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Zhou S, Cao C, Hu J. Long Non-Coding RNA Small Nucleolar RNA Host Gene 4 Induced by Transcription Factor SP1 Promoted the Progression of Nasopharyngeal Carcinoma Through Modulating microRNA-510-5p/Centromere Protein F Axis. Biochem Genet 2023; 61:1967-1986. [PMID: 36899270 DOI: 10.1007/s10528-023-10351-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/15/2023] [Indexed: 03/12/2023]
Abstract
Long non-coding RNAs (LncRNAs) are implicated with tumorigenesis and the development of nasopharyngeal carcinoma (NPC). Previous studies suggested that long non-coding RNA small nucleolar RNA host gene 4 (SNHG4) exerted oncogenic roles in various cancers. However, the function and molecular mechanism of SNHG4 in NPC have not been investigated. In our study, it was confirmed that the SNHG4 level was enriched in NPC tissues and cells. Functional assays indicated that SNHG4 depletion inhibited the proliferation and metastasis but promoted apoptosis of NPC cells. Furthermore, we identified miR-510-5p as a downstream gene of SNHG4 in NPC cells and SNHG4 upregulated CENPF expression by binding to miR-510-5p. Moreover, there was a positive (or negative) association between CENPF and SNHG4 (or miR-510-5p) expression in NPC. In addition, rescue experiments verified that CENPF overexpression or miR-510-5p silencing abrogated inhibitory effects on NPC tumorigenesis caused by SNHG4 deficiency. The study demonstrated that SNHG4 promoted NPC progression via miR-510-5p/CENPF axis, providing a novel potential therapeutic target for NPC treatments.
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Affiliation(s)
- Shao Zhou
- Department of Otorhinolaryngology, The Affiliated People's Hospital of Ningbo University, No. 251 East Baizhang Road, Ningbo, 315000, Zhejiang, China.
| | - Cheng Cao
- Department of Otorhinolaryngology, The Affiliated People's Hospital of Ningbo University, No. 251 East Baizhang Road, Ningbo, 315000, Zhejiang, China
| | - Jiandao Hu
- Department of Otorhinolaryngology, The Affiliated People's Hospital of Ningbo University, No. 251 East Baizhang Road, Ningbo, 315000, Zhejiang, China
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2
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Wardana T, Chasanah SN, Oktriani R, Herawati C, Anwar SL, Astuti I, Mubarika Haryana S. Circulation microRNA expression profiles in patients with complete responses to chemoradiotherapy in nasopharyngeal carcinoma. Noncoding RNA Res 2022; 7:233-241. [PMID: 36203524 PMCID: PMC9519485 DOI: 10.1016/j.ncrna.2022.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/28/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022] Open
Abstract
Background Aims Methods Results Conclusion
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Affiliation(s)
- Tirta Wardana
- Department of Biomedicine, Faculty of Medicine, Jenderal Soedirman University, Purwokerto, Central Java, Indonesia
- Corresponding author.
| | - Siti Nur Chasanah
- Graduate Student, Biomedical Science, Faculty of Medicine, Nursing, and Public Health, Gadjah Mada University, Yogyakarta, Indonesia
| | - Risky Oktriani
- Department of Biochemistry, Faculty of Medicine, Nursing, and Public Health, Gadjah Mada University, Yogyakarta, Indonesia
| | - Cita Herawati
- Department of THT, Dharmais Hospital National Cancer Center, West Jakarta, Indonesia
| | - Sumadi Lukman Anwar
- Department of Surgery, Faculty of Medicine, Nursing, and Public Health, Gadjah Mada University, Yogyakarta, Indonesia
| | - Indwiani Astuti
- Department of Pharmacology and Therapy, Faculty of Medicine, Nursing, and Public Health, Gadjah Mada University, Yogyakarta, Indonesia
| | - Sofia Mubarika Haryana
- Department of Histology and Cell Biology, Faculty of Medicine, Nursing, and Public Health, Gadjah Mada University, Yogyakarta, Indonesia
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Susanto SA, Dewi YA, Saputri RAH. Assessment of Response to Chemoradiation and Radiation Therapy in Patients with Nasopharyngeal Carcinoma. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND: Nasopharyngeal carcinoma (NPC) is a head-and-neck cancer that develops in the epithelial lining of the nasopharynx. The provision of radiotherapy and chemoradiation therapy in NPC can be evaluated by assessing the tumor response.
AIM: The present study aims to determine the response in patients with nasopharyngeal carcinoma (NPC) to radiotherapy and chemoradiation therapy.
METHODOLOGY: The study design is a retrospective bivariate analytic study from the Otorhinolaryngology-Head and Neck Society Head-Neck Surgical Oncology data registry program for the period of 2016−2021 at Dr. Hasan Sadikin General Hospital, Bandung. A total sample of 447 patients with NPC was used, and data were processed with descriptive and bivariate analytical tests. The variables used were patient characteristics and tumor response to radiotherapy and chemoradiation therapy. The tumor response was obtained based on the results of the examination at least 3 months after the administration of therapy and categorized according to the Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1).
RESULTS: Three hundred and eighty-three NPC patients (252 men and 131 women) underwent chemoradiation or radiation therapy, and their tumor response had been evaluated. Most patients were diagnosed at Stages III and IV and treated by chemoradiation. In total, 314 of 383 patients (82%) achieved CR (complete response), 50 patients (13.1%) achieved PR (partial response), 11 patients (2.9%) had PD (progressive disease), and 8 (2.1%) patients had SD (stable disease). There is no statistically significant difference in the type of therapy response when correlated with the each of the variables; age, sex, and educational level (p > 0.05). There is a statistically significant difference in the type of therapy response among different clinical stage groups (p < 0.0001).
CONCLUSION: Most nasopharyngeal carcinoma patients in the study had a complete response (82%) for either chemoradiation or radiotherapy alone. Age, sex, and education level have no significant effect on therapy response. On the other hand, the response to therapy is significantly correlated to the clinical stage of the disease.
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Role of Pretreatment Hemoglobin-to-Platelet Ratio in Predicting Survival Outcome of Locally Advanced Nasopharyngeal Carcinoma Patients. J Cancer Epidemiol 2021; 2021:1103631. [PMID: 34751228 PMCID: PMC8572126 DOI: 10.1155/2021/1103631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/13/2021] [Indexed: 12/28/2022] Open
Abstract
Background The three-year survival rate of locally advanced nasopharyngeal carcinoma (NPC) patients in Indonesia is lower than in other Asian countries. Calculation of hemoglobin-to-platelet ratio (HPR) may become a more practical predictor than the ratios using leukocyte cell components. Yet, no study has been conducted to investigate the potential of HPR in predicting survival outcomes in locally advanced nasopharyngeal cancer patients. Objective To determine the role of pretreatment hemoglobin-to-platelet ratio in predicting the three-year overall survival (OS) of locally advanced NPC. Method A retrospective cohort study followed up on 289 locally advanced NPC patients who had undergone therapy at the Dr. Cipto Mangunkusumo National General Hospital between January 2012 and October 2016. HPR cut-off was determined using ROC. Subjects were classified into two groups according to the HPR value. Kaplan-Meier curve was utilized to illustrate patients' three-year survival, and Cox regression test analyzed confounding variables to yield an adjusted hazard ratio (HR). Results The optimal cut-off for HPR was 0.362 (AUC 0.6228, 95% CI: 0.56-0.69, sensitivity 61.27%, specificity 60.34%). Of the subjects, 48.44% had HPR ≤ 0.362, and they had a higher three-year mortality rate than those with HPR > 0.362 (50% vs. 31.54%). In bivariate analysis, HPR ≤ 0.362 and age ≥ 60 significantly showed a worse three-year OS (p value = 0.003 and 0.075, respectively). In multivariate analysis, we concluded that a pretreatment HPR ≤ 0.362 was an independent negative predictor of three-year OS in locally advanced NPC patients (adjusted HR 1.82; 95% CI: 1.25–2.65). Conclusion Pretreatment HPR ≤ 0.362 was a negative predictor of three-year OS in locally advanced nasopharyngeal cancer patients.
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Corry J, Ng WT, Moore A, Choi HCW, Le Q, Holmes S, Munandar A, Wang S, Camacho A, Setakornnukul J, Jiarpinitnun C, Hiep PN, Laskar SG, Benjaafar N, Faheem M, Jin F, Ammar CNB, Ali R, Boualga K, Abdelwahab S, Sommat K, Tao Y, O'Sullivan B, Lee N, Zubizaretta E, Prajogi B, Hopkins K, Rosenblatt E, Lee AWM. Can Radiation Therapy Quality Assurance Improve Nasopharyngeal Cancer Outcomes in Low- and Middle-Income Countries: Reporting the First Phase of a Prospective International Atomic Energy Agency Study. Int J Radiat Oncol Biol Phys 2021; 111:1227-1236. [PMID: 34418466 DOI: 10.1016/j.ijrobp.2021.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/21/2021] [Accepted: 08/05/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Most new nasopharyngeal cancer cases occur in low-income and middle-income countries, and these patients experience poorer overall survival than that of new nasopharyngeal cancer cases in high-income countries. The goal of this research project is to determine whether the introduction of a radiation therapy quality assurance program can ultimately improve outcomes for nasopharyngeal cancer patients in lower-income and middle-income countries. This study reports the results of the first phase of the International Atomic Energy Agency Coordinated Research Project (325-E3-TM-47712). METHODS AND MATERIALS This prospective study has 2 phases. Phase 1 is a survey of radiation therapy resources, patient characteristics and treatment, and results of radiation therapy quality assurance performed by the expert panel. An educational workshop reviewing phase 1 results for each center was completed before accrual of patients for phase 2. The ultimate aim of the study is to compare the first and second cohort of patients to see if quality assurance can result in fewer major protocol deviations and a 15% improvement in patients' 3-year progression-free survival. RESULTS Of 14 participating centers, 13 (93%) had computed tomography simulators and linear accelerators (LINAC) with intensity modulated radiation therapy (IMRT) capacity, median 3 LINAC (range, 1-13), and median 10 radiation oncologists (range, 5-51). The annual number of nasopharyngeal cancer cases irradiated was median 54 (range, 10-627). Five of 14 centers (36%) had no local radiation therapy quality assurance. For the current phase 1 study, 134 patients were evaluated, 82.1% had MRI staging, 99.3% had metastatic workup, 65.6% undifferentiated histology, 51% stage 3 and 49% stage 4. Radiation therapy quality assurance revealed 81 (60.4%) of 134 patients had major protocol violations in gross tumor volume and high dose planning target volume contours and/or dosimetry, 28.4% patients had borderline plans, 15 (11.2%) acceptable, and only 6 (4.2%) had inevitable compromise due to tumor extent. CONCLUSIONS This is the first International Atomic Energy Agency study to address the fundamental issue of treatment quality rather than altered treatment regimens. The high rate of unacceptable radiation therapy plans is a major concern, and we hope phase 2 will show a significant reduction and improved patient outcomes.
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Affiliation(s)
- June Corry
- Division of Radiation Oncology, GenesisCare Radiation Oncology, St. Vincent's Hospital, Melbourne, Victoria, Australia; University Melbourne, Department of Medicine, Parkville, Australia.
| | - Wai Tong Ng
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China; Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Alisha Moore
- Trans Tasman Radiation Oncology Group (TROG), University of Newcastle, Newcastle, Australia
| | - Horace C W Choi
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Quynh Le
- Department of Radiation Oncology, Stanford University, NRG Oncology and HNCIG, Stanford, California
| | - Sofee Holmes
- Trans Tasman Radiation Oncology Group (TROG), University of Newcastle, Newcastle, Australia
| | - Arie Munandar
- Cipto Mangunkusumo National General Hospital, Jl. Diponegoro, Indonesia
| | - Shengzi Wang
- Eye, Ear, Nose & Throat Hospital, Fudan University, Fenyang Road, Shanghai, China
| | | | | | | | - P N Hiep
- Oncology Center, Hue Central Hospital, Hue, Vietnam
| | | | | | | | - Feng Jin
- Guizhou Medical University Affiliated Hospital, Guiyang, China
| | | | - Rubina Ali
- Bahawalpur Institute of Nuclear Medicine and Oncology, Bahawalpur, Pakistan
| | - Kada Boualga
- Hôpital Frantz Fanon Centre Anti-Cancer, Blida, Algeria
| | | | - Kiattisa Sommat
- Division of Radiation Oncology, National Cancer Centre Singapore/Duke-NUS Medical School, Singapore
| | - Yungan Tao
- Department of Radiation Oncology, Institut Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Brian O'Sullivan
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, Canada
| | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | | | - Ben Prajogi
- International Atomic Energy Agency, Vienna, Austria
| | | | | | - Anne W M Lee
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital and the University of Hong Kong, Hong Kong, China
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Hutajulu SH, Howdon D, Taroeno-Hariadi KW, Hardianti MS, Purwanto I, Indrasari SR, Herdini C, Hariwiyanto B, Ghozali A, Kusumo H, Dhamiyati W, Dwidanarti SR, Tan IB, Kurnianda J, Allsop MJ. Survival outcome and prognostic factors of patients with nasopharyngeal cancer in Yogyakarta, Indonesia: A hospital-based retrospective study. PLoS One 2021; 16:e0246638. [PMID: 33577563 PMCID: PMC7880494 DOI: 10.1371/journal.pone.0246638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 01/22/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose This study aimed to determine the survival outcome and prognostic factors of patients with nasopharyngeal cancer accessing treatment in Yogyakarta, Indonesia. Methods Data on 759 patients with NPC diagnosed from 2007 to 2016 at Dr Sardjito General Hospital were included. Potential prognostic variables included sociodemographic, clinicopathology and treatment parameters. Multivariable analyses were implemented using semi-parametric Cox proportional hazards modelling and fully parametric survival analysis. Results The median time of observation was 14.39 months. In the whole cohort the median observed survival was 31.08 months. In the univariable analysis, age, education status, insurance type, BMI, ECOG index, stage and treatment strategy had an impact on overall survival (OS) (p values <0.01). Semi-parametric multivariable analyses with stage stratification showed that education status, ECOG index, and treatment modality were independent prognostic factors for OS (p values <0.05). In the fully parametric models age, education status, ECOG index, stage, and treatment modality were independent prognostic factors for OS (p values <0.05). For both multivariable analyses, all treatment strategies were associated with a reduced hazard (semi-parametric models, p values <0.05) and a better OS (parametric models, p values <0.05) compared with no treatment. Furthermore, compared with radiation alone or chemotherapy alone, a combination of chemotherapy and radiation either in a form of concurrent chemoradiotherapy (CCRT), sequential chemotherapy and radiation, or induction chemotherapy followed by CCRT demonstrated a reduced hazard (hazard ratio/HR 0.226, 95% confidence interval/CI 0.089–0.363, and HR 0.390, 95%CI 0.260–0.519) and a better OS (time ratio/TR 3.108, 95%CI 1.274–4.942 and TR 2.531, 95%CI 1.829–3.233) (p values < 0.01). Conclusions Median OS for the cohort was low compared to those reported in both endemic and non-endemic regions. By combining the findings of multivariable analyses, we showed that age, education status, ECOG index, stage and first treatment modality were independent predictors for the OS.
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Affiliation(s)
- Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
- * E-mail:
| | - Daniel Howdon
- Leeds Institute of Health Sciences, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Kartika Widayati Taroeno-Hariadi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Mardiah Suci Hardianti
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ibnu Purwanto
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Sagung Rai Indrasari
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Camelia Herdini
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Bambang Hariwiyanto
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ahmad Ghozali
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Henry Kusumo
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Wigati Dhamiyati
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Sri Retna Dwidanarti
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - I. Bing Tan
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Johan Kurnianda
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Matthew John Allsop
- Leeds Institute of Health Sciences, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
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Faisal HH, Kubo N, Nuryadi E, Prihartono J, Atmakusuma TD, Rachmadi L, Oike T, Nakano T, Gondhowiardjo SA, Adham M. Patterns of Care and Outcome Analysis of Nasopharyngeal Carcinoma: An Indonesian Single Institution Study. Asian Pac J Cancer Prev 2020; 21:1481-1485. [PMID: 32458659 PMCID: PMC7541880 DOI: 10.31557/apjcp.2020.21.5.1481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 05/10/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Nasopharyngeal cancer is endemic to Southeast Asia. However, there is limited clinical evidence of nasopharyngeal cancer in Indonesia, which has the largest population in Southeast Asia. METHODS Patterns of care and treatment outcomes in 428 patients with newly-diagnosed and pathologically-confirmed nasopharyngeal cancer were retrospectively analyzed. RESULTS Concurrent chemo-radiotherapy (CCRT) was the first-line treatment for stages I-IVB diseases. The 2-year overall survival (OS) of all patients were 100.0%, 100.0%, 93.8%, 86.2%, 82.9%, and 62.4% for stages I, II, III, IVA, IVB, and IVC, respectively. The 2-year OS of CCRT-treated patients were 100.0%, 100.0%, 92.6%, 82.4%, and 78.3% for stages I, II, III, IVA, and IVB, respectively. CONCLUSION The patterns of care and treatment outcomes were potentially consistent with world standards, needing future validation. This is the largest study of newly diagnosed nasopharyngeal cancer in Indonesia, a huge disease burden, providing an important basis for the clinical management of this disease.
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Affiliation(s)
- Hamida Hayati Faisal
- Department of Ear, Nose and Throat, Head and Neck Surgery, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Nobuteru Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
| | - Endang Nuryadi
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
- Department of Radiation Oncology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Joedo Prihartono
- Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Tubagus Djumhana Atmakusuma
- Department of Internal Medicine, Hematology and Medical Oncology Division, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Lisnawati Rachmadi
- Department of Pathological Anatomy, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Takahiro Oike
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
| | - Takashi Nakano
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
| | - Soehartati A Gondhowiardjo
- Department of Radiation Oncology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Marlinda Adham
- Department of Ear, Nose and Throat, Head and Neck Surgery, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
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Guo H, Wang F, Diao Y, Zhang Z, Chen Q, Qian CN, Keller ET, Zhang J, Lu Y. Knockdown of Notch1 inhibits nasopharyngeal carcinoma cell growth and metastasis via downregulation of CCL2, CXCL16, and uPA. Mol Carcinog 2019; 58:1886-1896. [PMID: 31270884 DOI: 10.1002/mc.23082] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 06/05/2019] [Accepted: 06/17/2019] [Indexed: 12/21/2022]
Abstract
Notch pathway is a highly conserved cell signaling system that plays very important roles in controlling multiple cell differentiation processes during embryonic and adult life. Multiple lines of evidence support the oncogenic role of Notch signaling in several human solid cancers; however, the pleiotropic effects and molecular mechanisms of Notch signaling inhibition on nasopharyngeal carcinoma (NPC) remain unclear. In this study, we evaluated Notch1 expression in NPC cell lines (CNE1, CNE2, SUNE1, HONE1, and HK1) by real-time quantitative PCR and Western blot analysis, and we found that CNE1 and CNE2 cells expressed a higher level of Notch1 compared with HONE1, SUNE1, and HK1 cells. Then Notch1 expression was specifically knocked down in CNE1 and CNE2 cells by Notch1 short hairpin RNA (shRNA). In Notch1 knockdown cells, cell proliferation, migration, and invasion were significantly inhibited. The epithelial-mesenchymal transition of tumor cells was reversed in Notch1-shRNA-transfected cells, accompanied by epithelioid-like morphology changes, increased protein levels of E-cadherin, and decreased expression of vimentin. In addition, knockdown of Notch1 markedly inhibited the expression of urokinase plasminogen activator (uPA) and its receptor uPAR, and chemokines C-C motif chemokine ligand 2 and C-X-C motif chemokine ligand 16, indicating that these factors are downstream targets of Notch1. Furthermore, deleting uPA expression had similar effects as Notch1. Finally, knockdown of Notch1 significantly diminished CNE1 cell growth in a murine model concomitant with inhibition of cell proliferation and induction of apoptosis. These results suggest that Notch1 may become a novel therapeutic target for the clinical treatment of NPC.
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Affiliation(s)
- Huajiao Guo
- Department of Oncology, Beihai People's Hospital, Beihai, Guangxi, China
| | - Fuhao Wang
- School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Yuwen Diao
- School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Zhe Zhang
- Department of Otolaryngology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Qiuyan Chen
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Chao-Nan Qian
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Evan T Keller
- Department of Urology and Pathology, School of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Jian Zhang
- School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China.,Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen, Guangdong, China
| | - Yi Lu
- School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China.,Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen, Guangdong, China
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Huang L, Hu C, Chao H, Wang R, Lu H, Li H, Chen H. miR-29c regulates resistance to paclitaxel in nasopharyngeal cancer by targeting ITGB1. Exp Cell Res 2019; 378:1-10. [DOI: 10.1016/j.yexcr.2019.02.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 01/20/2023]
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10
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Lee HM, Okuda KS, González FE, Patel V. Current Perspectives on Nasopharyngeal Carcinoma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1164:11-34. [PMID: 31576537 DOI: 10.1007/978-3-030-22254-3_2] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Of the ~129,079 new cases of nasopharyngeal carcinoma (NPC) and 72,987 associated deaths estimated for 2018, the majority will be geographically localized to South East Asia, and likely to show an upward trend annually. It is thought that disparities in dietary habits, lifestyle, and exposures to harmful environmental factors are likely the root cause of NPC incidence rates to differ geographically. Genetic differences due to ethnicity and the Epstein Barr virus (EBV) are likely contributing factors. Pertinently, NPC is associated with poor prognosis which is largely attributed to lack of awareness of the salient symptoms of NPC. These include nose hemorrhage and headaches and coupled with detection and the limited therapeutic options. Treatment options include radiotherapy or chemotherapy or combination of both. Surgical excision is generally the last option considered for advanced and metastatic disease, given the close proximity of nasopharynx to brain stem cell area, major blood vessels, and nerves. To improve outcome of NPC patients, novel cellular and in vivo systems are needed to allow an understanding of the underling molecular events causal for NPC pathogenesis and for identifying novel therapeutic targets and effective therapies. While challenges and gaps in current NPC research are noted, some advances in targeted therapies and immunotherapies targeting EBV NPCs are discussed in this chapter, which may offer improvements in outcome of NPC patients.
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Affiliation(s)
- Hui Mei Lee
- Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | - Kazuhida Shaun Okuda
- Division of Genomics of Development and Disease, Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD, Australia
| | - Fermín E González
- Laboratory of Experimental Immunology and Cancer, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Vyomesh Patel
- Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia.
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Chai SJ, Fong SCY, Gan CP, Pua KC, Lim PVH, Lau SH, Zain RB, Abraham T, Ismail SM, Abdul Rahman ZA, Ponniah S, Patel V, Cheong SC, Lim KP. In vitro evaluation of dual-antigenic PV1 peptide vaccine in head and neck cancer patients. Hum Vaccin Immunother 2018; 15:167-178. [PMID: 30193086 DOI: 10.1080/21645515.2018.1520584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Peptide vaccines derived from tumour-associated antigens have been used as an immunotherapeutic approach to induce specific cytotoxic immune response against tumour. We previously identified that MAGED4B and FJX1 proteins are overexpressed in HNSCC patients; and further demonstrated that two HLA-A2-restricted 9-11 amino acid peptides derived from these proteins were able to induce anti-tumour immune responses in vitro independently using PBMCs isolated from these patients. In this study, we evaluated the immunogenicity and efficacy of a dual-antigenic peptide vaccine (PV1), comprised of MAGED4B and FJX1 peptides in HNSCC patients. We first demonstrated that 94.8% of HNSCC patients expressed MAGED4B and/or FJX1 by immunohistochemistry, suggesting that PV1 could benefit the majority of HNSCC patients. The presence of pre-existing MAGED4B and FJX1-specific T-cells was detected using a HLA-A2 dimer assay and efficacy of PV1 to induce T-cell to secrete cytotoxic cytokine was evaluated using ELISPOT assay. Pre-existing PV1-specific T-cells were detected in all patients. Notably, we demonstrated that patients' T-cells were able to secrete cytotoxic cytokines upon exposure to target cells expressing the respective antigen post PV1 stimulation. Furthermore, patients with high expression of MAGED4B and FJX1 in their tumours were more responsive to PV1 stimulation, demonstrating the specificity of the PV1 peptide vaccine. Additionally, we also demonstrated the expression of MAGED4B and FJX1 in breast, lung, colon, prostate and rectal cancer suggesting the potential use of PV1 in these cancers. In summary, PV1 could be a good vaccine candidate for the treatment of HNSCC patients and other cancers expressing these antigens.
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Affiliation(s)
- San Jiun Chai
- a Cancer Research Malaysia , Subang Jaya , Selangor , Malaysia
| | | | - Chai Phei Gan
- a Cancer Research Malaysia , Subang Jaya , Selangor , Malaysia
| | - Kin Choo Pua
- b Department of Otorhinolaryngology , Hospital Pulau Pinang , Penang , Malaysia
| | - Paul Vey Hong Lim
- c Ear, Nose and Throat Department , Tung Shin Hospital , Kuala Lumpur , Malaysia
| | - Shin Hin Lau
- d Stomatology Unit , Cancer Research Centre, Institute for Medical Research , Kuala Lumpur , Malaysia
| | - Rosnah Binti Zain
- e Faculty of Dentistry , MAHSA University , Selangor , Malaysia.,f Oral Cancer Research and Coordinating Centre, Faculty of Dentistry , University of Malaya , Kuala Lumpur , Malaysia
| | - Thomas Abraham
- g Department of Oral & Maxillofacial Surgery , Tengku Ampuan Rahimah Hospital , Klang , Malaysia
| | - Siti Mazlipah Ismail
- h Department of Oro-Maxillofacial Surgery and Medical Sciences, Faculty of Dentistry , University of Malaya , Kuala Lumpur , Malaysia
| | - Zainal Ariff Abdul Rahman
- h Department of Oro-Maxillofacial Surgery and Medical Sciences, Faculty of Dentistry , University of Malaya , Kuala Lumpur , Malaysia
| | - Sathibalan Ponniah
- i Cancer Vaccine Development Program, Department of Surgery , Uniformed Services University of the Health Sciences , Bethesda , MD , USA
| | - Vyomesh Patel
- a Cancer Research Malaysia , Subang Jaya , Selangor , Malaysia
| | - Sok Ching Cheong
- a Cancer Research Malaysia , Subang Jaya , Selangor , Malaysia.,h Department of Oro-Maxillofacial Surgery and Medical Sciences, Faculty of Dentistry , University of Malaya , Kuala Lumpur , Malaysia
| | - Kue Peng Lim
- a Cancer Research Malaysia , Subang Jaya , Selangor , Malaysia
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12
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Ramayanti O, Brinkkemper M, Verkuijlen SAWM, Ritmaleni L, Go ML, Middeldorp JM. Curcuminoids as EBV Lytic Activators for Adjuvant Treatment in EBV-Positive Carcinomas. Cancers (Basel) 2018; 10:cancers10040089. [PMID: 29565326 PMCID: PMC5923344 DOI: 10.3390/cancers10040089] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/19/2018] [Accepted: 03/21/2018] [Indexed: 12/24/2022] Open
Abstract
Epstein-Barr virus (EBV) persists in nasopharyngeal (NPC) and gastric carcinomas (EBVaGC) in a tightly latent form. Cytolytic virus activation (CLVA) therapy employs gemcitabine and valproic acid (GCb+VPA) to reactivate latent EBV into the lytic phase and antiviral valganciclovir to enhance cell death and prevent virus production. CLVA treatment has proven safe in phase-I/II trials with promising clinical responses in patients with recurrent NPC. However, a major challenge is to maximize EBV lytic reactivation by CLVA. Curcumin, a dietary spice used in Asian countries, is known for its antitumor property and therapeutic potential. Novel curcuminoids that were developed to increase efficacy and bioavailability may serve as oral CLVA adjuvants. We investigated the potential of curcumin and its analogs (curcuminoids) to trigger the EBV lytic cycle in EBVaGC and NPC cells. EBV-reactivating effects were measured by immunoblot and immunofluorescence using monoclonal antibodies specific for EBV lytic proteins. Two of the hit compounds (41, EF24) with high lytic inducing activity were further studied for their synergistic or antagonistic effects when combined with GCb+VPA and analyzed by cytotoxicity and mRNA profiling assays to measure the EBV reactivation. Curcuminoid as a single agent significantly induced EBV reactivation in recombinant GC and NPC lines. The drug effects were dose- and time-dependent. Micromolar concentration of curcuminoid EF24 enhanced the CLVA effect in all cell systems except SNU719, a naturally infected EBVaGC cell that carries a more tightly latent viral genome. These findings indicated that EF24 has potential as EBV lytic activator and may serve as an adjuvant in CLVA treatment.
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Affiliation(s)
- Octavia Ramayanti
- Department of Pathology, VU University Medical Center, 1081HV Amsterdam, The Netherlands.
| | - Mitch Brinkkemper
- Department of Pathology, VU University Medical Center, 1081HV Amsterdam, The Netherlands.
| | | | - Leni Ritmaleni
- Laboratory of Medicinal Chemistry, Gadjah Mada University, Yogyakarta 55281, Indonesia.
| | - Mei Lin Go
- Department of Pharmacy, National University of Singapore, Singapore 117543, Singapore.
| | - Jaap M Middeldorp
- Department of Pathology, VU University Medical Center, 1081HV Amsterdam, The Netherlands.
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13
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Chen Q, Qin S, Liu Y, Hong M, Qian CN, Keller ET, Zhang J, Lu Y. IGFBP6 is a novel nasopharyngeal carcinoma prognostic biomarker. Oncotarget 2018; 7:68140-68150. [PMID: 27623076 PMCID: PMC5356544 DOI: 10.18632/oncotarget.11886] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 09/01/2016] [Indexed: 11/25/2022] Open
Abstract
Insulin-like growth factor binding proteins (IGFBPs) play critical roles in carcinogenesis. This study assessed the impact of IGFBP6 on the progression of nasopharyngeal carcinoma (NPC). Using immunohistochemical analysis, we found that IGFBP6 was differentially expressed in primary malignant NPC tissues. Clinical samples were divided into two groups: IGFBP6(+) and IGFBP6(−). Five years of follow-up revealed that overall survival and distant metastasis-free survival rates were significantly higher in the IGFBP6(+) than IGFBP6(−) group. We also used real-time PCR, ELISA and western blot assays to measure IGFBP6 levels in five NPC cell lines (CNE1, CNE2, HONE1, HK1 and SUNE1). All the cell lines expressed IGFBP6, but at different levels, reflecting disease heterogeneity. In addition, exogenous expression of IGFBP6 inhibited CNE2 cell proliferation and invasion in vitro. IGFBP6 knockdown activated the GSK3β/β-catenin/cyclin D1 pathway and enhanced CNE2 tumor cell growth and metastasis in a mouse model. These results suggest that IGFBP6 may be an independent prognostic biomarker for NPC.
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Affiliation(s)
- Qiuyan Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Siyuan Qin
- Key Laboratory of Longevity and Aging-related Diseases, Ministry of Education, Guangxi Medical University, Nanning, Guangxi, China.,Center for Translational Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Yang Liu
- Key Laboratory of Longevity and Aging-related Diseases, Ministry of Education, Guangxi Medical University, Nanning, Guangxi, China.,Center for Translational Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Minghuang Hong
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Chao-Nan Qian
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Evan T Keller
- Department of Urology and Pathology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Jian Zhang
- Key Laboratory of Longevity and Aging-related Diseases, Ministry of Education, Guangxi Medical University, Nanning, Guangxi, China.,Center for Translational Medicine, Guangxi Medical University, Nanning, Guangxi, China.,Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Yi Lu
- Key Laboratory of Longevity and Aging-related Diseases, Ministry of Education, Guangxi Medical University, Nanning, Guangxi, China.,Center for Translational Medicine, Guangxi Medical University, Nanning, Guangxi, China.,Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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14
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Hutajulu SH, Fachiroh J, Argy G, Indrasari SR, Indrawati LPL, Paramita DK, Jati TBR, Middeldorp JM. Seroprevalence of IgA anti Epstein-Barr virus is high among family members of nasopharyngeal cancer patients and individuals presenting with chronic complaints in head and neck area. PLoS One 2017; 12:e0180683. [PMID: 28800616 PMCID: PMC5553716 DOI: 10.1371/journal.pone.0180683] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 06/19/2017] [Indexed: 12/16/2022] Open
Abstract
Epstein-Barr (EBV) infection and presence of a nasopharyngeal cancer (NPC) case in the family increases the risk of developing NPC. Aberrant anti-EBV immunoglobulin A (IgA) antibodies (EBV-IgA) may be present in the sera of non-cancer individuals and predict NPC. Limited studies report the presence of EBV-IgA antibodies within non-cancer individuals in Indonesia where the disease is prevalent. This study aimed at exploring whether EBV-IgA was found more frequently among first degree relatives of NPC patients and individuals presenting with chronic symptoms in the head and neck area compared to healthy controls. A total of 967 non-cancer subjects were recruited, including 509 family members of NPC cases, 196 individuals having chronic complaints in the head and neck region, and 262 healthy donors of the local blood bank. Sera were analyzed using a standardized peptide-based EBV-IgA ELISA. Overall, 61.6% of all individuals had anti-EBV IgA reactivity equal to or below cut off value (CoV). Seroreactivity above CoV was significantly higher in females (38.7%) compared to males (28.7%) (p = 0.001). Older individuals had more seroreactivity above CoV (42.5%) than the younger ones (26.4%) (p< 0.001). Seroprevalence was significantly higher in family members of NPC patients (41.7%), compared to 32.7% of individuals with chronic head and neck problems (p = 0.028) and 16.4% healthy blood donors (p< 0.001). As conclusion, this study showed a significant higher seroprevalence in healthy family members of NPC cases and subjects presenting with chronic symptoms in the head and neck area compared to healthy individuals from the general community. This finding indicates that both groups have elevated risk of developing NPC and may serve as targets for a regional NPC screening program.
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Affiliation(s)
- Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
- * E-mail:
| | - Jajah Fachiroh
- Department of Histology and Cell Biology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Gabriella Argy
- Study Program of Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Sagung Rai Indrasari
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Luh Putu Lusy Indrawati
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Dewi Kartikawati Paramita
- Department of Histology and Cell Biology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Theodola Baning Rahayu Jati
- Field Epidemiology Training Program, Department of Public Health, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Jaap M. Middeldorp
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
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15
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The role of Indonesian patients' health behaviors in delaying the diagnosis of nasopharyngeal carcinoma. BMC Public Health 2017; 17:510. [PMID: 28545416 PMCID: PMC5445307 DOI: 10.1186/s12889-017-4429-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 05/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With an estimated 13,000 newly diagnosed patients per year, nasopharyngeal carcinoma (NPC) is one of the most common types of cancer in males in Indonesia. Moreover, most patients are diagnosed at an advanced stage of the disease. This study aimed to explore the health behaviors of patients diagnosed with NPC and the possible causes of patient delay in NPC diagnosis. METHODS A qualitative research method was used to gain better insight into patient behaviors. Twelve patients were interviewed using semi-structured interview guidelines. All interviews were recorded, transcribed verbatim and analyzed according to a standard content analysis framework. RESULTS Most patients had limited knowledge regarding NPC and its causes. Fifty percent of the patients had a delay of six months from the onset of symptoms to diagnosis. The main reason for this delay was the lack of awareness among the patients, which was influenced by their environment, economic status, family, culture, and religion. The perceived barriers to seeking medical help included direct non-medical costs not covered by health insurance, complex and time-consuming insurance and referral systems, and negative experiences in the past. Health insurance did motivate people to seek medical help. CONCLUSION This study provides additional insight into patients' motivations to delay seeking medical help and can facilitate the design of NPC education programs. To improve awareness of the abovementioned causes for delay, community-based education programs are highly warranted and should focus on the recognition of NPC symptoms and possible solutions to overcome the main barriers at an earlier disease stage.
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16
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Mahdavifar N, Towhidi F, Makhsosi BR, Pakzad R, Moini A, Ahmadi A, Lotfi S, Salehiniya H. Incidence and Mortality of Nasopharynx Cancer and Its Relationship With Human Development Index in the World in 2012. World J Oncol 2016; 7:109-118. [PMID: 28983375 PMCID: PMC5624652 DOI: 10.14740/wjon980w] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND One of the most common cancers in head and neck is nasopharynx. Knowledge about the incidence and mortality of this disease and its distribution in terms of geographical areas is necessary for further study, better planning and prevention. Therefore, this study aimed to determine the incidence and mortality of nasopharynx cancer and its relationship with human development index (HDI) in the world in 2012. METHODS This study was an ecological study conducted based on GLOBOCAN project of World Health Organization (WHO) for the countries in world. The correlation between standardized incidence rates (SIRs) and standardized mortality rates (SMRs) of nasopharynx cancer with HDI and its components was assessed with correlation coefficient by using SPSS 15. RESULTS In 2012, 86,691 nasopharynx cancer cases occurred in the world, so that 60,896 new cases were seen in men and 25,795 new cases in women (sex ratio = 2.36). SIR of the cancer was 1.2 per 100,000 (1.7 in men and 0.7 in women per 100,000) in the world. In 2012, 50,831 nasopharynx death cases occurred in the world, so that 35,756 death cases were seen in men and 15,075 death cases in women (sex ratio = 2.37). SIR of mortality from the cancer was 0.7 per 100,000 (0.7 in women and 1 in men per 100,000) in the world. The results of correlation analysis showed a negative correlation between the SIR and HDI (r = -0.037, P = 0.629), and also the results of correlation analysis showed a negative correlation between the SMR and HDI (r = -0.237, P = 0.002). CONCLUSION Nasopharyngeal cancer is native to Southeast Asia and the highest incidence and mortality were seen in countries with moderate and low HDI. It is suggested that studies are conducted on determining the causes of the cancer incidence and mortality in the world and the differences between various regions.
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Affiliation(s)
- Neda Mahdavifar
- Health Promotion Research Center, Department of Epidemiology and Biostatistics, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farhad Towhidi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Reza Pakzad
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Moini
- Department of Internal Medicine, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abbas Ahmadi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sarah Lotfi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Salehiniya
- Zabol University of Medical Sciences, Zabol, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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17
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Epidemiology and Inequality in the Incidence and Mortality of Nasopharynx Cancer in Asia. Osong Public Health Res Perspect 2016; 7:360-372. [PMID: 28053841 PMCID: PMC5194228 DOI: 10.1016/j.phrp.2016.11.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/21/2016] [Accepted: 11/07/2016] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES One of the most common head and neck cancers is nasopharynx cancer. Knowledge about the incidence and mortality of this disease and its distribution in terms of geographical areas is necessary for further study and better planning. Therefore, this study was conducted with the aim of determining the incidence and mortality rates of nasopharynx cancer and its relationship with the Human Development Index (HDI) in Asia in 2012. METHODS The aim of this ecologic study was to assess the correlation between age-specific incidence rate (ASIR) and age-specific mortality rate (ASMR) with HDI and its components, which include the following: life expectancy at birth, mean years of schooling, and gross national income per capita. Data about SIR and SMR for every Asian country for 2012 were obtained from the global cancer project. We used the correlation bivariate method for the assessment. Statistical significance was assumed if p < 0.05. All reported p values are two-sided. Statistical analyses were performed using SPSS (Version 15.0, SPSS Inc.). RESULTS A total of 68,272 cases (males, 71.02%; females, 28.97%; sex ratio, 2.45) and 40,530 mortalities (males, 71.63%; females, 28.36%; sex ratio, 2.52) were recorded in Asian countries in 2012. The five countries with the highest ASIR of nasopharynx cancer were Malaysia, Singapore, Indonesia, Vietnam, and Brunei, and the five countries with the highest ASMR were Indonesia, Vietnam, Singapore, Malaysia, and Brunei. The correlation between HDI and ASIR was 0.097 (p = 0.520) [0.105 in men (p = 0.488) and 0.119 in women (p = 0.901)]. The correlation between HDI and ASMR was -0.102 (p = 0.502) [-0.072 in men (p = 0.633) and -0.224 in women (p = 0.134)]. CONCLUSION Nasopharynx cancer is native to Southeast Asia. The highest incidence and mortality rates are found in Malaysia, Singapore, Indonesia, Vietnam, and Brunei. No significant relation was found between the standardized incidence and mortality rates of nasopharynx cancer and the HDI components. Further studies are recommended in Southeast Asian countries in order to find the etiology of cancer, as well as its diagnosis and treatment.
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18
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Lam KO, Lee AW, Choi CW, Sze HC, Zietman AL, Hopkins KI, Rosenblatt E. Global Pattern of Nasopharyngeal Cancer: Correlation of Outcome With Access to Radiation Therapy. Int J Radiat Oncol Biol Phys 2016; 94:1106-12. [DOI: 10.1016/j.ijrobp.2015.11.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 11/22/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022]
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19
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The Impact of the Overall Radiotherapy Time on Clinical Outcome of Patients with Nasopharyngeal Carcinoma; A Retrospective Study. PLoS One 2016; 11:e0151899. [PMID: 27030990 PMCID: PMC4816552 DOI: 10.1371/journal.pone.0151899] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 02/26/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose In Yogyakarta, nasopharyngeal carcinoma (NPC) shows a poor response to radiotherapy treatment. Previous study showed a prolonged overall treatment time (OTT), due to interruptions during treatment. This study explores the association between clinical outcome and OTT. Secondary, the relation between clinical outcome and disease stage, waiting time to radiation (WT) and chemotherapy schedule was explored. Methods In this retrospective cohort, 142 patients who started curative intent radiotherapy for NPC between March 2009 and May 2014, with or without chemotherapy, were included. The median follow up time was 1.9 years. Data was collected on WT, OTT, disease stage, and chemotherapy schedule. Time factors were log-transformed. Clinical outcome was defined as therapy response, loco-regional control (LRC), disease free survival (DFS) and overall survival (OS). Results The median WT was 117 days (range 12–581) and OTT was 58 days (43–142). OTT and disease stage were not associated to any of the clinical outcome parameters. The log- WT was associated to poor therapy outcome (HR 1.68; 95% ci: 1.09–2.61), LRC (HR 1.66; 95% ci: 1.15–2.39), and DFS (HR 1.4; 95% ci: 1.09–1.81). In the multivariable analysis, significant hazard risk for poor therapy response, LRC, DFS and OS were seen for patients who didn’t received concurrent chemotherapy. Conclusion Not receiving concurrent chemotherapy showed the strongest risk for poor outcome. Since the choice of chemotherapy is related to a variety of factors, like the WT and patient’s physical condition when radiation can start, careful interpretation is needed. Reason for not finding a relation between OTT and clinical outcome might be the low number of patients who finished radiotherapy within 7 weeks, or by a stronger detrimental effect of other factors.
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20
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Guo Y, Luo W, Hu Z, Li J, Li X, Cao H, Li J, Wen B, Zhang J, Cheng H, Guo W, Tan T, Luo D. Low expression of Aldo-keto reductase 1B10 is a novel independent prognostic indicator for nasopharyngeal carcinoma. Cell Biosci 2016; 6:18. [PMID: 26949513 PMCID: PMC4779195 DOI: 10.1186/s13578-016-0082-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 02/14/2016] [Indexed: 01/19/2023] Open
Abstract
Background Nasopharyngeal carcinoma (NPC) is one of the most common human head and neck cancers with high incidence in Southern China, Southeast Asia and North Africa. Because of its nonspecific symptoms, the early diagnosis of NPC is very difficult. The 5-year survival rate is not ideal in spite of great innovations in radiation and chemotherapy treatments. Highly sensitive and specific prognostic biomarkers are eager for NPC clinical diagnosis. To find specific target molecules is very important for individualized treatment. Aldo–keto reductase B10 (AKR1B10) is closely related to tumorigenesis and tumor development, and however, its expression level in NPC tissues is not clear. Results AKR1B10 expression levels were validated in benign, para-cancerous nasopharyngeal and NPC tissues by immunohistochemical evaluation. AKR1B10 was positively expressed in 42 (82.4 %) of 51 benign specimens, and 235 (98.7 %) of 238 para-carcinoma specimens. This percentage was significantly higher than 44.5 % (133/299) in nasopharyngeal carcinoma tissue (p < 0.01). AKR1B10 mRNA quantitative levels detected by real-time quantitative RT-PCR in 90 NPC tissue samples (0.10 ± 0.21) were significantly lower than that in 15 benign tissue samples (1.03 ± 1.12) (p < 0.01). AKR1B10 expression levels in NPC were correlated negatively with T-classification, lymph node metastasis (p < 0.05). We established nasopharyngeal cancer monoclonal cells CNE-2/AKR1B10 with AKR1B10 stable expression and CNE-2/vector cells without AKR1B10 expression by using a modified lentivirus-mediated method, and found that AKR1B10 inhibited the proliferation of CNE-2/AKR1B10 cells by using MTT assay and flow cytometry, and cell migration by in vitro scratch test. Conclusion Taken together, our data suggest that low expression of AKR1B10 is an independent prognostic indicator in nasopharyngeal carcinoma, and that AKR1B10 may be involved in regulating the proliferation and migration of nasopharyngeal cancer cells.
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Affiliation(s)
- Yuanwei Guo
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-through Molecular Diagnosis Technology, Collaborative Research Center for Post-doctoral Mobile Stations of Central South University, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China.,Center for Clinical Pathology, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China
| | - Weihao Luo
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-through Molecular Diagnosis Technology, Collaborative Research Center for Post-doctoral Mobile Stations of Central South University, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China
| | - Zheng Hu
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-through Molecular Diagnosis Technology, Collaborative Research Center for Post-doctoral Mobile Stations of Central South University, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China.,Department of Clinical Pharmacology, Xiangya Hospital and Institute of Clinical Pharmacology, Central South University and Hunan Key Laboratory of Pharmacogenetics, 410078 Changsha, Hunan People's Republic of China
| | - Jia Li
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-through Molecular Diagnosis Technology, Collaborative Research Center for Post-doctoral Mobile Stations of Central South University, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China
| | - Xiaojie Li
- Center for Clinical Pathology, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China
| | - Huiqiu Cao
- Center for Clinical Pathology, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China
| | - Jun Li
- E.N.T. Department, The First People's Hospital of Chenzhou, 432000 Chenzhou, People's Republic of China
| | - Bo Wen
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-through Molecular Diagnosis Technology, Collaborative Research Center for Post-doctoral Mobile Stations of Central South University, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China
| | - Jian Zhang
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-through Molecular Diagnosis Technology, Collaborative Research Center for Post-doctoral Mobile Stations of Central South University, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China
| | - Hao Cheng
- E.N.T. Department, The First People's Hospital of Chenzhou, 432000 Chenzhou, People's Republic of China
| | - Wangyuan Guo
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-through Molecular Diagnosis Technology, Collaborative Research Center for Post-doctoral Mobile Stations of Central South University, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China
| | - Tan Tan
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-through Molecular Diagnosis Technology, Collaborative Research Center for Post-doctoral Mobile Stations of Central South University, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China.,Center for Clinical Pathology, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China
| | - Dixian Luo
- Translational Medicine Institute, National and Local Joint Engineering Laboratory for High-through Molecular Diagnosis Technology, Collaborative Research Center for Post-doctoral Mobile Stations of Central South University, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China.,Center for Clinical Pathology, Affiliated The First People's Hospital of Chenzhou, University of South China, 432000 Chenzhou, People's Republic of China
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21
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Fles R, Indrasari SR, Herdini C, Martini S, Isfandiari A, Romdhoni AC, Adham M, Mayangsari ID, van Werkhoven E, Wildeman MA, Hariwiyanto B, Hermani B, Kentjono WA, Haryana SM, Schmidt MK, Tan IB. Effectiveness of a multicentre nasopharyngeal carcinoma awareness programme in Indonesia. BMJ Open 2016; 6:e008571. [PMID: 26932137 PMCID: PMC4785340 DOI: 10.1136/bmjopen-2015-008571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of a nasopharyngeal carcinoma (NPC) awareness programme on the short-term and long-term improvement of knowledge and referral of patients with NPC by primary healthcare centres (PHCCs) staff in Indonesia. DESIGN The NPC awareness programme consisted of 12 symposia including a Train-The-Trainer component, containing lectures about early symptoms and risk factors of NPC, practical examination and the referral system for NPC suspects. Before and after training participants completed a questionnaire. The Indonesian Doctors Association accredited all activities. PARTICIPANTS 1 representative general practitioner (GP) from each PHCC attended an NPC awareness symposium. On the basis of the Train-The-Trainer principle, GPs received training material and were obligated to train their colleagues in the PHCC. RESULTS 703 GPs attended the symposia and trained 1349 staff members: 314 other GPs, 685 nurses and 350 midwives. After the training, respondents' average score regarding the knowledge of NPC symptoms increased from 47 points (of the 100) to 74 points (p<0.001); this increase was similar between symposium and Train-The-Trainer component (p=0.88). At 1½ years after the training, this knowledge remained significantly increased at 59 points (p<0.001). CONCLUSIONS The initial results of this NPC awareness programme indicate that the programme effectively increases NPC knowledge in the short and long term and therefore should be continued. Effects of the improved knowledge on the stage at diagnoses of the patients with NPC will still need to be scrutinised. This awareness programme can serve as a blueprint for other cancer types in Indonesia and for other developing countries.
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Affiliation(s)
- Renske Fles
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sagung R Indrasari
- Department of Otorhinolaryngology, Dr. Sardjito General Hospital, Faculty of Medicine Gadjah Mada University, Yogyakarta, Indonesia
| | - Camelia Herdini
- Department of Otorhinolaryngology, Dr. Sardjito General Hospital, Faculty of Medicine Gadjah Mada University, Yogyakarta, Indonesia
| | - Santi Martini
- Department of Public Health, Airlangga University, Surabaya, Indonesia
| | | | - Achmad C Romdhoni
- Department of Otorhinolaryngology, Dr. Soetomo Hospital, Faculty of Medicine Airlangga University, Surabaya, Indonesia
| | - Marlinda Adham
- Department of Otorhinolaryngology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine University of Indonesia, Jakarta, Indonesia
| | - Ika D Mayangsari
- Department of Otorhinolaryngology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine University of Indonesia, Jakarta, Indonesia
| | - Erik van Werkhoven
- Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Maarten A Wildeman
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Bambang Hariwiyanto
- Department of Otorhinolaryngology, Dr. Sardjito General Hospital, Faculty of Medicine Gadjah Mada University, Yogyakarta, Indonesia
| | - Bambang Hermani
- Department of Otorhinolaryngology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine University of Indonesia, Jakarta, Indonesia
| | - Widodo A Kentjono
- Department of Otorhinolaryngology, Dr. Soetomo Hospital, Faculty of Medicine Airlangga University, Surabaya, Indonesia
| | - Sofia M Haryana
- Department of Histology, Cell and Tumour Biology, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - Marjanka K Schmidt
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - I Bing Tan
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Otorhinolaryngology, Dr. Sardjito General Hospital, Faculty of Medicine Gadjah Mada University, Yogyakarta, Indonesia
- Department of Oral and Maxillofacial Surgery, Academic medical Centre, Amsterdam, The Netherlands
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22
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Epstein–Barr virus-targeted therapy in nasopharyngeal carcinoma. J Cancer Res Clin Oncol 2015; 141:1845-57. [DOI: 10.1007/s00432-015-1969-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/30/2015] [Indexed: 01/28/2023]
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23
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Stoker SD, Indrasari SR, Herdini C, Hariwiyanto B, Karakullukcu B, Dhamiyati W, Widayati K, Romdhoni AC, Fles R, Haryana SM, Wildeman MAM, Tan IB. Photodynamic therapy as salvage therapy for patients with nasopharyngeal carcinoma experiencing local failures following definitive radiotherapy. Photodiagnosis Photodyn Ther 2015; 12:519-25. [PMID: 25917042 DOI: 10.1016/j.pdpdt.2015.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 04/12/2015] [Accepted: 04/14/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Treating local failures of nasopharyngeal carcinoma (NPC) is a challenge. This study evaluates photodynamic therapy (PDT) in the treatment of residual and recurrent NPC. METHOD In this phase II study, patients with local recurrent or residual NPC after curative intent (chemo-) radiation could be included. Exclusion criterion was a tumour depth more than 10mm. Foscan® 0.15mg/kg was administered intravenously. After 96h, the illumination was performed under local anaesthesia with a nasopharyngeal light applicator. Tumour response was measured 10 weeks after illumination by endoscopy, biopsy and CT-scan. Kaplan-Meier method was used for survival analysis. RESULTS Twenty-one patients were included. Fourteen patients were treated for residual disease (67%), and two for recurrent (10%). For five patients this distinction could not be made, due to uncertainty about complete response after initial treatment. The median follow-up time was 32 months. Twenty patients (95%) had a complete response 10 weeks post-treatment. Two patients had recurrent local disease at 5 and 7 months post-PDT. They received another course of PDT, one with success. The 2-year local control rate was 75%, progression free survival was 49% and overall survival was 65%. Nine patients (43%) had no evidence of disease and were in a good clinical condition (ECOG Performance Scale 0) at the end of the study period. No serious adverse events were observed. CONCLUSION This study showed that PDT is effective in treating local failures of NPC with a depth of less than 10mm. The treatment was easy to perform under local anaesthesia. Especially in regions were other modalities like radiation and surgery are limited PDT can be a good alternative treatment.
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Affiliation(s)
- S D Stoker
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S R Indrasari
- Department of Otorhinolaryngology, Dr. Sardjito General Hospital/Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - C Herdini
- Department of Otorhinolaryngology, Dr. Sardjito General Hospital/Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - B Hariwiyanto
- Department of Otorhinolaryngology, Dr. Sardjito General Hospital/Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - B Karakullukcu
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - W Dhamiyati
- Department of Radiotherapy, Faculty of Medicine/Dr. Sardjito Hospital, Gadjah Mada University, Yogyakarta, Indonesia
| | - K Widayati
- Department of Internal Medicine, Faculty of Medicine/Dr. Sardjito Hospital, Gadjah Mada University, Yogyakarta, Indonesia
| | - A C Romdhoni
- Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - R Fles
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S M Haryana
- Department of Bio-Molecular, Faculty of Medicine/Dr. Sardjito Hospital, Gadjah Mada University, Yogyakarta, Indonesia
| | - M A M Wildeman
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - I B Tan
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Dr. Sardjito General Hospital/Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia; Department of Maxillofacial Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
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24
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The use of biologically related model (Eclipse) for the intensity-modulated radiation therapy planning of nasopharyngeal carcinomas. PLoS One 2014; 9:e112229. [PMID: 25372041 PMCID: PMC4221619 DOI: 10.1371/journal.pone.0112229] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 10/06/2014] [Indexed: 01/22/2023] Open
Abstract
Purpose Intensity-modulated radiation therapy (IMRT) is the most common treatment technique for nasopharyngeal carcinoma (NPC). Physical quantities such as dose/dose-volume parameters are used conventionally for IMRT optimization. The use of biological related models has been proposed and can be a new trend. This work was to assess the performance of the biologically based IMRT optimization model installed in a popular commercial treatment planning system (Eclipse) as compared to its dose/dose volume optimization model when employed in the clinical environment for NPC cases. Methods Ten patients of early stage NPC and ten of advanced stage NPC were selected for this study. IMRT plans optimized using biological related approach (BBTP) were compared to their corresponding plans optimized using the dose/dose volume based approach (DVTP). Plan evaluation was performed using both biological indices and physical dose indices such as tumor control probability (TCP), normal tissue complication probability (NTCP), target coverage, conformity, dose homogeneity and doses to organs at risk. The comparison results of the more complex advanced stage cases were reported separately from those of the simpler early stage cases. Results The target coverage and conformity were comparable between the two approaches, with BBTP plans producing more hot spots. For the primary targets, BBTP plans produced comparable TCP for the early stage cases and higher TCP for the advanced stage cases. BBTP plans reduced the volume of parotid glands receiving doses of above 40 Gy compared to DVTP plans. The NTCP of parotid glands produced by BBTP were 8.0±5.8 and 7.9±8.7 for early and advanced stage cases, respectively, while those of DVTP were 21.3±8.3 and 24.4±12.8, respectively. There were no significant differences in the NTCP values between the two approaches for the serial organs. Conclusions Our results showed that the BBTP approach could be a potential alternative approach to the DVTP approach for NPC.
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Adham M, Stoker SD, Wildeman MA, Rachmadi L, Gondhowiardjo S, Atmakusumah D, Gatot D, Fles R, Greijer AE, Hermani B, Middeldorp JM, Tan IB. Current status of cancer care for young patients with nasopharyngeal carcinoma in Jakarta, Indonesia. PLoS One 2014; 9:e102353. [PMID: 25019625 PMCID: PMC4096755 DOI: 10.1371/journal.pone.0102353] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 06/03/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Nasopharyngeal carcinoma (NPC) is endemic in Indonesia and 20% of the patients are diagnosed before the age of 31. This study evaluates presentation and treatment outcome of young patients in Jakarta, in a tertiary referral centre. METHODS Forty-nine patients under the age of 31, diagnosed with NPC between July 2004 and January 2007, were evaluated. Baseline data included histological type, stage of disease and presenting symptoms. We intended to follow all patients after diagnosis to reveal treatment outcome and overall survival (OS). RESULTS All but two patients had advanced stage disease (94%), 7 (14%) had distant metastasis. The median interval between start of complaints and diagnosis was 9 months. Forty-two patients were planned for curative intent treatment. Eleven patients (26%) never started treatment, 2 patients did not complete treatment and 3 patients did not return after finishing treatment. Four patients died before radiation could start. Three patients died within 4 months after treatment. Nine patients (21%) had a complete response. Due to the high number of patients who were lost to follow-up (LFU), OS was analyzed as follows: a best-case (patients censored at last contact) and a worst-case scenario (assuming that patients who did not finish treatment or had disease at last contact would have died). The 2-year OS for patients without distant metastases was 39-71%. CONCLUSION Treatment outcome for young patients with NPC in this institute was poor. Improvement can be achieved when NPC is diagnosed at an earlier stage and when there is better treatment compliance.
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Affiliation(s)
- Marlinda Adham
- Ear, Nose and Throat, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia
| | - Sharon D. Stoker
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Maarten A. Wildeman
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Lisnawati Rachmadi
- Anatomy-Pathology, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia
| | | | - Djumhana Atmakusumah
- Haematology-Medical Oncology Internal Medicine, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia
| | - Djayadiman Gatot
- Medical Oncology Pediatric Department, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia
| | - Renske Fles
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Astrid E. Greijer
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Bambang Hermani
- Ear, Nose and Throat, University of Indonesia, Dr. Cipto Mangunkusumo hospital, Jakarta, Indonesia
| | - Jaap M. Middeldorp
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - I. Bing Tan
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Ear, Nose and Throat Department, Gadjah Mada University, Yogyakarta, Indonesia
- Department of Oral and Maxillofacial Surgery, Academic Medical Centre, Amsterdam, The Netherlands
- * E-mail:
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Stoker SD, Wildeman MA, Fles R, Indrasari SR, Herdini C, Wildeman PL, van Diessen JNA, Tjokronagoro M, Tan IB. A prospective study: current problems in radiotherapy for nasopharyngeal carcinoma in yogyakarta, indonesia. PLoS One 2014; 9:e85959. [PMID: 24465811 PMCID: PMC3900459 DOI: 10.1371/journal.pone.0085959] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 11/29/2013] [Indexed: 11/19/2022] Open
Abstract
Introduction Nasopharyngeal carcinoma (NPC) has a high incidence in Indonesia. Previous study in Yogyakarta revealed a complete response of 29% and a median overall survival of less than 2 years. These poor treatment outcome are influenced by the long diagnose-to-treatment interval to radiotherapy (DTI) and the extended overall treatment time of radiotherapy (OTT). This study reveals insight why the OTT and DTI are prolonged. Method All patients treated with curative intent radiotherapy for NPC between July 2011 until October 2012 were included. During radiotherapy a daily diary was kept, containing information on DTI, missed radiotherapy days, the reason for missing and length of OTT. Results Sixty-eight patients were included. The median DTI was 106 days (95% CI: 98−170). Fifty-nine patients (87%) finished the treatment. The median OTT for radiotherapy was 57 days (95% CI: 57–65). The main reason for missing days was an inoperative radiotherapy machine (36%). Other reasons were patient’s poor condition (21%), public holidays (14%), adjustment of the radiation field (7%), power blackout (3%), inoperative treatment planning system (2%) and patient related reasons (9%). Patient’s insurance type was correlated to DTI in disadvantage for poor people. Conclusion Yogyakarta has a lack of sufficient radiotherapy units which causes a delay of 3–4 months, besides the OTT is extended by 10–12 days. This influences treatment outcome to a great extend. The best solution would be creating sufficient radiotherapy units and better management in health care for poor patients. The growing economy in Indonesia will expectantly in time enable these solutions, but in the meantime solutions are needed. Solutions can consist of radiation outside office hours, better maintenance of the facilities and more effort from patient, doctor and nurse to finish treatment in time. These results are valuable when improving cancer care in low and middle income countries.
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Affiliation(s)
- Sharon D. Stoker
- Department of head and neck oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Maarten A. Wildeman
- Department of head and neck oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of otorhinolaryngology, Academic Medical Centre, Amsterdam, the Netherlands
| | - Renske Fles
- Department of head and neck oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sagung R. Indrasari
- Department of otorhinolaryngology, Dr Sardjito General Hospital/Faculty of Medicine Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Camelia Herdini
- Department of otorhinolaryngology, Dr Sardjito General Hospital/Faculty of Medicine Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Judi N. A. van Diessen
- Department of radiation and oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Maesadji Tjokronagoro
- Department of radiotherapy, Dr Sardjito General Hospital/Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - I. Bing Tan
- Department of head and neck oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of otorhinolaryngology, Academic Medical Centre, Amsterdam, the Netherlands
- Department of oral and maxillofacial surgery, Academic Medical Centre, Amsterdam, the Netherlands
- * E-mail:
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Stoker SD, van Diessen JNA, de Boer JP, Karakullukcu B, Leemans CR, Tan IB. Current treatment options for local residual nasopharyngeal carcinoma. Curr Treat Options Oncol 2013; 14:475-91. [PMID: 24243165 PMCID: PMC3841576 DOI: 10.1007/s11864-013-0261-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OPINION STATEMENT Local residual disease occurs in 7-13 % after primary treatment for nasopharyngeal carcinoma (NPC). To prevent tumor progression and/or distant metastasis, treatment is indicated. Biopsy is the "gold standard" for diagnosing residual disease. Because late histological regression frequently is seen after primary treatment for NPC, biopsy should be performed when imaging or endoscopy is suspicious at 10 weeks. Different modalities can be used in the treatment of local residual disease. Interestingly, the treatment of residual disease has better outcomes than treatment of recurrent disease. For early-stage disease (rT1-2), treatment results and survival rates are very good and comparable to patients who had a complete response after the first treatment. Surgery (endoscopic or open), brachytherapy (interstitial or intracavitary), external or stereotactic beam radiotherapy, or photodynamic therapy all have very good and comparable response rates. Choice should depend on the extension of disease, feasibility of the treatment, and doctor's and patient's preferences and experience, as well as the risks of the adverse events. For the more extended tumors, choice of treatment is more difficult, because complete response rates are poorer and severe side effects are not uncommon. The results of external beam reirradiation and stereotactic radiotherapy are better than brachytherapy for T3-4 tumors. Photodynamic therapy resulted in good palliative responses in a few patients with extensive disease. Also, chemotherapeutics or the Epstein-Barr virus targeted therapies can be used when curative intent treatment is not feasible anymore. However, their advantage in isolated local failure has not been well described yet. Because residual disease often is a problem in countries with a high incidence of NPC and limited radiotherapeutic and surgical facilities, it should be understood that most of the above mentioned therapeutic modalities (radiotherapy and surgery) will not be readily available. More research with controlled, randomized trials are needed to find realistic treatment options for residual disease.
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Affiliation(s)
- S. D. Stoker
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, The Netherlands
| | - J. N. A. van Diessen
- Department of Radiotherapy, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, The Netherlands
| | - J. P. de Boer
- Department of Hemato-oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, The Netherlands
| | - B. Karakullukcu
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, The Netherlands
| | - C. R. Leemans
- Department of otolaryngology/head and neck surgery, VU University Medical Center Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
| | - I. B. Tan
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, The Netherlands
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Kardinah D, Anderson BO, Duggan C, Ali IA, Thomas DB. Short report: Limited effectiveness of screening mammography in addition to clinical breast examination by trained nurse midwives in rural Jakarta, Indonesia. Int J Cancer 2013; 134:1250-5. [DOI: 10.1002/ijc.28442] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/15/2013] [Accepted: 07/29/2013] [Indexed: 11/08/2022]
Affiliation(s)
- D. Kardinah
- National Cancer CenterDharmais HospitalJakarta Indonesia
| | - Benjamin O. Anderson
- Breast Health Global InitiativeFred Hutchinson Cancer Research CenterSeattle WA USA
- Department of SurgeryUniversity of Washington, School of MedicineSeattle WA USA
| | - Catherine Duggan
- Breast Health Global InitiativeFred Hutchinson Cancer Research CenterSeattle WA USA
- Program in EpidemiologyPublic Health Sciences, Fred Hutchinson Cancer Research CenterSeattle WA USA
| | - Ibrahim A Ali
- Breast Health Global InitiativeFred Hutchinson Cancer Research CenterSeattle WA USA
| | - David B Thomas
- Breast Health Global InitiativeFred Hutchinson Cancer Research CenterSeattle WA USA
- Program in EpidemiologyPublic Health Sciences, Fred Hutchinson Cancer Research CenterSeattle WA USA
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