Purpose: To construct a free and accurate breast cancer mortality prediction tool by incorporating lifestyle factors, aiming to assist healthcare professionals in making informed decisions. Patients and Methods: In this retrospective study, we utilized a ten-year follow-up dataset of female breast cancer patients from a major Chinese hospital and included 1,390 female breast cancer patients with a 7% (96) mortality rate. We employed six machine learning algorithms (ridge regression, k-nearest neighbors, neural network, random forest, support vector machine, and extreme gradient boosting) to construct a mortality prediction model for breast cancer. Results: This model incorporated significant lifestyle factors, such as postsurgery sexual activity, use of totally implantable venous access ports, and prosthetic breast wear, which were identified as independent protective factors. Meanwhile, ten-fold cross-validation demonstrated the superiority of the random forest model (average AUC = 0.918; 1-year AUC = 0.914, 2-year AUC = 0.867, 3-year AUC = 0.883). External validation further supported the model’s robustness (average AUC = 0.782; 1-year AUC = 0.809, 2-year AUC = 0.785, 3-year AUC = 0.893). Additionally, a free and user-friendly web tool was developed using the Shiny framework to facilitate easy access to the model. Conclusion: Our breast cancer mortality prediction model is free and accurate, providing healthcare professionals with valuable information to support their clinical decisions and potentially promoting healthier lifestyles for breast cancer patients.
Keywords: breast cancer, machine learning, predict model, mortality, lifestyle, SHAP
{"title":"Machine Learning-Based Predictive Model for Mortality in Female Breast Cancer Patients Considering Lifestyle Factors","authors":"Meixin Zhen, Haibing Chen, Qing Lu, Hui Li, Huang Yan, Ling Wang","doi":"10.2147/cmar.s460811","DOIUrl":"https://doi.org/10.2147/cmar.s460811","url":null,"abstract":"<strong>Purpose:</strong> To construct a free and accurate breast cancer mortality prediction tool by incorporating lifestyle factors, aiming to assist healthcare professionals in making informed decisions.<br/><strong>Patients and Methods:</strong> In this retrospective study, we utilized a ten-year follow-up dataset of female breast cancer patients from a major Chinese hospital and included 1,390 female breast cancer patients with a 7% (96) mortality rate. We employed six machine learning algorithms (ridge regression, k-nearest neighbors, neural network, random forest, support vector machine, and extreme gradient boosting) to construct a mortality prediction model for breast cancer.<br/><strong>Results:</strong> This model incorporated significant lifestyle factors, such as postsurgery sexual activity, use of totally implantable venous access ports, and prosthetic breast wear, which were identified as independent protective factors. Meanwhile, ten-fold cross-validation demonstrated the superiority of the random forest model (average AUC = 0.918; 1-year AUC = 0.914, 2-year AUC = 0.867, 3-year AUC = 0.883). External validation further supported the model’s robustness (average AUC = 0.782; 1-year AUC = 0.809, 2-year AUC = 0.785, 3-year AUC = 0.893). Additionally, a free and user-friendly web tool was developed using the Shiny framework to facilitate easy access to the model.<br/><strong>Conclusion:</strong> Our breast cancer mortality prediction model is free and accurate, providing healthcare professionals with valuable information to support their clinical decisions and potentially promoting healthier lifestyles for breast cancer patients.<br/><br/><strong>Keywords:</strong> breast cancer, machine learning, predict model, mortality, lifestyle, SHAP<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"110 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: The prognosis of locally advanced non-small cell lung cancer (NSCLC) remains poor despite the addition of neoadjuvant chemotherapy, as it has been shown to improve 5-year absolute benefit survival by only 5%. Recently, neoadjuvant immunotherapy with immune checkpoint inhibitors (ICIs), combined with chemotherapy has shown promise in the treatment of locally advanced NSCLC. For NSCLC invading the main bronchus, sleeve resection has become the preferred modality to avoid pneumonectomy and reserve more cardiac or pulmonary function and to reduce postoperative morbidity and mortality. However, there has been a paucity of evidence to evaluate the safety and efficacy of neoadjuvant chemoimmunotherapy on bronchial-vascular reconstruction owing to the limited number of patients treated by sleeve lobectomy. Despite promising initial results, key knowledge gaps remain, including the impact on bronchial-vascular reconstruction, biomarkers predictive of ICI response, and the potential for specific perioperative complications associated with neoadjuvant chemoimmunotherapy in the context of sleeve resection. This review summarizes the latest literature evidence on the efficacy and safety of neoadjuvant chemoimmunotherapy approaches to address the unmet needs of sleeve resection of NSCLC treatment, describes the biomarkers predictive of ICI responses, and perioperative outcomes of sleeve resection after neoadjuvant chemoimmunotherapy.
{"title":"Safety and Efficacy of Neoadjuvant Chemoimmunotherapy versus Chemotherapy for Non-Small Cell Lung Cancer Undergoing Sleeve Resection","authors":"Yanjun Qiu, Jinjiang Yu, Quanmin Guo, Jingyan Xu","doi":"10.2147/cmar.s453924","DOIUrl":"https://doi.org/10.2147/cmar.s453924","url":null,"abstract":"<strong>Abstract:</strong> The prognosis of locally advanced non-small cell lung cancer (NSCLC) remains poor despite the addition of neoadjuvant chemotherapy, as it has been shown to improve 5-year absolute benefit survival by only 5%. Recently, neoadjuvant immunotherapy with immune checkpoint inhibitors (ICIs), combined with chemotherapy has shown promise in the treatment of locally advanced NSCLC. For NSCLC invading the main bronchus, sleeve resection has become the preferred modality to avoid pneumonectomy and reserve more cardiac or pulmonary function and to reduce postoperative morbidity and mortality. However, there has been a paucity of evidence to evaluate the safety and efficacy of neoadjuvant chemoimmunotherapy on bronchial-vascular reconstruction owing to the limited number of patients treated by sleeve lobectomy. Despite promising initial results, key knowledge gaps remain, including the impact on bronchial-vascular reconstruction, biomarkers predictive of ICI response, and the potential for specific perioperative complications associated with neoadjuvant chemoimmunotherapy in the context of sleeve resection. This review summarizes the latest literature evidence on the efficacy and safety of neoadjuvant chemoimmunotherapy approaches to address the unmet needs of sleeve resection of NSCLC treatment, describes the biomarkers predictive of ICI responses, and perioperative outcomes of sleeve resection after neoadjuvant chemoimmunotherapy.<br/><br/><strong>Keywords:</strong> NSCLC, neoadjuvant chemotherapy, immune checkpoint inhibitors, sleeve lobectomy<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"5 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Primary breast Burkitt lymphoma (PB-BL) is an exceedingly rare form of primary breast lymphoma. Ultrasonography is the preferred modality for diagnosing breast diseases; however, the ultrasonic features of Burkitt lymphoma have rarely been reported. Herein, we report a case of ultrasonically diagnosed bilateral PB-BL in a lactating patient and present a literature review. A 28-year-old female patient experienced bilateral breast engorgement starting more than a month after childbirth. At three months postpartum, the patient experienced extreme bilateral breast engorgement, with the skin appearing dark purple and jaundiced. Based on the imaging diagnosis, pathological, immunohistochemical, and molecular biological findings, she was diagnosed with Burkitt lymphoma involves bilateral breasts, right adrenal glands, uterus, and multiple bones. After 4 cycles of combination chemotherapy, the tumor basically disappeared, and then after autologous stem cell transplantation and one cycle of combination chemotherapy, the patient is generally in good condition and is under follow-up. We found that the ultrasonic characteristics of PB-BL are different from those of common breast cancer or lactation mastitis. PB-BL lesions are often multiple, large masses, and even involve the whole breast. The characteristic reticular structures are common in lesions, and irregular hyperechoic masses can be seen around it. The mass has abundant peripheral and internal blood flow signals, but internal calcification and attenuated posterior echoes of masses are rarely observed. Thus, the ultrasonic features of breast Burkitt lymphoma are somewhat specific and understanding these features is conducive to its early identification.
Keywords: Burkitt lymphoma, ultrasonography, case report
{"title":"Ultrasound Diagnosis of Bilateral Primary Breast Burkitt Lymphoma in a 28-Year-Old Lactating Patient: A Case Report","authors":"Qiu-Xia Jiang, Li-Jing Shi, Xiu-Yang Hong, Yu-Qin Zhu, Qiu-Ling Guo, Wen Xie, Guo-Rong Lyu","doi":"10.2147/cmar.s483592","DOIUrl":"https://doi.org/10.2147/cmar.s483592","url":null,"abstract":"<strong>Abstract:</strong> Primary breast Burkitt lymphoma (PB-BL) is an exceedingly rare form of primary breast lymphoma. Ultrasonography is the preferred modality for diagnosing breast diseases; however, the ultrasonic features of Burkitt lymphoma have rarely been reported. Herein, we report a case of ultrasonically diagnosed bilateral PB-BL in a lactating patient and present a literature review. A 28-year-old female patient experienced bilateral breast engorgement starting more than a month after childbirth. At three months postpartum, the patient experienced extreme bilateral breast engorgement, with the skin appearing dark purple and jaundiced. Based on the imaging diagnosis, pathological, immunohistochemical, and molecular biological findings, she was diagnosed with Burkitt lymphoma involves bilateral breasts, right adrenal glands, uterus, and multiple bones. After 4 cycles of combination chemotherapy, the tumor basically disappeared, and then after autologous stem cell transplantation and one cycle of combination chemotherapy, the patient is generally in good condition and is under follow-up. We found that the ultrasonic characteristics of PB-BL are different from those of common breast cancer or lactation mastitis. PB-BL lesions are often multiple, large masses, and even involve the whole breast. The characteristic reticular structures are common in lesions, and irregular hyperechoic masses can be seen around it. The mass has abundant peripheral and internal blood flow signals, but internal calcification and attenuated posterior echoes of masses are rarely observed. Thus, the ultrasonic features of breast Burkitt lymphoma are somewhat specific and understanding these features is conducive to its early identification.<br/><br/><strong>Keywords:</strong> Burkitt lymphoma, ultrasonography, case report<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"55 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Faris Hernando Reviansyah, Daffa Rahmad Dwiyana Putra, Juan Alexander Supriatna, Veni Takarini, Maria Komariah
Abstract: Oral cancer is a worldwide health issue with high incidence and mortality, demands an effective treatment to improve patient prognosis. Superparamagnetic iron oxide nanoparticles (SPIONs) emerged as a candidate for oral cancer treatment due to their unique attributes, enabling a synergistic combination with its drug-delivery capabilities and hyperthermia when exposed to magnetic fields. SPIONs can be synthesized using biopolymers from agricultural waste like lignin from paddy, which produce biogenic nano iron oxide with superparamagnetic and antioxidant effects. In addition, lignin also acts as a stabilizing agent in creating SPIONs. This study aimed to explore how agricultural waste could be used to prepare SPIONs using the green synthesis method and to evaluate its potential for oral cancer specifically focusing on its effectiveness, side effects, biocompatibility, and toxicity. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. PubMed, EBSCO, and Scopus databases were exploited in the selection of articles published within the last decade. This study quality assessment uses OHAT for critical appraisal tools. Only 10 studies met the inclusion criteria. The findings suggest that the use of agricultural waste in the preparation of SPIONs not only holds potency for oral cancer treatment through drug delivery and hyperthermia but also aligns with the concept of green dentistry. SPIONs as a treatment modality for oral cancer have demonstrated notable effectiveness and versatility. This study provides robust evidence supporting green dentistry by using agricultural waste in the preparation and formulation of SPIONs for managing oral cancer. Its multifunctional nature and ability to enhance treatment efficacy while minimizing adverse effects on healthy tissues highlights the potency of SPION-based oral cancer treatments.
Keywords: SPIONs, oral cancer, treatment, biosynthesis, green dentistry
{"title":"Green Dentistry in Oral Cancer Treatment Using Biosynthesis Superparamagnetic Iron Oxide Nanoparticles: A Systematic Review","authors":"Faris Hernando Reviansyah, Daffa Rahmad Dwiyana Putra, Juan Alexander Supriatna, Veni Takarini, Maria Komariah","doi":"10.2147/cmar.s477791","DOIUrl":"https://doi.org/10.2147/cmar.s477791","url":null,"abstract":"<strong>Abstract:</strong> Oral cancer is a worldwide health issue with high incidence and mortality, demands an effective treatment to improve patient prognosis. Superparamagnetic iron oxide nanoparticles (SPIONs) emerged as a candidate for oral cancer treatment due to their unique attributes, enabling a synergistic combination with its drug-delivery capabilities and hyperthermia when exposed to magnetic fields. SPIONs can be synthesized using biopolymers from agricultural waste like lignin from paddy, which produce biogenic nano iron oxide with superparamagnetic and antioxidant effects. In addition, lignin also acts as a stabilizing agent in creating SPIONs. This study aimed to explore how agricultural waste could be used to prepare SPIONs using the green synthesis method and to evaluate its potential for oral cancer specifically focusing on its effectiveness, side effects, biocompatibility, and toxicity. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. PubMed, EBSCO, and Scopus databases were exploited in the selection of articles published within the last decade. This study quality assessment uses OHAT for critical appraisal tools. Only 10 studies met the inclusion criteria. The findings suggest that the use of agricultural waste in the preparation of SPIONs not only holds potency for oral cancer treatment through drug delivery and hyperthermia but also aligns with the concept of green dentistry. SPIONs as a treatment modality for oral cancer have demonstrated notable effectiveness and versatility. This study provides robust evidence supporting green dentistry by using agricultural waste in the preparation and formulation of SPIONs for managing oral cancer. Its multifunctional nature and ability to enhance treatment efficacy while minimizing adverse effects on healthy tissues highlights the potency of SPION-based oral cancer treatments.<br/><br/><strong>Keywords:</strong> SPIONs, oral cancer, treatment, biosynthesis, green dentistry<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"55 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wei Hong, Lei Zhang, Youkun Qi, Yanjun Wang, Wentao Wang
Purpose: Lung cancer remains a leading cause of cancer-related death and chemotherapy stands as a fundamental component in therapy. Chemotherapy-induced myelosuppression encompasses a spectrum of hematological declines, including not only neutrophils but also lymphocytes, hemoglobin levels and platelets. This retrospective cohort study investigates alterations in peripheral blood lymphocyte subsets. By uncovering these changes, our goal is to refine patient management strategies, ensuring that the benefits of chemotherapy are maximized while minimizing its detrimental effects. Patients and Methods: We retrospectively analyzed 159 lung cancer patients. Patients were categorized as “NT” (n=108, no previous anti-tumor therapy), and “PT” (n=51, prior therapy followed by at least a two-month treatment-free interval). Post-chemotherapy, patients were reassessed and grouped into “EarlyCycle” for those who underwent four or fewer cycles, and “LateCycle” for those who underwent more than four cycles. Results: The study focused on analyzing the percentages of lymphocyte subsets, including T cells (CD4+, CD8+), B cells, and natural killer (NK) cells, across these groups. For T cells, the EarlyCycle group exhibited a significant increase compared to NT (0.7783 vs 0.7271; p=0.0017) and PT (0.7783 vs 0.6804; p=1.6e-05). B cells showed a significant decrease from NT to LateCycle (0.1014 vs 0.0817; p=2.2e-05) and from PT to LateCycle (0.1317 vs 0.0817; p=6.2e-10). NK cells significantly decreased in the EarlyCycle group compared to NT (0.1109 vs 0.1462; p=0.00816) and PT (0.1109 vs 0.1513; p=0.00992), with no significant change in the LateCycle group compared to either NT or PT (p> 0.05). Conclusion: Chemotherapy significantly affects lymphocyte subsets in a treatment-specific manner. The EarlyCycle group experienced a reduction in NK cell and an increase in T cell, suggesting a damage of innate immunity and an early shift towards adaptive immunity. The LateCycle group showed a substantial decrease in B cell, indicating a delayed effect on humoral immunity components.
目的：肺癌仍然是癌症相关死亡的主要原因，而化疗是治疗的基本组成部分。化疗引起的骨髓抑制包括一系列血液学指标的下降，不仅包括中性粒细胞，还包括淋巴细胞、血红蛋白水平和血小板。这项回顾性队列研究调查了外周血淋巴细胞亚群的变化。通过揭示这些变化，我们的目标是完善患者管理策略，确保最大限度地发挥化疗的益处，同时最大限度地减少化疗的不利影响：我们对 159 名肺癌患者进行了回顾性分析。患者被分为 "NT"（人数=108，既往未接受过抗肿瘤治疗）和 "PT"（人数=51，既往接受过治疗后至少有两个月的无治疗间隔期）两类。化疗后，对患者进行重新评估，并将接受四个或四个以下周期治疗的患者分为 "早期周期 "和 "晚期周期"：研究重点是分析各组淋巴细胞亚群的百分比，包括 T 细胞（CD4+、CD8+）、B 细胞和自然杀伤细胞（NK）。就 T 细胞而言，EarlyCycle 组比 NT 组（0.7783 vs 0.7271; p=0.0017）和 PT 组（0.7783 vs 0.6804; p=1.6e-05）显著增加。B细胞从NT到LateCycle（0.1014 vs 0.0817；p=2.2e-05）和从PT到LateCycle（0.1317 vs 0.0817；p=6.2e-10）均有显著下降。与NT（0.1109 vs 0.1462; p=0.00816）和PT（0.1109 vs 0.1513; p=0.00992）相比，早周期组的NK细胞明显减少，晚周期组与NT或PT相比无明显变化（p> 0.05）：结论：化疗对淋巴细胞亚群的影响具有治疗特异性。早周期组 NK 细胞减少，T 细胞增加，表明先天性免疫受到破坏，适应性免疫早期转移。晚周期组 B 细胞大幅减少，表明对体液免疫成分的影响延迟。
{"title":"Impact of Chemotherapy on Circulating Lymphocyte Subsets in Lung Cancer Patients","authors":"Wei Hong, Lei Zhang, Youkun Qi, Yanjun Wang, Wentao Wang","doi":"10.2147/cmar.s475967","DOIUrl":"https://doi.org/10.2147/cmar.s475967","url":null,"abstract":"<strong>Purpose:</strong> Lung cancer remains a leading cause of cancer-related death and chemotherapy stands as a fundamental component in therapy. Chemotherapy-induced myelosuppression encompasses a spectrum of hematological declines, including not only neutrophils but also lymphocytes, hemoglobin levels and platelets. This retrospective cohort study investigates alterations in peripheral blood lymphocyte subsets. By uncovering these changes, our goal is to refine patient management strategies, ensuring that the benefits of chemotherapy are maximized while minimizing its detrimental effects.<br/><strong>Patients and Methods:</strong> We retrospectively analyzed 159 lung cancer patients. Patients were categorized as “NT” (n=108, no previous anti-tumor therapy), and “PT” (n=51, prior therapy followed by at least a two-month treatment-free interval). Post-chemotherapy, patients were reassessed and grouped into “EarlyCycle” for those who underwent four or fewer cycles, and “LateCycle” for those who underwent more than four cycles.<br/><strong>Results:</strong> The study focused on analyzing the percentages of lymphocyte subsets, including T cells (CD4+, CD8+), B cells, and natural killer (NK) cells, across these groups. For T cells, the EarlyCycle group exhibited a significant increase compared to NT (0.7783 vs 0.7271; p=0.0017) and PT (0.7783 vs 0.6804; p=1.6e-05). B cells showed a significant decrease from NT to LateCycle (0.1014 vs 0.0817; p=2.2e-05) and from PT to LateCycle (0.1317 vs 0.0817; p=6.2e-10). NK cells significantly decreased in the EarlyCycle group compared to NT (0.1109 vs 0.1462; p=0.00816) and PT (0.1109 vs 0.1513; p=0.00992), with no significant change in the LateCycle group compared to either NT or PT (p> 0.05).<br/><strong>Conclusion:</strong> Chemotherapy significantly affects lymphocyte subsets in a treatment-specific manner. The EarlyCycle group experienced a reduction in NK cell and an increase in T cell, suggesting a damage of innate immunity and an early shift towards adaptive immunity. The LateCycle group showed a substantial decrease in B cell, indicating a delayed effect on humoral immunity components.<br/><br/><strong>Keywords:</strong> chemotherapy, lung cancer, myelosuppression, peripheral blood, lymphocyte subsets<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"16 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: This study aimed to determine the combination of factors associated with continuity of care in outpatients with cancer-related edema six months after the initial visit. Patients and Methods: A total of 101 outpatients were divided into two groups: continuation (n=65) and non-continuation (n=36) groups. Details regarding age, body mass index, sex, affected extremities (upper or lower), site of edema (unilateral or bilateral), International Society of Lymphology (ISL) classification, presence of distant metastasis, and overall score on the lymphedema quality of life questionnaire (LYMQOL) were obtained before initial lymphedema care. In this study, we performed a decision tree analysis using a classification and regression tree (CART) to detect the combination of factors associated with the continuity of edema care for cancer-related edema. Results: Significant differences were observed in the site of edema (unilateral or bilateral) and distant metastasis between the two groups. In the decision tree using CART analysis, the factors selected to influence the possibility of continuation were the side of edema as the first layer, and body mass index of 23.0 and distant metastasis (with/without) as the second layer. Outpatients with unilateral edema and a body mass index higher than 23.0 were most likely to be able to continue care. In contrast, outpatients with bilateral edema and distant metastasis had greater difficulty in continuing care. Conclusion: In this study, factors that were suggested to influence the continuity of cancer-related edema care were the side with edema, body mass index higher than 23.0, and distant metastasis. This information may be helpful for developing care strategies and improving patient adherence.
Keywords: cancer-related edema, continuation, decision tree analysis, outpatient, predicted factor
{"title":"Factors Predicting Treatment Adherence in Outpatients with Cancer-Related Edema: Decision Tree Analysis","authors":"Yudai Fujimoto, Yoshimi Yuri, Miki Fujii, Hironari Tamiya","doi":"10.2147/cmar.s476588","DOIUrl":"https://doi.org/10.2147/cmar.s476588","url":null,"abstract":"<strong>Purpose:</strong> This study aimed to determine the combination of factors associated with continuity of care in outpatients with cancer-related edema six months after the initial visit.<br/><strong>Patients and Methods:</strong> A total of 101 outpatients were divided into two groups: continuation (n=65) and non-continuation (n=36) groups. Details regarding age, body mass index, sex, affected extremities (upper or lower), site of edema (unilateral or bilateral), International Society of Lymphology (ISL) classification, presence of distant metastasis, and overall score on the lymphedema quality of life questionnaire (LYMQOL) were obtained before initial lymphedema care. In this study, we performed a decision tree analysis using a classification and regression tree (CART) to detect the combination of factors associated with the continuity of edema care for cancer-related edema.<br/><strong>Results:</strong> Significant differences were observed in the site of edema (unilateral or bilateral) and distant metastasis between the two groups. In the decision tree using CART analysis, the factors selected to influence the possibility of continuation were the side of edema as the first layer, and body mass index of 23.0 and distant metastasis (with/without) as the second layer. Outpatients with unilateral edema and a body mass index higher than 23.0 were most likely to be able to continue care. In contrast, outpatients with bilateral edema and distant metastasis had greater difficulty in continuing care.<br/><strong>Conclusion:</strong> In this study, factors that were suggested to influence the continuity of cancer-related edema care were the side with edema, body mass index higher than 23.0, and distant metastasis. This information may be helpful for developing care strategies and improving patient adherence.<br/><br/><strong>Keywords:</strong> cancer-related edema, continuation, decision tree analysis, outpatient, predicted factor<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"27 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiafeng Lu, Zhaoyan Li, Xingjing Liu, Bin Xu, Weiyu Zhang
Background: The resistance to endocrine therapy can lead to recurrence and metastasis of breast cancer (BC), affecting the survival period. Tiaogan Bushen Xiaoji (TGBSXJ) Formula, a traditional Chinese medicine (TCM) decoction, has been widely used in the treatment of estrogen receptor-positive (ER+) BC. However, the underlying mechanism of TGBSXJ Formula in ER+BC treatment has not been totally elucidated. Methods: Network pharmacology (NP) and RNA sequencing were used to predict the candidate ingredients and explore the potential targets of TGBSXJ Formula. Then, the results of NP and RNA sequencing were investigated by in vitro experiments. Results: Active ingredients of TGBSXJ Formula mainly included Mangiferin, Rutin, Anemarrhena asphodeloides saponin BII, Ganoderic acid A and Acacetin, etc. A protein-protein interaction (PPI) network was created based on the active ingredients of TGBSXJ Formula and target genes of ER+ BC, in which TGF-β, MMP2 and SMAD3 were defined as the hub genes. In vitro experiments showed that TGBSXJ Formula significantly inhibited the viability, colony ability and migration of ER+ BC cells, and significantly increased the sensitivity to TAM. Western blot analysis showed that TGBSXJ Formula significantly downregulated TGF-β, E-cadherin, MMP2, MMP9, N-cadherin, p-Smad2 and p-Smad3 in ER+ BC cells. Conclusion: TGBSXJ Formula increases the sensitivity of ER+ BC cells to TAM by inhibiting the TGF-β/Smad signaling pathway.
背景：内分泌治疗耐药可导致乳腺癌（BC）复发和转移，影响患者的生存期。传统中药 "天干地支汤 "已被广泛应用于雌激素受体阳性（ER+）乳腺癌的治疗。然而，TGBSXJ方治疗ER+BC的内在机制尚未完全阐明：方法：利用网络药理学（NP）和 RNA 测序预测 TGBSXJ 方剂的候选成分并探索其潜在靶点。方法：采用网络药理学（NP）和 RNA 测序方法预测 TGBSXJ 方剂的候选成分并探索其潜在靶点，然后通过体外实验研究 NP 和 RNA 测序的结果：结果：TGBSXJ 方剂的有效成分主要包括芒果苷、芦丁、天南星皂苷 BII、灵芝酸 A 和乙酰乙酸等。根据 TGBSXJ 方剂的有效成分和 ER+ BC 的靶基因建立了蛋白-蛋白相互作用（PPI）网络，其中 TGF-β、MMP2 和 SMAD3 被定义为中心基因。体外实验表明，TGBSXJ 方剂能显著抑制 ER+ BC 细胞的活力、集落能力和迁移，并能显著提高其对 TAM 的敏感性。Western印迹分析表明，TGBSXJ配方能明显下调ER+ BC细胞中的TGF-β、E-cadherin、MMP2、MMP9、N-cadherin、p-Smad2和p-Smad3：结论：TGBSXJ配方通过抑制TGF-β/Smad信号通路提高了ER+ BC细胞对TAM的敏感性。
{"title":"Tiaogan Bushen Xiaoji Formula Enhances the Sensitivity of Estrogen Receptor- Positive Breast Cancer to Tamoxifen by Inhibiting the TGF-β/SMAD Pathway","authors":"Jiafeng Lu, Zhaoyan Li, Xingjing Liu, Bin Xu, Weiyu Zhang","doi":"10.2147/cmar.s477399","DOIUrl":"https://doi.org/10.2147/cmar.s477399","url":null,"abstract":"<strong>Background:</strong> The resistance to endocrine therapy can lead to recurrence and metastasis of breast cancer (BC), affecting the survival period. Tiaogan Bushen Xiaoji (TGBSXJ) Formula, a traditional Chinese medicine (TCM) decoction, has been widely used in the treatment of estrogen receptor-positive (ER<sup>+</sup>) BC. However, the underlying mechanism of TGBSXJ Formula in ER<sup>+</sup>BC treatment has not been totally elucidated.<br/><strong>Methods:</strong> Network pharmacology (NP) and RNA sequencing were used to predict the candidate ingredients and explore the potential targets of TGBSXJ Formula. Then, the results of NP and RNA sequencing were investigated by in vitro experiments.<br/><strong>Results:</strong> Active ingredients of TGBSXJ Formula mainly included Mangiferin, Rutin, Anemarrhena asphodeloides saponin BII, Ganoderic acid A and Acacetin, etc. A protein-protein interaction (PPI) network was created based on the active ingredients of TGBSXJ Formula and target genes of ER<sup>+</sup> BC, in which TGF-β, MMP2 and SMAD3 were defined as the hub genes. In vitro experiments showed that TGBSXJ Formula significantly inhibited the viability, colony ability and migration of ER<sup>+</sup> BC cells, and significantly increased the sensitivity to TAM. Western blot analysis showed that TGBSXJ Formula significantly downregulated TGF-β, E-cadherin, MMP2, MMP9, N-cadherin, p-Smad2 and p-Smad3 in ER<sup>+</sup> BC cells.<br/><strong>Conclusion:</strong> TGBSXJ Formula increases the sensitivity of ER<sup>+</sup> BC cells to TAM by inhibiting the TGF-β/Smad signaling pathway.<br/><br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"140 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Allison F O'Neill, Raul C Ribeiro, Emilia M Pinto, Michael R Clay, Gerard P Zambetti, Brent A Orr, Christopher B Weldon, Carlos Rodriguez-Galindo
Abstract: Adrenocortical tumors (ACTs) are infrequent neoplasms in children and adolescents and are typically associated with clinical symptoms reflective of androgen overproduction. Pediatric ACTs typically occur in the context of a germline TP53 mutation, can be cured when diagnosed at an early stage, but are difficult to treat when advanced or associated with concurrent TP53 and ATRX alterations. Recent work has demonstrated DNA methylation patterns suggestive of prognostic significance. While current treatment standards rely heavily upon surgical resection, chemotherapy, and hormonal modulation, small cohort studies suggest promise for multi-tyrosine kinases targeting anti-angiogenic pathways or immunomodulatory therapies. Future work will focus on novel risk stratification algorithms and combination therapies intended to mitigate toxicity for patients with perceived low-risk disease while intensifying therapy or accelerating discoveries aimed at improving survival for patients with difficult-to-treat disease.
{"title":"Pediatric Adrenocortical Carcinoma: The Nuts and Bolts of Diagnosis and Treatment and Avenues for Future Discovery","authors":"Allison F O'Neill, Raul C Ribeiro, Emilia M Pinto, Michael R Clay, Gerard P Zambetti, Brent A Orr, Christopher B Weldon, Carlos Rodriguez-Galindo","doi":"10.2147/cmar.s348725","DOIUrl":"https://doi.org/10.2147/cmar.s348725","url":null,"abstract":"<strong>Abstract:</strong> Adrenocortical tumors (ACTs) are infrequent neoplasms in children and adolescents and are typically associated with clinical symptoms reflective of androgen overproduction. Pediatric ACTs typically occur in the context of a germline <em>TP53</em> mutation, can be cured when diagnosed at an early stage, but are difficult to treat when advanced or associated with concurrent <em>TP53</em> and <em>ATRX</em> alterations. Recent work has demonstrated DNA methylation patterns suggestive of prognostic significance. While current treatment standards rely heavily upon surgical resection, chemotherapy, and hormonal modulation, small cohort studies suggest promise for multi-tyrosine kinases targeting anti-angiogenic pathways or immunomodulatory therapies. Future work will focus on novel risk stratification algorithms and combination therapies intended to mitigate toxicity for patients with perceived low-risk disease while intensifying therapy or accelerating discoveries aimed at improving survival for patients with difficult-to-treat disease.<br/><br/><strong>Keywords:</strong> adrenocortical, pediatric, management, discovery, carcinoma, tumors<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"55 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Petra Maresova, Jan Hruška, Kristina Randlova, Lukas Rezny, María Teresa Carrillo-de-la-Peña, Kamil Kuca
Background: The increased prevalence of cancer and the negative impact of pain on the quality of life of patients underscore the need to implement efficient palliative care interventions and management of pain. The cost-effectiveness of palliative care interventions for cancer, mostly pharmacological and delivered through home-based palliative care services, is unclear. Most of the studies do not take into account indirect costs nor consider variations across different geographical regions. Objective: To describe existing and cutting-edge knowledge on cost-effectiveness or item costs related to palliative home-based care for patients with cancer. We evaluated various costs, including direct medical, non-medical, and indirect costs in different geographical regions and analysed how different options for care affect the patients’ quality of life and associated expenses. Methods: This Prospero-registered systematic review (CRD42023404217) adhered to the PRISMA criteria. Following a multistep selection process, we selected 22 articles published between 2013 and 2023 focused on quality of life outcomes and cost-effectiveness of home-based palliative care for cancer patients. Results: Home-based palliative care decreases the number of hospital visits, while its influence on patients quality of life is currently difficult to demonstrate across geographic regions based on available evidence. Overall, home care decreases the costs associated to the palliative care of patients with cancer. The cost structure analysis revealed that besides healthcare costs, informal care expenses and productivity losses represent a significant proportion of overall expenses). In Europe, the direct medical, non-medical, and indirect costs (in purchasing power parity) were on average &dollar1,941, &dollar842, and &dollar1,241, per month per person, respectively. In the USA and Asia, direct medical and indirect costs are on average &dollar1,095 (USA) vs &dollar1,444 (Asia) and &dollar2,192 (USA) vs &dollar1,162 (Asia). Conclusion: In conclusion, the studies reviewed highlight significant cost variations and potential savings associated with palliative home-based care for cancer patients. Home-based palliative care, particularly involving medications, has shown favorable cost-effectiveness compared to hospital care. Specialized palliative home care, psychological interventions, and outpatient services further contribute to overall cost savings. However, the economic impact varies across different geographical contexts and cost categories, emphasizing the need for tailored approaches in palliative care planning and implementation.
{"title":"Systematic Review of the Cost-Effectiveness of Home-Based Palliative Care Interventions in Patients with Cancer: A Critical Analysis","authors":"Petra Maresova, Jan Hruška, Kristina Randlova, Lukas Rezny, María Teresa Carrillo-de-la-Peña, Kamil Kuca","doi":"10.2147/cmar.s472649","DOIUrl":"https://doi.org/10.2147/cmar.s472649","url":null,"abstract":"<strong>Background:</strong> The increased prevalence of cancer and the negative impact of pain on the quality of life of patients underscore the need to implement efficient palliative care interventions and management of pain. The cost-effectiveness of palliative care interventions for cancer, mostly pharmacological and delivered through home-based palliative care services, is unclear. Most of the studies do not take into account indirect costs nor consider variations across different geographical regions.<br/><strong>Objective:</strong> To describe existing and cutting-edge knowledge on cost-effectiveness or item costs related to palliative home-based care for patients with cancer. We evaluated various costs, including direct medical, non-medical, and indirect costs in different geographical regions and analysed how different options for care affect the patients’ quality of life and associated expenses.<br/><strong>Methods:</strong> This Prospero-registered systematic review (CRD42023404217) adhered to the PRISMA criteria. Following a multistep selection process, we selected 22 articles published between 2013 and 2023 focused on quality of life outcomes and cost-effectiveness of home-based palliative care for cancer patients.<br/><strong>Results:</strong> Home-based palliative care decreases the number of hospital visits, while its influence on patients quality of life is currently difficult to demonstrate across geographic regions based on available evidence. Overall, home care decreases the costs associated to the palliative care of patients with cancer. The cost structure analysis revealed that besides healthcare costs, informal care expenses and productivity losses represent a significant proportion of overall expenses). In Europe, the direct medical, non-medical, and indirect costs (in purchasing power parity) were on average &dollar1,941, &dollar842, and &dollar1,241, per month per person, respectively. In the USA and Asia, direct medical and indirect costs are on average &dollar1,095 (USA) vs &dollar1,444 (Asia) and &dollar2,192 (USA) vs &dollar1,162 (Asia).<br/><strong>Conclusion:</strong> In conclusion, the studies reviewed highlight significant cost variations and potential savings associated with palliative home-based care for cancer patients. Home-based palliative care, particularly involving medications, has shown favorable cost-effectiveness compared to hospital care. Specialized palliative home care, psychological interventions, and outpatient services further contribute to overall cost savings. However, the economic impact varies across different geographical contexts and cost categories, emphasizing the need for tailored approaches in palliative care planning and implementation.<br/><br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"4 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Furui Zhai, Shanshan Mu, Yinghui Song, Min Zhang, Cui Zhang, Ze Lv
Purpose: This study aims to develop a machine learning (ML) model to predict the risk of residual or recurrent high-grade cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP), addressing a critical gap in personalized follow-up care. Methods: A retrospective analysis of 532 patients who underwent LEEP for high-grade CIN at Cangzhou Central Hospital (2016– 2020) was conducted. In the final analysis, 99 women (18.6%) were found to have residual or recurrent high-grade CIN (CIN2 or worse) within five years of follow-up. Four feature selection methods identified significant predictors of residual or recurrent CIN. Eight ML algorithms were evaluated using performance metrics such as AUROC, accuracy, sensitivity, specificity, PPV, NPV, F1 score, calibration curve, and decision curve analysis. Fivefold cross-validation optimized and validated the model, and SHAP analysis assessed feature importance. Results: The XGBoost algorithm demonstrated the highest predictive performance with the best AUROC. The optimized model included six key predictors: age, ThinPrep cytologic test (TCT) results, HPV classification, CIN severity, glandular involvement, and margin status. SHAP analysis identified CIN severity and margin status as the most influential predictors. An online prediction tool was developed for real-time risk assessment. Conclusion: This ML-based predictive model for post-LEEP high-grade CIN provides a significant advancement in gynecologic oncology, enhancing personalized patient care and facilitating early intervention and informed clinical decision-making.
{"title":"Machine Learning Prediction of Residual and Recurrent High-Grade CIN Post-LEEP","authors":"Furui Zhai, Shanshan Mu, Yinghui Song, Min Zhang, Cui Zhang, Ze Lv","doi":"10.2147/cmar.s484057","DOIUrl":"https://doi.org/10.2147/cmar.s484057","url":null,"abstract":"<strong>Purpose:</strong> This study aims to develop a machine learning (ML) model to predict the risk of residual or recurrent high-grade cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP), addressing a critical gap in personalized follow-up care.<br/><strong>Methods:</strong> A retrospective analysis of 532 patients who underwent LEEP for high-grade CIN at Cangzhou Central Hospital (2016– 2020) was conducted. In the final analysis, 99 women (18.6%) were found to have residual or recurrent high-grade CIN (CIN2 or worse) within five years of follow-up. Four feature selection methods identified significant predictors of residual or recurrent CIN. Eight ML algorithms were evaluated using performance metrics such as AUROC, accuracy, sensitivity, specificity, PPV, NPV, F1 score, calibration curve, and decision curve analysis. Fivefold cross-validation optimized and validated the model, and SHAP analysis assessed feature importance.<br/><strong>Results:</strong> The XGBoost algorithm demonstrated the highest predictive performance with the best AUROC. The optimized model included six key predictors: age, ThinPrep cytologic test (TCT) results, HPV classification, CIN severity, glandular involvement, and margin status. SHAP analysis identified CIN severity and margin status as the most influential predictors. An online prediction tool was developed for real-time risk assessment.<br/><strong>Conclusion:</strong> This ML-based predictive model for post-LEEP high-grade CIN provides a significant advancement in gynecologic oncology, enhancing personalized patient care and facilitating early intervention and informed clinical decision-making.<br/><br/><strong>Keywords:</strong> cervical intraepithelial neoplasia, loop electrosurgical excision procedure, residual or recurrent, machine learning, predictive modeling<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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