Objective:The aim of this study is to develop a multimodal MRI radiomics-based model for predicting long-term overall survival in hypopharyngeal cancer patients undergoing definitive radiotherapy.Methods:We enrolled 2...Objective:The aim of this study is to develop a multimodal MRI radiomics-based model for predicting long-term overall survival in hypopharyngeal cancer patients undergoing definitive radiotherapy.Methods:We enrolled 207 hypopharyngeal cancer patients who underwent definitive radiotherapy and had 5-year overall survival outcomes from two major cancer centers in China.Pretreatment MRI images and clinical features were collected.Regions of interest(ROIs)for primary tumors and lymph node metastases(LNM)were delineated on T2 and contrast-enhanced T1(CE-T1)sequences.Principal component analysis(PCA),support vector machine(SVM),and 5-fold cross-validation were used to develop and evaluate the models.Results:Multivariate Cox regression analysis identified age under 50 years,advanced T stage,and N stage as risk factors for overall survival.Predictive models based solely on clinical features(Model A),single radiomics features(Model B),and their combination(Model C)performed poorly,with mean AUC values in the validation set of 0.663,0.772,and 0.779,respectively.The addition of multimodal LNM and CE-T1 radiomics features significantly improved prediction accuracy(Models D and E),with AUC values of 0.831 and 0.837 in the validation set.Conclusion:We developed a well-discriminating overall survival prediction model based on multimodal MRI radiomics,applicable to patients receiving definitive radiotherapy,which may contribute to personalized treatment strategies.展开更多
Nasopharyngeal carcinoma(NPC)is a malignant epithelial tumor originating in the nasopharynx and has a high incidence in Southeast Asia and North Africa.To develop these comprehensive guidelines for the diagnosis and m...Nasopharyngeal carcinoma(NPC)is a malignant epithelial tumor originating in the nasopharynx and has a high incidence in Southeast Asia and North Africa.To develop these comprehensive guidelines for the diagnosis and management of NPC,the Chinese Society of Clinical Oncology(CSCO)arranged a multi-disciplinary team comprising of experts from all sub-specialties of NPC to write,discuss,and revise the guidelines.Based on the findings of evidencebased medicine in China and abroad,domestic experts have iteratively developed these guidelines to provide proper management of NPC.Overall,the guidelines describe the screening,clinical and pathological diagnosis,staging and risk assessment,therapies,and follow-up of NPC,which aim to improve the management of NPC.展开更多
Background:Nasopharyngeal carcinoma (NPC) is sensitive to radiotherapy (RT).However,neurocognitive complications such as memory loss and learning and attention deficits emerge in the survivors of NPC who received RT.I...Background:Nasopharyngeal carcinoma (NPC) is sensitive to radiotherapy (RT).However,neurocognitive complications such as memory loss and learning and attention deficits emerge in the survivors of NPC who received RT.It remains unclear how radiation affects patient brain function.This pilot study aimed at finding cerebral functional alterations in NPC patients who have received RT.Methods:From September 2014 to December 2016,42 individuals,including 22 NPC patients and 20 normal volunteer controls in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences,and Peking Union Medical College,were recruited in this study.All patients received resting-state functional magnetic resonance imaging scans and neurocognitive tests 1 day before the initiation of RT (baseline) and 1 day after the completion of RT;the 20 normal controls were also subjected to the same scans and tests.The amplitude of the low-frequency fluctuations (ALFF) in blood oxygen level-dependent signals and functional connectivity (FC) were used to characterize cerebral functional changes.Independent t test,paired t test,and analysis of variances were used to obtain statistical significance across groups.Results:After RT,NPC patients showed significantly decreased ALFF values in the calcarine sulcus,lingual gyrus,cuneus,and superior occipital gyrus and showed significantly reduced FC mainly in the default mode network (P < 0.05,corrected by AlphaSim).Relative to the controls,ALFF was decreased in the lingual gyrus,calcarine sulcus,cingulate cortex,medial prefrontal gyrus (P < 0.05,corrected by AlphaSim),and FC reduction was found in multiple cerebellar-cerebral regions,including the cerebellum,parahippocampus,hippocampus,fusiform gyrus,inferior frontal gyrus,inferior occipital gyrus,precuneus,and cingulate cortex (P < 0.001,corrected by AlphaSim).Conclusions:Cerebral functional alterations occur immediately after RT.This study may provide an explanation for the cognitive deficits in the morphologically normal-appearing brains of NPC patients after RT and may contribute to the understanding of the complex mechanism of RT.展开更多
Purpose Nasopharyngeal carcinoma(NPC)is a malignant epithelial tumor originating in the nasopharynx and is particularly prevalent in southern China.Unfortunately,international guidelines,such as NCCN or ESMO,fail to a...Purpose Nasopharyngeal carcinoma(NPC)is a malignant epithelial tumor originating in the nasopharynx and is particularly prevalent in southern China.Unfortunately,international guidelines,such as NCCN or ESMO,fail to adequately coincide with clinical practice in China,making it difficult to achieve precision personalized therapy in China.The aim of this guideline is to better promote a"Multidisciplinary Team to Holistic Integrative Medicine"(MDT to HIM)system for the prevention,screening,diagnosis,treatment,and rehabilitation of NPC.Methods The China Anti-Cancer Association(CACA)invited domestic multi-disciplinary experts,involving radiologists,oncologists,surgeons,pathologists,herbalists,physiatrists,and psychologists,to write,discuss,and revise the guidelines.Based on the integration of research evidence,clinical experience,and patient needs,the domestic experts have iteratively developed these guidelines to provide proper and feasible management of NPC.Results and conclusion The CACA Guidelines for Holistic Integrative Management of Nasopharyngeal Carcinoma are more suitable for China’s clinical practice,highlight Chinese characteristics,and have important clinical significance.展开更多
基金CAMS Innovation Fund for Medical Sciences(CIFMS)under the Chinese Academy of Medical Sciences for Clinical and Translational Medicine Research Special Project(2023-I2M-C&T-B-072)Capital's Funds for Health Improvement and Research for the Beijing Municipal Health Development Scientific Research Special Project(2024-2-40212)。
文摘Objective:The aim of this study is to develop a multimodal MRI radiomics-based model for predicting long-term overall survival in hypopharyngeal cancer patients undergoing definitive radiotherapy.Methods:We enrolled 207 hypopharyngeal cancer patients who underwent definitive radiotherapy and had 5-year overall survival outcomes from two major cancer centers in China.Pretreatment MRI images and clinical features were collected.Regions of interest(ROIs)for primary tumors and lymph node metastases(LNM)were delineated on T2 and contrast-enhanced T1(CE-T1)sequences.Principal component analysis(PCA),support vector machine(SVM),and 5-fold cross-validation were used to develop and evaluate the models.Results:Multivariate Cox regression analysis identified age under 50 years,advanced T stage,and N stage as risk factors for overall survival.Predictive models based solely on clinical features(Model A),single radiomics features(Model B),and their combination(Model C)performed poorly,with mean AUC values in the validation set of 0.663,0.772,and 0.779,respectively.The addition of multimodal LNM and CE-T1 radiomics features significantly improved prediction accuracy(Models D and E),with AUC values of 0.831 and 0.837 in the validation set.Conclusion:We developed a well-discriminating overall survival prediction model based on multimodal MRI radiomics,applicable to patients receiving definitive radiotherapy,which may contribute to personalized treatment strategies.
文摘Nasopharyngeal carcinoma(NPC)is a malignant epithelial tumor originating in the nasopharynx and has a high incidence in Southeast Asia and North Africa.To develop these comprehensive guidelines for the diagnosis and management of NPC,the Chinese Society of Clinical Oncology(CSCO)arranged a multi-disciplinary team comprising of experts from all sub-specialties of NPC to write,discuss,and revise the guidelines.Based on the findings of evidencebased medicine in China and abroad,domestic experts have iteratively developed these guidelines to provide proper management of NPC.Overall,the guidelines describe the screening,clinical and pathological diagnosis,staging and risk assessment,therapies,and follow-up of NPC,which aim to improve the management of NPC.
基金This work was supported by grants from the National Natural Science Foundation of China(No.81402528,No.11275270).
文摘Background:Nasopharyngeal carcinoma (NPC) is sensitive to radiotherapy (RT).However,neurocognitive complications such as memory loss and learning and attention deficits emerge in the survivors of NPC who received RT.It remains unclear how radiation affects patient brain function.This pilot study aimed at finding cerebral functional alterations in NPC patients who have received RT.Methods:From September 2014 to December 2016,42 individuals,including 22 NPC patients and 20 normal volunteer controls in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences,and Peking Union Medical College,were recruited in this study.All patients received resting-state functional magnetic resonance imaging scans and neurocognitive tests 1 day before the initiation of RT (baseline) and 1 day after the completion of RT;the 20 normal controls were also subjected to the same scans and tests.The amplitude of the low-frequency fluctuations (ALFF) in blood oxygen level-dependent signals and functional connectivity (FC) were used to characterize cerebral functional changes.Independent t test,paired t test,and analysis of variances were used to obtain statistical significance across groups.Results:After RT,NPC patients showed significantly decreased ALFF values in the calcarine sulcus,lingual gyrus,cuneus,and superior occipital gyrus and showed significantly reduced FC mainly in the default mode network (P < 0.05,corrected by AlphaSim).Relative to the controls,ALFF was decreased in the lingual gyrus,calcarine sulcus,cingulate cortex,medial prefrontal gyrus (P < 0.05,corrected by AlphaSim),and FC reduction was found in multiple cerebellar-cerebral regions,including the cerebellum,parahippocampus,hippocampus,fusiform gyrus,inferior frontal gyrus,inferior occipital gyrus,precuneus,and cingulate cortex (P < 0.001,corrected by AlphaSim).Conclusions:Cerebral functional alterations occur immediately after RT.This study may provide an explanation for the cognitive deficits in the morphologically normal-appearing brains of NPC patients after RT and may contribute to the understanding of the complex mechanism of RT.
文摘Purpose Nasopharyngeal carcinoma(NPC)is a malignant epithelial tumor originating in the nasopharynx and is particularly prevalent in southern China.Unfortunately,international guidelines,such as NCCN or ESMO,fail to adequately coincide with clinical practice in China,making it difficult to achieve precision personalized therapy in China.The aim of this guideline is to better promote a"Multidisciplinary Team to Holistic Integrative Medicine"(MDT to HIM)system for the prevention,screening,diagnosis,treatment,and rehabilitation of NPC.Methods The China Anti-Cancer Association(CACA)invited domestic multi-disciplinary experts,involving radiologists,oncologists,surgeons,pathologists,herbalists,physiatrists,and psychologists,to write,discuss,and revise the guidelines.Based on the integration of research evidence,clinical experience,and patient needs,the domestic experts have iteratively developed these guidelines to provide proper and feasible management of NPC.Results and conclusion The CACA Guidelines for Holistic Integrative Management of Nasopharyngeal Carcinoma are more suitable for China’s clinical practice,highlight Chinese characteristics,and have important clinical significance.
