phenylephrine-hydrochloride and Nasopharyngeal-Carcinoma

To evaluate the therapeutic effect of clarithromycin combined with tanshinone in the treatment of rhinosinusal and laryngeal radiation injury induced by radiotherapy in patients with nasopharyngeal carcinoma (NPC).. A total of 255 NPC patients with rhinosinusal and laryngeal radiation injury following radiotherapy were randomized into 3 groups for treatment with clarithromycin (group A, n=69), tanshinone (group B, n=69), and clarithromycin + tanshinone (group C, n=69), and the clinical outcomes of the patients were evaluated.. In all the 3 groups the patients responded favorably to the treatments and showed obvious improvements (P<0.05). The therapeutic effects were similar between groups A and B (P>0.05), but the patients in group C showed the most obvious improvements (P<0.05).. Clarithromycin combined with tanshinone can be an effective regimen for treatment of rhinosinusal and laryngeal radiation injury induced by radiotherapy in NPC patients.

Topics: Abietanes; Adult; Aged; Carcinoma; Clarithromycin; Combined Modality Therapy; Female; Humans; Larynx; Male; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Paranasal Sinuses; Pharynx; Radiation Injuries; Young Adult

Treatment of tumors arising in the upper parapharyngeal space (PPS) or the floor of the middle cranial fossa is challenging. This study aims to present anatomical landmarks for a combined endoscopic transnasal and anterior transmaxillary approach to the upper PPS and the floor of the middle cranial fossa and to further evaluate their clinical application.. Dissection of the upper PPS using a combined endoscopic endonasal transpterygoid and anterior transmaxillary approach was performed in six cadaveric heads. Surgical landmarks associated with the approach were defined. The defined approach was applied in patients with tumors involving the upper PPS.. The medial pterygoid muscle, tensor veli palatini muscle and levator veli palatini muscle were key landmarks of the approach into the upper PPS. The lateral pterygoid plate, foramen ovale and mandibular nerve were important anatomical landmarks for exposing the parapharyngeal segment of the internal carotid artery through a combined endoscopic transnasal and anterior transmaxillary approach. The combined approach provided a better view of the upper PPS and middle skull base, allowing for effective bimanual techniques and bleeding control. Application of the anterior transmaxillary approach also provided a better view of the inferior limits of the upper PPS and facilitated control of the internal carotid artery.. Improving the knowledge of the endoscopic anatomy of the upper PPS allowed us to achieve an optimal approach to tumors arising in the upper PPS. The combined endoscopic transnasal and anterior transmaxillary approach is a minimally invasive alternative approach to the upper PPS.

Topics: Cadaver; Cranial Fossa, Middle; Dissection; Endoscopy; Female; Head; Humans; Infratemporal Fossa; Magnetic Resonance Imaging; Male; Maxillary Sinus; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Parapharyngeal Space; Skull Base; Transanal Endoscopic Surgery

Given the reliability of circRNAs in symbolizing cancer progression, this investigation was designed to expound the involvement of hsa_circ_0028007 in regulating chemosensitivity of nasopharyngeal carcinoma (NPC) cells.. Altogether, 241 pairs of NPC tissues and para-cancerous normal tissues were collected to identify NPC-symbolic circRNAs, which have been screened by circRNA microarray in advance. Expressions of the circRNAs were determined by means of real-time polymerase chain reaction (PCR). Besides, human NPC cell lines (ie, CNE2 and HONE1) were transfected by si-hsa_circ_0028007 and si-NC. Scratch assay, transwell assay, and MTT assay were performed to assess migration, invasion, and paclitaxel/cisplatin-resistance of NPC cell lines.. Hsa_circ_0028007 expression was abnormally heightened within NPC tissues in comparison with matched non-tumor tissues (P < .05). Over-expressed hsa_circ_0028007 was strongly associated with advanced (III-IV) tumor stage, aggressive infiltration, and metastatic lymph nodes of NPC patients (P < .05). Regarding in vitro experiments, hsa_circ_0028007 expression was elevated in CNE2 and HONE1 cell lines as compared with HENE cell line (P < .05). Silencing of hsa_circ_0028007 not merely sensitized CNE2 and HONE1 cells against paclitaxel and cisplatin (P < .05), but also significantly repressed migration and invasion of the cell lines (P < .05).. Hsa_circ_0028007 was involved in facilitating progression and chemo-resistance of NPC, which might offer an alternative for NPC treatment.

Topics: Antineoplastic Agents; Cell Line, Tumor; Cell Movement; Drug Resistance, Neoplasm; Female; Humans; Male; MicroRNAs; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Neoplasm Invasiveness; Nose; Paclitaxel

Topics: Antineoplastic Combined Chemotherapy Protocols; Arm; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Lymphoma, Extranodal NK-T-Cell; Middle Aged; Nasopharyngeal Carcinoma; Neoplasms, Multiple Primary; Nose; Positron-Emission Tomography; Skin

Epstein-Barr virus detection using nasopharyngeal swabs has been suggested as a potential screening test that could improve the specificity of current EBV-based serological assays. However, application requires insertion of the swab deep into the nasopharynx, a procedure not amenable to non-clinic screening. We reasoned that swabbing the more easily accessible nasal cavity might provide an appealing alternative for NPC detection. Patients > 18 years of age diagnosed with histologically confirmed NPC were recruited from the Otolaryngology Department at the National Taiwan University Hospital. ENT clinicians collected both nasal and nasopharyngeal swabs. EBV DNA and cellular beta-globulin DNA were quantified using quantitative PCR targeting a highly-conserved region of the BKRF1 gene. EBV DNA was detectable (non-zero) in all 34 nasopharyngeal swabs and above the positivity threshold of 1666 EBV copies in 30 (88.2%) patients. EBV DNA was detectable in 50% of 34 nasal swabs and above the positivity threshold in four (11.8%) patients. Average EBV DNA levels were >3-fold higher (P < 0.001) in nasopharyngeal compared to nasal swabs. Among the 17 NPC patients with detectable EBV DNA in both swab types, we observed correlation (P < 0.01) between EBV DNA measurements. Our data represent the first evaluation of EBV DNA collected from nasal swabs. Given current EBV DNA amplification techniques, nasopharyngeal swabs remain more sensitive than nasal swabs for NPC detection.

Topics: Adult; Aged; Antigens, Viral; Carcinoma; DNA, Viral; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Male; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Real-Time Polymerase Chain Reaction; Sensitivity and Specificity; Specimen Handling; Taiwan; Viral Load; Young Adult

We report a case of low-grade nasopharyngeal papillary adenocarcinoma in a 9 year-old male that was diagnosed incidentally after an adenoidectomy procedure and treated with endonasal endoscopic nasopharyngectomy without any adjuvant therapy. The patient has been followed up for 3 years with no evidence of recurrence. We point out the importance of preoperative fiberoptic nasopharyngoscopy in the absence of longstanding symptoms in school-aged children and histopathologic examination of adenoidectomy specimens in the presence of atypical findings. We also suggest endonasal endoscopic resection in case of papillary adenocarcinoma.

Topics: Adenocarcinoma, Papillary; Adenoidectomy; Carcinoma; Child; Endoscopy; Humans; Male; Nasal Surgical Procedures; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Pharyngectomy

Topics: Carcinoma; Endoscopy; Humans; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Pharyngectomy; Retrospective Studies; Survival Rate; Time Factors; Treatment Outcome

Although endoscopic nasopharyngectomy and intensity-modulated radiotherapy (IMRT) have been reported to be useful in treating isolated local recurrent nasopharyngeal carcinoma (NPC), their efficacy needs to be revaluated with comparison to 2D conventional radiotherapy (RT).. Four hundred ten patients with recurrent NPC were retrospectively analyzed, among whom the patients underwent IMRT, endoscopic nasopharyngectomy, and 2D conventional RT.. The 5-year overall survival (OS) and distant metastasis-free survival were significantly higher in endoscopic nasopharyngectomy and IMRT groups than in 2D conventional RT group both in the entire series and in the subgroup of patients with recurrent T1 to 2 NPC (p < .05), except in the subgroup of recurrent T3 to 4 stratifications (IMRT vs 2D conventional RT; 28.8% vs 16.8%; p = .351). Furthermore, endoscopic nasopharyngectomy was associated with better OS than IMRT in the recurrent T1 to 2 subgroup (79.2% vs 62.1%; p = .007). Multivariate analysis indicated therapeutic modality was an independent predictor of OS and distant metastasis-free survival (p < .001).. Endoscopic nasopharyngectomy and IMRT are associated with an improved OS and distant metastasis-free survival of patients with recurrent NPC compared to 2D conventional RT in early recurrent disease.

Topics: Adult; Carcinoma; Chemotherapy, Adjuvant; China; Female; Humans; Male; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Natural Orifice Endoscopic Surgery; Neoplasm Recurrence, Local; Nose; Radiotherapy, Conformal; Radiotherapy, Intensity-Modulated; Salvage Therapy; Survival Analysis; Treatment Outcome

The posterior skull base and the nasopharynx have historically represented technically difficult regions to approach surgically given their central anatomical locations. Through continued improvements in endoscopic instrumentation and technology, the expanded endonasal approach (EEA) has introduced a new array of surgical options in the management of pathology involving these anatomically complex areas. Similarly, the transoral robotic surgical (TORS) approach was introduced as a minimally invasive surgical option to approach tongue base, nasopharyngeal, parapharyngeal, and laryngeal lesions. Although both the EEA and the TORS approach have been extensively described as viable surgical options in managing nasopharyngeal and centrally located head and neck pathology, both endonasal and transoral techniques have inherent limitations. Given these limitations, several institutions have published feasibility studies with the combined EEA and TORS approaches for a variety of skull base and nasopharyngeal pathologies. In this article, the authors present their clinical experience with the combined endonasal and transoral approach through a case series presentation, and discuss advantages and limitations of this approach for surgical management of the middle and posterior skull base and nasopharynx. In addition, a presentation is included of a unique, simultaneous endonasal and transoral dissection of the nasopharynx through an innovative intraoperative setup.

Topics: Adult; Aged, 80 and over; Carcinoma; Carcinoma, Papillary; Endoscopy; Female; Humans; Magnetic Resonance Imaging; Male; Minimally Invasive Surgical Procedures; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Nose Diseases; Retrospective Studies; Robotics; Skull Base; Thyroid Cancer, Papillary; Thyroid Neoplasms

To observe the effect of hypothermia plasma radiofrequency ablation to the adhesion of nasal cavity after radiotherapy of nasopharyngeal carcinoma.. The subjective score combined with nasal ventilation function test were used to reflect the degree of patients with nasal adhesion.. There is a significant improvement in subjective feeling after treatment. Nasal cavity volume began to increase and nasal expiratory resistance decrease obviously 3M later.. Hypothermia plasma radiofrequency ablation technology can improve the nasal cavity adhesion in patients with nasopharyngeal carcinoma after radiotherapy, and also the patients quality of life.

Topics: Carcinoma; Catheter Ablation; Female; Humans; Hypothermia, Induced; Male; Nasal Cavity; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Nose Diseases; Quality of Life; Tissue Adhesions

A global regulator of chromatin remodelling and gene expression, special AT-rich-binding protein 1 (SATB1) has been implicated in promotion of growth and metastasis of a number of cancers. Here, we demonstrate that the principal oncogene of Epstein-Barr virus (EBV), latent membrane protein 1 (LMP1) upregulates SATB1 RNA and protein expression in human nasopharyngeal cell lines. Silencing of endogenously expressed SATB1 with specific short hairpin RNA decreases cell proliferation and resistance to apoptosis induced by growth factor withdrawal. Additionally, we provide evidence that LMP1-mediated expression of Survivin, a multifunctional protein involved in promoting cell growth and survival, is mediated at least in part by SATB1 in human nasopharyngeal cells. Finally, we show that SATB1 protein levels are elevated in tissue samples from patients with nasopharyngeal carcinoma (NPC), and are directly correlated with the expression of LMP1. Taken together, our results suggest that SATB1 functions as a pro-metastatic effector of LMP1 signalling in EBV-positive NPC.

Topics: Carcinoma; Cell Line; Cell Proliferation; Gene Expression Regulation; Herpesvirus 4, Human; Humans; Matrix Attachment Region Binding Proteins; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Pharynx; RNA, Small Interfering; Signal Transduction; Viral Matrix Proteins