7%) showing partial remission.The most frequently observed acute toxicities during the concurrent chemoradiotherapy were mucositis and leucopenia. Four patients (6.9%) had RTOG grade 3 mucositis, whereas four patients (6.9%) had grade 3 leucopenia. No patient had grade 4 acute toxicity. Three (5.17%) of the patients exhibited injury to the brain on routine MRI examination, with a median observation of 32 months (range, 25-42months). All of them were RTOG grade 0. The 3-year overall, regional-free and distant metastasis-free survival rates were 85%, 94% and 91%, respectively. Conclusion: Simultaneous boost irradiation radiotherapy is feasible in patients with locally advanced nasopharyngeal carcinoma. The results showed excellent local control and overall survival, with no significant increase the incidence of radiation brain injury or the extent of damage. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and late toxicity.

Objective: Studies discussed few risk factors for specific patients, such as duration of disease; or surgical factors, such as duration and time of surgery; or C3 or C7 involvement, which could have led to the formation of hematomas (HTs). To investigate the incidence, risk factors especially the factors mentioned above, and management of postoperative HTs following anterior cervical decompression and fusion (ACF) for degenerative cervical diseases.Methods: Medical records of 1,150 patients who underwent ACF for degenerative cervical diseases at our hospital between 2013 and 2019 were identified and reviewed. Patients were categorized into the HT group (HT group) or normal group (no-HT group). Demographic, surgical and radiographic data were recorded prospectively to identify risk factors for HT.Results: Postoperative HT was identified in 11 patients, with an incidence rate of 1.0% (11 of 1,150). HT occurred within 24 hours postoperatively in 5 patients (45.5%), while it occurred at an average of 4 days postoperatively in 6 patients (54.5%). Eight patients (72.7%) underwent HT evacuation; all patients were successfully treated and discharged. Smoking history (odds ratio [OR], 5.193; 95% confidence interval [CI], 1.058–25.493; p = 0.042), preoperative thrombin time (TT) value (OR, 1.643; 95% CI, 1.104–2.446; p = 0.014) and antiplatelet therapy (OR, 15.070; 95% CI, 2.663–85.274; p = 0.002) were independent risk factors for HT. Patients with postoperative HT had longer days of first-degree/intensive nursing (p < 0.001) and greater hospitalization costs (p = 0.038).Conclusion: Smoking history, preoperative TT value and antiplatelet therapy were independent risk factors for postoperative HT following ACF. High-risk patients should be closely monitored through the perioperative period. Postoperative HT in ACF was associated with longer days of first-degree/intensive nursing and more hospitalization costs.

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chemotherapy. Radiosurgery was delivered to the primary tumor site 4 weeks after the completion of EBRT in one fraction of 7-15 Gy (median 12 Gy).Results: With a median follow up of 31.4 months (range: 3.9-84.6), there were 14 distant relapses, but no local failures. The 3-year local control rate was 100%, freedom from distant metastasis (FFDM) was 69% and overall survival was 75%. Univariate analysis revealed that N-stage (favoring N0-1, p ϭ 0.04) and WHO histology (favoring WHO III, p ϭ 0.0001) were significant prognostic factors for FFDM. WHO histology was the only significant factor for FFDM on multivariate analysis (pϭ 0.002, hazard ratio (HR) ϭ 13). Age (p ϭ 0.04), gender (favoring female, p ϭ 0.04) and WHO histology were significant prognostic factors for survival on univariate analysis. WHO histology (pϭ0.004, HR ϭ 10.5) and age (pϭ0.01, HR 1.07/year) were significant factors for survival on multivariate analysis. Late toxicity included transient cranial nerve weakness in 4, radiation-related retinopathy in 1 and asymptomatic temporal lobe necrosis in 3 patients who originally had intracranial tumor extension.Conclusions: Stereotactic radiosurgical boost following fractionated EBRT provides excellent local control in NPC patients. Late toxicity appears to be acceptable to date. With improved local control, more effective systemic treatment is needed in these patients.

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