Journal of cancer research and therapeutics最新文献

Background: The optimal radiation dose for the treatment of small cell carcinoma of the esophagus (SCEC) has not been established. This study aimed to investigate the treatment outcomes and toxicities in patients with limited-stage SCEC (LS-SCEC) treated by radiotherapy.

Methods: Patients with LS-SCEC from 14 institutions were retrospectively identified between December 2000 and October 2021. The primary endpoints of the study included overall survival (OS), progression-free survival (PFS), and local regional control (LRC), and the secondary endpoints were treatment-related toxicity parameters. Patients were categorized into a high-dose (HD, ≥ 60 Gy) group and low-dose (LD, <60 Gy) group based on the radiation dose. Additionally, they were classified into two groups based on the treatment sequence: concurrent chemoradiotherapy (CCRT) and sequential chemoradiotherapy (SCRT). A 1:1 propensity score matching (PSM) approach was applied to balance the observable potential confounding factors between the groups.

Results: Of the 150 patients included in the study, 56 received LD, and 94 received HD radiotherapy. After 1:1 PSM, the OS, PFS, and LRC in the HD group were higher than those in the LD group; however, the difference was not statistically significant (P > 0.05). No significant differences in survival and the occurrence of treatment-related toxicity were observed between the CCRT and SCRT groups.

Conclusions: Neither CCRT nor SCRT was significantly associated with longer survival in LS-SCEC when a higher radiation dose was selected. A lower radiation dose might be a preferable time-dose fraction scheme; however, additional studies are required to validate these findings.

Background: This study analyzes adverse event (AE) signals associated with ramucirumab using data from the FDA Adverse Event Reporting System (FAERS) to provide evidence supporting the safety of the drug for clinical use.

Methods: Data were extracted from the FAERS database using Open Vigil 2.1. Signal detection was performed using the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), and Bayesian Confidence Propagation Neural Network (BCPNN) methods. AEs were categorized and described using the Preferred Terms (PTs) and System Organ Class (SOC) classifications from the Medical Dictionary for Regulatory Activities.

Results: A total of 1,701 AE reports related to ramucirumab were retrieved. Most reported cases involved male patients (59.79%), most aged 65-74 years (25.57%), with Asia being the primary region of report origin (59.08%). Based on the screening criteria, 130 PT signals across 18 SOC categories were identified, of which 72 PTs were not listed in the drug label. Frequently reported and strongly signaled AEs included hypertension, ascites, proteinuria, edema, and neutropenia-events already noted in the prescribing information of the drug. However, additional AEs, such as pyogenic granuloma, brainstem hemorrhage, interstitial lung disease, and peritonitis, which were not included in the labeling, also showed strong signals and warrant further exploration.

Conclusions: The commonly reported AEs of ramucirumab observed in real-world data are consistent with those listed on the drug label. Nevertheless, new suspicious AEs were identified. Enhanced clinical vigilance, through pretreatment risk assessment and ongoing posttreatment monitoring, is recommended to ensure patient safety.

Background: Noninvasive and functional tumor vascular system imaging at the microscopic scale is greatly significant. Using animal models, we investigated the feasibility of using superresolution ultrasound (SR-US) imaging to visualize and quantify the microvessels during tumor growth.

Methods: This study established nine rabbit VX2 tumor models. Conventional US, contrast-enhanced US (CEUS), and SR-US images were acquired on Days 5, 8, and 14 postimplantation in 18 VX2 tumors. The imaging capabilities of CEUS and SR-US were compared, and hemodynamic changes were assessed using SR-US parameters. Pearson's correlation was calculated to analyze the association between the microvessel density (MVD) from histopathology and the vascular density (VD) from SR-US.

Results: SR-US demonstrated superior resolution compared with conventional CEUS. The minimum discernible vessel diameter of 105.2 ± 7.5 μm was observed in the VX2 tumor microvasculature visualized with SR-US. A strong positive correlation (r = 0.82, P = 0.006) was found between MVD and VD. The tumor size progression exhibited distinct stages: stable stage (Days 5 and 8) and growth stage (Days 8-14). Vessel pixels significantly increased throughout all experimental stages (P < 0.05), whereas both the VD and perfusion index demonstrated transient increases during the early stage before returning to baseline levels. The mean velocity and flow direction entropy initially decreased but returned to baseline later. The maximum velocity and fractal dimension significantly increased during the accelerated stage (P < 0.05).

Conclusions: Quantitative SR-US parameters provided a valuable tool for assessing microvascular changes during tumor progression.

Abstract: Esophageal pericardial fistula is a rare complication of esophageal cancer. This article reports the first documented case of an esophageal pericardial fistula following radiotherapy in the presence of an esophageal stent. A 62-year-old man with advanced esophageal and cardiac cancer underwent radiotherapy after esophageal stent placement and subsequently developed an esophageal pericardial fistula. He was admitted to the hospital with symptoms of epigastric pain and breathlessness. A computed tomography scan of the chest revealed an esophageal pericardial fistula, massive pericardial effusion, and pneumopericardium. The esophagogram revealed esophageal extravasation and an enlarged pericardium. On the basis of these findings, the patient was diagnosed with an esophageal pericardial fistula. His symptoms improved after pericardiocentesis with drainage, nasogastric tube feeding, and short-term antibiotic therapy. Unfortunately, he died 1 month after discharge from the hospital due to sudden massive upper gastrointestinal bleeding.

Abstract: Recent studies have demonstrated a significant correlation between Fusobacterium nucleatum (F. nucleatum) and colorectal cancer. However, the prognostic significance of this microorganism in patients with colorectal cancer remains unclear. This meta-analysis aimed to evaluate the impact of F. nucleatum on the overall survival of patients with colorectal cancer. A thorough literature search of PubMed, Embase, and Cochrane Library databases was conducted until December 2023. The hazard ratio (HR) with the corresponding 95% confidence interval (CI) was analyzed using Review Manager 5.4 software for survival outcomes, including the overall survival (OS). A total of 13 studies, covering 4475 samples with colorectal cancer, were selected based on specified inclusion and exclusion criteria. In the univariate and multivariate analyses, patients with positive or high abundance of Fusobacterium in the cancer tissues displayed poorer OS (univariate HR = 1.28, 95% CI: 1.08-1.53, P = 0.006; multivariate HR = 1.61, 95% CI: 1.37-1.88, P < 0.0001) than those with negative/low bacteria levels. Subgroup analysis revealed that Fusobacterium in cancer tissues was associated with tumor stage and differentiation. Patients with stage III and IV, T3 and T4, or poorly differentiated tumors had a higher abundance of Fusobacterium in cancer tissues than those with stage I and II, T1 and T2, or well-to-moderately differentiated tumors (P < 0.05). No statistically significant difference in lymph node metastasis was observed. These findings suggest that the Fusobacterium microbiome may play a significant role in predicting the survival outcomes in patients with colorectal cancer.

Objective: This study aimed to evaluate the safety and efficacy of improved supine positioning components for lung tumor microwave ablation (MWA), with the goal of enhancing surgical efficiency, reducing complications, and improving patient experience.

Materials and methods: One hundred patients undergoing MWA for lung tumors were randomly divided into two groups (n = 50 each): experimental (using improved components) and control (using traditional components). The improved positioning system included a high-density memory foam head pillow, lumbar and leg pillows, and adjustable fixing bands tailored to individual patient needs. A comparative analysis was performed on the positioning time, surgical localization time, number of intraoperative computed tomography (CT) scans, changes in vital signs, incidence of postoperative complications, and patient satisfaction between the groups.

Results: The experimental group showed significantly shorter positioning (9.48 ± 1.79 min) and surgical localization times (15.08 ± 2.76 min) compared to the control group (P < 0.05). They also required fewer intraoperative CT scans and exhibited more efficient surgical procedures. The experimental group demonstrated a smaller fluctuation range in vital signs and a significantly lower incidence of hypoxemia (P < 0.05), indicating enhanced intraoperative safety in the experimental group. Additionally, the experimental group showed lower pneumothorax and hemothorax rates and higher postoperative patient satisfaction scores (P < 0.05).

Conclusion: The use of improved positioning components during MWA for lung tumors effectively reduces positioning time, improves surgical efficiency, lowers intraoperative complication risks, and enhances patient satisfaction. Thus, their application may be recommended for lung tumor MWA.

Objectives: We aimed to verify the efficacy and safety of microwave ablation (MWA) in combination with third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) administration for EGFR-mutant advanced non-small cell lung cancer (NSCLC).

Materials and methods: Individuals with advanced NSCLC and EGFR mutations who underwent third-generation EGFR-TKI treatment and MWA (EGFR-TKI treatment followed by MWA [Group E + M] and MWA followed by EGFR-TKI treatment [Group M + E]) were retrospectively enrolled. The primary endpoint was duration of response (DoR).

Results: There were 12 patients in Group E + M and 16 in Group M + E. The overall median DoR was 21.9 months (95% confidence interval [CI]: 17.3-26.4). The median DoR was 25.7 months (95% CI: 20.6-30.9) and 20.5 months (95% CI: 5.9-35.1) in Group E + M and Group M + E ( P = 0.996), respectively. When EGFR-TKIs were used as a first-line treatment, the median DoR overall and that of patients in Groups E + M and M + E were 29.3 months (95% CI: 19.2-39.4), 29.3 months (95% CI: 21.0-37.5), and not reached ( P = 0.252), respectively. Major complications related to pneumothorax were observed in five patients, with no difference observed between the groups.

Conclusion: Patients with advanced EGFR-mutant NSCLC who underwent third-generation EGFR-TKI treatment plus MWA had a superior DoR and experienced minimal complications.

Objective: This study aimed to establish an evaluation index system for intelligent minimally invasive tumor ablation based on telemedicine, thereby providing theoretical support for the assessment, application, and promotion of remote intelligent ablation therapies.

Methods: An expert consultation questionnaire was developed based on a review of the literature. Purposive sampling was performed to select 16 experts specializing in minimally invasive oncology, telemedicine management, and healthcare informatics. Two rounds of Delphi questionnaire surveys were conducted. The index system was finalized through iterative discussions based on expert feedback. The analytical hierarchy process (AHP) was utilized to determine the indicator weights.

Results: Both rounds of the questionnaire achieved 100% response rates. The expert authority coefficient reached 0.789, while the Kendall's W coefficients for the two rounds were 0.138 (P < 0.001) and 0.224 (P < 0.001), respectively. The finalized system comprised 6 first-level indicators, 13 second-level indicators, and 45 third-level indicators, establishing a comprehensive management framework for telemedicine-based intelligent tumor ablation.

Conclusion: The evaluation system established in this study demonstrated scientific validity and reliability. It identified critical success factors for implementing remote ablation procedures, offering a practical reference for advancing telemedicine-enabled minimally invasive cancer therapies.

Background: Lung squamous cell carcinoma (LUSC) is the dominant histological subtype of lung cancer, accounting for 30% of all cases. Most patients develop distant metastases by the time they are diagnosed with the disease, owing to a delay in the appearance of symptoms. Therefore, accurate prognostic prediction is essential for personalized treatment. However, existing models tend to ignore competing risks, leading to an overestimation of the incidence. This study aimed to construct an accurate mortality risk prediction model for LUSC patients from the perspective of competing risks.

Methods: A total of 28,312 patients with LUSC from 2000 to 2019 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Potential predictors included age, sex, treatments, race, marital status, tumor site, differentiation, and stage. Statistical analyses were performed using cause-specific hazard and Fine-Gray risk models to assess competing risks. Model performance was evaluated using Harrell's concordance index and calibration plots.

Results: Age, sex, treatment, marital status, tumor site, differentiation, and stage significantly affected the prognosis of LUSC. Both risk models showed good predictive power. The Fine-Gray risk model was slightly better than the cause-specific hazard model in terms of the 3- and 5-year mortality. The key risk factors for LUSC outcomes included age, male gender, absence of surgery, chemotherapy or radiotherapy, being unmarried or divorced, primary tumors in the lower lobe or main bronchus, low differentiation, and high tumor stage.

Conclusion: The Fine-Gray model excels in predicting LUSC death risk and holds significant clinical value.

Objective: To evaluate the efficacy and safety of neoadjuvant chemoimmunotherapy (NICT) in treating locally advanced resectable esophageal squamous cell carcinoma (ESCC).

Materials and methods: This retrospective analysis included 379 patients, who received NICT (PD-1 inhibitors + chemotherapy) before surgery at Shandong Cancer Hospital from January 1, 2020, to January 1, 2025. Pathological responses were assessed using standardized criteria, including pathological complete response (pCR), major pathological response (MPR), and tumor regression grade (TRG). Survival analysis was performed using Kaplan-Meier methods, and multivariate Cox regression models were constructed to evaluate the relationship between NICT and survival outcomes.

Results: The pCR, MPR, and significant tumor reduction rates were 27.2%, 41.8%, and 81.6%, respectively. Poor tumor differentiation and early clinical stage were associated with improved treatment responses. Patients achieving pCR, MPR, or TRG0-1 had significantly better overall survival rates compared with other groups (P < 0.0001). NICT demonstrated acceptable toxicity, with anastomotic leakage (9.0%) and pneumonia (17.9%) being the primary complications.

Conclusion: NICT significantly improves pathological response and survival rates in patients with locally advanced resectable ESCC, with a favorable safety profile. These findings highlight the potential of NICT to transform the treatment landscape of ESCC. Future research should focus on the optimizing treatment regimens, identifying predictive biomarkers, and reducing toxicity to improve clinical outcomes and achieve personalized treatment.