Clinical oncology最新文献

英文中文

Comparative Outcomes and Toxicity in Patients With Esophageal Cancer After Trimodality Therapy With Step-and-Shoot Intensity-Modulated Radiation Therapy Versus Volumetric Modulated Arc Therapy: The MD Anderson Experience 食管癌患者在三段式治疗中采用步射调强放疗与体积调弧放疗的比较结果和毒性：MD安德森经验。

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.clon.2024.103668

C.O. Abana , P.P. Carriere , P.J. Damen , P.S.N. van Rossum , A.K. Yoder , P.L. Bravo , X. Wei , J.M. Pollard-Larkin , P.L. Nitsch , M.B. Murphy , W.L. Hofstetter , Z. Liao , S.H. Lin

Aims

To evaluate outcomes and toxicity after intensity-modulated radiation therapy given as step-and-shoot (SS) or volumetric modulated arc therapy (VMAT) for patients with locally advanced esophageal cancer treated with trimodality therapy (i.e. neoadjuvant concurrent chemoradiation therapy followed by surgery).

Materials and Methods

Patients consecutively treated with trimodality therapy including IMRT in 2001–2022 (n = 449) were retrospectively reviewed, and 106 pairs of propensity-matched SS and VMAT patients were identified. Survival, recurrence, surgery-related prognostic factors, and chemoradiation-related toxicities were evaluated between groups.

Results

Baseline characteristics were balanced between both groups except for body mass index, history of other cancer, clinical disease stage, and use of induction chemotherapy. Median follow-up time was 40 months. Relative to SS, VMAT led to higher 3-year overall survival (OS; P = 0.028, hazard ratio [HR] 0.645, 95% confidence interval [CI] 0.436–0.954) but not progression-free, locoregional recurrence-free, or distant metastasis-free survival. No predictor of excellent OS by SS versus VMAT was identified in multivariable analyses. However, VMAT was associated with reduced odds of postoperative cardiac complications (P < 0.001, odds ratio [OR] 0.296, 95% CI 0.148–0.591), pulmonary complications (P = 0.048, OR 0.539, 95% CI 0.292–0.994), pathologic partial response or worse (≥10% viable cells; P = 0.003, OR 0.418, 95% CI 0.235–0.743), and positive/close margins (P = 0.023, OR 0.346, 95% CI 0.138–0.867) relative to SS. VMAT was also associated with reduced rates of chemoradiation therapy-related weight loss (33.0% versus 79.2%, P < 0.001), fatigue (40.6% versus 68.9%, P < 0.001), nausea (31.1% versus 58.5%, P < 0.001) and cardiac toxicity (0% versus 6.6%, P = 0.007) than SS.

Conclusion

Based on this single institution, retrospective study with a 40-month median follow-up, VMAT utilization in trimodality treatment for locally advanced esophageal cancer appears to be associated with improved OS and rates of concurrent chemoradiation therapy-related toxicity and reduced initial 12-month postoperative complications relative to SS IMRT. Multi-institutional prospective trials addressing the limitations of this study and with longer follow-ups are warranted to validate these findings.

目的：评价局部晚期食管癌患者在接受三模式治疗（即手术后新辅助同步放化疗）后，采用步射调强放射治疗（SS）或体积调弧放射治疗（VMAT）的结果和毒性。材料与方法：回顾性分析2001-2022年连续接受包括IMRT在内的三段式治疗的患者（n = 449），发现106对倾向匹配的SS和VMAT患者。评估两组患者的生存、复发、手术相关预后因素和放化疗相关毒性。结果：两组患者除体重指数、其他肿瘤病史、临床疾病分期和诱导化疗使用情况外，基线特征基本平衡。中位随访时间为40个月。相对于SS， VMAT导致更高的3年总生存期(OS；P = 0.028，危险比[HR] 0.645, 95%可信区间[CI] 0.436-0.954)，但无进展、局部无复发或远处无转移生存期不存在差异。在多变量分析中，没有发现SS与VMAT的良好OS预测因子。然而，VMAT与术后心脏并发症（P < 0.001，比值比[OR] 0.296, 95% CI 0.148-0.591）、肺部并发症（P = 0.048, OR 0.539, 95% CI 0.292-0.994）、病理部分反应或更差(活细胞≥10%；与SS相比，VMAT还与放化疗相关的体重减轻（33.0%比79.2%,P < 0.001）、疲劳（40.6%比68.9%,P < 0.001）、恶心（31.1%比58.5%,P < 0.001）和心脏毒性（0%比6.6%,P = 0.007）发生率降低相关。基于这一单一机构，中位随访时间为40个月的回顾性研究，相对于SS IMRT， VMAT在局部晚期食管癌三段式治疗中的应用似乎与改善的OS和同步放化疗相关毒性发生率以及减少最初12个月术后并发症有关。多机构前瞻性试验解决了本研究的局限性，并进行了更长时间的随访，以验证这些发现。

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引用次数: 0

Virtual follow-up after prostate radiotherapy: A successful model utilising non-clinical personnel to streamline care and optimise patient outcomes

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.clon.2024.10.016

S. Dipro, S. Appleyard

引用次数: 0

Prospective analysis of patient reported outcomes following rectal spacer insertion prior to Prostate radiotherapy

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.clon.2024.10.017

M. Hughes, K.D. Linton, A. Sykes, D.P. Rosario, O.S. Din

引用次数: 0

A sub-study to assess the agreement between the anti-cancer treatment records in Systemic Anticancer Therapy (SACT) and Hospital Episode Statistics (HES) database from a large-scale retrospective cohort study with patients with renal cell carcinoma in England

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.clon.2024.10.012

M. Ling , P. Das , A. Clark , L. Vaz , A. Booth , R. Das

引用次数: 0

Chemotherapy tolerance and outcomes in geriatric breast cancer patients aged >70 assessed using the Edmonton Frail Scale

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.clon.2024.103723

S. Mumtaz , R. Muhammad , N. Goyal , A. Konstantis

引用次数: 0

Developing a Paired Whole Genome Sequencing Service for Children With Cancer 为癌症儿童开发配对全基因组测序服务。

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.clon.2024.07.009

L. Sarkies , P. Thomas , E.A. Edeko , S. Leiter , J. Trotman , R. Armstrong , A. Vedi

Background

The uniqueness of paired (tumor and germline) whole genome sequencing (PWGS) in cancer diagnosis and management lies in not just its ability to uncover oncogenic drivers and potential treatment targets but also on the identification of underlying cancer predisposition syndromes, which has significant implications for the patient and their family.

Aims

This is a descriptive article highlighting the processes taken by our team to incorporate PWGS into routine National Health Service (NHS) clinical care for children with cancer. The main aim of this article is to share our experience with other centers that may wish to set up similar services and set the stage for future quantitative/qualitative research.

Methods

This article is further supported by an audit focusing on children in whom an underlying cancer predisposition was confirmed.

Results

The audit highlights the success of the program to date, with 100% of families identified as being at risk of a cancer predisposition syndrome being offered referral to clinical genetics and 100% of at-risk first-degree relatives being offered predictive counseling and testing. Areas requiring improvement included discussion of reproductive options as only six out of nine families (67%) had a documented discussion.

Conclusions

Incorporation of the audit recommendations will improve our service, and sharing of our experience will hopefully encourage more pediatric oncology services to introduce PWGS into routine clinical care and reduce inequity of access. Further work is required to assess the long-term cancer risk reduction and establish the psychosocial impact of PWGS for the child and family.

背景：配对（肿瘤和种系）全基因组测序（PWGS）在癌症诊断和管理中的独特之处在于，它不仅能够发现致癌驱动因素和潜在的治疗靶点，还能识别潜在的癌症易感综合征，这对患者及其家庭具有重大影响。本文的主要目的是与其他希望建立类似服务的中心分享我们的经验，并为未来的定量/定性研究奠定基础：方法：本文通过对已确认有潜在癌症倾向的儿童进行审计来进一步证实：审计结果表明，该计划迄今为止取得了巨大成功，100% 被确认有癌症易感综合征风险的家庭都获得了临床遗传学转介服务，100% 有风险的一级亲属都获得了预测咨询和检测服务。需要改进的方面包括对生育选择的讨论，因为九个家庭中只有六个家庭（67%）进行了有记录的讨论：采纳审计建议将改善我们的服务，分享我们的经验将有望鼓励更多儿科肿瘤服务机构将 PWGS 纳入常规临床护理，减少不公平的机会。还需要进一步开展工作，评估长期癌症风险的降低情况，并确定PWGS对儿童和家庭的社会心理影响。

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引用次数: 0

Clinical Impact of Constitutional Genomic Testing on Current Breast Cancer Care 宪法基因组检测对当前乳腺癌治疗的临床影响。

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.clon.2024.08.006

W. Cheah, R.I. Cutress, D. Eccles, E. Copson

The most commonly diagnosed cancer in women worldwide is cancer of the breast. Up to 20% of familial cases are attributable to pathogenic mutations in high-penetrance (BReast CAncer gene 1 [BRCA1], BRCA2, tumor protein p53 [TP53], partner and localizer of breast cancer 2 [PALB2]) or moderate-penetrance (checkpoint kinase 2 [CHEK2], Ataxia-telangiectasia mutated [ATM], RAD51C, RAD51D) breast-cancer-predisposing genes. Most of the breast-cancer-predisposing genes are involved in DNA damage repair via homologous recombination pathways. Understanding these pathways can facilitate the development of risk-reducing and therapeutic strategies. The number of breast cancer patients undergoing testing for pathogenic mutations in these genes is rapidly increasing due to various factors. Advances in multigene panel testing have led to increased detection of pathogenic mutation carriers at high risk for developing breast cancer and contralateral breast cancer. However, the lack of long-term clinical outcome data and incomplete understanding of variants, particularly for moderate-risk genes limits clinical application. In this review, we have summarized the key functions, risks, and prognosis of breast-cancer-predisposing genes listed in the National Health Service (NHS) England National Genomic Test Directory for inherited breast cancer and provide an update on current management implications including surgery, radiotherapy, systemic treatments, and post-treatment surveillance.

乳腺癌是全世界妇女最常确诊的癌症。多达 20% 的家族性病例是由于高遗传率（乳腺癌基因 1 [BRCA1]、BRCA2、肿瘤蛋白 p53 [TP53]、乳腺癌伴侣和定位器 2 [PALB2]）或中遗传率（检查点激酶 2 [CHEK2]、共济失调-特朗根氏症突变 [ATM]、RAD51C、RAD51D）乳腺癌易感基因的致病突变所致。大多数乳腺癌易感基因通过同源重组途径参与 DNA 损伤修复。了解这些途径有助于制定降低风险和治疗策略。由于各种因素，接受这些基因致病突变检测的乳腺癌患者人数正在迅速增加。多基因面板检测技术的进步使越来越多的人被检测出具有患乳腺癌和对侧乳腺癌高风险的致病基因突变携带者。然而，由于缺乏长期临床结果数据以及对变异的不完全了解，特别是对中度风险基因的了解，限制了临床应用。在这篇综述中，我们总结了英国国家医疗服务系统（NHS）国家遗传性乳腺癌基因组检测目录中列出的乳腺癌易感基因的主要功能、风险和预后，并提供了当前管理影响的最新信息，包括手术、放疗、系统治疗和治疗后监测。

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引用次数: 0

OncoFlash—Research Updates in a Flash! OncoFlash - 即时研究更新！

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.clon.2024.10.031

S. Parikh , K.T. Jayaprakash

引用次数: 0

Sequencing Targeted Therapy in Era of Precision Medicine for Thyroid Cancers 精准医学时代甲状腺癌的测序靶向治疗。

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.clon.2024.103704

I.S. Boon

引用次数: 0

Exploring gene expression in localised prostate cancer: Insights from a randomised control trial with a focus on hypoxia and angiogenic genomic biomarkers post-EBRT and HDR-BTb

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.clon.2024.10.020

T. Lodhi , M. Reardon , A.M. Rojas , A. Choudhury , P. Hoskin

引用次数: 0

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