Survival of patients with gastric cancer surgically treated at the National Cancer Center of China from 2011 to 2018 according to stage at diagnosis

Objective:The postoperative survival rates of patients with gastric cancer at different stages treated at the National Cancer Center(NCC)of China have not been reported.Therefore,we evaluated the survival of patients with gastric cancer who underwent surgery at the NCC from 2011 to 2018 to provide baseline information for further studies.Methods:We identified 7,301 patients with primary gastric carcinoma who underwent surgery at the NCC be-tween January 2011 and May 2018;among these,5,008 patients were enrolled in this study.Follow up was completed on April 30,2020.We analyzed the 5-year survival according to the stage,sex,age,and other clini-copathological features.Results:Five-year survival rates of patients with pTNM stages ⅠA,ⅠB,ⅡA,ⅡB,ⅢA,ⅢB,ⅢC,and Ⅳ treated at the NCC were 94.9%,91.8%,86.5%,76.1%,61.1%,44.2%,29.7%,and 8.1%,respectively,which were similar to those reported in Japan during the same period.Five-year survival rates of patients with ypTNM stages I,II,III,and IV were 93.1%,63.2%,27.2%,and 0.0%,respectively.In multivariable analysis,age,signet ring cell carcinoma,adjuvant chemotherapy,and degree of differentiation were revealed as important prognostic factors.Conclusion:The survival rates of patients with gastric cancer treated at the NCC have been significantly improved,reaching the levels of Japan in the same period.

Development and Current Status of National Cancer Center for Chinese Medicine

Chinese medicine （CM） is an important feature of cancer treatment in China. Especially in the last 10 years, the effect of CM in cancer treatment has been of high concern and has been accepted by experts and patients locally and overseas. The oncology department （OD） of Guang＇anmen Hospital （GAMH） of China Academy of Chinese Medical Sciences （CATCM）, which will mark its 50th anniversary in 2013, is one of China＇s most-respected centers devoted exclusively to cancer patient care, research, education, and prevention through CM. It is located at the campus of GAMH, central Beijing.

Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

Could Sequential Residual Centering Resolve Low Sensitivity in Moderated Regression? Simulations and Cancer Symptom Clusters

Multicollinearity constitutes shared variation among predictors that inflates standard errors of regression coefficients. Several years ago, it was proven that the common practice of mean centering in moderated regression cannot alleviate multicollinearity among variables comprising an interaction, but merely masks it. Residual centering (orthogonalizing) is unacceptable because it biases parameters for predictors from which the interaction derives, thus precluding interpretation of moderator effects. I propose and validate residual centering in sequential re-estimations of a moderated regression—sequential residual centering (SRC)—by revealing unbiased multicollinearity conditioning across the interaction and its related terms. Across simulations, SRC reduces variance inflation factors (VIF) regardless of distribution shape or pattern of regression coefficients across predictors. For any predictor, the reduced VIF is used to derive a lower standard error of its regression coefficient. A cancer sample illustrates SRC, which allows unbiased interpretations of symptom clusters. SRC can be applied efficiently to alleviate multicollinearity after data collection and shows promise for advancing synergistic frontiers of research.

Envita’s Precision Cancer Care: 35-Fold Improvement in Response Rates

New clinical approaches are imperative beyond the widely adopted National Comprehensive Cancer Network (NCCN) guidelines, utilized by prominent cancer institutions. Cancer is the leading cause of death among individuals younger than 85 years within the United States. Despite significant technological advances, including the expenditure of hundreds of billions, treatment outcomes and overall survival have not notably improved for most types of advanced cancer over the last several decades. Over the past 24 years, Envita Medical Centers has pioneered a unique form of personalized treatment approach for late-stage and refractory cancer patients, introducing groundbreaking innovations in the field. Our integrated algorithm utilizes advanced genomics, transcriptomics, and highly tailored immunotherapy, resulting in remarkable outcome improvements. This study presents Envita’s innovative personalized treatment algorithms and examines the response outcomes of 199 late-stage cancer patients treated at Envita Medical Centers over a two-year period. Compared to standard of care and palliative chemotherapy, Envita’s treatment demonstrated a remarkable 35-fold improvement in overall response rates (Figure 1). Moreover, 88% of the patients, the majority presenting with Stage 3 or 4 cancer, experienced a 43-fold improvement in quality of life with minimal side effects, as compared to standard of care chemotherapy and palliative care. This revolutionary success is attributed to Envita’s personalized therapeutic algorithms, which incorporate customized immunotherapy. Envita’s precision care approach has also achieved a 100% better response rate compared to over 65 global chemotherapy clinical trials with more than 2700 patients. The results from this study suggest that a wider utilization of Envita’s personalized approach can significantly benefit patients with late-stage and refractory cancer.

Multidisciplinary Approach to Breast Cancer:A New Outlook on Nursing Care

The treatment and general care for womendiagnosed with breast cancer has made a tremendous change andadvance in the last decades. Better methods for early detectionand screening of the disease, higher compliance of women to gofor screening, an open social and political discourse of women andthe health care team and others, are just a few that both enabledand are a result of this change. Nurses have been highly involvedin these changes, which resulted in the specialization of nursingin the field of breast cancer. This article will focus on the mainfour points that influence the nursing specialist care, that is, thetailoring of treatment and the ability to offer women treatmentwhich is more specific to their own cancer; the importance of themultidisciplinary team as providing a State of the Art care; theinvolvement of women in the decision-making regarding theirtreatment and the specific developing role of the specialist breastcare nurse.

The genetics and biology of KRAS in lung cancer

Mutational activation of KRAS is a common oncogenic event in lung cancer and other epithelial cancer types.Efforts to develop therapies that counteract the oncogenic effects of mutant KRAS have been largely unsuccessful,and cancers driven by mutant KRAS remain among the most refractory to available treatments.Studies undertaken over the past decades have produced a wealth of information regarding the clinical relevance of KRAS mutations in lung cancer.Mutant Kras-driven mouse models of cancer,together with cellular and molecular studies,have provided a deeper appreciation for the complex functions of KRAS in tumorigenesis.However,a much more thorough understanding of these complexities is needed before clinically effective therapies targeting mutant KRAS-driven cancers can be achieved.

Performance of risk stratification systems for gastrointestinal stromal tumors: A multicenter study

BACKGROUND Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal tumor type in the gastrointestinal system. Presently, various classification systems to prognosticate GISTs have been proposed.AIM To evaluate the application value of four different risk stratification systems for GISTs.METHODS Patients who were diagnosed with GISTs and underwent surgical resection at four hospitals from 1998 to 2015 were identified from a database. Risk of recurrence was stratified by the modified National Institute of Health(NIH)criteria, the Armed Forces Institute of Pathology(AFIP) criteria, the Memorial Sloan Kettering Cancer Center(MSKCC) prognostic nomogram, and the contour maps. Receiver operating characteristic(ROC) curves were established to compare the four abovementioned risk stratification systems based on the area under the curve(AUC).RESULTS A total of 1303 patients were included in the study. The mean age of the patients was 55.77 ± 13.70 yr; 52.3% of the patients were male. The mean follow-up period was 64.91 ± 35.79 mo. Approximately 67.0% the tumors were located in the stomach, and 59.5% were smaller than 5 cm; 67.3% of the patients had a mitotic count ≤ 5/50 high-power fields(HPFs). Thirty-four tumors ruptured before and during surgery. Univariate analysis demonstrated that tumor size > 5 cm(P <0.05), mitotic count > 5/50 HPFs(P < 0.05), non-gastric location(P < 0.05), and tumor rupture(P < 0.05) were significantly associated with increased recurrence rates. According to the ROC curve, the AFIP criteria showed the largest AUC(0.754).CONCLUSION According to our data, the AFIP criteria were associated with a larger AUC than the NIH modified criteria, the MSKCC nomogram, and the contour maps, which might indicate that the AFIP criteria have better accuracy to support therapeutic decision-making for patients with GISTs.

Clinical Communication, Cancer Patients &Considerations to Minimize the Challenges

Clinical communication is a multidimensional concept, which encompasses the core of effective clinical practice. Communication in cancer patients is particularly challenging and yet a less focused area in cancer care. Various barriers and challenges in communication may affect the management protocol of cancer patients. Challenges may arise in various dimensions of cancer care including breaking bad news to delivery of complex clinical information, determination of appropriate treatment strategies, dealing with uncertainties, end of life counseling as well as cultural and language barriers affecting the whole communication dynamics. Effective communication is the basic foundation for responsive treatment decisions, positive health outcome, patient driven compliance and overall high quality of care. Thus, there is a need for acknowledging and actively deciphering the challenges and developing and promoting various protocols of effective communication skills in cancer patients.

重离子医学中心建设工程造价控制的要点分析

重离子医学中心的建设和重离子治疗系统装置的购置费用较为高昂,如何在确保工程质量和效率的前提下,做好重离子医学中心的基本建设和成本管理,科学、合理、有效地控制建设工程造价,成为每一位医院基本建设管理者需要思考的问题。本文以医院建设者的视角,介绍了重离子医学中心建设工程中造价控制的难点,对做好造价控制的关键要素进行分析并提出了建议,可以为其他重离子医学中心建设项目的工程造价控制提供参考。

乳腺癌患者自我倡权体验的质性研究

目的 深入了解乳腺癌患者自我倡权的真实体验。方法 采用现象学研究方法,对20名乳腺癌患者进行半结构式访谈,并采用Colaizzi 7步分析法分析资料。结果 提炼出4个主题和11个亚主题:自我倡权意识薄弱(症状报告不主动和过度依赖医生)、自我倡权积极性受多种因素影响(存在逃避心态、信心不足、病耻感严重和害怕破坏医患关系)、自我倡权过程中面临诸多挑战(医护态度欠缺、家庭成员不支持和害怕增加经济负担)及自我倡权积极体验(增强战胜疾病的信心和提高疾病应对能力)。结论 乳腺癌患者自我倡权意识薄弱、积极性较差,在自我倡权过程中面临各种挑战,部分患者积极体验自我倡权。医务人员应多关注自我倡权意识薄弱和积极性较差的乳腺癌患者,给予其更多的帮助和鼓励,同时也应树立“以病人为中心”的服务理念,营造良好氛围促进患者自我倡权。

以家庭为中心的照护在癌症患者中的研究现状

本文介绍了以家庭为中心的照护在癌症患者中的研究现状,包括以家庭为中心的照护的定义、照护内容、应用的重要意义,以家庭为中心的预立医疗计划、不同人群之间的沟通模式(患者与医护人员的沟通、患者与家庭成员之间的沟通、多学科协作成员参加的沟通)等方面进行了综述,介绍了三种有效的干预措施(症状管理、患者赋权和信息支持),并提出以家庭为中心的照护模式对临床实践的启示,为后期在癌症患者中开展以家庭为中心的照护提供参考。

国家肿瘤区域医疗中心高质量建设的发展研究

目的评价国家肿瘤区域医疗中心阶段性建设成效,挖掘并分析关键问题,为推进国家肿瘤区域医疗中心高质量建设提供建议。方法在国家肿瘤区域医疗中心开展实地调研,对输出医院、依托医院的635名医务人员进行问卷调查,组织科室研讨并征集访谈意见19份,运用描述性分析、卡方检验进行统计分析。结果医务人员对建设工作的了解程度较高、参与程度相对较低但建设意愿强烈,人力资源不足与依托医院基础相对薄弱是医务人员及科室落实建设任务面临的主要挑战。结论国家肿瘤区域医疗中心建设取得一定成效。为推动中心高质量建设,输出医院应坚持“国考”导向,加强人才队伍培养,加大宣传动员力度;依托医院应激发人才队伍活力,强化建设支撑力度,深化多元共治的配套机制。

家庭赋权模式对癌症患者干预效果的Meta分析

目的系统评价家庭赋权模式(Family-Centered Empowerment Model,FCEM)在癌症患者中的应用效果。方法计算机检索从建库至2023年11月15日在中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library中收录的关于FCEM对癌症患者干预效果的随机对照试验。两位研究者独立进行文献筛选、资料提取和质量评价后,使用RevMan5.4软件进行Meta分析。结果共纳入10篇文献,974例癌症患者。Meta分析结果显示,FCEM可以改善癌症患者的生活质量[SMD=2.04,95%CI(1.22,2.87),P<0.00001]、增强心理韧性[SMD=2.77,95%CI(0.41,5.12),P=0.02]和患者出院准备度[MD=5.30,95%CI(2.61,7.99),P=0.0001],同时,有利于提高主要照顾者准备度[MD=5.30,95%CI(2.61,7.99),P=0.0001]及照顾能力[MD=-9.07,95%CI(-15.95,-2.19),P=0.01]。结论现有证据表明,与常规护理相比,FCEM对癌症患者的生活质量、心理韧性、出院准备度及主要照顾者准备度、照顾能力具有积极意义。

食管癌调强放疗计划中心与靶区中心位置偏差的研究

目的探索放疗计划设计时,当食管癌定位中心与靶区中心位置偏差在X(左右方向)、Y(头脚方向)、Z(上下方向)三维方向小于±15 mm时,计划中心的改变情况对放疗计划质量的影响。方法选取在商洛市中心医院接受食管癌放射治疗的40例患者为研究对象。首先以计划靶区(Planning Target Volume,PTV)中心为计划中心设计放疗计划,待计划优化完成后,将靶区中心沿X、Y、Z三个方向分别平移±5、±10、±15 mm,并以此点为计划中心,重新设计放疗计划,统计剂量学参数,评价计划的可行性。结果靶区、危及器官、计划执行效率指标差异均无统计学意义(P>0.05)。与计划中心在PTV中心组相比,其他组PTV最大剂量(D_(max))、最小剂量、平均剂量(D_(mean))、均匀性指数、适形度指数的变化范围(百分比)为:-0.15%~0.12%、-0.05%~0.05%、-0.07%~0.09%、-0.09%~0.28%、-0.36%~0.48%;肺V5(器官受到500 cGy剂量的体积百分比,其他以此类推)、V_(10)、V_(20)、V_(30)、D_(mean)最大偏差分别为0.68%、0.29%、0.40%、-0.14%、7.75 cGy;心脏V_(10)、V_(20)、V_(30)、V_(40)、D_(mean)最大偏差分别为0.66%、-0.30%、-0.47%、0.54%、-14.08 cGy;脊髓D_(max)最大偏差为28.98 cGy;机器跳数、计划执行时间、计划优化时间最大偏差分别为-34.01 MU、5.33 s、-6.09 s。结论当定位中心和靶区中心在X、Y、Z三个方向的位移小于±15 mm时,可以直接将定位中心作为计划中心进行放疗计划的设计,以便减少患者的复位时间和复位时的二次摆位误差。

系统论视域下肺癌诊疗中心运行模式设计与实践

肺癌诊疗中心是多学科协作融合的系统工程,运用系统论来研究肺癌诊疗中心具有一定适用性。本文基于系统论,从整体、层次、开放、动态、目的五个特点对建立肺癌诊疗中心进行理论分析,设计系统模型并提出“一二三四五”运行模式,通过创新实践将建设研究型MDT的肺癌诊疗中心融入到肿瘤综合防治工作中。

以家庭为中心的预立医疗照护计划在癌症患者中的研究进展

国家相关政策显示,以家庭为中心的预立医疗照护计划已成为社会关注热点,是目前中国重点发展的医学领域之一。阐述以家庭为中心的预立医疗照护计划在癌症患者中开展的必要性、应用效果,分析其发展阻力,并提出相应的对策及建议,旨在加快中国以家庭为中心的预立医疗照护计划的规范化建设,推动中国安宁疗护的进一步发展。

以家庭为中心的护理模式对肺癌首次化疗患者的影响研究

目的通过调查肺癌初次接受化疗的患者,探究家庭为中心的护理模式对其心理状态、生活质量及对医疗照护满意度的影响,以便为日后临床制定护理方案提供参考。方法选取2022年1月至2023年1月期间在洛阳伊洛医院收入的62例肺癌首次化疗患者进行回顾性分析,根据不同护理模式分为对照组与观察组,各31例。对照组接受常规护理,观察组接受以家庭为中心的护理模式,对两组患者心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)、压力知觉量表(CPSS)]、生活质量[生活质量测定量表(QLQ-C30)]、医疗照护满意度[使用癌症照护满意度量表(SCA)评估]进行组间比较。结果两组患者护理后心理状态评分均低于护理前,且生活质量各项评分均高于护理前,差异有统计学意义(P<0.05);观察组患者护理后SAS、SDS、CPSS评分均低于对照组,且观察组患者护理后生活质量、SCA评分均高于对照组,差异有统计学意义(P<0.05)。结论通过以家庭为中心的护理模式,对初次接受肺癌化疗的患者进行护理,可以有效改善患者负面心理状态,提升生活质量和对医疗照护的满意度,具有良好的临床应用前景。

人本位护理应用于宫颈癌患者围手术期的护理效果研讨

目的探讨围手术期宫颈癌护理中人本位护理的作用。方法选取78例行手术治疗的宫颈癌患者,根据随机数字表法分为对照组与观察组,每组39例。观察组采用人本位护理,对照组采用常规护理,比较两组心理状态、依从性。结果干预前两组抑郁-焦虑-压力量表(DASS-21)评分比较,差异无统计学意义(P>0.05);观察组干预后DASS-21评分明显低于对照组(P<0.05)。观察组依从性(100%)明显高于对照组(89.74%)(P<0.05)。结论宫颈癌围手术期应用人本位护理具有积极意义,可缓解患者不良心态,增强患者依从性,值得临床推广。

以家庭为中心的护理干预在肺癌化疗患者护理中的应用价值

目的探讨以家庭为中心的护理干预方法在肺癌化疗患者护理中的应用价值。方法回顾性选取2020年1月—2022年12月菏泽医学专科学校附属医院收治的72例肺癌化疗患者的临床资料,根据不同护理方式分为两组。对照组(36例)实施常规护理,观察组(36例)实施以家庭为中心的护理干预。比较两组护理满意度和生活质量评分。结果观察组护理满意度(97.22%)明显高于对照组(80.56%),差异有统计学意义(χ^(2)=5.063,P<0.05)。护理后,两组认知功能、躯体功能、社会功能、情绪功能评分均升高,且观察组高于对照组,差异有统计学意义(P均<0.05)。结论以家庭为中心的护理干预方法在肺癌化疗患者护理中有较高的应用价值。