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Etiology and Outcome of Seizures in Children during Induction Remission Chemotherapy for Acute Lymphoblastic Leukaemia 急性淋巴细胞白血病诱导缓解化疗期间儿童癫痫发作的病因和结局
Pub Date : 2022-06-22 DOI: 10.1055/s-0042-1748322
S. A. Soma, C. Jamal, Indira Chowdhury
Seizure is one of the most frequent neurological complication and morbid phenomenon among children receiving chemotherapy for acute lymphoblastic leukemia. As overall survival of children with acute lymphoblastic leukemia is improving, now the challenge is to reduce treatment-related adverse effect. However, not much is known about the etiology and natural history of these seizure in our pediatric population. This is a single centered study conducted in the Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University. This prospective observational study was conducted over a period of 1 year from May 2017 to April 2018. A total of 105 patients aged 1 year to 17.9 years newly diagnosed as acute lymphoblastic leukemia were the study population. This study showed that in five (33.3%) patients, the underlying cause was suspected intracranial hemorrhage and it was the most common cause. All these five patients had features of severe sepsis and upper motor neuron sign associated with severe thrombocytopenia. Among them three had coagulopathy. Three (20%) patients had CNS leukemic infiltration. Suspected meningitis was attributed as the possible cause of seizure in two (13.33%) patients. Other identifiable causes were brain abscess in one patient, multiple cerebral infarction in one patient, hypertensive encephalopathy in one patient, and vincristine-induced neurotoxicity in one patient. In one patient no identifiable cause was found. Among 15 patients with seizure five (33.3%) patients were improved and completed induction remission chemotherapy. Ten (66.7%) patients died. In this study, we found sepsis and coagulopathy as the major underlying cause of seizure. Outcome was found very dismal in patients who developed seizure.
癫痫发作是接受急性淋巴细胞白血病化疗的儿童中最常见的神经系统并发症和病态现象之一。随着儿童急性淋巴细胞白血病的总体生存率不断提高,现在的挑战是减少与治疗相关的不良反应。然而,在我们的儿科人群中,对这些癫痫发作的病因和自然史知之甚少。这是一项在Bangabandhu Sheikh Mujib医科大学儿科血液学和肿瘤学系进行的单中心研究。这项前瞻性观察性研究于2017年5月至2018年4月进行,为期1年。共有105名1岁至17.9岁的新诊断为急性淋巴细胞白血病的患者为研究人群。这项研究表明,在5名(33.3%)患者中,潜在原因是疑似颅内出血,这是最常见的原因。这五名患者均具有严重败血症和与严重血小板减少症相关的上运动神经元体征的特征。其中3例有凝血障碍。3例(20%)患者有中枢神经系统白血病浸润。疑似脑膜炎被认为是两名(13.33%)患者癫痫发作的可能原因。其他可识别的原因包括一名患者的脑脓肿、一名患者多发性脑梗死、一名病人的高血压脑病和一名病人长春新碱引起的神经毒性。在一名患者中,未发现可识别的病因。在15例癫痫患者中,5例(33.3%)患者病情好转并完成诱导缓解化疗。死亡10例(66.7%)。在这项研究中,我们发现败血症和凝血障碍是癫痫发作的主要潜在原因。癫痫发作患者的预后非常糟糕。
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引用次数: 0
Alleviative Effect of Herbal Extract Containing Phytoconstituents of Bambusa vulgaris and Opuntia ficus-indica against AOM/DSS-Induced Colorectal-Carcinoma-Bearing Mice 竹叶和无花果植物成分提取物对AOM/ dss诱导的结直肠癌小鼠的缓解作用
Pub Date : 2022-06-02 DOI: 10.1055/s-0042-1745729
M. Komala, C. Ravishankar, Anbu Jayaram
The study includes preliminary phytochemical screening and assessing alleviative effects of ethanolic extract of Bambusa vulgaris shoots and Opuntia ficus-indica fruits (EEBO) on azoxymethane/dextran sodium sulfate (AOM/DSS)-induced colorectal cancer in rodents. Acute oral toxicity study was performed to find the therapeutic dose of EEBO. In animals, cancer was induced by single injection of AOM 10 mg/kg intraperitoneally followed by supply of three repeated cycles of 2.5% of DSS solution. Then animals were treated with EEBO from third day of experiment and treatment was continued throughout the experimental period. The anticancer effect was assessed by studying body weight (b. wt) changes, macroanatomy, antioxidant level, and microanatomy of colon. The phytochemical evaluation revealed the presence of alkaloid, glycoside, carbohydrate, and flavonoid in bamboo extract, whereas glycoside and flavonoid in cactus extract. The results found that EEBO increases the b. wt and level of antioxidants like sodium dismutase, glutathione, and catalase and meanwhile decreases malondialdehyde. Macroanatomy study indicated a decrease in the numbers of adenoma and inflammatory signs in the treated group when compared with diseased group. Histopathology revealed that the presence of EEBO improved the colon histoarchitecture similar to normal and masked the crypt appearance. Decreased chromosomal aberrations and micronucleus numbers were observed in EEBO treated group. Overall, results suggest that the EEBO 400 mg/kg exhibited highest activity compared with 200 and 100 mg/kg and the effect may be attributed to its antigenotoxic or antioxidant effect.
本研究对竹笋和无花果果实乙醇提取物(EEBO)进行初步的植物化学筛选,并评价其对偶氮氧甲烷/葡聚糖硫酸钠(AOM/DSS)诱导的啮齿动物大肠癌的缓解作用。进行急性口服毒性研究,以确定ebo的治疗剂量。在动物实验中,通过单次腹腔注射AOM 10 mg/kg,然后连续3次重复注射2.5%的DSS溶液来诱导癌症。从实验第3天开始给予EEBO治疗,并在整个实验期间持续治疗。通过研究结肠的体重(b. wt)变化、宏观解剖、抗氧化水平和微观解剖来评估其抗癌作用。植物化学评价表明,竹提取物中含有生物碱、糖苷、碳水化合物和类黄酮,而仙人掌提取物中含有糖苷和类黄酮。结果发现,EEBO提高了b. wt和抗氧化剂(如钠歧化酶、谷胱甘肽、过氧化氢酶)的水平,同时降低了丙二醛。宏观解剖研究表明,治疗组与病变组相比,腺瘤数量和炎症体征均有所减少。组织病理学显示,EEBO的存在改善了结肠组织结构,与正常组织结构相似,掩盖了隐窝外观。ebo治疗组小鼠染色体畸变和微核数明显减少。综上所述,与200和100 mg/kg的ebo400 mg/kg相比,ebo400 mg/kg的活性最高,其作用可能是由于其抗原毒性或抗氧化作用。
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引用次数: 0
Serum 25-Hydroxyvitamin D Level and Breast Cancer Risk in Egyptian Females 埃及女性血清25-羟基维生素D水平与癌症风险
Pub Date : 2022-05-20 DOI: 10.1055/s-0042-1748494
M. Khedr, Samia Abdel Fattah Sharaf, Ahmed Nagdy Abdel Aal, I. Dessouky, M. Soliman
Vitamin D has potent antiproliferative, prodifferentiative, and immune-modulatory effects. Vitamin D deficiency has been suggested to be very prevalent and there is growing evidence for the association between vitamin D deficiency and risk of breast cancer. The aim of this study was to evaluate the association of serum 25-hydroxyvitamin D [25(OH)D] level with breast cancer risk among Egyptian women. The current study included 40 breast cancer cases and 40 healthy control women. Serum 25(OH)D levels were measured using enzyme-linked immunosorbent assay for all women and together with other clinical factors were correlated to the risk of breast cancer. A total of 80 women including 40 breast cancer cases and 40 controls were included in this analysis. The clinical characteristics were well balanced with no significant difference between cases and controls regarding age, menopausal status, weight, height, body mass index, serum calcium, and phosphorus levels. The mean serum 25(OH)D level in cases (12.11 ng/mL) was significantly lower than in controls (19.77 ng/mL). Ninety percent of cases had 25(OH)D deficiency (<20 ng/mL) compared with 57.5% of the controls. After adjustment for potentially confounding variables, women with vitamin D deficiency were associated with a high significant risk of breast cancer compared to women with sufficient vitamin D with OR of 6.99 (95% CI = 2.01–24.32, p = 0.002). A significant association exists between vitamin D deficiency and the risk of breast cancer in Egyptian women.
维生素D具有强大的抗增殖、促分化和免疫调节作用。维生素D缺乏被认为是非常普遍的,越来越多的证据表明维生素D缺乏与癌症风险之间的联系。本研究的目的是评估埃及妇女血清25-羟基维生素D[25(OH)D]水平与乳腺癌症风险的关系。目前的研究包括40例癌症病例和40名健康对照女性。使用酶联免疫吸附测定法测量所有女性的血清25(OH)D水平,并与其他临床因素一起与癌症风险相关。共有80名女性,包括40例癌症病例和40例对照纳入本分析。临床特征平衡良好,病例和对照组在年龄、更年期状态、体重、身高、体重指数、血清钙和磷水平方面没有显著差异。病例的平均血清25(OH)D水平(12.11 ng/mL)显著低于对照组(19.77 ng/mL)。90%的病例有25(OH)D缺乏(<20 ng/mL),而对照组为57.5%。在对潜在的混淆变量进行调整后,与维生素D充足的女性相比,维生素D缺乏的女性患乳腺癌症的显著风险较高,OR为6.99(95%CI = 2.01–24.32,p = 0.002)。维生素D缺乏与埃及妇女患癌症的风险之间存在显著关联。
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引用次数: 1
Prognostic Potential of MicroRNAs in Glioma Patients: A Meta-Analysis 微rna在胶质瘤患者中的预后潜力:一项荟萃分析
Pub Date : 2022-04-21 DOI: 10.1055/s-0042-1744448
A. Laghari, Z. Suchal, R. Avani, Daniyal Aziz Khan, A. Kabani, M. Nouman, S. Enam
Introduction MicroRNAs are a noncoding RNA involved in affecting several transcription and translation pathways. Their use has been discussed as potential predictors of several tumors. Their use as potential biomarker in glioma patients is still controversial. The purpose of this meta-analysis is to explore the possible role of such microRNAs in glioma patients. Methods After an extensive literature search done on PubMed and Embase, 20 studies were chosen for our analyses with the 9 discussing 11 tumor promoting microRNAs and 11 studies discussing 11 tumor suppressing microRNAs. The data needed was extracted from these studies including the hazard ratio that was used as the effect size for the purpose of our analysis. The needed analysis was performed using Stata and Excel. Results The pooled hazard ratio for our analysis with patients having a lower microRNA expression for tumor promoting microRNAs came to be 2.63 (p < 0.001), while the hazard ratio for patients with higher expression of tumor promoting microRNA was 2.47 (p < 0.001) with both results being statistically significant. However, as significant heterogeneity was observed a random effect model for analysis was used. Subgroup analysis was further performed using grade, cutoff value (mean or median), sample type (Serum or Blood), and Karnofsky performance score, all of them showing a high hazard ratio. Conclusion Our results showed that both tumor inhibitory and promoting microRNA can be used as prognostic tool in glioma patients with a poorer prognosis associated with a lower expression in tumor suppressive and higher expression in tumor promoting microRNA, respectively. However, to support this, future studies on a much larger scale would be needed.
介绍 微小核糖核酸是一种非编码核糖核酸,参与影响多种转录和翻译途径。它们的使用已经被讨论为几种肿瘤的潜在预测因子。它们作为神经胶质瘤患者的潜在生物标志物的使用仍然存在争议。这项荟萃分析的目的是探索这种微小RNA在神经胶质瘤患者中的可能作用。方法 在PubMed和Embase上进行了广泛的文献检索后,我们选择了20项研究进行分析,其中9项研究讨论了11种肿瘤促进微小RNA,11项研究讨论11种肿瘤抑制微小RNA。所需的数据是从这些研究中提取的,包括用于我们分析的影响大小的风险比。使用Stata和Excel进行所需的分析。后果 我们对肿瘤促进微小RNA表达较低的患者进行分析的合并风险比为2.63(p < 0.001),而肿瘤促进微小RNA表达较高的患者的风险比为2.47(p < 0.001),两个结果都具有统计学意义。然而,由于观察到显著的异质性,因此使用了随机效应模型进行分析。使用等级、临界值(平均值或中位数)、样本类型(血清或血液)和Karnofsky表现评分进一步进行亚组分析,所有这些都显示出高风险比。结论 我们的研究结果表明,肿瘤抑制性和促进性微小RNA都可以作为神经胶质瘤患者的预后工具,这些患者的预后较差,分别与肿瘤抑制性的表达较低和肿瘤促进性的微小RNA的表达较高有关。然而,为了支持这一点,未来需要进行更大规模的研究。
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引用次数: 0
Capecitabine Maintenance Chemotherapy in the Treatment of Metastatic Colorectal Cancer: A Meta-Analysis 卡培他滨维持化疗治疗转移性结直肠癌:荟萃分析
Pub Date : 2022-04-21 DOI: 10.1055/s-0042-1744439
B. Ong, A. Rocimo, R. King, E. Yasay
Many agents have been evaluated as maintenance therapy for metastatic colorectal cancer (mCRC), but there is no consensus on the optimal regimen. This study assessed the effect of single-agent capecitabine maintenance therapy on the survival outcomes of mCRC patients. A comprehensive literature search was performed according to prespecified inclusion and exclusion criteria for randomized controlled trials (RCTs) comparing capecitabine as maintenance monotherapy versus active monitoring for mCRC patients. Data on overall survival (OS), progression-free survival (PFS), time to tumor progression (TTP), adverse events, and quality of life (QoL) scores were extracted. Three RCTs with a total of 576 patients were included. Pooled analyses found neither OS benefit (HR:0.85, 95% CI:0.64–1.13) nor reduction in mortality at 24 months (RR:0.88, 95% CI:0.66–1.17) with capecitabine maintenance. Compared with active monitoring, capecitabine maintenance therapy improved PFS (HR:0.36, 95% CI:0.26–0.61) and reduced the risk of progression at 6 months (HR:0.78, 95% CI:0.56–1.10). The incidence of any grade ≥ 3 toxicity was higher with maintenance therapy than with observation (OR:2.02, 95% CI:1.42–2.88). No difference in terms of QoL was observed. Single-agent capecitabine as maintenance for patients with mCRC provides no OS benefit but results in statistically significant improvement in PFS with increased risk of toxicity. Hence, it may be considered particularly for patients who wish to delay the need for second-line treatment and who can tolerate it well.
许多药物已被评估为转移性结直肠癌(mCRC)的维持治疗,但对最佳方案尚无共识。本研究评估单药卡培他滨维持治疗对mCRC患者生存结局的影响。根据预先指定的纳入和排除标准,对比较卡培他滨作为维持单药治疗与主动监测的mCRC患者的随机对照试验(rct)进行了全面的文献检索。提取总生存期(OS)、无进展生存期(PFS)、肿瘤进展时间(TTP)、不良事件和生活质量(QoL)评分数据。3项随机对照试验共纳入576例患者。合并分析发现卡培他滨维持既没有OS获益(HR:0.85, 95% CI: 0.64-1.13),也没有降低24个月死亡率(RR:0.88, 95% CI: 0.66-1.17)。与主动监测相比,卡培他滨维持治疗改善了PFS (HR:0.36, 95% CI: 0.26-0.61),并降低了6个月时进展的风险(HR:0.78, 95% CI: 0.56-1.10)。维持治疗组任何≥3级毒性的发生率均高于观察组(OR:2.02, 95% CI: 1.42-2.88)。在生活质量方面没有观察到差异。单药卡培他滨作为mCRC患者的维持性治疗没有提供OS益处,但在统计学上显著改善了PFS,同时增加了毒性风险。因此,可以特别考虑那些希望推迟二线治疗的需要并能很好地耐受的患者。
{"title":"Capecitabine Maintenance Chemotherapy in the Treatment of Metastatic Colorectal Cancer: A Meta-Analysis","authors":"B. Ong, A. Rocimo, R. King, E. Yasay","doi":"10.1055/s-0042-1744439","DOIUrl":"https://doi.org/10.1055/s-0042-1744439","url":null,"abstract":"Many agents have been evaluated as maintenance therapy for metastatic colorectal cancer (mCRC), but there is no consensus on the optimal regimen. This study assessed the effect of single-agent capecitabine maintenance therapy on the survival outcomes of mCRC patients. A comprehensive literature search was performed according to prespecified inclusion and exclusion criteria for randomized controlled trials (RCTs) comparing capecitabine as maintenance monotherapy versus active monitoring for mCRC patients. Data on overall survival (OS), progression-free survival (PFS), time to tumor progression (TTP), adverse events, and quality of life (QoL) scores were extracted. Three RCTs with a total of 576 patients were included. Pooled analyses found neither OS benefit (HR:0.85, 95% CI:0.64–1.13) nor reduction in mortality at 24 months (RR:0.88, 95% CI:0.66–1.17) with capecitabine maintenance. Compared with active monitoring, capecitabine maintenance therapy improved PFS (HR:0.36, 95% CI:0.26–0.61) and reduced the risk of progression at 6 months (HR:0.78, 95% CI:0.56–1.10). The incidence of any grade ≥ 3 toxicity was higher with maintenance therapy than with observation (OR:2.02, 95% CI:1.42–2.88). No difference in terms of QoL was observed. Single-agent capecitabine as maintenance for patients with mCRC provides no OS benefit but results in statistically significant improvement in PFS with increased risk of toxicity. Hence, it may be considered particularly for patients who wish to delay the need for second-line treatment and who can tolerate it well.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42958843","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
Evaluation of High-Risk Human Papillomavirus Testing in Women with Atypical Squamous Cells of Undetermined Significance to Detect Cervical Intraepithelial Neoplasia 高危人类乳头状瘤病毒检测在具有不确定意义的非典型鳞状细胞的妇女中检测宫颈上皮内肿瘤的评估
Pub Date : 2022-04-21 DOI: 10.1055/s-0042-1744437
R. Kawase, Shunji Suzuki
Introduction We retrospectively examined the changes in the management and outcomes of the cases with atypical squamous cells of undetermined significance (ASC-US) according to the Bethesda system (TBS). Materials and Methods Between May 2009 and December 2018, 432 cases with ASC-US were retrospectively examined for the implementation of high-risk human papillomavirus (hrHPV) testing and/or cervical biopsy and clinical courses. Results The hrHPV testing was performed in 277 cases (64.1%). Of these, there were 80 with positive hrHPV (28.9%). Of the 80 cases, cervical biopsy was performed in 71 (88.9%) cases based on the finding of colposcopy. Cervical intraepithelial neoplasia (CIN) was diagnosed in 55 cases (77.4%). The sensitivity, specificity, positive predictive value, and negative predictive value of CIN diagnosis by hrHPV testing in cases of ASC-US were 72.5, 95.0, 88.7, and 86.3%, respectively (p < 0.01). Conclusion The conducting of hrHPV test on women who were evaluated as ASC-US according to TBS affirmed its clinical usefulness.
介绍 根据Bethesda系统(TBS),我们回顾性研究了意义不明的非典型鳞状细胞(ASC-US)病例的处理和结果的变化。材料和方法 2009年5月至2018年12月,对432例ASC-US患者进行了回顾性检查,以了解高危人乳头瘤病毒(hrHPV)检测和/或宫颈活检和临床过程。后果 277例(64.1%)进行了hrHPV检测。其中80例hrHPV阳性(28.9%)。在80例中,71例(88.9%)根据阴道镜检查结果进行了宫颈活检。宫颈上皮内瘤变(CIN)55例(77.4%),hrHPV检测对ASC-US诊断CIN的敏感性、特异性、阳性预测值和阴性预测值分别为72.5%、95.0%、88.7%和86.3%(p < 0.01)。结论 对根据TBS评估为ASC-US的女性进行hrHPV检测证实了其临床实用性。
{"title":"Evaluation of High-Risk Human Papillomavirus Testing in Women with Atypical Squamous Cells of Undetermined Significance to Detect Cervical Intraepithelial Neoplasia","authors":"R. Kawase, Shunji Suzuki","doi":"10.1055/s-0042-1744437","DOIUrl":"https://doi.org/10.1055/s-0042-1744437","url":null,"abstract":"\u0000 Introduction We retrospectively examined the changes in the management and outcomes of the cases with atypical squamous cells of undetermined significance (ASC-US) according to the Bethesda system (TBS).\u0000 Materials and Methods Between May 2009 and December 2018, 432 cases with ASC-US were retrospectively examined for the implementation of high-risk human papillomavirus (hrHPV) testing and/or cervical biopsy and clinical courses.\u0000 Results The hrHPV testing was performed in 277 cases (64.1%). Of these, there were 80 with positive hrHPV (28.9%). Of the 80 cases, cervical biopsy was performed in 71 (88.9%) cases based on the finding of colposcopy. Cervical intraepithelial neoplasia (CIN) was diagnosed in 55 cases (77.4%). The sensitivity, specificity, positive predictive value, and negative predictive value of CIN diagnosis by hrHPV testing in cases of ASC-US were 72.5, 95.0, 88.7, and 86.3%, respectively (p < 0.01).\u0000 Conclusion The conducting of hrHPV test on women who were evaluated as ASC-US according to TBS affirmed its clinical usefulness.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42906553","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
Quality of Life among Survivors of Locally Advanced Cervical Cancer Treated with Definitive Chemoradiotherapy in a Decade of Transition 转型期10年局部晚期癌症放疗后生存者的生活质量
Pub Date : 2022-04-19 DOI: 10.1055/s-0042-1744300
V. Chua, K. Yu, Patricia Andrea Chua, Raphael Joseph Chua, Robeley May Chua, Yae Na Chun, J. Mariano, G. González, T. S. Ortin, W. Bacorro
Introduction The standard treatment for locally advanced cervical cancer (LACC) is concurrent chemoradiotherapy (CRT). External beam radiotherapy (EBRT) and brachytherapy (BRT) advances in the last decade have resulted in improved local control and survival. There is a lack of data on quality of life (QoL) among survivors. Objective This systematic review aimed to synthesize published data on QoL among LACC survivors treated with CRT and determine clinical factors of QoL. Methods Systematic literature search was conducted in PubMed, EBSCO, and ScienceDirect for relevant articles published in 2010 to 2020. Eligible studies on LACC survivors aged 18 years and above, who reported QoL after CRT, were included. Screening and data extraction were done by two pairs of independent reviewers. Results Five cohort studies, three cross sectional studies, and one clinical trial were included. Reported temporal evolution of QoL varied: two studies reported improvement of overall QoL, while four reported worsening of symptoms. Gastrointestinal, genitourinary, sexual, and psychosocial domains showed significant impairment. Age, stage, and baseline distress and physical condition were clinical determinants of body image, sexual activity, menopausal symptoms, distress, and dyspnea. Peripheral neuropathy, lymphedema, and dyspnea were reported, while grade 3 to 4 gastrointestinal, genitourinary, and musculoskeletal toxicities were rare. Conclusion Use of advanced EBRT and BRT techniques is associated with improving QoL in the first 3 years from treatment completion. Gastrointestinal, genitourinary, sexual, and psychosocial functions remain impaired on the long-term. Other late toxicities worth noting include peripheral neuropathy, lower limb edema, and insufficiency fractures.
局部晚期宫颈癌(LACC)的标准治疗是同步放化疗。近十年来,外束放疗(EBRT)和近距离放疗(BRT)的进展改善了局部控制和生存率。缺乏关于幸存者生活质量(QoL)的数据。目的本系统综述旨在综合已发表的LACC患者接受CRT治疗后生活质量的相关资料,探讨影响生活质量的临床因素。方法在PubMed、EBSCO和ScienceDirect中系统检索2010 ~ 2020年发表的相关文献。纳入了年龄在18岁及以上且报告CRT后生活质量的LACC幸存者的合格研究。筛选和数据提取由两对独立的审稿人完成。结果纳入5项队列研究、3项横断面研究和1项临床试验。报告的生活质量的时间演变各不相同:两项研究报告总体生活质量改善,而四项研究报告症状恶化。胃肠道、泌尿生殖系统、性和社会心理领域表现出明显的损害。年龄、阶段、基线痛苦和身体状况是身体形象、性活动、更年期症状、痛苦和呼吸困难的临床决定因素。周围神经病变、淋巴水肿和呼吸困难有报道,而3 - 4级胃肠道、泌尿生殖系统和肌肉骨骼毒性很少见。结论使用先进的EBRT和BRT技术与改善治疗完成后3年的生活质量有关。胃肠道、泌尿生殖系统、性功能和社会心理功能长期受损。其他值得注意的晚期毒性包括周围神经病变、下肢水肿和不全性骨折。
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引用次数: 1
Digital Mapping of a Massive Skull-Base Ameloblastoma with Intracranial Extension, Resection, and Reconstruction Using 3D Templates and Molds: Descriptive Case Report and Review 大量颅底成釉细胞瘤颅内扩展,切除和重建的数字测绘使用3D模板和模具:描述性病例报告和回顾
Pub Date : 2022-04-19 DOI: 10.1055/s-0042-1744555
V. Shetty, Akash Menon, N. Sharma, Fatema Boootwala
Radical surgery is the mainstay for the treatment of recurrent ameloblastomas; however, it leads to large, complex defects. In this case report, we present an innovative technique of digitally aided resection and reconstruction. A massive histologically confirmed acanthomatous ameloblastoma of the skull-base was digitally mapped with the help of three-dimensional (3D) computed tomography and a custom resection template was fabricated. Digital resection of the skull-base tumor with intracranial extension was done virtually and the resultant defect was reconstructed to create an anatomical replica of the contralateral unaffected side. The tumor was successfully resected with adequate margins guided by the resection template to avoid injury to adjacent vital structures. Subsequent reconstruction was performed by first adapting polymethyl methacrylate bone cement into a series of custom-made 3D molds. Once set, this bone cement served as a reconstructive implant to bridge the ablative defect. The implant offered a precise fit and was secured to healthy adjacent bone using titanium microplates. We present a 6-month follow-up of the case with satisfactory aesthetic results. 3D printing technology has the potential to revolutionize the arena of craniofacial resection with excellent cosmesis and no donor site morbidity if applied appropriately as described here.
根治性手术是治疗复发性成釉细胞瘤的主要手段;然而,它会导致大的、复杂的缺陷。在这个病例报告中,我们提出了一种数字辅助切除和重建的创新技术。在三维(3D)计算机断层扫描的帮助下,对一例经组织学证实的颅底棘皮瘤性成釉细胞瘤进行了数字定位,并制作了一个定制的切除模板。对颅内延伸的颅底肿瘤进行了数字化切除,并对由此产生的缺陷进行了重建,以创建对侧未受影响侧的解剖复制品。肿瘤在切除模板的引导下以足够的边缘成功切除,避免了对邻近重要结构的损伤。随后的重建首先将聚甲基丙烯酸甲酯骨水泥放入一系列定制的3D模具中。一旦凝固,这种骨水泥就可以作为重建植入物来桥接消融缺陷。植入物提供了精确的配合,并使用钛微型板固定在健康的相邻骨骼上。我们对该病例进行了6个月的随访,取得了令人满意的美学效果。如果如本文所述应用得当,3D打印技术有可能彻底改变颅面切除术领域,使其具有良好的美容效果,并且不会导致供区发病。
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引用次数: 0
Clinical Features, Treatment, and Outcomes of Retinoblastoma in China 中国视网膜母细胞瘤的临床特点、治疗和预后
Pub Date : 2022-04-19 DOI: 10.1055/s-0042-1744449
R. J. D. Tan
Background This review determined clinical features and treatment outcomes of retinoblastoma patients in China, which ranks second in incidence globally and is among the countries listed to produce 4,000 new cases of the estimated world's retinoblastoma cases in 2023. Methods A search was done using different databases for literatures on retinoblastoma in China published from 2010 to 2020. The articles were then reviewed for clinical features, treatment, and outcomes. Results Ten articles that included 3,702 patients involving ∼4,412 eyes seen in China from 1957 to 2019 were analyzed. Median age at consult ranged from 18 to 30 months and mean lag of consultation was 4 to 6 months. More males were affected (58%). Seventy-nine percent had unilateral disease. Retinoblastoma was assumed intraocular in 4,123(89%) eyes with ≥996(22%) belonging to group E of International Intraocular Retinoblastoma Classification/International Classification of Retinoblastoma. Extraocular extension was present in 415 (9%) eyes with 845 patients having direct extraocular extension, while 54 had distant metastasis. Enucleation was the most used treatment procedure specially in unilateral disease done in at least 2,781 (74%) eyes. Median follow-up period ranged from 14 to 47 months. Functional vision was retained in 48 (2%) eyes. Globe salvage rate for group A to D eyes ranged from 56 to 100%. Highest globe salvage rate for group D was 87% and 70% for group E. Overall survival rate was 1,655/1898 (87%), ranging from 81 to 100%. Overall mortality was 4%. Discussion Clinical profile and management options for retinoblastoma in China changed overtime improving outcomes. Globe salvage and survival rate were high for those with intraocular disease.
背景 这篇综述确定了中国视网膜母细胞瘤患者的临床特征和治疗结果,中国的发病率在全球排名第二,是2023年全球估计视网膜母细胞癌病例中新增4000例的国家之一。方法 使用不同的数据库检索2010年至2020年发表的关于中国视网膜母细胞瘤的文献。然后对这些文章的临床特征、治疗和结果进行回顾。后果 分析了1957年至2019年在中国看到的10篇文章,包括3702名患者,涉及~4412只眼睛。咨询时的中位年龄为18至30个月,咨询的平均滞后时间为4至6个月。受影响的男性更多(58%)。79%的患者患有单侧疾病。4123(89%)眼(≥996(22%)属于国际眼内视网膜母细胞瘤分类/国际视网膜母细胞癌分类的E组)的视网膜母细胞细胞瘤被认为是眼内的。415眼(9%)存在眼外转移,845名患者存在直接眼外转移;54名患者存在远处转移。去核术是最常用的治疗方法,尤其是对至少2781只(74%)眼睛的单侧疾病。中位随访期为14至47个月。48眼(2%)保持了功能性视力。A组至D组的眼球挽救率在56%至100%之间。D组和E组的全球最高挽救率分别为87%和70%。总生存率为1655/1898(87%),从81%到100%不等。总死亡率为4%。讨论 中国视网膜母细胞瘤的临床特征和治疗方案随着时间的推移而改变,改善了疗效。眼内疾病患者的眼球挽救率和生存率较高。
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引用次数: 2
Randomized Double-Blind Comparative Study of First Global Denosumab Biosimilar in Oncology 肿瘤领域首个全球Denosumab生物类似物的随机双盲比较研究
Pub Date : 2022-04-19 DOI: 10.1055/s-0042-1744505
Prasad Apsangikar, Prashant Shirsath, M. Naik, Sonya Vasudeva
Purpose The aim of this study was to compare first global biosimilar denosumab for the prevention of skeletal-related events (SREs) in patients with bone metastases from solid tumors. Methods It was a randomized, double-blind, comparative clinical study. Total of 136 patients of solid tumor were dosed (i.e., 102 subjects in study arm and 34 subjects in the reference arm) with initial double-blind period of 24 weeks (primary efficacy) followed by open-label phase till week 36. Primary endpoint was the incidence of first on-study SRE including hypercalcemia of malignancy with co-primary endpoint of median time to first on-study SRE. Secondary endpoints included mean number and time to first and subsequent on-study SREs (week 12, 24, 36), incidence/proportion of patients with first and subsequent on-study SREs (week 24, 36), change from baseline in nuclear bone scan, quality of life assessment, pharmacokinetics, pharmacodynamic, and safety. Results In biosimilar study arm, 06 (5.83%) patients suffered SRE from baseline to week 24 compared with 02 (5.71%) patients in reference arm with one (0.97%) patient showing pathological fracture in study arm and one (2.86%) patient having spinal cord compression in reference arm. There was no statistically significant difference in median time to first SRE, mean number of SRE/patient in both arms and improvement in bone repair on nuclear scan at 12, 24 and 36 weeks. Though the study arm showed better health-related quality of life (HRQoL), mean change in HRQoL was statistically not different in both the arms. Pharmacodynamics, serum bone-specific alkaline phosphatase, pharmacokinetic and safety evaluation did not show any statistical difference between arms. Conclusion There was no clinically meaningful difference in the biosimilar denosumab and reference product after detailed efficacy and safety evaluation.
意图 本研究的目的是比较第一个全球生物仿制药替诺沙单抗在实体瘤骨转移患者中预防骨骼相关事件(SRE)的作用。方法 这是一项随机、双盲、比较临床研究。共有136名实体瘤患者(即研究组102名受试者和参考组34名受试人)接受了给药,最初的双盲期为24周(主要疗效),随后是开放标签期,直到第36周。主要终点是首次研究SRE的发生率,包括恶性肿瘤的高钙血症,共同主要终点是第一次研究SRE中位时间。次要终点包括首次和随后的研究SRE的平均数量和时间(第12、24、36周),首次和随后研究SRE患者的发生率/比例(第24、36周),核骨扫描与基线相比的变化,生活质量评估,药代动力学,药效学和安全性。后果 在生物相似性研究组中,从基线到第24周,06名(5.83%)患者患有SRE,而参考组为02名(5.71%)患者,其中一名(0.97%)患者在研究组中出现病理性骨折,一名(2.86%)患者在参考组中出现脊髓压迫。在第12、24和36周时,首次SRE的中位时间、双臂SRE/患者的平均数量以及核扫描骨修复的改善没有统计学上的显著差异。尽管研究组显示出更好的健康相关生活质量(HRQoL),但两组的HRQoL平均变化在统计学上没有差异。药效学、血清骨特异性碱性磷酸酶、药代动力学和安全性评估没有显示出任何统计学差异。结论 经过详细的疗效和安全性评估,生物仿制药狄诺沙单抗和参考产品没有临床意义的差异。
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引用次数: 0
期刊
Asian Journal of Oncology
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