Significant progress has been made in cancer control in China over the past decades,but one of the crucial issues remains the low proportions of early-stage diseases among the leading cancers.Subnational cancer contro...Significant progress has been made in cancer control in China over the past decades,but one of the crucial issues remains the low proportions of early-stage diseases among the leading cancers.Subnational cancer control in China has diverse and specific features,especially in rural areas,where needs support to improve screening accessibility and medical intervention quality.Using cancer registry data from Yibin for a subnational observational study,urban-rural disparities in cancer incidence,mortality,and mortality indexes were analyzed.The crude incidence of all-site cancers was higher in urban districts.The crude mortality of all-site cancers was comparable between urban and rural areas,but the mortality index of all-site cancers was higher in rural areas.Awareness of cancer control both among public healthcare providers and the public should be enhanced to improve the early detection of cancers.In particular,more facilitated medical education and public health education are needed to improve domestic awareness of cancer control and increase the public awareness rate of core knowledge on cancer control.Massive and opportunistic screening and surveillance of high-risk subpopulations require more comprehensive encouragement and greater compliance.Therefore,increasing the detection rate of early-stage cancers is of paramount importance to substantially improve cancer survival rates in China.展开更多
Shandong Province, with a population of 84 million and located in the east coastline of China, is rich in natural resources and ranks middle in economic develpment of the whole nation. Around 90000 people are dead of ...Shandong Province, with a population of 84 million and located in the east coastline of China, is rich in natural resources and ranks middle in economic develpment of the whole nation. Around 90000 people are dead of cancer each year. In the recent twenty years, trends in malignant neoplasm展开更多
Cancer outcomes in Australia are among the best in the world,but this is not the story for all Australians,with sig-nificant disparities in cancer outcomes and experiences among specific groups in Australian society.T...Cancer outcomes in Australia are among the best in the world,but this is not the story for all Australians,with sig-nificant disparities in cancer outcomes and experiences among specific groups in Australian society.The Australian Government developed the Australian Cancer Plan(the Plan)as a national approach to improve cancer outcomes and experience for all.The Plan identifies six strategic objectives that require nationally coordinated effort,to achieve the Plan’s vision of world class cancer outcomes and experience for all Australians affected by cancer.The Plan empha-sises person-centred approaches to cancer care,underpinned by a Health Equity in Cancer Outcomes Framework.As the Australian Government’s national cancer control agency,Cancer Australia is driving the Plan’s reform agenda through five implementation policy priorities:the development and establishment of an Australian Comprehensive Cancer Network;the development of a National Optimal Care Pathways Framework;the development of a National Comprehensive Cancer Data Framework and minimum dataset;the development of a National Genomics in Cancer Control Framework;and initiatives to improve cancer outcomes for Aboriginal and Torres Strait Islander people.These priorities will lay the foundation to deliver an integrated,accessible,and equitable cancer control system to deliver the Plan’s vision over the next decade.展开更多
Cancers remain a major health burden with a high mortality rate in China.Basic medical insurance,is the most important element in the financial support system of healthcare resources in both urban and rural areas,and ...Cancers remain a major health burden with a high mortality rate in China.Basic medical insurance,is the most important element in the financial support system of healthcare resources in both urban and rural areas,and requires further understanding to improve health policy.For instance,a single hospital-based prospective cohort study found that esophageal cancer survival outcomes were associated with different healthcare payment patterns and situations.Comparing the extracted literature-data between urban employee basic medical insurance and urban and rural resident basic medical insurance,the proportions of tumor-node-metastasis(TNM)stage I-II were 27.1%and 34.6%,while those of TNM stage IV were 35.0%and 26.1%,respectively.Additionally,high out-of-pocket rate(>60%)of hospitalization was associated with a higher proportion of TNM stage I-II(40.3%vs 26.9%)and a lower proportion of TNM stage IV(22.7%vs 32.8%).In addition,healthcare payment simultaneously influenced or was influenced by the proportions of early and advanced esophageal cancers.The critical difficulty in improving survival of esophageal cancer in populations should be a low proportion of early disease.A more comprehensive and robust public healthcare insurance system is desired to support cancer prevention and control in particular,in order to increase the proportion of early cancers and consequently improve patient survival.Additionally,commercial medical insurance and social charities hope to be fully introduced and encouraged to achieve these goals as active supplement.展开更多
Aim： To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods： We carded out a mass screening of prostate cancer in Changchun, China, using a prostat...Aim： To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods： We carded out a mass screening of prostate cancer in Changchun, China, using a prostate-specific antigen assisted by Japan International Cooperation Agency. From June 1998 to December 2000, 3 940 men over 50 years old were screened. Of these, 29 men were diagnosed with prostate cancer. We selected 28 cases and matched them with controls of low prostate-specific antigen value （〈 4.1 ng/mL） by 1：10 according to age and place of employment. A case-control study of diet and prostate cancer was then carded out. Results： After adjustment for education, body mass index （BMI）, smoking, alcohol consumption, marriage and diet, intake of soybean product was discovered to be inversely related to prostate cancer. Men who consumed soybean product more than twice per week on different days had a multivariate odds ratio （OR） of 0.38 （95% confidence interval [CI], 0.13-1.12）. In addition, men who consumed soybean products more than once per day had a multivariate OR of 0.29 （95% CI, 0.11-0.79） compared with men who consumed soybean products less than once per week. The P for trend was 0.02, which showed significant difference. There was no significant difference in P trend for any dairy food. Even when we matched the cases and controls by other criteria, we found that soybean food was the only preventive factor associated with prostate cancer. Conclusion： Our study suggests that consumption of soybeans, one of the most popular foods in Asia, would decrease the risk of prostate cancer.展开更多
Background： Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been d...Background： Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been developed to target such side effects. While Tai Chi offers benefits for the health and well-being of breast cancer survivors, the effectiveness of Tai Chi across the treatment continuum has not been evalu- ated. Improved patient education and support has been suggested as a priority for breast cancer care. This pilot study assesses the feasibility of a randomized controlled trial （RCT） to evaluate the effectiveness of ＂an integrative Tai Chi＂ （ANITA） program for breast cancer patients undergoing cancer therapy. Methods/design： This is a single-centre, two-arm feasibility RCT. Twenty-four patients with breast cancer who have undergone surgical treatment will be recruited from the Dunedin Hospital （New Zealand） over a 12-month period （from August 2017 to July 2018）. Subject to informed consent, patients will be ran- domized to receive standard cancer treatment alone or standard cancer treatment plus the ANITA pro- gram, consisting of peer support, health education, and Tai Chi Ruler exercise. The program runs alongside the patient＇s adjuvant cancer therapy, which may include chemotherapy, radiation therapy, antibody treatment, and/or antihormonal therapy. Analysis in this study will focus on process evaluation of participant recruitment, retention, treatment fidelity, acceptability of the program, and occurrence of adverse events. Clinical outcomes （i.e., fatigue, sleep quality, anxiety and depression and quality of life） will be assessed at baseline, and at 12 weeks and 24 weeks post-randomization. Discussion： Outcomes from this study will inform the feasibility and methodology for a future fully- powered RCT.展开更多
Water-soluble three-dimensional porous supramolecular organic frameworks（SOFs） have been demonstrated as a new generation of homogeneous polycationic platforms for anti-cancer drug delivery.The new SOF drug delivery...Water-soluble three-dimensional porous supramolecular organic frameworks（SOFs） have been demonstrated as a new generation of homogeneous polycationic platforms for anti-cancer drug delivery.The new SOF drug delivery systems（sof-DDSs） can adsorb dianionic pemetrexed（PMX）,a clinically used chemotherapeutic agent instantaneously upon dissolving in water,which is driven by both electrostatic attraction and hydrophobicity.The in situ-prepared PMX@SOFs are highly stable and can avoid important release of the drug during plasm circulation and overcome the multidrug resistance of human breast MCF-7/Adr cancer cells to enter the cancer cells.Acidic microenvironment of cancer cells promotes the release of the drug in cancer cells.Both in vitro and in vivo studies have revealed that sofDDSs considerably improve the treatment efficacy of PMX,leading to 6-12-fold reduction of the IC50 values,as compared with that of PMX alone.The new drug delivery strategy omits the loading process required by most of reported nanoparticle-based delivery systems and thus holds promise for future development of low-cost drug delivery systems展开更多
The purpose of this study was to review the magnitude of contribution of chemotherapy(CT) in the local control of muscle invasive bladder carcinoma in the studies where a combined radio-chemotherapy(RCT) was used(how ...The purpose of this study was to review the magnitude of contribution of chemotherapy(CT) in the local control of muscle invasive bladder carcinoma in the studies where a combined radio-chemotherapy(RCT) was used(how much higher local control rates are obtained with RCT compared to RT alone).Studies on radiotherapy(RT) and combined RCT,neo-adjuvant,concurrent,adjuvant or combinations,reported after 1990 were reviewed.The mean complete response(CR) rates were significantly higher for the RCT studies compared to RT-alone studies:75.9% vs 64.4%(Wilcoxon ranksum test,P = 0.001).Eleven of the included RCT studies involved 2-3 cycles of neo-adjuvant CT,in addition to concurrent RCT.The RCT studies included the onephase type(where a full dose of RCT was given and then assessment of response and cystectomy for nonresponders followed) and the two-phase types(where an assessment of response was undertaken after an initial RCT course,followed 6 wk later by a consolidation RCT for those patients with a CR).CR rates between the two subgroups of RCT studies were 79.6%(one phase) vs 71.6%(two-phase)(P = 0.015).Theaverage achievable tumour control rates,with an acceptable rate of side effects have been around 70%,which may represent a plateau.Further increase in CR response rates demands for new chemotherapeutic agents,targeted therapies,or modified fractionation in various combinations.Quantification of RT and CT contribution to local control using radiobiological modelling in trial designs would enhance the potential for both improved outcomes and the estimation of the potential gain.展开更多
<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA),...<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.展开更多
BACKGROUND Adjuvant radiotherapy is given following surgery in breast cancer patients. Hypofractonated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits ...BACKGROUND Adjuvant radiotherapy is given following surgery in breast cancer patients. Hypofractonated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material and Methods 244 patients with high-risk breast cancer (stage IIB, stage III and stage IA with any of the following criteria: lymphovascular invasion, hormonal receptor negative, young age) who underwent Breast conservative surgery (BCS) or Modified radical mastectomy (MRM) were enrolled in this study. All patients received adjuvant radiotherapy with different hypofractionation schedules either 3900 cGY/13 fractions or 4240 cGY/16 fractions or 4005 cGY/15 fractions using linear accelerator with 6 MV photon beam. Lateral/Medial tangential and Ipsilateral supraclavicular fields were employed and the ipsilateral axilla was also irradiated if required to the same dose with posteroanterior field. Patients were followed every 3 mons for the first 2 years and every 6 mons thereafter. Outcomes were analyzed in terms of tumor control and survival. Results 244 patients with high-risk breast cancer requiring postoperative radiotherapy to the intact breast or chest wall were treated. The mean age was 48 years (range 28 - 69 years). The 5-year locoregional free survival of all patients was 93.8% the local relapse reported in 15 patients (6.2%) 7 patients at site of operated scar & 8 patients at the regional lymph nodes. The median follow up period was 75 months ranged from 49 to 102 months. Distant metastasis free survival was 92.2%, the distant metastasis reported in 19 patients which represent (7.8%) of all patients, median survival is 75 months ranged from 49 to 102 months and overall survival was 88.6%. Conclusion It is concluded that hypofractionated radiotherapy is a simple and effective protocol in patients with high-risk breast cancer regarding tumor control and survival.展开更多
Patients are often nervous prior to surgery and females might suffer the most. Increased nervousness needs attention as it can negatively affect postoperative recovery. Support from nurses, i.e. being present, attenti...Patients are often nervous prior to surgery and females might suffer the most. Increased nervousness needs attention as it can negatively affect postoperative recovery. Support from nurses, i.e. being present, attentive, empowering and helpful to the patient, and talking about what is on the patient’s mind, might help to reduce nervousness. However, there is a lack of evidence as to the ideal level of attention and resources to reduce preoperative nervousness. The objective of the current study was to compare a range of care combinations with standard care to female patients prior to sedation and cancer surgery primarily on difference in change in nervousness from admission until sedation before cancer surgery, measured on a Visual Analouge Scale. Using simple randomization and numbers in sealed envelopes, adult gynaecological patients scheduled for open cancer surgery were allocated to care provided by a nurse anaesthetist and: A) a surgical nurse, B) no additional care, C) a known nurse , and D) a relative. Only the statistician was blinded. The trial stopped when the calculated numbers were included. In the full analysis set, compared to standard care A) (n = 61), we observed the following mean changes and [95% confidence intervals]: B) (n = 65) 1.05 [CI: 0.298 to 1.794] with p = 0.006, C) (n = 61): -0.38 [-1.140 to 0.385] with p = 0.330, D) (n = 71): 0.23 [-0.498 to 0.967] with p = 0.528. Female cancer patients will benefit from supportive care by a surgical nurse from the time of arrival on the operating ward plus supportive care from a nurse anesthetist from 5 - 10 minutes after entering the operating ward. It is not recommended at any time to rely fully on the support of relatives. The effect on adults of preoperative painful procedures and patients’ time alone on the operating ward should be further investigated.展开更多
Objective: To study the expression and clinical value of apoptosis control gene bcl-2 and bax in breast cancer. Methods: Protein bax and bcl-2 in 41 breast cancers obtained from operations in our hospital in 1996 were...Objective: To study the expression and clinical value of apoptosis control gene bcl-2 and bax in breast cancer. Methods: Protein bax and bcl-2 in 41 breast cancers obtained from operations in our hospital in 1996 were detected using ABC immunohistochemical stain assay and compared with 10 cases with normal breast tissues. Results: The positive rate of bax in normal breast tissue was 90% and in breast cancer was 59%, with a significant statistical difference between them (P<0.05), but there was no statistical difference in bcl-2 protein expression. Among the 41 breast cancer, the group with lymph node metastasis (21 cases) had obviously low bax expression (43%) and high bcl-2 expression (76%), showing significant difference to the group without lymph node metastasis (P<0.05). Conclusion: The antiapoptosis function of bcl-2 was stronger than bax in breast cancer. Protein bax and bcl-2 assay may be useful in understanding the biological behaviors of breast cancer.展开更多
Surgery following neoadjuvant chemoradiotherapy(NCRT) is a common multidisciplinary treatment for resectable esophageal cancer(EC). After analyzing 12 randomized controlled trials(RCTs), we discuss the key issues of s...Surgery following neoadjuvant chemoradiotherapy(NCRT) is a common multidisciplinary treatment for resectable esophageal cancer(EC). After analyzing 12 randomized controlled trials(RCTs), we discuss the key issues of surgery in the management of resectable EC. Along with chemoradiotherapy, NCRT is recommended for patients with squamous cell carcinoma(SCC) and adenocarcinoma(AC), and most chemotherapy regimens are based on cisplatin, fluorouracil(FU), or both(CF). However, taxane-based schedules or additional studies, together with newer chemotherapies, are warranted. In nine clinical trials, post-operative complications were similar without significant differences between two treatment groups. In-hospital mortality was significantly different in only 1 out of 10 trials. Half of the randomized trials that compare NCRT with surgery in EC demonstrate an increase in overall survival or disease-free survival. NCRT offers a great opportunity for margin negative resection, decreased disease stage, and improved loco-regional control. However, NCRT does not affect the quality of life when combined with esophagectomy. Future trials should focus on the identification of optimum regimens and selection of patients who are most likely to benefit from specific treatment options.展开更多
Objective： To evaluate the efficacy and feasibility of screening procedure for upper gastrointestinal cancer in both high-risk and non-high-risk areas in China. Setting： Seven cities/counties, representing three eco...Objective： To evaluate the efficacy and feasibility of screening procedure for upper gastrointestinal cancer in both high-risk and non-high-risk areas in China. Setting： Seven cities/counties, representing three economical-geographical regions （Eastern, Central and Western） in China, were selected as screening centers： three in high-risk areas and four in non-high-risk areas. Participants： Villages/communities in these seven centers regarded as clusters were randomly assigned to either intervention group （screening by endoscopic examination） or control group （with normal community care） in a 1：1 ratio stratified by each center. Eligible participants are local residents aged 40-69 years in the selected villages/communities with no history of cancer or endoscopic examination in the latest 3 years who are mentally and physically competent. Those who are not willing to take endoscopic examination or are unwilling to sign the consent form are excluded from the study. Totally 140,000 participants will be enrolled. Interventions： In high-risk areas of upper gastrointestinal cancer, all subjects in screening group will be screened by endoscopy. In non-high-risk areas, 30% of the subjects in screening group, identified through a survey, will be screened by endoscopy. Primary and secondary outcome measures： The primary outcome is the mortality caused by upper gastrointestinal cancer. The secondary outcomes include detection rate, incidence rate, survival rate, and clinical stage distribution. Additional data on quality of life and cost-effectiveness will also be collected to answer important questions regarding screening effects. Conclusions： Screening strategy evaluated in those areas with positive findings may be promoted nationally and applied to the majority of Chinese people. On the other hand, negative findings will provide scientific evidence for abandoning a test and shifting resources elsewhere. Trial registration： The study has been registered with the Protocol Registration System in Chinese Clinical Trial Registry （identifier： ChiCTR-EOR-16008577）.展开更多
The goal of the present study is to utilize cis-diamminedichloroplatinum (cisplatin) loaded polymer nanoparticles (NPs) to give a controlled, extended, and local drug therapy for the treatment of cancer. We have used ...The goal of the present study is to utilize cis-diamminedichloroplatinum (cisplatin) loaded polymer nanoparticles (NPs) to give a controlled, extended, and local drug therapy for the treatment of cancer. We have used biodegradable and biocompatible poly(lactic-co-glycolic acid) (PLGA) to prepare the NPs by adjusting the double emulsion technique using poly(vinylalcohol) as a surface active agent. The PLGA NPs were characterized for particle size and shape, controlled release of cisplatin, and degradation. Cisplatin solubility in deionized water was increased up to 4 mg/mL by simply changing the solution parameters. Cisplatin encapsulated NPs were incubated in phosphate buffered saline (PBS) at 37?C to study the release kinetics of cisplatin. Cisplatin was released in a sustained manner with less than 20% release during a 3-day period followed by 50% release during a 21-day period. A degradation study of PLGA NPs demonstrated the loss of spherical shape during a 21-day period. We also examined the cisplatin sensitive A2780 cell apoptosis when cells were incubated with cisplatin encapsulated PLGA NPs. A large number of cell apoptosis occurred as a result of cisplatin release from the PLGA NPs. These results suggest that cisplatin encapsulated PLGA NPs can be used to treat the cancer cells by injecting them into a localized site minimizing the side effects.展开更多
Background: Worldwide, breast cancer (BC) is the most frequently diagnosed neoplastic disease in women around menopause that is the leading cause of DALYs, because it causes a significant reduction of these women’s a...Background: Worldwide, breast cancer (BC) is the most frequently diagnosed neoplastic disease in women around menopause that is the leading cause of DALYs, because it causes a significant reduction of these women’s ability to function normally in everyday life. Methods: The present hospital-based case-control study was carried out between January and August 2018 using a structured questionnaire on 105 breast cancer women and 210 controls who are clinically free from breast cancer. Data about the study cases were collected in the oncology day-care clinics of the two main hospitals in Gaza strip “Al-Shifa and European Gaza hospitals”. Univariate logistic regression and multivariate logistic regression analyses were employed to identify the significant factors associated with BC. Results: Multivariate logistic regression analyses with adjustment for all confounders revealed that woman with BMI more than or equal 30 kg/m2 are under risk of getting BC 2.9 times greater than those having BMI less than 29 kg/m2 (AOR = 2.895;95% CI: 1.305 - 6.423). Analysis of risk according to reaching menopause showed that the estimated AOR was greater among those reached menopause (3.137, 95% CI 1.824 - 5.395) than among those that did not reach menopause. The risk of developing BC in the case of a history of incidence of BC in the family was more than two times higher (AOR = 2.632, 95% CI 1.528 - 4.535) than in case of the history of a free family of BC. Conclusion: In this context, the above-mentioned risk factors must be taken into consideration in BC management processes in the Gaza strip.展开更多
Average size of hematite and magnetite micro and nanopowders and polydispersity index, zeta potential and distribution of particles were studied. Analysis showed that average size of the obtained particles for magneti...Average size of hematite and magnetite micro and nanopowders and polydispersity index, zeta potential and distribution of particles were studied. Analysis showed that average size of the obtained particles for magnetite is 740.9 nm, for hematite particles 30 - 35 nm. Alternate current feed source was created for hyperthermia. Proceeding from the requirements of the objectives, the U type MnZn material magneto conductors were selected, in which 10.0 and 8.0 mm width gaps were cut and glass test tubes with magnetite or hematite suspensions were placed in them. Series of experiments at various field intensity and frequencies showed that for efficient magnetic hyperthermia therapy more powerful device was needed with frequency of up to 10 Mega Hertz to achieve the temperature 43°C - 45°C necessary for full activation of Neel and Brown mechanisms in particles. At the next stage, on the basis of experimental material the anticancer mono-therapeutic effect of hyperthermia and its adjuvant action in poly chemotherapeutic treatment was presented by the use of a device created by us “Lezi”. As a result of the experiment it was shown that in all animals (outbred albino mice, 3 months old) inhibition of cancer growth was fixed and intratumoral necrosis was developed, while after 7 and 10 sessions tumors were ulcerated, which refers to positive effect of the experiment (Conclusion of Pathologicanatomical Laboratory “PATGEO”, Tbilisi, Georgia ).展开更多
Objective To compute and compare the tumor control probability(TCP) of volumetric modulated arc therapy(VMAT) for breast cancer after conservative surgery based on two types of multileaf collimator(MLC) through a retr...Objective To compute and compare the tumor control probability(TCP) of volumetric modulated arc therapy(VMAT) for breast cancer after conservative surgery based on two types of multileaf collimator(MLC) through a retrospective planning study.Methods For a group of 9 patients diagnosed with left breast cancer,VMAT plan based on Agility MLC and beam modulator(BM) MLC were designed.The prescription dose was 50 Gy covering at least 95% of the planning target volume,2 Gy per fraction.TCPs were calculated according to dose-volume histogram(DVH) analysis.Results The TCP of the BM VMAT plan was slightly higher than that of the Agility VMAT plan(94.61% vs 94.23%) but was inferior with respect to delivery efficiency;the delivery time was reduced for Agility VMAT plan by 35% compared to BM VMAT plan.Conclusion For breast cancer radiation therapy after conservative surgery,BM VMAT plans provide slightly higher TCP while the delivery of Agility VMAT plans is significantly faster than the BM VMAT plans.展开更多
A mathematical optimal-control tumor therapy framework consisting of radio- and anti-angiogenesis control strategies that are included in a tumor growth model is investigated. The governing system, resulting from the ...A mathematical optimal-control tumor therapy framework consisting of radio- and anti-angiogenesis control strategies that are included in a tumor growth model is investigated. The governing system, resulting from the combination of two well established models, represents the differential constraint of a non-smooth optimal control problem that aims at reducing the volume of the tumor while keeping the radio- and anti-angiogenesis chemical dosage to a minimum. Existence of optimal solutions is proved and necessary conditions are formulated in terms of the Pontryagin maximum principle. Based on this principle, a so-called sequential quadratic Hamiltonian (SQH) method is discussed and benchmarked with an “interior point optimizer—a mathematical programming language” (IPOPT-AMPL) algorithm. Results of numerical experiments are presented that successfully validate the SQH solution scheme. Further, it is shown how to choose the optimisation weights in order to obtain treatment functions that successfully reduce the tumor volume to zero.展开更多
Objective:To observe the clinical efficacy difference between sliding-cupping along meridian combined with short-stretch elastic bandage wrapping and comprehensive detumescence therapy in treating lymphedema after bre...Objective:To observe the clinical efficacy difference between sliding-cupping along meridian combined with short-stretch elastic bandage wrapping and comprehensive detumescence therapy in treating lymphedema after breast cancer surgery.Methods:Sixty patients with lymphedema after breast cancer surgery were randomly divided into the sliding-cupping group and the comprehensive detumescence therapy(CDT)group,with 30 cases in each one.The sliding-cupping group used the sliding-cupping along meridian therapy,and the sliding-cupping was applied along the three yin meridians and three yang meridians on the hand of the affected-side upper limbs,continuing for 25-30 min.After the sliding-cupping was finished,the affected limb was wrapped with the short-stretch elastic bandage.The CDT group was treated with comprehensive detumescence therapy(CDT).Both groups were treated once a day,with14 times as one course of treatment,and there was totally 1 course of treatment.The changes of circumferences before and after treatment of the affected limb were measured by a flexible ruler,and the efficacy was evaluated.The subcutaneous tissue thickness and the full skin layer thickness of the patients with moderate to severe edema in sliding-cupping group were measured by color Doppler ultrasound.Results:After treatment,the circumferences at the cubital crease,5 cm above olecranon,and 10 cm above the olecranon of the affected limbs in the sliding-cupping group were(26.02±2.42)cm,(28.43±3.13)cm,and(30.05±2.80)cm respectively,which were all reduced compared with the pre-treatment circumference(27.95±3.00)cm,(30.80±3.38)cm,and(32.17±2.96 cm).In the sliding-cupping group,the post-treatment subcutaneous tissue thicknesses at 5 cm above the olecranon,10 cm above the olecranon and 5 cm below the olecranon,and full skin layer thickness at 10 cm below the olecranon of the 15 patients with moderate to severe edema were(8.71±2.83)cm,(8.53±2.4)cm,(6.46±1.38)cm,and(1.61±0.17)cm respectively,which were all reduced compared with pre-treatment(11.90±3.56)cm,(11.84±3.27)cm,(9.12±1.84)cm,and(1.87±0.23)cm,and the difference was statistically significant(all P<0.05).The total effective rate of the sliding-cupping group was 86.6%,and the total effective rate of the CDT group was 80%,and the difference was statistically significant(P<0.05).Conclusion:Compared with CDT,the sliding-cupping along meridian combined with short-stretch elastic bandage wrapping for the treatment of lymphedema after breast cancer surgery was more effective.展开更多
基金Supported by Foundation of Science and Technology Department of Sichuan Province,China,No.23ZDYF0839Medical Research Project of Yibin Health Commission,No.2021-34+1 种基金Ya'an Science and Technology Plan of Economic and Social Development(Health Field),No.2024-1Ya’an Philosophic and Social Science Research Plan,No.YAA20240035.
文摘Significant progress has been made in cancer control in China over the past decades,but one of the crucial issues remains the low proportions of early-stage diseases among the leading cancers.Subnational cancer control in China has diverse and specific features,especially in rural areas,where needs support to improve screening accessibility and medical intervention quality.Using cancer registry data from Yibin for a subnational observational study,urban-rural disparities in cancer incidence,mortality,and mortality indexes were analyzed.The crude incidence of all-site cancers was higher in urban districts.The crude mortality of all-site cancers was comparable between urban and rural areas,but the mortality index of all-site cancers was higher in rural areas.Awareness of cancer control both among public healthcare providers and the public should be enhanced to improve the early detection of cancers.In particular,more facilitated medical education and public health education are needed to improve domestic awareness of cancer control and increase the public awareness rate of core knowledge on cancer control.Massive and opportunistic screening and surveillance of high-risk subpopulations require more comprehensive encouragement and greater compliance.Therefore,increasing the detection rate of early-stage cancers is of paramount importance to substantially improve cancer survival rates in China.
文摘Shandong Province, with a population of 84 million and located in the east coastline of China, is rich in natural resources and ranks middle in economic develpment of the whole nation. Around 90000 people are dead of cancer each year. In the recent twenty years, trends in malignant neoplasm
文摘Cancer outcomes in Australia are among the best in the world,but this is not the story for all Australians,with sig-nificant disparities in cancer outcomes and experiences among specific groups in Australian society.The Australian Government developed the Australian Cancer Plan(the Plan)as a national approach to improve cancer outcomes and experience for all.The Plan identifies six strategic objectives that require nationally coordinated effort,to achieve the Plan’s vision of world class cancer outcomes and experience for all Australians affected by cancer.The Plan empha-sises person-centred approaches to cancer care,underpinned by a Health Equity in Cancer Outcomes Framework.As the Australian Government’s national cancer control agency,Cancer Australia is driving the Plan’s reform agenda through five implementation policy priorities:the development and establishment of an Australian Comprehensive Cancer Network;the development of a National Optimal Care Pathways Framework;the development of a National Comprehensive Cancer Data Framework and minimum dataset;the development of a National Genomics in Cancer Control Framework;and initiatives to improve cancer outcomes for Aboriginal and Torres Strait Islander people.These priorities will lay the foundation to deliver an integrated,accessible,and equitable cancer control system to deliver the Plan’s vision over the next decade.
基金Supported by the Foundation of Science and Technology Department of Sichuan Province,China,No.23ZDYF0839Ya'an Science and Technology Plan of Economic and Social Development(Health Field),Ya’an,China,No.2024-1the Ya’an Philosophic and Social Science Research Plan,Ya’an,China,No.YAA20240035.
文摘Cancers remain a major health burden with a high mortality rate in China.Basic medical insurance,is the most important element in the financial support system of healthcare resources in both urban and rural areas,and requires further understanding to improve health policy.For instance,a single hospital-based prospective cohort study found that esophageal cancer survival outcomes were associated with different healthcare payment patterns and situations.Comparing the extracted literature-data between urban employee basic medical insurance and urban and rural resident basic medical insurance,the proportions of tumor-node-metastasis(TNM)stage I-II were 27.1%and 34.6%,while those of TNM stage IV were 35.0%and 26.1%,respectively.Additionally,high out-of-pocket rate(>60%)of hospitalization was associated with a higher proportion of TNM stage I-II(40.3%vs 26.9%)and a lower proportion of TNM stage IV(22.7%vs 32.8%).In addition,healthcare payment simultaneously influenced or was influenced by the proportions of early and advanced esophageal cancers.The critical difficulty in improving survival of esophageal cancer in populations should be a low proportion of early disease.A more comprehensive and robust public healthcare insurance system is desired to support cancer prevention and control in particular,in order to increase the proportion of early cancers and consequently improve patient survival.Additionally,commercial medical insurance and social charities hope to be fully introduced and encouraged to achieve these goals as active supplement.
基金We would appreciate the contribution of Prof. Kuwahara （Miyagi Prefecture Cancer Center, Japan） in this project. We would appreciate Mr. Robert Lister＇s critical reading and revision of our manuscript. This research was supported by the National Natural Science Foundation of China （Grant No. 30700827）, Changchun City Science and Technology Department （Grant No. 2007125）, and Northeast Normal University （Grant No. NENU-STC07005）.
文摘Aim： To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods： We carded out a mass screening of prostate cancer in Changchun, China, using a prostate-specific antigen assisted by Japan International Cooperation Agency. From June 1998 to December 2000, 3 940 men over 50 years old were screened. Of these, 29 men were diagnosed with prostate cancer. We selected 28 cases and matched them with controls of low prostate-specific antigen value （〈 4.1 ng/mL） by 1：10 according to age and place of employment. A case-control study of diet and prostate cancer was then carded out. Results： After adjustment for education, body mass index （BMI）, smoking, alcohol consumption, marriage and diet, intake of soybean product was discovered to be inversely related to prostate cancer. Men who consumed soybean product more than twice per week on different days had a multivariate odds ratio （OR） of 0.38 （95% confidence interval [CI], 0.13-1.12）. In addition, men who consumed soybean products more than once per day had a multivariate OR of 0.29 （95% CI, 0.11-0.79） compared with men who consumed soybean products less than once per week. The P for trend was 0.02, which showed significant difference. There was no significant difference in P trend for any dairy food. Even when we matched the cases and controls by other criteria, we found that soybean food was the only preventive factor associated with prostate cancer. Conclusion： Our study suggests that consumption of soybeans, one of the most popular foods in Asia, would decrease the risk of prostate cancer.
基金funded by the Breast Cancer Foundation New Zealandsupport of which is gratefully acknowledged+1 种基金This funding source has no role in this study other than providing funding supportLL is funded as the Breast Cancer Foundation New Zealand Belinda Scott Clinical Fellowship 2017
文摘Background： Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been developed to target such side effects. While Tai Chi offers benefits for the health and well-being of breast cancer survivors, the effectiveness of Tai Chi across the treatment continuum has not been evalu- ated. Improved patient education and support has been suggested as a priority for breast cancer care. This pilot study assesses the feasibility of a randomized controlled trial （RCT） to evaluate the effectiveness of ＂an integrative Tai Chi＂ （ANITA） program for breast cancer patients undergoing cancer therapy. Methods/design： This is a single-centre, two-arm feasibility RCT. Twenty-four patients with breast cancer who have undergone surgical treatment will be recruited from the Dunedin Hospital （New Zealand） over a 12-month period （from August 2017 to July 2018）. Subject to informed consent, patients will be ran- domized to receive standard cancer treatment alone or standard cancer treatment plus the ANITA pro- gram, consisting of peer support, health education, and Tai Chi Ruler exercise. The program runs alongside the patient＇s adjuvant cancer therapy, which may include chemotherapy, radiation therapy, antibody treatment, and/or antihormonal therapy. Analysis in this study will focus on process evaluation of participant recruitment, retention, treatment fidelity, acceptability of the program, and occurrence of adverse events. Clinical outcomes （i.e., fatigue, sleep quality, anxiety and depression and quality of life） will be assessed at baseline, and at 12 weeks and 24 weeks post-randomization. Discussion： Outcomes from this study will inform the feasibility and methodology for a future fully- powered RCT.
基金the National Natural Science Foundation of China(Nos.21432004,21529201,and 91527301)the Ministry of Science and Technology of China(No.2013CB834501)+1 种基金the Ministry of Education of China Research Fund for the Doctoral Program and of China for financial supportsupport from the Molecular Foundry,Lawrence Berkeley National Laboratory,supported by the Office of Science,Office of Basic Energy Sciences,Scientific User Facilities Division,of the U.S.Department of Energy under Contract No.DE-AC02-05CH11231
文摘Water-soluble three-dimensional porous supramolecular organic frameworks（SOFs） have been demonstrated as a new generation of homogeneous polycationic platforms for anti-cancer drug delivery.The new SOF drug delivery systems（sof-DDSs） can adsorb dianionic pemetrexed（PMX）,a clinically used chemotherapeutic agent instantaneously upon dissolving in water,which is driven by both electrostatic attraction and hydrophobicity.The in situ-prepared PMX@SOFs are highly stable and can avoid important release of the drug during plasm circulation and overcome the multidrug resistance of human breast MCF-7/Adr cancer cells to enter the cancer cells.Acidic microenvironment of cancer cells promotes the release of the drug in cancer cells.Both in vitro and in vivo studies have revealed that sofDDSs considerably improve the treatment efficacy of PMX,leading to 6-12-fold reduction of the IC50 values,as compared with that of PMX alone.The new drug delivery strategy omits the loading process required by most of reported nanoparticle-based delivery systems and thus holds promise for future development of low-cost drug delivery systems
文摘The purpose of this study was to review the magnitude of contribution of chemotherapy(CT) in the local control of muscle invasive bladder carcinoma in the studies where a combined radio-chemotherapy(RCT) was used(how much higher local control rates are obtained with RCT compared to RT alone).Studies on radiotherapy(RT) and combined RCT,neo-adjuvant,concurrent,adjuvant or combinations,reported after 1990 were reviewed.The mean complete response(CR) rates were significantly higher for the RCT studies compared to RT-alone studies:75.9% vs 64.4%(Wilcoxon ranksum test,P = 0.001).Eleven of the included RCT studies involved 2-3 cycles of neo-adjuvant CT,in addition to concurrent RCT.The RCT studies included the onephase type(where a full dose of RCT was given and then assessment of response and cystectomy for nonresponders followed) and the two-phase types(where an assessment of response was undertaken after an initial RCT course,followed 6 wk later by a consolidation RCT for those patients with a CR).CR rates between the two subgroups of RCT studies were 79.6%(one phase) vs 71.6%(two-phase)(P = 0.015).Theaverage achievable tumour control rates,with an acceptable rate of side effects have been around 70%,which may represent a plateau.Further increase in CR response rates demands for new chemotherapeutic agents,targeted therapies,or modified fractionation in various combinations.Quantification of RT and CT contribution to local control using radiobiological modelling in trial designs would enhance the potential for both improved outcomes and the estimation of the potential gain.
文摘<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.
文摘BACKGROUND Adjuvant radiotherapy is given following surgery in breast cancer patients. Hypofractonated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material and Methods 244 patients with high-risk breast cancer (stage IIB, stage III and stage IA with any of the following criteria: lymphovascular invasion, hormonal receptor negative, young age) who underwent Breast conservative surgery (BCS) or Modified radical mastectomy (MRM) were enrolled in this study. All patients received adjuvant radiotherapy with different hypofractionation schedules either 3900 cGY/13 fractions or 4240 cGY/16 fractions or 4005 cGY/15 fractions using linear accelerator with 6 MV photon beam. Lateral/Medial tangential and Ipsilateral supraclavicular fields were employed and the ipsilateral axilla was also irradiated if required to the same dose with posteroanterior field. Patients were followed every 3 mons for the first 2 years and every 6 mons thereafter. Outcomes were analyzed in terms of tumor control and survival. Results 244 patients with high-risk breast cancer requiring postoperative radiotherapy to the intact breast or chest wall were treated. The mean age was 48 years (range 28 - 69 years). The 5-year locoregional free survival of all patients was 93.8% the local relapse reported in 15 patients (6.2%) 7 patients at site of operated scar & 8 patients at the regional lymph nodes. The median follow up period was 75 months ranged from 49 to 102 months. Distant metastasis free survival was 92.2%, the distant metastasis reported in 19 patients which represent (7.8%) of all patients, median survival is 75 months ranged from 49 to 102 months and overall survival was 88.6%. Conclusion It is concluded that hypofractionated radiotherapy is a simple and effective protocol in patients with high-risk breast cancer regarding tumor control and survival.
文摘Patients are often nervous prior to surgery and females might suffer the most. Increased nervousness needs attention as it can negatively affect postoperative recovery. Support from nurses, i.e. being present, attentive, empowering and helpful to the patient, and talking about what is on the patient’s mind, might help to reduce nervousness. However, there is a lack of evidence as to the ideal level of attention and resources to reduce preoperative nervousness. The objective of the current study was to compare a range of care combinations with standard care to female patients prior to sedation and cancer surgery primarily on difference in change in nervousness from admission until sedation before cancer surgery, measured on a Visual Analouge Scale. Using simple randomization and numbers in sealed envelopes, adult gynaecological patients scheduled for open cancer surgery were allocated to care provided by a nurse anaesthetist and: A) a surgical nurse, B) no additional care, C) a known nurse , and D) a relative. Only the statistician was blinded. The trial stopped when the calculated numbers were included. In the full analysis set, compared to standard care A) (n = 61), we observed the following mean changes and [95% confidence intervals]: B) (n = 65) 1.05 [CI: 0.298 to 1.794] with p = 0.006, C) (n = 61): -0.38 [-1.140 to 0.385] with p = 0.330, D) (n = 71): 0.23 [-0.498 to 0.967] with p = 0.528. Female cancer patients will benefit from supportive care by a surgical nurse from the time of arrival on the operating ward plus supportive care from a nurse anesthetist from 5 - 10 minutes after entering the operating ward. It is not recommended at any time to rely fully on the support of relatives. The effect on adults of preoperative painful procedures and patients’ time alone on the operating ward should be further investigated.
文摘Objective: To study the expression and clinical value of apoptosis control gene bcl-2 and bax in breast cancer. Methods: Protein bax and bcl-2 in 41 breast cancers obtained from operations in our hospital in 1996 were detected using ABC immunohistochemical stain assay and compared with 10 cases with normal breast tissues. Results: The positive rate of bax in normal breast tissue was 90% and in breast cancer was 59%, with a significant statistical difference between them (P<0.05), but there was no statistical difference in bcl-2 protein expression. Among the 41 breast cancer, the group with lymph node metastasis (21 cases) had obviously low bax expression (43%) and high bcl-2 expression (76%), showing significant difference to the group without lymph node metastasis (P<0.05). Conclusion: The antiapoptosis function of bcl-2 was stronger than bax in breast cancer. Protein bax and bcl-2 assay may be useful in understanding the biological behaviors of breast cancer.
文摘Surgery following neoadjuvant chemoradiotherapy(NCRT) is a common multidisciplinary treatment for resectable esophageal cancer(EC). After analyzing 12 randomized controlled trials(RCTs), we discuss the key issues of surgery in the management of resectable EC. Along with chemoradiotherapy, NCRT is recommended for patients with squamous cell carcinoma(SCC) and adenocarcinoma(AC), and most chemotherapy regimens are based on cisplatin, fluorouracil(FU), or both(CF). However, taxane-based schedules or additional studies, together with newer chemotherapies, are warranted. In nine clinical trials, post-operative complications were similar without significant differences between two treatment groups. In-hospital mortality was significantly different in only 1 out of 10 trials. Half of the randomized trials that compare NCRT with surgery in EC demonstrate an increase in overall survival or disease-free survival. NCRT offers a great opportunity for margin negative resection, decreased disease stage, and improved loco-regional control. However, NCRT does not affect the quality of life when combined with esophagectomy. Future trials should focus on the identification of optimum regimens and selection of patients who are most likely to benefit from specific treatment options.
基金supported by the Special Fund for Health Research in the Public Interest(No.201502001)
文摘Objective： To evaluate the efficacy and feasibility of screening procedure for upper gastrointestinal cancer in both high-risk and non-high-risk areas in China. Setting： Seven cities/counties, representing three economical-geographical regions （Eastern, Central and Western） in China, were selected as screening centers： three in high-risk areas and four in non-high-risk areas. Participants： Villages/communities in these seven centers regarded as clusters were randomly assigned to either intervention group （screening by endoscopic examination） or control group （with normal community care） in a 1：1 ratio stratified by each center. Eligible participants are local residents aged 40-69 years in the selected villages/communities with no history of cancer or endoscopic examination in the latest 3 years who are mentally and physically competent. Those who are not willing to take endoscopic examination or are unwilling to sign the consent form are excluded from the study. Totally 140,000 participants will be enrolled. Interventions： In high-risk areas of upper gastrointestinal cancer, all subjects in screening group will be screened by endoscopy. In non-high-risk areas, 30% of the subjects in screening group, identified through a survey, will be screened by endoscopy. Primary and secondary outcome measures： The primary outcome is the mortality caused by upper gastrointestinal cancer. The secondary outcomes include detection rate, incidence rate, survival rate, and clinical stage distribution. Additional data on quality of life and cost-effectiveness will also be collected to answer important questions regarding screening effects. Conclusions： Screening strategy evaluated in those areas with positive findings may be promoted nationally and applied to the majority of Chinese people. On the other hand, negative findings will provide scientific evidence for abandoning a test and shifting resources elsewhere. Trial registration： The study has been registered with the Protocol Registration System in Chinese Clinical Trial Registry （identifier： ChiCTR-EOR-16008577）.
文摘The goal of the present study is to utilize cis-diamminedichloroplatinum (cisplatin) loaded polymer nanoparticles (NPs) to give a controlled, extended, and local drug therapy for the treatment of cancer. We have used biodegradable and biocompatible poly(lactic-co-glycolic acid) (PLGA) to prepare the NPs by adjusting the double emulsion technique using poly(vinylalcohol) as a surface active agent. The PLGA NPs were characterized for particle size and shape, controlled release of cisplatin, and degradation. Cisplatin solubility in deionized water was increased up to 4 mg/mL by simply changing the solution parameters. Cisplatin encapsulated NPs were incubated in phosphate buffered saline (PBS) at 37?C to study the release kinetics of cisplatin. Cisplatin was released in a sustained manner with less than 20% release during a 3-day period followed by 50% release during a 21-day period. A degradation study of PLGA NPs demonstrated the loss of spherical shape during a 21-day period. We also examined the cisplatin sensitive A2780 cell apoptosis when cells were incubated with cisplatin encapsulated PLGA NPs. A large number of cell apoptosis occurred as a result of cisplatin release from the PLGA NPs. These results suggest that cisplatin encapsulated PLGA NPs can be used to treat the cancer cells by injecting them into a localized site minimizing the side effects.
文摘Background: Worldwide, breast cancer (BC) is the most frequently diagnosed neoplastic disease in women around menopause that is the leading cause of DALYs, because it causes a significant reduction of these women’s ability to function normally in everyday life. Methods: The present hospital-based case-control study was carried out between January and August 2018 using a structured questionnaire on 105 breast cancer women and 210 controls who are clinically free from breast cancer. Data about the study cases were collected in the oncology day-care clinics of the two main hospitals in Gaza strip “Al-Shifa and European Gaza hospitals”. Univariate logistic regression and multivariate logistic regression analyses were employed to identify the significant factors associated with BC. Results: Multivariate logistic regression analyses with adjustment for all confounders revealed that woman with BMI more than or equal 30 kg/m2 are under risk of getting BC 2.9 times greater than those having BMI less than 29 kg/m2 (AOR = 2.895;95% CI: 1.305 - 6.423). Analysis of risk according to reaching menopause showed that the estimated AOR was greater among those reached menopause (3.137, 95% CI 1.824 - 5.395) than among those that did not reach menopause. The risk of developing BC in the case of a history of incidence of BC in the family was more than two times higher (AOR = 2.632, 95% CI 1.528 - 4.535) than in case of the history of a free family of BC. Conclusion: In this context, the above-mentioned risk factors must be taken into consideration in BC management processes in the Gaza strip.
文摘Average size of hematite and magnetite micro and nanopowders and polydispersity index, zeta potential and distribution of particles were studied. Analysis showed that average size of the obtained particles for magnetite is 740.9 nm, for hematite particles 30 - 35 nm. Alternate current feed source was created for hyperthermia. Proceeding from the requirements of the objectives, the U type MnZn material magneto conductors were selected, in which 10.0 and 8.0 mm width gaps were cut and glass test tubes with magnetite or hematite suspensions were placed in them. Series of experiments at various field intensity and frequencies showed that for efficient magnetic hyperthermia therapy more powerful device was needed with frequency of up to 10 Mega Hertz to achieve the temperature 43°C - 45°C necessary for full activation of Neel and Brown mechanisms in particles. At the next stage, on the basis of experimental material the anticancer mono-therapeutic effect of hyperthermia and its adjuvant action in poly chemotherapeutic treatment was presented by the use of a device created by us “Lezi”. As a result of the experiment it was shown that in all animals (outbred albino mice, 3 months old) inhibition of cancer growth was fixed and intratumoral necrosis was developed, while after 7 and 10 sessions tumors were ulcerated, which refers to positive effect of the experiment (Conclusion of Pathologicanatomical Laboratory “PATGEO”, Tbilisi, Georgia ).
基金Supported by a grant from the Innovation Project of the PLA Army General Hospital of China(No.2015-LC-18)
文摘Objective To compute and compare the tumor control probability(TCP) of volumetric modulated arc therapy(VMAT) for breast cancer after conservative surgery based on two types of multileaf collimator(MLC) through a retrospective planning study.Methods For a group of 9 patients diagnosed with left breast cancer,VMAT plan based on Agility MLC and beam modulator(BM) MLC were designed.The prescription dose was 50 Gy covering at least 95% of the planning target volume,2 Gy per fraction.TCPs were calculated according to dose-volume histogram(DVH) analysis.Results The TCP of the BM VMAT plan was slightly higher than that of the Agility VMAT plan(94.61% vs 94.23%) but was inferior with respect to delivery efficiency;the delivery time was reduced for Agility VMAT plan by 35% compared to BM VMAT plan.Conclusion For breast cancer radiation therapy after conservative surgery,BM VMAT plans provide slightly higher TCP while the delivery of Agility VMAT plans is significantly faster than the BM VMAT plans.
文摘A mathematical optimal-control tumor therapy framework consisting of radio- and anti-angiogenesis control strategies that are included in a tumor growth model is investigated. The governing system, resulting from the combination of two well established models, represents the differential constraint of a non-smooth optimal control problem that aims at reducing the volume of the tumor while keeping the radio- and anti-angiogenesis chemical dosage to a minimum. Existence of optimal solutions is proved and necessary conditions are formulated in terms of the Pontryagin maximum principle. Based on this principle, a so-called sequential quadratic Hamiltonian (SQH) method is discussed and benchmarked with an “interior point optimizer—a mathematical programming language” (IPOPT-AMPL) algorithm. Results of numerical experiments are presented that successfully validate the SQH solution scheme. Further, it is shown how to choose the optimisation weights in order to obtain treatment functions that successfully reduce the tumor volume to zero.
基金Supported by Performance Incentives and Special Project of Chongqing Scientific Research Institutes:cstc2017jxj1130009
文摘Objective:To observe the clinical efficacy difference between sliding-cupping along meridian combined with short-stretch elastic bandage wrapping and comprehensive detumescence therapy in treating lymphedema after breast cancer surgery.Methods:Sixty patients with lymphedema after breast cancer surgery were randomly divided into the sliding-cupping group and the comprehensive detumescence therapy(CDT)group,with 30 cases in each one.The sliding-cupping group used the sliding-cupping along meridian therapy,and the sliding-cupping was applied along the three yin meridians and three yang meridians on the hand of the affected-side upper limbs,continuing for 25-30 min.After the sliding-cupping was finished,the affected limb was wrapped with the short-stretch elastic bandage.The CDT group was treated with comprehensive detumescence therapy(CDT).Both groups were treated once a day,with14 times as one course of treatment,and there was totally 1 course of treatment.The changes of circumferences before and after treatment of the affected limb were measured by a flexible ruler,and the efficacy was evaluated.The subcutaneous tissue thickness and the full skin layer thickness of the patients with moderate to severe edema in sliding-cupping group were measured by color Doppler ultrasound.Results:After treatment,the circumferences at the cubital crease,5 cm above olecranon,and 10 cm above the olecranon of the affected limbs in the sliding-cupping group were(26.02±2.42)cm,(28.43±3.13)cm,and(30.05±2.80)cm respectively,which were all reduced compared with the pre-treatment circumference(27.95±3.00)cm,(30.80±3.38)cm,and(32.17±2.96 cm).In the sliding-cupping group,the post-treatment subcutaneous tissue thicknesses at 5 cm above the olecranon,10 cm above the olecranon and 5 cm below the olecranon,and full skin layer thickness at 10 cm below the olecranon of the 15 patients with moderate to severe edema were(8.71±2.83)cm,(8.53±2.4)cm,(6.46±1.38)cm,and(1.61±0.17)cm respectively,which were all reduced compared with pre-treatment(11.90±3.56)cm,(11.84±3.27)cm,(9.12±1.84)cm,and(1.87±0.23)cm,and the difference was statistically significant(all P<0.05).The total effective rate of the sliding-cupping group was 86.6%,and the total effective rate of the CDT group was 80%,and the difference was statistically significant(P<0.05).Conclusion:Compared with CDT,the sliding-cupping along meridian combined with short-stretch elastic bandage wrapping for the treatment of lymphedema after breast cancer surgery was more effective.
