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BackgroundMost nasopharyngeal carcinoma (NPC) protocols define primary gross tumor volume (GTVnx) plus a range from 2 to 5 mm as the high-dose clinical target volume (hd-CTV). However, in China, hd-CTV is defined as GTVnx plus 0 mm. MethodsA total of 40 patients with newly diagnosed nonmetastatic NPC (T1-T4 ten cases each) treated with IMRT were consecutively enrolled. Real and virtual treatment plans were designed according to the definitions of hd-CTV recommended by China and Radiation Therapy Oncology Group (RTOG), respectively. ResultsThe hd-CTV in China was significantly smaller than that of RTOG. Exposure doses to 5 mm subclinical involvement and OARs as well as NTCP in the China treatment plan were significantly lower than those of RTOG. ConclusionIt could be recommended to divide the hd-CTV into GTV and subclinical target volume and to prescribe different doses for the GTV and subclinical involvement in the IMRT plan of NPC.

BACKGROUND: This study presents a summary of the clinical characteristics of non-nasopharyngeal lymphoepithelial carcinoma (NNPLEC), effects of combined modality treatment and prognostic value of plasma Epstein-Barr virus (EBV) deoxyribonucleic acid (DNA) load, with the aim of providing a reference framework for optimizing treatment practices and outcomes.METHODS: Patients with NNPLEC treated by our center between January 2000 and December 2020 were retrospectively reviewed.RESULTS: In total, 728 patients were included. The lung was identified as the most common primary tumor site (64.0%), followed by the salivary gland (19.2%). A total of 539 (74.0%) patients underwent surgery, 459 (63.0%) received chemotherapy, and 361 (49.6%) were subjected to radiotherapy. The median follow-up time was 45 months (range, 6-212 months) and 5-year overall survival (OS) was 79.1%. Increased plasma EBV-DNA load of >513.5 copies/mL was predictive of disease progression, with a specificity of 98.1% and a sensitivity of 98.9%. In multivariate Cox analysis, N stage, surgery, and radiotherapy were independent prognostic factors for both OS and PFS. Radiotherapy significantly improves OS in comparison with no radiotherapy group for salivary LEC, while surgery significantly improves OS for pulmonary LEC.CONCLUSION: Based on our analysis, surgery and radiotherapy are associated with better OS and PFS for NNPLEC. Radiotherapy could be recommended for salivary LEC, while surgery remains the primary treatment strategy for pulmonary LEC patients. An increased plasma EBV-DNA load of >513.5 copies/mL is strongly predictive of disease progression, supporting the importance of regular evaluation of plasma EBV-DNA as part of the diagnostic routine.

Perceived overqualification has been a hot topic in the field of organizational behavior in recent years and has become very common with the spread of education. In addition, in the current era of open innovation, the demand for innovative behaviors by enterprises is increasing day by day. Therefore, this study intended to link the two to explore the relationship between them. Based on self-evaluation theory and face theory, taking enterprise employees as the research object, this paper discusses the impact of perceived overqualifications on employees’ innovative behavior and the internal mechanism and examines the first-order and high-order moderating effects of ability–face pressure and length of service in turn. The results showed that perceived overqualifications had a positive impact on employees’ innovation behavior, and felt trust had a mediating role in the relationship. Ability face pressure played a negative moderating role in the impact of felt trust on innovative behavior and played a negative moderating role in the impact of perceived overqualifications on innovative behavior. With the increase in the length of service, the negative moderating effect of ability face pressure on the relationship between perceived overqualifications and employees’ innovative behavior weakened. It is expected that these results will enable companies to understand the internal mechanisms of employee perceived overqualification, enlighten leaders to give more trust to employees, help companies to improve employees’ innovative behavior, and pay attention to the psychological factors of employees, which will help to create a sustainable work environment and promote sustainable business development.

Although the literature suggests that firms tend to adopt “conservative” behavior in the face of positive performance feedback, there are also studies that take the opposite view on the impact of positive performance feedback. Based on the behavior theory of the firm and regulatory focus theory, this study explored the impact of positive performance feedback on innovation search behavior and the boundary effect of CEO regulatory focus to gain insight into the mechanisms of innovation search behavior and to promote innovation for sustainable development. Based on data from 230 biopharmaceutical companies in China, the analysis found that: (1) positive performance feedback had a significant positive effect on depth search behavior and a significant negative effect on breadth search behavior; (2) CEOs’ promotion focus had a negative moderating effect on the relationship between positive performance feedback and depth search behavior and a positive moderating effect on the relationship between positive performance feedback and breadth search behavior; and (3) CEOs’ prevention focus positively moderated the relationship between positive performance feedback in relation to depth search behavior. This study extends the behavior theory of the firm and reveals the mechanism of the differential impact of positive performance feedback on innovation search behavior, which has implications for the study of which innovation search practices should be conducted by high-performing firms to promote sustainable development.

Background The present study aimed to determine a treatment strategy and Intensity-Modulated Radiotherapy (IMRT) target volume for major salivary gland carcinoma (SGC). Methods Patients with SGC treated at our cancer center between August 2009 and August 2020 were retrospectively reviewed. Results The following primary tumor sites were identified: parotid gland in 61 (69.3%) patients, submandibular gland in 21 (23.9%) patients, and sublingual gland in six (6.8%) patients. Lymphoepithelial carcinoma (LEC) was the most common tumor subtype that accounted for 23.9% of cases. A total of 80 (90.9%) patients received radical surgery combined with postoperative radiotherapy. Eight patients (9.1%) received definitive radiotherapy: six patients with advanced-stage disease received induction chemotherapy (IC) combined with concurrent chemoradiotherapy (CCRT), and two patients with early-stage disease received CCRT. Complete response was observed in these eight patients after treatment completion. The median follow-up time of all patients was 42 months (range: 4–129 months). No patient developed local recurrence. The 5-year overall survival, regional failure-free survival, distant metastasis-free survival, and progression-free survival probabilities were 84.1%, 95.6%, 75.3%, and 75.7%, respectively. Distant metastasis was observed in 18 (20.5%) patients, followed by regional 2 (2.3%) recurrence. Permanent facial nerve injury was confirmed in 31 patients by follow-up. None of the patients experienced facial nerve paralysis in the definitive radiotherapy group. Conclusions LECs may be sensitive to chemoradiotherapy, which may achieve a radical effect and avoid unnecessary surgical injury. IC combined with CCRT is expected to become a new treatment strategy for advanced LECs. The IMRT target volume delineation according to the surgical principles may be a more promising method with good clinical efficacy that is worthy of further study.