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Post-operative Post Irradiation using Ultrasound Breast Tumor 乳腺肿瘤超声术后放疗
Pub Date : 2019-12-17 DOI: 10.19080/ctoij.2019.15.555911
Dalia Aly Mohamed Aly Abou Taleb
The commonest abnormality is a hematoma, producing a rounded lesion which, in the early stages is , ill defined but which later becomes better defined. Blood clots adjacent to the inner wall of the haematoma may mimic a solid lesion. Associated to this there may be skin thickening, focally increased reflectivity and trabecular distortion, producing quite marked focal attenuation. Eventually a scar results, seen sonographically as a narrow band of attenuation extending down from the skin deeper in the tissue, perhaps persisting trabecular distortion and skin thickening.
最常见的异常是血肿,产生圆形病变,在早期是不明确的,但后来变得更明确。血肿内壁附近的血凝块可能与实性病变相似。与此相关的可能是皮肤增厚,局部反射率增加和小梁扭曲,产生相当明显的病灶衰减。最终形成疤痕,超声检查显示为一个狭窄的衰减带,从皮肤向组织深处延伸,可能持续存在小梁扭曲和皮肤增厚。
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引用次数: 0
Meningeal Sarcomas 脑膜肉瘤
Pub Date : 2019-12-13 DOI: 10.19080/ctoij.2019.15.555910
B. Saberi
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引用次数: 0
Assessment of Target definition based on Multimodality Imaging for Radiosurgical Management of Glomus Jugulare Tumors (gjts) 基于多模态成像的颈内静脉球瘤(gjts)放射外科治疗靶区定位评价
Pub Date : 2019-12-12 DOI: 10.19080/ctoij.2019.15.555909
S. Demiral
Glomus jugulare tumors (GJTs), also referred to as chemodectomas or paragangliomas are typically benign, highly vascular tumors which are derived from the paraganglionic cells [1-5]. While GJTs arise from the glomus bodies found along the Jacobson nerve (tympanic branch of the glossopharyngeal nerve) or Arnold nerve (auricular branch of the vagus nerve) located within the jugular foramen, glomus tympanicum tumors arise from glomus bodies found along the Jacobson nerve located within the middle ear and cochlear promontory. These rare and highly vascular tumors typically follow an indolent disease course with a low tendency for metastatic spread, however, a wide spectrum of symptoms including pulsatile tinnitus, otalgia, ear fullness, headache, vertigo, dizziness, dysphagia, dysphonia, conductive or sensorineural hearing loss may occur in the setting of mass effect or invasion of nearby critical structures such as the internal carotid artery, jugular bulb, or lower cranial nerves [1-6].
颈静脉球瘤(Glomus jugulare tumor, GJTs),也被称为化学瘤或副神经节瘤,是典型的良性、高度血管性肿瘤,起源于副神经节细胞[1-5]。GJTs起源于颈静脉孔内Jacobson神经(舌咽神经的鼓室支)或Arnold神经(迷走神经的耳支)的球囊小体,而鼓室球瘤则起源于中耳和耳蜗角内Jacobson神经的球囊小体。这些罕见且高度血管性的肿瘤通常呈惰性病程,转移扩散倾向较低,然而,在肿块效应或侵犯附近关键结构(如颈内动脉、颈静脉球或下颅神经)的情况下,可能出现广泛的症状,包括脉动性耳鸣、耳痛、耳胀、头痛、眩晕、头晕、吞咽困难、发音困难、传导性或感音神经性听力损失[1-6]。
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引用次数: 32
A Bibliometric Analysis of the Top 100 Most-Cited Articles in Chemotherapy (1910- 2019) 化疗领域100篇被引次数最多的论文(1910- 2019)的文献计量分析
Pub Date : 2019-12-06 DOI: 10.19080/ctoij.2019.15.555908
M. Faisaluddin, P. Iftikhar, Roopam Bansal, Azeem Husain Arast, Javidulla Khan, Azadeh Khayat, A. Jain
Background: Chemotherapy is the foundation for the treatment of various cancers. The advent of targeted treatment and chemotherapy has excited clinicians and scientists to perform clinical trials and studies. With limited medical care resources, bibliometric studies can help guide both researchers and research funding organizations to reallocate and increase the research activity.
背景:化疗是治疗各种癌症的基础。靶向治疗和化疗的出现激发了临床医生和科学家进行临床试验和研究。在医疗资源有限的情况下,文献计量学研究可以帮助指导研究人员和研究资助机构重新分配和增加研究活动。
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引用次数: 1
Dosimetric Comparison of Simultaneous Integrated vs. Sequential Boost in Radiotherapy for High Grade Gliomas 高级别胶质瘤放射治疗中同步整合与顺序强化的剂量学比较
Pub Date : 2019-11-07 DOI: 10.19080/ctoij.2019.15.555907
T. Nageeti
Despite of the use of combined treatment modalities including surgery, radiotherapy, and chemotherapy for the management of high-grade gliomas, the prognosis is still poor with a median survival of 14.6 months following combined treatment [1]. These tumours exhibit an infiltrative growth and it is necessary to control the peripheral infiltrating parts of microscopic tumor, which is usually not visible on imaging, as well as the visible tumor on diagnostic imaging. Therefore, it very important to target both areas with deliver different dose levels trying to spare the critical structures while maximize the dose to the area at risk [2-7]. Intensity modulated radiotherapy (IMRT) is advantageous owing to its better dose distribution and better sparing of normal tissues when compared with traditional 3D radiation treatment [8-11]. Volumetric-modulated arc therapy (VMAT) is a special kind of rotational IMRT [12]. In VMAT during rotation of the gantry, the dose rate and shape Abstract
尽管采用手术、放疗、化疗等联合治疗方式治疗高级别胶质瘤,但预后仍然较差,联合治疗后的中位生存期为14.6个月[1]。这些肿瘤表现为浸润性生长,需要控制显微镜下肿瘤的周围浸润部分,这些部分通常在成像上不可见,以及诊断成像上可见的肿瘤。因此,对两个区域分别施加不同剂量水平是非常重要的,尽量不影响关键结构,同时最大限度地对危险区域施加剂量[2-7]。与传统的三维放射治疗相比,调强放疗(IMRT)具有更好的剂量分布和更好地保留正常组织的优势[8-11]。体积调制弧线治疗(volume - modulation arc therapy, VMAT)是一种特殊的旋转IMRT[12]。在VMAT中,龙门旋转期间,剂量率和形状抽象
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引用次数: 0
Colorectal Cancer Prevention with a Plant-Based diet 植物性饮食预防结直肠癌
Pub Date : 2019-10-24 DOI: 10.19080/ctoij.2019.15.555906
Stewart D Rose
A plant-based diet is valuable in the primary and secondary prevention of colorectal cancer. Epidemiological studies show a 46%-88% reduced risk of colorectal cancer for those following a plant-based diet. In light of evidence, the World Health Organization International Agency for Research on Cancer (IARC) has classified processed meat as a carcinogen and red meat as a probable carcinogen and has since reaffirmed their decision in light of more recent studies. The pathogenic mechanisms by which processed and red meat can cause colon cancer to have been determined. Several exogenous carcinogens are contained in meat and others are formed as a byproduct of its preparation. Bacterial flora produces several carcinogens endogenously in response to processed and red meat intake. Some of the ways plant foods and their phytonutrients protect against colon cancer are also now understood. The chemoprotective mechanisms of plant foods are through the direct actions of phytochemicals, through the action of fiber, and as a result of the anti-inflammatory environment produced by the colonic flora. While colonoscopy and FIT-DNA tests remain very valuable for secondary prevention, a plant-based diet can provide both primary and secondary prevention of colorectal cancer. Making prevention of colon cancer with a plant-based diet all the more desirable is that it is also a safe and efficacious prophylaxis and treats common comorbidities such as coronary artery disease and type II diabetes.
植物性饮食在结直肠癌的一级和二级预防中是有价值的。流行病学研究表明,食用植物性饮食的人患结直肠癌的风险降低了46%-88%。根据证据,世界卫生组织国际癌症研究机构(IARC)将加工肉类列为致癌物,将红肉列为可能致癌物,并根据最近的研究重申了他们的决定。加工肉和红肉导致结肠癌的致病机制已经确定。肉类中含有几种外源性致癌物,而其他致癌物则是肉类加工过程中的副产品。细菌菌群内源性产生几种致癌物,以响应加工肉和红肉的摄入。植物性食物及其植物营养素预防结肠癌的一些方式现在也被了解了。植物性食物的化学保护机制是通过植物化学物质的直接作用,通过纤维的作用,以及结肠菌群产生的抗炎环境的结果。虽然结肠镜检查和FIT-DNA测试对于二级预防仍然非常有价值,但植物性饮食可以提供结肠直肠癌的一级和二级预防。用植物性饮食来预防结肠癌更受欢迎,因为它也是一种安全有效的预防方法,可以治疗常见的合并症,如冠状动脉疾病和II型糖尿病。
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引用次数: 3
Laparoscopy-Assisted Versus Open Gastrectomy for Gastric Cancer: A Comprehensive Systematic Review and Meta-Analysis Based on Randomized Controlled Trials 腹腔镜辅助胃癌与开放式胃切除术:基于随机对照试验的综合系统评价和荟萃分析
Pub Date : 2019-10-14 DOI: 10.19080/ctoij.2019.15.555904
Rawan Khalid Abdulgadir Salih
Gastric cancer is a major health problem worldwide [1,2]. It is now the fifth common cancer and the second leading cause of cancer-related mortality in the world, accounting for more the 10% of the annual cancer deaths globally [3-6]. There is global variation in the incidence of gastric cancers with higher incidence in Southeast Asia specially Korea and Japan and much lower incidence in Africa, Australia and USA. The treatment of gastric cancer depends upon the stage of the disease. One of the commonest staging systems is the American Joint Committee on Cancer (AJCC) gastric cancer staging system AJCC 7th edition, known as the TNM classification [7,8]. In stage I to III, radical surgery in the form of gastrectomy and lymph nodes dissection is the mainstay of the treatment and the aim is cure of the disease. In stage IV, palliative treatment is recommended.
胃癌是世界范围内的主要健康问题[1,2]。目前是世界上第五大常见癌症和第二大癌症相关死亡原因,占全球每年癌症死亡人数的10%以上[3-6]。胃癌的发病率在全球范围内存在差异,东南亚特别是韩国和日本的发病率较高,非洲、澳大利亚和美国的发病率较低。胃癌的治疗取决于疾病的分期。最常见的分期系统之一是美国癌症联合委员会(AJCC)胃癌分期系统AJCC第7版,被称为TNM分类[7,8]。在I至III期,以胃切除术和淋巴结清扫为主要治疗形式的根治性手术,目的是治愈疾病。在第四期,建议姑息治疗。
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引用次数: 0
Blood Brain Barrier (Bbb) Role in Delivering the Chemotherapeutic Agents to the Brain in the Treatment of Brain Tumors 血脑屏障(Bbb)在脑肿瘤治疗中向脑部输送化疗药物中的作用
Pub Date : 2019-09-26 DOI: 10.19080/ctoij.2019.15.555903
B. Saberi
Systemic chemotherapy would be challenging to treat brain tumors. Achieving the required concentrations of the chemotherapeutic agents in the brain would be influenced by some factors like the volume of distribution of the agent in the brain parenchyma, the ability of the agent to cross the blood brain barrier and active amount of the drug which can be transported out of the brain. Because of difficulties to reach the specific sites of the brain, drug delivering in systemic chemotherapy for brain tumors would encounter various failures [1]. Also, there are other barriers which influence drug delivering to the brain including blood-cerebrospinal fluid barrier, brain-cerebrospinal fluid barrier and the brain tumor barrier. A monolayer of brain capillary endothelial cells is the main part of the blood brain barrier. The interaction between endothelial and astrocyte cells and the tight junctions between endothelial cells, restrict the brain penetration by the chemotherapeutic agents [2]. Lacking intercellular fenestrations and having low ionic permeability and high electrical resistance in the endothelial cells of brain capillaries, make many of water-soluble agents to be unable to reach the brain.
全身化疗对治疗脑肿瘤具有挑战性。在脑内达到所需的化疗药物浓度会受到一些因素的影响,如药物在脑实质中的分布体积、药物穿过血脑屏障的能力以及药物可被运出脑外的活性量。由于难以到达大脑的特定部位,在脑肿瘤的全身化疗中给药会遇到各种各样的失败。此外,还有其他屏障影响药物向大脑的输送,包括血-脑脊液屏障、脑-脑脊液屏障和脑肿瘤屏障。单层脑毛细血管内皮细胞是血脑屏障的主要部分。内皮细胞和星形胶质细胞之间的相互作用以及内皮细胞之间的紧密连接限制了化疗药物[2]对脑的渗透。脑毛细血管内皮细胞缺乏细胞间开孔,离子渗透性低,电阻高,使许多水溶性药物无法到达脑。
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引用次数: 0
Important considerations before Initiation of Ibrutinib Treatment 伊鲁替尼治疗开始前的重要考虑
Pub Date : 2019-09-03 DOI: 10.19080/ctoij.2019.15.555902
N. Hamed
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引用次数: 0
How to Decide about Robotic Surgery in Patients with Locally Advanced Gastric Cancer? 局部进展期胃癌患者如何选择机器人手术?
Pub Date : 2019-08-29 DOI: 10.19080/ctoij.2019.15.555901
B. Cristea
Aim: Surgery is the cornerstone in the treatment of gastric cancer and includes conventional open gastrectomy and minimally invasive techniques. Preoperative criteria should be established in order to decrease the rate of conversion to open surgery. To evaluate such criteria, we must focus on computer tomography and upper endoscopy workup. Methods: This is a hospital-based observational retrospective study including 205 patients treated in Fundeni Clinical Institute, during the interval of 2008-2014. The patients were diagnosed with advanced gastric cancer according to endoscopic, computer-tomographic and histopathologic techniques. None of the patients received any neoadjuvant chemotherapy. 144 of patients underwent a curative surgical resection with D2 lymphadenectomy. Results: Minimally invasive surgery was performed on 51 patients; other 26 patients were initially treated by MIS but during operation they were converted to open surgery. Open surgery was performed on 128 patients. Risk factors that led to converting an initially MIS intervention to open intervention comprise: Borrmann 1 (p=0.0275) identified by endoscopy, metastasis (p=0.0416), peritoneal carcinomatosis (p=0.0156) identified by CT scan. On the contrary, endoscopic staging Borrmann 3 proved to be a preventing factor against surgical conversion (p=0.0169). Conclusion: A multivariate analysis of all prospective clinical, endoscopic and tomographic parameters is required to identify the patients with gastric cancer that could benefit more from the robotic platform. Endoscopic parameters as the distance from cardia, distance to pylorus, the invasion of more than one gastric wall, the invasion of both vertical and horizontal portion, might constitute criteria for the selection of surgical methods.
目的:手术是胃癌治疗的基石,包括传统的开放式胃切除术和微创技术。术前应建立标准,以减少转换为开放手术的比率。为了评估这些标准,我们必须关注计算机断层扫描和上颌内窥镜检查。方法:这是一项以医院为基础的观察性回顾性研究,包括2008-2014年期间在Fundeni临床研究所治疗的205例患者。经内镜、计算机断层扫描及组织病理学检查均诊断为晚期胃癌。所有患者均未接受任何新辅助化疗。144例患者行根治性D2淋巴结切除术。结果:51例患者行微创手术;其他26例患者最初接受MIS治疗,但在手术期间转为开放手术。128例患者行开放手术。导致最初MIS干预转为开放式干预的危险因素包括:内窥镜发现的Borrmann 1 (p=0.0275),转移(p=0.0416), CT扫描发现的腹膜癌(p=0.0156)。相反,内镜分期Borrmann 3被证明是阻止手术转化的因素(p=0.0169)。结论:需要对所有前瞻性临床、内镜和断层扫描参数进行多变量分析,以确定可以从机器人平台中获益更多的胃癌患者。内镜参数如离贲门的距离、到幽门的距离、侵犯一处以上胃壁、侵犯垂直部分和水平部分均可作为选择手术方法的标准。
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引用次数: 0
期刊
Cancer Therapy & Oncology International Journal
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