Nasopharyngeal Neoplasms Research Articles

Anti-angiogenesis agents plus chemoradiotherapy for locally advanced nasopharyngeal cancer: a systematic review and meta-analysis.

To evaluate literature evidences about the efficacy and safety of anti-angiogenesis agents plus chemoradiotherapy versus chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma. The relevant literature was systematically searched from the date of establishment to April 2023 in PubMed, Embase, Web of Science, The Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biological Medicine, Wanfang and VIP database. Search terms included: Nasopharyngeal Neoplasms, Angiogenesis inhibitors, Endostar, Anlotinib, Apatinib, Bevacizumab, Sunitinib, Pazopanib, Chemoradiotherapy. The literature was strictly screened according to the inclusion and exclusion criteria, and 8 eligible studies were finally included in our meta-analysis (4 randomized controlled trials and 4 retrospective studies). A total of 642 patients were included, with 316 in the anti-angiogenesis agents plus chemoradiotherapy group and 326 in the chemoradiotherapy group. The results of our meta-analysis showed that compared with chemoradiotherapy group, the complete response rate (RR = 1.35, 95% CI 1.05-1.74, P = 0.02), objective response rate (RR = 1.26, 95% CI 1.12-1.43, P = 0.0002) in the anti-angiogenesis agents plus chemoradiotherapy group were significantly improved. In terms of safety, there was a higher incidence of cardiac arrhythmia (RR = 3.63, 95% CI 1.16-11.37, P = 0.03) and hypertension (RR = 1.85, 95% CI 1.04-3.27, P = 0.004) in the anti-angiogenesis agents plus chemoradiotherapy group, while no statistically significant differences were reported in other adverse reactions (all P > 0.05). Compared with chemoradiotherapy, anti-angiogenesis agents plus chemoradiotherapy could bring more benefits in terms of short-term efficacy, particularly by notably improving both complete response rate and objective response rate, and overall adverse reactions were acceptable. Anti-angiogenesis agents plus chemoradiotherapy may provide a promising direction for the treatment of locally advanced nasopharyngeal carcinoma. https://inplasy.com/inplasy-2023-8-0076/ , registration number INPLASY202380076.

Primary Nasopharyngeal Melanoma without invasive and Metastasis: A Rare Case Reports and Literature Reviews.

Objective: Nasopharyngeal melanoma is a rare mucosal malignant melanoma with high recurrence rate, metastasis rate and vascular invasion rate. In this paper, we report a case of primary nasopharyngeal mucosal melanoma. Methods: A case of primary nasopharyngeal mucosal melanoma was reported, and its clinical symptoms, pathological characteristics, treatment and follow-up were described in detail. Results: This report describes a 59-year-old male patient with persistent nasal congestion and suspected malignant nasopharyngeal neoplasm. Patients receive surgical resection and adjuvant radiotherapy after complete resection. Imaging studies showed no tissue invasion or lymph node metastases. The results of immunohistochemistry were Melan-A(+), HMB45(+), and S100(+). The final diagnosis was malignant nasopharyngeal melanoma. After 2 years of follow-up, the prognosis was good, and there was no metastasis or recurrence. Discussion: Nasopharyngeal melanoma is a rare malignancy with a poor prognosis, and surgical resection is the mainstay of treatment. Postoperative adjuvant therapy can improve the rate of local control of lesions. Early diagnosis and thorough examination are extremely important for the patient's prognosis.

Incidence, Pattern, and Possible Risk Factors for Nasopharyngeal Cancer in the Qassim Region.

Objective To evaluate and assess the incidence, patterns, and possible risk factors for nasopharyngeal cancer among the Qassim population. Methods A retrospective study was conducted at Dr. Suliman Al-Habib Hospital in Qassim. The study included all previously confirmed cases of nasopharyngeal neoplasms between 2016 and 2022. Data was collected retrospectively from the hospital's health record, including the patient'sdemographics, clinical presentation, and comorbidities. IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp. was used for data entry, management, and analysis. Results A total of 84 records of patients were included in the study.Males (n=55, 65.5%) were more than females (n=29, 34.5%). The majority of the patients (n=51, 62%)were aged 31-60 years. About 32 (38.0%) patients were obese. Mostof the patients (n=49, 58%) presented with malignant neoplasms of the nasopharynx. The most frequent clinical presentations were nasal obstruction, runny nose, hearing loss, and neck mass. Conclusion The incidence rate of nasopharyngeal cancer was significantly higher in males compared to females(p=.003). There was no statistically significant association between age and comorbidity and the development of nasopharyngeal cancer.

Adult Nasopharyngeal Hamartoma: A Case Report.

Hamartomas are benign tumors characterized by an abnormal combination and arrangement of normal tissues during development. It is more common in lung, gastrointestinal tract and other parts, rare in the head and neck, such as oral cavity, nasal cavity, nasopharynx, etc. This case report describes a patient with nasopharyngeal hamartoma who presented with headache and rhinorrhea and was confirmed to have smooth nasopharyngeal neoplasm by electronic fibro laryngoscopy. After admission, the nasopharyngeal neoplasm was removed under general anesthesia and was postoperatively diagnosed as a hamartoma polyp. The patient recovered well postoperatively.

Identification of BRAF, CCND1, and MYC mutations in a patient with multiple primary malignant tumors: a case report and review of the literature

BackgroundMultiple primary malignant tumors (MPMTs), usually associated with worse malignant behavior and prognosis comparing to a single primary tumor, and have recently been found to have an increasing incidence globally. However, the pathogenesis of MPMTs remains to be clarified. Here, we report a unique case of the coexistence of malignant melanoma (MM), papillary thyroid carcinoma (PTC), and clear-cell renal cell carcinoma (ccRCC) along with our perceptions on its pathogenesis.Case presentationThe case reported is of a 59-year-old male patient with unilateral nasal obstruction as well as a renal occupying lesion. Positron emission tomography-computed tomography (PET-CT) revealed a palpable mass of 32 × 30 mm on the posterior and left walls of the nasopharynx. In addition, an isodense nodule was observed in the right superior renal pole, approximately 25 mm in diameter, as well as a slightly hypodense shadow in the right leaf of the thyroid, approximately 13 mm in diameter. Nasal endoscopy and magnetic resonance imaging (MRI) confirmed the existence of a nasopharyngeal neoplasm. Afterward, biopsies of the nasopharyngeal neoplasm, thyroid gland and kidney were performed, and the patient was diagnosed with MM, PTC, and ccRCC according to the pathological and immunohistochemical results. Moreover, mutation of BRAFV600E was detected in bilateral thyroid tissues, and amplification of both CCND1 and MYC oncogenes were detected in the nasopharyngeal melanoma. After chemotherapy, the patient is now in good overall condition.ConclusionsThis is the first reported case of a patient with the co-existence of MM, PTC and ccRCC undergoing chemotherapy with a favorable prognosis. Herein, we suggest that such a combination may be non-random, as for mutation of BRAFV600E might account for the co-occurrence of PTC and MM, while mutations of CCND1 and MYC cause the coexistence of MM and ccRCC. This finding may provide valuable guidance on the diagnosis and treatment of such disease, as well as the prevention of developing a second or third tumor for patients with a single primary.

Epidemiology and Histopathology of Nasopharyngeal Neoplasms in Iran.

This study aimed to study the trend, histologic pattern, geographical distribution, and characteristics of nasopharyngeal carcinoma (NPC) and nasopharyngeal neoplasms (NPN) from 2003 to 2017 in Iran. The Ministry of Health and Medical Education collected NPN cases from the corresponding university in each province and stored them in Iran National Cancer Registry (INCR) database. The Joinpoint program calculated the average annual percent change (AAPC) and its 95% confidence interval (CI). The jump model minimized the interfering effect of INCR transformation. 3653 NPN cases were reported between 2003-2010 and 2014-2017, with a mean age of 49.04 ± 18.31 years and a male-to-female ratio of 2.15. The age-standardized incidence rate (ASIR) per 100,000 person-years was 0.30 for females and 0.68 for males in 2017. Although the ASIR/100,000 of NPN raised from 0.35 to 0.49 during 2003-2017, the trend was constant with an AAPC of -2% (95% CI: -4.8% to 0.9%). The age-specific incidence rate was highest in the older than 70 population (1.56/100,000). NPC formed 77.1% of NPNs and showed a constant pattern (AAPC CI: -5.7% to 0.2%), in contrast to the significant increase of non-keratinizing squamous cell carcinoma (AAPC CI: 2.3%to 24.5%). Nasopharynx cancer is rare in Iran, and NPC incidence remained constant from 2003 to 2017, unlike previously reported rising trend. However, non-keratinizing squamous cell carcinoma exhibited a significant increase, and future studies are needed to examine the role of the Epstein-Barr virus on this growth rate.

Advanced Nasopharyngeal Carcinoma with Generalized Lymphadenopathy Masquerade as Lymphoma.

Introduction:Nasopharyngeal carcinoma (NPC) is a nasopharyngeal epithelial neoplasm that has distinct aetiological, epidemiological and biological characteristics compared to other head and neck malignancies. Patients usually present late due to non-specific symptoms and deep location of the tumour in the nasopharynx.Case Report:We would like to highlight a case of advanced NPC presenting with generalised lymphadenopathy, without the presence of an obvious nasopharyngeal mass that masqueraded as lymphoma in the initial stage.Conclusions:NPC may share clinical features with other sinonasal pathologies or other malignant lymphoproliferative disorders that lead to a delay in diagnosis. NPC should be one of the differential diagnoses for any cases presenting with cervical lymphadenopathy, especially in adult male patients originating from East or Southeast Asia. Early diagnosis and treatment are crucial because early-stage NPC has an excellent chemoradiotherapy response and high survival rate.

Phantosmia Among Pediatric, Adolescent, and Young Adult Patients Receiving Proton Beam Therapy

PurposePhantosmia, an underreported toxicity of brain radiation therapy (RT), is defined as an olfactory disorder resulting in a malodorous phantom smell. This study aimed to characterize the incidence of phantosmia in patients treated with intensity modulated proton therapy (IMPT). Methods and MaterialsIn this institutional review board–approved retrospective study, the electronic medical record of a pencil beam scanning-only proton center was queried for patients ≤39 years of age who received IMPT for primary intracranial, metastatic intracranial, skull base, nasopharyngeal or sinonasal neoplasms between August 2019 and December 2020. Patient, clinical, and phantosmia-related characteristics were collected. The olfactory region was defined to include the olfactory bulb and tract. Phantosmia severity was graded by intervention use (mild, no intervention; moderate, supportive treatment; severe, RT discontinuation). ResultsNinety-nine patients met the inclusion criteria. Twelve patients (12.1%) reported phantosmia. Patients described perceiving a “chlorine,” “broccoli,” “stale water,” “metallic,” or “noxious” smell. Of the patients who reported phantosmia, median age was 17 (12-33) years, 66.7% were male, and 91.7% had intracranial tumors. None of the patients had prior RT. Chemoradiotherapy treatment did not correlate with phantosmia development (odds ratio, 1.09; 95% confidence interval, 0.32-3.70; P = .90). Ten patients experienced accompanying toxicities, including taste changes (n = 3), vision disturbances (n = 5), and nausea/emesis (n = 7). Phantosmia was mild (n = 7) or moderate (n = 5). All patients completed their RT course. Sixty-seven percent received craniospinal irradiation (CSI) while 33% received focal brain RT, with the olfactory region receiving doses as low as 0.5 Gy. Notably, 8 of 27 patients who received CSI (30%) reported phantosmia (odds ratio, 7.66; 95% confidence interval, 2.07-28.34; P = .002). ConclusionsIn the first-ever study examining radiation-induced phantosmia among children and young adults treated with IMPT, all affected patients received irradiation dose to the olfactory region. Physician awareness of phantosmia, especially in the context of CSI, may improve the patient experience and treatment compliance. A prospective study is needed to elucidate frequency, severity, and phantosmia mechanism.

Multidisciplinary management of juvenile nasopharyngeal angiofibroma

BackgroundJuvenile nasopharyngeal angiofibroma (JNA) is a rare benign, but the locally aggressive, vascular tumor that occurs almost exclusively in young men. Although this tumor accounts for only about 0.5% of head and neck tumors, it is by far the most common benign nasopharyngeal neoplasm. It is presented typically with epistaxis, obstructive symptoms, and chronic otomastoiditis. The examination of this tumor reveals pale reddish-blue mass. The tumor is seen on imaging as vividly augmenting soft-tissue mass centered on the sphenopalatine foramen. The treatment of choice is usually surgical resection; either open or endoscopic. Pre-operative embolization is usually done to help with hemostasis. We aim to address the efficiency and the safety of endovascular modality in JNA.MethodsIn the period between January 2012 to December 2017, 20 male patients with age ranging from 6 to 20 years were referred to the Endovascular Unit, at Departments of Neurosurgery in Sohag, Alexandria, and Tanta University Hospitals with JNF. Preoperative trans-arterial embolization was done, followed by endoscopic surgical resection by our ENT surgeons. All patients were subjected to clinical and radiological Imaging evaluation pre embolization, post embolization, and post endoscopic resection. All patients had clinical and radiological follow-ups for at least 1 year.Results20 male patients with JNA underwent preoperative super-selective trans-arterial embolization. The average age at presentation was 13 years. All patients underwent successful embolization with total obliteration of vascular blush of the tumor in 15 patients, and near-total obliteration of blush in 5 patients. The dramatic effect of preoperative embolization was observed on limiting intraoperative blood loss (average 200 ml) and decreasing the time of surgery (average 2.5 h). There was no permanent morbidity or mortality related to either embolization or endoscopic resection in all patients.ConclusionsTrans-arterial embolization is strongly recommended in patients with JNA, it offers a good assist to the surgeon, reduces blood loss, decreases the amount of transfusion, improves the degree of resection, reduces operative time, and decreases the incidence of recurrence.

Phantosmia Among Pediatric, Adolescents and Young Adult Patients Receiving Proton Beam Therapy

Phantosmia is defined as an olfactory disorder resulting in a malodorous phantom smell and is a largely underreported toxicity of radiation therapy (RT). We hypothesized that pediatric, adolescent and young adult patients who receive proton beam therapy to tumors located in or adjacent to olfactory region are likely to develop phantosmia. This study aimed to characterize the incidence of phantosmia in a cohort of patients treated with intensity-modulated proton therapy (IMPT).This was an IRB-approved retrospective study. The electronic medical record of a pencil beam scanning-only proton center was queried for all consecutive patients ≤ 39 years old who received IMPT for primary intracranial, metastatic intracranial, skull base, nasopharyngeal or sinonasal neoplasms between August 2019 and December 2020. Patient, clinical, and phantosmia-related characteristics were collected. The olfactory region was defined to include the olfactory bulb and tract. The severity of phantosmia was graded by the intervention needed (mild: no intervention, moderate: supportive treatment, and severe: discontinuation of radiation).A total of 100 patients met the inclusion criteria. Twelve patients developed and reported phantosmia during irradiation. They described the odor as a "chlorine," "broccoli," "stale water," "metallic" or "noxious" smell. Of the patients who reported phantosmia, median age was 17 [12-33] years, 66.7% were male, 91.7% had intracranial tumors, 8.3% skull base tumor. 12.5% of patients under 18 years old reported phantosmia versus 11.5% of patients 18 and older (P = 1). All 12 patients had not previously received RT. Use of chemotherapy with RT did not correlate with presence of phantosmia (OR: 0.76, 95% CI: 0.23-2.54, P = 0.66). Ten patients experienced accompanying toxicities, including taste changes (n = 3), vision disturbances (n = 5) such as flashing and purple lights, and nausea/emesis (n = 5). Phantosmia was categorized as mild for 8 patients and moderate for 4 patients. All patients noted phantosmia during the first fraction of RT and completed RT course as planned. Eight (67%) received craniospinal irradiation (CSI) and reported symptom resolution upon completion of whole brain portion of treatment. The other four patients received focal brain RT, with olfactory region receiving doses as low as 0.5 - 5 Gy. Significantly, 8 of the 27 patients who received CSI (30%) reported phantosmia (OR: 7.26, 95% CI: 1.97-26.74, P = 0.003).Phantosmia is a frequent but underreported toxicity of RT. All patients in our series who developed phantosmia received some dose of radiation to the olfactory region. There is a need for physician awareness of phantosmia, especially in CSI treatment, in order to improve the patient experience and compliance with treatment. A prospective study is needed to elucidate the frequency, severity, and mechanism of this toxicity.

Exudative otitis media in children: the main causes. Part I

Otitis media, including exudative otitis, is one of the most common childhood diseases. Almost asymptomatic course in children of early and preschool age leads to undiagnosed hearing loss. In such cases the minimal auditory deficit significantly affects the auditory-speech development and the formation of higher cortical functions in children. It is pediatricians who are the first to deal with the manifestations of exudative otitis media. Consequently, their knowledge and understanding of the disease, including the most common causes and risk factors, is important. The first part of the literature review considers the theories of the exudative otitis media formation, the role of viral and bacterial flora in the development of the disease, the effect of obstruction of the auditory tube against the background of nasopharyngeal neoplasms, craniofacial anomalies (including chromosomal aberrations), allergic diseases, rhinosinusitis and adenoiditis.

Novel Modifications to Total Maxillary Swing Approach in Extensive Nasopharyngeal Angiofibroma to Minimize Complications.

Maxillary swing approaches provide excellent exposure of the anterior, mid, and anterolateral skull base offering a wide window to approach nasopharyngeal neoplasms; however, they are also associated with complications. The present study aimed to evaluate the results of a modified total maxillary swing (TMS) approach developed to minimize postoperative complications. The modified TMS approach was used to treat five patients who had extensive juvenile nasopharyngeal angiofibromas between March and October 2019 at our tertiary care center. Surgical technique, preoperative image findings, and intra-operative findings were recorded. In the postoperative follow-up, patients were examined to rule out all possible complications associated with the procedure according to the literature. A retrospective analysis was performed to assess tumor extensions, surgical modifications, and postoperative complications. All tumors had orbital and infratemporal (lateral limit) involvement while four had intracranial involvement. No per-operative complications were reported, and postoperative clinical and endoscopic evaluation was performed at 1, 2, and 3months. There was no evidence of complications including residue, recurrence, maxillary necrosis, ophthalmoplegia, epiphora, palatal fistula, or jaw malocclusion. Besides, minor complications such as infraorbital margin skin retraction, infraorbital serous collection, maxillo-zygomatic abscess, and unsightly scar were also not seen. Only one case presented with maxillary osteomyelitis which was resolved with mini-plate removal and antibiotics. A modified TMS approach is a prudent option to ensure complete removal of juvenile nasopharyngeal angiofibromas with negligible complications.

Clinical application of endonasopharyngeal ultrasound-guided transnasopharyngeal needle aspiration in the diagnosis of submucosal nasopharyngeal carcinoma.

Background and Objectives: Submucosal nasopharyngeal carcinoma (NPC) is a rare type, which is usually difficult to obtain tissue samples. We aimed to evaluate the diagnostic yield and safety of a new technique of endonasopharyngeal ultrasound-guided transnasopharyngeal needle aspiration (ENUS-TNNA) for submucosal NPC.Subjects and Methods: This was a retrospective study. Between March 2018 and September 2019, 11 patients with submucosal nasopharyngeal neoplasms detected with previously computed tomography or magnetic resonance imaging underwent ENUS-TNNA. All patients had cytological evaluation by smears and tissue evaluation of aspiration specimens. Mean and rate.Results: There were seven males and four females, with ages ranging from 33 to 77 years. Needle puncture biopsies were successfully performed in all cases, and sufficient tissue sample for histopathological examination was obtained from each of the 11 patients. Of the 11 patients, nine of these patients were diagnosed using ENUS-TNNA without on-site cytology assistance, false negative in two cases. The sensitivity of the ENUS-TNNA technique in diagnosing submucosal NPC was 81.82%. In the absence of any major complications, the procedure was uneventful.Conclusions: ENUS-TNNA is a safe and effective method to provide a pathological diagnosis of submucosal growth type of nasopharyngeal neoplasms, which has a great clinical value.

Demographical Investigations of Iraqi Patients with Nasopharyngeal and Sinonasal Neoplasms

Demographical Investigations of Iraqi Patients with Nasopharyngeal and Sinonasal Neoplasms

Analysis of MRI radiomic features of hypoxic area in nasopharyngeal carcinoma patients

Objective To analyze the magnetic resonance imaging (MRI) radiomic performance of hypoxic area in nasopharyngeal carcinoma patients, aiming to provide a reference for identification and analysis of hypoxic area. Methods The MRI-T1, MRI-T2, MRI-T1+ and PET/CT images of 32 patients initially diagnosed with nasopharyngeal carcinoma were retrospectively analyzed. The gross tumor volume (GTV) of nasopharynx was countoured and the hypoxic areas (GTV-H) were identified by 18F-FMISO-PET images. The non-hypoxic areas (GTV-NH) were defined as the rest of areas removed GTV-H from GTV. The radiomic features of GTV-H and GTV-NH were extracted and compared. Results The average volume of GTV-H and GTV-NH was (10.92±11.02) cm3 and (7.21±5.70) cm3, respectively. The maximum rate of change was 46% for intensity direct-global min (ID-GM) on MRI-T1(P 0.7 and Youden index>0.5). The average rate of change was 136% for long run emphasis (LRE), long run high gray level emphasis (LRHGLE) and long run low gray level emphasis (LRLGLE) on MRI-T2(P 0.7 and Youden index>0.5). The high change rates was greater than 90% on MRI-T1+ (P 0.7 and Youden index>0.5) for ID-GM, LRE, LRHGLE and LRLGLE. Conclusions The hypoxic area of tumor target can be reflected by MRI radiomics on T1/T2/T1+ . Quantifying and tracking the variations of these features can bring benefit to recognize the hypoxic area of nasopharyngeal carcinoma tumor target. Key words: Nasopharyngeal neoplasm hypoxic area; Radiomics; Hypoxic area identification

Effects of buccal green tea ice on preventing oral mucositis in patients undergoing radiotherapy for nasopharyngeal carcinoma

Objective To observe the effects of buccal green tea ice on preventing and controlling radioactive oral mucositis caused by radiotherapy for nasopharyngeal carcinoma. Methods In this single-blind quasi-experiment, totally 160 patients diagnosed with nasopharyngeal carcinoma by histopathology or cytology and treated in the Department of Oncology, Taizhou People's Hospital from April 2014 to April 2018 were selected by convenient sampling and randomized into control (n=41) , buccal ice (n=40) , green tea mouthwash (n=40) and buccal green ice tea (n=39) groups. Since radiotherapy, patients in the control group received conventional nursing care; patients in the buccal ice group received buccal ice; patients in the green tea mouthwash group received green tea mouthwash; and patients in the buccal green tea ice group received buccal green tea ice. The incidence of oral mucosa response and pain grading were compared among the four groups. Results The incidence rates of oral mucosa response after radiotherapy were 85.37%, 97.50%, 92.50% and 79.49% in control, buccal ice, green tea mouthwash and buccal green ice tea groups. The incidence rates of oral mucosa response 1 week after radiotherapy were 100.00%, 72.50%, 77.50% and 66.67% in control, buccal ice, green tea mouthwash and buccal green ice tea groups and there was statistically significant difference between the four groups (P<0.05) . There was statistically significant difference in the pain levels 1 week after radiotherapy between the four groups (P<0.05) . Totally 41 cases (100.0%) in the control group, 35 (87.5%) in the ice group, 39 (97.5%) in the green tea group and 26 (66.7%) in the buccal green tea ice group suffered pain 1 week after radiotherapy. Conclusions Buccal green tea ice can effectively alleviate the severity of oral mucositis in patients undergoing radiotherapy for nasopharyngeal carcinoma, reduce their pain, ameliorate their clinical symptoms, and prevent radioactive oral mucositis caused by nasopharyngeal carcinoma. Key words: Nasopharyngeal neoplasms; Radiotherapy; Pain; Radioactive oral mucositis; Green tea; Ice

The expression and clinical significance of DDR2 and IFITM1 in nasopharyngeal carcinoma

Objective To investigate the expression of discoid domain receptor 2 (DDR2) and interferon-induced transmembrane protein 1 (IFITM1) in nasopharyngeal carcinoma (NPC) patients and their clinical significance. Methods From November 2014 to November 2015, 65 patients with nasopharyngeal carcinoma were selected. All patients underwent nasopharyngeal biopsy. All specimens were embedded in paraffin after biopsy. All specimens were confirmed by pathology. Another 65 rhinitis mucosa specimens with chronic inflammation confirmed by pathology in the same period were selected as control group. The clinical and pathological data of the two groups were collected. The mRNA and protein expression levels of DDR2 and IFITM1 in nasopharyngeal carcinoma tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry. The correlation between them was analyzed by Pearson. All patients were followed up for 3 years, and the 3-year survival period of the patients was analyzed by Kaplan-Meier method. Results The results of qRT-PCR showed that the relative expression levels of DDR2 and IFITM1 in nasopharyngeal carcinoma tissues were significantly higher than those in control group (P<0.05). Immunohistochemical results showed that the positive rates of DDR2 and IFITM1 in nasopharyngeal carcinoma were significantly higher than those in control group (P<0.05). The results of expressions of DDR2 and IFITM1 and the clinicopathological analysis of the patients showed that the expression of DDR2 was correlated with TNM stage, differentiation degree and infiltration depth, and IFITM1 was correlated with lymph node metastasis, TNM stage, differentiation degree and infiltration depth (P<0.05). Pearson correlation analysis showed that there was correlation between DDR2 and IFITM1 (r=0.608, P<0.01). Kaplan-Meier analysis showed that the progression-free survival rate (41.17%) and total survival rate (52.94%) in DDR2 negative expression group were significantly higher than those in positive expression group (16.67%, 18.75%, P<0.05). The progression-free survival rate (42.86%) and total survival rate (61.90%) in IFITM1 negative expression group were significantly higher than those in positive expression group (18.18%, 20.45%, P<0.05). Conclusions DDR2 and IFITM1 are highly expressed in nasopharyngeal carcinoma, which may be involved in the occurrence and development of nasopharyngeal carcinoma and significantly affect the prognosis of patients. Key words: Nasopharyngeal neoplasms; Discoidin domain receptor 2; Interferon-induced transmembrane protein 1

The failure patterns and related factors of nasopharyngeal carcinoma treated by intensity modulated radiation therapy in Xiangxi area

Objective To analyze the failure patterns and related factors of intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) in Xiangxi. Methods 107 patients with nasopharyngeal carcinoma without distant metastasis were selected from December 2012 to June 2015 in the first affiliated hospital of Jishou University. Locoreginal recurrence-fee survival rate (LRFS), distant metastasis-free survival rate (DMFS) and progression-free survival (FPS) rate were collected. The survival rate was analyzed by Kaplan-Meier method, univariate analysis was analyzed by Logrank method, and multivariate analysis was analyzed by Cox regression. Results Tumor progression occurred in 40 cases of 107 patients with nasopharyngeal carcinoma. Among them, 14 cases(13.1%) had local recurrence and 33 cases (30.8%) had distant metastasis. Univariate analysis showed that there was significant difference in LRFS between different ages and T staging (P<0.05). There was significant difference in DMFS and PFS between different gender, ages, diabete history, smoking history, T staging, N stage, clinical stage and treatment mode (P<0.05). Multivariate analysis showed that age and T staging were independent prognostic factors for LRFS. Age, T staging and N staging were independent prognostic factors for DMFS. Age, diabetes, T staging, and N staging were independent prognostic factors for PFS (P<0.05). Conclusions Distant metastasis is still the main model of treatment failure of NPC. Age, T staging and N staging before treatment are the significant prognostic factors. Key words: Nasopharyngeal neoplasms; Radiotherapy, intensity-modulated; Prognosis; Factor analysis, statistical

Effects of cancer case management in the whole processing management of nasopharyngeal carcinoma patients

Objective To explore the application and effect of the cancer case management led by cancer case managers in the whole processing management of nasopharyngeal carcinoma (NPC) patients. Methods A randomized controlled study was designed. 510 patients with nasopharyngeal carcinoma were randomly divided into two groups: the observation group (255 cases) and the control group (255 cases). The observation group adopted the case management led by cancer case managers, and the control group adopted the cancer case management. To evaluate the rate of seeing a doctor, the implementation rate of the treatment plan and the rate of the first follow-up visit between the two groups. M.D. Anderson symptom Inventory-head-neck (MDASI-H&N) was used to evaluate the symptom disturbance (the day of hospitalization, the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge). Results The treatment rate was 90.2% (230/255) in the observation group, 78.04% (199/255) in the control group, The rate of implementation of established treatment plans 99.57% (229/230) in the observation group and 90.95% (181/199) in the control group. The first follow-up rate was 98.70% (227/230) in the observation group and 84.42% (168/199) in the control group. The difference was statistically significant (Z=19.768, 15.207, 7.042, P < 0.01). In the observation group, the average value of symptom disturbance, the average severity of symptom distress and the average degree of symptom disturbance in 3 times (the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge) were (3.00±0.95) , (2.43±0.16) , (2.03±0.34) , (2.95±0.97) , (2.46±0.12) , (2.11±0.16) , (2.89±0.46) , (2.41±0.33) , (1.99±0.16) ; Significantly lower than the control group (3.69±1.51) , (2.82±0.23) , (2.42±0.13) , (3.88±1.39) , (2.87±0.34) , (2.54±0.22) , (3.61±0.75) , (2.72±0.42) , (2.38±0.17) , the difference has the statistical significance (t=-21.152—10.372, P < 0.01). Conclusion The case management led by cancer case manager can effectively improve the rate of seeing a doctor, the rate of completion of the plan and the rate of the first visit, and ensure the patients to receive effective, standard and full treatment in time. In addition, the case management can effectively improve the symptoms of patients and promote their early return to the community. Key words: Nasopharyngeal neoplasms; Cancer case management; Symptomatic disturbance

Research progress of aerobic exercise in patients with nasopharyngeal carcinoma

This paper reviews the concept of aerobic exercise, the influence of aerobic exercise on cancer patients and the importance of aerobic exercise for nasopharyngeal carcinoma patients, which provides theoretical basis for clinical research on aerobic exercise for nasopharyngeal carcinoma patients. Key words: Nasopharyngeal neoplasms; Aerobic exercise; Neoplastic cells; Fatigue; Quality of Life