Association of public health insurance with cancer-specific mortality risk among patients with nasopharyngeal carcinoma: a prospective cohort study in China.

Objective: Health insurance programs are effective in preventing financial hardship in patients with cancer. However, not much is known about how health insurance policies, especially in Southwest China with a high incidence of nasopharyngeal carcinoma (NPC), influence patients' prognosis. Here, we investigated the association of NPC-specific mortality with health insurance types and self-paying rate, and the joint effect of insurance types and self-paying rate. Materials and methods: This prospective cohort study was conducted at a regional medical center for cancer in Southwest China and included 1,635 patients with pathologically confirmed NPC from 2017 to 2019. All patients were followed up until May 31, 2022. We determine the cumulative hazard ratio of all-cause and NPC-specific mortality in the groups of various insurance kinds and the self-paying rate using Cox proportional hazard. Results: During a median follow-up period of 3.7 years, 249 deaths were recorded, of which 195 deaths were due to NPC. Higher self-paying rate were associated with a 46.6% reduced risk of NPC-specific mortality compared to patients with insufficient self-paying rate (HR: 0.534, 95% CI: 0.339-0.839, p = 0.007). For patients covered by Urban and Rural Residents Basic Medical Insurance (URRMBI), and for patients covered by Urban Employee Basic Medical Insurance, each 10% increase in the self-paying rate reduced the probability of NPC-specific death by 28.3 and 25%, respectively (UEBMI). Conclusion: Results of this study showed that, despite China's medical security administration improved health insurance coverage, NPC patients need to afford the high out-of-pocket medical costs in order to prolong their survival time.

Transcriptional E2F1/2/3/6 as potential prognostic biomarkers in cutaneous melanoma.

Although the abnormal expression of members of the E2F family has been reported to participate in carcinogenesis in many human types of cancer, the bioinformatics role of the E2F family in melanoma is unknown. This research was designed to detect the expression, methylation, prognostic value and potential effects of the E2F family in melanoma. We investigated E2F family mRNA expression from the Oncomine and GEPIA databases and their methylation status in the MethHC database. Meanwhile, we detected the relative E2F family expression levels by qPCR and immunohistochemistry. Kaplan-Meier Plotter was used to draw survival analysis charts, and gene functional enrichment analyses were applied through cBioPortal database analysis. E2F1/2/3/4/5/6 mRNA and proteins were clearly upregulated in cutaneous melanoma patients, and high expression levels of E2F1/2/3/6 were statistically related to high methylation levels. Increased mRNA expression of E2F1/2/3/6 was related to lower overall survival rates (OS) and disease-free survival (DFS) in cutaneous melanoma cases. Meanwhile, E2F1/2/3/6 carried out these effects through regulating multiple signaling pathways, including the MAPK, PI3K-Akt and p53 signaling pathways. Taking together, our findings suggest that E2F1/2/3/6 could act as potential targets for precision therapy in cutaneous melanoma patients.

[Preliminary study of intensity-modulated radiation therapy for recurrent cervical cancer].

OBJECTIVE: To assess feasibility of intensity-modulated radiation therapy for recurrent cervical cancer. METHODS: Totally 21 patients with recurrent cervical cancer between April 2004 and January 2007 treated with intensity-modulated radiation therapy (IMRT) and conventional external radiation therapy were evaluated. Twenty-one patients treated with IMRT was group A, and the other 18 patients with anterior posterior field radiotherapy was group B. Preliminary outcome and toxicity were evaluated between two groups. RESULTS: All patients completed the prescribed dose. Group A was (50 +/- 11) Gy and group B was (39 +/- 5) Gy. There were no significant differences in the two groups (P > 0.05). The effective rate of group A was 71% (15/21) and of group B 39% (7/18), with a significant difference in the two groups (P < 0.05). The average survival time of group A was (25 +/- 6) months, and of group B (12 +/- 5) months, with a significant difference in the two groups (P < 0.05). In group A, acute grade > or = 3 gastrointestinal, genitourinary, and myelotoxicity were seen in 0, 0, and 2 patients, respectively. While in group B, these were seen in none. CONCLUSIONS: The curative effect of IMRT is better than anterior posterior field radiotherapy. The acute toxicity of IMRT is acceptable.