Diagnostic Value of Quantitative Parameters of DCE-MRI in Endometrial Carcinoma and Its Correlation with Clinicopathological Factors

In the study,108 patients with endometrial cancer were selected as the observation group,and 105 patients with benign endometrial lesions were selected as the control group.After DCE-MRI examination,it was found that the volume transfer constant(K^(trans)),rate constant(K_(e))and extracellular space volume ratio(V_(e))in the observation group were higher than those in the control group(P<0.05).The area under curve(AUC)of combined K^(trans),K_(e) and V_(e) values in the diagnosis of endometrial cancer was 0.841.The values of K^(trans),K_(e )and V_(e) were positively correlated with the clinical stage and the degree of muscular invasion,but negatively correlated with the degree of differentiation(P<0.05).The results of the study suggested that DCE-MRI quantitative parameters have a certain value in the differential diagnosis of endometrial cancer,which helped to further distinguish the degree of muscular invasion,clinical stage,and differentiation of endometrial cancer patients.

To Explore the Correlation between Tumor and Immune Markers and HPV Expression and Prognosis in Patients with Cervical Cancer

The aim of this study was to investigate the correlation between immune cells and tumor markers and HPV levels in patients with cervical cancer with high-risk human papilloma virus(HPV)rate and their prognosis.Firstly,83 cases of cervical intraepithelial neoplasia were selected as CINI group,72 cases of cervical carcinoma as cervical cancer group and 50 cases of chronic cervicitis as chronic cervicitis group.The different expression levels of immune cells(CD4+,CD8+,Treg,CD4+/CD8+,CD56+,)and the positive expression of tumor markers(K-ras,Ki-67)inpatients with HPV were studied to explore the correlation between HPV levels and immune cells and tumor markers in cervical cancer patients with high-risk HPV infection,and that between positive expression of immune cells and tumor markers in patients with lymph node metastasis of cervical cancer with high-risk HPV infection,as well as that between the survival rate of patients and the immune cell levels and positive expression of tumor markers in patients who die of cervical cancer.The results showed that the levels of CD8+and Treg in cervical cancer patients were higher than those in CIN group and chronic cervicitis group(P<0.05).The levels of tumor markers were lower in those in CIN group and chronic cervicitis group(P<0.05).The positive expression rates of K-ras and KI-67 in the three groups were significantly different(P<0.05).In cervical cancer group,CD4+and CD56+were negatively correlated with HPV-DNA levels,and CD8+and Treg levels as well as k-RAS and KI-67 positive expression were positively correlated with HPV-DNA levels.The levels of immune markers in cervical cancer group were significantly lower than those in surviving patients(P<0.01),while the levels of CD8+and Treg,the proportion of K-RA and KI-67 were significantly higher than those in surviving patients(P<0.01).Therefore,for patients with CIN,chronic cervicitis patients with high-risk HPV infection,and cervical cancer patients with reduced immune function and high-risk HPV infection,the expression of tumor markers K-ras and Ki-67 was increased.The detection of immune cells and tumor markers is helpful for the early prevention,diagnosis and prognosis evaluation of high-risk HPV infection in patients with cervical cancer.

Clinical Application of Lobaplatin Combined with Docetaxel in Adjuvant Chemotherapy for Triple-Negative Breast Cancer in Elderly Patients

To investigate the adverse reactions and efficacy of docetaxel combined with lobaplatin in adjuvant chemotherapy for triple-negative breast cancer in elderly patients.A total of 96 elderly triple-negative breast cancer patients admitted to our hospital from January 2008 to December 2011 were randomly divided into two groups.A group of 56 patients received docetaxel 75 mg·m^(-2),intravenous drip,d1;lobaplatin 30 mg·m^(-2),intravenous drip,d1;21 days repeat,a total of 6 cycles.A group of 40 patients received chemotherapy for 6 cycles with an anthracycline-containing(TEC)regimen.Comparison of adverse reactions and 5-year diseasefree survival in both groups.The incidence of thrombocytopenia was significantly higher in 56 patients with TL regimen than those with TCE-containing anthracyclines(P=0.005).But the incidence of cardiotoxicity was 32.5%in the TEC group.And the difference was statistically significant(P=0.008).The 5-year disease-free survival rate was 73.2%in the TL group and 67.5%in the TEC group.There was no statistical difference.Docetaxel combined with lobaplatin in the treatment of elderly triple-negative breast cancer has no significant difference in efficacy compared with traditional anthracycline-containing drugs,but it can avoid the cardiotoxicity caused by anthracyclines.It’s a new option for elderly TNBC adjuvant chemotherapy,suggesting to expand the sample content for further research.

Insights into the Use of CDK 4/6 Inhibitors in Patients with HR-positive Advanced or Metastatic Breast Cancer

Hormone receptor(HR)-positive breast cancer(BC)is the most common subtype of BC and some patients with such tumors experience recurrences.Endocrine-based therapy(ET)(e.g.,tamoxifen,aromatase inhibitors(AIs),and fulvestrant)that has improved outcomes in such patients represents the initial therapy for women with HR-positive/human epidermal growth factor receptor 2(HER2)-negative BC(considering no evidence of visceral crisis).However,the resistance to ET can occur in almost 50%of HR-positive BCs.In order to improve outcomes of patients with HR-positive metastatic BC,new treatment strategies are required.One such therapy is the new class of medications,cyclin-dependent kinase(CDK)4/6 inhibitors,that have improved the outcomes in such patients(both endocrine-sensitive and endocrine-resistant).This article presents evidence from the main clinical trials,which led to the approval of palbociclib,ribociclib,and abemaciclib.These three CDK 4/6 inhibitors have shown a significant improvement of the progression-free survival(PFS)in patients with HR-positive/HER2-negative metastatic BC when used in combination with selected ETs.In addition,some important patient management considerations,when choosing a particular CDK 4/6 inhibitor for an individual patient are presented.Furthermore,a need to find biomarkers for CDK 4/6 inhibitor sensitivity,efficacy,and resistance,to be able to precisely select the best patientcandidates for this treatment is highlighted.

The testis:an accessible Mesenchymal Stem Cells source

Mesenchymal stem cells(MSCs)are adult stem cells that are predominantly found in bone marrow but also cord blood,peripheral blood,lungs,and adipose tissue.They are considered multipotent cells,which can differentiate to form multiple cells types—adipocytes,bone,cartilage,skin,and muscle.This potential elicits a great deal of attention because it appears to hold great promise regarding regenerative cell-based therapy to treat various diseases,including cancer.They are considered powerful allogeneic nonhematopoietic transplantation stem cells due to their low immunogenicity.Recently,several researchers have identified and isolated MSCs from primary human testes cultures.This review aimed to highlight the latest advances in MSC biological properties and characteristics studies,focusing on testicular mesenchymal stromal stem cells(tMSC),their differentiation capacity,and immunosuppressive properties—all of which have the potential to establish MSCs as powerful therapeutic agents for various diseases,including cancer.

Interrelations Between Psychological Stress and Cancer-Deciphering Molecular Signals in the Tumor Microenvironment

Current research has revealed some links between psychological stress and cellular mutation,neoplastic proliferation and metastasis in patients with cancer.In stressful situations,the stress-related neuroendocrine mediators(e.g.,catecholamines,and glucocorticoids(GSs))are being secreted,via stimulation of the sympathetic nervous system(SNS),and the hypothalamic-pituitaryadrenocortical(HPA)axis.Catecholamine may affect the malignant progression,since they can regulate various cellular signaling pathways,via adrenergic receptors(ARs)that are expressed by different types of neoplastic cells.The ARs increase the proliferation and invasive potential of such cells,and change their“behavior”in the tumor microenvironment.Similarly,cortisol and its glucocorticoid receptors(GRs)can promote stress-induced malignant growth and metastasis.Maladaptation to stressful situations,often relevant to the cancer diagnosis and treatment,may accelerate tumor growth and spread(e.g.,via inflammation,angiogenesis,and migration).Studies have shown that psychological interventions can be helpful for adaptation to adverse circumstances during the therapeutic process in patients with cancer.This mini-review will address some interrelations between psychological stress and cancer.It will discuss how the receptor-mediated signaling pathways may lead to cancer initiation,propagation,and spread.In addition,it will describe a supportive role of the stress reduction strategies,for example,in patients with breast cancer(BC).

Dysphagia Associated Organ Sparing Radiotherapy:Defining the Limits of Tolerance for Late Toxicity

Background:Dysphagia after radiotherapy in head and neck malignancies can severely impact a patient’s physical,social and psychological quality of life.Aspiration remains the major cause of non-disease related mortality in treated patients.The purpose of this study was to analyze the dosimetric correlates in a selective Asian subset of patients who are most eligible for Dysphagia aspiration related structure(DARS)sparing.Materials and Methods:Thirty patients with Oral or Oropharyngeal malignancies treated from March 2014 to September 2017 were analyzed for dosimetric parameters to DARS.A dosimetric and volumetric evaluation of dose parameters to the dysphagia and Aspiration associated normal structures were analyzed.The National cancer institute Common toxicity criteria for adverse events Version-3 was used to grade late dysphagia.Subjective evaluation of dysphagia was done with University of Washington Head and Neck related quality of life Questionnaire.Dosimetric comparison between IMRT and 3DCRT technique was done and correlated to toxicity.Results:Greater than Grade 2 dysphagia was observed in 10 patients(33%).In the 3DCRT cohort Grade 3&4 toxicity was higher,50%vs.25%.A threshold Mean dose of 63 Gy was identified as a significant parameter above which observed Gr 3/4 toxicity was 33%(P value=0.028).The maximum dose to the base of tongue(BOT)and Superior constrictor(SC)were dosimetric parameters which achieved significance(P value=0.013&0.005).There was no difference in the dose delivered to DARS between 3DCRT and IMRT.However,the patient reported Dysphagia scores were higher for pain(P=0.0014)in the 3DCRT cohort and can be attributed to a higher percentage of patients exceeding Parotid tolerance(70%vs.40%).The impact of Gr 3/4 toxicity on all aspects of quality of life parameters were significantly impaired with maximum compromise on late chewing,swallowing and general perception of well-being(P value=0.001).Conclusion:This suggests that a threshold mean dose(MD)of 63 Gy to the constrictors is statistically correlated to significant Gr 3/4 late toxicity.The high doses to the BOT and SC independently contribute to late toxicity.IMRT is more efficient in reducing severe late toxicity with a better patient reported quality of life parameters and should be the preferred treatment of choice.

Surgical Procedures,Pathological Features and Prognosis in Young Women with Breast Cancer in China--a Single Institute Experience

Objective:To compare the differences in surgical procedures,pathological features and prognosis between young and elderly women with breast cancer in China.Methods:A retrospective study compared the data of surgical procedures,pathological features and prognosis of 61 cases of young females(≤40 years)and 507 cases of elderly females(>40 years),treated in our department from August 2011 to July 2018.This data was analyzed using SPSS 23.0 program.Results:10.74% of total cases,in this period of time,involve young females.In terms of surgical procedures,24.59%of young patients underwent breast conserving surgery(8.48% elderly,respectively),and 13.11%underwent reconstruction surgery(1.18% elderly,respectively),with statistically significant differences existing between the two groups(P<0.05).Progesterone receptor(PR)expression in young women was significantly higher than in elderly females(P<0.05).There were no significant differences between the two groups in the proportion of invasive ductal carcinoma(IDC),axillary lymph node metastasis(ALNM),expression of estrogen receptor(ER),human epidermal growth factor receptor-2(HER-2)and Ki-67,but the lymphatic metastasis stage showed an increasing rate with younger age.No significant difference was found in 3-year disease-free survival(DFS)and overall survival(OS).Conclusion:The selection rate of breast conserving and reconstructive surgery in young women with breast cancer is significantly higher than that in elderly women.The younger the patient,the more frequently the PR positive expression,and the more likely ALNM to occur.The 3-year prognosis of the young and elderly patients is similar.

Dysregulated TCA Cycle Pathway in Endometrial Cancer

Background:Numerous questions regarding metabolism alterations in endometrial cancer remain unanswered.Methods:We used the Mann-Whitney test to identify significantly downregulated genes in Cluster II,which were then subject to Ingenuity Pathway Analysis and Gene Ontology(GO)enrichment analysis.We next compared the expression levels of several key enzymes between the CTNNB1 mutant and wide-type patients to correlate“TCA Cycle”alterations with CTNNB1 mutation status.Finally,we performed a Spearman correlation between the TCA Cycle genes and the immune checkpoint molecule to understand the relationship between TCA Cycle dysfunction and immune response.All statistical tests were two-sided.Results:A total of 603 genes were significantly downregulated in Cluster II.Pathway analysis showed that metabolic pathways were frequently dysregulated,and GO analysis demonstrated that metabolic processes were commonly retarded.In particular,TCA Cycle is the most significantly altered metabolic pathway(P=1.45×10-07),with one-third of the enzymes altered.The TCA Cycle pathway activity and the expression levels of several key enzymes were significantly lower in CTNNB1 mutant patients,compared to CTNNB1 wide-type patients.In addition,the TCA Cycle pathway activity and the expression levels of pathway genes were significantly and positively correlated with PD-L1 gene expression.Conclusion:This study systematically characterizes a subset of endometrioid endometrial cancer patients with dysregulated TCA Cycle pathway,which may contribute to immune resistance in endometrial cancer.

Development of a Novel Tissue-Specific Method to Detect Cytokeratin 20-Positive Circulating Tumor Cells in Metastatic Colorectal Cancer

Introduction:Although many studies have shown the vast potential of circulating tumor cells(CTCs)detection in cancer diagnosis and prognosis,our understanding of their clinical significance is still far from complete.A major obstacle arises from the lack of well-established tumor or tissue-specific markers to detect CTCs by immunocytochemical staining after immunomagnetic enrichment(IE).Methods:We have established the utility of cytokeratin 20(CK20),a gastrointestinal tract specific marker,for the specific detection and identification of colorectal cancer(CRC)CTCs.This breakthrough was successfully validated in spike-in experiments using CRC cell line models followed by a pilot study which recruited 32 metastatic CRC patients,25 benign colorectal diseases patients and 27 normal subjects.Results:CK20-positive CTCs were detected in 90%metastatic CRC patients but not in benign colorectal diseases patients and normal subjects using this refined assay.Conclusions:These impressive results have laid the foundation for further development of CK20-positive CTCs as a promising marker in diagnosis,prognostication and treatment monitoring of metastatic CRC.

Target Delineation in High-grade Glioma Do CTV Margins Make a Difference? ESTRO ACROP versus RTOG Guidelines a Comparative Dosimetric Study

Background and purpose:There exist two major consensus guidelines for target delineation in glioblastoma(GBM).Namely the established radiation therapy oncology group(RTOG)and the recently redefined European society for radiation oncology(EORTC)-advisory committee on radiation oncology practice(ACROP),clinical studies evaluating the pattern of recurrence with relation to the CTV margins have as of date not evidenced statistically significant difference in relation to the two guidelines.However,considering the standardization of concurrent chemo-radiation with Temozolomide nearly 20%off patients can be expected to survive 2years or beyond.Quality of life issues will play a higher role in defining the better protocol.In the current study,we have dosimetrically compared these guidelines in both perspectives.Material and methods:Thirty patients of GBM who had been planned for conformal radiotherapy during Jan 2017 to Feb 2019 were considered.Each patient dataset contoured with ESTRO-ACROP guidelines to create PLAN A and RTOG guidelines to create PLAN B.Both plans were compared to evaluate the volumetric difference in terms of PTV and the relative proximity to critical normal structures.Results:The median volume of brain irradiated to high doses(60Gy)was significantly greater in PLAN B,566cc vs 398 cc(P<0.0002).The organs at risk were better spared with PLAN A in terms of encroachment of high dose PTV volume.This achieved significance for Brainstem(P<0.01),Chiasma(P<0.04)and hippocampus(P<0.016).We were able to identify patients with PTV volume>400cc and with tumor in Parietal or Temporal regions wouldn’t benefit from PLAN A.Conclusion:The use of target delineation based on a single step plan,excluding expanded edema(ESTRO-ACROP)could potentially reduce high dose target volumes and significantly spare brainstem,optic-chiasma,and hippocampus.Patients with tumor volume<400 cc and frontal lesions are most likely to benefit.

Clinical Study on TACE Combined with Elemene Injection and Cinobufagin Injection Respectively for Middle and Advanced Primary Hepatic Carcinoma

Objective: To observe and compare the differences in the clinical effect and the incidences of adverse reactions oftranscatheter arterial chemoembolization(TACE) combined with elemene injection and cinobufagin injection respectively for middleand advanced primary hepatic carcinoma. Methods: A total of 104 cases of patients with middle and advanced primary hepaticcarcinoma who were treated in the oncology department from August 2018 to January 2020 were included as the study objects, andwere randomly divided into two groups according to different treatment regimens, 52 cases in each group. Both groups were treatedwith TACE once;the cinobufagin injection group was given intravenous infusion with 500 mL of 5% glucose injection and 10 mLof cinobufagin injection once a day. The elemene injection group was given intravenous infusion with elemene injection of 0.4 geach time and once a day. Both groups were treated for two courses, 15 days of continuous treatment with a rest of 15 days beingone course. The clinical effect, the changes in the indexes of liver function including alanine amino transferase(ALT), aspartatetransaminase(AST) and total bilirubin(TBil), the scores of alpha-fetoprotein(AFP) and Karnofsky (KPS) and tumor volumes aswell as the difference in the incidences of adverse reactions between the two groups were observed and compared. Results: Thetotal clinical effective rate was 88.46% in the elemene injection group and 71.15% in the cinobufagin injection group, and thedifference was significant(P<0.05). After treatment, the levels of ALT, AST and TBil in serum in the two groups were significantlydecreased when compared with those before treatment, differences being significant(P<0.05). There was no significant differencebeing found in the comparison of the levels of ALT, AST and TBil in serum between the two groups (P>0.05). After treatment, thedecrease of AFP, tumor volume and the increase of KPS scores in the elemene injection group were significantly more than thosein the cinobufagin injection group, differences being significant (P<0.01). During treatment, there was no significant differencebeing found in the comparison of the total incidences of adverse reactions between the two groups(P>0.05). The adverse reactionsin the cinobufagin injection group were mainly nausea and vomiting, with higher incidence than that in the elemene injection group,the difference being significant (P<0.05). The adverse reactions in the elemene injection group were mainly pain at the injectionsite, with higher incidence than that in the cinobufagin injection group, the difference being significant (P<0.05). Conclusion: Thetherapy of elemene injection combined with TACE for middle and advanced primary hepatic carcinoma has better clinical effect thanthat of cinobufagin injection, but the occ.

Re-treatment Using Cetuximab and Chemotherapy in Patients with Metastatic Colorectal Cancer Harboring Wild-type RAS Gene

Colorectal cancer is a heterogeneous disease.Activating mutations in genes like K-RAS,BRAF,and PI3K contribute towards a poor prognosis of the disease.In this report,we present the case of re-treatment of a 58-year old patient of metastatic colorectal cancer with a combination of anti-EGFR and chemotherapy.The patient who harbored wild-type RAS gene was administered several lines of therapies including anti-EGFR antibodies.In spite of the different regimens involved,a significant progression of disease involving metastasis to the lungs and the brain was observed.On re-treatment with cetuximab and chemotherapy,the quality of life improved and the tumor biomarkers decreased.Re-treatment with anti-EGFR antibodies and chemotherapeutic agents can be an option for patients showing adverse prognosis after several lines of therapies.

Biomaterial Implants:A Gateway to Cancer Through Genetics and Epigenetics

Biomaterials are currently and will continue to exert a high impact in the field of medicine and biological systems.Despite their great importance to humans,biomaterials have been reported to increase the risk of various kinds of cancers.Herein we shed light on the impact of biomaterial on the accumulation of genetic and epigenetic alterations that may boost cancer risk.In addition,we identify the key elements for the selection of the most reconcilable biomaterials and tests to ensure their biocompatibility.We examined the downsides of the usage of these biomaterials;specifically,immunological foreign body response due to wear and corrosion and their ability to cause cancers.The main focus of our review is to highlight the current knowledge about how orthopedic implants may contribute to cancer formation.We conclude that,although the risk appears to be minimal,implants may contribute to the development of cancer demanding the employment of a test that gauges the mutagenicity of the biomaterial used in the various implants’applications.

Urinary Continence after Orthotopic Detubularized Ileocaecal Pouch Versus Ileal Neobladder:Does it Differ?

Objective:To compare both techniques of detubularized ileocaecal and ileal neobladder post radical cystectomy with regards to functional results in the form of continence(day and night)with the use of urodynamics(for assessment of voiding volume and pouch capacity).Methods:This is a prospective randomized clinical trial that was done at the National Cancer Institute,Cairo University from August 2016 and January 2018.Sixty-two patients presented with muscle invasive urinary bladder cancer and no history of urinary incontinence or urethral stricture were included in this study.All patients underwent preoperative cystoscopic examination.Radical cystectomy was done,and patients were divided into two groups according to the type of diversion.Group A included 31 patients with orthotopoic detubularized ileal neobladder and group B included 31 patients with orthotopic detubularized ileocaecal neobladder.Urodynamic studies were done to 27 patients in group A and 27 patients in group B at just 6 and 12 months postoperatively.Results:The mean age in group A was 59.2±8.0 while in group B was 57.8±6.6.In each group,we compared day and night continence in a period of 3 and 6 months.Postoperatively in group A,day continence after 3 months was 81.5% which improved to 96.3% after 6 months postoperatively with significant P-value(0.025).Night continence after 3 months was fair in 66.7%,unsatisfactory in 33.3% and 0% for good state which improved to 70% for fair state,18% unsatisfactory and 11% for good state after 6 months with significant P-value(0.035)while in group B,day continence after 3 months and 6 months postoperatively was 100% and night continence after 3 months was good in 0.0%,fair in 78.6% and unsatisfactory in 21.4% which improved to 10.7% for good state,85.7% for fair state and 3.6% for unsatisfactory after 6 months with significant P-value(0.005).Conclusion:There are no significant differences between detubularized ileocaecal and ileal neobladder in relation to continence.However,there is significant change in each type of diversion separately with time.

Clinical Effect of Photodynamic Therapy Combined Cryotherapy on Nonmelanoma Skin Cancer

The purpose of this study was to investigate the clinical efficacy of photodynamic combined freezing in patients with non-melanoma skin cancer(NMSC).First,according to the treatment regimen,96 patients with NMSC were divided into study group(n=50)and control group(n=46).The control group was treated with 5-amino-ketovalic acid photodynamic therapy(ALAPDT),while the study group was treated with ala-PDT combined with cryotherapy.Visual analogue scale(VAS)scores,visual satisfaction,clinical efficacy,adverse reactions,and progression-free survival were compared between the two groups.The results showed that VAS score in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).The appearance satisfaction and total effective rate of patients in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).3 years progressionfree survival time and 3 years progression-free survival rate were compared between the two groups,and the difference was not statistically significant(P>0.05).Therefore,the combination of PDT and cryotherapy for non-melanoma skin cancer has a good clinical effect,which is conducive to the recovery of skin lesions,high patient satisfaction,fewer adverse reactions,and longer progression-free survival.In addition,the combined therapy can provide a new treatment idea for non-melanoma skin cancer patients who are not suitable for surgical treatment.

Clinical Study on Adjuvant Chemotherapy of Cinobufacin Injection in Senior Patients with Colorectal Cancer

To investigate the clinical efficacy of adjuvant chemotherapy of cinobufacin injection in the treatment of senior patients with colorectal cancer and its influence on serum tumor markers and immune function,from November 2018 to November 2019,84 senior colorectal cancer patients in author's hospital were al randomly divided into control group and observation group,42 cases in each group,and the control group was treated with routine chemotherapy,the observation group was treated with routine chemotherapy and intravenous injection of cinobufacin,the two groups were all treated for 4 cycles,then the short-term efficacy,serum tumor markers[carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 724(CA724),carcinoembryonic antigen(CEA)]and immune function indexes(CD3+,CD4+,CD4+/CD8+),as well as the unward reaction of chemotherapy were compared between the two groups before and after treatment.As results,Short-term efficacy:the total effective rate of observation group was significantly higher than that of control group(78.57%vs 47.62%,P<0.05).Tumor markers:after treatment,the levels of CA19-9,CA724 and CEA in the two groups were significantly lower than those before treatment(P<0.05).Compared between the two groups,the levels of each index in observation group were lower(P<0.05).Immune function after treatment the levels of CD3+,CD4+,CD4+/CD8+in observation group were significantly higher than those before treatment while the levels of CD3+,CD4+,CD4+/CD8+in control group were significantly lower(P<0.05).After treatment,the above each index in observation group were higher than those in control group(P<0.05).Untoward reaction:the incidence of leukopenia,thrombocytopenia,gastrointestinal response,fatigue and myelosuppresion in observation group were significantly lower than those in control group(P<0.05).The results show that cinobufacin injection in the adjuvant treatment of senior patients with colorectal cancer can improve the shortterm efficacy of chemotherapy,reduce the untoward reaction,and reduce the serum levels of CA19-9,CA724 and CEA,improve the immune function of the body,thus with high clinical application value.

Effect of Docetaxel and Cisplatin Chemotherapy Combined with Intensitymodulated Radiotherapy in the Treatment of Postoperative Recurrence of Esophageal Cancer and Its Effect on Serum Tumor Markers

Objective: To investigate the effect of docetaxel and cisplatin combined with intensity-modulated radiotherapy in thetreatment of postoperative recurrence of esophageal cancer and the content of tumor markers in serum. Methods: According tosimple randomization method, 60 patients with postoperative recurrence of esophageal cancer admitted from February 2018 toSeptember 2019 were divided into control group (n = 30 cases) and observation group (n = 30 cases). All patients received IMRT.Fluorouracil + cisplatin was used in the control group and docetaxel + cisplatin was used in the observation group. After 2 coursesof continuous treatment, the therapeutic effect, serum tumor marker content and adverse reactions were compared between thetwo groups. Results: After treatment, the effective rate of observation group was higher than control group, and the difference wasstatistically significant (P < 0.05).The contents of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) andcarbohydrate antigen 19-9 (CA19-9) in observation group were lower than those in control group, and the difference was statisticallysignificant (P < 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, and thedifference was statistically significant (P < 0.05). Conclusion: Docetaxel and cisplatin combined with intensemodulated radiotherapyfor postoperative recurrence of esophageal cancer can improve the therapeutic effect, inhibit the malignant degree of tumor, andreduce the incidence of adverse reactions.

Searching for Better Outcomes among Patients with Metastatic Triple- Negative Breast Cancer – Do We Have Novel Options on the Treatment Landscape?

Triple-negative breast cancer(TNBC),which accounts for approximately 15%of breast cancers(BCs)is characterized by a lack of expression of the hormone receptors(HRs)(estrogen receptor(ER)and progesterone receptor(PR)),and human epidermal growth factor receptor 2(HER2).TNBC reveals very aggressive behavior and often leads to poor prognosis.Unfortunately,standard chemotherapy(CHT)is related to low response rates and short progression-free survival(PFS)in patients with metastatic TNBC,creating an unmet need.However,recent recognition of different molecular subtypes and mutations within TNBC has allowed exploring some innovative targeted therapies,bringing new hope for women suffering from TNBC.Currently,some promising systemic treatment options in this area have been developed,including targeted therapies,such as poly(ADP-ribose)polymerase(PARP)inhibitors,immune checkpoint inhibitors,antibody-drug conjugates,and AKT inhibitors.The aim of this mini-review is to address these novel treatment modalities and highlight the main directions for further research and clinical practice in the advanced or metastatic forms of TNBC.This article presents poly(ADP-ribose)polymerase(PARP)inhibitors(e.g.,olaparib,talazoparib,and valaparib for treatment of BRCA-mutated,HER2-negative metastatic BC),immune checkpoint inhibitors(atezolizumab and pembrolizumab),an antibody-drug conjugate(ADC)(sacituzumab govitecan),and AKT inhibitors(ipatasertib and capivasertib).A brief outline of the main clinical trials leading to the approval of these new medications has been provided.Moreover,this overview discusses the efficacy and safety of these innovative treatment options,focusing on women with metastatic TNBC.In addition,this paper comments on some recent considerations,regarding avenues of delivering care and conduct clinical trials in patients with BC,during the COVID-19 pandemic.

Polydopamine Modified Biomimetic Gold Nanoparticles for Dual Photothermal Therapy

Our study producted Polydopamine modified gold nanoflowers with controlled morphology for anti-tumor photothermal therapy.The branch structure containsabundant(Au NFs).By adjusting the reduction rate,the dosage of reducing agent(sodium borohydride)and the reduction temperature,we can adjust tthe morphology and particle size of Au NFs.We found that the lower reaction temperature is,the more abundant the surface branching structure of gold nanoflowers is,by adjusting the reaction temperature.and the largest specific surface area of golden nanopowder was found at 0℃.The results of TEM indicated that with the increase of sodium borohydride,the diameter of gold nano flowers gold nanoflowers decreased and was in the range of 60~100nm,and it has good EPR effect After that,we modify poly(dopamine)(PDA)biomimetic layer on the surface of golden nanoparticles to obtain Au NFS@PDA.Poly(dopamine)has the ability,of photothermal conversion,which can enhance the plasma resonance ability and biocompatibility of gold nanoflowers in the near infrared region.We can control the thickness of polydopamine layer on the surface of gold nanoflowers between 7~15nm by adjusting dopamine DA concentrationgold nanoflowers.Au NFS@PDA was characterized by its morphology and physical properties.We detect(UV-Vis)spectra in the near infrared region.And it showed obvious absorption peaks in the near infrared region of 575~650nm.Under the 808nm irradiation laser,the photothermal conversion of gold nanoflowers and polydopamine can be rapidly increased to 57°C.Fourier Transform Infrared Absorption Spectroscopy(FTIR)and X-ray Diffraction(XRD)analysis showed that polydopamine was modified successfully,Au NFS@PDA and Au NFs had no obvious difference in crystal form.The cell viability test showed that the bionic Au NFS@PDA had good biocompatibility and showed good antitumor activity against HeLa cells under NIR irradiation.The cell viability was only 12%.Therefore,we can use Au NFS@PDA with good biocompatibility as a promising photothermal conversion agent in tumor therapy.