Current oncology最新文献

{"title":"Pain-Related Emergency Department Visits and Hospitalizations Following Hydrocodone Rescheduling in Metastatic Lung Cancer.","authors":"Chan Shen, Mohammad Ikram, Shouhao Zhou, Roger Klein, Douglas Leslie, James Douglas Thornton","doi":"10.3390/curroncol33080495","DOIUrl":"10.3390/curroncol33080495","url":null,"abstract":"<p><p><b>Background:</b> Emergency department (ED) use for cancer-related pain is common, particularly among patients with metastatic disease who frequently require opioid analgesia. In October 2014, the U.S. Drug Enforcement Administration rescheduled hydrocodone combination products from Schedule III to Schedule II, introducing stricter prescribing and dispensing requirements. We evaluated whether hydrocodone rescheduling was associated with pain-related ED visits and hospitalizations among older adults with metastatic lung cancer. <b>Methods:</b> We conducted a retrospective SEER-Medicare cohort study of beneficiaries aged 66 years or older diagnosed with metastatic lung cancer. Diagnoses from January 2011 through September 2014 were classified as pre-policy, October 2014 was excluded as a transition month, and November 2014 through December 2018 constituted the post-policy period. Monthly 365-day cumulative incidences were estimated using the Aalen-Johansen estimator with death treated as a competing event. Segmented interrupted time-series models estimated immediate level and slope changes. Adjusted cause-specific Cox models evaluated time to first event. <b>Results:</b> The cohort included 52,371 beneficiaries. For narrowly defined neoplasm-related pain ED visits, the policy was associated with an immediate increase of 0.834 percentage points (95% CI, 0.330-1.338) and a post-policy slope increase of 0.030 percentage points per month (95% CI, 0.011-0.049). Pain-related hospitalizations increased immediately by 0.946 percentage points (95% CI, 0.336-1.556), with a slope increase of 0.024 percentage points per month (95% CI, 0.005-0.042). At 12 months, fitted cumulative incidences exceeded no-policy projections by 1.193 percentage points for ED visits and 1.228 percentage points for hospitalizations. Adjusted cause-specific hazard ratios were 1.14 for pain-related ED visits (95% CI, 1.00-1.30; <i>p</i> = 0.054) and 1.14 for hospitalizations (95% CI, 1.00-1.29; <i>p</i> = 0.049). <b>Conclusions:</b> Hydrocodone rescheduling was temporally associated with modest increases in acute-care encounters explicitly coded for neoplasm-related pain. The findings underscore the importance of preserving timely analgesic access for patients with advanced cancer.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Social and Stigma-Related Lived Experiences of Pediatric Cancer Survivors in a Canadian Province.","authors":"Rasel Siddique, Georgia Skardasi, Kayla Crichton, Lisa Goodyear, Teri Stuckless, Holly Etchegary, Sevtap Savas","doi":"10.3390/curroncol33080494","DOIUrl":"10.3390/curroncol33080494","url":null,"abstract":"<p><p><b>Background</b>: Worldwide, around 400,000 children are diagnosed with cancer every year. Understanding survivors' social and stigma-related experiences may help address their needs and improve their outcomes. <b>Objectives</b>: To explore the social and stigma-related experiences, coping strategies, and support needs of pediatric cancer survivors in Newfoundland and Labrador, a province of Canada. <b>Methods</b>: This is a qualitative, cross-sectional study focusing on retrospective participant experiences. Eligibility criteria included being diagnosed with cancer before the age of 18 and being diagnosed or treated in the province. Extensive recruitment activities were employed. Data collection occurred through semi-structured virtual interviews and completion of a sociodemographic survey. Participant interviews were transcribed verbatim, and themes were identified iteratively through inductive thematic analysis. Descriptive statistics were used to define the participants' sociodemographic characteristics. <b>Results</b>: Seven participants were recruited. Thematic analysis identified five major themes: (i) isolation and being treated differently; (ii) support received, coping mechanisms, and support needs; (iii) resilience and interest to give back; (iv) workplace and disability related experiences; and (v) additional impacts of cancer. Our results showed that participants received substantial social support in various ways but inadequate professional mental health support. School was a significant setting for cancer-related stigmatization. Discrimination in the workplace was rare and was disability-related rather than cancer-related. <b>Conclusions</b>: Our results show that there are significant issues to address, such as stigma and isolation experienced by pediatric cancer survivors as well as the need to improve the psychosocial support programs offered to them. Our results also show that the participants had distinct lived experiences compared to adult-onset cancer populations. Overall, the findings presented are expected to inform further studies and healthcare-education policies to help address these issues and improve the experiences of pediatric cancer survivors.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Breast-Involved Diffuse Large B-Cell Lymphoma Treated with R-CHOP: A Real-World Study with Insights into CNS Prophylaxis.","authors":"Thi Thu Huong Nguyen, Thi Yen Le, Thanh Tung Nguyen, Thanh Long Nguyen, Xuan Dai Nguyen, Tuan Anh Pham, Anh Tu Do, Thi Thanh Ha Lai, Van Quang Le","doi":"10.3390/curroncol33080493","DOIUrl":"10.3390/curroncol33080493","url":null,"abstract":"<p><p>This study evaluated clinical characteristics, treatment outcomes, and CNS relapse patterns in patients with breast-involved diffuse large B-cell lymphoma (DLBCL), a rare extranodal presentation with limited real-world data. We conducted a retrospective study on 33 consecutive patients with newly diagnosed breast-involved DLBCL treated from 2019 to 2024. All patients received R-CHOP. Baseline CNS screening-including neurological examination, fundoscopy, brain magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) analysis-was routinely performed. High-dose methotrexate (HD-MTX) was offered as CNS prophylaxis after completion of systemic therapy based on multidisciplinary team evaluation and clinician-patient shared decision-making according to institutional treatment protocols. Median age was 52.6 years; 84.8% had ECOG 0. Non-GCB subtype predominated (84.8%), and Ki-67 >70% was present in 69.7%. The overall response rate was 90.9%, with 84.8% complete responses. At a median follow-up of 44 months, 5-year Overall Survival (OS) and Progression-Free Survival (PFS) were 84.8% and 66.7%. CNS relapse occurred in 4 of 6 patients (66.7%) without prophylaxis, all within 5-11 months after R-CHOP, whereas no CNS relapses were observed among prophylaxis recipients (<i>p</i> < 0.001), although this observation should be interpreted with extreme caution given the very small non-prophylaxis subgroup (<i>n</i> = 6), limited statistical power, and non-randomized treatment allocation. Exploratory analyses suggested that bulky disease was associated with inferior OS. R-CHOP achieved high response rates and favorable long-term outcomes in breast-involved DLBCL. The absence of CNS relapse among HD-MTX prophylaxis recipients, contrasted with a high relapse rate in those without prophylaxis, provides only a hypothesis-generating observation that requires confirmation in larger prospective studies; this warrants further investigation of the role of systemic CNS prophylaxis.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fagotti Score (FS) Compared with Peritoneal Cancer Index (PCI) for Preoperative Assessment of Optimal Cytoreduction in Upfront Laparoscopy.","authors":"Dimitrios Tsolakidis, Efthalia Markopoulou, Nikolaos Thomakos, Dimitris Haidopoulos, Dimitrios Zouzoulas, Vasilis Theodoulidis, Kimon Chatzistamatiou, Maria Topalidou, Eleni Timotheadou, Grigoris Grimbizis","doi":"10.3390/curroncol33080490","DOIUrl":"10.3390/curroncol33080490","url":null,"abstract":"<p><p><b>Background:</b> Ovarian cancer is the eighth most common cancer in women worldwide. Prognosis in ovarian cancer patients is mainly affected by the complete resectability of the tumor at the time of surgery. Among the methods used to determine resectability are laparotomy, laparoscopy, and imaging techniques. In ovarian cancer patients, the Fagotti Score (FS) and Peritoneal Cancer Index (PCI) can be used during upfront diagnostic laparoscopy to quantify disease burden, resectability, and prognosis. <b>Methods:</b> The aim of this retrospective study was to assess the FS and PCI as tools for predicting optimal cytoreduction (R = 0, <1) and correctly assigning patients for primary debulking surgery (PDS) or interval debulking surgery (IDS). An ROC was used to compare the accuracy of both FS and PCI scores for assessing resectability. Diagnostic measures for both were calculated. <b>Results:</b> A total of 45 patients were ultimately included in this study. The area under the curve was 0.801 for the FS and 0.705 for the laparoscopic PCI, with an optimal cut-off score of 24.5. In our cohort, the FS demonstrated a sensitivity of 90%, a specificity of 64%, a PPV of 66.7%, and an NPV of 88.9%. Similarly, using a cut-off of 24.5, the PCI demonstrated a sensitivity of 80%, a PPV of 59.3%, and an NPV of 56%. <b>Conclusions:</b> Laparoscopic PCI is a useful tool for predicting resectability in ovarian cancer patients. However, when compared with the PCI, it seems that the FS performs better as a predictive score for resectability.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolving Role of Immunotherapy in the Treatment with Curative Purpose of Early, Intermediate and Advanced Stage Hepatocellular Carcinoma.","authors":"Anastasia D Karampa, Anna Goussia, Evangelos G Baltagiannis, Nikolaos-Andreas T Anastasopoulos, Dimitrios K Christodoulou, Georgios K Glantzounis","doi":"10.3390/curroncol33080492","DOIUrl":"10.3390/curroncol33080492","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is the most common primary liver cancer and is frequently diagnosed at advanced stages, thereby limiting curative treatment options. Although interventions with curative intent, such as liver resection and ablation, are available, recurrence rates exceed 70%. Recent developments in HCC management have shifted the focus from conventional surgery and targeted therapies to immunotherapy. This review synthesizes current evidence on immunotherapy for curative purposes in HCC, including both neoadjuvant and adjuvant strategies. It evaluates completed and ongoing clinical trials of immune checkpoint inhibitors (ICIs), administered as monotherapy or in combination with anti-angiogenic agents or dual-checkpoint blockade. ICIs may transform the initial treatment paradigm for advanced HCC, although their applications remain in the investigational stage. Preliminary results from the IMbrave050 trial suggested that adjuvant immunotherapy following radical liver resection improves recurrence-free survival (RFS) in high-risk patients. However, the initially promising outcomes of the combination of atezolizumab and bevacizumab compared with active surveillance were not sustained in the median follow-up, and long-term survival results are awaited. Although several studies have demonstrated encouraging preliminary results, a clear survival benefit has not yet been established. Further studies are necessary to establish definitive conclusions. Immunotherapy has a pathophysiological basis and preliminary evidence to redefine HCC management across disease stages; its integration into pre- and post-operative strategies may increase resectability, reduce recurrence, and improve survival. Ongoing trials are expected to clarify its exact role.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinguishing Organizing Pneumonia from Malignancy During Cancer Surveillance: Predominant Diagnostic Value of Imaging over Systemic Inflammatory Biomarkers.","authors":"Hacer Boztepe Yesilcay, Asim Armagan Aydin","doi":"10.3390/curroncol33080491","DOIUrl":"10.3390/curroncol33080491","url":null,"abstract":"<p><p><b>Background:</b> Distinguishing organizing pneumonia from recurrent malignancy in patients undergoing cancer surveillance remains a major clinical challenge. Although inflammatory biomarkers have emerged as potential diagnostic tools, their incremental value beyond imaging-based assessment remains uncertain. <b>Methods:</b> In this retrospective single-center study, we evaluated 170 patients with prior malignancy who underwent surgical assessment for suspicious lung-only pulmonary lesions between 2013 and 2023. Histopathology confirmed organizing pneumonia in 61 patients and malignancy in 109 patients. Preoperative clinical, radiologic, Positron emission tomography/computed tomography (PET/CT), and inflammatory biomarker variables were incorporated into predefined clinical, radiology-PET/CT, biomarker, and integrated models using Least absolute shrinkage and selection operator (LASSO)-penalized logistic regression with internal cross-validation. <b>Results:</b> The radiology/PET model demonstrated excellent discrimination (AUC 0.927), closely approximating the performance of the integrated model (AUC 0.935). The clinical and biomarker-only models showed moderate discrimination (AUC 0.764 and 0.778, respectively). Adding inflammatory biomarkers to imaging-derived features resulted in only a minimal improvement in diagnostic performance (ΔAUC = 0.009, 95% CI -0.019 to 0.037), indicating no statistically significant incremental benefit. Calibration, decision curve, and predictor stability analyses consistently identified radiologic and PET/CT-derived variables as the principal sources of predictive information. <b>Conclusions:</b> In patients with suspicious pulmonary lesions during cancer surveillance, diagnostic discrimination was driven predominantly by imaging-derived features, whereas conventional inflammatory biomarkers provided limited incremental value. These findings support an imaging-centered approach to preoperative risk stratification and multidisciplinary decision-making.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Response to an Individualized Multimodal Treatment Strategy in Advanced Pancreatic Adenocarcinoma: A Case Report.","authors":"Mehmet Salih İyikesici, Oral Oncul, Metin Hallaç, Sena Şen, Şirin Taflan, Selin Oncul, Tomas Duraj, Thomas N Seyfried","doi":"10.3390/curroncol33080489","DOIUrl":"10.3390/curroncol33080489","url":null,"abstract":"<p><p><b>Background</b>: Metastatic pancreatic adenocarcinoma carries a dismal prognosis, and treatment options after progression on standard chemotherapy remain limited. We report a metabolic response in a patient with drug-resistant disease treated with a combined multimodal regimen that paired dose-reduced (\"activated\") multi-agent chemotherapy with targeted agents and metabolic/microenvironmental support, set against an unusually long overall survival. <b>Case Presentation</b>: A 46-year-old man was diagnosed with inoperable, locally advanced/stage IV pancreatic adenocarcinoma in June 2023 and maintained disease control for approximately 2.5 years on a combined multimodal regimen, termed here metabolically controlled oncologic therapy (MCOT): dose-reduced chemotherapy given with regional hyperthermia, hyperbaric oxygen, and a carbohydrate-restricted diet. In February 2026 he developed local recurrence and diffuse liver metastases, and by May 2026 had deteriorated rapidly, with ¹⁸F-FDG PET/CT showing a peak SUVmax of 18.2 and CA 19-9 of 2788 U/mL. His regimen was intensified to a low-dose, multi-agent \"activated\" chemotherapy protocol combined with lenvatinib, everolimus, hyperthermia, and hyperbaric oxygen. <b>Clinical Findings and Outcomes</b>: One month later, his performance status had recovered from ECOG PS 2 to PS 0, CA 19-9 was 31 U/mL, and follow-up PET/CT showed a 63.7% decrease in SUVmax (from 18.2 to 6.6). Treatment-related adverse events included Grade 1 nausea, Grade 1 vomiting, and thrombocytopenia; no Grade 2 or higher non-hematological toxicity was observed. <b>Conclusions</b>: In selected patients who are considered to have exhausted standard options, a combined multimodal regimen pairing dose-reduced chemotherapy with metabolic and microenvironmental support may produce a well-tolerated metabolic response. As a single, uncontrolled observation, these findings cannot establish causality and require confirmation in prospective, controlled studies.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trastuzumab Deruxtecan in HER2-Positive Metastatic Breast Cancer: Real-World Outcomes and Treatment Transition Patterns in a Chinese Cohort.","authors":"Yifei Chen, Ruyan Zhang, Ran Ran, Yaxin Liu, Jiayang Zhang, Ying Yan, Bin Shao, Xu Liang, Hanfang Jiang, Lijun Di, Guohong Song, Huiping Li","doi":"10.3390/curroncol33080487","DOIUrl":"10.3390/curroncol33080487","url":null,"abstract":"<p><p>We retrospectively analyzed consecutive patients with HER2-positive metastatic breast cancer who received T-DXd at a single Chinese cancer center between March 2023 and March 2026. Progression-free survival (PFS), overall survival (OS), systemic and intracranial response, safety, prognostic factors, and exploratory subsequent treatment strategies were assessed. Among 173 eligible patients, 80.3% had received prior HER2-directed TKIs and 41.6% had CNS metastases. After a median follow-up of 14.3 months, median PFS and OS were 14.1 and 31.1 months, respectively. The objective response rate was 54.5% among 154 patients with measurable systemic disease, while the CNS objective response rate was 46.3% among 67 patients with measurable CNS lesions. Among patients with measurable CNS lesions, the CNS-ORR was comparable between patients with and without peri-T-DXd local treatment (53.8% vs. 44.4%, <i>p</i> = 0.21). Greater prior treatment exposure was associated with shorter PFS, whereas HER2 IHC 3+ disease was independently associated with longer OS and showed a trend toward improved PFS compared with HER2 IHC 2+/FISH-positive disease. Interstitial lung disease occurred in 13 patients (7.5%), all grade 1-2. Among 148 patients included in the maintenance analysis, 23 switched to alternative maintenance regimens after initial benefit from T-DXd. In an exploratory analysis, no statistically significant differences in PFS or OS were observed between patients who continued T-DXd and those who switched to maintenance therapy. However, these findings require cautious interpretation because of immortal-time bias, selection bias, and limited sample size. T-DXd demonstrated clinically meaningful systemic and intracranial activity with manageable toxicity in this heavily pretreated real-world cohort.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional Radiology in the Treatment of Musculoskeletal Tumours.","authors":"Sude Yarar, Panagiotis Tsagkozis","doi":"10.3390/curroncol33080488","DOIUrl":"10.3390/curroncol33080488","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Primary benign and malignant musculoskeletal tumours are generally treated with surgical excision. Metastatic musculoskeletal disease may require both systemic and local treatment. This review focuses on the use of radiofrequency ablation (RFA), cryoablation, cementoplasty, and high-intensity focused ultrasound (HIFU) in primary musculoskeletal tumours and bone and soft-tissue metastases. <b>Methods:</b> We reviewed English-language studies addressing the indications, clinical outcomes, patient selection, and complications of these techniques in patients with primary musculoskeletal tumours or bone and soft-tissue metastases. <b>Results:</b> RFA is the preferred minimally invasive treatment for osteoid osteoma and may be considered for selected small intraosseous tumours. In symptomatic bone metastases, RFA may provide pain relief and can be combined with cementoplasty when structural support is needed. Cryoablation is used selectively for benign, locally aggressive, recurrent, and metastatic tumours, with the advantage of visualizing the ablation zone. Cementoplasty is mainly used to relieve mechanical pain and reinforce weakened bone. HIFU has been studied mainly for pain palliation in bone metastases, while evidence in primary malignant tumours remains limited. <b>Conclusions:</b> Image-guided interventions can complement surgery and radiotherapy in selected patients. Treatment choice depends on tumour type, location, treatment intent, skeletal stability, and proximity to critical structures.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning-Based Detection Model for Leukemia Cells in Peripheral Blood Smears Using YOLOv11-Large.","authors":"Johan M Diaz, Arunima Deb, Alexandra Lyubimova, Cedric Nasnas, Leily Santos, Carla Romagnoli, Jacqueline C Barrientos","doi":"10.3390/curroncol33080486","DOIUrl":"10.3390/curroncol33080486","url":null,"abstract":"<p><strong>Background: </strong>Accurate identification and classification of white blood cell (WBC) subtypes in peripheral blood smears (PBS) is essential for the diagnosis and monitoring of hematological malignancies, including leukemia. Conventional manual microscopy, although clinically established, is labor-intensive and subject to inter- and intra-observer variability. Deep learning-based object detection offers a route to automation, yet most prior studies are limited by small datasets, restricted cell taxonomies, or single-microscope acquisition. This study evaluates a YOLOv11-large (YOLOv11L) detector for simultaneous localization and classification of 13 leukemia-relevant WBC subtypes plus an artifact class (14 classes total), trained on the large-scale, multi-domain, open-source LeukemiaAttri dataset.</p><p><strong>Methods: </strong>From the LeukemiaAttri dataset, 18,664 annotated images (67,347 objects) acquired at 40× and 100× magnification were partitioned by stratified sampling into training (70%), validation (15%), and test (15%) sets. The training set was expanded to 65,785 images through extensive geometric, photometric, and AugMix augmentation. A YOLOv11L model pretrained on MS COCO was fine-tuned for 250 epochs (640 × 640 input) on a single NVIDIA H200 SXM GPU, using an auto-selected optimizer (momentum 0.9; weight decay 5 × 10^-4), automatic mixed precision (AMP), and mosaic augmentation for the first 240 epochs.</p><p><strong>Results: </strong>On an internal held-out test set, the model achieved an mAP50 of 93.9%, mAP50-95 of 77.9%, precision of 94.1%, recall of 88.8%, and an F1 score of 0.913, with similar performance in the validation and test sets. Class-wise average precision (AP) ranged from 89.3% (monocyte) to 98.2% (monoblast), confirming consistent detection across morphologically diverse subtypes.</p><p><strong>Conclusions: </strong>The YOLOv11L detector achieved high performance across all 14 categories on the internal test set, with metrics exceeding those previously reported for subset-specific baselines. These findings support further evaluation of the model as a decision-support tool for peripheral blood smear analysis. External validation is required to determine its clinical utility and generalizability.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 8","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}