Oncology Research and Treatment最新文献

Introduction: Radiotherapy resistance leads to treatment failure and disease progression in patients with cervical cancer. This study aims to elucidate the molecular underpinnings of radiotherapy response in cervical cancer by identifying radiotherapy sensitivity genes (RSGs).

Methods: We utilized two GEO expression profiling datasets (GSE3578 and GSE6213) comprising cervical cancer biopsy samples taken before and during radiotherapy to identify differentially expressed genes (DEGs) using the RankProd meta-analysis approach. Subsequent analysis was conducted using data from the TCGA-CESE project to further determine the RSGs and investigate their associations with survival prognosis, immune cell infiltration, and drug sensitivities. The differential expressions of the candidate RSGs were validated in an independent set of cervical cancer patients by qPCRs.

Results: A total of 518 DEGs were identified, with 305 genes upregulated and 213 genes down-regulated during radiotherapy. Six key RSGs were identified as significantly associated with radiotherapy response. Cox regression analysis revealed that upregulations of IL1RAP and GPR15 were associated with an increased risk of poor survival prognosis. Functional enrichment analysis highlighted the involvement of these genes in critical biological processes such as cytokine signaling and immune regulation. Correlation analyses demonstrated significant associations between RSG expressions and M2 macrophage and γδT cell abundances in tumor microenvironment, as well as drug sensitivities. The expression of IL1RAP was significantly higher in the complete response group, supporting the bioinformatic finding.

Conclusion: Our findings on RSGs could potentially serve as potential biomarkers for predicting radiotherapy response and as therapeutic targets to enhance the efficacy of radiotherapy.

Introduction: Cancer-related malnutrition is a highly prevalent, yet often overlooked concern in clinical practice. Although cancer-related management guidelines recommend standardized nutritional care, its implementation is scarce. The aim of this study was to investigate the prevalence of malnutrition and the medical need for nutrition counseling in cancer patients employing a novel standardized nutritional management program (containing malnutrition risk screening, nutritional assessment, and counseling). Furthermore, differences of malnutrition parameters in different cancer patient cohorts were examined.

Methods: Cancer patients were screened for malnutrition using the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) on the first day of their inpatient admission to the internal oncology or hematology wards. PG-SGA total score and classification into the three PG-SGA nutrition stages (A, B, C) were used to determine nutritional status. In case of a positive screening, nutritional assessment and individualized counseling by a nutritionist followed. For group comparisons, patients were divided into different groups (e.g., age, gender, tumor entity) and were evaluated accordingly.

Results: A total of 1,100 inpatients were included. 56.8% of the patients had suspected or already existing malnutrition. The most common nutrition impact symptom was loss of appetite (26.7%), followed by fatigue (16.5%) and pain (16.0%). Female (p < 0.001), elderly (p < 0.001), and patients with upper gastrointestinal tract tumors (p < 0.001) showed an unfavorable nutritional status and higher need for counseling. Despite suffering from malnutrition, patients had body mass indices within the upper end of the normal range.

Conclusion: This study shows a high prevalence of malnutrition in hospitalized cancer patients and highlights the need for a standardized nutritional management in the clinical setting. Therefore, it is recommended to provide a malnutrition risk screening for all cancer patients and a following adequate assessment and personalized nutritional care if needed.

Introduction: Endometrium cancer is the most common gynecological malignancy in developed countries. In this study, we aimed to investigate the effect of HER2 positivity on prognosis in endometrial cancer.

Methods: In our study, patients admitted to our clinic with a diagnosis of endometrial cancer between September 2019 and December 2023 were retrospectively evaluated. Human epidermal growth factor receptor 2 (HER2) immunohistochemistry was performed in 121 patients. HER2-low group (HER2 score: 0 and 1) and HER2-high group (HER2 score: 2 and 3) were defined according to the HER2 immunohistochemistry score in the pathology, and patients were compared accordingly.

Results: We observed that 97 (80.2%) of the patients were in the HER2-low group, while 24 (19.8%) were in the HER2-high group. In the OS analysis, age (p = 0.381), menopausal status (p = 0.511), ECOG performance status (p = 0.087), histological type of tumor (p = 0.727), pathological grade (p = 0.206), serum LDH (p = 0.091), and albumin (p = 0.315) levels did not affect the prognosis. Patients with lower FIGO stage (p = 0.003) and HER2-high patients (p = 0.040) had better survival outcomes. Multivariable analysis showed that FIGO stage (p = 0.004) and HER2 status (p = 0.040) were independent risk factors affecting survival in endometrial cancer.

Conclusion: As a result of our study, it was observed that FIGO stage and HER2 status were independent risk factors affecting OS in endometrial cancer patients. HER2-high group had a better prognosis than HER2-low group.

Introduction: The study evaluates the performance of large language model versions of ChatGPT - ChatGPT-3.5, ChatGPT-4, and ChatGPT-Omni - in addressing inquiries related to the diagnosis and treatment of gynecological cancers, including ovarian, endometrial, and cervical cancers.

Methods: A total of 804 questions were equally distributed across four categories: true/false, multiple-choice, open-ended, and case-scenario, with each question type representing varying levels of complexity. Performance was assessed using a six-point Likert scale, focusing on accuracy, completeness, and alignment with established clinical guidelines.

Results: For true/false queries, ChatGPT-Omni achieved accuracy rates of 100% for easy, 98% for medium, and 97% for complicated questions, higher than ChatGPT-4 (94%, 90%, 85%) and ChatGPT-3.5 (90%, 85%, 80%) (p = 0.041, 0.023, 0.014, respectively). In multiple-choice, ChatGPT-Omni maintained superior accuracy with 100% for easy, 98% for medium, and 93% for complicated queries, compared to ChatGPT-4 (92%, 88%, 80%) and ChatGPT-3.5 (85%, 80%, 70%) (p = 0.035, 0.028, 0.011). For open-ended questions, ChatGPT-Omni had mean Likert scores of 5.8 for easy, 5.5 for medium, and 5.2 for complex levels, outperforming ChatGPT-4 (5.4, 5.0, 4.5) and ChatGPT-3.5 (5.0, 4.5, 4.0) (p = 0.037, 0.026, 0.015). Similar trends were observed in case-scenario questions, where ChatGPT-Omni achieved scores of 5.6, 5.3, and 4.9 for easy, medium, and hard levels, respectively (p = 0.017, 0.008, 0.012).

Conclusions: ChatGPT-Omni exhibited superior performance in responding to clinical queries related to gynecological cancers, underscoring its potential utility as a decision support tool and an educational resource in clinical practice.

Background: Cancer survivorship brings numerous challenges extending beyond physical health to include psychological, social, and functional aspects that define the quality of life (QoL) of survivors. Although recognizing that diverse gender experiences lead to different ways of coping with these challenges, many clinical trials fail to account for the distinct constructs of "sex" and "gender," often conflating the two. This review highlights how gender-related aspects can manifest in core QoL domains for cancer survivors, emphasizing the importance of inclusive and effective support systems and interventions.

Summary: While interest in the impact of gender is increasing in cancer survivor research, the terms "sex" and "gender" are still often conflated in research. Gender is a social concept consisting of multiple dimensions, such as gender identity, gender roles and norms, and gender relations. Each of these dimensions can have a distinct impact on the QoL domain of cancer survivors. Research indicates that not gender identity, but gender roles, norms, and relations can significantly influence coping behaviors that, subsequently, impact QoL domains such as physical, emotional, social, and role functioning. Understanding the interplay of gender roles, norms, and their relations with other contextual social factors is crucial for developing inclusive and effective support systems and interventions for cancer survivors.

Key messages: Gender roles and norms impact important QoL domains of cancer survivors. It is important to recognize that gendered behaviors, as a result of internalized or socially desired gender roles and norms, can both help and hinder effective coping with cancer, affecting QoL.