Combinational therapy with Myc decoy oligodeoxynucleotides encapsulated in nanocarrier and X-irradiation on breast cancer cells

The Myc gene is the essential oncogene in triple-negative breast cancer(TNBC).This study investigates the synergistic effects of combining Myc decoy oligodeoxynucleotides-encapsulated niosomes-selenium hybrid nanocarriers with X-irradiation exposure on the MDA-MB-468 cell line.Decoy and scramble ODNs for Myc transcription factor were designed and synthesized based on promoter sequences of the Bcl2 gene.The nanocarriers were synthesized by loading Myc ODNs and selenium into chitosan(Chi-Se-DEC),which was then encapsulated in niosome-nanocarriers(NISM@Chi-Se-DEC).FT-IR,DLS,FESEM,and hemolysis tests were applied to confirm its characterization and physicochemical properties.Moreover,cellular uptake,cellular toxicity,apoptosis,cell cycle,and scratch repair assays were performed to evaluate its anticancer effects on cancer cells.All anticancer assessments were repeated under X-ray irradiation conditions(fractionated 2Gy).Physicochemical characteristics of niosomes containing SeNPs and ODNs showed that it is synthesized appropriately.It revealed that the anticancer effect of NISM@Chi-Se-DEC can be significantly improved in combination with X-ray irradiation treatment.It can be concluded that NISM@Chi-Se-DEC nanocarriers have the potential as a therapeutic agent for cancer treatment,particularly in combination with radiation therapy and in-vivo experiments are necessary to confirm the efficacy of this nano-drug.

Hyperbaric oxygen therapy as a complementary treatment for radiation proctitis:Useless or useful?-A literature review

Radiotherapy(RT)is the backbone of multimodality treatment of more than half of cancer cases.Despite new modern RT techniques,late complications may occur such as radiation proctitis(RP).The natural history of RP is unpredictable.Minor symptoms may resolve spontaneously or require conservative treatment.On the other hand,for similar and uncomplicated clinical contexts,symptoms may persist and can even be refractory to the progressive increase in treatment measures.Over the last decades,an enormous therapeutic armamentarium has been considered in RP,including hyperbaric oxygen therapy(HBOT).Currently,the evidence regarding the impact of HBOT on RP and its benefits is conflicting.Additional prospective and randomised studies are necessary to validate HBOT’s effectiveness in the‘real world’clinical practice.This article reviewed the relevant literature on pathophysiology,clinical presentation,different classifications and discuss RP management including a proposal for a therapeutic algorithm with a focus on HBOT.

Efficacy and safety of berberine in the prophylactic treatment of acute radiation proctitis in postoperative patients with cervical cancer:a randomized controlled study

Objective The aiom of this study was to study the efficacy and safety of berberine as a prophylactic treatment of acute radiation proctitis in postoperative patients with cervical cancer.Methods A total of 120 postoperative patients with cervical cancer were enrolled between July 2016 and October 2019,and randomly divided into a treatment group(berberine 300 mg three times a day,n=60)and a control group(receiving vitamin C tablets,100 mg three times a day;n=60)using the random number table method.All patients received pelvic intensity-modulated radiation therapy(IMRT)and concurrent sensitizing chemotherapy weekly.The difference in the percentage of irradiation volume to the rectum and small intestine as well as the incidence,onset time,severity,and duration of acute radiation proctitis and cystitis during radiotherapy were compared between the two groups.The completion rate,completion time,number of chemotherapy sessions,and quality of life during radiotherapy were also compared.Results There were no statistical differences in age,FIGO stage,pathological type,complications,highrisk factors,and rectum and small intestine irradiation dose distribution(V20,V30,V40,and V50)between the two groups(P>0.05).No acute radiation proctitis of grade 3 or above occurred in the two groups.There was no significant difference in the incidence of acute radiation cystitis,grade 2 acute radiation proctitis,completion rate of IMRT,and frequency of sensitization chemotherapy between the two groups.After prophylactic treatment with berberine,the incidence of grade 1 acute radiation proctitis,occurrence of grade 1 radiation proctitis,and completion time of radiotherapy in the treatment group were significantly lower than those in the control group(P<0.05).The SF-36 score of the treatment group after radiotherapy was 67.53±4.21,which was significantly better than that of the control group(64.90±6.32;P<0.05).The incidence of grade 3-4 neutropenia in the treatment group was 10%and lower than that in the control group(31.7%,P=0.003).No adverse reactions related to berberine were observed.Conclusion Prophylactic prescription with oral berberine can reduce the incidence,onset time,and duration of grade 1 acute radiation proctitis,and improve the quality of life of postoperative patients with cervical cancer receiving concurrent chemoradiotherapy.

Stereotactic body radiation therapy in patients with hepatocellular carcinoma: A mini-review

Stereotactic body radiation therapy(SBRT) is an emerging treatment for hepatocellular carcinoma. This technique results in excellent local control rates with favorable toxicity profile despite being predominantly used in heavily pretreated patients or those unsuitable for other local therapies. SBRT may be used as a sole treatment or in combination with other local therapies as well as a bridging strategy for patient awaiting liver transplants. This brief review describes current practice of SBRT with respect to radiation technique, patient selection and treatment concepts. It summarizes available evidence from retroand prospective studies evaluating SBRT alone, SBRT in combination with other treatments and SBRT compared to other local treatment approaches.

Injectable hydrogel-based drug delivery systems for enhancing the efficacy of radiation therapy:A review of recent advances

Radiotherapy(RT)is a crucial treatment for cancer;however,its effectiveness is limited by adverse effects on normal tissues,radioresistance,and tumor recurrence.To overcome these challenges,hydrogels have been employed for delivery of radiosensitizers and other therapeutic agents.This review summarizes recent advancements in the application of hydrogel-based local drug delivery systems for improving the therapeutic efficacy of RT in cancer treatment.Firstly,we introduce the classification and properties of hydrogels.Next,we detail hydrogel-based platforms designed to enhance both external beam radiation therapy and brachytherapy.We also discuss hydrogels used in combination therapy involving RT and immunotherapy.Lastly,we highlight the challenges that hydrogels face in RT.By surveying the latest developments in hydrogel applications for RT,this review aims to provide insights into the development of more effective and targeted cancer therapies.

Endoscopic and non-endoscopic approaches for the management of radiation-induced rectal bleeding

Pelvic radiation is a commonly utilized treatment for malignancy of the genitourinary and lower gastrointestinal tract. Radiation proctitis and the resultant clinical picture varies from asymptomatic to potentially life threatening. Similarly, treatment options also vary greatly, from medical therapy to surgical intervention. Commonly utilized medical therapy includes sucralfate enemas, antibiotics, 5-aminosalicylic acid derivatives, probiotics, antioxidants, short-chain fatty acids, formalin instillation and fractionated hyperbaric oxygen. More invasive treatments include endoscopic-based, focally ablative interventions such as dilation, heater and bipolar cautery, neodymium/yttrium aluminum garnet argon laser, radiofrequency ablation or argon plasma coagulation. Despite its relatively common frequency, there is a dearth of existing literature reporting headto-head comparisons of the various treatment options via a randomized controlled approach. The purpose of our review was to present the reader a consolidation of the existing evidence-based literature with the goal of highlighting the comparative effectiveness and risks of the various treatment approaches. Finally, we outline a pragmatic approach to the treatment of radiation proctitis. In light of the lack of randomized data, our goal is to pursue as least invasive an approach as possible, with escalation of care tailored to the severity of the patient's symptoms. For those cases that are clinicallyasymptomatic or only mildly symptomatic, observation or medical management can be considered. Once a patient fails such management or symptoms become more severe, invasive procedures such as endoscopically based focal ablation or surgical intervention can be considered. Although not all recommendations are supported by level I evidence, reported case series and single-institutional studies in the literature suggest that successful treatment with cessation of symptoms can be obtained in the majority of cases.

Biological effects of radiation on cancer cells

With the development of radiotherapeutic oncology, computer technology and medical imaging technology, radiation therapy has made great progress. Research on the impact and the specific mechanism of radiation on tumors has become a central topic in cancer therapy. According to the traditional view, radiation can directly affect the structure of the DNA double helix, which in turn activates DNA damage sensors to induce apoptosis, necrosis, and aging or affects normal mitosis events and ultimately rewires various biological characteristics of neoplasm cells. In addition, irradiation damages subcellular structures, such as the cytoplasmic membrane, endoplasmic reticulum, ribosome, mitochondria, and lysosome of cancer cells to regulate various biological activities of tumor cells. Recent studies have shown that radiation can also change the tumor cell phenotype, immunogenicity and microenvironment, thereby globally altering the biological behavior of cancer cells. In this review, we focus on the effects of therapeutic radiation on the biological features of tumor cells to provide a theoretical basis for combinational therapy and inaugurate a new era in oncology.

Immunotherapy in pancreatic cancer:Unleash its potential through novel combinations

Pancreatic cancer is the third leading cause of cancer mortality in both men and women in the United States,with poor response to current standard of care,short progression-free and overall survival.Immunotherapies that target cytotoxic T lymphocyte antigen-4,programmed cell death protein-1,and programmed death-ligand 1 checkpoints have shown remarkable activities in several cancers such as melanoma,renal cell carcinoma,and nonsmall cell lung cancer due to high numbers of somatic mutations,combined with cytotoxic T-cell responses.However,single checkpoint blockade was ineffective in pancreatic cancer,highlighting the challenges including the poor antigenicity,a dense desmoplastic stroma,and a largely immunosuppressive microenvironment.In this review,we will summarize available clinical results and ongoing efforts of combining immune checkpoint therapies with other treatment modalities such as chemotherapy,radiotherapy,and targeted therapy.These combination therapies hold promise in unleashing the potential of immunotherapy in pancreatic cancer to achieve better and more durable clinical responses by enhancing cytotoxic T-cell responses.

Treatment of Chronic Pelvic Inflammation with Acupuncture and TDP Irradiation—A Report of 23 Cases

With electro-acupuncture, red-hot needling and TDP irradiation, we have successfully treated 23 cases of chronic pelvic inflammation. A report follows.

Tracing and targeting cancer stem cells:New venture for personalized molecular cancer therapy

Tumors consist of a mixture of heterogeneous cell types. Cancer stem cells(CSCs) are a minor sub-population within the bulk cancer fraction which has been foundto reconstitute and propagate the disease and to be frequently resistant to chemotherapy, irradiation, cytotoxic drugs and probably also against immune attack. CSCs are considered as the seeds of tumor recurrence, driving force of tumorigenesis and metastases. This underlines the urgent need for innovative methods to identify and target CSCs. However, the role and existence of CSCs in therapy resistance and cancer recurrence remains a topic of intense debate. The underlying biological properties of the tumor stem cells are extremely dependent on numerous signals, and the targeted inhibition of these stem cell signaling pathways is one of the promising approaches of the new antitumor therapy approaches. This perspective review article summarizes the novel methods of tracing CSCs and discusses the hallmarks of CSC identification influenced by the microenvironment or by having imperfect detection markers. In addition, explains the known molecular mechanisms of therapy resistance in CSCs as reliable and clinically predictive markers that could enable the use of new targeted antitumor therapy in the sense of personalized medicine.

A Survey of Researches on Synergy and Toxicity Abatement of Traditional Chinese Medicine in Radiotherapy of Nasopharyngeal Carcinoma

Even though radiotherapy is a therapy of first choice in the treatment of nasopharyngeal carcinoma, its radiotoxicity is often difficult to bear for patients in addition to the unsatisfactory effect in some patients. Therefore, an important problem in the treatment of nasopharyngeal carcinoma is to abate radiotherapeutic toxicity and improve its effect. Some progresses in promoting the effect of radiotherapy and abating its toxicity have been made through application of traditional Chinese medicine (TCM) which is briefly reviewed as follows.

Radiotherapy for Carcinoma of the Esophagus: Progress of Treatment and Research in China

Carcinoma of the esophagus is a common malignancy in China. Radiotherapy is one of the most important modalities of treatment. This article provides a review of the natural history of this disease, the results of radiotherapy for esophageal cancer and the recent advances in radiation techniques in China. Significant progress has been made in this area of research and treatment. Combined treatment modalities and new therapies are being evaluated and may be expected to contribute to improved patient outcomes and better palliation of symptoms in the future.

化浊灌肠方保留灌肠治疗热毒伤络型急性放射性直肠炎临床观察

目的观察化浊灌肠方保留灌肠治疗热毒伤络型急性放射性直肠炎的临床疗效。方法将80例热毒伤络型急性放射性直肠炎患者按照随机数字表法分为2组,对照组40例予蒙脱石散+地塞米松磷酸钠注射液灌肠,治疗组40例予化浊灌肠方保留灌肠治疗。2组均治疗4周。比较2组治疗前后中医证候评分变化;比较2组中医证候疗效;比较2组治疗前后急性放射性直肠炎分级、卡氏功能状态(KPS)评分变化。结果2组治疗后中医证候各项评分及总评分均较本组治疗前降低(P<0.05),治疗组治疗后中医证候各项评分及总评分均低于对照组(P<0.05)。治疗组总有效率90.0%(36/40),对照组总有效率72.5%(29/40),治疗组中医证候疗效优于对照组(P<0.05)。治疗后治疗组急性放射性直肠炎分级优于对照组(P<0.05)。2组治疗后KPS评分均较本组治疗前升高(P<0.05),治疗后治疗组KPS评分高于对照组(P<0.05)。结论化浊灌肠方保留灌肠治疗热毒伤络型急性放射性直肠炎,能减轻患者腹痛、腹泻、便血、黏液便等症状,改善生活质量,无不良反应。

Radiation Therapy in Keloids Treatment： History, Strategy,Effectiveness, and Complication

Objective：Radiation therapy combined with surgical excision was considered as one of the most effective treatment plans for keloid lesions.However,there was no unanimity found over present literatures regarding the issue on optimized treatment strategy for keloids.We here provide a comprehensive review over this issue and emphasize on the influencing factors.Data Sources：The data analyzed in this review were searched from articles included in PubMed and EMBASE databases.Study Selection：The original articles and critical reviews discussing the application of radiation therapy in keloids treatment were selected for this review.Results：The application of radiation therapy has transitioned from simple superficial X-ray irradiation to brachytherapy.Furthermore,several factors including radiation type,dose,fraction,interval,and complications were reviewed,and the results revealed that these factors were significant toward clinical outcome at various levels.Conclusions：Both past and present evidence support the idea that combination therapy of radiation and surgical therapy is safe and feasible.However,the optimization of treatment strategy was based on different radiation types and should take dose,fractions,interval,and complications into consideration,which will then decrease the rate of recurrence and increase the level of satisfaction.

The radiation therapy in keloids treatment: a comprehensive review of pathomechanism, damage mechanisms and cellular response

Keloid management has always been frustrating and challenging. The combination therapy of surgical excision and radiation therapy was deemed as the last resort for decades. The authors performed a thorough and comprehensive review over the mechanisms on how radiation therapy damages the keloid cells. The keloid cells' cellular response towards damage induced by irradiation was also studied based on original and current literatures. Mechanisms of damage generated by radiation therapy on keloid cells remained partially understood. However, direct damage was identified playing dominant role, in contrast to damage involved cancer cell apoptosis. Moreover, the p53 pathway and some inflammatory factors like interleukin-6 were believed to function in cellular response to irradiation. However, the transforming growth factor beta, which was the major dysregulated pathway involved in pathogenesis of keloid formation showed no apparent correlation with cellular response to irradiation damage. These pathways could partially explain radiation resistance in some refractory keloid lesions. The scientific basis and experimental proof in this field was still inadequate, which drove us to find more evidence to identify the key regulator response to damage engendered by radiation therapy. Further pathway identification may benefit the drug development to prevent keloid recurrence.

Stereotactic body radiation therapy for the management of HCC

Hepatocellular carcinoma(HCC)is a common malignant tumor in China.After years of efforts,there has been great progress in the management of liver cancer,but overall,it is still not ideal.At present,there are many therapies for liver cancer,including surgical resection,transcatheter arterial chemoembolization(TACE),ablation,molecular targeted therapy,stereotactic body radiation therapy,chemotherapy,immunotherapy,and so on.Studies have reported that TACE combined with radiotherapy can shrink the tumor,and some of the remainder will be resectable,resulting in cure.For HCC with tumor thrombus,the tumor thrombus was reduced and then resected after neoadjuvant radiotherapy.The survival time of the patients with portal vein tumor thrombus was significantly longer than that of the patients without neoadjuvant radiotherapy.Large liver cancer will be reduced to small liver cancer after comprehensive treatment,which can be transformed into stereotactic radiotherapy or radiofrequency ablation,and can also be palliative to radical treatment.Individualized and multidisciplinary therapy for liver cancer is the direction of future development.More clinical evidence-based level of radiotherapy treatment of liver cancer should be done in the future.

对放射性直肠炎的中药保留灌肠技术优化研究

目的探讨中药保留灌肠治疗放射性直肠炎最优技术方案(包括给药温度、滴注时间、药量、插管深度)。方法采用正交试验设计方法,将63例放射性直肠炎患者随机分为9组,按照不同的试验条件灌肠给药。疗程均为6周。分别以治疗后中医证候积分、放射损伤疗效评定结果、体力状况评分为效应指标,对正交试验结果进行方差分析,得出中药保留灌肠治疗放射性直肠炎最优技术方案。结果给药温度(39±0.5)℃、滴注时间30 min、药量100 mL、插管深度20 cm为中药保留灌肠最优技术方案。结论本研究所得放射性直肠炎灌肠条件的优化方案合理可行。

放射性直肠炎的中医临床与实验研究进展

在盆腔肿瘤患者的放射治疗中,放射性直肠炎的防治一直是困扰临床工作者的一大难题。中医认为,放射性直肠炎的发生是正气亏虚、湿热毒邪蕴结肠道的结果,采用内外治法结合、中西医并重的疗法,效果突出。本文就放射性直肠炎在中医领域的临床及实验研究近况作一概述。

高压氧治疗缓解宫颈癌放疗后并发症研究

目的 改善由宫颈癌盆腔放射引起的严重放射性直肠炎.方法 24例宫颈癌外照射或合并近距离照射后放射性直肠炎患者,经过药物及内窥镜治疗无效者,进行2.4个大气压100%氧气;90min治疗;每周治疗5～7次;治疗10～28个疗程.结果 高压氧治疗结束后89%（18例患者中16例）出血症状减轻或消失;71%（17例中12例）疼痛症状缓解或消失;62%（13例中8例）排便紧迫感减轻或消失.结论 高压氧治疗对于难治性放射性直肠炎有较高的有效率和耐受性是治疗这种常见、难治病例的重要选择.

后程加速超分割放射治疗加同步化疗治疗食管癌

目的 :探讨食管癌后程加速超分割放射治疗加顺铂、氟尿嘧啶同步化疗的疗效和毒性 .方法 :95例食管癌患者随机分成后程加速超分割放射治疗加顺铂、氟尿嘧啶同步化疗组 (综合组 )和后程加速超分割放射治疗组 (后超组 ) .后超组 (4 7例 )前 2 / 3疗程为常规分割 (2Gy/次 ,5次·wk-1 )照射 36～ 4 0Gy后缩野改加速超分割 (1 .5Gy/次 ,2 次·d-1 )照射 2 7～ 30Gy .综合组 (4 8例 )在后超组的基础上静脉内输注顺铂 2 0mg·d-1 ,氟尿嘧啶 5 0 0mg·d-1 ,连用 5d为 1周期 .分别在第 1 ,4周实施 ,共 2个周期 .结果 :1 ,2和 3a生存率 ,综合组分别为 83.3% ,6 4 .6 %和 5 6 .3% ,后超组分别为76 .5 % ,5 1 .1 %和 34.0 % (χ2 =4 .1 6 4 ,P =0 .0 4 1 3) .1 ,2和 3a局部控制率 ,综合组分别为 87.5 % ,77.1 %和 6 6 .7% ;后超组分别为 80 .9% ,6 1 .7%和 4 2 .5 % (χ2 =5 .4 1 9,P =0 .0 2 0 ) .综合组Ⅰ～Ⅲ度急性放射性气管炎发生率分别为 2 0 .8% ,1 2 .5 % ,4 .2 % ;后超组分别为 1 9.2 % ,1 0 .6 % ,2 .1 % ,两组差异无显著性意义 (χ2 =0 .2 0 6 ,P >0 .0 5 ) .综合组Ⅰ～Ⅳ度急性放射性食管炎的发生率分别为 2 9.2 % ,35 .4 % ,8.3%和 2 .1 % ;后超组分别为 2 5 .5 % ,31 .9% ,6 .4 %和 0 .两组差异无显著?