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Analysis of the impact of cytoreductive surgery in patients with oligometastatic renal cell carcinoma in clinical practice 分析细胞切除手术对少转移性肾细胞癌患者临床实践的影响
Q4 Medicine Pub Date : 2024-03-22 DOI: 10.21294/1814-4861-2024-23-1-53-62
D. V. Semenov, R. V. Orlova, V. I. Shirokorad, S. V. Kostritsky, M. Gluzman, Y. Korneva
Cytoreductive nephrectomy (CN) and metastasectomy are justified in patients with oligometastatic renal cell carcinoma (RCC). Objective: to evaluate the impact of cytoreductive surgery on survival rates in patients with oligometastatic RCС. Material and Methods. We retrospectively analyzed the data of 342 patients with oligometastatic RCC, who underwent systemic therapy and different types of cytoreductive surgeries at the Municipal Oncology Hospital No. 62 in Moscow and the Municipal Oncoloy Center in Saint Petersburg from 2006 to 2022. Cytoreductive nephrectomy was performed in 332 (97.1 %) patients, metastasectomy in 103 (30.1 %) patients. The survival rates of patients in treatment groups were evaluated using the Survival Analysis by calculating descriptive characteristics of survival time by means of a life-table and Kaplan–Meier curves. The results were considered statistically significant at p<0.05. Results. In the univariate analysis, in patients who underwent CN, the factors that had a negative effect on the prognosis of survival rates were the tumor grade, evidence of bone metastases, levels of ALP, LdH, ESR, as well as prognosis according to the IMdC model and metastasectomy. In the multivariate analysis, only IMdC prognosis was found to have a negative effect on survival rates. In both the univariate and multivariate analysis, in the group of patients who underwent metastasectomy, IMdC prognosis alone had an unfavorable impact on survival rates of patients with oligometastatic RCC. Conclusion. Our study showed that CN and metastasectomy had a statistically significant effect on OS (p=0.02 and p=0.032) of patients with oligometastatic RCC. division of the patients into prognosis groups according to the IMdC model showed that CN did not improve the OS rates in patients with oligometastatic RCC with intermediate and unfavorable prognosis, and metastasectomy significantly increased the OS rates in oligometastatic RCC patients with favorable and unfavorable prognosis (p=0.0055 and p=0.047). When evaluating prognostic factors in patients undergoing CN and metastasectomy, only IMdC prognosis had an impact on the OS rates (p<0.001).
对少转移性肾细胞癌(RCC)患者进行囊肿肾切除术(CN)和转移灶切除术是合理的。目的:评估细胞切除手术对少转移性肾细胞癌患者生存率的影响。材料与方法。我们回顾性分析了2006年至2022年期间在莫斯科第62市立肿瘤医院和圣彼得堡市立肿瘤中心接受全身治疗和不同类型细胞剥脱手术的342例寡转移性RCC患者的数据。332名(97.1%)患者接受了细胞切除肾切除术,103名(30.1%)患者接受了转移切除术。通过生命表和卡普兰-梅耶曲线计算生存时间的描述性特征,使用生存分析法评估了治疗组患者的生存率。结果以 P<0.05 为有统计学意义。结果在单变量分析中,在接受 CN 治疗的患者中,对生存率预后有负面影响的因素包括肿瘤分级、骨转移证据、ALP、LdH 和 ESR 水平,以及 IMdC 模型和转移灶切除术的预后。在多变量分析中,只有 IMdC 预后对生存率有负面影响。在单变量和多变量分析中,在接受转移灶切除术的患者组中,只有IMdC预后对少转移性RCC患者的生存率有不利影响。结论我们的研究显示,CN和转移灶切除术对少转移RCC患者的OS有统计学意义的影响(P=0.02和P=0.032)。根据IMdC模型将患者分为不同的预后组,结果显示,CN并不能改善中等和不利预后的少转移RCC患者的OS率,而转移灶切除术能显著提高有利和不利预后的少转移RCC患者的OS率(P=0.0055和P=0.047)。在评估接受CN和转移灶切除术患者的预后因素时,只有IMdC预后对OS率有影响(p<0.001)。
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引用次数: 0
miR-155 and miR-223 as markers of biological and clinical features of chronic lymphocytic leukemia miR-155 和 miR-223 作为慢性淋巴细胞白血病生物学和临床特征的标志物
Q4 Medicine Pub Date : 2024-03-22 DOI: 10.21294/1814-4861-2024-23-1-75-86
M. Perepechaeva, O. Goreva, O. Berezina, T. I. Pospelova, A. Grishanova
Introduction. Chronic lymphocytic leukemia (CLL) is a disease characterized by large individual differences both in the clinical course and in molecular patterns of expression of genes and regulatory RNAs, which can influence pathological changes. The involvement of regulatory microRNAs miR-155 and miR-223 in the pathogenesis of CLL is fairly well known, but there is insufficient information about possible fluctuations in the expression of miR-155 and miR-223 depending on the time course of pathology development and on parameters of medical treatment. Purpose – to investigate the expression of miR-155 and miR-223 in patients having CLL with different biological and clinical features and different characteristics of treatment in terms of peripheral-blood substrates (plasma, lymphocytes, and extracellular vesicles) and bone marrow. Material and Methods. This work involved samples of peripheral blood and bone marrow from 38 patients with a diagnosis of CLL from the City Hematology Center at the government-funded healthcare institution (Novosibirsk Oblast) City Clinical Hospital No. 2 from the years 2016 to 2017. Assessment of miR-155 and miR-223 expressions was carried out by reverse-transcription real-time PCR according to the TaqMan principle. Significance of differences between groups was evaluated either by the nonparametric Mann–Whitney test or by the nonparametric Kruskal–Wallis test with subsequent pairwise comparisons via the Mann–Whitney test. Results. High variation of the analyzed parameters was found. The expression levels of miR-155 and miR-223 in microvesicles of patients with unfavorable chromosomal anomalies were lower than those in patients with the chromosomal aberrations (or the normal karyotype) associated with a moderate effect on CLL prognosis. The expression level of miR-223 in peripheral blood lymphocytes of untreated patients with CLL was higher than that observed in treated patients. Conclusion. differences in the expression levels of miR-155 and miR-223 were identified depending on chromosomal aberrations and polychemotherapy. Our preliminary results will provide the basis for future larger studies on levels of microRNAs in CLL patients having specific features of the development, clinical course, and treatment of the disease.
简介慢性淋巴细胞白血病(CLL)是一种在临床病程以及基因和调控 RNA 分子表达模式方面都存在巨大个体差异的疾病,而这些差异会影响病理变化。众所周知,调控微RNA miR-155和miR-223参与了CLL的发病机制,但关于miR-155和miR-223的表达可能随病理发展的时间进程和药物治疗参数而波动的信息尚不充分。目的--从外周血基质(血浆、淋巴细胞和细胞外囊泡)和骨髓的角度,研究具有不同生物学和临床特征以及不同治疗特点的 CLL 患者体内 miR-155 和 miR-223 的表达情况。材料和方法。这项工作涉及政府资助医疗机构(新西伯利亚州)市第二临床医院市血液学中心 2016 年至 2017 年诊断为 CLL 的 38 名患者的外周血和骨髓样本。根据TaqMan原理,通过反转录实时PCR技术对miR-155和miR-223的表达进行了评估。组间差异的显著性通过非参数 Mann-Whitney 检验或非参数 Kruskal-Wallis 检验进行评估,随后通过 Mann-Whitney 检验进行配对比较。结果所分析的参数差异很大。染色体异常患者微囊中 miR-155 和 miR-223 的表达水平低于染色体畸变(或正常核型)患者,这对 CLL 预后有一定影响。未接受治疗的 CLL 患者外周血淋巴细胞中 miR-223 的表达水平高于接受治疗的患者。结论:miR-155 和 miR-223 的表达水平因染色体畸变和多化疗而异。我们的初步研究结果将为今后对具有疾病发展、临床过程和治疗特点的 CLL 患者的 microRNA 水平进行更大规模的研究奠定基础。
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引用次数: 0
Visualization of PD-L1-positive and PD-1-positive immune cell contact in the breast cancer microenvironment 乳腺癌微环境中 PD-L1 阳性和 PD-1 阳性免疫细胞接触可视化
Q4 Medicine Pub Date : 2024-03-21 DOI: 10.21294/1814-4861-2024-23-1-87-97
A. Kalinchuk, V. Perelmuter, L. Tashireva
Functioning of the Pd-1/Pd-L1 immune checkpoint in the microenvironment of breast cancer may lead to the tumor escape from the immune response. However, it is unknown how often Pd-L1 binds to Pd-1 in breast cancer patients, which Pd-L1-positive cells are predominantly involved in the interaction, and what prognostic significance it has. The objective of the study was to assess the frequency of co-location of Pd-1/Pd-L1-positive cells in the microenvironment of breast cancer as well as to determine the population of these cells. Material and Methods. The study included 25 patients with invasive breast carcinoma. Interaction between cells carrying the Pd-1 receptor and the Pd-L1 ligand in the tumor microenvironment were visualized using multiplex TSA (tyramide signal amplification)-modified immunohistochemistry. Participation of M1 macrophages (Cd68+Cd163-Cd3-CKAE1/3-), M2 macrophages (Cd68+/-Cd163+Cd3-CKAE1/3-), lymphocytes (Cd68-Cd163-Cd3+CKAE1/3-) and other immune cells in these interactions was assessed. Results. Half of the breast cancer patients included in the study had interactions of immune cells of the microenvironment, one of which carried Pd-1, and the other carried Pd-L1. The contact of cells carrying Pd-1 and Pd-L1 was associated with the level of TILs and the ratio of Pd-1+/ Pd-L1+ cells in the tumor microenvironment. The Pd-1/Pd-L1 interaction was found with similar frequency in Pd-L1 positive and negative patients. In the cell contacts, macrophages acted as Pd-L1+ cells in the vast majority of cases. Lymphocytes were Pd-1-positive cells rather than Pd-L1-carrying cells. In addition, it was found that metastasis-free survival was not associated with the presence or absence of co-localized cells carrying Pd-1 and Pd-L1 in the tumor microenvironment. Conclusion. Co-location of immune cells carrying Pd-1 and Pd-L1 occurs in breast cancer. M1 and M2 macrophages, Cd3+ lymphocytes and other immune cells are involved in these interactions. However, further studies are needed to establish the prognostic significance of these contacts.
乳腺癌微环境中Pd-1/Pd-L1免疫检查点的功能可能导致肿瘤逃避免疫反应。然而,目前还不清楚乳腺癌患者体内 Pd-L1 与 Pd-1 结合的频率、哪些 Pd-L1 阳性细胞主要参与了这种相互作用以及这种相互作用对预后有何意义。本研究旨在评估乳腺癌微环境中 Pd-1/Pd-L1 阳性细胞共定位的频率,并确定这些细胞的群体。材料与方法。研究对象包括 25 名浸润性乳腺癌患者。使用多重 TSA(酪胺信号放大)修饰免疫组化技术观察肿瘤微环境中携带 Pd-1 受体的细胞与 Pd-L1 配体之间的相互作用。对参与这些相互作用的 M1 巨噬细胞(Cd68+Cd163-Cd3-CKAE1/3-)、M2 巨噬细胞(Cd68+/-Cd163+Cd3-CKAE1/3-)、淋巴细胞(Cd68-Cd163-Cd3+CKAE1/3-)和其他免疫细胞进行了评估。结果研究中一半的乳腺癌患者与微环境中的免疫细胞发生了相互作用,其中一个携带 Pd-1,另一个携带 Pd-L1。携带 Pd-1 和 Pd-L1 的细胞的接触与肿瘤微环境中 TIL 的水平和 Pd-1+/ Pd-L1+ 细胞的比例有关。Pd-1/Pd-L1相互作用在Pd-L1阳性和阴性患者中出现的频率相似。在细胞接触中,绝大多数情况下巨噬细胞是 Pd-L1+ 细胞。淋巴细胞是 Pd-1 阳性细胞,而不是携带 Pd-L1 的细胞。此外,研究还发现,无转移生存期与肿瘤微环境中是否存在携带 Pd-1 和 Pd-L1 的共定位细胞无关。结论乳腺癌中存在携带 Pd-1 和 Pd-L1 的免疫细胞共定位现象。M1 和 M2 巨噬细胞、Cd3+ 淋巴细胞和其他免疫细胞参与了这些相互作用。然而,要确定这些接触的预后意义,还需要进一步的研究。
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引用次数: 0
The 45th anniversary of Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences 俄罗斯科学院托木斯克国家医学研究中心癌症研究所 45 周年纪念
Q4 Medicine Pub Date : 2024-03-21 DOI: 10.21294/1814-4861-2024-23-1-5-35
E. Choinzonov, S. A. Nekrylov, N. V. Cherdyntseva, V. I. Chernov, V. E. Goldberg
Решение об открытии в Томске филиала Онкологического научного центра Академии медицинских наук СССР было принято 3 января 1979 г. Государственным комитетом СССР по науке и технике, а уже 8 января 1979 г. министром здравоохранения СССР академиком АМН СССР Б.В. Петровским был подписан Приказ № 20 «Об организации в г. Томске Сибирского филиала Онкологического научного центра АМН СССР».
1979 年 1 月 3 日,苏联国家科学技术委员会做出了在托木斯克开设苏联医学科学院肿瘤科学中心分部的决定,1979 年 1 月 8 日,苏联卫生部长、苏联医学科学院院士 B.V. 彼得罗夫斯基签署了《关于在托木斯克组建苏联医学科学院肿瘤科学中心西伯利亚分部》的第 20 号命令。
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引用次数: 0
Comparison of the effectiveness of intraoperative radiotherapy with external beam radiotherapy in patients with early breast cancer 早期乳腺癌患者术中放疗与外照射放疗的疗效比较
Q4 Medicine Pub Date : 2024-03-21 DOI: 10.21294/1814-4861-2024-23-1-36-44
A. Manikhas, L. A. Gor, E. E. Topuzov, A. V. Morozova, I. Kalinin
Background. Breast cancer is the most common cancer in women. The main treatment for breast cancer includes surgery, chemotherapy, radiation therapy, and hormone therapy. The role of radiation therapy in the management of breast cancer continues to evolve. Radiation therapy is currently being de-escalated to include the use of intraoperative radiotherapy (IORT) and adjuvant endocrine therapy. Purpose of the study: to compare the efficacy of IORT with that of external beam radiotherapy (EBRT) in the treatment of early breast cancer. Material and Methods. A retrospective study of 559 patients with early breast cancer was conducted in Clinical Oncology Center of Saint Petersburg. The main treatment group included 273 patients who underwent breast-conserving surgery with IORT and sentinel lymph node biopsy. The control group included 286 patients who underwent breast-conserving surgery with sentinel lymph node biopsy and EBRT. Results. For all patients, the median follow-up time was 59.1 months (interquartile range: 43.7 to 80.7), the minimum follow-up period was 0.6 months, and the maximum follow-up period was 110.4 months. Recurrence occurred in 18 (6.6 %) patients of the main group and in 8 (2.8 %) patients of the control group. A statistically significant association of biological subtype with survival outcomes was found (p=0.02). The hazard ratio for Luminal B of 1.88 (95 % CI 1.02, 3.46) corresponded to a 65 % chance of an earlier onset of a negative outcome. The hazard ratio for triple-negative breast cancer of 3.01 (95 % CI 1.53, 5.95) corresponded to a 75 % chance of an earlier negative outcome. In the main treatment group, 11 (4 %) patients developed disease progression, and 2 of them died of multiple organ failure. In the control group, disease progression was observed in 18 (6.3 %) patients, 6 of whom died. However, the analysis of overall survival using the Kaplan–Meier curve showed a statistically non-significant log-rank p-value (0.73). The 3-year survival rates were 100 % (100 – 100) in the treatment group and 98.2 % (96.7 – 99.8) in the control group. The 5-yaer survival rates were 99.3 % (97.9 – 100) in the treatment group and 97.8 % (96.2 – 99.6) in the control group. These results showed advantage of IORT over EBRT. Conclusions. Intraoperative radiotherapy is a safe and effective alternative to external beam radiotherapy for early breast cancer.
背景:乳腺癌是女性最常见的癌症。乳腺癌是女性最常见的癌症。乳腺癌的主要治疗方法包括手术、化疗、放疗和激素治疗。放射治疗在乳腺癌治疗中的作用在不断发展。目前,放射治疗正在降级,包括使用术中放射治疗(IORT)和辅助内分泌治疗。研究目的:比较术中放疗(IORT)与外照射放疗(EBRT)在早期乳腺癌治疗中的疗效。材料与方法。圣彼得堡临床肿瘤中心对 559 名早期乳腺癌患者进行了回顾性研究。主要治疗组包括 273 名接受保乳手术、IORT 和前哨淋巴结活检的患者。对照组包括286名接受保乳手术、前哨淋巴结活检和EBRT的患者。研究结果所有患者的中位随访时间为59.1个月(四分位间范围:43.7至80.7),最短随访时间为0.6个月,最长随访时间为110.4个月。主治组中有 18 例(6.6%)患者复发,对照组中有 8 例(2.8%)患者复发。研究发现,生物亚型与存活率的关系具有统计学意义(P=0.02)。Luminal B 的危险比为 1.88 (95 % CI 1.02, 3.46),这意味着有 65% 的机会提前出现阴性结果。三阴性乳腺癌的危险比为 3.01 (95 % CI 1.53, 5.95),这意味着有 75% 的机会提前出现阴性结果。在主要治疗组中,有11名(4%)患者出现疾病进展,其中2人死于多器官功能衰竭。在对照组中,有 18 名患者(6.3%)病情恶化,其中 6 人死亡。然而,使用卡普兰-梅耶曲线对总生存率进行的分析表明,对数秩p值(0.73)在统计学上并不显著。治疗组的 3 年生存率为 100%(100 - 100),对照组为 98.2%(96.7 - 99.8)。治疗组的 5 年生存率为 99.3%(97.9 - 100),对照组为 97.8%(96.2 - 99.6)。这些结果表明,IORT 比 EBRT 更具优势。结论术中放疗是早期乳腺癌外照射放疗的一种安全有效的替代疗法。
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引用次数: 0
The role of molecular diagnostics in the choice of therapy for biliary tract cancers 分子诊断在胆道癌治疗选择中的作用
Q4 Medicine Pub Date : 2024-03-21 DOI: 10.21294/1814-4861-2024-23-1-130-141
N. Mitiushkina, E. N. Imyanitov
The aim of the study was to assess the frequency and clinical significance of various molecular genetic aberrations in biliary tract tumors and to determine the optimal methods of their testing. Material and Methods. We searched the literature sources containing information on predictive molecular markers relevant for the choice of therapy in biliary tract tumors in PubMed and eLibrary databases for the period from 2010 to 2023. data from 60 studies were included in this review. Results. Biliary tract tumors are characterized by poor prognosis and low sensitivity to major systemic therapies. Nevertheless, the emergence of new targeting drugs and prescription of therapy based on the results of molecular genetic analysis can increase the life expectancy and improve the quality of life of a significant proportion of patients. The most frequently detected clinically significant abnormalities in all biliary tract tumors include HER2 gene amplification/hyperexpression (5–20 % of cases), microsatellite instability (1–2 % of cases), BRAF V600E oncogene mutation (1–2 % of cases) and KRAS G12C oncogene mutation (about 1 % of cases). Specific targetable abnormalities unique to intrahepatic cholangiocarcinomas include aberrations in the gene encoding fibroblast growth factor receptor 2, FGFR2 (10–20 % of cases) and mutations in the gene encoding the enzyme isocitrate dehydrogenase 1, IDH1 (5–30 % of cases). Very rare clinically significant molecular markers for biliary tract tumors include translocations involving the receptor tyrosine kinase genes NTRK1-3, RET, ALK and ROS1. Mutations in the genes of the dNA double-strand break repair system by the mechanism of homologous recombination are also potentially significant for the choice of therapy. First of all, these are BRCA1/2 genes, hereditary mutations in which, according to two studies, are characteristic of 5–7 % of patients with biliary cancer. Although a significant part of the above-mentioned disorders can be detected by traditional molecular biological approaches such as PCR, IHC, FISH and Sanger sequencing, a comprehensive analysis of all molecular markers of predictive value in biliary tract tumors is difficult to perform without the help of next-generation sequencing (NGS). Conclusion. To improve treatment outcomes of patients with advanced and metastatic biliary tract cancer by individualizing drug therapy, it is necessary to perform comprehensive molecular genetic analysis of tumour tissue.
本研究旨在评估胆道肿瘤中各种分子遗传畸变的频率和临床意义,并确定其最佳检测方法。材料和方法。我们在 PubMed 和 eLibrary 数据库中检索了 2010 年至 2023 年期间与胆道肿瘤治疗选择相关的预测性分子标记物的文献资料。结果。胆道肿瘤的特点是预后差,对主要的全身疗法敏感性低。然而,新靶向药物的出现以及根据分子基因分析结果开出的治疗处方可以延长相当一部分患者的预期寿命并改善其生活质量。在所有胆道肿瘤中,最常发现的具有临床意义的异常包括 HER2 基因扩增/高表达(5%-20% 的病例)、微卫星不稳定性(1%-2% 的病例)、BRAF V600E 致癌基因突变(1%-2% 的病例)和 KRAS G12C 致癌基因突变(约 1%的病例)。肝内胆管癌特有的靶向异常包括编码成纤维细胞生长因子受体 2(FGFR2)基因的畸变(占病例的 10-20%)和编码异柠檬酸脱氢酶 1(IDH1)基因的突变(占病例的 5-30%)。非常罕见的具有临床意义的胆道肿瘤分子标记物包括涉及受体酪氨酸激酶基因 NTRK1-3、RET、ALK 和 ROS1 的易位。通过同源重组机制产生的 dNA 双链断裂修复系统基因突变对治疗方法的选择也具有潜在意义。首先是 BRCA1/2 基因,根据两项研究,5%-7% 的胆道癌患者都存在遗传性突变。虽然上述疾病中的很大一部分可以通过传统的分子生物学方法(如 PCR、IHC、FISH 和 Sanger 测序)检测出来,但如果没有新一代测序技术(NGS)的帮助,就很难对胆道肿瘤中所有具有预测价值的分子标记物进行全面分析。结论为了通过个体化药物治疗改善晚期和转移性胆道癌患者的治疗效果,有必要对肿瘤组织进行全面的分子遗传分析。
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引用次数: 0
Re-irradiation combined with bevacizumab in the treatment of glioblastoma recurrence 再照射联合贝伐单抗治疗胶质母细胞瘤复发
Q4 Medicine Pub Date : 2024-03-21 DOI: 10.21294/1814-4861-2024-23-1-142-154
S. V. Belokon, I. Gulidov, D. Gogolin, K. E. Medvedeva, S. A. Ivanov, A. Kaprin
Background. Glioblastoma (GB) remains an aggressive disease with a poor prognosis. despite a comprehensive approach to the treatment of the primary disease, recurrence is almost inevitable. There is still no standard of care for GB recurrence, and many guidelines recommend treating these patients within clinical trials. There are various treatment options available. They include surgery, radiation therapy, systemic or regional chemotherapy or targeted therapy, various immunotherapy strategies, low- and medium-frequency electric fields, and their combinations. The combination of two non-invasive techniques: re-irradiation and systemic targeted therapy remains the most commonly used approach in this group of patients, the potential of which has not been fully realized. The aim of the study was to analyze the literature data on the use of the combination of re-irradiation with bevacizumab as a therapeutic option in patients with GB. Material and Methods. Literature search was performed using Medline, Cochrane Library, E-library, Scopus, PubMed and Google Scholar databases. Results. The current state of the problem was determined, the data available to date on the use of repeated radiotherapy with competitive and/or adjuvant bevacizumab in the treatment of GB recurrence were summarized and analyzed, different regimens of this approach were compared, and the prospects and possible ways of solving the existing problems of this therapeutic option were described. Conclusion. Re-irradiation with concomitant administration of bevacizumab may provide safer treatment of GB recurrence, including large-volume glioblastoma, with acceptable toxicity, in particular radiation necrosis, especially when an appropriate fractionation schedule is used.
背景。胶质母细胞瘤(GB)是一种侵袭性疾病,预后较差。尽管对原发疾病采取了综合治疗方法,但复发几乎不可避免。目前仍没有针对胶质母细胞瘤复发的标准治疗方法,许多指南都建议在临床试验中对这些患者进行治疗。目前有多种治疗方案可供选择。其中包括手术、放射治疗、全身或区域化疗或靶向治疗、各种免疫治疗策略、中低频电场及其组合。再照射和全身靶向治疗这两种非侵入性技术的组合仍是这类患者最常用的方法,但其潜力尚未得到充分发挥。本研究的目的是分析将再照射与贝伐珠单抗联合使用作为 GB 患者治疗方案的文献数据。材料与方法。使用 Medline、Cochrane Library、E-library、Scopus、PubMed 和 Google Scholar 数据库进行文献检索。结果。确定了问题的现状,总结并分析了迄今为止使用重复放疗联合竞争性和/或辅助贝伐珠单抗治疗 GB 复发的数据,比较了该方法的不同方案,并描述了该治疗方案的前景和解决现有问题的可能方法。结论再次放疗同时应用贝伐珠单抗可为包括大体积胶质母细胞瘤在内的GB复发提供更安全的治疗,且毒性(尤其是放射性坏死)可接受,特别是在采用适当的分次治疗方案时。
{"title":"Re-irradiation combined with bevacizumab in the treatment of glioblastoma recurrence","authors":"S. V. Belokon, I. Gulidov, D. Gogolin, K. E. Medvedeva, S. A. Ivanov, A. Kaprin","doi":"10.21294/1814-4861-2024-23-1-142-154","DOIUrl":"https://doi.org/10.21294/1814-4861-2024-23-1-142-154","url":null,"abstract":"Background. Glioblastoma (GB) remains an aggressive disease with a poor prognosis. despite a comprehensive approach to the treatment of the primary disease, recurrence is almost inevitable. There is still no standard of care for GB recurrence, and many guidelines recommend treating these patients within clinical trials. There are various treatment options available. They include surgery, radiation therapy, systemic or regional chemotherapy or targeted therapy, various immunotherapy strategies, low- and medium-frequency electric fields, and their combinations. The combination of two non-invasive techniques: re-irradiation and systemic targeted therapy remains the most commonly used approach in this group of patients, the potential of which has not been fully realized. The aim of the study was to analyze the literature data on the use of the combination of re-irradiation with bevacizumab as a therapeutic option in patients with GB. Material and Methods. Literature search was performed using Medline, Cochrane Library, E-library, Scopus, PubMed and Google Scholar databases. Results. The current state of the problem was determined, the data available to date on the use of repeated radiotherapy with competitive and/or adjuvant bevacizumab in the treatment of GB recurrence were summarized and analyzed, different regimens of this approach were compared, and the prospects and possible ways of solving the existing problems of this therapeutic option were described. Conclusion. Re-irradiation with concomitant administration of bevacizumab may provide safer treatment of GB recurrence, including large-volume glioblastoma, with acceptable toxicity, in particular radiation necrosis, especially when an appropriate fractionation schedule is used.","PeriodicalId":21881,"journal":{"name":"Siberian journal of oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140223954","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
The abscopal effect: mechanism of occurrence and prospects of using it in therapy of metastatic cancer 腹水效应:发生机制及在转移性癌症治疗中的应用前景
Q4 Medicine Pub Date : 2024-03-20 DOI: 10.21294/1814-4861-2024-23-1-120-129
A. V. Khachaturyan, P. V. Bulychkin
The abscopal effect in oncology has been known for 70 years, but until recently its clinical significance was rather low. The development of immune response checkpoint inhibitors has led to an active study of this phenomenon. There is now evidence of improved survival among patients, in whom the abscopal effect has been documented, opening new perspectives for the treatment of cancers at different stages. This review presents data on the mechanisms of the abscopal effect, experimental and clinical data, current limitations and possible perspectives. The aim of the study was to investigate the current concept of the abscopal effect occurrence and to evaluate the prospects of using the abscopal effect in therapy of metastatic cancer. Material and Methods. We searched publications in Pubmed system from 2010 to 2023. Of 286 publications, 72 were used for writing the review. Results. In the era of widespread use of immune checkpoint inhibitors (ICIs) for cancer therapy, the abscopal effect appears to be an effective therapeutic approach with broad prospects of application in the treatment of patients with metastatic cancer. Conclusion. The incidence of the abscopal effect has increased with the advent of immune therapy, and the use of ICIs with radiation therapy (RT) has shown improved survival even in patients with advanced disease. More research is needed to establish standardized treatment protocols, including the optimal dose and timing of RT, as well as the efficacy and safety of combination therapy with different classes of ICIs. Further search for clinical and laboratory abscopal effect predictors, which could allow personalized treatment approaches, is required.
肿瘤学中的腹水效应已有 70 年的历史,但直到最近,其临床意义还很低。免疫反应检查点抑制剂的开发促使人们积极研究这一现象。现在有证据表明,有腹水效应记录的患者生存率有所提高,这为不同阶段癌症的治疗开辟了新的前景。本综述介绍了有关潜逃效应机制的数据、实验和临床数据、目前的局限性以及可能的前景。本研究的目的是调查目前关于腹回声效应发生的概念,并评估利用腹回声效应治疗转移性癌症的前景。材料和方法。我们在 Pubmed 系统中搜索了 2010 年至 2023 年期间的出版物。在286篇文献中,有72篇用于撰写综述。结果。在广泛使用免疫检查点抑制剂(ICIs)治疗癌症的时代,腹水效应似乎是一种有效的治疗方法,在治疗转移性癌症患者方面具有广阔的应用前景。结论随着免疫疗法的出现,腹水效应的发生率有所上升,而 ICIs 与放射治疗(RT)的结合使用甚至改善了晚期患者的生存率。需要开展更多的研究来制定标准化的治疗方案,包括 RT 的最佳剂量和时机,以及与不同类别 ICIs 联合治疗的有效性和安全性。此外,还需要进一步寻找临床和实验室缺氧效应预测指标,以便采取个性化治疗方法。
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引用次数: 0
Early-onset gasrtric cancer (review) 早期胃癌(回顾)
Q4 Medicine Pub Date : 2024-01-05 DOI: 10.21294/1814-4861-2023-22-6-153-171
D. M. Pugaev, L. N. Lyubchenko, A. Ryabov, A. Kaprin
Objective. Early-onset gastric cancer (EOGC) constitutes a serious medical and social problem. Early-onset gastric cancer accounts for approximately 6% of all malignant epithelial neoplasms.Material and Methods. We reviewed retrospective and prospective randomized trials using Medline and Elibrary databases.Results. The applied significance of the molecular genetic classifications consist in the formation of groups for evaluating prognosis of the disease using multifactorial analysis. This classification indicates that EOGC diagnosed at a locally advanced stage and primary dissemination is most often caused by GS (TCGA) and MSS/EMT(ACRG) subtypes and is characterized by mutations in CDH1, RhoA, CLDN18-ARHGAP genes. These changes are accompanied by the prevalence of diffuse histological type of gastric cancer according to the Lauren classification and ulcerated or infiltrative type according to the Borrmann classification (type III and IV) with the presence of high-grade adenocarcinoma with a signet ring cell component.Conclusion. Considering the aggressiveness of gastric cancer in young patients, who more frequently present with locally advanced and metastatic disease at the time of diagnosis, there is a need for increased cancer alertness among physicians of other specialties, early endoscopic controls to detect cancer at early stages and benefit from both surgical and multimodal treatment.
目的。早发胃癌(EOGC)是一个严重的医疗和社会问题。早发胃癌约占所有恶性上皮肿瘤的 6%。我们利用 Medline 和 Elibrary 数据库回顾了回顾性和前瞻性随机试验。分子遗传学分类的应用意义在于通过多因素分析,形成评估疾病预后的组别。该分类表明,在局部晚期和原发性播散阶段确诊的EOGC最常见于GS(TCGA)和MSS/EMT(ACRG)亚型,其特点是CDH1、RhoA、CLDN18-ARHGAP基因发生突变。伴随这些变化的是,根据劳伦分类法(Lauren classification),胃癌的组织学类型为弥漫型;根据博尔曼分类法(III 型和 IV 型),胃癌的组织学类型为溃疡型或浸润型,并存在带有标志环细胞成分的高级别腺癌。考虑到胃癌在年轻患者中的侵袭性,在确诊时更多地表现为局部晚期和转移性疾病,因此需要提高其他专业医生对癌症的警惕性,及早进行内镜检查,以便在早期阶段发现癌症,并从手术和多模式治疗中获益。
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引用次数: 0
Thyroid cаncer occuring during pregnаncy. Literаture review 孕期发生的甲状腺癌文献回顾
Q4 Medicine Pub Date : 2024-01-05 DOI: 10.21294/1814-4861-2023-22-6-179-184
A. A. Chernyаkov, S. Y. Chizhevskаyа, E. Choynzonov, L. N. Bаlаtskаyа, L. V. Spirinа, A. L. Chernyshovа, M. R. Mukhаmedov, O. S. Dil
Introduction. Thyroid cаncer is the most common endocrine malignancies accounting for approximately 2 % of all cancers in Russiа аnd 2.3 % in the world. Several studies have reported on the infuence of hormonаl status on the prognosis of thyroid cаncer, in pаrticulаr, femаle sex hormones, such as estrogens аnd progesterone, contribute to thyroid cell proliferation. In this regard, thyroid cancer occurring during pregnancy is of particular interest.The purpose of the study was to аnаlyze the literаture sources concerning thyroid cаncer occurring during pregnаncy and to evaluate the impact of pregnаncy on the progression of thyroid cancer.Mаteriаl аnd Methods. A literature seаrch wаs conducted using Cochrаne, Librаry, and Elibrаry databases. The review included studies from 1981 to 2022.Conclusion. Currently, most studies report thаt pregnаncy does not adversely affect the outcomes of thyroid cancer; however, many aspects concerning the hormonаl effect аnd receptor stаtus of thyroid cancer require more detаiled study.
简介甲状腺癌是最常见的内分泌恶性肿瘤,在俄罗斯约占所有癌症的2%,在全世界约占2.3%。一些研究报告指出,激素状况对甲状腺癌的预后有影响,其中最重要的是,女性性激素(如雌激素和孕激素)会促进甲状腺细胞增殖。本研究的目的是分析有关妊娠期甲状腺癌的文献资料,并评估妊娠对甲状腺癌进展的影响。利用Cochráne、Libráry和Elibráry数据库进行了文献综述。综述包括 1981 年至 2022 年的研究。目前,大多数研究报告称,妊娠不会对甲状腺癌的预后产生不利影响;但是,有关甲状腺癌的激素效应和受体状态的许多方面还需要更详细的研究。
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引用次数: 0
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Siberian journal of oncology
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