Artificial intelligence(AI)has seen tremendous growth over the past decade and stands to disrupts the medical industry.In medicine,this has been applied in medical imaging and other digitised medical disciplines,but i...Artificial intelligence(AI)has seen tremendous growth over the past decade and stands to disrupts the medical industry.In medicine,this has been applied in medical imaging and other digitised medical disciplines,but in more traditional fields like medical physics,the adoption of AI is still at an early stage.Though AI is anticipated to be better than human in certain tasks,with the rapid growth of AI,there is increasing concerns for its usage.The focus of this paper is on the current landscape and potential future applications of artificial intelligence in medical physics and radiotherapy.Topics on AI for image acquisition,image segmentation,treatment delivery,quality assurance and outcome prediction will be explored as well as the interaction between human and AI.This will give insights into how we should approach and use the technology for enhancing the quality of clinical practice.展开更多
Background: Since advanced hepatocellular carcinoma (HCC) is potentially fatal, and patients’ quality of life (QOL) often deteriorates during their treatment, improving the prognosis and QOL of patients given chemoth...Background: Since advanced hepatocellular carcinoma (HCC) is potentially fatal, and patients’ quality of life (QOL) often deteriorates during their treatment, improving the prognosis and QOL of patients given chemotherapy is very important. In addition, cost-effective treatments are highly desirable when chemotherapy must be given repeatedly. The aim of this study was to evaluate the efficacy and usefulness of 5-fluorouracil (5-FU) and high-concentration cisplatin by short-term hepatic arterial infusion chemotherapy (3-day FPL) in advanced HCC patients. Methods: Thirty patients with unresectable advanced HCC were enrolled. The patients underwent hepatic arterial infusion chemotherapy via the implanted port system with 5-FU on days 1 - 3 and a fine-powder formulation of cisplatin in suspended pre-warmed lipiodol on day 2 every 4 to 10 weeks. Tumor response was assessed one month later with CT. Results: All patients had evidence of portal vein invasion (Vp2-4). Four patients achieved a complete response (CR), 8 patients achieved a partial response (PR), and 7 patients had stable disease (SD). The median progression-free survival (PFS) and overall survival (OS) were 198 days and 452 days, respectively. The OS was significantly longer in the successful disease control group (CR, PR, and SD) than in the progressive disease group (P < 0.005). Conclusions: Three-day FPL was effective and tolerable in advanced HCC patients due to its shorter time of administration than conventional FP therapy. Therefore, repetitive 3-day FPL appears useful and contributes to improving the prognosis and QOL of patients with advanced HCC. In addition, this protocol is a cost-effective treatment.展开更多
Pancreatic neuroendocrine neoplasms(PanNENs)are rare neoplasms with strong heterogeneity that have experienced an increasing incidence rate in recent years.For patients with locally advanced or distant metastatic PanN...Pancreatic neuroendocrine neoplasms(PanNENs)are rare neoplasms with strong heterogeneity that have experienced an increasing incidence rate in recent years.For patients with locally advanced or distant metastatic PanNENs,systemic treatment options vary due to the different differentiations,grades and stages.The available options for systemic therapy include somatostatin analogs,molecularly targeted agents,cytotoxic chemotherapeutic agents,immune checkpoint inhibitors,and peptide receptor radionuclide therapy.In addition,the development of novel molecularly targeted agents is currently in progress.The sequence of selection between different chemotherapy regimens has been of great interest,and resistance to chemotherapeutic agents is the major limitation in their clinical application.Novel agents and high-level clinical evidence continue to emerge in the field of antiangiogenic agents.Peptide receptor radionuclide therapy is increasingly employed for the treatment of advanced neuroendocrine tumors,and greater therapeutic efficacy may be achieved by emerging radiolabeled peptides.Since immune checkpoint inhibitor monotherapies for PanNENs appear to have limited antitumor activity,dual immune checkpoint inhibitor therapies or combinations of antiangiogenic therapies and immune checkpoint inhibitors have been applied in the clinic to improve clinical efficacy.Combining the use of a variety of agents with different mechanisms of action provides new possibilities for clinical treatments.In the future,the study of systemic therapies will continue to focus on the screening of the optimal benefit population and the selection of the best treatment sequence strategy with the aim of truly achieving individualized precise treatment of PanNENs.展开更多
AIM：To compare quality of life and treatment satisfaction between patients who had selective laser trabeculoplasty（SLT） and those on medication.METHODS：A prospective clinical trial on 143 glaucoma patients that re...AIM：To compare quality of life and treatment satisfaction between patients who had selective laser trabeculoplasty（SLT） and those on medication.METHODS：A prospective clinical trial on 143 glaucoma patients that received SLT and a control group that continued using anti glaucoma medication was conducted. Tear break-up time（BUT）, punctuate keratitis, need for help, use of artificial tears and the treatment satisfaction survey of intraocular pressure（IOP） were measured at baseline, 6 and 12 mo. RESULTS：SLT was able to reduce the mean number of medications needed from 1.56±0.81 to 0.42±0.66 at six months and to 0.33±0.69 at one year. Punctuate keratitis was observed significantly less often（12.24%） after SLT than before（35.94%; P=0.03）. Use of artificial tears and BUT did not change significantly after SLT（P〉0.05）. At baseline, patients in the SLT group were significantly less convinced of medication effectiveness（P=0.006） and complained more about side effects（P=0.003）. After SLT, these patients had significantly more confidence in their therapy（P〈0.001）, showed less side effects（P=0.006）, complained less about changes in appearance of the eyes（P=0.003） and were less inconvenienced by the use of eye drops（P〈0.001）.CONCLUSION：SLT is able to improve treatment-related quality of life in glaucoma patients.展开更多
目的:基于治未病理论探讨灸药同治对实体恶性肿瘤化疗患者骨髓抑制的预防作用。方法:选取2019年1月至2022年1月于武汉科技大学附属武汉亚心总医院接受治疗的实体恶性肿瘤化疗患者120例作为研究对象,采用随机数字表法分为对照组和观察组...目的:基于治未病理论探讨灸药同治对实体恶性肿瘤化疗患者骨髓抑制的预防作用。方法:选取2019年1月至2022年1月于武汉科技大学附属武汉亚心总医院接受治疗的实体恶性肿瘤化疗患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组常规接受化疗,观察组化疗前连续3 d给予灸药同治(艾灸+加味八珍汤)。比较治疗前、化疗后7 d 2组患者中医证候积分、血常规[血红蛋白(Hb)、白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞计数(NEUT)]、生命质量[卡诺夫斯凯计分(KPS)、中国癌症患者生命质量(QOL_(2))调查问卷],比较化疗后7 d 2组患者骨髓抑制情况[发生率、严重程度、重组人粒细胞集落刺激因子(rhG-CSF)使用情况]。结果:化疗后7 d,2组患者中医证候积分升高,但观察组低于对照组(P<0.05);Hb、WBC、PLT、NEUT、KPS评分及QOL_(2)评分降低,但观察组高于对照组(均P<0.05);观察组骨髓抑制发生率、rhG-CSF使用率低于对照组,0、Ⅰ度比例高于对照组(均P<0.05)。结论:基于治未病理论,灸药同治能够改善实体恶性肿瘤化疗患者临床症状及血常规,提高患者生命质量,减少骨髓抑制的发生。展开更多
目的基于倾向性评分匹配法探讨复方守宫散辅助治疗晚期结直肠恶性肿瘤的疗效。方法采用倾向性评分匹配法,将匹配成功的70例患者分为对照组(化学治疗)和观察组(复方守宫散联合化学治疗),每组35例;比较两组患者瘤体客观疗效[客观缓解率(ob...目的基于倾向性评分匹配法探讨复方守宫散辅助治疗晚期结直肠恶性肿瘤的疗效。方法采用倾向性评分匹配法,将匹配成功的70例患者分为对照组(化学治疗)和观察组(复方守宫散联合化学治疗),每组35例;比较两组患者瘤体客观疗效[客观缓解率(objective response rate,ORR),疾病控制率(disease control rate,DCR)]、生活质量评分、免疫功能指标、安全性指标,并对生存期进行分析。结果观察组ORR、DCR优于对照组(P<0.05);观察组患者治疗后功能维度(躯体功能、角色功能、情绪功能、认知功能、社会功能),症状领域(疲劳、疼痛、恶心呕吐)评分改善程度显著优于对照组(P<0.05);观察组患者血清CD4+T细胞、CD8+T细胞、自然杀伤细胞水平,CD4+/CD8+均显著高于对照组(P<0.05);治疗组患者总不良反应发生率显著低于对照组(P<0.05);观察组的中位无进展生存期显著高于对照组(P<0.05),中位总生存期高于对照组(P>0.05)。结论相较于单纯化学治疗,复方守宫散与化学治疗联合应用能显著提高疗效,增强机体免疫力,改善晚期结直肠癌患者生活质量,降低化学治疗的毒性及不良反应,在一定程度上延长患者生存时间。展开更多
文摘Artificial intelligence(AI)has seen tremendous growth over the past decade and stands to disrupts the medical industry.In medicine,this has been applied in medical imaging and other digitised medical disciplines,but in more traditional fields like medical physics,the adoption of AI is still at an early stage.Though AI is anticipated to be better than human in certain tasks,with the rapid growth of AI,there is increasing concerns for its usage.The focus of this paper is on the current landscape and potential future applications of artificial intelligence in medical physics and radiotherapy.Topics on AI for image acquisition,image segmentation,treatment delivery,quality assurance and outcome prediction will be explored as well as the interaction between human and AI.This will give insights into how we should approach and use the technology for enhancing the quality of clinical practice.
文摘Background: Since advanced hepatocellular carcinoma (HCC) is potentially fatal, and patients’ quality of life (QOL) often deteriorates during their treatment, improving the prognosis and QOL of patients given chemotherapy is very important. In addition, cost-effective treatments are highly desirable when chemotherapy must be given repeatedly. The aim of this study was to evaluate the efficacy and usefulness of 5-fluorouracil (5-FU) and high-concentration cisplatin by short-term hepatic arterial infusion chemotherapy (3-day FPL) in advanced HCC patients. Methods: Thirty patients with unresectable advanced HCC were enrolled. The patients underwent hepatic arterial infusion chemotherapy via the implanted port system with 5-FU on days 1 - 3 and a fine-powder formulation of cisplatin in suspended pre-warmed lipiodol on day 2 every 4 to 10 weeks. Tumor response was assessed one month later with CT. Results: All patients had evidence of portal vein invasion (Vp2-4). Four patients achieved a complete response (CR), 8 patients achieved a partial response (PR), and 7 patients had stable disease (SD). The median progression-free survival (PFS) and overall survival (OS) were 198 days and 452 days, respectively. The OS was significantly longer in the successful disease control group (CR, PR, and SD) than in the progressive disease group (P < 0.005). Conclusions: Three-day FPL was effective and tolerable in advanced HCC patients due to its shorter time of administration than conventional FP therapy. Therefore, repetitive 3-day FPL appears useful and contributes to improving the prognosis and QOL of patients with advanced HCC. In addition, this protocol is a cost-effective treatment.
基金Supported by National Key R&D Program of China,No.2019YFB1309704.
文摘Pancreatic neuroendocrine neoplasms(PanNENs)are rare neoplasms with strong heterogeneity that have experienced an increasing incidence rate in recent years.For patients with locally advanced or distant metastatic PanNENs,systemic treatment options vary due to the different differentiations,grades and stages.The available options for systemic therapy include somatostatin analogs,molecularly targeted agents,cytotoxic chemotherapeutic agents,immune checkpoint inhibitors,and peptide receptor radionuclide therapy.In addition,the development of novel molecularly targeted agents is currently in progress.The sequence of selection between different chemotherapy regimens has been of great interest,and resistance to chemotherapeutic agents is the major limitation in their clinical application.Novel agents and high-level clinical evidence continue to emerge in the field of antiangiogenic agents.Peptide receptor radionuclide therapy is increasingly employed for the treatment of advanced neuroendocrine tumors,and greater therapeutic efficacy may be achieved by emerging radiolabeled peptides.Since immune checkpoint inhibitor monotherapies for PanNENs appear to have limited antitumor activity,dual immune checkpoint inhibitor therapies or combinations of antiangiogenic therapies and immune checkpoint inhibitors have been applied in the clinic to improve clinical efficacy.Combining the use of a variety of agents with different mechanisms of action provides new possibilities for clinical treatments.In the future,the study of systemic therapies will continue to focus on the screening of the optimal benefit population and the selection of the best treatment sequence strategy with the aim of truly achieving individualized precise treatment of PanNENs.
文摘AIM：To compare quality of life and treatment satisfaction between patients who had selective laser trabeculoplasty（SLT） and those on medication.METHODS：A prospective clinical trial on 143 glaucoma patients that received SLT and a control group that continued using anti glaucoma medication was conducted. Tear break-up time（BUT）, punctuate keratitis, need for help, use of artificial tears and the treatment satisfaction survey of intraocular pressure（IOP） were measured at baseline, 6 and 12 mo. RESULTS：SLT was able to reduce the mean number of medications needed from 1.56±0.81 to 0.42±0.66 at six months and to 0.33±0.69 at one year. Punctuate keratitis was observed significantly less often（12.24%） after SLT than before（35.94%; P=0.03）. Use of artificial tears and BUT did not change significantly after SLT（P〉0.05）. At baseline, patients in the SLT group were significantly less convinced of medication effectiveness（P=0.006） and complained more about side effects（P=0.003）. After SLT, these patients had significantly more confidence in their therapy（P〈0.001）, showed less side effects（P=0.006）, complained less about changes in appearance of the eyes（P=0.003） and were less inconvenienced by the use of eye drops（P〈0.001）.CONCLUSION：SLT is able to improve treatment-related quality of life in glaucoma patients.
文摘目的:基于治未病理论探讨灸药同治对实体恶性肿瘤化疗患者骨髓抑制的预防作用。方法:选取2019年1月至2022年1月于武汉科技大学附属武汉亚心总医院接受治疗的实体恶性肿瘤化疗患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组常规接受化疗,观察组化疗前连续3 d给予灸药同治(艾灸+加味八珍汤)。比较治疗前、化疗后7 d 2组患者中医证候积分、血常规[血红蛋白(Hb)、白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞计数(NEUT)]、生命质量[卡诺夫斯凯计分(KPS)、中国癌症患者生命质量(QOL_(2))调查问卷],比较化疗后7 d 2组患者骨髓抑制情况[发生率、严重程度、重组人粒细胞集落刺激因子(rhG-CSF)使用情况]。结果:化疗后7 d,2组患者中医证候积分升高,但观察组低于对照组(P<0.05);Hb、WBC、PLT、NEUT、KPS评分及QOL_(2)评分降低,但观察组高于对照组(均P<0.05);观察组骨髓抑制发生率、rhG-CSF使用率低于对照组,0、Ⅰ度比例高于对照组(均P<0.05)。结论:基于治未病理论,灸药同治能够改善实体恶性肿瘤化疗患者临床症状及血常规,提高患者生命质量,减少骨髓抑制的发生。
文摘目的基于倾向性评分匹配法探讨复方守宫散辅助治疗晚期结直肠恶性肿瘤的疗效。方法采用倾向性评分匹配法,将匹配成功的70例患者分为对照组(化学治疗)和观察组(复方守宫散联合化学治疗),每组35例;比较两组患者瘤体客观疗效[客观缓解率(objective response rate,ORR),疾病控制率(disease control rate,DCR)]、生活质量评分、免疫功能指标、安全性指标,并对生存期进行分析。结果观察组ORR、DCR优于对照组(P<0.05);观察组患者治疗后功能维度(躯体功能、角色功能、情绪功能、认知功能、社会功能),症状领域(疲劳、疼痛、恶心呕吐)评分改善程度显著优于对照组(P<0.05);观察组患者血清CD4+T细胞、CD8+T细胞、自然杀伤细胞水平,CD4+/CD8+均显著高于对照组(P<0.05);治疗组患者总不良反应发生率显著低于对照组(P<0.05);观察组的中位无进展生存期显著高于对照组(P<0.05),中位总生存期高于对照组(P>0.05)。结论相较于单纯化学治疗,复方守宫散与化学治疗联合应用能显著提高疗效,增强机体免疫力,改善晚期结直肠癌患者生活质量,降低化学治疗的毒性及不良反应,在一定程度上延长患者生存时间。
