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In Vitro Investigation of Renal Cell Carcinoma Response to Combination Sorafenib and Cryoablation Treatment 索拉非尼联合冷冻消融治疗肾细胞癌疗效的体外研究
Pub Date : 2022-01-24 DOI: 10.31487/j.cor.2022.01.01
John M. Baust, Kimberly L. Santucci, Kristi K. Snyder, A. Robilotto, John G. Baust, R. V. Van Buskirk, Thomas J. Polascik
The 5-year survival rate for localized kidney cancer is 93%, but only 13% for those presenting with metastatic disease (2019 SEER data). Cryosurgery is an established treatment modality for renal cell cancer (RCC), with outcomes showing equipoise to radiofrequency ablation (RFA) and partial nephrectomy. Sorafenib is a targeted therapy for RCC utilized in more advanced stage diseases. Given the success of both cryoablation and sorafenib as monotherapies for RCC, in this study, we investigated the cellular response of RCC to combinatorial sorafenib pre-treatment and cryoablation in vitro using cell culture and tissue-engineered tumor models. In vitro samples were exposed to a single or repeat (double) 5-minute freeze at -10°C, -15°C, or -20°C representing temperatures within the periphery of a cryolesion. A repeat freeze to -20°C was necessary to fully ablate samples yielding day 1 viability of 2.9% (±0.2) with no recovery observed over the 7 days post-treatment culture. These findings were consistent with published data on the lethal temperature in RCC, suggesting that -25°C is necessary to destroy RCC following a single freeze event. Pre-treatment of samples with sorafenib at concentrations of 10.61 and 21.21 µM (½ clinical and clinical dose, respectively) was combined with a single or repeat 5-minute freeze to -10°C, -15°C, or -20°C. At the time of drug removal (day 0/pre-freeze), 10.61 µM sorafenib treated samples yielded 25.3% (±0.4) viability, yet samples regrew to control levels by day 7. Following combination freeze and sorafenib exposure, sample viability was found to be 27.5% (±0.7), 2.9% (±0.4), and 0.2% (±0.02) following a single freeze and 15.6% (±0.5), 0.7% (±0.1), and 0.1% (±0.01) following a repeat (double freeze), respectively. Regrowth was observed over the 7-day assessment period in samples exposed to a -10°C single or double freeze and a -15°C single freeze, but not in the -20°C single freeze or -15°C double freeze conditions. Thus, pre-treatment with 10.61 µM sorafenib was found to increase the minimum lethal temperature from the reported -25°C to -20°C following a single freeze event and from -20°C to -15°C following a double freeze. Results of the cell culture studies were confirmed in the 3D tissue-engineered tumor model, wherein the combination of 10.61 µM sorafenib and freezing was found to further increase the lethal temperature from <-20°C to -15°C following a single freeze event. This increased freeze susceptibility yielded a 32% improvement in the overall ablative volume of the ice ball following combinatorial treatment versus freezing alone. These in vitro results suggest that the combination of sorafenib and cryoablation may provide a possible combinatorial treatment path for RCC.
局部肾癌的5年生存率为93%,但转移性肾癌的5年生存率仅为13%(2019年SEER数据)。冷冻手术是肾细胞癌(RCC)的一种既定治疗方式,其结果与射频消融(RFA)和部分肾切除术相当。索拉非尼是一种用于晚期疾病的RCC靶向治疗药物。鉴于冷冻消融和索拉非尼作为RCC单药治疗的成功,在本研究中,我们利用细胞培养和组织工程肿瘤模型研究了RCC对体外联合索拉非尼预处理和冷冻消融的细胞反应。体外样品暴露于-10°C, -15°C或-20°C的单次或重复(两次)冷冻5分钟,代表冷冻创口周围的温度。需要重复冷冻至-20°C才能完全消融样品,产生2.9%(±0.2)的第1天存活率,并且在处理后培养的7天内未观察到恢复。这些发现与已发表的关于碾压混凝土致死温度的数据一致,表明-25°C是在单次冻结事件后破坏碾压混凝土所必需的。用浓度为10.61和21.21µM(分别为½临床和临床剂量)的索拉非尼对样品进行预处理,并将样品单次或重复冷冻至-10°C、-15°C或-20°C,冷冻5分钟。在去除药物(第0天/预冷冻)时,10.61µM索拉非尼处理的样品产生25.3%(±0.4)的活力,但样品在第7天恢复到控制水平。联合冷冻和索拉非尼暴露后,单次冷冻后样品活力分别为27.5%(±0.7)、2.9%(±0.4)和0.2%(±0.02),重复(两次冷冻)后分别为15.6%(±0.5)、0.7%(±0.1)和0.1%(±0.01)。在7天的评估期内,暴露于-10°C单次或双次冻结和-15°C单次冻结的样品观察到再生,但在-20°C单次冻结或-15°C双次冻结条件下没有观察到再生。因此,10.61µM索拉非尼预处理被发现可以将最低致死温度从报道的单次冷冻事件后的-25°C提高到-20°C,将双次冷冻后的-20°C提高到-15°C。在3D组织工程肿瘤模型中证实了细胞培养研究的结果,其中10.61µM索拉非尼和冷冻的组合被发现在单次冷冻事件后进一步将致死温度从<-20°C提高到-15°C。与单独冷冻相比,联合治疗后,冷冻敏感性的增加使冰球的总消融体积提高了32%。这些体外实验结果表明,索拉非尼联合冷冻消融可能为RCC提供一种可能的联合治疗途径。
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引用次数: 0
Multiple Paraneoplastic Neurological and Rheumatological Syndromes Revealing an Ovarian Cancer 揭示卵巢癌的多种副肿瘤神经系统和风湿病综合征
Pub Date : 2021-12-31 DOI: 10.31487/j.cor.2021.11.01
Ioana Maria Ion, Anca Badoiu, E. Thouvenot, Morgane Petot, V. Boudousq
Multiple paraneoplastic syndromes are a rare clinical manifestation. We describe the case of an 82-year-old woman who presented with neurological (rapidly progressive cerebellar syndrome and combined sensory-motor neuronopathy) and rheumatological (palmar fasciitis and polyarthritis syndrome) paraneoplastic syndromes associated with two onconeural antibodies (anti-Yo and Zic4), that revealed an ovarian cancer. The involvement of multiple organ systems should be a clue to take into consideration a paraneoplastic etiology that could permit early detection of cancer. However, despite the existence of treatments, the prognosis of these conditions remains poor.
多发性副肿瘤综合征是一种罕见的临床表现。我们描述了一例82岁的女性,她表现为神经系统(快速进行性小脑综合征和联合感觉-运动神经病变)和风湿病(掌筋膜炎和多发性关节炎综合征)副肿瘤综合征,伴有两种肿瘤神经抗体(抗yo和Zic4),显示为卵巢癌。多器官系统的参与应该是一个线索,考虑到可能允许早期发现癌症的副肿瘤病因。然而,尽管有治疗方法,这些疾病的预后仍然很差。
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引用次数: 0
Factors Influencing the Prognosis of Acute Myeloid Leukemia 影响急性髓系白血病预后的因素
Pub Date : 2021-12-29 DOI: 10.31487/j.cor.2021.12.01
Bao‐an Chen, Yi Zhu, Fei Wang, Xue Wu
Objective: To investigate the prognostic factors of adult acute myeloid leukemia (AML). Methods: A total of 51 patients with AML initially treated in Zhongda Hospital affiliated to Southeast University in the past 7 years were selected to investigate the gender, age (60-year-old) and WBC count (>=30*109/L), whether there is a history of MDS and other factors related to survival rate.Results: The results showed that age and the history of MDS prodrome were independent prognostic factors affecting OS. The OS rates of CD19 negative, CD11b positive and CD64 negative patients were significantly lower than those without the above factors at the onset of the disease, and the differences were statistically significant (all P<0.05).Conclusion: The prognosis of AML patients is affected by multiple factors, so prognosis should be stratified according to risk factors, and appropriate chemotherapy regimens should be selected for patients of different age groups.
目的:探讨影响成人急性髓性白血病(AML)预后的因素。方法:选取东南大学附属中大医院7年来首次治疗的AML患者51例,调查性别、年龄(60岁)、白细胞计数(>=30*109/L)、是否有MDS病史等与生存率相关的因素。结果:年龄和MDS前驱病史是影响OS的独立预后因素。CD19阴性、CD11b阳性、CD64阴性患者发病时的OS率均显著低于无上述因素的患者,差异均有统计学意义(P<0.05)。结论:AML患者预后受多种因素影响,应根据危险因素对预后进行分层,针对不同年龄段患者选择合适的化疗方案。
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引用次数: 0
In Search of a Histopathological Pattern of Immune-Mediated Gastritis from Nivolumab Therapy: A Case Report with Literature Review 从纳武单抗治疗中寻找免疫介导的胃炎的组织病理学模式:一个病例报告并文献复习
Pub Date : 2021-11-11 DOI: 10.31487/j.cor.2021.10.03
F. M. Fernández-Gordón Sánchez, E. Gómez Domínguez, C. Garfia Castillo, Jorge Arroyo Andres, L. Robles Díaz, Y. Rodríguez Gil
Immunotherapy with checkpoint inhibitors is associated with termed inflammatory and immune-related side effects (irAE). Upper gastrointestinal symptoms are infrequent and appear mainly in patients on combination therapy with two checkpoint inhibitor drugs. We present the case of a patient with IIIB stage cutaneous melanoma treated with Nivolumab in monotherapy who developed an immune-mediated gastritis. Histopathologically, due to the paucity of published cases, no specific pattern of Nivolumab-immune-mediated gastritis has been described. We have reviewed the literature and compared the histopathology of the cases available in the literature.
使用检查点抑制剂的免疫治疗与炎症和免疫相关副作用(irAE)相关。上消化道症状不常见,主要出现在联合使用两种检查点抑制剂药物的患者中。我们报告了一例IIIB期皮肤黑色素瘤患者,接受纳武单抗单药治疗,并发免疫介导性胃炎。组织病理学上,由于缺乏发表的病例,没有特定模式的尼沃鲁单抗免疫介导的胃炎已被描述。我们回顾了文献并比较了文献中可用病例的组织病理学。
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引用次数: 0
Vitamin D Deficiency and Tumor Response Failure in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy at a Medical Center in Mexico 维生素D缺乏和肿瘤反应失败的乳腺癌患者接受新辅助化疗在墨西哥的医疗中心
Pub Date : 2021-10-28 DOI: 10.31487/j.cor.2020.10.04
S. Macías-Díaz, Ana Lilia Castruita Avila, J. G. Reinoso Toledo, M. García Carrasco
Background: Vitamin D deficiency has been associated with not achieving a complete pathological response in patients with breast cancer after neoadjuvant chemotherapy. The objective of this study was to determine whether vitamin D deficiency is associated with tumor response failure in patients with breast cancer operated and who received neoadjuvant chemotherapy.Materials and Methods: This was a prospective, cross-sectional, analytical and observational study. Vitamin D was measured in patients with breast cancer who had received neoadjuvant chemotherapy and its association with tumor response was determined. For the inferential analysis, the Student’s t-test, chi-square test, and Fisher’s exact test were used. A p value <0.05 was considered statistically significant.Results: Thirty-six patients were included. There was tumor response failure to treatment in 69.3% and vitamin D deficiency occurred in 58.3%. No association was found between vitamin D deficiency and tumor response failure (p = 0.729), histological type (p = 0.691), molecular profile (p = 0.969), clinical stage (p = 0.468) or menopause status (p = 0.701).Conclusion: Vitamin D deficiency is not associated with tumor response failure in breast cancer patients who received neoadjuvant chemotherapy.
背景:维生素D缺乏与乳腺癌患者在新辅助化疗后未达到完全病理反应有关。本研究的目的是确定维生素D缺乏是否与接受新辅助化疗的乳腺癌手术患者的肿瘤反应失败有关。材料和方法:这是一项前瞻性、横断面性、分析性和观察性研究。在接受新辅助化疗的乳腺癌患者中测量维生素D,并确定其与肿瘤反应的关系。对于推理分析,使用了学生t检验、卡方检验和Fisher精确检验。p值<0.05认为有统计学意义。结果:纳入36例患者。治疗无效的患者占69.3%,维生素D缺乏的患者占58.3%。维生素D缺乏与肿瘤反应失败(p = 0.729)、组织学类型(p = 0.691)、分子谱(p = 0.969)、临床分期(p = 0.468)和绝经期(p = 0.701)无相关性。结论:在接受新辅助化疗的乳腺癌患者中,维生素D缺乏与肿瘤反应失败无关。
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引用次数: 0
Biochemical and Molecular Diagnostic Indicators for Cancer 癌症的生化和分子诊断指标
Pub Date : 2021-10-15 DOI: 10.31487/j.cor.2021.08.11
N. Baskaran, S. Vignesh, V. Chandrasekar
Biomarkers are substances that are either secreted by the tumor or produced by the body in response to the presence of cancer. Biomarkers serve as an objective measure for evaluation of normal and pathological processes as well as pharmacological responses to a therapeutic intervention. Cancer studies are usually difficult to interpret, especially based on the contemporary medical diagnosis. In this circumstance, biomarkers are developing as reliable diagnostic metabolites, which have many promising applications in oncological screening, differential diagnosis, risk assessment, response to treatment, and examining the progression of disease. Genome or protein based prognostic biomarkers are available, for numerous cancer types, for potential inclusion into clinical prognostic staging methods. However, there lies difficulty in translating these biomarkers into clinical outcomes. This review concerns important biomarkers related to wide varieties of cancer and also elucidates mode of action of few major biomarkers.
生物标志物是由肿瘤分泌的物质,或者是机体对癌症的反应产生的物质。生物标志物作为评估正常和病理过程以及对治疗干预的药理学反应的客观措施。癌症研究通常很难解释,特别是基于当代医学诊断。在这种情况下,生物标志物正在发展成为可靠的诊断代谢物,在肿瘤筛查、鉴别诊断、风险评估、治疗反应和检查疾病进展方面具有许多有前途的应用。基因组或蛋白质为基础的预后生物标志物是可用的,对于许多癌症类型,潜在纳入临床预后分期方法。然而,将这些生物标志物转化为临床结果存在困难。本文综述了与多种癌症相关的重要生物标志物,并阐明了几种主要生物标志物的作用模式。
{"title":"Biochemical and Molecular Diagnostic Indicators for Cancer","authors":"N. Baskaran, S. Vignesh, V. Chandrasekar","doi":"10.31487/j.cor.2021.08.11","DOIUrl":"https://doi.org/10.31487/j.cor.2021.08.11","url":null,"abstract":"Biomarkers are substances that are either secreted by the tumor or produced by the body in response to the presence of cancer. Biomarkers serve as an objective measure for evaluation of normal and pathological processes as well as pharmacological responses to a therapeutic intervention. Cancer studies are usually difficult to interpret, especially based on the contemporary medical diagnosis. In this circumstance, biomarkers are developing as reliable diagnostic metabolites, which have many promising applications in oncological screening, differential diagnosis, risk assessment, response to treatment, and examining the progression of disease. Genome or protein based prognostic biomarkers are available, for numerous cancer types, for potential inclusion into clinical prognostic staging methods. However, there lies difficulty in translating these biomarkers into clinical outcomes. This review concerns important biomarkers related to wide varieties of cancer and also elucidates mode of action of few major biomarkers.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"10 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91442094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deep-Inspirational Breath-Hold (DIBH) Technique in Left-Sided Breast Cancer: An Institutional Review 深吸气屏气(DIBH)技术在左侧乳腺癌中的应用:一项制度回顾
Pub Date : 2021-10-13 DOI: 10.31487/j.cor.2021.09.06
K. Iqbal, Noreen Amjad, S. Butt, Fajar Rafi Ranjha, S. Minhas, Q. Shamsi
Purpose: The study of clinical effectiveness of deep-inspirational breath-hold (DIBH) in left breast cancer radiotherapy (RT) was aimed at focusing on dosimetry and organs at risk (OARs) evaluation. A retrospective study was conducted to assess the heart and ipsilateral lung V30 for DIBH technique and to compare with free breathing (FB) technique. Clinical data shows that by increasing the inhalation amplitude value (cm), the maximum heart distance decreases in the treatment field.Materials and Methods: Thirty left-sided breast and chest wall patients were CT scanned on 4DCT with DIBH. These patients were chosen for the DIBH technique with the ability to hold their breath for more than 20 seconds. Radiotherapy of these patients was planned using field-in-field planning technique, and OAR doses were observed using the institutionally specified DIBH protocol.Results: The mean heart dose was less than 3Gy. Whereas V2Gy and V10Gy were less than 30% and 5%. The mean ipsilateral lung dose was 7.59 Gy. Ipsilateral lung V30 was less than 25% with ±10% margins. It is found that by increasing the inhaling amplitude (cm) heart involvement in the tangential treatment field decreases.Conclusion: DIBH is an easy and highly efficient treatment technique for reducing the mean dose of the heart and V30 of ipsilateral lung. The maximum heart distance decreases as the baseline of inhalation increases due to heart doses.
目的:探讨深吸气式屏气(DIBH)在左乳腺癌放疗(RT)中的临床疗效,探讨放射剂量学和危及器官(OARs)评价。回顾性研究DIBH技术的心脏和同侧肺V30,并与自由呼吸(FB)技术进行比较。临床资料显示,随着吸入幅度值(cm)的增加,治疗场内最大心脏距离减小。材料与方法:对30例左侧乳腺及胸壁患者进行4DCT扫描。这些患者被选中进行DIBH技术,能够屏住呼吸超过20秒。这些患者的放疗计划采用现场规划技术,并使用机构指定的DIBH方案观察OAR剂量。结果:心脏平均剂量小于3Gy。而V2Gy和V10Gy分别小于30%和5%。同侧肺平均剂量为7.59 Gy。同侧肺V30小于25%,边缘±10%。研究发现,随着吸入振幅(cm)的增加,切向治疗场对心脏的影响减小。结论:DIBH是一种简便有效的治疗方法,可降低心脏的平均剂量和同侧肺的V30。由于心脏剂量的增加,最大心脏距离随着吸入基线的增加而减小。
{"title":"Deep-Inspirational Breath-Hold (DIBH) Technique in Left-Sided Breast Cancer: An Institutional Review","authors":"K. Iqbal, Noreen Amjad, S. Butt, Fajar Rafi Ranjha, S. Minhas, Q. Shamsi","doi":"10.31487/j.cor.2021.09.06","DOIUrl":"https://doi.org/10.31487/j.cor.2021.09.06","url":null,"abstract":"Purpose: The study of clinical effectiveness of deep-inspirational breath-hold (DIBH) in left breast cancer radiotherapy (RT) was aimed at focusing on dosimetry and organs at risk (OARs) evaluation. A retrospective study was conducted to assess the heart and ipsilateral lung V30 for DIBH technique and to compare with free breathing (FB) technique. Clinical data shows that by increasing the inhalation amplitude value (cm), the maximum heart distance decreases in the treatment field.\u0000Materials and Methods: Thirty left-sided breast and chest wall patients were CT scanned on 4DCT with DIBH. These patients were chosen for the DIBH technique with the ability to hold their breath for more than 20 seconds. Radiotherapy of these patients was planned using field-in-field planning technique, and OAR doses were observed using the institutionally specified DIBH protocol.\u0000Results: The mean heart dose was less than 3Gy. Whereas V2Gy and V10Gy were less than 30% and 5%. The mean ipsilateral lung dose was 7.59 Gy. Ipsilateral lung V30 was less than 25% with ±10% margins. It is found that by increasing the inhaling amplitude (cm) heart involvement in the tangential treatment field decreases.\u0000Conclusion: DIBH is an easy and highly efficient treatment technique for reducing the mean dose of the heart and V30 of ipsilateral lung. The maximum heart distance decreases as the baseline of inhalation increases due to heart doses.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79939976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Platelet-Lymphocyte Ratio, Circulating Tumor Cells and Circulating Tumor Microemboli as Predictors of Thrombosis in Patients with Gastric Cancer 血小板淋巴细胞比、循环肿瘤细胞和循环肿瘤微栓子作为胃癌患者血栓形成的预测因子
Pub Date : 2021-09-29 DOI: 10.31487/j.cor.2021.10.01
Bruno Soriano Pignataro, Emne Ali Abdallah, Vinicius Fernando Calsavara, Celso Abdon Lopes Mello, K. Nishinari, Guilherme Yazbek, L. T. Domingos Chinen
Background: Cancer-associated thrombosis (CAT) is a major cause of morbidity and mortality in oncology patients. There are no accurate risk assessment tools to predict venous thromboembolism (VTE). Circulating tumor cells (CTCs), circulating tumor microemboli (CTM), and high platelet-lymphocyte ratio (PLR) may predispose to VTE. Objective: To evaluate correlations of CTCs, CTM, and PLR with VTE and progression-free survival (PFS) in gastric cancer patients.Methods: Patients with gastric cancer were recruited (March 2016 to April 2017). CTCs were assayed by ISET at two timepoints: before neoadjuvant treatment (CTC1) and after surgery/before adjuvant therapy (CTC2) for patients with localized disease, and before first-line chemotherapy (CTC1) and after 6 months (CTC2) for patients with metastases. VTE incidence was determined retrospectively. PFS was estimated by Kaplan-Meier analysis.Results: We studied 93 patients. According to Khorana scores, 63 (67.7%) patients were at intermediate and 30 (32.3%) were at high risk for VTE. VTE incidence was 20.4% and CTM were found in 39.8%. VTE developed in 7/37 (18.9%) CTM-positive and in 11/50 (22%) CTM-negative patients (p=0.93). When PLR >288, VTE occurred in 7/14 patients (p=0.005). PLR also associated with poor PFS (p<0.0001). CTC2 was associated with poor PFS (p<0.0001). CTC2, PLR and VTE were independent prognostic factors for PFS (p=0.005, 0.043, and <0.0001 respectively).Conclusion: PLR is a prognostic indicator for PFS and for VTE in gastric cancer. Neither CTC, nor CTM improved risk stratification for VTE in our population.
背景:肿瘤相关血栓形成(CAT)是肿瘤患者发病和死亡的主要原因。目前还没有准确的风险评估工具来预测静脉血栓栓塞(VTE)。循环肿瘤细胞(CTCs)、循环肿瘤微栓塞(CTM)和高血小板淋巴细胞比(PLR)可能易患静脉血栓栓塞。目的:评价胃癌患者CTCs、CTM、PLR与VTE及无进展生存期(PFS)的相关性。方法:招募胃癌患者(2016年3月~ 2017年4月)。ISET在两个时间点检测ctc:局部疾病患者新辅助治疗前(CTC1)和手术后/辅助治疗前(CTC2),转移患者一线化疗前(CTC1)和6个月后(CTC2)。回顾性测定静脉血栓栓塞发生率。采用Kaplan-Meier分析估计PFS。结果:我们研究了93例患者。根据Khorana评分,63例(67.7%)患者处于中度危危,30例(32.3%)患者处于高危危危。静脉血栓栓塞发生率为20.4%,CTM发生率为39.8%。7/37 (18.9%) ctm阳性患者和11/50 (22%)ctm阴性患者发生静脉血栓栓塞(p=0.93)。当PLR >288时,7/14的患者发生静脉血栓栓塞(p=0.005)。PLR也与不良PFS相关(p<0.0001)。CTC2与不良PFS相关(p<0.0001)。CTC2、PLR和VTE是PFS的独立预后因素(p分别为0.005、0.043和<0.0001)。结论:PLR是胃癌PFS和VTE的预后指标。在我们的人群中,CTC和CTM都没有改善静脉血栓栓塞的风险分层。
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引用次数: 0
A Rare Malignancy of Head And Neck Region: Sinonasal Undifferentiated Carcinoma 一罕见的头颈部恶性肿瘤:鼻窦未分化癌
Pub Date : 2021-09-29 DOI: 10.31487/j.cor.2021.09.02
Ihsan Ceceli, S. Ceylan
Sinonasal undifferentiated carcinoma is a rare malignancy of the head and neck region. Its diagnosis and treatment are difficult due to its rare and aggressive tumor nature and the complex anatomy of its localization. A 70-year-old male who presented with symptoms caused by this rare tumor was reported. The patient presented with pain on the left side of the head and vision loss in the left eye for 1 month, and his endoscopic biopsy was reported as undifferentiated carcinoma. This case report aimed to discuss the diagnosis and treatment of sinonasal undifferentiated carcinoma.
摘要鼻窦未分化癌是一种罕见的头颈部恶性肿瘤。由于其罕见和侵袭性,以及其定位的复杂解剖结构,其诊断和治疗都很困难。我们报告了一位70岁的男性,他表现出由这种罕见肿瘤引起的症状。患者表现为头部左侧疼痛,左眼视力下降1个月,内镜活检报告为未分化癌。本病例报告旨在探讨鼻窦未分化癌的诊断和治疗。
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引用次数: 0
Establishing A Virtual Planning Protocol for Functional Maxillomandibular Reconstruction in Oral Cancer Patients 建立口腔癌患者功能性上颌骨重建的虚拟规划方案
Pub Date : 2021-09-29 DOI: 10.31487/j.cor.2021.09.04
N. Subramaniam, K. Parthasarathi, K. Cheng, D. Leinkram, D. Howes, J. Wykes, S. Ch’ng, Tsu-Hui (Hubert) Low, C. Palme, Jonathan Robert Clark
Background: Virtual surgical planning (VSP) helps optimize vascularized bone flap reconstruction and dental rehabilitation in maxillomandibular defects, improving accuracy, reducing errors and reducing the time required for surgery. In this manuscript, we describe a robust but flexible virtual protocol for functional maxillomandibular reconstruction optimized for oral cancer patients using in-house digital planning and provide templates to streamline communication among the team members. Methods: Based on our previous experience of VSP in oral cancer (n=17), we derived a workflow to improve efficiency. It included a virtual surgical template and a protocol focused on the minimal time requirements for three different reconstructive approaches: prefabrication/prelamination, primary implant placement using the SM-ART approach, and digital planning without primary implant placement. We performed a prospective validation (n=4) to determine its validity and if the proposed timelines could be adhered to. Results: The protocol allowed a smooth and coordinated framework for team members to communicate and plan the patient’s treatment. The time period required for VSP was described for patients undergoing bony reconstruction with primary dental placement in those with and without custom plates, drill guides and for patients with prefabrication (Rohner’s procedure). The minimum time required for VSP ranged between 17 and 30 days. The protocol could be reliably applied to the prospective group without any modification. Conclusion: Bony reconstruction with primary dental implant placement in the context of oral cancer can be performed successfully with good functional outcomes. By adopting this protocol, virtual surgical planning can be performed efficiently, avoiding potentially costly delays in treatment.
背景:虚拟手术计划(Virtual surgical planning, VSP)有助于优化上颌下颌骨缺损血管化骨瓣重建和牙体康复,提高准确性,减少错误,缩短手术时间。在这篇文章中,我们描述了一个强大而灵活的虚拟协议,用于功能性上颌下颌骨重建,使用内部数字计划优化口腔癌患者,并提供模板来简化团队成员之间的沟通。方法:根据我们以往在口腔癌(n=17)中使用VSP的经验,我们得出了一个工作流程来提高效率。它包括一个虚拟手术模板和一个方案,重点关注三种不同重建方法的最短时间要求:预制/预层压,使用SM-ART方法的初级植入物放置,以及不进行初级植入物放置的数字计划。我们进行了前瞻性验证(n=4),以确定其有效性以及是否可以遵守所建议的时间表。结果:该方案为团队成员沟通和计划患者的治疗提供了一个顺畅和协调的框架。VSP所需的时间描述了在有或没有定制板、钻导和预制(Rohner手术)的患者中进行骨重建并进行初级牙放置的患者。VSP所需的最短时间在17至30天之间。该方案无需任何修改即可可靠地应用于前瞻性组。结论:在口腔癌的情况下,植牙骨重建可以成功地进行,并具有良好的功能效果。通过采用该协议,可以有效地进行虚拟手术计划,避免潜在的昂贵的治疗延误。
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引用次数: 0
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Clinical Oncology and Research
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