Effect of perioperative chemotherapy on resection of isolated pulmonary metastases from colorectal cancer:A single center experience

BACKGROUND Numerous studies have assessed surgical resection as a standard treatment option for patients with colorectal cancer(CRC)and resectable pulmonary metastases(PM).However,the role of perioperative chemotherapy after complete resection of isolated PM from patients with CRC patients remains controversial.We hypothesize that perioperative chemotherapy does not provide significant survival benefits for patients undergoing resection of PM from CRC.AIM To determine whether perioperative chemotherapy affects survival after radical resection of isolated PM from CRC.METHODS We retrospectively collected demographic,clinical,and pathologic data on patients who underwent radical surgery for isolated PM from CRC.Cancerspecific survival(CSS)and disease-free survival were calculated using Kaplan-Meier analysis.Inter-group differences were compared using the log-rank test.For multivariate analysis,Cox regression was utilized when indicated.RESULTS This study included 120 patients with a median age of 61.6 years.The 5-year CSS rate was 78.2%,with 36.7% experiencing recurrence.Surgical resection for isolated PM resulted in a 5-year CSS rate of 50.0% for second metastases.Perioperative chemotherapy(P=0.079)did not enhance survival post-resection.Factors associated with improved survival included fewer metastatic lesions[hazard ratio(HR):2.51,P=0.045],longer disease-free intervals(HR:0.35,P=0.016),and wedge lung resections(HR:0.42,P=0.035).Multiple PM predicted higher recurrence risk(HR:2.22,P=0.022).The log-rank test showed no significant difference in CSS between single and repeated metastasectomy(P=0.92).CONCLUSION Perioperative chemotherapy shows no survival benefit post-PM resection in CRC.Disease-free intervals and fewer metastatic lesions predict better survival.Repeated metastasectomy is warranted for eligible patients.

Adjuvant chemotherapy for isolated resectable colorectal lung metastasis: A retrospective study using inverse probability treatment weighting propensity analysis

BACKGROUND The benefit of adjuvant chemotherapy(ACT)for patients with no evidence of disease after pulmonary metastasis resection(PM)from colorectal cancer(CRC)remains controversial.AIM To assess the efficacy of ACT in patients after PM resection for CRC.METHODS This study included 96 patients who underwent pulmonary metastasectomy for CRC at a single institution between April 2008 and July 2023.The primary end-point was overall survival(OS);secondary endpoints included cancer-specific survival(CSS)and disease-free survival(DFS).An inverse probability of treat-ment-weighting(IPTW)analysis was conducted to address indication bias.Sur-vival outcomes compared using Kaplan-Meier curves,log-rank test,Cox regre-ssion and confirmed by propensity score-matching(PSM).RESULTS With a median follow-up of 27.5 months(range,18.3-50.4 months),the 5-year OS,CSS and DFS were 72.0%,74.4%and 51.3%,respectively.ACT had no significant effect on OS after PM resection from CRC[original cohort:P=0.08;IPTW:P=0.15].No differences were observed for CSS(P=0.12)and DFS(P=0.68)between the ACT and non-ACT groups.Multivariate analysis showed no association of ACT with better survival,while sublobar resection(HR=0.45;95%CI:0.20-1.00,P=0.049)and longer disease-free interval(HR=0.45;95%CI:0.20-0.98,P=0.044)were associated with improved survival.CONCLUSION ACT does not improve survival after PM resection for CRC.Further well-designed randomized controlled trials are needed to determine the optimal ACT regimen and duration.

Azo dye degradation behavior of AlFeMnTiM(M = Cr, Co, Ni) high-entropy alloys

Because of the potential carcinogenic effects and difficult degradation of azo dyes, their degradation has been a longstanding problem. The degradation of azo dye Direct Blue 6(DB6) using ball-milled(BM) high-entropy alloy(HEA) powders was characterized in this work. Newly designed AlFeMnTiM(M = Cr, Co, Ni) HEAs synthesized by mechanical alloying(MA) showed excellent performance in the degradation of azo dye DB6. The degradation efficiency of AlFeMnTiCr is approximately 19 times greater than that of the widely used commercial Fe–Si–B amorphous alloy ribbons and more than 100 times greater than that of the widely used commercial zero-valent iron(ZVI) powders. The galvanic-cell effect and the unique crystal structure are responsible for the good degradation performance of the BM HEAs. This study indicates that BM HEAs are attractive, valuable, and promising environmental catalysts for wastewater contaminated by azo dyes.

Evaluation of treatment response for breast cancer:are we entering the era of "biological complete remission"?

Breast cancer is one of the most common malignancies in women. The post-operative recurrence and metastasis are the leading causes of breast cancer-related mortality. In this study, we tried to explore the role of circulating tumor cell （CTC） detection combination PET/CT technology evaluating the prognosis and treatment response of patients with breast cancer; meanwhile, we attempted to assess the concept of ＂biological complete remission＂ （bCR） in this regard. A 56-year-old patient with breast cancer （T2N1M1, stage IV left breast cancer, with metastasis to axillary lymph nodes and lungs） received 6 cycles of salvage treatment with albumin-bound paditaxd plus eapecitaabine and trastuzumah. Then, she underwent CTC detection and PET/CT for efficacy evaluation. CTC detection combination PET/CT is useful for the evaluation of the biological efficacy of therapies for breast cancer. The bCR of the patient appeared earlier than the conventional clinical imaging complete remission and promised the histological （pathological） complete remission. The integrated application of the concepts including bCR, imageological CR, and histological CR can achieve the early and prognosis of breast cancer. accurate assessment of biological therapeutic reponse and

Value of Preoperative Hematological Parameters in the Prognosis of Gastric Cancer Patients Undergoing a Total Gastrectomy

Objective This study aimed to evaluate the relationships between the albumin/globulin ratio(AGR),neutrophil/lymphocyte ratio(NLR),and platelet/lymphocyte ratio(PLR)and clinicopathological information for gastric cancer patients.In addition,the prognostic values of these hematological parameters for resectable gastric cancer patients undergoing a total gastrectomy were determined.Methods A total of 245 patients with gastric cancer who underwent a total gastrectomy at our hospital between January 1,2005,and December 30,2015,were enrolled into this study.The preoperative AGR,NLR,and PLR in the serum samples of the patients were measured.The relationships between the hematological parameters and the disease-free survival(DFS)as well as overall survival(OS)were analyzed by statistical analysis.Results The cutoff values of AGR,NLR,and PLR were 1.57,3.5,and 193,respectively.Univariate analyses demonstrated that a low AGR,a high NLR,and a high PLR were significant risk factors for a poor prognosis.According to multivariate analysis,a high PLR was found to be independently associated with a poor survival.Additionally,when age was considered as a stratified factor,univariate analyses demonstrated that a low AGR had the tendency to be correlated with a shorter DFS in nonelderly patients(<65 years old).A low AGR was significantly correlated with a shorter DFS and OS in elderly patients(≥65 years old).Conclusion AGR,NLR,and PLR are independent risk factors associated with a poor gastric cancer survival by univariate analysis,and AGR is an independent risk factor for predicting DFS and OS in elderly patients(≥65 years old)with gastric cancer after total gastrectomy.

Stereotactic radiation therapy in the era of precision medicine for cancer

Unlike conventional radiation therapy, stereotactic radiation therapy(SRT) is an emerging tumor-ablative radiation technology with a high-dose delivery to targets while dramatically sparing adjacent normal tissues. The strengths of SRT involve noninvasive and short-course treatment, high rates of tumor local control with a low risk of side effects. Although the scientific concepts of radiobiology fail to be totally understood currently, SRT has shown its potential and advantages against various tumors, especially for those adjacent to less tolerable normal organs(spinal cord, optic nerve, bowels, etc.). Nowadays, the clinical efficacy of SRT has been widely confirmed in certain patients, especially for those medically inoperable, unwilling to undergo surgery, medicine ineffective with tumor progression. Moreover, SRT could be properly used as palliative treatment aiming at relieving local symptoms and pain, and eventually achieving a potential survival benefit of several months. However, the weaknesses of SRT relate to inevitable radiation-induced toxicities as well as the inaccessibility of prophylactic irradiation. In general, one flaw cannot obscure the splendor of the jade. The emergence and development of SRT has opened the new era of precision radiation therapy, and SRT will probably step gloriously onto the remarkable stage for precision medicine.

Relief Effect of Bevacizumab on Severe Edema Induced by Re-irradiation in Brain Tumor Patients

INTRODUCTION Brain edema is a serious clinical event and could cause various neurological symptoms such as dizziness and headache.Drugs frequently used to relieve brain edema include steroid,dehydrant （e.g.,mannitol）,and diuretics.But the effects of these drugs were limited in patients with severe edema.Bevacizumab has been applied in the treatment of cerebral radiation necrosis. Case studies have reported on the application of bevacizumab in the treatment of severe brain edema. In the present study,we describe significant effects of bevacizumab on severe brain edema in patients with re-irradiation.

Trends of Superoxide Dismutase and Soluble Protein of Aquatic Plants in Lakes of Different Trophic Levels in the Middle and Lower Reaches of the Yangtze River, China

A limnological study was carried out to determine the responses of superoxide dismutase （SOD） activities and soluble protein （SP） contents of 11 common aquatic plants to eutrophication stress. Field investigation in 12 lakes in the middle and lower reaches of the Yangtze River was carried out from March to September 2004. Our results indicated that non- submersed （emergent and floating-leafed） plants and submersed plants showed different responses to eutrophication stress. Both SOD activities of the non-submersed and submersed plants were negatively correlated with their SP contents （P 〈 0.000 1）. SP contents of non-submersed plants were significantly correlated with all nitrogen variables in the water （P 〈 0.05）, whereas SP contents of submersed plants were only significantly correlated with carbon variables as well as ammonium and Secchi depth （SD） in water （P 〈 0.05）. Only SOD activities of submersed plants were decreased with decline of SD in water （P 〈 0.001）. Our results indicate that the decline of SOD activities of submersed plants were mainly caused by light limitation, this showed a coincidence with the decline of macrophytes in eutrophic lakes, which might imply that the antioxidant system of the submersed plants were impaired under eutrophication stress.

Dendritic Boundary Corrosion of AA2198 Weld Using Fiber Laser Welding with Al–Cu Filler Wire

The microstructures and corrosion behaviors of AA2198-T851 alloy and weld were analyzed under corrosive conditions. Weld was formed using an innovative fiber laser welding process with AA2319 Al-Cu filler wire. The metallurgic morphology and distribution of the chemical compositions were determined using imaging techniques such as optical micrograph, scanning electron micrograph, high-resolution transmission electron microscopy, energy-dispersive X-ray spectrometry and X-ray diffraction. Corrosion was evaluated using an immersion test and electrochemical impedance spectroscopy in 3.5% NaC1 solution at room temperature. Results indicate that the parent alloy suffered from pitting corrosion during the initial 4-h immersion which was caused by the inhomogeneous distribution of its chemical compo- nents and the different intermetallics formed during the rolling process. The weld experienced dendritic boundary corrosion under the same conditions due to the addition of the Al-Cu filler and rapid solidification during laser welding, which led to the precipitates Cu enrichment along the grain boundary. When a welding joint was immersed in the solution for 5 days, a big crack was observed across the center of the weld. In comparison, there was good corrosion resistance in the heat- affected zone with a compact protective film.