Multi-environment evaluations across ecological regions reveal climate and soil effects on amides contents in Chinese prickly ash peels (Zanthoxylum bungeanum Maxim.).

BACKGROUND: Environmental factors difference is the key factor for the difference in the production, transformation and accumulation of effective components in plants. UPLC-MS/MS and multivariate statistical methods were applied to describe the region difference of amides compounds in Chinese prickly ash peels from different regions and their correlation with climatic factors and soil factors. RESULTS: Amides compounds contents were significantly higher in high altitude areas, with obvious altitude change trend. Two ecotypes were classified based on the amides compounds contents, one was the high altitude-cool type from Qinghai, Gansu, Sichuan and western Shaanxi province, and the other one was low altitude-warm type from eastern Shaanxi, Shanxi, Henan, Hebei and Shandong province. Amides compounds content were negatively correlated with annual mean temperature, max temperature of warmest month, mean temperature of wettest quarter and mean temperature of warmest quarter (P < 0.01). Except for hydroxy-γ-sanshool and ZP-amide A, the residual amides contents were significantly positively correlated with organic carbon, available nitrogen, phosphorus and potassium in soil and negatively correlated with soil bulk density. Low temperature, low precipitation and high organic carbon in soil were conducive to amides accumulation. CONCLUSIONS: This study aided in site specific exploration of high amides contents yielding samples, enriched the environment factors effects on amides compounds, and provided scientific foundation for the improvement of Chinese prickly ash peels quality and the location of high-quality production areas.

Regulation mechanisms of flavonoids biosynthesis of Hancheng Dahongpao peels (Zanthoxylum bungeanum Maxim) at different development stages by integrated metabolomics and transcriptomics analysis.

BACKGROUND: Flavonoids have strong free radical scavenging and antioxidant capacity. The high abundance of flavonoids in Chinese prickly ash peels have many benefits to human health. In this study, 'Hancheng Dahongpao', a main cultivar, was taken as materials to investigate the flavonoids biosynthesis mechanism of Zanthoxylum bungeanum Maxim at three key development stages by integration of metabolomics and transcriptomics analysis. RESULTS: A total of 19 differentially accumulated metabolites were identified, the key flavonoids compounds were kaempferol, quercetin and their glycoside derivatives, and two major anthocyanins (peonidin O-hexoside and peonidin 3-O-glucoside). 5 gene networks/modules including 15 important candidate genes were identified, which was highly correlated with flavonoids. Among these genes, ZM-163828 and ZM-184209 were strongly correlated with kaempferol and quercetin, and ZM-125833 and ZM-97481 were controlled the anthocyanins biosynthesis. Moreover, it was shown that MYB-ZM1, MYB-ZM3, MYB-ZM5, MYB-ZM6 and MYB-ZM7 coordinately controlled flavonoids accumulation through regulating the structural genes. CONCLUSIONS: Generally, this study systematically revealed the flavonoids metabolic pathways and candidate genes involved in flavonoids biosynthesis and laid a foundation for the potential targets for the breeding of new valuable Chinese prickly ash cultivars.

Quality Evaluation of Wild Germplasm of Chinese Prickly Ash (Zanthoxylum bungeanum Maxim) from Qinling Mountains at Different Elevations Based on HPLC-Fingerprint.

Wild Chinese prickly ash resources provide a valuable genetic resource for Zanthoxylum bungeanum Maxim improvement and breeding. The Qinling Mountains was an abundant source for wild Chinese prickly ash. In this study, the phenolic and flavonoid compounds of wild germplasm resources from different altitudes and six cultivated varieties were analyzed by high performance liquid chromatography (HPLC). The chromatograms of them were essentially consistent, although their chemical composition contents were greatly different. The thirty samples were divided into three categories through the hierarchical clustering analysis. Catechin, hyperoside and quercitrin were considered to be key compounds for the quality evaluation, and by contrast, the wild samples with an altitude of 2300±50 m (Group IV) had the highest content of key compounds, and presented stronger antioxidant activity and antibacterial ability, indicating that these wild samples could be identified as the excellent breeding resources. This is the first time to evaluate the quality of wild Chinese prickly ash at different altitudes in Qinling Mountains. These excellent wild germplasm resources provided substantial potential accessions for use directly in Chinese prickly ash breeding programs.

Chemotaxonomic Identification of Key Taste and Nutritional Components in 'Shushanggan Apricot' Fruits by Widely Targeted Metabolomics.

The chemotypic and the content variation in taste substances and nutrients in 'Shushanggan apricot' fruits were detected by UPLC-MS/MS. A total of 592 compounds were identified, of which sucrose contributed mainly to the sweet taste and malic acid and citric acid were important organic acids affecting sweet-sour taste. γ-linolenic acid, α-linolenic acid and linoleic acid were the dominant free fatty acids, and neochlorogenic acid and chlorogenic acid were the predominant phenolic acids. Fruit taste was positively correlated with sucrose and negatively correlated with malic acid and citric acid. The differential metabolites were significantly enriched in the biosynthesis of amino acids and 2-oxocarboxylic acid metabolism pathways, regulating the sugar and organic acid biosynthesis. Taste and nutrient differences could be revealed by variations in composition and abundance of carbohydrates, organic acids and amino acids. The purpose of this study was to provide a comprehensive chemical characterization of taste and nutrient compounds in 'Shushanggan apricot' fruits.

Subcutaneous Injection of Hyaluronic Acid to Decrease Acute Skin Toxicity After Adjuvant Interstitial Brachytherapy in Parotid Gland Cancer Patients: A Nonrandomized Controlled Trial.

PURPOSE: The aim was to evaluate the safety and efficacy of subcutaneous injection of hyaluronic acid in decreasing acute skin toxicity after adjuvant interstitial brachytherapy in parotid gland cancer patients. MATERIALS AND METHODS: Patients with histologically proven parotid gland cancer who would be treated with adjuvant interstitial brachytherapy were included in this nonrandomized controlled trial. Participants were nonrandomly divided into the experimental group and control group. Participants in the experimental group received an injection of hyaluronic acid subcutaneously immediately after interstitial brachytherapy during the operation. Acute toxicity was evaluated in the first 2 months. RESULTS: Thirty consecutive participants were included from April to September 2018. Twenty participants were in the experimental group, and 10 were in the control group. The median volume of hyaluronic acid was 8 mL (range, 4 to 11 mL). In total, the incidence of acute skin toxicity was 40% (8 of 20 patients) and 100% (10 of 10 patients) in the experimental group and control group, respectively. The difference in the dose delivered to 90% of the target volume of the affected skin was significant between the pre-plan (mean, 36.93 Gy) and the actuarial quality verification (mean, 27.70 Gy) in the experimental group (P = .004). The difference in scoring of acute skin toxicity was significant between the experimental and control groups (P = .001). No clear correlation was found between the dose delivered to 90% of the target volume of the affected skin and the scoring of acute skin toxicity (P = .266). CONCLUSIONS: Subcutaneous injection of hyaluronic acid was safe and efficient in decreasing acute skin toxicity after adjuvant interstitial brachytherapy in parotid gland cancer patients according to the preliminary results.

Antibacterial mode of fibrauretine and synergistic effect with kanamycin against multi-drug resistant Escherichia coli.

OBJECTIVE: The present study evaluated the antibacterial activity and mode of action of fibrauretine on Escherichia coli (E. coli) and Staphylococcus aureus, and synergistic effect with kanamycin against multi-drug resistant E. coli. RESULTS: The fibrauretine exhibited inhibitory effect on the growth of the tested bacteria with minimum inhibitory concentration (MIC) and minimum bactericidal concentration of 2.5-5 and 5-10 mg/ml, respectively. Morphological changes of cell microstructure were observed after adding fibrauretine at MIC. The mode of action was further confirmed by measuring release of 260-nm absorbing materials and extracellular potassium ions. Checkerboard dilution test suggested that fibrauretine exhibited synergistic activity when combined with kanamycin (FICI ranging from 0.5625 to 0.625). CONCLUSIONS: Our results indicated that fibrauretine exerted synergistic effect with kanamycin and its antibacterial mode of action mainly attributed to disruption of cell membrane integrity.

The deactivation mechanism of Pb on the Ce/TiO2 catalyst for the selective catalytic reduction of NOx with NH3: TPD and DRIFT studies.

It was well recognized that Pb had a poisoning effect on a SCR catalyst. In this study, the deactivation mechanism of Pb on the Ce/TiO2 catalyst was investigated based on the characterization results of TPD and in situ DRIFT studies. It was found that the addition of Pb on the Ce/TiO2 catalyst not only inhibited the adsorption and activation of NH3 species, but also led to the decrease of the activity of adsorbed NH3 species in the SCR reaction. The adsorption of NOx species and the oxidation of NO by O2 over the Ce/TiO2 catalyst were also suppressed by the addition of Pb, while the reactivity of adsorbed NO2 species did not decrease. Moreover, the results revealed that the NH3-SCR reaction over the Ce/TiO2 catalyst followed both the E-R and L-H mechanisms, while the NH3-SCR reaction over Ce/TiO2-Pb was mainly controlled by the L-H mechanism. The contributions of the L-H mechanism to the SCR reactions over Ce/TiO2 and Ce/TiO2-Pb decreased with increasing reaction temperature. The deactivation of Ce/TiO2-Pb was mainly attributed to the suppressed NH3 adsorption and activation, accompanied by the inhibited NO oxidation and the decrease of Brønsted acid sites.

Whole genome sequencing of an ExPEC that caused fatal pneumonia at a pig farm in Changchun, China.

BACKGROUND: In recent years, highly frequent swine respiratory diseases have been caused by extraintestinal pathogenic Escherichia coli (ExPEC) in China. Due to this increase in ExPECs, this bacterial pathogen has become a threat to the development of the Chinese swine industry. To investigate ExPEC pathogenesis, we isolated a strain (named SLPE) from lesioned porcine lungs from Changchun in China, reported the draft genome and performed comparative genomic analyses. RESULTS: Based on the gross post-mortem examination, bacterial isolation, animal regression test and 16S rRNA gene sequence analysis, the pathogenic bacteria was identified as an ExPEC. The SLPE draft genome was 4.9 Mb with a G + C content of 51.7%. The phylogenomic comparison indicated that the SLPE strain belongs to the B1 monophyletic phylogroups and that its closest relative is Avian Pathogenic Escherichia coli (APEC) O78. However, the distribution diagram of the pan-genome virulence genes demonstrated significant differences between SLPE and APEC078. We also identified a capsular polysaccharide synthesis gene cluster (CPS) in the SLPE strain genomes using blastp. CONCLUSIONS: We isolated the ExPEC (SLPE) from swine lungs in China, performed the whole genome sequencing and compared the sequence with other Escherichia coli (E. coli). The comparative genomic analysis revealed several genes including several virulence factors that are ExPEC strain-specific, such as fimbrial adhesins (papG II), ireA, pgtP, hlyF, the pix gene cluster and fecR for their further study. We found a CPS in the SLPE strain genomes for the first time, and this CPS is closely related to the CPS from Klebsiella pneumoniae.

The efficacy of iodine-125 permanent brachytherapy versus intensity-modulated radiation for inoperable salivary gland malignancies: study protocol of a randomised controlled trial.

BACKGROUND: Radiation therapy is the method of choice for subjects with inoperable salivary gland malignancies. I-125 brachytherapy, delivering a high radiation dose to a tumor but sparing surrounding normal tissues, is supposed to be ideal modality for the treatment of salivary gland malignancies. We designed a randomised controlled clinical trial to compare the efficacy of I-125 permanent brachytherapy (PBT) versus intensity-modulated radiation therapy (IMRT) for inoperable salivary gland malignancies. METHODS/DESIGN: In this study, inclusion criteria are subjects with inoperable salivary gland malignancies, aged 18-80 years, have provided informed consent, with at least one measurable tumor focus, be able to survive ≥3 months, Karnofsky performance status ≥60, have adequate hematopoietic function of bone marrow, have normal liver and kidney function, and are willing to prevent pregnancy. Exclusion criteria include a history of radiation or chemotherapy, a history of other malignant tumors in the past 5 years, receiving other effective treatments, participating in other clinical trials, with circulatory metastasis, cognitive impairment, severe cardiovascular and cerebrovascular diseases, acute infection, uncontrolled systemic disease, history of interstitial lungdisease, and being pregnant or breast feeding. The study will be conducted as a clinical, prospective, randomised controlled trial with balanced randomisation (1:1). The planned sample size is 90 subjects. Subjects with inoperable salivary gland malignancies are randomised to receive either I-125 PBT or IMRT, with stratification by tumor size and neck lymph node metastasis. Participants in both groups will be followed up at 2, 4, 6, 9, 12, 15, 18, 21 and 24 months after randomization. The primary outcome is local control rate of the primary site (based on imaging findings and clinical examination, RECIST criteria) in 1 year. Secondary outcomes are progression-free survival, overall survival, quality of life (QOL) measured with the European Organization for Research and Treatment of Cancer QOL Questionnaire (EORTC QLQ-C30 and QLQ-H&N35) of Chinese version, and safety of treatment. Chi-squared test is used to compare the local control rates in both groups. The survival curves are estimated by the Kaplan-Meier method, and log-rank test is used to test the significant difference. DISCUSSION: Only few observational studies have investigated the effect of I-125 PBT on inoperable salivary gland malignancies. To our knowledge, this is the first randomised controlled trial to investigate the efficacy of I-125 PBT for subjects with inoperable salivary gland malignancies, and will add to the knowledge base for the treatment of these subjects. TRIAL REGISTRATION: The study is registered to Clinical Trials.gov ( NCT02048254 ) on Jan 29, 2014.

The incidence of radioepidermitis and the dose-response relationship in parotid gland cancer patients treated with 125I seed brachytherapy: incidence of radioepidermitis and the dose-response relationship.

BACKGROUND: We studied the incidence and dose-response relationship of radioepidermitis in parotid gland carcinoma patients treated with [(125)I] seed brachytherapy in the hopes of designing an optimized pre-implant treatment plan that would reduce the incidence and severity of radioepidermitis in patients receiving this therapy. PATIENTS AND METHODS: Between January 2007 and May 2010, 100 parotid gland cancer patients were treated postoperatively with [(125)I] seed brachytherapy. The matched peripheral dose (MPD) was 80-140 Gy, and [(125)I] seed activity was 0.7-0.8 mCi. The mean dose delivered to the skin was calculated in the post-implant CT on day 0 following implantation. Grades of acute and late dermatitis were evaluated at 2, 6, 12, and 18 months post-implantation. RESULTS: Most patients experienced grade 0-2 acute and late skin side effects (86 and 97%, respectively), though a small subset developed severe complications. Most grade 1-3 effects resolved within 6 months of implantation, though some grade 1-3 effects and all grade 4 effects remained unchanged throughout the 18-month follow-up period. Grade 3 and 4 effects were most prominent (75 and 25%, respectively) with doses of 110-140 Gy; doses higher than 140 Gy produced only grade 4 effects. CONCLUSION: [(125)I] seed brachytherapy produced acceptable levels of acute and late radioepidermitis with a good clinical outcome. A mean dose under 100 Gy delivered to the skin was safe, though doses of 110-140 Gy should be given with caution and extra monitoring; doses greater than 140 Gy are dangerous and likely to produce grade 4-5 effects.

[Clinical investigation on distant metastases of salivary gland carcinoma after being treated by surgery combined with 125I internal brachytherapy].

OBJECTIVE: To investigate clinical features of distant metastases (DM) and analyze clinicopathologic risk factors associated with DM from salivary gland carcinomas after being treated by surgery combined with 125I internal brachytherapy. METHODS: Between October 2001 and March 2010, 197 patients with salivary gland carcinoma were treated by surgery combined with 125I internal brachytherapy and had follow-up for 2 years or more. Univariate and multivariate analyses were performed to evaluate clinicopathologic risk factors that might influence the risk of distant metastases. RESULTS: DM occurred in 28 of 197 patients (14.2%). The commonest site of distant metastases overall was the lung 89.3% (25/28), followed by bones 17.9% (5/28) and liver (4/28). DM developed after an average interval of (44.2±45.8) months from the time of initial diagnosis, and the mean interval was 64 months. The average time to death after the diagnosis of DM was only (9.7±13.4) months, and the mean time was 12 months. The 3-year locoregional control rate and survival rate were 90.8%, and 87.8% respectively,and the 5-year ones 84.0% and 81.0%, respectively. Univariate analyses revealed that the risk of distant metastases was significantly influenced by locoregional tumor failure (F=26.997, P<0.01) and histologic differentiation (F=1.592, P<0.01). Multivariate analysis of freedom from distant metastases revealed that locoregional control (F=29.332, P<0.01) significantly influenced this end point. CONCLUSION: Salivary gland carcinoma could achieve high local control rate after being treated by surgery combined with 125I internal brachytherapy, and the average interval from diagnosis to DM was prolonged, DM was significantly influenced bylocoregional control.

Postoperative [¹²5I] seed brachytherapy in the treatment of acinic cell carcinoma of the parotid gland: with associated risk factors.

BACKGROUND: This retrospective study was undertaken to analyze data from patients receiving iodine-125 ([(125)I]) seed brachytherapy postoperatively for the treatment of acinic cell carcinoma (ACC) of the parotid gland along with the following risk factors: residual tumor, recurrent tumor, facial nerve invasion, positive resection margins, advanced tumor stage, or tumor spillage. PATIENTS AND METHODS: Twenty-nine patients with ACC (17 females, 12 males; age range, 13-73 years; median age, 37.3 years) were included. Median follow-up was 58.2 months (range, 14-122 months). Patients received [(125)I] seed brachytherapy (median actuarial D90, 177 Gy) 3-41 days (median, 14 days) following surgery. Radioactivity was 18.5-33.3 MBq per seed, and the prescription dose was 80-120 Gy. RESULTS: The 3-, 5-, and 10-year rates of local control were 93.1, 88.7, and 88.7 %, respectively; overall survival was 96.6, 92, and 92 %; disease-free survival was 93.1, 88.4, and 88.4 %; and freedom from distant metastasis was 96.6, 91.2, and 91.2 %. Lymph node metastases were absent in all patients, although two patients died with distant metastases. Facial nerve recovery was quick, and no severe radiotherapy-related complications were noted. Recurrence history, local recurrence, and distant metastasis significantly affected overall survival. CONCLUSION: Postoperative [(125)I] seed brachytherapy is effective in treating ACC and has minor complications. Patients with a history of recurrence showed poor prognosis and were more likely to experience disease recurrence and develop metastases.

Nimotuzumab suppresses epithelial-mesenchymal transition and enhances apoptosis in low-dose UV-C treated salivary adenoid cystic carcinoma cell lines in vitro.

Salivary adenoid cystic carcinoma (SACC), which is one of the most common malignant tumors of the salivary glands, is associated with a poor long-term outcome. There are currently few therapeutic options for patients with SACC. Recent studies have shown the potential of the application of ultraviolet-C (UV-C) irradiation for the treatment of human cancer. In the present study, we investigated the effects of UV-C in the SACC cell lines SACC-83 and SACC-LM. High-dose UV-C (200 J/m) induced apoptosis and inhibited colony formation significantly. However, low-dose UV-C (10 J/m), which had little effect on apoptosis and colony formation, increased the ability of migration in SACC cells accompanied by a decrease in E-cadherin and an increase in vimentin, suggesting the occurrence of epithelial-mesenchymal transition (EMT). Low-dose UV-C (10 J/m) also resulted in upregulation of the phosphorylated forms of epidermal growth factor receptor (EGFR) and Akt (p-EGFR and p-Akt, respectively). Pretreatment with Nimotuzumab, an anti-EGFR monoclonal antibody, reversed the EMT as well as upregulation of p-EGFR/p-Akt induced by UV-C. Moreover, Nimotuzumab enhanced UV-C induced apoptosis and inhibition of colony formation. Our results indicate that EMT exerts a protective effect against apoptosis induced by low-dose UV-C. Thus, the combined application of Nimotuzumab and low-dose UV-C in vitro has an advantageous antitumor effect in SACC compared with the application of UV-C alone.

[Core needle biopsy in the diagnosis of oral and maxillofacial tumors].

OBJECTIVE: To summarize and evaluate the utility of core needle biopsy in diagnosis of head neck tumors. METHODS: Lesions were performed with core needle biopsy in 47 patients who were considered with tumors or other diseases in the head neck. According to the pathological diagnoses, their treating plans were made. If the pathological results could not give definite diagnoses and the lesions were considered tumors or other diseases, then operation or another biopsy was needed and, the other patients could be followed-up. The accurate rate was calculated. RESULTS: The biopsy tissue was enough for pathological diagnosis and immunohistochemical staining. Compared with the pathological results and follow-up, positive diagnosis was in 36 cases, negative diagnosis in 9 cases, false-negative in 2 cases, and the accurate rate was 95.7%. The pathological results had guided the treatment in 43 patients, accounting for 91.5%. No serious side effects were found. CONCLUSION: The core needle biopsy is significant for diagnosis and treatment of head neck tumors.

Evaluating the Impacts of Climate Factors and Flavonoids Content on Chinese Prickly Ash Peel Color Based on HPLC-MS and Structural Equation Model.

Climate affects Chinese prickly ash peel color directly through temperature and illumination and indirectly influences it through its effect on flavonoid compounds. In this study, a comprehensive evaluation strategy based on high performance liquid chromatography-mass spectrometry (HPLC-MS) technology and a structural equation model was applied to evaluate the effects of climate factors and flavonoids on Chinese prickly ash peel color. There were obvious geographical variations of peel color and flavonoid compounds with an obvious east-west distribution trend which were divided into high-altitude type and low-altitude type. Through path analysis, the wind speed, temperature and annual sunshine duration were found to be the key environmental factors affecting the flavonoids content and peel color, and their direct effects were higher than their indirect effect. Based on HPLC-MS technology and a structural equation model, correlation models of climatic factors and flavonoids with peel color were established, and the factors that had greater weight on pericarp color were obtained. Our results provide experimental evidence that climate factors affect the peel color by affecting flavonoid biosynthesis and accumulation, reveal the geographical variation of peel color and flavonoid component contents in Chinese prickly ash peel, establish a quantization color method for rapid evaluation of peel quality, expand on the influence of climatic factors on flavonoids content and peel coloration and promote agricultural practice in areas with similar climatic conditions.

Evaluation of climate factors affecting the quality of red huajiao (Zanthoxylum bungeanum maxim.) based on UPLC-MS/MS and MaxEnt model.

Through field investigation, UPLC-MS/MS technology and MaxEnt model were performed to predict the suitable distribution area for red huajiao (Zanthoxylum bungeanum maxim.) in China from 2021 s to 2060 s, and evaluate the effects of climate factors on the quality of red huajiao. The results demonstrated that mean temperature of the coldest quarter and min temperature of the coldest month were the most important environmental variables influencing red huajiao distribution. Suitable habitats for red huajiao were located mainly in dry and hot valley zone in the Qinba Mountains and the semi-humid and semi-arid areas of the Loess Plateau. The amides contents were higher in high suitability areas, while it was decreased in medium and low suitability areas, and temperature, wind speed and precipitation played a key role in their accumulation. This investigation was of great significance for the planting area optimization, quality control, benefit improvement and industrial development of red huajiao.

Self-assembled wide bandgap nanocoatings enabled outstanding dielectric characteristics in the sandwich-like structure polymer composites.

Polymer dielectrics are insulators or energy storage materials widely used in electrical and electronic devices. Polymer dielectrics are needed with outstanding dielectric characteristics than current technologies. In this study, the self-assembly of boron nitride nanosheets (BNNSs) was applied to form an inorganic-organic nanocoating on various common polymer dielectrics. It is inexpensive and easy to fabricate this thin coating on a large scale. The coating has a wide bandgap and thus can significantly improve the breakdown strength of polymer dielectrics. The charge characteristics and trapping parameters of nano-domains on the surfaces of polymer dielectrics were measured, and the coating had shallow trap levels. This facilitated the dissipation of surface charges and thus greatly increased the flashover voltage. The coating also effectively improved the temperature stability and dielectric constant of the polymer dielectric. This nanocoating shows potential as a method to effectively improve the dielectric characteristics of polymer dielectrics and outperform existing composite polymer dielectrics, which are crucial for large-scale applications in energy storage and power and electronic devices.

[Radioactivity seeds interstitial brachytherapy treating malignant salivary gland tumors].

OBJECTIVE: To detect the efficacy of (125)I radioactive seeds implanting treating malignant salivary gland tumors. METHODS: Forty-three patients with malignant salivary gland tumors of head neck were treated with (125)I radioactivity seeds interstitial brachytherapy at Peking University Stomatologic Hospital between 2001 and 2008. These patients were implanted with (125)I radioactivity seeds with the dosage of 120 to 160 Gy. The treatment response, local control rate and survival rate were evaluated and the adverse events observed. RESULTS: Twenty-nine patients had complete remission (CR)of their tumors, and seven patients partial remission (PR), The response rate was 83.7%. The patients were followed up for 8 to 48 months (median 21 months). The local control rate was 79%, and total survival rate 76.7%. No serious side radiotherapeutic effect was observed. CONCLUSION: Radioactivity seeds interstitial brachytherapy is an effective form of treatment for patients with unresectable malignant salivary gland tumors.

[Combined external radiotherapy and 125I-particle implantation for treatment of head and neck cancers].

OBJECTIVE: To evaluate the relative incidence of local control and toxicity in patients with head and neck cancers who underwent external beam radiotherapy (EBRT) plus (125)I seeds implantation. METHODS: Ten patients diagnosed as head and neck cancers at the department of oral and maxillofacial surgery of Peking University School of Stomatology during the period of February 2008 to July 2010 were collected. The histologic types included squamous cell carcinoma in 8 patients, poorly differentiated adenocarcinoma of salivary gland in 2 patients. All patients could not receive surgical treatment due to poor medical status or unresectable advanced-stage tumors and underwent EBRT plus (125)I seeds implantation. Eight patients with squamous cell carcinoma had conventional fractionated EBRT with a total dose of 50 Gy; two patients with poorly differentiated adenocarcinoma had conventional fractionated EBRT with a total dose of 70 Gy. They all then had (125)I seeds implantation with matched peripheral dose of 60 Gy (TNM stage I-II) or 80 Gy (TNM stage III-IV ). The apparent activity per seed ranged from 25.9 to 29.6 MBq. follow-up of the patients was done to analyze acute and late toxicity, local control, and survival. RESULTS: After a median follow-up of 12 months (range 2-28 months), soft tissue necrosis was seen in one patient, dysphagia and hemorrhage in another. No other serious side effects were observed. All the tumor mass of 10 cases disappeared within 6 months, regional metastases was observed in one patient, and distant metastases was observed in another. Seven of 10 patients survived till the date of investigation. CONCLUSION: External beam radiotherapy plus (125)I seeds implantation is a safe and effective therapy regimen for patients with unrectable head and neck cancers.

Surgery combined with iodine-125 interstitial brachytherapy for treatment of parotid adenoid cystic carcinoma: A single-institution experience.

PURPOSE: The purpose of this study was to analyze the effectiveness and safety of the combination of surgery plus postoperative iodine-125 interstitial brachytherapy for treatment of adenoid cystic carcinoma (ACC) of the parotid. METHODS AND MATERIALS: This study included a retrospective analysis of the data of patients who underwent postoperative iodine-125 interstitial brachytherapy for histology-confirmed ACC of the parotid between January 2002 and November 2018 in Peking University Hospital of Stomatology. Acute and long-term radiation-related toxicities were assessed by the criteria of the Radiation Therapy Oncology Group and European Organization for Research and Treatment of Cancer. Multivariate analysis was used to identify the factors affecting overall survival, disease-free survival (DFS), and distant metastasis-free survival (DMFS). RESULTS: A total of 86 patients (53 women; median age 50 years, SD = 13.1) were included. Median followup was for 45.5 months. About half the patients (44/86, 51.3%) had clinical stage IV disease. Local recurrence occurred in 11 of 86 (12.8%) patients. No patient had nodal metastases in the followup period. The five- and 10-year DFS rates were 74.8% and 66.6%, respectively. The mean DMFS was 60.6 months. On multivariate analysis, preoperative facial palsy, type of surgery, perineural spread (PNS), and distant metastases were independent prognostic factors for DFS; preoperative facial palsy, nodal metastases, and PNS were independent prognostic factors for overall survival; and preoperative facial palsy, type of surgery, PNS, and pathological type were independent prognostic factor for DMFS. CONCLUSIONS: The combination of surgery and iodine-125 interstitial brachytherapy appears to be an effective and safe treatment for primary ACC of the parotid.