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BackgroundPeripheral lymphatic radiotherapy in patients with pT3N0M0 and pT4N0M0 breast cancer has been a matter of considerable debate among radiation oncologists. This is the first report in a non-Caucasian population.Patients and MethodsThe study included 165 pT3N0M0 and pT4N0M0 patients. Univariate, multivariate, propensity score matching (PSM), and Kaplan-Meier analyses were conducted to evaluate the survival of patients. We also review all the literature about regional lymph nodes radiation in T3-4N0M0 patients and summarize them with tables to compare with the present study.ResultsThe median follow-up duration was 58.7 months. Multivariate analyses showed that advance T stage and grade were dependent poor prognostic factors for OS, DMFS, LRFS, and DFS between group A (chest wall radiation) and group B (chest wall and regional lymph nodes radiation). The overall survival (OS), disease-free survival (DFS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) rates were not significantly different between group A and group B. The 5-year OS rate was 92.3% vs 89.7% for group A and group B, respectively (P=0.819). The 5-year LRFS rate was 94.9% vs 94.3% for group A and group B, respectively (P=0.852). Fifty-four pairs of patients were selected after propensity score matching (PSM) analysis was conducted. There was also no significant difference between group A and group B in regard to the OS, DFS, LRFS, and DMFS rates after PSM. The patients included in previous studies were all Caucasians, and our study was focused on non-Caucasians. The cases of previous studies were 10 to 20 years ago, but our study has more recent cases. The radiotherapy techniques of previous studies were conventional, and the techniques used in our study were three-dimensional conformal radiotherapy (3DCRT) or intensity modulated radiotherapy (IMRT).ConclusionBoth our study and previous studies suggested that regional lymph nodes radiation cannot improve the survival rate for breast cancer patients with T3-4N0M0 in non-Caucasian population. Advance T stage and grade were the dependent poor prognostic factors for T3-4N0M0 patients.

The primary gene mutations associated with nasopharyngeal carcinoma (NPC) are located within phosphoinositide 3-kinase (PI3K)-mammalian target of rapamycin (mTOR) signaling pathways. These pathways have inhibitory effects on autophagy, and autophagy has become an important area of NPC research. However, the potential molecular targets related to autophagy in NPC remain to be elucidated. The current study examined levels of autophagy-related genes, including autophagy related 4B cysteine peptidase (ATG4B) and gamma aminobutyric acid (GABA) type A receptor associated protein like 1 (GABARAPL1), in nasopharyngeal carcinoma tissues and explored their potential role as novel targets for the treatment of NPC. Overexpression of GABARAPL1 was shown to decrease the level of hypoxia-inducible factor (HIF)-2α and induce apoptosis in NPC cells. Importantly, when nude mice were subcutaneously inoculated with NPC cells, overexpression of GABARAPL1 slowed tumor growth. Furthermore, the underlying mechanism by which GABARAPL1 regulated nasopharyngeal tumor growth was investigated. HIF-2α, as a substrate for autophagic degradation, may play an interesting role during NPC progression. This study highlighted novel targets that may be used to treat NPC patients in the future.