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08 October 2024, Volume 51 Issue 10 Previous Issue

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Original Articles

Efficacy and safety of simultaneous integrated boost intensity-modulated radiotherapy for the treatment of lung cancer brain metastases Yang Jing, Liu Fang, Ma Meili, Huang Dongshuai, Wang Junhua 2024, 51 (10): 609-613. doi:10.3760/cma.j.cn371439-20240606-00102 Abstract( 27) HTML( 4) PDF(767KB) ( 11) Save ObjectiveTo analyze the therapeutic effect and safety of simultaneous integrated boost intensity-modulated radiotherapy for lung cancer brain metastases.MethodsA total of 300 patients with lung cancer brain metastases admitted to the Department of Oncology， Qingdao Municipal Hospital from March 2021 to March 2023 were selected as the study objects. The patients were divided into control group （n=150） and study group （n=150） by random number table method. The control group received sequential three-dimensional conformal radiotherapy， while the study group received simultaneous integrated boost intensity-modulated radiotherapy. The short-term and medium-term efficacy， target dose， and adverse reactions were compared between the two groups.ResultsThe short-term and medium-term total effective rates of the study group were 73.33% （110/150） and 88.67% （133/150）， respectively， which were higher than those of the control group [51.33% （77/150） and 71.33% （107/150）] （χ2=15.46，P<0.001；χ2=14.08，P<0.001）. The Dminin gross tumor planning target volume and whole brain clinical planning target volume of the study group were （23.78±1.11） and （58.46±0.55） Gy， respectively， which were higher than those in the control group [（16.67±1.08） and （53.44±0.74） Gy]， with statistically significant differences （t=56.22，P<0.001；t=66.68，P<0.001）. The Dmeanin gross tumor planning target volume and whole brain clinical planning target volume of the study group were （44.12±0.87） and （62.19±0.57） Gy， respectively， which were higher than those in the control group [（37.55±0.89） and （57.78±0.82） Gy]， with statistically significant differences （t=64.65，P<0.001；t=54.08，P<0.001）. The total incidence of adverse reactions was 30.67% （46/150） in the study group and 36.67% （55/150） in the control group， with no significantly significant difference （χ2=1.20，P=0.271）.ConclusionCompared with sequential three-dimensional conformal radiotherapy， simultaneous integrated boost intensity-modulated radiotherapy has better short-term and medium-term efficacy in patients with lung cancer brain metastases. Target dose can be increased without increasing adverse reactions. Figures and Tables|References|Related Articles|Metrics

Analysis of related factors of electrocoagulation syndrome after esophageal tumor endoscopic submucosal dissection Xie Chao, Zhang Mingxin, Lu Ning, Miao Tao 2024, 51 (10): 614-619. doi:10.3760/cma.j.cn371439-20240727-00103 Abstract( 22) HTML( 3) PDF(896KB) ( 13) Save ObjectiveTo analyze the factors related to the occurrence of electrocoagulation syndrome after esophageal tumor endoscopic submucosal dissection （ESD）， thus to construct and validate a nomogram prediction model.MethodsA total of 240 patients who underwent esophageal tumor ESD in the First Affiliated Hospital of Xi'an Medical University， Huazhou District of Weinan City People's Hospital of Shaanxi Province， and Chenggu County Hospital of Shaanxi Province from October 2018 to May 2024 were selected as the study objects. The patients were divided into a modeling group and a validation group using the "createDataPartition" of caret package in R software at a ratio of 7:3. Univariate and multivariate logistic regression were used to analyze the factors related to the occurrence of esophageal tumor post-endoscopic submusocal dissection electrocoagulation syndrome （PEECS） in the modeling group， and the nomogram prediction model was constructed. C-index and calibration curve were used to verify the prediction model.ResultsAll data in the modeling group （n=168） and the validation group （n=72） were comparable. Univariate analysis showed that gender （OR=2.15， 95%CI： 1.38-3.76，P=0.004）， age （OR=2.53， 95%CI： 1.39-4.61，P=0.001）， surgical time （OR=5.88， 95%CI： 2.15-8.41，P<0.001） and lesion length （OR=5.16， 95%CI： 1.85-7.33，P<0.001） were related factors influencing the occurrence of esophageal tumor PEECS. Multivariate analysis showed that gender （OR=2.94， 95%CI： 1.46-5.33，P=0.011）， age （OR=2.12， 95%CI： 1.20-3.88，P=0.042）， surgical time （OR=4.62， 95%CI： 2.11-7.26，P<0.001） and lesion length （OR=3.93， 95%CI： 1.78-5.94，P=0.003） were independent factors for the occurrence of esophageal tumor PEECS. Based on the above indexes， a nomogram prediction model for the occurrence of esophageal tumor PEECS was constructed， and its C-index value was 0.787 （95%CI： 0.692-0.863）. The calibration curve showed that with the modeling group as the internal verification and the validation group as the external verification， the predicted probability was in good agreement with the actual probability.ConclusionGender， age， surgical time and lesion length are independent factors influencing the occurrence of esophageal tumor PEECS. The nomogram prediction model based on the above indexes has high predictive efficacy. Figures and Tables|References|Related Articles|Metrics

Evaluation of efficacy and safety of tislelizumab combined with chemotherapy in neoadjuvant treatment for resectable esophageal cancer Wu Qin, Wu Dong, Xie Jianlong, Luo Qinhui, Lao Liangling, Zeng Yubin, Lin Liyao 2024, 51 (10): 620-626. doi:10.3760/cma.j.cn371439-20240410-00104 Abstract( 35) HTML( 4) PDF(779KB) ( 14) Save ObjectiveTo analyze the short-term efficacy and safety of tislelizumab combined with neoadjuvant chemotherapy in the treatment of resectable esophageal squamous cell carcinoma （ESCC）.MethodsThe clinical data of 56 patients with ESCC who received neoadjuvant therapy combined with surgical resection in the Department of Thoracic Surgery， Affiliated Hospital of Guangdong Medical University from April 2021 to October 2023 were collected. According to the different preoperative neoadjuvant therapy methods， the patients were divided into neoadjuvant chemotherapy combined with immunotherapy group （chemoimmunization group，n=24） and neoadjuvant chemotherapy group （chemotherapy group，n=32）. The postoperative tumor regression grade， objective response rate （ORR）， disease control rate （DCR）， pathological complete response （pCR） rate， major pathological remssion （MPR） rate， R0 resection rate， perioperative indicators， and security were compared between the two groups.ResultsIn chemoimmunization group， the tumor regression grade was better than that in chemotherapy group， with a statistically significant difference （Z=9.39，P=0.025）. The ORR and the DCR were 75.00% （18/24） and 91.67% （22/24） in chemoimmunization group， and 46.88% （15/32） and 65.62% （21/32） in chemotherapy group， with statistically significant differences （χ2=4.48，P=0.034；χ2=5.21，P=0.022）. The R0 resection rate was 87.50% （21/24） in chemoimmunization group， which was higher than that of the chemotherapy group [59.38% （19/32）]， with a statistically significant difference （χ2=5.31，P=0.021）. The pCR rate and MPR rate were 29.17% （7/24） and 54.17% （13/24） in chemoimmunization group， and 6.25% （2/32） and 28.12% （9/32） in chemotherapy group， there was no statistically significant difference in pCR rate （χ2=3.78，P=0.052）， but there was a statistically significant difference in MPR rate （χ2=3.89，P=0.048）. The interval between the end of neoadjuvant treatment and the start of surgery was （42.71±8.29） days in chemoimmunization group， and （42.25±8.03） days in chemotherapy group. The intraoperative blood loss of patients was （215.54±57.85） ml in chemoimmunization group， and （229.65±57.74） ml in chemotherapy group. The operation time of patients was （293.52±37.50） minutes in chemoimmunization group， and （295.31±37.66） minutes in chemotherapy group. The postoperative hospitalization time of patients was （17.90±3.49） days in chemoimmunization group， and （18.42±3.82） days in chemotherapy group， all with no statistically significant differences （t=0.21，P=0.835；t=0.90，P=0.370；t=0.18，P=0.861；t=0.52，P=0.603）. In terms of postoperative complications， there was no statistically significant difference in the total incidence of postoperative complications between the two groups [62.50% （15/24）vs.84.38% （27/32），χ2=0.59，P=0.440]. The main adverse drug reactions in the two groups included decreased white blood cell count， nausea and vomiting， liver dysfunction， pruritus， hypothyroidism，etc. Most of them were grade 1-2， 3 cases were grade 3， and no grade 4 adverse reactions occurred. The total incidence of adverse reactions was 62.50% （15/24） in chemoimmunization group， and 65.62% （21/32） in chemotherapy group， with no statistically significant difference （χ2=0.06，P=0.809）.ConclusionFor the preoperative neoadjuvant therapy of resectable ESCC， the combination of tislelizumab and chemotherapy has better short-term efficacy and better safety than the single chemotherapy scheme， which can improve the surgical efficacy. Figures and Tables|References|Related Articles|Metrics

Application of miR-9 and miR-195-3p in the diagnosis of primary hepatic carcinoma and their changes before and after interventional therapy Zhang Dongqian, Zhang Haiguang, Zhang Xiaoru, Zheng Xuan, Han Sugui, Li Ying, Hao Chunhai 2024, 51 (10): 627-631. doi:10.3760/cma.j.cn371439-20240115-00105 Abstract( 18) HTML( 1) PDF(967KB) ( 14) Save ObjectiveTo investigate the diagnostic efficacy of miR-9 and miR-195-3p for primary hepatic carcinoma （PHC）， and the changes in miR-9 and miR-195-3p levels after interventional therapy.MethodsA total of 123 cases of PHC patients and 30 cases of liver cirrhosis patients attending Tangshan People's Hospital from May 2019 to May 2020 were selected as the PHC group and the liver cirrhosis group， respectively， and 50 people who were physically healthy during the same period were selected as the healthy group. Serum miR-9 and miR-195-3p levels were detected by real-time quantitative PCR. The relationship between serum miR-9 and miR-195-3p levels and clinical-pathological characteristics of PHC patients was analyzed. Receiver operator characteristic （ROC） curve was applied to analyze the diagnostic efficacy of miR-9 and miR-195-3p for PHC. The changes in serum miR-9 and miR-195-3p levels in PHC patients before and after transcatheter arterial chemoembolization（TACE） were compared.ResultsThere were statistically significant differences in serum miR-9 （0.99±0.10， 1.31±0.28， 1.68±0.43） and miR-195-3p （0.97±0.10， 0.83±0.22， 0.63±0.18） levels among the healthy group， liver cirrhosis group， and PHC group （F=69.78，P<0.001；F=74.82，P<0.001）， with serum miR-9 levels increased successively and miR-195-3p levels decreased successively among the three groups （allP<0.05）. There were statistically significant differences in serum miR-9 （t=7.45，P<0.001；t=5.32，P<0.001；t=4.96，P<0.001）and miR-195-3p （t=16.17，P<0.001；t=4.21，P<0.001；t=7.53，P<0.001） levels in PHC patients with different maximum diameters of tumor， clinical stages and degrees of differentiation. ROC curve analysis showed that the area under the curve （AUC） for the combined differential diagnosis of liver cirrhosis and PHC by serum miR-9 and miR-195-3p testing was 0.919， which was higher than the AUC for the differential diagnosis of serum miR-9 （AUC： 0.712，Z=4.38，P<0.001） and miR-195-3p （AUC： 0.844，Z=2.04，P=0.042） alone. After TACE treatment， serum miR-9 levels decreased （1.39±0.21vs.1.68±0.43，t=14.22，P<0.001） and miR-195-3p levels increased （0.78±0.22vs.0.63±0.18，t=14.84，P<0.001） in patients compared to pre-treatment levels.ConclusionSerum miR-9 level is increased and miR-195-3p level is decreased in patients with PHC compared with patients with liver cirrhosis and healthy subjects， and the combination of the two has high differential diagnostic efficacy for liver cirrhosis and PHC. After TACE treatment， serum miR-9 level is decreased and miR-195-3p level is increased in PHC patients. Figures and Tables|References|Related Articles|Metrics

Analysis of incidence and mortality of male urogenital system tumors in China from 1990 to 2019 Zhao Mingjun, Yu Chunhu 2024, 51 (10): 632-638. doi:10.3760/cma.j.cn371439-20240509-00106 Abstract( 17) HTML( 2) PDF(1172KB) ( 8) Save ObjectiveTo examine the prevalence and trends of male urogenital system tumors in China from 1990 to 2019.MethodsThe Global Burden of Disease Study 2019 database was used to analyze the incidence and mortality of male urogenital tumors among different age groups and years in China. Joinpoint 5.2.0 software was utilized to analyze the incidence and mortality trends of male urogenital tumors in China from 1990 to 2019. Standardized incidence and mortality rates of male urogenital system tumors in China， in the world and in different sociodemographic index （SDI） regions were compared.ResultsIn 2019， the rank of incidence of male urogenital system tumors in China from high to low was prostate cancer （21.17/100 000）， bladder cancer （11.41/100 000）， kidney cancer （5.87/100 000） and testicular cancer （2.37/100 000）. The rank of mortality was consistent with the rank of incidence， which was prostate cancer （7.50/100 000）， bladder cancer （4.35/100 000）， kidney cancer （2.33/100 000） and testicular cancer （0.17/100 000）. The ranks of incidence and mortality of male urogenital tumors in China in 1990 were the same as those in 2019. In 2019， prostate cancer cases began to appear in the 20-year-old age group， bladder cancer cases in the 15-year-old age group， while kidney cancer and testicular cancer cases began to emerge in the 1-4-year-old age group. Before the age of 55， the incidence and mortality rates of four types of tumors in the male urogenital system did not differ significantly. After the age of 55， the incidence and mortality rate of prostate cancer surpassed those of kidney cancer， bladder cancer and testicular cancer. The incidence rate of male urogenital tumors in 2019 was higher in all age groups than in 1990. From 1990 to 2019， the incidence， mortality and standardized incidence rates of prostate cancer， bladder cancer， kidney cancer and testicular cancer all showed increasing trends. The standardized mortality rate of kidney cancer showed an upward trend， while prostate cancer exhibited a downward trend. Compared with global averages， the standardized incidence and mortality rates of male urogenital system tumors in China were lower in 1990 and 2019. Compared with different SDI regions， the standardized incidence and mortality rates of male kidney cancer， testicular cancer and bladder cancer in China in 1990 and 2019 were similar to those in moderate and low SDI regions. The standardized incidence and mortality rates of prostate cancer in 1990 and 2019 were lower in China than in different SDI regions.ConclusionIn 1990 and 2019， the incidence and mortality ranks of male urogenital tumors in China are the same， with prostate cancer， bladder cancer， kidney cancer and testicular cancer in order from high to low. From 1990 to 2019， the incidence， mortality and standardized incidence rates of male urogenital system tumors in China show increasing trends. In 1990 and 2019， compared with the global average， the standardized incidence and mortality rates of male urogenital system tumors in China are lower. Figures and Tables|References|Related Articles|Metrics

Reviews

Advances in the study of the role of tumor treating fields therapy in the treatment of glioblastoma Du Aichao, Cheng Houxiang, Dai Junqiang, Pan Yawen 2024, 51 (10): 639-644. doi:10.3760/cma.j.cn371439-20240407-00107 Abstract( 21) HTML( 2) PDF(765KB) ( 16) Save Glioblastoma （GBM） is one of the most threatening diseases of the central nervous system， and the prognosis has not improved despite the constant updating of therapeutic approaches. However， the introduction of tumor treating fields （TTFields） has changed the treatment of newly diagnosed and recurrent GBM. TTFields is a novel non-invasive therapy for the treatment of tumors using mid-frequency and low-intensity alternating electric fields， which is important for the treatment of central nervous system diseases such as GBM. TTFields has fewer side effects and greater local efficacy than traditional treatment modalities. In addition， the combination of chemotherapeutic drugs and radiotherapy with TTFields has shown significant advantages and may become one of the future clinical treatment strategies. Despite the potential of TTFields in the treatment of GBM， a number of limitations remain， including issues of device dependency， discomfort during use and tolerability in some patients. Therefore， the use of TTFields needs to be further optimized to maximize their therapeutic potential in patients with GBM and to provide more effective treatment options for patients. References|Related Articles|Metrics

Progress of manganese-based nanomaterials in breast cancer diagnosis and treatment Tao Jin, Kan Junnan, Yang Caixia, Liu Yan, Lyu Yijie, Wei Junhui, Li Xianglin 2024, 51 (10): 645-649. doi:10.3760/cma.j.cn371439-20240429-00108 Abstract( 16) HTML( 2) PDF(773KB) ( 19) Save Breast cancer is the most common malignant tumor among women， and early diagnosis， coupled with optimized treatment strategies is crucial for improving the prognosis. In recent years， with the advancement of nanotechnology， manganese-based nanomaterials have shown potential in various aspects of early breast cancer diagnosis， drug delivery， and tumor treatment. Compared to other nanomaterials， manganese-based nanomaterials exhibit excellent biocompatibility and have become a significant focus in the research of breast cancer diagnosis and treatment. References|Related Articles|Metrics

Role of tumor cell-derived exosomes in the pre-metastatic niche formation in colorectal cancer Chen Jie, Xu Hong, Chen Yutian 2024, 51 (10): 650-654. doi:10.3760/cma.j.cn371439-20240429-00109 Abstract( 12) HTML( 1) PDF(774KB) ( 5) Save Distant metastasis is the main cause of death in patients with advanced colorectal cancer， and tumor cell-derived exosomes， as mediators of information transfer， are widely involved in all aspects of pre-metastatic niche formation in colorectal cancer. In-depth study of the mechanism of exosomes in the formation of pre-metastatic niche can provide new ideas for targeted therapy and prediction of tumor progression in colorectal cancer. References|Related Articles|Metrics

Research status and prospect of tumor microenvironment and ablation therapy for liver cancer He Peipei, Yang Chaofeng, Li Yang 2024, 51 (10): 655-659. doi:10.3760/cma.j.cn371439-20240328-00110 Abstract( 15) HTML( 4) PDF(749KB) ( 7) Save Liver cancer is one of the common malignant tumors， and most patients are in the middle and advanced stages when they seek medical attention. Ablation therapy is the main treatment for patients with early or unresectable liver cancer. Changes in the tumor microenvironment may affect the efficacy and prognosis of patients after ablation of liver cancer. In recent years， more and more studies have explored the potential synergistic effect between ablation therapy for liver cancer and the tumor microenvironment to improve the efficacy of ablation therapy and improve survival rate. Exploring the key components of the tumor microenvironment and the immunomodulatory role of the tumor microenvironment in the ablation treatment of liver cancer can provide a new strategy for the treatment of liver cancer. References|Related Articles|Metrics

PI3K inhibitors in the treatment of lymphoma： present and challenges Fu Ying, Wang Huaqing 2024, 51 (10): 660-666. doi:10.3760/cma.j.cn371439-20240407-00111 Abstract( 18) HTML( 1) PDF(788KB) ( 25) Save Abnormal activation of phosphoinositide 3-kinase （PI3K） pathway is one of the pathogenesis of malignant lymphoma. PI3K inhibitors are new targets for lymphoma treatment in recent years. At present， a variety of different types of PI3K inhibitors have been developed， some of which have been approved for clinical use， and some are still in clinical trials. PI3K inhibitors have multiple side effects. Improving safety and efficacy is an important direction for the future development of PI3K inhibitors. Figures and Tables|References|Related Articles|Metrics