Integrative Cancer Therapies最新文献

Cancer pain is a complex issue of significant importance in daily clinical practice, requiring a multidimensional approach. Approximately 90% of cancer pain cases can be effectively managed through the appropriate and often combined use of pharmacological and non-pharmacological treatments. In addition to the analgesic drugs outlined in the WHO analgesic ladder, the concurrent use of adjuvant drugs may be considered, which are sometimes essential for effective cancer pain management. These treatments can be adjusted based on the presence of inflammatory processes and oxidative stress.

Methodology: This is an observational, descriptive, retrospective, real-world data study conducted in daily practice at the Country Medical Center in Bogotá, Colombia. It involved patients with any type of cancer diagnosis who were receiving chemotherapy, radiotherapy, oncological surgery, and/or hormonal therapy. From 2018 to 2023, protocols for intravenous high dose of sodium ascorbate were applied, resulting in a sample of 92 patients.

Results: The administration of sodium ascorbate at dose of 100 to 300 and 300 to 600 mg/kg/day showed statistically significant improvements in quality of life (P = .000). However, only the 300 to 600 mg/kg/day dose demonstrated a statistically significant reduction in pain (P = .0061).

Conclusions: It is possible that by controlling or reducing inflammation, pain sensation can be decreased, therefore high dose of an antioxidant such as sodium ascorbate may be an alternative to improve oxidative stress and inflammation as an adjuvant to analgesic prescription according to pain management guidelines for cancer patients.

Background: Cancer patients increasingly use YouTube for nutritional guidance, yet information quality varies substantially. Existing text-based assessment tools fail to capture audiovisual content characteristics. This study aimed to (1) develop a video-specific assessment tool, (2) evaluate German-language YouTube videos on cancer nutrition, and (3) identify quality indicators for laypersons.

Methods: A 20-criteria assessment tool integrating established instruments and video-specific elements was developed. The first 30 YouTube videos on cancer nutrition were systematically evaluated. Spearman correlation and Kruskal-Wallis tests identified associations between video characteristics and quality scores. Interrater reliability was assessed.

Results: Intraclass correlation coefficient indicated good to very good interrater reliability (95% CI: 0.87-0.96). Overall video quality was poor (mean: 38.6/60, SD: 5.3). Videos from hospitals (P = .002) and healthcare organizations (P = .006) scored significantly higher than those from independent persons. Videos with clearly formulated goals (r_s = 0.71, P < .001) and cited references (r_s = 0.43, P = .019) demonstrated stronger evidence-based content. High-quality videos more frequently addressed missing evidence (r_s = 0.51, P = .004). Quality scores inversely correlated with likes (r_s = -0.55, P = .002) and views (r_s = -0.46, P = .01).

Conclusion: YouTube videos on cancer nutrition exhibit substantial quality deficits, even from institutional providers. The validated assessment tool identifies observable quality indicators including clear objectives, scientific citations, transparent discussion of evidence gaps, and institutional authorship. However, no single feature reliably predicts quality. Strengthening digital health literacy and improving evidence-based content production and visibility remain essential priorities.

Non-small-cell lung cancer (NSCLC) research has focused on complementary and well-established treatments with clear mechanisms and less toxicity. Immune dysregulation is vital in NSCLC progression and metastasis. Ze-qi decoction (ZQD) exhibits therapeutic effects in patients with NSCLC; however, its pharmacodynamic material basis and specific mechanisms remain unclear. In this study, we integrated UPLC-HRMS, pharmacological analysis, and transcriptomic analysis to identify the potential effective components of ZQD and elucidate its intrinsic mechanisms. ZQD exhibited potent anti-NSCLC activity in the mouse subcutaneous tumor model. A total of 297 bioactive compounds were identified in mouse plasma following ZQD administration. Pharmacological analysis revealed liquiritigenin, vibsanin B, and 11-keto-beta-boswellic acid as the potential active ingredients of ZQD and suggested that ZQD exerted anti-NSCLC effects primarily via immunomodulatory and anti-inflammatory pathways. Integrative analysis of network pharmacology and transcriptomics indicated the neutrophil extracellular trap (NET) formation as a key pathway. Further analysis showed that ZQD disrupted the neutrophil recruitment environment by decreasing hypoxia-inducible factor-1α, CD18, and intercellular adhesion molecule-1 levels and downregulating NET-related markers (citrullinated histone H3, myeloperoxidase, and neutrophil elastase). Finally, these results were confirmed in a lung metastasis model. This is the first study designed to analyze the material basis of ZQD responsible for its effect on NSCLC. Our results indicate that the mechanisms of action of ZQD involve impeding neutrophil recruitment and activation, as well as reducing the levels of NETs-related markers. These suggest the potential of ZQD in suppressing NETs formation or release, inhibiting NSCLC progression and metastasis.

Cancer survivors experience a range of side effects during and after treatment. There is a need for a rigorous synthesis of the most recent and best available evidence on the role of nutritional supplements for supportive care in cancer, to inform shared decision-making. We searched 5 databases for umbrella reviews, meta-analyses and systematic reviews on nutritional supplements for supportive cancer care, excluding studies on pain, anxiety and depression, which are covered in recent guidelines. We found 52 reviews that reported on 250 RCTs on 18 supplements for 16 indications. Almost all reviews were of low/critically low quality (assessed using A MeaSurement Tool to Assess systematic Reviews version 2). There was moderate-certainty evidence for benefit from the following supplements: amino acids and oral proteolytic enzymes for severity of radiation-induced dermatitis, N-acetyl cysteine for prevention of chemotherapy-induced peripheral neuropathy (CIPN) in individuals with gastrointestinal cancers. There was low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis; Vitamin E, omega-3 fatty acids, glutamine and other amino acids may be effective for preventing CIPN. Serious adverse events were reported for high-dose Vitamin A, and dose-related adverse events were reported with zinc and Vitamin E. However, the majority of nutritional supplements were associated with only minor adverse events. Due to the low to very low certainty of the majority of evidence, firm clinical recommendations cannot be made. Further research to conclusively evaluate benefit and harm, including potential impact on efficacy of standard treatments, should be conducted.

Background: Colorectal cancer is one of the most common and fatal cancers worldwide. Despite therapeutic advancements, patients with stage II and III colon cancer often experience recurrences and metastases, particularly to the liver, leading to suboptimal disease-free survival (DFS) rates and decreased long-term survival. Qu-Shi-Jie-Du decoction (QSJDD), a traditional Chinese herbal formula, may prevent cancer recurrence and spread by boosting immunity, reducing inflammation, and inhibiting tumour growth. Preliminary studies have demonstrated that QSJDD reduces liver metastasis in patients with colon cancer. However, robust clinical evidence is required to confirm its efficacy and safety.

Objective: This study aims to evaluate the safety and efficacy of QSJDD in preventing colon cancer recurrence and liver metastasis, thereby offering a potential adjunctive therapy to improve patient outcomes.

Methods: This multicentre, double-blind, randomised, placebo-controlled trial involves 336 high-risk stage II or III colon cancer patients from 10 Chinese hospitals. Post-surgery and chemotherapy, 168 patients will receive either QSJDD compound granules or a placebo for 6 months, with a 3-year follow-up and evaluations every 6 months. The primary endpoint is to measure the 3-year DFS rate, while secondary endpoints include 1- and 2-year DFS rates, overall survival, and changes in the Traditional Chinese Medicine Dampness Syndrome Scale. Safety and adverse events will be tracked, and blood and gut microbiomes will be analysed to assess QSJDD's impact on delaying colon cancer metastasis.

Discussion: This trial will determine the efficacy and safety of QSJDD and provide evidence regarding its role in the adjuvant treatment of colon cancer.

Objective: This study delves into the therapeutic effects of combining GEM and Angelica polysaccharide (APS) on triple-negative breast cancer.

Methods: In vitro, proliferation, apoptosis of 4T-1 cells and MDSC were detected by flow cytometry. Migration of 4T-1 cell was detected by scratch healing experiment after treatment by GEM (0, 2.5, 5 μM), APS (160,320 mg/ml), or GEM + APS (2.5 μM + 160 mg/ml, 5 μM + 320 mg/ml). In vivo, 4T-1 cells were injected into the mammary fat pad under the mammary gland of BALB/c mice to establish an orthotopic breast cancer tumor model. They were randomly divided into control group (0.9% normal saline + ultrapure water), GEM group (0.9% normal saline preparation, 100 mg/kg, intraperitoneal injection twice a week), APS group (ultrapure water preparation, 200 mg/kg, intraperitoneal injection once a day), GEM + APS group (GEM 100 mg/kg, intraperitoneal injection twice a week and APS 200 mg/kg, intraperitoneal injection once a day) for 3 weeks. The proportion of immune cells in the spleen and tumor microenvironment were detected by flow cytometry, immunofluorescence and Mindray hematology analyzer. The tumor volume and weight, spleen index were recorded.

Results: The in vitro experimental results revealed that GEM effectively inhibited the proliferation and migration of 4T-1 cells and induced apoptosis in both 4T-1 cells and MDSCs. In contrast, APS had no impact on 4T-1 cells or MDSCs. The in vivo experimental findings indicated that compared with the single-drug treatment groups, the combination treatment of GEM + APS more effectively regulated the proportion of peripheral and local anti-tumor MDSCs and T cells, and more significantly curbed the progression of breast cancer in mice.

Conclusion: APS can exert a synergistic effect through immune regulation to enhance the therapeutic efficacy of GEM on triple-negative breast cancer. It aims to offer novel insights for the clinical application of combining GEM with immunotherapy for patients with triple negative breast cancer.

Objectives: To investigate acupuncture-induced changes in targeted glutathione metabolites in breast cancer survivors with psychoneurological symptoms (PNS) and to examine associations between these metabolic changes and PNS improvements.

Methods: This exploratory phase II single-arm study (N = 42) evaluated a 10-session, 5-week acupuncture intervention for PNS management in breast cancer survivors. Targeted glutathione metabolites (ie, reduced glutathione (GSH), oxidized glutathione (GSSG), cysteine-glutathione disulfide (CySSG), GSH/GSSG ratio) and reactive oxygen species (ROS) were measured pre- and post-treatment. Paired t-test and Wilcoxon signed-rank tests assessed changes in these biomarkers. The PNS were assessed using Patient-Reported Outcomes Measurement Information System (PROMIS)-29.

Results: ROS levels significantly increased post-treatment (2.34 ± 1.02-2.83 ± 1.23 μmol/L, P = .017), while GSSG levels significantly decreased (0.19 ± 0.23-0.12 ± 0.23 µmol/L, P < .001). GSH/GSSG ratio significantly increased (2.73 ± 1.21-5.38 ± 1.99, P < .001), indicating a shift toward reduced oxidative stress. GSH and CySSG levels showed non-significant increases after acupuncture (GSH: 0.38 ± 0.14-0.42 ± 0.16 µmol/L, P = .07; CySSG: 0.00503 ± 0.00082-0.00532 ± 0.00076 µmol/L, P = .06). No significant correlations were found between changes in GSH metabolites and PNS composite scores or individual symptom scores.

Conclusion: Acupuncture may modulate GSH metabolism, improve redox balance, and enhance antioxidant capacity in breast cancer survivors with PNS. However, these biochemical changes were not correlated with PNS improvement, suggesting that alternative pathways may mediate acupuncture's therapeutic effects.Trial registry information:The study was registered in ClinicalTrials.gov (Identifier: NCT05417451).