International Journal of Cancer最新文献

{"title":"Early-life anthropometry and colorectal cancer risk in adulthood: Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis of prospective studies.","authors":"Moniek van Zutphen, Auke J C F Verkaar, Fränzel J B van Duijnhoven, Trudy Voortman, Monica L Baskin, Rajiv Chowdhury, Ellen Copson, Sarah J Lewis, Lynette Hill, John Krebs, Matty P Weijenberg, Jacob C Seidell, Yikyung Park, Jennifer L Baker, Mojgan Amiri, Tosca O E de Crom, Erand Llanaj, Amber Meulenbeld, Macarena Lara, Yuchan Mou, Vanessa L Z Gordon-Dseagu, Esther M González-Gil, Georgios Markozannes, Konstantinos K Tsilidis, Doris S M Chan, Ellen Kampman, Dieuwertje E Kok","doi":"10.1002/ijc.35461","DOIUrl":"https://doi.org/10.1002/ijc.35461","url":null,"abstract":"<p><p>While adult anthropometric measures are well-studied in relation to colorectal cancer (CRC) risk, the impact of early-life anthropometry remains unclear. We conducted a systematic literature review and meta-analysis examining early-life anthropometry, including birth size, height and adiposity and adult CRC risk. We searched Medline, Embase, Web of Science and CENTRAL. Early-life stages were categorised as at birth, infancy (0 to <2 years), childhood (2 to 9 years), adolescence (10 to 19 years) and young adulthood (18 to 25 years). Random-effects meta-analyses were conducted when ≥3 prospective observational studies provided sufficient information; otherwise, results were descriptively synthesised. We included 37 publications, and evidence was graded by the Global Cancer Update Programme Expert Panel. Higher birthweight (relative risk [RR] per 1000 g: 1.09, 95% confidence interval [CI] 1.01-1.16; 8 studies, 8134 cases) and young adult body mass index (BMI, RR per 5 kg/m²: 1.12, 95% CI 1.07-1.17; 16 studies, 20,365 cases) were associated with higher CRC risk. Associations for young adult BMI were most pronounced for colon cancer (RR per 5 kg/m²: 1.15, 95% CI: 1.06-1.24). Descriptive synthesis showed that childhood and adolescent BMI were also associated with higher colon and/or CRC risk. Evidence for all the above associations was graded by the Expert Panel as \"strong-probable.\" Additionally, there was \"limited-suggestive\" evidence linking higher birthweight to higher colon cancer risk, taller childhood height to higher CRC risk, early-life adiposity-measured by BMI pictograms-to higher colon and CRC risk and higher young adult BMI to rectal cancer risk. Other exposure-outcome associations were graded as \"limited-no conclusion.\" Altogether, these results imply that larger body size during early life is associated with higher adult CRC risk.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of prognostic nutritional index on oncological outcomes and mortality among advanced gastric cancer patients: European GASTRODATA registry analysis.","authors":"Zuzanna Pelc, Katarzyna Sędłak, Radosław Mlak, Yutaka Endo, Ines Gockel, Johanna van Sandick, Gian Luca Baiocchi, Bas Wijnhoven, Suzanne Gisbertz, Manuel Pera, Paolo Morgagni, Massimo Framarini, Arnulf Hoelscher, Stefan Moenig, Piotr Kołodziejczyk, Guillaume Piessen, Clarisse Eveno, Paulo Matos da Costa, Cara Baker, Andrew Davies, William Allum, Uberto Fumagalli Romario, Ricardo Rosati, Daniel Reim, Lucio Lara Santos, Domenico D'ugo, Giovanni de Manzoni, Wojciech Kielan, Paul Schneider, Timothy M Pawlik, Wojciech Polkowski, Karol Rawicz-Pruszyński","doi":"10.1002/ijc.35489","DOIUrl":"https://doi.org/10.1002/ijc.35489","url":null,"abstract":"<p><p>While Prognostic Nutritional Index (PNI) is an established predictor of outcomes in Asian gastric cancer (GC) patients, data among Western populations are limited. This study assessed the predictive value of PNI in European GC patients undergoing multimodal treatment. Data from GASTRODATA, the largest European repository of GC patients undergoing gastrectomy, were collected between 2017 and 2022. The primary outcome was textbook outcome (TO) achievement, and the secondary was 90-day mortality. PNI was calculated one day before surgery, with a cut-off of 45.5 based on ROC analysis. Among 721 patients included 60.7% were men. Most patients had advanced tumors (cT3-4 = 75.2%) and metastatic lymph nodes (57.7%). Neoadjuvant chemotherapy (NAC) was administered to 46.7% of patients, and 32.9% received adjuvant chemotherapy. Median PNI was 49.5 (IQR 45.0-56.4). Low PNI was present among 30% of patients and was associated with decreased odds of TO achievement (OR = 0.57, 95% CI 0.37-0.89), higher 90-day mortality (OR = 4.99, 95% CI 2.32-10.73). NAC administration was associated with lower morbidity risk (OR = 0.56, p = 0.0408), and low PNI was a predictor of receiving AC (p = 0.0005). PNI was a valuable predictor for oncological outcomes and morbidity among European GC patients undergoing multimodal. While low PNI was associated with decreased odds of TO achievement and increased risk of 90-day mortality, further prospective and nutritional intervention studies are warranted to standardize the PNI threshold and improve its clinical applicability.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of cutaneous melanoma incidence attributable to ultraviolet radiation in 2022.","authors":"Oliver Langselius, Harriet Rumgay, Esther de Vries, David C Whiteman, Ahmedin Jemal, D Maxwell Parkin, Isabelle Soerjomataram","doi":"10.1002/ijc.35463","DOIUrl":"https://doi.org/10.1002/ijc.35463","url":null,"abstract":"<p><p>Cutaneous melanoma (CM) accounted for around 331,700 cancer cases globally in 2022. Ultraviolet radiation (UVR) is a major CM risk factor. In this study, we update and improve global estimates of UVR-attributable CM cases. Population attributable fractions (PAFs) were calculated by age, sex, and country using GLOBOCAN 2022 national incidence estimates comparing to a minimally exposed Nordic 1930 birth cohort reference population. Adjustments for acral lentiginous melanoma were made to exclude non-UVR-associated melanomas. In sensitivity analyses, PAFs were recalculated with a theoretical minimally exposed 1903 South Thames, England birth cohort and world region-specific reference populations. An estimated 267,353 (95% uncertainty intervals [UI]: 242,818, 278,638) CM cases were UVR attributable globally in 2022. Males contributed to a larger proportion (57%, 151,921 out of 267,353) of UVR-attributable CMs. We found significant regional variation with the highest PAF observed in Australia/ New Zealand, Northern Europe, and North America, all with more than 95% CM cases UVR-attributable. Attributable age-standardized rates were highest in regions with populations of lighter skin color such as Australia/New Zealand, Northern Europe, and North America, with 75.68 (95%UI: 74.50, 76.86), 36.82 (95%UI: 36.38, 37.26) and 33.69 (95%UI: 33.47, 33.91) attributable cases per 100,000 people. By age group, the burden increased with age, with PAF of 76.39% (95%UI: 66.24, 81.01) among people aged 30-49 versus 86.13% (95%UI: 80.04, 88.99) among 70+ years. Most of the global CM burden in 2022 was UVR-attributable. Primary prevention through increasing sun safety awareness and affordable sun protection provision options is key to reducing CM.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased mortality from colorectal cancer in younger individuals: The preventive role of aspirin and statins.","authors":"Giulia Sterpetti, Antonio V Sterpetti","doi":"10.1002/ijc.35495","DOIUrl":"https://doi.org/10.1002/ijc.35495","url":null,"abstract":"","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of interventions aimed at reducing inequalities along the cancer continuum: A scoping review.","authors":"Wende C Safari, Katja Gravenhorst, Clemence Leyrat, Koki Shimizu, Matthew J Smith, Ajay Aggarwal, Camille Maringe","doi":"10.1002/ijc.35478","DOIUrl":"https://doi.org/10.1002/ijc.35478","url":null,"abstract":"<p><p>Cancer inequalities are wide and enduring, within countries between socio-demographic groups and between countries. These are generated and sustained throughout the key phases of the cancer pathway, from investigation, clinical assessment, decision and access to treatment, and follow-up care. We aimed to describe the characteristics of implemented interventions, evaluated in published controlled experiments in the medical literature, specifically designed to target reductions in inequalities along the cancer pathway. We searched the Ovid Medline and Embase databases from January 2005 to April 2024 for controlled experiments reporting on interventions tackling inequalities. We extracted information on the publication, the aim and type of intervention, its setting, the characteristics of the sample and of the interventions, and summarised their results and limitations. We identified 56 articles reporting on 57 interventions. Of these, 51 (89.5%) focused on access to screening; 56 (98.2%) focused on colorectal, breast, and cervical cancers; 37 (64.9%) concentrated on ethnic inequalities and 48 (84.2%) were based in the USA. In addition, the majority of interventions sought to change individual knowledge, beliefs, and behaviour rather than issues at the system-level. The importance of addressing how healthcare is delivered equitably to all individuals is widely recognised, and there is evidence that individual factors account for only a small part of cancer pathway inequalities. Yet, this scoping review reports a lack of diversity in the implementation of interventions addressing cancer inequalities, and a minority of them target health system issues.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of outcomes between haploidentical and matched related donors for chronic myelomonocytic leukemia: A multicenter real-world study.","authors":"Yu-Qian Sun, Li-Xin Wu, Yi-Cheng Zhang, Ya-Jing Xu, Xiao-Bing Huang, Bao-Dong Ye, Hai-Long Yuan, Jian-Ying Zhou, Su-Jun Gao, Fang Zhou, Yue Liu, Xian-Min Song, Yu Cai, Xiao-Liang Liu, Yi Luo, Lu-Xin Yang, Jian-Min Yang, Li-Bing Wang, Yu-Hua Li, Rui Huang, Shun-Qing Wang, Ming Zhou, Yu-Jun Dong, Qian Wang, Yi-Mei Feng, Xi Zhang, Xin Du, Wei Ling, Han Zhu, Zun-Min Zhu, Xiang-Li Chen, Shi-Yu Wang, Fan-Kai Meng, Ke-Hong Bi, Ning Huang, Ming Jiang, Ting Niu, Jie Ji, Ding-Ming Wan, Zhi-Lei Bian, Yi Chen, Li Liu, Xue-Qian Yan, Xi Yang, Hai Yi, Xu-Dong Wei, Xin Li, Qian Cheng, Cheng-Lu Yuan, Wen Wang, Yu-Hong Zhou, Yu-Hong Chen, Feng-Rong Wang, Yuan-Yuan Zhang, Zhi-Dong Wang, Xiao-Dong Mo, Wei Han, Jing-Zhi Wang, Yu Wang, Huan Chen, Xiang-Yu Zhao, Ying-Jun Chang, Kai-Yan Liu, Jia Feng, Lan-Ping Xu, Hong-Yu Zhang, Xiao-Jun Huang, Xiao-Hui Zhang","doi":"10.1002/ijc.35485","DOIUrl":"https://doi.org/10.1002/ijc.35485","url":null,"abstract":"<p><p>Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative strategy for patients with chronic myelomonocytic leukemia (CMML). However, few reports have investigated the outcomes of patients receiving haploidentical HSCT. To this end, we included 117 patients with haploidentical donors (HID) and 75 patients with matched related donors (MRD) from 28 centers across China to explore the prognostic impact of different transplantation modalities. We found no significant difference between these two groups in terms of event-free survival (EFS, p = .211), overall survival (OS, p = .503), cumulative incidence of relapse (CIR, p = .076) or non-relapse mortality (NRM, p = .794). The predominance of peripheral blood (PB) graft source over bone marrow and PB since 2020 may have contributed to the worse outcomes in the MRD group. Moreover, CMML-specific prognostic scoring system (CPSS) lower-risk patients benefited more from the HID modality with superior EFS (p = .006). Multivariate analysis indicated that advanced age (p = .013), anemia at diagnosis (p = .010), and donor relationship (parent-to-child, p = .013) were independently associated with worse EFS in the HID group. Our data suggested that HID was comparable to MRD in CMML. However, under certain conditions, such as CPSS lower-risk ones, HID was preferred.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term cardiac outcomes in breast cancer patients treated with helical tomotherapy: Evaluating the applicability of 3D-based dose constraints for intensity modulated radiation therapy.","authors":"Pierre Loap, Abdelkarim Uakkas, Jihane Bouziane, Alain Fourquet, Youlia Kirova","doi":"10.1002/ijc.35474","DOIUrl":"https://doi.org/10.1002/ijc.35474","url":null,"abstract":"<p><p>Adjuvant breast radiotherapy has been associated with cardiac toxicity due to older 2D and 3D techniques, with a linear relationship between mean heart dose (MHD) and ischemic cardiac events. Cardiac dose distribution differs with modern techniques like intensity-modulated radiotherapy (IMRT), potentially affecting this relationship. This study evaluates long-term cardiac toxicity in breast cancer patients treated with tomotherapy to reassess 3D-derived dose constraints. Breast cancer patients treated with tomotherapy at Institut Curie from August 2010 to December 2015 were included. Patients had undergone breast-conserving surgery or mastectomy, with some receiving chemotherapy or trastuzumab. Tomotherapy was used for anatomically challenging cases. The primary endpoint was cardiac toxicity correlated with MHD; secondary endpoints were overall and disease-specific survival. Statistical analyses included logistic regression and Cox models. Among 179 patients, the median MHD was 7.04 Gy, with 95.6% having an MHD above 5 Gy. Sixty-six patients had cardiovascular risk factors, and 28.5% were obese. Over a median follow-up of 9.1 years, eight patients (4.5%) experienced cardiovascular events-all with pre-existing risks or obesity. No significant correlation was found between MHD and major coronary events (p = 0.607) or heart failure (p = 0.800). Cardiac mortality was absent, and 10-year overall and disease-specific survival were 88.0% and 94.3%, respectively. Cardiac events in patients treated with tomotherapy were rare and driven by pre-existing risk factors. The linear MHD-toxicity relationship observed in 3D radiotherapy may not apply to IMRT, potentially leading to overestimated risks. Long-term studies are needed to refine IMRT dose constraints.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apoptosis regulators of the Bcl-2 family play a key role in chemoresistance of cholangiocarcinoma organoids.","authors":"Wunan Mi, Gilles S van Tienderen, Shaojun Shi, Amy Broeders, Kathryn Monfils, Henk P Roest, Luc J W van der Laan, Monique M A Verstegen","doi":"10.1002/ijc.35483","DOIUrl":"https://doi.org/10.1002/ijc.35483","url":null,"abstract":"<p><p>Cholangiocarcinoma (CCA) is a rare but devastating liver cancer which is commonly diagnosed at a late stage and often resistant to chemotherapy. Bcl-2 family members, which control apoptotic cell death, are known to be involved in the chemoresistance of some cancer types. This study investigated the role of Bcl-2 family members in the chemoresistance of cholangiocarcinoma organoids (CCAOs) in both undifferentiated and matured branching phenotypes (BRCCAOs). Patient-derived CCAOs and BRCCAOs were cultured to assess chemoresistance to an FDA-approved anticancer drug panel by testing cell viability using ATP quantification and apoptotic cell death by cleaved caspase 3 staining. More specifically, sensitivity to the first-line drug gemcitabine was tested in combination with Bcl-2 family inhibitors or activators. We found that in gemcitabine-resistant CCAOs, inhibition of Bcl-xl could overcome gemcitabine resistance and induce apoptotic cell death. Although inhibition of Mcl-1 or activation of Bax induced spontaneous cell death, this could not overcome gemcitabine resistance. The BRCCAOs, which mimic tumor architecture better than CCAOs, show broader chemoresistance to anticancer drugs. Of note, in the resistant BRCCAOs, Bcl-xl inhibition could restore gemcitabine sensitivity. In conclusion, this study shows that targeting Bcl-xl can overcome chemoresistance to gemcitabine in CCA organoids. CCAOs and BRCCAOs provide good preclinical models for testing new drug combinations and assessing personalized therapeutic approaches.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between prediagnostic serum metabolites and pancreatic ductal adenocarcinoma risk in two prospective cohorts.","authors":"Ting Zhang, Steven C Moore, Sheng Fu, Xiaoyu Wang, Demetrius Albanes, Stephanie J Weinstein, Kai Yu, Rachael Z Stolzenberg-Solomon","doi":"10.1002/ijc.35479","DOIUrl":"https://doi.org/10.1002/ijc.35479","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) is highly fatal, with incidence rising worldwide. Metabolomics may provide insight into etiology and mechanisms contributing to pancreatic carcinogenesis. We examined associations between 1483 prediagnostic (up to 24 years) serum metabolites and PDAC in nested case-control studies within a cohort of male Finnish smokers and another of American men and women (n = 732 matched pairs). We used conditional logistic regression to calculate odds ratios (OR) and 95% confidence intervals per standard deviation increase in log-metabolite level within each cohort and combined using fixed-effect meta-analyses. We performed elastic net regression (EN) to select metabolites and calculated area under the curve (AUC) for established PDAC risk factors (smoking, diabetes, and overweight/obesity), selected metabolites, and their combination. Sixty-six metabolites were associated with PDAC at false discovery rate <0.05, with 26 below Bonferroni threshold (p < 3.4 × 10^-5) and 38 not reported previously. Notable findings include fibrinopeptide B (1-9); 13 modified, di- or poly-peptides; 11 tobacco-chemical related xenobiotics; glycolysis-gluconeogenesis-tricarboxylic acid (TCA) cycle metabolites (aspartate, glutamate, lactate, α-ketoglutarate, and pyruvate); and four secondary and two primary bile acids that were positively (OR = 1.18-1.58) and five fibrinogen cleavage peptides that were inversely (OR = 0.70-0.84) associated with PDAC. AUCs for combined metabolites-risk factors outperformed known risk factors (p ≤ .01) but not metabolites (p ≥ .31) alone. Systemic metabolism is prospectively associated with PDAC. New metabolite associations include those related to immune response, tobacco, microbiome, glycolysis-gluconeogenesis and TCA cycle, and adiposity or diabetes. The EN selected metabolites were more sensitive indicators of prediagnostic metabolic processes and exposures associated with PDAC than established risk factors.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot randomized controlled trial of transcranial magnetic stimulation for the treatment of insomnia in cancer survivors: An efficacy, safety, and feasibility therapy.","authors":"Shanshan Tian, Longtao Huangfu, Yuyang Fanan, Xuejiao Gao, Jie Chen, Hui Li, Detian Guo, Qiying Deng, Tingfang Wu, Ling Zhang, Jingjing Zhou, Pengfei Wang, Anning Li, Gang Wang","doi":"10.1002/ijc.35482","DOIUrl":"https://doi.org/10.1002/ijc.35482","url":null,"abstract":"<p><p>Nearly 60% of cancer survivors experience insomnia symptoms, which is 2-3 times higher than the general population. This study examined the efficacy, safety, and feasibility of repetitive transcranial magnetic stimulation (rTMS) for the treatment of insomnia in cancer survivors. Sixty-six cancer survivors with insomnia were randomly assigned to receive rTMS (n = 22), Sham-rTMS (n = 21), and CBT-I (n = 23) treatment for a 6-week period. Participants completed assessments at baseline, 3 weeks, and 6 weeks, respectively. The primary outcome was the change in Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) from baseline to 6 weeks. The secondary outcome included the change in Hospital Anxiety and Depression Scale (HADS) and Epworth Sleeping Scale (ESS). The generalized estimating equations (GEE) analysis showed a significant difference in reduced ISI (β = -4.58, 95% CI -8.25, -0.91, p = .009) and PSQI (β = -2.35, 95% CI -4.63, -0.07, p = .041) between intervention rTMS and Sham-rTMS, respectively. A significant between-group difference was also observed in reduced ESS (β = -4.65, 95% CI -8.24, -1.06, p = .006). However, the GEE analysis showed that there was no difference between rTMS and CBT-I for relieving insomnia symptoms and daytime sleepiness. After the 6-week treatment, rTMS, Sham-rTMS, and CBT-I demonstrated 60.0%, 28.6%, and 61.5% response rates for insomnia severity and 66.7%, 35.7%, and 53.8% for sleep quality improvement. The rate of adverse events was 9.1%, 0%, and 4.3% in the rTMS, Sham-rTMS, and CBT-I groups, respectively, and no serious adverse events were reported. Given the critical role of good sleep for cancer prognosis, there is an urgent need to increase access to evidence-based treatment for insomnia in cancer survivors. TMS offers an efficacy, safety, and feasibility therapy.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}