Efficacy and safety of CT-guided 125I seed implantation by coplanar template as a salvage therapy for vertebral metastases after failure of external beam radiation therapy: a retrospective study.

Purpose: To evaluate the efficacy safety of computed tomography (CT)-guided 125I seed implantation by coplanar template for vertebral metastases after failure of external beam radiation therapy (EBRT). Material and methods: Retrospective analysis of the clinical outcomes of 58 patients with vertebral metastases after failure of EBRT, who underwent 125I seed implantation as a salvage treatment with a CT-guided coplanar template-assisted technique from January 2015 to January 2017. Results: The mean post-operative NRS score decreased significantly at T4w (3.5 ± 0.9, p<0.01), T8w (2.1 ± 0.9, p<0.01), T12w (1.5 ± 0.7, p< 0.01) and T6m (1.2 ± 0.6, p< 0.01) respectively. The local control rates after 3, 6, 9 and 12 months were 100% (58/58), 93.1% (54/58), 87.9% (51/58), and 81% (47/58), respectively. The median overall survival time was 18.52months (95% CI, 16.24-20.8), and 1- and 2-year survival rates were 81% (47/58) and 34.5% (20/58), respectively. By performing a paired t-test analysis, there was no significant difference in D90, V90, D100, V100, V150, V200, GTV volume, CI, EI and HI between preoperative and postoperative (p>0.05). Conclusions: 125I seed implantation can be used as a salvage treatment for patients with vertebral metastases after failure of EBRT.

The Roles of microRNAs in Regulating Chemotherapy Resistance of Non-Small Cell Lung Cancer.

Lung cancer is considered the leading cause of cancer death in the word. Among all lung cancer cases, non-small cell lung cancer (NSCLC) accounts for 85%. Currently, chemotherapy is still the major therapeutic method of lung cancer. However, chemoresistance is a serious obstacle in treating NSCLC. Up to now, many reports have suggested that microRNAs(miRNAs) could contribute to lung cancer cell chemosensitivity. MicroRNAs, a class of endogenous non-coding small RNAs, regulate gene expression by binding to their complementary target messenger RNAs, leading to mRNA degradation or translational suppression. Numerous studies indicate that changes of specific miRNA expression may contribute to chemoresistance or chemosensitivity. Consequently, targeting specific miRNAs could become an effective approach to predict the therapeutic effect of different anticancer agents, achieve more effective personalised treatments and enhance chemosensitivity. This review summarizes the several major drug resistance mechanisms and focuses on the roles of miRNAs in regulating chemoresistance in NSCLC.

Association between CXCL16/CXCR6 expression and the clinicopathological features of patients with non-small cell lung cancer.

Lung cancer is a major cause of morbidity and mortality worldwide, therefore identifying biomarkers for the early detection, grading or postoperative follow-up of lung cancer is of clinical significance. In the present study, expression of lung tissue (t)-CXCL16 and t-CXCR6 was examined in 58 patients with non-small cell lung cancer (NSCLC) using immunohistochemical staining, and serum (s)-CXCL16 levels were detected in 58 patients with NSCLC and in 32 normal volunteers using an ELISA. A follow-up was performed every 4 months between January 2014 and January 2015. Compared with the normal volunteers, the s-CXCL16 concentration in patients with NSCLC significantly increased (329.47±135.38 vs. 572.82±116.05 pg/ml, respectively; P<0.001). When grouped according to TNM stage, the expression of t-CXCL16 (60 vs. 85.71%; P=0.029), t-CXCR6 (53.33 vs. 78.57%; P=0.043) and s-CXCL16 (26.67 vs. 57.14%, P=0.019) in the stage I-II subgroup was significantly lower compared with that of the stage III-IV subgroup. The positive expression rate of t-CXCL16 (91.18%) and t-CXCR6 (79.41%) in the lymph node metastasis subgroup was significantly higher compared with that of the corresponding non-lymph node metastasis subgroup (50 and 45.83%, respectively; P<0.01). Additionally, the positive expression rate of t-CXCL16 in the smoking subgroup was 100%, which was significantly higher compared with that of the non-smoking subgroup (23.81%) (P<0.001). The follow-up and mortality rates were 100% (58/58) and 13.79% (8/58), respectively. Within the time period of the present study, the survival time was 4-18 months, and the mean survival time was 16.6 months. In conclusion, the expression of t-CXCL16 and t-CXCR6 is positively correlated with the TNM stage and lymph node metastasis in patients with NSCLC. Additionally, there was a significant increase in s-CXCL16 levels in patients with NSCLC, suggesting that CXCL16 could be used as a supplementary biomarker for the early detection of NSCLC.

Diagnostic accuracy of computed tomography imaging for the detection of differences between peripheral small cell lung cancer and peripheral non-small cell lung cancer.

BACKGROUND: To evaluate the computed tomography features of peripheral small cell lung cancer and non-small cell lung cancer and to establish a predictive model to conveniently distinguish between them. MATERIALS AND METHODS: We retrospectively reviewed the computed tomography features of 51 patients with peripheral small cell lung cancer and 207 patients with peripheral non-small cell lung cancer after pathological diagnosis. Thirteen computed tomography morphologic findings were included and analyzed statistically. Meaningful features were analyzed by logistic regression for multivariate analysis. We then used ß-coefficients as the basis to establish an image scoring prediction model. RESULT: The meaningful morphologic features for distinguishing between peripheral small cell lung cancer and other tumor types are multinodular shape and lymphadenectasis, with scores of 12 and 11, respectively. The scores ranged from -51 to 23, and the most reasonable cut-off was -24. The available area under the curve was 0.834 (95% confidence interval [CI] 0.783-0.877). Sensitivity and specificity were 86.3% (95% CI 0.737-0.943) and 69.6% (95% CI 0.628-0.758), respectively. CONCLUSION: The image scoring predictive model that we constructed provides a simple and economical noninvasive method for distinguishing between peripheral small cell lung cancer and peripheral non-small cell lung cancer.

Minimally invasive esophagectomy versus open esophagectomy for esophageal cancer: a meta-analysis.

BACKGROUND AND OBJECTIVES: The safety and effectiveness of minimally invasive esophagectomy (MIE) in comparison with the open esophagectomy (OE) remain uncertain in esophageal cancer treatment. The purpose of this meta-analysis is to compare the outcomes of the two surgical modalities. METHODS: Searches were conducted in MEDLINE, EMBASE, and ClinicalTrials.gov with the following index words: "esophageal cancer", "VATS", "MIE", "thoracoscopic esophagectomy", and "open esophagectomy" for relative studies that compared the effects between MIE and OE. Random-effect models were used, and heterogeneity was assessed. RESULTS: A total of 20 studies were included in the analysis, consisting of four randomized controlled trials and 16 prospective studies. MIE has reduced operative blood loss (P=0.0009) but increased operation time (P=0.009) in comparison with OE. Patients get less respiratory complications (risk ratio =0.74, 95% CI =0.58-0.94, P=0.01) and better overall survival (hazard ratio =0.54, 95% CI =0.42-0.70, P<0.00001) in the MIE group than the OE group. No statistical difference was observed between the two groups in terms of lymph node harvest, R0 resection, and other major complications. CONCLUSION: MIE is a better choice for esophageal cancer because patients undergoing MIE may benefit from reduced blood loss, less respiratory complications, and also improved overall survival condition compared with OE. However, more randomized controlled trials are still needed to verify these differences.