•Treatment outcomes of 3328 NPC patient treated with IMRT in Hong Kong.•8 year local/regional control remained promising.•Confirmed benefits of concurrent chemotherapy with IMRT.•Additional ...chemotherapy onto backbone of concurrent chemo-irradiation warrants further investigation.•Various severe symptomatic complications after IMRT remained low.
To evaluate treatment outcomes, failure patterns and late toxicities in patients with nasopharyngeal carcinoma (NPC) treated by intensity modulated radiotherapy (IMRT) in 6 public hospitals in Hong Kong over a 10-year period from 2001 to 2010.
Eligible patients were identified through the Hong Kong Cancer Registry data base. Clinical information was retrieved and verified by oncologists working in the individual centers. Treatment details, survival outcomes and late toxicities were analyzed.
A total of 3328 patients were recruited. The median follow-up time was 80.2 months. The 8-year actuarial overall survival (OS), local failure-free survival (LFFS), regional failure-free survival (RFFS), distant failure free survival (DFFS), progression-free survival (PFS) for the whole group was 68.5%, 85.8%, 91.5%, 81.5% and 62.6% respectively. Male gender, older age, advanced T and N stage were adverse prognostic factors for OS, DFFS and PFS, whereas use of chemotherapy in form of concurrent chemo-irradiation (CRT), neoadjuvant + CRT, or CRT + adjuvant chemotherapy were favorable prognostic factors for OS and PFS. The local control was adversely affected by advanced T stage. N stage remained as the single adverse prognostic factor for regional control. Distant metastasis was the commonest site of failure.
IMRT is an effective treatment for NPC with excellent overall loco-regional control. Distant metastasis is the major site of failure. Concurrent chemotherapy with cisplatin has an established role in NPC patients treated by IMRT.
A new class of amphiphilic anionic platinum(II) bzimpy complexes has been demonstrated to show aggregation in water through Pt···Pt and π–π stacking interactions. An interesting aggregation–partial ...deaggregation–aggregation process and a morphological transformation from vesicles to nanofibers have been demonstrated. These changes can be systematically controlled by the variation of solvent composition and could readily be probed by UV–vis absorption, emission, NMR, transmission electron microscopy, and even with our naked eyes.
Corynantheine-type alkaloids are major components of the Mitragyna speciosa, also known as kratom, that exhibit unique pharmacological activity. However, no universal method to prepare these ...alkaloids has been reported. Disclosed herein is a catalytic, asymmetric platform that enables rapid access to corynantheine alkaloids. The first enantioselective total synthesis of (−)-corynantheidine pseudoindoxyl is described. The first asymmetric syntheses of (+)-corynoxine and (−)-corynoxine B were also achieved, along with enantioselective syntheses of (−)-corynantheidol and (−)-corynantheidine. Through this work, all series of corynantheine alkaloids including indole, spirooxindole, and pseudoindoxyl can now be accessed in the laboratory, enabling comprehensive biological investigation of kratom alkaloids to be undertaken.
A series of platinum(II) terpyridine complexes with L‐valine‐modified alkynyl ligands has been synthesized. A complex with an unsubstituted terpyridine and one valine unit on the alkynyl is shown to ...be capable of gel formation, which is in sharp contrast to the gelation properties of the corresponding organic counterparts. Upon sol–gel transition, a drastic color change from yellow to red is observed, which is indicative of the involvement of Pt⋅⋅⋅Pt interactions. Through the concentration‐ and temperature‐dependent UV/Vis absorption, emission, circular dichroism, and 1H NMR studies, the contribution of hydrogen bonding, Pt⋅⋅⋅Pt and π–π stacking interactions as driving forces for gelation have been established, and the importance of maintaining a delicate balance between different intermolecular forces has also been illustrated.
Balancing act: Through the delicate balance of hydrogen bonding, Pt⋅⋅⋅Pt and π–π stacking interactions, the platinum(II) terpyridine complex with one amino acid unit on the alkynyl ligand shows drastic spectroscopic changes upon gelation (see figure, Boc=tert‐butoxycarbonyl).
Photoinduced hydrogen atom transfer (HAT) has been developed as a powerful tool to generate synthetically valuable radical species. The direct photoexcitation of ketones has been known to promote HAT ...or to generate acyl radicals through Norrish-type pathways, but these modalities remain severely limited by radical side reactions. We report herein a catalyst- and transition metal-free method for the acylation of C–H bonds that leverages the unique properties of stable, isolable acyl azolium species. Specifically, acyl azolium salts are shown to undergo an intermolecular and regioselective HAT upon LED irradiation with a range of substrates bearing active C–H bonds followed by C–C bond formation to afford ketones. Experimental and computational studies support photoexcitation of the acyl azolium followed by facile intersystem crossing to access triplet diradical species that promote selective HAT and radical–radical cross-coupling.
Consistent with our previous study,4 there was no significant difference at nearly 1 month after the last booster for the two vaccine cohorts (figure A). At approximately 3 months after the last ...booster there were, again, no statistical differences between the two groups (figure B), although there was a trend toward higher titres in the bivalent group against omicron lineages (1·4–1·6 times higher; eg, 509 VS 835 against BA.5). Over the approximately 2-month follow-up period, mean NAb titres in both vaccine cohorts decreased approximately two-fold (or 50%) against all tested viruses (eg, 1218 to 509 for monovalent cohorts against BA.5 and 1553 to 835 for bivalent cohorts against BA.5; appendix p 8), consistent with findings published in 2023.5 There was no discernible waning of antibody responses in the BA.5 breakthrough infection cases over the same observation period.
A series of alkynylplatinum(II) complexes of 2,6-bis(N-alkylbenzimidazol-2′-yl)pyridine has been synthesized and characterized by 1H NMR, IR, FAB mass spectrometry, and elemental analysis; the ...photophysical properties have also been investigated. All the complexes have been shown to exhibit interesting gelation properties. Scanning electron microscopy (SEM) of the xerogels showed a network of fibrous structures, typical of morphologies of organogels/metallogels. Interestingly, two of the complexes were found to show strong luminescence enhancement upon a gel-to-sol phase transition upon increasing the temperature. This unusual behavior is rarely encountered, as it represents a sharp contrast to that exhibited by other typical thermotropic organogels and metallogels reported so far. Variable-temperature UV−vis and luminescence spectroscopies were performed to probe the gel-to-sol phase transition. Concentration-dependent, variable-temperature, and time-resolved emission studies in dilute benzene solution have also been made to provide further insights into the spectroscopic origin in the sol forms. A quantitative treatment of the system based on the Birks scheme has been performed.
Background
This study evaluates the contemporary care for patients with locally recurrent nasopharyngeal carcinoma after failure of the primary course of intensity modulated radiotherapy.
Methods
...Eligible patients were identified through the Hong Kong Cancer Registry database. Patterns of care and treatment outcomes were analyzed.
Results
Two hundred seventy‐two patients with locally recurrent tumors were identified. Of them, 30.9% received surgery, whereas 35.7% received re‐irradiation (re‐RT). The 5‐year overall survival (OS) for the whole group was 30.2%. Old age and advanced rT classification were adverse prognostic factors, whereas surgery (mainly in resectable recurrence) was associated with favorable survival outcome. The 5‐year OS rates for patients who received surgery and re‐RT were 56.3% and 21.8%, respectively.
Conclusions
Early detection of resectable recurrence is of paramount importance as surgery for resectable tumors offers the potential to achieve excellent outcomes. Re‐RT could be considered in selected patients with unresectable disease and favorable prognostic features.
Patients with chronic obstructive pulmonary disease (COPD) are highly susceptible from respiratory exacerbations from viral respiratory tract infections. However, it is unclear whether they are at ...increased risk of COVID-19 pneumonia or COVID-19-related mortality. We aimed to determine whether COPD is a risk factor for adverse COVID-19 outcomes including hospitalization, severe COVID-19, or death.
Following the PRISMA guidelines, we performed a systematic review of COVID-19 clinical studies published between November 1st, 2019 and January 28th, 2021 (PROSPERO ID: CRD42020191491). We included studies that quantified the number of COPD patients, and reported at least one of the following outcomes stratified by COPD status: hospitalization; severe COVID-19; ICU admission; mechanical ventilation; acute respiratory distress syndrome; or mortality. We meta-analyzed the results of individual studies to determine the odds ratio (OR) of these outcomes in patients with COPD compared to those without COPD.
Fifty-nine studies met the inclusion criteria, and underwent data extraction. Most studies were retrospective cohort studies/case series of hospitalized patients. Only four studies examined the effects of COPD on COVID-19 outcomes as their primary endpoint. In aggregate, COPD was associated with increased odds of hospitalization (OR 4.23, 95% confidence interval CI 3.65–4.90), ICU admission (OR 1.35, 95% CI 1.02–1.78), and mortality (OR 2.47, 95% CI 2.18–2.79).
Having a clinical diagnosis of COPD significantly increases the odds of poor clinical outcomes in patients with COVID-19. COPD patients should thus be considered a high-risk group, and targeted for preventative measures and aggressive treatment for COVID-19 including vaccination.
PDF
