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Oncofertility as an Essential Part of Comprehensive Cancer Treatment in Patients of Reproductive Age, Adolescents and Children 肿瘤不孕症是育龄患者、青少年和儿童癌症综合治疗的重要组成部分
Pub Date : 2024-05-13 DOI: 10.3390/cancers16101858
Dominika Łubik-Lejawka, I. Gabriel, Adrianna Marzec, Anita Olejek
The number of children, adolescents and young adults diagnosed with cancer has been rising recently. Various oncological treatments have a detrimental effect on female fertility, and childbearing becomes a major issue during surveillance after recovery. This review discusses the impact of oncological treatments on the ovarian reserve with a thorough explanation of oncologic treatments’ effects and modes of oncofertility procedures. The aim of this review is to help clinicians in making an informed decision about post-treatment fertility in their patients. Ultimately, it may lead to improved overall long-term outcomes among young populations suffering from cancer.
近来,被诊断出患有癌症的儿童、青少年和年轻人的数量不断上升。各种肿瘤治疗会对女性的生育能力产生不利影响,在康复后的监测期间,生育成为一个主要问题。本综述讨论了肿瘤治疗对卵巢储备功能的影响,并对肿瘤治疗的效果和辅助生育程序的模式进行了详尽的解释。本综述旨在帮助临床医生就患者治疗后的生育问题做出明智的决定。最终,它可能会改善年轻癌症患者的整体长期治疗效果。
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引用次数: 0
Surgical Treatment for Endometrial Cancer, Hysterectomy Performed via Minimally Invasive Routes Compared with Open Surgery: A Systematic Review and Network Meta-Analysis 子宫内膜癌的手术治疗:微创子宫切除术与开腹手术的比较:系统回顾和网络元分析
Pub Date : 2024-05-13 DOI: 10.3390/cancers16101860
Purushothaman Natarajan, G. Delanerolle, Lucy Dobson, Cong Xu, Yutian Zeng, Xuan Yu, Kathleen Marston, Thuan Phan, Fiona Choi, Vanya Barzilova, S. Powell, James Wyatt, Sian Taylor, Jian Qing Shi, D. Hapangama
Background: Total hysterectomy with bilateral salpingo-oophorectomy via minimally invasive surgery (MIS) has emerged as the standard of care for early-stage endometrial cancer (EC). Prior systematic reviews and meta-analyses have focused on outcomes reported solely from randomised controlled trials (RCTs), overlooking valuable data from non-randomised studies. This inaugural systematic review and network meta-analysis comprehensively compares clinical and oncological outcomes between MIS and open surgery for early-stage EC, incorporating evidence from randomised and non-randomised studies. Methods: This study was prospectively registered on PROSPERO (CRD42020186959). All original research of any experimental design reporting clinical and oncological outcomes of surgical treatment for endometrial cancer was included. Study selection was restricted to English-language peer-reviewed journal articles published 1 January 1995–31 December 2021. A Bayesian network meta-analysis was conducted. Results: A total of 99 studies were included in the network meta-analysis, comprising 181,716 women and 14 outcomes. Compared with open surgery, laparoscopic and robotic-assisted surgery demonstrated reduced blood loss and length of hospital stay but increased operating time. Compared with laparoscopic surgery, robotic-assisted surgery was associated with a significant reduction in ileus (OR = 0.40, 95% CrI: 0.17–0.87) and total intra-operative complications (OR = 0.38, 95% CrI: 0.17–0.75) as well as a higher disease-free survival (OR = 2.45, 95% CrI: 1.04–6.34). Conclusions: For treating early endometrial cancer, minimal-access surgery via robotic-assisted or laparoscopic techniques appears safer and more efficacious than open surgery. Robotic-assisted surgery is associated with fewer complications and favourable oncological outcomes.
背景:通过微创手术(MIS)进行全子宫切除术和双侧输卵管切除术已成为早期子宫内膜癌(EC)的标准治疗方法。之前的系统综述和荟萃分析只关注随机对照试验(RCT)报告的结果,忽略了非随机研究的宝贵数据。这篇首次发表的系统综述和网络荟萃分析全面比较了MIS和开放手术治疗早期EC的临床和肿瘤学结果,并纳入了随机和非随机研究的证据。研究方法:本研究在 PROSPERO 上进行了前瞻性注册(CRD42020186959)。所有报告子宫内膜癌手术治疗的临床和肿瘤学结果的任何实验设计的原创研究均被纳入其中。研究筛选仅限于 1995 年 1 月 1 日至 2021 年 12 月 31 日发表的英语同行评审期刊文章。进行了贝叶斯网络荟萃分析。结果:网络荟萃分析共纳入99项研究,包括181716名女性和14项结果。与开腹手术相比,腹腔镜手术和机器人辅助手术减少了失血量和住院时间,但增加了手术时间。与腹腔镜手术相比,机器人辅助手术可显著减少回肠梗阻(OR = 0.40,95% CrI:0.17-0.87)和术中总并发症(OR = 0.38,95% CrI:0.17-0.75),并提高无病生存率(OR = 2.45,95% CrI:1.04-6.34)。结论对于早期子宫内膜癌的治疗,通过机器人辅助或腹腔镜技术进行微创手术似乎比开腹手术更安全、更有效。机器人辅助手术的并发症更少,肿瘤治疗效果更佳。
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引用次数: 0
What Is a Sarcoma ‘Specialist Center’? Multidisciplinary Research Finds an Answer 什么是肉瘤 "专科中心"?多学科研究找到答案
Pub Date : 2024-05-13 DOI: 10.3390/cancers16101857
Roger Wilson, Denise Reinke, G. van Oortmerssen, O. Gonzato, Gabriele Ott, Chandrajit P Raut, B. Guadagnolo, Rick L. M. Haas, Jonathan Trent, Robin L. Jones, Lauren Pretorius, Brandi Felser, Mandy Basson, K. Schuster, Bernd Kasper
The management of sarcomas in specialist centers delivers significant benefits. In much of the world, specialists are not available, and the development of expertise is identified as a major need. However, the terms ‘specialist’ or ‘expert’ center are rarely defined. Our objective is to offer a definition for patient advocates and a tool for healthcare providers to underpin improving the care of people with sarcoma. SPAGN developed a discussion paper for a workshop at the SPAGN 2023 Conference, attended by 75 delegates. A presentation to the Connective Tissue Oncology Society (CTOS) and further discussion led to this paper. Core Principles were identified that underlie specialist sarcoma care. The primary Principle is the multi-disciplinary team discussing every patient, at first diagnosis and during treatment. Principles for optimal sarcoma management include accurate diagnosis followed by safe, high-quality treatment, with curative intent. These Principles are supplemented by Features describing areas of healthcare, professional involvement, and service provision and identifying further research and development needs. These allow for variations because of national or local policies and budgets. We propose the term ‘Sarcoma Intelligent Specialist Network’ to recognize expertise wherever it is found in the world. This provides a base for further discussion and local refinement.
在专科中心治疗肉瘤可带来巨大的收益。世界上很多地方都没有专科医生,因此发展专业技术被认为是一项重大需求。然而,"专科 "或 "专家 "中心很少有定义。我们的目标是为患者权益倡导者提供一个定义,为医疗服务提供者提供一个工具,以支持改善对肉瘤患者的护理。SPAGN 为 SPAGN 2023 大会的一个研讨会编写了一份讨论文件,共有 75 名代表参加。在结缔组织肿瘤学会 (CTOS) 上的发言和进一步的讨论促成了这份文件的诞生。会议确定了肉瘤专科治疗的核心原则。首要原则是多学科团队在初诊和治疗期间讨论每位患者。最佳肉瘤治疗原则包括准确诊断,然后进行安全、高质量的治疗,以达到治愈目的。除这些原则外,还有一些特点,描述了医疗保健、专业参与和服务提供的领域,并确定了进一步的研究和发展需求。这些原则允许因国家或地方政策和预算而有所变化。我们建议使用 "肉瘤智能专家网络 "这一术语,以认可世界各地的专业技术。这为进一步讨论和地方完善提供了基础。
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引用次数: 0
Novel Endocrine Therapeutic Opportunities for Estrogen Receptor-Positive Ovarian Cancer—What Can We Learn from Breast Cancer? 雌激素受体阳性卵巢癌的新型内分泌治疗机会--我们能从乳腺癌中学到什么?
Pub Date : 2024-05-13 DOI: 10.3390/cancers16101862
Tine Ottenbourgs, E. Van Nieuwenhuysen
Low-grade serous ovarian cancer (LGSOC) is a rare ovarian malignancy primarily affecting younger women and is characterized by an indolent growth pattern. It exhibits indolent growth and high estrogen/progesterone receptor expression, suggesting potential responsiveness to endocrine therapy. However, treatment efficacy remains limited due to the development of endocrine resistance. The mechanisms of resistance, whether primary or acquired, are still largely unknown and present a significant hurdle in achieving favorable treatment outcomes with endocrine therapy in these patients. In estrogen receptor-positive breast cancer, mechanisms of endocrine resistance have been largely explored and novel treatment strategies to overcome resistance have emerged. Considering the shared estrogen receptor positivity in LGSOC and breast cancer, we wanted to explore whether there are any parallel mechanisms of resistance and whether we can extend endocrine breast cancer treatments to LGSOC. This review aims to highlight the underlying molecular mechanisms possibly driving endocrine resistance in ovarian cancer, while also exploring the available therapeutic opportunities to overcome this resistance. By unraveling the potential pathways involved and examining emerging strategies, this review explores valuable insights for advancing treatment options and improving patient outcomes in LGSOC, which has limited therapeutic options available.
低级别浆液性卵巢癌(LGSOC)是一种罕见的卵巢恶性肿瘤,主要影响年轻女性,其特点是生长缓慢。它生长缓慢,雌激素/孕激素受体高表达,表明可能对内分泌治疗有反应。然而,由于出现内分泌抗药性,治疗效果仍然有限。无论是原发性还是获得性耐药,其机制在很大程度上仍是未知的,这也是这些患者在接受内分泌治疗时获得良好治疗效果的一大障碍。在雌激素受体阳性的乳腺癌中,内分泌耐药的机制已基本探明,克服耐药的新型治疗策略也已出现。考虑到LGSOC和乳腺癌具有共同的雌激素受体阳性性,我们希望探索是否存在平行的耐药机制,以及是否可以将乳腺癌的内分泌治疗扩展到LGSOC。本综述旨在强调可能导致卵巢癌内分泌耐药性的潜在分子机制,同时探讨克服这种耐药性的现有治疗机会。通过揭示相关的潜在途径和研究新出现的策略,本综述为推进治疗方案和改善 LGSOC 患者的预后提供了有价值的见解,因为 LGSOC 的治疗方案非常有限。
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引用次数: 0
The Transformative Role of 3D Culture Models in Triple-Negative Breast Cancer Research 三维培养模型在三阴性乳腺癌研究中的变革性作用
Pub Date : 2024-05-13 DOI: 10.3390/cancers16101859
Xavier S. Bittman-Soto, Evelyn S. Thomas, Madeline E. Ganshert, Laura L. Mendez‐Santacruz, J. C. Harrell
Advancements in cell culturing techniques have allowed the development of three-dimensional (3D) cell culture models sourced directly from patients’ tissues and tumors, faithfully replicating the native tissue environment. These models provide a more clinically relevant platform for studying disease progression and treatment responses compared to traditional two-dimensional (2D) models. Patient-derived organoids (PDOs) and patient-derived xenograft organoids (PDXOs) emerge as innovative 3D cancer models capable of accurately mimicking the tumor’s unique features, enhancing our understanding of tumor complexities, and predicting clinical outcomes. Triple-negative breast cancer (TNBC) poses significant clinical challenges due to its aggressive nature, propensity for early metastasis, and limited treatment options. TNBC PDOs and PDXOs have significantly contributed to the comprehension of TNBC, providing novel insights into its underlying mechanism and identifying potential therapeutic targets. This review explores the transformative role of various 3D cancer models in elucidating TNBC pathogenesis and guiding novel therapeutic strategies. It also provides an overview of diverse 3D cell culture models, derived from cell lines and tumors, highlighting their advantages and culturing challenges. Finally, it delves into live-cell imaging techniques, endpoint assays, and alternative cell culture media and methodologies, such as scaffold-free and scaffold-based systems, essential for advancing 3D cancer model research and development.
细胞培养技术的进步使得直接取自患者组织和肿瘤的三维(3D)细胞培养模型得以开发,从而忠实地复制了原生组织环境。与传统的二维(2D)模型相比,这些模型为研究疾病进展和治疗反应提供了更贴近临床的平台。患者来源器官组织(PDOs)和患者来源异种移植器官组织(PDXOs)作为创新的三维癌症模型应运而生,它们能够准确模拟肿瘤的独特特征,增强我们对肿瘤复杂性的了解,并预测临床结果。三阴性乳腺癌(TNBC)由于其侵袭性、早期转移倾向和有限的治疗方案,给临床带来了巨大挑战。TNBC PDOs 和 PDXOs 极大地促进了对 TNBC 的理解,提供了对其潜在机制的新见解,并确定了潜在的治疗靶点。本综述探讨了各种三维癌症模型在阐明 TNBC 发病机制和指导新型治疗策略方面的变革性作用。它还概述了源自细胞系和肿瘤的各种三维细胞培养模型,强调了它们的优势和培养挑战。最后,它深入探讨了活细胞成像技术、终点检测以及替代细胞培养基和方法,例如无支架和基于支架的系统,这些对于推进三维癌症模型的研究和开发至关重要。
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引用次数: 0
Daratumumab during Myeloma Induction Therapy Is Associated with Impaired Stem Cell Mobilization and Prolonged Post-Transplant Hematologic Recovery 骨髓瘤诱导治疗期间的达拉单抗与干细胞动员受损和移植后血液学恢复期延长有关
Pub Date : 2024-05-13 DOI: 10.3390/cancers16101854
Julian Mehl, D. Akhoundova, Ulrike Bacher, B. Jeker, Gaëlle Rhyner Agocs, A. Ruefer, Susanne Soltermann, Martin Soekler, Annette Winkler, M. Daskalakis, Thomas Pabst
Daratumumab is being increasingly integrated into first-line multiple myeloma (MM) induction regimens, leading to improved response depth and longer progression-free survival. Autologous stem cell transplantation (ASCT) is commonly performed as a consolidation strategy following first-line induction in fit MM patients. We investigated a cohort of 155 MM patients who received ASCT after first-line induction with or without daratumumab (RVd, n = 110; D-RVd, n = 45), analyzing differences in stem cell mobilization, apheresis, and engraftment. In the D-RVd group, fewer patients successfully completed mobilization at the planned apheresis date (44% vs. 71%, p = 0.0029), and more patients required the use of rescue plerixafor (38% vs. 28%, p = 0.3052). The median count of peripheral CD34+ cells at apheresis was lower (41.37 vs. 52.19 × 106/L, p = 0.0233), and the total number of collected CD34+ cells was inferior (8.27 vs. 10.22 × 106/kg BW, p = 0.0139). The time to recovery of neutrophils and platelets was prolonged (12 vs. 11 days, p = 0.0164; and 16 vs. 14 days, p = 0.0002, respectively), and a higher frequency of erythrocyte transfusions (74% vs. 51%, p = 0.0103) and a higher number of platelet concentrates/patients were required (4 vs. 2; p = 0.001). The use of daratumumab during MM induction might negatively impact stem cell mobilization and engraftment in the context of ASCT.
达拉单抗越来越多地被纳入一线多发性骨髓瘤(MM)诱导治疗方案,从而提高了反应深度,延长了无进展生存期。自体干细胞移植(ASCT)通常作为适合MM患者的一线诱导治疗后的巩固治疗策略。我们调查了155名一线诱导后接受或不接受达拉单抗(RVd,n = 110;D-RVd,n = 45)ASCT的MM患者,分析了干细胞动员、无血细胞分离和移植的差异。在D-RVd组中,较少患者在计划的无细胞采集日期成功完成动员(44%对71%,P = 0.0029),更多患者需要使用普乐沙福(38%对28%,P = 0.3052)。无细胞采集时外周 CD34+ 细胞的中位数较低(41.37 对 52.19 × 106/L,p = 0.0233),采集的 CD34+ 细胞总数较低(8.27 对 10.22 × 106/kg BW,p = 0.0139)。中性粒细胞和血小板的恢复时间延长(分别为12天 vs. 11天,p = 0.0164;16天 vs. 14天,p = 0.0002),红细胞输注频率更高(74% vs. 51%,p = 0.0103),血小板浓缩次数/患者更高(4次 vs. 2次;p = 0.001)。在MM诱导期间使用达拉单抗可能会对ASCT中的干细胞动员和移植产生负面影响。
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引用次数: 0
Molecular Characterization and Therapeutic Opportunities in KRAS Wildtype Pancreatic Ductal Adenocarcinoma KRAS 野生型胰腺导管腺癌的分子特征和治疗机会
Pub Date : 2024-05-13 DOI: 10.3390/cancers16101861
Aakash Desai, Alexander Xiao, Daheui Choi, M. D. Toruner, Daniel J. Walden, T. Halfdanarson, Steven R Alberts, Robert R. McWilliams, Amit Mahipal, Daniel H Ahn, Hani Babiker, Gulnaz Stybayeva, Alexander Revzin, S. Kizilbash, Alex Adjei, Tanios B. Bekaii-Saab, A. S. Mansfield, Ryan M. Carr, Wen Wee Ma
Purpose: To investigate the molecular characteristics of and potential for precision medicine in KRAS wildtype pancreatic ductal adenocarcinoma (PDAC). Patients and Methods: We investigated 27 patients with KRASWT PDAC at our institution. Clinical data were obtained via chart review. Tumor specimens for each subject were interrogated for somatic single nucleotide variants, insertion and deletions, and copy number variants by DNA sequencing. Gene fusions were detected from RNA-seq. A patient-derived organoid (PDO) was developed from a patient with a MET translocation and expanded ex vivo to predict therapeutic sensitivity prior to enrollment in a phase 2 clinical trial. Results: Transcriptomic analysis showed our cohort may be stratified by the relative gene expression of the KRAS signaling cascade. The PDO derived from our patient harboring a TFG-MET rearrangement was found to have in vitro sensitivity to the multi-tyrosine kinase inhibitor crizotinib. The patient was enrolled in the phase 2 SPARTA clinical trial and received monotherapy with vebrelitinib, a c-MET inhibitor, and achieved a partial and durable response. Conclusions: KRASWT PDAC is molecularly distinct from KRASMUT and enriched with potentially actionable genetic variants. In our study, transcriptomic profiling revealed that the KRAS signaling cascade may play a key role in KRASWT PDAC. Our report of a KRASWT PDAC patient with TFG-MET rearrangement who responded to a cMET inhibitor further supports the pursuit of precision oncology in this sub-population. Identification of targetable mutations, perhaps through approaches like RNA-seq, can help enable precision-driven approaches to select optimal treatment based on tumor characteristics.
目的:研究 KRAS 野生型胰腺导管腺癌 (PDAC) 的分子特征和精准医疗的潜力。患者和方法:我们调查了本院的 27 例 KRASWT PDAC 患者。临床数据通过病历审查获得。通过 DNA 测序对每个受试者的肿瘤标本进行体细胞单核苷酸变异、插入和缺失以及拷贝数变异的检测。通过 RNA-seq 检测基因融合。从一名患有 MET 易位的患者身上提取出患者衍生类器官(PDO),并进行体外扩增,以便在加入 2 期临床试验之前预测治疗敏感性。结果转录组分析表明,我们的队列可能会根据 KRAS 信号级联的相对基因表达进行分层。我们发现,从携带 TFG-MET 重排的患者身上提取的 PDO 对多酪氨酸激酶抑制剂克唑替尼具有体外敏感性。该患者参加了 SPARTA 2 期临床试验,并接受了 c-MET 抑制剂维布雷替尼的单药治疗,取得了部分和持久的应答。结论KRASWT PDAC在分子上有别于KRASMUT,富含潜在的可操作基因变异。在我们的研究中,转录组分析显示 KRAS 信号级联可能在 KRASWT PDAC 中起着关键作用。我们报告的一名患有 TFG-MET 重排的 KRASWT PDAC 患者对 cMET 抑制剂产生了反应,这进一步支持了在该亚群中开展精准肿瘤学研究。通过RNA-seq等方法鉴定可靶向的突变,有助于实现精准驱动,根据肿瘤特征选择最佳治疗方法。
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引用次数: 0
Characterization of FOLH1 Expression in Renal Cell Carcinoma 肾细胞癌中 FOLH1 的表达特征
Pub Date : 2024-05-13 DOI: 10.3390/cancers16101855
Eric Ovruchesky, Elizabeth Pan, Melis Guer, Andrew Elliott, Shankar Siva, P. Ravi, B. McGregor, Aditya Bagrodia, I. Derweesh, Pedro C Barata, Elisabeth I Heath, Emmanuel S. Antonarakis, S. Darabi, Dave S. B. Hoon, Amir Mortazavi, Toni K. Choueiri, C. Nabhan, Shuanzeng Wei, Rana R McKay
Purpose: Given the emergence of PSMA-targeted diagnostic agents and therapeutics, we sought to investigate patterns of FOLH1 expression in RCC and their impacts on RCC outcomes. Methods: We conducted a pooled multi-institutional analysis of patients with RCC having undergone DNA and RNA next-generation sequencing. FOLH1-high/low expression was defined as the ≥75th/<25th percentile of RNA transcripts per million (TPM). Angiogenic, T-effector, and myeloid expression signatures were calculated using previously defined gene sets. Kaplan–Meier estimates were calculated from the time of tissue collection or therapy start. Results: We included 1,724 patients in the analysis. FOLH1 expression was significantly higher in clear cell (71%) compared to non-clear cell RCC tumors (19.0 versus 3.3 TPM, p < 0.001) and varied by specimen site (45% primary kidney/55% metastasis, 13.6 versus 9.9 TPM, p < 0.001). FOLH1 expression was correlated with angiogenic gene expression (Spearman = 0.76, p < 0.001) and endothelial cell abundance (Spearman = 0.76, p < 0.001). While OS was similar in patients with FOLH1-high versus -low ccRCC, patients with FOLH1-high clear cell tumors experienced a longer time on cabozantinib treatment (9.7 versus 4.6 months, respectively, HR 0.57, 95% CI 0.35–0.93, p < 0.05). Conclusions: We observed differential patterns of FOLH1 expression based on histology and tumor site in RCC. FOLH1 was correlated with angiogenic gene expression, increased OS, and a longer duration of cabozantinib treatment.
目的:鉴于 PSMA 靶向诊断药物和疗法的出现,我们试图研究 FOLH1 在 RCC 中的表达模式及其对 RCC 预后的影响。方法:我们对接受了DNA和RNA新一代测序的RCC患者进行了多机构汇总分析。FOLH1高/低表达定义为每百万RNA转录本(TPM)≥第75/<第25百分位数。血管生成基因、T效应基因和髓系基因表达特征采用之前定义的基因集进行计算。卡普兰-梅耶估计值从组织采集时间或治疗开始时间开始计算。结果我们分析了 1724 名患者。FOLH1在透明细胞(71%)RCC肿瘤中的表达明显高于非透明细胞(19.0 TPM对3.3 TPM,p <0.001),并且因标本部位而异(原发性肾脏45%/转移瘤55%,13.6 TPM对9.9 TPM,p <0.001)。FOLH1 的表达与血管生成基因表达(Spearman = 0.76,p < 0.001)和内皮细胞丰度(Spearman = 0.76,p < 0.001)相关。虽然FOLH1高的ccRCC患者与FOLH1低的ccRCC患者的OS相似,但FOLH1高的透明细胞肿瘤患者接受卡博替尼治疗的时间更长(分别为9.7个月和4.6个月,HR 0.57,95% CI 0.35-0.93,p <0.05)。结论我们在RCC中观察到了基于组织学和肿瘤部位的不同FOLH1表达模式。FOLH1与血管生成基因表达、OS增加和卡博替尼治疗时间延长相关。
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引用次数: 0
Targeting Anterior Commissure Involvement with Hyperfractionated Radiotherapy for T1–T2 Squamous Cell Carcinoma of the Glottic Larynx 喉声门 T1-T2 鳞状细胞癌的超分割放疗以前会厌受累为目标
Pub Date : 2024-05-12 DOI: 10.3390/cancers16101850
Satoshi Seno, K. Iwashita, Akifumi Kajiwara, Rie Sasaki, Tatsuya Furukawa, M. Teshima, H. Shinomiya, Naomi Kiyota, Rod Lynch, Kenji Yoshida, T. Ishihara, D. Miyawaki, K. Nibu, Ryohei Sasaki
Anterior commissure is involved in about 20% of early-stage glottic squamous cell carcinomas (EGSCCs). Treatment outcomes and prognostic factors for EGSCC with anterior commissure involvement (ACI) were evaluated by focusing on hyperfractionated radiotherapy (74.4 Gy in 62 fractions). One-hundred and fifty-three patients with T1–T2 EGSCC were included in this study. The median total doses for T1a, T1b, and T2 were 66, 74.4, and 74.4 Gy, respectively. Overall, 49 (32%) patients had T1a, 38 (25%) had T1b, and 66 (43%) had T2 disease. The median treatment duration was 46 days. The median follow-up duration was 5.1 years. The 10-year overall and cause-specific survival rates were 72% and 97%, respectively. The 10-year local control rates were 94% for T1a, 88% for T1b, and 81% for T2 disease. Local control rates in patients with ACI were slightly better than those in patients without ACI with T1a and T1b diseases; however, the difference was not significant. The 10-year laryngeal preservation rate was 96%. Six patients experienced grade 3 mucositis, and four patients had grade 3 dermatitis. Hyperfractionated radiotherapy was effective for T1 disease with ACI, but insufficient for T2 disease with ACI. Our treatment strategy resulted in excellent laryngeal preservation.
约20%的早期声门鳞状细胞癌(EGSCC)累及前会厌。通过重点关注超分割放疗(62次分割,每次74.4 Gy),评估了前会厌受累(ACI)EGSCC的治疗效果和预后因素。本研究共纳入153例T1-T2 EGSCC患者。T1a、T1b和T2的中位总剂量分别为66、74.4和74.4 Gy。总体而言,49 名(32%)患者患有 T1a,38 名(25%)患者患有 T1b,66 名(43%)患者患有 T2。中位治疗时间为 46 天。中位随访时间为 5.1 年。10年总生存率和病因特异性生存率分别为72%和97%。T1a、T1b和T2疾病的10年局部控制率分别为94%、88%和81%。ACI 患者的局部控制率略高于无 ACI 的 T1a 和 T1b 患者,但差异并不显著。10年喉保留率为96%。6名患者出现3级粘膜炎,4名患者出现3级皮炎。超分割放疗对伴有 ACI 的 T1 病变有效,但对伴有 ACI 的 T2 病变效果不佳。我们的治疗策略很好地保留了喉部。
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引用次数: 0
The Role of T-Cadherin (CDH13) in Treatment Options with Garcinol in Melanoma T-粘连蛋白(CDH13)在黑色素瘤加西诺治疗方案中的作用
Pub Date : 2024-05-12 DOI: 10.3390/cancers16101853
Sebastian Staebler, Sebastian Hoechst, Aranya Thongmao, Nadja Schneider, Anja K. Bosserhoff, S. Kuphal
Targeted therapies with chemotherapeutic agents and immunotherapy with checkpoint inhibitors are among the systemic therapies recommended in the guidelines for clinicians to treat melanoma. Although there have been constant improvements in the treatment of melanoma, resistance to the established therapies continues to occur. Therefore, the purpose of this study was to explore the function of garcinol with regards to specific cancer properties such as proliferation and apoptosis. Garcinol, a natural compound isolated from the plant also known as mangosteen (Garcinia mangostana), is a newly discovered option for cancer treatment. Numerous pharmaceutical substances are derived from plants. For example, the derivates of camptothecin, extracted from the bark of the Chinese tree of happiness (Camptotheca acuminate), or paclitaxel, extracted from the bark of the Western yew tree (Taxus brevifolia), are used as anti-cancer drugs. Here, we show that garcinol reduced proliferation and induced apoptosis in melanoma cell lines. In addition, we found that those cells that are positive for the expression of the cell–cell adhesion molecule T-cadherin (CDH13) respond more sensitively to treatment with garcinol. After knock-down experiments with an siRNA pool against T-cadherin, the sensitivity to garcinol decreased and proliferation and anti-apoptotic behavior of the cells was restored. We conclude that patients who are T-cadherin-positive could especially benefit from a therapy with garcinol.
化疗药物的靶向疗法和检查点抑制剂的免疫疗法是临床医生治疗黑色素瘤指南中推荐的系统疗法之一。虽然黑色素瘤的治疗方法在不断改进,但对既有疗法的耐药性仍时有发生。因此,本研究的目的是探索加西诺对特定癌症特性(如增殖和凋亡)的作用。加西诺是从山竹(Garcinia mangostana)植物中分离出来的一种天然化合物,是一种新发现的癌症治疗方法。许多药物物质都是从植物中提取的。例如,从喜树(Camptotheca acuminate)树皮中提取的喜树碱衍生物,或从西洋紫杉(Taxus brevifolia)树皮中提取的紫杉醇,都被用作抗癌药物。在这里,我们发现加西诺可以减少黑色素瘤细胞株的增殖并诱导其凋亡。此外,我们还发现,细胞-细胞粘附分子 T-cadherin(CDH13)表达阳性的细胞对加西醇的治疗反应更敏感。在使用针对T-cadherin的siRNA池进行基因敲除实验后,细胞对加西诺的敏感性降低,并恢复了增殖和抗凋亡行为。我们的结论是,T-cadherin阳性的患者尤其可以从使用加西诺的治疗中获益。
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