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Dose-adjusted EPOCH-R vs.R-CHOP in frontline management of waldeyer’s ring diffuse large B-cell lymphoma:a retrospective study from a single institution

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Chinese Medical Journal 2023年第2期136卷 167-175页

作者： Yuanzheng Liang Xindi Liu Jing Yang Henan Wang Yingshi Piao Liqiang Wei Liang Wang Department of Hematology Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China Department of Pathology Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China

Background: To compare the efficacy and safety of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin plus rituximab (DA-EPOCH-R) with standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in waldeyer’s ring diffuse large B-cell lymphoma (WR-DLBCL) at a single institution. Methods: This retrospective study included 115 newly diagnosed patients with WR-DLBCL, of whom 68 patients received R-CHOP, and 47 patients received DA-EPOCH-R as their first-line treatment. The baseline features of the two groups were well balanced using a 1:1 propensity score matching method, and a total of 84 cases were obtained, including respective 42 cases in the R-CHOP and DA-EPOCH-R groups, for further survival and prognosis analysis. The primary objectives included progression-free survival (PFs) and overall survival (Os). Results: During a median follow-up of 45 months, there were nine (21.4%) deaths in the R-CHOP group and two (4.8%) in the DA-EPOCH-R group. Kaplan-Meier analysis showed statistically significant improvements in PFs and Os in patients with DA-EPOCH-R compared with those treated with R-CHOP (log-rank test, P = 0.025 and P = 0.035, respectively). The 2-year PFs and Os rates in the DA-EPOCH-R group were 90.1% (95% confidence interval [CI]: 81.4-99.8%) and 95.2% (95% CI: 89.0-100.0%), respectively, and 80.5% (95% CI: 69.3-93.6%) and 90.5% (95% CI: 52.8-99.8%) in the R-CHOP group. Patients without B symptoms and elevated lactate dehydrogenase levels had a higher PFs in the DA-EPOCH-R group, with P values of 0.038 (hazard ratio [HR]: 0.11;95% CI: 0.01-0.88) and 0.042 (HR: 0.19;95% CI: 0.04-0.94), respectively. There were no statistically significant differences in clinical responses and treatment-related toxicities between the two groups. Conclusion: Compared with patients received R-CHOP, those treated by DA-EPOCH-R had superior PFs, Os, and controlled toxicity in patients with WR-DLBCL.

关键词： waldeyer’s ring B-cell lymphoma DA-EPOCH-R R-CHOP

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Anatomy and physiology of the palatine tonsils, adenoids, and lingual tonsils

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World Journal of Otorhinolaryngology-Head and Neck surgery 2021年第3期7卷 155-160页

作者： Alexandra Arambula Jason RBrown Laura Neff Department of Otolaryngology-Head and Neck surgery University of KansasKansas CityKSUSA Division of Pediatric Otolaryngology Children's Mercy Hospital and ClinicsKansas CityMOUSA Department of surgery-University of Missouri-Kansas City school of Medicine Kansas CityMOUSA

Objective::This review aims to discuss the basic anatomy and physiology of the palatine and pharyngeal tonsils,with reference to how this foundational understanding may affect patient management and surgical procedures in these regions of the upper airway.Methods::A literature search was performed using PubMed and Google scholar using the MesH terms tonsils,adenoids,anatomy,physiology,and adenotonsillectomy.Primary sources were excluded if they were abstracts only,non-English language,or non-human studies.Thirty-five sources were included in this review.Results and conclusions::The pharyngeal and palatine tonsils are compact yet physiologically complex mucosa-associated lymphoid tissues that make up a portion of waldeyer’s ring.As part of the mucosal immune system,these structures function in exogenous antigen sampling and stimulation of immune responses.Aberrant immune activation and/or regulation can lead to a myriad of pathologies,with adenotonsillar hypertrophy,chronic tonsillitis/adenoiditis,and recurrent otitis media among the most commonly encountered conditions by otolaryngologists.While the pathophysiology of these conditions is still incompletely understood,current evidence and future investigations may reveal patterns amenable to targeted medical management.When medical management fails,tonsillectomy and/or adenoidectomy may be indicated for patient care.Though routine procedures,the execution of tonsil and/or adenoid removal requires a thorough understanding of the anatomy of these lymphoepithelial organs so as to minimize the risk for rare serious complications that can occur.

关键词： Anatomy of tonsils Adenoids waldeyer’s ring

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Clinical Analysis of Non-Hodgkin's Lymphoma Presenting in Oral & Maxillofacial Region

Clinical Analysis of Non-Hodgkin's Lymphoma Presenting in Or...

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作者： subhash Kumar Ghimire 大连医科大学

学位级别：硕士

Objective: Non-hodgkin’s lymphoma (NHL) refers to a group of malignant neoplasms that arise from cellular elements of lymphoid or extranodal tissue. Lymphomas are a frequent cause of malignant lymphadenopathy in the head &neck. The head &neck is the second must frequent anatomical site of extranodal lymphomas after gastrointestinal tract. That’s why dental & maxillofacial surgeon should be aware of malignant lymphoma to diagnose properly & efficiently. This study was performed to evaluate oral & maxillofacial region manifestations, staging, grading and prognosis of NHL.Materials & Method: A retrospective analysis or review of 25patients with oral &maxillofacial region lymphoma was made in our hospital (Dalian Medical University, stomatology Department of First Affiliated hospital) from 2002jan to 2006 august .specifically, clinical presentation, staging, grading & therapy for NHL with oral &maxillofacial region involvement were sought. staging was done according to the Ann Arbor staging system and diagnosis made by immunohistochemistry.Result: 25 patients of NHL were included in our study, among them 20(80%) patients with extra nodal (eNHL) &5(20%) patients with nodal (NHL) involvement. The incidence rate increases exponentially with age between 24 and 79 years. The median age at the diagnosis of the patients was 60yrs.Patients above 50 years were 72%.Male (60%) is slightly more than female (40%). Among 20 patients, NHL of waldeyer’s ring was the most frequent site occurring in 10 patients (50%) followed by NHL of oral cavity (20%), of salivary glands (30%). Constitutional B symptomatology was uncommon, occurring in 25% patients. The typical clinical appearance is a painless local mass lateral or bilateral (90%) and confused with squamous cell carcinoma. Most of the non-Hodgkin’s lymphoma was B-cell lineage (90%), & overall diffuse large B-cell lymphoma (76%) was the most common type. Mostly patients involving non-Hodgkin’s lymphoma in oral &maxillofacial region were 64%stageI&II (stage I(

关键词： non-Hodgkin’s lymphoma oral &maxillofacial neoplasms immunohistochemistry Ann Arbor staging system constitutional B symptom Ann Arbor system working formulation waldeyer’s ring

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