目的 探讨术后单纯放疗和术后放化疗治疗软组织肉瘤(STS)的临床结局和不良反应方面的差异,以及影响STS患者预后的因素.方法 回顾性分析浙江省肿瘤医院2012年5月至2019年5月首诊确诊为原发性STS的患者,术后接受辅助放疗,伴或不伴术后化疗.共入组100例患者,将其分为术后单纯放疗组(52例)与术后放化疗组(48例),中位随访时间为65个月(24～124个月).统计两组患者的无局部复发生存(LRFS)期、无远处转移生存(DMFS)期、总生存(OS)期和治疗相关不良反应.采用Kaplan-Meier法计算生存率,log-rank检验进行单因素分析,Cox模型行多因素分析.结果 多因素分析显示,肿瘤最长径是肿瘤局部复发的独立预测因素(HR=4.80,95％CI=1.16～19.85,P=0.031),同时也是远处转移(HR=4.67,95％CI 为 1.53～14.26,P=0.007)和患者 OS 期(HR=4.10,95％CI为1.35～12.48,P=0.013)的独立预测因素.另外,接受放化疗患者的骨髓抑制程度显著高于单纯放疗患者(P＜0.001).结论 在患者样本量有限的情况下,与单纯放疗相比,放化疗在远处转移或生存率方面没有改善,不良反应增加,但总体耐受性尚好.有必要进行大规模人群的前瞻性随机研究,并对组织学亚型进行亚组分析,以确保获得更有参考价值的结果.

目的 回顾性分析根治性切除术后的原发性输尿管癌患者的辅助放疗效果.方法 收集2008年1月～2017年12月期间在我院接受根治性切除术的77例原发性输尿管癌患者,其中接受术后辅助放疗的患者采用三维适形或调强放疗技术,放疗的中位剂量为46 Gy(45～60 Gy),分次剂量为2.0 Gy(1.8～2.2 Gy),每周5次.比较术后放疗组与术后未放疗组在无病生存期及总生存期方面的差异.结果 两组在年龄、性别、临床分期、病理分级、有无腰腹痛、有无肉眼血尿、是否接受辅助化疗方面比较均无统计学差异(P均>0.05).两组在总生存期及无病生存期方面比较均无统计学差异(P均>0.05).多因素分析显示,临床分期是影响原发性输尿管癌无病生存期的独立预后因子(P<0.05).结论 术后辅助放疗未能改善原发性输尿管癌患者的总生存期和无病生存期,早诊早治是提高原发性输尿管癌患者生存期的关键.

胆系恶性肿瘤主要包括胆囊癌及胆管癌,在亚洲国家较为常见.胆系恶性肿瘤的预后很差,手术是唯一可能治愈的治疗方法,但术后复发转移比例高.在过去的几十年中,我们对这一类恶性肿瘤的分子生物学有了一定的了解,诊断技术也有了很大的发展,但术后辅助治疗一直没有明确的方案.该文拟就胆系恶性肿瘤的术后辅助化疗、辅助放化疗和预后因素等问题,综述其现状和研究进展,并讨论未来的治疗策略.

The treatment strategy for elderly patients with locally advanced rectal cancer (LARC) remains controversial. The aim of this study was to identify the significance of adjuvant chemotherapy (AC) for elderly patients with LARC after neoadjuvant chemoradiotherapy (nCRT) and surgical resection. Between February 2002 and December 2012, a total of 43 patients aged ≥70 years with LARC following nCRT and surgery were retrospectively reviewed. The median follow-up time was 51 months (range 15-161 months). All patients completed the programmed chemoradiotherapy, of which 20 patients (46.5%) received 5-fluorouracil-based AC, and other 23 patients (53.5%) received no adjuvant chemotherapy. The 5-year overall survival and disease-free survival rates for AC group and non-adjuvant chemotherapy (NAC) group were 74.7% vs 63.4% (P = .562) and 73.4% vs 66.3% (P = .445), respectively. More patients in AC group suffered from severe leucopenia than that in NAC group (60% vs 17.4%, P = .004). For elderly patients with LARC following nCRT and surgery, AC may not benefit for survival, but increase treatment related leucopenia.

Objective: Optimal approaches to patients with local recurrence of rectal cancer are unclear in China. This study aimed to evaluaty-30te the clinical outcomes and toxicity associated with different treatment regimens for patients with local recurrence of rectal cancer. Methods: A retrospective chart review of patients with local recurrence of rectal cancer and previous radical surgical treatment between March 2010 and December 2017 with curative intent was performed. Disease-related endpoints included treatment progression-free survival (PFS) and overall survival (OS) using the Kaplan-Meier method. Toxicities were assessed using Common Terminology Criteria for Adverse Events, version 5.0, and complications were scored according to the Clavien-Dindo classification. Results: A total of 71 patients met the inclusion criteria in this study. The recurrence sites were mainly local recurrence in the pelvic cavity and regional lymph node metastasis. Twenty patients received chemoradiotherapy combined with surgery, 10 underwent surgery alone, and others received chemoradiotherapy-alone (n = 27) and chemotherapy-alone (n = 14) treatment. A clear difference was found in PFS between surgery/chemoradiotherapy with surgery and chemoradiotherapy/chemotherapy groups (26.6 months vs 14.1 months, P = 0.033). The PFS of patients in the surgery combined with chemoradiotherapy, surgery alone, and chemotherapy/chemoradiotherapy groups was 65.2 months, 20.2 months, and 14.2 months, respectively (P = 0.042). The multivariate analysis of PFS demonstrated that surgery was an independent factor. The proportion of patients with distant metastases after chemoradiotherapy/chemotherapy was higher than that of patients undergoing surgery (36.6% vs 21.4%, P = 0.179). The OS of patients in the surgery combined with chemoradiotherapy, surgery alone, and chemotherapy/chemoradiotherapy groups was 89.4 months, 66.0 months, and 62.8 months, respectively (P = 0.189). Radiation treatment and surgery did not increase extra severe toxicities. Conclusion: Surgery combined with chemoradiotherapy was a beneficial treatment mode for managing patients with locally recurrent, nonmetastatic rectal cancer. It was associated with better local disease control, no increase in toxicity, and prolonged survival among patients with locally recurrent rectal cancer.

Early diagnosis is important to improve the prognosis of pancreatic cancer (PC). Identifying potential biomarkers is essential for the monitoring and treatment of PC. The long noncoding RNA (lncRNA) UFC1 has been identified as an oncogenic factor in many cancers. However, the expression of UFC1 and its potential role in diagnosis and prognosis of PC remain largely unknown. The present study aimed to investigate the role of serum UFC1 in diagnosis and prognosis. The results indicated that serum UFC1 expression was relatively higher in PC patients than that in healthy volunteers. ROC curve analysis revealed that the serum UFC1 levels could distinguish PC patients from healthy controls, with an AUC value of 0.810. In addition, the serum UFC1 expression level was associated with lymph nodes metastasis, distant metastasis, and clinical stage. Kaplan-Meier analysis indicated that patients with high UFC1 expression exhibited shorter progression-free survival (PFS) and overall survival (OS) than those with low UFC1 expression. Multivariate analysis demonstrated that clinical stage and UFC1 expression level were significant, independent prognostic factors in PC patients. Our data demonstrate that serum UFC1 might serve as a potential biomarker for diagnosis and prognosis of PC.

[目的]研究miR-519b-3p表达与局部晚期直肠癌术前放化疗应答的相关性,并探讨miR-519b-3p是否通过靶向作用ARID4B提高局部晚期直肠癌患者术前放化疗的反应性.[方法]实时定量PCR检测局部晚期直肠癌患者miR-519b-3p的表达水平,用miR-519b-3p模拟物或抑制剂转染HCT116或SW480细胞,体外验证其表达水平与放化疗反应的相关性;双荧光素酶报告实验用于检测miR-519b-3p与ARID4B之间的相互作用;通过重组质粒构建及细胞转染调节相关基因在细胞内的表达,通过建立裸鼠异位移植瘤模型,在体验证miR-519b-3p对ARID4B的调节作用.[结果]实验发现miR-519b-3p表达与局部晚期直肠癌患者对pCRT的反应性相关,miR-519b-3p在局部晚期直肠癌应答患者中呈现为高表达.miR-519b-3p的过表达增强了体外放化疗的反应性.在机理上,我们发现miR-519b-3p直接与ARID4B mRNA的3'UTR结合,其表达与miR-519b-3p表达呈负相关.功能实验显示miR-519b-3p以ARID4B依赖方式直接与直肠癌患者对术前放化疗的反应密切相关.[结论]miR-519b-3p通过靶向作用ARID4B提高局部晚期直肠癌患者术前放化疗的反应性.

Background: Perineural invasion (PNI) and lymphovascular invasion (LVI) are associated with poor prognosis in colorectal cancer, but their clinical significance is still controversial for patients with locally advanced rectal cancer (LARC) who had received neoadjuvant chemoradiotherapy (nCRT) and surgical resection. The aim of this study was to confirm the correlation between PNI and/or LVI and clinical prognosis and to further confirm whether PNI and/or LVI can be used as potential prognostic indicators of adjuvant chemotherapy after nCRT and surgery in LARC. Methods: From February 2002 to December 2012, a total of 181 patients with LARC who had received nCRT and surgical resection were retrospectively reviewed. Overall survival (OS) and disease-free survival (DFS) were determined by the Kaplan-Meier method, log-rank test, and Cox proportional hazard regression model. Results: The median follow-up time was 48 months (range, 3 to 162 months). All the PNI-positive and/or LVI-positive patients showed adverse DFS and OS (P<0.001). In multivariate analysis, PNI and LVI were independent prognostic factors for DFS. PNI, rather than LVI, was also an independent prognostic factor for OS. In a subgroup analysis, PNI-positive, rather than LVI-positive, may benefit from adjuvant chemotherapy. Conclusion: For patients with LARC undergoing nCRT and surgery, PNI-positive and/or LVI positive were associated with poorer DFS and OS. And PNI-positive, rather than LVI-positive, may benefit from adjuvant chemotherapy.

Background: Increasing evidence suggests that cancer-associated inflammation is associated with poorer outcomes. The neutrophil- to-lymphocyte ratio (NLR), considered as a systemic inflammation marker, is thought to predict prognoses in colorectal cancer. In this study, we explored the association between the NLR and prognoses following neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC).Material/Methods: From February 2002 to December 2012, a group of 202 patients diagnosed with LARC and receiving neoadjuvant CRT followed by radical surgery was included in our retrospective study. The associations between the pre-CRT NLR and clinicopathological characteristics, as well as the predictive value of pre-CRT NLR against survival outcomes, were analyzed.Results: The average NLR was 2.7 +/- 1.5 (median 2.4, range 0.6-12.8). There were 63 (31.2%) patients with NLR >= 3.0, and 139 (68.8%) patients with NLR < 3.0. Correlation analyses showed that no clinicopathological characteristics except age were associated with NLR. We did not find an association between NLR and survival outcomes. In multivariate Cox model analyses, the R1/R2 resection, lymph node ratio >= 0.1, and perineural/lymphovascular invasion were independently associated with worse disease-free survival and overall survival.Conclusions: In our cohort, the NLR did not correlate with survival outcomes in LARC patients undergoing neoadjuvant CRT. The prognostic value of NLR should be validated in large-scale prospective studies.

Objective To investigate the impacts of adjuvant radiotherapy on the prognosis of patients with stage Ⅰ-Ⅱ diffuse large B cell lymphoma of Waldeyer's ring (WR-DLBCL) who achieved complete remission (CR) after chemotherapy.Methods Clinical data were collected from 130 patients with stage Ⅰ-Ⅱ WR-DLBCL who were admitted to our hospital from 2005 and 2013.All the patients achieved CR after at least two cycles of cyclophosphamide,doxorubicin/epirubicin,vincristine,and prednisone (CHOP)-based chemotherapy or rituximab plus CHOP (R-CHOP)-based chemotherapy.In the 130 patients,43 received R-CHOP (including 25 patients undergoing radiotherapy) and 87 CHOP (including 76 patients undergoing radiotherapy);29 received chemotherapy alone and 101 chemoradiotherapy.The survival rates were calculated by the Kaplan-Meier method and analyzed by the log-rank test.Univariate and multivariate prognostic analyses were made by the log-rank test and the Cox model,respectively.Results In all patients,the 5-year sample size was 101.The univariate analysis showed that patients with an Eastern Cooperative Oncology Group (ECOG) score of 0 had significantly higher 5-year overall survival (OS) and disease-free survival (DFS) rates than those with an ECOG score of 1 (95.6％ vs.80.1％,P=0.000;95.7％ vs.75.4％,P=0.029).Patients treated with chemotherapy alone had significantly lower 5-year OS and DFS rates than those treated with chemoradiotherapy (77.1％ vs.91.7％,P=0.048;77％ vs.87.4％,P=0.037).The multivariate analysis by the Cox model showed that ECOG score was a prognostic factor for both OS and DFS (P=0.047,0.003).Adjuvant radiotherapy was related to improved DFS rather than OS (P=0.039,0.133).Conclusions Stage Ⅰ-Ⅱ WR-DLBCL patients with low ECOG scores have better prognosis than those with high ECOG scores.Patients with CR after chemotherapy may benefit from adjuvant radiotherapy.The conclusions need to be further confirmed by prospective randomized controlled trials.

Objective To summarize the clinical characteristics and evaluate the feasible treatments of primary breast lymphoma (PBL).Methods The clinical data of 34 PBL patients (age 24-79 years) who were treated in our hospital between April 2006 and December 2013 were reviewed.Of these 34 patients, 18 had stage ⅠE PBL and 16 had stage ⅡE PBL.Pathological types included diffuse large B cell lymphoma (29 patients), anaplastic large cell lymphoma (2 patients), marginal zone lymphoma (2 patients), and mantle cell lymphoma (1 patient).Two patients underwent surgery, four patients received chemotherapy alone, five patients received chemoradiotherapy, fourteen patients underwent surgery plus chemotherapy, and nine patients underwent surgery plus chemoradiotherapy.The 5-year overall survival (OS) and progression-free survival (PFS) rates were determined by the Kaplan-Meier estimator.Results During follow-up, 26 patients were alive without lymphoma and 8 patients had died by the end of follow-up (7 died from lymphoma and 1 died from chemotherapy-related hepatic failure).Among the 6 patients who relapsed, 5(83.3%) had recurrence within the first 2 years of treatment.In particular, 1 patient who had bilateral breast involvement developed left breast relapse after bilateral mastectomy and chemotherapy, 2 patients had bone marrow metastasis, 1 patient had lung and mediastinal lymph node metastases, and 2 had skin relapse.The 5-year OS and PFS rates of all patients were 75% and 75%, respectively.Conclusions Since PBL is a rare malignancy, its overall prognosis is fair and the incidence of local relapse is low with chemotherapy alone or in combination with other treatments.However, further studies on the development of more effective treatments will be required for patients who have failed the existing treatments.

The aim of the present study was to summarize the clinical characteristics of primary breast lymphoma (PBL) and evaluate its management approaches. A total of 29 patients newly diagnosed with PBL, and treated between April 2006 and May 2013, were analyzed retrospectively. The median survival follow-up time for all patients was 66.8 (range, 25.4-110.0) months. The results of the follow-up revealed 22 living lymphoma-free patients and 7 patients who had succumbed to PBL. Of the 7 deceased patients, 6 had succumbed to lymphoma and 1 to chemotherapy-associated hepatic failure. In total, 1 patient who presented with bilateral breast lymphoma developed left breast relapse following lumpectomy and chemotherapy, 2 patients developed a bone marrow relapse, 1 patient developed lung and mediastinal lymph node relapses, and 1 patient developed a skin relapse. The Kaplan-Meier estimator predicted 5-year overall survival and progression-free survival rates for all patients of 74.4 and 74.6%, respectively. PBL appears to be a rare disease with a good overall prognosis and low incidence of local relapse, following chemotherapy alone or in combination with other treatments. Further studies investigating the development of effective agents for use in treatment-resistant patients are required.

BACKGROUND AND OBJECTIVE:The aim of this study was to summarize the clinical characteristics and evaluate the management approaches of primary breast diffuse large B-cell lymphoma (DLBCL) in the era of rituximab.PATIENTS AND METHODS:A total of 24 female patients with newly diagnosed primary breast DLBCL treated between April 2006 and May 2013 were analyzed retrospectively. Ten patients (41.7%) received rituximab.RESULTS:For the whole group, the median age was 50 years (range 24-69 years). All patients had the disease detected with a palpable mass. The estimated 5-year overall survival and progression-free survival (PFS) rates of all the patients were 78.9% and 79.2%, respectively. A nonstatistically significant increase in PFS and overall survival was observed when rituximab was administered (5-year PFS: 90% vs 71.4%, P=0.285; 5-year overall survival: 90% vs 71.4%, P=0.239).CONCLUSION:Primary breast DLBCL appears to be a rare disease. Adding rituximab might improve survival in patients with primary breast DLBCL. Further prospective studies are needed to evaluate the role of rituximab for primary breast DLBCL.

BACKGROUND AND OBJECTIVE:The objective of the study was to evaluate the efficiency of chemotherapy (CT) combined with high-dose extended-field radiotherapy (RT) in stage I extranodal nasal-type natural killer/T-cell lymphoma (NKTCL).PATIENTS AND METHODS:Between January 2001 and November 2010, 103 stage I extranodal nasal-type NKTCL patients were retrospectively analyzed. Of these patients, 75 patients were treated by RT plus CT and 28 patients were treated by RT alone. CT included cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), or CHOP-like regimen.RESULTS:The median follow-up time was 42.6 months (range, 7.4-126.7 months). For patients in the RT alone group, the 5-year estimated progression-free survival (PFS) and overall survival (OS) rates were 67.0% and 71.4%, respectively. For patients in the RT + CT group, the 5-year estimated PFS and OS rates were 69.0% and 63.7%, respectively. In multivariate analysis, CT was an independent factor for PFS.CONCLUSION:The doxorubicin-based CT combined with high-dose extended-field RT yielded promising outcomes for stage I extranodal nasal-type NKTCL, and CT was an independent factor for PFS.

e19502 Background: In the rituximab era, results of randomized trials and relevant studies focused on the role of consolidation radiotherapy (RT) in stage I–II diffuse large B cell lymphoma (DLBCL) were very few. The objective of this study is to investigate the role of consolidation radiotherapy (RT) in patients with stage I–II diffuse large B cell lymphoma (DLBCL) who had achieved complete remission after chemotherapy. Methods: Between January 2005 and December 2012, data for 376 patients with early stage DLBCL in complete remission after receiving cyclophosphamide, doxorubicin/epirubicin, vincristine and prednisone (CHOP) or rituximab plus CHOP (R-CHOP) for at least three cycles were analyzed retrospectively. The median age was 53 years. Patients were divided into four groups: the R-CHOP group (93 patients), the R-CHOP+RT group (78 patients), the CHOP group (107 patients) and the CHOP+RT group (98 patients). All patients used Involved –field radiotherapy and the total dosage ranged from 30 Gy to 56Gy. Results: During a median follow-up of 53 months (range 4–128 months), the 5-year actuarial rates for disease free survival (DFS) and overall survival (OS) across all 376 patients were 80.7% and 87.6%, respectively. The 5-year DFS and OS of the R-CHOP+RT group were better than the R-CHOP group (5-year DFS: 94.9% vs. 88.1%, P = 0.030; 5-year OS: 97.9% vs. 86.0%, P = 0.026). No significant DFS or OS benefits were observed between the CHOP+RT group and the CHOP group (5-year DFS: 74.2% vs. 71.4%, P = 0.623; 5-year OS: 74.2% vs. 71.4%, P = 0.623). Conclusions: Our study indicates that consolidation radiotherapy can only improve DFS or OS of the patients with early stage DLBCL in complete remission after R-CHOP chemotherapy not CHOP regimen. All early stage patients are recommended to undergo rituximab-containing chemotherapy followed by consolidation radiotherapy. Relevant randomized trials are needed to testify this question.

Objective To investigate the value of radiotherapy (RT) in patients with early diffuse large B-cell lymphoma (DLBCL) who have achieved a complete remission (CR) after chemotherapy.Methods A retrospective analysis was performed on 376 patients with stage Ⅰ and Ⅱ DLBCL who were admitted to our hospital from 2004 to 2012.All patients achieved a CR after receiving chemotherapy with cyclophosphamide,doxorubicin/epirubicin,vincristine and prednisone (CHOP) or rituximab combined with CHOP (R-CHOP) for at least three cycles.The median age was 53 years.Patients were divided into four groups:R-CHOP group (n =92),R-CHOP + RT group (n =79),CHOP group (n =107),and CHOP + RT group (n =98).The RT used was involved-field irradiation and the total dose ranged from 30 to 56 Gy.The survival rate was determined using the Kaplan-Meier method,and the survival difference analysis was performed using the log-rank test.Multivariate prognostic analysis was performed using the Cox proportional hazard model.Results The 5-year sample size was 188.The 5-year disease-free survival (DFS) and overall survival (OS) rates in all patients were 80.7％ and 87.6％,respectively.The 5-year DFS and OS rates in the R-CHOP + RT group were significantly higher than those in the R-CHOP group (94.9％ vs.88.1％,P =0.030;97.9％ vs.86.0％,P=0.026).No significant differences in DFS and OS rates were observed between the CHOP + RT and CHOP groups (74.2％ vs.71.4％,P =0.623 ;74.2％ vs.71.4％,P =0.623).Multivariate prognostic analysis revealed that the smoking index ＜ 500,international prognostic index ＜ 2,and use of rituximab were favorable prognostic factors (P =0.034-0.000).Conclusions Radiotherapy can improve the DFS and OS in early DLBCL patients with CR after R-CHOP chemotherapy.All early stage DLBCL patients are recommended to undergo rituximab-containing chemotherapy followed by radiotherapy.Randomized controlled trials are needed to validate the results.

The aim of this study was to report long-term results of patients with locally advanced rectal cancer treated by neoadjuvant chemoradiotherapy with fluorouracil, leucovorin, and oxaliplatin. From February 2002 to November 2006, a total of 58 patients with locally advanced rectal cancer were recruited. Secondary endpoints included the cumulative incidence of local and distant recurrences, disease-free survival, and overall survival. The median follow-up time was 138 months (109-151 months). The cumulative incidence of local recurrence at 10 years was 12.1%. The cumulative incidence of distant recurrence at 10 years was 53.4%. The overall survival in the intention-to-treat population was 39.5% at 10 years. Disease-free survival in the intention-to-treat population was 41.8% at 10 years. Univariate analysis revealed that pathologic complete response was associated with local recurrence, distant recurrence, disease-free survival, and overall survival (p < .05). Distant recurrence remains the predominant pattern of failure for patients with locally advanced rectal cancer after preoperative chemoradiotherapy and total mesorectal excision. Pathologic complete response is an independent prognostic factor for locally advanced rectal cancer after preoperative chemoradiotherapy.

Background/Aims: The aim of this study was to determine the efficacy and acute toxicity of our early experience with treating postoperatively non-metastatic gastric cancer with intensity-modulated radiotherapy (IMRT). Methodology: A. retrospective review was performed on 47 consecutive patients with gastric cancer and treated with postoperatively adjuvant IMRT at Department of radiation oncology, Zhejiang cancer hospital, China, between January 2007 and August 2009. One patient who did not complete his radiation course was excluded, leaving 46 patients for analyses. The median radiation dose delivered was 4500cGy using 180cGy fractions. Concurrent chemotherapy administered were 5-fluorouracil (n=36), capecitabine (n=9) and none (n=1). Results: The median follow-up time was fifteen months (range 6-28 months). 1-year OS and 2-year OS were 98.0% and 80.0%, assessed by Kaplan-Meier methods. Of the six patients who died, five (83.3%) developed a distant metastases. The overall survival time by tumor size was significantly different (>6cm vs. 5.6cm, p<0.05). There was no significant survival difference between 5-fluorouracil group and capecitabine group (p=0.80). Conclusions: The data support the use of IMRT in the adjuvant treatment in high risk gastric cancer postoperatively. Acute toxicity is tolerable. Capecitabine with concurrent IMRT was as effective and tolerable as 5-FU/IMRT. Distant metastasis was the main reason of treatment failure that must be addressed in future trials.

Unbalance and reactive power currents of electric railway will result in poor power quality of three-phase industrial power grid. A co-phase traction power supply system is introduced in this paper to solve these problems by adopting single-phase ac-dc-ac converter. The converter is connected between two secondary windings of traction transformer with abilities of active power transmission and reactive power compensation. Because of the power conversion, the co-phase supply system can utilize single-phase feeding connection scheme instead of traditional two-phase feeding scheme. An actual 10 MVA/27.5 kV co-phase system with impedance-matching balance transformer is designed, developed, and tested. Its real-time detection, control, and distribution algorithms with field programmable gate array-based implementation are introduced. Some test running results validate the performance of the digital controller and demonstrate the feasibility of the proposed co-phase power supply system.

BACKGROUND:Th1/Th2 cytokine network imbalance plays a major role in cancer development and progression. In this study, we aim to evaluate the relationship between those cytokines and clinical outcome in patients with nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS:The concentrations of Th1 cytokines (IL-2, TNF-α, IFN-γ) and Th2 cytokines (IL-4, IL-5, IL-10) in the serum were examined by Cytometric Bead Array in a total of 80 nasopharyngeal carcinoma patients pre and post treatment. Associations of those cytokines with clinical pathological factors, treatment response, and overall survival were analyzed. RESULTS:Pretreatment serum levels of IL-2 and TNF-α were closely associated with overall survival. Compared to patients with low IL-2 expression, those with high expression had less risk of death (hazard ratio (HR) = 0.31, 95% confidence interval (CI) 0.13-0.75, p = 0.009). In contrast, TNF-α showed opposite effects on overall survival in patients with NPC. Patients with high TNF-α expression had a more than 2-fold increase in risk of death than those with low TNF-α (HR = 2.66, 95% CI 1.04-6.78, p = 0.041). All HRs were adjusted for age, sex, stage, histology, and treatment. Kaplan-Meier survival analysis showed similar survival differences between the 2 groups. CONCLUSION:Lower serum IL-2 or elevated serum TNF-α concentrations predict an unfavorable prognosis for patients with NPC.