Clinical features and treatment outcomes of PD-1 inhibitor therapy in elderly patients (≥ 65 years) with advanced esophageal squamous cell carcinoma: a real-world study.

PURPOSE: This study aims to determine the clinical features and outcomes of PD-1 inhibitor therapy as the initial treatment in patients aged 65 years or older with locally advanced or metastatic esophageal squamous cell carcinoma (ESCC). MATERIALS AND METHODS: The retrospective study conducted a comprehensive analysis of elder patients diagnosed with locally advanced or metastatic ESCC who underwent combined immunochemotherapy in the first affiliated hospital of Nanchang University from January 2019 to January 2023. The main efficacy measures were the objective response rate (ORR) and progression-free survival (PFS). The secondary endpoints were disease control rate (DCR) and overall survival (OS). The evaluation of safety was based on the assessment of adverse events (AEs). RESULTS: A total of 88 patients were enrolled in the study. All patients received PD-1 inhibitors combined with chemotherapy including taxane and platinum as the first-line treatment. The median PFS was 6.2 months (95% CI: 5.1-7.3), and the median OS was 15.3 months (95% CI: 12.9-17.7). The ORR and DCR were 42.0% and 72.7%, correspondingly. 68 (77.3%) patients experienced treatment-related adverse events (TRAEs) of various degrees, with neutrophil count decreased (21, 23.9%) being the most frequent. TRAEs of grade 3 or 4 occurred in 13 (14.8%) patients. CONCLUSION: The study demonstrated that individuals older than 65 years with locally advanced or metastatic ESCC have a survival benefit from the first-line treatment of PD-1 inhibitors combined therapy, with a manageable safety profile.

Impacts of the pnf technique on flexibility and strength in martial arts athletes / Impactos da técnica pnf sobre flexibilidade e força em atletas de artes marciais / Impacto de la técnica pnf sobre la flexibilidad y la fuerza en atletas de artes marciales

ABSTRACT Introduction: Joint flexibility and muscle strength play a vital role in the training process of martial arts athletes. The proprioceptive neuromuscular facilitation (PNF) technique encourages the neural receptors, through the application of manual resistances, in the gain of functional range of motion and stability to its patients. It is believed that this technique can be adapted to the sports environment. Objective: Evaluate the impact of stretching using the PNF technique on martial arts athletes' flexibility and muscle strength. Methods: Through a controlled experiment, 100 martial arts athletes, without significant differences, were selected as experimental subjects, and randomly divided into two groups for a 4-week experiment. The experimental group added a protocol with PNF stretching exercises in the training, while the control group performed the usual training without interventions. Indicators of flexibility, functional activities, and strength were measured before and after the intervention, compared, and statistically analyzed. Results: Joint flexibility with the shoulder rotation test evolved from 21.88±5.71 to 19.22±5.94, and the left and right division was from 16.90±5.36 to 10.57±3.75; as for muscle strength, the flexor peak moment elevated from 210.36±51.18 to 251.37± 45.72, and flexor power had a gain from 111.76±30.63 to 135.20±2,.42. The extensor peak moment also showed expressive evolutions from 179.47±43.96 to 221.52±33.60. Conclusion: The PNF stretching exercise technique effectively optimizes martial arts athletes' joint flexibility and muscle strength. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A flexibilidade articular e a força muscular desempenham um papel vital no processo de treinamento dos atletas de artes marciais. A técnica de facilitação neuromuscular proprioceptiva (PNF) incentiva os receptores neurais, através da aplicação de resistências manuais, no ganho da amplitude de movimento funcional e da estabilidade aos seus pacientes. Acredita-se que essa técnica possa ser adaptada ao meio esportivo. Objetivo: Avaliar os impactos do alongamento utilizando a técnica de PNF sobre a flexibilidade e a força muscular dos atletas de artes marciais. Métodos: Através de um experimento controlado, 100 atletas de artes marciais, sem diferenças significativas, foram selecionados como objetos experimentais, divididos aleatoriamente em dois grupos para um experimento de 4 semanas. Ao grupo experimental foi adicionado um protocolo com exercícios de alongamento PNF no treinamento, enquanto o grupo de controle efetuou o treinamento habitual sem intervenções. Indicadores de flexibilidade, atividades funcionais e força foram aferidos antes e depois da intervenção, comparados e analisados estatisticamente. Resultados: A flexibilidade articular com o teste de giro do ombro evoluiu de 21,88±5,71 para 19,22±5,94, sendo a divisão esquerda e direita de 16,90±5,36 para 10,57±3,75; quanto a força muscular, o momento de pico do flexor elevou-se de 210,36±51,18 para 251,37± 45,72, e a potência do flexor teve um ganho de 111,76±30.63 para 135,20±2,.42. O momento de pico do extensor também demonstrou evoluções expressivas de 179,47±43,96 para 221,52±33,60. Conclusão: O exercício de alongamento com a técnica PNF demonstrou ser efetivo em otimizar a flexibilidade articular e a força muscular dos atletas de artes marciais. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La flexibilidad articular y la fuerza muscular desempeñan un papel vital en el proceso de entrenamiento de los atletas de artes marciales. La técnica de facilitación neuromuscular propioceptiva (FNP) estimula los receptores neurales, a través de la aplicación de resistencias manuales, en la ganancia de rango funcional de movimiento y estabilidad a sus pacientes. Se cree que esta técnica puede adaptarse al ámbito deportivo. Objetivo: Evaluar el impacto de los estiramientos con la técnica PNF en la flexibilidad y fuerza muscular de atletas de artes marciales. Métodos: A través de un experimento controlado, 100 atletas de artes marciales, sin diferencias significativas, fueron seleccionados como sujetos experimentales, divididos aleatoriamente en dos grupos para un experimento de 4 semanas. Al grupo experimental se le añadió un protocolo con ejercicios de estiramiento PNF en el entrenamiento, mientras que el grupo de control realizó el entrenamiento habitual sin intervenciones. Se midieron indicadores de flexibilidad, actividades funcionales y fuerza antes y después de la intervención, se compararon y se analizaron estadísticamente. Resultados: La flexibilidad articular con la prueba de rotación del hombro evolucionó de 21,88±5,71 a 19,22±5,94, siendo la división izquierda y derecha de 16,90±5,36 a 10,57±3,75; en cuanto a la fuerza muscular, el momento pico flexor se elevó de 210,36±51,18 a 251,37± 45,72, y la potencia flexora tuvo una ganancia de 111,76±30,63 a 135,20±2,, 42. El momento máximo del extensor también mostró evoluciones expresivas de 179,47±43,96 a 221,52±33,60. Conclusión: El ejercicio de estiramiento con técnica PNF demostró ser eficaz para optimizar la flexibilidad articular y la fuerza muscular de los atletas de artes marciales. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.