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Chemotherapeutic drugs and radiotherapy are fundamental treatments to combat cancer, but, often, the doses in these treatments are restricted by their non-selective toxicities, which affect healthy tissues surrounding tumors. On the other hand, drug resistance is recognized as the main cause of chemotherapeutic treatment failure. Rosmarinic acid (RA) is a polyphenol of the phenylpropanoid family that is widely distributed in plants and vegetables, including medicinal aromatic herbs, consumption of which has demonstrated beneficial activities as antioxidants and anti-inflammatories and reduced the risks of cancers. Recently, several studies have shown that RA is able to reverse cancer resistance to first-line chemotherapeutics, as well as play a protective role against toxicity induced by chemotherapy and radiotherapy, mainly due to its scavenger capacity. This review compiles information from 56 articles from Google Scholar, PubMed, and ClinicalTrials.gov aimed at addressing the role of RA as a complementary therapy in cancer treatment.
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Cinnamates , Depsides , Drug Resistance, Neoplasm , Neoplasms , Rosmarinic Acid , Depsides/pharmacology , Depsides/chemistry , Depsides/therapeutic use , Cinnamates/pharmacology , Cinnamates/therapeutic use , Cinnamates/chemistry , Humans , Neoplasms/drug therapy , Drug Resistance, Neoplasm/drug effects , Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Animals , Antioxidants/pharmacology , Antioxidants/therapeutic useABSTRACT
PURPOSE: This study investigated the role of resilience and coping strategies on breast cancer patients' well-being using a structural equation model. To achieve this objective, a model previously developed by Mayordomo's group was partially replicated using a longitudinal study design in an oncological sample. METHODS: The study was a longitudinal observational survey. Patients with breast cancer were recruited (N = 166). Resilience was measured with the Mexican Resilience Measurement Scale, coping strategies with the Forms of Coping and Dimensions Scale and perception of the psychological well-being with a short-form of Ryff's Scales of Psychological Well-Being at the start and end of adjuvant chemotherapy (T1 and T2 respectively). RESULTS: The results showed stability in the variables over time and revealed differences with respect to Mayordomo's model. The best predictor of well-being at T2 was well-being at T1. In addition, the model indicated that resilience had a direct impact on well-being through problem-focused coping. Indeed, resilience and problem-focused coping best explained well-being at T2. CONCLUSIONS: Both at the start and end of adjuvant chemotherapy for breast cancer, problem-focused coping positively predicted resilience, which in turn was a positive predictor of well-being. On the other hand, emotion-focused coping showed no association with resilience or well-being. As part of the multidisciplinary cancer team, oncology nurses have a key role to play in promoting resilience and problem-focused coping as an important goal of psychosocial interventions in breast cancer patients.
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Adaptation, Psychological , Breast Neoplasms , Resilience, Psychological , Humans , Female , Breast Neoplasms/psychology , Breast Neoplasms/therapy , Breast Neoplasms/drug therapy , Middle Aged , Longitudinal Studies , Adult , Aged , Chemotherapy, Adjuvant/psychology , Mexico , Quality of Life , Surveys and Questionnaires , Coping SkillsABSTRACT
Cancer is a global health concern influenced by genetics, environment and lifestyle choices. Recent research shows that a ketogenic diet (KD) might ease cancer symptoms and reduce tumour size. We hypothesised that the KD could result in improvements in cancer-related variables. Therefore, this study aims to perform a systematic review and meta-analysis to assess the KD's efficacy for patients with cancer. The databases PubMed (MEDLINE), Web of Science, CINAHL and Open Grey were utilised for conducting a systematic review and meta-analysis. The analysis was limited to randomised controlled trials with adult participants aged 18 years and above. Levels of glucose, cholesterol, insulin-like growth factor 1, weight and quality of life were evaluated following the KD. After identifying 596 articles in the initial search, eight studies, lasting between 4 and 16 weeks, were included in the systematic review and seven in the meta-analysis. The KD led to decreased glucose levels in patients with cancer but did not show significant improvements in cholesterol, insulin-like growth factor 1, weight or quality of life. Based on the results of this systematic review and meta-analysis, there is insufficient evidence to establish a definitive link between the KD and cancer-related parameters. While some studies suggest potential benefits in terms of some outcomes and tumour size reduction, further research is required to fully comprehend the effects of this diet.
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Blood Glucose , Diet, Ketogenic , Neoplasms , Quality of Life , Randomized Controlled Trials as Topic , Humans , Neoplasms/diet therapy , Blood Glucose/metabolism , Blood Glucose/analysis , Cholesterol/blood , Insulin-Like Growth Factor I/metabolism , Body Weight , AdultABSTRACT
BACKGROUND: This study examined temporal shifts in adjuvant therapy patterns in Japanese patients with resectable gastric cancer (GC) and treatment patterns of first-line and subsequent therapy among those with recurrent disease. METHODS: This retrospective analysis of hospital-based administrative claims data (April 1, 2008 to March 31, 2022) included adults (aged ≥ 20 years) with GC who started adjuvant therapy on or after October 1, 2008 (adjuvant cohort) and patients in the adjuvant cohort with disease recurrence (recurrent cohort), further defined by the time to recurrence (≤ 180 or > 180 days after adjuvant therapy). RESULTS: In the adjuvant cohort (n = 17,062), the most common regimen during October 2008-May 2016 was tegafur/gimeracil/oteracil potassium (S-1; 95.7%). As new standard adjuvant regimen options were established, adjuvant S-1 use decreased to 65.0% and fluoropyrimidine plus oxaliplatin or docetaxel plus S-1 use increased to 15.0% and 20.0%, respectively, in September 2019-March 2022. In the recurrent cohort with no history of trastuzumab/trastuzumab deruxtecan treatment (n = 1257), the most common first-line regimens were paclitaxel plus ramucirumab (34.0%), capecitabine plus oxaliplatin (CapeOX; 17.0%), and nab-paclitaxel plus ramucirumab (10.1%) in patients with early recurrence, and S-1 plus oxaliplatin (26.3%), S-1 plus cisplatin (15.3%), CapeOX (14.0%), S-1 (13.2%), and paclitaxel plus ramucirumab (10.8%) in those with late recurrence. CONCLUSIONS: This study demonstrated temporal shifts in adjuvant treatment patterns that followed the establishment of novel regimens, and confirmed that post-recurrent treatment patterns were consistent with the Japanese Gastric Cancer Association guideline recommendations.
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Antineoplastic Combined Chemotherapy Protocols , Neoplasm Recurrence, Local , Stomach Neoplasms , Tegafur , Humans , Stomach Neoplasms/drug therapy , Stomach Neoplasms/surgery , Stomach Neoplasms/pathology , Stomach Neoplasms/therapy , Female , Male , Retrospective Studies , Middle Aged , Aged , Japan , Chemotherapy, Adjuvant , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neoplasm Recurrence, Local/drug therapy , Neoplasm Recurrence, Local/pathology , Tegafur/administration & dosage , Tegafur/therapeutic use , Adult , Oxonic Acid/administration & dosage , Oxonic Acid/therapeutic use , Drug Combinations , Databases, Factual , Cohort Studies , Oxaliplatin/administration & dosage , Oxaliplatin/therapeutic use , Young Adult , Aged, 80 and over , PyridinesABSTRACT
Introduction: The bladder exstrophy-epispadias complex is a rare congenital disease. Urothelial carcinomas rarely occur in patients with this disease, and there have been few reports on its treatment. Case presentation: We report the case of a 44-year-old man with a hemorrhage from the external urethral meatus. He was diagnosed with bladder exstrophy-epispadias complex and underwent urinary diversion with substitution cystoplasty and Mitrofanoff appendicovesicostomy. Because computed tomography and magnetic resonance imaging suggested invasive bladder carcinoma in the defunctionalized bladder, we performed a cystectomy. The patient was diagnosed with urothelial carcinoma with glandular differentiation. One month after the surgery, nivolumab adjuvant chemotherapy was administered. The patient showed no signs of recurrence or metastasis after the treatment. Conclusion: This is the first case of adjuvant nivolumab therapy for urothelial carcinoma with the bladder exstrophy-epispadias complex.
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Neoadjuvant chemoradiotherapy is a part of the current standard treatment mode for locally advanced rectal cancer,which enables a certain proportion of patients to achieve complete tumor response,improving the surgical resection rate and anal retention rate,and then prolonging the disease-free survival period of patients.MRI is the preferred imaging examination to evaluate the efficacy of neoadjuvant therapy.With the development of functional MRI,quantitative parameters derived from different imaging principles can provide more biological information about tumors,improving the clinical application value of MRI.Multi-parameter MRI combining conventional MRI sequences and functional sequences can more comprehensively evaluate the efficacy of neoadjuvant therapy,which is conducive to developing individualized treatment plans for patients in clinical practice and realize precision medicine.
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Objective:To assess the effectiveness and safety of beat chemotherapy in treating non-small cell lung cancer, and to investigate its anti-tumor molecular mechanism.Methods:In this study, we developed a subcutaneous tumor model of lung cancer in mice.The mice were subsequently divided into two groups: the beat chemotherapy group and the placebo group(negative control group).Throughout the treatment period, we monitored the changes in body weight and tumor size of the mice.At the conclusion of the treatment, we collected blood samples from the mice to conduct blood routine and biochemical examinations.Furthermore, we obtained tumor tissues from the mice to perform immunohistochemical staining and sequencing of the transcriptome.Results:The study found that beat chemotherapy could effectively delay the growth of lung cancer.The tumor tissues in the beat chemotherapy group were significantly smaller compared to the placebo group.The results of routine blood and blood biochemistry tests showed that the levels of red blood cells(RBCs), white blood cells(WBCs), alanine aminotransferase(ALT), aspartate aminotransferase(AST)and blood creatinine(Scr)were similar between the placebo group and the beat chemotherapy group.The values for RBCs, WBCs, ALT, AST and Scr in the placebo group were(6.97 ± 0.41)× 10 12/L, (13.26 ± 0.29)× 10 9/L, (33.33 ± 2.51)U/L, (235.33 ± 57.62)U/L and(20.67 ± 2.08)μmol/L, respectively.The corresponding values in the beat chemotherapy group were(6.87 ± 0.66)× 10 12/L, (12.59 ± 2.27)× 10 9/L, (38.67 ± 3.79)U/L, (225.33 ± 6.81)U/L and(20.33 ± 3.79)μmol/L.Statistical analysis showed no significant differences between the two groups( t=0.509, 0.209, 2.032, 0.299, 0.134, P=0.638, 0.845, 0.112, 0.780, 0.900).Furthermore, there were no signs of inflammatory infiltration or pathological changes in the liver, kidney, spleen, and lung tissues of the mice.Transcriptome analysis identified 68 differentially expressed genes, which were mainly associated with signal transduction and immunity.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis revealed the involvement of several signaling pathways, including the transforming growth factor β(TGF-β)signaling pathway, the interleukin-17(IL-17)signaling pathway, and the tumor necrosis factor(TNF)signaling pathway. Conclusions:The use of chemotherapy has been proven to be safe and effective in treating non-small cell lung cancer.It primarily functions by regulating tumor growth through various signaling pathways, including the TGF-β signaling pathway, IL-17 signaling pathway, and TNF.
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ABSTRACT Background: The depth of response to platinum in urothelial neoplasm tissues varies greatly. Biomarkers that have practical value in prognosis stratification are increasingly needed. Our study aimed to select a set of BC (bladder cancer)-related genes involved in both platinum resistance and survival, then use these genes to establish the prognostic model. Materials and Methods: Platinum resistance-related DEGs (differentially expressed genes) and tumorigenesis-related DEGs were identified. Ten most predictive co-DEGs were acquired followed by building a risk score model. Survival analysis and ROC (receiver operating characteristic) plot were used to evaluate the predictive accuracy. Combined with age and tumor stages, a nomogram was generated to create a graphical representation of survival rates at 1-, 3-, 5-, and 8-year in BC patients. The prognostic performance was validated in three independent BC datasets with platinum-based chemotherapy. The potential mechanism was explored by enrichment analysis. Results: PPP2R2B, TSPAN7, ATAD3C, SYT15, SAPCD1, AKR1B1, TCHH, AKAP12, AGLN3, and IGF2 were selected for our prognostic model. Patients in high- and low-risk groups exhibited a significant survival difference with HR (hazard ratio) = 2.7 (p < 0.0001). The prognostic nomogram of predicting 3-year OS (overall survival) for BC patients could yield an AUC (area under the curve) of 0.819. In the external validation dataset, the risk score also has a robust predictive ability. Conclusion: A prognostic model derived from platinum resistance-related genes was constructed, we confirmed its value in predicting platinum-based chemotherapy benefits and overall survival for BC patients. The model might assist in therapeutic decisions for bladder malignancy.
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Objective:To investigate the effects of different radiotherapy regimens on the short-term and long-term prognosis of patients with limited-stage small cell lung cancer (SCLC).Methods:Sixty patients with limited-stage SCLC in the Third People′s Hospital of Yangquan City from September 2017 to September 2019 were selected. The patients who received concurrent radiotherapy and chemotherapy were in group A and the patients who received sequential radiotherapy and chemotherapy were in group B, 30 cases in each group. The short-term efficacy and adverse reactions of the two groups were compared, and the levels of neuron-specific enolase (NSE), gastrin release precursor (ProGRP), carcinoembryonic antigen (CEA), vascular endothelial growth factor (VEGF), endostatin (ES), circulating endothelial cells (CEC) were compared between the two groups. The survival status of the two groups were followed-up.Results:After treatment, the disease control rate in group A was higher than that in the group B : 80.00%(24/30) vs. 53.33%(16/30), the difference was statistically significant ( χ2 = 4.80, P<0.05). The levels of serum NSE, ProGRP and CEA in the group A after treatment were lower than those in the group B: (19.42 ± 3.31) pg/L vs. (24.58 ± 4.42) pg/L, (95.45 ± 10.33) ng/L vs. (115.54 ± 15.66) ng/L, (8.25 ± 1.02) μg/L vs. (10.33 ± 1.15) μg/L, the differences were statistically significant ( P<0.05). The levels of VEGF and CEC in the group A were lower than those in the group B after treatment and ES was higher than that in the group B: (356.62 ± 56.63) ng/L vs. (442.21 ± 55.38) ng/L, (65.56 ± 5.41) × 10 6/L vs. (99.28 ± 7.24) ×10 6/L, (52.65 ± 6.44) μmol/L vs. (31.85 ± 5.49) μmol/L, the differences were statistically significant ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05). The survival rate in the group A was higher than that in the group B at 1 year after treatment: 82.14%(23/28) vs. 56.00%(14/25), the difference was statistically significant ( χ2 = 4.28, P = 0.038). Conclusions:Compared with sequential radiotherapy and chemotherapy, concurrent radiotherapy and chemotherapy is effective in treating limited-stage SCLC, which can adjust the level of tumor markers and angiogenesis indicators, and improve the treatment effect and survival rate.
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Objective:To identify the risk factors associated with postoperative adjuvant chemotherapy in patients with stage I gastric cancer and establish nomograms model based on risk factors.Methods:In this retrospective case-control study, 161 cases with stage Ⅰ primary gastric adenocarcinoma were included who underwent gastrectomy at the Department of General Surgery of the First Medical Center of Chinese PLA General Hospital from January to December in 2020, including 129 male cases and 32 females cases, with the average age of (59.90±0.80) years. Among them, 41 cases were treated with postoperative adjuvant chemotherapy (chemotherapy group), while 120 cases who did not receive postoperative adjuvant chemotherapy (no chemotherapy group). Univariate and multivariate Logistic regression analyses were used to identify the risk factors of adjuvant chemotherapy in stage Ⅰ gastric cancer patients and establish the nomograms predictive model. ROC curve and calibration curve were used to evaluate the performance of the model.Results:Multivariate analysis revealed that primary tumor site, tumor size, T stage, N stage lymph-vascular tumor embolus or perineural invasion were the independent risk factors of postoperative adjuvant chemotherapy for stage Ⅰ gastric cancer( P<0.05). The ROC curve indicated that area under the curve (AUC) of the multivariate model was 0.91(95% CI: 0.86-0.97). The calibration curve showed that probability predicted by nomograms was consistent with the actual situation(C-index: 0.91). Conclusions:The tumor located in the proximal stomach, tumor size>2 cm, T 2, N 1, lymph-vascular tumor embolus or perineural invasion maybe be the risk factors for chemotherapy decision in stage Ⅰ gastric cancer patients. The established model has good predictive ability for postoperative chemotherapy of stage Ⅰ gastric cancer patients, which might provide reference for the selection of clinical decisions in this part of patients.
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Objective:To analyze the effects of the primary location of colorectal cancer on the surgical outcome of liver metastases.Methods:A cross-sectional study was conducted on 178 patients with liver metastases from colorectal cancer admitted to Binzhou Central Hospital from January 2012 to January 2022. According to whether the patients had recurrence after surgery, they were divided into a recurrence group ( n = 88) and a control group ( n = 90). The general and clinical data were compared between the two groups. Logistic multivariate analysis of the factors with statistical significance was further performed to identify the risk factors of postoperative recurrence of liver metastases from colorectal cancer after surgery. The correlation between the primary location of colorectal cancer and each risk factor was analyzed. The recurrence of colorectal cancer was compared anong patients with different primary locations of colorectal cancer at 12 months after surgery. Results:Primary location at the right colon [55.68% (49/88), lymph node metastasis [92.05% (81/88)], D-dimer ≥ 180 μ g/L, albumin < 29 g/L, ineffective/no neoadjuvant chemotherapy [43.18% (33/38)], and high-risk clinical risk score [53.41% (47/88)] were risk factors for postoperative recurrence of liver metastases from colorectal cancer after surgery ( P = 0.024, 0.019, 0.001, 0.028, < 0.001, 0.001). The primary location of colorectal cancer was positively correlated with lymph node metastasis, D-dimer, and clinical risk score ( P = 0.043, 0.046, 0.030), and negatively correlated with albumin and the efficacy of neoadjuvant chemotherapy ( P = 0.004, 0.033). In 178 patients, the recurrence rate of liver metastases from colorectal cancer at 3 months [53.57% (15/70)], 6 months [55.17% (32/70)], and 12 months [55.68% (49/70)] was significantly higher in the right colon compared with the left colon [32.14% (9/40), 24.14% (14/40), 26.14% (23/40) and the rectum [14.29% (4/68), 20.69% (12/68), 18.18% (16/68)] ( χ2= 4.73, 7.85, 6.27, all P < 0.05). Conclusion:Right colon, lymph node metastasis, D-dimer, albumin, neoadjuvant chemotherapy efficacy, and clinical risk score are the risk factors for postoperative recurrence of liver metastases from colorectal cancer. Patients with the primary location at the right colon have a higher postoperative recurrence rate.
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Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. With the emergence of chemotherapy resistance in recent years, the survival rate of osteosarcoma patients has reached a bottleneck. Therefore, exploration of its chemoresistance mechanism is one of the popular research directions currently. Non-coding RNA (ncRNA) is a class of RNA without the ability to encode proteins, which is classified into microRNA, long non-coding RNA, and circular RNA based on length and shape. With the development of high-throughput sequencing technology, there is increasing evidence that some non-coding RNAs are abnormally upregulated or downregulated in osteosarcoma cells and affect the response of osteosarcoma to four commonly used chemotherapeutic drugs (methotrexate, doxorubicin, cisplatin and ifosfamide) through mechanisms such as regulation of apoptosis, cell cycle, signaling pathways, intracellular drug concentration, and cellular autophagy. Therefore, thesenon-coding RNAs are expected to be novel targets for osteosarcoma treatment. In this paper, the current studies were searched and reviewed on the above three non-coding RNAs mediating chemoresistance in osteosarcoma, aiming to provide a reference for breaking the bottleneck of survival rate of osteosarcoma patients.
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Objective:To analyze the correlation between the level of circulating tumor cells(CTC)and the efficacy of neoadjuvant therapy in breast cancer.Methods:A total of 79 patients with breast cancer who underwent neoadjuvant therapy between October 2020 and December 2022 were included in this study.Venous blood samples were collected before and after treatment to measure the number of mononuclear cells and the presence of cytokeratin-19(CK-19)positive circulating tumor cells(CTCs).Results:The pre-treatment positive detection rate of CTC in patients was 26.6%(21/79), and it was found to be correlated with HER-2 expression, TNM staging, and KI-67 percentage.After neoadjuvant therapy, the positive rate of CTC decreased to 8.9%(7/79), which was lower than the rate before neoadjuvant therapy( χ2=16.185, P<0.001).Based on the CTC results measured before and after neoadjuvant therapy, the groups were classified into negative/negative, positive/positive, negative/positive, and positive/negative groups.In accordance with the RECIST standard, the predicted efficacy was 75.0%(36/48)in the CTC negative/negative group and 83.3%(20/24)in the positive/negative group.The treatment effectiveness rate was notably higher compared to the CTC positive/positive group, which had a rate of 25.0%(1/4), and the negative/positive group, which had a rate of 0.0%(0/3)( χ2=13.886, P=0.003).According to Miller Payne's standard for predicting efficacy, the treatment effectiveness rate in the CTC negative/negative group was 72.9%(35/48), while in the positive/negative group it was 79.2%(19/24).These rates were significantly higher than the rates in the CTC positive/positive group(50.0%, 2/4)and the negative/positive group(0.0%, 0/3).( χ2=9.043, P=0.029). Conclusion:There is a correlation between the level of circulating tumor cells(CTC)and the efficacy of neoadjuvant therapy.CTC can be considered as an evaluation indicator for assessing the efficacy of neoadjuvant therapy.
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Objective:To investigate the clinical effects of neoadjuvant chemotherapy on different types of borderline resectable pancreatic cancer.Methods:The clinical data of 46 patients with borderline resectable pancreatic cancer admitted to Peking University Third Hospital from Jan 2017 to Aug 2021 were retrospectively analyzed, including 26 with arterial borderline resectable pancreatic cancer (ABRPC) and 20 with venous borderline resectable pancreatic cancer (VBRPC). Eighteen patients of VBRPC and 15 patients of ABRPC were then successfully received surgical resection.Results:After neoadjuvant chemotherapy, CA19-9 levels decreased significantly ( P<0.05), while other indicators were not statistically different ( P>0.05). Compared with the non-surgical group, the diameter of the tumour was significantly reduced after neoadjuvant chemotherapy ( P<0.05). The surgical resection rate of 90.0% in the VBRPC group was higher than that of 57.7% in the ABRPC group ( P=0.037). Conclusions:Patients with significantly tumour progress after neoadjuvant chemotherapy are difficult to benefit from neoadjuvant chemotherapy; Venous borderline resectable pancreatic cancer patients had a higher surgical resection rate than those with ABRPC after neoadjuvant chemotherapy.
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Introducción: El cáncer colorrectal es un problema de salud creciente en el mundo, el aumento en la expectativa de vida de las poblaciones, el continuo mejoramiento de las técnicas de tamizaje y la búsqueda activa de casos, son las razones por las cuales cada año se informa un aumento en el número global de casos diagnosticados con cáncer. Objetivo: Caracterizar a los pacientes operados de cáncer colorrectal tratados con quimioterapia. Métodos: Se realizó un estudio observacional, descriptivo de corte transversal, en pacientes atendidos en la consulta multidisciplinaria de cáncer colorrectal. El universo lo conformaron todos los pacientes que acudieron a consulta en ese período, la muestra a criterio de los autores la conformaron 55 pacientes tratados con quimioterapia adyuvantes por cáncer colorrectal. La fuente primaria de la investigación estuvo dada por la historia clínica. Resultados: En cuanto a la relación sexo y edad, se observó una mayor frecuencia del grupo de 70-79 años y en el sexo femenino. Según la localización topográfica existió predominio en colon sigmoides con 33 pacientes para un 60 % de la muestra estudiada. La variante histológica adenocarcinoma moderadamente diferenciado fue la de mayor presentación. Predominaron los pacientes en estadio IIIa de la enfermedad. El esquema de quimioterapia usado con mayor frecuencia fue el Folfox. Conclusiones: En la muestra, la mayoría de los pacientes estuvieron incluidos en el grupo etáreo entre 70-79 años de edad. La localización topográfica más frecuente fue el colon sigmoide y el tipo histológico, el adenocarcinoma moderadamente diferenciado. Predominaron los pacientes en el estadio IIIa y el tratamiento con quimioterapia adyuvante más utilizado fue el esquema de Folfox.
Introduction: Colorectal cancer is a growing health problem in the world, the increase in the life expectancy of populations, the continuous improvement of screening techniques and the active search for cases, are the reasons why an increase in the global number of cases diagnosed with cancer is reported each year. Objective: To characterize the patients operated on for colorectal cancer treated with adjuvant chemotherapy. Methods: An observational, descriptive, cross-sectional study was carried out in patients seen at the multidisciplinary colorectal cancer clinic. The universe was made up of all the patients who attended the consultation in that period, the sample at the authors' criteria was made up of 55 patients treated with adjuvant chemotherapy for colorectal cancer. The primary source of the investigation was given by the clinical history. Results: Regarding the relationship between sex and age, a higher frequency was observed in the group of 70-79 years and in the female sex. Regarding the topographic location, there was a predominance in the sigmoid colon with 33 patients for 60% of the sample studied. The moderately differentiated adenocarcinoma histological variant was the one with the highest presentation. Patients in stage IIIa of the disease were more frequent. The most frequently used chemotherapy regimen was Folfox. Conclusions: In the sample, most of the patients were included in the age group between 70-79 years of age. The most frequent topographic location was the sigmoid colon and the histological type was moderately differentiated adenocarcinoma. Patients in stage IIIa predominated and the most widely used adjuvant chemotherapy treatment was the Folfox regimen.
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Locally advanced rectal cancer has historically been considered as a challenge in colorectal surgery. Preoperative neoadjuvant chemoradiotherapy combined with total mesorectal excision is the current standard mode. However, there are differences between domestic and foreign guidelines for patients with different stages. Neoadjuvant treatment of locally advanced rectal cancer has improved local control and enhanced sphincter preservation but has not improved overall survival. In addition, neoadjuvant therapy also brings related complications and affects the quality of life of patients. Stratified treatment according to accurate staging of rectal MRI is the focus of current clinical research. For low-intermediate risk patients, surgery alone or neoadjuvant chemotherapy combined with selective radiotherapy will hopefully lead to a more personalized treatment of rectal cancer. For high risk patients, total neoadjuvant therapy mode enhances the intensity of neoadjuvant chemotherapy, which may prevent distant failure and benefit overall survival. The role of immunotherapy in neoadjuvant treatment of rectal cancer has achieved exciting short-term results, while the long-term efficacy needs to be further confirmed. This article will describe the revelant strategies for optimizing the neoadjuvant treatment mode of rectal cancer based on the existing evidence.
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Objective:To investigate the correlation between serum microRNA (miR)-15a-5p and prognosis, neoadjuvant chemotherapy (NAC) response in patients with locally advanced gastric cancer (LAGC).Methods:The clinical data of 122 patients with LAGC who underwent surgery after NAC in Eastern Theater Air Force Hospital of the Chinese People′s Liberation Army from May 2016 to April 2020 were analyzed retrospectively. The general clinical data and laboratory examination results of the patients were recorded. The expression level of serum miR-15a-5p was detected by real-time fluorescence quantitative polymerase chain reaction, and the relationship between the expression of miR-15a-5p and different clinical characteristics in patients with LAGC was analyzed. The pathological response was evaluated by Becker tumor regression grading, in which patients with grade 1a, 1b and 2 were sensitive group and patients with grade 3 were resistant group.Results:The patients with LAGC were divided into high expression (>1.038) and low expression (≤1.038) according to the median miR-15a-5p of 1.038 with 61 cases each. The expression level of serum miR-15a-5p was related to the preference for spicy food, endoscopic ultrasonography (EUS)-T stage and EUS-N stage ( P<0.01 or <0.05). According to the evaluation result of pathological reaction, there were 47 cases in resistance group and 74 cases in sensitive group. The serum miR-15a-5p in resistance group was significantly higher than that in sensitive group: 1.69 (1.39, 1.97) vs. 0.99 (0.96, 1.02), and there was statistical difference ( Z =-8.55, P<0.01). The receiver operating characteristic curve analysis result showed that the area under the curve of serum miR-15a-5p predicting NAC response was 0.959 (95% CI 0.929 to 0.990), the optimal cut-off value was 1.049, the sensitivity was 100.0%, and the specificity was 85.1%. Multivariate Logistic regression analysis result showed that miR-15a-5p was an independent risk factor for NAC response in patients with LAGC ( HR = 1 880.840, 95% CI 123.510 to 28 641.846, P<0.01). Kaplan-Meier survival curve analysis result showed that the median overall survival time and median progression free survival time in patients with high expression of miR-15a-5p were significantly shorter than those in patients with low expression of miR-15a-5p (19 months vs. 62 months and 12 months vs. 51 months), and there were statistical differences (log-rank χ2 = 41.99 and 61.97, P<0.01); the 10-year overall survival rate and 10-year progression free survival rate in patients with high expression of miR-15a-5p were significantly lower than those in patients with low expression of miR-15a-5p (4.9% vs. 52.5% and 24.6% vs. 85.2%), and there were statistical differences (log-rank χ2 = 33.70 and 45.32, P<0.01). Multivariate Cox regression analysis result showed that R 0 resection and miR-15a-5p were the independent risk factors affecting the overall survival time and progression free survival time in patients with LAGC (overall survival time: HR = 1.945 and 3.487, 95% CI 1.033 to 3.660 and 2.112 to 5.759, P<0.05 or <0.01; progression free survival time: HR = 2.427 and 6.335, 95% CI 1.069 to 5.510 and 3.341 to 12.013, P<0.05 or <0.01). Conclusions:The increase of serum miR-15a-5p level is related to NAC response and poor prognosis in patients with LAGC. It can be used as a reliable biomarker to predict the prognosis and NAC response of LAGC.
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In recent years, the incidence rate of breast cancer has increased rapidly and is tending to be younger. The application of neoadjuvant chemotherapy (NAC) can reduce the tumor stage, which is conducive to surgical resection or breast conserving surgery. Therefore, it is very important to evaluate the curative effect of NAC in breast cancer by imaging for the choice of operation timing. In recent years, with the rapid development of new ultrasound technologies such as contrast-enhanced ultrasound and elastography, these new technologies can provide more abundant imaging information and basis for individualized treatment of breast cancer, which has become a research hotspot of the curative effect of breast cancer NAC. This article reviews the research progress of new ultrasound technology in evaluating the curative effect of NAC in breast cancer in recent years.
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Breast cancer has become the most common malignant tumor among women worldwide. Neoadjuvant chemotherapy (NAC) is a systemic cytotoxic drug therapy for breast cancer before local therapy, which can reduce the tumor staging, improve the pathological complete response rate and breast preservation rate. The therapeutic efficacy of NAC is affected by many factors. Imaging examination is of great clinical value to accurately evaluate the efficacy of patients undergoing NAC. This article reviews the progress of imaging methods such as X-ray, ultrasound, magnetic resonance imaging and PET in evaluating the efficacy of NAC in breast cancer.
ABSTRACT
Objective:To investigate the efficacy and safety of DOS regimen in adjuvant chemotherapy after D2 radical resection for advanced gastric adenocarcinoma.Methods:The clinical data of 130 patients who received adjuvant chemotherapy after D2 radical resection for advanced gastric adenocarcinoma in Jincheng People's Hospital from January 2017 to January 2019 were retrospectively analyzed. According to treatment regimens, the patients were divided into DOS regimen chemotherapy group (DOS group, 63 cases) and SOX (oxaliplatin, S-1) regimen chemotherapy group (SOX group, 67 cases). The short-term efficacy and adverse reactions of the two groups were compared.Results:Due to the irregular treatment time, 2 cases in each group were removed. Finally, there were 61 cases in DOS group and 65 cases in SOX group. The 1-, 2- and 3-year disease-free survival (DFS) rates of the DOS group were 80.33%, 73.77% and 62.30%, and the DFS rates of the SOX group were 73.85%, 55.38% and 41.54%. The difference in DFS between the two groups was statistically significant ( χ2 = 5.43, P = 0.022). The 1-, 2- and 3-year overall survival (OS) rates of the DOS group were 93.44%, 80.33% and 70.50%, and the OS rates of the SOX group were 96.92%, 73.85% and 52.31%. The difference in OS between the two groups was statistically significant ( χ2 = 4.38, P = 0.045). There were no statistical differences in the incidence rates of grade Ⅰ-Ⅱ nausea, vomiting, diarrhea, bone marrow suppression and fatigue between the two groups (all P > 0.05). There were no statistical differences in the incidence rates of grade Ⅲ-Ⅳ nausea, vomiting and fatigue (both P > 0.05), but there were statistical significances in the incidence rates of grade Ⅲ-Ⅳ diarrhea and bone marrow suppression (both P < 0.05). Conclusions:Adjuvant DOS regimen in the treatment of advanced gastric adenocarcinoma after D2 radical resection has good curative efficacy and can improve the survival of patients, and the adverse reactions can be tolerated.