Multidisciplinary team （MDT） model is a diagnostic and treatment model characterized by interdisciplinarity, integration, centralism, individualization, and precision and is becoming more common in the management of...Multidisciplinary team （MDT） model is a diagnostic and treatment model characterized by interdisciplinarity, integration, centralism, individualization, and precision and is becoming more common in the management of complex malignancies. MDT emphasizes team spirit and a personalized treatment strategy according to the actual condition of each patient. A cooperative and effective multidisciplinary team is an important guarantee for delivering high-quality services to patients. Under the guidance of a medical humanistic concept, MDT provides reasonable, effective, convenient, and a full range of excellent quality medical service to patients. The MDT maximizes patient benefits, and it is the developmental direction for large-scale general hospitals. At the same time, the MDT is also an important measure to strengthen the core competitiveness of hospitals. Here, we introduce the clinical application of the model in tumor therapy as well as the current state and development in our hospital.展开更多
AIM:To assess the efficacy and safety of bevacizumab in the treatment of colorectal cancer.METHODS:All randomized controlled trials of bevacizumab for the treatment of colorectal cancer from January 2003 to June 2013 ...AIM:To assess the efficacy and safety of bevacizumab in the treatment of colorectal cancer.METHODS:All randomized controlled trials of bevacizumab for the treatment of colorectal cancer from January 2003 to June 2013 were collected by searching the Cochrane Library, Pub Med, Chinese National Knowledge Infrastructure and Wanfang databases.The primary endpoint was overall survival(OS), and the secondary endpoints were progression-free survival, overall response rate and adverse events.Two reviewers extracted data independently.Statistical analyses were performed with Stata 12.0.The degree of bias was assessed using funnel plots for the effect size of OS at the primary endpoint.RESULTS:Following the inclusion criteria and exclusion criteria, ten studies comprising 6977 cases were finally included, of which nine were considered to be of high quality(4-7 points) and one of low quality(1-3 points).Our meta-analysis revealed the efficacy of bevacizumab in patients with colorectal cancer in terms of OS(HR = 0.848, 95%CI:0.747-0.963), progressionfree survival(HR = 0.617, 95%CI:0.530-0.719), and overall response rate(OR = 1.627, 95%CI:1.199-2.207).Regarding safety, higher rates of grade ≥ 3 hypertension, proteinuria, bleeding, thrombosis, and gastrointestinal perforation were observed in the bevacizumab treatment group(P < 0.05); however, the incidence of serious toxicity was very low.There was no publication bias in the 10 reports included in this meta-analysis.CONCLUSION:The clinical application of bevacizumab in colorectal cancer is effective with good safety.展开更多
Gastrointestinal stromal tumors(GISTs)are uncommon neoplasms of the gastrointestinal tract with peculiar clinical,genetic,and imaging characteristics.Preoperative knowledge of risk stratification and mutational status...Gastrointestinal stromal tumors(GISTs)are uncommon neoplasms of the gastrointestinal tract with peculiar clinical,genetic,and imaging characteristics.Preoperative knowledge of risk stratification and mutational status is crucial to guide the appropriate patients’treatment.Predicting the clinical behavior and biological aggressiveness of GISTs based on conventional computed tomography(CT)and magnetic resonance imaging(MRI)evaluation is challenging,unless the lesions have already metastasized at the time of diagnosis.Radiomics is emerging as a promising tool for the quantification of lesion heterogeneity on radiological images,extracting additional data that cannot be assessed by visual analysis.Radiomics applications have been explored for the differential diagnosis of GISTs from other gastrointestinal neoplasms,risk stratification and prediction of prognosis after surgical resection,and evaluation of mutational status in GISTs.The published researches on GISTs radiomics have obtained excellent performance of derived radiomics models on CT and MRI.However,lack of standardization and differences in study methodology challenge the application of radiomics in clinical practice.The purpose of this review is to describe the new advances of radiomics applied to CT and MRI for the evaluation of gastrointestinal stromal tumors,discuss the potential clinical applications that may impact patients’management,report limitations of current radiomics studies,and future directions.展开更多
基金supported by a grant (No. Z151100002615031) from the Project of Science and Technology in Beijing, China
文摘Multidisciplinary team （MDT） model is a diagnostic and treatment model characterized by interdisciplinarity, integration, centralism, individualization, and precision and is becoming more common in the management of complex malignancies. MDT emphasizes team spirit and a personalized treatment strategy according to the actual condition of each patient. A cooperative and effective multidisciplinary team is an important guarantee for delivering high-quality services to patients. Under the guidance of a medical humanistic concept, MDT provides reasonable, effective, convenient, and a full range of excellent quality medical service to patients. The MDT maximizes patient benefits, and it is the developmental direction for large-scale general hospitals. At the same time, the MDT is also an important measure to strengthen the core competitiveness of hospitals. Here, we introduce the clinical application of the model in tumor therapy as well as the current state and development in our hospital.
文摘AIM:To assess the efficacy and safety of bevacizumab in the treatment of colorectal cancer.METHODS:All randomized controlled trials of bevacizumab for the treatment of colorectal cancer from January 2003 to June 2013 were collected by searching the Cochrane Library, Pub Med, Chinese National Knowledge Infrastructure and Wanfang databases.The primary endpoint was overall survival(OS), and the secondary endpoints were progression-free survival, overall response rate and adverse events.Two reviewers extracted data independently.Statistical analyses were performed with Stata 12.0.The degree of bias was assessed using funnel plots for the effect size of OS at the primary endpoint.RESULTS:Following the inclusion criteria and exclusion criteria, ten studies comprising 6977 cases were finally included, of which nine were considered to be of high quality(4-7 points) and one of low quality(1-3 points).Our meta-analysis revealed the efficacy of bevacizumab in patients with colorectal cancer in terms of OS(HR = 0.848, 95%CI:0.747-0.963), progressionfree survival(HR = 0.617, 95%CI:0.530-0.719), and overall response rate(OR = 1.627, 95%CI:1.199-2.207).Regarding safety, higher rates of grade ≥ 3 hypertension, proteinuria, bleeding, thrombosis, and gastrointestinal perforation were observed in the bevacizumab treatment group(P < 0.05); however, the incidence of serious toxicity was very low.There was no publication bias in the 10 reports included in this meta-analysis.CONCLUSION:The clinical application of bevacizumab in colorectal cancer is effective with good safety.
文摘Gastrointestinal stromal tumors(GISTs)are uncommon neoplasms of the gastrointestinal tract with peculiar clinical,genetic,and imaging characteristics.Preoperative knowledge of risk stratification and mutational status is crucial to guide the appropriate patients’treatment.Predicting the clinical behavior and biological aggressiveness of GISTs based on conventional computed tomography(CT)and magnetic resonance imaging(MRI)evaluation is challenging,unless the lesions have already metastasized at the time of diagnosis.Radiomics is emerging as a promising tool for the quantification of lesion heterogeneity on radiological images,extracting additional data that cannot be assessed by visual analysis.Radiomics applications have been explored for the differential diagnosis of GISTs from other gastrointestinal neoplasms,risk stratification and prediction of prognosis after surgical resection,and evaluation of mutational status in GISTs.The published researches on GISTs radiomics have obtained excellent performance of derived radiomics models on CT and MRI.However,lack of standardization and differences in study methodology challenge the application of radiomics in clinical practice.The purpose of this review is to describe the new advances of radiomics applied to CT and MRI for the evaluation of gastrointestinal stromal tumors,discuss the potential clinical applications that may impact patients’management,report limitations of current radiomics studies,and future directions.
