Background: The criterion of two target lesions per organ in the Response Evaluation Criteria in Solid Tumors (RECIST) version I. 1 is an arbitrary one, being supported by no objective evidence. The optimal number ...Background: The criterion of two target lesions per organ in the Response Evaluation Criteria in Solid Tumors (RECIST) version I. 1 is an arbitrary one, being supported by no objective evidence. The optimal number of target lesions per organ still needs to be investigated. We compared tumor responses using the RECIST 1.1 (measuring two target lesions per organ) and modified RECIST I. 1 (measuring the single largest lesion in each organ) in patients with small cell lung cancer (SCLC). Methods: We reviewed medical records of patients with SCLC who received first-line treatment between January 2004 and December 2014 and compared tumor responses according to the two criteria using computed tomography. Results: There were a total of 34 patients who had at least two target lesions in any organ according to the RECIST 1.1 during the study period. The differences in the percentage changes of the sum of tumor measurements between RECIST 1.1 and modified RECIST 1.1 were all within 13%. Seven patients showed complete response and fourteen showed partial response according to the RECIST I.I. The overall response rate was 61.8%. When assessing with the modified RECIST 1.1 instead of the RECIST 1.1, tumor responses showed perfect concordance between the two criteria (k= 1.0). Conclusions: The modified RECIST 1.I showed perfect agreement with the original RECIST 1.I in the assessment of tumor response of SCLC. Our result suggests that it may be enough to measure the single largest target lesion per organ for evaluating tumor response.展开更多
BACKGROUND Given the clinical challenges posed by drug-eluting stents,drug-coated balloons offer a promising alternative by delivering antiproliferative medications directly to the vessel wall.AIM To compare the effic...BACKGROUND Given the clinical challenges posed by drug-eluting stents,drug-coated balloons offer a promising alternative by delivering antiproliferative medications directly to the vessel wall.AIM To compare the efficacy of paclitaxel-coated balloon(PCB)angioplasty vs sirolimus-coated balloon(SCB)angioplasty in the treatment of coronary artery disease(CAD),focusing on both in-stent restenosis(ISR)and de-novo lesions(DNL).METHODS A comprehensive literature search on PubMed,EMBASE,and Cochrane Central from inception to 5th February 2025.Only randomized controlled trials and observational studies comparing outcomes of PCB vs SCB angioplasty in patients with ISR or DNL were included.RESULTS A total of nine studies with 1981 patients(949 in PCB arm and 1032 in SCB arm)were included for further quantitative analysis.The results indicated that both PCB and SCB angioplasty are effective in treating CAD,with PCB showing a greater minimal lumen diameter for DNL[mean difference:-0.11(95% confidence interval:-0.22 to-0.01,P=0.03)].However,the risk of target lesion revascularization and diameter stenosis was identical for both PCB and SCB during the 9-12-month follow-up period.CONCLUSION This meta-analysis highlights that PCB angioplasty may offer superior angiographic outcomes compared to SCB angioplasty,specifically in achieving greater minimal lumen diameter in patients with DNL.These findings suggest that while PCB has certain advantages in terms of tissue retention and immediate efficacy,both PCB and SCB are viable options for treating ISR or DNL in CAD patients.Further large-scale studies are required to conclusively determine the long-term benefits and potential risks associated with each type of drug-coated balloons angioplasty.展开更多
文摘Background: The criterion of two target lesions per organ in the Response Evaluation Criteria in Solid Tumors (RECIST) version I. 1 is an arbitrary one, being supported by no objective evidence. The optimal number of target lesions per organ still needs to be investigated. We compared tumor responses using the RECIST 1.1 (measuring two target lesions per organ) and modified RECIST I. 1 (measuring the single largest lesion in each organ) in patients with small cell lung cancer (SCLC). Methods: We reviewed medical records of patients with SCLC who received first-line treatment between January 2004 and December 2014 and compared tumor responses according to the two criteria using computed tomography. Results: There were a total of 34 patients who had at least two target lesions in any organ according to the RECIST 1.1 during the study period. The differences in the percentage changes of the sum of tumor measurements between RECIST 1.1 and modified RECIST 1.1 were all within 13%. Seven patients showed complete response and fourteen showed partial response according to the RECIST I.I. The overall response rate was 61.8%. When assessing with the modified RECIST 1.1 instead of the RECIST 1.1, tumor responses showed perfect concordance between the two criteria (k= 1.0). Conclusions: The modified RECIST 1.I showed perfect agreement with the original RECIST 1.I in the assessment of tumor response of SCLC. Our result suggests that it may be enough to measure the single largest target lesion per organ for evaluating tumor response.
文摘BACKGROUND Given the clinical challenges posed by drug-eluting stents,drug-coated balloons offer a promising alternative by delivering antiproliferative medications directly to the vessel wall.AIM To compare the efficacy of paclitaxel-coated balloon(PCB)angioplasty vs sirolimus-coated balloon(SCB)angioplasty in the treatment of coronary artery disease(CAD),focusing on both in-stent restenosis(ISR)and de-novo lesions(DNL).METHODS A comprehensive literature search on PubMed,EMBASE,and Cochrane Central from inception to 5th February 2025.Only randomized controlled trials and observational studies comparing outcomes of PCB vs SCB angioplasty in patients with ISR or DNL were included.RESULTS A total of nine studies with 1981 patients(949 in PCB arm and 1032 in SCB arm)were included for further quantitative analysis.The results indicated that both PCB and SCB angioplasty are effective in treating CAD,with PCB showing a greater minimal lumen diameter for DNL[mean difference:-0.11(95% confidence interval:-0.22 to-0.01,P=0.03)].However,the risk of target lesion revascularization and diameter stenosis was identical for both PCB and SCB during the 9-12-month follow-up period.CONCLUSION This meta-analysis highlights that PCB angioplasty may offer superior angiographic outcomes compared to SCB angioplasty,specifically in achieving greater minimal lumen diameter in patients with DNL.These findings suggest that while PCB has certain advantages in terms of tissue retention and immediate efficacy,both PCB and SCB are viable options for treating ISR or DNL in CAD patients.Further large-scale studies are required to conclusively determine the long-term benefits and potential risks associated with each type of drug-coated balloons angioplasty.