[The Application Value of True Whole-body PET/CT Scanning Protocol in Patients of Extranodal NK/T Cell Lymphoma].

OBJECTIVE: To assess the staging, restaging, and treatment strategy determination of extranodal NK/T cell lymphoma (ENKT) by PET/CT real body (true whole-body, TWB) imaging, which is superior to PET/CT limitation of the whole body (limited whole-body, LWB, from skull vertex to upper thighs) by adding 'distal lower extremity' images. METHODS: TWB 18F-FDG PET/CT studies performed for staging and follow-up of ENKTL patients between January 2012 and September 2017 were retrospectively reviewed. Patients in staging group received TWB PET/CT evaluation for staging at the first diagnosis. In follow-up group, patients received follow-up evalution with TWB PET/CT and progressive disease (PD) in the LWB range with or without clinical diagnosis or suspicion before follow-up examination, and then divided into four subgroups: staging (+) PD (－), staging (+) PD (+), staging (－) PD (－), staging (－) PD (+). Then the percentage of unexpected ENKTL lesions found at the distal extremity (outside the LWB range) (P1), and the percentage of changes in the staging, restaging/outcome evaluation (P2) in each group were recorded. RESULTS: Among the 225 patients in the staging group, 200 (88.9%) had tumors confined to LWB, while P1 was 11.1% (25 cases) and P2 was 0.4% (1 case). In the follow-up group, the P1 in staging (+) PD (－)( n=85), staging (+) PD (+)( n=4), staging (－) PD (－)( n=43), staging (－) PD (+) goups ( n=15) were 1.2%, 75.0%, 0%, 26.7%, and P2 were 1.2%, 0%, 0%, 13.3%, respectively. In the follow-up group, regardless of whether the TWB PET/CT examination was performed at the initial diagnosis stage, P1 in PD (－) group and PD (+) group was 0.8 vs. 36.8% ( P<0.000 1), and P2 was 0.8% vs. 10.5% ( P<0.000 1). CONCLUSION: It is not recommended that the TWB PET/CT imaging from the top of the head to the bottom of the foot use for the first diagnosis of ENKTL patients. And for follow-up patients with no clinical evidence of tumor progression or with evidence of tumor progression but whose lesions were limited to LWB at the initial diagnosis of TWB PET/CT staging, LWB PET/CT from the top of the head to the middle of the thigh is recommended for routine follow-up. For ENKTL patients, TWB PET/CT was not performed at the initial stage of diagnosis to detect the condition of lower limbs. If the evidence of tumor progression in the LWB range appeared before the follow-up examination, TWB PET/CT was recommended for the follow-up evaluation to evaluate the systemic tumor involvement.

[Short-term results of audiological change of nasopharyngeal carcinoma patient after radiotherapy and chemotherapy].

OBJECTIVE: To investigate short-stage results of audiological change of nasopharyngeal carcinoma patients after radiotherapy and chemotherapy treatment. METHODS: According to treatment modus of nasopharyngeal carcinoma, 64 cases (128 ears) patients were divided to simple radiotherapy group (45 cases, 90 ears) and radiotherapy with chemotherapy group (combination treatment group, 19 cases, 38 ears). Meanwhile, 25 cases (50 ears) people took as control group, who had no obviously ear and nose disease. About two or three months after radiotherapy and chemotherapy treatment completion, three groups were detected by otoscopy, pure tone test, tympanogram and eustachian tube function, respectively. Then, hearing variation of all patients after radiotherapy and chemotherapy treatment were investigated and compared each other. At the same time, the character and level of audiological change were also analyzed. RESULTS: Eardrum character of nasopharyngeal carcinoma patients appeared change after radiotherapy. Simple radiotherapy and combination treatment groups were found having hearing impairment and eustachian tube functional disturbance. Moreover, most patients of simple radiotherapy group showed conductive deaf (24%, 22/90), and combination treatment group exhibited mingle (24%, 9/38) or sensorineural deafness (29%, 11/38). CONCLUSIONS: Recent hearing of nasopharyngeal carcinoma patients were damaged by radiotherapy and chemotherapy treatment, radiotherapy treatment induced middle ear or eustachian tube function disturbance, chemotherapy treatment had cochleotoxicity, compared with other treatment, combination treatment was more aggravated hearing impairment.