In December 2019, a pneumonia outbreak, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China and presented a major threat to public health. Nationwide, there were more than 70 000 confirmed cases and 2500 deaths. Most patients were elderly, with severe disease. For acute respiratory infection, reverse-transcription polymerase chain reaction (RT-PCR) is routinely used to detect causative viruses in respiratory secretions. Coronavirus RNA can be detected from nose and throat swabs, sputum and other lower respiratory tract secretions, blood, and feces. Such specimens were examined by RT-PCR. Three targets, RdRP, E, and N genes were detected, indicating samples were positive for SARS-CoV-2. After patient recovery, a chest computed tomography examination, combined with SARS-CoV-2 RNA detection, confirmed diagnosis. However, some recovery patients with negative RNA tests turned RNA positive. The preliminary data is about 14% of discharged patients in Guangdong reported by the Guangdong Center for Disease Control (CDC). This is an important scientific issue. If samples are positive for SARS-CoV-2 RNA, patients should be managed according to infection source. Fortunately, there were no close contacts of second-generation cases. We herein report six SARS-CoV-2 cases confirmed in our hospital, for the changes of results of SARS-CoV-2 RNA should attract attention. Most patients were elderly, with a low Geriatric Nutritional Risk Index (GNRI). However, the association of the phenomenon with aging and GNRIhas not yet been reported in detail. Further investigations are necessary to confirm and improve these findings. Similarly, discharged patient follow-up should be strengthened.
Capecitabine combined with nedaplatin offers a satisfactory clinical activity and an acceptable safety profile for recurrent and metastatic nasopharyngeal carcinoma patients after failure of cisplatin-based chemotherapy.
PurposeThis retrospective study evaluates the efficacy and safety of S-1 chemotherapy for recurrent and metastatic nasopharyngeal carcinoma patients after failure of platinum-based chemotherapy.Patients and methodsThirty-nine patients with recurrent and metastatic nasopharyngeal carcinoma who failed previous platinum-based chemotherapy received oral S-1 chemotherapy (twice daily from day 1 to 14) every 3 weeks. The dose of S-1 was determined according to the body surface area (BSA): 40 mg twice a day for BSA <1.25 m2; 50 mg twice a day for 1.25 m2 ≤BSA<1.5 m2; and 60 mg twice a day for BSA ≥1.5 m2.ResultsTreatment was well tolerated. Most adverse events were mild. Grade 3 hematological toxicity occurred in 7.7%. There was one complete response (2.6%) and 12 partial responses (30.7%), giving an overall response rate of 33.3% (95% CI [confidence interval], 21.7–50.8). Median time-to-progression was 5.6 months, and median survival was 13.9 months. One- and 2-year survival rates were 60% and 26%, respectively.ConclusionS-1 monotherapy is considered a safe and effective treatment option for recurrent and metastatic nasopharyngeal carcinoma patients after failure of platinum-based chemotherapy.
Gemcitabine plus S-1 offers a satisfactory clinical activity and an acceptable safety profile for recurrent and metastatic NPC patients after failure of platinum-based chemotherapy.
Background: To assess the prognostic value of the systemic inflammation response index (SIRI) combined with plasma load of Epstein-Barr virus (EBV) DNA in children and adolescents with locoregionally advanced nasopharyngeal carcinoma (CALANPC). Methods: A total of 205 consecutive patients with CALANPC were enrolled.We used recursive partitioning analysis (RPA) to classify patients into various risk groups, with a primary endpoint of overall survival (OS).Results: Elevated SIRI (≥1.53) and EBV DNA (≥4000 copy/ml) were significantly associated with inferior OS in CALANPC. RPA categorized patients into low-and high-risk groups based on prognostic factors. Survival curves showed excellent discrimination in OS (95.3% vs 77.6%; p < 0.001) between the lowand high-risk groups. A significant improvement was confirmed using the prognostic methods for conventional TNM staging systems (p < 0.05).
Conclusions:The combination of SIRI with EBV DNA provided a more detailed understanding of patient risks, and enhanced risk discrimination in CALANPC.
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