Tzu Chi Medical Journal最新文献

{"title":"Repeated intravesical injections of platelet-rich plasma are safe and effective in the treatment of interstitial cystitis/bladder pain syndrome.","authors":"Wan-Ru Yu, Yuan-Hong Jiang, Jia-Fong Jhang, Hann-Chorng Kuo","doi":"10.4103/tcmj.tcmj_166_24","DOIUrl":"10.4103/tcmj.tcmj_166_24","url":null,"abstract":"<p><strong>Objectives: </strong>Interstitial cystitis/bladder pain syndrome (IC/BPS) is a challenging chronic inflammatory condition affecting the urinary bladder, with limited treatment options. This study aims to assess the clinical efficacy of repeated intravesical platelet-rich plasma (PRP) injections for promoting urothelial regeneration and reducing inflammation in patients with IC/BPS and investigate its correlation with subjective and objective treatment-related outcomes.</p><p><strong>Materials and methods: </strong>Four monthly intravesical PRP injections were given to 98 patients with non-Hunner-type IC/BPS. Treatment outcomes were assessed using a global response assessment (GRA) score 3 months posttreatment. In addition, clinical symptom scores, pain severity, voiding diary data, uroflowmetry parameters, and GRA scores were compared before and after treatment and between different treatment outcome groups (satisfactory: GRA≥2 unsatisfactory: GRA<2). Baseline urine biomarkers were analyzed to identify potential treatment outcome predictors.</p><p><strong>Results: </strong>After four PRP injections, 54 (55.1%) patients reported satisfactory outcomes. Lower urinary tract symptoms, bladder pain, urinary frequency, anxiety, and flow rate significantly improved from baseline (<i>P</i> < 0.05) in all patients, regardless of the treatment outcome. All patients experienced improved treatment outcomes and increased maximum bladder capacity with successive PRP treatments, and no major complications were reported. Urine biomarkers indicated elevated inflammation and oxidative stress biomarkers in patients with IC/BPS compared to controls.</p><p><strong>Conclusion: </strong>Repeated PRP injections are safe and effective for reducing symptoms and bladder pain and improving bladder capacity in a majority of IC/BPS patients, with better outcomes observed in patients with a mild form of bladder inflammation. These results support PRP as a promising novel bladder therapy for IC/BPS.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 1","pages":"72-79"},"PeriodicalIF":1.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of simultaneous treatment with intradetrusor onabotulinumtoxinA injections during transurethral prostate surgery for men with bladder outlet obstruction and overactive bladder.","authors":"Chun-Kai Hsu, Wan-Ling Young, Shu-Yu Wu","doi":"10.4103/tcmj.tcmj_180_24","DOIUrl":"10.4103/tcmj.tcmj_180_24","url":null,"abstract":"<p><p>Bladder outlet obstruction (BOO) is common in males with benign prostate enlargement (BPE) and often presents with different lower urinary tract symptoms. Overactive bladder (OAB) has been reported to be related to BOO, although it can also be idiopathic. The storage symptoms of BOO are often similar to those of OAB. The etiology and pathophysiology of both BPE and OAB are multifactorial with metabolic syndrome known as one of the factors. As of today, transurethral prostate surgery remains the gold standard for treating BOO associated with BPE. Intradetrusor onabotulinumtoxinA (BoNT-A) injections have been shown to be effective in treating OAB. However, they are usually administered after transurethral prostate surgery. In view of the strong therapeutic effects of both surgery and injections, the feasibility of combining them in one setting to increase patient comfort, convenience, and possibly results while decreasing costs is appealing to physicians. However, patient safety and possible complications have to be considered. In this article, we review available studies of concurrent intradetrusor BoNT-A injections during transurethral prostate surgery. Although there is no definitive evidence supporting the concurrent use of intradetrusor BoNT-A during transurethral prostate surgery, there are no reports of increased complications too. Further large-scale randomized controlled trials would be necessary to validate the feasibility of combining the treatments in one setting and observe for possible complications.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 1","pages":"42-48"},"PeriodicalIF":1.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived stress and coping strategies among undergraduate nursing students in the psychiatric practicum during the COVID-19 pandemic: A cross-sectional quantitative study.","authors":"Shiou-Fang Lu, Shu-Wan Chiang, Ya-Chuan Hsu","doi":"10.4103/tcmj.tcmj_132_24","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_132_24","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore perceived stress and coping strategies among undergraduate nursing students in the psychiatric practicum during the pandemic.</p><p><strong>Materials and methods: </strong>A cross-sectional quantitative design was employed in this study. Data were collected through self-administered questionnaires consisting of demographic variables, the Perceived Stress Scale (PSS), and the Coping Behavior Inventory (CBI).</p><p><strong>Results: </strong>Of the 73 participants, 82.2% were women. The mean age was 21.25 ± 0.69 years. The overall mean score of PSS was 1.45 ± 0.48, and that of CBI was 1.93 ± 0.31. The major sources of perceived stress were taking care of patients (1.72 ± 0.54) and assignments and workload (1.72 ± 0.75). The major coping strategies to deal with stress were problem-solving (2.66 ± 0.52) and staying optimistic (2.43 ± 0.73). Pearson's correlation analyses revealed that participants who utilized the avoidance strategy (<i>r</i> = 0.416) reported high-stress levels, whereas participants who utilized problem-solving (<i>r</i> = -0.306) and staying optimistic (<i>r</i> = -0.527) reported low-stress levels.</p><p><strong>Conclusion: </strong>The nursing students perceived moderate stress mainly from taking care of patients as well as assignments and workload. Problem-solving and staying optimistic were the most frequently used coping strategies. Compared with findings from other studies, our data suggested that the impact of the COVID-19 pandemic on perceived stress was not apparent possibly due to well-established approaches and education for infection prevention and control in our hospitals and schools. Our findings may provide valuable information to maximize students' learning opportunities.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 2","pages":"216-222"},"PeriodicalIF":1.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is intranasal dexamethasone effective in reducing sore throat following surgery?","authors":"Hamidreza Shetabi, Ehsan Momeni","doi":"10.4103/tcmj.tcmj_99_24","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_99_24","url":null,"abstract":"<p><strong>Objectives: </strong>Postextubation, individuals may experience the discomfort of a sore throat. Our main aim of the study was to investigate if intranasal dexamethasone is successful in reducing postoperative sore throat occurrence.</p><p><strong>Materials and methods: </strong>The study involved 96 adult individuals who were scheduled for elective eye surgery at Faiz Medical Center, which is affiliated with Isfahan University, between July 2020 and March 2021. The individuals were assigned by chance to two cohorts of 48 people each, with one cohort getting dexamethasone (IND) through the nose and the other cohort getting normal saline (INS) through the nose right after the endotracheal tube insertion. The presence of symptoms such as aching throat, cough, and hoarseness after surgery was recorded and examined with version 23 of the SPSS software.</p><p><strong>Results: </strong>Upon analysis, it was observed that there were no statistically significant alterations in demographic attributes, tracheal intubation variables, duration of surgery, and postoperative outcomes (P < 0.05). Within the IND cohort, a notable 80.2% decrease in the occurrence of sore throat was noted immediately following the surgical procedure, along with a 34% reduction within the initial 6 hours of hospital stay (<i>P</i> < 0.001). Moreover, dexamethasone also decreased the occurrence of cough and hoarseness by 31.7% and 38.2% during recovery, as well as 19% and 25.4% within the initial 2 h upon admission to the ward (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The current study showcased the preventive impact of dexamethasone intranasally in decreasing the occurrence of sore throat in the early stages of postoperative period. Nevertheless, its efficacy diminished after 6 h. Furthermore, the intranasal application of dexamethasone exhibited the ability to alleviate hoarseness and cough within the first 2 h following surgical intervention.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 2","pages":"198-203"},"PeriodicalIF":1.4,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blockade of Src signaling prevented stemness gene expression and proliferation of patient-derived gastric cancer stem cells.","authors":"Chi-Tan Hu, Chen-Fang Lin, Hsiu-Ming Shih, Ren-In You, Wen-Sheng Wu, Yen-Cheng Chen","doi":"10.4103/tcmj.tcmj_133_24","DOIUrl":"10.4103/tcmj.tcmj_133_24","url":null,"abstract":"<p><strong>Objectives: </strong>Gastric cancer (GC) is one of the most malignant tumors. Mounting studies highlighted gastric cancer stem cells (GCSCs) were responsible for the failure of treatment due to recurrence and drug resistance of advanced GC. However, targeted therapy against GCSC for improving GC prognosis suffered from lack of suitable models and molecular targets in terms of personalized medicine. To address this issue, two patient-derived GC cell lines SD209 and SD292 with cancer stem cells (CSCs) such as phenotype were isolated for establishing targeted therapy aiming at critical metastatic signaling in GC.</p><p><strong>Materials and methods: </strong>The primary patient-derived GCSCs were established from parts of GC tissues for characterization of stem cells (SCs) phenotype at both cellular and molecular levels. Western blot and Immunohistochemistry (IHC) were performed for identifying the deregulated signaling in GC tissue. Immunofluorescence was used for analyzing proliferating and SC markers in GCSC attached on fibroblast. Acridine orange and propidium iodide analyses were performed for the survival of GCSC in suspensions.</p><p><strong>Results: </strong>In the culture environments of both SD209 and SD292, a lot of mesenchymal fibroblasts spread and crowd together on which a lot of cell clumps, suspected as GCSC, were firmly attached. In the IHC analysis, the GCSC stemness genes CD44 and Ep-CAM increased in tumor tissues of SD209, whereas Nanog-1 and octamer-binding transcription factor 3 (OCT-3) increased in that of SD292. By immunofluorescent analysis of a proliferation marker Ki67, the growth of SD209 and SD292 on mesenchymal fibroblasts was found to be reduced by dasatinib, the inhibitor of the Src kinase whose activity was upregulated in tumor tissues of both GCs. Dasatinib also suppressed the expression of Nanog-1 and OCT-3 in SD292 attached on mesenchymal fibroblasts.</p><p><strong>Conclusion: </strong>This study may provide a base for targeted therapy against GCSCs/GCs progression in future preclinical/clinical settings.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 1","pages":"65-71"},"PeriodicalIF":1.4,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic implication of polymerase epsilon-mutated endometrial cancer.","authors":"Kai-Hung Wang, Dah-Ching Ding","doi":"10.4103/tcmj.tcmj_120_24","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_120_24","url":null,"abstract":"<p><p>The traditional classification and risk stratification systems of endometrial cancer (EC), which relied on histomorphological features, were limited and poor reproducible. The classification of new molecular subtypes of EC has been developing, including The Cancer Genome Atlas (TCGA)-four molecular subtypes: Polymerase epsilon (POLE) mutation (POLEmut), microsatellite instability hypermutated, copy number-low, and copy number-high and ProMisE-four molecular subtypes: POLEmut, mismatch repair deficiency, no specific molecular profile, and p53 abnormal. POLEmut usually correlates with a favorable outcome. Hence, we reviewed the research since the TCGA molecular subtypes developed in 2013 and summarized the characteristics and prognosis of POLEmut EC patients. In summary, we found POLEmut occurs in 7.3%-9.6% of EC in the previous studies. POLEmut EC consistently exhibits favorable patient outcomes, regardless of adjuvant therapy. The research of POLEmut in EC is absent in Taiwan, and the underlying mechanisms and cost-effectiveness need further investigation.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 2","pages":"135-144"},"PeriodicalIF":1.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between postdiagnosis smoking cessation and survival in advanced non-small cell lung cancer patients in Southern Taiwan: A retrospective cohort study.","authors":"Chi-Hsiang Shen, Li-Yu Yang","doi":"10.4103/tcmj.tcmj_109_24","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_109_24","url":null,"abstract":"<p><strong>Objectives: </strong>Smoking is a major lung cancer risk factor. Studies show that smoking after lung cancer diagnosis is associated with an increased risk of developing other cancers and shorter survival. The purpose of this study was to examine the association between postdiagnosis smoking cessation and survival in patients with advanced non-small cell lung cancer (NSCLC).</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted. Data were collected between January 2014 and December 2019 in three hospitals in Southern Taiwan. Patient data were collected from the hospitals' databases, and the correlation between smoking status and patient survival was analyzed using Kaplan-Meier curves and Cox proportional hazards regression modeling.</p><p><strong>Results: </strong>A total of 681 patients with advanced NSCLC were included in this study. The numbers (percentage) of ex-smokers and current smokers were 334 (49%) and 347 (51%), respectively. More than half of the patients in this study continued to smoke postdiagnosis advanced NSCLC. Furthermore, ex-smokers had lower mortality risk, even though this was not statistically significant (<i>P</i> = 0.212). The results of this study suggest that older than 65 years, men, Eastern Cooperative Oncology Group performance score of 3 and higher, history of chronic disease, receive chemotherapy, and targeted therapy are correlated with and have predictive effects on advanced NSCLC survival.</p><p><strong>Conclusion: </strong>There is no significant difference between postdiagnosis smoking cessation and survival in patients with advanced NSCLC. The reason for this finding may be due to lower survival rates after diagnosis with advanced NSCLC, and the benefits of smoking cessation cannot be seen immediately.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 2","pages":"211-215"},"PeriodicalIF":1.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural phytochemicals as small-molecule proprotein convertase subtilisin/kexin type 9 inhibitors.","authors":"Je-Wen Liou, Pei-Yi Chen, Wan-Yun Gao, Jui-Hung Yen","doi":"10.4103/tcmj.tcmj_46_24","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_46_24","url":null,"abstract":"<p><p>A decrease in the levels of low-density lipoprotein receptors (LDLRs) leads to the accumulation of LDL cholesterol (LDL-C) in the bloodstream, resulting in hypercholesterolemia and atherosclerotic cardiovascular diseases. Increasing the expression level or inducing the activity of LDLR in hepatocytes can effectively control hypercholesterolemia. Proprotein convertase subtilisin/kexin type 9 (PCSK9) protein, primarily produced in the liver, promotes the degradation of LDLR. Inhibiting the expression and/or function of PCSK9 can increase the levels of LDLR on the surface of hepatocytes and promote LDL-C clearance from the plasma. Thus, targeting PCSK9 represents a new strategy for developing preventive and therapeutic interventions for hypercholesterolemia. Currently, monoclonal antibodies are used as PCSK9 inhibitors in clinical practice. However, the need for oral and affordable anti-PCSK9 medications limits the perspective of choosing PCSK9 inhibitors for clinical usage. Emerging research reports have demonstrated that natural phytochemicals have efficacy in maintaining cholesterol stability and regulating lipid metabolism. Developing novel natural phytochemical PCSK9 inhibitors can serve as a starting point for developing small-molecule drugs to reduce plasma LDL-C levels in patients. In this review, we summarize the current literature on the critical role of PCSK9 in controlling LDLR degradation and hypercholesterolemia, and we discuss the results of studies attempting to develop PCSK9 inhibitors, with an emphasis on the inhibitory effects of natural phytochemicals on PCSK9. Furthermore, we provide insight into the mechanisms of action by which the reported phytochemicals exert their potential PCSK9 inhibitory effects against hypercholesterolemia.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"36 4","pages":"360-369"},"PeriodicalIF":1.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the interplay between inflammation and stem cell mobilization or homing: Implications for tissue repair and therapeutics.","authors":"Hsin-Hou Chang, Yu-Shan Liou, Der-Shan Sun","doi":"10.4103/tcmj.tcmj_100_24","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_100_24","url":null,"abstract":"<p><p>Inflammation and stem cell mobilization or homing play pivotal roles in tissue repair and regeneration. This review explores their intricate interplay, elucidating their collaborative role in maintaining tissue homeostasis and responding to injury or disease. While examining the fundamentals of stem cells, we detail the mechanisms underlying inflammation, including immune cell recruitment and inflammatory mediator release, highlighting their self-renewal and differentiation capabilities. Central to our exploration is the modulation of hematopoietic stem cell behavior by inflammatory cues, driving their mobilization from the bone marrow niche into circulation. Key cytokines, chemokines, growth factors, and autophagy, an intracellular catabolic mechanism involved in this process, are discussed alongside their clinical relevance. Furthermore, mesenchymal stem cell homing in response to inflammation contributes to tissue repair processes. In addition, we discuss stem cell resilience in the face of inflammatory challenges. Moreover, we examine the reciprocal influence of stem cells on the inflammatory milieu, shaping immune responses and tissue repair. We underscore the potential of targeting inflammation-induced stem cell mobilization for regenerative therapies through extensive literature analysis and clinical insights. By unraveling the complex interplay between inflammation and stem cells, this review advances our understanding of tissue repair mechanisms and offers promising avenues for clinical translation in regenerative medicine.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"36 4","pages":"349-359"},"PeriodicalIF":1.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic modification in radiotherapy and immunotherapy for cancers.","authors":"Shih-Kai Hung, Moon-Sing Lee, Wen-Yen Chiou, Dai-Wei Liu, Chih-Chia Yu, Liang-Cheng Chen, Ru-Inn Lin, Chia-Hui Chew, Feng-Chun Hsu, Hsuan-Ju Yang, Michael W Y Chan, Hon-Yi Lin","doi":"10.4103/tcmj.tcmj_3_24","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_3_24","url":null,"abstract":"<p><p>Radiotherapy (RT) is one of the primary treatment modalities in managing cancer patients. Recently, combined RT and immunotherapy (IT) (i.e., radio-IT [RIT]) have been aggressively investigated in managing cancer patients. However, several issues in conducting RIT are challenging, such as incorporating advanced irradiation techniques, predictive/prognostic biomarkers, and other treatment modalities. Several clinical efforts and novel biomarkers have been introduced and developed to solve these challenges. For example, stereotactic radiosurgery/stereotactic radiotherapy, stereotactic body radiotherapy/stereotactic ablative body radiotherapy, and FLASH-RT have been applied for delivering precise irradiation to lung and liver tumors in conjunction with IT. Besides, several novel IT agents and incorporations of other therapies, such as targeted and thermal therapies, have been further investigated. The present study reviewed the emerging challenges of RIT in modern oncology. We also evaluated clinical practice, bench research, and multimodality treatments. In addition to several clinically applicable biomarkers, we emphasize the roles of advanced irradiation techniques and epigenetic modification as predictive/prognostic biomarkers and potential therapeutic targets. For example, 6(m) A-based epigenetic agents demonstrate the potential to enhance the treatment effects of RIT. However, further prospective randomized trials should be conducted to confirm their roles.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"36 4","pages":"396-406"},"PeriodicalIF":1.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}