Journal of cancer research and therapeutics最新文献

Abstract: Metabolic reprogramming alters the processes by which tumor cells generate energy and synthesize products, affecting their growth and survival. It also reshapes the tumor microenvironment by influencing immune cell function and interaction. Current literature suggests that the metabolic characteristics of gastric malignancies are closely associated with tumor immune evasion and inflammatory responses, thereby influencing immune cell infiltration, tumor progression, and patient prognosis. Despite some progress, research on metabolic reprogramming in gastric cancer (GC) is challenging, particularly in understanding the specific mechanisms involved and their clinical applications. This review aims to comprehensively explore the mechanisms of metabolic reprogramming in GC and analyze its impact on the tumor immune microenvironment. We also propose potential metabolic-immune therapeutic strategies, such as glutaminase inhibitors, lactate transport blockers, and immune checkpoint therapy combined with metabolic regulators, providing new ideas and directions for immunotherapy in GC.

Background: Gamma knife radiosurgery (GKRS) is a key treatment method for intracranial neoplasms, particularly primary jugular foramen tumors. The risks associated with surgical resection and conventional radiotherapy have prompted interest in GKRS, which facilitates precise, high-dose delivery with minimal collateral damage.

Methods: This retrospective study comprised 219 patients with primary jugular foramen tumors treated from June 2014 to June 2024. The patients were divided into two groups based on the treatment received: conventional fractionated external beam radiotherapy (EBRT, n = 103) and GKRS (n = 116). Treatment efficacy was evaluated using magnetic resonance imaging and the Response Evaluation Criteria in Solid Tumors criteria 6 months post-treatment. Correlation and regression analyses were conducted to identify factors affecting the treatment outcomes.

Results: The GKRS group exhibited a significantly higher complete and partial response rates compared to the EBRT group (25.86% vs. 9.71% and 30.17% vs. 22.33%, respectively). The GKRS group showed a significantly lower rate of progressive disease (5.17% vs. 23.3%, P < 0.001) and fewer cranial nerve-related adverse effects (P = 0.008) compared to the EBRT group. The factors predicting poor GKRS efficacy included a large tumor volume, intra-/extracranial extension, and transient expansion (P = 0.005, 0.010, and 0.005, respectively).

Conclusion: GKRS demonstrated superior efficacy and a better safety profile than EBRT for managing primary jugular foramen tumors. Tumor type, volume, and morphology significantly influenced GKRS outcomes, highlighting the need for tailored treatment strategies based on individual tumor characteristics.

Abstract: Inflammatory myofibroblastoma tumor (IMT) is rare neoplasm that has high recurrence rate and low likelihood of metastasis. Here, we report the efficacy and safety of microwave ablation (MWA) combined with transarterial embolization in a patient with unresectable retroperitoneal IMT measuring 89 mm in maximum diameter. Multiple courses of MWA, the last of which was performed under magnetic resonance imaging guidance, and one course of transarterial embolization resulted in complete response without complications. After more than 1.5 years of the last MWA treatment, follow-up showed sustained complete response. This case suggested that the combination of MWA and transarterial embolization is a new option for retroperitoneal IMT. A multicenter and large-sample clinical trial is required to confirm the efficacy and safety of MWA combined with transarterial embolization for retroperitoneal IMT.

Purpose: To summarize and analyze the computed tomography (CT) and magnetic resonance imaging (MRI) features of uterine sarcoma.

Methods and material: This retrospective study reviewed the clinical data and CT/MRI findings of 15 patients with uterine sarcomas confirmed by surgery and pathology, focusing on their characteristic imaging manifestations.

Results: Among the 15 patients, eight had uterine smooth muscle sarcoma (four with lesions confined to the uterine cavity and four presenting as large pelvic masses; all were cystic); one had undifferentiated uterine sarcoma [low signal on TI-weighted imaging (T1WI), high signal on T2-weighted imaging (T2WI) with the clear border, and marginal ring-shaped high signals on diffusion-weighted image (DWI)]; two had uterine adenosarcoma (mixed-density nodular and mass-like lesions with marked heterogeneous enhancement); three had low-grade endometrial stromal sarcoma (iso- or hypointense on T1WI, hyper- or slightly hyperintense on T2WI, and markedly hyperintense on DWI); and one had high-grade endometrial stromal sarcoma (a large cystic-solid pelvic mass). Pathology confirmed that this last lesion invaded the plasma membrane and involved local sub-plasma tissue of the intestinal wall.

Conclusion: Uterine sarcoma commonly presents as the large cystic pelvic mass with indistinct margins, irregular shape, and possible invasion of adjacent structures. MRI typically shows iso- or slightly low T1WI signals, mixed high T2WI signals, high or slightly high DWI signals, and heterogeneous enhancement. These findings may aid in improving diagnostic accuracy and guiding clinical management of uterine sarcoma.

Objective: To explore the evaluation value of different reconstruction methods of enhanced computed tomography (CT) images on the cardiac structure dose in patients undergoing radiotherapy for breast cancer.

Methods: A retrospective analysis of the cardiac structure data of 200 female patients with left-sided breast cancer, who underwent enhanced CT scans was conducted. Image reconstruction was performed with a time interval of 5% of the cardiac cycle (0%-95%), obtaining maximum intensity projection (MIP), minimum intensity projection (MinIP), and average intensity projection (AIP) images. The left ventricle (LV) and the left anterior descending artery (LAD) were delineated on the four types of images.

Results: The MinIP, MIP, and AIP images showed larger LAD volumes than enhanced CT images (P < 0.05). Compared with the dose sum, the changes in V5Gy, V30Gy, V40Gy, Dmax, and Dmean for LV on MIP images were all <5% (4.02%, 2.17%, 1.39%, 2.99%, and 1.93%, respectively). The Dmax and Dmean change rates for LV on MinIP images were both <5%, at 2.00% and 4.73%, respectively; the Dmax and Dmean change rates for LV on AIP images were also both <5%, at 3.01% and 3.99%. Compared with the dose sum, only the Dmax change rates for LAD on MIP, MinIP, and AIP images were <5% (all P > 0.05), at 4.96%, 4.01%, and 4.07%, respectively.

Conclusion: In LV dose-volume assessment, the differences in assessment metrics between MIP images and enhanced CT images are small, indicating that MIP imaging can serve as a supplementary method to enhanced CT imaging for this form of assessment.

Background: Chondrosarcoma is the second most common malignant primary bone tumor. Given the poorer prognosis of high-grade chondrosarcomas and the lack of prognostic tools, this study aimed to develop a nomogram for better prognosis evaluation.

Methods: A comprehensive approach was adopted, involving Kaplan-Meier analysis for survival curve generation, log-rank test for comparing survival differences, and multivariate Cox regression analysis for identifying independent prognostic determinants. Utilizing the "rms" package, nomograms were constructed to predict overall survival (OS) and cancer-specific survival (CSS) of patients with high-grade chondrosarcoma. Nomogram reliability was validated through the concordance index (C-index) and calibration curves, which quantitatively and graphically evaluated the predictive accuracy.

Results: A total of 1,198 high-grade chondrosarcoma cases retrieved from the SEER database were retrospectively analyzed. Following Kaplan-Meier survival analysis, several variables (age, sex, tumor size, stage, metastasis, surgery, chemotherapy, and radiation for OS) were incorporated into the multivariate Cox regression models for OS and CSS. Nomograms for OS and CSS were established based on the derived independent prognostic factors. The C-indices of the training and validation cohorts were 0.8117 and 0.7642 for the OS and 0.8475 and 0.8173 for the CSS analysis, respectively. The calibration plots further corroborated the nomograms' accurate predictive capacity for both OS and CSS.

Conclusion: Nomograms capable of precisely estimating OS and CSS in high-grade chondrosarcoma were successfully developed. These nomograms offer clinicians a valuable tool for more accurate survival prediction of patients with high-risk chondrosarcoma, which optimizes postoperative treatment strategies and improves patient management and outcomes.

Context: Thyroid nodules with intermediate- and low-suspicion patterns are difficult to diagnose, based on the 2015 American Thyroid Association (ATA) stratification.

Aims: We evaluated the performance of shear wave elastography (SWE) as an adjunctive tool to ultrasound (US) in predicting the malignancy of these thyroid nodules.

Settings and design: Thyroid nodules (n = 270) collected from January to April 2018 with low or intermediate suspicion for malignancy were evaluated.

Methods, materials, and statistical analyses: The maximum SWE elasticity values (Emax) for the nodules were examined and subsequently confirmed by pathology. SWE and ATA guidelines, as well as a combination of the two, were applied.

Results: Combined with SWE, the diagnostic accuracy of the ATA categories was superior to the ATA categories alone (area under the curve, AUC 0.81 vs. 0.72, P < 0.05). Based on the ATA categories, the percentages of malignancy in the nodules with low and intermediate suspicion for malignancy were 21.1% (12/57) and 54.2% (13/24), respectively. After adjustments for the use of SWE, the nodules were restratified as very low, low, intermediate, and high suspicion of malignancy. The percentages of malignancy for the very low, low, intermediate, and high suspicion nodules were 0 (0/26), 27.3% (3/11), 37.8% (12/31), and 76.9% (10/13), respectively.

Conclusion: SWE may be used to differentiate malignant and benign nodules in addition to the ATA pattern. Combined with the ATA pattern, SWE supplemented US for predicting nodules with low and intermediate suspicion of malignancy.

Background: The prognosis for patients with small cell lung cancer (SCLC), who develop liver metastases (LM) is extremely poor, and treatment options are limited. This study aimed to evaluate the efficacy and safety of hepatic arterial infusion (HAI) chemotherapy combined with systemic chemotherapy for patients diagnosed with LM-SCLC.

Subject and methods: From January 2019 to December 2023, HAI catheter systems were implanted in 15 patients with LM-SCLC, guided by digital subtraction angiography. All patients received systemic chemotherapy in combination with HAI using gemcitabine and floxuridine (FUDR).

Results: The overall response rate for intrahepatic lesions was 66.7%, including one patient (6.7%) with a complete response and nine (60.0%) with a partial response. Additionally, the median overall survival (mOS) was 13 months (95% confidence interval, 11.4-14.6 months). Notably, none of the patients experienced grade 4 adverse effects. However, the grade 3 adverse effects included leukopenia and neutropenia, which were well tolerated by all the patients.

Conclusions: HAI of gemcitabine and FUDR, alongside systemic chemotherapy, may serve as an effective treatment strategy for achieving a high local response and prolonging mOS in patients with LM-SCLC, while also being associated with a relatively low incidence of adverse effects.