Efficacy and safety of recombinant human endostatin combined with whole-brain radiation therapy in patients with brain metastases from non-small cell lung cancer.

BACKGROUND AND PURPOSE: Brain metastasis (BM) is the leading cause of poor prognosis in non-small cell lung cancer (NSCLC) patients. To date, whole-brain radiation therapy (WBRT) is a standard treatment for patients with multiple BMs, while its effectiveness is currently unsatisfactory. This study aimed to investigate the effects of Rh-endostatin combined with WBRT on NSCLC patients with BMs. MATERIALS AND METHODS: A total of 43 patients with BM were randomly divided into two groups. The Rh-endostatin combination group (n = 19) received Rh-endostatin combined with WBRT, and the radiation group (n = 24) received WBRT only. The primary endpoint of the study was progression-free survival (PFS), and the secondary endpoints were intracranial progressionfree survival (iPFS), overall survival (OS), objective response rate (ORR), and changes in the cerebral blood volume (CBV) and cerebral blood flow (CBF). RESULTS: Median PFS (mPFS) was 8.1 months in the Rh-endostatin combination group and 4.9 months in the radiation group (95%CI 0.2612-0.9583, p = 0.0428). Besides, the median iPFS was 11.6 months in the Rh-endostatin combination group and 4.8 months in the radiation group (95%CI 0.2530-0.9504, p = 0.0437). OS was 14.2 months in the Rh-endostatin combination group and 6.4 months in the radiation group (95%CI 0.2508-1.026, p = 0.0688). CBV and CBF in the Rh-endostatin combination group were better improved than that in the radiation group, which indicated that Rh-endostatin might improve local blood supply and microcirculation. CONCLUSION: Rh-endostatin showed better survival and improved cerebral perfusion parameters, which may provide further insights into the application of Rh-endostatin for NSCLC patients with BMs.

Programmed cell death 1 inhibitors with or without concurrent brain radiotherapy for lung cancer patients with brain metastases.

BACKGROUND: Data focusing on the synergistic effect of programmed cell death 1 (PD-1) inhibitors and brain radiotherapy for brain metastases (BMs) in lung cancer is scarce. METHODS: A total of 60 lung cancer patients receiving PD-1 inhibitors with or without brain radiotherapy were identified in this retrospective study. The primary endpoints were intracranial progression-free survival (iPFS), extracranial progression-free survival (PFS), and overall survival (OS) among three groups. RESULTS: Twenty-one patients received PD-1 inhibitors and concurrent brain radiotherapy, 20 patients were treated with PD-1 inhibitors and non-concurrent brain radiotherapy, and the other 19 patients were treated with PD-1 inhibitors alone. Patients in the concurrent group achieved a higher intracranial objective response rate (iORR, 61.1% vs. 29.4% vs. 25.0%) and a higher intracranial disease control rate (iDCR, 83.3% vs. 58.8% vs. 56.3%) compared with those in the non-concurrent group and PD-1 inhibitors alone group. The median iPFS was significantly longer in the concurrent group than the non-concurrent group and the PD-1 inhibitors alone group (9.8, 5.7, and 4.8 months, P=0.039, respectively). The median PFS were 9.2, 5.7 and 4.6 months (P=0.347) in the concurrent group, non-concurrent group and PD-1 inhibitors alone group. And the median OS were not reached, 12.1 and 6.9 months (P=0.206), respectively. Multivariate analysis revealed that the lack of concurrent brain radiotherapy was independently associated with a shorter iPFS. CONCLUSIONS: PD-1 inhibitors with concurrent brain radiotherapy achieved a higher iORR, iDCR, and iPFS in lung cancer patients with treated or newly diagnosed BMs.

Upgrading the school entry vaccination record check strategy to improve varicella vaccination coverage: results from a quasi-experiment study.

BACKGROUND: The school entry vaccination record check strategy (SECS) is an appropriate opportunity to recommend vaccines for students to improve vaccination coverage (VC). However, it is only utilized for providing necessary catch-up vaccination for students who are missing the Expanded Program on Immunization (EPI) vaccines in China. We aimed to address that gap and quantify the relationship between the SECS policy and the increase of coverage in varicella vaccine (VarV). METHODS: We employed a pretest and posttest quasi-experimental design to examine the effect of the upgraded SECS policy on the change of VarV coverage in newly enrolled students in Lu'an, 2019-2020. RESULTS: Eight hundred participants were randomly divided into the control group (C group, 31.8%), the telephone-based intervention group (T group, 31.2%), and the written notification intervention group (W group, 37.0%). Totally, 84 students received VarV during the study period, with a VC of 10.5%. The possibility of vaccination in the T group (RR = 4.9, 95% CI:2.2-10.9) and W group (RR = 5.2, 95% CI:2.4-11.5) was significantly higher than that in the C group (p< .001). CONCLUSIONS: Our study demonstrates that the upgraded SECS produce a positive effect on improving the VC of VarV. This nudge strategy may decrease varicella outbreaks in schools in China, especially in provinces where VarV is not introduced into EPI.

Mindfulness and Smartphone Addiction before Going to Sleep among College Students: The Mediating Roles of Self-Control and Rumination.

This study aims to examine the effects among college students of mindfulness on smartphone addiction before going to bed at night. We examined the mediating roles of self-control and rumination on the mindfulness-smartphone addiction path. Participants (n = 270, 59.3% females, 18-24 years old) completed self-reporting questionnaires measuring mindfulness, self-control, smartphone addiction, and rumination. In addition to the correlation analysis, we adopted a stepwise regression analysis with bootstrapping to test the mediating effects. It was found that mindfulness was inversely related to smartphone addiction before going to sleep. Most importantly, self-control and rumination significantly mediated the effects of mindfulness on smartphone addiction among college students. The findings of this study indicated that mindfulness training is beneficial to improve the ability of self-control and reduce rumination levels, thereby inhibiting the negative impact of smartphone addiction on college students before they go to sleep, and further promoting their sleep health and mental health.

An Update on Physical Activity Research among Children in Hong Kong: A Scoping Review.

Similar to their Western counterparts, children in Hong Kong generally fail to reach the recommended levels of physical activity (PA). As an ultra-dense metropolis, Hong Kong is different from most Western cities. It is therefore important to update and appraise previous PA research in order to inform future PA promotion for Hong Kong children. Using a scoping review, the current study aimed to evaluate PA research among preschool and school-aged children in Hong Kong aged 3-12 years old who are at a critical development stage. Literature was searched from four English databases: Medline via EBSCOhost, SPORTDiscus, ERIC and PsycINFO via ProQuest; and three Chinese databases: CNKI, CQVIP and WAN-FANG. PA research among Hong Kong children published from 1 January 1997 to the searching date, 31 March 2020 was included. A total of 63 studies were identified, with the majority of studies focused on school-aged children as compared to preschoolers, adopted a cross-sectional design, using self-reported PA measures, and with small to medium sample sizes. We classified eligible studies into five main categories: (a) Health benefits of PA (k = 12). Consistent evidence on the health benefits of skeletal and cardiovascular capacity, quality of life, cognitive function, and sleep quality was revealed. However, inconsistent evidence was found on the benefits of weight-related indicators and academic performance. (b) Patterns of PA (k = 12). There is a general pattern of low levels of PA among Hong Kong children, in particular girls and children with special educational needs. (c) Measures of PA and related constructs (k = 11). The Chinese versions of self-reported measures of PA, PA-related social environment, and PA-related psychological constructs showed acceptable reliabilities and validities. (d) Correlates of PA (k = 18). The correlates of PA include physical environment, social environment, physical factors, psychological factors, and multiple correlates, which is in line with the social-ecological model. (e) Interventions for promoting PA (k = 10). PA interventions among Hong Kong children were conducted for healthy children, children with special educational needs, and children with cancer. Overall, there is a growing volume of PA research among children in Hong Kong in the recent decade. Yet, there is a lack of high-quality research for measuring, understanding, and promoting PA among Hong Kong children. It is highly recommended that future PA research among children should pay more attention on the preschoolers, adopting robust research design (e.g., randomized controlled trials), recruiting large and representative sample, and collecting device-assessed data.

The influence of pemetrexed-based continuous maintenance therapy on survival of locally advanced and metastatic lung adenocarcinoma.

BACKGROUND: Patients may receive delayed maintenance therapy (stopping interval over 21 days) due to multi factors in the real-life setting. This retrospective study aims to collect data of pemetrexed-based continuous maintenance therapy, evaluate the impact of prolonged interval periods on clinical outcomes. METHODS: A total of 168 previously untreated stage IIIB or IV lung adenocarcinoma patients received induction chemotherapy with pemetrexed-platinum (PP) with or without antiangiogenesis inhibitors (bevacizumab or rh-endostatin) every 3 weeks for 4-6 cycles. Among them, 112 patients who did not show progression after induction chemotherapy completion were enrolled. RESULTS: Seventy of the 112 patients received continuous maintenance therapy with pemetrexed with or without antiangiogenesis inhibitors until disease progression; 42 patients did not receive continuous maintenance therapy. Multivariate analysis revealed that only lack of maintenance therapy was independently associated with shorter progression-free survival (PFS) [HR, 4.516 (2.332-8.744), P<0.001]. Brain metastases [HR, 4.263 (1.499-12.127), P=0.007] and lack of maintenance therapy [HR, 4.304 (1.566-11.825), P=0.005] were independent adverse prognostic factors for overall survival (OS). In the maintenance group, most patients delayed continuous maintenance treatment and the median interval between each maintenance therapy cycle was 40 days (range, 21-77 days). The median number of maintenance therapy cycles was 4 (range, 1-26). The best objective response rate (ORR) was higher in the maintenance group than in the non-maintenance group (48.6% and 33.3%). During a median follow-up of 14.6 months, patients in the maintenance group achieved significantly longer PFS (11.5 vs. 6.8 months, P<0.001) and OS (40.1 vs. 18.0 months, P=0.001) compared with those in the non-maintenance group. CONCLUSIONS: Extending maintenance intervals is feasible and continuous maintenance therapy could offer survival benefit in patients who did not show progression after first-line induction treatment for lung adenocarcinoma.