Pub Date : 2024-08-08DOI: 10.3389/fonc.2024.1413505
SiYuan Wang, Qin Liu
Recent advances in genomic research have increasingly focused on the fat mass- and obesity-associated (FTO) gene due to its notable correlation with obesity. Initially explored for its contribution to increased body weight, FTO was later discovered to function as an m6A demethylase. This pivotal role enhances our understanding of its broader implications across various pathologies. Epigenetic modifications, such as m6A, have been implicated in gynecological cancers, including ovarian, endometrial, and cervical malignancies. However, the precise mechanisms by which FTO influences the development of gynecological cancers remain largely unknown. This analysis underscores the growing relevance of investigations into the FTO gene in elucidating the mechanisms underlying gynecological cancers and exploring potential therapeutic avenues.
{"title":"Research progress on m6A demethylase FTO and its role in gynecological tumors","authors":"SiYuan Wang, Qin Liu","doi":"10.3389/fonc.2024.1413505","DOIUrl":"https://doi.org/10.3389/fonc.2024.1413505","url":null,"abstract":"Recent advances in genomic research have increasingly focused on the fat mass- and obesity-associated (FTO) gene due to its notable correlation with obesity. Initially explored for its contribution to increased body weight, FTO was later discovered to function as an m6A demethylase. This pivotal role enhances our understanding of its broader implications across various pathologies. Epigenetic modifications, such as m6A, have been implicated in gynecological cancers, including ovarian, endometrial, and cervical malignancies. However, the precise mechanisms by which FTO influences the development of gynecological cancers remain largely unknown. This analysis underscores the growing relevance of investigations into the FTO gene in elucidating the mechanisms underlying gynecological cancers and exploring potential therapeutic avenues.","PeriodicalId":507440,"journal":{"name":"Frontiers in Oncology","volume":"14 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141928493","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}
Implant-based breast reconstruction (IBR), following mastectomy, significantly impacts patients’ quality of life (QoL), necessitating accurate measurement through psychometrically robust patient-reported outcome measure (PROM) tools. This bibliometric analysis aims to discern trends, identify gaps, and evaluate the use of such tools in the IBR literature.The 100 most cited publications regarding QoL in implant-based reconstruction were identified on Web of Science, across all available journal years (from 1977 to 2024) on 10 March 2024. Study details, including the citation count, main content focus, outcome measures, and usage of psychological questionnaires, were extracted and tabulated from each publication. The Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence (LOE) of each study were assessed.The 100 most cited publications on QoL in implant-based reconstruction were identified, encompassing 64,192 patients and 28,114 reconstructed breasts. Citations per publication ranged from 62 to 457 (mean, 124.95 ± 73.05), with the highest-cited study being authored by Al-Ghazal (n = 457). The vast majority of publications were LOE II (n = 52), representative of prospective cohort studies, systematic reviews of non-randomised studies, and systematic review and meta-analysis. The number of publications for LOE V, IV, III, and I was 0, 7, 41, and 0, respectively. The main content focus was “quality of life” in 83 publications, with significant utilisation of the BREAST-Q questionnaire. A total of 80 publications used validated questionnaires with psychometric development.This analysis demonstrates that the research methodologies within IBR mostly consist of moderate-quality publications; however, notably, there was a lack of LOE I studies, underscoring a gap in high-quality research within the field. Moreover, only 62/100 used validated PROM tools. Future IBR research studies should be focussed on most robust methodologies, incorporating validated PROM tools, to optimise shared-decision making and informed consent.
乳房切除术后的植入式乳房再造（IBR）会对患者的生活质量（QoL）产生重大影响，因此有必要通过心理统计学上可靠的患者报告结果测量（PROM）工具进行精确测量。本文献计量学分析旨在辨别趋势、找出差距并评估此类工具在 IBR 文献中的使用情况。2024 年 3 月 10 日，我们在 Web of Science 上确定了 100 篇有关植入式重建中 QoL 的最高引用率出版物，涉及所有可用期刊年份（从 1977 年到 2024 年）。从每篇出版物中提取了研究细节，包括引用次数、主要内容重点、结果测量和心理问卷的使用情况，并制成表格。对每项研究的牛津循证医学中心（OCEBM）证据等级（LOE）进行了评估。确定了100篇关于植入物重建中QoL的最常被引用的出版物，涉及64192名患者和28114个重建乳房。每篇论文的引用次数从62次到457次不等（平均值为124.95 ± 73.05），引用次数最高的研究由Al-Ghazal撰写（n = 457）。绝大多数出版物为 LOE II（n = 52），代表前瞻性队列研究、非随机研究的系统综述以及系统综述和荟萃分析。LOE V、IV、III 和 I 的出版物数量分别为 0、7、41 和 0。83篇出版物的主要内容是 "生活质量"，其中大量使用了BREAST-Q问卷。这项分析表明，IBR 的研究方法大多由中等质量的出版物组成；但值得注意的是，缺乏 LOE I 研究，这凸显了该领域在高质量研究方面的差距。此外，只有 62/100 的研究使用了经过验证的 PROM 工具。未来的 IBR 研究应将重点放在最可靠的方法上，并结合有效的 PROM 工具，以优化共同决策和知情同意。
{"title":"Bibliometric analysis of quality of life in implant-based breast reconstruction","authors":"Kian Daneshi, Francesca Ruccia, Radhika Merh, Tommaso Barlattani, Raed Alderhalli, Mark Warren Clemens, Ankur Khajuria","doi":"10.3389/fonc.2024.1429885","DOIUrl":"https://doi.org/10.3389/fonc.2024.1429885","url":null,"abstract":"Implant-based breast reconstruction (IBR), following mastectomy, significantly impacts patients’ quality of life (QoL), necessitating accurate measurement through psychometrically robust patient-reported outcome measure (PROM) tools. This bibliometric analysis aims to discern trends, identify gaps, and evaluate the use of such tools in the IBR literature.The 100 most cited publications regarding QoL in implant-based reconstruction were identified on Web of Science, across all available journal years (from 1977 to 2024) on 10 March 2024. Study details, including the citation count, main content focus, outcome measures, and usage of psychological questionnaires, were extracted and tabulated from each publication. The Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence (LOE) of each study were assessed.The 100 most cited publications on QoL in implant-based reconstruction were identified, encompassing 64,192 patients and 28,114 reconstructed breasts. Citations per publication ranged from 62 to 457 (mean, 124.95 ± 73.05), with the highest-cited study being authored by Al-Ghazal (n = 457). The vast majority of publications were LOE II (n = 52), representative of prospective cohort studies, systematic reviews of non-randomised studies, and systematic review and meta-analysis. The number of publications for LOE V, IV, III, and I was 0, 7, 41, and 0, respectively. The main content focus was “quality of life” in 83 publications, with significant utilisation of the BREAST-Q questionnaire. A total of 80 publications used validated questionnaires with psychometric development.This analysis demonstrates that the research methodologies within IBR mostly consist of moderate-quality publications; however, notably, there was a lack of LOE I studies, underscoring a gap in high-quality research within the field. Moreover, only 62/100 used validated PROM tools. Future IBR research studies should be focussed on most robust methodologies, incorporating validated PROM tools, to optimise shared-decision making and informed consent.","PeriodicalId":507440,"journal":{"name":"Frontiers in Oncology","volume":"18 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141926900","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 : 2024-08-08DOI: 10.3389/fonc.2024.1440944
Ying Hu, Mengjie Cheng, Hui Wei, Zhiwen Liang
Cone-beam computed tomography (CBCT) is a convenient method for adaptive radiation therapy (ART), but its application is often hindered by its image quality. We aim to develop a unified deep learning model that can consistently enhance the quality of CBCT images across various anatomical sites by generating synthetic CT (sCT) images.A dataset of paired CBCT and planning CT images from 135 cancer patients, including head and neck, chest and abdominal tumors, was collected. This dataset, with its rich anatomical diversity and scanning parameters, was carefully selected to ensure comprehensive model training. Due to the imperfect registration, the inherent challenge of local structural misalignment of paired dataset may lead to suboptimal model performance. To address this limitation, we propose SynREG, a supervised learning framework. SynREG integrates a hybrid CNN-transformer architecture designed for generating high-fidelity sCT images and a registration network designed to correct local structural misalignment dynamically during training. An independent test set of 23 additional patients was used to evaluate the image quality, and the results were compared with those of several benchmark models (pix2pix, cycleGAN and SwinIR). Furthermore, the performance of an autosegmentation application was also assessed.The proposed model disentangled sCT generation from anatomical correction, leading to a more rational optimization process. As a result, the model effectively suppressed noise and artifacts in multisite applications, significantly enhancing CBCT image quality. Specifically, the mean absolute error (MAE) of SynREG was reduced to 16.81 ± 8.42 HU, whereas the structural similarity index (SSIM) increased to 94.34 ± 2.85%, representing improvements over the raw CBCT data, which had the MAE of 26.74 ± 10.11 HU and the SSIM of 89.73 ± 3.46%. The enhanced image quality was particularly beneficial for organs with low contrast resolution, significantly increasing the accuracy of automatic segmentation in these regions. Notably, for the brainstem, the mean Dice similarity coefficient (DSC) increased from 0.61 to 0.89, and the MDA decreased from 3.72 mm to 0.98 mm, indicating a substantial improvement in segmentation accuracy and precision.SynREG can effectively alleviate the differences in residual anatomy between paired datasets and enhance the quality of CBCT images.
{"title":"A joint learning framework for multisite CBCT-to-CT translation using a hybrid CNN-transformer synthesizer and a registration network","authors":"Ying Hu, Mengjie Cheng, Hui Wei, Zhiwen Liang","doi":"10.3389/fonc.2024.1440944","DOIUrl":"https://doi.org/10.3389/fonc.2024.1440944","url":null,"abstract":"Cone-beam computed tomography (CBCT) is a convenient method for adaptive radiation therapy (ART), but its application is often hindered by its image quality. We aim to develop a unified deep learning model that can consistently enhance the quality of CBCT images across various anatomical sites by generating synthetic CT (sCT) images.A dataset of paired CBCT and planning CT images from 135 cancer patients, including head and neck, chest and abdominal tumors, was collected. This dataset, with its rich anatomical diversity and scanning parameters, was carefully selected to ensure comprehensive model training. Due to the imperfect registration, the inherent challenge of local structural misalignment of paired dataset may lead to suboptimal model performance. To address this limitation, we propose SynREG, a supervised learning framework. SynREG integrates a hybrid CNN-transformer architecture designed for generating high-fidelity sCT images and a registration network designed to correct local structural misalignment dynamically during training. An independent test set of 23 additional patients was used to evaluate the image quality, and the results were compared with those of several benchmark models (pix2pix, cycleGAN and SwinIR). Furthermore, the performance of an autosegmentation application was also assessed.The proposed model disentangled sCT generation from anatomical correction, leading to a more rational optimization process. As a result, the model effectively suppressed noise and artifacts in multisite applications, significantly enhancing CBCT image quality. Specifically, the mean absolute error (MAE) of SynREG was reduced to 16.81 ± 8.42 HU, whereas the structural similarity index (SSIM) increased to 94.34 ± 2.85%, representing improvements over the raw CBCT data, which had the MAE of 26.74 ± 10.11 HU and the SSIM of 89.73 ± 3.46%. The enhanced image quality was particularly beneficial for organs with low contrast resolution, significantly increasing the accuracy of automatic segmentation in these regions. Notably, for the brainstem, the mean Dice similarity coefficient (DSC) increased from 0.61 to 0.89, and the MDA decreased from 3.72 mm to 0.98 mm, indicating a substantial improvement in segmentation accuracy and precision.SynREG can effectively alleviate the differences in residual anatomy between paired datasets and enhance the quality of CBCT images.","PeriodicalId":507440,"journal":{"name":"Frontiers in Oncology","volume":"50 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141928097","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 : 2024-08-08DOI: 10.3389/fonc.2024.1417765
Shui Liu, Lin Qiao, Yang Liu, Hangmei Liu, Yiwen Li, Jingbo Sun, Wei Chen, Rongguo Shang, Lili Zhang, Xiaochuan Liu
The purpose of this study was to evaluate the clinical effect of mixed nutrition and parenteral nutrition support on postoperative patients with esophageal cancer.By searching PubMed, Web of Science, Cochrane, CNKI, Wanfang and other databases, all the literatures until March 2024 about the comparison of randomized controlled Trial (RCT) of mixed nutrition and parenteral nutrition support in postoperative patients with esophageal cancer were screened. The inclusion criteria were that the patients were from randomized controlled trials or clinical trials in China, and the patients were all diagnosed with esophageal cancer by pathological biopsy. The exclusion criteria were the literature other than the above, including repeated published literature, non-Chinese and English literature, incomplete or missing analysis data, etc. After two researchers independently screened the literature, extracted the data and evaluated the risk of bias according to the criteria, Meta-analysis was carried out with RevMan 5.4 software.A total of 11 studies were included, including 1216 patients. Meta-analysis showed that, compared with parenteral nutrition, mixed nutrition can improve the levels of transferrin, serum albumin, prealbumin and lymphocyte counts in patients with esophageal cancer after surgery, shorten the time of anal recovery of exhaust, defecation and hospital stay after surgery, and reduce the incidence of pulmonary infection, abdominal distension, incision infection and anastomotic fistula, with statistical significance between the two groups (P < 0.05). The heterogeneity of individual results in this study is relatively high, the analysis comes from clinical heterogeneity, and the publication bias is analyzed through Funnel plot. Taking the incidence of lung infection as an example, the results are evenly distributed on both sides of the Funnel plot, and the publication bias has little impact on the results of the study.Compared with parenteral nutrition, mixed nutrition can improve the prognosis of postoperative patients with esophageal cancer and reduce the incidence of related adverse events.
通过检索PubMed、Web of Science、Cochrane、CNKI、万方等数据库，筛选了截至2024年3月有关食管癌术后患者混合营养与肠外营养支持随机对照试验（RCT）比较的所有文献。纳入标准为患者来自中国的随机对照试验或临床试验，且患者均经病理活检确诊为食管癌。排除标准为上述以外的文献，包括重复发表的文献、非中英文文献、分析数据不完整或缺失等。两名研究人员独立筛选文献、提取数据并根据标准评估偏倚风险后，使用RevMan 5.4软件进行了Meta分析。Meta分析表明，与肠外营养相比，混合营养可提高食管癌术后患者转铁蛋白、血清白蛋白、前白蛋白和淋巴细胞计数水平，缩短术后肛门排气、排便和住院恢复时间，降低肺部感染、腹胀、切口感染和吻合口瘘的发生率，两组比较差异有统计学意义（P<0.05）。本研究个体结果异质性较高，分析来源于临床异质性，通过漏斗图分析发表偏倚。以肺部感染发生率为例，两组结果均匀分布在漏斗图两侧，发表偏倚对研究结果影响不大。与肠外营养相比，混合营养可改善食管癌术后患者的预后，降低相关不良事件的发生率。
{"title":"Efficacy and safety evaluation of mixed nutrition for postoperative esophageal cancer patients in China: a meta-analysis","authors":"Shui Liu, Lin Qiao, Yang Liu, Hangmei Liu, Yiwen Li, Jingbo Sun, Wei Chen, Rongguo Shang, Lili Zhang, Xiaochuan Liu","doi":"10.3389/fonc.2024.1417765","DOIUrl":"https://doi.org/10.3389/fonc.2024.1417765","url":null,"abstract":"The purpose of this study was to evaluate the clinical effect of mixed nutrition and parenteral nutrition support on postoperative patients with esophageal cancer.By searching PubMed, Web of Science, Cochrane, CNKI, Wanfang and other databases, all the literatures until March 2024 about the comparison of randomized controlled Trial (RCT) of mixed nutrition and parenteral nutrition support in postoperative patients with esophageal cancer were screened. The inclusion criteria were that the patients were from randomized controlled trials or clinical trials in China, and the patients were all diagnosed with esophageal cancer by pathological biopsy. The exclusion criteria were the literature other than the above, including repeated published literature, non-Chinese and English literature, incomplete or missing analysis data, etc. After two researchers independently screened the literature, extracted the data and evaluated the risk of bias according to the criteria, Meta-analysis was carried out with RevMan 5.4 software.A total of 11 studies were included, including 1216 patients. Meta-analysis showed that, compared with parenteral nutrition, mixed nutrition can improve the levels of transferrin, serum albumin, prealbumin and lymphocyte counts in patients with esophageal cancer after surgery, shorten the time of anal recovery of exhaust, defecation and hospital stay after surgery, and reduce the incidence of pulmonary infection, abdominal distension, incision infection and anastomotic fistula, with statistical significance between the two groups (P < 0.05). The heterogeneity of individual results in this study is relatively high, the analysis comes from clinical heterogeneity, and the publication bias is analyzed through Funnel plot. Taking the incidence of lung infection as an example, the results are evenly distributed on both sides of the Funnel plot, and the publication bias has little impact on the results of the study.Compared with parenteral nutrition, mixed nutrition can improve the prognosis of postoperative patients with esophageal cancer and reduce the incidence of related adverse events.","PeriodicalId":507440,"journal":{"name":"Frontiers in Oncology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927226","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 : 2024-07-16DOI: 10.3389/fonc.2024.1407828
Hee-Sung Kim, Chang-Min Heo, Yoo-Shin Choi, Suk-Won Suh, Seung Eun Lee
Periampullary adenocarcinomas typically exhibit either intestinal or pancreatobiliary (PB) differentiation, and the type of differentiation may be prognostically more important than the anatomic site of origin. This study aimed to evaluate prognostic significance of histological type of periampullary carcinomas.Microscopic slides from 110 consecutive pancreatoduodenectomies performed between 2010 and 2020 were reviewed and classified as intestinal or PB type. Clinicopathological factors were compared between PB-(n=93) and intestinal-type (n=17) differentiation.The intestinal type included significantly more patients with well-differentiated histology (35.3% vs. 11.8%, p=0.001) and fewer patients with perineural invasion (41.2% vs. 76.4%, p=0.029), advanced T stage (> T3; 41.2% vs.74.2%, p=0.007), and systemic recurrence (71.4% vs. 92.9%, p=0.005) than PB type. The 5-year-overall survival rate of intestinal-type was significantly higher than that of PB-type (58.8% vs. 20.4%, p=0.003). When pancreatic cancer was separately analyzed, the intestinal type showed the best 5-year-overall survival rate, with no significant difference between the PB types excluding PDAC and PDAC (39.4% vs. 19.2%, p=0.148). In multivariate analysis, curative resection (hazard ratio, 0.417; 95% CI, 0.219-0.792, p=0.008) was the only significant prognostic factor.Although intestinal histologic phenotype was not an independent prognostic factor on multivariate analysis, it showed pathologic features associated with better survival, while the PB type showed more aggressive tumor biology and consequently worse survival. Further studies are needed to demonstrate the prognostic significance of histologic phenotype.
胰腺周围腺癌通常表现为肠道或胰胆管（PB）分化，分化类型可能比起源的解剖部位对预后更重要。本研究旨在评估胰周癌组织学类型的预后意义。研究人员回顾了2010年至2020年间连续进行的110例胰十二指肠切除术的显微切片，并将其分为肠型和胰胆管型。比较了 PB 型（n=93）和肠型（n=17）分化的临床病理因素。肠型中，组织学分化良好的患者明显较多（35.3% vs. 11.8%，p=0.001），有神经周围侵犯（41.2% vs. 76.4%，p=0.029）、晚期 T 分期（> T3; 41.2% vs. 74.2%，P=0.007）和全身复发（71.4% vs. 92.9%，P=0.005）。肠型患者的5年总生存率明显高于PB型（58.8%对20.4%，P=0.003）。在对胰腺癌进行单独分析时，肠型胰腺癌的5年总生存率最高，而排除PDAC的PB型胰腺癌和PDAC型胰腺癌的5年总生存率无明显差异（39.4% vs. 19.2%，P=0.148）。在多变量分析中，根治性切除（危险比，0.417；95% CI，0.219-0.792，p=0.008）是唯一显著的预后因素。虽然肠道组织学表型在多变量分析中不是独立的预后因素，但它显示出与较好生存率相关的病理特征，而PB型显示出更具侵袭性的肿瘤生物学特征，因此生存率较差。要证明组织学表型的预后意义，还需要进一步的研究。
{"title":"Prognostic significance of histologic phenotype in periampullary adenocarcinomas","authors":"Hee-Sung Kim, Chang-Min Heo, Yoo-Shin Choi, Suk-Won Suh, Seung Eun Lee","doi":"10.3389/fonc.2024.1407828","DOIUrl":"https://doi.org/10.3389/fonc.2024.1407828","url":null,"abstract":"Periampullary adenocarcinomas typically exhibit either intestinal or pancreatobiliary (PB) differentiation, and the type of differentiation may be prognostically more important than the anatomic site of origin. This study aimed to evaluate prognostic significance of histological type of periampullary carcinomas.Microscopic slides from 110 consecutive pancreatoduodenectomies performed between 2010 and 2020 were reviewed and classified as intestinal or PB type. Clinicopathological factors were compared between PB-(n=93) and intestinal-type (n=17) differentiation.The intestinal type included significantly more patients with well-differentiated histology (35.3% vs. 11.8%, p=0.001) and fewer patients with perineural invasion (41.2% vs. 76.4%, p=0.029), advanced T stage (> T3; 41.2% vs.74.2%, p=0.007), and systemic recurrence (71.4% vs. 92.9%, p=0.005) than PB type. The 5-year-overall survival rate of intestinal-type was significantly higher than that of PB-type (58.8% vs. 20.4%, p=0.003). When pancreatic cancer was separately analyzed, the intestinal type showed the best 5-year-overall survival rate, with no significant difference between the PB types excluding PDAC and PDAC (39.4% vs. 19.2%, p=0.148). In multivariate analysis, curative resection (hazard ratio, 0.417; 95% CI, 0.219-0.792, p=0.008) was the only significant prognostic factor.Although intestinal histologic phenotype was not an independent prognostic factor on multivariate analysis, it showed pathologic features associated with better survival, while the PB type showed more aggressive tumor biology and consequently worse survival. Further studies are needed to demonstrate the prognostic significance of histologic phenotype.","PeriodicalId":507440,"journal":{"name":"Frontiers in Oncology","volume":"7 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141641752","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}
Breast cancer-related lymphedema (BCRL) profoundly impacts patients’ quality of life, causing heightened depression, anxiety, and physical limitations. Surgical removal of the axillary nodes, combined with radiation therapy, is a significant risk factor for BCRL. Smarter axillary surgery, coupled with early detection and fostering lymphedema education, significantly improves BCRL management, promoting timely diagnosis and treatment. A lymphedema prevention program encompassing all these factors can significantly aid in preventing, treating, and reducing the severity of BCRL cases. Therefore, our study aims to share our insights and experiences gained from implementing a lymphedema prevention program at our institution.At our institution, axillary reverse mapping (ARM) is performed on all patients undergoing axillary surgery. We surveil these patients with pre- and postoperative SOZO® measurements using bioimpedance spectroscopy to detect sub-clinical lymphedema. Concerning education, we use a 3-pronged approach with surgeons, nurse practitioners, and video representation for patients. We have had 212 patients undergo the ARM procedure since 2019, with three (1.41%) developing persistent lymphedema.Our study underscores the significance of a comprehensive lymphedema prevention program, integrating smarter axillary surgery, early detection, and patient education. The lymphedema rate of 1.41% not only validates the success rate of these interventions but also advocates for their widespread adoption to enhance the holistic care of breast cancer survivors. As we continue to refine and expand our program, further research, and long-term follow-up are crucial to improve prevention strategies continually and enhance the overall well-being of individuals at risk of BCRL.
{"title":"Comprehensive strategies in breast cancer-related lymphedema prevention: insights from a multifaceted program","authors":"Fardeen Bhimani, Maureen P McEvoy, Yu Chen, Anjuli Gupta, Jessica Pastoriza, Arianna Cavalli, Liane Obaid, Carolyn Rachofsky, Shani Fruchter, S. Feldman","doi":"10.3389/fonc.2024.1418610","DOIUrl":"https://doi.org/10.3389/fonc.2024.1418610","url":null,"abstract":"Breast cancer-related lymphedema (BCRL) profoundly impacts patients’ quality of life, causing heightened depression, anxiety, and physical limitations. Surgical removal of the axillary nodes, combined with radiation therapy, is a significant risk factor for BCRL. Smarter axillary surgery, coupled with early detection and fostering lymphedema education, significantly improves BCRL management, promoting timely diagnosis and treatment. A lymphedema prevention program encompassing all these factors can significantly aid in preventing, treating, and reducing the severity of BCRL cases. Therefore, our study aims to share our insights and experiences gained from implementing a lymphedema prevention program at our institution.At our institution, axillary reverse mapping (ARM) is performed on all patients undergoing axillary surgery. We surveil these patients with pre- and postoperative SOZO® measurements using bioimpedance spectroscopy to detect sub-clinical lymphedema. Concerning education, we use a 3-pronged approach with surgeons, nurse practitioners, and video representation for patients. We have had 212 patients undergo the ARM procedure since 2019, with three (1.41%) developing persistent lymphedema.Our study underscores the significance of a comprehensive lymphedema prevention program, integrating smarter axillary surgery, early detection, and patient education. The lymphedema rate of 1.41% not only validates the success rate of these interventions but also advocates for their widespread adoption to enhance the holistic care of breast cancer survivors. As we continue to refine and expand our program, further research, and long-term follow-up are crucial to improve prevention strategies continually and enhance the overall well-being of individuals at risk of BCRL.","PeriodicalId":507440,"journal":{"name":"Frontiers in Oncology","volume":"33 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141644241","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 : 2024-07-16DOI: 10.3389/fonc.2024.1384906
Qiang Chen, Shuo Ying, Jianwen Qin, Li Zhang
Lung cancer stands as a malignant neoplasm bearing the highest burden of morbidity and mortality within the elderly population on a global scale. Among the lung cancer subtypes, non-small cell lung cancer (NSCLC) prevails as the most prevalent. As age advances, elderly patients often present with an increased prevalence of comorbidities, diminished organ reserve function, and alterations in drug pharmacokinetics, including absorption, distribution, metabolism, and clearance. These factors collectively contribute to a reduction in their capacity to tolerate therapeutic interventions. Regrettably, there exists a paucity of research data and evidence regarding the management of elderly patients afflicted by advanced lung cancer. This article endeavors to compile and elucidate strategies for the enhancement of treatment approaches, with the aim of aiding clinical decision-making. Prior to the selection of clinical treatment modalities for elderly patients with advanced NSCLC, a comprehensive assessment should be conducted, taking into account various facets, including tumor characteristics, patient age, physiological status, and the presence of comorbidities. The treatment strategy should be implemented in a tiered fashion, thereby affording the opportunity for the tailoring of individualized therapeutic approaches for elderly patients afflicted by advanced NSCLC. The demographic of elderly patients confronting advanced NSCLC presents a complex landscape marked by intricate underlying conditions, necessitating the imperative optimization of treatment strategies.
{"title":"Optimization of treatment strategies for elderly patients with advanced non-small cell lung cancer","authors":"Qiang Chen, Shuo Ying, Jianwen Qin, Li Zhang","doi":"10.3389/fonc.2024.1384906","DOIUrl":"https://doi.org/10.3389/fonc.2024.1384906","url":null,"abstract":"Lung cancer stands as a malignant neoplasm bearing the highest burden of morbidity and mortality within the elderly population on a global scale. Among the lung cancer subtypes, non-small cell lung cancer (NSCLC) prevails as the most prevalent. As age advances, elderly patients often present with an increased prevalence of comorbidities, diminished organ reserve function, and alterations in drug pharmacokinetics, including absorption, distribution, metabolism, and clearance. These factors collectively contribute to a reduction in their capacity to tolerate therapeutic interventions. Regrettably, there exists a paucity of research data and evidence regarding the management of elderly patients afflicted by advanced lung cancer. This article endeavors to compile and elucidate strategies for the enhancement of treatment approaches, with the aim of aiding clinical decision-making. Prior to the selection of clinical treatment modalities for elderly patients with advanced NSCLC, a comprehensive assessment should be conducted, taking into account various facets, including tumor characteristics, patient age, physiological status, and the presence of comorbidities. The treatment strategy should be implemented in a tiered fashion, thereby affording the opportunity for the tailoring of individualized therapeutic approaches for elderly patients afflicted by advanced NSCLC. The demographic of elderly patients confronting advanced NSCLC presents a complex landscape marked by intricate underlying conditions, necessitating the imperative optimization of treatment strategies.","PeriodicalId":507440,"journal":{"name":"Frontiers in Oncology","volume":"4 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141641350","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}
This study aimed to assess the role and effect of neoadjuvant targeted therapy (TT) versus targeted combined with chemotherapy (TC) for resectable EGFR-mutant non–small cell lung cancer (NSCLC).Between March 2021 and June 2023, 20 patients with stage IA3-IIIB NSCLC were enrolled in the study. Eleven patients received EGFR-TKIs in the TT group, while nine patients received EGFR-TKIs and two cycles of cisplatin-based doublet chemotherapy (TC group). We compare the differences between the two groups through the following variables, including age, sex, surgical approach, postoperative complications, neoadjuvant therapy adverse events, complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), objective response rate (ORR), major pathologic response (MPR), and pathologic complete response (pCR).Patients were predominantly female (75%) and never-smokers (95%). The average age was 59.2 years (range 46-79 years). Fifty-five percent harbored an exon 19 EGFR mutation and 45% an exon 21 mutation. The average targeted drug dosing time was 2.91 ± 1.7 (range 1-6) months in the TT group and 3.56 ± 3.54 (range 1-12) months in the TC group (P=0.598). The most common side effects were rash and diarrhea. No grade 5 events with neoadjuvant therapy were observed. The rate of R0 resection was 100% in all patients. Among the 11 patients in the TT group, 6 achieved a PR and 5 had SD, resulting in an ORR of 54.5%. Among the 9 patients in the TC group, 6 had PR and the remaining 3 had SD, resulting in an ORR of 66.6%. one patient (11.1%) in the TC group achieved pCR, while no patients in the TT group achieved pCR (P = 0.142). Two patients (18.2%) in the TT group reached MPR, and 2 patients (22.2%) in the TC group reached MPR (P = 0.257). The overall clinical downstage rate is 60%. Only 9 (45%) cases of yield clinical TNM (ycTNM) were consistent with yield pathologic TNM (ypTNM).Results from this retrospective controlled research indicate that the neoadjuvant TT group is likely to be more effective outcomes and has safer profile in patients with EGFR-positive NSCLC than the neoadjuvant TC group. However, our results need to be validated in a multicenter, large sample prospective study.
{"title":"Neoadjuvant targeted therapy versus targeted combined with chemotherapy for resectable EGFR-mutant non–small cell lung cancer: a retrospective controlled real-world study","authors":"Weipeng Shao, Zhan Liu, Bobo Li, Feng Chen, J. Liu, Hui Li, Hongbo Guo","doi":"10.3389/fonc.2024.1349300","DOIUrl":"https://doi.org/10.3389/fonc.2024.1349300","url":null,"abstract":"This study aimed to assess the role and effect of neoadjuvant targeted therapy (TT) versus targeted combined with chemotherapy (TC) for resectable EGFR-mutant non–small cell lung cancer (NSCLC).Between March 2021 and June 2023, 20 patients with stage IA3-IIIB NSCLC were enrolled in the study. Eleven patients received EGFR-TKIs in the TT group, while nine patients received EGFR-TKIs and two cycles of cisplatin-based doublet chemotherapy (TC group). We compare the differences between the two groups through the following variables, including age, sex, surgical approach, postoperative complications, neoadjuvant therapy adverse events, complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), objective response rate (ORR), major pathologic response (MPR), and pathologic complete response (pCR).Patients were predominantly female (75%) and never-smokers (95%). The average age was 59.2 years (range 46-79 years). Fifty-five percent harbored an exon 19 EGFR mutation and 45% an exon 21 mutation. The average targeted drug dosing time was 2.91 ± 1.7 (range 1-6) months in the TT group and 3.56 ± 3.54 (range 1-12) months in the TC group (P=0.598). The most common side effects were rash and diarrhea. No grade 5 events with neoadjuvant therapy were observed. The rate of R0 resection was 100% in all patients. Among the 11 patients in the TT group, 6 achieved a PR and 5 had SD, resulting in an ORR of 54.5%. Among the 9 patients in the TC group, 6 had PR and the remaining 3 had SD, resulting in an ORR of 66.6%. one patient (11.1%) in the TC group achieved pCR, while no patients in the TT group achieved pCR (P = 0.142). Two patients (18.2%) in the TT group reached MPR, and 2 patients (22.2%) in the TC group reached MPR (P = 0.257). The overall clinical downstage rate is 60%. Only 9 (45%) cases of yield clinical TNM (ycTNM) were consistent with yield pathologic TNM (ypTNM).Results from this retrospective controlled research indicate that the neoadjuvant TT group is likely to be more effective outcomes and has safer profile in patients with EGFR-positive NSCLC than the neoadjuvant TC group. However, our results need to be validated in a multicenter, large sample prospective study.","PeriodicalId":507440,"journal":{"name":"Frontiers in Oncology","volume":"9 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141644221","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 : 2024-07-16DOI: 10.3389/fonc.2024.1400193
Jiamin Xu, Shukun Mu, Yun Wang, Suchun Yu, Zhongming Wang
The incidence of melanoma is increasing year by year and is highly malignant, with a poor prognosis. Its treatment has always attracted much attention. Among the more clinically applied immunotherapies are immune checkpoint inhibitors, bispecific antibodies, cancer vaccines, adoptive cell transfer therapy, and oncolytic virotherapy. With the continuous development of technology and trials, in addition to immune monotherapy, combinations of immunotherapy and radiotherapy have shown surprising efficacy. In this article, we review the research progress of immune monotherapy and combination therapy for advanced melanoma, with the aim of providing new ideas for the treatment strategy for advanced melanoma.
{"title":"Recent advances in immunotherapy and its combination therapies for advanced melanoma: a review","authors":"Jiamin Xu, Shukun Mu, Yun Wang, Suchun Yu, Zhongming Wang","doi":"10.3389/fonc.2024.1400193","DOIUrl":"https://doi.org/10.3389/fonc.2024.1400193","url":null,"abstract":"The incidence of melanoma is increasing year by year and is highly malignant, with a poor prognosis. Its treatment has always attracted much attention. Among the more clinically applied immunotherapies are immune checkpoint inhibitors, bispecific antibodies, cancer vaccines, adoptive cell transfer therapy, and oncolytic virotherapy. With the continuous development of technology and trials, in addition to immune monotherapy, combinations of immunotherapy and radiotherapy have shown surprising efficacy. In this article, we review the research progress of immune monotherapy and combination therapy for advanced melanoma, with the aim of providing new ideas for the treatment strategy for advanced melanoma.","PeriodicalId":507440,"journal":{"name":"Frontiers in Oncology","volume":"20 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141641665","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 : 2024-07-16DOI: 10.3389/fonc.2024.1445222
Xiaodong Wang, Fancheng Meng, Jingxin Mao
Hepatocellular carcinoma is one of the common malignant tumors of digestive tract, which seriously threatens the life of patients due to its high incidence rate, strong invasion, metastasis, and prognosis. At present, the main methods for preventing and treating HCC include medication, surgery, and intervention, but patients frequently encounter with specific adverse reactions or side effects. Many Traditional Chinese medicine can improve liver function, reduce liver cancer recurrence and have unique advantages in the treatment of HCC because of their acting mode of multi-target, multi-pathway, multi-component, and multi-level. Sesquiterpenoids, a class of natural products which are widely present in nature and exhibit good anti-tumor activity, and many of them possess good potential for the treatment of HCC. This article reviewed the anti-tumor activities, natural resources, pharmacological mechanism of natural sesquiterpenoids against HCC, providing the theoretical basis for the prevention and treatment of HCC and a comprehensive understanding of their potential for development of new clinical drugs.
{"title":"Progress of natural sesquiterpenoids in the treatment of hepatocellular carcinoma","authors":"Xiaodong Wang, Fancheng Meng, Jingxin Mao","doi":"10.3389/fonc.2024.1445222","DOIUrl":"https://doi.org/10.3389/fonc.2024.1445222","url":null,"abstract":"Hepatocellular carcinoma is one of the common malignant tumors of digestive tract, which seriously threatens the life of patients due to its high incidence rate, strong invasion, metastasis, and prognosis. At present, the main methods for preventing and treating HCC include medication, surgery, and intervention, but patients frequently encounter with specific adverse reactions or side effects. Many Traditional Chinese medicine can improve liver function, reduce liver cancer recurrence and have unique advantages in the treatment of HCC because of their acting mode of multi-target, multi-pathway, multi-component, and multi-level. Sesquiterpenoids, a class of natural products which are widely present in nature and exhibit good anti-tumor activity, and many of them possess good potential for the treatment of HCC. This article reviewed the anti-tumor activities, natural resources, pharmacological mechanism of natural sesquiterpenoids against HCC, providing the theoretical basis for the prevention and treatment of HCC and a comprehensive understanding of their potential for development of new clinical drugs.","PeriodicalId":507440,"journal":{"name":"Frontiers in Oncology","volume":"63 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141643695","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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