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Radiation-Induced Cognitive Decline: Challenges and Solutions. 辐射导致的认知能力下降:挑战与解决方案。
IF 2.5 4区 医学 Q3 ONCOLOGY Pub Date : 2024-08-21 eCollection Date: 2024-01-01 DOI: 10.2147/CMAR.S441360
Parisa Shamsesfandabadi, Arpeet Patel, Yun Liang, Matthew J Shepard, Rodney E Wegner

Radiation therapy, a common treatment for central nervous system cancers, can negatively impact cognitive function, resulting in radiation-induced cognitive decline (RICD). RICD involves a decline in cognitive abilities such as memory and attention, likely due to damage to brain white matter, inflammation, and oxidative stress. The multifactorial nature of RICD poses challenges including different mechanisms of injury (neurogenesis, oxidative stress and neuroinflammation, dendritic structure alterations and vascular effects) and confounding factors like advanced age, and pre-existing conditions. Despite these challenges, several potential solutions exist. Neuroprotective agents like antioxidants can mitigate radiation damage, while cognitive rehabilitation techniques such as cognitive training and memory strategies improve cognitive function. Advanced imaging techniques like magnetic resonance imaging (MRI) help identify vulnerable brain areas, and proton therapy offers precise targeting of cancer cells, sparing healthy tissue. Multidisciplinary care teams are crucial for managing RICD's cognitive and psychological effects. Personalized medicine, using genetic and molecular data, can identify high-risk patients and tailor treatments accordingly. Emerging therapies, including stem cell therapy and regenerative medicine, offer hope for repairing or replacing damaged brain tissue. Addressing RICD is vital for cancer survivors, necessitating consideration of cognitive function and provision of appropriate support and resources for those experiencing cognitive decline.

放射治疗是治疗中枢神经系统癌症的一种常见方法,会对认知功能产生负面影响,导致辐射诱发的认知功能下降(RICD)。RICD 包括记忆力和注意力等认知能力的下降,可能是由于脑白质受损、炎症和氧化应激造成的。RICD 的多因素性质带来了挑战,包括不同的损伤机制(神经发生、氧化应激和神经炎症、树突结构改变和血管效应)以及高龄和原有疾病等混杂因素。尽管存在这些挑战,但仍有几种潜在的解决方案。抗氧化剂等神经保护剂可以减轻辐射损伤,而认知训练和记忆策略等认知康复技术则可以改善认知功能。磁共振成像(MRI)等先进的成像技术有助于识别脑部的脆弱区域,质子疗法可以精确定位癌细胞,保护健康组织。多学科护理团队对于控制 RICD 的认知和心理影响至关重要。利用基因和分子数据的个性化医疗可以识别高风险患者,并相应地调整治疗方法。干细胞疗法和再生医学等新兴疗法为修复或替代受损脑组织带来了希望。对于癌症幸存者来说,解决 RICD 问题至关重要,需要考虑认知功能,并为认知能力下降的患者提供适当的支持和资源。
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引用次数: 0
Clinicopathological Characteristics of Oral Squamous Cell Carcinoma at the Central Referral and Teaching Hospital in West Java, Indonesia. 印度尼西亚西爪哇中央转诊和教学医院口腔鳞状细胞癌的临床病理特征。
IF 2.5 4区 医学 Q3 ONCOLOGY Pub Date : 2024-08-21 eCollection Date: 2024-01-01 DOI: 10.2147/CMAR.S476557
Irna Sufiawati, Alamsyah Piliang, Adi Ahmad Yusuf, Tenny Setiani Dewi, Hasrayati Agustina, Yohana Azhar, Adi Idris

Purpose: This study aimed to investigate the clinicopathological characteristics of oral squamous cell carcinoma (OSCC) patients and analyze the relationship between the degree of differentiation and factors including age, sex, stage, and tumor location in West Java, Indonesia.

Patients and methods: A retrospective cross-sectional study was conducted at the Central Referral and Teaching Hospital in West Java, Indonesia. The data were collected by reviewing medical records with International Classification of Diseases (ICD) codes C00-C06 from 2016 to 2023. Descriptive statistics were employed to summarize the clinicopathological characteristics of OSCC patients. Chi-square, rank Spearman tests, and contingency correlation coefficients were used to analyze the relationship between the degree of differentiation and various factors, such as age, sex, stage, and tumor location of OSCC.

Results: Out of the 627 oral cancer patients, 70.49% were diagnosed with OSCC with a gender distribution of 45.7% males and 54.3% females, predominantly within the age range of 30-49 (37.2%). Most OSCC cases were stage IV (37.7%), with the tongue identified as the most common site (68.8%). A consistent trend of higher well-differentiated and moderately differentiated OSCC by age and gender was observed. Statistical analysis revealed no significant correlation between age, gender, tumor location, and the degree of OSCC differentiation (p>0.05). However, a statistically significant correlation was identified between the degree of OSCC differentiation and stage (p<0.001, r=0.460).

Conclusion: There is a correlation between the degree of differentiation of OSCC and stage, suggesting significant prognostic implications that can aid in treatment planning and outcome prediction. However, further studies are needed due to the lack of comprehensive data on risk factors and survival rates of oral cancer patients, which is essential for enhancing prevention and treatment strategies for OSCC.

目的:本研究旨在调查印度尼西亚西爪哇省口腔鳞状细胞癌(OSCC)患者的临床病理学特征,并分析分化程度与年龄、性别、分期和肿瘤位置等因素之间的关系:在印度尼西亚西爪哇的中央转诊和教学医院进行了一项回顾性横断面研究。数据是通过查阅2016年至2023年国际疾病分类(ICD)代码为C00-C06的病历收集的。研究采用描述性统计来总结OSCC患者的临床病理特征。采用Chi-square、等级Spearman检验和或然相关系数分析OSCC的分化程度与年龄、性别、分期和肿瘤位置等各种因素之间的关系:在 627 名口腔癌患者中,70.49% 被确诊为 OSCC,性别分布为男性 45.7%,女性 54.3%,年龄主要集中在 30-49 岁之间(37.2%)。大多数 OSCC 病例处于 IV 期(37.7%),舌头是最常见的部位(68.8%)。根据年龄和性别的不同,分化良好和中度分化的 OSCC 呈上升趋势。统计分析表明,年龄、性别、肿瘤部位与 OSCC 分化程度之间无明显相关性(P>0.05)。然而,OSCC 分化程度与分期之间存在统计学意义上的明显相关性(p 结论:OSCC 分化程度与分期之间存在相关性:OSCC的分化程度与分期之间存在相关性,这表明分化程度对预后有重要影响,有助于制定治疗计划和预测预后。然而,由于缺乏有关口腔癌患者风险因素和生存率的全面数据,因此还需要进一步的研究,这对加强 OSCC 的预防和治疗策略至关重要。
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引用次数: 0
Latest Research Progress of Liquid Biopsy in Tumor-A Narrative Review. 肿瘤液体活检的最新研究进展--综述
IF 2.5 4区 医学 Q3 ONCOLOGY Pub Date : 2024-08-16 eCollection Date: 2024-01-01 DOI: 10.2147/CMAR.S479338
Hua Jiang

Human life expectancy is significantly impacted by cancer, with liquid biopsy emerging as an advantageous method for cancer detection because of its noninvasive nature, high accuracy, ease of sampling, and cost-effectiveness compared with conventional tissue biopsy techniques. Liquid biopsy shows promise in early cancer detection, real-time monitoring, and personalized treatment for various cancers, including lung, cervical, and prostate cancers, and offers innovative approaches for cancer diagnosis and management. By utilizing circulating tumor DNA, circulating tumor cells, and exosomes as biomarkers, liquid biopsy enables the tracking of cancer progression. Various techniques commonly used in life sciences research, such as polymerase chain reaction (PCR), next-generation sequencing (NGS), and droplet digital PCR, are employed to assess cancer progression on the basis of different indicators. This review examines the latest advancements in liquid biopsy markers-circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), and exosomes-for cancer diagnosis over the past three years, with a focus on their detection methodologies and clinical applications. It encapsulates the pivotal aims of liquid biopsy, including early detection, therapy response prediction, treatment monitoring, prognostication, and its relevance in minimal residual disease, while also addressing the challenges facing routine clinical adoption. By combining the latest research advancements and practical clinical experiences, this work focuses on discussing the clinical significance of DNA methylation biomarkers and their applications in tumor screening, auxiliary diagnosis, companion diagnosis, and recurrence monitoring. These discussions may help enhance the application of liquid biopsy throughout the entire process of tumor diagnosis and treatment, thereby providing patients with more precise and effective treatment plans.

与传统的组织活检技术相比,液体活检具有无创、准确性高、取样简便、成本效益高等优点,是检测癌症的一种有效方法。液体活检在早期癌症检测、实时监测和个性化治疗各种癌症(包括肺癌、宫颈癌和前列腺癌)方面大有可为,为癌症诊断和管理提供了创新方法。液体活检利用循环肿瘤 DNA、循环肿瘤细胞和外泌体作为生物标记物,可追踪癌症进展。生命科学研究中常用的各种技术,如聚合酶链反应(PCR)、新一代测序(NGS)和液滴数字 PCR 等,都可用于根据不同指标评估癌症进展。本综述探讨了过去三年来用于癌症诊断的液体活检标志物--循环肿瘤 DNA(ctDNA)、循环肿瘤细胞(CTC)和外泌体的最新进展,重点介绍了它们的检测方法和临床应用。它概括了液体活检的关键目标,包括早期检测、治疗反应预测、治疗监测、预后判断及其与极小残留病的相关性,同时也探讨了常规临床应用所面临的挑战。本研究结合最新研究进展和临床实践经验,重点讨论了 DNA 甲基化生物标志物的临床意义及其在肿瘤筛查、辅助诊断、伴随诊断和复发监测中的应用。这些讨论将有助于加强液体活检在肿瘤诊断和治疗全过程中的应用,从而为患者提供更精确、更有效的治疗方案。
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引用次数: 0
Prognostic Nutritional Index (PNI): A More Promising Nutritional Predictor for Patients Undergoing Surgery for Retroperitoneal Liposarcoma. 预后营养指数 (PNI):腹膜后脂肪肉瘤手术患者更有希望的营养预测指标。
IF 2.5 4区 医学 Q3 ONCOLOGY Pub Date : 2024-08-13 eCollection Date: 2024-01-01 DOI: 10.2147/CMAR.S474801
Guo-Qiang Xue, Cheng-Peng Li, Ang Lv, Jian-Hui Wu, Xiu-Yun Tian, Hui Qiu, Chunyi Hao

Background: Extended surgery with multi-visceral resection is the standard treatment for retroperitoneal liposarcoma (RLPS). Malnutrition tends to result in increased surgical complications and reduced survival. The aim of this study was to identify the prognostic role of nutritional status in patients with RLPS.

Patients and methods: Data from 189 consecutive patients with RLPS who underwent surgical treatment at the Peking University Cancer Hospital Sarcoma Center between April 2011 and August 2022 were retrospectively reviewed. The following nutritional parameters were calculated: nutritional risk index, prognostic nutritional index (PNI) and Nutrition Risk Screening 2002. Time-dependent receiver operating characteristic (time-ROC) curve analysis was conducted to compare the prognostic utility of nutritional indicators. The associations between nutritional indicators and major complications, local recurrence-free survival (LRFS) and overall survival (OS) were investigated.

Results: Based on the time-ROC curve analysis, the PNI was superior to other nutritional indices at predicting OS. The optimal cut-off value of PNI was 41.2. The PNI was significantly inversely associated with tumor size, tumor grade, and histological subtype. Patients in the low PNI group (< 41.2) had significantly shorter LRFS and OS than those in the high PNI (≥ 41.2) group, with higher major morbidity and mortality rates. The PNI was found to be a unique nutritional predictor that independently predicted LRFS and OS in the multivariate analysis.

Conclusion: The PNI is an effective tool for nutritional assessment in patients with RLPS. A low PNI value in patients with RLPS predicts worse survival outcomes.

背景:多脏器切除的扩大手术是腹膜后脂肪肉瘤(RLPS)的标准治疗方法。营养不良往往会导致手术并发症增加和生存率降低。本研究旨在确定营养状况对RLPS患者预后的影响:回顾性分析2011年4月至2022年8月期间在北京大学肿瘤医院肉瘤中心接受手术治疗的189例连续RLPS患者的数据。计算了以下营养参数:营养风险指数、预后营养指数(PNI)和2002年营养风险筛查。为比较营养指标的预后效用,进行了时间依赖性接收者操作特征(time-ROC)曲线分析。研究了营养指标与主要并发症、无局部复发生存率(LRFS)和总生存率(OS)之间的关系:结果:根据时间-ROC曲线分析,PNI在预测OS方面优于其他营养指标。PNI的最佳临界值为41.2。PNI与肿瘤大小、肿瘤分级和组织学亚型明显成反比。低 PNI 组(< 41.2)患者的 LRFS 和 OS 明显短于高 PNI 组(≥ 41.2)患者,主要发病率和死亡率也更高。在多变量分析中发现,PNI是一个独特的营养预测因子,可独立预测LRFS和OS:结论:PNI是对RLPS患者进行营养评估的有效工具。结论:PNI 是对 RLPS 患者进行营养评估的有效工具,RLPS 患者的 PNI 值越低,预示着生存率越低。
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引用次数: 0
The Effect of Hounsfield Unit Value on the Differentiation of Malignant/Benign Mediastinal Lymphadenopathy and Masses Diagnosed by Endobronchial Ultrasonography. Hounsfield单位值对支气管内超声诊断恶性/良性纵隔淋巴腺病和肿块鉴别的影响
IF 2.5 4区 医学 Q3 ONCOLOGY Pub Date : 2024-08-13 eCollection Date: 2024-01-01 DOI: 10.2147/CMAR.S473653
Savaş Gegin, Ahmet Cemal Pazarlı, Burcu Özdemir, Levent Özdemir, Esra Arslan Aksu

Aim: In cases where standardized maximum uptake (SUVmax) values in positron emission tomography (PET-CT) were not sufficient to differentiate mediastinal lymphadenopathy and masses from malignant or benign, the contribution of Hounsfield unit (HU) values in thorax computed tomography to the diagnosis was evaluated.

Material method: The study was conducted by evaluating the data of 182 patients between 2019 and 2023. HU values on non-contrast thorax computed tomography and PET-CT SUVmax values of biopsied masses and lymph nodes were compared with histopathological diagnoses.

Results: Patients, 58 females (31.9%) and 124 males (68.1%), who underwent EBUS were included in the study. Biopsies were taken from 233 stations (199 lymph nodes, 34 masses) from 182 patients. A total of 135 of the biopsies taken from 233 stations were histopathologically malignant and 98 were benign. While PET-CT SUVmax values of cases with benign histopathology were 4.5 ± 3.5, it was 7.6 ± 4.2 in patients with malignant pathology (p<0.05). The HU value on non-contrast thorax tomography in patients with benign histopathology was 43.1 ± 15.7, and in patients with malignant histopathology it was 40.5 ± 13.7 (p>0.05). When HU was compared according to lung cancer type, it was found to be significantly higher in non-small cell lung cancer (p=0.035). A weak (r=0.182) positive and significant relationship (p<0.01) was found between PET-CT values and HU values in thorax computed tomography.

Conclusion: While positron emission tomography maintains its importance in the differentiation of mediastinal lymphadenopathy and masses from malignant to non-malignant, it was concluded that HU values in computed tomography are not sufficient to distinguish malignant/non-malignant.

目的:在正电子发射计算机断层扫描(PET-CT)的标准化最大摄取值(SUVmax)不足以区分纵隔淋巴结病变和肿块是恶性还是良性的情况下,评估胸部计算机断层扫描的Hounsfield单位(HU)值对诊断的贡献:研究通过评估2019年至2023年期间182名患者的数据进行。将非对比胸部计算机断层扫描的 HU 值以及活检肿块和淋巴结的 PET-CT SUVmax 值与组织病理学诊断进行比较:58名女性(31.9%)和124名男性(68.1%)患者接受了EBUS检查。活检取自 182 名患者的 233 个部位(199 个淋巴结、34 个肿块)。从 233 个部位提取的活检组织病理学结果显示,其中 135 例为恶性,98 例为良性。良性组织病理学病例的 PET-CT SUVmax 值为 4.5 ± 3.5,而恶性病理学病例的 SUVmax 值为 7.6 ± 4.2(P0.05)。根据肺癌类型比较 HU 值时发现,非小细胞肺癌患者的 HU 值明显更高(P=0.035)。两者之间存在微弱(r=0.182)的显著正相关关系(pConclusion):虽然正电子发射断层扫描在纵隔淋巴结病和肿块的恶性与非恶性鉴别中仍具有重要意义,但结论是计算机断层扫描的 HU 值不足以区分恶性/非恶性。
{"title":"The Effect of Hounsfield Unit Value on the Differentiation of Malignant/Benign Mediastinal Lymphadenopathy and Masses Diagnosed by Endobronchial Ultrasonography.","authors":"Savaş Gegin, Ahmet Cemal Pazarlı, Burcu Özdemir, Levent Özdemir, Esra Arslan Aksu","doi":"10.2147/CMAR.S473653","DOIUrl":"10.2147/CMAR.S473653","url":null,"abstract":"<p><strong>Aim: </strong>In cases where standardized maximum uptake (SUVmax) values in positron emission tomography (PET-CT) were not sufficient to differentiate mediastinal lymphadenopathy and masses from malignant or benign, the contribution of Hounsfield unit (HU) values in thorax computed tomography to the diagnosis was evaluated.</p><p><strong>Material method: </strong>The study was conducted by evaluating the data of 182 patients between 2019 and 2023. HU values on non-contrast thorax computed tomography and PET-CT SUV<sub>max</sub> values of biopsied masses and lymph nodes were compared with histopathological diagnoses.</p><p><strong>Results: </strong>Patients, 58 females (31.9%) and 124 males (68.1%), who underwent EBUS were included in the study. Biopsies were taken from 233 stations (199 lymph nodes, 34 masses) from 182 patients. A total of 135 of the biopsies taken from 233 stations were histopathologically malignant and 98 were benign. While PET-CT SUV<sub>max</sub> values of cases with benign histopathology were 4.5 ± 3.5, it was 7.6 ± 4.2 in patients with malignant pathology (p<0.05). The HU value on non-contrast thorax tomography in patients with benign histopathology was 43.1 ± 15.7, and in patients with malignant histopathology it was 40.5 ± 13.7 (p>0.05). When HU was compared according to lung cancer type, it was found to be significantly higher in non-small cell lung cancer (p=0.035). A weak (r=0.182) positive and significant relationship (p<0.01) was found between PET-CT values and HU values in thorax computed tomography.</p><p><strong>Conclusion: </strong>While positron emission tomography maintains its importance in the differentiation of mediastinal lymphadenopathy and masses from malignant to non-malignant, it was concluded that HU values in computed tomography are not sufficient to distinguish malignant/non-malignant.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"16 ","pages":"1013-1020"},"PeriodicalIF":2.5,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Efficiency and Safety of Triple-Drug Combination of Albumin-Bound Paclitaxel, Anlotinib and PD-1/L1 Inhibitors in the 2nd or Above Line of Advanced NSCLC: A Retrospective Cohort Study 白蛋白结合型紫杉醇、安罗替尼和 PD-1/L1 抑制剂三药联合用于晚期 NSCLC 二线或二线以上治疗的有效性和安全性:一项回顾性队列研究
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-08-08 DOI: 10.2147/cmar.s472196
Xiaobing Li, De Wu, Jing Tang, Yuebing Wu
Background: Existing research data indicates that albumin-bound paclitaxel (nab-ptx), anlotinib, and PD-1/L1 inhibitors have individually shown efficacy in second-line and subsequent treatments for advanced non-small cell lung cancer (NSCLC). This study seeks to investigate the potential of an optimized treatment regimen in this context by combining these three drugs and evaluating both efficacy and safety outcomes.
Patients and Methods: Between January 2020 and January 2022, we collected data from pre-treated advanced NSCLC patients who received a combination therapy of nab-ptx, anlotinib, and PD-1/L1 inhibitors as a second-line or later treatment. The primary endpoints for the study included the objective response rate (ORR), progression-free survival (PFS), disease control rate (DCR) and overall survival (OS), while adverse events (AEs) were also recorded.
Results: Our findings revealed that the ORR of this regimen in pretreated NSCLC patients was 35.71%, with mean PFS of 5.0 months and mean OS of 10.0 months. Further analysis suggested correlations between the efficacy of the regimen and factors such as PD-L1 expression levels, the occurrence of certain types of adverse events, and the status of NK cell activity. Additionally, the tolerable toxicity profile of this regimen indicates its potential applicability in the treatment of pretreated advanced NSCLC.
Conclusion: Our study displayed that triple-drug combination of nab-ptx, anlotinib and PD-1/L1 inhibitors showed promising efficiency and tolerated cytotoxicity in the 2nd or above line treatment of advanced NSCLC, indicating the potential of such regimen as an important option for second-line treatment of advanced NSCLC. However, due to limitations in patient numbers, its actual clinical value awaits further research confirmation.

研究背景现有研究数据表明,白蛋白结合型紫杉醇(nab-ptx)、安罗替尼和PD-1/L1抑制剂在晚期非小细胞肺癌(NSCLC)的二线及后续治疗中显示出了各自的疗效。本研究旨在通过联合使用这三种药物并评估疗效和安全性结果,研究在这种情况下优化治疗方案的潜力:2020年1月至2022年1月期间,我们收集了接受纳博-ptx、安罗替尼和PD-1/L1抑制剂联合治疗的晚期NSCLC患者的数据,作为二线或更后治疗方案。研究的主要终点包括客观反应率(ORR)、无进展生存期(PFS)、疾病控制率(DCR)和总生存期(OS),同时还记录了不良事件(AEs):结果:我们的研究结果表明,该疗法在NSCLC预处理患者中的ORR为35.71%,平均PFS为5.0个月,平均OS为10.0个月。进一步分析表明,该疗法的疗效与 PD-L1 表达水平、某些类型不良事件的发生以及 NK 细胞活性状况等因素相关。此外,该方案可耐受的毒性特征表明,它可能适用于治疗预处理的晚期NSCLC:我们的研究显示,纳博-ptx、安洛替尼和PD-1/L1抑制剂三药联合治疗晚期NSCLC二线或以上疗程显示出良好的疗效和可耐受的细胞毒性,表明该方案有望成为晚期NSCLC二线治疗的重要选择。然而,由于患者人数的限制,其实际临床价值还有待进一步研究证实。
{"title":"The Efficiency and Safety of Triple-Drug Combination of Albumin-Bound Paclitaxel, Anlotinib and PD-1/L1 Inhibitors in the 2nd or Above Line of Advanced NSCLC: A Retrospective Cohort Study","authors":"Xiaobing Li, De Wu, Jing Tang, Yuebing Wu","doi":"10.2147/cmar.s472196","DOIUrl":"https://doi.org/10.2147/cmar.s472196","url":null,"abstract":"<strong>Background:</strong> Existing research data indicates that albumin-bound paclitaxel (nab-ptx), anlotinib, and PD-1/L1 inhibitors have individually shown efficacy in second-line and subsequent treatments for advanced non-small cell lung cancer (NSCLC). This study seeks to investigate the potential of an optimized treatment regimen in this context by combining these three drugs and evaluating both efficacy and safety outcomes.<br/><strong>Patients and Methods:</strong> Between January 2020 and January 2022, we collected data from pre-treated advanced NSCLC patients who received a combination therapy of nab-ptx, anlotinib, and PD-1/L1 inhibitors as a second-line or later treatment. The primary endpoints for the study included the objective response rate (ORR), progression-free survival (PFS), disease control rate (DCR) and overall survival (OS), while adverse events (AEs) were also recorded.<br/><strong>Results:</strong> Our findings revealed that the ORR of this regimen in pretreated NSCLC patients was 35.71%, with mean PFS of 5.0 months and mean OS of 10.0 months. Further analysis suggested correlations between the efficacy of the regimen and factors such as PD-L1 expression levels, the occurrence of certain types of adverse events, and the status of NK cell activity. Additionally, the tolerable toxicity profile of this regimen indicates its potential applicability in the treatment of pretreated advanced NSCLC.<br/><strong>Conclusion:</strong> Our study displayed that triple-drug combination of nab-ptx, anlotinib and PD-1/L1 inhibitors showed promising efficiency and tolerated cytotoxicity in the 2<sup>nd</sup> or above line treatment of advanced NSCLC, indicating the potential of such regimen as an important option for second-line treatment of advanced NSCLC. However, due to limitations in patient numbers, its actual clinical value awaits further research confirmation.<br/><br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"1 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141948639","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}
引用次数: 0
Urine Phthalate Metabolites are Elevated in Patients with Esophageal Squamous Cell Carcinoma and Associated with Advanced Cancer Stage and Poor Survival 食管鳞状细胞癌患者尿液中邻苯二甲酸酯代谢物升高,与癌症晚期和生存率低有关
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.2147/cmar.s469007
Yen-Hao Chen, Wan-Ting Huang, Wen-Chin Lee, Ching-Mei Chen, Fu-Jen Cheng, Chia-Te Kung, Chin-Chou Wang, Liang-Jen Wang, Yu-Che Ou, Shau-Hsuan Li
Background: The aim of this study was to investigate the role of phthalate in patients with esophageal squamous cell carcinoma (ESCC).
Methods: A total of 116 ESCC patients and 58 controls without any known histories of malignancies were enrolled. All eight urine phthalate metabolites were measured to assess phthalate levels. Clinical and urine phthalate metabolite profiles were compared between subgroups to identify differences, and the effects of phthalates on clinical ESCC outcomes were also examined.
Results: The concentrations of some urine phthalate metabolites were higher in the ESCC group than in the control group, including mono-(3-carboxypropyl) phthalate (MCPP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-n-butyl phthalate (MnBP). Higher concentrations of urine phthalate metabolites were associated with clinical T3–T4 status. Patients with higher concentration of mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-2-ethylhexyl phthalate (MEHP), and MEOHP had lower 1-year and 2-year overall survival (OS) rates than those with lower concentrations of these metabolites in our univariate analysis. Multivariate analysis showed that urinary MEHP of ≥ 3 μg/L and clinical stage IVB were independent prognostic factors for worse OS.
Conclusion: The results of our study showed that urine phthalate metabolites are elevated in ESCC patients and associated with advanced tumor stage, and that a high urinary concentration of MEHP is an independent prognostic factor of worse OS.

背景:本研究旨在探讨邻苯二甲酸盐在食管鳞癌(ESCC)患者中的作用:本研究旨在探讨邻苯二甲酸盐在食管鳞状细胞癌(ESCC)患者中的作用:方法:共招募了 116 名 ESCC 患者和 58 名无任何已知恶性肿瘤病史的对照组。测量了尿液中所有八种邻苯二甲酸酯代谢物,以评估邻苯二甲酸酯水平。对不同亚组的临床和尿液邻苯二甲酸酯代谢物谱进行比较,以确定差异,同时还研究了邻苯二甲酸酯对ESCC临床结果的影响:ESCC组尿液中某些邻苯二甲酸酯代谢物的浓度高于对照组,包括邻苯二甲酸单(3-羧丙基)酯(MCPP)、邻苯二甲酸单(2-乙基-5-羟基己基)酯(MEHHP)、邻苯二甲酸单(2-乙基-5-氧代己基)酯(MEOHP)和邻苯二甲酸单正丁酯(MnBP)。尿液中邻苯二甲酸酯代谢物浓度较高与临床 T3-T4 状态有关。在单变量分析中,邻苯二甲酸单(2-乙基-5-羧基戊基)酯(MECPP)、邻苯二甲酸单-2-乙基己酯(MEHP)和邻苯二甲酸单正丁酯(MEOHP)浓度较高的患者的1年和2年总生存率(OS)低于这些代谢物浓度较低的患者。多变量分析表明,尿液中 MEHP ≥ 3 μg/L 和临床分期 IVB 是导致较差 OS 的独立预后因素:结论:我们的研究结果表明,ESCC患者尿液中邻苯二甲酸酯代谢物升高,且与肿瘤晚期相关,尿液中MEHP浓度高是OS恶化的独立预后因素。
{"title":"Urine Phthalate Metabolites are Elevated in Patients with Esophageal Squamous Cell Carcinoma and Associated with Advanced Cancer Stage and Poor Survival","authors":"Yen-Hao Chen, Wan-Ting Huang, Wen-Chin Lee, Ching-Mei Chen, Fu-Jen Cheng, Chia-Te Kung, Chin-Chou Wang, Liang-Jen Wang, Yu-Che Ou, Shau-Hsuan Li","doi":"10.2147/cmar.s469007","DOIUrl":"https://doi.org/10.2147/cmar.s469007","url":null,"abstract":"<strong>Background:</strong> The aim of this study was to investigate the role of phthalate in patients with esophageal squamous cell carcinoma (ESCC).<br/><strong>Methods:</strong> A total of 116 ESCC patients and 58 controls without any known histories of malignancies were enrolled. All eight urine phthalate metabolites were measured to assess phthalate levels. Clinical and urine phthalate metabolite profiles were compared between subgroups to identify differences, and the effects of phthalates on clinical ESCC outcomes were also examined.<br/><strong>Results:</strong> The concentrations of some urine phthalate metabolites were higher in the ESCC group than in the control group, including mono-(3-carboxypropyl) phthalate (MCPP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-n-butyl phthalate (MnBP). Higher concentrations of urine phthalate metabolites were associated with clinical T3–T4 status. Patients with higher concentration of mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-2-ethylhexyl phthalate (MEHP), and MEOHP had lower 1-year and 2-year overall survival (OS) rates than those with lower concentrations of these metabolites in our univariate analysis. Multivariate analysis showed that urinary MEHP of ≥ 3 μg/L and clinical stage IVB were independent prognostic factors for worse OS.<br/><strong>Conclusion:</strong> The results of our study showed that urine phthalate metabolites are elevated in ESCC patients and associated with advanced tumor stage, and that a high urinary concentration of MEHP is an independent prognostic factor of worse OS.<br/><br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"150 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141867358","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}
引用次数: 0
The Effect of Intracranial Control After Intracranial Local Therapy on the Prognosis of Patients with Brain Metastasis of Lung Adenocarcinoma 颅内局部治疗后颅内控制对肺腺癌脑转移患者预后的影响
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-31 DOI: 10.2147/cmar.s476837
Minmin Shen, Qiaojing Lin, Xi Zou, Yufan Wu, Zhihong Lin, Linglong Shao, JinSheng Hong, Jinmei Chen
Purpose: The aim of the present study was to assess the clinical outcomes and prognostic factors of lung adenocarcinoma patients with brain metastases (BMs) after intracranial local therapy.
Patients and Methods: A total of 83 lung adenocarcinoma patients with BMs who underwent craniotomy combined with radiotherapy or intracranial radiotherapy alone were retrospectively analyzed. The intracranial tumor response was determined according to the Response Assessment in Neuro-Oncology of Brain Metastases (RANO-BM) criteria. The median overall survival (OS), intracranial progression-free survival (iPFS), and related prognostic factors were analyzed with the Kaplan‒Meier estimator method and Cox proportional hazards regression model.
Results: Among 83 patients, 20 patients received craniotomy combined with radiotherapy, and 63 patients received intracranial radiotherapy alone. Following intracranial local therapy, 11 patients (13.3%) achieved complete response (CR); among them, 8 patients underwent neurosurgical resection. In addition, 32 patients (38.55%) achieved partial response (PR), 32 patients (38.55%) experienced stable disease (SD), and 8 (9.6%) experienced progressive disease (PD). The median follow-up period was 25.4 months (range 0.8– 49.6 months). The median follow-up time for the iPFS was 16.2 months (range 0.6– 41.2 months). The median OS, iPFS were 28.2 months and 24.7 months. Epidermal growth factor receptor (EGFR) / anaplastic lymphoma kinase (ALK) mutations (HR 3.216, 95% confidence interval (CI) 1.269– 8.150, p = 0.014) and iPFS (HR 0.881, 95% CI 0.836– 0.929, p < 0.001) were found to be beneficial factors for OS. An intracranial-tumor CR was associated with a longer iPFS (PR: HR 0.052, 95% CI 0.009– 0.297, p = 0.001; SD: HR 0.081, 95% CI 0.025– 0.259, p < 0.001; PD: HR 0.216, 95% CI 0.077– 0.606, p = 0.004).
Conclusion: Prolonged iPFS was associated with better OS in lung adenocarcinoma patients with BMs following intracranial local therapy, and mutations of EGFR / ALK or an intracranial-tumor CR are independent prognostic factors for prolonged survival.

Keywords: lung adenocarcinoma, brain metastases, intracranial local therapy, survival, prognostic factors
目的:本研究旨在评估肺腺癌脑转移(BMs)患者接受颅内局部治疗后的临床疗效和预后因素:对83例接受开颅手术联合放疗或单纯颅内放疗的肺腺癌脑转移患者进行回顾性分析。颅内肿瘤反应根据脑转移瘤神经肿瘤学反应评估(RANO-BM)标准确定。中位总生存期(OS)、颅内无进展生存期(iPFS)及相关预后因素采用卡普兰-梅耶估计法和Cox比例危险回归模型进行分析:在83例患者中,20例患者接受了开颅手术联合放疗,63例患者仅接受了颅内放疗。颅内局部治疗后,11 名患者(13.3%)获得了完全反应(CR),其中 8 名患者接受了神经外科切除术。此外,32 名患者(38.55%)获得部分反应(PR),32 名患者(38.55%)病情稳定(SD),8 名患者(9.6%)病情进展(PD)。中位随访时间为 25.4 个月(0.8-49.6 个月)。iPFS的中位随访时间为16.2个月(0.6- 41.2个月)。OS 和 iPFS 的中位数分别为 28.2 个月和 24.7 个月。研究发现,表皮生长因子受体(EGFR)/无性淋巴瘤激酶(ALK)突变(HR 3.216,95% 置信区间(CI)1.269- 8.150,p = 0.014)和iPFS(HR 0.881,95% CI 0.836- 0.929,p <0.001)是影响OS的有利因素。颅内肿瘤CR与iPFS的延长有关(PR:HR 0.052,95% CI 0.009- 0.297,p = 0.001;SD:HR 0.081,95% CI 0.025- 0.259,p <0.001;PD:HR 0.216,95% CI 0.077- 0.606,p = 0.004):iPFS延长与颅内局部治疗后脑转移肺腺癌患者较好的OS相关,EGFR/ALK突变或颅内肿瘤CR是延长生存期的独立预后因素。
{"title":"The Effect of Intracranial Control After Intracranial Local Therapy on the Prognosis of Patients with Brain Metastasis of Lung Adenocarcinoma","authors":"Minmin Shen, Qiaojing Lin, Xi Zou, Yufan Wu, Zhihong Lin, Linglong Shao, JinSheng Hong, Jinmei Chen","doi":"10.2147/cmar.s476837","DOIUrl":"https://doi.org/10.2147/cmar.s476837","url":null,"abstract":"<strong>Purpose:</strong> The aim of the present study was to assess the clinical outcomes and prognostic factors of lung adenocarcinoma patients with brain metastases (BMs) after intracranial local therapy.<br/><strong>Patients and Methods:</strong> A total of 83 lung adenocarcinoma patients with BMs who underwent craniotomy combined with radiotherapy or intracranial radiotherapy alone were retrospectively analyzed. The intracranial tumor response was determined according to the Response Assessment in Neuro-Oncology of Brain Metastases (RANO-BM) criteria. The median overall survival (OS), intracranial progression-free survival (iPFS), and related prognostic factors were analyzed with the Kaplan‒Meier estimator method and Cox proportional hazards regression model.<br/><strong>Results:</strong> Among 83 patients, 20 patients received craniotomy combined with radiotherapy, and 63 patients received intracranial radiotherapy alone. Following intracranial local therapy, 11 patients (13.3%) achieved complete response (CR); among them, 8 patients underwent neurosurgical resection. In addition, 32 patients (38.55%) achieved partial response (PR), 32 patients (38.55%) experienced stable disease (SD), and 8 (9.6%) experienced progressive disease (PD). The median follow-up period was 25.4 months (range 0.8– 49.6 months). The median follow-up time for the iPFS was 16.2 months (range 0.6– 41.2 months). The median OS, iPFS were 28.2 months and 24.7 months. Epidermal growth factor receptor (EGFR) / anaplastic lymphoma kinase (ALK) mutations (HR 3.216, 95% confidence interval (CI) 1.269– 8.150, p = 0.014) and iPFS (HR 0.881, 95% CI 0.836– 0.929, p &lt; 0.001) were found to be beneficial factors for OS. An intracranial-tumor CR was associated with a longer iPFS (PR: HR 0.052, 95% CI 0.009– 0.297, p = 0.001; SD: HR 0.081, 95% CI 0.025– 0.259, p &lt; 0.001; PD: HR 0.216, 95% CI 0.077– 0.606, p = 0.004).<br/><strong>Conclusion:</strong> Prolonged iPFS was associated with better OS in lung adenocarcinoma patients with BMs following intracranial local therapy, and mutations of EGFR / ALK or an intracranial-tumor CR are independent prognostic factors for prolonged survival.<br/><br/><strong>Keywords:</strong> lung adenocarcinoma, brain metastases, intracranial local therapy, survival, prognostic factors<br/>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"282 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141867359","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}
引用次数: 0
Predictive Value of PERCIST for Locally Advanced Non-Small Cell Lung Cancer Treated with Preoperative Induction Therapy – A Multicenter Study in Japan PERCIST 对接受术前诱导治疗的局部晚期非小细胞肺癌的预测价值 - 日本一项多中心研究
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-30 DOI: 10.2147/cmar.s464265
Katsuhiko Shimizu, Masao Nakata, Shinsuke Saisho, Masayuki Inubushi, Norihito Okumura, Tomohiro Murakawa, Motohiro Yamashita, Hiroshige Nakamura, Yoshifumi Sano, Kazuhiko Kataoka, Shinichi Toyooka
Background: Induction therapy followed by surgery is recommended as an alternative treatment strategy for locally advanced non-small cell lung cancer (NSCLC). Patients who achieve pathologic response after induction therapy have better outcomes than non-responders; therefore, therapeutic response must be evaluated. Recently, new approaches for monitoring therapeutic responses, which are based on 18F‐Fluorodeoxyglucose positron emission tomography (FDG‐PET), have been developed. In this study, we evaluated the predictive value of Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST), which uses standardized uptake values corrected for lean body mass (SUL) and total lesion glycolysis (TLG).
Methods: A total of 130 patients in the Setouchi Lung Cancer Group who underwent FDG-PET imaging before and after induction therapy prior to a planned surgical resection for NSCLC between 2007 and 2016 were studied retrospectively. The pathologic responses of the primary lung tumors and metastatic lymph nodes were compared with their responses based on evaluation using PERCIST.
Results: Postoperative pathologic studies revealed pathologic complete response (pCR) in 42 (32.3%) patients. PERCIST was significantly correlated with pathologic response (p < 0.001). The sensitivity, specificity, and accuracy of PERCIST for predicting pCR were 16.7% (7/42), 88.6% (78/88), and 65.4% (85/130), respectively. Patients with pCR had significantly higher reduction rates in SULpeak for both primary lung tumors and metastatic lymph nodes and TLG for primary tumors than non-responders. In a multivariate Cox regression analysis, tumor site in upper lobes, reduction rate of TLG in primary tumor, and pathologic N0 were independent predictors of favorable recurrence-free survival (RFS).
Conclusion: Our study suggested that PERCIST, especially the rate of TLG reduction rate, are useful to predict the pathological response and prognosis after induction therapy. Although improvement is necessary, PERCIST can be a promising method of the post-induction status in lung cancer. Further research is needed to confirm our findings.

背景:对于局部晚期非小细胞肺癌(NSCLC),诱导治疗后手术是推荐的替代治疗策略。诱导治疗后获得病理反应的患者比无应答的患者有更好的预后;因此,必须对治疗反应进行评估。最近,基于 18F-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)的治疗反应监测新方法应运而生。在这项研究中,我们评估了实体瘤正电子发射断层扫描反应标准(PERCIST)的预测价值,该标准使用根据瘦体重(SUL)和总病变糖酵解(TLG)校正的标准化摄取值:2007年至2016年期间,濑户内肺癌研究组共对130名NSCLC患者在计划手术切除前接受诱导治疗前后进行了FDG-PET成像进行了回顾性研究。将原发肺肿瘤和转移淋巴结的病理反应与基于 PERCIST 评估的反应进行了比较:42例(32.3%)患者的术后病理检查显示病理完全反应(pCR)。PERCIST 与病理反应明显相关(p < 0.001)。PERCIST 预测 pCR 的敏感性、特异性和准确性分别为 16.7% (7/42)、88.6% (78/88) 和 65.4% (85/130)。与无应答患者相比,获得 pCR 的患者原发肺肿瘤和转移淋巴结的 SULpeak 降低率以及原发肿瘤的 TLG 降低率均明显较高。在多变量考克斯回归分析中,肿瘤部位位于上叶、原发肿瘤的TLG降低率和病理N0是良好无复发生存期(RFS)的独立预测因素:我们的研究表明,PERCIST,尤其是 TLG 减少率,有助于预测诱导治疗后的病理反应和预后。尽管还需要改进,但 PERCIST 可以作为肺癌诱导治疗后状况的一种有前途的方法。我们还需要进一步的研究来证实我们的发现。
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引用次数: 0
Focusing on the Immune Cells: Recent Advances in Immunotherapy for Biliary Tract Cancer 关注免疫细胞:胆道癌免疫疗法的最新进展
IF 3.3 4区 医学 Q3 ONCOLOGY Pub Date : 2024-07-29 DOI: 10.2147/cmar.s474348
Luohang Ni, Jianing Xu, Quanpeng Li, Xianxiu Ge, Fei Wang, Xueting Deng, Lin Miao
Abstract: Biliary tract cancer (BTC) represents a challenging malignancy characterized by aggressive behavior, high relapse rates, and poor prognosis. In recent years, immunotherapy has revolutionized the treatment landscape for various cancers, but its efficacy in BTC remains limited. This article provides a comprehensive overview of the advances in preclinical and clinical studies of immunotherapy for BTC. We explore the potential of immune checkpoint inhibitors in reshaping the management of BTC. Despite disappointing results thus far, ongoing clinical trials are investigating the combination of immunotherapy with other treatment modalities. Furthermore, research on the tumor microenvironment has unveiled novel targets for immunotherapeutic interventions. By understanding the current state of immunotherapy in BTC and highlighting future directions, this article aims to fuel further exploration and ultimately improve patient outcomes in this challenging disease.

Keywords: biliary tract cancer, cancer immunotherapy, tumor microenvironment, immune checkpoint inhibitors, clinical trials
摘要:胆道癌(BTC)是一种具有挑战性的恶性肿瘤,其特点是侵袭性强、复发率高、预后差。近年来,免疫疗法彻底改变了各种癌症的治疗格局,但其对 BTC 的疗效仍然有限。本文全面概述了免疫疗法治疗 BTC 的临床前和临床研究进展。我们探讨了免疫检查点抑制剂在重塑 BTC 治疗中的潜力。尽管迄今为止的结果令人失望,但正在进行的临床试验正在研究免疫疗法与其他治疗方式的结合。此外,对肿瘤微环境的研究揭示了免疫治疗干预的新靶点。通过了解 BTC 免疫疗法的现状并强调未来的发展方向,本文旨在推动进一步的探索,并最终改善这种具有挑战性疾病的患者预后。 关键词:胆道癌;癌症免疫疗法;肿瘤微环境;免疫检查点抑制剂;临床试验
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引用次数: 0
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Cancer Management and Research
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