Frontiers in Oncology最新文献

{"title":"Case report: Abscopal response and reversal of PD-1 resistance in a patient with nephroblastoma following radiofrequency ablation.","authors":"Mengyang Ju, Mingjuan Sun, Wenfeng Li, Sheng Zhang","doi":"10.3389/fonc.2025.1640409","DOIUrl":"https://doi.org/10.3389/fonc.2025.1640409","url":null,"abstract":"<p><p>Nephroblastoma (Wilms tumor, WT) is an extremely rare and aggressive malignancy in adults with nonspecific clinical and imaging features. There is no standard therapy for patients with progressive disease despite surgery and chemotherapy. Here, we report a unique case of a 27-year-old male patient with recurrent metastatic nephroblastoma who developed resistance to PD-1 inhibitor and targeted therapy. Radiofrequency ablation (RFA) was performed on the largest porta pulmonic lesion. Notably, 3 months post-ablation, a non-ablated pleural lesion exhibited a partial response. Follow-up confirmed PR of the pleural lesion and total disappearance of pleura-irritative symptoms. This case demonstrates a potential abscopal effect induced by RFA, in which local treatment of one tumor site coincided with systemic regression of distant, untreated lesions and reversal of prior PD-1 inhibitor resistance.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1640409"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: A rare cause of duodenal intussusception: the pedunculated Brunner's gland hamartoma.","authors":"Yi-Hua Wang, Jing Zhou, Xiao-Shan Huang, Xiao-Zhong Zheng, Meng-Ying Gu, Jia-Qi Duan, Shu-Feng Fan, Jian-Xia Xu","doi":"10.3389/fonc.2025.1699786","DOIUrl":"https://doi.org/10.3389/fonc.2025.1699786","url":null,"abstract":"<p><strong>Background: </strong>Brunner's gland hamartomas (BGHs) are primarily benign and typically do not exhibit characteristic clinical symptoms. The discovery and diagnosis of duodenal BGHs may require imaging assistance. Dissemination of this case can help inform future diagnosis and effective treatment.</p><p><strong>Case summary: </strong>Herein, we report a case of a 43-year-old man presenting with bloating. The computed tomography (CT) found a strip-like, mixed-density lesion with fat attenuation in the duodenal canal, and the proximal intestine was dilated. Contrast-enhanced abdominal CT revealed that the lesion had mild to moderate enhancement with incomplete intussusception. The lesion was resected entirely with the endoscope. Postoperative pathology results confirmed a BGH.</p><p><strong>Conclusion: </strong>CT findings exhibit specific characteristics that are valuable for visualizing these lesions or their secondary manifestations. An elongated intraluminal mass lesion with heterogeneous density and fat attenuation may indicate a pedunculated duodenal Brunner's gland hamartoma.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1699786"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence versus radiologists in predicting lung cancer treatment response: a systematic review and meta-analysis.","authors":"Nehemias Guevara Rodriguez, Noemy Coreas Mercado, Kumar Panjiyar, Ranju Kunwor","doi":"10.3389/fonc.2025.1634694","DOIUrl":"https://doi.org/10.3389/fonc.2025.1634694","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) has emerged as a promising adjunct to radiologist interpretation in oncology imaging. This systematic review and meta-analysis compares the diagnostic performance of AI systems versus radiologists in predicting lung cancer treatment response, focusing solely on treatment response rather than diagnosis.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library from inception to March 31, 2025; Google Scholar and CINAHL were used for citation chasing/grey literature. The review protocol was prospectively registered in PROSPERO (CRD420251048243). Studies directly comparing AI-based imaging analysis with radiologist interpretation for predicting treatment response in lung cancer were included. Two reviewers extracted data independently (Cohen's κ = 0.87). We pooled sensitivity, specificity, accuracy, and risk differences using DerSimonian-Laird random-effects models. Heterogeneity (I²), threshold effects (Spearman correlation), and publication bias (funnel plots, Egger's test) were assessed. Subgroups were prespecified by imaging modality and therapy class.</p><p><strong>Results: </strong>Eleven retrospective studies (n = 6,615) were included. Pooled sensitivity for AI was 0.9 (95% CI: 0.8-0.9; I² = 58%), specificity 0.8 (95% CI: 0.8-0.9; I² = 52%), and accuracy 0.9 (95% CI: 0.8-0.9; pooled OR = 1.4, 95% CI: 1.2-1.7). Risk difference favored AI by 0.06 for sensitivity and 0.04 for specificity. AI's advantage was most apparent in CT and PET/CT, with smaller/non-significant gains in MRI. Egger's test suggested no significant publication bias (p = 0.21).</p><p><strong>Conclusion: </strong>AI demonstrates modest but statistically significant superiority over radiologists in predicting lung cancer treatment response, particularly in CT and PET/CT imaging. However, generalizability is limited by retrospective study dominance, incomplete demographic reporting, lack of regulatory clearance, and minimal cost-effectiveness evaluation. Prospective, multicenter trials incorporating explainable AI (e.g., SHAP, Grad-CAM), equity assessments, and formal economic analyses are needed.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD420251048243.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1634694"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an AI-driven digital assistance system for real-time safety evaluation and quality control in laparoscopic liver surgery.","authors":"Zi-Yang Peng, Zhi-Bo Wang, Yan Yan, Hao-Qian Peng, Yong-Tai Ma, Yu-Tong Li, Yao-Xing Ren, Jun-Xi Xiang, Kun Guo, Gang Wang, Jian-Feng Duan, Xiao-Wen Li, Yu Guan, Xue-Min Liu, Rong-Qian Wu, Yi Lyu, Li Yu","doi":"10.3389/fonc.2025.1678525","DOIUrl":"https://doi.org/10.3389/fonc.2025.1678525","url":null,"abstract":"<p><strong>Background: </strong>By performing AI-driven workflow analysis, intelligent surgical systems can provide real-time intraoperative quality control and alerts. We have upgraded an Intelligent Surgical Assistant (ISA) through integrating a redesigned hierarchical recognition algorithm, an expanded surgical dataset, and an optimized real-time intraoperative feedback framework.</p><p><strong>Objective: </strong>We aimed to assess the accuracy of the ISA in real-time instrument tracking, organ segmentation, and phase classification during laparoscopic hemi-hepatectomy.</p><p><strong>Methods: </strong>In this retrospective multi-center analysis, a total of 142861 annotated frames were collected from 403 laparoscopic hemi-hepatectomy videos across 4 centers to build a comprehensive database of surgical video annotations. Each frame was labeled for surgical phase, organs, and instruments. The algorithm in the ISA was retrained using a hybrid deep learning framework integrating instrument tracking, organ segmentation, and phase classification. We then established a scoring system for surgical image recognition and evaluated the algorithm's recognition accuracy and inter-operator consistency across different surgical teams.</p><p><strong>Results: </strong>The upgraded ISA achieved an accuracy of 89% in real-time recognition of instruments and organs. The programmatic phase classification for laparoscopic hemi-hepatectomy reached an average accuracy of 91% (p<0.001), enabling a correct recognition of surgical events. The inter-operator variability in recognition was reduced to 14.3%, highlighting the potential of AI-assisted quality control to standardize intraoperative alerts. Overall, the ISA demonstrated high precision and consistency in phase recognition and operative field evaluation across all phases (accuracy >87%, specificity ~90% in each phase). Notably, critical phases (Phase 1 and Phase 5) were identified with an exceptional accuracy area under the curve (AUC 0.96 in Phase 1; AUC 0.87 in Phase 5), indicating that key surgical procedures could be phased with very low false-alarm rates.</p><p><strong>Conclusions: </strong>The optimized ISA provides a highly accurate real-time interpretation of surgical phases and a strong potential to standardize surgical procedures, thus guaranteeing the outcomes and safety of laparoscopic hemi-hepatectomy.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1678525"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12541588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Innovative surgical management of ileal neobladder fistula after radical cystectomy.","authors":"Zhiyang Ma, Xiaopin Ji, Wenbin Rui, Xiaojing Wang","doi":"10.3389/fonc.2025.1635458","DOIUrl":"https://doi.org/10.3389/fonc.2025.1635458","url":null,"abstract":"<p><p>An ileal neobladder fistula is a rare but serious complication of radical cystectomy with orthotopic neobladder reconstruction. Owing to its low incidence, the challenges posed by dense adhesions, and the risk to urinary function, there is little consensus on optimal management. A 68-year-old male with low-grade non-muscle-invasive bladder cancer underwent transurethral resection, followed by radical cystectomy and total laparoscopic orthotopic neobladder reconstruction. One month after surgery, the patient developed fecaluria. Imaging revealed a fistula between the neobladder and the ileum. Proximal ileostomy was performed to eliminate fecaluria. Seven months later, an open surgical repair was performed. Severe adhesions around the original ileal anastomosis and neobladder apex precluded safe separation. Rather than risking neobladder injury and loss of capacity, the surgical team preserved approximately 2 cm of the adherent ileum and restored intestinal continuity using overlap anastomosis. Postoperative recovery was uneventful, and follow-up revealed no recurrence of the fistula. This case demonstrates that the rapid identification and staged management of ileal neobladder fistulas can ensure favorable outcomes. The innovative surgical approach described here is effective in preserving both neobladder function and intestinal integrity and provides a viable, less invasive alternative for patients presenting with complex adhesions.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1635458"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Pemetrexed-induced pseudocellulitis: a rare adverse effect to be recognized for better management.","authors":"Emma Proux, Jeanne Chen, Caroline Bonhomme, Pierre Pottier, Marie Piroth","doi":"10.3389/fonc.2025.1619250","DOIUrl":"https://doi.org/10.3389/fonc.2025.1619250","url":null,"abstract":"<p><p>Pseudocellulitis, a non-infectious inflammatory reaction mimicking infectious cellulitis, is a rare and often underrecognized adverse reaction to pemetrexed, frequently diagnosed late and leading to inappropriate treatments, particularly unnecessary antibiotic use. Through the presentation of a new case and a literature review conducted using Scopus and PubMed, we aim to clarify its clinical presentation and management. We report a new case of pemetrexed-induced pseudocellulitis (PIP), initially misdiagnosed and treated unnecessarily with multiple antibiotics. Following the correct diagnosis, the patient was successfully treated with both oral and topical corticosteroids. Pemetrexed had to be discontinued. PIP clinically mimics cellulitis, presenting unilaterally or bilaterally, sometimes accompanied by fever and inflammatory syndrome. Its onset is variable, occurring either after the initial pemetrexed administration or following subsequent cycles, with no clear dose dependency. Skin biopsy is not essential for diagnosis. Management typically involves local and/or systemic corticosteroids. Discontinuation of pemetrexed should be evaluated on a case-by-case basis and is not always necessary. Improved recognition of this condition is essential to avoid unnecessary interventions, enhance patient care, and prevent long-term complications due to prolonged inflammation.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1619250"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential intravesical Bacillus Calmette-Güerin and mitomycin C applied with electromotive drug administration therapy for non-muscle invasive bladder cancer.","authors":"Mirko Bakula, Tvrtko Hudolin, Tomislav Kulis, Toni Zekulic, Jerko Andelic, Zoran Zimak, Bojan Cikic, Ilija Juric, Zeljko Kastelan","doi":"10.3389/fonc.2025.1682918","DOIUrl":"https://doi.org/10.3389/fonc.2025.1682918","url":null,"abstract":"<p><p>Intravesical therapy plays a crucial role in reducing the risk of recurrence and progression in patients with non-muscle invasive bladder cancer (NMIBC). Among the most widely used intravesical treatments is Bacillus Calmette-Guérin (BCG). To enhance therapeutic outcomes, sequential treatment strategies have been explored, including the combination of BCG with Mitomycin C (MMC) delivered via Electromotive Drug Administration (EMDA). In this retrospective clinical study, we report the results of sequential intravesical administration of BCG and MMC administered via EMDA (MMC EMDA) in 25 patients with intermediate- and high-risk NMIBC. Primary tumors were observed in 11 patients, while 14 had recurrent disease. Only one patient experienced recurrence during follow-up, after the 3 months of the therapy, resulting in an overall recurrence rate of 4%. The median follow-up duration was 16 months. In conclusion, our results support and expand the evidence indicating that sequential BCG and MMC EMDA offer a highly effective treatment approach for patients with intermediate- and high-risk NMIBC.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1682918"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-angiogenesis in human lymphomas. New insights.","authors":"Domenico Ribatti, Roberto Tamma, Giuseppe Ingravallo, Giorgina Specchia","doi":"10.3389/fonc.2025.1636332","DOIUrl":"https://doi.org/10.3389/fonc.2025.1636332","url":null,"abstract":"<p><p>Targeting tumor angiogenesis is an advancement in the treatment of hematological malignancies. This article summarizes the most recent advancements in the use of anti-angiogenic agents in the treatment of human lymphomas. Preclinical and clinical studies have evidenced that treating lymphomas with anti-angiogenic monotherapy may not be successful. Alternative therapeutic strategies may be used to overcome resistance to anti-angiogenic therapy, including the association of different anti-angiogenic molecules or their combination with other treatment regimens.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1636332"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Efficacy of preoperative conversion therapy with lenvatinib, toripalimab, and hepatic arterial infusion chemotherapy in an advanced hepatocellular carcinoma.","authors":"Jing Mao, Hengzhi Zhang, Xingxia Yang, Yanjun Yao, Xu Sun, Qiang Yan","doi":"10.3389/fonc.2025.1627281","DOIUrl":"https://doi.org/10.3389/fonc.2025.1627281","url":null,"abstract":"<p><p>Advanced hepatocellular carcinoma (HCC) has a poor prognosis. Conversion therapy based on non-surgical local therapy and drug therapy is an effective treatment for unresectable HCC. We report a case of HCC with intrahepatic metastasis and multiple venous tumor thrombi. After nearly 4 months of conversion therapy with lenvatinib, toripalimab combined with hepatic arterial infusion chemotherapy (HAIC), the lesions were significantly reduced, the portal vein tumor thrombus resolved, and the alpha-fetoprotein (AFP) decreased to the normal range. This patient had no serious adverse events during treatment. After a comprehensive assessment of the patient's status, the patient eventually underwent curative surgical resection of the tumor and had a complete response. The successful experience of this case indicates that lenvatinib, toripalimab combined with HAIC has a good prospect as a conversion therapy for HCC with intrahepatic metastasis and multiple venous tumor thrombi.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1627281"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Spontaneous pregnancy after fertility-preserving treatment in a patient with low-grade endometrial stromal sarcoma and literature review.","authors":"Manrong Wang, Pengfei Wu, Lulu Wang, Sijia Liu, Qujia Gama, Qiaoying Lv, Jinyu Zhang, Min Yu, Yiqin Wang, Fenghua Ma, Weiwei Shan, Xuezhen Luo","doi":"10.3389/fonc.2025.1572914","DOIUrl":"https://doi.org/10.3389/fonc.2025.1572914","url":null,"abstract":"<p><strong>Introduction: </strong>Low-grade endometrial stromal sarcoma (LGESS) is a rare malignant tumor of the uterus, characterized by slow growth. Early-stage LGESS is associated with favorable survival, but it has a high recurrence rate. The primary treatment for this disease is full-staging surgery. In this report, we present a case to explore the potential for fertility-preserving treatment in young women with LGESS.</p><p><strong>Case presentation: </strong>A 29-year-old nulliparous patient diagnosed with stage IA LGESS underwent conservative treatment at the Obstetrics and Gynecology Hospital of Fudan University. After fertility-sparing surgery and three months of hormone treatment, no residual lesions were found. Subsequently, the patient conceived spontaneously and successfully delivered a healthy baby. However, she experienced recurrence eight months after delivery but declined hysterectomy and follow-up care.</p><p><strong>Conclusions: </strong>Currently, there is still no standard management protocol for fertility preservation therapy in LGESS. Both previously reported cases and our case suggest that fertility-sparing treatment may be an option for carefully selected patients with LGESS. Further research and larger clinical studies are necessary to explore fertility-preserving treatments for young nulliparous patients with LGESS to establish guidelines or consensus.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1572914"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}