原发性乳腺癌:化疗前和化疗期间固有磁敏感加权成像与组织学相关性研究

目的探讨原发性乳腺癌固有磁敏感加权(ISW)成像与MR动态成像和组织学表现的相关性,并评价化疗前基线横向弛豫率(R2*)、T2*弛豫变化(ΔR2*)与新辅助化疗(NAC)

The role of radiotherapy in metastatic bladder cancer

The management of metastatic bladder cancer is palliative.Best outcomes are achieved in those who are fit enough for systemic therapies.The place of radiotherapy in these patients is mainly for symptom control,in particular haematuria.However,a small proportion,especially those with oligometastases,will benefit from more radical treatment.In this review,we look at the evidence currently available for radiotherapy in this setting.

Single tertiary cancer center experience on the management of pT3b prostate cancer after robotic-assisted laparoscopic prostatectomy

Background:Pathological involvement of the seminal vesicle poses a treatment dilemma following robotic prostatectomy.Margin status plays an important role in deciding further management.A wide range of treatment options are available,including active monitoring,adjuvant radiotherapy,salvage radiotherapy,and occasionally androgen deprivation therapy.Patients undergoing postoperative radiotherapy tend to have higher risk of urinary and bowel morbidities.The recent RADICALS-RT concluded that adjuvant radiotherapy did not have any benefit compared with salvage radiotherapy.We aim to audit the incidence,margin status,and management of T3b cancer cases at our center.Materials and methods:A retrospective analysis was conducted of all patients diagnosed with pathological T3b(pT3b)prostate cancer following robotic-assisted laparoscopic prostatectomy from January 2012 to July 2020.Preoperative parameters analyzed included prostate-specific antigen(PSA),T stage,and age.A chi-square test and 2-tailed t test were used to determine the relationship between categorical and continuous variables,respectively.Kaplan-Meier survival curves were generated to assess overall survival in patients with pT3b prostate cancer and used to compare unadjusted progression-free survival among those who underwent adjuvant and salvage radiotherapy.Results:A total of 83(5%)of 1665 patients who underwent robotic prostatectomy were diagnosed with pT3b prostate cancer between January 2012 and July 2020.Among these,36 patients(44%)did not receive any radiotherapy during follow-up,compared with 26 patients(31%)who received adjuvant radiotherapy and 21(25%)who received salvage radiotherapy.The median age of our cohort was 64(SD,6.4)years.Mean PSA at presentation was 12.7 pg/L.Positive margins were seen in 36 patients(43%);however,there was no statistically significant difference between treatment groups(p=0.49).The median overall survival was 96%.There was no significant difference between the adjuvant and salvage groups in terms of biochemical progression-free survival(p=0.66).Five-year biochemical progression-free survival was 94%for those in the adjuvant radiotherapy group and 97%for those in the salvage radiotherapy group.Conclusions:Our audit corroborates with the recently concluded RADICALS-RT study,although we had fewer patients with positive margins.Radiotherapy can be avoided in patients with T3b prostate cancer,even if margin is positive,until there is definitive evidence of PSA recurrence.In keeping with the conclusion of RADICALS-RT,salvage radiotherapy may be preferable to adjuvant radiotherapy.

癌症多学科团队工作：证据是什么？

癌症治疗越来越多地由多学科团队完成。Cath Taylor及其同事认为，需要更有力的证据证实其有效性。

胃食管癌的评估与管理：NICE指南概要

在英国，胃食管癌是第四位癌症致死原因。每年有16000例新发病例，其发病率亦呈上升趋势。患者往往经过一系列的复杂检查后接受各种短期、长期疗效不一的治疗，这自始至终都需要不间断的支持和帮助。胃食管癌的根治性治疗一般在专家中心进行，这里有一系列领域的专家，但患者也需要来自初级医疗机构的建议和支持。仅能接受缓和医疗的患者也将从不同专家的支持中获益，如癌症治疗营养师、缓和医疗专家等。