Knowlesbrun2434

PURPOSE Concurrent chemoradiotherapy (CCRT) is the mainstay of treatment for nasopharyngeal carcinoma (NPC) patients. It remains unclear whether double-agent CCRT (d-CCRT) is more effective than single-agent CCRT (s-CCRT). In this study, we compared the treatment efficiency and toxicity of d-CCRT with s-CCRT in NPC patients. METHODS AND MATERIALS Patients with stage II-IV NPC treated with d-CCRT or s-CCRT were retrospectively reviewed. The d-CCRT group patients were compared with s-CCRT group patients for overall survival (OS), locoregional relapse-free survival (LRRFS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and toxicity. Differences in baseline characteristics were adjusted using the pair-matching method. RESULTS In this study, 933 patients who received CCRT for NPC between 2011 and 2014 were pair-matched at a 12 ratio (n = 311 for d-CCRT; n = 622 for s-CCRT). The d-CCRT treated patients showed no significant advantages in terms of 4-year OS (87.2% vs. 85.5%), DFS (84.1% vs. 79.5%), LRRFS (94.6% vs. 91.8%), DMFS (87.5% vs. 85.5%) compared with s-CCRT treated patients (P = 0.450, 0.106, 0.203, 0.366, respectively). Multivariate analysis showed that CCRT regimen had no significant effects on survival. In the d-CCRT group, the incidence of grade 3-4 hematological toxicities was significantly higher. CONCLUSIONS The d-CCRT regimen did not confer significant survival benefits compared with the s-CCRT regimen in the treatment of stage II-IV NPC patients. Furthermore, patients treated with the d-CCRT regimen experienced greater hematological toxicity. OBJECTIVES In current guidelines, early tongue cancer status post partial glossectomy without adverse risk features do not require adjuvant treatment. click here However, many of these patients developed recurrence with neck metastases soon. The objectives of this study were to investigate the potential risk factors in early tongue cancer that prophylactic management of neck may be considered. MATERIALS AND METHODS From January 2010 to September 2015, this retrospective study enrolled 102 patients with T1-2N0 primary oral tongue squamous cell carcinoma according to AJCC 8th edition Cancer Staging System. All patients underwent partial glossectomy with or without selective neck dissection, and did not receive any adjuvant treatment. Patients with any adverse risk features were excluded. We have studied the 4-year cancer-specific survival and neck recurrence rate, and analyzed the relevance between pathologic tumor classification, tumor depth, tumor histologic grade, and measured surgical margin of primary tumor. RESULTS The median follow up duration was 47 months (range 6-93 months) with the median recurrence interval was 13 months. Histologic grade ≥2 of primary tumor was significantly associated with increased risk of neck recurrence and disease-specific mortality in both univariate and multivariate analysis. CONCLUSION Histologic grade ≥2 was an adverse prognostic factor of neck recurrence and was significantly associated with poor cancer-specific survival in T1-2N0 early oral tongue cancer patients. Therefore, prophylactic neck dissection or prophylactic adjuvant radiation therapy to neck may be considered in T1-2N0 early oral tongue cancer with histologic grade ≥2 of primary tumor. In response to a flickering visual stimulus, the BOLD response in primary visual cortex varies with the flickering frequency and is maximal when it is close to 8Hz. In previous studies we demonstrated that BOLD signals in specific white matter (WM) pathways covary with the alternations between stimulus conditions in a block design in similar manner to gray matter (GM) regions. Here we investigated whether WM tracts show varying responses to changes in flicker frequency and are modulated in the same manner as cortical areas. We used a Fourier analysis of BOLD signals to measure the signal amplitude and phase at the fundamental frequency of a block-design task in which flickering visual stimuli alternated with blank presentations, avoiding the assumption of any specific hemodynamic response function. The BOLD responses in WM pathways and the primary visual cortex were evaluated for flicker frequencies varying between 2 and 14Hz. The variations with frequency of BOLD signals in specific WM tracts followed closely those in primary visual cortex, suggesting that variations in cortical activation are directly coupled to corresponding BOLD signals in connected WM tracts. Statistically significant differences in the timings of BOLD responses were also measured between visual cortex and specific WM bundles. These results confirm that when cortical BOLD responses are modulated by selecting different task parameters, relevant WM tracts exhibit corresponding BOLD signals that are also affected. Febrile infection-related epilepsy syndrome (FIRES) is an intractable neurological disease characterized by an unexplained refractory status epilepticus triggered by febrile infection. A Consensus definition of FIRES was proposed in 2018, and its clinical features and prognosis are gradually being clarified. However, the development of effective treatments has been hindered as the etiology of this rare disease is as yet unelucidated. The basic approach to the management of FIRES, like other forms of epilepsy, is based on the control of seizures, however seizures are extremely intractable and require intravenous administration of large doses of anticonvulsants, mainly barbiturates. This treatment strategy produces various complications including respiratory depression and drug hypersensitivity syndrome, which make it more difficult to control seizures. Consequently, it is crucial to predict these events and to formulate a planned treatment strategy. As well, it is important to grow out of conventional treatment strategies that rely on only anticonvulsants, and alternative therapies are gradually being developed. One such example is the adoption of a ketogenic diet which may lead to reduced convulsions as well as improve intellectual prognosis. Further, overproduction of inflammatory cytokines in the central nervous system has been shown to be strongly related to the pathology of FIRES which has led to attempts at immunomodulation therapy including anti-cytokine therapy.