values in the observation group and control group turned out a statistical difference. The combination of endostatin and chemoradiotherapy significantly reduced parameters of peripheral blood CECs in these patients. According to the CEC parameters’ variety that we observed in the combined therapies, this study demonstrated that the CECs might be a clinical clue to evaluate this antiangiogenic chemoradiotherapy. And the clinical value of CECs will be further determined along with increasing comparative studies and clinical long-term efficacy observation.

目的 分析老年声门型喉癌患者保留甲状软骨喉部分切除术后复发的影响因素.方法 回顾性分析接受保留甲状软骨的喉部分切除术且术后完成1年随访的135例声门型喉癌患者病历资料,依据随访期间是否复发分为复发组和未复发组.翻阅患者病历资料,记录并比较两组一般资料,通过单因素与多因素分析,找出老年声门型喉癌患者保留甲状软骨喉部分切除术后复发的影响因素.结果 135例病历资料中,有17例(12.59％)术后出现复发;复发组前联合侵犯、TNM分期(Ⅲ期)、切缘阳性和吸烟史占比均高于未复发组,差异有统计学意义(P<0.05);经多项Logistic回归分析结果显示,前联合侵犯、TNM分期Ⅲ期、切缘阳性和吸烟史均是老年声门型喉癌患者保留甲状软骨喉部分切除术后复发的影响因素(OR>1,P<0.05).结论 老年声门型喉癌患者保留甲状软骨喉部分切除术后复发可能受前联合侵犯、TNM分期、切缘阳性和吸烟史等多种因素的影响.

Objective:To explore the clinical significance and prognostic value of fibrinogen (FIB) in the treatment of locally advanced head and neck squamous cell carcinoma with induction chemotherapy combined with radiotherapy.Methods:A retrospective analysis was conducted for the clinical data of 114 patients with locally advanced head and neck squamous cell carcinoma receiving non-surgical treatment in the Department of Head and Neck Oncology, the Affiliated Cancer Hospital of Guizhou Medical University from May 2011 to May 2021. The FIB critical value was determined based on the median FIB level before induction chemotherapy, by which patients were divided into high-FIB and low-FIB groups. The ROC curves were used to determine the optimal cut-off value for other hematologic-related parameters such as neutrophils, lymphocytes, and platelets. Statistical methods were used to analyze the results. The enumeration data were analyzed by Chi-square test or Fisher exact probability method. Survival curves for OS and PFS were plotted by Kalplan-Meier method and tested by Log-rank method. Prognostic factors were evaluated by Cox proportional hazard regression model.Results:There were 59 cases in the high-FIB group (FIB > 3.6 g/L) and 55 cases in the low-FIB group (FIB ≤ 3.6 g/L). The high FIB group had higher neutrophils, platelets, NLR, and PLR ( χ2= 7.84, 12.80, 15.04, 9.14; P<0.05) than the low FIB group. The 3- and 5-year overall survival (OS) rates were significantly longer in the low FIB group than those in the high-FIB group (62.9% vs. 39.6%; 46.9% vs. 25.8%), and progression-free survival (PFS) rates of the low FIB group significantly longer than those of the high-FIB group (63.3% vs. 40.3%; 48.1% vs. 26.2%). The univariate analysis showed that the OS and PFS in patients with locally advanced head and neck squamous cell carcinoma were related to FIB, the application of concurrent chemoradiotherapy, and the efficacy of radiotherapy for lymph nodes. The multivariate analysis showed that FIB, the application of concurrent chemoradiotherapy, and the efficacy of radiotherapy for lymph nodes were independent prognostic factors of the OS [ HR (95% CI): 1.89 (1.08-3.31), 3.76 (1.12-12.65), 2.14 (1.09-4.21), P < 0.05]and PFS HR (95% CI): 1.92 (1.90-3.36), 3.93 (1.01-11.34), 2.15 (1.09-4.22), P < 0.05]of patients with locally advanced head and neck squamous cell carcinoma. Conclusions:Patients with low FIB receive high OS and PFS rates after induction chemotherapy combined with radiotherapy. Therefore, FIB can be used as a prognostic factor in the evaluation of non-surgical treatment of patients with locally advanced head and neck squamous cell carcinoma.

目的 研究Per1对鼻咽癌CNE2细胞增殖、凋亡、侵袭及细胞周期分布的影响,初步探讨Per1在鼻咽癌中可能扮演的角色.方法 通过实时荧光定量PCR法及蛋白质印迹法检测低分化鼻咽癌细胞CNE2及正常鼻咽上皮细胞NP69中核心生物钟基因Per1 mRNA及蛋白的表达;采用基因过表达及干扰技术将实验分为过表达组(Per1-oe)、过表达对照组(Per1-oeNC)、干扰组(Per1-shRNA-646)、干扰对照组(CNE2)和空载体组(control-shRNA);采用CCK8测定Per1-shRNA、control-shRNA和CNE2组细胞增殖能力;采用流式细胞仪分析Per1对CNE2细胞周期分布的影响;采用Transwell小室及细胞划痕实验验证过表达和低表达各组细胞的迁移及侵袭能力.结果 CNE2细胞Per1 mRNA表达量为0.002±0.001,低于NP69细胞的1.000±0.001,t=4771.56,P<0.05;CNE2细胞Per1蛋白表达为0.60±0.15,低于NP69细胞的0.90±0.26,t=4.267,P<0.05.流式细胞分析显示,CNE2、control-shRNA和Per1-shRNA组S期比例分别为(36.54±0.19)％、(36.18±0.69)％和(44.31±0.36)％(F=323.423,P<0.001),G1期比例分别为(52.88±1.27)％、(53.72±0.51)％和(37.68±0.62)％(F=55.356,P<0.001),G2/M期比例分别为(10.58±1.21)％、(10.10±0.88)％和(18.00±0.98)％,F=296.47,P<0.001.CCK8实验检测0～5 d的光密度值,CNE2、con-trol-shRNA和Per1-shRNA组差异有统计学意义,F=10.63,P<0.001;两两比较显示,Per1-shRNA组高于CNE2和control-shRNA组,均P<0.05.细胞划痕实验显示,CNE2、control-shRNA和Per1-shRNA组24 h迁移率分别为(15.02±0.57)％、(14.46±1.08)％和(21.55±0.52)％,F=66.241,P<0.001;干扰Per1使细胞迁移率增高,Per1-oe组24 h迁移率(7.00±1.59)％低于Per1-oeNC组(14.00±2.36)％(t=3.394,P<0.05),Per1-oe组48 h迁移率(18.00±2.01)％低于Per1-oeNC组(25.00±3.04)％,t=4.292,P<0.05.Transwell实验显示,CNE-2、control-shRNA和Per1-shRNA组穿膜细胞数分别为64.00±1.73、62.00±2.08和90.00±1.00,F=256.447,P<0.001;Per1-oe组细胞数(109.00±3.10)低于Per1-oeNC组(168.00±2.00),t=6.804,P<0.05.结论 核心生物钟基因Per1在鼻咽癌细胞CNE2中可能扮演抑癌基因的角色,对癌细胞增殖甚至迁移、侵袭能力具有一定的抑制作用.

目的 探究lnc?MEG3对垂体瘤细胞增殖、侵袭的调控机制.方法 取垂体瘤HP75细胞分为对照组、si?NC组、si?MEG3组、pcDNA3.1?NC组、oe?MEG3组、oe?MEG3+mimic?NC组、oe?MEG3+miR?10b?5p mimic组.转染后,检测细胞中lnc?MEG3、miR?10b?5p和CD82 mRNA的表达水平、细胞增殖、迁移、侵袭能力和细胞中CD82、PCNA、E?cadherin、N?cadherin、MMP?9蛋白表达.结果 Lnc?MEG3过表达可降低miR?10b?5p,上调CD82和E?cadherin水平,降低PCNA、N?cadherin、MMP?9水平,抑制垂体瘤细胞增殖、迁移和侵袭(P<0.05);上调miR?10b?5p可抑制CD82,减弱lnc?MEG3过表达对垂体瘤细胞增殖、侵袭和迁移的抑制作用.双荧光素酶报告基因检测结果显示,转染miR?10b?5p mimic后,细胞中MEG3?WT和CD82?WT的荧光素酶活性显著降低(P<0.05).结论 Lnc?MEG3过表达可能通过靶向下调miR?10b?5p,进而上调CD82的表达,抑制垂体瘤细胞增殖、迁移和侵袭.