BACKGROUND Advanced gastric cancer is characterized by fast tumor growth and aggressive biological behavior.During neoadjuvant chemotherapy,patients are at risk of distant metastasis or local progression.Anemia is a f...BACKGROUND Advanced gastric cancer is characterized by fast tumor growth and aggressive biological behavior.During neoadjuvant chemotherapy,patients are at risk of distant metastasis or local progression.Anemia is a frequent complication in these patients.AIM To analyze whether changes in hemoglobin and hematocrit can predict the survival and efficacy of neoadjuvant chemotherapy in patients with advanced gastric cancer.METHODS The clinical data of 185 patients with advanced gastric cancer admitted to the Third Affiliated Hospital of Chengdu Medical College,Pidu District People’s Hospital,Chengdu,China,between January 2016 and January 2021,were retrospectively analyzed.All patients underwent a tegafur+oxaliplatin+apatinib chemotherapy regimen.According to the efficacy of chemotherapy,they were divided into an effective group(complete or partial response,n=121)and an ineffective group(stable disease or disease progression,n=64).The factors related to chemotherapy efficacy in patients with advanced gastric cancer were analyzed by univariate and logistic multivariate analyses.The 3-year survival rates of the patients with different hemoglobin and hematocrit levels were compared.RESULTS Univariate analysis showed that the proportion of patients with a tumor diameter>5 cm,non-tubular adenocarcinoma,lymph node metastasis,hematocrit<33%,low mean red blood cell(RBC)protein content,low RBC distribution width,hemoglobin<107 g/L,and platelets>266×109/L in the ineffective group were significantly higher than those in the effective group(P<0.05).Logistic multivariate analysis showed that a tumor diameter>5 cm,lymph node metastasis,≤3 chemotherapy cycles,hematocrit<33%,and hemoglobin<107 g/L are risk factors for neoadjuvant chemotherapy failure in advanced gastric cancer(P<0.05).The 1-year,2-year,and 3-year survival rates in the effective group were 93.39%,83.47%,and 60.33%,respectively.These rates were significantly higher than those in the ineffective group(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hematocrit<33%were 74.67%,49.33%,and 29.33%,respectively,which were significantly lower than those of patients with hematocrit≥33%(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hemoglobin<107 g/L were 80.39%,58.82%,and 39.22%,respectively,which were significantly lower than those of patients with hemoglobin≥107 g/L(P<0.05).CONCLUSION Hematocrit<33%and hemoglobin<107 g/L are risk factors for chemotherapy failure in patients with advanced gastric cancer.They are associated with poorer prognosis and reduced 3-year survival rates.展开更多
This study reviews the findings of a recent study by Li et al,which demonstrated that perioperative chemotherapy benefits patients with diffuse-type gastric cancer compared to surgery alone.Despite potential biases,th...This study reviews the findings of a recent study by Li et al,which demonstrated that perioperative chemotherapy benefits patients with diffuse-type gastric cancer compared to surgery alone.Despite potential biases,the study supports the inclusion of perioperative chemotherapy in treatment guidelines.Neoadjuvant and adjuvant chemotherapy may also provide similar survival outcomes,allowing for flexible treatment planning.展开更多
Objective:Adverse-risk acute myeloid leukemia(AML)patients should receive allogeneic hematopoietic stem cell transplantation(allo-HSCT)at first complete remission(CR1).However,the influence of prior therapies[i.e.,ven...Objective:Adverse-risk acute myeloid leukemia(AML)patients should receive allogeneic hematopoietic stem cell transplantation(allo-HSCT)at first complete remission(CR1).However,the influence of prior therapies[i.e.,venetoclax plus azacitidine(VEN-AZA)or intensive chemotherapy(IC)]on post-transplant outcomes remains inconclusive.This multicenter,retrospective study compared the post-transplant outcomes between patients receiving VEN-AZA and those receiving IC before allo-HSCT.Methods:This study was based on the transplant database of TROPHY group.Consecutive adverse-risk AML patients receiving allo-HSCT from January 2021 to June 2023 were screened in five Chinese transplant centers.Patients were categorized into VEN-AZA group if they received venetoclax combined with azacitidine as first-line therapy followed by allo-HSCT.Patients who received first-line therapy consisting of a mainstay treatment of cytarabine and anthracycline followed by allo-HSCT were categorized into IC group.Results:In the total cohort,the 3-year probabilities of overall survival,leukemia-free survival,and event-free survival were better in the IC group than VEN-AZA group,particularly for patients with ASXL1 mutations or SF3B1 mutations.However,the survival of the VEN-AZA group was not superior to that of IC group in patients aged≥55 years or those with the hematopoietic cell transplantation-comorbidity index scores≥1 before allo-HSCT.After propensity score matching(median age:VEN-AZA group:57 years;IC group:55 years),only the probability of overall survival for the IC group was better than that of VEN-AZA group(93.6%vs.78.0%,P=0.034)at the 1-year follow-up;however,all of the other clinical outcomes were comparable between the VEN-AZA and IC groups.The TP53 mutation was independently associated with post-transplant relapse and survival.Conclusions:Our results suggest that IC remains the cornerstone of therapy,whereas VEN-AZA may also be used in younger patients and medically fit patients with adverse-risk AML who are receiving allo-HSCT in CR1.展开更多
BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the ...BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.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
This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinom...This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.展开更多
Objective:To analyze the clinical efficacy and safety of toripalimab combined with the GC chemotherapy regimen in the treatment of advanced urothelial carcinoma.Methods:A retrospective study was conducted on 102 patie...Objective:To analyze the clinical efficacy and safety of toripalimab combined with the GC chemotherapy regimen in the treatment of advanced urothelial carcinoma.Methods:A retrospective study was conducted on 102 patients with advanced urothelial carcinoma treated at our hospital between March 2021 and August 2024.Based on treatment regimens,patients were divided into a chemotherapy group(n=52)and a combination group(n=50).The chemotherapy group received the GC chemotherapy regimen,while the combination group received GC chemotherapy combined with toripalimab.Both groups underwent 4-6 cycles of treatment based on patient tolerance.Clinical efficacy,immune-related factor levels,survival outcomes,and safety were observed and compared.Results:The disease control rate(DCR)and overall response rate(ORR)in the combination group were slightly higher than those in the chemotherapy group,but the differences were not statistically significant(P>0.05).After treatment,levels of IFN-γand IL-2 increased significantly,while VEGF levels decreased significantly in both groups(P<0.05),with superior outcomes observed in the combination group(P<0.05).Follow-up analysis showed progression-free survival(PFS)and median overall survival(OS)in the chemotherapy group were 5.19 and 10.15 months,respectively,compared to 8.24 and 18.23 months in the combination group,with statistically significant differences(P<0.05).During treatment,the incidence of adverse reactions such as rash,immune-related pneumonia,and immune-related diarrhea was higher in the combination group than in the chemotherapy group(P<0.05).However,the incidence of gastrointestinal reactions,fever,and leukopenia did not differ significantly between the two groups(P>0.05).Conclusion:The use of toripalimab combined with the GC chemotherapy regimen for advanced urothelial carcinoma can effectively improve clinical outcomes and extend patient survival,with good overall safety.However,attention should be given to preventing adverse reactions such as rash and pneumonia during treatment.展开更多
Objective:To evaluate the efficacy of Sanhua essential oil inhalation as aromatherapy in patients with breast cancer-related depression.Methods:In total,144 patients with breast cancer-related depression who underwent...Objective:To evaluate the efficacy of Sanhua essential oil inhalation as aromatherapy in patients with breast cancer-related depression.Methods:In total,144 patients with breast cancer-related depression who underwent postoperative chemotherapy were recruited.The participants in the control group(n=52)were offered a placebo(sunflower oil)daily,whereas those in the essential oil group(n=52)were administered Sanhua essential oil.This study evaluated depression improvement,Hamilton Depression Scale score,scores of symptoms in traditional Chinese medicine(TCM),Pittsburgh Sleepiness Quotient Index score,incidence of nausea and vomiting,and signal changes on functional magnetic resonance imaging.Results:Depression improved by 48.1%and 21.2%in the essential oil and control groups,respectively(P=.010).The Hamilton Depression Scale score(P=.017),scores for symptoms in TCM(P=.002),and the incidence of nausea and vomiting in the acute and delayed phases were lower in the essential oil group than in the control group(nausea in the acute phase,P=.017;nausea in the delayed phase,P=.039;vomiting in the acute phase,P=.008;vomiting in the delayed phase,P=.081).The Pittsburgh Sleepiness Quotient Index score was lower in the essential oil group than in the control group(P=.005).Significant differences existed between the two groups in the left superior parietal gyrus,right precuneus,left dorsolateral superior frontal gyrus,and right precentral gyrus according to functional connectivity on functional magnetic resonance imaging.Conclusion:Inhalation of Sanhua essential oil alleviated depression in patients undergoing chemotherapy for breast cancer,improved sleep quality,relieved TCM symptoms,reduced nausea and vomiting,and regulated activities in the brain regions.展开更多
BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)is one of the methods to prevent peritoneal metastasis of advanced gastric cancer(AGC).However,the prognosis of gastric cancer patients who recei...BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)is one of the methods to prevent peritoneal metastasis of advanced gastric cancer(AGC).However,the prognosis of gastric cancer patients who receive this treatment are different.AIM To investigate whether inflammation and nutritional indicators affect the pro-gnosis of AGC patients undergoing gastrectomy and prophylactic HIPEC,and to develop a novel inflammatory nutritional prognostic index(INPI).Additionally,we aimed to construct a nomogram model to visually predict the prognosis of these patients and provide more accurate guidance for clinical decision-making.METHODS Clinical data from 181 Locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and least absolute shrinkage and selection operator(LASSO)Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were used to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.RESULTS Clinical data from 181 locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and LASSO Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were applied to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.CONCLUSION Inflammation and nutrition indicators are associated with the prognosis of AGC patients undergoing gastrectomy and prophylactic HIPEC.The nomogram based on the INPI and clinical features supports personalized treatment strategies improving prognosis for AGC patients undergoing gastrectomy and prophylactic HIPEC.展开更多
Lymphomas represent one of the most common malignant diseases in young men and an important issue is how treatments will affect their reproductive health.It has been hypothesized that chemotherapies,similarly to envir...Lymphomas represent one of the most common malignant diseases in young men and an important issue is how treatments will affect their reproductive health.It has been hypothesized that chemotherapies,similarly to environmental chemicals,may alter the spermatogenic epigenome.Here,we report the genomic and epigenomic profiling of the sperm DNA from a 31-year-old Hodgkin lymphoma patient who faced recurrent spontaneous miscarriages in his couple 11-26 months after receiving chemotherapy with adriamycin,bleomycin,vinblastine,and dacarbazine(ABVD).In order to capture the potential deleterious impact of the ABVD treatment on mutational and methylation changes,we compared sperm DNA before and 26 months after chemotherapy with whole-genome sequencing(WGS)and reduced representation bisulfite sequencing(RRBS).The WGS analysis identified 403 variants following ABVD treatment,including 28 linked to genes crucial for embryogenesis.However,none were found in coding regions,indicating no impact of chemotherapy on protein function.The RRBS analysis identified 99high-quality differentially methylated regions(hqDMRs)for which methylation status changed upon chemotherapy.Those hqDRMs were associated with 87 differentially methylated genes,among which 14 are known to be important or expressed during embryo development.While no variants were detected in coding regions,promoter regions of several genes potentially important for embryo development contained variants or displayed an altered methylated status.These might in turn modify the corresponding gene expression and thus affect their function during key stages of embryogenesis,leading to potential developmental disorders or miscarriages.展开更多
Immunotherapy offers significant potential but is often hampered by the immunosuppressive environment in oral squamous cell carcinoma(OSCC).To address this,we propose an enhanced immunotherapeutic strategy that revita...Immunotherapy offers significant potential but is often hampered by the immunosuppressive environment in oral squamous cell carcinoma(OSCC).To address this,we propose an enhanced immunotherapeutic strategy that revitalizes the tumor immune microenvironment(TIME)in OSCC by integrating upconversion-based photodynamic therapy(PDT)with chemotherapy.Using a red blood cell membraneinspired biomimetic nanoplatform,our approach concurrently delivers chlorin e6@upconversion nanoparticles(Ce6@UCNP)and doxorubicin(DOX).By leveraging fluorescence resonance energy transfer(FRET)for 980 nm to 660 nm upconversion excitation,we address challenges such as limited tissue penetration and tissue damage,as well as nanoplatform issues including immunogenicity and targeting inaccuracy Our integrated approach enhances PDT and chemotherapy with the goal of transforming immunologically“cold”tumors into“hot”ones through a cascaded therapy,thereby revitalizing the tumor immune microenvironment in OSCC.展开更多
Osteogenic ability impairment and myelosuppression are common complications of chemotherapy and many chemotherapeutics can affect the skeletal system.Skeletal system protection is necessary for cancer chemotherapy.In ...Osteogenic ability impairment and myelosuppression are common complications of chemotherapy and many chemotherapeutics can affect the skeletal system.Skeletal system protection is necessary for cancer chemotherapy.In this study,osteogenic growth peptide(OGP)and tetrahedral framework nucleic-acid nanostructures(tFNAs)are combined to form a peptide-DNA complex OGP-tFNAs,which aims to combine the positive biological effect on tissue protection and regeneration.The bone marrow protection and bone formation effect of OGP-tFNAs are investigated in chemotherapy-induced myelosuppressive mice.The results show that OGP-tFNAs could reduce the cell damage degree from 5-fluorouracil(5-FU)in vitro and maintained the osteogenic differentiation potential.Furthermore,OGP-tFNAs accelerate bone defect regeneration in myelosuppressive mice.In conclusion,OGP-tFNAs could protect the osteogenic differentiation potential of bone marrow stromal cells(BMSCs)from 5-FU injury and maintain the bone formation ability of myelosuppressive mice suffering from chemotherapy.展开更多
Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are complex surgical procedures that are often used to treat advanced cancers of the abdominal cavity with peritoneal metastasis.Although t...Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are complex surgical procedures that are often used to treat advanced cancers of the abdominal cavity with peritoneal metastasis.Although these treatments can be lifesaving,patients often experience a significant decrease in their overall quality of life(QoL),especially in the early stages of recovery,owing to the physical burden of surgery and the effects of chemotherapy.Many traditional QoL questionnaires have been used to measure CRS and HIPEC.However,these classical current QoL assessment tools often fail to capture the unique challenges faced by this population,including bowel dysfunction,stoma-related distress,and long-term survivorship issues.Therefore,additional parameters that assess bowel function and stoma opening status and especially patient-reported outcome measures would be useful in QoL measurements to provide a more detailed understanding of recovery and general well-being in these patients.展开更多
BACKGROUND In patients with metastatic colorectal cancer,chemotherapy may lead to changes in body composition,including skeletal muscle quantity and quality,and body fat area and distribution.Longitudinal follow-up da...BACKGROUND In patients with metastatic colorectal cancer,chemotherapy may lead to changes in body composition,including skeletal muscle quantity and quality,and body fat area and distribution.Longitudinal follow-up data in a homogeneous population are required to understand these changes better.AIM To comprehensively evaluate changes in body composition and their prognostic value in patients with metastatic colorectal cancer undergoing palliative chemo-therapy.METHODS This retrospective study included patients with recurrent or metastatic colorectal cancer who received palliative chemotherapy between 2008 and 2017.Computed tomography scans were analyzed at multiple time points(before each new chemotherapy regimen and after discontinuing all chemotherapy).Body composition was analyzed from each scan using artificial intelligence software(AID-UTM,iAID Inc.),and its association with survival was evaluated through time-dependent Cox regression to adjust for time-varying effects.RESULTS This analysis included 1805 patients,with a median age at diagnosis of 57 years,and 62%were male.At first-line chemotherapy initiation,4.7%,30.9%,36.5%,and 37.1%of the patients had sarcopenia,myosteatosis,and visceral and subcutaneous obesity,respectively.During treatment,approximately 54.5%of the patients experienced significant changes in body composition,with 9.1%and 19.2%developing new sarcopenia and myosteatosis,respectively.Sarcopenia and myosteatosis were associated with poorer survival outcomes[hazard ratio(HR)for sarcopenia,2.55(95%CI:2.06-3.16,P<0.001;HR for myosteatosis,2.37(95%CI:2.00-2.82),P<0.001].In contrast,visceral and subcutaneous obesity were associated with improved survival[HR for visceral obesity,0.69(95%CI:0.57-0.82),P<0.001;HR for subcutaneous obesity,0.78(95%CI:0.64-0.95),P=0.015],with no negative impacts observed at higher fat levels.These changes correlated with end-of-life survival time.CONCLUSION Abnormalities and body composition changes were frequently observed during palliative chemotherapy for advanced colorectal cancer;myosteatosis was common.Comprehensive body composition assessment offers valuable prognostic insights without requiring additional testing.展开更多
Background:Neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ration(PLR)have been shown to contribute to tumour progression and response to therapy.Methods:We retrospectively counted NLR and PLR in 719 patients ...Background:Neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ration(PLR)have been shown to contribute to tumour progression and response to therapy.Methods:We retrospectively counted NLR and PLR in 719 patients with advanced malignancies receiving chemo-and/or immuno-therapy.Results:Both the pretreatment NLR and PLR were significantly elevated in patients with progressive disease than in those without progressive disease.Compared to low groups,the high NLR and PLR groups showed significantly worse event free survival.Conclusion:We propose that NLR and PLR are not only effective blood markers for predicting therapeutic responses to chemo-and/or immuno-therapy,but also useful in detecting survival in diverse malignancies.展开更多
Objectives:To identify the subgroups of self-reported outcomes and associated factors among breast cancer patients undergoing surgery and chemotherapy.Methods:A cross-sectional study was conducted between January and ...Objectives:To identify the subgroups of self-reported outcomes and associated factors among breast cancer patients undergoing surgery and chemotherapy.Methods:A cross-sectional study was conducted between January and November 2021.We recruited patients from two tertiary hospitals in Shanghai,China,using convenience sampling during their hospitalization.Patients were assessed using a questionnaire that included sociodemographic and clinical characteristics,the Patient Reported Outcomes Measurement Information System profile-29(PROMIS-29),and the PROMIS-cognitive function short form 4a.Latent class analysis was performed to examine possible classes regarding self-reported outcomes.Multiple logistic regression analysis was used to determine the associated factors.Analysis of variance(ANOVA)was conducted for symptoms across the different classes.Results:A total of 640 patients participated in this study.The findings revealed three subgroups in terms of self-reported outcomes among breast cancer patients undergoing surgery and chemotherapy:low physical-social-cognitive function,high physical-low cognitive function,and high physical-socialcognitive function.Multivariable logistic regression analysis showed that age(≥60 years old),menopause,the third chemotherapy cycle,undergoing simple mastectomy and breast reconstruction,duration of disease 3-12 months,stageⅢ/Ⅳcancer,and severe pain were associated factors of the functional decline groups.Besides,significant differences in depression and sleep disorders were observed among the three groups.Conclusions:Breast cancer patients receiving surgery and chemotherapy can be divided into three subgroups.Aging,menopause,chemotherapy cycle,surgery type,duration and stage of disease,and severe pain affected the functional decline groups.Consequently,healthcare professionals should make tailored interventions to address the specific functional rehabilitation and symptom relief needs.展开更多
Vascular disrupting agents(VDAs)can destroy tumor vasculature and lead to tumor ischemia and hypoxia,resulting in tumor necrosis.However,VDAs are easy to induce the upregulation of genes that are associated with cance...Vascular disrupting agents(VDAs)can destroy tumor vasculature and lead to tumor ischemia and hypoxia,resulting in tumor necrosis.However,VDAs are easy to induce the upregulation of genes that are associated with cancer cell drug resistance and angiogenesis in tumor cells.Hypoxia-activated chemotherapy will be an ideal supplement to VDAs therapy since it can help to fully utilize the ischemia and hypoxia induced by VDAs to realize a synergistic antitumor therapeutic outcome.Here,we design a liposome whose surface is modified with a tumor-homing peptide Cys-Arg-Glu-Lys-Ala(CREKA,which can specifically target tumor vessels and stroma)and whose aqueous cavity and lipid bilayer are loaded by a hypoxia-activatable drug banoxantrone dihydrochloride(AQ4N)and a VDA combretastatin A4(CA4),respectively.CA4 can selectively target vascular endothelial cells and destroy the tumor blood vessels,which will cause the rapid inhibition of blood flow in tumor and enhance the hypoxia in the tumor region.As a consequence,AQ4N can exert its boosted cytotoxicity under the enhanced hypoxic environment.The as-prepared liposome with a uniform particle size exhibits good stability and high cancer cell killing efficacy in vitro.In addition,in vivo experiments confirm the excellent tumortargeting/accumulation,tumor vasculature-damaging,and tumor inhibition effects of the liposome.This work develops a liposomal which can achieve safe and effective tumor suppression without external stimulus excitation by only single injection,and is expected to benefit the future development of effective antitumor liposomal drugs.展开更多
We commend the work of Liu et al,who provide compelling preclinical evidence that rosmarinic acid(RA),a natural dietary polyphenol,exerts potent anti-tumor effects in colorectal cancer(CRC)by selectively suppressing t...We commend the work of Liu et al,who provide compelling preclinical evidence that rosmarinic acid(RA),a natural dietary polyphenol,exerts potent anti-tumor effects in colorectal cancer(CRC)by selectively suppressing the NF-κB signaling pathway.The study’s integrative approach—encompassing molecular docking,transcriptional analysis,and apoptosis induction—demonstrates RA’s ability to inhibit key oncogenic mediators,including cyclin D1 and MYC.Notably,RA enhances the efficacy of chemotherapeutics such as 5-fluorouracil and oxaliplatin synergistically,suggesting its potential as a chemosensitizer to overcome resis-tance.Given RA’s established safety profile and its broad spectrum of biological activities,this study provides a strong rationale for advancing RA toward transla-tional applications in CRC management.We highlight the relevance of this work in the broader context of natural compound-based therapeutics and inflam-mation-driven tumor biology.展开更多
BACKGROUND The National Comprehensive Cancer Network guidelines recommend adjuvant chemotherapy(ACT)for patients with stage II colon cancer who have undergone curative surgery when fewer than 12 lymph nodes(LNs)are re...BACKGROUND The National Comprehensive Cancer Network guidelines recommend adjuvant chemotherapy(ACT)for patients with stage II colon cancer who have undergone curative surgery when fewer than 12 lymph nodes(LNs)are retrieved.This study seeks to further examine the requirement for ACT in individuals who had 12 or more LNs harvested.AIM To investigate if stage II colon cancer patients with 12 or more LNs retrieved benefit from ACT.METHODS This retrospective cohort study included individuals diagnosed with stage II colon cancer who underwent surgery between 2008 and 2017 from the Surveillance,Epidemiology,and End Results(SEER)registry and a Chinese multicenter database.All patients had at least 12 LNs retrieved.The key endpoint was overall survival(OS).Cox regression analysis was performed to assess independent OS predictors.Propensity score matching controlled for confounders,and Kaplan-Meier analysis evaluated the impact of ACT on survival.RESULTS A total of 32742 patients with stage II colon cancer from the SEER cohort and 3153 patients from the Chinese cohort were included.The average number of LNs retrieved was 20.0(15.0,26.0)in the SEER cohort and 18.0(15.0,22.0)in the Chinese cohort.No-ACT remained an independent risk factor in both cohorts(hazard ratio=1.589,95%confidence interval:1.485-1.700 and hazard ratio=1.865,95%confidence interval:1.465-2.375,respectively).In the SEER cohort,patients in the ACT group consistently demonstrated better 5-year OS rates both before and after propensity score matching(79.4%vs 66.1%and 79.4%vs 69.4%,both P<0.0001).Similarly,these findings were further validated in the Chinese cohort(91.2%vs 82.1%and 90.0%vs 82.8%,both P<0.0001).ACT improved prognosis even in T3 and grade 1/2 patients.CONCLUSION This research,based on two large population-based cohorts,demonstrates that stage II colon cancer patients with 12 or more LNs retrieved can still benefit from ACT.展开更多
BACKGROUND Peritoneal lavage cytology-positive(CY1)gastric cancer(stage IV)has a poor prognosis,though some cases fare better.Therefore,identifying prognostic factors and an optimal treatment strategy is crucial.AIM T...BACKGROUND Peritoneal lavage cytology-positive(CY1)gastric cancer(stage IV)has a poor prognosis,though some cases fare better.Therefore,identifying prognostic factors and an optimal treatment strategy is crucial.AIM To investigate prognostic factors in patients with gastric cancer who underwent gastrectomy with CY1,and to evaluate the optimal postoperative chemotherapy regimen.METHODS This multicenter retrospective cohort study analyzed prognostic factors and postoperative chemotherapy in patients with CY1 gastric cancer who underwent gastrectomy,excluding those with macroscopic peritoneal dissemination.Data from 13 institutions(2015-2019)were reviewed.RESULTS Overall,82 patients met the inclusion criteria.The median overall survival was 22.8 months,and diffuse-type histology and the absence of postoperative chemotherapy were identified as independent poor prognostic factors.The 5-year survival rate was 82.4%for those receiving fluoropyrimidine plus docetaxel/oxaliplatin vs 21.8%for those with S-1 monotherapy or a cisplatin-based regimen.Median overall survival was not reached in the fluoropyrimidine+docetaxel/oxaliplatin group but was 22.9 months in the S-1/cisplatin group.Chemotherapy regimen was an independent prognostic factor(hazard ratio=5.47,P=0.004).The fluoropyrimidine plus docetaxel/oxaliplatin group had an average relative dose intensity of 82.1%,with significantly more patients achieving a relative dose intensity≥80%than in the S-1 monotherapy or cisplatin-based group(P=0.001).CONCLUSION Diffuse-type histology and the absence of postoperative chemotherapy influence the prognosis of patients with CY1 gastric cancer.Combination therapy with oxaliplatin or docetaxel may enhance the treatment intensity and improve survival outcomes after gastrectomy.展开更多
文摘BACKGROUND Advanced gastric cancer is characterized by fast tumor growth and aggressive biological behavior.During neoadjuvant chemotherapy,patients are at risk of distant metastasis or local progression.Anemia is a frequent complication in these patients.AIM To analyze whether changes in hemoglobin and hematocrit can predict the survival and efficacy of neoadjuvant chemotherapy in patients with advanced gastric cancer.METHODS The clinical data of 185 patients with advanced gastric cancer admitted to the Third Affiliated Hospital of Chengdu Medical College,Pidu District People’s Hospital,Chengdu,China,between January 2016 and January 2021,were retrospectively analyzed.All patients underwent a tegafur+oxaliplatin+apatinib chemotherapy regimen.According to the efficacy of chemotherapy,they were divided into an effective group(complete or partial response,n=121)and an ineffective group(stable disease or disease progression,n=64).The factors related to chemotherapy efficacy in patients with advanced gastric cancer were analyzed by univariate and logistic multivariate analyses.The 3-year survival rates of the patients with different hemoglobin and hematocrit levels were compared.RESULTS Univariate analysis showed that the proportion of patients with a tumor diameter>5 cm,non-tubular adenocarcinoma,lymph node metastasis,hematocrit<33%,low mean red blood cell(RBC)protein content,low RBC distribution width,hemoglobin<107 g/L,and platelets>266×109/L in the ineffective group were significantly higher than those in the effective group(P<0.05).Logistic multivariate analysis showed that a tumor diameter>5 cm,lymph node metastasis,≤3 chemotherapy cycles,hematocrit<33%,and hemoglobin<107 g/L are risk factors for neoadjuvant chemotherapy failure in advanced gastric cancer(P<0.05).The 1-year,2-year,and 3-year survival rates in the effective group were 93.39%,83.47%,and 60.33%,respectively.These rates were significantly higher than those in the ineffective group(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hematocrit<33%were 74.67%,49.33%,and 29.33%,respectively,which were significantly lower than those of patients with hematocrit≥33%(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hemoglobin<107 g/L were 80.39%,58.82%,and 39.22%,respectively,which were significantly lower than those of patients with hemoglobin≥107 g/L(P<0.05).CONCLUSION Hematocrit<33%and hemoglobin<107 g/L are risk factors for chemotherapy failure in patients with advanced gastric cancer.They are associated with poorer prognosis and reduced 3-year survival rates.
文摘This study reviews the findings of a recent study by Li et al,which demonstrated that perioperative chemotherapy benefits patients with diffuse-type gastric cancer compared to surgery alone.Despite potential biases,the study supports the inclusion of perioperative chemotherapy in treatment guidelines.Neoadjuvant and adjuvant chemotherapy may also provide similar survival outcomes,allowing for flexible treatment planning.
基金supported by the Beijing Natural Science Foundation(No.Z230016)the National Key Research and Development Program of China(No.2022YFC 2502606)+4 种基金the Major Program of the National Natural Science Foundation of China(No.82293630)the Peking University Medicine Fund for the World’s Leading Discipline or Discipline Cluster Development(No.71003Y3035)the Plan Project of Tongzhou Municipal Science and Technology(No.KJ2024CX045)the National Natural Science Foundation of China(No.82170208)the Fundamental Research Funds for the Central Universities。
文摘Objective:Adverse-risk acute myeloid leukemia(AML)patients should receive allogeneic hematopoietic stem cell transplantation(allo-HSCT)at first complete remission(CR1).However,the influence of prior therapies[i.e.,venetoclax plus azacitidine(VEN-AZA)or intensive chemotherapy(IC)]on post-transplant outcomes remains inconclusive.This multicenter,retrospective study compared the post-transplant outcomes between patients receiving VEN-AZA and those receiving IC before allo-HSCT.Methods:This study was based on the transplant database of TROPHY group.Consecutive adverse-risk AML patients receiving allo-HSCT from January 2021 to June 2023 were screened in five Chinese transplant centers.Patients were categorized into VEN-AZA group if they received venetoclax combined with azacitidine as first-line therapy followed by allo-HSCT.Patients who received first-line therapy consisting of a mainstay treatment of cytarabine and anthracycline followed by allo-HSCT were categorized into IC group.Results:In the total cohort,the 3-year probabilities of overall survival,leukemia-free survival,and event-free survival were better in the IC group than VEN-AZA group,particularly for patients with ASXL1 mutations or SF3B1 mutations.However,the survival of the VEN-AZA group was not superior to that of IC group in patients aged≥55 years or those with the hematopoietic cell transplantation-comorbidity index scores≥1 before allo-HSCT.After propensity score matching(median age:VEN-AZA group:57 years;IC group:55 years),only the probability of overall survival for the IC group was better than that of VEN-AZA group(93.6%vs.78.0%,P=0.034)at the 1-year follow-up;however,all of the other clinical outcomes were comparable between the VEN-AZA and IC groups.The TP53 mutation was independently associated with post-transplant relapse and survival.Conclusions:Our results suggest that IC remains the cornerstone of therapy,whereas VEN-AZA may also be used in younger patients and medically fit patients with adverse-risk AML who are receiving allo-HSCT in CR1.
基金Supported by General Project of Natural Science Foundation of Chongqing,China,No.cstc2021jcyj-msxmX0604Chongqing Doctoral"Through Train"Research Program,China,No.CSTB2022BSXM-JCX0045.
文摘BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.
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This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.
文摘Objective:To analyze the clinical efficacy and safety of toripalimab combined with the GC chemotherapy regimen in the treatment of advanced urothelial carcinoma.Methods:A retrospective study was conducted on 102 patients with advanced urothelial carcinoma treated at our hospital between March 2021 and August 2024.Based on treatment regimens,patients were divided into a chemotherapy group(n=52)and a combination group(n=50).The chemotherapy group received the GC chemotherapy regimen,while the combination group received GC chemotherapy combined with toripalimab.Both groups underwent 4-6 cycles of treatment based on patient tolerance.Clinical efficacy,immune-related factor levels,survival outcomes,and safety were observed and compared.Results:The disease control rate(DCR)and overall response rate(ORR)in the combination group were slightly higher than those in the chemotherapy group,but the differences were not statistically significant(P>0.05).After treatment,levels of IFN-γand IL-2 increased significantly,while VEGF levels decreased significantly in both groups(P<0.05),with superior outcomes observed in the combination group(P<0.05).Follow-up analysis showed progression-free survival(PFS)and median overall survival(OS)in the chemotherapy group were 5.19 and 10.15 months,respectively,compared to 8.24 and 18.23 months in the combination group,with statistically significant differences(P<0.05).During treatment,the incidence of adverse reactions such as rash,immune-related pneumonia,and immune-related diarrhea was higher in the combination group than in the chemotherapy group(P<0.05).However,the incidence of gastrointestinal reactions,fever,and leukopenia did not differ significantly between the two groups(P>0.05).Conclusion:The use of toripalimab combined with the GC chemotherapy regimen for advanced urothelial carcinoma can effectively improve clinical outcomes and extend patient survival,with good overall safety.However,attention should be given to preventing adverse reactions such as rash and pneumonia during treatment.
基金supported by grants from the National Natural Science Foundation of China Youth Project(82104952)Shanghai Science and Technology Commission Medical Innovation Research Special Fund(21Y11923600,23Y11921600)+2 种基金Shanghai Municipal Health Commission Clinical Research Special Fund(202140172)Yueyang Hospital Translational Medicine Research Institute Level Fund(2024yyzh05)Yueyang Hospital Young Talent Training Project(RY411.07.02.04).
文摘Objective:To evaluate the efficacy of Sanhua essential oil inhalation as aromatherapy in patients with breast cancer-related depression.Methods:In total,144 patients with breast cancer-related depression who underwent postoperative chemotherapy were recruited.The participants in the control group(n=52)were offered a placebo(sunflower oil)daily,whereas those in the essential oil group(n=52)were administered Sanhua essential oil.This study evaluated depression improvement,Hamilton Depression Scale score,scores of symptoms in traditional Chinese medicine(TCM),Pittsburgh Sleepiness Quotient Index score,incidence of nausea and vomiting,and signal changes on functional magnetic resonance imaging.Results:Depression improved by 48.1%and 21.2%in the essential oil and control groups,respectively(P=.010).The Hamilton Depression Scale score(P=.017),scores for symptoms in TCM(P=.002),and the incidence of nausea and vomiting in the acute and delayed phases were lower in the essential oil group than in the control group(nausea in the acute phase,P=.017;nausea in the delayed phase,P=.039;vomiting in the acute phase,P=.008;vomiting in the delayed phase,P=.081).The Pittsburgh Sleepiness Quotient Index score was lower in the essential oil group than in the control group(P=.005).Significant differences existed between the two groups in the left superior parietal gyrus,right precuneus,left dorsolateral superior frontal gyrus,and right precentral gyrus according to functional connectivity on functional magnetic resonance imaging.Conclusion:Inhalation of Sanhua essential oil alleviated depression in patients undergoing chemotherapy for breast cancer,improved sleep quality,relieved TCM symptoms,reduced nausea and vomiting,and regulated activities in the brain regions.
文摘BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)is one of the methods to prevent peritoneal metastasis of advanced gastric cancer(AGC).However,the prognosis of gastric cancer patients who receive this treatment are different.AIM To investigate whether inflammation and nutritional indicators affect the pro-gnosis of AGC patients undergoing gastrectomy and prophylactic HIPEC,and to develop a novel inflammatory nutritional prognostic index(INPI).Additionally,we aimed to construct a nomogram model to visually predict the prognosis of these patients and provide more accurate guidance for clinical decision-making.METHODS Clinical data from 181 Locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and least absolute shrinkage and selection operator(LASSO)Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were used to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.RESULTS Clinical data from 181 locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and LASSO Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were applied to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.CONCLUSION Inflammation and nutrition indicators are associated with the prognosis of AGC patients undergoing gastrectomy and prophylactic HIPEC.The nomogram based on the INPI and clinical features supports personalized treatment strategies improving prognosis for AGC patients undergoing gastrectomy and prophylactic HIPEC.
文摘Lymphomas represent one of the most common malignant diseases in young men and an important issue is how treatments will affect their reproductive health.It has been hypothesized that chemotherapies,similarly to environmental chemicals,may alter the spermatogenic epigenome.Here,we report the genomic and epigenomic profiling of the sperm DNA from a 31-year-old Hodgkin lymphoma patient who faced recurrent spontaneous miscarriages in his couple 11-26 months after receiving chemotherapy with adriamycin,bleomycin,vinblastine,and dacarbazine(ABVD).In order to capture the potential deleterious impact of the ABVD treatment on mutational and methylation changes,we compared sperm DNA before and 26 months after chemotherapy with whole-genome sequencing(WGS)and reduced representation bisulfite sequencing(RRBS).The WGS analysis identified 403 variants following ABVD treatment,including 28 linked to genes crucial for embryogenesis.However,none were found in coding regions,indicating no impact of chemotherapy on protein function.The RRBS analysis identified 99high-quality differentially methylated regions(hqDMRs)for which methylation status changed upon chemotherapy.Those hqDRMs were associated with 87 differentially methylated genes,among which 14 are known to be important or expressed during embryo development.While no variants were detected in coding regions,promoter regions of several genes potentially important for embryo development contained variants or displayed an altered methylated status.These might in turn modify the corresponding gene expression and thus affect their function during key stages of embryogenesis,leading to potential developmental disorders or miscarriages.
基金supported by the National Natural Science Foundation of China(No.81802709)the Shandong Provincial Natural Science Foundation,China(Nos.ZR2023MH230,ZR2023MH096)+1 种基金the Shandong Provincial Postdoctoral Innovative Talents Funded SchemePlan of Young Scholars of Shandong University。
文摘Immunotherapy offers significant potential but is often hampered by the immunosuppressive environment in oral squamous cell carcinoma(OSCC).To address this,we propose an enhanced immunotherapeutic strategy that revitalizes the tumor immune microenvironment(TIME)in OSCC by integrating upconversion-based photodynamic therapy(PDT)with chemotherapy.Using a red blood cell membraneinspired biomimetic nanoplatform,our approach concurrently delivers chlorin e6@upconversion nanoparticles(Ce6@UCNP)and doxorubicin(DOX).By leveraging fluorescence resonance energy transfer(FRET)for 980 nm to 660 nm upconversion excitation,we address challenges such as limited tissue penetration and tissue damage,as well as nanoplatform issues including immunogenicity and targeting inaccuracy Our integrated approach enhances PDT and chemotherapy with the goal of transforming immunologically“cold”tumors into“hot”ones through a cascaded therapy,thereby revitalizing the tumor immune microenvironment in OSCC.
基金supported by National Natural Science Foundation of China(Nos.82322015,82171006)Sichuan Province Youth Science and Technology Innovation Team(No.2022JDTD0021)+3 种基金Sichuan Science and Technology Program(No.2022NSFSC0002)West China Hospital of Stomatology Sichuan University(No.RCDWJS2024-3)Sichuan Science and Technology Program(Nos.2023NSFSC1706,2024NSFSC1589)Postdoctoral Science Foundation of China(No.BX20220220)。
文摘Osteogenic ability impairment and myelosuppression are common complications of chemotherapy and many chemotherapeutics can affect the skeletal system.Skeletal system protection is necessary for cancer chemotherapy.In this study,osteogenic growth peptide(OGP)and tetrahedral framework nucleic-acid nanostructures(tFNAs)are combined to form a peptide-DNA complex OGP-tFNAs,which aims to combine the positive biological effect on tissue protection and regeneration.The bone marrow protection and bone formation effect of OGP-tFNAs are investigated in chemotherapy-induced myelosuppressive mice.The results show that OGP-tFNAs could reduce the cell damage degree from 5-fluorouracil(5-FU)in vitro and maintained the osteogenic differentiation potential.Furthermore,OGP-tFNAs accelerate bone defect regeneration in myelosuppressive mice.In conclusion,OGP-tFNAs could protect the osteogenic differentiation potential of bone marrow stromal cells(BMSCs)from 5-FU injury and maintain the bone formation ability of myelosuppressive mice suffering from chemotherapy.
文摘Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are complex surgical procedures that are often used to treat advanced cancers of the abdominal cavity with peritoneal metastasis.Although these treatments can be lifesaving,patients often experience a significant decrease in their overall quality of life(QoL),especially in the early stages of recovery,owing to the physical burden of surgery and the effects of chemotherapy.Many traditional QoL questionnaires have been used to measure CRS and HIPEC.However,these classical current QoL assessment tools often fail to capture the unique challenges faced by this population,including bowel dysfunction,stoma-related distress,and long-term survivorship issues.Therefore,additional parameters that assess bowel function and stoma opening status and especially patient-reported outcome measures would be useful in QoL measurements to provide a more detailed understanding of recovery and general well-being in these patients.
基金Supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute,by the Ministry of Health&Welfare,Republic of Korea,No.RS-2018-KH049509the 2022 Cancer Research Support Project from the Korea Foundation for Cancer Research,No.CB-2022-A-3.
文摘BACKGROUND In patients with metastatic colorectal cancer,chemotherapy may lead to changes in body composition,including skeletal muscle quantity and quality,and body fat area and distribution.Longitudinal follow-up data in a homogeneous population are required to understand these changes better.AIM To comprehensively evaluate changes in body composition and their prognostic value in patients with metastatic colorectal cancer undergoing palliative chemo-therapy.METHODS This retrospective study included patients with recurrent or metastatic colorectal cancer who received palliative chemotherapy between 2008 and 2017.Computed tomography scans were analyzed at multiple time points(before each new chemotherapy regimen and after discontinuing all chemotherapy).Body composition was analyzed from each scan using artificial intelligence software(AID-UTM,iAID Inc.),and its association with survival was evaluated through time-dependent Cox regression to adjust for time-varying effects.RESULTS This analysis included 1805 patients,with a median age at diagnosis of 57 years,and 62%were male.At first-line chemotherapy initiation,4.7%,30.9%,36.5%,and 37.1%of the patients had sarcopenia,myosteatosis,and visceral and subcutaneous obesity,respectively.During treatment,approximately 54.5%of the patients experienced significant changes in body composition,with 9.1%and 19.2%developing new sarcopenia and myosteatosis,respectively.Sarcopenia and myosteatosis were associated with poorer survival outcomes[hazard ratio(HR)for sarcopenia,2.55(95%CI:2.06-3.16,P<0.001;HR for myosteatosis,2.37(95%CI:2.00-2.82),P<0.001].In contrast,visceral and subcutaneous obesity were associated with improved survival[HR for visceral obesity,0.69(95%CI:0.57-0.82),P<0.001;HR for subcutaneous obesity,0.78(95%CI:0.64-0.95),P=0.015],with no negative impacts observed at higher fat levels.These changes correlated with end-of-life survival time.CONCLUSION Abnormalities and body composition changes were frequently observed during palliative chemotherapy for advanced colorectal cancer;myosteatosis was common.Comprehensive body composition assessment offers valuable prognostic insights without requiring additional testing.
基金supported by the project of Young Technical Talents of Tianjin Medical University General Hospital(GG-2021-08).
文摘Background:Neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ration(PLR)have been shown to contribute to tumour progression and response to therapy.Methods:We retrospectively counted NLR and PLR in 719 patients with advanced malignancies receiving chemo-and/or immuno-therapy.Results:Both the pretreatment NLR and PLR were significantly elevated in patients with progressive disease than in those without progressive disease.Compared to low groups,the high NLR and PLR groups showed significantly worse event free survival.Conclusion:We propose that NLR and PLR are not only effective blood markers for predicting therapeutic responses to chemo-and/or immuno-therapy,but also useful in detecting survival in diverse malignancies.
基金supported by the Hospital-level Nursing Research Project of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(xhhlcx2023-017)the third period of the 14th Five-Year nursing talent project of Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine(Xhlxm014)the Ministry of Education of Humanities and Social Science Project(23YJC630002)and High-level local university construction project founded by Shanghai Municipal Education Commission.
文摘Objectives:To identify the subgroups of self-reported outcomes and associated factors among breast cancer patients undergoing surgery and chemotherapy.Methods:A cross-sectional study was conducted between January and November 2021.We recruited patients from two tertiary hospitals in Shanghai,China,using convenience sampling during their hospitalization.Patients were assessed using a questionnaire that included sociodemographic and clinical characteristics,the Patient Reported Outcomes Measurement Information System profile-29(PROMIS-29),and the PROMIS-cognitive function short form 4a.Latent class analysis was performed to examine possible classes regarding self-reported outcomes.Multiple logistic regression analysis was used to determine the associated factors.Analysis of variance(ANOVA)was conducted for symptoms across the different classes.Results:A total of 640 patients participated in this study.The findings revealed three subgroups in terms of self-reported outcomes among breast cancer patients undergoing surgery and chemotherapy:low physical-social-cognitive function,high physical-low cognitive function,and high physical-socialcognitive function.Multivariable logistic regression analysis showed that age(≥60 years old),menopause,the third chemotherapy cycle,undergoing simple mastectomy and breast reconstruction,duration of disease 3-12 months,stageⅢ/Ⅳcancer,and severe pain were associated factors of the functional decline groups.Besides,significant differences in depression and sleep disorders were observed among the three groups.Conclusions:Breast cancer patients receiving surgery and chemotherapy can be divided into three subgroups.Aging,menopause,chemotherapy cycle,surgery type,duration and stage of disease,and severe pain affected the functional decline groups.Consequently,healthcare professionals should make tailored interventions to address the specific functional rehabilitation and symptom relief needs.
基金supported by the Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor(Guangxi Medical University),Ministry of Education(No.GKE-KF202305)the Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor,and the Natural Science Foundation of Jiangsu Province(No.BK20211510)。
文摘Vascular disrupting agents(VDAs)can destroy tumor vasculature and lead to tumor ischemia and hypoxia,resulting in tumor necrosis.However,VDAs are easy to induce the upregulation of genes that are associated with cancer cell drug resistance and angiogenesis in tumor cells.Hypoxia-activated chemotherapy will be an ideal supplement to VDAs therapy since it can help to fully utilize the ischemia and hypoxia induced by VDAs to realize a synergistic antitumor therapeutic outcome.Here,we design a liposome whose surface is modified with a tumor-homing peptide Cys-Arg-Glu-Lys-Ala(CREKA,which can specifically target tumor vessels and stroma)and whose aqueous cavity and lipid bilayer are loaded by a hypoxia-activatable drug banoxantrone dihydrochloride(AQ4N)and a VDA combretastatin A4(CA4),respectively.CA4 can selectively target vascular endothelial cells and destroy the tumor blood vessels,which will cause the rapid inhibition of blood flow in tumor and enhance the hypoxia in the tumor region.As a consequence,AQ4N can exert its boosted cytotoxicity under the enhanced hypoxic environment.The as-prepared liposome with a uniform particle size exhibits good stability and high cancer cell killing efficacy in vitro.In addition,in vivo experiments confirm the excellent tumortargeting/accumulation,tumor vasculature-damaging,and tumor inhibition effects of the liposome.This work develops a liposomal which can achieve safe and effective tumor suppression without external stimulus excitation by only single injection,and is expected to benefit the future development of effective antitumor liposomal drugs.
文摘We commend the work of Liu et al,who provide compelling preclinical evidence that rosmarinic acid(RA),a natural dietary polyphenol,exerts potent anti-tumor effects in colorectal cancer(CRC)by selectively suppressing the NF-κB signaling pathway.The study’s integrative approach—encompassing molecular docking,transcriptional analysis,and apoptosis induction—demonstrates RA’s ability to inhibit key oncogenic mediators,including cyclin D1 and MYC.Notably,RA enhances the efficacy of chemotherapeutics such as 5-fluorouracil and oxaliplatin synergistically,suggesting its potential as a chemosensitizer to overcome resis-tance.Given RA’s established safety profile and its broad spectrum of biological activities,this study provides a strong rationale for advancing RA toward transla-tional applications in CRC management.We highlight the relevance of this work in the broader context of natural compound-based therapeutics and inflam-mation-driven tumor biology.
基金Supported by Shanxi Special Projects of the Central Government Guiding Local Science and Technology Development of China,No.YDZJSX2021B016Shanxi Cancer Hospital Doctoral Master’s Guide and Companion Flying Fund,No.SD2023010.
文摘BACKGROUND The National Comprehensive Cancer Network guidelines recommend adjuvant chemotherapy(ACT)for patients with stage II colon cancer who have undergone curative surgery when fewer than 12 lymph nodes(LNs)are retrieved.This study seeks to further examine the requirement for ACT in individuals who had 12 or more LNs harvested.AIM To investigate if stage II colon cancer patients with 12 or more LNs retrieved benefit from ACT.METHODS This retrospective cohort study included individuals diagnosed with stage II colon cancer who underwent surgery between 2008 and 2017 from the Surveillance,Epidemiology,and End Results(SEER)registry and a Chinese multicenter database.All patients had at least 12 LNs retrieved.The key endpoint was overall survival(OS).Cox regression analysis was performed to assess independent OS predictors.Propensity score matching controlled for confounders,and Kaplan-Meier analysis evaluated the impact of ACT on survival.RESULTS A total of 32742 patients with stage II colon cancer from the SEER cohort and 3153 patients from the Chinese cohort were included.The average number of LNs retrieved was 20.0(15.0,26.0)in the SEER cohort and 18.0(15.0,22.0)in the Chinese cohort.No-ACT remained an independent risk factor in both cohorts(hazard ratio=1.589,95%confidence interval:1.485-1.700 and hazard ratio=1.865,95%confidence interval:1.465-2.375,respectively).In the SEER cohort,patients in the ACT group consistently demonstrated better 5-year OS rates both before and after propensity score matching(79.4%vs 66.1%and 79.4%vs 69.4%,both P<0.0001).Similarly,these findings were further validated in the Chinese cohort(91.2%vs 82.1%and 90.0%vs 82.8%,both P<0.0001).ACT improved prognosis even in T3 and grade 1/2 patients.CONCLUSION This research,based on two large population-based cohorts,demonstrates that stage II colon cancer patients with 12 or more LNs retrieved can still benefit from ACT.
文摘BACKGROUND Peritoneal lavage cytology-positive(CY1)gastric cancer(stage IV)has a poor prognosis,though some cases fare better.Therefore,identifying prognostic factors and an optimal treatment strategy is crucial.AIM To investigate prognostic factors in patients with gastric cancer who underwent gastrectomy with CY1,and to evaluate the optimal postoperative chemotherapy regimen.METHODS This multicenter retrospective cohort study analyzed prognostic factors and postoperative chemotherapy in patients with CY1 gastric cancer who underwent gastrectomy,excluding those with macroscopic peritoneal dissemination.Data from 13 institutions(2015-2019)were reviewed.RESULTS Overall,82 patients met the inclusion criteria.The median overall survival was 22.8 months,and diffuse-type histology and the absence of postoperative chemotherapy were identified as independent poor prognostic factors.The 5-year survival rate was 82.4%for those receiving fluoropyrimidine plus docetaxel/oxaliplatin vs 21.8%for those with S-1 monotherapy or a cisplatin-based regimen.Median overall survival was not reached in the fluoropyrimidine+docetaxel/oxaliplatin group but was 22.9 months in the S-1/cisplatin group.Chemotherapy regimen was an independent prognostic factor(hazard ratio=5.47,P=0.004).The fluoropyrimidine plus docetaxel/oxaliplatin group had an average relative dose intensity of 82.1%,with significantly more patients achieving a relative dose intensity≥80%than in the S-1 monotherapy or cisplatin-based group(P=0.001).CONCLUSION Diffuse-type histology and the absence of postoperative chemotherapy influence the prognosis of patients with CY1 gastric cancer.Combination therapy with oxaliplatin or docetaxel may enhance the treatment intensity and improve survival outcomes after gastrectomy.
