Asia-Pacific journal of clinical oncology最新文献

Purpose: Breast and gynecological cancers can significantly impact patients' quality of life (QoL), which has become an important outcome measure in cancer care. This review aims to provide an updated synthesis of the literature on the QoL among patients with breast and gynecological cancers.

Methods: A review of systematic reviews was conducted using PubMed, Scopus, Science Direct, and Wiley Online Library to identify papers from 1985 to 2025. Publications were screened following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and methodological quality was assessed using the A Measurement Tool to Assess Systematic Review (AMSTAR) criteria. The findings were summarized in tables.

Results: Twenty-four studies were selected for inclusion. Findings were summarized under the following themes: quality-of-life measurements; treatments (including exercise, therapy, and digital intervention); and QoL among different nations, races, and regions. The EORTC QLQ-C30 emerged as the most widely used assessment tool in cancer research. Most reviews focused on the impact of treatments. According to the reviews, aerobic exercise, Baduanjin exercise, and acupuncture were the top recommended interventions for improving QoL in patients with breast cancer (BC).

Conclusion: There are many perceived challenges to collecting the data. Most of them involve obstacles in reporting and a variety of designs, interventions, and outcomes, making it hard to identify the most effective methods for improving QoL. However, some interventions have been proven to be effective for BC patients, including aerobic and Baduanjin exercises, yoga, acupuncture, and cognitive-behavioral stress management. Randomized controlled trials are needed to validate and refine treatment protocols. Future systematic reviews and meta-analyses should follow the reporting guidelines.

Aims: The Cancer Council Australia Cancer Pain Management in Adults Clinical Guideline aimed to inform timely, evidence-based guidance for managing cancer-related pain.

Methods: The ADAPTE approach for guideline updates was adopted. Source guidelines were selected following the AGREE II criteria. The target population was adults with chronic cancer-related pain. The interventions were screening, assessment, and management of cancer-related pain. Target users and settings were all health professionals caring for adults with cancer in any healthcare setting. Outcomes are reduction in cancer-related pain.

Results: Recommendations were mostly adopted directly from source guidelines and the recommendation strength reflected those of the source guidelines. Those which were developed de novo were either based on Level 1 evidence or consensus within the context of a documented need in the Australian setting.

Conclusions: The Cancer Council Australia guideline for managing cancer pain in adults contains evidence-based recommendations to guide appropriate evidence-based care.

Breast cancer is a ubiquitous health problem in the world, and recent studies point toward an increase in breast cancer incidence in the Middle East. The prevalence of breast cancer in the United Arab Emirates (UAE) has evidently increased dramatically throughout the decades, making breast cancer one of the most prevalent types of cancer. In addition, breast cancer is alarmingly being diagnosed at an earlier age, almost a decade younger in the UAE compared to Western regions. Several causative risk factors may be attributed to this increase, such as obesity caused by a developing sedentary lifestyle and consuming a high-caloric diet, genetic factors, and other relevant issues, including limited knowledge and awareness regarding breast cancer, low participation levels in breast cancer examinations, and lack of medical insurance coverage. Herein, we discuss the incidence of breast cancer, screening, risk factors, treatment, and cancer registry in the UAE. We also deliberate current advances in breast cancer diagnosis and treatment in the UAE, as well as relate breast cancer in the UAE with other Middle Eastern countries, such as Saudi Arabia, Kuwait, and Oman. Future clinical trials with a focus on the local population are encouraged, along with the establishment of a clinical trials unit that has a focus on cancer and breast cancer in particular, within the region.

Background and aims: The incidence of thyroid cancer (TC) has increased globally over the last three decades. Overdiagnosis appears to be the primary factor driving an increasing number of TC diagnoses. Most documented TC cases involve small, well-differentiated lesions. This study aimed to evaluate the changing trends in TC diagnoses and mortality over the last 10 years.

Methods: This retrospective study included patients registered between January 2013 and December 2022. Data on the number of patients diagnosed over 10 years were presented, and data on the types of treatment used were analyzed. This study aimed to investigate possible overdiagnosis and the approach to treatment of TC.

Results: The total number of registered cases was 342; the majority of cases were females (295, 86%), and only 47 cases were males (14%), with a female-to-male ratio of 6:1. The age-standardized rate (ASR) has increased over 10 years, from 47 cases to 621 per 1,000,000 people. Between 2013 and 2022, the ASR of TC increased from 58 to 1030 cases/1,000,000 and from 30 to 212 cases among women and men, respectively. Among the 184 patients with micropapillary TC, 173 (94%) underwent total thyroidectomy, whereas only 11 (6%) underwent lobectomy. In 2022, TC became the third most common cancer in this region, following breast and colorectal cancers in females. Of the 80 new cases diagnosed in 2022, only 47% had adjuvant radioactive iodine. The mortality rate over the 10-year period from 2013 to 2022 did not increase and remained relatively stable, with minor variations between 0 and 2 cases per year.

Conclusions: This study demonstrated a significant increase in TC diagnosis, especially in early-stage disease, without a corresponding increase in the mortality rate. This finding suggests that the current incidence of TC may be an example of overdiagnosis and overtreatment.

Oral cancer, specifically oral squamous cell carcinoma, is rapidly progressive, with a high recurrence rate and grave prognosis. Treatment modalities like surgery, chemotherapy, and radiotherapy are customarily associated with noxious side effects as well as drug resistance. The food constituent flavonoid quercetin has been identified as anticancer through several mechanisms, including apoptosis induction, suppression of metastasis, cell cycle arrest, and chemosensitization. Its clinical application is, however, restricted by poor systemic absorption. Novel nano-formulations such as liposomes, polymeric nanoparticles, etc., have emerged for improving the stability, bioavailability, and therapeutic action of quercetin. Artificial intelligence has also been reported to be of potential use in predicting patient response to quercetin, recognizing new molecular targets, and customizing treatment regimens. Future research should be conducted with clinical trials to establish the effectiveness of quercetin as an adjuvant treatment and fine-tune targeted delivery systems for it. There is a therapeutic promise for quercetin across multiple types of oral cancer due to its multi-targeting potential. Quercetin, in combination with traditional and immunotherapeutic strategies, represents a promising new strategy with the potential to overcome treatment barriers and reduce toxicity in oral cancer management.

Purpose: To evaluate the real-world effectiveness of adjuvant nivolumab following radical surgery in patients with high-risk urothelial carcinoma, using historical data for comparison.

Materials and methods: Patients who underwent radical surgery at our institution were retrospectively analyzed. They were divided into two groups: one group received adjuvant nivolumab, and the other received no adjuvant therapy. Oncological outcomes, adverse events, and treatment completion rates were assessed.

Results: A total of 158 patients were included: 20 in the adjuvant nivolumab group and 138 in the control group. The median observation periods were 20.4 months in the nivolumab group and 36.7 months in the control group. The nivolumab group showed significantly improved recurrence-free survival compared to the control group (hazard ratio: 0.21; 95% confidence interval: 0.10-0.42; p = 0.01). Although overall survival tended to improve in the nivolumab group, the difference was not statistically significant (hazard ratio: 0.32; 95% confidence interval: 0.01-1.01; p = 0.22). Multivariate analysis confirmed adjuvant nivolumab as a significant favorable prognostic factor for recurrence-free survival (hazard ratio: 0.18; 95% confidence interval: 0.044-0.73; p = 0.017). One-year treatment was completed in 55.0% of patients. Adverse events led to discontinuation in 25.0%, with major events including interstitial lung disease (three patients), hormonal disorders such as isolated adrenocorticotropic hormone deficiency (2), rash (3), hypothyroidism (1), and hepatitis (1).

Conclusion: Adjuvant nivolumab demonstrated clinical benefit in Asian patients with high-risk urothelial carcinoma in a real-world setting.

Purpose: Induction chemotherapy (ICT) followed by concurrent chemoradiotherapy is a standard of care in locoregionally advanced nasopharyngeal carcinoma (LA-NPC). However, there is a lack of consensus on appropriate radiotherapy (RT) target volumes and prescriptions after ICT. We systematically reviewed the literature to inform a planned international consensus guideline development.

Methods and materials: A scoping review was done to define the areas of significant practice differences, followed by a systematic review. The reviews were conducted by a Steering Committee (SC) and an Evidence Review Committee (ERC) consisting of radiation oncologists with expertise in treating NPC.

Results: The scoping review revealed significant practice differences on (1) optimal timing for post-ICT RT, (2) ideal imaging modalities for RT target delineation, (3) RT dose prescription and fractionation, and (4) RT target volume delineation. The systematic review found no specific recommendations on optimal timing for post-ICT RT and optimal imaging modalities. Regarding dose prescription, current guidelines advocate including two or three dose levels. Differences in post-induction target volume delineation were found. The data show that volume reduction may be possible without compromising oncologic outcomes and may improve quality of life.

Conclusion: There is a lack of evidence and guidelines on post-ICT RT timing and optimal imaging modalities. Guidelines on post-ICT target volumes and dose levels differ significantly; published evidence from clinical trials is limited. Considering this lack of consensus after ICT in LA-NPC, international consensus guidelines among experts from endemic regions are needed and may help harmonize practices.