Diagnosis and treatment of congenital nasal dermoid and sinus cysts in 11 infants: A consort compliant study.
11 例婴儿先天性鼻皮样囊肿和鼻窦囊肿的诊断和治疗: consort依从性研究。
- 作者列表："Ni K","Li X","Zhao L","Wu J","Liu X","Shi H
:There have been few studies on congenital nasal dermoid and sinus cysts (NDSCs) in infants.This study was performed to obtain clinical data for the diagnosis and treatment of NDSCs in infants.We performed a retrospective analysis of 11 infants admitted with NDSCs between 2014 and 2019. Patient demographics, lesion site, preoperative radiological findings, surgical technique, intraoperative findings, and postoperative sequelae were analyzed.In total, 11 infants (average age, 19 months; lowest age, 10 months) were included in this study. All patients presented with a nasal root mass, 2 patients also had nasal tip fistula, and only 1 case had a history of preoperative infection. Preoperative enhanced computed tomography (CT) examination showed nasal surface lesion (type I) in 3, nasal intraosseous (type II) in 5, intracranial epidural (type III) in 2, and intracranial dural (type IV) in 1 patient. The main surgical methods included direct resection with a vertical midline incision (9 patients), vertical incision + transnasal endoscopic resection + skull base repair (1 patient), and transverse incision of the lower margin of the left eyebrow (1 patient). All wounds healed well without serious complications.Using the 4-type classification method in combination with the preoperative CT findings to analyze the extent of NDSC in infants is helpful for formulating the surgical plan. Using vertical incision approach alone or combined with nasal endoscopy for minimally invasive surgery can meet the needs of complete resection and reconstruction.Our results provide clinical data that can help establish standardized criteria for the diagnosis and treatment of NDSCs in infants.
: 关于婴儿先天性鼻皮样囊肿和鼻窦囊肿 (NDSCs) 的研究很少。本研究旨在获得婴儿NDSCs诊断和治疗的临床资料。我们对 2014 年至 2019 年间收治的 11 例NDSCs婴儿进行了回顾性分析。分析患者人口统计学、病变部位、术前影像学检查结果、手术技术、术中检查结果和术后后遗症。本研究共纳入 11 例婴儿 (平均年龄，19 个月; 最低年龄，10 个月)。所有患者均表现为鼻根肿块，2 例患者同时出现鼻尖瘘，仅 1 例有术前感染史。术前增强计算机断层扫描 (CT) 检查显示鼻表面病变 (ⅰ 型) 3 例，鼻骨内 (ⅱ 型) 5 例，颅内硬膜外 (ⅲ 型) 2 例，和颅内硬脑膜 (IV型) 1 例。主要手术方式有垂直正中切口直接切除 (9 例) 、垂直切口 + 经鼻内镜切除 + 颅底修补术 (1 例) 、和左眉下缘横切口 (1 例患者)。所有伤口均愈合良好，无严重并发症。采用 4 型分类方法结合术前CT表现分析婴儿NDSC的范围，有助于制定手术方案。采用垂直切口入路单独或联合鼻内镜进行微创手术，可满足完整切除重建的需要。我们的结果提供了临床数据，可以帮助建立婴儿NDSCs诊断和治疗的标准化标准。
METHODS:OBJECTIVE:Large inoperable sacral chordomas show unsatisfactory local control rates even when treated with high dose proton therapy (PT). The aim of this study is assessing feasibility and reporting early results of patients treated with PT and concomitant hyperthermia (HT). METHODS: :Patients had histologically proven unresectable sacral chordomas and received 70 Gy (relative biological effectiveness) in 2.5 Gy fractions with concomitant weekly HT. Toxicity was assessed according to CTCAE_v4. A volumetric tumor response analysis was performed. RESULTS: :Five patients were treated with the combined approach. Median baseline tumor volume was 735 cc (range, 369-1142). All patients completed PT and received a median of 5 HT sessions (range, 2-6). Median follow-up was 18 months (range, 9-26). The volumetric analysis showed an objective response of all tumors (median shrinkage 46%; range, 9-72). All patients experienced acute Grade 2-3 local pain. One patient presented with a late Grade 3 iliac fracture. CONCLUSION:Combining PT and HT in large inoperable sacral chordomas is feasible and causes acceptable toxicity. Volumetric analysis shows promising early results, warranting confirmation in the framework of a prospective trial. ADVANCES IN KNOWLEDGE: :This is an encouraging first report of the feasibility and early results of concomitant HT and PT in treating inoperable sacral chordoma.
METHODS:BACKGROUND:National guidelines recommend screening and treatment for cancer-related bone disease and continued monitoring of bone-modifying agents. It is unclear whether a standardized screening tool is utilized to identify eligible patients and ensure appropriate supportive care is implemented. The purpose of this study was to evaluate current prescribing practices and optimize management of bone-modifying agents. METHODS:A retrospective chart review was performed to identify patients who received hormone deprivation therapy or had bone metastases through Hematology/Oncology or Urology clinics from 1 November 2016 to 31 October 2017. The primary endpoints of this study were the incidence of completed baseline dual-energy X-ray absorptiometry (DEXA) scan for patients on hormone deprivation therapy and percent of patients started on a bone-modifying agent for the prevention of skeletal-related events secondary to bone metastasis. Secondary endpoints included percent of patients with dental examinations prior to initiation, adequate calcium and vitamin D supplementation, incidence of osteonecrosis of the jaw or flu-like symptoms and education, and percent of bisphosphonate doses appropriately adjusted based on renal function. RESULTS:A total of 375 patients were assessed for baseline DEXA scans and bone-modifying therapy. Of the 226 patients on hormone deprivation therapy, 111 (49%) patients were appropriately screened with a DEXA scan prior to initiation of hormone deprivation therapy. Among the 149 patients with bone metastases, only 94 (63.1%) patients were started on a bone-modifying agent. CONCLUSIONS:Opportunities have been identified to optimize management of patients with cancer-related bone disease. Implementation of standardized tools may increase the rate of appropriate screening and initiation of bone-modifying therapy when warranted.
METHODS:PURPOSE:Low skeletal muscle mass has been associated with poor prognosis in patients with advanced lung cancer. However, little is known about the relationship between skeletal muscle mass and overall survival in patients with bone metastases from lung cancer. The objective of the present study was to evaluate the prognostic value of low trunk muscle mass in predicting overall survival in these patients. METHODS:The data from 198 patients who were diagnosed with bone metastases from lung cancer from April 2009 to May 2017 were retrospectively reviewed. The areas of the psoas and paravertebral muscles were measured at the level of the third lumbar vertebra on computed tomography scans taken at the time nearest to the diagnosis of bone metastasis. Muscle area was evaluated for male and female cohorts separately using different cutoff points. Cox proportional hazards analysis was performed to evaluate the factors independently associated with overall survival. RESULTS:The overall survival of patients in the lowest quartile for psoas muscle area or paravertebral muscle area was significantly shorter than that of patients above the 25th percentile for muscle area (p < 0.001). Multivariate analyses showed that paravertebral muscle mass (hazard ratio, 1.73; 95% confidence interval, 1.17-2.56; p = 0.006), epidermal growth factor receptor-targeted therapy, and performance status were independent prognostic factors. CONCLUSIONS:Low paravertebral muscle mass was associated with shorter survival, independently of known prognostic factors.