The Integration of the Pre-Treatment Neutrophil-to-Lymphocyte Ratio in the Eighth Edition of the AJCC Staging System for Nasopharynx Cancer

ObjectiveThe present study aimed to evaluate the role of integrating the pretreatment neutrophil-to-lymphocyte ratio (NLR) into the eighth edition of the AJCC staging system for nasopharynx cancer in an endemic region.MethodsBetween May 2007 and December 2012, a total of 713 cases with NPC were retrospectively analyzed. The separation ability in terms of overall survival (OS), local failure-free survival (LFFS), distant metastasis-free survival (DMFS), and failure-free survival (FFS) was evaluated. The discriminatory ability was assessed using Harrell’s concordance index (c-index). Recursive partitioning analysis (RPA) was conducted and incorporated with pretreatment NLR.ResultsWhen integrated with NLR, the separate and discriminatory abilities for N classifications were improved in terms of OS and DMFS, but not for T categories. By using Recursive partitioning analysis, five subgroups were generated. Compared with the overall stage, the integration of NLR could not enhance the separate and discriminatory abilities. However, patients in the RPA 4 group gained significant benefits in terms of OS (HR 0.390 (95%CI 0.212-0.716), P = 0.002) and FFS (HR 0.548 (95%CI 0.314-0.958), P = 0.032) from the additional adjuvant chemotherapy after concurrent chemoradiotherapy.ConclusionThe integration of NLR into the 8th edition of the AJCC staging system could enhance the separation and discriminatory abilities for N classifications, but not for T categories. In addition, patients in the RPA 4 group could benefit from the addition of adjuvant chemotherapy to concurrent chemoradiotherapy.

Evaluation of Thyroid Cancer Risk After Laryngeal and Nasopharyngeal Radiotherapy

Background: Nasopharyngeal carcinoma is an uncommon head and neck cancer, which is commonly seen in young people aged from 15 to 25 years. Laryngeal cancer, on the other hand, is the second most common cancer among head and neck cancers. The primary treatment for patients with these carcinomas is radiotherapy. Objectives: This study aimed at estimation of thyroid cancer risk, as an organ at risk after laryngeal and nasopharyngeal radiotherapy Methods: with permission from the author, data related to thyroid dose of 20 patients who underwent radiotherapy of laryngeal and nasopharynx cancer in Soleimani et al. paper were used, and using the BEIR VII model, we calculated thyroid cancer risk. Results: lifetime attributable risk (LAR) of thyroid increased up to 2.7% in the treatment of nasopharyngeal cancer and up to 1.8% in the treatment of laryngeal cancer. The highest LAR values belonged to the treatment of nasopharyngeal cancer. Conclusions: radiotherapy for nasopharyngeal and laryngeal cancers considerably increased the risk of thyroid cancer in patients undergoing radiotherapy; such that the risk increased by more than 2.5% at younger ages. It is recommended to use an advanced treatment technique to reduce thyroid cancer risk and perform follow-ups annually in terms of the status of the thyroid gland and its changes.

Family Support: A Caregiver Experience in Caring for Nasopharynx Cancer Patients in Yogyakarta

BACKGROUND: Increasing the incidence of nasopharyngeal cancer causes an increase mortality in sufferers. Family support is an important aspect of the treatment of patients that very helpful to strengthen psychologically and make patients more enthusiastic about undergoing treatment. Patients who have high enthusiasm will improve their quality of life so that family support is needed in treating patients. AIM: This study aims to explore family experiences in providing support in the care of nasopharyngeal cancer patients in Yogyakarta. METHODS: This research uses qualitative method with phenomenological approach. Data collected through in-depth interviews. Informants in this study amounted to 12 people consisting of patients and families determined by purposive sampling. This research was conducted in Sleman Regency from January to April 2019. Data validity uses source triangulation, member checking, and peer debriefing. Analysis of the data in this study using the help of OpenCode 4.02 software. RESULTS: The results showed that the treatment of patients with nasopharyngeal cancer was influenced by several factors, namely, family perceptions in caring for patients, family knowledge about the disease, and family information sources. These factors will affect the family process in providing care to patients including family support, family communication, and medication that have been undertaken. Family support is provided in the care of nasopharyngeal cancer patients in the form of emotional, informational, instrumental, appreciation, and spiritual support. In addition, in carrying out patient care, there are several obstacles, namely, transportation, administrative, and financial obstacles. CONCLUSION: The family is expected to always provide support to patients in the form of emotional support, informational, instrumental, and appreciation as well as spiritual support for the success of treatment of the patient.

Preparation of Isorhamnetin Nanoparticles and Their Targeting Efficiency to Nasopharynx Cancer

Cancer is a serious threat to human health and longevity, and is an important cause of disease death. At present, cancer is mainly treated by surgery, radiotherapy, chemotherapy, etc. The existing various methods of treating tumors have their limitations. Although there are immune, genetic and other treatment methods, they are still immature. Therefore, tumor-targeted drug delivery systems have attracted more and more attention in cancer treatment. Targeted nano-drugs are selectively targeted to the tumor surface to achieve targeted drug delivery. New nano-drugs have created new hotspots in medical research. It could be a new strategy for treating cancer. Carboxymethyl chitosan (CMC) is formed by the carboxylation of chitosan. It has good water solubility and biodegradability, biocompatibility and antibacterial properties, so CMC is the best choice as a nanomaterial. Isorhamnetin (Iso) is an important anticancer drug. This article uses nanomedicine technology to construct CMC as a carrier, Iso as an antitumor drug, and using polydopamine (PDA) to modify the surface of the particles. Through in vitro and in vivo experiments, the Iso/CMC-PDA nanosphere Targeting and Growth Inhibition of Cervical Cancer Cells.