Purpose: Inflammatory markers have been widely used in various cancers, but rarely in nasopharyngeal carcinoma (NPC). Here, we evaluated the prognostic value of pretreatment neutrophil-to-lymphocyte ratio (NLR), platelet-lymphocyte-ratio (PLR), systemic immune index (SII), and systemic inflammation response index (SIRI) on NPC in the intensitymodulated radiotherapy (IMRT) era. Methods: We retrospectively analyzed data from NPC patients from the Renmin Hospital of Wuhan University, between January 2012 and July 2020. We used Chi-square test or Fisher's exact test to compare the baseline characteristics, then applied Kaplan-Meier (K-M) survival analysis to compare the overall survival (OS) and progression-free survival (PFS) rates. Multivariate Cox proportional risk models were applied to identify independent prognostic factors. Results: We enrolled a total of 342 NPC patients and found optimal cut-off values of 2.65, 184.91, 804.08, and 1.34 for NLR, PLR, SII, and SIRI, respectively. K-M survival analysis revealed that high NLR, PLR, SII, and SIRI were significantly associated with worse OS and PFS relative to those in the low groups. Results from univariate Cox analysis showed that clinical, T, and M stages, as well as NLR, PLR, SII, and SIRI were associated with OS, whereas age, alongside the aforementioned parameters, was associated with PFS. Moreover, multivariate Cox analysis showed that age ≥49 years (HR=2.48, 95% CI=1.21-5.05, P=0.013) and M1 stage (HR=3.84, 95% CI=1.52-9.73, P=0.013) were independent prognostic factors for OS, whereas SIRI ≥1.34 (HR=1.91, 95% CI=1.05-3.47, P=0.034) and M1 stage (HR=2.91, 95% CI=1.44-5.86, P=0.003) were independent prognostic factors for PFS. Conclusion: Overall, our findings indicated that high NLR, PLR, SII, and SIRI were significantly associated with poor OS and PFS in NPC patients. High SIRI may be an independent risk factor for PFS of NPC patients in the IMRT era.
The coronavirus disease 2019 (COVID-19) outbreak in Wuhan, China, has caused considerable infection in health-care workers (HCWs). More than 3,000 cases in 422 involved medical facilities have been reported by the Chinese Center for Disease Control and Prevention (China CDC) as of February 22, 2020; 64% occurred in Wuhan. 1 However, the incidence and patterns of infection in medical staff have not yet been described. Patients and Methods COVID-19 infection rates, models of infection, and clinical characteristics and outcomes among HCWs were examined in
Background and purpose. A large sample size study on survival analysis of radiotherapy in ovarian cancer is deficient. This study aimed to explore the survival impact of radiotherapy in ovarian cancer. Materials and methods. Data of patients diagnosed with ovarian cancer between 2010 and 2015 were collected from Surveillance, Epidemiology, and End Results (SEER) Database. Survival comparisons were analyzed using Kaplan–Meier analysis and log-rank tests. Univariate and multivariate Cox regression analyses were used to select predictors associated with survival. Propensity score matching (PSM) analysis was employed to balance baseline variables. Results. A total of 20031 ovarian cancer patients were included, with 291 (1.45%) patients who received radiotherapy. The median overall survival (OS) in patients who received radiotherapy was shorter than which in patients without radiotherapy (23 vs. 75 months, P < 0.001 ). The Elderly, nonepithelial pathology, advanced American Joint Committee on Cancer (AJCC) stage, elevated level of CA125, and receiving radiotherapy were risk predictors to survival in both multivariable analyses before and after PSM. Among 11872 patients with III/IV stage, the radiotherapy group also showed a significantly worse prognosis (median OS: 19 vs. 44 months in patients without radiotherapy, P < 0.001 ). Consistent results were observed in stratification analyses on pathology and stage among patients with III/IV stage. Conclusions. For patients with ovarian cancer, radiotherapy was associated with a poor prognosis regardless of pathology or stage. Considering this is a retrospective study, future studies concerning radiotherapy combination with other new agents in ovarian cancer are needed.
Background Since December 2019, a novel corona virus disease named COVID-19 outbreak in Wuhan, China and spread worldwide then. Active prevention and control measures have been carried out in China, such as vigorous publicity, active screening and rapid isolation. As the major epidemic area, the passages in and out of Wuhan were temporarily closed since January 23. We aimed to demonstrate the effectiveness of rigorous measures by comparing the characteristics of patients hospitalized before and after implementation of vital measures. Methods Clinical data of patients admitted to hospital with COVID-19 during January 17-23 (Phase I) and February 3-9 (Phase II) were collected and compared. The cut-off date for follow-up was March 13, 2020. Results Of 176 patients with COVID-19, 97 were admitted in Phase I (43 [44.3%] male; mean age: 47.7), and 79 were in Phase II (33 [41.8%] male; mean age: 50.1). The proportions of severe cases were 21.6% and 10.1% respectively. Fewer patients had comorbidities (13 [16.5%] vs. 7 [7.2%]) and more asymptomatic patients were in Phase II (27.8% vs. 13.9%). Patients in Phase II had less fever (53.2% vs. 70.1%), cough (34.2% vs. 52.6%) and myalgia (11.4% vs.28.9%), while more diarrhea (11.4% vs. 2.1%). Lymphopenia and elevated CRP, as well as eosinopenia and elevated SAA were common in two groups, but all of that were significantly better in Phase II. More patients in Phase II preformed normal CT image on admission (10 [12.7%] vs. 7 [7.2%]). And lower CT scores (3 [2-4] vs. 2 [1-3]) were observed in Phase II. Up to cut-off date, average response time on CT image were 11.2 and 8.1 days in Phase I and II respectively. Shorter average hospitalized days were in Phase II (18.9 vs. 23.3 days). Four patients (4.1%) in Phase I and two (2.5%) in Phase II died. Conclusions Various actions (including vigorous publicity, active screening and rapid isolation) prompted more early patients with COVID-19 found, diagnosed and remedied, leading to good prognosis. Call for pretty attention to the epidemics of COVID-19 and timely measures around the world.
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