RESUMEN
Perioperative adjuvant treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). In particular, the success of immune checkpoint inhibitors, such as antibodies against PD-1 and PD-L1, in patients with lung cancer has increased our expectations for the success of these therapeutics as neoadjuvant immunotherapy. Neoadjuvant therapy is widely used in patients with resectable stage IIIA NSCLC and can reduce primary tumor and lymph node stage, improve the complete resection rate, and eliminate microsatellite foci; however, complete pathological response is rare. Moreover, because the clinical benefit of neoadjuvant therapy is not obvious and may complicate surgery, it has not yet entered the mainstream of clinical treatment. Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancellation of surgery, additional illness, and even death, and have therefore attracted much attention. In this article, we draw on several sources of information, including (i) guidelines on adverse reactions related to immune checkpoint inhibitors, (ii) published data from large-scale clinical studies in thoracic surgery, and (iii) practical experience and published cases, to provide clinical recommendations on adverse events in NSCLC patients induced by perioperative immunotherapy.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/complicaciones , Inmunoterapia/efectos adversos , Neoplasias Pulmonares/complicaciones , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/patología , Femenino , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/patología , Masculino , Periodo PerioperatorioRESUMEN
The modulation bandwidth of a light-emitting diode is inversely proportional to the carrier lifetime, which changes with varying injected current. However, in conventional implementations of visible light communications, the influence of bias current is always emphasized, while the effects of modulation indices and signal components are ignored. In this Letter, it is the first time, to the best of our knowledge, that the mechanism on how modulated signal components impact modulation bandwidth is clarified. We reveal and interpret this impact by featuring the response at different modulation indices and intensity distributions mathematically and experimentally, proposing a series of theoretical approaches for the insight of modulation at a high index. This Letter donates a novel perspective on deciding appropriate configurations for modulators according to the modulation characteristics at a high index of the input signal.