Thoracic Cancer最新文献

{"title":"Association Between Osimertinib Dose Reduction and Treatment Outcomes in First-Line EGFR-Mutated Advanced NSCLC: The Impact of Post-Progression Management.","authors":"Issei Oi, Kohei Fujita, Takuma Imakita, Mitsuhiro Tukino, Tetsuo Noguchi, Yuta Okada, Saiki Yoshimura, Naoki Fujimoto, Shogo Toyama, Atsuko Watanabe, Takanori Ito, Ryosuke Kaku, Osamu Kanai, Masatsugu Ohuchi, Kiminobu Tanizawa, Satoru Sawai, Tadashi Mio","doi":"10.1111/1759-7714.70328","DOIUrl":"10.1111/1759-7714.70328","url":null,"abstract":"<p><strong>Background: </strong>Osimertinib is the standard first-line treatment for epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer (NSCLC). However, the impact of dose-reduction on survival and the role of post-progression management in real-world settings remain unclear.</p><p><strong>Methods: </strong>We conducted a multi-institutional retrospective cohort study on patients with EGFR-mutated advanced NSCLC who received first-line osimertinib between January 2018 and December 2023. Patients were classified into dose-reduced and full-dose groups. Primary endpoints were time to treatment failure (TTF) and overall survival (OS). The subsequent treatment after progression was also exploratively assessed to evaluate the impact of initial dose modification on the entire treatment sequence.</p><p><strong>Results: </strong>A total of 90 patients were analyzed, consisting of 61 patients in the full-dose group and 29 in the dose-reduction group. Median follow-up was 21.5 months (IQR 9.1-37.2). The dose-reduced group had significantly worse baseline performance status (PS) (PS 2-3: 37.9% vs. 14.8%, p = 0.014). Despite this, dose reduction showed no significant impact on TTF (adjusted HR 0.66, 95% CI 0.40-1.10, p = 0.11) or OS (HR 0.97, 95% CI 0.59-1.58, p = 0.89). Multivariate analysis revealed that transition to best supportive care (BSC) after progression, rather than initial dose reduction, was associated with OS (hazard ratio, 7.40; p < 0.0001). The proportions of patients receiving subsequent chemotherapy were comparable between the groups.</p><p><strong>Conclusions: </strong>Osimertinib dose reduction in the first-line setting was not associated with inferior OS, suggesting that appropriate dose modification helps maintain PS. Transition to BSC after progression, rather than initial dose intensity, was associated with poor prognosis.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 12","pages":"e70328"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273281","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":"The Long-Term Quality of Life Study for Patients Received Chest Wall Reconstruction by Using 3D-Printed PEEK Implants.","authors":"Ge Li, Xiao Liang, Xing Li, Yangfan Huo, Minghai Ma, Yuanquan Zhang, Minglei Zhuo, Lei Wang","doi":"10.1111/1759-7714.70323","DOIUrl":"10.1111/1759-7714.70323","url":null,"abstract":"<p><strong>Background: </strong>For the repair of chest wall defects, three-dimensional-printed PEEK implants show great potential due to their excellent anatomical matching and mechanical properties. However, Quality-Of-Life assessments after using these implants in chest wall reconstruction remain underexplored.</p><p><strong>Methods: </strong>A retrospective cohort study included 20 patients who underwent chest wall defect reconstruction with 3D-printed PEEK implants at our center between April 2017 and June 2024 and were followed up long-term. Clinical data collected at various time points included safety indicators (long-term adverse reactions, blood routine, hepatic and renal function), respiratory function assessments (pulmonary function tests, arterial blood gas analysis), Quality-Of-Life indicators (SF-36 health survey).</p><p><strong>Results: </strong>Through a median follow-up of 35.3 months, we found that personalized PEEK thoracic rib implants achieved precise anatomical reconstruction and effective respiratory dynamics maintenance. Complete recovery of preoperative hematological parameters (p > 0.05) and liver/kidney function confirmed their biochemical safety. ≥ 1 year after surgery, the restrictive ventilation function of the patients was still lower than that before the operation, and the CO₂ excretion increased (p < 0.05), but the alveolar ventilation function wasn't impaired. Oxygenation was normal (p > 0.05). The patient's physical health scores (SF-36 PCS) remained unchanged from preoperative levels (p > 0.05), while psychosocial functioning (SF-36 MCS) showed significant improvement (p < 0.05).</p><p><strong>Conclusions: </strong>3D-printed PEEK implants used in chest wall reconstruction exhibited favorable safety and were associated with improved long-term Quality Of Life. These findings support that PEEK reconstruction may contribute to a combined benefit of disease control, functional preservation, and psychological recovery.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 12","pages":"e70323"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273265","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":"Clinicopathological and Prognostic Disparities in Part-Solid Versus Pure Solid Pulmonary Nodules as Early-Stage Lung Adenocarcinoma.","authors":"Hanyue Li, Runhua Yu, Songyuan Guo, Yiyang Wang, Zhitao Gu, Wentao Fang","doi":"10.1111/1759-7714.70330","DOIUrl":"10.1111/1759-7714.70330","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal surgical strategy for early-stage lung adenocarcinoma appearing as part-solid nodules (PSN) versus pure solid nodules (SPN) remains debated. This study directly compares their clinicopathological features, surgical outcomes, and recurrence patterns to inform personalized management based on CT characteristics.</p><p><strong>Methods: </strong>This retrospective study analyzed 710 surgical patients with clinical stage IA lung adenocarcinoma. Nodules were categorized as PSN or SPN by the presence of a GGO component on preoperative CT. Interaction-effect analysis assessed CT-attenuation dynamics in solid components. Propensity-score matching balanced intergroup confounders, and Cox regression identified recurrence risk factors for each type.</p><p><strong>Results: </strong>Mean CT-solid value (-13.2 Hu vs. 22.2 Hu, p < 0.001) and the trend of change in CT-solid value during follow-up (Interaction effect Index: -0.011078, p < 0.001) were significantly different between PSN and SPN. Upon histological examination, PSN had significantly lower incidences of visceral pleural invasion (11.7% vs. 30.4%, p < 0.001) and lymph node metastasis (11.2% vs. 20.6%, p = 0.008) than SPN. After propensity-score matching, patients with PSN had significantly better recurrence-free survival (86.8% vs. 70.7%, p < 0.001) than those with SPN. In Cox regression analysis, sublobar resection and lymph node sampling-only were associated with increased risk of loco-regional recurrence in SPN, but not in PSN.</p><p><strong>Conclusion: </strong>PSN and SPN show distinct clinicopathological features and prognostic profiles, suggesting potentially different biological behaviors. CT features need to be incorporated with clinical tumor stage in deciding surgical strategies on resection extent and lymph node examination for early-stage lung adenocarcinoma.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 12","pages":"e70330"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303287","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":"Systemic Inflammation Modifies the Efficacy of Bevacizumab Added to Atezolizumab Plus Chemotherapy for Advanced Non-Squamous Non-Small Cell Lung Cancer: A Multicenter Retrospective Study.","authors":"Keijiro Yamauchi, Kinnosuke Matsumoto, Takayuki Shiroyama, Akihiro Tamiya, Motohiro Tamiya, Akihiro Tsukaguchi, Akito Miyazaki, Kiyohide Komuta, Yasuhiro Mihashi, Hirotomo Machiyama, Kensuke Kanaoka, Tomoki Kuge, Yuhei Kinehara, Nao Shoshihara, Toshie Niki, Soichiro Kato, Yuki Nishikawa, Koji Azuma, Satoshi Tanaka, Akio Osa, Hidekazu Suzuki, Izumi Nagatomo, Junji Uchida, Yoshito Takeda, Atsushi Kumanogoh","doi":"10.1111/1759-7714.70317","DOIUrl":"10.1111/1759-7714.70317","url":null,"abstract":"<p><strong>Introduction: </strong>Bevacizumab, an anti-VEGF antibody, inhibits angiogenesis and modulates the tumor microenvironment. Because systemic inflammation is linked to VEGF activation and immune modulation, it may affect bevacizumab efficacy. However, this relationship remains unclear. We therefore evaluated whether systemic inflammation, assessed via the serum C-reactive protein (CRP) level, modifies survival benefit when adding bevacizumab to chemoimmunotherapy in advanced non-squamous non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>We retrospectively analyzed patients with advanced non-squamous NSCLC from 13 Japanese institutions receiving first-line atezolizumab plus chemotherapy with or without bevacizumab between December 2018 and December 2022. The primary endpoint was overall survival (OS). The interaction between CRP level (< 1 mg/dL vs. ≥ 1 mg/dL) and bevacizumab treatment was evaluated, and sensitivity analyses were performed to confirm the robustness of our findings.</p><p><strong>Results: </strong>Among 193 eligible patients, 109 (56.5%) received bevacizumab. With a median follow-up of 44.2 months, the median OS was 24.5 months in patients with low CRP and 17.3 months in those with high CRP (log-rank test for trend, p = 0.04). Bevacizumab significantly improved OS in patients with high CRP (hazard ratio [HR] 0.63; 95% confidence interval, 0.40-0.99; p = 0.04), but not in those with low CRP (HR 1.22; p = 0.50). The interaction between CRP level and bevacizumab treatment was significant (p = 0.033). Sensitivity analyses supported these results.</p><p><strong>Conclusions: </strong>Systemic inflammation, as assessed by CRP level, may modify the efficacy of bevacizumab in advanced non-squamous NSCLC. These hypothesis-generating findings warrant prospective validation to clarify the role of CRP in treatment stratification.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 11","pages":"e70317"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151707","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":"Cervical Anastomotic Leakage After Minimally Invasive McKeown Esophagectomy in the SAFER Surgical System: Clinical Course and Predictors of Delayed Healing.","authors":"Youyu Zhang, Weishi Wang, Yongjun Yu, Lixia Yin, Jintao Li, Weixin Liu, Xuefeng Zhang, Xingbo Zhang, Hong Yang, Youyu Wang, Shenhai Wei, Yong Li","doi":"10.1111/1759-7714.70314","DOIUrl":"10.1111/1759-7714.70314","url":null,"abstract":"<p><strong>Background: </strong>Cervical anastomotic leakage (AL) remains a major complication after esophagectomy. We investigated the clinical course of cervical AL after minimally invasive McKeown esophagectomy within the SAFER surgical system and identified predictors of delayed healing.</p><p><strong>Methods: </strong>This retrospective study included 517 consecutive patients who underwent minimally invasive McKeown esophagectomy with retrosternal reconstruction under SAFER between January 2023 and December 2025. Among them, 50 developed cervical AL. A posterior mediastinal comparator cohort of 37 patients with cervical AL was included for comparison of leak severity and healing outcomes. AL severity was assessed using ECCG and Clavien-Dindo classifications. Cox regression was used to identify predictors of time to closure.</p><p><strong>Results: </strong>In SAFER group, cervical AL occurred in 50 of 517 patients (9.7%). Compared with the historical same-surgeon PM leakage cohort, SAFER related leaks showed a lower severity profile, with fewer advanced ECCG events and a less severe Clavien-Dindo distribution. All SAFER group patients with cervical AL achieved eventual healing, and the median time to closure was shorter in the SAFER group. Low postoperative day 1 serum albumin (< 35 g/L) independently predicted delayed healing. Patients with low albumin had longer healing time and longer postoperative hospitalization.</p><p><strong>Conclusions: </strong>Within the SAFER surgical system, cervical AL after minimally invasive McKeown esophagectomy was predominantly low grade, manageable, and ultimately healed in all affected patients. Postoperative day 1 serum albumin may help identify patients at risk of prolonged recovery.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 11","pages":"e70314"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212485","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":"Rethinking Invasive Mediastinal Staging in the Era of Neoadjuvant Immune-Checkpoint Inhibitors.","authors":"Saulo Brito Silva, Danilo Tadao Wada, Lycio Umeda Dessotte, Li Siyuan Wada, Adilson Aparecido Faccio, Federico Garcia Cipriano","doi":"10.1111/1759-7714.70292","DOIUrl":"10.1111/1759-7714.70292","url":null,"abstract":"<p><p>Over the past several decades, the management of nonmetastatic nonsmall cell lung cancer (NSCLC) has centered on identifying patients eligible for upfront surgical treatment. This selection has traditionally relied on multidisciplinary assessments of clinical operability and oncologic resectability, with the latter depending primarily on mediastinal lymph node evaluation, a key prognostic factor in determining whether patients should be directed toward upfront surgery or definitive chemoradiotherapy. The recent incorporation of immune checkpoint inhibitors (ICIs) into standard neoadjuvant therapy has transformed this paradigm. By significantly enhancing pathologic response and improving survival across the full spectrum of N2 disease, neoadjuvant ICI therapy is reshaping the prognostic weight traditionally assigned to mediastinal nodal involvement, challenging long-standing staging practices. Rather than serving primarily to exclude patients from surgery, mediastinal assessment in the immunotherapy era may play a more selective role in baseline risk stratification while also potentially gaining new roles, such as in the evaluation of treatment response and nodal downstaging, which could support broader refinements in clinical decision-making. This update synthesizes emerging evidence and evolving clinical concepts to re-examine mediastinal assessment in the immunotherapy era, with implications for clinical decision-making and future trial design in nonmetastatic NSCLC.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 9","pages":"e70292"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821269","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":"Tailoring the Extent of Lymphadenectomy for Esophageal Squamous Cell Carcinoma: Insights From a Comparative Study of Neoadjuvant Chemo-Immunotherapy and Surgery Cohort.","authors":"Kunheng Du, Hongwei Lin, Chenyi Xie, Ziyu Ning, Jiahui Chen, Changhong Liang, Haiyu Zhou, Zaiyi Liu, Yihuai Hu","doi":"10.1111/1759-7714.70297","DOIUrl":"10.1111/1759-7714.70297","url":null,"abstract":"<p><strong>Background: </strong>Lymph node dissection is crucial for accurate staging and prognosis assessment in esophageal squamous cell carcinoma (ESCC). While sufficient examined lymph nodes (ELNs) are generally linked to better outcomes, how ELN count affects prognosis under immunotherapy remains unclear.</p><p><strong>Methods: </strong>This study analyzed 621 ESCC patients who underwent R0 resection with or without neoadjuvant chemo-immunotherapy (NACI). Patients were stratified into surgery alone (SA) (n = 451) and NACI (n = 170) groups. Propensity score matching balanced baseline characteristics. The relationship between ELN count and overall survival was analyzed using Cox regression models. Single-cell RNA and T-cell receptor sequencing were performed on paired tumor and lymph node samples to elucidate underlying immune mechanisms.</p><p><strong>Results: </strong>In the NACI cohort, both insufficient (ELN ≤ 23) and excessive (ELN > 31) lymph node resection were independent risk factors for worse overall survival (ELN ≤ 23: HR = 2.29, 95% CI 1.11-4.71, p = 0.024; ELN > 31: HR = 2.71, 95% CI 1.17-6.26, p = 0.020). However, the SA cohort derived continuous survival benefit from higher ELN counts. Single-cell sequencing revealed that NACI enriched a population of activated, tumor-reactive cytotoxic T cells within metastasis-negative lymph nodes.</p><p><strong>Conclusions: </strong>The optimal ELN count is contingent on treatment strategy. For SA, a more extensive lymphadenectomy improves survival. However, for NACI, a \"Goldilocks\" principle applies-an ELN count between 24 and 31 balances accurate staging with the preservation of antitumor immunity, advocating for function-preserving, personalized surgery in the immunotherapy era.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 9","pages":"e70297"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843272","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":"Predictive Value of Circulating Tumor Cells in Neoadjuvant Chemoimmunotherapy for Non-Small Cell Lung Cancer.","authors":"Jianyi Yang, Ziwen Qin, Zhiwei Zhou, Jixian Liu, Lin Chen, Ziyan Mo, Mengying Liao, Dongliang Cui, Kaiqin Wu, Dongjiang Tang, Jinfeng Chen, Chao Chen","doi":"10.1111/1759-7714.70288","DOIUrl":"10.1111/1759-7714.70288","url":null,"abstract":"<p><strong>Background: </strong>The incorporation of immune checkpoint blockade into preoperative regimens has significantly advanced the clinical management of locally advanced non-small cell lung cancer (NSCLC). Standard imaging modalities frequently fall short in assessing actual pathological regression. Our research sought to evaluate circulating tumor cells (CTCs) as an adjunct predictive tool, while uncovering the transcriptomic shifts within the tumor microenvironment that facilitate cellular shedding.</p><p><strong>Methods: </strong>A prospective cohort of 39 patients with NSCLC received neoadjuvant programmed cell death protein 1 (PD-1) inhibitors combined with platinum-doublet chemotherapy. Preoperative radiographic evaluations using RECIST 1.1 were cross-referenced with final pathological outcomes. Peripheral blood CTCs were enriched and phenotypically characterized via multiparametric immunofluorescence (CK, PD-L1). Bulk RNA-sequencing of residual tissue specimens was performed to identify gene signatures associated with CTC dissemination.</p><p><strong>Results: </strong>The cohort achieved a major pathologic response (MPR) rate of 38.5%, including a pathological complete response (pCR) rate of 23.1%. Preoperative cytokeratin-positive (CK+) CTC burden emerged as a potential independent predictor of pathological non-response (AUC = 0.757), outperforming total CTCs and PD-L1+ CTCs. Crucially, integrating CK+ CTC counts with standard radiographic imaging improved predictive accuracy for pathological outcomes (AUC = 0.79) compared to imaging alone (AUC = 0.54, p = 0.022). Transcriptomic profiling of the residual tumor microenvironment suggested that CTC dissemination may be associated with enhanced proliferative activity, severe local hypoxia and a broad immunological suppression within local microenvironments.</p><p><strong>Conclusions: </strong>Preoperative CTC monitoring may serve as a promising complementary biomarker to conventional radiographic imaging, with the potential to help resolve predictive ambiguities in neoadjuvant chemoimmunotherapy for NSCLC.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 9","pages":"e70288"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782355","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":"Global Burden of Respiratory Tract Cancers From 1990 to 2021: Systematic Analysis of the Global Burden of Disease Study 2021.","authors":"Yuqing Wang, Yi Yao, Xinchen Sun, Di Yu, Chi Zhang","doi":"10.1111/1759-7714.70302","DOIUrl":"10.1111/1759-7714.70302","url":null,"abstract":"<p><strong>Background: </strong>Respiratory tract cancers account for a large proportion of new cancers and cause a major global health burden.</p><p><strong>Objective: </strong>This study aimed to analyze global and regional trends in the incidence, mortality, and disability-adjusted life years (DALYs) of these cancers from 1990 to 2021 and to project future burden to 2040.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using data from the Global Burden of Disease 2021 study, assessing incidence, mortality, and DALYs globally and across 5 Socio-demographic Index (SDI) regions, including risk factor attribution and health inequality trends.</p><p><strong>Findings: </strong>In 2021, there were 2.60 million new cases globally. Between 1990 and 2021, incident cases, deaths, and DALYs increased by 95.01%, 60.48%, and 56.68%, respectively, while age-standardized rates declined (estimated annual percentage change: -2.39%, -4.37%, -4.98%). By 2040, 2.45 million new cases are projected (67.11% male), with corresponding rates of 53.51, 46.90, and 1001.79 per 100 000. The highest age-standardized burden was observed in high and high-middle SDI regions. Smoking was the leading specific risk factor for deaths and DALYs, particularly for tracheal, bronchus, and lung cancer (TBLC) and laryngeal cancer (LC). Health inequalities increased from 1990 to 2021, especially for TBLC, with the slope inequality index for age-standardized incidence rate, DALYs rate, and mortality rate rising from 36.54, 878.54, and 34.92 to 51.38, 953.63, and 44.52, respectively.</p><p><strong>Conclusion: </strong>The absolute burden of respiratory tract cancers continues to rise despite declining rates, with significant inequalities. Enhanced, context-specific prevention and control strategies are urgently needed.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 10","pages":"e70302"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949678","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":"The Impact of Adjuvant Radiotherapy Combined With Targeted or Immunotherapy on the Heart in Breast Cancer.","authors":"Dongmin Liu, Yanling Yang, Tingting Chen, Haonan Han, Yajing Yuan, Liming Xu","doi":"10.1111/1759-7714.70298","DOIUrl":"10.1111/1759-7714.70298","url":null,"abstract":"<p><p>With the increasing adoption of combination therapies involving targeted therapy, immunotherapy, and radiotherapy in breast cancer treatment, the potential cardiotoxicity risks have emerged as a major clinical concern. This article reviews key clinical trial evidence from recent years, including studies published up to March 2025, focusing on the short-term and long-term cardiovascular impacts of combination therapies, aiming to provide clinically relevant guidance for decision-making. Current clinical studies indicate relatively low rates of acute cardiac adverse events during the treatment period. However, long-term follow-up data reveal that patients receiving high-dose radiotherapy (cardiac radiation dose ≥ 25 Gy) show a significantly increased 10-year risk of cardiovascular events. Emerging evidence suggests that cardiotoxicity exhibits delayed onset characteristics and significant interindividual variability. Therefore, future research should prioritize long-term cardiac monitoring in combined treatment regimens and actively explore effective strategies to mitigate cardiotoxicity risks. Proposed approaches include establishing comprehensive dynamic monitoring systems integrating radiomics and biomarkers, optimizing radiotherapy dosing to minimize cardiac damage, and developing myocardial protective agents, ultimately achieving optimal balance between treatment efficacy and patient safety.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 10","pages":"e70298"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017535","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}