Head and neck squamous cell cancer(HNSCC) is the sixth most common cancer in the world. Effective therapeutic modalities such as surgery, radiation, chemotherapy and combinations of each are used in the management of ...Head and neck squamous cell cancer(HNSCC) is the sixth most common cancer in the world. Effective therapeutic modalities such as surgery, radiation, chemotherapy and combinations of each are used in the management of the disease. In most cases, treatment fails to obtain total cancer cure. In recent years, it appears that one of the key determinants of treatment failure may be the presence of cancer stem cells(CSCs) that escape currently available therapies. CSCs form a small portion of the total tumor burden but may play a disproportionately important role in determining outcomes. CSCs have stem features such as self-renewal, high migration capacity, drug resistance, high proliferation abilities. A large body of evidence points to the fact that CSCs are particularly resistant to radiotherapy and chemotherapy. In HNSCC, CSCs have been increasingly shown to have an integral role in tumor initiation, disease progression, metastasis and treatment resistance. In the light of such observations, the present review summarizes biological characteristics of CSCs in HNSCC, outlines targeted strategies for the successful eradication of CSCs in HNSCC including targeting the self-renewal controlling pathways, blocking epithelial mesenchymal transition, niche targeting, immunotherapy approaches and highlights the need to better understand CSCs biology for new treatments modalities.展开更多
目的检索并总结食管癌术后患者早期经口进食管理的最佳证据。方法按照循证“6S”检索证据模型,检索UpToDate、BMJ Best Practice、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、英国国家卫生与临床优化研究所、中国知网、万方...目的检索并总结食管癌术后患者早期经口进食管理的最佳证据。方法按照循证“6S”检索证据模型,检索UpToDate、BMJ Best Practice、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、英国国家卫生与临床优化研究所、中国知网、万方数据库、中国生物医学文献数据库等数据库及相关网站中有关食管癌术后患者早期经口进食的所有证据,包括临床决策、指南、系统评价、Meta分析、专家共识、证据总结及随机对照试验。检索时限为建库至2022年5月。由2名接受过循证护理系统培训的研究者独立完成文献质量评价,并结合专业人员判断,对符合质量标准的证据进行提取和汇总。结果最终纳入14篇文献,包括临床决策2篇、指南4篇、专家共识3篇、系统评价1篇、随机对照试验4篇。从早期经口进食时机选择、吞咽功能评估、进食方案制订、风险识别及预防4个方面汇总24条最佳证据。结论食管癌术后患者早期经口进食安全可行。护理人员应结合临床情景、应用证据的促进因素和阻碍因素、患者意愿选择最佳证据,为临床提供科学、有循证依据的食管癌术后患者早期经口进食管理方案,从而加速患者术后康复,减少并发症,缩短住院时间。展开更多
文摘Head and neck squamous cell cancer(HNSCC) is the sixth most common cancer in the world. Effective therapeutic modalities such as surgery, radiation, chemotherapy and combinations of each are used in the management of the disease. In most cases, treatment fails to obtain total cancer cure. In recent years, it appears that one of the key determinants of treatment failure may be the presence of cancer stem cells(CSCs) that escape currently available therapies. CSCs form a small portion of the total tumor burden but may play a disproportionately important role in determining outcomes. CSCs have stem features such as self-renewal, high migration capacity, drug resistance, high proliferation abilities. A large body of evidence points to the fact that CSCs are particularly resistant to radiotherapy and chemotherapy. In HNSCC, CSCs have been increasingly shown to have an integral role in tumor initiation, disease progression, metastasis and treatment resistance. In the light of such observations, the present review summarizes biological characteristics of CSCs in HNSCC, outlines targeted strategies for the successful eradication of CSCs in HNSCC including targeting the self-renewal controlling pathways, blocking epithelial mesenchymal transition, niche targeting, immunotherapy approaches and highlights the need to better understand CSCs biology for new treatments modalities.
文摘目的检索并总结食管癌术后患者早期经口进食管理的最佳证据。方法按照循证“6S”检索证据模型,检索UpToDate、BMJ Best Practice、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、英国国家卫生与临床优化研究所、中国知网、万方数据库、中国生物医学文献数据库等数据库及相关网站中有关食管癌术后患者早期经口进食的所有证据,包括临床决策、指南、系统评价、Meta分析、专家共识、证据总结及随机对照试验。检索时限为建库至2022年5月。由2名接受过循证护理系统培训的研究者独立完成文献质量评价,并结合专业人员判断,对符合质量标准的证据进行提取和汇总。结果最终纳入14篇文献,包括临床决策2篇、指南4篇、专家共识3篇、系统评价1篇、随机对照试验4篇。从早期经口进食时机选择、吞咽功能评估、进食方案制订、风险识别及预防4个方面汇总24条最佳证据。结论食管癌术后患者早期经口进食安全可行。护理人员应结合临床情景、应用证据的促进因素和阻碍因素、患者意愿选择最佳证据,为临床提供科学、有循证依据的食管癌术后患者早期经口进食管理方案,从而加速患者术后康复,减少并发症,缩短住院时间。
