Nasopharyngeal cancer(NPC) is endemic in Southern China,with Guandong province and Hong Kong reporting some of the highest incidences in the world.The journal Science has called it a "Cantonese cancer".We pr...Nasopharyngeal cancer(NPC) is endemic in Southern China,with Guandong province and Hong Kong reporting some of the highest incidences in the world.The journal Science has called it a "Cantonese cancer".We propose that in fact NPC is a cancer that originated in the Bai-Yue("proto-Tai-Kadai" or "proto-Austronesian" or "proto-Zhuang") peoples and was transmitted to the Han Chinese in southern China through intermarriage.However,the work by John Ho raised the profile of NPC,and because of the high incidence of NPC in Hong Kong and Guangzhou,NPC became known as a Cantonese cancer.We searched historical articles,articles cited in PubMed,Google,monographs,books and Internet articles relating to genetics of the peoples with high populations of NPC.The migration history of these various peoples was extensively researched,and where possible,their genetic fingerprint identified to corroborate with historical accounts.Genetic and anthropological evidence suggest there are a lot of similarities between the Bai-Yue and the aboriginal peoples of Borneo and Northeast India;between Inuit of Greenland,Austronesian Mayalo-Polynesians of Southeast Asia and Polynesians of Oceania,suggesting some common ancestry.Genetic studies also suggest the present Cantonese,Minnans and Hakkas are probably an admixture of northern Han and southern Bai-Yue.All these populations have a high incidence of NPC.Very early contact between southern Chinese and peoples of East Africa and Arabia can also account for the intermediate incidence of NPC in these regions.展开更多
Background and Objective:Concurrent chemoradiation therapy(CCRT) is the standard treatment for patients with locally advanced nasopharyngeal carcinoma(NPC).The effect of neoadjuvant chemotherapy followed by CCRT has n...Background and Objective:Concurrent chemoradiation therapy(CCRT) is the standard treatment for patients with locally advanced nasopharyngeal carcinoma(NPC).The effect of neoadjuvant chemotherapy followed by CCRT has not been determined.Therefore,we conducted 2 phase Ⅱ studies to evaluate the efficacy and safety of neoadjuvant chemotherapy with a regimen of docetaxel,cisplatin,and 5-fluorouracil(5-Fu)(TPF) followed by radiotherapy and concurrent cisplatin in patients with stage-Ⅲ and -Ⅳ(A -B) NPC.This article is the preliminary report on treatment-related toxicities and response.Methods:Graded according to the 2002 American Joint Committee on Cancer(AJCC) staging criteria,only patients with stage-Ⅲ or -Ⅳ(A-B) poorly differentiated or undifferentiated NPC(World Health Organization type Ⅱ/Ⅲ) were included.We planned to recruit 52 patients with stage-Ⅲ disease and 64 patients with stage-Ⅳ(A-B) disease.All patients received neoadjuvant chemotherapy with TPF(docetaxel 75 mg/m2,day 1;cisplatin 75 mg/m2,day 1;5-Fu 500 mg/(m2·day),continuous intravenous infusion for 120 h),every 3 weeks for 3 cycles,followed by weekly cisplatin(40 mg/m2) concurrent with radiotherapy.Three-dimensional conformal radiotherapy(3D-CRT) and intensity-modulated radiotherapy(IMRT) were used.Gross disease planning target volume(PTV),high-risk and low-risk subclinical PTV doses were prescribed at 70-76 Gy,66-70 Gy,and 60-61.25 Gy at 1.75-2.0 Gy per fraction.The lower neck or supraclavicular fields may be treated with conventional AP/PA fields for a total of 54 Gy at 1.8 Gy per fraction.Patients were evaluated for tumor response after the completion of neoadjuvant chemotherapy,and at 3 months after radiation according to the Response Evaluation Criteria In Solid Tumors(RECIST).The latest version of the National Cancer Institute's Common Terminology Criteria for Adverse Events(NCI CTCAE 3.0) was used for grading all adverse events.Results:Fifty-nine patients were evaluable for treatment response.Thirty patients had stage-III diseas展开更多
文摘Nasopharyngeal cancer(NPC) is endemic in Southern China,with Guandong province and Hong Kong reporting some of the highest incidences in the world.The journal Science has called it a "Cantonese cancer".We propose that in fact NPC is a cancer that originated in the Bai-Yue("proto-Tai-Kadai" or "proto-Austronesian" or "proto-Zhuang") peoples and was transmitted to the Han Chinese in southern China through intermarriage.However,the work by John Ho raised the profile of NPC,and because of the high incidence of NPC in Hong Kong and Guangzhou,NPC became known as a Cantonese cancer.We searched historical articles,articles cited in PubMed,Google,monographs,books and Internet articles relating to genetics of the peoples with high populations of NPC.The migration history of these various peoples was extensively researched,and where possible,their genetic fingerprint identified to corroborate with historical accounts.Genetic and anthropological evidence suggest there are a lot of similarities between the Bai-Yue and the aboriginal peoples of Borneo and Northeast India;between Inuit of Greenland,Austronesian Mayalo-Polynesians of Southeast Asia and Polynesians of Oceania,suggesting some common ancestry.Genetic studies also suggest the present Cantonese,Minnans and Hakkas are probably an admixture of northern Han and southern Bai-Yue.All these populations have a high incidence of NPC.Very early contact between southern Chinese and peoples of East Africa and Arabia can also account for the intermediate incidence of NPC in these regions.
文摘Background and Objective:Concurrent chemoradiation therapy(CCRT) is the standard treatment for patients with locally advanced nasopharyngeal carcinoma(NPC).The effect of neoadjuvant chemotherapy followed by CCRT has not been determined.Therefore,we conducted 2 phase Ⅱ studies to evaluate the efficacy and safety of neoadjuvant chemotherapy with a regimen of docetaxel,cisplatin,and 5-fluorouracil(5-Fu)(TPF) followed by radiotherapy and concurrent cisplatin in patients with stage-Ⅲ and -Ⅳ(A -B) NPC.This article is the preliminary report on treatment-related toxicities and response.Methods:Graded according to the 2002 American Joint Committee on Cancer(AJCC) staging criteria,only patients with stage-Ⅲ or -Ⅳ(A-B) poorly differentiated or undifferentiated NPC(World Health Organization type Ⅱ/Ⅲ) were included.We planned to recruit 52 patients with stage-Ⅲ disease and 64 patients with stage-Ⅳ(A-B) disease.All patients received neoadjuvant chemotherapy with TPF(docetaxel 75 mg/m2,day 1;cisplatin 75 mg/m2,day 1;5-Fu 500 mg/(m2·day),continuous intravenous infusion for 120 h),every 3 weeks for 3 cycles,followed by weekly cisplatin(40 mg/m2) concurrent with radiotherapy.Three-dimensional conformal radiotherapy(3D-CRT) and intensity-modulated radiotherapy(IMRT) were used.Gross disease planning target volume(PTV),high-risk and low-risk subclinical PTV doses were prescribed at 70-76 Gy,66-70 Gy,and 60-61.25 Gy at 1.75-2.0 Gy per fraction.The lower neck or supraclavicular fields may be treated with conventional AP/PA fields for a total of 54 Gy at 1.8 Gy per fraction.Patients were evaluated for tumor response after the completion of neoadjuvant chemotherapy,and at 3 months after radiation according to the Response Evaluation Criteria In Solid Tumors(RECIST).The latest version of the National Cancer Institute's Common Terminology Criteria for Adverse Events(NCI CTCAE 3.0) was used for grading all adverse events.Results:Fifty-nine patients were evaluable for treatment response.Thirty patients had stage-III diseas
