ABSTRACT
Although several prognostic factors in nivolumab therapy have been reported in recurrent or metastatic head and neck cancer (RM-HNC) patients, these factors remain controversial. Here, we conducted a multicenter retrospective cohort study to investigate the impact of clinico-hematological factors on survival in RM-HNC patients treated with nivolumab. We reviewed 126 RM-HNC patients from seven institutes. We evaluated the prognostic effects of clinico-hematological factors on survival. The median overall survival (OS) was 12.3 months, and the 1 year-OS rate was 51.2%. Patients without immune-related adverse events, lower relative eosinophil count, worse best overall response, higher performance status, and higher modified Glasgow Prognostic Score had worse survival. The score, generated by combining these factors, was associated with survival. Patients with score of 4-5 had worse survival than those with score of 2-3 and 0-1 [adjusted HR for PFS: score of 4-5, 7.77 (3.98-15.15); score of 2-3, 3.44 (1.95-6.06), compared to score of 0-1], [adjusted HR for OS: score of 4-5, 14.66 (4.28-50.22); score of 2-3, 7.63 (2.29-25.37), compared to score of 0-1]. Our novel prognostic score utilizing clinico-hematological factors might be useful to establish an individual treatment strategy in RM-HNC patients treated with nivolumab therapy.
Subject(s)
Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/drug therapy , Neoplasm Recurrence, Local/pathology , Nivolumab/therapeutic use , Adult , Aged , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Neoplasm Metastasis , Prognosis , Progression-Free Survival , Treatment OutcomeABSTRACT
The application of ultraviolet-B (UVB) radiation to control spider mites is challenging as a key technology for integrated pest management (IPM) in greenhouse strawberries in Japan. To address this, concurrent use of phytoseiid mites and reduced UVB irradiance is desirable to ensure control effects in areas shaded from UVB radiation and to minimize the sunscald in winter, respectively. We designed experiments reproducing the UVB dose on the lower leaf surfaces in strawberry and evaluated the effects of intermittent UVB irradiation at midnight for practical application in the greenhouse and low temperature on the survival of the spider mite Tetranychus urticae Koch (Acari: Tetranychidae) and damage to the phytoseiid mite Neoseiulus californicus (McGregor) (Acari: Phytoseiidae). The midnight intermittent UVB irradiation effectively suppressed egg hatching and development of larvae of T. urticae, and the control effect was reinforced at 20°C (no eggs hatched at 0.13 kJ m-2 d-1) rather than, at 25°C (70.8% eggs hatched). In contrast, the hatchability of N. californicus eggs was unaffected by intermittent UVB irradiation at 0.27 kJ m-2 d-1 at 25°C and 20°C. However, residual effects of UVB irradiation to N. californicus eggs on survival of hatched larvae were seen, so that reducing the UVB dose is also advantageous for this phytoseiid mite. N. californicus showed a photoreactivation capacity, whereas their UVB tolerance was improved by prey species, suggesting the possibility of the improvement of phytoseiid mites by diet. The reduction of UVB dose and concurrent use of phytoseiid mites increase reliability of the UVB method in IPM strategies in strawberry greenhouse.