Photodynamic therapy in the therapy for recurrent/persistent nasopharyngeal cancer

To determine the efficacy of Photodynamic therapy of patients with recurrent Nasopharyngeal Carcinoma we reviewed all available literature

Photodynamic therapy of early stage oral cavity and oropharynx neoplasms: an outcome analysis of 170 patients

The indications of photodynamic therapy (PDT) of oral cavity and oropharynx neoplasms are not well defined. The main reason is that the success rates are not well established. The current paper analyzes our institutional experience of early stage oral cavity and oropharynx neoplasms (Tis-T2) to identify the success rates for each subgroup according to T stage, primary or non-primary treatment and subsites. In total, 170 patients with 226 lesions are treated with PDT. From these lesions, 95 are primary neoplasms, 131 were non-primaries (recurrences and multiple primaries). The overall response rate is 90.7% with a complete response rate of 70.8%. Subgroup analysis identified oral tongue, floor of mouth sites with more favorable outcome. PDT has more favorable results with certain subsites and with previously untreated lesions. However, PDT can find its place for treating lesions in previously treated areas with acceptable results

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Differential inhibition of Hedyotis diffusa (HD) and Scutellaria barbata (SB) on human nasopharyngeal carcinoma cells

There are increasing interests and growing opportunities for different investigations to verify Traditional Chinese medicines (TCM) as a complementary therapy for cancers. TCM has a growing popularity as a less intensive and more natural approach to achieve health or improve quality of life. Hedyotis diffusa (HD) and Scutellaria barbata (SB) are two popularly used TCM with documented lethal activities on hepatoma, cervical, gastric and intestinal carcinoma. In this study, we aimed to explore the inhibitory mechanism of the HD and SB extracts on Nasopharyngeal Carcinoma Cells (NPC/CNE2), which is a prevalent cancer in Hong Kong and Southern China. We determined the Chinese Medicine formula with restrict pharmaceutical procedures and performed the chemical fingerprint with HPLC for assessing the quality consistency of SB and HD. At 2-hour drug incubation, the CNE2 cells were well-responsive to both extracts and a lethal dose of 50 (LD50) was achieved with HD (276 µg/mL) and SB (65µg/mL) using trypan blue exclusion assay. At LD10, early apoptotic cell death was triggered by both extracts (HD: 28µg/mL; SB: 3µg/mL); and at LD30, late apoptotic/necrotic cells were significantly increased to 80% (HD: 276µg/mL; SB: 13µg/mL) by Annexin-V-FLOUS staining under fluorescent microscopy. The cytotoxic effect of HD and SB on CNE2 cells was predominantly mediated by H2O2 released by both extracts demonstrated by PerXOquantTM Quantitative Peroxide Assay. DNA damage was evident at half hour post treatment for both extracts using comet assay. In order to verify H2O2 was the toxic species that induced DNA damage, catalase was used to scavenge the H2O2 upon co-incubation with the herb extracts on the CNE2 cells. In conclusion, both HD and SB extracts exhibited a potent growth inhibition on NPC/CNE2 cells due to the induction of DNA damage and apoptosis via the generation of H2O2; hence both herbs can be potential therapeutic interventions for nasopharyngeal carcinoma