The findings from the present study suggest that 24 weeks of sofosbuvir plus ribavirin is an efficacious and well tolerated treatment in patients with HCV genotype 4 infection.

No abstract

Purpose: The objective of this study was to assess a contemporary cohort of patients with multiple myeloma referred for palliative radiation to the mobile spine for clinical and radiological responses. Materials/Methods: The records of patients treated between 2009 and 2016 with radiotherapy for multiple myeloma of the spine were retrospectively reviewed. Demographics, systemic therapy, radiation dose, number of fractions, radiographic response based upon adapted RECIST criteria, and symptomatic response were recorded. Results: Eighty eight patients and 98 treatment courses were analyzed. All courses were analyzed for symptomatic response and 61 of the treatment courses were available for radiologic follow-up. The median follow-up was 9.7 months with a median radiation dose of 25 Gy (12.5–50 Gy) delivered in a median of 10 fractions (5–25 fractions). Fifty-four percent of patients had a high-risk lesion. Symptomatic response as measured by a decrease of ≤5 points on the pain related scale was 83% and 34% of patients had a decrease of >5 points. Of 35% of patients that had neurologic impairments prior to treatment, improvement was identified 83% of the time. Radiographic response was noted as 13% complete response, 16% partial response, 57% stable disease, and 13% disease progression. Specifically, high-risk lesions treated with radiation alone demonstrated no regression with only 10% demonstrating partial response. Conclusion: This retrospective series of patients treated with palliative intent for multiple myeloma using various dose and fractionation schemes showed favorable symptomatic relief in most patients. Radiographic response did not correlate with clinical response with fewer patients having radiologic disease regression. Longer follow-up is necessary to determine if the lack of radiologic response is associated with clinically relevant recurrent pain.

No abstract

Purpose/Objective(s): Age above 60 is an adverse factor for aggressive Lymphoma, however, the majority of patients with extranodal nasal-type NK/T-cell lymphoma (NKTCL) were younger than 60 years. The relationship between patient age as a continuous variable and treatment choice or survival outcome in early stage NKTCL is rarely studied. Materials/Methods: Between January 2000 and June 2015, 1354 patients with early stage (I-II) NKTCL from 10 institutions in China were retrospectively reviewed. Clinical characteristics and treatment strategies were compared according to patients' quartile age strata (33 vs. 34-43 vs. 44-53 vs. 54). Multivariable proportional hazards modeling using penalized spline regression was used to examine the association between age and overall survival (OS) and progression free survival (PFS), and to determine whether there was an age cutoff point denoting OS and PFS difference. Competing risk regression was used to identify the independent impact of age on local-regional relapse (LRR) and cancer-specific survival (CSS). Results: For all patients, 19.2% patients with age 54 had IPI 2-3 compared with 4.1% for patients aged 33. Treatment varied markedly with age; older patients were more likely to receive radiotherapy alone (28.4% in age 54 vs. 16.0% in age 33). After a median follow up time of 64 months, the 5-year OS in the four age groups were 65.3%, 69.0%, 65.9% and 54.7%, respectively (P Z 0.001). The 5-year PFS were 57.0%, 56.2%, 57.1% and 47.7%, respectively (P Z 0.018). After adjustment for gender, ECOG, stage, LDH, primary tumor invasion (PTI), primary site and B symptoms, increasing age was associated with increasing mortality and progression in a time-dependent fashion, without an apparent cutoff point. After controlling for clinical characteristics +/-treatment modality and radiation dose, age could independently predict CSS and LRR. Conclusion: Older patients are more likely to have high risk factors at diagnosis and receive radiotherapy alone. Patient age is significantly associated with survival outcome, without an apparent age cutoff point demarcating survival differences.