【摘要】 目的 探討SPECT及CT對鼻咽癌顱底骨侵犯的檢測能力。 方法 2006年5月-2009年12月對159例經病理確診的初治鼻咽癌患者行顱底SPECT斷層顯像，同期行CT檢查，分別計算顱底受侵的陽性率。 結果 ①159例鼻咽癌SPECT顱底斷層陽性率46.5%（74/159），CT陽性率25.2%（40/159），SPECT檢測敏感性高于CT（Plt;0.001）。 ②鼻咽癌伴顱神經損害SPECT檢測敏感性高于CT（P=0.004）。 結論 SPECT對鼻咽癌顱底骨侵犯的檢測敏感性優于CT。【Abstract】 Objective To compare the results of single-photon emission computed tomography (SPECT) and CT in skull base invasion in nasopharyngeal carcinoma (NPC). Methods A total of 159 patients with nasopharyngeal carcinoma were examined by SPECT and CT of nasopharynx and skull base from May 2006 to December 2009. The positive rates were compared by McNemar test. Results The positive rate of skull base invasion detected by SPECT and CT were 46.5% and 25.2% respectively (Plt;0.001). SPECT appeared to be superior to CT in the detection of skull base invasion in NPC with cranial nerve palsy (P=0.004). ConclusionsThe detection ability of SPECT in skull base invasion is superior to that of CT.
ObjectiveTo research on the influence of cluster management on the nutritional intervention for nasopharynx cancer patients undergoing intensity modulated radiation therapy (IMRT), in order to discuss effective and feasible nutrition management method. MethodEighty-three nasopharynx cancer patients undergoing IMRT between June 2013 and December 2014 were selected as the study subjects. They were divided into two groups randomly. Regular health education and nutritional guidance were carried out for the 41 patients in the control group, while nutritional risk screening (NRS)-2002 nutrition screening, nutrition assessment and nutritional intervention were carried out for the 42 patients in the intervention group. Nutrition risk, nutritional status and side-reaction were recorded and evaluated for both groups of patients. ResultsAfter treatment, NRS-2002 score of the intervention group was lower than the control group (P<0.05). Body weight, constitutional index, skinfold thickness of triceps brachii muscle, mid-arm circumference and mid-arm muscle circumference of the intervention group were better than the control group (P<0.05). Total serum protein, serum albumin, serum transferrin were better and the rate of levelⅢ-Ⅳ radiation-induced oral mucositis was lower in the intervention group than that in the control group (P<0.05). ConclusionsThe application of cluster management model in nutritional intervention is a way to promote patients' rehabilitation, which can effectively improve the whole body situation of nasopharynx cancer patients, and reduce malnutrition rate and side-reaction.
ObjectiveTo systematically review the correlation between the expression of P53 and nasopharyngeal carcinoma. MethodsDatabases including The Cochrane Library (Issue 1, 2016), PubMed, EMbase, CBM, CNKI, VIP, and WanFang Data were searched from the inception to January 1st 2016 to collect case-control studies about the correlation between the expression of P53 and nasopharyngeal carcinoma, as well as its clinically pathologic features. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.2 software. Results Twelve studies were finally included in this meta-analysis. There were 630 cases of nasopharyngeal carcinoma and 253 controls. The results of meta-analysis showed that, the expression of P53 protein were significantly different between the nasopharyngeal carcinoma group and the control group (OR=21.34, 95%CI 13.59 to 33.50, P < 0.000 01), between the nasopharyngeal carcinoma with lymphatic node metastasis group and without lymphatic node metastasis group (OR=3.69, 95%CI 1.67 to 8.17, P=0.001), between the clinical stage Ⅰ to Ⅱ group and the clinical stage Ⅲ to Ⅳ group (OR=0.19, 95%CI 0.08 to 0.49, P=0.000 6). However, there were no significant differences in expression of P53 between the male nasopharyngeal carcinoma group and the female nasopharyngeal carcinoma group (OR=0.92, 95%CI 0.49 to 1.74, P=0.80), and between the < 50 nasopharyngeal carcinoma group and the≥50 nasopharyngeal carcinoma group (OR=1.70, 95%CI 0.70 to 4.11, P=0.24). ConclusionsCurrent evidence shows that, the expression of P53 protein is associated with the occurrence, development of nasopharyngeal carcinoma and may be positively correlated to degree of tumor malignance. It may be an indicator poor prognosis.
ObjectiveTo comprehensively analyze the disease burden of respiratory cancers in China from 1990 to 2021, and predict the trend of disease burden changes from 2022 to 2031, in order to improve its prevention and treatment strategies. MethodsData from the Global Burden of Disease (GBD) 2021 database were extracted and analyzed for the disease burden of nasopharyngeal cancer, laryngeal cancer, and tracheal, bronchial and lung cancers (hereinafter referred to as lung cancer) in China from 1990 to 2021. The Joinpoint 4.9.1.0 software was utilized to analyze the corresponding trends. The grey prediction model [GM (1,1)] was employed to forecast the disease burden of respiratory cancers in China from 2022 to 2031. ResultsThe disease burden of respiratory cancers attributed to tobacco and occupational carcinogens in China raised from 1990 to 2021. Among the respiratory cancers, lung cancer led in terms of incidence, mortality, and disability-adjusted life years (DALY) and their respective age-standardized rates from 1990 to 2021, followed by nasopharyngeal cancer, with laryngeal cancer being the lowest. Analysis via the Joinpoint regression model indicated that, overall, the disease burden of nasopharyngeal and laryngeal cancers in China decreased during this time period, while that of lung cancer increased. From a gender perspective, the disease burden of male patients was significantly higher than that of female patients from 1990 to 2021. Compared to the global average, the disease burden of respiratory cancers in China from 1990 to 2021 was still relatively heavy. As of 2021, the middle-aged and elderly population above 50 years old was the primary group suffering from the disease burden of respiratory cancers in China. The prediction model showed that the age-standardized rate of nasopharyngeal cancer in China would decline from 2022 to 2031; the age-standardized incidence rate of laryngeal cancer in China would increase, while its age-standardized mortality rate and DALY rate would both decrease; the age-standardized rates of lung cancer in China would increase. ConclusionIn the past 30 years, the disease burden of nasopharyngeal and laryngeal cancers in China has lightened, but the overall disease burden of lung cancer is still on the rise. Compared to the global average, the disease burden of respiratory cancers in China is still relatively heavy. The disease burden in male patients is significantly higher than that in female patients, and the population above 50 years old is the main group suffering from the disease burden. In the next 10 years, the disease burden of respiratory cancers in China will still tend to increase. Therefore, targeted prevention and treatment strategies for men and the middle-aged and elderly populations remain key challenges that urgently need to be addressed in China's response to respiratory cancers.
ObjectiveTo systematically review the health economic evaluation of nasopharyngeal carcinoma (NPC). MethodsThe PubMed, Web of Science, EMbase, CNKI, WanFang Data and CBM databases were electronically searched to collect the health economic evaluations on NPC from inception to December 18, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. A descriptive analysis was performed. ResultsA total of 20 studies were included, which contained 14 about different drug combinations, 6 about chemotherapy and the comparison among intensity modulated radiotherapy, conventional radiotherapy and surgery. The results showed that for patients with recurrent, metastatic, or advanced NPC, compared with docetaxel plus cisplatin, fluorouracil plus cisplatin or docetaxel and cisplatin plus fluorouracil, gemcitabine plus cisplatin (GP) was the most economical, and compared with GP or camrelizumab plus GP, toripalimab plus GP (TGP) was more economical. For early-stage NPC, intensity modulated radiotherapy was not economical compared with conventional radiotherapy and surgery. ConclusionCurrent evidence shows that GP and TGP are economical and can be popularized clinically.
目的 檢測血管內皮生長因子（VEGF）、白細胞分化抗原34（CD34）及CXC趨化因子受體4（CXCR4）在轉移性鼻咽癌患者鼻咽部腫瘤組織中的表達，探討它們與鼻咽癌各種臨床病理因素的關系以及它們之間的相互聯系。 方法 采用免疫組織化學鏈霉素抗生物素蛋白-過氧化物酶連結法檢測2003年3月－2009年5月35例轉移性鼻咽癌患者VEGF、CD34及CXCR4在鼻咽部腫瘤組織中的表達情況，結合患者臨床病理特征進行分析。 結果 轉移性鼻咽癌患者鼻咽部腫瘤組織中的VEGF及CXCR4陽性表達率分別為62.9%（22∕35）和42.9%（15∕35），CD34計數為11～92，平均43.2 ± 20.5。無肺轉移較有肺轉移的患者VEGF的陽性表達率高（78.9%、43.8%，P=0.043），多器官轉移較單器官轉移的患者CXCR4的表達強度高（62.5%、26.3%，P=0.044）。 結論 VEGF表達陽性的患者易發生肺轉移；CXCR4強表達的患者易發生多器官轉移。
【摘要】目的探討鼓膜置管對鼻咽癌(NPC)患者放療前后分泌性中耳炎(SOM)的療效。方法2005年3月2010年1月將60例(84耳)NPC并發SOM患者分為兩組:A組30例行鼓膜切開鼓膜置管;B組30例保守治療為對照組,并行隨訪,對兩組患者有效率和并發癥發生率進行統計。結果60例中58例存活,1例死于全身衰竭,1例死于大出血。存活患者中治療SOM有效率為:A組85.4%(35/41),B組為30.2%(13/43),兩組差異有統計學意義(Plt;0.05);并發癥發生率A組為14.6%(6/41),B組為69.8%(30/43),B組并發癥高于A組,差異有統計學意義(Plt;0.05)。結論NPC患者在放療后,咽鼓管功能受到嚴重損害,是不可逆的病變,鼓膜置管治療NPC并發SOM較保守治療效果好,并發癥的發生率低。
ObjectiveCompare the two-degrade collimator (MLC) angle selection's impact on plan quality and operational efficiency for volumetric intensity-modulated radiotherapy (VMAT) in the treatment planning system, and to explore the scheme for treatment plan optimization. MethodsTwenty patients with nasopharyngeal carcinoma underwent the treatment between March and December 2013 were randomly selected and planned for SIBVMAT treatment with different parameters set in the range of 0-60°with 15°interval for collimator angles. Planned dose distribution to the target volumes, organs at risk, and monitor units were compared. ResultsAs the MLC angle increased, target conformal index and homogeneity index had a trend to became deteriorated. The optimal plans were 0°and 15°, while 45°and 60°plans gave poor protection for the organ at risk compare to other angle plans and the monitor units were significantly increased. ConclusionChange the MLC angle had visible impact on treatment plans,there was a trend to deteriorate with the MLC angle increased, but small changes in MLC angle range can theoretically reduce the influence from leakage radiation on the human body.