Circulating tumour cells (CTCs) are referred to the tumour cells that disseminated from the primary tumour and survive in circulating during the pro-ceeding of tumour growth. As surgical treatment evolves and local co...Circulating tumour cells (CTCs) are referred to the tumour cells that disseminated from the primary tumour and survive in circulating during the pro-ceeding of tumour growth. As surgical treatment evolves and local control has improved, the failure of cancer treatment has largely remained the re-sult of systemic metastasis. Selection of patients most likely to benefit from adjuvant strategies remains problematic. In order to develop a new standard of curative effect, this study was de-signed to track the number of CTCs in patients with lung cancer during chemotherapy. Methods: Samples of peripheral blood was taken from each lung cancer patients (n=32) on the day before chemotherapy as well as the third week after the chemotherapy cycle. The samples were subjected to real-time fluorescent quantitative reverse-tran- scriptase polymerase chain reaction (fqRT-PCR). Meanwhile the tumour size was determined by chest X-ray or computed tomograghy. Results Compared to that of pre-chemotherapy, the ex-pression level of cytokeratin (CK) 19 in the pa-tients significantly declined after chemotherapy (t=4.659,P=0.000). The level of CK19 mRNA in pa-tients with small cell lung cancer (SCLC) was higher than that of patients with non-small cell lung cancer (NSCLC) (t=1.944, P=0.061). The de-crease of CK19 mRNA level correlated well with the type during the treatment. Relatively the de-crease of SCLC is more obvious (t=6.073,P=0.000). The variation of CK19 mRNA level before and after chemotherapy was positively related to the dis-parity of tumour burden (r=0.593). There was also a significant association between the type (NSCLC vs. SCLC) and the change of tumour size (t=3.686, P=0.001).The positive rate before chemotherapy Supported by grant from the Natural Science Foundation in China (No.30972961). was 71.9% (23/32), while that after chemotherapy was 37.5% (12/32), indicating that 11 patients con- verted into negative after chemotherapy. Of the 16 patients which were in Ⅳ-stage, 11 cases were po- sitive (11/16,68.8%). Surprisingly, of the remaining 16 patients which were Ⅱ/Ⅲ stage, 12 cases were regarded as positive according to the criteria (12/6,75%). Conclusions: The real-time flu- ores-cent quantitative-PCR approach is useful for mea- suring the relative number of CTCs in a patients’ peripheral blood to monitor the effectiveness of treatment, and for designing more comprehensive and reasonable therapeutic regimes at earlier dates for patients. The treatment response can be immediately assessed by serial quantitation of CTCs after chemotherapy, and therefore this method highlights an alternative approach to rapidly access the patient’s response to treatment.展开更多
Epigenetic modifications have been observed as a decline in miRNA-21 expression and breast cancer stem cell(CSC)population after 3 cycles of standard chemotherapy.The epigenetic response(miRNAs expression)and CSCs are...Epigenetic modifications have been observed as a decline in miRNA-21 expression and breast cancer stem cell(CSC)population after 3 cycles of standard chemotherapy.The epigenetic response(miRNAs expression)and CSCs are also correlated in patients with Breast Cancer.In patients who tolerated chemotherapy well,miRNA-21(non-coding RNA)expression decreased significantly after three cycles of chemotherapy.The miRNA-21 expression in breast cancer tissue was quantified by quantitative PCR(real-time PCR)using the standard protocol.In addition,breast CSCs(CD44+/CD24-)were also decreased in these patients.The miRNA-21 regulates cell division,proliferation,and autophagy of cancerous cells(as it targets phosphatase and tensin homolog/AKT/transcription factor EB/programmed cell death 4/autophagy-related protein 5 and chemotherapy also produces similar effects),thereby contributing to these benefits.Therefore,when all of the targets on genes have been explored by mimic miRNA,chemotherapy combined with anti-miRNA21 therapy may prove useful in the care of cancer patients.展开更多
This paper aims to update the therapeutical strategies in liver metastasis with complete clinical response(CCR) after chemotherapy and to determine if surgery is always necessary after CCR.The aim of chemotherapy is t...This paper aims to update the therapeutical strategies in liver metastasis with complete clinical response(CCR) after chemotherapy and to determine if surgery is always necessary after CCR.The aim of chemotherapy is to achieve a good clinical response rather than CCR of liver metastasis.The CCR of liver metastasis after chemotherapy cannot be considered synonymous with a cure.The resection of the hepatic segment where there was hepatic metastases with CCR after chemotherapy theoretically prevents recurrence,improves survival and makes it possible to conf irm whether there has been a complete pathological response.However,the medical literature about this topic is scarce and sometimes contradictory.展开更多
The efficiency of dendritic cell-activated and cytokine-induced killer cell(DC-CIK) therapy on children with acute myeloid leukemia(AML) after chemotherapy was investigated. Mononuclear cells were collected from child...The efficiency of dendritic cell-activated and cytokine-induced killer cell(DC-CIK) therapy on children with acute myeloid leukemia(AML) after chemotherapy was investigated. Mononuclear cells were collected from children achieving complete remission after chemotherapy,cultured in vitro and transfused back into the same patient. Interleukin-2(IL-2) was injected subcutaneously every other day 10 times at the dose of 1×106 units. Peripheral blood lymphocyte subsets and minimal residual disease(MRD) were detected by flow cytometry. Function of bone marrow was monitored by methods of morphology,immunology,cytogenetics and molecular biology. The side effects were also observed during the treatment. The average follow-up period for all the 22 patients was 71 months and relapse occurred in two AML patients(9.1%). The percentage of CD3+/CD8+ cells in peripheral blood of 15 patients at the 3rd month after DC-CIK treatment(36.73%±12.51%) was dramatically higher than that before treatment(29.20%±8.34%,P<0.05). The MRD rate was >0.1% in 5 patients before the treatment,and became lower than 0.1% 3 months after the treatment. During the transfusion of DC-CIK,side effects including fever,chills and hives appeared in 7 out of 22(31.82%) cases but disappeared quickly after symptomatic treatments. There were no changes in electrocardiography and liver-renal functions after the treatment. MRD in children with AML can be eliminated by DC-CIK therapy which is safe and has fewer side effects.展开更多
Reactivation of Hepatitis B virus causing liver damage is a concern in patients with chronic HBV infections who receive immunosuppressive or cytotoxic treatments. HBV screening should be considered for all patients go...Reactivation of Hepatitis B virus causing liver damage is a concern in patients with chronic HBV infections who receive immunosuppressive or cytotoxic treatments. HBV screening should be considered for all patients going to receive immunosuppressive regimens which have the potential to induce reactivation of HBV infection. We discuss here a case of occult Hepatitis B flare after chemotherapy in a patient who had negative acute hepatitis profile including HBsAg prior to therapy and baseline serum AST, ALT, INR, albumin, bilirubin and serum creatinine were within normal limits.展开更多
<strong>Introduction: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">Morbidity and Mortality (M&M) rounds can ident...<strong>Introduction: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">Morbidity and Mortality (M&M) rounds can identify adverse events and improve patient safety however adoption in cancer centers is not routine. Herein we report the results of a chemotherapy-specific gynecologic oncology M&M rounds and identify reasons for hospital admission < 30 days after chemotherapy treatment. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Between July 2014 and April 2016, all admissions < 30 days from chemotherapy administration were prospectively collected along with clinical data. Admissions were described and classified as planned or unplanned and as associated with chemotherapy or with underlying disease. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">585 patients were admitted, 78% of whom had ovarian cancer and 43% of whom had recurrent disease. Overall, 47% of admissions were unplanned and these were significantly longer than planned admissions (5.6 vs. 2.4 days, p = 0.0003). Of unplanned admissions, 43% were due to chemotherapy, and 57% were due to disease burden. 74% of patients had received >1 prior line of chemotherapy, and 22% were on clinical trial. The most common causes of unplanned admission were nausea, vomiting or failure to thrive (28.9%), fever (17.9%) and small bowel obstruction (19.9%). </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">There is a high rate of unplanned admission < 30 days after chemotherapy and patients with ovarian cancer and recurrent disease are at the highest risk. This information can be used to counsel patients about complications of chemotherapy and to improve supportive management. M&M conferences surrounding unplanned admissions after chemotherapy may help guide therapy, encourage best supportive care, and prompt re-evaluation of treatment goals in heavily pretreated patients with recurrent.</span></span></span></span>展开更多
Antitumor chemotherapy is often limited by hematopoietic toxicity.TO attenuate themyelosuppressive effects of chemotherapy, successfulengraftment of unmodified fetal liver cells (FLCs) hasbeen achieved across allogene...Antitumor chemotherapy is often limited by hematopoietic toxicity.TO attenuate themyelosuppressive effects of chemotherapy, successfulengraftment of unmodified fetal liver cells (FLCs) hasbeen achieved across allogeneic barriers in a number ofanimal models and patients, GM-CSF is a展开更多
Infection rate of hepatitis B virus (HBV) in our country remains high. Many patients showed combined HBV infection; the most common blood system disease is non-Hodgkin’s lymphoma (NHL)-combined HBV infection. Drugs u...Infection rate of hepatitis B virus (HBV) in our country remains high. Many patients showed combined HBV infection; the most common blood system disease is non-Hodgkin’s lymphoma (NHL)-combined HBV infection. Drugs used in treating lymphoma may induce different degrees of HBV reactivation. Such condition may lead to hepatic failure or death. Currently, scholars pay increasing attention to reactivation of HBV by rituximab and/or chemotherapy for NHL-combined HBV patients. This study summarizes research advances in this topic, with a view of providing background information for further research.展开更多
<strong>Objective:</strong> To investigate the changes of related immune cytokines (Dendritic Cells (DC) cells, CD4<sup>+</sup>, CD8<sup>+</sup>, Th17, IgG, IgM, IgA) in patients wi...<strong>Objective:</strong> To investigate the changes of related immune cytokines (Dendritic Cells (DC) cells, CD4<sup>+</sup>, CD8<sup>+</sup>, Th17, IgG, IgM, IgA) in patients with non-small cell lung cancer (NSCLC) before and after chemotherapy. <strong>Methods: </strong>Eighty-five NSCLC patients who were treated in the Oncology Department of the Affiliated Hospital of Chengde Medical College from December 2018 to February 2021 were selected as the research objects, and the patients were analyzed at different time points (before chemotherapy, after the first chemotherapy, and after the second chemotherapy) Changes in the expression levels of DC cells, CD4<sup>+</sup>, CD8<sup>+</sup>, Th17, IgG, IgM, IgA in peripheral blood, and explore their correlation. <strong>Results:</strong> Before chemotherapy, after the first chemotherapy, and after the second chemotherapy, the peripheral blood CD4<sup>+</sup> and CD8<sup>+</sup> were significantly increased, and the Th17, IgG, IgM, and IgA levels gradually decreased. The difference was statistically significant. But there was no obvious change in DC cells. <strong>Conclusion:</strong> There is no significant change in DC cells in peripheral blood of NSCLC patients before and after chemotherapy. CD4<sup>+</sup> and CD8<sup>+</sup> are significantly increased, Th17, IgG, IgM, and IgA levels are all decreased, which is a manifestation of impaired immune function of patients after chemotherapy.展开更多
Objective:The expression of tumor biomarkers may change after chemotherapy. However, whether secreted protein acidic and rich in cysteine(SPARC) expression changes after chemotherapy in gastric cancer(GC) is unclear. ...Objective:The expression of tumor biomarkers may change after chemotherapy. However, whether secreted protein acidic and rich in cysteine(SPARC) expression changes after chemotherapy in gastric cancer(GC) is unclear. This study investigated the influence of chemotherapy on SPARC expression in GC.Methods: Immunohistochemistry was used to analyze SPARC expression in 132 GC cases(including 54 cases with preoperative chemotherapy and 78 cases without preoperative chemotherapy). SPARC expression of postoperative specimens with and without preoperative chemotherapy was assessed to analyze the influence of chemotherapy on SPARC expression.Results: SPARC was highly expressed in GC compared with the desmoplastic stroma surrounding tumor cells and noncancerous tissues. High SPARC expression was correlated with invasion depth, lymph node, and TNM stage. After chemotherapy, a lower proportion of high SPARC expression was observed in patients with preoperative chemotherapy than in the controls. For 54 patients with preoperative chemotherapy, gross type, histology, depth of invasion, lymph node, TNM stage, and SPARC expression were related to overall survival. Further multivariate analysis showed that lymph node, histology, and SPARC expression after chemotherapy were independent prognostic factors.Conclusion: SPARC expression may change after chemotherapy in GC. SPARC expression should be reassessed for patients with GC after chemotherapy.展开更多
Objective:By comparing the efficacy of different frequency application of polyethylene glycol recombinant human granulocyte stimulating factor in the prevention of neutropenia after chemotherapy with dose-intensive re...Objective:By comparing the efficacy of different frequency application of polyethylene glycol recombinant human granulocyte stimulating factor in the prevention of neutropenia after chemotherapy with dose-intensive regimen in breast cancer, the more optimized administration scheme of polyethylene glycol recombinant human granulocyte stimulating factor in the prevention of neutropenia after chemotherapy in breast cancer was further explored.Methods:From June 2017 to May 2019, 64 patients with breast cancer who had received dose-intensive chemotherapy from June 2017 to May 2019 were randomly divided into two groups: control group (n=31) and observation group (n=33). Control group: after dose-intensive chemotherapy, PEG-rhG-CSF was injected subcutaneously with 100μg/kg, and given 24 hours after chemotherapy. Observation group: after dose-intensive chemotherapy, PEG-rhG-CSF: 50μg/kg, was injected subcutaneously and given 24 hours and 72 hours after chemotherapy. With PEG-rhG-CSF on the number of neutrophils in the two groups and the incidence, duration, fever incidence and duration of neutropenia in the two groups were observed. The curative effect was evaluated after 2 cycles of treatment.Results: There was no significant difference in the number of neutrophils between the two groups before chemotherapy in the first cycle and the second cycle (P>0.05), but the neutrophils in the observation group decreased slowly on the 3rd day, 5th day, 10th day and 5th day and 10th day after the first cycle of chemotherapy, and there was significant difference between the two groups (P<0.001). In the second cycle, there was no significant difference in neutrophils between the two groups on the third day after chemotherapy (P<0.05). In the control group, 7 patients were delayed by the second week because the neutrophil value was less than 2.0109/ L. The time of chemotherapy was delayed in 5 patients in the observation group. The incidence of neutropenia in the control group and the observation group was 41.9% VS 12.1%, and the duration of neutropenia in the observation group was significantly shorter than that in the control group (3.25 ±0.84d VS 5.12 ±1.24d), and the incidence of neutropenia in the observation group was 41.9% VS 12.1%, the duration of neutropenia in the observation group was significantly shorter than that in the control group (3.25 ±0.84d VS 5.12 ±1.24d). The number of patients with fever in the control group and the observation group were 10 cases of VS, the incidence rate was 32.2% VS 12.1%, compared with the control group and the observation group, the incidence of febrile fever was 32.2% and 12.1%, respectively. The duration of fever in the observation group was significantly shorter than that in the control group (2.46 ±1.24 d VS 4.05 ±1.01).Conclusions: Low dose of PEG-rhG-CSF can increase the absolute value of neutrophils after multiple administration, and its curative effect is better than that of single administration in dose-intensive chemotherapy, and the incidence of neutropenia and associated fever is lower, which is worthy of further clinical study and promotion.展开更多
Objective:To evaluate the effect of acupuncture on myelosuppression after chemotherapy and summarize its acupoint selection strategy.Methods:After a systematic search,an acupoint database on myelosuppression after che...Objective:To evaluate the effect of acupuncture on myelosuppression after chemotherapy and summarize its acupoint selection strategy.Methods:After a systematic search,an acupoint database on myelosuppression after chemotherapy was constructed.A meta-analysis was conducted to assess the efficacy of acupuncture.On this basis,association analysis and cluster analysis were performed to explore the distribution of acupoints in SPSS Modeler18.0 and SPSS 22.0.Results:40 studies with 2988 patients were included.The white blood cell count,platelet count,red blood cell count,and hemoglobin were significantly higher in patients receiving acupuncture versus convention therapy exclusively.The two groups,however,did not differ in neutrophils count.Most acupoints,mainly distributed in the limbs and the back,were from the bladder meridian,the stomach meridian,and the spleen meridian.The lower sea and transport points were the most preferred specific points,in which ST36 and SP6 ranked highest in use.ST36-RN6,SP6-SP10,and ST36-SP10 turned out to be the most significant correlations in association rule mining.In cluster analysis,LI4-RN12,ST36-RN4-RN6 were grouped for their high similarity.Conclusion:For patients with myelosuppression after chemotherapy,acupuncture significantly inhibited the decline in blood cell components(white blood cell count,platelet count,red blood cell count,and hemoglobin)except for neutrophils.As the central combination of acupuncture prescriptions for this population,ST36-SP6-RN6-SP10-RN4 presented promising prospects and deserved more exploration for clinical use.展开更多
BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for ...BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.展开更多
BACKGROUND Lung cancer(LC)is a global medical,social and economic problem and is one of the most common cancers and the leading cause of mortality from malignant neoplasms.LC is characterized by an aggressive course,a...BACKGROUND Lung cancer(LC)is a global medical,social and economic problem and is one of the most common cancers and the leading cause of mortality from malignant neoplasms.LC is characterized by an aggressive course,and in the presence of disease recurrence risk factors,patients,even at an early stage,may be indicated for adjuvant therapy to improve survival.However,combined treatment does not always guarantee a favorable prognosis.In this regard,establishing predictors of LC recurrence is highly important both for determining the optimal treatment plan for the patients and for evaluating its effectiveness.AIM To establish predictors of disease recurrence after radical resection and adjuvant chemotherapy in patients with stage IIb-IIIa lung squamous cell carcinoma(LSCC).METHODS A retrospective case-control cohort study included 69 patients with LSCC who underwent radical surgery at the Orenburg Regional Clinical Oncology Center from 2009 to 2018.Postoperatively,all patients received adjuvant chemotherapy.Histological samples of the resected lung were stained with Mayer's hematoxylin and eosin and examined under a light microscope.Univariate and multivariate analyses were used to identify predictors associated with the risk of disease recurrence.Receiver operating characteristic curves were constructed to discriminate between patients with a high risk of disease recurrence and those with a low risk of disease recurrence.Survival was analyzed using the Kaplan-Meier method.The log-rank test was used to compare survival curves between patient subgroups.Differences were considered to be significant at P<0.05.RESULTS The following predictors of a high risk of disease recurrence in patients with stage IIb-IIa LSCC were established:a low degree of tumor differentiation[odds ratio(OR)=7.94,95%CI=1.08-135.81,P=0.049];metastases in regional lymph nodes(OR=5.67,95%CI=1.09-36.54,P=0.048);the presence of loose,fine-fiber connective tissue in the tumor stroma(OR=21.70,95%CI=4.27-110.38,P=0.0002);and fragmentation of the tumor solid component(OR=2.53,95%CI=1.01-12.23,P=0.049).The area under the curve of the predictive model was 0.846(95%CI=0.73-0.96,P<0.0001).The sensitivity,accuracy and specificity of the method were 91.8%,86.9%and 75.0%,respectively.In the group of patients with a low risk of LSCC recurrence,the 1-,2-and 5-year disease-free survival(DFS)rates were 84.2%,84.2%and 75.8%,respectively,while in the group with a high risk of LSCC recurrence the DFS rates were 71.7%,40.1%and 8.2%,respectively(P<0.00001).Accordingly,in the first group of patients,the 1-,2-and 5-year overall survival(OS)rates were 94.7%,82.5%and 82.5%,respectively,while in the second group of patients,the OS rates were 89.8%,80.1%and 10.3%,respectively(P<0.00001).CONCLUSION The developed method allows us to identify a group of patients at high risk of disease recurrence and to adjust to ongoing treatment.展开更多
BACKGROUND Prostate cancer(PC)is currently the most common malignant tumor of the genitourinary system in men.Radical prostatectomy(RP)is recommended for the treatment of patients with localized PC.Adjuvant hormonal t...BACKGROUND Prostate cancer(PC)is currently the most common malignant tumor of the genitourinary system in men.Radical prostatectomy(RP)is recommended for the treatment of patients with localized PC.Adjuvant hormonal therapy(AHT)can be administered postoperatively in patients with high-risk or locally advanced PC.Chemotherapy is a vital remedy for castration-resistant prostate cancer(CRPC),and may also benefit patients with PC who have not progressed to CRPC.CASE SUMMARY A 68-year-old male was admitted to our hospital because of urinary irritation and dysuria with increased prostate-specific antigen(PSA)levels.After detailed examination,he was diagnosed with PC and treated with laparoscopic RP on August 3,2020.AHT using androgen deprivation therapy(ADT)was performed postoperatively because of the positive surgical margin,extracapsular extension,and neural invasion but lasted only 6 mo.Unfortunately,he was diagnosed with rectal cancer about half a year after self-cessation of AHT,and was then treated with laparoscopic radical rectal resection and adjuvant chemotherapy using the capecitabine plus oxaliplatin(CapeOx)regimen.During the entire treatment process,the patient's PSA level first declined significantly after treatment of PC with laparoscopic RP and ADT,then rebounded because of self-cessation of ADT,and finally decreased again after CapeOx chemotherapy.CONCLUSION CapeOx chemotherapy can reduce PSA levels in patients with high-risk locally advanced PC,indicating that CapeOx may be an alternative chemotherapy regimen for PC.展开更多
BACKGROUND According to relevant investigation and analysis,there are few research studies on the effect of excessive chemotherapy cycles after D2 gastrectomy on the survival of patients with gastric cancer.AIM To det...BACKGROUND According to relevant investigation and analysis,there are few research studies on the effect of excessive chemotherapy cycles after D2 gastrectomy on the survival of patients with gastric cancer.AIM To determine whether excessive chemotherapy cycles provide extra survival benefits,reduce recurrence rate,and improve survival rate in patients with stage Ⅱ or Ⅲ gastric cancer.METHODS We analyzed and summarized 412 patients with stage Ⅱ gastric cancer and 902 patients with stage Ⅲ gastric cancer who received D2 gastrectomy plus adjuvant chemotherapy or neoadjuvant chemotherapy.Analysis and comparison at a ratio of 1:1 is aimed at reducing realistic baseline differences(n=97 in each group of stage Ⅱ,n=242 in each group of stage Ⅲ).Progression-free survival,overall survival and recurrence were the main outcome indicators.RESULTS When the propensity score was matched,the baseline features of stage Ⅱ and Ⅲ gastric cancer patients were similar between the two groups.After a series of investigations,Kaplan-Meier found that the progression-free survival and overall survival of stage Ⅱ and Ⅲ gastric cancer patients were consistent between the two groups.The local metastasis rate(P=0.002),total recurrence rate(P<0.001)and distant metastasis rate(P=0.001)in the≥9 cycle group of stage Ⅲ gastric cancer were statistically lower than those in the<9 cycle group.The interaction analysis by Cox proportional hazard regression model showed that intestinal type,proximal gastrectomy,and≥6 cm maximum diameter of tumor had a higher risk of total mortality in the<9 cycles group.CONCLUSION Overall,≥9 chemotherapy cycles is not recommended for patients with stage Ⅱ and stage Ⅲ gastric cancer because it has an insignificant role in the prognosis of gastric cancer.However,for patients with stage Ⅲ gastric cancer,≥9 cycles of chemotherapy was shown to significantly decrease recurrence.展开更多
BACKGROUND Neoadjuvant therapy is an essential modality for reducing the clinical stage of esophageal cancer;however,the superiority of neoadjuvant chemotherapy(nCT)or neoadjuvant chemoradiotherapy(nCRT)is unclear.The...BACKGROUND Neoadjuvant therapy is an essential modality for reducing the clinical stage of esophageal cancer;however,the superiority of neoadjuvant chemotherapy(nCT)or neoadjuvant chemoradiotherapy(nCRT)is unclear.Therefore,a discussion of these two modalities is necessary.AIM To investigate the benefits and complications of neoadjuvant modalities.METHODS To address this concern,predefined criteria were established using the PICO protocol.Two independent authors performed comprehensive searches using predetermined keywords.Statistical analyses were performed to identify significant differences between groups.Potential publication bias was visualized using funnel plots.The quality of the data was evaluated using the Risk of Bias Tool 2(RoB2)and the GRADE approach.RESULTS Ten articles,including 1928 patients,were included for the analysis.Significant difference was detected in pathological complete response(pCR)[P<0.001;odds ratio(OR):0.27;95%CI:0.16-0.46],30-d mortality(P=0.015;OR:0.4;95%CI:0.22-0.71)favoring the nCRT,and renal failure(P=0.039;OR:1.04;95%CI:0.66-1.64)favoring the nCT.No significant differences were observed in terms of survival,local or distal recurrence,or other clinical or surgical complications.The result of RoB2 was moderate,and that of the GRADE approach was low or very low in almost all cases.CONCLUSION Although nCRT may have a higher pCR rate,it does not translate to greater long-term survival.Moreover,nCRT is associated with higher 30-d mortality,although the specific cause for postoperative complications could not be identified.In the case of nCT,toxic side effects are suspected,which can reduce the quality of life.Given the quality of available studies,further randomized trials are required.展开更多
Objective:To explore and analyze the effect and safety of personalized nursing in improving thrombocytopenia after lymphoma chemotherapy.Methods:80 lymphoma patients with thrombocytopenia after lymphoma chemotherapy i...Objective:To explore and analyze the effect and safety of personalized nursing in improving thrombocytopenia after lymphoma chemotherapy.Methods:80 lymphoma patients with thrombocytopenia after lymphoma chemotherapy in the Department of Hematology of our hospital from May 2021 to May 2023 were selected as the research objects,and they were divided into an experimental group and reference group by random drawing,with 40 cases in each group.The experimental group received individualized nursing,and the reference group received routine nursing.The platelet count,platelet-related indicators,incidence of adverse reactions,and life scores were compared between the two groups.Results:Before the intervention,there was no significant difference in platelet count between the groups(P>0.05);after the intervention,the platelet count in the experimental group was significantly higher compared to the reference group(P<0.05).In the experimental group,the duration for platelet decline and the time for platelets to normalize were notably shorter compared to the reference group(P<0.05).Moreover,the personality group displayed a significantly lower incidence of adverse reactions than the reference group(P<0.05).Prior to the intervention,there were no statistically significant differences(P>0.05)in the life scores between the two groups,such as functional condition,symptom manifestation,and health scores among the groups.However,post-intervention,the personality group exhibited a significant improvement in those scores compared to the reference group(P<0.05).Conclusion:Individualized nursing can optimize the platelet level in thrombocytopenia after lymphoma chemotherapy,improve symptoms,and reduce the occurrence of adverse reactions.展开更多
BACKGROUND Advanced pancreatic cancer is resistant to chemotherapeutic drugs,resulting in limited treatment efficacy and poor prognosis.Combined administration of the chemotherapeutic gemcitabine and erlotinib is cons...BACKGROUND Advanced pancreatic cancer is resistant to chemotherapeutic drugs,resulting in limited treatment efficacy and poor prognosis.Combined administration of the chemotherapeutic gemcitabine and erlotinib is considered a potential first-line treatment for advanced pancreatic cancer.However,their comparative benefits and potential risks remain unclear.AIM To assess the clinical efficacy and safety of erlotinib combined with other chemotherapy regimens for the treatment of advanced pancreatic cancer.METHODS Literature on the clinical efficacy and safety of erlotinib combined with chemotherapy for advanced pancreatic cancer was retrieved through an online search.The retrieved literature was subjected to a methodological qualitative assessment and was analyzed using the RevMan 5.3 software.Ten randomized controlled trials involving 2444 patients with advanced pancreatic cancer were included in the meta-analysis.RESULTS Compared with chemotherapeutic treatment,erlotinib combined with chemotherapy significantly prolonged the progression-free survival time of pancreatic cancer patients[hazard ratio(HR)=0.78,95%CI:0.66-0.92,P=0.003].Meanwhile,the overall survival(HR=0.99,95%CI:0.72-1.37,and P=0.95)and disease control rate(OR=0.93,95%CI:0.45-0.91,P=0.84)were not significantly favorable.In terms of safety,the erlotinib and chemotherapy combination was associated with a significantly higher risk of diarrhea(OR=3.59,95%CI:1.63-7.90,P<0.05)and rash(OR=3.63,95%CI:1.64-8.01,P<0.05)compared with single-agent chemotherapy.Moreover,the risk of vomiting(OR=1.27,95%CI:0.62-2.59,P=0.51),regurgitation/anorexia(OR=1.61,95%CI:0.25-10.31,P=0.62),and infection(OR=0.72,95%CI:0.28-1.87,P=0.50)were not significant in either group.CONCLUSION Compared with a single chemotherapeutic modality,erlotinib combined with gemcitabine can prolong progression-free survival in pancreatic cancer,but does not improve survival benefit or disease control rate,and can increase the risk of diarrhea and rash.展开更多
文摘Circulating tumour cells (CTCs) are referred to the tumour cells that disseminated from the primary tumour and survive in circulating during the pro-ceeding of tumour growth. As surgical treatment evolves and local control has improved, the failure of cancer treatment has largely remained the re-sult of systemic metastasis. Selection of patients most likely to benefit from adjuvant strategies remains problematic. In order to develop a new standard of curative effect, this study was de-signed to track the number of CTCs in patients with lung cancer during chemotherapy. Methods: Samples of peripheral blood was taken from each lung cancer patients (n=32) on the day before chemotherapy as well as the third week after the chemotherapy cycle. The samples were subjected to real-time fluorescent quantitative reverse-tran- scriptase polymerase chain reaction (fqRT-PCR). Meanwhile the tumour size was determined by chest X-ray or computed tomograghy. Results Compared to that of pre-chemotherapy, the ex-pression level of cytokeratin (CK) 19 in the pa-tients significantly declined after chemotherapy (t=4.659,P=0.000). The level of CK19 mRNA in pa-tients with small cell lung cancer (SCLC) was higher than that of patients with non-small cell lung cancer (NSCLC) (t=1.944, P=0.061). The de-crease of CK19 mRNA level correlated well with the type during the treatment. Relatively the de-crease of SCLC is more obvious (t=6.073,P=0.000). The variation of CK19 mRNA level before and after chemotherapy was positively related to the dis-parity of tumour burden (r=0.593). There was also a significant association between the type (NSCLC vs. SCLC) and the change of tumour size (t=3.686, P=0.001).The positive rate before chemotherapy Supported by grant from the Natural Science Foundation in China (No.30972961). was 71.9% (23/32), while that after chemotherapy was 37.5% (12/32), indicating that 11 patients con- verted into negative after chemotherapy. Of the 16 patients which were in Ⅳ-stage, 11 cases were po- sitive (11/16,68.8%). Surprisingly, of the remaining 16 patients which were Ⅱ/Ⅲ stage, 12 cases were regarded as positive according to the criteria (12/6,75%). Conclusions: The real-time flu- ores-cent quantitative-PCR approach is useful for mea- suring the relative number of CTCs in a patients’ peripheral blood to monitor the effectiveness of treatment, and for designing more comprehensive and reasonable therapeutic regimes at earlier dates for patients. The treatment response can be immediately assessed by serial quantitation of CTCs after chemotherapy, and therefore this method highlights an alternative approach to rapidly access the patient’s response to treatment.
基金Supported by SERB:Department of Science and Technology,New Delhi,No. NPDF:SERB 2015/000322
文摘Epigenetic modifications have been observed as a decline in miRNA-21 expression and breast cancer stem cell(CSC)population after 3 cycles of standard chemotherapy.The epigenetic response(miRNAs expression)and CSCs are also correlated in patients with Breast Cancer.In patients who tolerated chemotherapy well,miRNA-21(non-coding RNA)expression decreased significantly after three cycles of chemotherapy.The miRNA-21 expression in breast cancer tissue was quantified by quantitative PCR(real-time PCR)using the standard protocol.In addition,breast CSCs(CD44+/CD24-)were also decreased in these patients.The miRNA-21 regulates cell division,proliferation,and autophagy of cancerous cells(as it targets phosphatase and tensin homolog/AKT/transcription factor EB/programmed cell death 4/autophagy-related protein 5 and chemotherapy also produces similar effects),thereby contributing to these benefits.Therefore,when all of the targets on genes have been explored by mimic miRNA,chemotherapy combined with anti-miRNA21 therapy may prove useful in the care of cancer patients.
文摘This paper aims to update the therapeutical strategies in liver metastasis with complete clinical response(CCR) after chemotherapy and to determine if surgery is always necessary after CCR.The aim of chemotherapy is to achieve a good clinical response rather than CCR of liver metastasis.The CCR of liver metastasis after chemotherapy cannot be considered synonymous with a cure.The resection of the hepatic segment where there was hepatic metastases with CCR after chemotherapy theoretically prevents recurrence,improves survival and makes it possible to conf irm whether there has been a complete pathological response.However,the medical literature about this topic is scarce and sometimes contradictory.
基金supported by grants from the National Natural Science Foundation of China(No.81000211)Important Research Project from Health Department of Hubei Province,China(No.JX4A05)
文摘The efficiency of dendritic cell-activated and cytokine-induced killer cell(DC-CIK) therapy on children with acute myeloid leukemia(AML) after chemotherapy was investigated. Mononuclear cells were collected from children achieving complete remission after chemotherapy,cultured in vitro and transfused back into the same patient. Interleukin-2(IL-2) was injected subcutaneously every other day 10 times at the dose of 1×106 units. Peripheral blood lymphocyte subsets and minimal residual disease(MRD) were detected by flow cytometry. Function of bone marrow was monitored by methods of morphology,immunology,cytogenetics and molecular biology. The side effects were also observed during the treatment. The average follow-up period for all the 22 patients was 71 months and relapse occurred in two AML patients(9.1%). The percentage of CD3+/CD8+ cells in peripheral blood of 15 patients at the 3rd month after DC-CIK treatment(36.73%±12.51%) was dramatically higher than that before treatment(29.20%±8.34%,P<0.05). The MRD rate was >0.1% in 5 patients before the treatment,and became lower than 0.1% 3 months after the treatment. During the transfusion of DC-CIK,side effects including fever,chills and hives appeared in 7 out of 22(31.82%) cases but disappeared quickly after symptomatic treatments. There were no changes in electrocardiography and liver-renal functions after the treatment. MRD in children with AML can be eliminated by DC-CIK therapy which is safe and has fewer side effects.
文摘Reactivation of Hepatitis B virus causing liver damage is a concern in patients with chronic HBV infections who receive immunosuppressive or cytotoxic treatments. HBV screening should be considered for all patients going to receive immunosuppressive regimens which have the potential to induce reactivation of HBV infection. We discuss here a case of occult Hepatitis B flare after chemotherapy in a patient who had negative acute hepatitis profile including HBsAg prior to therapy and baseline serum AST, ALT, INR, albumin, bilirubin and serum creatinine were within normal limits.
文摘<strong>Introduction: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">Morbidity and Mortality (M&M) rounds can identify adverse events and improve patient safety however adoption in cancer centers is not routine. Herein we report the results of a chemotherapy-specific gynecologic oncology M&M rounds and identify reasons for hospital admission < 30 days after chemotherapy treatment. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Between July 2014 and April 2016, all admissions < 30 days from chemotherapy administration were prospectively collected along with clinical data. Admissions were described and classified as planned or unplanned and as associated with chemotherapy or with underlying disease. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">585 patients were admitted, 78% of whom had ovarian cancer and 43% of whom had recurrent disease. Overall, 47% of admissions were unplanned and these were significantly longer than planned admissions (5.6 vs. 2.4 days, p = 0.0003). Of unplanned admissions, 43% were due to chemotherapy, and 57% were due to disease burden. 74% of patients had received >1 prior line of chemotherapy, and 22% were on clinical trial. The most common causes of unplanned admission were nausea, vomiting or failure to thrive (28.9%), fever (17.9%) and small bowel obstruction (19.9%). </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">There is a high rate of unplanned admission < 30 days after chemotherapy and patients with ovarian cancer and recurrent disease are at the highest risk. This information can be used to counsel patients about complications of chemotherapy and to improve supportive management. M&M conferences surrounding unplanned admissions after chemotherapy may help guide therapy, encourage best supportive care, and prompt re-evaluation of treatment goals in heavily pretreated patients with recurrent.</span></span></span></span>
文摘Antitumor chemotherapy is often limited by hematopoietic toxicity.TO attenuate themyelosuppressive effects of chemotherapy, successfulengraftment of unmodified fetal liver cells (FLCs) hasbeen achieved across allogeneic barriers in a number ofanimal models and patients, GM-CSF is a
文摘Infection rate of hepatitis B virus (HBV) in our country remains high. Many patients showed combined HBV infection; the most common blood system disease is non-Hodgkin’s lymphoma (NHL)-combined HBV infection. Drugs used in treating lymphoma may induce different degrees of HBV reactivation. Such condition may lead to hepatic failure or death. Currently, scholars pay increasing attention to reactivation of HBV by rituximab and/or chemotherapy for NHL-combined HBV patients. This study summarizes research advances in this topic, with a view of providing background information for further research.
文摘<strong>Objective:</strong> To investigate the changes of related immune cytokines (Dendritic Cells (DC) cells, CD4<sup>+</sup>, CD8<sup>+</sup>, Th17, IgG, IgM, IgA) in patients with non-small cell lung cancer (NSCLC) before and after chemotherapy. <strong>Methods: </strong>Eighty-five NSCLC patients who were treated in the Oncology Department of the Affiliated Hospital of Chengde Medical College from December 2018 to February 2021 were selected as the research objects, and the patients were analyzed at different time points (before chemotherapy, after the first chemotherapy, and after the second chemotherapy) Changes in the expression levels of DC cells, CD4<sup>+</sup>, CD8<sup>+</sup>, Th17, IgG, IgM, IgA in peripheral blood, and explore their correlation. <strong>Results:</strong> Before chemotherapy, after the first chemotherapy, and after the second chemotherapy, the peripheral blood CD4<sup>+</sup> and CD8<sup>+</sup> were significantly increased, and the Th17, IgG, IgM, and IgA levels gradually decreased. The difference was statistically significant. But there was no obvious change in DC cells. <strong>Conclusion:</strong> There is no significant change in DC cells in peripheral blood of NSCLC patients before and after chemotherapy. CD4<sup>+</sup> and CD8<sup>+</sup> are significantly increased, Th17, IgG, IgM, and IgA levels are all decreased, which is a manifestation of impaired immune function of patients after chemotherapy.
文摘Objective:The expression of tumor biomarkers may change after chemotherapy. However, whether secreted protein acidic and rich in cysteine(SPARC) expression changes after chemotherapy in gastric cancer(GC) is unclear. This study investigated the influence of chemotherapy on SPARC expression in GC.Methods: Immunohistochemistry was used to analyze SPARC expression in 132 GC cases(including 54 cases with preoperative chemotherapy and 78 cases without preoperative chemotherapy). SPARC expression of postoperative specimens with and without preoperative chemotherapy was assessed to analyze the influence of chemotherapy on SPARC expression.Results: SPARC was highly expressed in GC compared with the desmoplastic stroma surrounding tumor cells and noncancerous tissues. High SPARC expression was correlated with invasion depth, lymph node, and TNM stage. After chemotherapy, a lower proportion of high SPARC expression was observed in patients with preoperative chemotherapy than in the controls. For 54 patients with preoperative chemotherapy, gross type, histology, depth of invasion, lymph node, TNM stage, and SPARC expression were related to overall survival. Further multivariate analysis showed that lymph node, histology, and SPARC expression after chemotherapy were independent prognostic factors.Conclusion: SPARC expression may change after chemotherapy in GC. SPARC expression should be reassessed for patients with GC after chemotherapy.
基金Beijing Xisco Clinical Oncology Research Foundation Project No.:Y-HR2018-271.
文摘Objective:By comparing the efficacy of different frequency application of polyethylene glycol recombinant human granulocyte stimulating factor in the prevention of neutropenia after chemotherapy with dose-intensive regimen in breast cancer, the more optimized administration scheme of polyethylene glycol recombinant human granulocyte stimulating factor in the prevention of neutropenia after chemotherapy in breast cancer was further explored.Methods:From June 2017 to May 2019, 64 patients with breast cancer who had received dose-intensive chemotherapy from June 2017 to May 2019 were randomly divided into two groups: control group (n=31) and observation group (n=33). Control group: after dose-intensive chemotherapy, PEG-rhG-CSF was injected subcutaneously with 100μg/kg, and given 24 hours after chemotherapy. Observation group: after dose-intensive chemotherapy, PEG-rhG-CSF: 50μg/kg, was injected subcutaneously and given 24 hours and 72 hours after chemotherapy. With PEG-rhG-CSF on the number of neutrophils in the two groups and the incidence, duration, fever incidence and duration of neutropenia in the two groups were observed. The curative effect was evaluated after 2 cycles of treatment.Results: There was no significant difference in the number of neutrophils between the two groups before chemotherapy in the first cycle and the second cycle (P>0.05), but the neutrophils in the observation group decreased slowly on the 3rd day, 5th day, 10th day and 5th day and 10th day after the first cycle of chemotherapy, and there was significant difference between the two groups (P<0.001). In the second cycle, there was no significant difference in neutrophils between the two groups on the third day after chemotherapy (P<0.05). In the control group, 7 patients were delayed by the second week because the neutrophil value was less than 2.0109/ L. The time of chemotherapy was delayed in 5 patients in the observation group. The incidence of neutropenia in the control group and the observation group was 41.9% VS 12.1%, and the duration of neutropenia in the observation group was significantly shorter than that in the control group (3.25 ±0.84d VS 5.12 ±1.24d), and the incidence of neutropenia in the observation group was 41.9% VS 12.1%, the duration of neutropenia in the observation group was significantly shorter than that in the control group (3.25 ±0.84d VS 5.12 ±1.24d). The number of patients with fever in the control group and the observation group were 10 cases of VS, the incidence rate was 32.2% VS 12.1%, compared with the control group and the observation group, the incidence of febrile fever was 32.2% and 12.1%, respectively. The duration of fever in the observation group was significantly shorter than that in the control group (2.46 ±1.24 d VS 4.05 ±1.01).Conclusions: Low dose of PEG-rhG-CSF can increase the absolute value of neutrophils after multiple administration, and its curative effect is better than that of single administration in dose-intensive chemotherapy, and the incidence of neutropenia and associated fever is lower, which is worthy of further clinical study and promotion.
基金supported by the Natural Science Foundation of China(Grant Nos.81703839,81874411).
文摘Objective:To evaluate the effect of acupuncture on myelosuppression after chemotherapy and summarize its acupoint selection strategy.Methods:After a systematic search,an acupoint database on myelosuppression after chemotherapy was constructed.A meta-analysis was conducted to assess the efficacy of acupuncture.On this basis,association analysis and cluster analysis were performed to explore the distribution of acupoints in SPSS Modeler18.0 and SPSS 22.0.Results:40 studies with 2988 patients were included.The white blood cell count,platelet count,red blood cell count,and hemoglobin were significantly higher in patients receiving acupuncture versus convention therapy exclusively.The two groups,however,did not differ in neutrophils count.Most acupoints,mainly distributed in the limbs and the back,were from the bladder meridian,the stomach meridian,and the spleen meridian.The lower sea and transport points were the most preferred specific points,in which ST36 and SP6 ranked highest in use.ST36-RN6,SP6-SP10,and ST36-SP10 turned out to be the most significant correlations in association rule mining.In cluster analysis,LI4-RN12,ST36-RN4-RN6 were grouped for their high similarity.Conclusion:For patients with myelosuppression after chemotherapy,acupuncture significantly inhibited the decline in blood cell components(white blood cell count,platelet count,red blood cell count,and hemoglobin)except for neutrophils.As the central combination of acupuncture prescriptions for this population,ST36-SP6-RN6-SP10-RN4 presented promising prospects and deserved more exploration for clinical use.
文摘BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.
文摘BACKGROUND Lung cancer(LC)is a global medical,social and economic problem and is one of the most common cancers and the leading cause of mortality from malignant neoplasms.LC is characterized by an aggressive course,and in the presence of disease recurrence risk factors,patients,even at an early stage,may be indicated for adjuvant therapy to improve survival.However,combined treatment does not always guarantee a favorable prognosis.In this regard,establishing predictors of LC recurrence is highly important both for determining the optimal treatment plan for the patients and for evaluating its effectiveness.AIM To establish predictors of disease recurrence after radical resection and adjuvant chemotherapy in patients with stage IIb-IIIa lung squamous cell carcinoma(LSCC).METHODS A retrospective case-control cohort study included 69 patients with LSCC who underwent radical surgery at the Orenburg Regional Clinical Oncology Center from 2009 to 2018.Postoperatively,all patients received adjuvant chemotherapy.Histological samples of the resected lung were stained with Mayer's hematoxylin and eosin and examined under a light microscope.Univariate and multivariate analyses were used to identify predictors associated with the risk of disease recurrence.Receiver operating characteristic curves were constructed to discriminate between patients with a high risk of disease recurrence and those with a low risk of disease recurrence.Survival was analyzed using the Kaplan-Meier method.The log-rank test was used to compare survival curves between patient subgroups.Differences were considered to be significant at P<0.05.RESULTS The following predictors of a high risk of disease recurrence in patients with stage IIb-IIa LSCC were established:a low degree of tumor differentiation[odds ratio(OR)=7.94,95%CI=1.08-135.81,P=0.049];metastases in regional lymph nodes(OR=5.67,95%CI=1.09-36.54,P=0.048);the presence of loose,fine-fiber connective tissue in the tumor stroma(OR=21.70,95%CI=4.27-110.38,P=0.0002);and fragmentation of the tumor solid component(OR=2.53,95%CI=1.01-12.23,P=0.049).The area under the curve of the predictive model was 0.846(95%CI=0.73-0.96,P<0.0001).The sensitivity,accuracy and specificity of the method were 91.8%,86.9%and 75.0%,respectively.In the group of patients with a low risk of LSCC recurrence,the 1-,2-and 5-year disease-free survival(DFS)rates were 84.2%,84.2%and 75.8%,respectively,while in the group with a high risk of LSCC recurrence the DFS rates were 71.7%,40.1%and 8.2%,respectively(P<0.00001).Accordingly,in the first group of patients,the 1-,2-and 5-year overall survival(OS)rates were 94.7%,82.5%and 82.5%,respectively,while in the second group of patients,the OS rates were 89.8%,80.1%and 10.3%,respectively(P<0.00001).CONCLUSION The developed method allows us to identify a group of patients at high risk of disease recurrence and to adjust to ongoing treatment.
基金Supported by Jiaxing Science and Technology Foundation,No.2021AY30018.
文摘BACKGROUND Prostate cancer(PC)is currently the most common malignant tumor of the genitourinary system in men.Radical prostatectomy(RP)is recommended for the treatment of patients with localized PC.Adjuvant hormonal therapy(AHT)can be administered postoperatively in patients with high-risk or locally advanced PC.Chemotherapy is a vital remedy for castration-resistant prostate cancer(CRPC),and may also benefit patients with PC who have not progressed to CRPC.CASE SUMMARY A 68-year-old male was admitted to our hospital because of urinary irritation and dysuria with increased prostate-specific antigen(PSA)levels.After detailed examination,he was diagnosed with PC and treated with laparoscopic RP on August 3,2020.AHT using androgen deprivation therapy(ADT)was performed postoperatively because of the positive surgical margin,extracapsular extension,and neural invasion but lasted only 6 mo.Unfortunately,he was diagnosed with rectal cancer about half a year after self-cessation of AHT,and was then treated with laparoscopic radical rectal resection and adjuvant chemotherapy using the capecitabine plus oxaliplatin(CapeOx)regimen.During the entire treatment process,the patient's PSA level first declined significantly after treatment of PC with laparoscopic RP and ADT,then rebounded because of self-cessation of ADT,and finally decreased again after CapeOx chemotherapy.CONCLUSION CapeOx chemotherapy can reduce PSA levels in patients with high-risk locally advanced PC,indicating that CapeOx may be an alternative chemotherapy regimen for PC.
文摘BACKGROUND According to relevant investigation and analysis,there are few research studies on the effect of excessive chemotherapy cycles after D2 gastrectomy on the survival of patients with gastric cancer.AIM To determine whether excessive chemotherapy cycles provide extra survival benefits,reduce recurrence rate,and improve survival rate in patients with stage Ⅱ or Ⅲ gastric cancer.METHODS We analyzed and summarized 412 patients with stage Ⅱ gastric cancer and 902 patients with stage Ⅲ gastric cancer who received D2 gastrectomy plus adjuvant chemotherapy or neoadjuvant chemotherapy.Analysis and comparison at a ratio of 1:1 is aimed at reducing realistic baseline differences(n=97 in each group of stage Ⅱ,n=242 in each group of stage Ⅲ).Progression-free survival,overall survival and recurrence were the main outcome indicators.RESULTS When the propensity score was matched,the baseline features of stage Ⅱ and Ⅲ gastric cancer patients were similar between the two groups.After a series of investigations,Kaplan-Meier found that the progression-free survival and overall survival of stage Ⅱ and Ⅲ gastric cancer patients were consistent between the two groups.The local metastasis rate(P=0.002),total recurrence rate(P<0.001)and distant metastasis rate(P=0.001)in the≥9 cycle group of stage Ⅲ gastric cancer were statistically lower than those in the<9 cycle group.The interaction analysis by Cox proportional hazard regression model showed that intestinal type,proximal gastrectomy,and≥6 cm maximum diameter of tumor had a higher risk of total mortality in the<9 cycles group.CONCLUSION Overall,≥9 chemotherapy cycles is not recommended for patients with stage Ⅱ and stage Ⅲ gastric cancer because it has an insignificant role in the prognosis of gastric cancer.However,for patients with stage Ⅲ gastric cancer,≥9 cycles of chemotherapy was shown to significantly decrease recurrence.
文摘BACKGROUND Neoadjuvant therapy is an essential modality for reducing the clinical stage of esophageal cancer;however,the superiority of neoadjuvant chemotherapy(nCT)or neoadjuvant chemoradiotherapy(nCRT)is unclear.Therefore,a discussion of these two modalities is necessary.AIM To investigate the benefits and complications of neoadjuvant modalities.METHODS To address this concern,predefined criteria were established using the PICO protocol.Two independent authors performed comprehensive searches using predetermined keywords.Statistical analyses were performed to identify significant differences between groups.Potential publication bias was visualized using funnel plots.The quality of the data was evaluated using the Risk of Bias Tool 2(RoB2)and the GRADE approach.RESULTS Ten articles,including 1928 patients,were included for the analysis.Significant difference was detected in pathological complete response(pCR)[P<0.001;odds ratio(OR):0.27;95%CI:0.16-0.46],30-d mortality(P=0.015;OR:0.4;95%CI:0.22-0.71)favoring the nCRT,and renal failure(P=0.039;OR:1.04;95%CI:0.66-1.64)favoring the nCT.No significant differences were observed in terms of survival,local or distal recurrence,or other clinical or surgical complications.The result of RoB2 was moderate,and that of the GRADE approach was low or very low in almost all cases.CONCLUSION Although nCRT may have a higher pCR rate,it does not translate to greater long-term survival.Moreover,nCRT is associated with higher 30-d mortality,although the specific cause for postoperative complications could not be identified.In the case of nCT,toxic side effects are suspected,which can reduce the quality of life.Given the quality of available studies,further randomized trials are required.
文摘Objective:To explore and analyze the effect and safety of personalized nursing in improving thrombocytopenia after lymphoma chemotherapy.Methods:80 lymphoma patients with thrombocytopenia after lymphoma chemotherapy in the Department of Hematology of our hospital from May 2021 to May 2023 were selected as the research objects,and they were divided into an experimental group and reference group by random drawing,with 40 cases in each group.The experimental group received individualized nursing,and the reference group received routine nursing.The platelet count,platelet-related indicators,incidence of adverse reactions,and life scores were compared between the two groups.Results:Before the intervention,there was no significant difference in platelet count between the groups(P>0.05);after the intervention,the platelet count in the experimental group was significantly higher compared to the reference group(P<0.05).In the experimental group,the duration for platelet decline and the time for platelets to normalize were notably shorter compared to the reference group(P<0.05).Moreover,the personality group displayed a significantly lower incidence of adverse reactions than the reference group(P<0.05).Prior to the intervention,there were no statistically significant differences(P>0.05)in the life scores between the two groups,such as functional condition,symptom manifestation,and health scores among the groups.However,post-intervention,the personality group exhibited a significant improvement in those scores compared to the reference group(P<0.05).Conclusion:Individualized nursing can optimize the platelet level in thrombocytopenia after lymphoma chemotherapy,improve symptoms,and reduce the occurrence of adverse reactions.
基金Supported by National Natural Science Foundation of China,No.31870993Fundamental Research Funds for the Central Universities,No.WK9110000005+3 种基金Anhui Provincial Health Research Project,No.AHWJ2022c020Anhui Medical University Campus Level Research Fund,No.2020xkj229Lu'an City Science and Technology Plan Project,No.2022Lakj009New Technology and Project of Lu'an People's Hospital,No.2021xjs10.
文摘BACKGROUND Advanced pancreatic cancer is resistant to chemotherapeutic drugs,resulting in limited treatment efficacy and poor prognosis.Combined administration of the chemotherapeutic gemcitabine and erlotinib is considered a potential first-line treatment for advanced pancreatic cancer.However,their comparative benefits and potential risks remain unclear.AIM To assess the clinical efficacy and safety of erlotinib combined with other chemotherapy regimens for the treatment of advanced pancreatic cancer.METHODS Literature on the clinical efficacy and safety of erlotinib combined with chemotherapy for advanced pancreatic cancer was retrieved through an online search.The retrieved literature was subjected to a methodological qualitative assessment and was analyzed using the RevMan 5.3 software.Ten randomized controlled trials involving 2444 patients with advanced pancreatic cancer were included in the meta-analysis.RESULTS Compared with chemotherapeutic treatment,erlotinib combined with chemotherapy significantly prolonged the progression-free survival time of pancreatic cancer patients[hazard ratio(HR)=0.78,95%CI:0.66-0.92,P=0.003].Meanwhile,the overall survival(HR=0.99,95%CI:0.72-1.37,and P=0.95)and disease control rate(OR=0.93,95%CI:0.45-0.91,P=0.84)were not significantly favorable.In terms of safety,the erlotinib and chemotherapy combination was associated with a significantly higher risk of diarrhea(OR=3.59,95%CI:1.63-7.90,P<0.05)and rash(OR=3.63,95%CI:1.64-8.01,P<0.05)compared with single-agent chemotherapy.Moreover,the risk of vomiting(OR=1.27,95%CI:0.62-2.59,P=0.51),regurgitation/anorexia(OR=1.61,95%CI:0.25-10.31,P=0.62),and infection(OR=0.72,95%CI:0.28-1.87,P=0.50)were not significant in either group.CONCLUSION Compared with a single chemotherapeutic modality,erlotinib combined with gemcitabine can prolong progression-free survival in pancreatic cancer,but does not improve survival benefit or disease control rate,and can increase the risk of diarrhea and rash.
