Current status and prospects of transarterial chemoembolization and its combined regimens in the treatment of hepatocellular carcinoma / 临床肝胆病杂志

Transarterial chemoembolization （TACE） is currently the primary treatment method for advanced liver cancer. This article elaborates on the current status of application of TACE in hepatocellular carcinoma from the aspects of existing techniques， patient selection， and efficacy assessment and summarizes the research advances and prospects of TACE combined with local treatment and systemic therapy， so as to provide new ideas for clinical practice and experimental studies.

Progress of diagnosis and treatment for gastrointestinal neuroendocrine neoplasms / 肿瘤研究与临床

Gastrointestinal neuroendocrine neoplasm (GI-NEN) is an important part of digestive system tumor. With the progress of diagnosis and the further understanding of GI-NEN, the diagnostic rate is increasing. However, GI-NEN is a rare tumor, thus clinicians are not familiar with the diagnosis and treatment. Misdiagnosis and missed diagnosis of GI-NEN often occur, and the treatment regimen is not standardized. In recent years, some progresses of the diagnosis and treatment have been made in GI-NEN, especially in the aspects of pathology, imaging diagnosis, radionuclide therapy, targeted therapy and immunotherapy, which have improved the diagnosis rate and efficacy for GI-NEN. This paper reviews recent literatures of GI-NEN, summarizes its epidemiology, pathological diagnosis, image diagnosis, surgery, targeted therapy, radionuclide therapy, chemotherapy, immunotherapy, and separates GI-NEN into metastatic and non-metastatic groups for detailed review to provide a reference for guiding clinical diagnosis and treatment as well as exploring the new treatment regimens of GI-NEN.

Function of Polo-like kinase 1 and its research progress in tumor therapy / 国际外科学杂志

Protein kinases are key regulators of cellular function and constitute one of the largest and participate in orch estrating the vast majority of cellular activities, forming a criss-cross regulatong network. Kinases, which play a key role in regulating the activity of cellular proteins, are prime targets for anticancer drugs because their abnormal forms can promote the proliferation of tumor cells. Polo-like kinase-1 (Plk-1) is a member of the polo-like family of serine/threonine (Ser/Thr) kinases, which is involved in many aspects of the mitotic process that regulates cell proliferation, which is one of the key kinases of cell mitosis, whose overexpression is closely related to the occurrence and development of many human cancers. Drug development targeting Plk-1 may be one of the promising directions for the treatment of cancer. This review will summarize the structural features of Plk-1 and the cellular processes involved, as well as the rationale for anti-tumor therapy against Plk-1, the latest progress in inhibitor development and the latest strategies.

Treatment progress of relapsed/refractory peripheral T-cell lymphoma / 白血病·淋巴瘤

Peripheral T-cell lymphoma (PTCL) is a group of heterogeneous diseases originating from retrothymic T lymphocytes or mature natural killer (NK) cells. With the innovation of medical technology, the prognosis of patients with PTCL has been greatly improved. However, there are still some patients who are refractory or relapsed after treatment and have poor prognosis. In recent years, the applications of second-line chemotherapy regimen, hematopoietic stem cell transplantation and several new drugs (histone deacetylase inhibitors, dihydrofolate reductase inhibitors, aurora A kinase inhibitors, phosphatidylinositol 3-kinase inhibitors, targeted therapy, etc.) have played an important role in the treatment of relapsed/refractory PTCL patients. Meanwhile, the choice of transplantation programs and the combination of new drug-based schemes have also become research hotspots.

Neoadjuvant therapy for hepatocellular carcinoma / 国际外科学杂志

Hepatocellular carcinoma (HCC) is a malignant tumor with high incidence rate and mortality in the world. Surgical resection is the main radical method. However, the high recurrence rate leads to poor prognosis. Neoadjuvant therapy refers to anti-tumor therapy for resectable HCC before surgery to reduce tumor load and postoperative recurrence. Although more and more studies show that neoadjuvant therapy can bring survival benefits to patients with liver cancer. However, the indication, applicable population, treatment mode, treatment cycle and safety of new adjuvant therapy are still controversial. In this review, we will review the above issues, as well as the clinical application and research progress of neoadjuvant in hepatocellular carcinoma.

Quimioterapia metronômica em tumores sólidos: dos conceitos à prática clínica - uma revisão narrativa / Metronomic chemotherapy in solid tumor: practice clinical and concepts ­ narrative review

O tratamento metronômico consiste na administração regular e contínua de quimioterápicos em baixa dose, preferivelmente via oral, sem pausas prolongadas, com objetivo de bloquear a proliferação tumoral. Este tratamento tem sido utilizado para uma série de tumores e nos últimos anos notou-se aumento da utilização em estudos clínicos, principalmente no cenário paliativo. Objetivo: Realizar uma revisão narrativa acerca do tema quimioterapia metronômica em tumores sólidos, nos seus aspectos de definição, racional biológico, indicação clínica, marcadores preditivos e prognósticos. Metodologia: Foi realizada uma pesquisa na base de dados PUBMED, maior base de dados de conteúdo médico, onde foram encontrados 575 artigos, dos quais 46 artigos se adequavam aos critérios de seleção (artigos em inglês publicados no período compreendido entre 2015 a 2020), dentre eles 32 artigos de revisão, 1 metanálise, 2 retrospectivos, 9 prospectivos e 2 descritivos. E, após análise pormenorizada, 529 artigos foram excluídos devido aos critérios de exclusão: artigos em outras línguas que não inglês e a utilização apenas de anticorpo, imunoterapia ou terapia alvo molecular sem quimioterapia associados. Resultados: A partir da análise dos 46 artigos, foram encontrados descrições acerca dos aspectos conceituais, teorias metronômicas, efeito angiogênico, imunológico e quiescência tumoral, efeito 4 "D" e indicação clínica, avaliação de eficácia, segurança, marcadores, precisão e custo efetividade. Conclusão: Verificou-se que evidências clínicas e pré-clínicas suportam o uso de quimioterapia metronômica como uma alternativa ao tratamento oncológico padrão em cenário de acesso restrito a novas drogas, tais como: terapia alvo ou imunoterapia, sendo a principal característica sua baixa toxicidade, acessibilidade, disponibilidade de drogas para administração oral e alta atividade anti-angiogênica, além de outros efeitos diretos e indiretos, os quais se traduzem em benefício clínico

Metronomic treatment consists of regular and continuous administration of low-dose chemotherapy, preferably orally, without prolonged pauses, with the aim of blocking tumor proliferation. This treatment has been used for a number of tumors and, in recent years, there has been an increase in its use in clinical studies, especially in the palliative setting. Objective: To carry out a narrative review on the topic metronomic chemotherapy in solid tumors, in its aspects of definition, biological rationale, clinical indication, predictive and prognostic markers. Methodology: A search was carried out in the PUBMED database, the largest database of medical content, where 575 articles were found, of which 46 articles fit the selection criteria (articles in English published between 2015 and 2020), among them 32 review articles, 1 meta-analysis, 2 retrospective, 9 prospective and 2 descriptive. And, after a detailed analysis, 529 articles were excluded, due to the exclusion criteria: articles in languages other than English and the use of antibody alone, immunotherapy or molecular targeted therapy without associated chemotherapy. Results: From the analysis of the 46 articles, descriptions were found about the conceptual aspects, metronomic theories, angiogenic, immunological and tumor quiescence effects, 4 "D" effect and clinical indication, evaluation of efficacy, safety, markers, precision and cost effectiveness . Conclusion: It was found that clinical and preclinical evidence support the use of metronomic chemotherapy as an alternative to standard cancer treatment in a scenario of restricted access to new drugs, such as targeted therapy or immunotherapy, the main feature being its low toxicity, accessibility, availability of drugs for oral administration and high anti-angiogenic activity, in addition to other direct and indirect effects, which translate into clinical benefit

Pay attention to the correct diagnosis and rational treatment of ciliary body tumors / 中华眼底病杂志

Ciliary body tumor is a rare intraocular tumor. Due to its unique anatomical location, its correct diagnosis and reasonable treatment are very difficult problems. In terms of diagnosis and differential diagnosis, ophthalmologists need to fully utilize the role of slit lamp microscope and transillumination experiment to capture secondary changes in the anterior segment caused by hidden ciliary body tumors, such as monocular localized cataract, lens indentation, and pigment dissemination, etc. Ophthalmological imaging methods, especially ultrasound biomicroscopy, can achieve the purpose of early detection and early diagnosis. According to the size, location and morphological characteristics of the tumor, a reasonable treatment plan is formulated. Since ciliary body tumors are mostly benign, the recurrence rate of local resection is low, which can satisfy the pathological diagnosis and preserve part of the patient's vision. Therefore, eye-preserving treatment should be advocated. However, enucleation remains the treatment of choice for tumors that are too large to be treated with local excision or radiation, eyes with refractory glaucoma, and tumors that do not respond to radiation therapy.

Clinical diagnosis and treatment progress of duodenal neuroendocrine neoplasms / 肿瘤研究与临床

Duodenal neuroendocrine neoplasms (D-NEN) is a kind of heterogeneous tumor originated from neuroendocrine cells. With the continuous progress of diagnostic technology, more and more examination methods and treatment methods are applied. This article reviews the characteristics, classification, imaging applications, biochemical markers' monitoring and treatment of D-NEN.

Toxicidades orales de la terapia contra el cáncer en niños y adolescentes: un estudio descriptivo / Toxicidades orais da terapia oncológica em crianças e adolescentes: um estudo descritivo / Oral toxicities of oncology therapy in children and adolescents: a descriptive study

Resumen Introducción y objetivo: El cáncer es la segunda causa de muerte entre niños y adolescentes en Brasil. Evaluar la prevalencia de toxicidades orales derivadas del tratamiento oncológico en niños y adolescentes atendidos en el Hospital Estadual da Criança, de 2016 a 2017. Materiales y métodos: Se trata de un estudio descriptivo con datos obtenidos de historias clínicas. Se estudiaron variables relacionadas con la neoplasia, el portador, las toxicidades orales y el tratamiento oncológico, las cuales fueron analizadas de forma descriptiva y se realizó la prueba de la χ2 de Fisher para algunas de ellas. Resultados: Se identificaron 58 pacientes, en su mayoría mujeres (53%) y con edades entre 3 y 5 años (28%), con una media de 6,62 años. La neoplasia más común fue la leucemia linfoide aguda (38%), siendo la quimioterapia sola, la modalidad terapéutica más utilizada (67%), especialmente con el uso de citarabina (60%) y vincristina (56%). Veintitrés (40%) de los niños y adolescentes presentaron alguna toxicidad oral durante la terapia oncológica, por lo que a 4 (17,4%) se les interrumpió el tratamiento antineoplásico. La mucositis oral (70%) fue la toxicidad más común, afectando los labios en el 55% y fue asociada a dolor en el 64% de los casos. Dieciocho (78,2%) pacientes recibieron tratamiento por toxicidad oral, prescribiéndose nistatina en el 88,9% de los casos. Además, hubo una asociación significativa entre el estado de supervivencia y el lugar de residencia (p=0,03). Conclusiones: Entre los 58 niños y adolescentes estudiados, el 40% presentó toxicidades orales y 4 tuvieron interrumpido el tratamiento antineoplásico por este motivo. Así, se refuerza la importancia y la necesidad de la actuación del odontólogo en el equipo multidisciplinario en oncología.

Abstract Introduction and objective: Cancer is the second leading cause of death among children and adolescents in Brazil. To evaluate the prevalence of oral toxicities resulting from cancer treatment in children and adolescents treated at the Hospital Estadual da Criança, from 2016 to 2017. Material and methods: This is a descriptive study with data obtained from medical records. Variables related to neoplasia, carrier, oral toxicities and cancer treatment were studied, which were analyzed descriptively and thFisher χ2 test was performed for some of them. Results: Fifty eigth patients were identified, mostly female (53%) and aged between 3 and 5 years (28%), with an average of 6.62 years. The most frequent neoplasm was acute lymphoid leukemia (38%), with chemotherapy alone being the most used therapeutic modality (67%), especially with the use of cytarabine (60%) and vincristine (56%). Twenty-three (40%) of the children and adolescents exhibited some oral toxicity during cancer therapy, and for this reason, 4 (17.4%) had their antineoplastic treatment interrupted. Oral mucositis (70%) was the most common toxicity, affecting the lips in 55% and being associated with pain in 64% of cases. Eighteen (78.2%) patients received treatment for oral toxicities, with nystatin being prescribed in 88.9% of cases. In addition, there was a significant association between survival status and place of residence (p=0.03). Conclusions: Among the 58 children and adolescents studied, 40% had oral toxicities and 4 had their antineoplastic treatment interrupted for this reason. Thus, the importance and the need for the performance of the dentist in the multidisciplinary team in oncology is reinforced.

Resumo Introdução e objetivo: O câncer é a segunda maior causa de morte entre crianças e adolescentes no Brasil. Avaliar a prevalência de toxicidades orais decorrentes do tratamento oncológico em crianças e adolescentes atendidos no Hospital Estadual da Criança, no período de 2016 a 2017. Materiais e métodos: Trata-se de um estudo descritivo com dados obtidos de prontuários médicos. Foram estudadas variáveis relacionadas à neoplasia, ao portador, às toxicidades orais e ao tratamento oncológico, que foram analisadas descritivamente e o teste χ2 de Fisher foi aplicado para algumas delas. Resultados: Foram identificados 58 pacientes, com maioria do sexo feminino (53%) e idade entre 3 e 5 anos (28%), com média de 6,62 anos. A neoplasia maligna mais frequente foi a leucemia linfóide aguda (38%), sendo a quimioterapia isolada a modalidade terapêutica mais empregada (67%), especialmente com uso de citarabina (60%) e vincristina (56%). Vinte e três (40%) das crianças e adolescentes exibiram alguma toxicidade oral durante a terapia oncológica, e por esta razão, 4 (17,4%) tiveram o tratamento antineoplásico interrompido. A mucosite oral (70%) foi a toxicidade mais comum, acometendo os lábios em 55% e estando associada a dor em 64% dos casos. Dezoito (78,2%) pacientes receberam tratamento para as toxicidades orais, sendo a nistatina prescrita em 88,9% dos casos. Ademais, observou-se associação significante entre status de sobrevida e local de residência (p=0.03). Conclusões: Dentre as 58 crianças e adolescentes estudadas, 40% apresentou toxicidades orais e 4 tiveram o tratamento antineoplásico interrompido por esta razão. Desta forma, reforça-se a importância e a necessidade da atuação do cirurgião-dentista na equipe multiprofissional em oncologia.

Risk stratified management of cervical adenocarcinoma in situ based on cone margin state / 中华妇产科杂志

Objective:To investigate the hierarchical management scheme of cervical adenocarcinoma in situ (AIS) based on cervical conization margin state.Methods:All medical records of 249 patients diagnosed as AIS by loop electrosurgical excision procedure (LEEP) conization from Jan. 2010 to Dec. 2015 in Obstetrics and Gynecology Hospital of Fudan University were retrospectively reviewed, to explore the relationship between the status of the resection margin and the residual lesion after LEEP, and the multivariate logistic regression method was used to analyze the related factors that affect the residual lesion after LEEP in cervical AIS patients.Results:(1) The age of 249 cervical AIS patients was (40±8) years old (range: 23-71 years old). Of the 249 patients, 19 (7.6%, 19/249) had residual lesions; 69 cases were pathologically diagnosed as AIS after LEEP, and the residual lesion rate was 13.0% (9/69), which was significantly higher than that of AIS + high-grade squamous intraepithelial lesion [5.6% (10/180); χ2=3.968, P=0.046]; 33 cases were multifocal lesions, the residual rate of lesions was 21.2% (7/33), which was significantly higher than that of single focal lesions patients [5.6% (12/216); χ2=7.858, P=0.005]; 181 patients underwent endocervical curettage (ECC) before surgery, the residual rate of lesions in ECC-positive patients was 14.0% (14/100) , significantly higher than that of ECC-negative patients [4.9% (4/81); χ2=4.103, P=0.043]. (2) Among 249 cases of AIS patients, the positive rate of resection margins after LEEP was 35.3% (88/249); the residual rate of lesions in patients with positive resection margins (14.8%, 13/88) was significantly higher than those with negative margins [3.8%(6/156); χ2=9.355, P=0.002]. The age of patients underwent total hysterectomy after LEEP was (43±7) years old, which was significantly higher than that of patients who did not undergo total hysterectomy [(37±8) years old; t=6.518, P<0.01].Among the patients underwent total hysterectomy after LEEP, 3 cases (2.0%, 3/152) had fertility requirements, while 38 cases (39.2%, 38/97) did not underwent total hysterectomy, the difference between the two groups was statistically significant ( χ2=59.579, P<0.01). Among the 152 patients who underwent total hysterectomy after LEEP, the residual rate of lesions was 11.8% (18/152); the residual rate of lesions in patients with positive resection margins was significantly higher than that of patients with negative resection margins [18.8% (12/64) vs 7.0% (6/86); χ2=4.861, P=0.028]. The median follow-up time of 97 patients who did not undergo total hysterectomy after LEEP was 32 months (range: 4-70 months). During the follow-up period, 3 cases of cervical AIS recurrence (3.1%, 3/97) and were followed by hysterectomy,no invasive adenocarcinoma were seen. (3) Multivariate logistic regression analysis showed that the positive resection margin ( OR=4.098, 95% CI: 1.235-13.595, P=0.021), multifocal lesions ( OR=5.464, 95% CI: 1.494-19.981, P=0.010) were independent risk factors that affected the residual lesions in patients with cervical AIS after LEEP. Conclusions:The cervical AIS patients after LEEP conization suggested be stratified by cone margin state as the first-line stratified index, age and fertility needs as the second-line stratified management index. The individualized management plan should be developed based on comprehensive assessment of high-risk factors of residual lesions.

Treatment options for colorectal cancer primary lesions with unresectable metastases at risk of acute abdomen / 国际肿瘤学杂志

For patients with metastatic colorectal cancer, it is still controversial whether the primary tumor needs surgery when the metastasis is unresectable. The effect of palliative surgical resection of the primary lesion on improving the prognosis and prolonging survival is still uncertain while the risks of acute abdomen trigger the discussion of early palliative surgical resection of the primary tumor. Evaluating and predicting the risk of acute abdomen complicated by colorectal cancer will help to choose the treatment of the primary lesion of unresectable metastatic colorectal cancer.

Use of audiovisual media to enhance patients' knowledge regarding the oral adverse effects of oncology treatment / Uso de mídia audiovisual para aprimorar o conhecimento dos pacientes sobre os efeitos adversos orais do tratamento oncológico

Objetivo: o presente estudo teve como objetivo avaliar a eficácia de alternativas didáticas, como a mídia audiovisual, na transmissão de informações sobre os efeitos adversos orais do tratamento oncológico em pacientes com câncer. Métodos: pacientes oncológicos foram divididos aleatoriamente em dois grupos: grupo controle (n = 40) e grupo audiovisual (n = 36). O grupo controle recebeu informações verbais sobre os efeitos colaterais orais do tratamento do câncer. Por outro lado, o grupo audiovisual recebeu a mesma informação verbal, juntamente com uma apresentação ilustrativa de mídia audiovisual. Além disso, foram aplicados questionários sobre o assunto antes e após a intervenção da equipe odontológica. Resultados: o presente estudo empregou o teste exato de Fisher para análise estatística, e os resultados mostraram similaridade estatística entre os dois grupos (P > 0,05). Ambas as abordagens educacionais alcançaram o objetivo pretendido. Conclusão: um diálogo bem conduzido pode criar uma compreensão adequada entre pacientes com câncer, melhorando a sua adaptação. Opcionalmente, o uso de técnicas inovadoras, como recursos audiovisuais, pode ser uma alternativa acessível e eficiente, que também pode ser usada na educação desses pacientes. Dessa forma, vídeos educacionais podem ser usados para melhorar a compreensão dos pacientes, a adesão a esquemas terapêuticos e a qualidade de vida, além de contribuir para um melhor prognóstico.(AU)

Objective: the present study aimed to evaluate the efficacy of didactic alternatives, namely the audiovisual media, in conveying information regarding the oral adverse effects of oncology treatment in cancer patients. Methods: cancer patients were randomly divided into two groups: control group (n = 40) and audiovisual group (n = 36). The control group received verbal information regarding the oral side effects of cancer treatment. Conversely, the audiovisual group received the same verbal information, along with an illustrative audiovisual media presentation. Additionally, questionnaires on the subject were administered before and after the intervention by the dental team. Results: the current study employed Fisher's exact test for statistical analysis, and the results showed statistical similarity between the two groups (P > 0.05). Both educational approaches achieved the intended objective. Conclusion: a well-conducted dialogue can create adequate awareness among cancer patients and improve adaptation. Optionally, the use of innovative techniques, such as audiovisual resources, was observed to be an accessible and efficient alternative that can also be used in patient education. Therefore, educational videos can be used to improve patients' understanding, adherence to therapeutic regimens, and quality of life and contribute to a better prognosis.(AU)

Disfunção sexual após tratamento para o câncer do colo do útero / Disfunción sexual después del tratamiento del cáncer cervical / Sexual dysfunction after cervical cancer treatment

RESUMO Objetivo Descrever as características sociodemográficas, clínicas e relacionadas à vida sexual e identificar a disfunção sexual em mulheres após o tratamento do câncer do colo do útero. Método Estudo transversal que incluiu mulheres com idade ≥18 anos e conclusão do tratamento de três meses. Foram utilizados dois instrumentos: formulário com informações sociodemográficas, clínicas e relacionadas à vida sexual; e o Índice da Função Sexual Feminina para avaliar a função sexual das participantes sexualmente ativas, sendo valores do escore ≤26 classificados como disfunção sexual. A estatística descritiva foi utilizada para verificar associações através do teste de Mann-Whitney e qui-quadrado de Pearson ou exato de Fisher. Resultados Do total de 46 mulheres, 15 (32,61%) mantiveram relações sexuais após o tratamento e oito tiveram indicativo de disfunção sexual (escore de 21,66; desvio padrão=7,06). Os tipos de tratamento (p=0,03) e de radioterapia (p=0,01), e o estadiamento da doença (p=0,02) interferiram na função sexual. Os domínios do Índice da Função Sexual Feminina mais afetados foram lubrificação (p=0,03) e dor (p=0,04). Conclusão A disfunção sexual esteve presente nas mulheres estudadas com impacto negativo na qualidade de vida.

RESUMEN Objetivo Describir las características sociodemográficas, clínicas y relacionadas con la vida sexual e identificar la disfunción sexual en mujeres después del tratamiento del cáncer cervical. Método Estudio transversal que incluyó mujeres de ≥18 años y la finalización del tratamiento de tres meses. Se utilizaron dos instrumentos: formulario con información sociodemográfica, clínica y relacionada con la vida sexual; y el Índice de Función Sexual Femenina para evaluar la función sexual de las participantes sexualmente activas, con valores de puntuación ≤26 clasificados como disfunción sexual. Se utilizó estadística descriptiva para verificar las asociaciones mediante la prueba de Mann-Whitney y la prueba de chi-cuadrado de Pearson o la prueba exacta de Fisher. Resultados De un total de 46 mujeres, 15 (32.61%) tuvieron relaciones sexuales después del tratamiento y ocho tuvieron una indicación de disfunción sexual (puntaje 21.66; desviación estándar=7.06). Los tipos de tratamiento (p=0.03) y radioterapia (p=0.01), además de la estadificación de la enfermedad (p=0.02), interfirieron con la función sexual. Los dominios del índice de función sexual femenina más afectados fueron la lubricación (p=0.03) y el dolor (p=0.04). Conclusión La disfunción sexual estuvo presente en las mujeres estudiadas, con un impacto negativo en la calidad de vida.

ABSTRACT Objective To describe the sociodemographic and clinical characteristics and those related to the sexual life, and to identify sexual dysfunction in women after cervical cancer treatment. Method Cross-sectional study including women aged ≥18 years and completion of the three-month treatment. Two instruments were used: form with sociodemographic, clinical and sexual life-related information; and the Female Sexual Function Index to assess the sexual function of sexually active participants, with score values ≤26 classified as sexual dysfunction. Descriptive statistics was used to check associations through the Mann-Whitney test and Pearson's chi-square test or Fisher's exact test. Results Out of a total of 46 women, 15 (32.61%) had sexual intercourse after treatment and eight had an indication of sexual dysfunction (score 21.66; standard deviation=7.06). The types of treatment (p=0.03) and of radiotherapy (p=0.01), in addition to the staging of the disease (p=0.02) interfered with the sexual function. The most affected domains of the Female Sexual Function Index were lubrication (p=0.03) and pain (p=0.04). Conclusion Sexual dysfunction was present in women studied and had a negative impact on quality of life.

Anticancer therapy mediated by glucose oxidase / 肿瘤

Glucose oxidase is a kind of endogenous oxidoreductase which exi sts wi del y i n organi sm. I n recent years, due to i ts i nherent biocompatibility, low toxicity and unique catalytic effect on betaD-glucose, glucose oxidase has attracted more and more attention in the field of biomedicine. Glucose oxidase can effectively catalyze the oxidation of glucose into gluconic acid and hydrogen peroxide. Researchers have developed various anticancer therapies based on gl ucose oxi dase usi ng t hi s cat al yt i c propert y: (1) gl ucose consumption provides alternative treatment strategies for cancer starvation; (2) oxygen consumption increases tumor hypoxia, which can be used for tumor hypoxia activation therapy; (3) the production of gluconic acid increases the acidity of tumor microenvironment, which can trigger the release of pH-responsive drugs; (4) the production of hydrogen peroxide increases the oxidative stress level of tumors. Hydrogen peroxide can be converted into toxic hydroxyl radicals by being exposed to light (such as near-infrared light) or fenton reaction, thus killing cancer cells. In addition, glucose oxidase can also be used in combination with other biological enzymes, hypoxia-activated prodrugs, photosensitizers or fenton reagents to produce the multi-mode synergistic anticancer therapies with starvation therapy as the main part, cooperating with hypoxia-activated therapy, oxidation therapy, photodynamic therapy and light therapy, etc. In this review, the glucose oxidase-mediated tumor monotherapy is firstly introduced, and the multi-mode synergistic anti-cancer therapy mediated by glucose oxidase as well as its specific anti-tumor mechanism are systematically elaborated.

Progress in nanodrug delivery system combined with photothermal therapy to treat multidrug resistance of tumor / 肿瘤

Multidrug resistance is one of the main causes of chemotherapy failure. In the past few decades, the development of nanotechnology has brought great hopes for the treatment of malignant tumors. Nanodrug delivery system effectively delivers the drug by endocytosis to avoid the drug being pumped out of the P-glycoprotein efflux pump, increasing the accumulation of the drug at the tumor site and reducing the toxicity of chemotherapeutic agents. Photothermal therapy uses the near-infrared laser for thermal ablation of tumors. The conversion of near-infrared light into high heat kills tumors, which is a new strategy for treating tumors. The use of nano-drug delivery system and photothermal therapy to overcome the multidrug resistance of tumors has incomparable advantages over traditional treatment. This paper reviewed the mechanism of multidrug resistance, the principle of reversal, the application of nano-drug delivery system and photothermal therapy in the reversal of multidrug resistance, the existing problems and prospects, in order to provide a new idea for reversing drug resistance.

Neutropenia febril asociada a quimioterapia en pacientes con neoplasias hematológicas de un centro de referencia en Colombia: características clínicas y desenlaces / Febrile neutropenia in patients with hematological malignancies at a reference center in Colombia

RESUMEN Objetivo: analizar las características epidemiológicas, clínicas y bacteriológicas que influyen en la supervivencia de los pacientes con neoplasias hematológicas que desarrollaron neutropenia febril posterior a quimioterapia. Materiales y métodos: estudio de corte transversal que incluyó adultos con diagnóstico de neoplasias hematológicas que presentaron neutropenia febril durante la hospitalización en 2014 en las sedes de Oncólogos de Occidente en Pereira, Manizales y Armenia (Colombia). Se realizaron análisis univariados y multivariados; la supervivencia se estableció según el método de Kaplan-Meier. Se estableció un valor de p <0.05. Se usó el software STATA. Se tuvo aval de bioética de la Universidad Tecnológica de Pereira. Resultados: se incluyó a 55 pacientes. La mediana de edad fue de 48 años (31-63), 27(49 %) fueron hombres. Los diagnósticos oncológicos más frecuentes fueron el linfoma no Ho-dgkin (29 %), leucemia mieloide aguda (24%) y leucemia linfoblástica aguda (20 %). La mayor letalidad se presentó en los días 21, 32 y 48. La mortalidad general fue del 9 % y la mortalidad por neutropenia profunda fue del 18 %. Conclusión: el número de neutropenias febriles, mayor tiempo de duración de la neutropenia febril, índice de Charlson y el antecedente de ingreso a UCI son factores de riesgo para mortalidad, mientras que el uso de piperacilina-tazobactam y el incremento en la puntuación del índice de MASCC son factores protectores.

ABSTRACT Objective: analyze the epidemiological, clinical and bacteriological characteristics that influence the survival of patients with haematological malignancies who developed febrile neutropenia after chemotherapy. Materials and methods: cross-sectional study of adult patients diagnosed with hema-tologic malignancies who presented febrile neutropenia during hospitalization in 2014 at Oncólogos de Occidente in Pereira, Manizales and Armenia (Colombia). Univariate and multivariate analyzes were performed. The survival analysis was established according to the Kaplan-Meier method. A value of p<0.05 was established for it. The STATA software was used. This study was endorsed by the bioethics committee of the Universidad Tecnológica de Pereira. Results: 55 patients were included. The median age was 48 years (31-63), 27 (49%) were men. The most frequent oncological diagnoses were non-Hodgkin's lymphoma (29 %), acute myeloid leukemia (24 %) and acute lymphoblastic leukemia (20 %). The highest lethality occurred on days 21, 32 and 48. Overall mortality was 9 %, mortality due to deep neutro-penia was 18 %. Conclusion: the number of febrile neutropenia, longer duration of febrile neutropenia, Charlson index and the history of admission to the ICU are risk factors for mortality, while the use of piperacillin-tazobactam and the increase in the score of the MASCC index are protective factors.

Recurrence of retroperitoneal localized perivascular epithelioid cell tumor two years after initial diagnosis: case report

ABSTRACT CONTEXT: Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors. Adjuvant radiotherapy and/or chemotherapy are administered according to the patient's clinical characteristics. CASE REPORT: A 42-year-old female patient was operated to treat a retroperitoneal mass. The diagnosis was established as PEComa with benign behavior. Two years after the diagnosis, chest and abdominal computed tomography scans showed intra-abdominal recurrence and lymphangioleiomyomatosis in the lung. Treatment with everolimus was started. The disease stabilized in the third month of treatment, according to the response evaluation criteria in solid tumors. CONCLUSION: PEComas are tumors with unpredictable behavior. Therefore, these patients require long-term follow-up, even in cases of correct diagnosis and benign PEComa.

Acompanhamento por telefone como intervenção de enfermagem a pacientes em quimioterapia ambulatorial: revisão integrativa / Seguimiento por teléfono como intervención de enfermería en pacientes en quimioterapia ambulatorial: revisión integrativa / Telephone follow-up as a nursing intervention for patients receiving outpatient chemotherapy: integrative review

Resumo OBJETIVO Conhecer a produção científica sobre o acompanhamento por telefone feito pelo enfermeiro junto a pacientes oncológicos em quimioterapia ambulatorial. MÉTODO Revisão integrativa de artigos disponíveis nas bases de dados LILACS e BDENF/BVS, MEDLINE/PubMed, CINAHL e Scopus utilizando os descritores: "Drug Therapy", "Antineoplastic protocols", "Antineoplastic agents", "Telemedicine", "Telenursing", "Telephone" e variações, nas bases CINAHL e Scopus, publicados nos últimos 5 anos. RESULTADOS Foram identificados 19 artigos com as seguintes temáticas: Gerenciamento e controle dos sintomas; Avaliação da qualidade de vida relacionada à saúde; Capacidade de autoeficácia; Apoio emocional, Estresse do Cuidador e Satisfação do paciente. CONCLUSÕES Estratégias e métodos de acompanhamento de pacientes em quimioterapia ambulatorial são viáveis e efetivos, sendo amplamente utilizados, principalmente nos Estados Unidos da América e na Ásia. O enfermeiro deve identificar métodos compatíveis e centrados no paciente de acordo com sua realidade institucional.

Resumen OBJETIVO Conocer la producción científica sobre el seguimiento por teléfono por el enfermero a pacientes oncológicos en tratamiento quimioterápico ambulatorial. MÉTODO Revisión integrativa de artículos diponibles en las bases de dados LILACS y BDENF/BVS, MEDLINE/PubMed, CINAHL y Scopus utilizando descriptores: "Drug Therapy", "Antineoplastic protocols", "Antineoplastic agents", "Telemedicine", "Telenursing", "Telephone" y variaciones em CINAHL y Scopus, publicado em los últimos 5 años. RESULTADOS Se identificaron 19 estudios analizados en temáticas: Gestión y control de los síntomas; Evaluación de la calidad de vida relacionada con la salud; Capacidad de Autoeficacia; Apoyo emocional, Estrés del cuidador y Satisfacción del paciente. CONCLUSIONES Estrategias y métodos de seguimiento de pacientes en quimioterapia ambulatorial son viables y efectivos, siendo ampliamente utilizados, principalmente en los Estados Unidos de América y en Asia. El enfermero debe identificar métodos compatibles y centrados en el paciente de acuerdo con su realidad institucional.

Abstract OBJECTIVE To identify the scientific production about telephone follow-up by nurses to oncological patients undergoing chemotherapy in an outpatient clinic. METHOD Integrative review of articles available in the LILACS and BDENF/BVS, MEDLINE/PubMed, CINAHL and Scopus databases, using the following descriptors: "Drug Therapy", "Antineoplastic protocols", "Antineoplastic agents", "Telemedicine", "Telenursing", "Telephone" and variations in the CINAHL and Scopus bases, published in the last 5 years. RESULTS In this review, 19 studies were identified and grouped in the following topics: Management and control of symptoms; Health-related quality of life assessment; Self-efficacy; Emotional support, Caregiver stress, and Patient satisfaction. CONCLUSIONS Strategies and methods of follow-up of patients in outpatient chemotherapy are feasible and effective, being widely used, mainly in the United States and Asia. Nurses should identify compatible and patient-centered methods according to their institutional profile.

Advances in the role of exosomes in gastric cancer / 肿瘤

Exosomes is a kind of nano-sized vesicles secreted into the extracellular environment. Exosomes contain many bioactive molecules including proteins, nucleic acids and lipids. Exosomes participate in the exchange of substances and information between cells, thus playing important roles in many physiological and pathological processes. In recent years, exosomes are found to be critically involved in the occurrence, development, metastasis and drug resistance of gastric cancer. Exosomes are present in various types of body fluids including blood and gastric juice. The detection of proteins and nucleic acids in exosomes from grastic cancer patients will be helpful to the early diagnosis, the evaluation of therapeutic effects, and the prediction of prognosis. This review summarizes the role, mechanism and clinical significance of exosomes in gastric cancer, in order to provide some new ideas and methods for the early diagnosis and treatment of gastric cancer.

Inhibitory effect of extremely low frequency-electromagnetic field combined with static magnetic field on tumor cell proliferation and the possible mechanism / 肿瘤

Objective: To investigate the inhibitory effect of a combination of static magnetic field (SMF) and extremely low frequency-electromagnetic field (ELF-EMF) on the proliferation of tumor cells, and its causal relationship with the induction of intracellular reactive oxygen species (ROS) after exposure. Methods: The intensities of SMF and 50 Hz ELF-EMF both changed periodically and generated a magnetic field (MF) with a time-averaged intensity of 5.1 mT in the center of exposure area. The bronchial epithelium of human lung Beas-2B cells, human renal epithelial 293T cells, human nephroblastoma G401 cells, human gastric adenocarcinoma AGS cells, human pancreatic cancer BxPC cells and human neuroblastoma CHLA255 cells were exposured in MF for 2 h/d (continuous 3 days). The effects of the combined MF on the growth, proliferation, apoptosis and intracellular ROS concentration were detected by trype blue method, BrdU method, FCM method and DCFH-DA fluorescence probe method, respectively. Results: This combined MF showed no inhibitory effect on non-tumor cells including Beas-2B and 293T (both P > 0.05), while it showed inhibitory effect on tumor cells including G401, AGS, BxPC, and CHLA255 cells (all P < 0.01). G401 and CHLA255 cells were more sensitive to the MF, the inhibitory rate of G401 and CHLA255 cells at the third day of exposure was (29.41±0.81)% and (31.71±4.59)%, respectively. The apoptosis rate of G401 cells exposed to MF for 2 h/d was increased in 3 days (P < 0.05, P < 0.01 and P < 0.01). As compared with daily exposure for 2 h, the inhibition rate of daily exposure for 8 h induced another 10% increase (all P < 0.01). Furthermore, the combined MF exhibited more pronounced antitumor effect than that of SMF or ELF-EMF alone, including SMF with the same intensity of the combined field (all P < 0.01). The peak of intracellular ROS levels was reached shortly after initial exposure (1-2 h), for long before the peak of cell inhibition was reached (day 2-3 with accumulated exposure of 4-6 h). Continuous or intermittent increase of MF exposure did not result in further accumulation of intracellular ROS. However, the peak of ROS levels persisted to the next day after termination of exposure. Both SMF and ELF-EMF could induce the elevation of ROS, but without superimposition effect. Conclusion: Extending the exposure time of MF can improve its inhibitory effect on tumor cells. The antitumor effect of the combined MF is related to free radical damage, but this may be not the only mechanism.