Abstract: Objectives: Are LANC patients with carotid artery invasion are at risk of massive neck hemorrhage after radiotherapy? Design: This retrospective study aims to assess the efficacy of HT with CCRT +/-EGFR inhibitor in LANC patients invading carotid artery and risk of fatal bleeding. Settings: Otolaryngology Head and Neck Surgery department in our hospital in China . Participants: Of 130 LANC patients with carotid artery invasion admitted to our hospital between January 2012 and September 2019. Main outcome measures: The 5-year survival rate of three degrees of the carotid artery invasion (<180°, 180°≤IG<270°, ≥270°) . Univariate and Multivariate Cox regression analysis were used for survival correlation factors. Results: The incidence of fatal bleeding after radiotherapy was 2.3% (3/130). The primary site of the three cases were all the pharyngeal recess, with more than 270º carotid artery invasion. Patients with hemoglobin levels >110 g/L had a higher PFS, DMFS and OS than with that ≤110 g/L (P<0.05). Multivariate analysis showed that the EGFR inhibitor was an independent risk factor for PFS and DMFS, while the lowest hemoglobin level was an independent risk factor for OS. Conclusion: In LANC patients whose carotid artery invasion was <270º, HT combined with CCRT and EGFR inhibitor after induction chemotherapy had mild and tolerable side effects, better PFS and DMFS, with no massive hemorrhage. In patients ≥270º, diabetes with poor control or re-radiotherapy led to a higher risk of massive hemorrhage after radiotherapy.

Objectives: Our study aimed to identify potential factors that influence rehabilitation outcomes in late-implanted adolescents and adults with prelingual deafness and attempted to develop a reliable nomogram. Design: This retrospective study included 120 subjects less than 30 years of age who had received cochlear implantation at a single medical center. The Categories of Auditory Performance (CAP) scale was used to evaluate the rehabilitation outcomes. A nomogram was constructed using the R and EmpowerStats software. Results: Univariate analysis indicated higher rates of auditory performance improvement in younger aged subjects. Residual hearing and regular and longer implant use were more common among subjects showing auditory performance improvement. Multivariate analysis identified residual hearing (Hazard Ratio, 6.11; 95% Confidence Interval, 1.83-20.41; P<0.01), age at implantation (Hazard Ratio, 0.31; 95% Confidence Interval, 0.14-0.83; P=0.02) and regular CI use (Hazard Ratio, 7.79; 95% Confidence Interval, 2.50-24.20; P<0.01) as independent predictors for auditory performance improvement. The nomogram’s predictive performance was satisfactory as verified by the calibration curve and Receiver operating characteristic (ROC) curve. Conclusions: We demonstrated that residual hearing, younger age, and regular CI use were associated with auditory performance improvement in this cochlear implant user population. Our nomogram model demonstrated satisfactory predictive performance for this population.