Advances in the treatment of immune checkpoint inhibitors for esophageal cancer / 中国医师杂志

As a new therapeutic strategy for esophageal cancer, immunotherapy has attracted more and more attention. The completed and ongoing clinical trials of immunotherapy for esophageal cancer confirm the great potential of immune checkpoint inhibitors in esophageal cancer. Future research will focus on the combination of immunotherapy with existing or new therapeutic modalities and the identification of populations likely to benefit from immunotherapy.

Establishment of acute radiation-induced esophagitis model of Wistar rats based on a small animal precision radiotherapy platform / 中华放射医学与防护杂志

Objective:To establish an in vivo model of acute radiation esophagitis in Wistar rats based on a small animal precision radiotherapy platform (SARRP). Methods:Thirty-six Wistar rats were randomly divided into control group, 40, 60 and 75 Gy groups. Based on MRI images, the esophageal target area of rats was outlined and the radiotherapy plan was formulated. The rats were respectively irradiated with 0, 8, 12 and 15 Gy per day for 5 consecutive days. The changes of body weight, food intake, esophageal pathology and magnetic resonance imaging were observed.Results:The body weight of rats in 75 Gy group decreased significantly on the 6th day after irradiation (IR) ( P<0.05). The esophageal tissue of rats in each IR group was thicker than that in control ( F = 14.20, P < 0.05). HE staining showed that the formation rate of radiation-induced esophagitis in 40 Gy and 60 Gy groups were 4/5 and 5/5, respectively, mainly mild. In 75 Gy group, the incidence of radiation-induced esophagitis approached to 5/5, of which 3/5 was severe at 9 d post-IR. The pathological injury scores [ M( Q1, Q3)] of rats in each group were 0, 1.0 (0.5, 2.5), 1.0 (1.0, 2.5) and 4.0 (1.5, 6.0) on the 9th day after IR. There was significant difference between the 75 Gy group and the control group ( H=12.69, P<0.05). After dynamic monitoring of neck MRI images, it was found that the esophageal signal of rats in each IR group increased and widened at 9 d post-irradiation. Conclusions:The animal model of acute radiation-induced esophagitis in rats was successfully established based on a small animal precision radiotherapy platform combined with MRI. 75 Gy was the best irradiation dose and the 9th day was the best observation time point.

Effect of epigallocatechin-3-gallate on radiation-induced esophagitis of rabbit / 中华放射医学与防护杂志

Objective To analyze the effect of epigallocatechin-3-gallate (EGCG) in radiation induced esophagitis of model rabbit.Methods Thirty male New Zealand rabbits were randomly divided into EGCG group,saline group,blank group.The rabbits in EGCG and saline groups were irradiated with 6 MV X-rays.The blank group did not receive radiation.After irradiation,rabbits were given with 440 μmol/L EGCG or saline three times a day in continuous 5 days.The scores of pathological changes of esophagus were observed by optical microscope.The serum levels of interleukine-1 beta (IL-1β),interleukine-6 (IL-6),transforming growth factor-β (TGF-β) and tumor necrosis factor-α (TNF-α) were detected by enzyme linked immunosorbent assay.The expression levels of 67KD laminin receptor (67LR)was detected by immunohistochemistry.Results After treatment,the scores of pathological changes of esophagus in blank group,saline group,EGCG group were 0,3.9± 1.10 and 2.80±0.92,respectively.At different time points after drug treatment,the levels of serum inflammatory factors among three groups were significantly different (F=23.66-236.32,P＜0.05).The expressions of 67LR in esophageal tissue of 3 groups were also significantly different (F=585.38,P＜0.05).Conclusions EGCG reduced radiationinduced esophagitis in rabbits by decreasing the levels of serum inflammatory factors,which may be related to the expression of 67LR protein.

Effect of epigallocatechin-3-gallate on radiation-induced esophagitis of rabbit / 中华放射医学与防护杂志

Objective@#To analyze the effect of epigallocatechin-3-gallate (EGCG) in radiation induced esophagitis of model rabbit.@*Methods@#Thirty male New Zealand rabbits were randomly divided into EGCG group, saline group, blank group. The rabbits in EGCG and saline groups were irradiated with 6 MV X-rays. The blank group did not receive radiation. After irradiation, rabbits were given with 440 μmol/L EGCG or saline three times a day in continuous 5 days. The scores of pathological changes of esophagus were observed by optical microscope.The serum levels of interleukine-1 beta (IL-1β), interleukine-6 (IL-6), transforming growth factor-β (TGF-β) and tumor necrosis factor-α (TNF-α) were detected by enzyme linked immunosorbent assay. The expression levels of 67KD laminin receptor (67LR) was detected by immunohistochemistry.@*Results@#After treatment, the scores of pathological changes of esophagus in blank group, saline group, EGCG group were 0, 3.9±1.10 and 2.80±0.92, respectively. At different time points after drug treatment, the levels of serum inflammatory factors among three groups were significantly different (F=23.66-236.32, P<0.05). The expressions of 67LR in esophageal tissue of 3 groups were also significantly different (F=585.38, P<0.05).@*Conclusions@#EGCG reduced radiation-induced esophagitis in rabbits by decreasing the levels of serum inflammatory factors, which may be related to the expression of 67LR protein.

Adverse events of radiotherapy combined with immune checkpoint inhibitors / 中华放射医学与防护杂志

Radiation therapy and immune checkpoint inhibitors(ICI) have a synergistic effect on anti-tumor,which involves a series of complex mechanisms of effects with the immune system,and can improve the clinical outcomes of cancer patients.However,the mechanism by which radiation therapy combined with ICI synergistically modulates the immune response may also trigger treatment-related adverse events.In view of the increasing number of clinical studies and practices of combination therapy,it is necessary to pay attention to the risk of adverse events in combination therapy of radiotherapy and ICI,so as to evaluate the safety of combination therapy.

Effect of human intestinal flora on tumorigenesis and therapeutic efficacy / 肿瘤研究与临床

The microorganism in human body is related to human health and disease,which plays a significant role in the exclusion of pathogen invading,participation of immune regulation and occurrence and development of the tumors.Studies have indicated that dysbacteriosis is often detected in cancer patients;especially,enteric dysbacteriosis can promote the occurrence and development of the tumors by influencing homeostatic balance of intestinal tract,gut metabolite and immunological function.Moreover,proportion detection of intestinal flora can be used as a non-invasive screening method and a diagnostic indicator for early detection of the malignant neoplasms.This review summarizes the recent studies on the associations of intestinal flora with human diseases and the possible mechanisms causing tumorigenesis,which may provide a novel research paradigm for cancer prevention and treatment.

Research progresses of green tea extract epigallocatechin-3-gallate on preventing and treating radiation injury / 中华放射医学与防护杂志

Radiotherapy is one of the important cancer therapy methods that can lead to tissue damage including radiation lung injury,radiation esophageal injury,radiation skin damage and abnormal changes in hemopoietic system and immune system.Epigallocatechin-3-gallate (EGCG) is the most abundant catechin in green tea.It has been demonstrated that EGCG has biological effects of antiinflammatory,antioxidant,anti-apoptosis and regulating immunity.Recently some studies of cell and animal models suggest that EGCG has radioprotective effect,but few clinical research was reported.In this review,the studies about EGCG in preventing and treating radiation injury were summarized from antiradiation mechanism in order to enhance the understanding of the potential clinical application of EGCG.

Influence of enteral nutrition on nutritional status,treatment toxicities,and short-term outcomes in esophageal carcinoma patients treated with concurrent chemoradiotherapy: a prospective, multicenter,randomized controlled study (NCT 02399306) / 中华放射肿瘤学杂志

Objective To investigate the influence of enteral nutrition on body weight,nutritional status,treatment toxicities,and short-term outcomes in esophageal carcinoma patients treated with concurrent chemoradiotherapy(CCRT). Methods Eligible esophageal carcinoma patients were randomly assigned(2:1) to receive either CCRT combined with enteral nutrition (study group) or CCRT alone (control group). The primary endpoint was changes in the body weight during and after radiotherapy. The secondary endpoints were nutrition-related hematological parameters,the toxicities of chemoradiotherapy,the completion rate of treatment,and short-term outcomes. The differences was using χ2 or t-test. Results Between September 2014 and June 2017,203 patients were included in the study,consisting of 139 patients in the study group and 64 patients in the control group. Compared with the control group,the study group had significantly less body weight loss during and after radiotherapy (P<0.05) and significantly less decreases in serum albumin and hemoglobin (P<0.05),but there was no significant difference in the reduction in total lymphocyte count between the two groups (P>0.05).The study group had significantly lower incidence rates of grade ≥3 myelosuppression and infection and a significantly higher completion rate of chemoradiotherapy compared with the control group (P<0.05).The incidence of radiation pneumonitis and esophagitis showed no significant difference between the two groups (P>0.05).The study group had an insignificantly higher objective response rate than the control group (P>0.05). Conclusions For esophageal carcinoma patients treated with CCRT,enteral nutrition can reduce body weight loss during and after radiotherapy,improve nutritional status and treatment tolerance,and reduce toxicities.

Advances in biological predictors of radioactive esophagitis / 中国医师杂志

Radioactive esophagitis is one of the most common complications in thoracic tumor radiotherapy,biological factors such as single nucleotide polymorphisms (SNPs),miRNAs,and HIV infection may play key roles in the occurrence and development of radioactive esophagitis,and they have become an active field in protection areas of radiotherapy.We can identify the patients who may cause radioactive esophageal in high dose radiotherapy as early as possible,and modify the treatment plan to protect the esophagus.Therefore the biological factors of radioactive esophagitis are of important clinical significance.

The current status and future perspective of personalized and precise medicine in cancer / 中国医师杂志

Cancer prevention and treatment have developed from evidence-based model into personalized model.Precise medicine has been developed in recent years.It is very important to incorporate personalized and precise idea into clinical practice and makes it accepted by the public.It is also a long way to go to provide precise service for numerous cancer patients through the research using special resource of our country.

Advances in immunocheckpoint blockades in the treatment of non-small cell lung cancer / 中国肿瘤临床

In China, most patients with non-small cell lung cancer (NSCLC) were diagnosed with advanced or metastatic disease on first admission. These patients were treated by chemotherapy, radiotherapy, or targeted therapy. However, the 5-year overall survival rate is still low. Immunocheckpoint blockades adjust the immune function, dispatch immune escape, enhance T cell activation, and kill tumor cells. Immunocheckpoint blockade becomes one of the important methods of anti-tumor treatments. This approach may also change the model of NSCLC treatment because of its promising anti-tumor activity. This review summarizes the clinical trials on immu-nocheckpoint blockades in NSCLC and the possibility of combining this technique with other treatments.

18F-FDG PET/CT in evaluation of the outcome after stereotactic body radiation therapy for early-stage non-small cell lung cancer / 中华核医学与分子影像杂志

Stereotactic body radiation therapy (SBRT) has been increasingly used in the treatment of early-stage NSCLC,especially for patients who cannot undergo surgery.Compared with other imaging modalities,PET/CT has higher sensitivity and specificity in diagnosis and staging of NSCLC as well as higher prediction value for prognosis.The progress of 18F-FDG PET/CT in evaluation of the therapeutic response and prognosis after SBRT for early-stage NSCLC is summarized in this review.

Molecular targeted therapy of tumor hypoxia / 国际肿瘤学杂志

Hypoxia is an inherent feature of the majority of solid tumors,which can increase the resistance of tumor cells to radiotherapy and chemotherapy,promote tumor angiogenesis and lead to poor prognosis.Therefore,targeting the hypoxic tumor cells has become a spot in cancer therapy.Bioreduction drugs can be activated by a specific reduction to become cytotoxic metabolites,thus killing hypoxic tumor cells,while small molecular targeting inhibitors can selectively act on the key point of hypoxia pathway.They have paved a new way for hypoxia targeted therapy.

Progress in enhancing radiosensitivity by inhibition of DNA double strand break repair / 国际肿瘤学杂志

DNA double strand breaks are potentially lethal DNA lesions induced by ionizing radiation, which can be repaired by homologous recombination and non- homologous end joining. Inhibition of the expression and function of genes in double strand breaks repair pathways using RNA interference and anti- sense techniques could improve the radiosensitivity of cancer cells.