Fear of cancer recurrence(FCR)is a psychological worry among cancer survivors,particularly among the elderly who are at risk of developing physiological and psychological vulnerabilities.In a cross-sectional survey of...Fear of cancer recurrence(FCR)is a psychological worry among cancer survivors,particularly among the elderly who are at risk of developing physiological and psychological vulnerabilities.In a cross-sectional survey of 264 elderly gastric cancer(GC)patients by Zhu et al,a high rate(63.64%)of clinically significant FCR was observed following laparoscopic radical gastrectomy.Factors affecting the high rate of FCR were a high level of self-perceived burden,lower education level,large tumour diameter,short duration of disease,and postoperative complications.They also established a validated nomogram model to predict the risk of FCR in this patient population.In this letter,we want to emphasize that,in addition to integrating psychological screening and focused interventions into the routine postoperative care of elderly GC patients,prehabilitation interventions before surgery,including psychological support,may provide a proactive response to mitigate FCR and improve long-term outcomes.展开更多
Cancer recurrence,driven by the phenomenon of tumor dormancy,presents a formidable challenge in oncology.Dormant cancer cells have the ability to evade detection and treatment,leading to relapse.This review emphasizes...Cancer recurrence,driven by the phenomenon of tumor dormancy,presents a formidable challenge in oncology.Dormant cancer cells have the ability to evade detection and treatment,leading to relapse.This review emphasizes the urgent need to comprehend tumor dormancy and its implications for cancer recurrence.Despite notable advancements,significant gaps remain in our understanding of the mechanisms underlying dormancy and the lack of reliable biomarkers for predicting relapse.This review provides a comprehensive analysis of the cellular,angiogenic,and immunological aspects of dormancy.It highlights the current therapeutic strategies targeting dormant cells,particularly combination therapies and immunotherapies,which hold promise in preventing relapse.By elucidating these mechanisms and proposing innovative research methodologies,this review aims to deepen our understanding of tumor dormancy,ultimately facilitating the development of more effective strategies for preventing cancer recurrence and improving patient outcomes.展开更多
BACKGROUND Fear of cancer recurrence(FCR)is a common psychological problem among patients with cancer,especially elderly patients.For patients with gastric cancer(GC)who have undergone treatments such as surgery,FCR m...BACKGROUND Fear of cancer recurrence(FCR)is a common psychological problem among patients with cancer,especially elderly patients.For patients with gastric cancer(GC)who have undergone treatments such as surgery,FCR may seriously affect their quality of life and psychological well-being.AIM To evaluate the FCR in elderly patients with GC undergoing laparoscopic radical surgery in Hefei City and to explore its related influencing factors.METHODS In this study 264 elderly patients with GC who underwent laparoscopic radical surgery in four hospital districts of The First Affiliated Hospital of Anhui Medical University from June 2021 to January 2024 were recruited.Information on basic characteristics,disease characteristics,psychological status,and social support was collected by a questionnaire.In statistical analysis,the t-test andχ^(2) test were used to analyze the differences between groups.The influencing factors of FCR were analyzed by logistic regression.Based on these influencing factors,a nomogram model was initially constructed to identify patients with GC with high FCR risk.RESULTS Elderly patients with GC generally faced higher FCR levels after laparoscopic radical surgery.Among the 264 patients,168 had clinical symptoms of FCR,and the prevalence rate was 63.64%.Further analysis showed that older age,high mental resilience,and sufficient social support were favorable factors for reducing FCR level,while heavier self-perceived burden,low education level,shorter duration of disease,larger tumor diameter,and more complications were associated with a higher FCR level.CONCLUSION This study demonstrated the significance of psychological interventions and social support strategies in reducing FCR among elderly patients with GC.In the future treatment protocols should be further optimized,and psychological and social support should be enhanced to improve the quality of life for this patient population.展开更多
BACKGROUND Emerging evidence links gut microbiota to various human diseases including colorectal cancer(CRC)initiation and development.However,gut microbiota profiles associated with CRC recurrence and patient prognos...BACKGROUND Emerging evidence links gut microbiota to various human diseases including colorectal cancer(CRC)initiation and development.However,gut microbiota profiles associated with CRC recurrence and patient prognosis are not completely understood yet,especially in a Chinese cohort.AIM To investigate the relationship between gut mucosal microbiota profiles and CRC recurrence and patient prognosis.METHODS We obtained the composition and structure of gut microbiota collected from 75 patients diagnosed with CRC and 26 healthy controls.The patients were followed up by regular examination to determine whether tumors recurred.Triplet-paired samples from on-tumor,adjacent-tumor and off-tumor sites of patients diagnosed with/without CRC recurrence were analyzed to assess spatial-specific patterns of gut mucosal microbiota by 16S ribosomal RNA sequencing.Next,we carried out bioinformatic analyses,Kaplan-Meier survival analyses and Cox regression analyses to determine the relationship between gut mucosal microbiota profiles and CRC recurrence and patient prognosis.RESULTS We observed spatial-specific patterns of gut mucosal microbiota profiles linked to CRC recurrence and patient prognosis.A total of 17 bacterial genera/families were identified as potential biomarkers for CRC recurrence and patient prognosis,including Anaerotruncus,Bacteroidales,Coriobacteriaceae,Dialister,Eubacterium,Fusobacterium,Filifactor,Gemella,Haemophilus,Mogibacteriazeae,Pyramidobacter,Parvimonas,Porphyromonadaceae,Slackia,Schwartzia,TG5 and Treponema.CONCLUSION Our work suggests that intestinal microbiota can serve as biomarkers to predict the risk of CRC recurrence and patient death.展开更多
The hedgehog （Hh） signaling pathway plays an essential role in the embryonic development and homeostasis of diverse adult tissues, and its deregulation has been implicated in the tumorigenesis and metastasis of vari...The hedgehog （Hh） signaling pathway plays an essential role in the embryonic development and homeostasis of diverse adult tissues, and its deregulation has been implicated in the tumorigenesis and metastasis of various malignancies including breast cancer. Aberrant activation of the Hh pathway includes the following mechanisms： （I） Hh ligand-independent mechanism - Loss of function mutations in the Hh receptor Patched 1 （PTCH1） or gain of function mutations in the Smoothened （SMO） lead to constitutive activation of this pathway; （II） Autocrine signaling- Ith ligand produced by tumor cells stimulates the Hh signaling in tumor cells; （III） Paracrine signaling - tumor cell produced-Hh ligand activates stromal and endothelial cells that produce growth factors in microenvironment for supporting tumor growth and survival; and （IV） Reverse paracrine signaling - Hh ligand produced by stromal cells support tumor growth and survival. Upon the pathway activation, the Gli transcription factors, effectors of the Hh signaling, activate or inhibit transcription by binding to their responsive genes and interacting with the transcriptional complex. The Gli transcription factor family includes Glil, Gli2, and Gli3 （1）. Glil is a transcriptional activator whose expression has been recognized as an activation state of the Hh signaling pathway, Gli2 is either an activator or repressor, and Gli3 is a strong repressor of transcriptional activities. To date, a ligand-dependent autocrine model of activating the Hh signaling has been described in breast cancer, and both an autocrine and paracrine mechanisms in colorectal cancer, pancreatic cancer and prostate cancer （2,3）. Notably, a ligand-independent mechanism （mutationsin PTCHI and SMO） of the signaling has been well demonstrated in basal cell carcinoma and medulloblastoma （4,5）.展开更多
Camptothecin has a strong tumor killing ability for a variety of tumor cells with its special anti-cancer mechanism including the breast cancer.However,because of its infinite hydrophobic property,its clinical applica...Camptothecin has a strong tumor killing ability for a variety of tumor cells with its special anti-cancer mechanism including the breast cancer.However,because of its infinite hydrophobic property,its clinical application has been greatly limited.Early prevention of loco regional recurrence for the breast cancer is critical for patients who have undergone breast-conserving therapy.In the study,CPT was used for the inhibition of the recurrence after the operation.The hollow mesoporous silica nanoparticles were used as the carrier to improve the hydrophilic property and increase its bioavailability with the high loading capacity.The ability of the cellular uptake and antitumor activity was increased.Hydrogel was the ideal carrier for local therapy,so the CPT@HMSNs were loaded into the PLEL thermo sensitive hydrogel to be injected into the tumor sites after the tumor was resected.The recurrence was reduced in the group of CPT-HMSNs-PLEL and the side effect of CPT was decreased.They exhibit distinguished potential as drug carrier for local delivery.展开更多
Objective:Non-small cell lung cancer(NSCLC)patients often experience significant fear of recurrence.To facilitate precise identification and appropriate management of this fear,this study aimed to compare the efficacy...Objective:Non-small cell lung cancer(NSCLC)patients often experience significant fear of recurrence.To facilitate precise identification and appropriate management of this fear,this study aimed to compare the efficacy and accuracy of a Backpropagation Neural Network(BPNN)against logistic regression in modeling fear of cancer recurrence prediction.Methods:Data from 596 NSCLC patients,collected between September 2023 and December 2023 at the Cancer Hospital of the Chinese Academy of Medical Sciences,were analyzed.Nine clinically and statistically significant variables,identified via univariate logistic regression,were inputted into both BPNN and logistic regression models developed on a training set(N=427)and validated on an independent set(N=169).Model performances were assessed using Area Under the Receiver Operating Characteristic(ROC)Curve and Decision Curve Analysis(DCA)in both sets.Results:The BPNN model,incorporating nine selected variables,demonstrated superior performance over logistic regression in the training set(AUC=0.842 vs.0.711,p<0.001)and validation set(0.7 vs.0.675,p<0.001).Conclusion:The BPNN model outperforms logistic regression in accurately predicting fear of cancer recurrence in NSCLC patients,offering an advanced approach for fear assessment.展开更多
Fear of disease progression is one of the most common psychological problems in the treatment of cancer patients. Early recognition and intervention can effectively control the level of fear of disease progression and...Fear of disease progression is one of the most common psychological problems in the treatment of cancer patients. Early recognition and intervention can effectively control the level of fear of disease progression and improve the quality of life of patients. The present situation and influencing factors of FoP in breast cancer patients were reviewed in this paper, in order to provide reference for clinical research of breast cancer patients.展开更多
To discuss recurrence patterns and their significance in colorectal cancer.Preexisting medical hypotheses and the clinical phenomena of recurrence in colorectal cancer were evaluated and integrated.Colorectal cancer r...To discuss recurrence patterns and their significance in colorectal cancer.Preexisting medical hypotheses and the clinical phenomena of recurrence in colorectal cancer were evaluated and integrated.Colorectal cancer recurrence/metastasis consists of two types:recurrence from the activation of dormant cancer cells and recurrence from postoperative residual cancer cells.These two recurrences have their own unique mechanisms,biological behaviors,responses to therapy,and prognoses.For type 1 recurrences,surgical resection should be considered.Type 2 recurrences should be managed systematically in addition to surgical resection.The two types of colorectal cancer recurrence should be evaluated and managed separately.展开更多
Background:Whether regional anesthesia may help to prevent disease recurrence in cancer patients is still controversial.The stage of cancer at the time of diagnosis is a key factor that defines prognosis and is one of...Background:Whether regional anesthesia may help to prevent disease recurrence in cancer patients is still controversial.The stage of cancer at the time of diagnosis is a key factor that defines prognosis and is one of the most important sources of heterogeneity for the treatment effect.We sought to update existing systematic reviews and clarify the effect of regional anesthesia on cancer recurrence in late-stage cancer patients.Methods:Medline,Embase,and Cochrane Library were searched from inception to September 2020 to identify randomized controlled trials(RCTs)and cohort studies that assessed the effect of regional anesthesia on cancer recurrence and overall survival(OS)compared with general anesthesia.Late-stage cancer patients were primarily assessed according to the American Joint Committee on Cancer Cancer Staging Manual(eighth edition),and the combined hazard ratio(HR)from random-effects models was used to evaluate the effect of regional anesthesia.Results:A total of three RCTs and 34 cohort studies(including 64,691 patients)were identified through the literature search for inclusion in the analysis.The risk of bias was low in the RCTs and was moderate in the observational studies.The pooled HR for recurrence-free survival(RFS)or OS did not favor regional anesthesia when data from RCTs in patients with late-stage cancer were combined(RFS,HR=1.12,95%confidence interval[CI]:0.58-2.18,P=0.729,I2=76%;OS,HR=0.86,95%CI:0.63-1.18,P=0.345,I^(2)=48%).Findings from observational studies showed that regional anesthesia may help to prevent disease recurrence(HR=0.87,95%CI:0.78-0.96,P=0.008,I2=71%)and improve OS(HR=0.88,95%CI:0.79-0.98,P=0.022,I^(2)=79%).Conclusions:RCTs reveal that OS and RFS were similar between regional and general anesthesia in late-stage cancers.The selection of anesthetic methods should still be based on clinical evaluation,and changes to current practice need more support from large,well-powered,and well-designed studies.展开更多
Cancer,potentially the second leading cause of mortality globally,poses a significant health challenge.The conventional treatment for solid tumors typically involves surgical intervention,followed by chemotherapy,radi...Cancer,potentially the second leading cause of mortality globally,poses a significant health challenge.The conventional treatment for solid tumors typically involves surgical intervention,followed by chemotherapy,radiotherapy,and targeted therapies.However,cancer recurrence and metastasis remain major issues.Anesthesia is essential for ensuring patient comfort and safety during surgery.Despite its crucial role in surgery,the precise effect of anesthesia on cancer patients'outcomes has not been clearly understood.This comprehensive review aims to elucidate perioperative anesthesia strategies for cancer patients and their potential effects on prognosis.Given the complexity of cancer treatments,understanding the relationship between anesthesia and cancer outcomes is crucial.By examining potential implications of anesthesia strategies for cancer prognosis,this review may help better understand treatment efficacy and risk factors for cancer recurrence and metastasis.Ultimately,a detailed analysis of anesthesia practices in cancer surgery may provide insights to refine existing anesthesia protocols and reduce risk factors for poor patient outcomes.展开更多
Objectives:This study aimed to explore the effectiveness and advantages of an“Internet+”nursing model based on user profilingin the rehabilitation of postoperative breast cancer patients.Methods:Breast cancer patien...Objectives:This study aimed to explore the effectiveness and advantages of an“Internet+”nursing model based on user profilingin the rehabilitation of postoperative breast cancer patients.Methods:Breast cancer patients admitted to the hospital from July 2023 to September 2024 were enrolled.These patients were randomly assigned to a control group and an intervention group,with 52 patients in each group.The control group received routine nursing care,while the intervention group received an“Internet+”nursing intervention based on user profilingin addition to routine care.The intervention period lasted for one month following discharge.Before and one month after the intervention,the Fear of Progression Questionnaire-Short Form(FOP-Q-SF),the Fear of Cancer Recurrence Inventory-Short Form(FCRI-SF),Chinese Posttraumatic Growth Inventory(C-PTGI),and the Functional Assessment of Cancer Therapy-Breast(FACT-B)were applied to assess the effects of interventions.Results:A total of 104 patients were analyzed.After the intervention,FOP-Q-SF and FCRI-SF scores were significantlylower in the intervention group compared to the control group,with statistical significance(t=3.98,P<0.001;t=-7.59,P<0.001),and Cohen’s d of 0.781 and 1.49,respectively.Additionally,CPTGI and FACT-B scores in the intervention group were significantly higher than those in the control group(t=-6.534,P<0.001;t=-4.579,P<0.001),with Cohen’s d of 0.585 and 0.656.Conclusions:An“Internet+”nursing model based on user profilingcould reduce postoperative breast cancer patients fear of disease progression and cancer recurrence,also enhancing posttraumatic growth and overall quality of life.展开更多
Objective:Recurrence continues to be a pivotal challenge among hormone receptor-positive(HR^(+))/human epidermal growth factor receptor 2^(−)negative(HER2^(−))breast cancers.In the international consensus guidelines,H...Objective:Recurrence continues to be a pivotal challenge among hormone receptor-positive(HR^(+))/human epidermal growth factor receptor 2^(−)negative(HER2^(−))breast cancers.In the international consensus guidelines,HR^(+)/HER2^(−)breast cancer relapse patterns are divided into three distinct types:primary resistant,secondary resistant,and endocrine sensitive.However,owing to the lack of cohorts with treatment and follow-up data,the heterogeneity among different recurrence patterns remains uncharted.Current treatments still lack precision.Methods:This analysis included data from a large-scale multiomics study of a HR^(+)/HER2^(−)breast cancer cohort(n=314).Through the analysis of transcriptomics(n=312),proteomics(n=124),whole-exome sequencing(n=290),metabolomics(n=217),and digital pathology(n=228)data,we explored distinctive molecular features and identified putative therapeutic targets for patients experiencing recurrence.Results:We explored distinct clinicopathological characteristics,biological heterogeneity,and potential therapeutic strategies for recurrence.Based on a shared relapse signature,we stratified patients into high-and lowrecurrence-risk groups.Patients with different relapse patterns presented unique molecular features in primary tumors.Specifically,receptor tyrosine kinase(RTK)pathway activation in the primary resistant group suggested the utility of RTK inhibitors,whereas mammalian target of rapamycin(mTOR)and cell cycle pathway activation in the secondary resistant group highlighted the potential of mTOR and CDK4/6 inhibitors.Interestingly,the endocrine-sensitive group displayed a quiescent state and high genomic instability,suggesting that targeting quiescent cells and using poly-ADP-ribose polymerase(PARP)inhibitors could be effective strategies.Conclusions:These findings illuminate the clinicopathological and molecular landscape of HR^(+)/HER2^(−)breast cancer patients with distinct recurrence patterns,highlighting potential targeted therapies.展开更多
The surgical outcome of most early gastric cancer （EGC） is usually satisfactory. Some cases show bone metastasis even though the depth of cancer invasion is confined to the mucosa. The most frequent site for recurre...The surgical outcome of most early gastric cancer （EGC） is usually satisfactory. Some cases show bone metastasis even though the depth of cancer invasion is confined to the mucosa. The most frequent site for recurrence of EGC is the liver. Cases of EGC with bone metastasis are reviewed to clarify the clinicopathological characteristics of EGC giving rise to bone metastasis. Possible mechanisms and risk factors underlying this rare condition are proposed. Forty-six cases of bone metastasis from EGC are reviewed from published reports and meeting proceedings in Japan. This investigation suggests that risk factors for bone metastasis from EGC include depressed-type signet-ring cell carcinoma, poorly differentiated carcinoma, and/or the likely involvement of lymph node metastasis, even though the cancer is confined to the gastric mucosa. The risk factors do not include recurrence of EGC in the liver. We speculate that the mechanism of bone metastasis from EGC is via lymphatic channels and systemic circulation. Postoperative follow-up of cases should consider the development of bone metastasis from EGC. We propose the use of elevated alkaline phosphatase levels for the detection of bone metastasis and recommend bone scintigraphy in positive cases. 2005 The WJG Press and Elsevier Inc. All rights reserved展开更多
Objective: To investigate the effect of docetaxel and cisplatin combined with intensity-modulated radiotherapy in thetreatment of postoperative recurrence of esophageal cancer and the content of tumor markers in serum...Objective: To investigate the effect of docetaxel and cisplatin combined with intensity-modulated radiotherapy in thetreatment of postoperative recurrence of esophageal cancer and the content of tumor markers in serum. Methods: According tosimple randomization method, 60 patients with postoperative recurrence of esophageal cancer admitted from February 2018 toSeptember 2019 were divided into control group (n = 30 cases) and observation group (n = 30 cases). All patients received IMRT.Fluorouracil + cisplatin was used in the control group and docetaxel + cisplatin was used in the observation group. After 2 coursesof continuous treatment, the therapeutic effect, serum tumor marker content and adverse reactions were compared between thetwo groups. Results: After treatment, the effective rate of observation group was higher than control group, and the difference wasstatistically significant (P < 0.05).The contents of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) andcarbohydrate antigen 19-9 (CA19-9) in observation group were lower than those in control group, and the difference was statisticallysignificant (P < 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, and thedifference was statistically significant (P < 0.05). Conclusion: Docetaxel and cisplatin combined with intensemodulated radiotherapyfor postoperative recurrence of esophageal cancer can improve the therapeutic effect, inhibit the malignant degree of tumor, andreduce the incidence of adverse reactions.展开更多
Backgroud:Summarize the formula rule of traditional Chinese medicine fOr preventing and treating bladder cancer recurrence after operation and explore the molecular mechanism of core medicines.Methods:Literatures coll...Backgroud:Summarize the formula rule of traditional Chinese medicine fOr preventing and treating bladder cancer recurrence after operation and explore the molecular mechanism of core medicines.Methods:Literatures collected from CNKI,Wanfang Med Online,CMJD,PUBMED and Elsiver databases were as prescription sources,and association rules and complex system entropy clustering analysis were carried out using the Traditional Chinese Medicine Inheritance Support System(TCMISSV2.5).BATMAN-TCM online analysis tool was used to construct target-pathway-disease correlation map to reveal the potential mechanism of action.Results:A total of 122 prescriptions were eligible for data analysis.The high-frequency traditional Chinese medicines are Poria,Radix et Rhizoma Rhei,Radix Astragali,Herba Hedyotidis Diffusae and Rhizoma Atractylodis Macrocephalae.The high-frequency drug pairs are Rhizoma Atractylodis MacrocephalaeIPoria,Poria/Rhizoma Alismatis,Radix Astragali/Rhizoma Atractylodis Macrocephalaeand and Herba Hedyotidis Diffusae/Herba Scutellariae Darbatae..There are 5 groups of drug pairs with high correlation strength.Cluster analysis shows 6 core drug combinations and 3 new prescriptions.In clinical practice,the core compatibility of traditional Chinese medicines for preventing postoperative recurrence of bladder cancer is Poria,Radix Astragali and Herba Hedyotidis Diffusae.The possible signaling pathways are the neuroactive ligand receptor interaction signaling pathway and calcium signaling pathway.Conclusion:Prevention and treatment of postoperative recurrence of bladder cancer mainly use medicines with effects of eliminating dampness and diuresis for removing edema,heat-clearing and detoxifying,and qi-invigorating.The potential mechanism of the compatibility of core drugs may be realized by interfering with the signal pathway of neuroactive ligand receptor interaction and calcium signal pathway.展开更多
Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients wit...Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients with superficial bladder cancers were randomized into combined interventional chemotherapy and intravesical instillation of mitomycin or intravesical instillation of mitomycin alone for preventing recurrence after local ablation. The result was assessed by x2 test. Results The patients have been followed up for 12-26 months (mean 21 months). 1 case has had tumor recurrence in the combined modality therapy group and 4 in the intravesical instillation alone group, the tumor recurrence rate being 7% (1/14) and 29% (4/14) respectively (P【0.05). Conclusion Combined use of interventional chemotherapy and intravesical instillation of mitomycin is effective in preventing superficial bladder cancer from recurring after local ablation with fewer adverse effects. The ragimen is not only reliable but展开更多
To investigate the effects of intravesical therapy with elemene in preventing postoperative recurrence of superficial bladder cancer and its toxic and side effects.Methods This series included 123 patients with superf...To investigate the effects of intravesical therapy with elemene in preventing postoperative recurrence of superficial bladder cancer and its toxic and side effects.Methods This series included 123 patients with superficial bladder cancer (T1),consisting of transitional cell carcinoma GⅠ in 37 cases,GⅡ in 73 and GⅢ in 13.They all underwent surgical treatment.Postoperatively,they were randomly assigned to 2 groups;63 patients in elemene group received instillation of elemene (400 mg,once a week) 2 weeks after operation and 60 patients in mitomycin C (MMC) group received instillation of MMC (40 mg,once a week) 2 weeks after operation.The instillations were repeated for 6 weeks and thereafter monthly for 1 year.The recurrence rates,side effects,and NK cell activity before and after treatment were evaluated.Results The recurrence rate of elemene group (mean follow-up of 19.7 months) was 7.9% (5 cases),which was significantly lower than that (25.0%,15 cases) of MMC group (mean follow-up of 19.4 months;P<0.05).The side effect in elemene group (3.2%,2 cases) was significantly milder than that in MMC group (25.0%,15 cases)(P<0.05).In elemene group,the NK cell activity after treatment (28±2)% was significantly higher than that before treatment(20±2)%(P<0.05).Conclusion Instillation of elemene after operation is effective and safe in preventing postoperative recurrence of bladder cancer.8 refs.展开更多
Cancer stem cells(CSCs)are a major challenge in cancer therapy.Stem cell-like cells form a unique subpopulation within many tumors,which govern the degree of malignancy by promoting metastasis,recurrence,heterogeneity...Cancer stem cells(CSCs)are a major challenge in cancer therapy.Stem cell-like cells form a unique subpopulation within many tumors,which govern the degree of malignancy by promoting metastasis,recurrence,heterogeneity,and resistance to drug and radiation.Furthermore,these cells can persist in patients even after undergoing multiple cycles of conventional cancer therapy via dormancy,where they no longer dividing but remain active.These may cause cancer recurrence at any time,even years after a supposed cure,and remain invisible to the immune system.Targeting specific surface markers,signaling pathways and tumor microenvironment,which all have a significant effect on CSC function and maintenance,could help to eradicate CSCs and improve patient survival.Combinations of traditional therapies with nano-based drug delivery systems can efficiently target CSCs.Considering the biology and properties of CSCs,we classify recent approaches involving nanoparticle engineering,extracellular matrix modulation,cocktail strategies,multi-stage therapy,CSC defanging,Trojan horse systems,targeted therapy and organelle targeting.We highlight the most recent advances in nanocarrier design and drug delivery technologies to target CSCs,combined with conventional treatment in preclinical and clinical trials.The prospects of these approaches for CSCs elimination and recurrent cancer treatment are discussed.展开更多
Endometrial cancer is the most common gynecologic cancer diagnosed in the United States and mortality is on the rise.Advanced and recurrent endometrial cancer represents a treatment challenge as historically there hav...Endometrial cancer is the most common gynecologic cancer diagnosed in the United States and mortality is on the rise.Advanced and recurrent endometrial cancer represents a treatment challenge as historically there have been limited therapeutic options for patients.In the last several years,multiple practice-changing clinical trials have led to significant improvements in the treatment landscape.This review will cover updates in the treatment and management of advanced and recurrent endometrial cancer with a focus on novel therapeutics,such as anti-PD-L1 and PD-1 inhibitors,poly ADP-ribose polymerase(PARP)inhibitors,antibody-drug conjugates,and hormonal therapy.展开更多
文摘Fear of cancer recurrence(FCR)is a psychological worry among cancer survivors,particularly among the elderly who are at risk of developing physiological and psychological vulnerabilities.In a cross-sectional survey of 264 elderly gastric cancer(GC)patients by Zhu et al,a high rate(63.64%)of clinically significant FCR was observed following laparoscopic radical gastrectomy.Factors affecting the high rate of FCR were a high level of self-perceived burden,lower education level,large tumour diameter,short duration of disease,and postoperative complications.They also established a validated nomogram model to predict the risk of FCR in this patient population.In this letter,we want to emphasize that,in addition to integrating psychological screening and focused interventions into the routine postoperative care of elderly GC patients,prehabilitation interventions before surgery,including psychological support,may provide a proactive response to mitigate FCR and improve long-term outcomes.
基金supported by the National Natural Sciences Foundation of China(82170974)the Central South University Research Program of Advanced Interdisciplinary Studies(2023QYJC038).
文摘Cancer recurrence,driven by the phenomenon of tumor dormancy,presents a formidable challenge in oncology.Dormant cancer cells have the ability to evade detection and treatment,leading to relapse.This review emphasizes the urgent need to comprehend tumor dormancy and its implications for cancer recurrence.Despite notable advancements,significant gaps remain in our understanding of the mechanisms underlying dormancy and the lack of reliable biomarkers for predicting relapse.This review provides a comprehensive analysis of the cellular,angiogenic,and immunological aspects of dormancy.It highlights the current therapeutic strategies targeting dormant cells,particularly combination therapies and immunotherapies,which hold promise in preventing relapse.By elucidating these mechanisms and proposing innovative research methodologies,this review aims to deepen our understanding of tumor dormancy,ultimately facilitating the development of more effective strategies for preventing cancer recurrence and improving patient outcomes.
文摘BACKGROUND Fear of cancer recurrence(FCR)is a common psychological problem among patients with cancer,especially elderly patients.For patients with gastric cancer(GC)who have undergone treatments such as surgery,FCR may seriously affect their quality of life and psychological well-being.AIM To evaluate the FCR in elderly patients with GC undergoing laparoscopic radical surgery in Hefei City and to explore its related influencing factors.METHODS In this study 264 elderly patients with GC who underwent laparoscopic radical surgery in four hospital districts of The First Affiliated Hospital of Anhui Medical University from June 2021 to January 2024 were recruited.Information on basic characteristics,disease characteristics,psychological status,and social support was collected by a questionnaire.In statistical analysis,the t-test andχ^(2) test were used to analyze the differences between groups.The influencing factors of FCR were analyzed by logistic regression.Based on these influencing factors,a nomogram model was initially constructed to identify patients with GC with high FCR risk.RESULTS Elderly patients with GC generally faced higher FCR levels after laparoscopic radical surgery.Among the 264 patients,168 had clinical symptoms of FCR,and the prevalence rate was 63.64%.Further analysis showed that older age,high mental resilience,and sufficient social support were favorable factors for reducing FCR level,while heavier self-perceived burden,low education level,shorter duration of disease,larger tumor diameter,and more complications were associated with a higher FCR level.CONCLUSION This study demonstrated the significance of psychological interventions and social support strategies in reducing FCR among elderly patients with GC.In the future treatment protocols should be further optimized,and psychological and social support should be enhanced to improve the quality of life for this patient population.
基金Supported by Tianjin Science and Technology Plan Project,No.19YFZCSY00170Tianjin Union Medical Center,No.2019YJ007+2 种基金Beijing Medical and Health Foundation,No.F1814BKey R&D Projects in the Tianjin Science and Technology Pillar Program,No.19YFZCSY00420National Key R&D Program of China,No.2017YFC1700606 and 2017YFC1700604.
文摘BACKGROUND Emerging evidence links gut microbiota to various human diseases including colorectal cancer(CRC)initiation and development.However,gut microbiota profiles associated with CRC recurrence and patient prognosis are not completely understood yet,especially in a Chinese cohort.AIM To investigate the relationship between gut mucosal microbiota profiles and CRC recurrence and patient prognosis.METHODS We obtained the composition and structure of gut microbiota collected from 75 patients diagnosed with CRC and 26 healthy controls.The patients were followed up by regular examination to determine whether tumors recurred.Triplet-paired samples from on-tumor,adjacent-tumor and off-tumor sites of patients diagnosed with/without CRC recurrence were analyzed to assess spatial-specific patterns of gut mucosal microbiota by 16S ribosomal RNA sequencing.Next,we carried out bioinformatic analyses,Kaplan-Meier survival analyses and Cox regression analyses to determine the relationship between gut mucosal microbiota profiles and CRC recurrence and patient prognosis.RESULTS We observed spatial-specific patterns of gut mucosal microbiota profiles linked to CRC recurrence and patient prognosis.A total of 17 bacterial genera/families were identified as potential biomarkers for CRC recurrence and patient prognosis,including Anaerotruncus,Bacteroidales,Coriobacteriaceae,Dialister,Eubacterium,Fusobacterium,Filifactor,Gemella,Haemophilus,Mogibacteriazeae,Pyramidobacter,Parvimonas,Porphyromonadaceae,Slackia,Schwartzia,TG5 and Treponema.CONCLUSION Our work suggests that intestinal microbiota can serve as biomarkers to predict the risk of CRC recurrence and patient death.
文摘The hedgehog （Hh） signaling pathway plays an essential role in the embryonic development and homeostasis of diverse adult tissues, and its deregulation has been implicated in the tumorigenesis and metastasis of various malignancies including breast cancer. Aberrant activation of the Hh pathway includes the following mechanisms： （I） Hh ligand-independent mechanism - Loss of function mutations in the Hh receptor Patched 1 （PTCH1） or gain of function mutations in the Smoothened （SMO） lead to constitutive activation of this pathway; （II） Autocrine signaling- Ith ligand produced by tumor cells stimulates the Hh signaling in tumor cells; （III） Paracrine signaling - tumor cell produced-Hh ligand activates stromal and endothelial cells that produce growth factors in microenvironment for supporting tumor growth and survival; and （IV） Reverse paracrine signaling - Hh ligand produced by stromal cells support tumor growth and survival. Upon the pathway activation, the Gli transcription factors, effectors of the Hh signaling, activate or inhibit transcription by binding to their responsive genes and interacting with the transcriptional complex. The Gli transcription factor family includes Glil, Gli2, and Gli3 （1）. Glil is a transcriptional activator whose expression has been recognized as an activation state of the Hh signaling pathway, Gli2 is either an activator or repressor, and Gli3 is a strong repressor of transcriptional activities. To date, a ligand-dependent autocrine model of activating the Hh signaling has been described in breast cancer, and both an autocrine and paracrine mechanisms in colorectal cancer, pancreatic cancer and prostate cancer （2,3）. Notably, a ligand-independent mechanism （mutationsin PTCHI and SMO） of the signaling has been well demonstrated in basal cell carcinoma and medulloblastoma （4,5）.
基金supported by the National Natural Science Foundation of China(Nos.31700869,31700868,31771096)the National Science Fund for Distinguished Young Scholars(No.NSFC31525009)+1 种基金the Fundamental Research Funds for the Central Universities/the Postdoctoral Research Foundation of Sichuan University(Nos.2017SCU12032,2017SCU12040)Sichuan Innovative Research Team Program for Young Scientists(No.2016TD0004)
文摘Camptothecin has a strong tumor killing ability for a variety of tumor cells with its special anti-cancer mechanism including the breast cancer.However,because of its infinite hydrophobic property,its clinical application has been greatly limited.Early prevention of loco regional recurrence for the breast cancer is critical for patients who have undergone breast-conserving therapy.In the study,CPT was used for the inhibition of the recurrence after the operation.The hollow mesoporous silica nanoparticles were used as the carrier to improve the hydrophilic property and increase its bioavailability with the high loading capacity.The ability of the cellular uptake and antitumor activity was increased.Hydrogel was the ideal carrier for local therapy,so the CPT@HMSNs were loaded into the PLEL thermo sensitive hydrogel to be injected into the tumor sites after the tumor was resected.The recurrence was reduced in the group of CPT-HMSNs-PLEL and the side effect of CPT was decreased.They exhibit distinguished potential as drug carrier for local delivery.
基金Supported by Beijing Hope Run Special Fund of Cancer Foundation of China(LC2022C05).
文摘Objective:Non-small cell lung cancer(NSCLC)patients often experience significant fear of recurrence.To facilitate precise identification and appropriate management of this fear,this study aimed to compare the efficacy and accuracy of a Backpropagation Neural Network(BPNN)against logistic regression in modeling fear of cancer recurrence prediction.Methods:Data from 596 NSCLC patients,collected between September 2023 and December 2023 at the Cancer Hospital of the Chinese Academy of Medical Sciences,were analyzed.Nine clinically and statistically significant variables,identified via univariate logistic regression,were inputted into both BPNN and logistic regression models developed on a training set(N=427)and validated on an independent set(N=169).Model performances were assessed using Area Under the Receiver Operating Characteristic(ROC)Curve and Decision Curve Analysis(DCA)in both sets.Results:The BPNN model,incorporating nine selected variables,demonstrated superior performance over logistic regression in the training set(AUC=0.842 vs.0.711,p<0.001)and validation set(0.7 vs.0.675,p<0.001).Conclusion:The BPNN model outperforms logistic regression in accurately predicting fear of cancer recurrence in NSCLC patients,offering an advanced approach for fear assessment.
文摘Fear of disease progression is one of the most common psychological problems in the treatment of cancer patients. Early recognition and intervention can effectively control the level of fear of disease progression and improve the quality of life of patients. The present situation and influencing factors of FoP in breast cancer patients were reviewed in this paper, in order to provide reference for clinical research of breast cancer patients.
基金the 345 Talent Project of Shengjing Hospital of China Medical University.
文摘To discuss recurrence patterns and their significance in colorectal cancer.Preexisting medical hypotheses and the clinical phenomena of recurrence in colorectal cancer were evaluated and integrated.Colorectal cancer recurrence/metastasis consists of two types:recurrence from the activation of dormant cancer cells and recurrence from postoperative residual cancer cells.These two recurrences have their own unique mechanisms,biological behaviors,responses to therapy,and prognoses.For type 1 recurrences,surgical resection should be considered.Type 2 recurrences should be managed systematically in addition to surgical resection.The two types of colorectal cancer recurrence should be evaluated and managed separately.
基金supported by a grant of Peking Union Medical College Hospital Research Grant for Young Scholar(No.pumch201912048)。
文摘Background:Whether regional anesthesia may help to prevent disease recurrence in cancer patients is still controversial.The stage of cancer at the time of diagnosis is a key factor that defines prognosis and is one of the most important sources of heterogeneity for the treatment effect.We sought to update existing systematic reviews and clarify the effect of regional anesthesia on cancer recurrence in late-stage cancer patients.Methods:Medline,Embase,and Cochrane Library were searched from inception to September 2020 to identify randomized controlled trials(RCTs)and cohort studies that assessed the effect of regional anesthesia on cancer recurrence and overall survival(OS)compared with general anesthesia.Late-stage cancer patients were primarily assessed according to the American Joint Committee on Cancer Cancer Staging Manual(eighth edition),and the combined hazard ratio(HR)from random-effects models was used to evaluate the effect of regional anesthesia.Results:A total of three RCTs and 34 cohort studies(including 64,691 patients)were identified through the literature search for inclusion in the analysis.The risk of bias was low in the RCTs and was moderate in the observational studies.The pooled HR for recurrence-free survival(RFS)or OS did not favor regional anesthesia when data from RCTs in patients with late-stage cancer were combined(RFS,HR=1.12,95%confidence interval[CI]:0.58-2.18,P=0.729,I2=76%;OS,HR=0.86,95%CI:0.63-1.18,P=0.345,I^(2)=48%).Findings from observational studies showed that regional anesthesia may help to prevent disease recurrence(HR=0.87,95%CI:0.78-0.96,P=0.008,I2=71%)and improve OS(HR=0.88,95%CI:0.79-0.98,P=0.022,I^(2)=79%).Conclusions:RCTs reveal that OS and RFS were similar between regional and general anesthesia in late-stage cancers.The selection of anesthetic methods should still be based on clinical evaluation,and changes to current practice need more support from large,well-powered,and well-designed studies.
基金Innovative and Entrepreneurial Team of Jiangsu Province(Grant No.JSSCTD202144)Nanjing Postdoctoral Program(Grant No.BSHNJ2023006)National Natural Science Foundation of China(Grant No.82201380)。
文摘Cancer,potentially the second leading cause of mortality globally,poses a significant health challenge.The conventional treatment for solid tumors typically involves surgical intervention,followed by chemotherapy,radiotherapy,and targeted therapies.However,cancer recurrence and metastasis remain major issues.Anesthesia is essential for ensuring patient comfort and safety during surgery.Despite its crucial role in surgery,the precise effect of anesthesia on cancer patients'outcomes has not been clearly understood.This comprehensive review aims to elucidate perioperative anesthesia strategies for cancer patients and their potential effects on prognosis.Given the complexity of cancer treatments,understanding the relationship between anesthesia and cancer outcomes is crucial.By examining potential implications of anesthesia strategies for cancer prognosis,this review may help better understand treatment efficacy and risk factors for cancer recurrence and metastasis.Ultimately,a detailed analysis of anesthesia practices in cancer surgery may provide insights to refine existing anesthesia protocols and reduce risk factors for poor patient outcomes.
基金funded by the 2023 Hospital Management Innovation Research Project by the Jiangsu Hospital Association(No.JSYGY-2-2023-551)。
文摘Objectives:This study aimed to explore the effectiveness and advantages of an“Internet+”nursing model based on user profilingin the rehabilitation of postoperative breast cancer patients.Methods:Breast cancer patients admitted to the hospital from July 2023 to September 2024 were enrolled.These patients were randomly assigned to a control group and an intervention group,with 52 patients in each group.The control group received routine nursing care,while the intervention group received an“Internet+”nursing intervention based on user profilingin addition to routine care.The intervention period lasted for one month following discharge.Before and one month after the intervention,the Fear of Progression Questionnaire-Short Form(FOP-Q-SF),the Fear of Cancer Recurrence Inventory-Short Form(FCRI-SF),Chinese Posttraumatic Growth Inventory(C-PTGI),and the Functional Assessment of Cancer Therapy-Breast(FACT-B)were applied to assess the effects of interventions.Results:A total of 104 patients were analyzed.After the intervention,FOP-Q-SF and FCRI-SF scores were significantlylower in the intervention group compared to the control group,with statistical significance(t=3.98,P<0.001;t=-7.59,P<0.001),and Cohen’s d of 0.781 and 1.49,respectively.Additionally,CPTGI and FACT-B scores in the intervention group were significantly higher than those in the control group(t=-6.534,P<0.001;t=-4.579,P<0.001),with Cohen’s d of 0.585 and 0.656.Conclusions:An“Internet+”nursing model based on user profilingcould reduce postoperative breast cancer patients fear of disease progression and cancer recurrence,also enhancing posttraumatic growth and overall quality of life.
基金supported by the National Key Research and Development Program of China (No. 2020YFA0112304)the National Natural Science Foundation of China (No. 82373167, 82341003 and 92159301)+4 种基金the Natural Science Foundation of Shanghai (No. 22ZR1479200)the Shanghai Key Laboratory of Breast Cancer (No. 12DZ2260100)the SHDC Municipal Project for Developing Emerging and Frontier Technology in Shanghai Hospitals (No. SHDC12 021103)Shanghai Medical Innovation Research Project (No. 22Y11912700)Shanghai Anticancer Association EYAS PROJECT (No. SACA-CY22A05)
文摘Objective:Recurrence continues to be a pivotal challenge among hormone receptor-positive(HR^(+))/human epidermal growth factor receptor 2^(−)negative(HER2^(−))breast cancers.In the international consensus guidelines,HR^(+)/HER2^(−)breast cancer relapse patterns are divided into three distinct types:primary resistant,secondary resistant,and endocrine sensitive.However,owing to the lack of cohorts with treatment and follow-up data,the heterogeneity among different recurrence patterns remains uncharted.Current treatments still lack precision.Methods:This analysis included data from a large-scale multiomics study of a HR^(+)/HER2^(−)breast cancer cohort(n=314).Through the analysis of transcriptomics(n=312),proteomics(n=124),whole-exome sequencing(n=290),metabolomics(n=217),and digital pathology(n=228)data,we explored distinctive molecular features and identified putative therapeutic targets for patients experiencing recurrence.Results:We explored distinct clinicopathological characteristics,biological heterogeneity,and potential therapeutic strategies for recurrence.Based on a shared relapse signature,we stratified patients into high-and lowrecurrence-risk groups.Patients with different relapse patterns presented unique molecular features in primary tumors.Specifically,receptor tyrosine kinase(RTK)pathway activation in the primary resistant group suggested the utility of RTK inhibitors,whereas mammalian target of rapamycin(mTOR)and cell cycle pathway activation in the secondary resistant group highlighted the potential of mTOR and CDK4/6 inhibitors.Interestingly,the endocrine-sensitive group displayed a quiescent state and high genomic instability,suggesting that targeting quiescent cells and using poly-ADP-ribose polymerase(PARP)inhibitors could be effective strategies.Conclusions:These findings illuminate the clinicopathological and molecular landscape of HR^(+)/HER2^(−)breast cancer patients with distinct recurrence patterns,highlighting potential targeted therapies.
基金Supported by the KOBAYASHI MAGOBE Memorial Medical Foundation
文摘The surgical outcome of most early gastric cancer （EGC） is usually satisfactory. Some cases show bone metastasis even though the depth of cancer invasion is confined to the mucosa. The most frequent site for recurrence of EGC is the liver. Cases of EGC with bone metastasis are reviewed to clarify the clinicopathological characteristics of EGC giving rise to bone metastasis. Possible mechanisms and risk factors underlying this rare condition are proposed. Forty-six cases of bone metastasis from EGC are reviewed from published reports and meeting proceedings in Japan. This investigation suggests that risk factors for bone metastasis from EGC include depressed-type signet-ring cell carcinoma, poorly differentiated carcinoma, and/or the likely involvement of lymph node metastasis, even though the cancer is confined to the gastric mucosa. The risk factors do not include recurrence of EGC in the liver. We speculate that the mechanism of bone metastasis from EGC is via lymphatic channels and systemic circulation. Postoperative follow-up of cases should consider the development of bone metastasis from EGC. We propose the use of elevated alkaline phosphatase levels for the detection of bone metastasis and recommend bone scintigraphy in positive cases. 2005 The WJG Press and Elsevier Inc. All rights reserved
文摘Objective: To investigate the effect of docetaxel and cisplatin combined with intensity-modulated radiotherapy in thetreatment of postoperative recurrence of esophageal cancer and the content of tumor markers in serum. Methods: According tosimple randomization method, 60 patients with postoperative recurrence of esophageal cancer admitted from February 2018 toSeptember 2019 were divided into control group (n = 30 cases) and observation group (n = 30 cases). All patients received IMRT.Fluorouracil + cisplatin was used in the control group and docetaxel + cisplatin was used in the observation group. After 2 coursesof continuous treatment, the therapeutic effect, serum tumor marker content and adverse reactions were compared between thetwo groups. Results: After treatment, the effective rate of observation group was higher than control group, and the difference wasstatistically significant (P < 0.05).The contents of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) andcarbohydrate antigen 19-9 (CA19-9) in observation group were lower than those in control group, and the difference was statisticallysignificant (P < 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, and thedifference was statistically significant (P < 0.05). Conclusion: Docetaxel and cisplatin combined with intensemodulated radiotherapyfor postoperative recurrence of esophageal cancer can improve the therapeutic effect, inhibit the malignant degree of tumor, andreduce the incidence of adverse reactions.
基金the National Natural Science Foundation of Hebei(No.H2018201179)Hebei University of Science and Technology(No.QN2016077)Health and Family Planning Commission of Hebei(No.20160388).
文摘Backgroud:Summarize the formula rule of traditional Chinese medicine fOr preventing and treating bladder cancer recurrence after operation and explore the molecular mechanism of core medicines.Methods:Literatures collected from CNKI,Wanfang Med Online,CMJD,PUBMED and Elsiver databases were as prescription sources,and association rules and complex system entropy clustering analysis were carried out using the Traditional Chinese Medicine Inheritance Support System(TCMISSV2.5).BATMAN-TCM online analysis tool was used to construct target-pathway-disease correlation map to reveal the potential mechanism of action.Results:A total of 122 prescriptions were eligible for data analysis.The high-frequency traditional Chinese medicines are Poria,Radix et Rhizoma Rhei,Radix Astragali,Herba Hedyotidis Diffusae and Rhizoma Atractylodis Macrocephalae.The high-frequency drug pairs are Rhizoma Atractylodis MacrocephalaeIPoria,Poria/Rhizoma Alismatis,Radix Astragali/Rhizoma Atractylodis Macrocephalaeand and Herba Hedyotidis Diffusae/Herba Scutellariae Darbatae..There are 5 groups of drug pairs with high correlation strength.Cluster analysis shows 6 core drug combinations and 3 new prescriptions.In clinical practice,the core compatibility of traditional Chinese medicines for preventing postoperative recurrence of bladder cancer is Poria,Radix Astragali and Herba Hedyotidis Diffusae.The possible signaling pathways are the neuroactive ligand receptor interaction signaling pathway and calcium signaling pathway.Conclusion:Prevention and treatment of postoperative recurrence of bladder cancer mainly use medicines with effects of eliminating dampness and diuresis for removing edema,heat-clearing and detoxifying,and qi-invigorating.The potential mechanism of the compatibility of core drugs may be realized by interfering with the signal pathway of neuroactive ligand receptor interaction and calcium signal pathway.
文摘Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients with superficial bladder cancers were randomized into combined interventional chemotherapy and intravesical instillation of mitomycin or intravesical instillation of mitomycin alone for preventing recurrence after local ablation. The result was assessed by x2 test. Results The patients have been followed up for 12-26 months (mean 21 months). 1 case has had tumor recurrence in the combined modality therapy group and 4 in the intravesical instillation alone group, the tumor recurrence rate being 7% (1/14) and 29% (4/14) respectively (P【0.05). Conclusion Combined use of interventional chemotherapy and intravesical instillation of mitomycin is effective in preventing superficial bladder cancer from recurring after local ablation with fewer adverse effects. The ragimen is not only reliable but
文摘To investigate the effects of intravesical therapy with elemene in preventing postoperative recurrence of superficial bladder cancer and its toxic and side effects.Methods This series included 123 patients with superficial bladder cancer (T1),consisting of transitional cell carcinoma GⅠ in 37 cases,GⅡ in 73 and GⅢ in 13.They all underwent surgical treatment.Postoperatively,they were randomly assigned to 2 groups;63 patients in elemene group received instillation of elemene (400 mg,once a week) 2 weeks after operation and 60 patients in mitomycin C (MMC) group received instillation of MMC (40 mg,once a week) 2 weeks after operation.The instillations were repeated for 6 weeks and thereafter monthly for 1 year.The recurrence rates,side effects,and NK cell activity before and after treatment were evaluated.Results The recurrence rate of elemene group (mean follow-up of 19.7 months) was 7.9% (5 cases),which was significantly lower than that (25.0%,15 cases) of MMC group (mean follow-up of 19.4 months;P<0.05).The side effect in elemene group (3.2%,2 cases) was significantly milder than that in MMC group (25.0%,15 cases)(P<0.05).In elemene group,the NK cell activity after treatment (28±2)% was significantly higher than that before treatment(20±2)%(P<0.05).Conclusion Instillation of elemene after operation is effective and safe in preventing postoperative recurrence of bladder cancer.8 refs.
基金supported by Tabriz University of Medical Sciences,grant number 65364.
文摘Cancer stem cells(CSCs)are a major challenge in cancer therapy.Stem cell-like cells form a unique subpopulation within many tumors,which govern the degree of malignancy by promoting metastasis,recurrence,heterogeneity,and resistance to drug and radiation.Furthermore,these cells can persist in patients even after undergoing multiple cycles of conventional cancer therapy via dormancy,where they no longer dividing but remain active.These may cause cancer recurrence at any time,even years after a supposed cure,and remain invisible to the immune system.Targeting specific surface markers,signaling pathways and tumor microenvironment,which all have a significant effect on CSC function and maintenance,could help to eradicate CSCs and improve patient survival.Combinations of traditional therapies with nano-based drug delivery systems can efficiently target CSCs.Considering the biology and properties of CSCs,we classify recent approaches involving nanoparticle engineering,extracellular matrix modulation,cocktail strategies,multi-stage therapy,CSC defanging,Trojan horse systems,targeted therapy and organelle targeting.We highlight the most recent advances in nanocarrier design and drug delivery technologies to target CSCs,combined with conventional treatment in preclinical and clinical trials.The prospects of these approaches for CSCs elimination and recurrent cancer treatment are discussed.
文摘Endometrial cancer is the most common gynecologic cancer diagnosed in the United States and mortality is on the rise.Advanced and recurrent endometrial cancer represents a treatment challenge as historically there have been limited therapeutic options for patients.In the last several years,multiple practice-changing clinical trials have led to significant improvements in the treatment landscape.This review will cover updates in the treatment and management of advanced and recurrent endometrial cancer with a focus on novel therapeutics,such as anti-PD-L1 and PD-1 inhibitors,poly ADP-ribose polymerase(PARP)inhibitors,antibody-drug conjugates,and hormonal therapy.
