Objective: This study aimed to establish a simplified T classification based on the 8th edition of the Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) staging system for nasopharyngeal carcinoma (NPC). Methods: In total, 325 patients with NPC were included in this study. All patients underwent magnetic resonance imaging, and the staging criteria were recorded. These patients were subjected to staging with the 8th edition of the UICC/AJCC staging system for NPC. Results:  Involvement of the oropharynx, nasal cavity, adjacent soft tissue (medial pterygoid, lateral pterygoid, and prevertebral muscles), cervical vertebra, orbit, and hypopharynx were always accompanied by other equivalently or more advanced T-stage classifications. All cases with involvement of the paranasal sinuses showed skull base erosion. The majority of cases with involvement of the pterygoid structure showed skull base erosion. Conclusion: According to the simplification principle, the following new T classification based on the 8th edition of the UICC/AJCC staging system was established: T1, tumor confined to nasopharynx, or beyond the nasopharynx without parapharyngeal involvement; T2, tumor with extension to the parapharyngeal space; T3, tumor with infiltration to bony structures at the skull base; T4, tumor with intracranial extension, involvement of the cranial nerves or parotid gland, and/or extensive soft tissue infiltration beyond the lateral surface of the lateral pterygoid muscle. Validation with a large series of patients is needed.

Current evidence for the combined use of immunotherapy, low-dose chemoradiotherapy, and epidermal growth factor receptor-targeted therapy for the treatment of advanced esophageal squamous cell carcinoma is lacking. We report the case of a 73-year-old woman with squamous cell carcinoma of upper middle thoracic esophagus. After undergoing concurrent chemoradiotherapy combined with immunotherapy and anti-angiogenic targeted therapy, the patient achieved a progression-free survival of 17 months. To date, the patient has achieved 35 months of overall survival, which continues to extend, with a good quality of life. Immunotherapy combined with low-dose concurrent chemoradiotherapy is a promising option for elderly patients with advanced esophageal cancer who are intolerant to standard treatments. The addition of an epidermal growth factor receptor monoclonal antibody as a radiosensitizer improves therapeutic efficacy. The combination of sintilimab and anlotinib has the potential to treat recurrent and metastatic esophageal cancer. Tailoring treatment strategies for specific patient groups is essential in personalized medicine.

Purpose: To evaluate the efficacy and safety of radiotherapy combined with immunotherapy and targeted therapy (RT+IO+T) versus immunotherapy plus targeted therapy alone (IO+T) in patients with unresectable hepatocellular carcinoma (HCC). Given the limited prospective evidence supporting the integration of radiotherapy into systemic regimens, particularly in real-world populations with advanced disease, this study aims to clarify the clinical value of this multimodal approach.Methods: This retrospective study analyzed 71 patients with unresectable HCC treated between 2020 and 2025. Patients received either IO+T (n=42) or RT+IO+T (n=29), including immune checkpoint inhibitors (ICIs) (e.g., camrelizumab), targeted agents (e.g., lenvatinib), and RT. Outcomes were assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Survival analysis was performed using Kaplan–Meier and Cox regression models.Results: Compared with the IO+T group, the RT+IO+T group demonstrated superior short-term efficacy, as indicated by the objective response (69.0% vs. 35.7%, p=0.006) and disease control (89.7% vs. 57.1%, p=0.003) rates. Additionally, the median progression-free survival (PFS) and overall survival (OS) were significantly prolonged in the RT+IO+T group compared with the IO+T group (PFS: 12.6 vs. 4.6 months, p<0.001; OS: 17.8 vs. 10.9 months, p=0.009). Subgroup analyses confirmed consistent survival benefits across patient characteristics. However, the RT+IO+T group showed increased hematologic toxicity (grade ≥3 lymphopenia: 62.1% vs. 19.0%, p<0.001) and hepatic enzyme elevation (aspartate aminotransferase: 75.9% vs. 35.7%, p<0.001).Conclusion: Adding RT to IO+T significantly improved tumor response and survival in unresectable HCC, despite higher manageable hematologic and hepatic toxicities.Clinical significance: The results of this study support RT+IO+T as a promising strategy for advanced HCC, particularly in patients with high tumor burden or portal vein invasion. The synergistic effect of RT, immunotherapy, and target therapy highlights its potential to redefine treatment paradigms, although toxicity monitoring remains critical.

Background: FIGO stage IVA cervical cancer is frequently associated with extensive pelvic organ invasion and high treatment complexity. In selected patients with severe hemorrhage, renal dysfunction, or poor baseline condition, delivery of standard therapy may be clinically challenging. Case Presentation: We report a patient with FIGO stage IVA cervical squamous cell carcinoma presenting with massive vaginal bleeding, severe anemia, and renal dysfunction caused by extensive invasion of the rectum, bladder, distal ureter, and lower vagina. Emergent hemostatic radiotherapy achieved rapid bleeding control and clinical stabilization. Subsequently, an individualized conversion-oriented multimodal strategy integrating radiotherapy, targeted therapy, immunotherapy, and later consolidation chemotherapy was adopted with surgery as the intended endpoint. During treatment, serial image-guided radiotherapy (IGRT) monitoring prompted repeat CT simulation, target volume recontouring, and adaptive replanning according to tumor regression, enabling progressive reduction of irradiated target volumes while limiting unnecessary radiation exposure to adjacent pelvic organs. Marked tumor regression was achieved, followed by definitive radical surgery and pathologic complete response without recurrence during follow-up. Conclusion: This case suggests that, in highly selected patients with FIGO stage IVA cervical cancer, an individualized conversion-oriented multidisciplinary strategy incorporating IGRT-based monitoring and adaptive replanning may facilitate subsequent radical surgery and durable disease control. However, further clinical validation is required.