Impact of different surgical and postoperative adjuvant treatment modalities on survival of sinonasal malignant melanoma.

BACKGROUND: The role of postoperative adjuvant treatment for sinonasal malignant melanoma remains unclear. This study evaluates the impact of three different surgical and postoperative adjuvant treatment modalities: surgery alone(open and endoscopic approaches), surgery plus radiotherapy and surgery, radiotherapy plus chemotherapy on survival of patients with primary sinonasal malignant melanoma (SMM). METHODS: The data of 69 patients who underwent primary surgical treatments at Eye & ENT hospital of Fudan University between January 1st, 2000 and December 31st, 2010 were retrospectively reviewed. Survival comparison of different surgical and postoperative adjuvant treatment modalities (surgery alone, surgery plus radiotherapy and surgery, radiotherapy plus chemotherapy), as well as survival comparison between open and endoscopic surgical approaches were performed. Curves depicting survival were performed using Kaplan-Meier method. Statistical analysis was performed using log-rank test software SPSS19 and p < .05 is considered as statistically significant. RESULTS: The median overall survival time was found to be 18 months for surgery alone (27 cases), 32 months for surgery plus radiotherapy (24 cases), 42 months for surgery, radiotherapy plus chemotherapy (18 cases). The 3 and 5 year survival rates for groups mentioned above were 14.8% and 5.6%, 45.1% and 31.6%, 55% and 32.1%, respectively. Statistical significances were found not only between surgery alone and surgery plus radiotherapy treatment group (P = 0.012), but also surgery alone and surgery, radiotherapy plus chemotherapy group (P = 0.002). There was no statistically significant survival difference found between the two different surgical approaches (41 cases for open approach and 28 cases for endoscopic approach). CONCLUSIONS: Sinonasal malignant melanoma is a disease with a poor prognosis. Patients who underwent surgery plus radiotherapy or surgery, radiotherapy plus chemotherapy had better survival outcomes than those underwent surgery alone. Endoscopic approach provided similar survival outcome as an open approach.

Histamine H4 receptor gene polymorphisms: a potential predictor of oral H1 antihistamine efficacy for allergic rhinitis.

BACKGROUND: Our study aimed to investigate the associations between Histamine H4 receptor (HRH4) gene polymorphisms (rs77485247, rs74604924, and rs77041280) and oral H1 antihistamine efficacy for the treatment of allergic rhinitis (AR) patients. METHODS: A total of 142 AR patients were selected as a case group and 160 healthy individuals were recruited as a control group. Single nucleotide polymorphisms (SNPs) in the HRH4 gene were detected using direct sequencing. Serum immunoglobulin E (IgE), specific IgE, and eosinophil cationic protein (ECP) levels were measured by enzyme-linked immunosorbent assay (ELISA). Clinical efficacy was evaluated by the visual analogue scale (VAS). The occurrence of adverse reaction was recorded. RESULTS: There were significant differences in the distribution frequencies of mutant genotype (TA + AA) and A allele of rs77485247, mutant genotype (AT + TT) and T allele of rs74604924, and mutant genotype (AT + TT) and T allele of rs77041280 between the case and control groups. AR patients with mutant genotype (TA + AA) of rs77485247 and AR patients with mutant genotype (AT + TT) of rs77041280 had higher specific IgE, ECP levels, and VAS scores after treatment and lower incidence of adverse reactions and total effective rate than those with TT genotype and those with AA genotype, respectively. However, for rs74604924, there were no differences was found between AR patients with mutant genotype (AT + TT) and those with AA genotype. CONCLUSION: Our findings provide evidence that HRH4 rs77485247 and rs77041280 polymorphisms may be associated with the risk of AR and the efficacy of H1 antihistamines for the treatment of AR patients.