简介：AbstractThe management of pancreatic cancer has dramatically changed since the first major randomized trial published in 2001 by the European Study Group for Pancreatic Cancer (ESPAC) stimulated the development of multimodality oncosurgical therapies. ESPAC-1 demonstrated a survival improvement from upfront surgery of only 8%, increasing to 21% 5-year survival for 5-fluorouracil/folinic acid but only 10.8% for chemoradiotherapy. ESPAC-4 has shown a 5-year survival rate of 30% for all patients without restriction of 30% using a combination of gemcitabine and capecitabine, rising to 40% in those with an R0 resection margin, or nearly 50% in those with N0 lymph node status. In selected patients with favorable prognostic features mFOLFIRINOX can produce a 50% 5-year survival rate but with added toxicity. While a positive resection margin is associated with an increased likelihood of local recurrence, this of itself is not the contributor to reduced survival, but rather reflects the increased probability of systemic disease. Thus, strategies aimed at local control, may reduce subsequent local progression, but will not improve overall survival. Neoadjuvant chemotherapy is increasingly utilized in cases of borderline resectable or locally advanced pancreatic cancer, but there is still a lack of proof of concept studies. High-quality evidence from randomized controlled trials to identify the indications and benefits of neoadjuvant therapy in pancreatic cancer are required. The use of patient-derived tumor organoids may predict response to chemotherapy which could open a new opportunity in pancreatic cancer treatment, stratifying patients into treatment groups based on their response to these therapies in the laboratory.

简介：AbstractPreoperative neoadjuvant chemoradiotherapy, combined with total mesorectal excision, has become the standard treatment for advanced localized rectal cancer (RC). However, the biological complexity and heterogeneity of tumors may contribute to cancer recurrence and metastasis in patients with radiotherapy-resistant RC. The identification of factors leading to radioresistance and markers of radiosensitivity is critical to identify responsive patients and improve radiotherapy outcomes. MicroRNAs (miRNAs) are small, endogenous, and noncoding RNAs that affect various cellular and molecular targets. miRNAs have been shown to play important roles in multiple biological processes associated with RC. In this review, we summarized the signaling pathways of miRNAs, including apoptosis, autophagy, the cell cycle, DNA damage repair, proliferation, and metastasis during radiotherapy in patients with RC. Also, we evaluated the potential role of miRNAs as radiotherapeutic biomarkers for RC.

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简介：Thecombinationofradiotherapy(RT)andfunction-preservingsurgeryisthemostusualcontemporaryapproachinthemanagementofsofttissuesarcomas(STS).Pre-andpostoperativeRTresultinsimilarlocalcontrolrates,asshownbyalandmarktrialinextremitySTS.Inthisreview,theroleofRTinthemanagementofextremitySTSwillbediscussed,butSTSinothersites,includingretroperitonealSTS,willalsobeaddressed.ThefocuswillconsidervariousaspectsofRTincludingstrategiestoreducethevolumeoftissuebeingirradiated,dose,scheduling,andthepossibleofomissionofRTinselectedcases.Finally,technologyadvancesthroughtheuseofintensity-modulatedradiotherapy(IMRT),image-guidedIMRT,intraoperativeradiotherapy(IORT)andparticletherapywillalsobediscussed.

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简介：Incomparisonwiththenormalpeoplegroup,valuesofbloodCD2+andCD4+inpa-tientswithmallgnanttumorstreatedwithradiotherapyandchemotherapyweresignificantlylowerandtheratioofCD助+andCD8+decreasedobviously（allP<0.001）;CD8+hadnoapparentchange（P>0.05）.Followingacupuncturaltreatment,valuesofCD2+,CD4+andtheratioofCD4+toCD8+increasedobviously（allP<0.001）;whilethoseofthemedicinalcontrolgrouphadnosignificantchangeaftertreatment（P>0.05）.ValuesofIgG,IgAandIgMinpatients’serumpresentedanabnormalde-creasingorincreasingtendency,andC3inminorityofpatientswereraised.ResultsindicatedthattherewasabiphasicregulatoryeffectofacupunctureonthedisturbanceofhumoralimmunityandcouldcorrectthedeviationofC3level;anditseffectwasbetterthanorsimilartothatofthemedicinecontrolgroup.Itdemonstratesthatacupuncturecanenhanceandregulate.theimmunefunctionofpa-tientstreatedwithradiotherapya

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简介：Inthemid1940s,RobertWilson(1)hypothesizedthatahighlylocalizeddepositionofenergyfromaprotonbeamcouldbeusedtoincreasetheradiationdosetotumorswhileminimizingradiationtoadjacentnormaltissues.Thedepthdosedistributionofaprotonbeamdifferssignificantlyfrom

简介：摘要：在中介或先进的胰腺的头癌上改进辩解的效果。方法：手术与intermediated或先进的胰腺的头癌在26个病人被动。在癌上与一根电子横梁与intraoperative放射疗法相结合的Cholecystojejunostomy或choledochojejunostomy从1996年5月被执行到1998年5月。同时，多功能的可植入的药交货系统的导管为手术后的灌注化疗经由胃与十二指肠的动脉被插入。结果：327月后续调查建议肿瘤在治疗的功课以后在不同的度缩小了。所有病人疼痛被减轻。6月、12月、24月的幸存率是100%，93.9%和20%分别地。5个死了的病人的平均幸存时间是17.8个月。结论：这操作是很完成与中介或先进的胰腺的头癌延长病人的生活。

简介：ＴＨＥＤＩＡＧＮＯＳＩＳＡＮＤＴＲＥＡＴＭＥＮＴＦＯＲＲＥＣＵＲＲＥＮＴＤＹＳＰＨＡＧＩＡＯＦＥＳＯＰＨＡＧＥＡＬＣＡＲＣＩＮＯＭＡＡＦＴＥＲＲＡＤＩＣＡＬＲＡＤＩＯＴＨＥＲＡＰＹＣｈｅｎＫｅｎｅｎｇ陈克能ＣｈｅｎｇＢａｎｇｃｈａｎｇ程邦昌Ｄｅｐａ...

简介：AbstractGastric cancer, which has a high incidence and poor prognosis, remains a therapeutic challenge. Recently, neoadjuvant therapy has attracted increasing attention due to high recurrence rate and low survival rate after resection in most patients with advanced stage. Clinical trials show that neoadjuvant approaches confer a significant survival advantage for resectable locally advanced gastric cancer. The specific advantages of chemoradiotherapy compared with chemotherapy have not been clarified; optimal regimens and cycles, particularly in the preoperative setting, should be studied further; and trials aimed at determining the role of targeted and immunological therapies should be conducted.

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简介：AIM:Toinvestigatetheefficacyofneoadjuvantchemoradiotherapy(NACRT)forresectabilityoflocallyadvancedgastriccancer(LAGC).METHODS:BetweenNovember2007andJanuary2014,29patientswithLAGC(clinicallyT3withdistalesophagusinvasion/T4orbulkyregionalnodemetastasis)thatweretreatedwithNACRTfollowedbyD2gastrectomywereincludedinthisstudy.ResectabilitywasevaluatedwithradiologicandendoscopicexamsbeforeandafterNACRT.Usingthreedimensionalconformalradiotherapy,patientsreceived45Gy,withadailydoseof1.8Gy.Theentiretumorextentandtheregionalmetastaticlymphnodeswereincludedinthegrosstumorvolume.PatientspresentingwitharesectabletumorafterNACRTreceivedatotalorsubtotalgastrectomywithD2dissection.ThepathologictumorresponsewasevaluatedusingJapaneseGastricCancerAssociationhistologicevaluationcriteria.PostoperativemorbiditywasevaluatedusingtheNationalCancerInstitute-CommonTerminologyCriteriaforAdverseEventsversion4.0.Overallsurvival(OS)andprogression-freesurvival(PFS)rateswereestimatedusingaKaplan-Meieranalysisandcomparedusingthelog-ranktest.RESULTS:Allpatientswereassessedasunresectablecases.Twenty-fourpatients(24/29;82.8%)showedLAGConpositronemissiontomography-computedtomography(CT)andcontrast-enhancedCT,whereasfourpatients(4/29;13.8%)withvagueinvasionorabutmenttoanadjacentorganunderwentdiagnosticlaparoscopy.Onepatient(1/29;3.4%),initiallyassessedasaresectablecase,underwentan'openandclosure'afterthetumorwasfoundtobeunresectable.Abutmenttoanadjacentorgan(34.5%)wasthemostcommonreasonforNACRT.TheclinicalresponserateonemonthafterNACRTwas44.8%.AfterNACRT,69%(20/29)ofpatientshadaresectabletumor.Ofthe20patientswitharesectabletumor,18patients(62.1%)underwentaD2gastrectomy.TheR0resectionratewas94.4%andtwopatients(2/18;11.1%)showedacompleteresponse.Themedianfollow-updurationwas13.5mo.Theone-yearOSandPFS

简介：客观：调查运动人工制品的影响在上三维(3D)重建体积和保角的放射疗法计划。方法：能沿着头部尾的方向模仿肺肿瘤的片断运动的一个幽灵被步进马达构造，聚乙烯和土豆的小球。十个不同扫描协议被设置，幽灵的CT数据被使用一台商业GELightSpeed16CT扫描仪获得。CT数据的3D重建被采用GEAdvantageSim6.0系统的显示卷的技术实现。在不同扫描协议的每个目标的重建的体积通过测量工具的3D被测量。因此，在动人的目标和静态的之间的重建体积的相对偏差是坚定的。三维的保角的放射治疗(3DCRT)计划和保角的地与计划系统(TPS)的WiMRT处理为一个静态/动人的目标被创造并且比较。结果:为一个静态的目标，当CT数据与不同程度和片被获得时，在3D重建卷之中没有明显的差别。3D重建体积和3D的外观一个动人的目标的保角的地与静态的的相当不同。最大的相对偏差为与不同扫描协议扫描的一个动人的目标是将近90%。相对偏差在不同目标之中是可变的，关于从-39.8%到89.5%为一个更小的目标并且从-18.4%到20.5%为更大的one.Conclusion:运动人工制品在3D-CRT计划和重建体积上有大效果，它将极大地为一个动人的目标导致弄歪的保角的放射域和假DVH。

简介：AbstractImmune checkpoint inhibitors (ICIs) have revolutionized the approach to advanced and locally advanced non-small-cell lung cancer (NSCLC). Antibodies blocking inhibitory immune checkpoints, such as programmed death 1 (PD-1) and its ligand (PD-L1), have remarkable antitumor efficacy and have been approved as a standard first- or second-line treatment in non-oncogene-addicted advanced NSCLC. The successful application of immunotherapy in advanced lung cancer has motivated researchers to further evaluate its clinical role as a neoadjuvant setting for resectable NSCLC and for improved long-term overall survival and curative rates. In this review, we discuss the efforts that incorporate ICIs into the treatment paradigm for surgically resectable lung cancer. We reviewed the early-phase results from neoadjuvant clinical trials, the landscape of the majority of ongoing phase III trials, and discuss the prospects of ICIs as a curative therapy for resectable lung cancer. We also summarized the potential biomarkers and beneficiaries involved in the current study, as well as the remaining unresolved challenges for neoadjuvant immunotherapy.

简介：AbstractPancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with poor survival. Local control through surgical resection paired with radiotherapy and chemotherapy comprise the primary tenets of treatment. Debate exists regarding the timing of treatment and ordering of systemic therapy and resection in the management of early stage disease. The goal of this study was to review the literature and describe the contemporary evidence basis for the role of neoadjuvant therapy (NAT) in the setting of upfront resectable (UP-R) PDAC. Five databases were searched in parallel to identify relevant original articles investigating neoadjuvant therapy where at least 1 study arm contained UP-R PDAC; studies with only borderline resectable or locally advanced disease were excluded. Due to the diversity in NAT regimens and study design between trials, qualitative analyses were performed to investigate patient selection, impact on perioperative and survival outcomes, safety, and cost effectiveness. Thirty-five studies met inclusion criteria, of which 24 unique trials are discussed here in detail. These studies included those trials using single agents as well as more recent trials comparing modern multiagent therapies, and several large database analyses. Overall the data suggest that NAT is safe, may confer survival benefit for appropriately selected patients, is cost effective, and is an appropriate approach for UP-R PDAC. Nevertheless, the risk for disease progression during upfront medical therapy, requires appropriate patient identification and close monitoring, and emphasizes the need for further discovery of more effective chemotherapeutics, useful biomarkers or molecular profiles, and additional prospective comparative studies.