The mechanism of chlorogenic acid against neuropathic pain induced by cisplatin / 药学学报

This study aimed to investigate the analgesic effect of chlorogenic acid on cisplatin-induced neuropathic pain and explored the underlying molecular mechanisms. The animal experimental protocol has been reviewed and approved by Laboratory Animal Ethics Committee of Xinxiang Central Hospital, in compliance with the Institutional Animal Care Guidelines. Von Frey hair and a radiant heat was employed to measure mechanical allodynia and thermal hyperalgesia; Western blot was used to examine transient receptor potential vanilloid type-1 (TRPV1) protein expression in the rat dorsal root ganglion (DRG); patch clamp was used to record TRPV1 currents in DRG neurons. The experimental results showed that chlorogenic acid could attenuate cisplatin-induce mechanical allodynia and thermal hyperalgesia in rats. The expression of TRPV1 protein in DRGs was increased in cisplatin-treated rats, while chlorogenic acid also could reverse cisplatin-induced the upregulation of TRPV1 protein. Forthermore, chlorogenic acid could attenuate cisplatin-mediated the upregulation of TRPV1 current density. These above results indicated that chlorogenic acid could alleviate cisplatin-induced pain hypersensitivity through inhibition of the expression and function of TRPV1 in rats.

Neuropatia periférica induzida por quimioterápicos: sintomas e o risco de queda em mulheres idosas com câncer / Peripheral neuropathy induced by chemotherapy: symptoms and the risk of falling in elderly women with cancer

Introdução: Os avanços nas áreas da saúde e tecnologia favoreceram o processo de transição demográfica e o aumento da expectativa de vida. Consequentemente, o aumento da população idosa ocasiona um aumento das doenças crônicas não-transmissíveis, que incluem o câncer, considerado a segunda principal causa de morte em todo mundo. Dentre as diversas opções de tratamento do câncer destaca-se a quimioterapia, que durante seu uso o paciente pode apresentar diferentes eventos adversos. Um destes eventos é a neurotoxicidade, conhecida como neuropatia periférica induzida por quimioterápicos (NPIQ), que é caracterizada como uma lesão inflamatória ou degenerativa dos nervos periféricos. Manifesta-se por sintomas sensoriais típicos, como perda de sensibilidade nos membros e perda de reflexos, fraqueza em mãos e pés e disestesias, perda de discriminação entre o toque e temperatura (frio e calor), cujas manifestações clínicas incluem dor, formigamento, choque e queimação, e podem implicar em consequências negativas para a vida cotidiana e tornando-se mais vulnerável a ocorrências de quedas. Objetivos: Avaliar a ocorrência da NPIQ e o risco de queda em mulheres idosas com diagnóstico de câncer. Métodos: Estudo quantitativo, descritivo e transversal, desenvolvido com 60 mulheres idosas que realizavam o tratamento quimioterápico para qualquer tipo de câncer. Os dados coletados foram sócio-demográficos e sobre o câncer, e foram aplicados os instrumentos: Escala de Risco de Queda (Fall Risk Score), Escala de Fragilidade de Edmonton (Edmonton Frail Scale) e Ferramenta de Avaliação de Neuropatia Periférica Induzida por Quimioterapia (FANPIQ). Os dados foram digitados no Microsoft Excel, e analisado no Statistical Package for the Social Sciences - SPSS v. 22.0. Foram realizadas análises descritivas com média e desvio padrão, analítica e testes de regressão multivariada. Resultados: A média de idade das participantes foi 69,57 (DP±7,63) anos, 58,3% apresentava hipertensão arterial e 30% diabetes mellitus, 96,7% utilizavam algum tipo de medicação e 75% apresentavam câncer de mama. Quanto ao risco de queda, 36,7% das participantes afirmaram já ter apresentado algum tipo de queda nos últimos 12 meses, com ou sem lesão; entretanto somente 6,7% apresentaram algum déficit sensorial. Na avaliação da fragilidade, 58,3% das idosas não precisavam de auxílio para realizar atividades básicas da vida diária, e 48,3% das participantes foram aprovadas na cognição. Quanto aos sintomas neuropáticos que avaliou a ocorrência de dormência, formigamento, sensibilidade e neuralgia durante o tratamento quimioterápico, todos com influência em algumas atividades cotidianas das mulheres. De acordo com as análises de regressão, a dormência e formigamento nas mãos, neuralgia, dormência nos pés e sensibilidade ao frio foram itens com associação estatística na escala de fragilidade. Conclusão: Este estudo avaliou a ocorrência da NPIQ e o risco de queda em mulheres idosas com diagnóstico de câncer. Apesar de pouco descrito na literatura, foi possível identificar a influência da NPIQ nas atividades cotidianas, com a associação entre os sintomas e o risco de queda, bem como as limitações funcionais no cotidiano da mulher

Introduction: Advances in the areas of health and technology favored the process of demographic transition and increased life expectancy. Consequently, the increase in the elderly population causes an increase in non-communicable chronic diseases, which include cancer, considered the second leading cause of death worldwide. Among the various cancer treatment options, chemotherapy stands out, as during its use the patient may experience different adverse events. One of these events is neurotoxicity, known as chemotherapy-induced peripheral neuropathy (CIPN), which is characterized as an inflammatory or degenerative lesion of the peripheral nerves. It is manifested by typical sensory symptoms, such as loss of sensitivity in the limbs and loss of reflexes, weakness in the hands and feet and dysesthesias, loss of discrimination between touch and temperature (cold and heat), whose clinical manifestations include pain, tingling, shock and burning, and may result in negative consequences for everyday life and make them more vulnerable to falls. Objective: To assess the occurrence of CIPN and the risk of falling in elderly women diagnosed with cancer. Method: Quantitative, descriptive and cross-sectional study, developed with 60 elderly women who underwent chemotherapy treatment for any type of cancer. The data collected were socio-demographic and about cancer, and the following instruments were applied: Fall Risk Score, Edmonton Frail Scale, and the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (FANPIQ). Data were entered into Microsoft Excel, and analyzed using the Statistical Package for the Social Sciences - SPSS v. 22.0. Descriptive analyzes were performed with mean and standard deviation, analytical and multivariate regression tests. Results: The participants' mean age was 69.57 (SD±7.63) years, 58.3% had arterial hypertension and 30% had diabetes mellitus, 96.7% used some type of medication and 75% had breast cancer. As for the risk of falling, 36.7% of the participants stated that they had already had some type of fall in the last 12 months, with or without injury; however, only 6.7% had some sensory deficit. In the assessment of frailty, 58.3% of the elderly women did not need help to carry out basic activities of daily living, and 48.3% of the participants passed the cognition test. As for the neuropathic symptoms, it evaluated the occurrence of numbness, tingling, sensitivity and neuralgia during chemotherapy treatment, all of which influenced some of the women's daily activities. According to the regression analyses, numbness and tingling in the hands, neuralgia, numbness in the feet and sensitivity to cold were items with statistical association in the frailty scale. Conclusion: This study evaluated the occurrence of CIPN and the risk of falling in elderly women diagnosed with cancer. Although little described in the literature, it was possible to identify the influence of CIPN on daily activities, with the association between symptoms and the risk of falling, as well as functional limitations in women's daily lives

Uso do dispositivo Pegfilgrastim OBI para prevenção de neutropenia: revisão de escopo / Uso del dispositivo Pegfilgrastim OBI para prevenir la neutropenia: revisión de alcance / Pegfilgrastim OBI device use for neutropenia prevention: a scoping review

Resumo Objetivo Mapear os cuidados em saúde do dispositivo Pegfilgrastim on-body injector na prevenção de neutropenia em adultos com câncer em assistência domiciliar após quimioterapia ambulatorial. Métodos Revisão de escopo baseada na metodologia do Joanna Briggs Institute . Foram incluídos somente estudos com adultos com câncer submetidos à quimioterapia ambulatorial. A busca foi realizada nas bases de dados Cochrane, CINAHL, EMBASE, LILACS , PubMed, Scopus, LIVIVO e Web of Science, além da literatura cinzenta ProQuest, Scielo, Banco de Dados em Enfermagem, Google Scholar, Open Grey, bula do medicamento e websites . Foram esgotadas as buscas nas referências dos estudos elegidos. Todos os estudos identificados foram exportados para o gerenciador de referências EndNote para organização e remoção das duplicadas. Utilizou-se o aplicativo web Rayyan para seleção das evidências. Os estudos foram selecionados por pares e de forma independente, sendo os conflitos solucionados por um terceiro pesquisador. Resultados Foram incluídos 10 artigos cujos resultados foram subdivididos nas categorias: adesão do paciente, opinião da equipe de saúde, carga de trabalho do paciente em tratamento do câncer e uso do dispositivo na prática clínica. O dispositivo apresenta poucas falhas e foi aceito pelas equipes de saúde e pacientes na maioria dos estudos. Conclusão Os principais cuidados em saúde para o uso do dispositivo Pegfilgrastim on-body injector estão relacionados à técnica de preparo da pele onde o dispositivo será aplicado, o preparo e a administração do dispositivo. Além disso, salienta-se a importância da avaliação do conhecimento do paciente e seu familiar sobre o dispositivo, o fornecimento de todas as orientações necessárias, verbalmente e por escrito, de forma clara e objetiva, e a validação dessas informações, certificando-se que o paciente compreendeu todas elas e está seguro.

Resumen Objetivo Mapear los cuidados de la salud al utilizar el dispositivo Pegfilgrastim on-body injector para prevenir la neutropenia en adultos con cáncer en atención domiciliaria después de quimioterapia ambulatoria. Métodos Revisión de alcance basada en la metodología del Joanna Briggs Institute . Se incluyeron solamente estudios con adultos con cáncer sometidos a quimioterapia ambulatoria. La búsqueda se realizó en las bases de datos Cochrane, CINAHL, EMBASE, LILACS , PubMed, Scopus, LIVIVO y Web of Science, además de la literatura gris ProQuest, Scielo, Banco de Datos de Enfermería, Google Scholar, Open Grey, prospecto del medicamento y sitios web. Se concluyeron las búsquedas en las referencias de los estudios seleccionados. Todos los estudios identificados se exportaron al programa de gestión de referencias EndNote para organizarlas y remover las duplicadas. Se utilizó la aplicación web Rayyan para seleccionar las evidencias. Se seleccionaron los estudios por pares y de forma independiente, y los conflictos se solucionaron mediante un tercer investigador. Resultados Se incluyeron diez artículos cuyos resultados fueron subdivididos en las siguientes categorías: adhesión del paciente, opinión del equipo de salud, carga de trabajo del paciente en tratamiento de cáncer y uso del dispositivo en la práctica clínica. El dispositivo presenta pocas fallas y fue aceptado por los equipos de salud y por los pacientes en la mayoría de los estudios. Conclusión Los principales cuidados de la salud para el uso del dispositivo Pegfilgrastim on-body injector se relacionan con la técnica de preparación de la piel donde se aplicará el dispositivo, la preparación y la administración del dispositivo. Además, se destaca la importancia de la evaluación de conocimientos del paciente y su familiar sobre el dispositivo, la entrega de todas las instrucciones necesarias, verbalmente y por escrito, de forma clara y objetiva, la validación de la información y la verificación de que el paciente haya comprendido todo y esté seguro.

Abstract Objective To map the health care of Pegfilgrastim On-body Injector in neutropenia prevention in adults with cancer in home care after outpatient chemotherapy. Methods This is a scoping review based on the JBI methodology. Only studies with adults with cancer undergoing outpatient chemotherapy were included. The search was carried out in the Cochrane, CINAHL, EMBASE, LILACS, PubMed, Scopus, LIVIVO and Web of Science databases, in addition to gray literature ProQuest, SciELO, Database in Nursing, Google Scholar, Open Grey, drug leaflet and websites. The searches in the references of selected studies were exhausted. All identified studies were exported to the EndNote reference manager for organization and removal of duplicates. The Rayyan web application was used for evidence selection. The studies were selected by pairs independently, with conflicts resolved by a third researcher. Results A total of 10 articles were included, whose results were subdivided into categories: patient compliance, health team opinion, patient workload in cancer treatment and device use in clinical practice. The device has few flaws and was accepted by health care teams and patients in most studies. Conclusion The main health care for Pegfilgrastim On-body Injector use is related to the skin preparation technique where the device will be applied, in addition to device preparation and administration. Moreover, the importance of assessing the knowledge of patients and their family about the device is highlighted, providing all the necessary guidelines, verbally and in writing, clearly and objectively, and validating this information, making sure that patients have understood all of them and are safe.

Bletilla striata polysaccharide improves toxic and side effects induced by 5-FU: an untargeted metabolomics study / 中国中药杂志

This study aimed to analyze the effect of Bletilla striata polysaccharide(BSP) on endogenous metabolites in serum of tumor-bearing mice treated with 5-fluorouracil(5-FU) by untargeted metabolomics techniques and explore the mechanism of BSP in alleviating the toxic and side effects induced by 5-FU. Male BALB/C mice were randomly divided into a normal group, a model group, a 5-FU group, and a 5-FU + BSP group, with eight mice in each group. Mouse colon cancer cells(CT26) were transplanted into the mice except for those in the normal group to construct the tumor-bearing mouse model by subcutaneous injection, and 5-FU chemotherapy and BSP treatment were carried out from the second day of modeling. The changes in body weight, diarrhea, and white blood cell count in the peripheral blood were recorded. The mice were sacrificed and sampled when the tumor weight of mice in the model group reached approximately 1 g. TUNEL staining was used to detect the cell apoptosis in the small intestine of each group. The proportions of hematopoietic stem cells and myeloid progenitor cells in bone marrow were measured by flow cytometry. Five serum samples were selected randomly from each group for untargeted metabolomics analysis. The results showed that BSP was not effective in inhibiting colon cancer in mice, but diarrhea, leukopenia, and weight loss caused by 5-FU chemotherapy were significantly improved after BSP intervention. In addition, apoptotic cells decreased in the small intestinal tissues and the percentages of hematopoietic stem cells and myeloid progenitor cells in bone marrow were significantly higher after BSP treatment. Metabolomics results showed that the toxic and side effects of 5-FU resulted in significant decrease in 29 metabolites and significant increase in 22 metabolites in mouse serum. Among them, 19 disordered metabolites showed a return to normal levels in the 5-FU+BSP group. The results of pathway enrichment indicated that metabolic pathways mainly involved pyrimidine metabolism, arachidonic acid metabolism, and steroid hormone biosynthesis. Therefore, BSP may ameliorate the toxic and side effects of 5-FU in the intestinal tract and bone marrow presumably by regulating nucleotide synthesis, inflammatory damage, and hormone production.

Consensus on clinical diagnosis, treatment, and prevention of chemotherapy-induced neutropenia in China (2023 edition) / 中华肿瘤杂志

Chemotherapy-induced neutropenia (CIN) is a common hematological adverse events and dose-limiting toxicities of chemotherapy. CIN may lead to dose reduction and delay of chemotherapeutic agents, febrile neutropenia and severe infection, which results in increased treatment cost, reduced efficacy of chemotherapy, and even life-threatening morbidities. Assessment of risk of CIN, early detection of FN and infection, and proper prevention and treatment play a crucial role in reducing the occurrence of CIN-related morbidities, improving patient treatment safety and anticancer efficacy. Based on evidence and expert opinion, the expert committee of Chinese Anti-Cancer Association issued "the consensus on diagnosis and treatment of chemotherapy-induced neutropenia in China (2023 edition)", which is an update version of the 2019 edition, aiming to provide reference for the diagnosis and treatment of CIN for Chinese oncologists.

Aldehyde dehydrogenase 2 rs671 genetic polymorphisms are associated with chemotherapy-induced nausea and vomiting / 南方医科大学学报

OBJECTIVE@#To investigate the correlation between aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphisms and chemotherapy-induced nausea and vomiting (CINV).@*METHODS@#A total of 90 Chinese patients with malignant tumors receiving chemotherapy for the first time were recruited in this study. The occurrence of CINV was observed within 120 h after treatment with docetaxel and cis-platinum chemotherapy (DP regimen). The data of the patients (including age, gender, tumor stage, habitual alcohol consumption, motion sickness, morning sickness, and average sleep time prior to chemotherapy) were collected through a questionnaire. ALDH2 rs671 polymorphisms of the patients were analyzed using a multiple single nucleotide polymorphism genotyping, and the Hardy-Weinberg equation was used for genetic linkage analysis. The correlations between the factors including ALDH2 rs671 polymorphisms and the occurrence of CINV were analyzed.@*RESULTS@#The incidence of CINV was 48.9% among the patients receiving their first chemotherapy with DP regimen. Univariate analysis indicated that the genetic polymorphisms of ALDH2 rs671 were significantly correlated with the occurrence of CINV (P < 0.05). Multivariate logistic analysis indicated that ALDH2 rs671 mutation (OR: 3.019, 95% CI: 1.056-8.628, P < 0.05) and average sleep time prior to chemotherapy no longer than 6 h (OR: 2.807, 95% CI: 1.033-7.628, P < 0.05) were risk factors for CINV in patients with malignant tumors receiving the first chemotherapy with DP regimen.@*CONCLUSION@#ALDH2 gene mutation at rs671 is a risk factor contributing to the occurrence of CINV, and understanding of the underlying mechanism may help to more effectively control the occurrence of CINV.

Clinical Efficacy of Bifid Triple Viable Capsules for Chemotherapy-induced Diarrhea: A Meta-analysis / 胃肠病学

Background: Chemotherapy-induced diarrhea (CID) is a major challenge during chemotherapy, which not only affects the quality of life, but also reduces the effectiveness of chemotherapy. Aims: To evaluate the clinical efficacy of Bifid triple viable capsules in the treatment of CID in malignant tumors by using meta - analysis. Methods: Randomized controlled trials (RCTs) on Bifid triple viable capsules for the treatment of CID were retrieved from CNKI, Wanfang, VIP, China Biology Medicine disc, Chinese Clinical Trial Registry, PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrails databases from the date of database establishment to December 2022. According to the inclusion and exclusion criteria, literatures were screened, extracted, and the quality of literature was evaluated. Meta - analysis was performed by using Stata/MP 14.0 software. Results: A total of 10 RCTs including 790 patients were enrolled. Meta - analysis results showed that efficacy of Bifid triple viable capsules in the treatment of CID was significantly increased than that of controls (OR=2.22, 95% CI: 1.69 - 2.92, P<0.000 1), and serum endotoxin, tumor necrosis factor - α, D - lactic acid, diamine oxidase were significantly decreased in Bifid triple viable capsules group than in controls (P<0.05). Conclusions: The addition of Bifid triple viable capsules adjuvant to the original symptomatic treatment of CID can optimize the treatment efficacy.

Study on the Development and Implementation of Electronic Patient Reported Outcome - Pharmaceutical Management System for Enhanced CINV Control - / 医薬品情報学

Objective: Chemotherapy-induced nausea and vomiting (CINV) can affect a patient’s quality of life and make them resistant to the treatment. We created an electronic patient reported outcome ePRO-linked pharmaceutical management system (PMS) for CINV (CINVePRO) for storing information, such as nausea and vomiting status, food intake, etc., and suggesting the type of anti-nausea medication and dosage changes to the physicians for controlling CINV.Design: At the Gifu University Hospital, the collaborative research institute, inpatients and pharmacists in charge used CINVePRO-PMS, and a questionnaire survey was done to assess the system’s reliability.Methods: The daily entry of data into CINVePRO shows the number and duration of vomiting, degree of nausea, and amount of food consumed and displays a list and graph of these data over time. The PMS enables pharmacists to list the presence or absence of nausea and the number of vomiting for all patients in their charge and record the intervention and display its list.Results: The questionnaire was distributed to 17 inpatients. All patients and pharmacists answered the questionnaire. According to the results of the questionnaire survey of patients, each screen of CINVePRO received a good evaluation that mentioned it was “easy to understand,” “easy to use,” and “especially useful for communicating one’s symptoms.” In addition, the results of a questionnaire survey of the pharmacists revealed that the system was rated as easy to check the patients’ symptoms and practical to use.Conclusion: CINVePRO-PMS was evaluated as a convenient and applicative system. However, linking CINVePRO to the electronic medical record of each hospital is necessary for sharing it among multiple professions.

Chemotherapy-induced oral mucositis induced by low dose methotrexate: a case report and literature review / 口腔疾病防治

Objective@# To investigate the diagnosis and treatment for oral mucositis induced by low-dose methotrexate and to provide a reference for clinicians@*Methods @# A case of severe chemotherapy-induced oral mucositis caused by short-term use of low-dose methotrexate (the maximum cumulative dose within 1 week) was reported and reviewed in combination with the literature.@*Results@# The patient was treated with low-dose methotrexate (2.5 mg orally every other day at weeks 1, 2, and 4; the third week, 2.5 mg each time for 3 consecutive days for twice, with a maximum cumulativedose of 15 mg within a week). After irregular medication for approximately three weeks, the patient gradually developed severe erosion of the lips, pain, difficulty eating, and skin erosion on both legs. Methotrexate was stopped after admission, and local symptomatic treatments such as Kangfuxin solution were given. Recombinant human granulocyte colony-stimulating factor was used systemically when combined with neutropenia. After treatment, the chemotherapy-induced oral mucositis and skin lesions were improved. A literature review shows that chemotherapy-induced oral mucositis is a toxic reaction to high-dose methotrexate, while cases of severe chemotherapy-induced oral mucositis caused by low-dose methotrexate are rare. Studies have found that the more risk factors patients have, such as poor local oral conditions and systemic diseases such as liver and kidney dysfunction and diabetes, the higher the risk of chemotherapy-induced oral mucositis. Clinicians should cooperate with dentists to address oral diseases as much as possible before using chemotherapy drugs. In addition, when ordering patients to take methotrexate, we should pay attention to the patient's general condition and susceptibility factors, standardize the frequency and dose of administration, adopt personalized treatment plans, and give patients detailed medication education to prevent the occurrence of adverse consequences caused by medication errors. If methotrexate poisoning occurs, the drug should be stopped in time, detoxification and active symptomatic and supportive treatment should be given. Basic oral care, cryotherapy, laser therapy, nutritional support and analgesic drugs are common treatments for chemotherapy-induced oral mucositis. Systemic administration of granulocyte colony-stimulating factor may be considered when accompanied by neutropenia.@*Conclusion@# It is necessary to be alert to the occurrence of severe chemotherapy-induced oral mucositis caused by low-dose methotrexate in clinical practice.

Cuidados no uso do dispositivo Pegfilgrastim On-body injector na profilaxia de neutropenia induzida por quimioterapia: revisão de escopo / Cautions in the use of the Pegfilgrastim On-body injector device in the prophylaxis of chemotherapy-induced neutropenia: a scoping review

Introdução: A neutropenia febril induzida por quimioterapia é um fator de risco predisponente para infecção grave e aumenta a mortalidade do paciente com câncer. O uso de G-CSF é recomendado quando o risco de desenvolver neutropenia febril, decorrente do protocolo quimioterápico, é maior ou igual a 20%. Foi recentemente aprovado pela ANVISA uma nova apresentação de G-CSF, o Pegfilgrastim OBI. Dispositivo que conta com um sistema de aplicação automático que é ativado 27 horas após o término da quimioterapia. Objetivo: Mapear os cuidados em saúde para o uso do dispositivo "Pegfilgrastim OBI", na prevenção de neutropenia em pacientes adultos com câncer em assistência domiciliar após quimioterapia ambulatorial. Métodos: A revisão de escopo foi conduzida de acordo com a metodologia da Joanna Briggs Institute. A questão norteadora foi formulada a partir da estratégia PCC. Foram incluídos estudos com pacientes adultos com câncer submetidos à quimioterapia ambulatorial e excluídos estudos com pacientes internados. O protocolo da revisão de escopo foi registrado na organização Open Science Framework. A estratégia de busca foi desenvolvida a partir de descritores controlados e não controlados e foi realizada em 03 de junho de 2022 nas seguintes bases de dados: CENTRAL, CINAHL, EMBASE, LILACS, PubMed, Scopus, LIVIVO e Web of Science. A busca também foi realizada na literatura cinzenta, incluindo Google Scholar, Open Grey, bula do medicamento e websites. Todos os estudos identificados nas bases de dados foram exportados para o gerenciador de referências bibliográficas (EndNote Desktop) para remoção das duplicadas e importados para o aplicativo web Rayyan para realização da seleção das fontes de evidências por pares e às cegas. Resultados: A busca nas bases de dados resultou em 301 artigos que após o processo de seleção resultaram em 11 artigos incluídos. Os resultados foram subdivididos em 4 categorias: adesão do paciente, opinião da equipe de saúde, carga de trabalho do paciente em tratamento oncológico e o uso do dispositivo na prática clínica. O dispositivo apresenta poucas falhas e é aceito pela equipe de saúde e pacientes na maioria dos estudos. O principal benefício do uso do Pegfilgrastim OBI foi o paciente não precisar retornar na clínica no dia seguinte. Já a segunda parte dos resultados foi proveniente das buscas em sites, bulas e manuais e os dados foram exibidos por meio de dois mapas conceituais detalhados. O primeiro mapa conceitual resumiu as informações ao paciente em uso de PegFilgrastim OBI, descrevendo sobre o que é o dispositivo, como é colocado na clínica, os cuidados que o paciente precisa ter em casa e como é realizado a retirada e descarte após aplicação. Já o segundo mapa conceitual resumiu os cuidados que a equipe de enfermagem precisa ter na aplicação e contém informações de como avaliar o local de aplicação, como preparar o dispositivo, etapas da aplicação e o monitoramento do paciente em casa. Conclusão: Compreender os cuidados em saúde no uso do dispositivo Pegfilgrastim OBI otimiza o trabalho da equipe de saúde, favorece melhorias na prática clínica e inclui o paciente com câncer no centro do cuidado

Introduction: Chemotherapy-induced febrile neutropenia is a predisposing risk factor for severe incidence and increased cancer patient mortality. The use of G-CSF is recommended when the risk of developing febrile neutropenia, resulting from the chemotherapy protocol, is greater than or equal to 20%. A new presentation of G-CSF, Pegfilgrastim OBI, was recently approved by ANVISA. Device that has an automatic application system that is activated 27 hours after the end of chemotherapy. Objective: Mapping health care for the use of the "Pegfilgrastim OBI" device in the prevention of neutropenia in adult cancer patients receiving home care after outpatient chemotherapy. Methods: The scoping review was conducted according to the Joanna Briggs Institute methodology. The guiding question was formulated from the PCC strategy. Studies with adult cancer patients undergoing outpatient chemotherapy were included and studies with inpatients were excluded. The scope review protocol was registered with the Open Science Framework organization. The search strategy was developed from controlled and uncontrolled descriptors and was performed on June 3, 2022 in the following databases: CENTRAL, CINAHL, EMBASE, LILACS, PubMed, Scopus, LIVIVO and Web of Science. The search was also performed in the gray literature, including Google Scholar, Open Grey, drug leaflet and websites. All studies identified in the databases were exported to the bibliographic reference manager (EndNote Desktop) to remove duplicates and imported into the Rayyan web application to carry out the selection of evidence sources by peers and blindly. Results: The search in the databases resulted in 301 articles which, after the selection process, resulted in 11 articles included. The results were subdivided into 4 categories: patient adherence, opinion of the health team, workload of the patient undergoing cancer treatment and the use of the device in clinical practice. The device has few flaws and is accepted by the healthcare team and patients in most studies. The main benefit of using Pegfilgrastim OBI was that the patient did not have to return to the clinic the next day. The second part of the results came from searches on websites, package inserts and manuals and the data were displayed through two detailed concept maps. The first concept map summarized the information for the patient using PegFilgrastim OBI, describing what the device is about, how it is placed in the clinic, the care that the patient needs to have at home and how the removal and disposal is performed after application. The second conceptual map summarized the care that the nursing team needs to take in the application and contains information on how to assess the application site, how to prepare the device, application steps and patient monitoring at home. Conclusion: Understanding health care in the use of the Pegfilgrastim OBI device optimizes the work of the health team, favors improvements in clinical practice and includes the cancer patient at the center of care

Application value of two-dimensional shear wave elastography for detecting chemotherapy-induced changes of liver stiffness in postoperative breast cancer patients / 中华超声影像学杂志

Objective:To detect the changes of liver stiffness before and after chemotherapy in postoperative breast cancer patients using the two-dimensional shear wave elastography (2D-SWE) technique, and analyze its correlation with liver serum indexs, then discuss the application value of 2D-SWE technique in the quantitative diagnosis for chemotherapeutic liver injury.Methods:Sixty breast cancer patients underwent postoperative chemotherapy in Qilu Hospital of Shandong University from January 2021 to November 2021 were included. Conventional two-dimensional ultrasound, 2D-SWE and the serum tests including alanine aminotransferase(ALT), aspartate aminotransferase(AST), γ-glutamyltransferase(γ-GT), alkaline phosphatase(AKP) were performed before and after chemotherapy, respectively. The medians of ElastQ Imaging stiffness (EQI meds) of the whole liver and different liver segments (S4, S5/S6, S7/S8) before and after chemotherapy were measured and compared. The EQI meds of different liver segments (S4, S5/S6, S7/S8) after chemotherapy were compared. The correlation between EQI med of the whole liver and serum indexes after chemotherapy was analyzed. Results:①Compared with before chemotherapy, the EQI meds of the whole liver and different liver segments after chemotherapy were significantly decreased ( P<0.001, respectively). ②The EQI meds among different liver segments were different after chemotherapy ( F=7.489, P=0.001). Moreover, the EQI meds of S5/S6 and S7/S8 were significantly lower than those of S4 after chemotherapy ( P=0.002, 0.001). ③The EQI med of the whole liver was negatively correlated with ALT, AST, and γ-GT ( r=-0.776, P<0.001; r=-0.656, P<0.001; r=-0.428, P=0.010), while there was no correlation between the EQI med of the whole liver and AKP ( r=-0.146, P=0.267). Conclusions:2D-SWE is expected to be a new, real-time, noninvasive and quantitative method to evaluate the changes of liver stiffness before and after chemotherapy in postoperative patients, thus provides a promising method for the early clinical diagnosis of chemotherapy-induced liver injury in breast cancer patients.

Mechanism of Fuzi Lizhongwan Improving Injury in Cisplatin-induced CIPN Mice by Regulating MAPK Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of Fuzi Lizhongwan alleviating the damage of chemotherapy-induced peripheral neuropathy （CIPN） mice caused by cisplatin based on mitogen-activated protein kinase （MAPK） signaling pathway. MethodA total of 40 female KM mice were randomized into blank group （distilled water， ig）， model group （distilled water， ig）， Fuzi Lizhongwan group （3.5 g·kg-1， ig）， and aspirin group （0.026 g·kg-1， ig）. Cisplatin （3 mg·kg-1， ip， 5 days） was used to induce CIPN in mice. Administration began while modeling and lasted 12 days. The general conditions and behaviors of mice were observed. After the last administration， samples were collected. Pathological changes of the soles were observed based on hematoxylin-eosin （HE） staining. Biochemical assay was employed to determine the levels of serum superoxide dismutase （SOD）， hydrogen peroxide （H2O2）， malondialdehyde （MDA）， and nitric oxide （NO）， enzyme-linked immunosorbent assay （ELISA） the content of interleukin-6 （IL-6）， interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， and glutathione peroxidase-3 （GPX-3） in kidney tissue， and Western blotting the expression of extracellular signal-regulated kinase1/2 （ERK1/2）， phosphorylated-ERK1/2 （p-ERK1/2）， p38 MAPK， and phosphorylated-p38 MAPK （p-p38 MAPK） in kidney tissue. ResultCompared with the blank group， model group demonstrated obvious pathological damage on the soles， hyperkeratosis of the epidermis with a basketweave pattern， atrophy of stratum spinosum， reduction of cells， and intracellular edema. Compared with the model group， Fuzi Lizhongwan significantly alleviated the pathological damage of the skin tissue of the soles. The model group showed lower body weight， mechanical pain threshold， thermal pain threshold （P<0.01）， and SOD activity （P<0.05）， higher content of H2O2， MDA， and NO （P<0.01）， and higher expression of IL-6， IL-1β， and TNF-α （P<0.01） than the blank group. Fuzi Lizhongwan group demonstrated higher body weight， mechanical pain threshold， thermal pain threshold （P<0.01）， and SOD activity （P<0.05）， lower content of H2O2， MDA， and NO （P<0.05）， and lower expression of IL-6， IL-1β， and TNF-α （P<0.01） than the model group. The expression of ERK1/2， p-ERK1/2， p38 MAPK， and p-p38 MAPK increased significantly （P<0.01） in the model group compared with that in the blank group， while the expression decreased significantly （P<0.01） in the Fuzi Lizhongwan group compared with that in the model group. ConclusionFuzi Lizhongwan can relieve the neurological injury of cisplatin-induced CIPN mice and increase the pain threshold of mice， possibly by regulating the MAPK signaling pathway and inhibiting inflammatory response and oxidative stress.

Valor del strain longitudinal global en la detección precoz de cardiotoxicidad inducida por quimioterapia / Global longitudinal strain value in the early detection of chemotherapy-induced cardiotoxicity

RESUMEN Introducción: Los avances en la detección precoz y el tratamiento del cáncer han reducido de manera significativa la mortalidad. El resultado neto es el surgimiento de una cohorte de pacientes cuya supervivencia es suficiente para evidenciar los efectos secundarios de las terapias utilizadas. La cardiotoxicidad es el conjunto de enfermedades cardiovasculares derivadas de los tratamientos onco-hematológicos. Objetivos: Evaluar el papel de la deformación miocárdica (strain) longitudinal global en la detección precoz de cardiotoxicidad en pacientes con tratamiento quimioterápico. Método: Se realizó un estudio cuantitativo, analítico, longitudinal, prospectivo en 44 pacientes con diagnóstico de cáncer de mama o linfoma, que iniciaron tratamiento con quimioterapia en el Instituto de Oncología y Radiobiología de Cuba, en el período comprendido entre febrero de 2017 y abril de 2018. Se utilizaron métodos primarios y secundarios para la recolección del dato primario y se emplearon varias pruebas estadísticas para su análisis. Resultados: Las medias de edad y tiempo de tratamiento fueron de 47,7 años y 5,05 meses, respectivamente. Predominó la hipertensión arterial (18,1%) como factor de riesgo y la mayor cardiotoxicidad (27,8%) en pacientes con disfunción diastólica previa. Entre los que desarrollaron cardiotoxicidad, la variable que demostró mayor afectación fue el strain longitudinal global (p<0,0001), con una reducción de 19,6% respecto al basal. Conclusiones: El strain longitudinal global es un índice ecocardiográfico de deformación miocárdica, que presentó un valor discriminante significativo con respecto a la cardiotoxicidad en pacientes que recibieron tratamiento quimioterápico.

ABSTRACT Introduction: Advances in early detection and treatment of cancer have significantly reduced mortality. The net result is the emergence of a cohort of patients whose survival is sufficient to evidence the side effects of the used therapies. Cardiotoxicity is the set of cardiovascular diseases resulting from onco-hematological treatments. Objectives: To evaluate the role of global longitudinal strain in the early detection of cardiotoxicity in patients undergoing chemotherapy. Method: A quantitative, analytical, prospective, longitudinal study was carried out in 44 patients diagnosed with breast cancer or lymphoma, who started chemotherapy treatment at the Instituto de Oncología y Radiobiología of Cuba, from February 2017 to April 2018. Primary and secondary methods were used for raw data collection and several statistical tests were used for its analysis. Results: The mean age and treatment period were 47.7 years old and 5.05 months, respectively. The most prevalent risk factor was high blood pressure and cardiotoxicity was higher (27.8%) in patients with previous diastolic dysfunction. Among those who developed cardiotoxicity, the variable that showed the greatest affectation was global longitudinal strain (p<0.0001), with a reduction of 19.6% with respect to the basal one. Conclusions: Global longitudinal strain is an echocardiographic index of myocardial performance, which presented a significant discriminating value with respect to cardiotoxicity in patients who received chemotherapeutic treatment.

Utilidad de las técnicas de deformación miocárdica (strain) para evaluar cardiotoxicidad en pacientes con enfermedades oncológicas y tratamiento quimioterápico / Usefulness of myocardial strain techniques to assess cardiotoxicity in patients with oncologic diseases undergoing chemotherapy

RESUMEN Introducción: La evaluación de la función miocárdica es fundamental para la toma de decisiones durante el seguimiento de pacientes con enfermedades oncológicas que reciben quimioterapia. Con las técnicas de speckle-tracking bidimensional se puede determinar el grado de deformación de la fibra miocárdica y obtener una medida más directa de la función sistólica que la que aporta la fracción de eyección del ventrículo izquierdo (FEVI). Objetivo: Evaluar la función miocárdica, mediante ecocardiografía, en pacientes con enfermedades oncológicas y tratamiento quimioterápico. Método: Se realizó un estudio descriptivo longitudinal prospectivo en 21 pacientes con diagnóstico de enfermedad oncoproliferativa e indicación de quimioterapia con trastuzumab, en el Hospital de Fuerteventura (España), entre enero de 2017 y mayo de 2020. A todos se les realizó ecocardiograma transtorácico con técnica de speckle-tracking (strain longitudinal global) antes del tratamiento y durante el seguimiento. Resultados: Predominaron las mujeres (95,2%) con diagnóstico de cáncer de mama (90,5%) y la edad promedio fue de 53,8 años (rango 38-75). La FEVI y el strain longitudinal global fueron normales (100%) antes del inicio de la quimioterapia. Fue necesario suspender el tratamiento en 3 pacientes (14,3%); pero solo en 2 de ellos (9,5%) por cardiotoxicidad detectada por ecocardiografía. Cinco pacientes (23,8%) presentaron síntomas de insuficiencia cardíaca, 1 (4,8%) tenía cardiotoxicidad y en los otros 4 (19,0%) se demostró ausencia de disfunción miocárdica, por lo que se pudo continuar el tratamiento con seguridad. Conclusiones: El ecocardiograma con técnica de speckle-tracking bidimensional fue de vital importancia para evaluar la función miocárdica y guiar el tratamiento quimioterápico en pacientes con enfermedades oncológicas.

ABSTRACT Introduction: Assessment of myocardial function is critical for decision making during the follow-up of patients with oncologic diseases undergoing chemotherapy. Two-dimensional speckle-tracking techniques help to determine the degree of myocardial fiber deformation and provide a more direct measure of systolic function than left ventricular ejection fraction (LVEF). Objective: To evaluate myocardial function by means of echocardiography in patients with oncological diseases undergoing chemotherapy. Methods: A prospective longitudinal descriptive study was performed in 21 patients diagnosed with cancer and with indication for chemotherapy with trastuzumab, in the Hospital of Fuerteventura (Spain), between January 2017 and May 2020. All underwent transthoracic echocardiography with speckle-tracking technique (global longitudinal strain) before treatment and during follow-up. Results: Women (95.2%) with a diagnosis of breast cancer (90.5%) predominated and the mean age was 53.8 years (range 38-75). Left ventricular ejection fraction and global longitudinal strain were normal (100%) before starting chemotherapy. It was necessary to suspend treatment in 3 patients (14.3%); but only in 2 of them (9.5%) due to cardiotoxicity detected by echocardiography. Five patients (23.8%) presented symptoms of heart failure, 1 (4.8%) had cardiotoxicity and in the other 4 (19.0%) the absence of myocardial dysfunction was demonstrated, so that treatment could be continued safely. Conclusions: Two-dimensional speckle-tracking echocardiography was of vital importance for assessing myocardial performance and guiding chemotherapy in patients with oncologic diseases.

Liujunzi decoction ameliorats cisplatin-induced anorexia via adjusting metabolic disorders in rats / 中国药理学与毒理学杂志

OBJECTIVE Cisplatin is a formidable chemotherapy agent widely applying in antineoplastic treatments, but its side effects often limit the clinical usage. Metabolic disorders are one of the side effects induced by cisplatin, which closely relate to the onset of chemotherapy-induced anorexia (CIA) in cancer patients but lacks effective controls. Liujunzi decoction (LJZD) is a traditional Chinese formula that has a promising effect in treating CIA. However, whether LJZD ameliorates CIA through adjusting cisplatin-induced metabolic disorders remain unknow. The present study evalu?ated the mechanism of cisplatin-induced metabolic disorders, and the effect of LJZD in ameliorating these disturbances. METHODS 42 male Sprague-Dawley (SD) rats (180-220 g) were randomly divided into 3 groups:normal control group (distilled water+saline), model group (distilled water+cisplatin), LJZD group (4.8 g·kg-1 Liujunzi decoction ingredients+cisplatin). Intragastrical administered each drug twice a day (7:00-19:00) since day 0 for 4 d, animals were intraperito?neal injected with cisplatin 6 mg·kg-11 h after administration while normal control groups were injected with same volume of saline. On day 3, each group was anesthetized with pentobarbital sodium 45 mg · kg-1 (ip), and blood samples were collected from aorta abdominalis. Then the samples were analyzed using an LC-ESI-MS/MS system. Significantly regu?lated metabolites between groups were determined by VIP≥1 and absolute Log2FC (fold change)≥1. Identified metabo?lites were mapped to Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway database using Metaboanalyst 5.0 (https://www.metaboanalyst.ca/). RESULTS A total of 133, 77 and 32 differential metabolites were filtrated in control vs model, control vs LJZD and model vs LJZD groups respectively. Comparing to control, the levels of hexadecanoic acid (Log2FC=6.3153), linoleic acid (Log2FC=5.3478), and 8, 11-icosadienoic acid (Log2FC=5.2342) significantly increased, and the levels of N-acetyl-L-tyrosine (Log2FC = -2.6283), cinnamic acid (Log2FC = -2.3381), N-acetylphenylalanine (Log2FC = -2.2501) significantly decreased in model group. The KEGG pathway enrichments of these metabolites indi?cated that, cisplatin-induced metabolic disorders by disturbing metabolism pathways such as linoleic acid metabolism, biosynthesis of unsaturated fatty acids, and phenylalanine metabolism, which suggested that the onset of CIA was partly associated with the metabolic disorders of linoleic acid, unsaturated fatty acids, and phenylalanine. Compared to control, treatment of LJZD significantly increased the levels of 4-hydroxytryptamine (Log2FC =12.0186), hexadecanoic acid (Log2FC = 5.7412), linoleic acid (Log2FC = 5.1877) and significantly decreased the levels of N-acetylmethionine (Log2FC=-1.7317), 2-aminoethanesulfinic acid (Log2FC=-1.6578), N-acetyl-L-tyrosine (Log2FC=-1.5355). And com?paring to the model group, 4-hydroxytryptamine (Log2FC = 12.0186), 7, 12-diketocholic acid (Log2FC = 2.0998), N-acetylneuraminic acid (Log2FC = 2.0560) markedly increased, and 3-hydroxy-3-methylpentane-1 (Log2FC = -1.9202), 5-dioic acid (Log2FC = -1.7166), N-isovaleroylglycine, hexanoyl glycine (Log2FC = -1.4958) markedly decreased in LJZD group. It was worth noting that, there were 23 differential metabolites filtrated both in control vs model and model vs LJZD groups, which were the key metabolites of LJZD in treating CIA. Among these 23 common metabolites, there were 16 metabolites excluding the control vs LJZD group, that was, LJZD had no effect in normal rats while being able to ameliorated cisplatin-induced metabolic disorders by regulating these 16 metabolites. Cisplatin-induced downregula?tion of 11 metabolites such as hydrocinnamic acid, (±)12(13)epoxy-9Z-octadecenoic acid, cinnamic acid were upregulated after LJZD treatment, and cisplatin-induced upregulation of imidazoleacetic acid, 2'-deoxycytidine-5'-monophosphate and other 5 metabolites were downregulated by LJZD. The KEGG pathway analysis indicated that the linoleic acid metabolism, histidine metabolism, and pyrimidine metabolism were the most enriched metabolic pathway. Thus, cisplatin-induced metabolic disturbances mainly by disturbing linoleic acid metabolism, histidine metabolism, and pyrimidine metabolism, and LJZD interacted with these metabolic pathways to reduce metabolic disorders and thus ameliorated CIA. CONCLUSION Cisplatin-induced anorexia was closely related to the metabolic disorders of linoleic acid metabo?lism, biosynthesis of unsaturated fatty acids, and phenylalanine metabolism. The mechanism of LJZD in ameliorating CIA was in concerned with the metabolic adjustments, relating to the regulation of linoleic acid metabolism, histidine metabolism, and pyrimidine metabolism.

Moxibustion Successfully Improved Chemotherapy-induced Peripheral Neuropathy in a Patient with Malignant Lymphoma / 日本東洋医学雑誌

A 70-year-old woman was diagnosed with peripheral T-cell lymphoma and received chemotherapy. She developed chemotherapy-induced peripheral neuropathy (CIPN), and her chief complaint was numbness of her fingertips and toes. However, the symptoms did not change even 9 months after the chemotherapy was completed. Our Kampo diagnosis was dual deficiency of qi (ki) and blood. Hence, we applied pedestal moxibustions to the following acupuncture points : SP 6 (Sanyinjiao), Ex-LE 10 (Bafeng), Ex-UE 9 (Baxie), CV 4 (Guanyuan). Her symptoms improved rapidly after moxibustion treatment. There were neither adverse events nor relapse of the numbness. Moxibustion treatment might reduce symptoms of CIPN.

Effect of Internet continuity nursing on the psychological status and adverse reactions of the colorectal cancer patients receiving oxaliplatin chemotherapy / 中国实用护理杂志

Objective:To explore whether Internet continuous nursing can reduce anxiety and depression, chemotherapy-induced peripheral neuropathy, improve treatment compliance and reduce adverse reactions in patients with colorectal cancer undergoing oxaliplatin chemotherapy.Methods:A total of 69 patients with colorectal cancer in the Department of oncology, General Hospital of Northern War Zone from July 2019 to June 2020 were selected and divided into the observation group (34 cases) and the control group (35 cases) by random digits table method. The control group was given conventional nursing mode, and the observation group was given Internet continuity nursing mode. All patients were followed up to 3 months after the end of chemotherapy. The basic information, treatment anxiety and depression, chemotherapy-induced peripheral neuropathy, compliance, incidence of adverse reactions and patient satisfaction of the two groups were compared.Results:There was no significant difference in the anxiety and depression before and after chemotherapy, chemotherapy-induced peripheral neuropathy after chemotherapy( P>0.05). After 3 months of chemotherapy, the anxiety and depression and chemotherapy-induced peripheral neuropathy were (20. 97± 3.46),(14.27 ± 1.14) points in the observation group, and (24. 99 ± 1.11),(18.16 ± 2.55) points in the control group, the differences were statistically significant ( t values were 3.80, 5.09, P<0.05). In the control group, there were 19 cases of regular review, 20 cases of persistent chemotherapy, 21 cases of disease awareness, 21 cases of scientific diet, 19 cases of psychological compliance and 19 cases of self-protection. In the observation group, there were 28 cases of regular review, 29 cases of persistent chemotherapy, 30 cases of disease awareness, 28 cases of scientific diet, 30 cases of psychological compliance and 28 cases of self-protection. The treatment compliance in the observation group were significantly higher than those in the control group (χ 2 values were 4.186-9.657, P<0.05). In the control group, there were 7 cases of peripheral neurotoxicity, 2 cases of acute laryngopharyngeal paresthesia, 18 cases of gastrointestinal reaction and 4 cases of hematotoxicity. Fourteen cases of gastrointestinal reaction in the observation group. The incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant ( χ2 value was 8.26, P<0.05). In the control group, 6 were very satisfied, 27 were satisfied and 2 were good.The observation group was very satisfied and satisfied with 16 people and 18 people. The satisfaction in the observation group was higher than that in the control group, and the difference was statistically significant ( Z value was 1.853, P<0.05). Conclusions:Internet continuous nursing can effectively reduce the anxiety and depression of patients and chemotherapy-induced peripheral neuropathy, improve the treatment compliance of patients, reduce the adverse reactions after medication, and improve the quality of life of patients, which is worthy of application and promotion.

Effect of Jianpi Bushen Sequential Formula on Adjuvant Chemotherapy of Colon Cancer: Study Protocol for a Randomized Controlled Trial / 中国结合医学杂志

BACKGROUND@#The side effects of chemotherapy-induced nausea and vomiting (CINV) and myelosuppression reduce the cancer patients' adherence to chemotherapy. Many Chinese patients choose Chinese medicine (CM) during chemotherapy to reduce side effects; however, the evidence is lacking. The efficacy of a CM herbal treatment protocol, Jianpi Bushen Sequential Formula (, JBSF) will be evaluated on chemotherapy completion rate among patients with colon cancer.@*METHODS@#A multi-center double-blind randomized controlled trial (RCT) will be conducted on 400 patients with colon cancer who will receive 8 cycles of adjuvant chemotherapy with oxaliplatin and capecitabine (CAPEOX). Patients will be randomized 1:1 to receive the JBSF or placebo formula. The primary outcome is the overall chemotherapy completion rate. The secondary outcomes include individual chemotherapy completion rate, 4-cycle completion rate of chemotherapy, time to treatment failure, relative dose intensity and treatment toxicity. Follow-up visits will be scheduled before every and after last chemotherapy.@*DISCUSSION@#This study will provide evidence on whether JBSF can improve the chemotherapy completion rate and reduce side effects among patients with colon cancer. (Trial registration: ClinicalTrials.gov, No. NCT03716518).

Research progress on biomarkers related to radiotherapy and/or chemotherapy-induced oral mucositis / 口腔疾病防治

@#Radiotherapy and/or chemotherapy-induced oral mucositis is a common oral complication in tumor patients undergoing radiotherapy and/or chemotherapy, which seriously compromises patients’ quality of life and even affects anti-tumor treatment. Biomarkers are signal indicators that appear at different biological levels before or during disease. A comprehensive understanding of the biomarkers associated with oral mucositis contributes to the early identification of high-risk patients with oral mucositis and aids in the screening of patients prone to develop severe oral mucositis, guiding the prevention and treatment of oral mucositis. This article reviews the existing biomarkers associated with oral mucositis. The literature review results showed that the biomarkers associated with oral mucositis included growth factors, inflammatory cytokines, genes, plasma antioxidants, and pro-apoptotic proteins/inhibitor of apoptosis proteins. These biomarkers can be used to predict the risk of oral mucositis or facilitate early discrimination of patients prone to exhibit severe radiotherapy and/or chemotherapy-induced oral mucositis. EGF, TNF-α, IL-6, IL-1β and CRP can be used to predict and evaluate the risk and development of oral mucositis, whereas genes such as excision repair cross complementing 1(ERCC1), X-ray repair cross complementing 1(XRCC1), methylenetetrahydrofolate reductase (MTHFR) and tumor necrosis factor receptor superfamily member 1A (TNFRSF1A) have been focus of research in recent years. The genotypes and expression levels of some of these genes exhibit variable capacities to predict the risk and severity of oral mucositis. However, no biomarkers have been used in clinical practice, and more studies are needed in the future to verify the reliability and accuracy of these biomarkers, to provide a reference for the early accurate prevention and treatment of radiation and chemotherapy oral mucositis.

Cost-utility Analysis of 3 Antiemetic Regimens to Prevent Nausea and Vomiting Caused by Multi-day Cisplatin- containing Chemotherapy Based on the Real World / 中国药房

OBJECTIVE：To provide reference for clinical decision-making related to chemotherapy-induced nausea and vomiting（CINV）. METHODS ：The medical records of patients diagnosed as malignant tumor receiving multi-day cisplatin-containing chemotherapy in our hospital were collected by hospital information system from Jan.-Dec. 2012. The medical records were divided into tropisetron group ，ramosetron group and palonosetron group according to different schemes of 5-hydroxytryptamine-3 receptor antagonist. The covariates of 3 groups were balanced by propensity score matching method ；cost-utility analysis was conducted for the 3 matched antiemetic schemes ；one-way sensitivity analysis and sampling uncertainty analysis were also conducted. RESULTS ： The results of cost-utility analysis showed that treatment cost of one observation period of tropisetron group was 237.71 yuan and utility were 0.054 68 QALYs；that of ramosetron group was 242.37 yuan and utility were 0.055 26 QALYs，and that of palonosetron group was 319.24 yuan and utility were 0.055 76 QALYs. Compared with tropisetron group ，the ICER of palonosetron group was 75 155.69 yuan/QALY；Compared with ramosetron group ，the ICER of palonosetron group was 152 062.07 yuan/QALY. Both of them were lower than 3 times of China ’s 2020 per capita GDP （217 341 yuan/QALY）. The results of sensitivity analysis and sampling uncertainty analysis demonstrated that the results of basic analysis were robust. CONCLUSIONS ：Under the current drug price，the antiemetic regimen based on palonosetron is more economical for the prevention of CINV caused by multi-day chemotherapy containing cisplatin.