Pub Date : 2025-08-23DOI: 10.3760/cma.j.cn112152-20240922-00409
G B Li, X Y Qiu, X Zhang, L Xu, B Z Niu, G N Zhang, J Y Lu, B Wu, Y Xiao, G L Lin
Objective: To detect the association of tumor circumferential involvement range (CIR) with neoadjuvant chemoradiotherapy (NCRT) efficacy and long-term survival outcomes in locally advanced rectal cancer (LARC) patients. Methods: Clinical data of 451 patients admitted to our hospital from January, 2018 to January, 2022 were retrospectively collected. According to the CIRs as determined by rectal magnetic resonance imaging, patients were divided into the High group (≥2/3 cycle, 270 patients) and the Low group (＜2/3 cycle, 181 patients). The primary outcome was three-year disease-free survival. The baseline characteristics, pathological features, and survival outcomes were compared. Results: Compared to patients in the Low group, patients in the High group exhibited significantly larger tumor vertical diameters [(4.7±1.7) vs. (3.6±1.4)cm, P＜0.001], higher rates of mrT4 stage (37.8% vs. 13.2%, P＜0.001), and higher rates of positive mesorectal fascia (54.1% vs. 29.8%, P＜0.001) and extramural vascular invasion (55.6% vs. 38.1%, P＜0.001). Patients in the High group were mainly pT3-4 stages (46.7% vs. 30.9%, P=0.002), with significantly lower rates of pathological complete response (22.2% vs. 33.1%, P=0.010) , poorer tumor regression grades (48.9% vs. 60.8%, P=0.013), and higher rates of positive peripheral nerve invasion (11.5% vs. 5.5%, P=0.031), as compared to patients in the Low group. The median follow-up time was 40 months. About 11 (2.4%) and 48 patients (10.6%) experienced tumor local recurrence and distant metastasis, respectively. The recurrence rates were 2.2% and 2.6%, and the distant metastasis rates were 7.7% and 12.6%, respectively, in the Low group and the High group, with no statistical significance (P=0.957, P=0.096). The three-year disease-free survival in the High group was significantly lower than that in the Low group (84.4% vs. 92.4%, P=0.014). Conclusions: The CIR is closely related to tumor burden, which can judge tumor response to NCRT, and is negatively related to survival prognosis. For patients who have more than a 2/3 cycle of CIR, intensified or consolidated treatments may be required to improve survival outcomes.
目的：探讨局部晚期直肠癌（LARC）患者肿瘤周向浸润范围（CIR）与新辅助放化疗（NCRT）疗效和长期生存结局的关系。方法：回顾性收集我院2018年1月至2022年1月收治的451例患者的临床资料。根据直肠磁共振成像测定的CIRs分为高组（≥2/3周期，270例）和低组（<2/3周期，181例）。主要终点为三年无病生存期。比较基线特征、病理特征和生存结果。结果：与Low组患者相比，High组患者肿瘤垂直直径明显增大[（4.7±1.7）比（3.6±1.4）cm， P<0.001]， mrT4分期率（37.8%比13.2%，P<0.001），直肠系膜筋膜阳性率（54.1%比29.8%，P<0.001）和外血管侵犯率（55.6%比38.1%，P<0.001）。High组患者主要为pT3-4期（46.7% vs. 30.9%， P=0.002），与Low组患者相比，病理完全缓解率（22.2% vs. 33.1%， P=0.010）明显较低，肿瘤消退等级较差（48.9% vs. 60.8%， P=0.013），周围神经侵袭阳性率较高（11.5% vs. 5.5%， P=0.031）。中位随访时间为40个月。肿瘤局部复发11例（2.4%），远处转移48例（10.6%）。低、高组复发率分别为2.2%、2.6%，远处转移率分别为7.7%、12.6%，差异均无统计学意义（P=0.957、P=0.096）。High组3年无病生存率明显低于Low组（84.4%比92.4%，P=0.014）。结论：CIR与肿瘤负荷密切相关，可判断肿瘤对NCRT的反应，与生存预后呈负相关。对于超过2/3周期CIR的患者，可能需要强化或巩固治疗来改善生存结果。
{"title":"[Association of tumor circumferential involvement range with neoadjuvant therapy efficacy and long-term outcomes in locally advanced rectal cancer].","authors":"G B Li, X Y Qiu, X Zhang, L Xu, B Z Niu, G N Zhang, J Y Lu, B Wu, Y Xiao, G L Lin","doi":"10.3760/cma.j.cn112152-20240922-00409","DOIUrl":"10.3760/cma.j.cn112152-20240922-00409","url":null,"abstract":"<p><p><b>Objective:</b> To detect the association of tumor circumferential involvement range (CIR) with neoadjuvant chemoradiotherapy (NCRT) efficacy and long-term survival outcomes in locally advanced rectal cancer (LARC) patients. <b>Methods:</b> Clinical data of 451 patients admitted to our hospital from January, 2018 to January, 2022 were retrospectively collected. According to the CIRs as determined by rectal magnetic resonance imaging, patients were divided into the High group (≥2/3 cycle, 270 patients) and the Low group (＜2/3 cycle, 181 patients). The primary outcome was three-year disease-free survival. The baseline characteristics, pathological features, and survival outcomes were compared. <b>Results:</b> Compared to patients in the Low group, patients in the High group exhibited significantly larger tumor vertical diameters [(4.7±1.7) vs. (3.6±1.4)cm, <i>P＜</i>0.001], higher rates of mrT4 stage (37.8% vs. 13.2%, <i>P</i>＜0.001), and higher rates of positive mesorectal fascia (54.1% vs. 29.8%, <i>P</i>＜0.001) and extramural vascular invasion (55.6% vs. 38.1%, <i>P</i>＜0.001). Patients in the High group were mainly pT3-4 stages (46.7% vs. 30.9%, <i>P</i>=0.002), with significantly lower rates of pathological complete response (22.2% vs. 33.1%, <i>P</i>=0.010) , poorer tumor regression grades (48.9% vs. 60.8%, <i>P</i>=0.013), and higher rates of positive peripheral nerve invasion (11.5% vs. 5.5%, <i>P</i>=0.031), as compared to patients in the Low group. The median follow-up time was 40 months. About 11 (2.4%) and 48 patients (10.6%) experienced tumor local recurrence and distant metastasis, respectively. The recurrence rates were 2.2% and 2.6%, and the distant metastasis rates were 7.7% and 12.6%, respectively, in the Low group and the High group, with no statistical significance (<i>P</i>=0.957, <i>P</i>=0.096). The three-year disease-free survival in the High group was significantly lower than that in the Low group (84.4% vs. 92.4%, <i>P</i>=0.014). <b>Conclusions:</b> The CIR is closely related to tumor burden, which can judge tumor response to NCRT, and is negatively related to survival prognosis. For patients who have more than a 2/3 cycle of CIR, intensified or consolidated treatments may be required to improve survival outcomes.</p>","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"47 8","pages":"750-755"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856624","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}
Pub Date : 2025-08-23DOI: 10.3760/cma.j.cn112152-20240924-00411
J W Gan, D Y Cao
The sentinel lymph node (SLN) is the first group of lymph nodes involved in cancer metastasis. SLN biopsy (SLNB) refers to the positioning and biopsy of the SLNs in the operation using specific tracers to assess the status of lymph node metastasis. It has attracted increasing attention and has been applied in gynecological malignant tumors due to its less invasiveness, fewer complications, and high diagnostic rate. However, it also has produced a series of problems to be explored and solved. This review introduces the existing tracer methods, and discusses the indications of application and the clinical trials of SLNB in vulvar cancer, cervical cancer, and endometrial cancer in order to provide reference for the rational application of SLNB in gynecological malignant tumors.
{"title":"[Progress and clinical application of sentinel lymph node biopsy technique in gynecological malignant tumors].","authors":"J W Gan, D Y Cao","doi":"10.3760/cma.j.cn112152-20240924-00411","DOIUrl":"10.3760/cma.j.cn112152-20240924-00411","url":null,"abstract":"<p><p>The sentinel lymph node (SLN) is the first group of lymph nodes involved in cancer metastasis. SLN biopsy (SLNB) refers to the positioning and biopsy of the SLNs in the operation using specific tracers to assess the status of lymph node metastasis. It has attracted increasing attention and has been applied in gynecological malignant tumors due to its less invasiveness, fewer complications, and high diagnostic rate. However, it also has produced a series of problems to be explored and solved. This review introduces the existing tracer methods, and discusses the indications of application and the clinical trials of SLNB in vulvar cancer, cervical cancer, and endometrial cancer in order to provide reference for the rational application of SLNB in gynecological malignant tumors.</p>","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"47 8","pages":"689-695"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856648","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}
Pub Date : 2025-08-23DOI: 10.3760/cma.j.cn112152-20240906-00388
J Bu, K Ning, Y C Yu, Z Jiao, T Wu, Z Y Yang, W C Chen, A K Yang
Objective: To explore the long-term survival outcomes of patients with anaplastic thyroid cancer (ATC) and analyze key factors influencing the prognosis. Methods: A retrospective analysis was conducted on the clinical and follow-up data of 77 ATC patients treated at the Sun Yat-sen University Cancer Center from March 2000 to July 2022, with tumor-specific survival as the primary endpoint. The Kaplan-Meier method was used to plot the survival curves, and univariate and multivariate Cox regression analyses were performed to identify the prognostic factors. Results: Among the 77 patients, 64 underwent surgical treatment, with 33 receiving surgery alone, 8 undergoing surgery combined with chemotherapy, 13 undergoing surgery with radiotherapy, 1 undergoing surgery with chemotherapy and radiotherapy, 2 receiving surgery combined with chemotherapy and targeted therapy, 3 receiving surgery with targeted therapy, and 4 receiving surgery with immunotherapy and targeted therapy. Among the 13 patients who did not undergo surgery, 2 received chemotherapy alone, 3 received targeted therapy alone, 1 received immunotherapy alone, 1 received chemoradiotherapy, 5 received chemotherapy combined with immunotherapy, and 1 received immunotherapy combined with targeted therapy. The median follow-up time was 8.4 months, with 58 patients (75.3%) died, and the median survival time was 6.63 months. Univariate Cox regression analysis showed that C-reactive protein, monocyte count, lymphocyte count, abnormal albumin levels, the maximum diameter of the primary tumor, BMI, and whether immunotherapy was administered were significantly associated with survival in ATC patients (all P＜0.05). Multivariate Cox regression analysis indicated that immunotherapy was an independent factor for survival in ATC patients (HR=0.18, 95% CI: 0.05-0.62, P=0.007). Among the 40 patients admitted after 2015, the 11 patients who received immunotherapy had a median survival time of 17.2 months, which was superior to the 29 patients who did not receive this treatment (median survival time 6.2 months, P=0.03). Conclusions: ATC patients receiving immunotherapy had a better prognosis and longer survival. Additionally, elevated C-reactive protein, abnormal albumin, monocyte count, lymphocyte count, and BMI might be associated with poorer prognosis in ATC. Tailoring treatment based on the individual characteristics of ATC patients may be beneficial for their long-term survival.
{"title":"[Analysis of factors affecting long-term survival in patients with anaplastic thyroid carcinoma and the efficacy of immunotherapy].","authors":"J Bu, K Ning, Y C Yu, Z Jiao, T Wu, Z Y Yang, W C Chen, A K Yang","doi":"10.3760/cma.j.cn112152-20240906-00388","DOIUrl":"10.3760/cma.j.cn112152-20240906-00388","url":null,"abstract":"<p><p><b>Objective:</b> To explore the long-term survival outcomes of patients with anaplastic thyroid cancer (ATC) and analyze key factors influencing the prognosis. <b>Methods:</b> A retrospective analysis was conducted on the clinical and follow-up data of 77 ATC patients treated at the Sun Yat-sen University Cancer Center from March 2000 to July 2022, with tumor-specific survival as the primary endpoint. The Kaplan-Meier method was used to plot the survival curves, and univariate and multivariate Cox regression analyses were performed to identify the prognostic factors. <b>Results:</b> Among the 77 patients, 64 underwent surgical treatment, with 33 receiving surgery alone, 8 undergoing surgery combined with chemotherapy, 13 undergoing surgery with radiotherapy, 1 undergoing surgery with chemotherapy and radiotherapy, 2 receiving surgery combined with chemotherapy and targeted therapy, 3 receiving surgery with targeted therapy, and 4 receiving surgery with immunotherapy and targeted therapy. Among the 13 patients who did not undergo surgery, 2 received chemotherapy alone, 3 received targeted therapy alone, 1 received immunotherapy alone, 1 received chemoradiotherapy, 5 received chemotherapy combined with immunotherapy, and 1 received immunotherapy combined with targeted therapy. The median follow-up time was 8.4 months, with 58 patients (75.3%) died, and the median survival time was 6.63 months. Univariate Cox regression analysis showed that C-reactive protein, monocyte count, lymphocyte count, abnormal albumin levels, the maximum diameter of the primary tumor, BMI, and whether immunotherapy was administered were significantly associated with survival in ATC patients (all <i>P</i>＜0.05). Multivariate Cox regression analysis indicated that immunotherapy was an independent factor for survival in ATC patients (<i>HR</i>=0.18, 95% <i>CI</i>: 0.05-0.62, <i>P</i>=0.007). Among the 40 patients admitted after 2015, the 11 patients who received immunotherapy had a median survival time of 17.2 months, which was superior to the 29 patients who did not receive this treatment (median survival time 6.2 months, <i>P</i>=0.03). <b>Conclusions:</b> ATC patients receiving immunotherapy had a better prognosis and longer survival. Additionally, elevated C-reactive protein, abnormal albumin, monocyte count, lymphocyte count, and BMI might be associated with poorer prognosis in ATC. Tailoring treatment based on the individual characteristics of ATC patients may be beneficial for their long-term survival.</p>","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"47 8","pages":"756-762"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856622","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}
Pub Date : 2025-08-23DOI: 10.3760/cma.j.cn112152-20241223-00583
J Feng, J B Yin, L Cui
Lung cancer is one of the leading causes of cancer-related mortality worldwide. Low-dose CT screening can increase the detection rate of early-stage lung cancer and reduce lung cancer mortality. This article compares and analyzes the latest Japanese and Chinese guidelines for low-dose CT lung cancer screening, exploring the commonalities and differences between the two countries in the construction of lung cancer screening systems and the detailed management of lung nodules. Both guidelines emphasize the importance of age and smoking in selecting screening candidates, but the specific criteria differ. The Japanese guideline targets heavy smokers aged 50-74 years, while its Chinese counterpart targets a broader high-risk population, including individuals with different ages, smoking histories, occupational exposures, and family genetic factors. In terms of equipment and radiation dose requirements, both guidelines consider individualization, but there are differences in specific values and methods. Regarding imaging and post-processing analysis, the Chinese guideline provides more detailed technical specifications, emphasizing the use of various post-processing techniques. In lung nodule management strategies, both guidelines adopt nodule classification, but there are differences in nodule size assessment criteria and follow-up intervention procedures, with the Chinese guideline placing greater emphasis on multidisciplinary team consultations. The Japanese guideline highlights easily overlooked imaging features of lung cancer and non-nodule manifestations, while the Chinese guideline emphasizes the integration of smoking cessation and lung cancer screening. Overall, the guidelines of the two countries share commonalities in many aspects of lung cancer screening but also have their own characteristics, and learning from each other can help improve lung cancer screening systems.
{"title":"[Comparative analysis on the 2024 Japanese guidelines for management of lung nodules detected by low-dose CT lung cancer screening and the 2023 Chinese guidelines for low-dose CT lung cancer screening].","authors":"J Feng, J B Yin, L Cui","doi":"10.3760/cma.j.cn112152-20241223-00583","DOIUrl":"10.3760/cma.j.cn112152-20241223-00583","url":null,"abstract":"<p><p>Lung cancer is one of the leading causes of cancer-related mortality worldwide. Low-dose CT screening can increase the detection rate of early-stage lung cancer and reduce lung cancer mortality. This article compares and analyzes the latest Japanese and Chinese guidelines for low-dose CT lung cancer screening, exploring the commonalities and differences between the two countries in the construction of lung cancer screening systems and the detailed management of lung nodules. Both guidelines emphasize the importance of age and smoking in selecting screening candidates, but the specific criteria differ. The Japanese guideline targets heavy smokers aged 50-74 years, while its Chinese counterpart targets a broader high-risk population, including individuals with different ages, smoking histories, occupational exposures, and family genetic factors. In terms of equipment and radiation dose requirements, both guidelines consider individualization, but there are differences in specific values and methods. Regarding imaging and post-processing analysis, the Chinese guideline provides more detailed technical specifications, emphasizing the use of various post-processing techniques. In lung nodule management strategies, both guidelines adopt nodule classification, but there are differences in nodule size assessment criteria and follow-up intervention procedures, with the Chinese guideline placing greater emphasis on multidisciplinary team consultations. The Japanese guideline highlights easily overlooked imaging features of lung cancer and non-nodule manifestations, while the Chinese guideline emphasizes the integration of smoking cessation and lung cancer screening. Overall, the guidelines of the two countries share commonalities in many aspects of lung cancer screening but also have their own characteristics, and learning from each other can help improve lung cancer screening systems.</p>","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"47 8","pages":"763-768"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856625","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}
Pub Date : 2025-08-23DOI: 10.3760/cma.j.cn112152-20231006-00164
S Y Shi, X C Jia, Y L Yang, N Sun, Y Zhang, W Wang
Objective: To investigate the survival outcomes and prognostic factors of patients with double primary breast cancer (BC) and endometrial cancer (EC). Methods: A retrospective cohort study was conducted using data for the period 1992-2018 from the Surveillance, Epidemiology, and End Results (SEER) database. There were 3 465 patients with BC as the first primary cancer (BC-EC group) and 2 804 patients with EC as the first primary cancer (EC-BC group). Kaplan-Meier analysis and cumulative incidence function were used to estimate overall mortality, breast cancer-specific mortality, and endometrial cancer-specific mortality, respectively. Cox regression and Fine-Gray regression were used to analyze the prognostic factors of overall mortality, breast cancer-specific mortality, and endometrial cancer-specific mortality, respectively. Results: During a median follow-up of 160 months, 1 616 deaths occurred in the BC-EC group, with EC being the leading cause of death (37.69%); 994 deaths occurred in the EC-BC group, with BC being the leading cause of death (28.77%). Cox regression identified patients with older ages at first primary cancer diagnosis (54-61 years: HR=1.46, 95% CI: 1.26-1.69; 62-68 years: HR=2.64, 95% CI: 2.29-3.03; ≥69 years: HR=4.89, 95% CI: 4.27-5.60), shorter time interval between the diagnoses (0-5 months: HR=6.13, 95% CI: 5.21-7.21; 6-23 months: HR=5.69, 95% CI: 4.95-6.55; 24-59 months: HR=3.44, 95% CI: 3.04-3.89; 60-119 months: HR=2.32, 95% CI: 2.07-2.59), mixed ductal-lobular BC (HR=1.29, 95% CI: 1.11-1.48), endometrial mixed cell adenocarcinoma (HR=1.23, 95% CI: 1.01-1.50), advanced tumor grade (grade Ⅱ BC: HR=1.13, 95% CI: 1.01-1.27; grade Ⅲ BC: HR=1.24, 95% CI: 1.10-1.41; grade Ⅱ EC: HR=1.19, 95% CI: 1.06-1.33; grade Ⅲ EC: HR=1.68, 95% CI: 1.48-1.90), advanced tumor stage of the two cancers (distant BC: HR=3.14, 95% CI: 2.50-3.94; regional EC: HR=1.53, 95% CI: 1.36-1.71; distant EC: HR=3.00, 95% CI: 2.59-3.47) had increased risk of overall mortality. Fine-Gray regression showed that compared with BC-EC patients, EC-BC patients had a higher risk of breast cancer-specific mortality [sub-distribution hazard ratio (sHR=1.24, 95% CI: 1.04-1.47], but a lower risk of endometrial cancer-specific mortality (sHR=0.37, 95% CI: 0.30-0.46). Older ages at first cancer diagnosis, shorter intervals between the diagnoses, negative ER and PR status, and advanced BC grades/stages were associated with increased breast cancer-specific mortality (P＜0.05). Similarly, older ages, shorter intervals, endometrial serous carcinoma/mixed cell adenocarcinoma, and advanced EC grades/stages correlated with elevated endometrial cancer-specific mortality (P＜0.05). Conclusi
{"title":"[Prognostic analysis of double primary breast cancer and endometrial cancer patients based on SEER database].","authors":"S Y Shi, X C Jia, Y L Yang, N Sun, Y Zhang, W Wang","doi":"10.3760/cma.j.cn112152-20231006-00164","DOIUrl":"10.3760/cma.j.cn112152-20231006-00164","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the survival outcomes and prognostic factors of patients with double primary breast cancer (BC) and endometrial cancer (EC). <b>Methods:</b> A retrospective cohort study was conducted using data for the period 1992-2018 from the Surveillance, Epidemiology, and End Results (SEER) database. There were 3 465 patients with BC as the first primary cancer (BC-EC group) and 2 804 patients with EC as the first primary cancer (EC-BC group). Kaplan-Meier analysis and cumulative incidence function were used to estimate overall mortality, breast cancer-specific mortality, and endometrial cancer-specific mortality, respectively. Cox regression and Fine-Gray regression were used to analyze the prognostic factors of overall mortality, breast cancer-specific mortality, and endometrial cancer-specific mortality, respectively. <b>Results:</b> During a median follow-up of 160 months, 1 616 deaths occurred in the BC-EC group, with EC being the leading cause of death (37.69%); 994 deaths occurred in the EC-BC group, with BC being the leading cause of death (28.77%). Cox regression identified patients with older ages at first primary cancer diagnosis (54-61 years: <i>HR</i>=1.46, 95% <i>CI:</i> 1.26-1.69; 62-68 years: <i>HR</i>=2.64, 95% <i>CI</i>: 2.29-3.03; ≥69 years: <i>HR</i>=4.89, 95% <i>CI</i>: 4.27-5.60), shorter time interval between the diagnoses (0-5 months: <i>HR</i>=6.13, 95% <i>CI</i>: 5.21-7.21; 6-23 months: <i>HR</i>=5.69, 95% <i>CI</i>: 4.95-6.55; 24-59 months: <i>HR</i>=3.44, 95% <i>CI</i>: 3.04-3.89; 60-119 months: <i>HR</i>=2.32, 95% <i>CI</i>: 2.07-2.59), mixed ductal-lobular BC (<i>HR</i>=1.29, 95% <i>CI</i>: 1.11-1.48), endometrial mixed cell adenocarcinoma (<i>HR</i>=1.23, 95% <i>CI</i>: 1.01-1.50), advanced tumor grade (grade Ⅱ BC: <i>HR</i>=1.13, 95% <i>CI</i>: 1.01-1.27; grade Ⅲ BC: <i>HR</i>=1.24, 95% <i>CI</i>: 1.10-1.41; grade Ⅱ EC: <i>HR</i>=1.19, 95% <i>CI</i>: 1.06-1.33; grade Ⅲ EC: <i>HR</i>=1.68, 95% <i>CI</i>: 1.48-1.90), advanced tumor stage of the two cancers (distant BC: <i>HR</i>=3.14, 95% <i>CI</i>: 2.50-3.94; regional EC: <i>HR</i>=1.53, 95% <i>CI</i>: 1.36-1.71; distant EC: <i>HR</i>=3.00, 95% <i>CI</i>: 2.59-3.47) had increased risk of overall mortality. Fine-Gray regression showed that compared with BC-EC patients, EC-BC patients had a higher risk of breast cancer-specific mortality [sub-distribution hazard ratio (s<i>HR</i>=1.24, 95% <i>CI</i>: 1.04-1.47], but a lower risk of endometrial cancer-specific mortality (s<i>HR</i>=0.37, 95% <i>CI</i>: 0.30-0.46). Older ages at first cancer diagnosis, shorter intervals between the diagnoses, negative ER and PR status, and advanced BC grades/stages were associated with increased breast cancer-specific mortality (<i>P</i>＜0.05). Similarly, older ages, shorter intervals, endometrial serous carcinoma/mixed cell adenocarcinoma, and advanced EC grades/stages correlated with elevated endometrial cancer-specific mortality (<i>P</i>＜0.05). <b>Conclusi","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"47 8","pages":"734-744"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856647","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}
Pub Date : 2025-08-23DOI: 10.3760/cma.j.cn112152-20240623-00263
X Q Mu, C N Yu, Y Q Zhao, X F Hu, H B Wu
Objective: To investigate the effects and underlying molecular mechanisms of Utidelone (UTD1) in small cell lung cancer (SCLC). Methods: The study utilized small cell lung cancer H446 and H1048 cell lines along with animal models. Cell proliferation, cell cycle progression, apoptosis, autophagy, and related activities following UTD1 treatment were assessed using Cell Counting Kit-8 (CCK-8), flow cytometry, immunofluorescence staining, reactive oxygen species (ROS) generation assay, and Western blot analysis. The involvement of the ROS/adenosine monophosphate-activated protein kinase (AMPK) signaling pathway was also examined. Data analysis was performed using GraphPad Prism version 8 software. Results: UTD1 inhibited the viability of H446 and H1048 cells in a dose- and time-dependent manner. The half inhibitory concentrations (IC50) of UTD1 for H446 and H1048 cells were 0.675 and 0.439 μg/ml, respectively. The proportion of cells in the G2/M phase for H446 and H1048 cells in the UTD1 group at 6 h, 12 h, and 24 h was [(53.86±4.54)%, (68.59±5.49)%, (60.89±3.26)%] and [(46.83±2.20)%, (60.67±3.44)%, (57.88±5.11)%], which were significantly higher than that in the control group, except for the proportion of H1048 cells at 6 h [(38.99±2.60)% vs. (40.73±2.50)%, P＜0.05]. The apoptosis rates were [(23.57±0.12)%, (35.79±1.59)%, and (46.15±4.57)%] for H446 cells and [(23.05±2.70)%, (37.73±2.97)%, and (43.39±3.31)% for H1048 cells], all of which were significantly higher than those in the control group [(6.44±0.96)%, (6.31±0.75)%, respectively; all P＜0.05]. The number of LC3 fluorescent spots was [(56±11), (69±8), and (66±8)] for H446 cells and [(39±7), (56±12), and (50±11)] for H1048 cells, both significantly higher than those in the control group [(13±6) and (12±5), respectively; both P＜0.05]. The relative fluorescence intensity of ROS was 2.54±0.48, 2.85±0.68, and 5.03±0.72 for H446 cells and 2.26±0.51, 4.17±0.35, and 4.66±0.51 for H1048 cells, which were also significantly higher than those in the control group (P＜0.05). The expression levels of cyclin B1, cyclin A2, and P21 of H446 cells in the three time points were [(0.63±0.07, 0.33±0.05, 0.23±0.04), (0.68±0.08, 0.46±0.03, 0.27±0.06), and (0.64±0.03, 0.32±0.05, 0.22±0.03), respectively], all significantly lower compared to the control group (P＜0.05). The apoptosis rates of H446 and H1048 cells in the UTD1+Z-VAD-FMK group were (19.97±3.19)% and (17.68±3.14)%, both lower than those in the UTD1 group [(40.73±3.35)% and (39.82±2.45)%, respectively; all P＜0.05]. The absorbance values of H446 and H1048 cells in the UTD1+3-MA group were significantly higher than those in the UTD1 group at 6h, 12h, and 24h (all P＜0.05). The levels of p-AMPKα/AMPKα, LC3-II expression, and the percentage of apoptotic cells in the H446 and H1048 cells of the UTD1+NAC group were [(1.33±0.09, 1.33±0.11), (1.49±0.16, 1.55±0.05), (17.24
{"title":"[Utidelone induces apoptosis and autophagy in small cell lung cancer cells through the ROS/AMPK signaling pathway].","authors":"X Q Mu, C N Yu, Y Q Zhao, X F Hu, H B Wu","doi":"10.3760/cma.j.cn112152-20240623-00263","DOIUrl":"10.3760/cma.j.cn112152-20240623-00263","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effects and underlying molecular mechanisms of Utidelone (UTD1) in small cell lung cancer (SCLC). <b>Methods:</b> The study utilized small cell lung cancer H446 and H1048 cell lines along with animal models. Cell proliferation, cell cycle progression, apoptosis, autophagy, and related activities following UTD1 treatment were assessed using Cell Counting Kit-8 (CCK-8), flow cytometry, immunofluorescence staining, reactive oxygen species (ROS) generation assay, and Western blot analysis. The involvement of the ROS/adenosine monophosphate-activated protein kinase (AMPK) signaling pathway was also examined. Data analysis was performed using GraphPad Prism version 8 software. <b>Results:</b> UTD1 inhibited the viability of H446 and H1048 cells in a dose- and time-dependent manner. The half inhibitory concentrations (IC<sub>50</sub>) of UTD1 for H446 and H1048 cells were 0.675 and 0.439 μg/ml, respectively. The proportion of cells in the G<sub>2</sub>/M phase for H446 and H1048 cells in the UTD1 group at 6 h, 12 h, and 24 h was [(53.86±4.54)%, (68.59±5.49)%, (60.89±3.26)%] and [(46.83±2.20)%, (60.67±3.44)%, (57.88±5.11)%], which were significantly higher than that in the control group, except for the proportion of H1048 cells at 6 h [(38.99±2.60)% vs. (40.73±2.50)%, <i>P</i>＜0.05]. The apoptosis rates were [(23.57±0.12)%, (35.79±1.59)%, and (46.15±4.57)%] for H446 cells and [(23.05±2.70)%, (37.73±2.97)%, and (43.39±3.31)% for H1048 cells], all of which were significantly higher than those in the control group [(6.44±0.96)%, (6.31±0.75)%, respectively; all <i>P</i>＜0.05]. The number of LC3 fluorescent spots was [(56±11), (69±8), and (66±8)] for H446 cells and [(39±7), (56±12), and (50±11)] for H1048 cells, both significantly higher than those in the control group [(13±6) and (12±5), respectively; both <i>P</i>＜0.05]. The relative fluorescence intensity of ROS was 2.54±0.48, 2.85±0.68, and 5.03±0.72 for H446 cells and 2.26±0.51, 4.17±0.35, and 4.66±0.51 for H1048 cells, which were also significantly higher than those in the control group (<i>P</i>＜0.05). The expression levels of cyclin B1, cyclin A2, and P21 of H446 cells in the three time points were [(0.63±0.07, 0.33±0.05, 0.23±0.04), (0.68±0.08, 0.46±0.03, 0.27±0.06), and (0.64±0.03, 0.32±0.05, 0.22±0.03), respectively], all significantly lower compared to the control group (<i>P</i>＜0.05). The apoptosis rates of H446 and H1048 cells in the UTD1+Z-VAD-FMK group were (19.97±3.19)% and (17.68±3.14)%, both lower than those in the UTD1 group [(40.73±3.35)% and (39.82±2.45)%, respectively; all <i>P</i>＜0.05]. The absorbance values of H446 and H1048 cells in the UTD1+3-MA group were significantly higher than those in the UTD1 group at 6h, 12h, and 24h (all <i>P</i>＜0.05). The levels of p-AMPKα/AMPKα, LC3-II expression, and the percentage of apoptotic cells in the H446 and H1048 cells of the UTD1+NAC group were [(1.33±0.09, 1.33±0.11), (1.49±0.16, 1.55±0.05), (17.24","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"47 8","pages":"703-714"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856649","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}
Pub Date : 2025-08-23DOI: 10.3760/cma.j.cn112152-20241031-00469
Y J Gu, H M Xu, Q Y Li, F Yuan, L Dong, C F Wang
Objective: This study investigated the underlying causes of discordance between multiplex fluorescence polymerase chain reaction (PCR)-capillary electrophoresis in determining MSI and immunohistochemistry (IHC) for mismatch repair (MMR) protein evaluation in gastrointestinal adenocarcinomas, aiming to improve interpretation accuracy and guide clinical precision treatment strategies. Methods: A retrospective analysis was conducted on 511 surgically resected or biopsied specimens (161 gastric adenocarcinomas and 350 colorectal adenocarcinomas) diagnosed at the Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to June 2024. MMR protein expression of tumors was evaluated by IHC, while MSI status was assessed using the 2B3D National Cancer Institute (NCI) Panel through multiplex fluorescence PCR-capillary electrophoresis on tumor DNA and matched normal DNA. The concordance between the two methods was analyzed, and factors contributing to the discordance were investigated. Cases with unstable dinucleotide loci only in the 2B3D NCI Panel, focal MMR protein loss, or unexplained discrepancies underwent validation using the non-NCI Panel through multiplex fluorescence PCR-capillary electrophoresis markers or next-generation sequencing (NGS). Results: In the 511 gastrointestinal adenocarcinomas, the results of the two methods were discordant in 15 cases (2.9%), with a significantly higher discordantrate in gastric cancers (7.5%, 12/161) compared to colorectal cancers (0.9%, 3/350; P＜0.001). Key contributors to the discordance included: sampling limitations (6 cases), 2B3D NCI Panel design constraints (3 cases),tumor heterogeneity (3 cases),isolated MSH6 deficiency (1 case),and unexplained discrepancies (2 cases).Validation studies demonstrated that cases with dinucleotide-only instability showed concordance with IHC after using the non-NCI Panel through multiplex fluorescence PCR-capillary electrophoresis and NGS verifications. Specimens with focal MMR protein loss and unexplained discrepancies aligned with initial PCR results upon NGS validation. Unexplained cases harbored Kirsten rat sarcoma class Ⅰ variants and multiple class Ⅱ genetic alterations. Conclusions: Colorectal adenocarcinoma demonstrated higher concordance between PCR-capillary electrophoresis and IHC than gastric adenocarcinoma.Discordant results require systematic evaluation including technical review, specimen quality control, and supplemental NGS analysis to resolve discrepancies.
{"title":"[Analysis of discordant results between multiplex fluorescence PCR-capillary electrophoresis for microsatellite instability (MSI) detection and immunohistochemistry (IHC) for mismatch repair (MMR) protein expression in gastrointestinal adenocarcinoma].","authors":"Y J Gu, H M Xu, Q Y Li, F Yuan, L Dong, C F Wang","doi":"10.3760/cma.j.cn112152-20241031-00469","DOIUrl":"10.3760/cma.j.cn112152-20241031-00469","url":null,"abstract":"<p><p><b>Objective:</b> This study investigated the underlying causes of discordance between multiplex fluorescence polymerase chain reaction (PCR)-capillary electrophoresis in determining MSI and immunohistochemistry (IHC) for mismatch repair (MMR) protein evaluation in gastrointestinal adenocarcinomas, aiming to improve interpretation accuracy and guide clinical precision treatment strategies. <b>Methods:</b> A retrospective analysis was conducted on 511 surgically resected or biopsied specimens (161 gastric adenocarcinomas and 350 colorectal adenocarcinomas) diagnosed at the Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to June 2024. MMR protein expression of tumors was evaluated by IHC, while MSI status was assessed using the 2B3D National Cancer Institute (NCI) Panel through multiplex fluorescence PCR-capillary electrophoresis on tumor DNA and matched normal DNA. The concordance between the two methods was analyzed, and factors contributing to the discordance were investigated. Cases with unstable dinucleotide loci only in the 2B3D NCI Panel, focal MMR protein loss, or unexplained discrepancies underwent validation using the non-NCI Panel through multiplex fluorescence PCR-capillary electrophoresis markers or next-generation sequencing (NGS). <b>Results:</b> In the 511 gastrointestinal adenocarcinomas, the results of the two methods were discordant in 15 cases (2.9%), with a significantly higher discordantrate in gastric cancers (7.5%, 12/161) compared to colorectal cancers (0.9%, 3/350; <i>P</i>＜0.001). Key contributors to the discordance included: sampling limitations (6 cases), 2B3D NCI Panel design constraints (3 cases),tumor heterogeneity (3 cases),isolated MSH6 deficiency (1 case),and unexplained discrepancies (2 cases).Validation studies demonstrated that cases with dinucleotide-only instability showed concordance with IHC after using the non-NCI Panel through multiplex fluorescence PCR-capillary electrophoresis and NGS verifications. Specimens with focal MMR protein loss and unexplained discrepancies aligned with initial PCR results upon NGS validation. Unexplained cases harbored Kirsten rat sarcoma class Ⅰ variants and multiple class Ⅱ genetic alterations. <b>Conclusions:</b> Colorectal adenocarcinoma demonstrated higher concordance between PCR-capillary electrophoresis and IHC than gastric adenocarcinoma.Discordant results require systematic evaluation including technical review, specimen quality control, and supplemental NGS analysis to resolve discrepancies.</p>","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"47 8","pages":"715-725"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856621","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}
Pub Date : 2025-08-23DOI: 10.3760/cma.j.cn112152-20241029-00467
Y M Ma, W L Xia, D B Wang, H Wu, M C Zhang, S X Cheng
Objective: To explore the safety and efficacy of computed tomography (CT) guided percutaneous interstitial brachytherapy in the treatment of recurrent cervical cancer with isolated lesions in the radiated field. Methods: A retrospective analysis was conducted on the clinical data of 30 patients with recurrent cervical cancer with isolated lesions in the radiated field who underwent CT guided percutaneous interstitial implantation for close range radiation treatment at Zhengzhou University Affiliated Cancer Hospital from March 2023 to August 2024. Under local anesthesia, a needle was implanted into the recurrent tumor in the pelvic or abdominal wall of the patients percutaneously guided by CT. The target area was delineated to ensure full dose coverage. The prescribed dose for high-risk clinical target areas was 600 cGy/time, once a week, followed by close range radiotherapy. The number of implanted needles were recorded, and the target area, radiation dose, and other parameters were evaluated through dose volume parameter maps. The degree of lesion shrinkage and the occurrence of complications during and after treatment were observed. Results: 30 patients underwent a total of 72 rounds of brachytherapy with implantation, with a technical success rate of 100% (72/72). 20 cases received 2 treatments, 8 cases received 3 treatments, and 2 cases received 4 treatments; 4 cases used 1needle, 20 cases used 2 needles, 4 cases used 3 needles, and 2 cases used 4 needles. The high-risk clinical target dose D90 was (718.17±222.61) cGy. The average dose D2cc of 2 cm3 surrounding the bladder, rectum, sigmoid colon, and small intestine was (168.29±53.80) cGy, (178.87±105.38) cGy, (136.05±78.06) cGy, and (288.91±117.49) cGy, respectively. The median follow-up time was 11 months. Among the 30 patients, there were 12 cases of complete remission,14 cases of partial remission, 3 cases of stable disease, and 1 case of disease progression, with an objective remission rate of 86.7%. None of the patients experienced significant bleeding or pain during treatment. After treatment, 3 patients with recurrent lymph nodes near the rectum developed grade 1 radiation proctitis, which was remitted after treatment. No significant complications were observed in the remaining patients. Conclusion: CT guided percutaneous brachytherapy is safe and feasible for the recurrence of single lesions in the radiated field of cervical cancer.
{"title":"[Application of CT guided percutaneous interstitial brachytherapy in the treatment of recurrent cervical cancer with isolated lesions in the radiated field].","authors":"Y M Ma, W L Xia, D B Wang, H Wu, M C Zhang, S X Cheng","doi":"10.3760/cma.j.cn112152-20241029-00467","DOIUrl":"10.3760/cma.j.cn112152-20241029-00467","url":null,"abstract":"<p><p><b>Objective:</b> To explore the safety and efficacy of computed tomography (CT) guided percutaneous interstitial brachytherapy in the treatment of recurrent cervical cancer with isolated lesions in the radiated field. <b>Methods:</b> A retrospective analysis was conducted on the clinical data of 30 patients with recurrent cervical cancer with isolated lesions in the radiated field who underwent CT guided percutaneous interstitial implantation for close range radiation treatment at Zhengzhou University Affiliated Cancer Hospital from March 2023 to August 2024. Under local anesthesia, a needle was implanted into the recurrent tumor in the pelvic or abdominal wall of the patients percutaneously guided by CT. The target area was delineated to ensure full dose coverage. The prescribed dose for high-risk clinical target areas was 600 cGy/time, once a week, followed by close range radiotherapy. The number of implanted needles were recorded, and the target area, radiation dose, and other parameters were evaluated through dose volume parameter maps. The degree of lesion shrinkage and the occurrence of complications during and after treatment were observed. <b>Results:</b> 30 patients underwent a total of 72 rounds of brachytherapy with implantation, with a technical success rate of 100% (72/72). 20 cases received 2 treatments, 8 cases received 3 treatments, and 2 cases received 4 treatments; 4 cases used 1needle, 20 cases used 2 needles, 4 cases used 3 needles, and 2 cases used 4 needles. The high-risk clinical target dose D<sub>90</sub> was (718.17±222.61) cGy. The average dose D<sub>2cc</sub> of 2 cm<sup>3</sup> surrounding the bladder, rectum, sigmoid colon, and small intestine was (168.29±53.80) cGy, (178.87±105.38) cGy, (136.05±78.06) cGy, and (288.91±117.49) cGy, respectively. The median follow-up time was 11 months. Among the 30 patients, there were 12 cases of complete remission,14 cases of partial remission, 3 cases of stable disease, and 1 case of disease progression, with an objective remission rate of 86.7%. None of the patients experienced significant bleeding or pain during treatment. After treatment, 3 patients with recurrent lymph nodes near the rectum developed grade 1 radiation proctitis, which was remitted after treatment. No significant complications were observed in the remaining patients. <b>Conclusion:</b> CT guided percutaneous brachytherapy is safe and feasible for the recurrence of single lesions in the radiated field of cervical cancer.</p>","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"47 8","pages":"745-749"},"PeriodicalIF":0.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856623","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}
Pub Date : 2025-07-23DOI: 10.3760/cma.j.cn112152-20250403-00147
R H Song, Y Wang
Objective: To explore the effects and prognosis of heavy ion therapy for thoracic and abdominal malignant tumors under different frequency settings of high-frequency oscillatory breathing control. Methods: A prospective randomized controlled trial was conducted on 45 patients with thoracic and abdominal malignant tumors who received heavy ion therapy under high-frequency oscillatory ventilation (HFOV) control at Gansu Wuwei Tumour Hospital from January 2023 to December 2024. The patients were randomly divided into three groups by block randomization, with 15 patients in each group, and they received different HFOV frequency settings (6 Hz, 7 Hz and 8 Hz, i.e., 360 breaths/min, 420 breaths/min and 480 breaths/min), while other parameters were kept constant (oxygen concentration: 40%, mean airway pressure: 10 cmH2O, amplitude: 6cm). The arterial blood gas, transcutaneous carbon dioxide partial pressure/transcutaneous oxygen partial pressure (TcPCO2/TcPO2), duration of HFOV ventilation, duration of invasive mechanical ventilation, length of hospital stay and complications of the patients under different frequency settings were analyzed. Results: Before and after treatment, there was no statistically significant difference in arterial blood gas parameters (PaCO2, PaO2), oxygenation index, blood lactate, bicarbonate ion) among the 6 Hz,7 Hz and 8 Hz HFOV frequency groups (all P＞0.05). At 30 minutes, 60 minutes, 120 minutes of treatment and at extubation, there was no statistically significant difference in TcPCO2, TcPO2, SpO2 and heart rate among the 6 Hz, 7 Hz and 8 Hz HFOV frequency groups (all P＞0.05). The HFOV duration of the 6 Hz, 7 Hz and 8 Hz HFOV frequency groups was (131.7±8.4) minutes, (125.3±6.9) minutes and (115.7±10.5) minutes, respectively; the duration of invasive mechanical ventilation was (212.3±21.2) minutes, (190.7±14.8) minutes and (199.3±18.4) minutes, respectively; the tumor shrinkage rate was (53.1±6.1)%, (64.7±5.1)% and (63.0±6.2)%, respectively; and the hospital stay was (22.7±2.9) days, (22.3±3.1) days and (20.8±3.3) days, respectively. There was no statistically significant difference among the groups (all P＞0.05). Only one patient developed reversible hypercapnia, which returned to the normal range within 30 minutes after adjusting the invasive ventilator parameters. No treatment-related adverse events such as hypoxemia, radiation pneumonitis, or hemodynamic instability occurred in any of the subjects. Conclusions: HFOV management under heavy ion therapy for thoracoabdominal malignancies shows no significant changes in arterial blood gas analysis before and after treatment at different frequencies (6 Hz, 7 Hz, 8 Hz). Continuous monitoring of transcutaneous TcPCO2/TcPO2 is stable. The treatment process is safe, with few complications and good results.
{"title":"[Influence of varying frequency parameters in high-frequency oscillatory ventilation on the therapeutic efficacy of heavy ion radiotherapy in patients with thoracic and abdominal neoplasms: a prospective randomized controlled trial].","authors":"R H Song, Y Wang","doi":"10.3760/cma.j.cn112152-20250403-00147","DOIUrl":"10.3760/cma.j.cn112152-20250403-00147","url":null,"abstract":"<p><p><b>Objective:</b> To explore the effects and prognosis of heavy ion therapy for thoracic and abdominal malignant tumors under different frequency settings of high-frequency oscillatory breathing control. <b>Methods:</b> A prospective randomized controlled trial was conducted on 45 patients with thoracic and abdominal malignant tumors who received heavy ion therapy under high-frequency oscillatory ventilation (HFOV) control at Gansu Wuwei Tumour Hospital from January 2023 to December 2024. The patients were randomly divided into three groups by block randomization, with 15 patients in each group, and they received different HFOV frequency settings (6 Hz, 7 Hz and 8 Hz, i.e., 360 breaths/min, 420 breaths/min and 480 breaths/min), while other parameters were kept constant (oxygen concentration: 40%, mean airway pressure: 10 cmH<sub>2</sub>O, amplitude: 6cm). The arterial blood gas, transcutaneous carbon dioxide partial pressure/transcutaneous oxygen partial pressure (TcPCO<sub>2</sub>/TcPO<sub>2</sub>), duration of HFOV ventilation, duration of invasive mechanical ventilation, length of hospital stay and complications of the patients under different frequency settings were analyzed. <b>Results:</b> Before and after treatment, there was no statistically significant difference in arterial blood gas parameters (PaCO<sub>2</sub>, PaO<sub>2</sub>), oxygenation index, blood lactate, bicarbonate ion) among the 6 Hz,7 Hz and 8 Hz HFOV frequency groups (all <i>P</i>＞0.05). At 30 minutes, 60 minutes, 120 minutes of treatment and at extubation, there was no statistically significant difference in TcPCO<sub>2</sub>, TcPO<sub>2</sub>, SpO<sub>2</sub> and heart rate among the 6 Hz, 7 Hz and 8 Hz HFOV frequency groups (all <i>P</i>＞0.05). The HFOV duration of the 6 Hz, 7 Hz and 8 Hz HFOV frequency groups was (131.7±8.4) minutes, (125.3±6.9) minutes and (115.7±10.5) minutes, respectively; the duration of invasive mechanical ventilation was (212.3±21.2) minutes, (190.7±14.8) minutes and (199.3±18.4) minutes, respectively; the tumor shrinkage rate was (53.1±6.1)%, (64.7±5.1)% and (63.0±6.2)%, respectively; and the hospital stay was (22.7±2.9) days, (22.3±3.1) days and (20.8±3.3) days, respectively. There was no statistically significant difference among the groups (all <i>P</i>＞0.05). Only one patient developed reversible hypercapnia, which returned to the normal range within 30 minutes after adjusting the invasive ventilator parameters. No treatment-related adverse events such as hypoxemia, radiation pneumonitis, or hemodynamic instability occurred in any of the subjects. <b>Conclusions:</b> HFOV management under heavy ion therapy for thoracoabdominal malignancies shows no significant changes in arterial blood gas analysis before and after treatment at different frequencies (6 Hz, 7 Hz, 8 Hz). Continuous monitoring of transcutaneous TcPCO<sub>2</sub>/TcPO<sub>2</sub> is stable. The treatment process is safe, with few complications and good results.</p>","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"47 7","pages":"679-685"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683358","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}
Pub Date : 2025-07-23DOI: 10.3760/cma.j.cn112152-20250604-00255
K X Chen, W Q Chen, Y B Huang, Z Y Lyu, F F Song, C F Xia, Y J Xu, L Yang, C Sheng, Y C Zhang, P Wang, Y M Zhang, Y T Ji, J J Li, W X Li, J Wu, Q Y Jin, F J Song
Malignant tumors (commonly referred to as cancer) represent a major global public health challenge and contribute significantly to the worldwide disease burden. Early screening plays a critical role in improving detection rates, enabling timely intervention, and enhancing patient survival rates. However, current cancer screening guidelines primarily focus on site-specific screening, which may not fully address the need for comprehensive early detection. A scientifically rational, multi-cancer screening approach offers several advantages: it optimizes the use of biological samples, reduces time costs for participants, enhances the efficiency and comprehensiveness of screening, and minimizes overall expenses. Such an approach also facilitates the rational allocation of healthcare resources, ultimately helping to reduce the societal burden of cancer. To address this need, the Cancer Epidemiology Committee of the Chinese Anti-Cancer Association has developed the Expert Consensus on Combined Screening for Common Cancers in China. This consensus integrates multidisciplinary expertise and synthesizes the latest domestic and international researches on cancer screening, early detection, and treatment for prevalent malignancies. Drawing upon China's unique demographic and healthcare context, as well as practical screening experiences, the consensus provides evidence-based recommendations on target populations, screening technologies, and procedural workflows for multi-cancer screening. These guidelines align with the principles and methodologies established by the World Health Organization (WHO), aiming to enhance the effectiveness of combined cancer screening in China, improve early detection rates, and provide a scientific foundation for national cancer prevention and control strategies.
{"title":"[Expert consensus on combined screening for common cancers(2025 edition)].","authors":"K X Chen, W Q Chen, Y B Huang, Z Y Lyu, F F Song, C F Xia, Y J Xu, L Yang, C Sheng, Y C Zhang, P Wang, Y M Zhang, Y T Ji, J J Li, W X Li, J Wu, Q Y Jin, F J Song","doi":"10.3760/cma.j.cn112152-20250604-00255","DOIUrl":"10.3760/cma.j.cn112152-20250604-00255","url":null,"abstract":"<p><p>Malignant tumors (commonly referred to as cancer) represent a major global public health challenge and contribute significantly to the worldwide disease burden. Early screening plays a critical role in improving detection rates, enabling timely intervention, and enhancing patient survival rates. However, current cancer screening guidelines primarily focus on site-specific screening, which may not fully address the need for comprehensive early detection. A scientifically rational, multi-cancer screening approach offers several advantages: it optimizes the use of biological samples, reduces time costs for participants, enhances the efficiency and comprehensiveness of screening, and minimizes overall expenses. Such an approach also facilitates the rational allocation of healthcare resources, ultimately helping to reduce the societal burden of cancer. To address this need, the Cancer Epidemiology Committee of the Chinese Anti-Cancer Association has developed the Expert Consensus on Combined Screening for Common Cancers in China. This consensus integrates multidisciplinary expertise and synthesizes the latest domestic and international researches on cancer screening, early detection, and treatment for prevalent malignancies. Drawing upon China's unique demographic and healthcare context, as well as practical screening experiences, the consensus provides evidence-based recommendations on target populations, screening technologies, and procedural workflows for multi-cancer screening. These guidelines align with the principles and methodologies established by the World Health Organization (WHO), aiming to enhance the effectiveness of combined cancer screening in China, improve early detection rates, and provide a scientific foundation for national cancer prevention and control strategies.</p>","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"47 7","pages":"533-557"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683355","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}
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