Integrative Cancer Therapies最新文献

Context: Due to therapeutic side effects and physical weakness, patients are not always able to carry out strenuous and lengthy exercises. Hence, this study investigated the effectiveness and feasibility of a short-term Whole-body electromyostimulation (WB-EMS) for oncological patients during and after anticancer treatment. The primary aim was to ensure the feasibility of WB-EMS training. Furthermore, the effects of WB-EMS training were investigated over a period of 2 weeks on parameters such as quality of life, body composition and physical performance.

Method: Thirteen cancer patients with different diagnosis, disease stages and treatment state were included. They participated in supervised WB-EMS sessions 4 times over a 2-week period. Physical functioning, body composition, depression, fatigue, and quality of life were measured before and after the intervention period. Moreover, a pre-post measurement of the patients' perceived body constitution was conducted in every exercise session.

Results: All included patients (n = 13) were able to complete the 4 WB-EMS sessions. At the end of the 2 weeks, a significant increase of the muscle strength could be observed. Additionally, patients improved their cardiovascular fitness. The body composition analyses showed significant reductions in body lean mass and extracellular water. Muscle mass remained unchanged. Furthermore, patients reported an improved perceived body constitution reduced pain and discomfort following all 4 WB-EMS sessions.

Conclusion: This study suggests that WB-EMS is safe and feasible for cancer patients. Furthermore, it showed that even after 2 weeks, improvements concerning the physical performance and patient-reported outcomes can be achieved. This study indicates benefits of WB-EMS as short-term exercise methode in cancer patients, that could be utelised in fields such as cancer prehabilitation.

Trial registration: This trial has been registered with the ISRCTN-Registry (ISRCTN68069634).

Background: Lung cancer remains the leading cause of cancer-related morbidity and mortality all over the world, with high rates of locoregional recurrence and distant metastasis even after curative-intent surgical resection. The mechanisms of the tumor microenvironment's role in supporting metastasis through the formation of pre-metastatic niches are crucial areas of investigation.

Methods: Lung metastasis models were established by injecting Lewis lung cancer cells (LLCs) into the tail vein of 20 specific pathogen free (SPF)-grade male C57BL/6 mice. The mice were divided into 4 groups: control (physiological saline), GuBenPeiYuan (GBPY) medium-dose (25 g/kg), GBPY high-dose (50 g/kg), all administered by gavage, and gemcitabine (50 mg/kg, administered by intraperitoneal injection on days 1, 4, 7, 10, and 13), the total treatment duration was 14 days. Qualitative and quantitative analyses of GBPY were performed using Ultra-Performance Liquid Chromatography (UPLC). Metastasis was observed using hematoxylin and eosin (H&E) staining, and the expression of immune cells was assessed by flow cytometry and immunofluorescence staining. Mechanistic insights were gained through Western blot.

Results: The high-dose GBPY and gemcitabine groups showed significantly fewer lung metastatic tumors (P = .002; P < .001), while no significant difference was observed between the medium-dose group and control group (P = .438). Flow cytometry results indicated that high-dose GBPY significantly downregulated Myeloid-Derived Suppressor Cells (MDSCs) and G-MDSCs (P = .002 and P = .001, respectively), upregulated dendritic cells (DCs; P = .021), increased M1 macrophages (F4/80⁺/iNOS⁺; P = .001) and decreased M2 macrophages (CD206⁺ F4/80⁺) (P < .001). Furthermore, Western blot results showed that the high-dose GBPY group significantly inhibited the expression of p-JAK2, p-STAT3 (P = .013, P = .001 respectively).

Conclusions: The GBPY Formula may reduce lung cancer metastasis and recurrence by inhibiting the JAK2/STAT3 pathway, downregulating the presence of MDSCs, upregulating the proportion of DCs, and promoting the polarization of M2 macrophages to M1 macrophages. These changes enhance the anti-tumor immune response, contributing to the reduction of lung cancer metastasis and recurrence.

Background: Numbness and tingling secondary to chemotherapy-induced peripheral neuropathy (CIPN) are frequent side effects that limit chemotherapy treatment and quality of life. Successful treatments for CIPN are limited. This preliminary report shows the potential long-term effects of ozone treatment in the management of persistent numbness and tingling secondary to CIPN.

Methods: Ozone treatment was administered by rectal insufflation in 15 patients (female/male: 8/7, age: 66 years old) suffering from persistent numbness and tingling secondary to grade-2 or grade-3 CIPN. Planned ozone treatment consisted of 40 sessions over 4 months. The initial concentration of 10 μg/mL was progressively increased to 30 μg/mL. The initial gas volume of 180 mL/session was progressively increased to 300 mL/session if tolerated. Before and after ozone treatment, and at 3- and 6- months after the end of treatment, they were assessed (i) the grade of CIPN-toxicity, and (ii) the self-reported decrease in numbness and tingling.

Results: After ozone treatment, 47% of patients experienced a decrease in the grade of CIPN-toxicity (P = .016), and 67% of patients reported a decrease in numbness and tingling ≥50% (P = .002). These effects were maintained at 3- and 6- months after the end of O₃T.

Conclusions: In this retrospective report, patients with persistent numbness and tingling secondary to CIPN showed clinically relevant and long-term improvements after ozone treatment. The magnitude and duration of the observed effects merit further research and support our ongoing clinical trials.

Objective: To observe the clinical efficacy of Dendrobium officinale in the treatment of radiotherapy-induced oral mucositis in nasopharyngeal carcinoma patients, and to explore its regulating effect on immune function and oral microbiota by comparing immune-related factors and oral microbiota before and after the intervention.

Methods: We conducted a randomized double-blinded controlled trial in Zhejiang Cancer Hospital. Sixty patients with nasopharyngeal cancer combined with radiotherapy-induced oral mucositis were randomly divided into a study group and control group, with 30 cases in each group The study group used compound vitamin B12 solution and Dendrobium tea drink, and the control group simply used compound vitamin B12 solution rinse. When the patients developed radiotherapy-induced oral mucositis (at the time of 10F radiotherapy), and after 1 month of Dendrobium treatment (at the end of radiotherapy), the salivary flow rate was measured without stimulation to evaluate the degree of oral mucositis and the clinical efficacy. We also detected the content of EGF in saliva and the content of IL-10 and IL-11 in serum, and analyzed the differences in microbial community structure. All patients consented before enrollment.

Results: The salivary flow rate and oral mucosal fraction of the study group after treatment were significantly improved, which was better than that of the control group(P < .05). The content of IL-10 in the study group after treatment increased significantly compared with that before treatment(P < .05). There was a significant difference between the oral flora of the study group before and after treatment (Unique OTU counts: 5390 vs 3906), and there was also a difference between the oral flora of the study group and control group after treatment (Unique OTU counts: 5671 vs 5439). After treatment, Erysipelotrichales (Phylum Firmicutes, LDA score = 2.80, P = .034), Leptotrichiaceae (Fusobacteria,LDA score = 3.38, P = .030) and Campylobacteraceae (Proteobacteria, LDA score = 3.35, P = .026) were significantly enriched in the study group. The use of Dendrobium officinale in nasopharyngeal carcinoma patients with radiotherapy-induced oral mucositis showed little difference in microbial diversity and abundance, but there were significant differences among oral bacteria genera.

Conclusions: Dendrobium officinale is effective in the treatment of radiotherapy-induced oral mucositis, which may be related to the improvement of salivary gland function and regulation of the oral microenvironment. Dendrobium officinale may reduce the symptoms of radiotherapy-induced oral mucositis by affecting the systemic cellular immune function. It may reduce the secretion of pro-inflammatory factors of the relevant flora by directly changing the oral flora and regulating the oral micro-ecology.

Purpose: Radiotherapy-induced oral mucositis is the most common side effect in nasopharyngeal carcinoma (NPC) patients. We aimed to evaluate the efficacy and safety of Rabdosia rubescens drop pills in NPC patients with radiation-induced oral mucositis (RTOM).

Methods: The study involved 40 NPC patients who were given Rabdosia rubescens drop pills thrice daily from the start of radiation therapy. The study monitored the incidence and severity of oral mucositis and oral pain. The main outcomes measured were the occurrence rate of oral mucositis, grade 3 oral mucositis, oral pain assessment, and changes in immunological function, body weight, BMI, NRS2002, and albumin levels.

Results: In the study, 38 patients completed the treatment. The incidence rates of Grade 0 to 3 oral mucositis were 5.26%, 21.05%, 47.37%, and 26.32% respectively. Pain levels were mild (42.11%), moderate (13.16%), and severe (13.16%). The onset of Grade 1, 2, and 3 oral mucositis occurred at 18, 24, and 30 days respectively. Grade 3 oral mucositis was associated with body weight, BMI, NRS2002 score, and albumin levels. Post-treatment, there was a decrease in CD4⁺/CD8⁺, CD3⁺, and CD4⁺ immune cells, but an increase in CD8⁺ cells. Mild to moderate gastrointestinal adverse events were observed in 13.2% of patients.

Conclusion: Rabdosia rubescens drop pills administration can reduce the incidence and severity of radiotherapy induced oral mucositis. Our finding suggested a positive impact of Rabdosia rubescens drops pills upon administration to NPC patients.

Systematic treatment and cocktailed drug applications have become a paradigm shift for cancer therapy. This study aims to explore the highly potent herbal cocktail strategies and pharmacological mechanisms, by which herbal medicines are effective in cancer treatment. A total of 397 cases of clinically reported cancer treatments with pure herbs were scrutinized, and the herbal prescription rules were systematically analyzed. The core prescriptions and their pharmacological mechanisms were revealed. The results unveiled specific rules for effective herbal treatment of cancer, including boosting energy metabolism, inhibiting tumor proliferation, improving digestion and defecation, enhancing blood circulation, promoting gas exchange, and facilitating water and toxic substance metabolism. Pharmacologically, anti-cancer effects are achieved through the manipulation of PI3K-Akt, IL-17, HIF-1, VEGF, TNF, Wnt, and other pathways. Following this unfolded integrative prescription rule, herbal therapy demonstrated remarkable effects in clinical practices, from which a few representative cases are presented herein.

Objectives: Hepatocellular carcinoma (HCC) represents the third-most prevalent cancer in humans worldwide. The current study's objective is to search for the potentiality of Washingtonia robusta H. Wendl (W. robusta) leaf extract in a nanoemulsion (NE) form in enhancing radiotherapy against HCC induced in rats using diethylnitrosamine (DEN).

Material and methods: The metabolic composition of the bioactive extract of W. robusta leaves was investigated by LC-MS. Oral epithelial (OEC) and liver carcinoma (HepG2) cell lines were used to examine the safety and anticancer activity of the NE, respectively. In the in vivo study, HCC was induced in male albino rats through administration of DEN in drinking water for 8 weeks, then treatment with NE (100 mg/kg) until the experiment's ending. Rats were irradiated by a fractionated dose of 2Gy*4.

Results: NE exerted remarkable cytotoxicity in comparison to the parent extract and the standard doxorubicin on the HepG2 cell line. Besides, the NE administration and/or γ-irradiation (IRR) significantly reduced the elevated alanine aminotransferase (ALT), total proteins, and albumin levels in HCC-induced rats. Likewise, the tumor markers alpha-fetoprotein (AFP) and gamma-glutamyl transferase (GGT) levels were considerably reduced in HCC rats. In addition, NE treatment before IRR significantly decreased the expression of the poly ADP ribose polymerase-1 (PARP1) enzyme and Ki67. Furthermore, the histological investigations strongly confirmed the combined effect of NE and IRR in fighting DEN-induced HCC.

Conclusion: NE of W. robusta extract may possess a radiosensitizing novel impact and provide a new strategy to combat HCC in clinical practices.

Background: Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Many researchers have previously reported that natural compounds from plants or Chinese Traditional Herbs have a potential to treat NSCLC. But it has not been reported that phytol can treat NSCLC. In this research, we first exposed this effect on A549 cells and researched the mechanism.

Methods: In order to evaluate whether phytol has a role in human NSCLC, a human non-tumoral bronchial epithelial cell line (NL20), adenocarcinomic human alveolar basal epithelial (A549) cell line, and NCI-H69 SCLC (H69) cell line were used for related experiments. After determining that phytol had no toxicity to NL20 cells, A549 cells, or H69 cells, the inhibitory effect of phytol on cancer cell related characteristics of cells were determined by luciferase assay, QRT-PCR, proliferation, invasion, and would healing cellular response experiments. Additionally, the quantification of apoptotic cells has been achieved through flow cytometry. Then, bioinformatics was used to establish a database to screen and speculate on phytol's corresponding targets in lung cancer. Finally, immunoblotting experiments were used to determine the specific pathways affected by phytol.

Results: Treatment with phytol at concentrations ranging from 0 to 80 µM for 24 hours was not cytotoxic to the A549 cells and H69 cells. Phytol inhibited AP-1-mediated and NF-κB-mediated luciferase activity in a dose-dependent manner in A549 cells, but not H69 cells. Additionally, phytol significantly inhibited the levels of MMP9, IL-6, VEGFA, IL-8, and NFKBIA in A549 cells, but had no significant effects on H69 cells. Phytol induced significant dose-dependent growth inhibitory effects on A549 cells. A significant decrease in colony formation and migration was observed. Bioinformatic and immunoblotting analysis indicated that phytol inhibited proliferation and migration of A549 cells through the PI3K-Akt signaling pathway.

Conclusions: Phytol exhibits anticancer activity by inhibiting PI3K-Akt signaling pathway and may be applicable in the clinical prevention and treatment of lung cancer in the future.

Background: Hepatocellular carcinoma (HCC) is the most prevalent form of primary liver cancer, characterized by high incidence and mortality rates. Yangzheng-Xiaoji capsules (YXC) have been widely used in Traditional Chinese Medicine for the treatment of HCC in China; however, the composition of compounds in YXC and its underlying anti-tumor mechanisms remain unclear.

Methods: High-performance liquid chromatography quadrupole time-of-flight mass spectrometry (HPLC-Q-TOF-MS/MS) was used to analyze the composition of YXC. An MHCC97H orthotopic mouse model of HCC was used to assess the therapeutic efficacy of YXC and its impact on the p53-induced apoptotic pathway and the PI3K/Akt pathway. YXC-mediated serum was prepared, and its optimal intervention concentration was determined using the MTT assay. The effects of YXC-mediated serum on apoptosis in MHCC97H cells, as well as on the p53-induced apoptotic pathway and the PI3K/Akt pathway, were investigated and verified through the TUNEL assay.

Results: HPLC-Q-TOF-MS/MS analysis identified 58 components in YXC. In vivo, YXC significantly improved body weight, dietary status, survival rate, and tissue pathology, inhibited xenografts growth, promoted apoptosis of HCC cells, activated the p53-induced apoptotic pathway, and inhibited the PI3K/Akt signaling pathway with good safety. In vitro, YXC-mediated serum showed similar efficacy. When 20% YXC-mediated serum was added to MHCC97H cells, the increased apoptosis was significantly rescued by the addition of p53 inhibitor (PFT-α) or PI3K activator (740Y-P).

Conclusion: The results of this study indicate that YXC exhibits anti-proliferative and pro-apoptotic pharmacological activity via activating the p53-induced apoptotic pathway and suppressing the PI3K/Akt pathway.

Background: Cancer-related fatigue is the most common complication in patients. Astragalus membranaceus is widely used in many countries to treat cancer, but its efficacy and safety is uncertain. Objectives: This study aimed to summarize the evidence on Astragalus membranaceus on cancer-related fatigue and quality of life in patients with cancer. Methods: Nine electronic databases were explored for the clinical randomized controlled trial of intervention with Astragalus membranaceus alone for cancer-related fatigue and quality of life in cancer patients from inception to July 1, 2022. The risk of bias assessment tool was adopted by Cochrane Handbook 6.1.0. The effect size was estimated using relative risk and mean difference with a corresponding 95% confidence interval. Review Manager 5.4 was used for meta-analysis. The evidence level was assessed using Grading of Recommendation, Assessment, Development and Evaluation (GRADE). Results: Eight studies were included. The results of the meta-analysis showed that the addition of Astragalus membranaceus to the control group was effective in reducing cancer-related fatigue (SMD = -1.63, 95% CI [-1.90, -1.36], P < .00001) and (RR = 1.55, 95% CI [1.19, 2.02], P = 0.001) in patients with cancer and improving quality of life (SMD = 0.86, 95% CI [0.17, 1.55], P = 0.01) and (RR = 1.57, 95% CI [1.10, 2.23], P = 0.01). Conclusion: The current evidence is supportive of the efficacy of Astragalus membranaceus in patients with cancer-related fatigue and their quality of life, but due to the small and low quality of the included literature and the lack of uniformity in terms of cancer type as well as treatment modalities, there is currently insufficient evidence to provide strong support for the clinical use of Astragalus membranaceus in the treatment of cancer-related fatigue. More high-quality evidence is needed in the future to further validate the use of Astragalus membranaceus in the treatment of clinical cancer-related fatigue. Registration: A review protocol was developed and registered in the International Prospective Register of Systematic Reviews (PROSPERO). Registration number: CRD42023442277. Registered 20 July 2023.