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1.
Mol Clin Oncol ; 21(4): 66, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39091418

RESUMEN

Radiotherapy (RT) is one of the most widely used and effective cancer treatments. With the increasing need for organ reconstruction and advancements in material technology, an increasing number of patients with cancer have metallic implants. These implants can affect RT dosage and clinical outcomes, warranting careful consideration by oncologists. The present review discussed the mechanisms by which different types of metallic implants impact various stages of the RT process, examined methods to mitigate these effects during treatment, and discussed the clinical implications of metallic implants on RT outcomes. In summary, when metallic implants are present within the RT field, oncologists should carefully assess their impact on the treatment.

2.
Sci Rep ; 14(1): 15606, 2024 Jul 06.
Artículo en Inglés | MEDLINE | ID: mdl-38971868

RESUMEN

Coaxial nozzles are widely used to produce fibers with core-shell structures. However, conventional coaxial nozzles cannot adjust the coaxiality of the inner and outer needles in real-time during the fiber production process, resulting in uneven fiber wall thickness and poor quality. Therefore, we proposed an innovative semi-flexible coaxial nozzle with a dynamic self-centering function. This new design addresses the challenge of ensuring the coaxiality of the inner and outer needles of the coaxial nozzle. First, based on the principles of fluid dynamics and fluid-structure interaction, a self-centering model for a coaxial nozzle is established. Second, the influence of external fluid velocity and inner needle elastic modulus on the centering time and coaxiality error is analyzed by finite element simulation. Finally, the self-centering performance of the coaxial nozzle is verified by observing the coaxial extrusion process online and measuring the wall thickness of the formed hollow fiber. The results showed that the coaxiality error increased with the increase of Young's modulus E and decreased with the increase of flow velocity. The centering time required for the inner needle to achieve force balance decreases with the increase of Young's modulus ( E ) and fluid velocity ( v f ). The nozzle exhibits significant self-centering performance, dynamically reducing the initial coaxiality error from 380 to 60 µm within 26 s. Additionally, it can mitigate the coaxiality error caused by manufacturing and assembly precision, effectively controlling them within 8 µm. Our research provides valuable references and solutions for addressing issues such as uneven fiber wall thickness caused by coaxiality errors.

3.
PLoS One ; 19(7): e0306595, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38968190

RESUMEN

PURPOSE: Given the unique features of the liver, it is necessary to combine immunotherapy with other therapies to improve its efficacy in patients of advanced cancer with liver metastases (LM). High-intensity focused ultrasound (HIFU) ablation is now widely used in clinical practice and can enhanced immune benefits. The study is intended to prospectively evaluate the safety and clinical feasibility of HIFU ablation in combination with systemic immunotherapy for patients with liver metastases. METHODS: The study enrolled 14 patients with LM who received ultrasound-guided HIFU ablation combined with immune checkpoint inhibitors (ICIs) such as anti-programmed cell death protein 1 (anti-PD-1 agents manufactured in China) at Mianyang Central Hospital. Patients were followed up for adverse events (AEs) during the trial, using the CommonTerminology Criteria for Adverse Events v5.0(CTCAE v5.0) as the standard. Tumour response after treatment was assessed using computerized tomography. RESULTS: The 14 patients (age range, 35-84 years) underwent HIFU ablation at 19 metastatic sites and systemic immunotherapy. The mean lesion volume was 179.9 cm3 (maximum: 733.1 cm3). Median follow-up for this trial was 9 months (range: 3-21) months. The study is clinically feasible and acceptable to patients. CONCLUSION: This prospective study confirmed that HIFU combined with immunotherapy is clinically feasible and safe for treating liver metastases.


Asunto(s)
Ultrasonido Enfocado de Alta Intensidad de Ablación , Inmunoterapia , Neoplasias Hepáticas , Humanos , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/terapia , Persona de Mediana Edad , Ultrasonido Enfocado de Alta Intensidad de Ablación/métodos , Masculino , Anciano , Femenino , Adulto , Estudios Prospectivos , Inmunoterapia/métodos , Anciano de 80 o más Años , Terapia Combinada , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Resultado del Tratamiento
4.
Anal Chem ; 96(33): 13410-13420, 2024 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-38967251

RESUMEN

As one of the most common cancers, accurate, rapid, and simple histopathological diagnosis is very important for breast cancer. Raman imaging is a powerful technique for label-free analysis of tissue composition and histopathology, but it suffers from slow speed when applied to large-area tissue sections. In this study, we propose a dual-modal Raman imaging method that combines Raman mapping data with microscopy bright-field images to achieve virtual staining of breast cancer tissue sections. We validate our method on various breast tissue sections with different morphologies and biomarker expressions and compare it with the golden standard of histopathological methods. The results demonstrate that our method can effectively distinguish various types and components of tissues, and provide staining images comparable to stained tissue sections. Moreover, our method can improve imaging speed by up to 65 times compared to general spontaneous Raman imaging methods. It is simple, fast, and suitable for clinical applications.


Asunto(s)
Neoplasias de la Mama , Espectrometría Raman , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Humanos , Espectrometría Raman/métodos , Femenino , Coloración y Etiquetado
5.
JAMA ; 332(7): 561-570, 2024 08 20.
Artículo en Inglés | MEDLINE | ID: mdl-38820549

RESUMEN

Importance: For patients with non-small cell lung cancer whose disease progressed while receiving EGFR tyrosine kinase inhibitor (EGFR-TKI) therapy, particularly third-generation TKIs, optimal treatment options remain limited. Objective: To compare the efficacy of ivonescimab plus chemotherapy with chemotherapy alone for patients with relapsed advanced or metastatic non-small cell lung cancer with the epidermal growth factor receptor (EGFR) variant. Design, Setting, and Participants: Double-blind, placebo-controlled, randomized, phase 3 trial at 55 sites in China enrolled participants from January 2022 to November 2022; a total of 322 eligible patients were enrolled. Interventions: Participants received ivonescimab (n = 161) or placebo (n = 161) plus pemetrexed and carboplatin once every 3 weeks for 4 cycles, followed by maintenance therapy of ivonescimab plus pemetrexed or placebo plus pemetrexed. Main Outcomes and Measures: The primary end point was progression-free survival in the intention-to-treat population assessed by an independent radiographic review committee (IRRC) per Response Evaluation Criteria in Solid Tumors version 1.1. The results of the first planned interim analysis are reported. Results: Among 322 enrolled patients in the ivonescimab and placebo groups, the median age was 59.6 vs 59.4 years and 52.2% vs 50.9% of patients were female. As of March 10, 2023, median follow-up time was 7.89 months. Median progression-free survival was 7.1 (95% CI, 5.9-8.7) months in the ivonescimab group vs 4.8 (95% CI, 4.2-5.6) months for placebo (difference, 2.3 months; hazard ratio [HR], 0.46 [95% CI, 0.34-0.62]; P < .001). The prespecified subgroup analysis showed progression-free survival benefit favoring patients receiving ivonescimab over placebo across almost all subgroups, including patients whose disease progressed while receiving third-generation EGFR-TKI therapy (HR, 0.48 [95% CI 0.35-0.66]) and those with brain metastases (HR, 0.40 [95% CI, 0.22-0.73]). The objective response rate was 50.6% (95% CI, 42.6%-58.6%) with ivonescimab and 35.4% (95% CI, 28.0%-43.3%) with placebo (difference, 15.6% [95% CI, 5.3%-26.0%]; P = .006). The median overall survival data were not mature; at data cutoff, 69 patients (21.4%) had died. Grade 3 or higher treatment-emergent adverse events occurred in 99 patients (61.5%) in the ivonescimab group vs 79 patients (49.1%) in the placebo group, the most common of which were chemotherapy-related. Grade 3 or higher immune-related adverse events occurred in 10 patients (6.2%) in the ivonescimab group vs 4 (2.5%) in the placebo group. Grade 3 or higher vascular endothelial growth factor-related adverse events occurred in 5 patients (3.1%) in the ivonescimab group vs 4 (2.5%) in the placebo group. Conclusions: Ivonescimab plus chemotherapy significantly improved progression-free survival with tolerable safety profile in TKI-treated non-small cell lung cancer. Trial Registration: ClinicalTrials.gov Identifier: NCT05184712.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Carboplatino , Carcinoma de Pulmón de Células no Pequeñas , Receptores ErbB , Neoplasias Pulmonares , Pemetrexed , Supervivencia sin Progresión , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carboplatino/administración & dosificación , Carboplatino/efectos adversos , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Método Doble Ciego , Receptores ErbB/genética , Análisis de Intención de Tratar , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/mortalidad , Mutación , Pemetrexed/administración & dosificación , Pemetrexed/efectos adversos , Anticuerpos Biespecíficos/administración & dosificación , Anticuerpos Biespecíficos/efectos adversos
6.
Exp Ther Med ; 27(5): 225, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38596660

RESUMEN

Radionuclide-based therapy represents a novel treatment regimen for tumors. Among these therapies, lutetium-177 (177Lu) has gained significant attention due to its stability and safety, as well as its ability to emit both γ and ß rays, allowing for both imaging with single photon emission computed tomography and tumor treatment. As a result, 177Lu can be used for both diagnosis and treatment for diseases such as prostatic and gastric cancer. Therefore, based on the available data, the present review provides a brief overview of the clinical applications of 177Lu-targeted radionuclide therapy in metastatic prostate cancer, neuroendocrine tumors and other types of solid tumors, and highlights the current therapeutic effect, reduction in damage to normal tissues and future research directions, including the development of new nuclides and the application of more nuclides in different tumors. In the future, such treatments could be used in more tumors.

7.
Mol Clin Oncol ; 20(5): 34, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38550510

RESUMEN

Flaps are commonly used to repair large tissue defects caused by tumor resection and are often combined with radiotherapy. Relevant explanations for the mechanism underlying the effect of radiotherapy on flaps and the selection of the sequence of flaps and radiotherapy plan have emerged. The combination of flap and radiotherapy is most widely used in breast, head and neck cancers, while free flaps are the most widely used. Although, reduction of the incidence of complications of flap reconstruction, prevention of flap reconstruction failure and best integration of flap reconstruction with radiation therapy remains controversial. In the present review, these questions and debates were addressed by reviewing the literature on radiotherapy and flap reconstruction in cancer treatment.

8.
Medicine (Baltimore) ; 103(10): e37391, 2024 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-38457587

RESUMEN

The coronavirus disease 2019 (COVID-19), a dual threat to public physical and mental health, prompted an investigation into the psychological well-being of residents in low- to medium-risk areas of China during the initial stages of the pandemic. We administered WeChat-based questionnaire surveys and employed chi-square tests and multiple logistic regression to analyze correlations between residents' age, gender, education, symptoms, COVID-19 close contact history, information sources, and anxiety, depression, and attitudes toward lockdown measures. We received 10,433 valid questionnaires, revealing 26% anxiety and 19.5% depression. Support for lockdown measures reached 98.2%. Factors such as female gender, self-diagnosed pneumonia symptoms, close contact history, and higher education levels increased anxiety risk. Having a doctorate posed a severe anxiety risk, at 4.5 times (P = .019, 95% CI 1.29-15.73). Older age acted as a protective factor, reducing severe anxiety risk to 0.98 and 0.22 times (P < .001, 95% CI 0.14-0.34). Females with a master degree or below and those receiving COVID-19 information from multiple channels faced higher depression risk. Pneumonia symptoms were a risk for all anxiety and depression degrees. Attitudes toward lockdown measures had no significant impact on psychological status, nor did any of the analyzed factors affect residents' overall attitude toward lockdown. Our findings underscore the need for increased psychological counseling, particularly for young females with lower educational backgrounds or self-suspected infection symptoms, to mitigate mild to moderate anxiety and depression in future epidemics or pandemics. The public, especially those of working age with doctorates or higher education, bears the highest risk of severe anxiety. Lockdown measures enjoy strong support in low- to medium-risk areas of China.


Asunto(s)
COVID-19 , Humanos , Femenino , COVID-19/epidemiología , COVID-19/prevención & control , SARS-CoV-2 , Depresión/epidemiología , Depresión/psicología , Estrés Psicológico/epidemiología , Control de Enfermedades Transmisibles , Ansiedad/epidemiología , Ansiedad/psicología , Encuestas y Cuestionarios , Pandemias/prevención & control , China/epidemiología
9.
World J Clin Cases ; 12(3): 630-636, 2024 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-38322473

RESUMEN

BACKGROUND: Esophageal adenoid cystic carcinoma (EACC) is an exceedingly rare malignant tumor of the esophagus, posing significant challenges in the clinic. CASE SUMMARY: This report detailed the case of a 72-year-old male whose diagnosis of EACC was confirmed through postoperative histopathological examination. The patient underwent thoracoscopy-assisted radical resection of the esophageal tumor, coupled with lymph node dissection. Pathological findings revealed an adenoid cystic carcinoma infiltrating the entire layer of the muscularis propria, locally extending into the outer membrane of the esophageal fiber, involving the cardia and exhibiting no lymph node metastasis. The patient's condition was classified as primary EACC, T3N0M0, per the American Joint Committee on Cancer (2017; 8th edition). One month after surgery, the patient received postoperative adjuvant radiation therapy. CONCLUSION: In addressing the rarity and high potential for biopsy misdiagnosis of EACC, this study delved into its diagnostic methods and treatment.

10.
ACS Appl Mater Interfaces ; 16(8): 11026-11034, 2024 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-38361494

RESUMEN

A Mo(S,Se)2 interfacial layer is formed inevitably and uncontrollably between the Mo electrode and Cu2ZnSn(S,Se)4 (CZTSSe) absorber during the selenization process, which significantly influences the performance of CZTSSe solar cells. In this work, an ultrathin MoS2 layer is intentionally inserted into Mo/CZTSSe to reduce the recombination and thus optimize the interface quality. It is revealed that the absorber exhibits a continuous and compact morphology with bigger grains and remarkably without pinholes across the surface or cross-sectional regions after MoS2 modification. Benefitting from this, the shunt resistance (RSh) of the device increased evidently from ∼395 to ∼634 Ω·cm2, and simultaneously, the reverse saturation current density (J0) realized an effective depression. As a result, the power conversion efficiency (PCE) of the MoS2-modified device reaches 9.64% via the optimization of the thickness of the MoS2 layer, indicating performance improvements with respect to the MoS2-free case. Furthermore, the main contribution to the performance improvement is derived and analyzed in detail from the increased RSh, decreased J0, and diode ideality factor. Our results suggest that the Mo/CZTSSe interface quality and performance of CZTSSe solar cells can be modulated and improved by appropriately designing and optimizing the thickness of the inserted MoS2 layer.

11.
Mol Clin Oncol ; 20(3): 22, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38357673

RESUMEN

The present study investigated the prognostic impact of preoperative serum ferritin (SF) levels on the survival of patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Clinicopathological characteristics and laboratory biomarkers of 223 patients with HCC who underwent TACE were retrospectively reviewed. The Kaplan-Meier method was used to calculate the overall survival (OS), and the log-rank test was used to evaluate statistical significance. Univariate and multivariate analyses were performed using Cox proportional hazards regression to evaluate the prognostic impact of SF in these patients. The present findings identified extrahepatic metastases [hazard ratio (HR)=0.490,95%; confidence interval (CI)=0.282-0.843; P=0.010)] and vascular invasion (HR=0.373; 95% CI=0.225-0.619; P<0.0001) as independent prognostic factors for OS. However, preoperative SF levels could not independently predict OS when compared with other prognostic factors (HR=0.810; 95% CI=0.539-1.216; P=0.309). In conclusion, preoperative SF level is an unreliable biochemical predictor of survival in patients with HCC undergoing TACE.

12.
Nanotechnology ; 35(8)2023 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-37963407

RESUMEN

Feroxyhite (δ-FeOOH) nanomaterials were successfully synthesized through the atmospheric AC microplasma method at room temperature from ferrous sulfate aqueous solutions. Various syntheses conditions, including electric voltage, electric field strength, ferrous concentration, hydrogen peroxide concentration, and reaction duration, were systematically investigated. The synthesized products were characterized through x-ray diffraction, UV-vis absorption spectroscopy, photoluminescence spectroscopy, infra-red spectroscopy, and electron microscopy. The bandgap of the produced materials were strongly dependent of the ferrous concentration while the product ratio was dependent on all experimental conditions. The synthesis mechanism was thoroughly discussed. The synthesized nanomaterials were amorphous nanospheres, showing superparamagnetic properties at room temperature. The synthesized oxyhydroxide is a potential photovoltaic material besides its reported applications in photocatalysts and supercapacitors. The application of this synthesis technique could be extended to synthesize other oxy-hydroxide nanomaterials for renewable energy applications facilely, scalablely, cost-effectively, and environmentally.

13.
Front Microbiol ; 14: 1256711, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38029090

RESUMEN

Autoblinking is a widespread phenomenon and exhibits high level of intensity in some bacteria. In Deinococcus radiodurans (D. radiodurans), strong autoblinking was found to be indistinguishable from PAmCherry and greatly prevented single-molecule tracking of proteins of interest. Here we employed the bright photoswitchable fluorescent protein mMaple3 to label PprI, one essential DNA repair factor, and characterized systematically the fluorescence intensity and bleaching kinetics of both autoblinking and PprI-mMaple3 molecules within cells grown under three different conditions. Under minimal media, we can largely separate autoblinking from mMaple3 molecules and perform reliably single-molecule tracking of PprI in D. radiodurans, by means of applying signal-to-noise ratio and constraining the minimal length for linking the trajectories. We observed three states of PprI molecules, which bear different subcellular localizations and distinct functionalities. Our strategy provides a useful means to study the dynamics and distributions of proteins of interest in bacterial cells with high level of autoblinking.

14.
Technol Cancer Res Treat ; 22: 15330338231218152, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38031361

RESUMEN

Introduction: This study aimed to compare the efficacy and safety of docetaxel + trastuzumab + pertuzumab and docetaxel + carboplatin + trastuzumab + pertuzumab for treating HER2-positive breast cancer. Method: HER2-positive breast cancer from patients diagnosed between January 2020 and September 2022 were included in this retrospective study. Docetaxel + trastuzumab + pertuzumab or docetaxel + carboplatin + trastuzumab + pertuzumab was selected as the neoadjuvant regimen. The primary endpoint was a complete pathological remission rate. Secondary endpoints were toxicity during neoadjuvant treatment, adjustment of the neoadjuvant therapy scheme, and adjuvant medication. Result: A total of 81 patients were included in this study (38 in the docetaxel + carboplatin + trastuzumab + pertuzumab treatment group and 43 in the docetaxel + trastuzumab + pertuzumab group). The complete pathological remission rates in the docetaxel + carboplatin + trastuzumab + pertuzumab and docetaxel + trastuzumab + pertuzumab groups were 44.7% (95% confidence interval: 30.2%-60.3%) and 51.2% (95% confidence interval: 36.8%-65.4%), respectively. The incidence of grade 3 or higher toxicity in the docetaxel + carboplatin + trastuzumab + pertuzumab group was significantly higher than that in the docetaxel + trastuzumab + pertuzumab group (68.4% vs 39.5%, P = .009). Neutropenia and asthenia were the most common grade 3 or higher toxicities. The incidence of neoadjuvant scheme adjustment was significantly higher in the docetaxel + carboplatin + trastuzumab + pertuzumab group than in the docetaxel + trastuzumab + pertuzumab group (26.3% vs 7.0%, P = .039). The proportion of patients who received <6 cycles of neoadjuvant therapy was significantly higher in the docetaxel + carboplatin + trastuzumab + pertuzumab group than in the docetaxel + trastuzumab + pertuzumab group (31.6% vs 4.7%, P = .004). Patients in the docetaxel + carboplatin + trastuzumab + pertuzumab group received higher doses of granulocyte-macrophage colony-stimulating factor. Conclusion: In the neoadjuvant treatment of HER2-positive breast cancer, the docetaxel + trastuzumab + pertuzumab regimen might be more tolerated than the docetaxel + carboplatin + trastuzumab + pertuzumab regimen and did not show a lower complete pathological remission rate. However, our findings require further validation through prospective studies.


Asunto(s)
Neoplasias de la Mama , Humanos , Femenino , Neoplasias de la Mama/patología , Docetaxel , Terapia Neoadyuvante/efectos adversos , Carboplatino , Estudios Retrospectivos , Estudios Prospectivos , Receptor ErbB-2 , Resultado del Tratamiento , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Trastuzumab/uso terapéutico
15.
Front Oncol ; 13: 1244488, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37941555

RESUMEN

Ultra-high dose rate radiotherapy (FLASH-RT) is an external beam radiotherapy strategy that uses an extremely high dose rate (≥40 Gy/s). Compared with conventional dose rate radiotherapy (≤0.1 Gy/s), the main advantage of FLASH-RT is that it can reduce damage of organs at risk surrounding the cancer and retain the anti-tumor effect. An important feature of FLASH-RT is that an extremely high dose rate leads to an extremely short treatment time; therefore, in clinical applications, the steps of radiotherapy may need to be adjusted. In this review, we discuss the selection of indications, simulations, target delineation, selection of radiotherapy technologies, and treatment plan evaluation for FLASH-RT to provide a theoretical basis for future research.

16.
Biochim Biophys Acta Gen Subj ; 1867(12): 130487, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37806463

RESUMEN

The bridging attraction of condensed bovine serum albumin (BSA) solution (D2O) in the presence of yttrium chloride (YCl3) was studied by small angle neutron scattering (SANS). With increasing the concentration of YCl3 (cY) from 3 to 15 mM and from 15 to 100 mM, the intensity in low-q region increases and then decreases. Combining the tri-axial ellipsoid (TaE) geometry and the multi-component sticky hard sphere (SHS) potential, a SHS-TaE model was established to quantitatively determine the size and distribution of particles. In this way, the structural mechanism of the aggregation-redissolution process in protein solution was demonstrated and discussed. As cY increases from 3 to 100 mM, the SHS radius rL decreases from ca. 2.97 to 2.50 nm, suggesting that the relatively well dispersed BSAs may form aggregates with various polydispersities. The axis a increases from 1.88 to 2.30 nm, while b and c decrease from 3.53 to 3.23 nm and from 4.12 to 3.55 nm, respectively. (RgTaE decreases from ca. 2.57 to 2.38 nm). Moreover, the scattering length density (SLD) of BSA decreases from 3.67 to 1.56 × 10-6 Å-2. All these results consistently indicate a strengthened attraction and the BSA molecules might shrink and tune out to be more like of oblate ellipsoid with increasing the amount of YCl3.


Asunto(s)
Albúmina Sérica Bovina , Albúmina Sérica Bovina/química , Iones , Dispersión del Ángulo Pequeño
17.
Int J Radiat Oncol Biol Phys ; 117(4): 914-924, 2023 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-37356553

RESUMEN

PURPOSE: The objective of this study was to estimate the long-term survival, late toxicity profile, and quality of life of patients with locoregionally advanced nasopharyngeal carcinoma (NPC) treated with combined induction chemotherapy (IC) and concurrent chemoradiotherapy from a clinical trial focused on reducing the target volume of intensity modulated radiation therapy (IMRT). METHODS AND MATERIALS: This prospective, randomized clinical trial was conducted across 6 Chinese hospitals and included 212 patients with stage III-IVB NPC who were randomly allocated to a pre-IC or post-IC group. Eligible patients were treated with 2 cycles of IC + CCRT. All patients underwent radical IMRT. Gross tumor volumes of the nasopharynx were delineated according to pre-IC and post-IC tumor extent in the pre-IC and post-IC groups, respectively. RESULTS: After a median follow-up of 98.4 months, 32 of 97 (32.9%) and 33 of 115 (28.7%) patients experienced treatment failure or died in the pre-IC and post-IC groups, respectively. None of the patients developed grade 4 late toxicity. Late radiation-induced toxicity predominantly manifested as grade 1 to 2 subcutaneous fibrosis, hearing loss, tinnitus, and xerostomia, whereas grade 3 late toxicity included xerostomia and hearing loss. The 5-year estimated overall, progression-free, locoregional recurrence-free, and distant metastasis-free survival rates in the pre-IC and post-IC groups were 78.2% versus 83.3%, 72.0% versus 78.1%, 90.2% versus 93.5%, and 78.1% versus 82.1%, respectively. The pre-IC group had a significantly higher incidence of xerostomia and hearing damage than the post-IC group. In terms of quality of life, compared with the pre-IC group, the post-IC group showed significant improvement in cognitive function (P = .045) and symptoms including dry mouth (P = .004), sticky saliva (P = .047), and feeling ill (P = .041). CONCLUSIONS: After long-term follow-up, we confirmed that reducing the target volumes of IMRT after IC in locoregionally advanced NPC showed no inferiority in terms of the risk of locoregional relapse and potentially improved quality of life and alleviated late toxicity.


Asunto(s)
Pérdida Auditiva , Neoplasias Nasofaríngeas , Traumatismos por Radiación , Radioterapia de Intensidad Modulada , Xerostomía , Humanos , Quimioradioterapia/efectos adversos , Quimioradioterapia/métodos , Cisplatino , Pérdida Auditiva/etiología , Quimioterapia de Inducción/efectos adversos , Carcinoma Nasofaríngeo/radioterapia , Neoplasias Nasofaríngeas/radioterapia , Neoplasias Nasofaríngeas/tratamiento farmacológico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Estudios Prospectivos , Calidad de Vida , Traumatismos por Radiación/etiología , Radioterapia de Intensidad Modulada/efectos adversos , Radioterapia de Intensidad Modulada/métodos , Xerostomía/etiología
18.
Front Oncol ; 13: 1089365, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37007134

RESUMEN

Purpose: This study aimed to investigate the ability of enhanced computed tomography (CT)-based radiomics and dosimetric parameters in predicting response to radiotherapy for esophageal cancer. Methods: A retrospective analysis of 147 patients diagnosed with esophageal cancer was performed, and the patients were divided into a training group (104 patients) and a validation group (43 patients). In total, 851 radiomics features were extracted from the primary lesions for analysis. Maximum correlation minimum redundancy and minimum least absolute shrinkage and selection operator were utilized for feature screening of radiomics features, and logistic regression was applied to construct a radiotherapy radiomics model for esophageal cancer. Finally, univariate and multivariate parameters were used to identify significant clinical and dosimetric characteristics for constructing combination models. The area evaluated the predictive performance under the receiver operating characteristics (AUC) curve and the accuracy, sensitivity, and specificity of the training and validation cohorts. Results: Univariate logistic regression analysis revealed statistically significant differences in clinical parameters of sex (p=0.031) and esophageal cancer thickness (p=0.028) on treatment response, whereas dosimetric parameters did not differ significantly in response to treatment. The combined model demonstrated improved discrimination between the training and validation groups, with AUCs of 0.78 (95% confidence interval [CI], 0.69-0.87) and 0.79 (95% CI, 0.65-0.93) in the training and validation groups, respectively. Conclusion: The combined model has potential application value in predicting the treatment response of patients with esophageal cancer after radiotherapy.

19.
Pharmaceutics ; 15(2)2023 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-36839784

RESUMEN

Drug and radiotherapy resistance is the primary cause of treatment failure and poor prognosis in patients with tumors. Exosomes are extracellular vesicles loaded with substances such as nucleic acids, lipids, and proteins that transmit information between cells. Studies have found that exosomes are involved in tumor therapy resistance through drug efflux, promotion of drug resistance phenotypes, delivery of drug-resistance-related molecules, and regulation of anti-tumor immune responses. Based on their low immunogenicity and high biocompatibility, exosomes have been shown to reduce tumor therapy resistance by loading nucleic acids, proteins, and drugs inside xosomes or expressing tumor-specific antigens, target peptides, and monoclonal antibodies on their phospholipid bimolecular membranes. Consequently, future research on genetically engineered exosomes is expected to eliminate resistance to tumor treatment, improving the overall prognosis of patients with tumors.

20.
Anal Chem ; 95(5): 3019-3027, 2023 02 07.
Artículo en Inglés | MEDLINE | ID: mdl-36706440

RESUMEN

Breast cancer is the most commonly diagnosed cancer type worldwide. Overexpression of human epidermal growth factor receptor 2 (HER2) is an important subtype of breast cancer and results in an increased risk of recurrence and metastasis in patients. At present, immunohistochemistry (IHC) is used to detect the expression of HER2 in breast cancer tissues as the golden standard. However, IHC has some shortcomings, such as large subjective impact, long time consumption, expensive reagents, etc. In this paper, a combined morphological and spectroscopic diagnostic method based on label-free surface-enhanced Raman scattering (SERS) for HER2 expression in breast cancer is proposed. It can not only quantitively detect HER2 expression in breast cancer tissues by spectroscopic measurements but also give morphological images reflecting the distribution of HER2 in tissues. The results show that the consistency between this method and IHC is 95% and achieves the annotation of tumor regions on tissue sections. This method is time-consuming, quantifiable, intuitive, scalable, and easy to understand. Combined with deep learning approaches, it is expected to promote the development of clinical detection and diagnosis technology for breast cancer and other cancers.


Asunto(s)
Neoplasias de la Mama , Espectrometría Raman , Humanos , Femenino , Neoplasias de la Mama/patología , Receptor ErbB-2/metabolismo , Inmunohistoquímica , Biomarcadores de Tumor
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