ObjectiveTo analyze whether neoadjuvant chemoradiotherapy can impact patients’ anal function and quality of life after rectal cancer surgery.MethodThe domestic and international publications on the studies how the neoadjuvant chemoradiotherapy impacted patients’ anal function and quality of life were collected and reviewed.ResultsThe neoadjuvant chemoradiotherapy negatively impacted the patients’ anal function and quality of life, but which would be improved over time. The impact had no obvious difference between the long-course chemoradiotherapy and short-couse radiotherapy on the patients’ anal function and quality of life. Compared with the neoadjuvant chemoradiotherapy, the neoadjuvant chemotherapy might impact less on the anal function, but which still needed to evaluate the lower anterior resection syndrome (LARS) score. In present, it lacked evidence of a higher rate of anastomotic leakage caused by the neoadjuvant chemoradiotherapy, which might lead to the bowel dysfunction.ConclusionsNeoadjuvant chemoradiotherapy negatively impacts patients’ anal function and quality of life. Further studies are needed to figure out the best choice between long-course neoadjuvant chemoradiotherapy and short-couse radiotherapy. In long term, impact of neoadjuvant therapy can be improved over time and be accepted by patients. Some intervention treatments including medicine and operations are needed if major LARS occurs.
Objective To review the recent studies on the multidrug resistance of breast cancer. Methods The literatures of recent years on the studies of multidrug resistance, multidrug resistance protein and breast cancer resistance protein were reviewed. Results Multidrug resistance resulted from multiple factors. How to identify the sensibility of chemotherapy drugs and select individual therapeutic regime early were important to improve the survival rate and life quality of breast cancer patients. Conclusion These studies on multidrug resistance of breast cancer are helpful to predicting the effect and outcome of chemotherapy and overcoming the barrier of drug resistance.
Lung cancer ranks first in the incidence of malignant tumors in China, which is seriously harmful to people’s life and health. Chemotherapy is an effective treatment for lung cancer, and it is also an important cause of cognitive dysfunction. Cognitive impairment is usually evaluated by subjective assessment, neuropsychological testing and neuroimaging research. The mechanism of cognitive impairment in patients with lung cancer caused by chemotherapy may include the accumulation of a large amount of endogenous tau protein in hippocampus, the induction of hippocampal neuroinflammation, and the direct killing effect of drugs on nerve cells. There is no effective treatment for chemotherapy-related cognitive impairment (CRCI), but current studies have found that cognitive education in the form of mind map, diet regulation, physical exercise and caring therapy may contribute to the improvement of cognitive function of lung cancer patients after chemotherapy. Based on the current research results, this article provides new ideas for the research and treatment of lung cancer patients with CRCI in terms of clinical characteristics, evaluation methods, influencing factors, mechanism and prevention strategies.
Objective To analyze the value of serum microRNAs (miR-218, miR-329, and miR-567) in predicting the clinical efficacy of programmed death-1 (PD-1) inhibitor combined with synchronous chemotherapy in patients with non-small cell lung cancer (NSCLC). Methods A total of 160 patients with NSCLC treated with PD-1 inhibitor combined with synchronous chemotherapy in Taiyuan Hospital, Peking University First Hospital between January 2021 and January 2023 were prospectively selected as the study objects by convenience sampling, and the serum levels of miR-218, miR-329, and miR-567 and the clinical efficacy of the patients were collected. According to the clinical efficacy, the patients were divided into remission group (partial remission and complete remission) and non-remission group (stable disease and disease progression). Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum miR-218, miR-329 and miR-567 levels in the clinical efficacy of PD-1 inhibitor combined with synchronous chemotherapy in patients with NSCLC. Results Of the 160 patients, 34 (21.2%) had disease progression, 85 (53.1%) had stable disease, 39 (24.4%) had partial remission, and 2 (1.2%) had complete remission. They were divided into remission group (41 cases) and non-remission group (119 cases). Multiple logistic regression analysis showed that high levels of serum miR-218, miR-329, and miR-567 could promote the clinical efficacy of PD-1 inhibitor combined with synchronous chemotherapy in patients with NSCLC (all P<0.05). ROC curve analysis showed that, for predicting the clinical efficacy of PD-1 inhibitor combined with synchronous chemotherapy in patients with NSCLC according to the cut-off value of the joint prediction probability of serum miR-218, miR-329, and miR-567, the area under the ROC curve was 0.938 [95% confidence interval (0.855, 0.964)], and the sensitivity, specificity, positive predictive value, and negative predictive value were 82.9%, 92.4%, 79.1%, and 94.0%, respectively. Conclusion The combined detection of serum miR-218, miR-329 and miR-567 levels has a high predictive value for the therapeutic effect of PD-1 inhibitor combined with synchronous chemotherapy in patients with NSCLC.
High-grade gliomas are the most common malignant primary central nervous system tumors with poor prognosis. The operation based on the principle of maximum safe resection of tumors, combined with radiation therapy and chemotherapy, is the primary treatment method. This treatment only delays the progression of high-grade gliomas, and almost all patients eventually develop disease progression or relapse. With the development of molecular biology, immunology, and genomics, people have a deeper understanding of the pathogenesis of gliomas. Targeted therapy, immunotherapy, and other comprehensive treatments are expected to become potential treatments for high-grade gliomas. This article reviews the current status of medical treatment of primary and recurrent high-grade gliomas, and the research progress of high-grade gliomas in targeted therapy and immunotherapy.
Fluoropyrimidines have been the standard care as ajuvant or palliative treatment for malignant gastrointestinal carcinoma over several decades. Their common adverse effects include gastrointestinal effects, myelosuppression, and hand-foot syndrome. Besides, fluoropyrimidines are the second cause of chemotherapy-induced cardiotoxicity and have the different manifestation and machanisms from anthracyclines. With the development of onco-cardiology, increasing concern is raised on fluoropyrimidine-induced cardiotoxicity. This review addresses the epidemiology, clinical manifestation, and proposed mechanisms; and also highlights the diagnosis, monitoring and management of fluoropyrimidine-induced cardiotoxicity.
ObjectiveTo systematically review the efficacy and safety of hyperthermia in combination with radiation, chemotherapy or both for middle/advanced cervical cancer patients (LACC). MethodsThe databases such as PubMed, The Cochrane Library (Issue 6, 2013), CNKI, WanFang Data and VIP were searched from inception to July 1st, 2013 for randomized controlled trials (RCTs) that investigated hyperthermia in combination with radiation, chemotherapy or both for LACC for cervical cancer at middle/advanced stage. Two reviewers screened literature according to the inclusion and exclusion criteria, extracted data, and evaluated methodological quality of included studies. Meta-analysis was then performed using RevMan 5.2.6 software. ResultsSix RCTs were included. A descriptive analysis was conducted due to significant heterogeneities among the results of studies. Out of 6 studies, the results of 4 studies showed that hyperthermia increased complete remission rate; the results of 3 studies reported objective effectiveness; while only one study showed statistical significance. Overall survival was reported in all studies, while only one study showed that hyperthermia significantly improved overall survival. Only one study reported 3-year progression-free survival with statistical significance. Two studies reported disease-free survival but only one showed statistical significance. Only two studies reported adverse events, and the data in one study showed acute toxicities of Grade 2-3 were higher for hyperthermia with unclear long-term reaction. ConclusionCurrent evidence is insufficient to confirm the efficacy and safety of hyperthermia for cervical cancer, and large-scale well-designed RCTs are further needed to verify the efficacy and safety of hyperthermia in the combined treatment of cervical cancer.