Adjuvant chemoradiotherapy in resected gallbladder cancer: A SEER-based study.

Background: The prognosis of gallbladder cancer (GBC) is dismal. This study aimed to compare the outcomes of adjuvant chemoradiotherapy (ACR) with those of surgery alone (S) and adjuvant chemotherapy (AC). Method: The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify patients diagnosed with GBC and undergoing surgery between 2004 and 2015. The patients were divided into the S, AC, and ACR groups according to their treatment. Categorical variables were compared by Pearson's chi-square test, and a 1:1:1 propensity score matching analysis (PSM) was performed. Overall survival was assessed by Kaplan-Meier curves with log-rank tests. Subgroup analyses were conducted. Result: A total of 5451 patients were identified in the SEER database. After PSM, the two-year survival among patients who received S, AC, and ACR was 36%, 39%, and 45%, respectively. ACR was associated with improved two-year survival (p < 0.001), while the survival rates were similar in the AC and S groups (p = 0.127) but better in the ACR group than in the AC group (p = 0.012). Subgroup analyses indicated that while the two-year survival rates did not differ significantly in stage II GBC patients between the groups (all p > 0.05), ACR was associated with significantly improved two-year survival in stage Ⅲa (p = 0.008), Ⅲb (p < 0.001), and Ⅳb (p < 0.001) GBC patients. Conclusion: The combination of surgery and ACR as the treatment modality provided greater survival benefits for GBC patients, particularly for those with advanced tumor staging.

The epidemiological trends of biliary tract cancers in the United States of America.

BACKGROUND: Biliary tract cancers (BTCs) are a series of heterogeneous malignancies that are broadly grouped based on the anatomical site where they arise into subtypes including intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma (ECC), gallbladder cancer (GBC), and ampulla of Vater cancer (AVC). METHODS AND RESULTS: The present study provides an overview of the epidemiology of the various BTCs based on data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2018. Distinct differences in both incidence and mortality rates were observed for these BTCs as a function of age, sex, ethnicity, and calendar year. In 2018, BTCs emerged as the fifth most prevalent form of alimentary tract cancer in the USA. While the incidence and mortality of ICC appear to be increasing, the incidence rates of GBC, ECC, and AVC have remained stable, as have the corresponding mortality rates. The most common and deadliest BTCs in 2018 were ICC and GBC among males and females, respectively. The ethnic groups exhibiting the highest incidence rates of these different BTCs were American Indians and Alaska Natives for GBC, and Asian and Pacific Islanders for ICC, ECC, and AVC. The incidence of all of these forms of BTC rose with age. There were some variations in BTCs in terms of staging, locoregional surgical treatments, adjuvant therapies, and prognostic outcomes from 2000 to 2018. CONCLUSIONS: The epidemiological characteristics, staging, locoregional surgical treatments, adjuvant therapies, and prognostic outcomes were distinct for each of these BTCs.

TiO2 nanotubular arrays decorated with ultrafine Ag nanoseeds enabling a stable and dendrite-free lithium metal anode.

To exploit next-generation high-energy Li metal batteries, it is vitally important to settle the issue of dendrite growth accompanied by interfacial instability of the Li anode. Applying 3D current collectors as hosts for Li deposition emerges as a prospective strategy to achieve uniform Li nucleation and suppress Li dendrites. Herein, well-aligned and spaced TiO2 nanotube arrays grown on Ti foil and surface decorated with dispersed Ag nanocrystals (Ag@TNTAs/Ti) were constructed and employed as a 3D host for regulating Li stripping/plating behaviors and suppressing Li dendrites, and also relieving volume fluctuation during repetitive Li plating/stripping. Uniform TiO2 nanotubular structures with a large surface allow fast electron/ion transport and uniform local current density distribution, leading to homogeneous Li growth on the nanotube surface. Moreover, Ag nanocrystals and TiO2 nanotubes have good Li affinity, which facilitates Li+ capture and reduces the Li nucleation barrier, achieving uniform nucleation and growth of Li metal over the 3D Ag@TNTAs/Ti host. As a result, the as-fabricated Ag@TNTAs/Ti electrode exhibits dendrite-free plating morphology and long-term cycle stability with coulombic efficiency maintained over 98.5% even after 1000 cycles at a current density of 1 mA cm-2 and cycling capacity of 1 mA h cm-2. In symmetric cells, the Ag@TNTAs/Ti-Li electrode shows a much lower hysteresis of 40 mV over an ultralong cycle period of 2600 h at a current density of 1 mA cm-2 and cycling capacity of 1 mA h cm-2. Moreover, the full cell with the Ag@TNTAs/Ti-Li anode and LiFePO4 cathode achieves a high capacity of 155.2 mA h g-1 at 0.5C and retains 77.9% capacity with an average CE of ≈99.7% over 200 cycles.

Significant Reduction in Vertebral Artery Dose by Intensity Modulated Proton Therapy: A Pilot Study for Nasopharyngeal Carcinoma.

Intensity modulated proton therapy (IMPT) with the vertebral artery (VA)-sparing technique has been initially proposed in our institution. This pilot study was conducted to compare the dose to VAs between IMPT and volumetric-modulated arc therapy (VMAT) for patients with nasopharyngeal carcinoma (NPC). A total of six patients with NPC treated by IMPT were enrolled in the study. Target volumes and organs at risk (OARs) were delineated, including 12 samples of right and left VAs, respectively, for each patient. Treatment planning by IMPT and dual-arc VMAT was carried out for comparison. The IMPT plan significantly reduced VA mean dose, V10, V20, V30, V40, and V50, compared to the VMAT plan in all 12 samples (p < 0.001). The average mean dose to VAs for IMPT was 35.2% (23.4-46.9%), which was less compared to VMAT (p < 0.001). Adequate dose coverage was achieved with both IMPT and VMAT plans for three different dose levels of target volumes for all patients. IMPT significantly reduces VA dose while maintaining adequate dose coverage of all target volumes. For patients with head and neck cancer who seek to preserve their blood flow to the brain in order to decrease late vascular and neurologic sequelae, IMPT should be considered. A prospective study with longer follow-up is ongoing to confirm our preliminary results.