BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically...BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically experience a poor prognosis,highlighting an urgent need to explore novel treatment approaches.This study evaluated the overall efficacy and safety of CMT vs CMT combined with immune checkpoint inhibitors(ICIs)in the treatment of EC patients with liver metastases.Furthermore,prognostic factors influencing outcomes in this patient population were identified.AIM To evaluate the efficacy and safety of first-line chemoimmunotherapy for EC patients with liver metastases and to analyze prognostic factors.METHODS This retrospective study included 126 EC patients with liver metastases at Zhejiang Cancer Hospital between 2014 and 2024.Patients receiving CMT were compared with those receiving CMT+ICI.Analyzed variables included clinicopathological features,treatment history,characteristics of metastasis,systemic and local treatments,overall survival(OS),and treatment-related adverse events(TRAEs).Prognostic factors were evaluated using univariate and multivariate Cox proportional-hazards regression models.Finally,efficacy outcomes and TRAE profiles were compared between the two groups.RESULTS A significant difference in median OS was identified between the two groups(10.8 months in the CMT group vs 20.8 months in the CMT+ICI group,P=0.004).The CMT+ICI group also demonstrated a significantly longer median progression-free survival of 11.7 months(P<0.001).Patients receiving combination therapy exhibited significantly improved systemic objective response rate and disease control rate.Multivariate analysis identified key factors significantly influencing OS in EC patients with liver metastases:Karnofsky Performance Status score≥70,receipt of local therapy for liver metastases,and the number of cycles of CMT and immunotherapy received.Furthermore,the incidence of TRAEs did not significantly differ between the CMT+ICI and CMT groups.CONCLUSION For EC patients with liver metastases,the combination of CMT and ICIs demonstrates significantly superior efficacy compared with CMT alone,while maintaining manageable TRAEs.展开更多
BACKGROUND Chemotherapy with an immune checkpoint inhibitor is one of the standard regimens for treating advanced gastric cancer(AGC).Ascites and peritoneal dissemination are common complications and poor prognostic f...BACKGROUND Chemotherapy with an immune checkpoint inhibitor is one of the standard regimens for treating advanced gastric cancer(AGC).Ascites and peritoneal dissemination are common complications and poor prognostic factors of AGC;however,reports regarding its efficacy and safety in patients with AGC and massive ascites are limited.AIM To evaluate the safety and efficacy of nivolumab combined with chemotherapy in patients with AGC and ascites.METHODS We retrospectively collected clinical data from 124 patients with AGC who received chemotherapy plus nivolumab as first-line treatment from July 2017 to December 2024.Based on computed tomography scans,massive or moderate ascites were classified as high ascites burden(HAB),whereas mild or no ascites were classified as low ascites burden.RESULTS Ascites was detected in 47 patients(38%);26(21%)were classified into the HAB group.Patients in the HAB group exhibited a significantly poorer performance status,a higher prevalence of diffuse-type histology,and lower programmed cell death ligand 1(PD-L1)expression.Combination therapy with FOLFOX and neutropenia was significantly more common in the HAB group.Progression-free survival(PFS)(4.4 months vs 9.3 months,P=0.0012)and overall survival(OS)(7.3 months vs 21.2 months,P<0.0001)were significantly poorer in the HAB group.However,an improvement in ascites was observed in 61.5%of patients in the HAB group.PD-L1 expression did not correlate with either PFS or OS in the HAB group.CONCLUSION Nivolumab plus chemotherapy demonstrated modest efficacy and acceptable toxicity in patients with AGC and HAB.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is a major type of liver cancer worldwide.In advanced stages,portal vein tumor thrombosis(PVTT)and jaundice are common,whereas obstructive jaundice(OJ)is relatively rare.Both co...BACKGROUND Hepatocellular carcinoma(HCC)is a major type of liver cancer worldwide.In advanced stages,portal vein tumor thrombosis(PVTT)and jaundice are common,whereas obstructive jaundice(OJ)is relatively rare.Both conditions markedly reduce survival and increase therapeutic complexity.Recently,hepatic artery infusion chemotherapy(HAIC)in combination with targeted immunotherapy has shown promise for advanced HCC.CASE SUMMARY We report a 47-year-old male with advanced HCC complicated by PVTT and OJ,who was admitted with marked jaundice of the skin and sclera.Imaging revealed a large hepatic mass(14.5 cm×11.3 cm)in the right lobe with associated portal vein tumor thrombus.The tertiary bile duct was only mildly dilated,making percutaneous transhepatic cholangiography drainage infeasible.The patient underwent reduced-dose HAIC,which resulted in significant tumor shrinkage and marked reduction in serum bilirubin.This improvement enabled sequential treatment with lenvatinib and camrelizumab.After six cycles,both liver function and alphafetoprotein levels improved.The patient achieved a progression-free survival of 20 months and an overall survival of 29 months.CONCLUSION HAIC can treat high-bilirubin HCC with PVTT and OJ,allowing for subsequent targeted immunotherapy.展开更多
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 Patients harboring gene mutations like KRAS,NRAS,and BRAF demonstrate highly variable responses to chemotherapy,posing challenges for treatment optimization.Multiparametric magnetic resonance imaging(MRI),w...BACKGROUND Patients harboring gene mutations like KRAS,NRAS,and BRAF demonstrate highly variable responses to chemotherapy,posing challenges for treatment optimization.Multiparametric magnetic resonance imaging(MRI),with its noninvasive capability to assess tumor characteristics in detail,has shown promise in evaluating treatment response and predicting therapeutic outcomes.This technology holds potential for guiding personalized treatment strategies tailored to individual patient profiles,enhancing the precision and effectiveness of colorectal cancer care.AIM To create a multiparametric MRI-based predictive model for assessing chemotherapy efficacy in colorectal cancer patients with gene mutations.METHODS This retrospective study was conducted in a tertiary hospital,analyzing 157 colorectal cancer patients with gene mutations treated between August 2022 and December 2023.Based on chemotherapy outcomes,the patients were categorized into favorable(n=60)and unfavorable(n=50)response groups.Univariate and multivariate logistic regression analyses were performed to identify independent predictors of chemotherapy efficacy.A predictive nomogram was constructed using significant variables,and its performance was assessed using the area under the receiver operating characteristic curve(AUC)in both training and validation sets.RESULTS Univariate analysis identified that tumor differentiation,T2 signal intensity ratio,tumor-to-anal margin distance,and MRI-detected lymph node metastasis as significantly associated with chemotherapy response(P<0.05).Multivariate Logistics regression confirmed these four parameters as independent predictors.The predictive model demonstrated strong discrimination,with an AUC of 0.938(sensitivity:86%;specificity:92%)in the training set,and 0.942(sensitivity:100%;specificity:83%)in the validation set.CONCLUSION We established and validated a multiparametric MRI-based model for predicting chemotherapy response in colorectal cancer patients with gene mutations.This model holds promise for guiding individualized treatment strategies.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
The study included all patients at risk for chemotherapy-related cardiotoxicity,without exclusions based on the type of cancer,reflecting the institution’s epidemiology with a predominance of breast cancer.Myocarditi...The study included all patients at risk for chemotherapy-related cardiotoxicity,without exclusions based on the type of cancer,reflecting the institution’s epidemiology with a predominance of breast cancer.Myocarditis was not an exclusion;its absence may reflect underdiagnosis.Age,although a known risk factor,showed no significant differences,and no upper chemotherapy dose limits were imposed to better capture real-world scenarios.A typographical error in the patient count was amended to 195.Limitations include its retrospective design,selection bias,and incomplete dose data.A prospective multicenter registry is underway to enhance diagnostic accuracy,include diverse types of cancer,and improve generalizability.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
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
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
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
基金Supported by National Natural Science Foundation of China,No.82303672Zhejiang Provincial Health Commission and Zhejiang Provincial Administration of Traditional Chinese Medicine through the Targeted Project for Medical and Health Research,No.2025ZL017and China Primary Health Care Foundation,No.ZLMY20240311001ZJ.
文摘BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically experience a poor prognosis,highlighting an urgent need to explore novel treatment approaches.This study evaluated the overall efficacy and safety of CMT vs CMT combined with immune checkpoint inhibitors(ICIs)in the treatment of EC patients with liver metastases.Furthermore,prognostic factors influencing outcomes in this patient population were identified.AIM To evaluate the efficacy and safety of first-line chemoimmunotherapy for EC patients with liver metastases and to analyze prognostic factors.METHODS This retrospective study included 126 EC patients with liver metastases at Zhejiang Cancer Hospital between 2014 and 2024.Patients receiving CMT were compared with those receiving CMT+ICI.Analyzed variables included clinicopathological features,treatment history,characteristics of metastasis,systemic and local treatments,overall survival(OS),and treatment-related adverse events(TRAEs).Prognostic factors were evaluated using univariate and multivariate Cox proportional-hazards regression models.Finally,efficacy outcomes and TRAE profiles were compared between the two groups.RESULTS A significant difference in median OS was identified between the two groups(10.8 months in the CMT group vs 20.8 months in the CMT+ICI group,P=0.004).The CMT+ICI group also demonstrated a significantly longer median progression-free survival of 11.7 months(P<0.001).Patients receiving combination therapy exhibited significantly improved systemic objective response rate and disease control rate.Multivariate analysis identified key factors significantly influencing OS in EC patients with liver metastases:Karnofsky Performance Status score≥70,receipt of local therapy for liver metastases,and the number of cycles of CMT and immunotherapy received.Furthermore,the incidence of TRAEs did not significantly differ between the CMT+ICI and CMT groups.CONCLUSION For EC patients with liver metastases,the combination of CMT and ICIs demonstrates significantly superior efficacy compared with CMT alone,while maintaining manageable TRAEs.
文摘BACKGROUND Chemotherapy with an immune checkpoint inhibitor is one of the standard regimens for treating advanced gastric cancer(AGC).Ascites and peritoneal dissemination are common complications and poor prognostic factors of AGC;however,reports regarding its efficacy and safety in patients with AGC and massive ascites are limited.AIM To evaluate the safety and efficacy of nivolumab combined with chemotherapy in patients with AGC and ascites.METHODS We retrospectively collected clinical data from 124 patients with AGC who received chemotherapy plus nivolumab as first-line treatment from July 2017 to December 2024.Based on computed tomography scans,massive or moderate ascites were classified as high ascites burden(HAB),whereas mild or no ascites were classified as low ascites burden.RESULTS Ascites was detected in 47 patients(38%);26(21%)were classified into the HAB group.Patients in the HAB group exhibited a significantly poorer performance status,a higher prevalence of diffuse-type histology,and lower programmed cell death ligand 1(PD-L1)expression.Combination therapy with FOLFOX and neutropenia was significantly more common in the HAB group.Progression-free survival(PFS)(4.4 months vs 9.3 months,P=0.0012)and overall survival(OS)(7.3 months vs 21.2 months,P<0.0001)were significantly poorer in the HAB group.However,an improvement in ascites was observed in 61.5%of patients in the HAB group.PD-L1 expression did not correlate with either PFS or OS in the HAB group.CONCLUSION Nivolumab plus chemotherapy demonstrated modest efficacy and acceptable toxicity in patients with AGC and HAB.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is a major type of liver cancer worldwide.In advanced stages,portal vein tumor thrombosis(PVTT)and jaundice are common,whereas obstructive jaundice(OJ)is relatively rare.Both conditions markedly reduce survival and increase therapeutic complexity.Recently,hepatic artery infusion chemotherapy(HAIC)in combination with targeted immunotherapy has shown promise for advanced HCC.CASE SUMMARY We report a 47-year-old male with advanced HCC complicated by PVTT and OJ,who was admitted with marked jaundice of the skin and sclera.Imaging revealed a large hepatic mass(14.5 cm×11.3 cm)in the right lobe with associated portal vein tumor thrombus.The tertiary bile duct was only mildly dilated,making percutaneous transhepatic cholangiography drainage infeasible.The patient underwent reduced-dose HAIC,which resulted in significant tumor shrinkage and marked reduction in serum bilirubin.This improvement enabled sequential treatment with lenvatinib and camrelizumab.After six cycles,both liver function and alphafetoprotein levels improved.The patient achieved a progression-free survival of 20 months and an overall survival of 29 months.CONCLUSION HAIC can treat high-bilirubin HCC with PVTT and OJ,allowing for subsequent targeted immunotherapy.
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 Shenzhen High-level Hospital Construction Fund.
文摘BACKGROUND Patients harboring gene mutations like KRAS,NRAS,and BRAF demonstrate highly variable responses to chemotherapy,posing challenges for treatment optimization.Multiparametric magnetic resonance imaging(MRI),with its noninvasive capability to assess tumor characteristics in detail,has shown promise in evaluating treatment response and predicting therapeutic outcomes.This technology holds potential for guiding personalized treatment strategies tailored to individual patient profiles,enhancing the precision and effectiveness of colorectal cancer care.AIM To create a multiparametric MRI-based predictive model for assessing chemotherapy efficacy in colorectal cancer patients with gene mutations.METHODS This retrospective study was conducted in a tertiary hospital,analyzing 157 colorectal cancer patients with gene mutations treated between August 2022 and December 2023.Based on chemotherapy outcomes,the patients were categorized into favorable(n=60)and unfavorable(n=50)response groups.Univariate and multivariate logistic regression analyses were performed to identify independent predictors of chemotherapy efficacy.A predictive nomogram was constructed using significant variables,and its performance was assessed using the area under the receiver operating characteristic curve(AUC)in both training and validation sets.RESULTS Univariate analysis identified that tumor differentiation,T2 signal intensity ratio,tumor-to-anal margin distance,and MRI-detected lymph node metastasis as significantly associated with chemotherapy response(P<0.05).Multivariate Logistics regression confirmed these four parameters as independent predictors.The predictive model demonstrated strong discrimination,with an AUC of 0.938(sensitivity:86%;specificity:92%)in the training set,and 0.942(sensitivity:100%;specificity:83%)in the validation set.CONCLUSION We established and validated a multiparametric MRI-based model for predicting chemotherapy response in colorectal cancer patients with gene mutations.This model holds promise for guiding individualized treatment strategies.
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The study included all patients at risk for chemotherapy-related cardiotoxicity,without exclusions based on the type of cancer,reflecting the institution’s epidemiology with a predominance of breast cancer.Myocarditis was not an exclusion;its absence may reflect underdiagnosis.Age,although a known risk factor,showed no significant differences,and no upper chemotherapy dose limits were imposed to better capture real-world scenarios.A typographical error in the patient count was amended to 195.Limitations include its retrospective design,selection bias,and incomplete dose data.A prospective multicenter registry is underway to enhance diagnostic accuracy,include diverse types of cancer,and improve generalizability.
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.
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.
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 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.
