The prognostic potential of pretreatment C-reactive protein to albumin ratio in stage IE/IIE extranodal natural killer/T-cell lymphoma

Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.

Analysis of clinical efficacy of P-Gemox regimen sandwich radiotherapy,P-Gemox regimen sequential radiotherapy,and radiotherapy alone treatment for extranodal natural killer/T-cell lymphoma

Objective The study aimed to explore the clinical efficacy of P-Gemox regimen sandwich radiotherapy, P-Gemox regimen sequential radiotherapy, and radiotherapy alone in early-stage extranodal natural killer/T-cell lymphoma(ENKTL).Methods In total, 124 patients with early-stage ENKTL, from June 2009 to January 2016, were retrospectively analyzed to compare the clinical efficacy of the three regimens. Results A total of 46 patients were treated with P-Gemox regimen sandwich radiotherapy, with complete remission(CR) of 91.3%, objective response rate(ORR) of 97.8%, 2-year progression-free survival(PFS) of 76.1%, and 2-year overall survival(OS) of 80.4%. Then, 37 patients received P-Gemox regimen sequential radiotherapy, with CR of 86.5%, ORR of 94.6%, 2-year PFS of 75.7%, and 2-year OS of 81.1%. Finally, 41 patients received radiotherapy alone, with CR of 61.0%, ORR of 80.5%, 2-year PFS of 51.2%, and 2-year OS of 65.9%. When the two groups were compared, significant differences in CR, PFS, and OS were observed among the sandwich radiotherapy, sequential radiotherapy, and radiotherapy alone groups(P < 0.05), respectively. However, no significant difference in CR, ORR, PFS, and OS was observed between the sandwich radiotherapy and sequential radiotherapy groups(P > 0.05). Multivariate analysis revealed that Eastern Cooperative Oncology Group(ECOG), serum lactate dehydrogenase(LDH), plateletto-lymphocyte ratio(PLR), local tumor invasion, and treatment modalities were independent prognostic factors for PFS(P < 0.05). ECOG, LDH, PLR, local tumor invasion, underlying disease, and treatment modalities were independent prognostic factors for OS(P < 0.05).Conclusion P-Gemox regimen combination radiotherapy for patients with early-stage ENKTL was better than the radiotherapy alone.

A case of sorafenib-induced severe thrombocytopenia during treatment of unresectable hepatocellular carcinoma

An 81-year-old male with unresectable hepatocellular carcinoma underwent transarterial chemoembolization(TACE)combined with sorafenib.Platelet count was normal before and after TACE treatment,after which oral administration of sorafenib(400 mg po bid)was initiated.During this period,the patient experienced significant diarrhea,so the dosage was reduced to 200 mg po bid.Later,the patient showed obvious gingival bleeding with progressive exacerbation,and his blood routine examination showed a platelet count of 2×109 cells/L.The patient was clinically diagnosed with extreme severe thrombocytopenia.The patient was advised to stop taking sorafenib and was immediately treated with hemostasis,platelet transfusion,and suspended red blood cells.After the above treatment,the patient’s symptoms improved,and he was discharged.Up to the date of follow-up,there was no further bleeding.

Case report of a mixed pulmonary large cell neuroendocrine carcinoma

A 57 year-old male patient was found to have a lesion in the middle lobe of his right lung using chest computed tomography(CT).Tumor cells were detected,and surgical excision was performed.The patient was diagnosed with mixed large cell neuroendocrine carcinoma,and underwent six cycles of a chemotherapy regimen comprising etoposide combined with cisplatin.Genetic testing revealed an EGFR mutation,which prompted oxitinib-targeted therapy.To date,no signs of recurrence or metastasis have been reported.

Machine learning the Hubbard U parameter in DFT+U using Bayesian optimization

Within density functional theory(DFT),adding a Hubbard U correction can mitigate some of the deficiencies of local and semi-local exchange-correlation functionals,while maintaining computational efficiency.However,the accuracy of DFT+U largely depends on the chosen Hubbard U values.We propose an approach to determining the optimal U parameters for a given material by machine learning.The Bayesian optimization(BO)algorithm is used with an objective function formulated to reproduce the band structures produced by more accurate hybrid functionals.This approach is demonstrated for transition metal oxides,europium chalcogenides,and narrow-gap semiconductors.The band structures obtained using the BO U values are in agreement with hybrid functional results.Additionally,comparison to the linear response(LR)approach to determining U demonstrates that the BO method is superior.