BACKGROUND The hospice care system of traditional Chinese medicine(TCM)provides a reference for relieving depression,anxiety,and sleep disorders in patients with advanced cancer.AIM To explore the effects of TCM hospi...BACKGROUND The hospice care system of traditional Chinese medicine(TCM)provides a reference for relieving depression,anxiety,and sleep disorders in patients with advanced cancer.AIM To explore the effects of TCM hospice care on depression,anxiety,and sleep disorders in patients with advanced cancer.METHODS This prospective study was conducted between July 2023 and June 2024.Patients with advanced cancer were selected and divided into observation and control groups(n=34 per group).The observation group received TCM hospice care,with a 4-week treatment cycle.The control group received routine hospice care.The Hamilton Depression Rating Scale,Hamilton Self-Rating Anxiety Scale,and Pittsburgh Sleep Quality Index were used to assess depression,anxiety,and sleep quality changes,and Statistical Package for the Social Sciences 26.0 was used for data analysis.RESULTS No significant differences were found in age,sex,cancer type,disease course,or baseline mental symptom scores between the groups(P>0.05).After treatment,the observation group showed significantly greater improvements in depression,anxiety,and sleep quality(P<0.05).The depression,anxiety,and sleep scores in the observation group decreased to 7.21±2.48,6.12±2.39,and 4.53±1.89,respectively.In the control group,these scores decreased to 11.42±3.12,10.14±3.21,and 6.21±1.79.The observation group demonstrated superior efficacy(P<0.05).Depression,anxiety,and sleep quality were significantly positively correlated(P<0.05).Logistic regression analysis identified the TCM hospice care system as an independent factor improving patients'health.CONCLUSION The TCM hospice care system effectively improves depression,anxiety,and sleep disorders in patients with advanced cancer,offering comprehensive care suitable for clinical promotion and application.展开更多
Objective： To assess the safety and clinical antiangiogenic effect of recombinant adenovirus-p53 （rAd-p53） combined with hyperthermia plus or not plus radiotherapy in advanced cancer. Methods： Expression of Vascul...Objective： To assess the safety and clinical antiangiogenic effect of recombinant adenovirus-p53 （rAd-p53） combined with hyperthermia plus or not plus radiotherapy in advanced cancer. Methods： Expression of Vascular epithelial growth factor （VEGF） after intratumoral injection of rAd-p53 was assayed by immunohistochemistry （IHC） imaging. Forty-four patients with advanced cancer were enrolled into this clinical study. The patients were intratumorally injected with rAd-p53 （Gendicine） at a dose of 1×1012 vp once a week, with a total of 4-54 （mean 7.7） times. Total of 4-29 （mean 8.5） times of hyperthermia was given to the patients. Among the 44 patients, 30 patients were concurrently added with radiotherapy of a total dose 30-76 Gy/15-38 f/3-8 w （mean 58 Gy）. Results： Before and after intratumoral injection of rAd-p53, the VEGF IHC positive cell scores were 2.80 and 1.50, respectively （P=0.031）. The treatment of rAd-p53 combined with hyperthermia plus or not plus radiotherapy in advanced cancer achieved CR rate of 13.60% （6/44）, and PR rate of 29.6% （13/44）, and thus the effective rate was 43.2%. In addition to 6 patients with CR, 19 patients （19/38, 50.0%） had low density area （LDA） of more than 50% area on CT image within tumor indicating tumor tissue necrosis. Conclusions： Our data indicate that rAd-p53 inhibits VEGF expression and angiogenesis, and promotes tumor necrosis and shrinkage induced by hyperthermia plus or not plus radiotherapy in advanced cancer.展开更多
BACKGROUND Hospice care plays an important role in improving the quality of life of advanced cancer patients,but controversy remains over whether age affects the attitudes of family members toward hospice care.AIM To ...BACKGROUND Hospice care plays an important role in improving the quality of life of advanced cancer patients,but controversy remains over whether age affects the attitudes of family members toward hospice care.AIM To investigate the attitudes of family members of advanced cancer patients of different ages toward hospice care.METHODS The study participants were 175 family members of patients with advanced cancer from January 2020 and October 2022.The participants were divided into youth(<40 years,n=65),middle-aged(40–60 years,n=59),and elderly(>60 years,n=51)groups.Researchers investigated and compared the degree of awareness regarding hospice care,attitudes,and whether the family members of patients would choose hospice care.RESULTS Among the family members of 175 patients,approximately 28%(49/175)were aware of hospice care.Awareness of hospice care,the proportion of hospice care acceptance and adaptation attitudes,and the proportion of those who chose hospice care in the youth group were higher in the middle-aged and elderly groups(P<0.05).No statistically significant difference was found in these three indicators between the middle-aged and elderly groups(P>0.05).Hospice care was chosen mainly to relieve pain and reduce unnecessary treatment,whereas the reasons for not choosing hospice care were mainly distrust and ethical concerns.CONCLUSION The family members of patients with advanced cancer had relatively low awareness of hospice care,while youth had a higher awareness of hospice care,acceptance,and adaptation attitudes,and were more willing to choose hospice care.展开更多
Objective: The aim of this study was to evaluate the efficacy and adverse reactions of OxyContin hydrochloride controlled release tablets in the treatment of moderate or severe pain in patients with terminal cancer an...Objective: The aim of this study was to evaluate the efficacy and adverse reactions of OxyContin hydrochloride controlled release tablets in the treatment of moderate or severe pain in patients with terminal cancer and to observe any improvement on the cancer patients' quality of life. Methods: Sixty-eight patients with moderate or severe cancer pain were treated with OxyContin hydrochloride controlled release tablets. The initial dose was 5 mg/12h, or 1/2 that of the standard morphine regimen. During the course of treatment, the dosage was adjusted according to the patients' condition until the pain completely disappeared or nearly did so. Each patient received a treatment for at least 15 days. At the same time, adverse reactions, the quality of life and scores for the intensity of pain were observed and recorded [1]. Results: The final titrated dosage of OxyContin was as follows: the patients in 30 cases (44.1%) received a dosage of ≤ 30 mg/d, those in 16 cases (23.5%) received a dosage of 31 to 60 mg/d, those in 18 cases (26.5%) received a dosage of 61 to 120 mg/d and those in 4 cases (5.9%) received a dosage of ≥ 120 mg/d. The overall rate of relief from pain was 95.6%, among which the rates of excellent, effective and moderate relief were respectively 39.7%, 48.5% and 7.4%. OxyContin had mild adverse reactions and patients' quality of life was markedly improved. Conclusion: OxyContin is effective in treatment of moderate and severe cancer pain. The adverse reactions of OxyContin are mild, and the drug can significantly improve the quality of life of patients with cancer pain.展开更多
Objective This study aims to test the acceptance, feasibility, and usefulness of the Arabic version of the revised Edmonton Symptom AssesSment System （ESAS-r） among Egyptian patients with advanced cancer and to comp...Objective This study aims to test the acceptance, feasibility, and usefulness of the Arabic version of the revised Edmonton Symptom AssesSment System （ESAS-r） among Egyptian patients with advanced cancer and to compare the rates of symptoms documented by patients and physicians. Methods Between August 2014 and February 2015, a total of 140 patients at Ain Shams University Hospitals in Cairo, Egypt received the Arabic version of the ESAS-r. For each patient, the ESAS-r was completed twice, first by the treating physician （as part of the basic assessment） and a second time by the patient, with a maximum of 2 hours between the two assessments. An additional survey was included to assess patients＇ acceptance of the survey and their preferences. Results Out of 140 enrolled patients in the study, 11 patients refused to complete the questionnaire, and 10 patients were excluded due to incomplete records in their medical records. Complete data was retrieved for 119 patients who were included for further analyses. The 78 （65%） patients declared that the test was clear and easy to complete. They were able to answer the test without help. Collectively, tiredness and sense of well-being were the most commonly encountered symptoms in ratings obtained by both patients and physicians. Tiredness was the only symptom showing a significant difference between the two rating methods, patient-rated scores being higher （P = 0.032）. Cronbach＇s alpha showed that both tests com- pleted by the physician and the patients were internally consistent： the physician-rated test had a coefficient of 0.877, and the patient-rated test had a coefficient of 0.863. All ESAS scores had good internal consis- tency, with a Cmnbach＇s alpha coefficient of 0.88. The internal consistency remained high after removal of individual symptom scores, with Cronbach＇s alpha coefficients ranging from 0.823 to 0.902, indicating that no individual question had undue influence on the total ESAS score. Conclusion The ESAS-r was easily understood by and applicable to patients. There was no significant discrepancy in the rates of symptoms reported by the patients and physicians, apart from tiredness. Based on this, the test could be applied on a larger scale with in-home patients. This test can be cost-effective and can decrease the number of hospital visits among advanced cancer patients in need of supportive treat- ment rather than active cancer therapy.展开更多
BACKGROUND Psilocybin,a naturally occurring psychedelic compound found in certain species of mushrooms,is known for its effects on anxiety and depression.It has recently gained increasing interest for its potential th...BACKGROUND Psilocybin,a naturally occurring psychedelic compound found in certain species of mushrooms,is known for its effects on anxiety and depression.It has recently gained increasing interest for its potential therapeutic effects,particularly in patients with advanced cancer.This systematic review and meta-analysis aim to evaluate the effects of psilocybin on adult patients with advanced cancer.AIM To investigate the therapeutic effect of psilocybin in patients with advanced cancer.METHODS A comprehensive search of electronic databases was conducted in PubMed,Cochrane Central Register of Controlled Trials,and Google Scholar for articles published up to February 2023.The reference lists of the included studies were also searched to retrieve possible additional studies.RESULTS A total of 7 studies met the inclusion criteria for the systematic review,comprising 132 participants.The results revealed significant improvements in quality of life,pain control,and anxiety relief following psilocybin-assisted therapy,specifically results on anxiety relief.Pooled effect sizes indicated statistically significant reductions in symptoms of anxiety at both 4 to 4.5 months[35.15(95%CI:32.28-38.01)]and 6 to 6.5 months[33.06(95%CI:28.73-37.40)].Post-administration compared to baseline assessments(P<0.05).Additionally,patients reported sustained improvements in psychological well-being and existential distress fo-llowing psilocybin therapy.CONCLUSION The findings provided compelling evidence for the potential benefits of psilocybin-assisted therapy in improving quality of life,pain control,and anxiety relief in patients with advanced cancer.展开更多
Purpose: This randomized controlled trial (RCT) protocol was designed to evaluate the effectiveness of the Cancer Pain Monitoring System (CAPAMOS), a telenursing system designed to alleviate pain in ambulatory patient...Purpose: This randomized controlled trial (RCT) protocol was designed to evaluate the effectiveness of the Cancer Pain Monitoring System (CAPAMOS), a telenursing system designed to alleviate pain in ambulatory patients with advanced cancer. Methods: The study design involved a randomized controlled trial consisting of an intervention group using CAPAMOS and a control group that received usual care. At the time of enrollment, both groups will be given a questionnaire regarding issues, such as concerns related to cancer pain and self-management of opioid medication. Patients will then receive pain relief education based on the results of the questionnaire. Subjects in the control group will receive a pain diary and pain-relief pamphlet that acts as an educational tool. They could also call the outpatient clinic if they wanted to ask for a nursing consultation. The intervention group will be able to use CAPAMOS to manage their pain and receive video consultation with a telenurse, who is an oncology nursing specialist. Educational tools will be built into CAPAMOS. The study will be conducted for one month. The primary endpoint of this study was to calculate the Japanese Brief Pain Inventory score. The secondary endpoints were to assess the opioid medication self-management, Barriers Questionnaire, Japanese EuroQol 5-dimensions 5-level, and economic evaluation. Assessment items will be evaluated at registration and 2 and 4 weeks after registration. Conclusions: A RCT based on this protocol is expected to validate the efficacy of telenursing using CAPAMOS in patients with advanced cancer and pain.展开更多
Objective: to observe the results of pain nursing intervention on patients with advanced cancer pain and analgesia treated by intravenous infusion of morphine self-controlled analgesia pump, so as to further relieve t...Objective: to observe the results of pain nursing intervention on patients with advanced cancer pain and analgesia treated by intravenous infusion of morphine self-controlled analgesia pump, so as to further relieve the pain of patients and improve the nursing effect. Methods: a total of 40 patients with advanced cancer pain who received intravenous infusion of morphine self-controlled analgesia pump in our hospital were selected as the research object. Envelope method was used to divide into 2 groups, the control group was routine nursing, the experimental group to strengthen the pain nursing intervention, compare the nursing effect. Results: the VAS score of the two groups after 7 days of controlled analgesia was 96.0% in the experimental group and 65.0% in the control group, the difference was statistically significant (P < 0.05). In addition, in terms of nursing satisfaction, patients in the observation group had higher evaluation and recognition of nursing work, with statistical significance (P < 0.05). Conclusion: the pain nursing of patients with advanced cancer pain treated by intravenous infusion of morphine self-controlled analgesia pump can make patients actively participate in pain treatment. It is worthy of clinical popularization and application to increase medication compliance and improve analgesic effect.展开更多
Background The aims of this study were to evaluate insomnia status in advanced cancer patients been served for 4 weeks symptom management in psycho-oncology service,and to explore predictors for the persistent or wors...Background The aims of this study were to evaluate insomnia status in advanced cancer patients been served for 4 weeks symptom management in psycho-oncology service,and to explore predictors for the persistent or worsen insomnia.Methods This was a real world longitudinal study among advanced cancer patients been referred to the psychooncology symptom management clinic in Peking University Cancer Hospital.Patients repeatedly completed the Insomnia Severity Index(ISI),Hospital Anxiety and Depression Scale(HADS),and MD Anderson Symptom Inventory(MDASI)on Day 0(baseline),Day 14,and Day 28 by using an electronic patient-reported outcomes(ePRO)system.Results At baseline,50.6%of the sample(78/161)had moderate to severe insomnia(>14 on ISI).Totally 111(68.9%)patients had completed the assessments at all 3 time points.The patients with insomnia and pain(66.7%)were more symptomatic with fatigue,distress,shortness of breath,drowsiness,dry mouth,and numbness(all P<0.05)at baseline.While observed 21%patients with significantly alleviated insomnia by Day 28(P<0.001),more severe disturbed sleep on MDASI(>=6)at baseline is a predictor for 30%of patients who had significant insomnia on Day 28(P<0.001).Conclusions Half of referred patients for symptom management consultation in psycho-oncology service reported moderate to severe insomnia,while 30%had significant insomnia after 4 weeks symptom management,highlighted the needs for routine insomnia monitoring in the clinic.Insomnia with pain is more symptomatic than insomnia without pain.More severe disturbed sleep at baseline is a predictor to persist or worsen insomnia.展开更多
Objective:To investigate the effect of acupuncture on advanced cancer patients by meta-analysis.Methods:Nine databases(the Cochrane Central Register of Controlled Trials,MEDLINE,Web of Science,Embase,China National Kn...Objective:To investigate the effect of acupuncture on advanced cancer patients by meta-analysis.Methods:Nine databases(the Cochrane Central Register of Controlled Trials,MEDLINE,Web of Science,Embase,China National Knowledge Infrastructure,the Cumulative Index to Nursing and Allied Health Literature,Chinese Biomedical Literature Database,China Science and Technology Journal Database,and Wan Fang Data)were searched for randomized controlled trials(RCTs)on acupuncture in advanced cancer patients published from inception to February 13,2023 and updated to June 1,2023.Primary outcomes were quality of life(QOL),while secondary outcomes were pain,fatigue,and adverse events(side effects).Data synthesis was performed using RevMan V.5.3 to calculate pooled effect sizes.RoB-2 was used for the risk of bias,and the quality of evidence was assessed using the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)tool.Results:Totally 17 RCTs involving 1,178 participants were included,15 of which were pooled for meta-analysis.Most studies demonstrated some concern for the overall risk of bias.The pooled data indicated that acupuncture was associated with improved QOL[mean difference(MD)=6.67,95%confidence interval(CI):5.09 to 8.26],pain(MD=–1.18,95%CI–2.28 to–0.08),and adverse events(risk ratio=0.30,95%CI:0.26to 0.57)compared with control groups.Fatigue outcome was not included.Heterogeneity was substantial,and GRADE evidence was very low for both QOL and pain.Conclusions:Acupuncture could benefit patients with advanced cancer and is considered safe compared with usual care.However,the evidence regarding QOL and pain outcomes requires further validation.It is crucial to encourage the development of high-quality studies to strengthen this evidence.(Registry No.CRD42023423539).展开更多
BACKGROUND Owing to the absence of specific symptoms in early-stage gastric cancer,most patients are diagnosed at intermediate or advanced stages.As a result,treatment often shifts from surgery to other therapies,with...BACKGROUND Owing to the absence of specific symptoms in early-stage gastric cancer,most patients are diagnosed at intermediate or advanced stages.As a result,treatment often shifts from surgery to other therapies,with chemotherapy and targeted therapies being the primary options for advanced gastric cancer treatment.A total of 116 patients with advanced gastric cancer,admitted from January 2021 to December 2023,were selected and divided into two groups of 58 each using the random number table method.The control group received FOLFOX4 chemothe-rapy(oxaliplatin+calcium+folinate+5-fluorouracil)combined with intravenous sindilizumab.The observation group received the same treatment as the control group,supplemented by oral administration of Senqi Shiyiwei granules.Both groups underwent treatment cycles of 3 weeks,with a minimum of two cycles.The therapeutic efficacy,immune mechanisms,and treatment-related toxicity and side effects were compared between the groups.The objective remission rate in the observation group(55.17%)was higher than that of the control group(36.21%)(P<0.05).After two treatment cycle,CD3+,CD4+,and CD4+/CD8+levels were higher in the observation group compared to the control group,while CD8+,regulatory T cells,and natural killer cells were lower(P<0.05).Additionally,the incidence of leukopenia,nausea,and vomiting was lower in observed group(P<0.05).No significant differences were observed in the incidence of other adverse reactions(P>0.05).CONCLUSION Adjuvant therapy with Shenqixian granules may enhance the efficacy of simudizumab combined with FOLFOX4 chemotherapy in advanced gastric cancer and the immune function by increasing immune cell counts,making it a valuable option in clinical treatment.展开更多
BACKGROUND The 5-year survival rate for patients with pancreatic cancer(PC)is 4%-12%.Surgery is the only treatment that offers curative potential,but only 15%-20%of patients are eligible for surgery.PC is prone to rec...BACKGROUND The 5-year survival rate for patients with pancreatic cancer(PC)is 4%-12%.Surgery is the only treatment that offers curative potential,but only 15%-20%of patients are eligible for surgery.PC is prone to recurrence and metastasis,and the antitumor effect of chemotherapy is notably limited.CASE SUMMARY Histopathological analysis of a 53-year-old female PC patient who underwent Whipple surgery revealed poorly differentiated tumor cells infiltrating nerves,lymphatics,and blood vessels.The patient received two different first-line chemotherapy regimens consecutively;however,both regimens struggled to control disease progression.During this period,the patient underwent liver metastasis ablation surgery,Candida albicans liver abscess,and stereotactic body radiotherapy.With the addition of camrelizumab to the modified FOLFIRINOX regimen,tumor control was achieved.The patient subsequently refused to continue chemotherapy,and the antitumor regimen was changed to a combination of camrelizumab and apatinib.After patients received a combination of immunotherapy and targeted therapy,the length of hospital stay was significantly reduced.Furthermore,all side effects were within acceptable limits,leading to an improved quality of life and prolonged progression-free survival.Unfortunately,the pain associated with cancer,coupled with the side effects of opioid analgesics,has led the patient to reject all available anticancer treatment options.Approximately one month after camrelizumab and apatinib were discontinued without medical authorization,the PC recurred and rapidly progressed to widespread metastasis,ultimately leading to the patient's death approximately one month later.The overall survival was 2 years.CONCLUSION Immunotherapy and targeted therapy have the potential to increase both the quality of life and survival time of PC patients,particularly those whose tumor progression is not effectively controlled by chemotherapy alone.Nevertheless,further clinical trials are necessary to validate these findings.展开更多
Background: Cancer-related fatigue(CRF) is a significant burden for patients with advanced lung cancer. While exercise is recommended for managing CRF during pre-and active treatment phases, evidence supporting its ef...Background: Cancer-related fatigue(CRF) is a significant burden for patients with advanced lung cancer. While exercise is recommended for managing CRF during pre-and active treatment phases, evidence supporting its efficacy in advanced stage remains limited. This systematic review and meta-analysis aimed to quantify the effects of exercise on CRF and its common complications in patients with advanced lung cancer.Methods: A systematic search of 4 databases(Pub Med, Embase, Cochrane, and Web of Science) was conducted up to July 10, 2024 to identify relevant randomized controlled trials(RCTs). Studies were selected based on predefined eligibility criteria, including adult patients with advanced lung cancer reporting fatigue as an outcome. Study selection followed Preferred Reporting Items for Systematic Reviews and MetaAnalyses(PRISMA) 2020 guidelines, and the risk of bias was assessed using the Cochrane Risk of Bias tool(Ro B 2.0). The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation(GRADE) system. Random-or fixed-effects models were used for meta-analyses based on heterogeneity levels.Results: Eight RCTs involving 749 patients were included. Meta-analysis revealed that exercise significantly improved CRF in patients with advanced lung cancer(standardized mean difference(SMD) =-0.33;95% confidence interval(95%CI):-0.54 to-0.12);p = 0.00;I2= 0.00%).Subgroup analysis showed greater efficacy in patients aged ≤60 years(p = 0.028), those engaging in traditional Chinese exercise(p = 0.003),and interventions lasting fewer than 12 weeks(p = 0.017). Exercise also significantly improved quality of life(SMD = 0.29;95%CI: 0.02-0.55;p = 0.04;I2= 0.00%) and reduced dyspnea(SMD =-0.43;95%CI:-0.71 to-0.16;p = 0.00;I2= 0.00%). No significant effects were observed on sleep quality, anxiety, or depression. The risk of bias across studies was moderate, and the quality of evidence, as evaluated by GRADE, was rated as low due to study limitations. Adverse events were minimal, with only one mild, exercise-related event reported.Conclusion: Exercise significantly alleviates CRF in patients with advanced lung cancer, improves certain complications, and enhances quality of life. The intervention's effectiveness varies by age, type of exercise, and duration. Further high-quality studies are needed to validate these findings.展开更多
BACKGROUND Chemotherapy combined with anti-angiogenic therapy has become an important strategy for the treatment of advanced gastric cancer(AGC);however,the regimen needs optimization.AIM To evaluate the efficacy of a...BACKGROUND Chemotherapy combined with anti-angiogenic therapy has become an important strategy for the treatment of advanced gastric cancer(AGC);however,the regimen needs optimization.AIM To evaluate the efficacy of albumin-bound paclitaxel(nab-ptx)combined with the small molecule vascular endothelial growth factor inhibitor anlotinib in secondline and beyond treatment of AGC.METHODS We collected data from AGC patients at our hospital who experienced disease progression after first-line chemotherapy and received anlotinib combined with nab-ptx.The primary endpoints included overall survival(OS)and progressionfree survival(PFS),while the secondary endpoints were objective response rate(ORR),disease control rate(DCR),and adverse events(AEs).RESULTS Preliminary results indicated that anlotinib combined with nab-ptx can provide significant efficacy in second-line or above treatment for AGC(median PFS=6.0 months,median OS=12.0 months),with an ORR of 42%and a DCR of 78%.Further analysis revealed that patients who experienced hypertension,proteinuria,and hand-foot syndrome during treatment had better efficacy compared to those who did not experience these AEs.Mechanistic studies suggest that this regimen likely exerts synergistic anti-tumor effects by activating the immune response through the reduction of regulatory T-cell proportions.Common adverse reactions included bone marrow suppression,peripheral neuropathy,hypertension,proteinuria,and hand-foot syndrome,which were manageable and resolved with appropriate interventions,indicating the promising application of this regimen in second-line or above treatment for AGC.CONCLUSION The combination of anlotinib and nab-ptx shows promising efficacy with fewer toxicities in AGC treatment.The regimen holds promise as a second-line treatment of AGC;however,its specific clinical value requires further research.展开更多
BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally adva...BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally advanced gastric cancer(LAGC)undergoing new treatments remains to be determined.AIM To determine whether hypercoagulation is an effective prognostic indicator in patients with LAGC who underwent radical resection after NICT.METHODS A retrospective analysis of clinical data from 104 patients with LAGC,who underwent radical resection after NICT between 2020 and 2023,was performed.Ddimer and fibrinogen concentrations were measured one week before NICT,and again one week before surgery,to analyze the association between these two indicators and their combined indices[non-hypercoagulation(D-dimer and fibrinogen concentrations within the upper limit of normal)vs hypercoagulation(D-dimer or fibrinogen concentrations above the upper limit of normal)]with prognosis.After radical resection,patients were followed-up periodically.The median follow-up duration was 21 months.RESULTS Data collected after NICT revealed that the three-year overall survival(OS)and disease-free survival(DFS)rates the non-hypercoagulation group were significantly better than those in the hypercoagulation group[94.4%vs 78.0%(P=0.019)and 87.0%vs 68.0%(P=0.027),respectively].Multivariate analysis indicated that hypercoagulation after NICT was an independent factor for poor postoperative OS[hazard ratio(HR)4.436,P=0.023]and DFS(HR 2.551,P=0.039).Pre-NICT data demonstrated no statistically significant difference in three-year OS between the non-hypercoagulation and hypercoagulation groups(88.3%vs 84.1%,respectively;P=0.443).CONCLUSION Hypercoagulation after NICT is an effective prognostic indicator in patients with LAGC undergoing radical gastrectomy.展开更多
Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor...Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor,underscoring the need for reliable prognostic tools to refine treatment strategies.A study by Yao et al explores the role of the triglyceride-glucose(TyG)index as a prognostic marker for advanced GC patients receiving immunotherapy combined with chemotherapy.The results of the study demonstrate that the TyG index correlates with improved survival outcomes,including better progression-free survival and overall survival.This editorial critically evaluates the significance of these findings,discusses their implications for future research,and highlights innovative directions that could drive further breakthroughs in the application of the TyG index to cancer therapy.This editorial also highlights the potential of TyG in advancing precision oncology and advocates for global validation and mechanistic investigations to further solidify its clinical utility.Future research should focus on validating the TyG index across various malignancies,exploring its potential to influence immunotherapy through metabolic interventions,and developing multi-biomarker models that integrate TyG with immune and genomic profiles.展开更多
Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the trig...Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the triglyceride-glucose(TyG)index as a potential surrogate marker for insulin resistance,which may significantly influence the prognosis of patients undergoing immunotherapy combined with chemotherapy.In this context,the study by Yao et al demonstrates that a high TyG index correlates with improved overall survival and progressionfree survival in advanced GC patients receiving sintilimab and chemotherapy.Specifically,patients in the high TyG group had a significantly longer median progression-free survival of 9.8 months[95%confidence interval(CI):9.2-10.9]compared to 8.0 months(95%CI:7.5-8.5)in the low TyG group(hazard ratio=0.58,95%CI:0.43-0.79,P<0.001).Similarly,the median overall survival was significantly longer in the high TyG group at 23.1 months(95%CI:21.2-NA)vs 16.5 months(95%CI:13.9-18.3)in the low TyG group(hazard ratio=0.30,95%CI:0.21-0.42,P<0.001).These findings underscore the strong prognostic potential of the TyG index in guiding treatment strategies for advanced GC.These findings underscore the need for further investigation into the TyG index’s role as a prognostic tool and its underlying mechanisms in influencing treatment efficacy.We advocate for additional multicenter studies to validate these results and explore the TyG index’s applicability across diverse patient populations,ultimately aiming to refine treatment strategies and improve patient outcomes in advanced GC.展开更多
Objective:To study the measures and effects of advanced lung cancer patients in terms of complication prevention and care.Methods:50 cases of advanced lung cancer patients were selected for data study during January-D...Objective:To study the measures and effects of advanced lung cancer patients in terms of complication prevention and care.Methods:50 cases of advanced lung cancer patients were selected for data study during January-December 2023,where the patients were divided into two groups.The study group used complication prevention and nursing care,while the control group used conventional care.The differences between the groups were compared.Results:Compared with the control group,the study group had significantly fewer complications,significantly lower psychological state scores,significantly higher quality of life scores,and significantly lower pain scores(P<0.05).Comparing the psychological state scores,quality of life scores,and pain scores before care,both groups showed insignificant differences(P>0.05).Conclusion:The results of patients with advanced lung cancer are ideal after the application of measures in the area of complication prevention and care.展开更多
Objective:To evaluate the predictive value of secreted phosphoprotein 1(SPP1)gene expression for postoperative survival in patients with advanced liver cancer undergoing hepatic artery interventional chemoembolization...Objective:To evaluate the predictive value of secreted phosphoprotein 1(SPP1)gene expression for postoperative survival in patients with advanced liver cancer undergoing hepatic artery interventional chemoembolization treatment.Method:Bioinformatics methods,including gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis,were used to identify genes related to survival prognosis in hepatocellular carcinoma(HCC)patients.A retrospective analysis of 115 advanced liver cancer patients treated between January 2016 and October 2017 was conducted.Patients were categorized into SPP1 high-expression(n=89)and low-expression groups(n=26).Additionally,115 healthy individuals served as the control group.The relationship between SPP1 expression and clinical pathological features was analyzed.A 60-month follow-up and logistic regression analysis identified risk factors affecting survival.Results:SPP1 mRNA expression was significantly higher in liver cancer patients compared to healthy controls(P<0.05).SPP1 expression levels were significantly associated with tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging(P<0.05).High SPP1 expression,along with tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging,were independent risk factors for survival(P<0.05).The 60-month survival rate was 17.39%,with a median survival of 40 months in the low-expression group versus 18 months in the high-expression group(P<0.05).Conclusion:SPP1 expression is significantly upregulated in advanced liver cancer patients and has predictive value for postoperative survival following hepatic artery chemoembolization treatment.SPP1,combined with clinical indicators such as tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging,may serve as a prognostic biomarker for interventional treatment outcomes.展开更多
BACKGROUND Pancreatic cancer(PC),ranking among the most aggressive solid malignancies,currently lacks validated prognostic biomarkers to guide survival stratification.With a 5-year survival rate under 10%,this maligna...BACKGROUND Pancreatic cancer(PC),ranking among the most aggressive solid malignancies,currently lacks validated prognostic biomarkers to guide survival stratification.With a 5-year survival rate under 10%,this malignancy urgently requires precision tools for outcome prediction to optimize therapeutic decision-making.AIM To analyze whether the advanced lung cancer inflammation index(ALI)is a prognostic indicator for PC.METHODS Patients who were diagnosed with PC and underwent radical resection were included from January 2007 to January 2023 in a clinical center from National Cancer Center of China.The patients were divided into low and high ALI groups according to an ALI cut-off of 34.0 calculated with software X-tile.Overall survival(OS)and surgical outcomes were calculated between the two groups.Follow-up was conducted through telephone interview.Kaplan-Meier analysis was performed to estimate OS,while the log-rank test was utilized to compare OS among different tumor stages.Cox regression was used to identify independent risk factors for OS.RESULTS This study included 611 patients who underwent radical PC surgery.Using an ALI cutoff of 34.0,the patients were categorized into a high ALI group(n=378)and a low ALI group(n=233).The low ALI group had significantly lower body mass index,serum albumin,lymphocyte count,and ALI(P<0.01),but higher neutrophil count,a higher proportion of head and neck PC,and longer operation time(P<0.01).As for prognosis,the low ALI group had worse OS in stage I patients(P<0.01),and low ALI(P=0.018,hazard ratio=0.784,95%confidence interval:0.641-0.960)independently conferred an increased risk for mortality.CONCLUSION Lower ALI is associated with worse OS for PC patients who underwent radical surgery.Patients demonstrating low ALI preoperatively require special attention from surgeons.展开更多
基金Supported by Joint Fund Project of Hunan University of Chinese Medicine,No.2024XYLH036National Advantageous Specialty of Traditional Chinese Medicine-Nursing(Guo Zhong Yao Yi Zheng Han[2024]No.90),No.czxm-yb-2024002Young Talent Program of Hunan Nursing Association.
文摘BACKGROUND The hospice care system of traditional Chinese medicine(TCM)provides a reference for relieving depression,anxiety,and sleep disorders in patients with advanced cancer.AIM To explore the effects of TCM hospice care on depression,anxiety,and sleep disorders in patients with advanced cancer.METHODS This prospective study was conducted between July 2023 and June 2024.Patients with advanced cancer were selected and divided into observation and control groups(n=34 per group).The observation group received TCM hospice care,with a 4-week treatment cycle.The control group received routine hospice care.The Hamilton Depression Rating Scale,Hamilton Self-Rating Anxiety Scale,and Pittsburgh Sleep Quality Index were used to assess depression,anxiety,and sleep quality changes,and Statistical Package for the Social Sciences 26.0 was used for data analysis.RESULTS No significant differences were found in age,sex,cancer type,disease course,or baseline mental symptom scores between the groups(P>0.05).After treatment,the observation group showed significantly greater improvements in depression,anxiety,and sleep quality(P<0.05).The depression,anxiety,and sleep scores in the observation group decreased to 7.21±2.48,6.12±2.39,and 4.53±1.89,respectively.In the control group,these scores decreased to 11.42±3.12,10.14±3.21,and 6.21±1.79.The observation group demonstrated superior efficacy(P<0.05).Depression,anxiety,and sleep quality were significantly positively correlated(P<0.05).Logistic regression analysis identified the TCM hospice care system as an independent factor improving patients'health.CONCLUSION The TCM hospice care system effectively improves depression,anxiety,and sleep disorders in patients with advanced cancer,offering comprehensive care suitable for clinical promotion and application.
文摘Objective： To assess the safety and clinical antiangiogenic effect of recombinant adenovirus-p53 （rAd-p53） combined with hyperthermia plus or not plus radiotherapy in advanced cancer. Methods： Expression of Vascular epithelial growth factor （VEGF） after intratumoral injection of rAd-p53 was assayed by immunohistochemistry （IHC） imaging. Forty-four patients with advanced cancer were enrolled into this clinical study. The patients were intratumorally injected with rAd-p53 （Gendicine） at a dose of 1×1012 vp once a week, with a total of 4-54 （mean 7.7） times. Total of 4-29 （mean 8.5） times of hyperthermia was given to the patients. Among the 44 patients, 30 patients were concurrently added with radiotherapy of a total dose 30-76 Gy/15-38 f/3-8 w （mean 58 Gy）. Results： Before and after intratumoral injection of rAd-p53, the VEGF IHC positive cell scores were 2.80 and 1.50, respectively （P=0.031）. The treatment of rAd-p53 combined with hyperthermia plus or not plus radiotherapy in advanced cancer achieved CR rate of 13.60% （6/44）, and PR rate of 29.6% （13/44）, and thus the effective rate was 43.2%. In addition to 6 patients with CR, 19 patients （19/38, 50.0%） had low density area （LDA） of more than 50% area on CT image within tumor indicating tumor tissue necrosis. Conclusions： Our data indicate that rAd-p53 inhibits VEGF expression and angiogenesis, and promotes tumor necrosis and shrinkage induced by hyperthermia plus or not plus radiotherapy in advanced cancer.
文摘BACKGROUND Hospice care plays an important role in improving the quality of life of advanced cancer patients,but controversy remains over whether age affects the attitudes of family members toward hospice care.AIM To investigate the attitudes of family members of advanced cancer patients of different ages toward hospice care.METHODS The study participants were 175 family members of patients with advanced cancer from January 2020 and October 2022.The participants were divided into youth(<40 years,n=65),middle-aged(40–60 years,n=59),and elderly(>60 years,n=51)groups.Researchers investigated and compared the degree of awareness regarding hospice care,attitudes,and whether the family members of patients would choose hospice care.RESULTS Among the family members of 175 patients,approximately 28%(49/175)were aware of hospice care.Awareness of hospice care,the proportion of hospice care acceptance and adaptation attitudes,and the proportion of those who chose hospice care in the youth group were higher in the middle-aged and elderly groups(P<0.05).No statistically significant difference was found in these three indicators between the middle-aged and elderly groups(P>0.05).Hospice care was chosen mainly to relieve pain and reduce unnecessary treatment,whereas the reasons for not choosing hospice care were mainly distrust and ethical concerns.CONCLUSION The family members of patients with advanced cancer had relatively low awareness of hospice care,while youth had a higher awareness of hospice care,acceptance,and adaptation attitudes,and were more willing to choose hospice care.
文摘Objective: The aim of this study was to evaluate the efficacy and adverse reactions of OxyContin hydrochloride controlled release tablets in the treatment of moderate or severe pain in patients with terminal cancer and to observe any improvement on the cancer patients' quality of life. Methods: Sixty-eight patients with moderate or severe cancer pain were treated with OxyContin hydrochloride controlled release tablets. The initial dose was 5 mg/12h, or 1/2 that of the standard morphine regimen. During the course of treatment, the dosage was adjusted according to the patients' condition until the pain completely disappeared or nearly did so. Each patient received a treatment for at least 15 days. At the same time, adverse reactions, the quality of life and scores for the intensity of pain were observed and recorded [1]. Results: The final titrated dosage of OxyContin was as follows: the patients in 30 cases (44.1%) received a dosage of ≤ 30 mg/d, those in 16 cases (23.5%) received a dosage of 31 to 60 mg/d, those in 18 cases (26.5%) received a dosage of 61 to 120 mg/d and those in 4 cases (5.9%) received a dosage of ≥ 120 mg/d. The overall rate of relief from pain was 95.6%, among which the rates of excellent, effective and moderate relief were respectively 39.7%, 48.5% and 7.4%. OxyContin had mild adverse reactions and patients' quality of life was markedly improved. Conclusion: OxyContin is effective in treatment of moderate and severe cancer pain. The adverse reactions of OxyContin are mild, and the drug can significantly improve the quality of life of patients with cancer pain.
文摘Objective This study aims to test the acceptance, feasibility, and usefulness of the Arabic version of the revised Edmonton Symptom AssesSment System （ESAS-r） among Egyptian patients with advanced cancer and to compare the rates of symptoms documented by patients and physicians. Methods Between August 2014 and February 2015, a total of 140 patients at Ain Shams University Hospitals in Cairo, Egypt received the Arabic version of the ESAS-r. For each patient, the ESAS-r was completed twice, first by the treating physician （as part of the basic assessment） and a second time by the patient, with a maximum of 2 hours between the two assessments. An additional survey was included to assess patients＇ acceptance of the survey and their preferences. Results Out of 140 enrolled patients in the study, 11 patients refused to complete the questionnaire, and 10 patients were excluded due to incomplete records in their medical records. Complete data was retrieved for 119 patients who were included for further analyses. The 78 （65%） patients declared that the test was clear and easy to complete. They were able to answer the test without help. Collectively, tiredness and sense of well-being were the most commonly encountered symptoms in ratings obtained by both patients and physicians. Tiredness was the only symptom showing a significant difference between the two rating methods, patient-rated scores being higher （P = 0.032）. Cronbach＇s alpha showed that both tests com- pleted by the physician and the patients were internally consistent： the physician-rated test had a coefficient of 0.877, and the patient-rated test had a coefficient of 0.863. All ESAS scores had good internal consis- tency, with a Cmnbach＇s alpha coefficient of 0.88. The internal consistency remained high after removal of individual symptom scores, with Cronbach＇s alpha coefficients ranging from 0.823 to 0.902, indicating that no individual question had undue influence on the total ESAS score. Conclusion The ESAS-r was easily understood by and applicable to patients. There was no significant discrepancy in the rates of symptoms reported by the patients and physicians, apart from tiredness. Based on this, the test could be applied on a larger scale with in-home patients. This test can be cost-effective and can decrease the number of hospital visits among advanced cancer patients in need of supportive treat- ment rather than active cancer therapy.
文摘BACKGROUND Psilocybin,a naturally occurring psychedelic compound found in certain species of mushrooms,is known for its effects on anxiety and depression.It has recently gained increasing interest for its potential therapeutic effects,particularly in patients with advanced cancer.This systematic review and meta-analysis aim to evaluate the effects of psilocybin on adult patients with advanced cancer.AIM To investigate the therapeutic effect of psilocybin in patients with advanced cancer.METHODS A comprehensive search of electronic databases was conducted in PubMed,Cochrane Central Register of Controlled Trials,and Google Scholar for articles published up to February 2023.The reference lists of the included studies were also searched to retrieve possible additional studies.RESULTS A total of 7 studies met the inclusion criteria for the systematic review,comprising 132 participants.The results revealed significant improvements in quality of life,pain control,and anxiety relief following psilocybin-assisted therapy,specifically results on anxiety relief.Pooled effect sizes indicated statistically significant reductions in symptoms of anxiety at both 4 to 4.5 months[35.15(95%CI:32.28-38.01)]and 6 to 6.5 months[33.06(95%CI:28.73-37.40)].Post-administration compared to baseline assessments(P<0.05).Additionally,patients reported sustained improvements in psychological well-being and existential distress fo-llowing psilocybin therapy.CONCLUSION The findings provided compelling evidence for the potential benefits of psilocybin-assisted therapy in improving quality of life,pain control,and anxiety relief in patients with advanced cancer.
文摘Purpose: This randomized controlled trial (RCT) protocol was designed to evaluate the effectiveness of the Cancer Pain Monitoring System (CAPAMOS), a telenursing system designed to alleviate pain in ambulatory patients with advanced cancer. Methods: The study design involved a randomized controlled trial consisting of an intervention group using CAPAMOS and a control group that received usual care. At the time of enrollment, both groups will be given a questionnaire regarding issues, such as concerns related to cancer pain and self-management of opioid medication. Patients will then receive pain relief education based on the results of the questionnaire. Subjects in the control group will receive a pain diary and pain-relief pamphlet that acts as an educational tool. They could also call the outpatient clinic if they wanted to ask for a nursing consultation. The intervention group will be able to use CAPAMOS to manage their pain and receive video consultation with a telenurse, who is an oncology nursing specialist. Educational tools will be built into CAPAMOS. The study will be conducted for one month. The primary endpoint of this study was to calculate the Japanese Brief Pain Inventory score. The secondary endpoints were to assess the opioid medication self-management, Barriers Questionnaire, Japanese EuroQol 5-dimensions 5-level, and economic evaluation. Assessment items will be evaluated at registration and 2 and 4 weeks after registration. Conclusions: A RCT based on this protocol is expected to validate the efficacy of telenursing using CAPAMOS in patients with advanced cancer and pain.
文摘Objective: to observe the results of pain nursing intervention on patients with advanced cancer pain and analgesia treated by intravenous infusion of morphine self-controlled analgesia pump, so as to further relieve the pain of patients and improve the nursing effect. Methods: a total of 40 patients with advanced cancer pain who received intravenous infusion of morphine self-controlled analgesia pump in our hospital were selected as the research object. Envelope method was used to divide into 2 groups, the control group was routine nursing, the experimental group to strengthen the pain nursing intervention, compare the nursing effect. Results: the VAS score of the two groups after 7 days of controlled analgesia was 96.0% in the experimental group and 65.0% in the control group, the difference was statistically significant (P < 0.05). In addition, in terms of nursing satisfaction, patients in the observation group had higher evaluation and recognition of nursing work, with statistical significance (P < 0.05). Conclusion: the pain nursing of patients with advanced cancer pain treated by intravenous infusion of morphine self-controlled analgesia pump can make patients actively participate in pain treatment. It is worthy of clinical popularization and application to increase medication compliance and improve analgesic effect.
文摘Background The aims of this study were to evaluate insomnia status in advanced cancer patients been served for 4 weeks symptom management in psycho-oncology service,and to explore predictors for the persistent or worsen insomnia.Methods This was a real world longitudinal study among advanced cancer patients been referred to the psychooncology symptom management clinic in Peking University Cancer Hospital.Patients repeatedly completed the Insomnia Severity Index(ISI),Hospital Anxiety and Depression Scale(HADS),and MD Anderson Symptom Inventory(MDASI)on Day 0(baseline),Day 14,and Day 28 by using an electronic patient-reported outcomes(ePRO)system.Results At baseline,50.6%of the sample(78/161)had moderate to severe insomnia(>14 on ISI).Totally 111(68.9%)patients had completed the assessments at all 3 time points.The patients with insomnia and pain(66.7%)were more symptomatic with fatigue,distress,shortness of breath,drowsiness,dry mouth,and numbness(all P<0.05)at baseline.While observed 21%patients with significantly alleviated insomnia by Day 28(P<0.001),more severe disturbed sleep on MDASI(>=6)at baseline is a predictor for 30%of patients who had significant insomnia on Day 28(P<0.001).Conclusions Half of referred patients for symptom management consultation in psycho-oncology service reported moderate to severe insomnia,while 30%had significant insomnia after 4 weeks symptom management,highlighted the needs for routine insomnia monitoring in the clinic.Insomnia with pain is more symptomatic than insomnia without pain.More severe disturbed sleep at baseline is a predictor to persist or worsen insomnia.
基金Supported by the National Natural Science Foundation of China (Nos. 82004487 and 82230127)Central Guidance for Local Projects of Sichuan Province (No. 2022ZYD0101)。
文摘Objective:To investigate the effect of acupuncture on advanced cancer patients by meta-analysis.Methods:Nine databases(the Cochrane Central Register of Controlled Trials,MEDLINE,Web of Science,Embase,China National Knowledge Infrastructure,the Cumulative Index to Nursing and Allied Health Literature,Chinese Biomedical Literature Database,China Science and Technology Journal Database,and Wan Fang Data)were searched for randomized controlled trials(RCTs)on acupuncture in advanced cancer patients published from inception to February 13,2023 and updated to June 1,2023.Primary outcomes were quality of life(QOL),while secondary outcomes were pain,fatigue,and adverse events(side effects).Data synthesis was performed using RevMan V.5.3 to calculate pooled effect sizes.RoB-2 was used for the risk of bias,and the quality of evidence was assessed using the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)tool.Results:Totally 17 RCTs involving 1,178 participants were included,15 of which were pooled for meta-analysis.Most studies demonstrated some concern for the overall risk of bias.The pooled data indicated that acupuncture was associated with improved QOL[mean difference(MD)=6.67,95%confidence interval(CI):5.09 to 8.26],pain(MD=–1.18,95%CI–2.28 to–0.08),and adverse events(risk ratio=0.30,95%CI:0.26to 0.57)compared with control groups.Fatigue outcome was not included.Heterogeneity was substantial,and GRADE evidence was very low for both QOL and pain.Conclusions:Acupuncture could benefit patients with advanced cancer and is considered safe compared with usual care.However,the evidence regarding QOL and pain outcomes requires further validation.It is crucial to encourage the development of high-quality studies to strengthen this evidence.(Registry No.CRD42023423539).
文摘BACKGROUND Owing to the absence of specific symptoms in early-stage gastric cancer,most patients are diagnosed at intermediate or advanced stages.As a result,treatment often shifts from surgery to other therapies,with chemotherapy and targeted therapies being the primary options for advanced gastric cancer treatment.A total of 116 patients with advanced gastric cancer,admitted from January 2021 to December 2023,were selected and divided into two groups of 58 each using the random number table method.The control group received FOLFOX4 chemothe-rapy(oxaliplatin+calcium+folinate+5-fluorouracil)combined with intravenous sindilizumab.The observation group received the same treatment as the control group,supplemented by oral administration of Senqi Shiyiwei granules.Both groups underwent treatment cycles of 3 weeks,with a minimum of two cycles.The therapeutic efficacy,immune mechanisms,and treatment-related toxicity and side effects were compared between the groups.The objective remission rate in the observation group(55.17%)was higher than that of the control group(36.21%)(P<0.05).After two treatment cycle,CD3+,CD4+,and CD4+/CD8+levels were higher in the observation group compared to the control group,while CD8+,regulatory T cells,and natural killer cells were lower(P<0.05).Additionally,the incidence of leukopenia,nausea,and vomiting was lower in observed group(P<0.05).No significant differences were observed in the incidence of other adverse reactions(P>0.05).CONCLUSION Adjuvant therapy with Shenqixian granules may enhance the efficacy of simudizumab combined with FOLFOX4 chemotherapy in advanced gastric cancer and the immune function by increasing immune cell counts,making it a valuable option in clinical treatment.
文摘BACKGROUND The 5-year survival rate for patients with pancreatic cancer(PC)is 4%-12%.Surgery is the only treatment that offers curative potential,but only 15%-20%of patients are eligible for surgery.PC is prone to recurrence and metastasis,and the antitumor effect of chemotherapy is notably limited.CASE SUMMARY Histopathological analysis of a 53-year-old female PC patient who underwent Whipple surgery revealed poorly differentiated tumor cells infiltrating nerves,lymphatics,and blood vessels.The patient received two different first-line chemotherapy regimens consecutively;however,both regimens struggled to control disease progression.During this period,the patient underwent liver metastasis ablation surgery,Candida albicans liver abscess,and stereotactic body radiotherapy.With the addition of camrelizumab to the modified FOLFIRINOX regimen,tumor control was achieved.The patient subsequently refused to continue chemotherapy,and the antitumor regimen was changed to a combination of camrelizumab and apatinib.After patients received a combination of immunotherapy and targeted therapy,the length of hospital stay was significantly reduced.Furthermore,all side effects were within acceptable limits,leading to an improved quality of life and prolonged progression-free survival.Unfortunately,the pain associated with cancer,coupled with the side effects of opioid analgesics,has led the patient to reject all available anticancer treatment options.Approximately one month after camrelizumab and apatinib were discontinued without medical authorization,the PC recurred and rapidly progressed to widespread metastasis,ultimately leading to the patient's death approximately one month later.The overall survival was 2 years.CONCLUSION Immunotherapy and targeted therapy have the potential to increase both the quality of life and survival time of PC patients,particularly those whose tumor progression is not effectively controlled by chemotherapy alone.Nevertheless,further clinical trials are necessary to validate these findings.
基金supported by funding from the National Key Research and Development Program of China(Research Project of Modernization on TCM,Grant number:2018YFC1707406)。
文摘Background: Cancer-related fatigue(CRF) is a significant burden for patients with advanced lung cancer. While exercise is recommended for managing CRF during pre-and active treatment phases, evidence supporting its efficacy in advanced stage remains limited. This systematic review and meta-analysis aimed to quantify the effects of exercise on CRF and its common complications in patients with advanced lung cancer.Methods: A systematic search of 4 databases(Pub Med, Embase, Cochrane, and Web of Science) was conducted up to July 10, 2024 to identify relevant randomized controlled trials(RCTs). Studies were selected based on predefined eligibility criteria, including adult patients with advanced lung cancer reporting fatigue as an outcome. Study selection followed Preferred Reporting Items for Systematic Reviews and MetaAnalyses(PRISMA) 2020 guidelines, and the risk of bias was assessed using the Cochrane Risk of Bias tool(Ro B 2.0). The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation(GRADE) system. Random-or fixed-effects models were used for meta-analyses based on heterogeneity levels.Results: Eight RCTs involving 749 patients were included. Meta-analysis revealed that exercise significantly improved CRF in patients with advanced lung cancer(standardized mean difference(SMD) =-0.33;95% confidence interval(95%CI):-0.54 to-0.12);p = 0.00;I2= 0.00%).Subgroup analysis showed greater efficacy in patients aged ≤60 years(p = 0.028), those engaging in traditional Chinese exercise(p = 0.003),and interventions lasting fewer than 12 weeks(p = 0.017). Exercise also significantly improved quality of life(SMD = 0.29;95%CI: 0.02-0.55;p = 0.04;I2= 0.00%) and reduced dyspnea(SMD =-0.43;95%CI:-0.71 to-0.16;p = 0.00;I2= 0.00%). No significant effects were observed on sleep quality, anxiety, or depression. The risk of bias across studies was moderate, and the quality of evidence, as evaluated by GRADE, was rated as low due to study limitations. Adverse events were minimal, with only one mild, exercise-related event reported.Conclusion: Exercise significantly alleviates CRF in patients with advanced lung cancer, improves certain complications, and enhances quality of life. The intervention's effectiveness varies by age, type of exercise, and duration. Further high-quality studies are needed to validate these findings.
基金Supported by Natural Science Foundation of Hubei Province,No.2019CFC929.
文摘BACKGROUND Chemotherapy combined with anti-angiogenic therapy has become an important strategy for the treatment of advanced gastric cancer(AGC);however,the regimen needs optimization.AIM To evaluate the efficacy of albumin-bound paclitaxel(nab-ptx)combined with the small molecule vascular endothelial growth factor inhibitor anlotinib in secondline and beyond treatment of AGC.METHODS We collected data from AGC patients at our hospital who experienced disease progression after first-line chemotherapy and received anlotinib combined with nab-ptx.The primary endpoints included overall survival(OS)and progressionfree survival(PFS),while the secondary endpoints were objective response rate(ORR),disease control rate(DCR),and adverse events(AEs).RESULTS Preliminary results indicated that anlotinib combined with nab-ptx can provide significant efficacy in second-line or above treatment for AGC(median PFS=6.0 months,median OS=12.0 months),with an ORR of 42%and a DCR of 78%.Further analysis revealed that patients who experienced hypertension,proteinuria,and hand-foot syndrome during treatment had better efficacy compared to those who did not experience these AEs.Mechanistic studies suggest that this regimen likely exerts synergistic anti-tumor effects by activating the immune response through the reduction of regulatory T-cell proportions.Common adverse reactions included bone marrow suppression,peripheral neuropathy,hypertension,proteinuria,and hand-foot syndrome,which were manageable and resolved with appropriate interventions,indicating the promising application of this regimen in second-line or above treatment for AGC.CONCLUSION The combination of anlotinib and nab-ptx shows promising efficacy with fewer toxicities in AGC treatment.The regimen holds promise as a second-line treatment of AGC;however,its specific clinical value requires further research.
基金Natural Science Foundation of Hubei Province of China,No.2024AFB655Key Research and Development Program of Hubei Province of China,No.2021BCA116National Natural Science Foundation of China,No.82072736,No.82003205,No.
文摘BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally advanced gastric cancer(LAGC)undergoing new treatments remains to be determined.AIM To determine whether hypercoagulation is an effective prognostic indicator in patients with LAGC who underwent radical resection after NICT.METHODS A retrospective analysis of clinical data from 104 patients with LAGC,who underwent radical resection after NICT between 2020 and 2023,was performed.Ddimer and fibrinogen concentrations were measured one week before NICT,and again one week before surgery,to analyze the association between these two indicators and their combined indices[non-hypercoagulation(D-dimer and fibrinogen concentrations within the upper limit of normal)vs hypercoagulation(D-dimer or fibrinogen concentrations above the upper limit of normal)]with prognosis.After radical resection,patients were followed-up periodically.The median follow-up duration was 21 months.RESULTS Data collected after NICT revealed that the three-year overall survival(OS)and disease-free survival(DFS)rates the non-hypercoagulation group were significantly better than those in the hypercoagulation group[94.4%vs 78.0%(P=0.019)and 87.0%vs 68.0%(P=0.027),respectively].Multivariate analysis indicated that hypercoagulation after NICT was an independent factor for poor postoperative OS[hazard ratio(HR)4.436,P=0.023]and DFS(HR 2.551,P=0.039).Pre-NICT data demonstrated no statistically significant difference in three-year OS between the non-hypercoagulation and hypercoagulation groups(88.3%vs 84.1%,respectively;P=0.443).CONCLUSION Hypercoagulation after NICT is an effective prognostic indicator in patients with LAGC undergoing radical gastrectomy.
基金Supported by the Natural Science Foundation of Fujian Province,No.2023J01160Scientific Research Project of Putian University,No.2022059Special Project for Outstanding Young Talents of Putian University,No.2024072.
文摘Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor,underscoring the need for reliable prognostic tools to refine treatment strategies.A study by Yao et al explores the role of the triglyceride-glucose(TyG)index as a prognostic marker for advanced GC patients receiving immunotherapy combined with chemotherapy.The results of the study demonstrate that the TyG index correlates with improved survival outcomes,including better progression-free survival and overall survival.This editorial critically evaluates the significance of these findings,discusses their implications for future research,and highlights innovative directions that could drive further breakthroughs in the application of the TyG index to cancer therapy.This editorial also highlights the potential of TyG in advancing precision oncology and advocates for global validation and mechanistic investigations to further solidify its clinical utility.Future research should focus on validating the TyG index across various malignancies,exploring its potential to influence immunotherapy through metabolic interventions,and developing multi-biomarker models that integrate TyG with immune and genomic profiles.
文摘Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the triglyceride-glucose(TyG)index as a potential surrogate marker for insulin resistance,which may significantly influence the prognosis of patients undergoing immunotherapy combined with chemotherapy.In this context,the study by Yao et al demonstrates that a high TyG index correlates with improved overall survival and progressionfree survival in advanced GC patients receiving sintilimab and chemotherapy.Specifically,patients in the high TyG group had a significantly longer median progression-free survival of 9.8 months[95%confidence interval(CI):9.2-10.9]compared to 8.0 months(95%CI:7.5-8.5)in the low TyG group(hazard ratio=0.58,95%CI:0.43-0.79,P<0.001).Similarly,the median overall survival was significantly longer in the high TyG group at 23.1 months(95%CI:21.2-NA)vs 16.5 months(95%CI:13.9-18.3)in the low TyG group(hazard ratio=0.30,95%CI:0.21-0.42,P<0.001).These findings underscore the strong prognostic potential of the TyG index in guiding treatment strategies for advanced GC.These findings underscore the need for further investigation into the TyG index’s role as a prognostic tool and its underlying mechanisms in influencing treatment efficacy.We advocate for additional multicenter studies to validate these results and explore the TyG index’s applicability across diverse patient populations,ultimately aiming to refine treatment strategies and improve patient outcomes in advanced GC.
文摘Objective:To study the measures and effects of advanced lung cancer patients in terms of complication prevention and care.Methods:50 cases of advanced lung cancer patients were selected for data study during January-December 2023,where the patients were divided into two groups.The study group used complication prevention and nursing care,while the control group used conventional care.The differences between the groups were compared.Results:Compared with the control group,the study group had significantly fewer complications,significantly lower psychological state scores,significantly higher quality of life scores,and significantly lower pain scores(P<0.05).Comparing the psychological state scores,quality of life scores,and pain scores before care,both groups showed insignificant differences(P>0.05).Conclusion:The results of patients with advanced lung cancer are ideal after the application of measures in the area of complication prevention and care.
基金Medical Research Project of Xi’an Science and Technology Bureau“Molecular Mechanism of miR-1305 Competitive Endogenous circRNA in the Development of Liver Cancer”(Project No.22YXYJ0134)General Project of Key Research and Development Program of Shaanxi Provincial Department of Science and Technology“Mechanism Study on the Inhibition of Liver Cancer Invasion and Metastasis by Downregulating METTL3 and Reducing the m6A Modification Level of MMP3 with Honokiol”(Project No.2023-YBSF-631)。
文摘Objective:To evaluate the predictive value of secreted phosphoprotein 1(SPP1)gene expression for postoperative survival in patients with advanced liver cancer undergoing hepatic artery interventional chemoembolization treatment.Method:Bioinformatics methods,including gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis,were used to identify genes related to survival prognosis in hepatocellular carcinoma(HCC)patients.A retrospective analysis of 115 advanced liver cancer patients treated between January 2016 and October 2017 was conducted.Patients were categorized into SPP1 high-expression(n=89)and low-expression groups(n=26).Additionally,115 healthy individuals served as the control group.The relationship between SPP1 expression and clinical pathological features was analyzed.A 60-month follow-up and logistic regression analysis identified risk factors affecting survival.Results:SPP1 mRNA expression was significantly higher in liver cancer patients compared to healthy controls(P<0.05).SPP1 expression levels were significantly associated with tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging(P<0.05).High SPP1 expression,along with tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging,were independent risk factors for survival(P<0.05).The 60-month survival rate was 17.39%,with a median survival of 40 months in the low-expression group versus 18 months in the high-expression group(P<0.05).Conclusion:SPP1 expression is significantly upregulated in advanced liver cancer patients and has predictive value for postoperative survival following hepatic artery chemoembolization treatment.SPP1,combined with clinical indicators such as tumor size,Child-Pugh grading,lymph node metastasis,and BCLC staging,may serve as a prognostic biomarker for interventional treatment outcomes.
基金Supported by Special Research Fund for Central Universities,Peking Union Medical College,No.3332023024Beijing Hope Run Special Fund of Cancer Foundation of China,No.LC2021B20.
文摘BACKGROUND Pancreatic cancer(PC),ranking among the most aggressive solid malignancies,currently lacks validated prognostic biomarkers to guide survival stratification.With a 5-year survival rate under 10%,this malignancy urgently requires precision tools for outcome prediction to optimize therapeutic decision-making.AIM To analyze whether the advanced lung cancer inflammation index(ALI)is a prognostic indicator for PC.METHODS Patients who were diagnosed with PC and underwent radical resection were included from January 2007 to January 2023 in a clinical center from National Cancer Center of China.The patients were divided into low and high ALI groups according to an ALI cut-off of 34.0 calculated with software X-tile.Overall survival(OS)and surgical outcomes were calculated between the two groups.Follow-up was conducted through telephone interview.Kaplan-Meier analysis was performed to estimate OS,while the log-rank test was utilized to compare OS among different tumor stages.Cox regression was used to identify independent risk factors for OS.RESULTS This study included 611 patients who underwent radical PC surgery.Using an ALI cutoff of 34.0,the patients were categorized into a high ALI group(n=378)and a low ALI group(n=233).The low ALI group had significantly lower body mass index,serum albumin,lymphocyte count,and ALI(P<0.01),but higher neutrophil count,a higher proportion of head and neck PC,and longer operation time(P<0.01).As for prognosis,the low ALI group had worse OS in stage I patients(P<0.01),and low ALI(P=0.018,hazard ratio=0.784,95%confidence interval:0.641-0.960)independently conferred an increased risk for mortality.CONCLUSION Lower ALI is associated with worse OS for PC patients who underwent radical surgery.Patients demonstrating low ALI preoperatively require special attention from surgeons.
