Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal ...Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.展开更多
Introduction:Chemotherapy-induced gastrointestinal symptom clusters in breast cancer impair quality of life and treatment adherence,yet lack effective interventions.While acupuncture mitigates isolated chemotherapy-in...Introduction:Chemotherapy-induced gastrointestinal symptom clusters in breast cancer impair quality of life and treatment adherence,yet lack effective interventions.While acupuncture mitigates isolated chemotherapy-induced symptoms,its mechanisms for multi-symptom clusters remain unclear.This study evaluates electroacupuncture's efficacy and explores its biological mechanisms in managing these clusters.Methods:This prospective,multicenter,block-randomized,double-blind,sham-controlled trial will enroll 388 patients with breast cancer undergoing neoadjuvant/adjuvant chemotherapy,to be randomly assigned(1:1)to electroacupuncture or sham electro-acupuncture groups.Both groups will receive the standard quadruple antiemetic regimen combined with electroacupuncture or sham intervention.The primary endpoint is the incidence of chemotherapy-induced gastrointestinal symptom clusters within 120 h after chemotherapy.Secondary endpoints include improvement in gastrointestinal symptom clusters post-first chemotherapy cycle,nausea-free rates during acute and delayed phases,vomiting-free rates during overall,acute,and delayed phases,complete response rate,complete protection rate,and quality of life.Adverse events will be documented throughout the study.Discussion:This study will assess the efficacy and safety of electroacupuncture in alleviating chemotherapy-induced gastro-intestinal symptom clusters in patients with breast cancer.By integrating multi-omics analyses,we aim to elucidate the biological mechanisms underlying its therapeutic effects.The findings may offer a robust clinical foundation for optimizing symptom cluster management in cancer care.Trial Registration:Clinical Trials ID:NCT06952920.Date of registration:April 16,2025.Prospectively registered.URL of Trial Registry Record:https://clinicaltrials.gov/study/NCT06952920cond=NCT06952920&rank=1.展开更多
BACKGROUND Chemotherapy-induced cardiotoxicity is a significant complication in cancer therapy,limiting treatment efficacy and worsening patient outcomes.Recent studies have implicated the gut microbiome and its key m...BACKGROUND Chemotherapy-induced cardiotoxicity is a significant complication in cancer therapy,limiting treatment efficacy and worsening patient outcomes.Recent studies have implicated the gut microbiome and its key metabolites,such as shortchain fatty acids(SCFAs)and trimethylamine-N-oxide(TMAO),in mediating inflammation,oxidative stress,and cardiac damage.The gut-heart axis is increasingly recognized as a pivotal pathway linking microbiota dysregulation to chemotherapy-related cardiac dysfunction.AIM To systematically review existing evidence on the role of gut microbiome alterations in chemotherapy-induced cardiotoxicity and evaluate emerging microbiome-based therapeutic strategies aimed at mitigating cardiovascular risk in cancer patients.METHODS A systematic literature search was conducted in PubMed,Scopus,and Web of Science for studies published between January 2013 and December 2024.Studies were included if they examined chemotherapy-induced cardiotoxicity in relation to gut microbiota composition,microbial metabolites(e.g.,SCFAs,TMAO),or microbiome-targeted interventions.Selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data extraction focused on microbiota alterations,mechanistic pathways,cardiac outcomes,and quality assessments using standardized risk-of-bias tools.RESULTS Eighteen studies met the inclusion criteria.Chemotherapy was consistently associated with gut dysbiosis characterized by reduced SCFA-producing bacteria and increased TMAO-producing strains.This imbalance contributed to gut barrier disruption,systemic inflammation,and oxidative stress,all of which promote myocardial damage.SCFA depletion weakened anti-inflammatory responses,while elevated TMAO levels exacerbated cardiac fibrosis and dysfunction.Preclinical studies showed promising cardioprotective effects from probiotics,prebiotics,dietary interventions,and fecal microbiota transplantation,though human data remain limited.CONCLUSION Gut microbiome dysregulation plays a crucial role in the development of chemotherapy-induced cardiotoxicity.Altered microbial composition and metabolite production trigger systemic inflammation and cardiac injury.Microbiome-targeted therapies represent a promising preventive and therapeutic approach in cardio-oncology,warranting further clinical validation through well-designed trials.展开更多
Objective:Breast cancer in India is growing at an alarming rate,and the fact that it is currently being detected more frequently in the younger age groups is even more concerning.In India,a woman dies of breast cancer...Objective:Breast cancer in India is growing at an alarming rate,and the fact that it is currently being detected more frequently in the younger age groups is even more concerning.In India,a woman dies of breast cancer every 8 min,which is a terrible situation.Breast cancer claims one life for every two women who are diagnosed with it.However,the morbidity level is gradually increasing due to advanced medical treatment,but we need to be aware and alert.Methods:The research has been structured as a randomized controlled trial.A total of 180 breast cancer patients were taken from Acharya Vinoba Bhave Rural Hospital(AVBRH),Cancer Center Sawangi Meghe for the study as per inclusion and exclusion criteria.With intervention,the period of the study was 11 months.A signed consent form was taken from each participant and based on the answers before,during,and after the trial the data were analyzed using IBM SPSS v29.Results:The investigator believes that the Buerger-Allen exercise and Epsom salt foot bath will improve the symptoms in the symptomatic group of breast cancer patients and will prevent or delay the occurrence of peripheral neuropathy symptoms among the asymptomatic group as well as improve the overall quality of life(QoL).However,during the trial,if any of the study participants developed any side effects,they would be identified early and prompt treatment would be initiated.Conclusions:This study protocol aims to evaluate and compare the non-pharmacological treatment options for chemotherapy-induced peripheral neuropathy(CIPN)and to develop a new treatment option that will pave the way to lead a new non-pharmacological cost-effective treatment option for breast cancer patients which also could improve the QoL.展开更多
Gastrointestinal tract toxicity represents a serious adverse effect of chemotherapy,leading to reduced quality of life and survival.For instance,irinotecan(CPT-11)usually causes severe gastrointestinal toxicity,with a...Gastrointestinal tract toxicity represents a serious adverse effect of chemotherapy,leading to reduced quality of life and survival.For instance,irinotecan(CPT-11)usually causes severe gastrointestinal toxicity,with a lack of effective therapeutic interventions,making treatment often unsustainable.Therefore,development of an effective and safe therapy is crucial for improving chemotherapy efficacy and the patients’quality of life.In this work,we developed a novel approach involving the helical-shaped cyanobacterium microalgae,Spirulina platensis(SP),to carry the bornyl acetate(BA)-loaded chitosan nanoparticles to enhance drug retention in the small intestine.We demonstrated the protection effect of BA against chemotherapy-induced intestinal injury using an epithelial cell model.In a mouse model,orally administered BA-ChNPs@SP accumulated in the small intestine and attenuated inflammation by reducing dsDNA release and oxidative stress.This was concomitant with the restoration of the intestinal barrier and modulation of the immune microenvironment.This work suggests the promise of the microalgae-carrying nanomedicine strategy for treatment of intestinal diseases,emphasizing its potential in addressing chemotherapy-induced gastrointestinal complications.展开更多
BACKGROUND Colorectal cancer is a common digestive malignancy,and chemotherapy remains a cornerstone of treatment.Myelosuppression,a frequent hematologic toxicity,poses significant clinical challenges.However,no inter...BACKGROUND Colorectal cancer is a common digestive malignancy,and chemotherapy remains a cornerstone of treatment.Myelosuppression,a frequent hematologic toxicity,poses significant clinical challenges.However,no interpretable machine learning-based nomogram exists to predict chemotherapy-induced myelosuppression in colorectal cancer patients.This study aimed to develop and validate an inter-pretable clinic-machine learning nomogram integrating clinical predictors with multiple algorithms via a feature mapping algorithm.The model provides accurate risk estimation and clinical interpretability,supporting individualized prevention strategies and optimizing decision-making in patients receiving first-line chemotherapy.AIM To develop and validate an interpretable clinic-machine learning nomogram predicting chemotherapy-induced myelosuppression in colorectal cancer.METHODS This retrospective study enrolled 855 colorectal cancer patients receiving first-line chemotherapy.Data were split into training(n=612),validation(n=153),and testing(n=90)cohorts.Ten predictors were identified through least absolute shrinkage and selection operator,decision tree,random forest,and expert con-sensus.Ten machine learning algorithms were applied,with performance assessed by area under the receiver operating characteristic curve(AUC),area under the precision-recall curve(AUPRC),calibration,and decision curves.The optimal model was integrated into a clinic-machine learning nomogram via the feature mapping algorithm,which was internally validated for predictive accuracy and clinical utility.(AUPRC),calibration,and decision curves.The optimal model was integrated into a clinic-machine learning nomogram via the feature mapping algorithm,which was internally validated for predictive accuracy and clinical utility.RESULTS A total of 855 colorectal cancer patients were enrolled,with 765 cases(April 2020 to December 2023)used for model training and validation,and 90 cases(January 2024 to July 2024)for internal testing.Baseline clinical features did not differ significantly between training and validation cohorts(P>0.05).Ten predictors were identified through integrated feature selection and expert consensus,including age,body surface area,body mass index,tumor position,albumin,carcinoembryonic antigen,carbohydrate antigen(CA)19-9,CA125,chemotherapy regimen,and chemotherapy cycles.Among ten machine learning algorithms,extreme gradient boosting achieved the best validation performance(AUC=0.97,AUPRC=0.92,sensitivity=0.79,specificity=0.92,accuracy=0.88).Logistic regression confirmed extra trees and random forest as independent predictors,which were incorporated into a clinic-machine learning nomogram.The clinic-machine learning nomogram demonstrated superior discrimination(AUC=0.96,AUPRC=0.93,accuracy=0.90,specificity=0.95),good calibration,and greater net clinical benefit across a wide probability range(10%-90%).Internal testing further confirmed its robustness and generalizability(AUC=0.95).CONCLUSION The clinic-machine learning nomogram accurately predicts chemotherapy-induced myelosuppression in colorectal cancer,providing interpretability and clinical utility to support individualized risk assessment and treatment decision-making.展开更多
Objectives:Chemotherapy-induced nausea and vomiting(CINV)is a common adverse effect among breast cancer patients,significantly affecting quality of life.Existing evidence on the prevention,assessment,and management of...Objectives:Chemotherapy-induced nausea and vomiting(CINV)is a common adverse effect among breast cancer patients,significantly affecting quality of life.Existing evidence on the prevention,assessment,and management of this condition is fragmented and inconsistent.This study constructed a CINV knowledge graph using a large language model(LLM)to integrate nursing and medical evidence,thereby supporting systematic clinical decision-making.Methods:A top-down approach was adopted.1)Knowledge base preparation:Nine databases and eight guideline repositories were searched up to October 2024 to include guidelines,evidence summaries,expert consensuses,and systematic reviews screened by two researchers.2)Schema design:Referring to the Unified Medical Language System,Systematized Nomenclature of Medicine-Clinical Terms,and the Nursing Intervention Classification,entity and relation types were defined to build the ontology schema.3)LLM-based extraction and integration:Using the Qwen model under the CRISPE framework,named entity recognition,relation extraction,disambiguation,and fusion were conducted to generate triples and visualize them in Neo4j.Four expert rounds ensured semantic and logical consistency.Model performance was evaluated using precision,recall,F1-score,and 95%confidence interval(95%CI)in Python 3.11.Result:A total of 47 studies were included(18 guidelines,two expert consensuses,two evidence summaries,and 25 systematic reviews).The Qwen model extracted 273 entities and 289 relations;after expert validation,238 entities and 242 relations were retained,forming 244 triples.The ontology comprised nine entity types and eight relation types.The F1-scores for named entity recognition and relation extraction were 82.97(95%CI:0.820,0.839)and 85.54(95%CI:0.844,0.867),respectively.The average node degree was 2.03,with no isolated nodes.Conclusion:The LLM-based CINV knowledge graph achieved structured integration of nursing and medical evidence,offering a novel,data-driven tool to support clinical nursing decision-making and advance intelligent healthcare.展开更多
Chemotherapy-induced toxicity(CIT)remains a major concern in cancer patients undergoing chemotherapy.New approaches to ameliorate the side effects of chemotherapy are urgently needed.Recently,the nutritional value of ...Chemotherapy-induced toxicity(CIT)remains a major concern in cancer patients undergoing chemotherapy.New approaches to ameliorate the side effects of chemotherapy are urgently needed.Recently,the nutritional value of citrus fruits has attracted wide attention.Hesperidin and its aglycone hesperetin are the main active components in citrus fruits.Hesperidin and hesperetin have a wide range of pharmacological activities,including antioxidant and anti-inflammatory properties.This review aims to provide insights into the potential application of citrus flavonoids in CIT and summarize the underlying mechanisms of hesperidin and hesperetin in alleviating CIT.We have collected and collated relevant scientific articles on hesperidin and hesperetin and their treatment of CIT from different scientific databases.Hesperidin and its glycosides can reduce the toxicity of chemotherapeutic drugs,and their therapeutic effects are mainly through anti-inflammatory and antioxidant effects.At present,modern medical treatment is the main treatment method for CIT,but hesperidin,as an extract of food and medicinal materials,can greatly alleviate CIT.While killing tumor cells,chemotherapeutic drugs also damage normal cells leading to toxic effect on various organs.The pathological mechanism of CIT has not been fully elucidated,but current evidences indicate that cellular stress plays a key role.The citrus flavonoids hesperidin and hesperetin have the protective effect against CIT,highlighting its potential as an adjuvant in chemotherapy regimens.Hesperidin may also have synergistic anti-tumor activity with chemotherapeutic agents.We believe that more functional foods and anti-CIT drugs based on natural foods will be developed.展开更多
Background Chemotherapy-induced peripheral neuropathy(CIPN)is a common neurotoxic reaction for patients undergoing anticancer regimens.More and more studies show that acupuncture-moxibustion plays a positive role in t...Background Chemotherapy-induced peripheral neuropathy(CIPN)is a common neurotoxic reaction for patients undergoing anticancer regimens.More and more studies show that acupuncture-moxibustion plays a positive role in the management and prevention of CIPN.Objective To evaluate the clinical effect of acupuncture-moxibustion in patients with CIPN,with a focus on assessing its effectiveness on improving treatment response rates,alleviating pain,enhancing quality of life(QoL),and improving nerve conduction.Additionally,the study compares the differences in clinical effectiveness among various acupuncture therapies for CIPN management.Methods Six databases(PubMed,Embase,Cochrane Library,Web of Science,OVID,and China National knowledge infrastructure[CNKI])were searched from earliest available dates to December 1,2024,and only randomized controlled trials(RCTs)containing relevant search terms were included.Network meta-analysis of the RCT data were conducted to assess the effective rate of the treatment as the primary outcome.Nerve conduction,pain scores,and QoL were assessed as secondary outcomes.The version 2 of the Cochrane risk-of-bias tool for randomized trials(RoB 2)was used to examine methodological quality,and Stata 15.1 was used to take network meta-analysis.Results A total of 34 RCTs involving 2039 participants and 9 acupuncture-moxibustion therapies were included.The network meta-analysis evaluated the effect of different acupuncture therapies across four outcomes:effective rate,pain scores,QoL,and nerve conduction.For effective rate,electroacupuncture combined with moxibustion ranked first with a surface under the cumulative ranking curve(SUCRA)value of 62.9%,followed by acupoint application(56.9%)and moxibustion(52.3%).Electroacupuncture combined with moxibustion had the highest effective rate compared to standard of care treatments(odds ratio[OR]=1.62,95%confidence interval[CI]−5.18 to 8.43).For alleviating pain,auricular acupressure had the highest SUCRA value(85.9%),while electroacupuncture and electroacupuncture combined with three-edged needle ranked second(63.4%)and third(51.0%),respectively.Auricular acupressure significantly reduced pain(SMD=−1.73,95%CI−3.54 to 0.08).For QoL,warming needle ranked first(SUCRA=92.0%),followed by electroacupuncture(48.7%)and filiform needle(43.0%).Warming needle significantly improved QoL scores(SMD=−0.75,95%CI−1.66 to 0.15).For nerve conduction,electroacupuncture combined with three-edged needle had the highest SUCRA value(100%),while moxibustion and filiform needle ranked second(65.3%)and third(39.2%),respectively.Electroacupuncture combined with three-edged had the best neuroprotective effect(SMD=1.85,95%CI 1.23 to 2.47).Conclusion Network meta-analysis based on the primary outcome(effective rate)suggests that electroacupuncture combined with moxibustion seems to be the optimal acupuncture therapy for chemotherapy-induced peripheral neuropathy(CIPN).Secondary outcomes exhibited considerable heterogeneity:auricular acupressure demonstrated superior efficacy in pain relief,electroacupuncture combined with three-edged needle showed greater advantages in improving nerve conduction function,while warm needling was associated with more significant improvements in QoL.Given the variability in interventions across different outcome measures and the methodological limitations of included studies,the current evidence requires cautious interpretation.Systematic review registration:Registration number in PROSPERO:CRD42024560017.展开更多
Objective To preliminarily investigate the rules of acupoint selection of acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting by retrospecting pertinent literature from 1986 to 20...Objective To preliminarily investigate the rules of acupoint selection of acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting by retrospecting pertinent literature from 1986 to 2013. Methods Literature of clinical studies on acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting published from 1986 to 2013 in CNKI, Wanfang and VlP databases and in PubMed database were retrieved. Data were analyzed statistically via Excel. Results One hundred and nineteen articles retrieved were related to the study. Based on the current literature analysis, meridians selected for acupuncture and moxibustion on chemotherapy-induced nausea and vomiting were mainly the stomach meridian, the pericardium meridian, the conception vessel, the spleen meridian and bladder meridian; point combination was applied more in prescription, accounting for 73.11%, while single point was applied less, only accounting for 26.89%. There were numerous methods for point combinations, but proximal and distal point combination was the most widely used method, accounting for 20.93%. Meanwhile, main acupoints selected were mostly Zusanli （足三里 ST 36）, Neiguan （内关 PC 6）, Zhongwan （中脘CV12）, Gongsun （公孙SP 4） and Taichong （太冲 LR 3） and point combinations were mainly Shenmen （神门 HT 7）, Geshu （膈俞 BL 17）, PishB （脾俞 BL 20）, Weishu （胃俞 BL 21） and Jianli （建里 CV 11）. Conclusion Acupoints selection on acupuncture and moxibustion for chemotherapy-induced nausea and vomiting shows a certain rules that the meridians selected are mainly stomach meridian, pericardium meridian and conception vessel and acupuncture points selected are normally ST 36, PC 6 and CV 12, proximal and distal point combination is applied more, while single point applied less.展开更多
Objective To observe the clinical efficacy of acupoint injection for chemotherapy-induced peripheral neuropathy （ClPN）. Methods Ninety ClPN patients with breast cancer conforming to inclusive criteria were randomly ...Objective To observe the clinical efficacy of acupoint injection for chemotherapy-induced peripheral neuropathy （ClPN）. Methods Ninety ClPN patients with breast cancer conforming to inclusive criteria were randomly divided into an acupuncture group （group A）, a mecobalamin group （group B） and an acupoint injection group （group C） according to random number table, with 30 cases in each group. In group A, acupuncture was conducted at bilateral Q0chi （I~ LI 11）, H6g6 （~ LI 4）, Z0s^nlT （~__~ ST 36）, S^nyinji^o （^-- ~ SP 6） and Xu^h~i （J~ SP 10）; in group B, intramuscular injection with I mL of mecobalamin injection was conducted; and in group C, acupoint selection was the same as group A, and 0.1 mL of mecobalamin injection was injected into each acupoint, respectively. The treatment was conducted once every three days in each group, and the changes of clinical efficacy, nerve electrophysiology and hemorrheology indicators after treatment for 10 times were observed. Result The total effective rate of group C was 93.1% （27/29）, which was higher than 78.6% （22/28） in group A and 83.3% （25/30） in group B, and the differences among three groups were statistically significant （all P〈0.01）; conduction velocity of lesion nerves was improved in group B and group C, the improvement in group C was obviously superior to the other two groups （all P〈0.01）, hemorrheology indicator was improved in group A and group C （both P〈0.05）. Conclusion The efficacy of acupoint injection with mecobalamin for breast cancer CIPN was significant, which can not only improve the nerve conduction velocity, but also improve the hemorrheology indicator.展开更多
Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current...Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.展开更多
Chemotherapy-induced neutropenia(CIN)is a potentially fatal and common complication in myelosuppressive chemotherapy.The timing and grade of CIN may play prognostic and predictive roles in cancer therapy.CIN is associ...Chemotherapy-induced neutropenia(CIN)is a potentially fatal and common complication in myelosuppressive chemotherapy.The timing and grade of CIN may play prognostic and predictive roles in cancer therapy.CIN is associated with older age,poor functional and nutritional status,the presence of significant comorbidities,the type of cancer,previous chemotherapy cycles,the stage of the disease,specific chemotherapy regimens,and combined therapies.There are many key points and new challenges in the management of CIN in adults including:(1)Genetic risk factors to evaluate the patient’s risk for CIN remain unclear.However,these risk factors urgently need to be identified.(2)Febrile neutropenia(FN)remains one of the most common reasons for oncological emergency.No consensus nomogram for FN risk assessment has been established.(3)Different assessment tools[e.g.,Multinational Association for Supportive Care in Cancer(MASCC),the Clinical Index of Stable Febrile Neutropenia(CISNE)score model,and other tools]have been suggested to help stratify the risk of complications in patients with FN.However,current tools have limitations.The CISNE score model is useful to support decision-making,especially for patients with stable FN.(4)There are still some challenges,including the benefits of granulocyte colony stimulating factor treatment and the optimal antibiotic regimen in emergency management of FN.In view of the current reports,our group discusses the key points,new challenges,and management of CIN.展开更多
Objective:To analyze the acupoint selection rules in acupuncture treatment for chemotherapy-induced nausea and vomiting(CINV)in China through data mining technology.Methods:The relevant literature on acupuncture treat...Objective:To analyze the acupoint selection rules in acupuncture treatment for chemotherapy-induced nausea and vomiting(CINV)in China through data mining technology.Methods:The relevant literature on acupuncture treatment for CINV were searched from SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang,VIP and Pubmed databases from the establishment to January 3,2021 and the worksheet was set up for the information extraction of acupuncture-moxibustion prescriptions.Using IBM SPSS Statistics 25.0 and SPSS Modeler 18.0 software,cluster analysis and association rule analysis were conducted to explore the rules of acupoint selection.Results:A total of 179 articles were eligible,including 206 acupuncture prescriptions and 64 acupoints.The total use frequency of acupoints was 784 times.The acupoints with the highest use frequency were Zúsānlǐ(足三里ST36),Zhōngwǎn(中脘CV12)and Nèiguān(内关PC6).The commonly used meridians included stomach meridian of foot-yangming,conception vessel,pericardium meridian of hand-jueyin and bladder meridian of foot-taiyang.The acupoints located on the chest,the abdomen and the lower limbs were mostly selected.Five-shu points and crossing points were highly involved in terms of the specific points.The most common combination was ST36,CV12 and PC6.Conclusion:In treatment of acupuncture for CINV,the acupoints were generally selected from stomach meridian of foot-yangming,conception vessel,pericardium meridian of hand-jueyin.Front-mu points on the chest and the abdomen,the he-sea points and lower he-sea points in the lower limbs are commonly used.The core acupoint prescription of acupuncture for CINV included ST36,CV12 and PC6.展开更多
BACKGROUND Chemotherapy-induced peripheral neuropathy(CIPN)is a severe and longlasting side effect caused by various anticancer agents that damage sensory,motor and autonomic nerves.It can cause maladaptive behaviors,...BACKGROUND Chemotherapy-induced peripheral neuropathy(CIPN)is a severe and longlasting side effect caused by various anticancer agents that damage sensory,motor and autonomic nerves.It can cause maladaptive behaviors,including disease severity,anxiety,depression,sleep disorders,falls,and social impairment.These disorders have physical,psychological and social effects on patients and can seriously influence their quality of life.AIM To investigate the current situation of psychosocial adaptation to the disease and its influencing factor in patients with CIPN.METHODS A convenience sampling method was used to select 233 patients with CIPN in our hospital from February to August 2021.In addition,a cross-sectional survey was conducted using a sociodemographic questionnaire,the Self-Report Psychosocial Adjustment to Illness Scale,and the European Organisation for the Research and Treatment of Cancer Quality of Life CIPN20(QLQ-CIPN20).Factors influencing psychosocial adaptation in patients with CIPN were analyzed by t-test or one-way analysis of variance,correlation analysis,multiple stepwise regression analysis,and structural equation models.RESULTS The psychosocial adaptation score of patients with CIPN was 52.51±13.18.Multivariate analysis showed that autonomic nerves,tumor stage,motor nerves,education level,availability of caregivers,semi-retirement status,CIPN grade were independent risk factors for patients with CIPN(P<0.05).Structural equation models showed that QLQ-CIPN20 mediated the relationship between CIPN grade,tumor stage,and psychosocial adaptation.CONCLUSION Patients with CIPN have poor psychosocial adaptation and are affected by a variety of physiological,psychological,and social factors.Patients’adaptive responses should be assessed,and targeted interventions implemented.展开更多
Chemotherapy-induced diarrhoea (CID) is a common side-effect experienced by patients being treated with a variety of antineoplastic agents. Approximately 80% of patients undergoing chemotherapeutic treatment for color...Chemotherapy-induced diarrhoea (CID) is a common side-effect experienced by patients being treated with a variety of antineoplastic agents. Approximately 80% of patients undergoing chemotherapeutic treatment for colorectal and other gastrointestinal cancers present with CID;moreover, about 5% of early deaths associated with combination anti-cancer chemotherapy are due to CID. Chronic post-treatment diarrhoea amongst cancer survivors can persist for more than 10 years greatly effecting long-term quality of life. Gastrointestinal toxicities such as diarrhoea and vomiting are amongst the primary contributors to dose reductions and delays throughout anti-cancer treatment, presenting a significant hurdle in clinical management of anti-cancer regimes and often result in sub-optimum treatment. However, little is known about pathophysiological mechanisms underlying CID. This work provides a review of chemotherapy-induced diarrhoea, current management guidelines, and shortcomings of current treatments as well as emerging and already existing anti-diarrhoeal treatments potentially suitable for CID.展开更多
Chemotherapy-induced peripheral neuropathy is a very frequent neurological complication in cancer. Oxaliplatin（OXA） is a platinum analogue used as a first-line agent in the treatment of colorectal cancer. OXA induce...Chemotherapy-induced peripheral neuropathy is a very frequent neurological complication in cancer. Oxaliplatin（OXA） is a platinum analogue used as a first-line agent in the treatment of colorectal cancer. OXA induced peripheral neuropathy（OIN） is the main toxicity both during and after the completion of chemotherapy that presents as two distinct syndromes： acute and chronic neuropathy. None of the neuroprotective agents previously tested had prevented or limited the acute and/or chronic OIN. MR309（previously developed as E-52862） is a novel selective sigma-1 receptor（S1R） antagonist with preclinical analgesic activity in OXA-induced neuropathic pain in animal models. This review analyzes the results of the recently published phase Ⅱ, randomized, double-blind, placebo-controlled clinical trial including 124 patients with colorectal cancer（CRC） treated with MR309. This study shows encouraging findings in the setting of neuroprotection against OIN with an acceptable safety profile. The study demonstrated MR309 usefulness in decreasing acute OIN, by reducing cold hypersensitivity experienced by patients, and pointed to the amelioration of chronic OIN by lowering the proportion of patients who developed severe chronic OIN. In addition, we provide a summary and discussion on the pathways that can be modulated by the S1R to explain the observed clinical benefits in the OIN.展开更多
OBJECTIVE:To evaluate the effect of electroacupuncture on chemotherapy-induced peripheral neuropathy(CIPN), quality of life and immune status of patients with malignant tumors.METHODS:From Jan, 2013 to May, 2014, 37 p...OBJECTIVE:To evaluate the effect of electroacupuncture on chemotherapy-induced peripheral neuropathy(CIPN), quality of life and immune status of patients with malignant tumors.METHODS:From Jan, 2013 to May, 2014, 37 patients with malignant tumors were included in this prospective single-blinded study, and randomized to receive either electroacupuncture or acupuncture treatment on basis of chemotherapy.The chemotherapy was continued for 2 courses as previous before the treatments, with 21 days as a course of treatment.Patients received acupuncture and electroacupuncture once per day starting at the day before chemotherapy for consecutive 7 days followed by 14 days off, with 21 days as a course of treatment, and continued for two courses of treatment.Then CIPN, traditional Chinese clinical symptoms,quality of life and immune status were all evaluated for each patient prior treatment and after two courses of treatment.RESULTS:The gender, age, cancer species as well as incidence(83.3% vs 84.2%) and grades of CIPN before treatments were all similar in patients receiving acupuncture or electroacupuncture(all P >0.05).After treatments, most patients with peripheral neuropathy were cured by two courses of electroacupuncture(84.2% vs 21.1%), whereas the other group of patients had similar incidences of peripheral neuropathy compared with prior-acupuncture(83.3% vs 72.2%).Besides, patients receiving electroacupuncture had lower incidence of peripheral neuropathy than those receiving acupuncture treatment(χ~2= 9.745, P = 0.002).The grades of peripheral neuropathy were significantly different in the two groups post-treatment(χ~2= 13.983, P =0.007).The total effective rates for traditional Chinese clinical symptoms were 16.7% and 84.2% in acupuncture and electroacupuncture groups, respectively(Z =-4.239, P < 0.001).The electroacupuncture treatment provided a more satisfactory life for patients compared with acupuncture(Z =-4.76, P < 0.001).Both electroacupuncture and acupuncture had no effects on immune function.CONCLUSION:Electroacupuncture could alleviate CIPN, and improve traditional Chinese clinical symptoms and quality of life, but did not affect immune function.展开更多
Chemotherapy-induced peripheral neuropathy(CIPN)is a common side effect that occurs in 20%of ovarian cancer patients treated with the combination of carboplatin/paclitaxel(CP).This toxicity is directly correlated with...Chemotherapy-induced peripheral neuropathy(CIPN)is a common side effect that occurs in 20%of ovarian cancer patients treated with the combination of carboplatin/paclitaxel(CP).This toxicity is directly correlated with the dose of paclitaxel administered.Several studies have investigated whether different formulations of taxane can induce this side effect at a lower rate,but,unfortunately,no significant improvement was obtained.CIPN can be disabling in the daily lives of patients and can cause dose reduction or early termination of the treatment.Neuropathy can last for months and even years after its onset.Moreover,patients responsive to CP treatment are candidates for a reintroduction of the same drugs when disease relapse occurs,and residual neuropathy can affect the continuation of treatment.There are no approved drugs that mitigate or prevent the onset of CIPN.In this review,we summarize the evidence regarding the incidence of CIPN with different taxane formulations,regimen schedules and prevention systems.In particular,the Hilotherm®Chemo care device is a regional cooling system that lowers the temperature of the hands and feet to reduce the flow of chemotherapy into the capillaries.We used hilotherapy during chemotherapy infusion to prevent the onset of CIPN.Updated data from 44 ovarian cancer patients treated with 6 cycle of CP show that hilotherapy was well tolerated;only two patients(4.5%)stopped hilotherapy because of cold intolerance,and only one patient(2.2%)experienced grade≥2 CIPN.展开更多
OBJECTIVE:Chemotherapeutic agents such as docetaxel(DTX)can trigger chemotherapy-induced peripheral neuropathy(CIPN),which is characterized by unbearable pain.This study was designed to investigate the analgesic effec...OBJECTIVE:Chemotherapeutic agents such as docetaxel(DTX)can trigger chemotherapy-induced peripheral neuropathy(CIPN),which is characterized by unbearable pain.This study was designed to investigate the analgesic effect and related neuronal mechanism of low-frequency median nerve stimulation(LFMNS)on DTX-induced tactile hypersensitivity in mice.METHODS:To produce CIPN,DTX was administered intraperitoneally 4 times,once every 2 d,to male ICR mice.LFMNS was performed on the wrist area,and the pain response was measured using von Frey filaments on both hind paws.Western blot and immunofluorescence staining were performed using dorsal root ganglion and spinal cord samples to measure the expression of brainderived neurotrophic factor(BDNF).RESULTS:Repeated LFMNS significantly attenuated the DTX-induced abnormal sensory response and suppressed the enhanced expression of BDNF in the DRG neurons and spinal dorsal area.CONCLUSIONS:LFMNS might be an effective nonpharmaceutical option for treating patients suffering from CIPN via regulating the expression of peripheral and central BDNF.展开更多
基金supported by the Innovative Team Project of Ordinary Universities in Guangdong Province(No.2022KCXTD016).
文摘Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.
基金Noncommunicable Chronic Diseases-National Science and Technology Major Project,Grant/Award Numbers:2024ZD0521400,2024ZD0521404Affiliated Hospital of Qinghai University。
文摘Introduction:Chemotherapy-induced gastrointestinal symptom clusters in breast cancer impair quality of life and treatment adherence,yet lack effective interventions.While acupuncture mitigates isolated chemotherapy-induced symptoms,its mechanisms for multi-symptom clusters remain unclear.This study evaluates electroacupuncture's efficacy and explores its biological mechanisms in managing these clusters.Methods:This prospective,multicenter,block-randomized,double-blind,sham-controlled trial will enroll 388 patients with breast cancer undergoing neoadjuvant/adjuvant chemotherapy,to be randomly assigned(1:1)to electroacupuncture or sham electro-acupuncture groups.Both groups will receive the standard quadruple antiemetic regimen combined with electroacupuncture or sham intervention.The primary endpoint is the incidence of chemotherapy-induced gastrointestinal symptom clusters within 120 h after chemotherapy.Secondary endpoints include improvement in gastrointestinal symptom clusters post-first chemotherapy cycle,nausea-free rates during acute and delayed phases,vomiting-free rates during overall,acute,and delayed phases,complete response rate,complete protection rate,and quality of life.Adverse events will be documented throughout the study.Discussion:This study will assess the efficacy and safety of electroacupuncture in alleviating chemotherapy-induced gastro-intestinal symptom clusters in patients with breast cancer.By integrating multi-omics analyses,we aim to elucidate the biological mechanisms underlying its therapeutic effects.The findings may offer a robust clinical foundation for optimizing symptom cluster management in cancer care.Trial Registration:Clinical Trials ID:NCT06952920.Date of registration:April 16,2025.Prospectively registered.URL of Trial Registry Record:https://clinicaltrials.gov/study/NCT06952920cond=NCT06952920&rank=1.
文摘BACKGROUND Chemotherapy-induced cardiotoxicity is a significant complication in cancer therapy,limiting treatment efficacy and worsening patient outcomes.Recent studies have implicated the gut microbiome and its key metabolites,such as shortchain fatty acids(SCFAs)and trimethylamine-N-oxide(TMAO),in mediating inflammation,oxidative stress,and cardiac damage.The gut-heart axis is increasingly recognized as a pivotal pathway linking microbiota dysregulation to chemotherapy-related cardiac dysfunction.AIM To systematically review existing evidence on the role of gut microbiome alterations in chemotherapy-induced cardiotoxicity and evaluate emerging microbiome-based therapeutic strategies aimed at mitigating cardiovascular risk in cancer patients.METHODS A systematic literature search was conducted in PubMed,Scopus,and Web of Science for studies published between January 2013 and December 2024.Studies were included if they examined chemotherapy-induced cardiotoxicity in relation to gut microbiota composition,microbial metabolites(e.g.,SCFAs,TMAO),or microbiome-targeted interventions.Selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data extraction focused on microbiota alterations,mechanistic pathways,cardiac outcomes,and quality assessments using standardized risk-of-bias tools.RESULTS Eighteen studies met the inclusion criteria.Chemotherapy was consistently associated with gut dysbiosis characterized by reduced SCFA-producing bacteria and increased TMAO-producing strains.This imbalance contributed to gut barrier disruption,systemic inflammation,and oxidative stress,all of which promote myocardial damage.SCFA depletion weakened anti-inflammatory responses,while elevated TMAO levels exacerbated cardiac fibrosis and dysfunction.Preclinical studies showed promising cardioprotective effects from probiotics,prebiotics,dietary interventions,and fecal microbiota transplantation,though human data remain limited.CONCLUSION Gut microbiome dysregulation plays a crucial role in the development of chemotherapy-induced cardiotoxicity.Altered microbial composition and metabolite production trigger systemic inflammation and cardiac injury.Microbiome-targeted therapies represent a promising preventive and therapeutic approach in cardio-oncology,warranting further clinical validation through well-designed trials.
基金supported by study protocol(No.DMIHER(DU)IEC/2023/22).
文摘Objective:Breast cancer in India is growing at an alarming rate,and the fact that it is currently being detected more frequently in the younger age groups is even more concerning.In India,a woman dies of breast cancer every 8 min,which is a terrible situation.Breast cancer claims one life for every two women who are diagnosed with it.However,the morbidity level is gradually increasing due to advanced medical treatment,but we need to be aware and alert.Methods:The research has been structured as a randomized controlled trial.A total of 180 breast cancer patients were taken from Acharya Vinoba Bhave Rural Hospital(AVBRH),Cancer Center Sawangi Meghe for the study as per inclusion and exclusion criteria.With intervention,the period of the study was 11 months.A signed consent form was taken from each participant and based on the answers before,during,and after the trial the data were analyzed using IBM SPSS v29.Results:The investigator believes that the Buerger-Allen exercise and Epsom salt foot bath will improve the symptoms in the symptomatic group of breast cancer patients and will prevent or delay the occurrence of peripheral neuropathy symptoms among the asymptomatic group as well as improve the overall quality of life(QoL).However,during the trial,if any of the study participants developed any side effects,they would be identified early and prompt treatment would be initiated.Conclusions:This study protocol aims to evaluate and compare the non-pharmacological treatment options for chemotherapy-induced peripheral neuropathy(CIPN)and to develop a new treatment option that will pave the way to lead a new non-pharmacological cost-effective treatment option for breast cancer patients which also could improve the QoL.
基金the National Key Research and Development Program of China(2022YFE0203600,China)NFSC(81925035,82341232)+2 种基金Program of Shanghai Committee of Science and Technology(21ZR1475200,China)Department of Science and Technology of Guangdong Province(High-Level R&D and Innovative Research Institute 2021B0909050003)SciTech Projects of Zhongshan(CXTD2022011,LJ2021001).
文摘Gastrointestinal tract toxicity represents a serious adverse effect of chemotherapy,leading to reduced quality of life and survival.For instance,irinotecan(CPT-11)usually causes severe gastrointestinal toxicity,with a lack of effective therapeutic interventions,making treatment often unsustainable.Therefore,development of an effective and safe therapy is crucial for improving chemotherapy efficacy and the patients’quality of life.In this work,we developed a novel approach involving the helical-shaped cyanobacterium microalgae,Spirulina platensis(SP),to carry the bornyl acetate(BA)-loaded chitosan nanoparticles to enhance drug retention in the small intestine.We demonstrated the protection effect of BA against chemotherapy-induced intestinal injury using an epithelial cell model.In a mouse model,orally administered BA-ChNPs@SP accumulated in the small intestine and attenuated inflammation by reducing dsDNA release and oxidative stress.This was concomitant with the restoration of the intestinal barrier and modulation of the immune microenvironment.This work suggests the promise of the microalgae-carrying nanomedicine strategy for treatment of intestinal diseases,emphasizing its potential in addressing chemotherapy-induced gastrointestinal complications.
基金Supported by the Beijing Municipal Natural Science Foundation,No.7252262High Level Chinese Medical Hospital Promotion Project,No.HLCMHPP2023085+2 种基金National Natural Science Foundation of China,No.82174463National Administration of Traditional Chinese Medicine,No.ZYYCXTD-C-C202205China Academy of Chinese Medical Sciences,No.CI2021A01804 and No.2022S469.
文摘BACKGROUND Colorectal cancer is a common digestive malignancy,and chemotherapy remains a cornerstone of treatment.Myelosuppression,a frequent hematologic toxicity,poses significant clinical challenges.However,no interpretable machine learning-based nomogram exists to predict chemotherapy-induced myelosuppression in colorectal cancer patients.This study aimed to develop and validate an inter-pretable clinic-machine learning nomogram integrating clinical predictors with multiple algorithms via a feature mapping algorithm.The model provides accurate risk estimation and clinical interpretability,supporting individualized prevention strategies and optimizing decision-making in patients receiving first-line chemotherapy.AIM To develop and validate an interpretable clinic-machine learning nomogram predicting chemotherapy-induced myelosuppression in colorectal cancer.METHODS This retrospective study enrolled 855 colorectal cancer patients receiving first-line chemotherapy.Data were split into training(n=612),validation(n=153),and testing(n=90)cohorts.Ten predictors were identified through least absolute shrinkage and selection operator,decision tree,random forest,and expert con-sensus.Ten machine learning algorithms were applied,with performance assessed by area under the receiver operating characteristic curve(AUC),area under the precision-recall curve(AUPRC),calibration,and decision curves.The optimal model was integrated into a clinic-machine learning nomogram via the feature mapping algorithm,which was internally validated for predictive accuracy and clinical utility.(AUPRC),calibration,and decision curves.The optimal model was integrated into a clinic-machine learning nomogram via the feature mapping algorithm,which was internally validated for predictive accuracy and clinical utility.RESULTS A total of 855 colorectal cancer patients were enrolled,with 765 cases(April 2020 to December 2023)used for model training and validation,and 90 cases(January 2024 to July 2024)for internal testing.Baseline clinical features did not differ significantly between training and validation cohorts(P>0.05).Ten predictors were identified through integrated feature selection and expert consensus,including age,body surface area,body mass index,tumor position,albumin,carcinoembryonic antigen,carbohydrate antigen(CA)19-9,CA125,chemotherapy regimen,and chemotherapy cycles.Among ten machine learning algorithms,extreme gradient boosting achieved the best validation performance(AUC=0.97,AUPRC=0.92,sensitivity=0.79,specificity=0.92,accuracy=0.88).Logistic regression confirmed extra trees and random forest as independent predictors,which were incorporated into a clinic-machine learning nomogram.The clinic-machine learning nomogram demonstrated superior discrimination(AUC=0.96,AUPRC=0.93,accuracy=0.90,specificity=0.95),good calibration,and greater net clinical benefit across a wide probability range(10%-90%).Internal testing further confirmed its robustness and generalizability(AUC=0.95).CONCLUSION The clinic-machine learning nomogram accurately predicts chemotherapy-induced myelosuppression in colorectal cancer,providing interpretability and clinical utility to support individualized risk assessment and treatment decision-making.
基金supported by Education and Research Project of Fujian Province Young and Middle-aged Teachers(JAT241035)High-level Talent Project of Fujian Medical University(XRCZX2024036)。
文摘Objectives:Chemotherapy-induced nausea and vomiting(CINV)is a common adverse effect among breast cancer patients,significantly affecting quality of life.Existing evidence on the prevention,assessment,and management of this condition is fragmented and inconsistent.This study constructed a CINV knowledge graph using a large language model(LLM)to integrate nursing and medical evidence,thereby supporting systematic clinical decision-making.Methods:A top-down approach was adopted.1)Knowledge base preparation:Nine databases and eight guideline repositories were searched up to October 2024 to include guidelines,evidence summaries,expert consensuses,and systematic reviews screened by two researchers.2)Schema design:Referring to the Unified Medical Language System,Systematized Nomenclature of Medicine-Clinical Terms,and the Nursing Intervention Classification,entity and relation types were defined to build the ontology schema.3)LLM-based extraction and integration:Using the Qwen model under the CRISPE framework,named entity recognition,relation extraction,disambiguation,and fusion were conducted to generate triples and visualize them in Neo4j.Four expert rounds ensured semantic and logical consistency.Model performance was evaluated using precision,recall,F1-score,and 95%confidence interval(95%CI)in Python 3.11.Result:A total of 47 studies were included(18 guidelines,two expert consensuses,two evidence summaries,and 25 systematic reviews).The Qwen model extracted 273 entities and 289 relations;after expert validation,238 entities and 242 relations were retained,forming 244 triples.The ontology comprised nine entity types and eight relation types.The F1-scores for named entity recognition and relation extraction were 82.97(95%CI:0.820,0.839)and 85.54(95%CI:0.844,0.867),respectively.The average node degree was 2.03,with no isolated nodes.Conclusion:The LLM-based CINV knowledge graph achieved structured integration of nursing and medical evidence,offering a novel,data-driven tool to support clinical nursing decision-making and advance intelligent healthcare.
基金Innovative Team Project of Ordinary Universities in Guangdong Province(No.2022KCXTD016).
文摘Chemotherapy-induced toxicity(CIT)remains a major concern in cancer patients undergoing chemotherapy.New approaches to ameliorate the side effects of chemotherapy are urgently needed.Recently,the nutritional value of citrus fruits has attracted wide attention.Hesperidin and its aglycone hesperetin are the main active components in citrus fruits.Hesperidin and hesperetin have a wide range of pharmacological activities,including antioxidant and anti-inflammatory properties.This review aims to provide insights into the potential application of citrus flavonoids in CIT and summarize the underlying mechanisms of hesperidin and hesperetin in alleviating CIT.We have collected and collated relevant scientific articles on hesperidin and hesperetin and their treatment of CIT from different scientific databases.Hesperidin and its glycosides can reduce the toxicity of chemotherapeutic drugs,and their therapeutic effects are mainly through anti-inflammatory and antioxidant effects.At present,modern medical treatment is the main treatment method for CIT,but hesperidin,as an extract of food and medicinal materials,can greatly alleviate CIT.While killing tumor cells,chemotherapeutic drugs also damage normal cells leading to toxic effect on various organs.The pathological mechanism of CIT has not been fully elucidated,but current evidences indicate that cellular stress plays a key role.The citrus flavonoids hesperidin and hesperetin have the protective effect against CIT,highlighting its potential as an adjuvant in chemotherapy regimens.Hesperidin may also have synergistic anti-tumor activity with chemotherapeutic agents.We believe that more functional foods and anti-CIT drugs based on natural foods will be developed.
基金Supported by National Key Research and Development Program of China:2022YFC3500701。
文摘Background Chemotherapy-induced peripheral neuropathy(CIPN)is a common neurotoxic reaction for patients undergoing anticancer regimens.More and more studies show that acupuncture-moxibustion plays a positive role in the management and prevention of CIPN.Objective To evaluate the clinical effect of acupuncture-moxibustion in patients with CIPN,with a focus on assessing its effectiveness on improving treatment response rates,alleviating pain,enhancing quality of life(QoL),and improving nerve conduction.Additionally,the study compares the differences in clinical effectiveness among various acupuncture therapies for CIPN management.Methods Six databases(PubMed,Embase,Cochrane Library,Web of Science,OVID,and China National knowledge infrastructure[CNKI])were searched from earliest available dates to December 1,2024,and only randomized controlled trials(RCTs)containing relevant search terms were included.Network meta-analysis of the RCT data were conducted to assess the effective rate of the treatment as the primary outcome.Nerve conduction,pain scores,and QoL were assessed as secondary outcomes.The version 2 of the Cochrane risk-of-bias tool for randomized trials(RoB 2)was used to examine methodological quality,and Stata 15.1 was used to take network meta-analysis.Results A total of 34 RCTs involving 2039 participants and 9 acupuncture-moxibustion therapies were included.The network meta-analysis evaluated the effect of different acupuncture therapies across four outcomes:effective rate,pain scores,QoL,and nerve conduction.For effective rate,electroacupuncture combined with moxibustion ranked first with a surface under the cumulative ranking curve(SUCRA)value of 62.9%,followed by acupoint application(56.9%)and moxibustion(52.3%).Electroacupuncture combined with moxibustion had the highest effective rate compared to standard of care treatments(odds ratio[OR]=1.62,95%confidence interval[CI]−5.18 to 8.43).For alleviating pain,auricular acupressure had the highest SUCRA value(85.9%),while electroacupuncture and electroacupuncture combined with three-edged needle ranked second(63.4%)and third(51.0%),respectively.Auricular acupressure significantly reduced pain(SMD=−1.73,95%CI−3.54 to 0.08).For QoL,warming needle ranked first(SUCRA=92.0%),followed by electroacupuncture(48.7%)and filiform needle(43.0%).Warming needle significantly improved QoL scores(SMD=−0.75,95%CI−1.66 to 0.15).For nerve conduction,electroacupuncture combined with three-edged needle had the highest SUCRA value(100%),while moxibustion and filiform needle ranked second(65.3%)and third(39.2%),respectively.Electroacupuncture combined with three-edged had the best neuroprotective effect(SMD=1.85,95%CI 1.23 to 2.47).Conclusion Network meta-analysis based on the primary outcome(effective rate)suggests that electroacupuncture combined with moxibustion seems to be the optimal acupuncture therapy for chemotherapy-induced peripheral neuropathy(CIPN).Secondary outcomes exhibited considerable heterogeneity:auricular acupressure demonstrated superior efficacy in pain relief,electroacupuncture combined with three-edged needle showed greater advantages in improving nerve conduction function,while warm needling was associated with more significant improvements in QoL.Given the variability in interventions across different outcome measures and the methodological limitations of included studies,the current evidence requires cautious interpretation.Systematic review registration:Registration number in PROSPERO:CRD42024560017.
基金Supported by the National Basic Research Program of China:2014 CB 543201
文摘Objective To preliminarily investigate the rules of acupoint selection of acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting by retrospecting pertinent literature from 1986 to 2013. Methods Literature of clinical studies on acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting published from 1986 to 2013 in CNKI, Wanfang and VlP databases and in PubMed database were retrieved. Data were analyzed statistically via Excel. Results One hundred and nineteen articles retrieved were related to the study. Based on the current literature analysis, meridians selected for acupuncture and moxibustion on chemotherapy-induced nausea and vomiting were mainly the stomach meridian, the pericardium meridian, the conception vessel, the spleen meridian and bladder meridian; point combination was applied more in prescription, accounting for 73.11%, while single point was applied less, only accounting for 26.89%. There were numerous methods for point combinations, but proximal and distal point combination was the most widely used method, accounting for 20.93%. Meanwhile, main acupoints selected were mostly Zusanli （足三里 ST 36）, Neiguan （内关 PC 6）, Zhongwan （中脘CV12）, Gongsun （公孙SP 4） and Taichong （太冲 LR 3） and point combinations were mainly Shenmen （神门 HT 7）, Geshu （膈俞 BL 17）, PishB （脾俞 BL 20）, Weishu （胃俞 BL 21） and Jianli （建里 CV 11）. Conclusion Acupoints selection on acupuncture and moxibustion for chemotherapy-induced nausea and vomiting shows a certain rules that the meridians selected are mainly stomach meridian, pericardium meridian and conception vessel and acupuncture points selected are normally ST 36, PC 6 and CV 12, proximal and distal point combination is applied more, while single point applied less.
基金Supported by Chongqing Municipal Health and Family Planning Commission(medical scientific research project):2015 MSXM 082
文摘Objective To observe the clinical efficacy of acupoint injection for chemotherapy-induced peripheral neuropathy （ClPN）. Methods Ninety ClPN patients with breast cancer conforming to inclusive criteria were randomly divided into an acupuncture group （group A）, a mecobalamin group （group B） and an acupoint injection group （group C） according to random number table, with 30 cases in each group. In group A, acupuncture was conducted at bilateral Q0chi （I~ LI 11）, H6g6 （~ LI 4）, Z0s^nlT （~__~ ST 36）, S^nyinji^o （^-- ~ SP 6） and Xu^h~i （J~ SP 10）; in group B, intramuscular injection with I mL of mecobalamin injection was conducted; and in group C, acupoint selection was the same as group A, and 0.1 mL of mecobalamin injection was injected into each acupoint, respectively. The treatment was conducted once every three days in each group, and the changes of clinical efficacy, nerve electrophysiology and hemorrheology indicators after treatment for 10 times were observed. Result The total effective rate of group C was 93.1% （27/29）, which was higher than 78.6% （22/28） in group A and 83.3% （25/30） in group B, and the differences among three groups were statistically significant （all P〈0.01）; conduction velocity of lesion nerves was improved in group B and group C, the improvement in group C was obviously superior to the other two groups （all P〈0.01）, hemorrheology indicator was improved in group A and group C （both P〈0.05）. Conclusion The efficacy of acupoint injection with mecobalamin for breast cancer CIPN was significant, which can not only improve the nerve conduction velocity, but also improve the hemorrheology indicator.
基金supported by MSD Holding Co.,Ltd.The funding was only for the payment of using CHIRA database
文摘Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.
基金supported by grants from the Demonstrative Research Platform of Clinical Evaluation Technology for New Anticancer Drugs(Grant Nos.18ZX09201-015 and 2017ZX09304015)the Innovation Fund for Medical Sciences of the Chinese Academy of Medical Sciences(Grant No.CIFMS,2016-I2M-1-001)。
文摘Chemotherapy-induced neutropenia(CIN)is a potentially fatal and common complication in myelosuppressive chemotherapy.The timing and grade of CIN may play prognostic and predictive roles in cancer therapy.CIN is associated with older age,poor functional and nutritional status,the presence of significant comorbidities,the type of cancer,previous chemotherapy cycles,the stage of the disease,specific chemotherapy regimens,and combined therapies.There are many key points and new challenges in the management of CIN in adults including:(1)Genetic risk factors to evaluate the patient’s risk for CIN remain unclear.However,these risk factors urgently need to be identified.(2)Febrile neutropenia(FN)remains one of the most common reasons for oncological emergency.No consensus nomogram for FN risk assessment has been established.(3)Different assessment tools[e.g.,Multinational Association for Supportive Care in Cancer(MASCC),the Clinical Index of Stable Febrile Neutropenia(CISNE)score model,and other tools]have been suggested to help stratify the risk of complications in patients with FN.However,current tools have limitations.The CISNE score model is useful to support decision-making,especially for patients with stable FN.(4)There are still some challenges,including the benefits of granulocyte colony stimulating factor treatment and the optimal antibiotic regimen in emergency management of FN.In view of the current reports,our group discusses the key points,new challenges,and management of CIN.
基金Supported by Shanghai Three-Year Action Plan for Advanced Accelerated Development of the Course of Traditional Chinese Medicine:ZY(2018-2020)-CCCX-2001-05。
文摘Objective:To analyze the acupoint selection rules in acupuncture treatment for chemotherapy-induced nausea and vomiting(CINV)in China through data mining technology.Methods:The relevant literature on acupuncture treatment for CINV were searched from SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang,VIP and Pubmed databases from the establishment to January 3,2021 and the worksheet was set up for the information extraction of acupuncture-moxibustion prescriptions.Using IBM SPSS Statistics 25.0 and SPSS Modeler 18.0 software,cluster analysis and association rule analysis were conducted to explore the rules of acupoint selection.Results:A total of 179 articles were eligible,including 206 acupuncture prescriptions and 64 acupoints.The total use frequency of acupoints was 784 times.The acupoints with the highest use frequency were Zúsānlǐ(足三里ST36),Zhōngwǎn(中脘CV12)and Nèiguān(内关PC6).The commonly used meridians included stomach meridian of foot-yangming,conception vessel,pericardium meridian of hand-jueyin and bladder meridian of foot-taiyang.The acupoints located on the chest,the abdomen and the lower limbs were mostly selected.Five-shu points and crossing points were highly involved in terms of the specific points.The most common combination was ST36,CV12 and PC6.Conclusion:In treatment of acupuncture for CINV,the acupoints were generally selected from stomach meridian of foot-yangming,conception vessel,pericardium meridian of hand-jueyin.Front-mu points on the chest and the abdomen,the he-sea points and lower he-sea points in the lower limbs are commonly used.The core acupoint prescription of acupuncture for CINV included ST36,CV12 and PC6.
基金Supported by the Nursing Research Project Funding by the Affiliated Changzhou Second People's Hospital of Nanjing Medical University,No.2020HZD003.
文摘BACKGROUND Chemotherapy-induced peripheral neuropathy(CIPN)is a severe and longlasting side effect caused by various anticancer agents that damage sensory,motor and autonomic nerves.It can cause maladaptive behaviors,including disease severity,anxiety,depression,sleep disorders,falls,and social impairment.These disorders have physical,psychological and social effects on patients and can seriously influence their quality of life.AIM To investigate the current situation of psychosocial adaptation to the disease and its influencing factor in patients with CIPN.METHODS A convenience sampling method was used to select 233 patients with CIPN in our hospital from February to August 2021.In addition,a cross-sectional survey was conducted using a sociodemographic questionnaire,the Self-Report Psychosocial Adjustment to Illness Scale,and the European Organisation for the Research and Treatment of Cancer Quality of Life CIPN20(QLQ-CIPN20).Factors influencing psychosocial adaptation in patients with CIPN were analyzed by t-test or one-way analysis of variance,correlation analysis,multiple stepwise regression analysis,and structural equation models.RESULTS The psychosocial adaptation score of patients with CIPN was 52.51±13.18.Multivariate analysis showed that autonomic nerves,tumor stage,motor nerves,education level,availability of caregivers,semi-retirement status,CIPN grade were independent risk factors for patients with CIPN(P<0.05).Structural equation models showed that QLQ-CIPN20 mediated the relationship between CIPN grade,tumor stage,and psychosocial adaptation.CONCLUSION Patients with CIPN have poor psychosocial adaptation and are affected by a variety of physiological,psychological,and social factors.Patients’adaptive responses should be assessed,and targeted interventions implemented.
文摘Chemotherapy-induced diarrhoea (CID) is a common side-effect experienced by patients being treated with a variety of antineoplastic agents. Approximately 80% of patients undergoing chemotherapeutic treatment for colorectal and other gastrointestinal cancers present with CID;moreover, about 5% of early deaths associated with combination anti-cancer chemotherapy are due to CID. Chronic post-treatment diarrhoea amongst cancer survivors can persist for more than 10 years greatly effecting long-term quality of life. Gastrointestinal toxicities such as diarrhoea and vomiting are amongst the primary contributors to dose reductions and delays throughout anti-cancer treatment, presenting a significant hurdle in clinical management of anti-cancer regimes and often result in sub-optimum treatment. However, little is known about pathophysiological mechanisms underlying CID. This work provides a review of chemotherapy-induced diarrhoea, current management guidelines, and shortcomings of current treatments as well as emerging and already existing anti-diarrhoeal treatments potentially suitable for CID.
文摘Chemotherapy-induced peripheral neuropathy is a very frequent neurological complication in cancer. Oxaliplatin（OXA） is a platinum analogue used as a first-line agent in the treatment of colorectal cancer. OXA induced peripheral neuropathy（OIN） is the main toxicity both during and after the completion of chemotherapy that presents as two distinct syndromes： acute and chronic neuropathy. None of the neuroprotective agents previously tested had prevented or limited the acute and/or chronic OIN. MR309（previously developed as E-52862） is a novel selective sigma-1 receptor（S1R） antagonist with preclinical analgesic activity in OXA-induced neuropathic pain in animal models. This review analyzes the results of the recently published phase Ⅱ, randomized, double-blind, placebo-controlled clinical trial including 124 patients with colorectal cancer（CRC） treated with MR309. This study shows encouraging findings in the setting of neuroprotection against OIN with an acceptable safety profile. The study demonstrated MR309 usefulness in decreasing acute OIN, by reducing cold hypersensitivity experienced by patients, and pointed to the amelioration of chronic OIN by lowering the proportion of patients who developed severe chronic OIN. In addition, we provide a summary and discussion on the pathways that can be modulated by the S1R to explain the observed clinical benefits in the OIN.
基金Supported by the Study of Electric Acupuncture in Preventing the Peripheral Neuritis Induced by Chemotherapy and Promoting the Immune Function in Cancer Patients from:Comprehensive and Integrative Medicine Institute,KoreaMechanism Study of Electric Acupuncture in Oxaliplatin-chemotherapy-induced Peripheral Neuropathy by SP-NMDAR Pathway from:Shanghai TCM-integrated Hospital+3 种基金Effect of Bushen-Jianpi Decoction on Postoperative Recurrence and Vasculogenic Mimicry Formation after Recurrence in Liver Cancer Tissues of Nude Mice with Transplanted Liver Cancer(No.2012J003A)Mechanism Study of Fuzheng Jianpi Decoction on Tumor Metastasis Inhibition by Protecting Intestinal Barrier and Regulating PI3K/AKT Signaling Pathway Expression in Colorectal Tumor Microenvironment(No.15ZR1438700)Effect of Jianpi-Guchang Decoction on the Gut Barrier Function and Immune Function in Lung or Colorectal Cancer Patients Treated by Chemotherapy Based on the Thought of "Same Treatment for Different Diseases"(No.15401930300)Effect of Jianpi-Guben Decoction on the Gut Barrier Function in Postoperative Colorectal Cancer Patients Treated by Chemotherapy to Balance the Gut Enviroment(No.Hongkou 1502-01)
文摘OBJECTIVE:To evaluate the effect of electroacupuncture on chemotherapy-induced peripheral neuropathy(CIPN), quality of life and immune status of patients with malignant tumors.METHODS:From Jan, 2013 to May, 2014, 37 patients with malignant tumors were included in this prospective single-blinded study, and randomized to receive either electroacupuncture or acupuncture treatment on basis of chemotherapy.The chemotherapy was continued for 2 courses as previous before the treatments, with 21 days as a course of treatment.Patients received acupuncture and electroacupuncture once per day starting at the day before chemotherapy for consecutive 7 days followed by 14 days off, with 21 days as a course of treatment, and continued for two courses of treatment.Then CIPN, traditional Chinese clinical symptoms,quality of life and immune status were all evaluated for each patient prior treatment and after two courses of treatment.RESULTS:The gender, age, cancer species as well as incidence(83.3% vs 84.2%) and grades of CIPN before treatments were all similar in patients receiving acupuncture or electroacupuncture(all P >0.05).After treatments, most patients with peripheral neuropathy were cured by two courses of electroacupuncture(84.2% vs 21.1%), whereas the other group of patients had similar incidences of peripheral neuropathy compared with prior-acupuncture(83.3% vs 72.2%).Besides, patients receiving electroacupuncture had lower incidence of peripheral neuropathy than those receiving acupuncture treatment(χ~2= 9.745, P = 0.002).The grades of peripheral neuropathy were significantly different in the two groups post-treatment(χ~2= 13.983, P =0.007).The total effective rates for traditional Chinese clinical symptoms were 16.7% and 84.2% in acupuncture and electroacupuncture groups, respectively(Z =-4.239, P < 0.001).The electroacupuncture treatment provided a more satisfactory life for patients compared with acupuncture(Z =-4.76, P < 0.001).Both electroacupuncture and acupuncture had no effects on immune function.CONCLUSION:Electroacupuncture could alleviate CIPN, and improve traditional Chinese clinical symptoms and quality of life, but did not affect immune function.
文摘Chemotherapy-induced peripheral neuropathy(CIPN)is a common side effect that occurs in 20%of ovarian cancer patients treated with the combination of carboplatin/paclitaxel(CP).This toxicity is directly correlated with the dose of paclitaxel administered.Several studies have investigated whether different formulations of taxane can induce this side effect at a lower rate,but,unfortunately,no significant improvement was obtained.CIPN can be disabling in the daily lives of patients and can cause dose reduction or early termination of the treatment.Neuropathy can last for months and even years after its onset.Moreover,patients responsive to CP treatment are candidates for a reintroduction of the same drugs when disease relapse occurs,and residual neuropathy can affect the continuation of treatment.There are no approved drugs that mitigate or prevent the onset of CIPN.In this review,we summarize the evidence regarding the incidence of CIPN with different taxane formulations,regimen schedules and prevention systems.In particular,the Hilotherm®Chemo care device is a regional cooling system that lowers the temperature of the hands and feet to reduce the flow of chemotherapy into the capillaries.We used hilotherapy during chemotherapy infusion to prevent the onset of CIPN.Updated data from 44 ovarian cancer patients treated with 6 cycle of CP show that hilotherapy was well tolerated;only two patients(4.5%)stopped hilotherapy because of cold intolerance,and only one patient(2.2%)experienced grade≥2 CIPN.
基金“Korea Health Technology R&D Project through the Korea Health Industry Development Institute,funded by the Ministry of Health and Welfare,Republic of Korea(HI15C0007)”“Chungnam National University,and Basic Science Research Program through the National Research Foundation of Korea(2021R1F1A1062509)+1 种基金Study on the Angiotensin Converting Enzyme Inhibitor(ACEi)-related Pain Mechanism by Mediating Substance P,Bradykinin and AngiotensinⅡActivities,(2021R1A6A3A01086598)Study on the Role and Interaction Mechanisms of BDNF and APE1/Ref-1 in Animal Models of Chronic Pain Accompanied with Depression。
文摘OBJECTIVE:Chemotherapeutic agents such as docetaxel(DTX)can trigger chemotherapy-induced peripheral neuropathy(CIPN),which is characterized by unbearable pain.This study was designed to investigate the analgesic effect and related neuronal mechanism of low-frequency median nerve stimulation(LFMNS)on DTX-induced tactile hypersensitivity in mice.METHODS:To produce CIPN,DTX was administered intraperitoneally 4 times,once every 2 d,to male ICR mice.LFMNS was performed on the wrist area,and the pain response was measured using von Frey filaments on both hind paws.Western blot and immunofluorescence staining were performed using dorsal root ganglion and spinal cord samples to measure the expression of brainderived neurotrophic factor(BDNF).RESULTS:Repeated LFMNS significantly attenuated the DTX-induced abnormal sensory response and suppressed the enhanced expression of BDNF in the DRG neurons and spinal dorsal area.CONCLUSIONS:LFMNS might be an effective nonpharmaceutical option for treating patients suffering from CIPN via regulating the expression of peripheral and central BDNF.
