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“The purpose of this work was to examine outcomes in patients with T4 nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT).\n\nBetween 2007 and 2010, 154 patients with nonmetastatic T4 NPC were treated with IMRT to a total dose of 70 Gy in 33-35 fractions. In addition, DMH1 TGF-beta/Smad inhibitor 97 % of patients received concurrent platinum-based chemotherapy. The median follow-up time was 52.8 months.\n\nThe rates of 5-year actuarial locoregional control, distant metastasis-free survival, progression free-survival, and overall survival (OS) were

81.2, 72.2, 61.9, and 78.1 %, respectively. A total of 27 patients had locoregional recurrence: 85.2 % in-field failures, 11.1 % marginal failures, and 3.7 % out-of-field failures. Fourteen patients see more with locoregional recurrence received aggressive treatments, including nasopharyngectomy, neck dissection, or

re-irradiation, and the 5-year OS rate tended to be better (61.9 %) compared to those receiving conservative treatment (32.0 %, p = 0.051). In patients treated with 1 course of radiotherapy, grade a parts per thousand yenaEuro parts per thousand 3 toxicities of ototoxicity, neck fibrosis, xerostomia, epistaxis, and radiographic temporal lobe necrosis occurred in 18.2, 9.8, 6.3, 2.1, and 5.6 % of patients, respectively. Increased ototoxicity, osteonecrosis, severe nasal bleeding, and temporal necrosis were observed in patients treated by re-irradiation.\n\nIMRT offers good locoregional control in patients with T4 NPC. For patients with locoregional recurrence after selleck screening library definitive

radiotherapy, aggressive local treatment may be considered for a better outcome.”
“Introduction: Serum transforming growth factor beta (TGF-beta) level is increased in type-2 diabetes mellitus (T2DM) and certain diabetic complications are mediated by this cytokine. Impaired glucose tolerance (IGT) is a prediabetic condition, and confers a risk for the development of certain diabetes-specific complications. However, no data is available regarding the alteration of TGF-beta in IGT subjects. Therefore, we aimed to investigate TGF-beta levels in otherwise healthy subjects with IGT.\n\nMaterial and methods: Thirty IGT subjects and 30 subjects relatively matched for age, sex and body mass index with normal glucose tolerance were enrolled. Subjects with overt diabetes, cardiovascular, renal or inflammatory disease, or on any medication were excluded. Relevant laboratory examinations were performed by routine methods. Assessment of TGF-beta was made by a commercially available enzyme-linked immunosorbent assay kit. IGT and control subjects were compared for their clinical and laboratory parameters.\n\nResults: Serum TGF-beta levels were found to be similar in IGT and normal glucose tolerance subjects (p < 0.05).