It is estimated that half of all patients with cancer eventually develop a syndrome of cachexia, with anorexia and a progressive loss of adipose tissue and skeletal muscle mass. Cancer cachexia is characterized by sys...It is estimated that half of all patients with cancer eventually develop a syndrome of cachexia, with anorexia and a progressive loss of adipose tissue and skeletal muscle mass. Cancer cachexia is characterized by systemic inflammation, negative protein and energy balance, and an involuntary loss of lean body mass. It is an insidious syndrome that not only has a dramatic impact on patient quality of life, but also is associated with poor responsesto chemotherapy and decreased survival. Cachexia is still largely an underestimated and untreated condition, despite the fact that multiple mechanisms are reported to be involved in its development, with a number of cytokines postulated to play a role in the etiology of the persistent catabolic state. Existing therapies for cachexia, including orexigenic appetite stimulants, focus on palliation of symptoms and reduction of the distress of patients and families rather than prolongation of life. Recent therapies for the cachectic syndrome involve a multidisciplinary approach. Combination therapy with diet modification and/or exercise has been added to novel pharmaceutical agents, such as Megestrol acetate, medroxyprogesterone, ghrelin, omega-3-fatty acid among others. These agents are reported to have improved survival rates as well as quality of life. In this review, we will discuss the emerging understanding of the mechanisms of cancer cachexia, the current treatment options including multidisciplinary combination therapies, as well an update on new and ongoing clinical trials.展开更多
Peritoneal carcinomatosis(PC),the dissemination of cancer cells throughout the lining of the abdominal cavity,is the second most common presentation of colon cancer distant metastasis.Despite remarkable advances in cy...Peritoneal carcinomatosis(PC),the dissemination of cancer cells throughout the lining of the abdominal cavity,is the second most common presentation of colon cancer distant metastasis.Despite remarkable advances in cytotoxic chemotherapy and targeted therapy for colon cancer over the last 15 years,it has been repeatedly shown that these therapies remain ineffective for colon cancer PC.Recently,there has been a rapid accumulation of reports that cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy(CRS-HIPEC) prolongs the life of colon cancer PC patients.Here,we will review the clinical presentation,the mechanisms of disease progression,and current treatment options for colon cancer PC,with a focus on the benefits and limitations of CRSHIPEC.展开更多
Neovascularization was reported to arise early in the adenoma-carcinoma sequence in colorectal cancer(CRC),and the importance of angiogenesis in cancer progression has been established.Computed tomography(CT)perfusion...Neovascularization was reported to arise early in the adenoma-carcinoma sequence in colorectal cancer(CRC),and the importance of angiogenesis in cancer progression has been established.Computed tomography(CT)perfusion(CTP)based on high temporal resolution CT images enables evaluation of hemodynamics of tissue in vivo by modeling tracer kinetics.CTP has been reported to characterize tumor angiogenesis,and to be a sensitive marker for predicting recurrence or survival in CRC.In this review,we will discuss the biomarker value of CTP in the management of CRC patients.展开更多
Esophageal cancer is known as one of the malignant cancers with poor prognosis.To improve the outcome,combined multimodality treatment is attempted.On the other hand,advances in genomics and other“omic”technologies ...Esophageal cancer is known as one of the malignant cancers with poor prognosis.To improve the outcome,combined multimodality treatment is attempted.On the other hand,advances in genomics and other“omic”technologies are paving way to the patient-oriented treatment called“personalized”or“precision”medicine.Recent advancements of imaging techniques such as functional imaging make it possible to use imaging features as biomarker for diagnosis,treatment response,and prognosis in cancer treatment.In this review,we will discuss how we can use imaging derived tumor features as biomarker for the treatment of esophageal cancer.展开更多
基金Supported by NIH,No.R01CA160688 and No.T32CA085159-10
文摘It is estimated that half of all patients with cancer eventually develop a syndrome of cachexia, with anorexia and a progressive loss of adipose tissue and skeletal muscle mass. Cancer cachexia is characterized by systemic inflammation, negative protein and energy balance, and an involuntary loss of lean body mass. It is an insidious syndrome that not only has a dramatic impact on patient quality of life, but also is associated with poor responsesto chemotherapy and decreased survival. Cachexia is still largely an underestimated and untreated condition, despite the fact that multiple mechanisms are reported to be involved in its development, with a number of cytokines postulated to play a role in the etiology of the persistent catabolic state. Existing therapies for cachexia, including orexigenic appetite stimulants, focus on palliation of symptoms and reduction of the distress of patients and families rather than prolongation of life. Recent therapies for the cachectic syndrome involve a multidisciplinary approach. Combination therapy with diet modification and/or exercise has been added to novel pharmaceutical agents, such as Megestrol acetate, medroxyprogesterone, ghrelin, omega-3-fatty acid among others. These agents are reported to have improved survival rates as well as quality of life. In this review, we will discuss the emerging understanding of the mechanisms of cancer cachexia, the current treatment options including multidisciplinary combination therapies, as well an update on new and ongoing clinical trials.
基金Supported by NIH grants,No.R01CA160688(to Takabe K)and No.T32CA085159-10(to Terracina KP)
文摘Peritoneal carcinomatosis(PC),the dissemination of cancer cells throughout the lining of the abdominal cavity,is the second most common presentation of colon cancer distant metastasis.Despite remarkable advances in cytotoxic chemotherapy and targeted therapy for colon cancer over the last 15 years,it has been repeatedly shown that these therapies remain ineffective for colon cancer PC.Recently,there has been a rapid accumulation of reports that cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy(CRS-HIPEC) prolongs the life of colon cancer PC patients.Here,we will review the clinical presentation,the mechanisms of disease progression,and current treatment options for colon cancer PC,with a focus on the benefits and limitations of CRSHIPEC.
文摘Neovascularization was reported to arise early in the adenoma-carcinoma sequence in colorectal cancer(CRC),and the importance of angiogenesis in cancer progression has been established.Computed tomography(CT)perfusion(CTP)based on high temporal resolution CT images enables evaluation of hemodynamics of tissue in vivo by modeling tracer kinetics.CTP has been reported to characterize tumor angiogenesis,and to be a sensitive marker for predicting recurrence or survival in CRC.In this review,we will discuss the biomarker value of CTP in the management of CRC patients.
文摘Esophageal cancer is known as one of the malignant cancers with poor prognosis.To improve the outcome,combined multimodality treatment is attempted.On the other hand,advances in genomics and other“omic”technologies are paving way to the patient-oriented treatment called“personalized”or“precision”medicine.Recent advancements of imaging techniques such as functional imaging make it possible to use imaging features as biomarker for diagnosis,treatment response,and prognosis in cancer treatment.In this review,we will discuss how we can use imaging derived tumor features as biomarker for the treatment of esophageal cancer.
