BMC Cancer最新文献

{"title":"Analysis of high-risk factors for hepatocellular carcinoma after sustained virological suppression of chronic hepatitis B.","authors":"Jianna Zhang, Zhiqiang Lan, Kailu Zhu, Sijie Yu, Shibo Li, Yu Huang","doi":"10.1186/s12885-025-14015-0","DOIUrl":"https://doi.org/10.1186/s12885-025-14015-0","url":null,"abstract":"<p><p>Chronic hepatitis B (CHB) patients who have sustained virological suppression (SVS) still develop hepatocellular carcinoma(HCC), and the risk factors for developing HCC in these patients are not fully understood. This study included a total of 5234 patients who achieved SVS. After SVS, the incidence rate of HCC was 1.9% in 1-8 years and 1.33% in 9-16 years. There was a significant difference between the two periods (P < 0.001). After 1-8 years and 9-16 years of SVS, after multivariate analysis and IPTW adjustment, the factors related to the occurrence of HCC were men, hypertensive patients, diabetes patients and high FIB-4 scores. In summary, patients with CHB who have achieved SVS may still develop HCC. Among them, men, hypertensive patients, diabetes patients and high FIB-4 scores should be listed as the key monitoring objects of HCC. Clinical trial number: Not applicable.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"635"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810528","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":"Real-world safety and efficacy of neoadjuvant docetaxel, cisplatin, and 5-fluorouracil therapy for locally advanced esophageal squamous cell carcinoma.","authors":"Mikako Tamba, Hiroki Osumi, Mariko Ogura, Shota Fukuoka, Akihiko Okamura, Jun Kanamori, Yu Imamura, Koichiro Yoshino, Shohei Udagawa, Takeru Wakatsuki, Eiji Shinozaki, Masayuki Watanabe, Kensei Yamaguchi, Keisho Chin, Akira Ooki","doi":"10.1186/s12885-025-14011-4","DOIUrl":"https://doi.org/10.1186/s12885-025-14011-4","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy with docetaxel, cisplatin plus 5-FU (DCF) has become the new standard of care for locally advanced esophageal squamous cell carcinoma (ESCC). In a real-world setting, the efficacy, recurrence, and adverse events (AEs) remain unclear.</p><p><strong>Methods: </strong>This retrospective cohort study included 86 patients who received neoadjuvant DCF followed by esophagectomy for resectable ESCC.</p><p><strong>Results: </strong>Following neoadjuvant DCF treatment, 75 patients underwent R0 curative resection. At the median follow-up of 19.2 months, the median disease-free survival (DFS)/recurrence-free survival (RFS) was not yet reached, with estimated 3-year DFS/RFS rates of 65.2%, respectively. The incidence of primary tumor regression grading (TRG) grade 1a and pathological complete response (pCR) were 21.3% (16/75) and 14.7% (11/75), respectively. The estimated 1-year DFS/RFS rates were 93.8% for primary TRG grade 1a and 100% for pCR. Baseline elevated serum SCC-antigen levels were inversely associated with achieving primary TRG grade 1a or pCR. In 64 patients who did not achieve pCR, residual tumor cells in the lymph nodes (ypN; HR, 16.96; 95% CI, 2.11-136.12; P < 0.01) and Glasgow prognostic score (GPS; HR, 8.34; 95% CI, 1.73-40.31; P < 0.01) were independent predictors of shorter DFS/RFS. The most common grade ≥ 3 AEs were neutropenia (61.6%) and febrile neutropenia (26.7%), which were not associated with clinicopathological factors. The most common non-hematological AEs were appetite loss (9.3%), pulmonary embolism (8.1%), diarrhea (7.0%), and nausea (2.3%). Nine patients discontinued neoadjuvant DCF due to toxicities.</p><p><strong>Conclusions: </strong>Neoadjuvant DCF was effective and well-tolerated in real-world ESCC patients. Primary TRG grade 1a or pCR showed a favorable DFS/RFS, while positive ypN and GPS were independent risk factors for worse DFS/RFS.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"636"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810578","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":"Hypothyroidism following immunotherapy predicts more postoperative complication in oral squamous cell carcinoma.","authors":"Wenwen Zhang, Ping Lu, Xing Li, Qigen Fang","doi":"10.1186/s12885-025-14070-7","DOIUrl":"https://doi.org/10.1186/s12885-025-14070-7","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of hypothyroidism that develops following immunotherapy on surgical outcomes in patients diagnosed with oral cancer.</p><p><strong>Methods: </strong>Patients with surgically treated oral cancer following neoadjuvant immunochemotherapy were retrospectively enrolled. Impact of hypothyroidism on postoperative complication were analyzed.</p><p><strong>Results: </strong>In total, 303 patients were enrolled. In comparison to patients with normal thyroid function, patients with subclinical or overt hypothyroidism did not exhibit a significantly increased risk of surgical site infection, but both conditions were associated with a higher risk of fistula formation and wound debridement. The cohort suffering from subclinical hypothyroidism exhibited odds ratios (ORs) of 1.88 [95% confidence interval (CI): 1.12-5.47] for fistula development and 1.95 [95% CI: 1.27-6.98] for wound debridement. Patients with overt hypothyroidism had a 2.03-fold higher risk of fistula formation (95% CI: 1.35-6.24) and a 2.17-fold higher risk of wound debridement (95% CI: 1.20-7.53). The rate of wound debridement escalated to 40.0% when both hypothyroidism and diabetes were present simultaneously; in contrast, it diminished to 20.0% in cases of isolated hypothyroidism, 12.1% in individuals with diabetes alone, and a mere 5.2% in patients devoid of both conditions. The incidence of fistula formation was most pronounced in patients with coexisting diabetes and hypothyroidism, followed closely by 6.7% in those with solely hypothyroidism. The occurrence of fistulas was remarkably rare among patients with only diabetes or those lacking both factors.</p><p><strong>Conclusions: </strong>Hypothyroidism induced by neoadjuvant immunotherapy exerts a considerable negative impact on the formation of fistulas and wound debridement in patients with locally advanced oral cancer, an effect that may be exacerbated by the presence of diabetes.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"643"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810563","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 the lactate dehydrogenase-to-albumin ratio and 28-day mortality in septic patients with malignancies: analysis of the MIMIC-IV database.","authors":"Yongshi Shen, Kangni Lin, Liuxin Yang, Peng Zheng, Wei Zhang, Jinsen Weng, Yong Ye","doi":"10.1186/s12885-025-14013-2","DOIUrl":"https://doi.org/10.1186/s12885-025-14013-2","url":null,"abstract":"<p><strong>Background: </strong>Sepsis remains a leading cause of mortality in critically ill patients, particularly those with malignancies who face heightened risks due to immunosuppression and metabolic dysregulation. This study aimed to evaluate the prognostic value of the lactate dehydrogenase-to-albumin ratio (LDAR) for predicting 28-day ICU mortality in septic patients with malignancies.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted using data from 1,635 septic patients with malignancies in the MIMIC-IV (3.1) database. Participants were stratified into quartiles based on LDAR values. The primary outcome was 28-day ICU mortality, with secondary outcomes including in-hospital and ICU mortality. Multivariable logistic regression, restricted cubic spline (RCS) analysis, and machine learning models were employed to assess associations between LDAR and outcomes. Subgroup analyses and feature importance evaluations were performed to validate robustness. The Shapley additive explanations method was used to enhance model interpretability and assess individual predictor contributions.</p><p><strong>Results: </strong>Higher LDAR is independently associated with increased 28-day ICU mortality (OR: 3.441, 95% CI: 2.497-4.741), ICU mortality (OR: 3.478, 95% CI: 2.396-5.049), and in-hospital mortality (OR: 3.747, 95% CI: 2.688-5.222), even after adjustment, highlighting its potential as a prognostic marker in ICU patients. RCS analysis revealed a nonlinear relationship, with mortality risk escalating sharply beyond log₂(LDAR) = 6.940. Metastatic cancer patients had higher median LDAR (135.0 vs. 118.5, P = 0.004) and mortality rates (52.0% vs. 36.4%, P < 0.001). Boruta feature selection showed that LDAR as the top predictor of mortality. Nine machine learning model with 20 variables were built, with random forest model performing best, achieving an AUC of 0.751 (0.708-0.794) in validation and 0.727 (0.682- 0.772) in text cohort.</p><p><strong>Conclusions: </strong>LDAR is a robust, independent prognostic biomarker for 28-day ICU mortality in septic patients with malignancies, outperforming traditional scoring systems. The identified threshold (log₂(LDAR) ≥ 6.940) may aid early risk stratification and clinical decision-making. Prospective studies are warranted to validate these findings and explore dynamic LDAR monitoring in diverse populations.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"637"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810543","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":"Construction and validation of a nomogram for identifying the patients at risk for rapid progression of advanced hormone-sensitive prostate cancer.","authors":"Xiaolong Xu, Weiyu Fei, Mingshuang Wu, Yi He, Bo Yang, Cuicui Lv","doi":"10.1186/s12885-025-14035-w","DOIUrl":"https://doi.org/10.1186/s12885-025-14035-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the prognostic significance of lactate dehydrogenase (LDH) and fasting triglyceride-glucose (TyG) index in advanced hormone-sensitive prostate cancer (HSPC) patients, with the ultimate goal of developing and validating a nomogram for predicting castration-resistant prostate cancer (CRPC) free survival.</p><p><strong>Materials and methods: </strong>The follow-up data of 207 CRPC patients who had androgen deprivation therapy as their initial and only treatment before progression were retrospectively reviewed. To assess prognostic variables, univariate and multivariate Cox regression analyses were performed. The concordance index (C-index), calibration curves, receiver operating characteristic (ROC) curves, and decision curve analyses (DCA) were utilized to construct and test a novel nomogram model.</p><p><strong>Results: </strong>TyG index, LDH, M stage and Gleason sum were determined to be independent prognostic markers and were combined to create a nomogram. This nomogram worked well in the tailored prediction of CRPC development at the sixth, twelve, eighteen, and twenty-fourth months. The C-indexes for the training and validation sets were 0.798 and 0.790, respectively. The ROC curves, calibration plots, and DCA all indicated good discrimination and prediction performance. Furthermore, the nomogram had a higher prognostic ability than the M stage and the Gleason sum. The nomogram-related risk score classified the patient population into two groups with significant progression differences.</p><p><strong>Conclusions: </strong>The created nomogram could help identify patients at high risk for rapid progression of advanced HSPC, allowing for the formulation of tailored therapy regimens and follow-up methods in a timely manner.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"634"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810560","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 tracer application methods for sentinel lymph node detection in open surgery patients with endometrial cancer: a retrospective cohort study.","authors":"Borek Sehnal, Petr Waldauf, Radoslav Matej, Martin Hruda, Helena Robova, Jana Drozenova, Tomas Pichlik, Jan Zapletal, Lukas Rob, Michael J Halaska","doi":"10.1186/s12885-025-14037-8","DOIUrl":"https://doi.org/10.1186/s12885-025-14037-8","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the effectiveness of different tracers´ application techniques for sentinel lymph node (SLN) detection in women with endometrial cancer undergoing laparotomy. Additionally, potential risk factors for SLN detection failure were assessed.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 248 endometrial cancer patients who underwent abdominal surgery with SLN mapping between January 2020 and March 2024. Statistical analyses were conducted using the Wilcoxon rank sum test for continuous variables and either Pearson's chi-square test or Fisher's exact test for categorical variables, with a significance level set at p < 0.05.</p><p><strong>Results: </strong>Group I + S consisted of 147 women with intracervical and subserosal tracers´application and group I + I included 101 women with intracervical and intrafundal application. Successful detection of SLN on both sides was achieved in 39.9% (99/248) of all patients, in 38.1% (56/147) in the I + S group and in 42.6% (43/101) in the I + I group, respectively. SLNs were identified in 32.7% (81/248) of all patients on only one side of the pelvis, in 31.3% (46/147) in the I + S and in 34.7% (35/101) in the I + I group, respectively. No SLNs were detected in 27.4% (68/248) of all subjects, comprising 30.6% (45/147) from the I + S and 22.8% (23/101) from the I + I group. Although the success rate of SLN detection was higher in the I + I group and on the right side of the pelvis regardless of the detection method, these differences were not statistically significant. An age exceeding 66.3 years was recognized as a critical risk factor for successful detection, other followed factors did not demonstrate a statistically significant impact on overall detection success. Additional significant risk factors were identified: depth of tumor myometrial invasion on the right side, history of pelvic surgery, and total tumor volume on the left side.</p><p><strong>Conclusions: </strong>The study did not reveal significant differences in SLN mapping success between the groups receiving intracervical + intrafundal and intracervical + subserosal tracers´applications among endometrial cancer patients treated via open surgery. Overall, older age emerged as the most critical risk factor for SLN detection failure, while other assessed factors did not show a statistically significant impact on overall detection success.</p><p><strong>Trial registration: </strong>Institution University Hospital Královské Vinohrady, Prague, Czech Republic.</p><p><strong>Registration number: </strong>EK-VP-21-0-2023. Date of registration 7-JUN-2023. This study was retrospectively registered in compliance with the Declaration of Helsinki.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"638"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810557","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":"Psychometric properties of the Chinese version of the M.D. Anderson symptom Inventory-Multiple Myeloma Module: a translation and validation study.","authors":"Ting Wang, Weiwei Chen, Yingying Lin, LeiWen Tang, Junxiang Sun, Yao Ge, Yanke Mao, Huan Liu","doi":"10.1186/s12885-025-14054-7","DOIUrl":"https://doi.org/10.1186/s12885-025-14054-7","url":null,"abstract":"<p><strong>Background: </strong>The reliability of the M.D. Anderson Symptom Inventory-Multiple Myeloma Module (MDASI-MM) was evaluated through its Chinese translation among Chinese patients with multiple myeloma.</p><p><strong>Methods: </strong>The MDASI-MM scale underwent translation into Chinese following Brislin's two-way translation paradigm, incorporating ortho-translation, back-translation, pre-surveying, and cultural adaptation. The scale's validity and reliability were assessed using a sample of five hundred multiple myeloma patients from three tertiary general hospitals in Zhejiang Province, China, selected through convenience sampling based on inclusion and exclusion criteria. Descriptive statistics provided demographic information, while item analysis evaluated scale components. The scale's validity was assessed through content, construct, discriminant, convergent, and criterion validity analyses. Reliability was evaluated using internal consistency and split-half reliability measures, while responsiveness was assessed using the Mann-Whitney U test.</p><p><strong>Results: </strong>The Chinese version of the MDASI-MM scale consists of 26 items, including 13 core symptom items, seven multiple myeloma-specific symptom items, and six interference items. The item-level content validity index ranges from 0.889 to 1.000, the scale-level content validity index/universal agreement is 0.846, and the scale-level content validity index/average is 0.983. Validated factor analysis showed good model fit with χ²/df = 1.687, GFI = 0.879, RMSEA = 0.053, CFI = 0.913, NFI = 0.813, TLI = 0.899, IFI = 0.915, AGFI = 0.848. The combination reliability (CR) values ranged from 0.747 to 0.865, and the average variance extracted (AVE) ranged from 0.529 to 0.643. Each dimension's correlation coefficient with other dimensions was lower than the corresponding AVE's square root. The total scale demonstrated a Cronbach's alpha of 0.908 (range: 0.856-0.889) and split-half reliability of 0.890 (range: 0.873-0.916).</p><p><strong>Conclusions: </strong>The Chinese version of the MDASI-MM scale demonstrates robust validity and reliability for evaluating clinical features in Chinese patients with multiple myeloma. This comprehensive symptom assessment tool enables healthcare professionals to examine disease characteristics thoroughly, providing a foundation for developing targeted and effective symptom management strategies.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"640"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810554","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":"Life's essential 8 and specific cancer risk and mortality in men and women: a population-based cohort analysis of 332,417 United Kingdom participants.","authors":"Chuang Yang, Wenke Cheng, Patrick S Plum, Florian Lordick, Jeanette Köppe, Ines Gockel, René Thieme","doi":"10.1186/s12885-025-14048-5","DOIUrl":"https://doi.org/10.1186/s12885-025-14048-5","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the association between Life's Essential 8 (LE8) and the risk of cancer occurrence and cancer-associated mortality across 24 cancer types. The cardiovascular health (CVH) score is constructed based on the overall LE8 score, providing a more direct measure of CVH and its potential relationship with cancer risk.</p><p><strong>Methods: </strong>This cohort enrolled participants from a prospective cohort of the United Kingdom Biobank, including individuals aged 37-73 years, with 332,417 cancer-free participants. CVH scores were assessed using the LE8 metrics. The primary outcome of this study was the risk of cancer events, and the secondary outcome was cancer mortality. Competitive models were used to examine the associations between each 10-point increment in the CVH score and the outcomes, with stratified analyses conducted for both men and women to assess sex differences.</p><p><strong>Results: </strong>The mean CVH score was 64.4(55.6,72.5) in men and 70.0 (61.2,78.1) in women (P < 0.001). During a mean follow-up time of 12.0 years, 12.32% (95% confidence interval [CI]: 12.21-12.43%) of participants developed cancer, and 2.13% (95% CI: 2.08-2.18%) died from cancer. A 10-point rise in CVH score was negatively associated with overall cancer occurrence in men (hazard ratio [HR]: 0.97, 95% CI: 0.96-0.98) and women (HR: 0.96, 95% CI: 0.95-0.97), along with reduced cancer mortality risk in both sexes. Moreover, sex differences were observed in the impact of a 10-point CVH increase on esophageal, gastric, colorectal, and liver cancers.</p><p><strong>Conclusions: </strong>Lower CVH scores were associated with an increased overall cancer risk and higher cancer-related mortality, highlighting the need for cancer screening in patients with low CVH scores.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"632"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810540","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 comprehensive geriatric assessment on treatment decisions in older prostate cancer patients.","authors":"Maëva Bonneau, Zara Steinmeyer, Mathilde Morisseau, Stéphanie Lozano, Patricia Barbe, Catherine Chauvet, Delphine Brechemier, Loïc Mourey, Laurent Balardy","doi":"10.1186/s12885-025-13961-z","DOIUrl":"https://doi.org/10.1186/s12885-025-13961-z","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is the most common cancer in men aged above 75 years old. Given their heterogeneity, the International Society of Geriatric Oncology recommends using a comprehensive geriatric assessment (CGA) to adapt anticancer treatment management according to their geriatric status. While the theoretical value of this approach is in no doubt, the impact of the CGA on the final therapeutic decision remains elusive. This study therefore investigated the impact of comprehensive geriatric assessment on treatment decisions in older patients diagnosed with prostate cancer and described the factors associated with a change in treatment plan.</p><p><strong>Methods: </strong>This single-centre retrospective study included prostate cancer patients who received a CGA prior to a therapeutic decision from January 2012 to December 2022. The CGA included medical, nutritional, cognitive, social, functional and psychological evaluation.</p><p><strong>Results: </strong>140 patients were included, of whom 57 (40.7%) benefited from a change in their therapeutic plan after CGA, all in favour of a less aggressive treatment. There was no difference in event-free (EFS) or overall survival (OS) between patients with or without a therapeutic modification (HR for OS = 1.12 [0.68;1.84] p = 0.048). Factors associated with a change in treatment plan were a WHO performance status > 1, a high age-adjusted Charlson score, polymedication, an impaired functional independence with the ADL (Activities of Daily Living) scale and a 'frail' or 'vulnerable' geriatric profile according to Balducci's classification.</p><p><strong>Conclusion: </strong>A comprehensive geriatric assessment prior to prostate cancer treatment plan initiation lead to therapeutic de-escalation in 40% of cases of without affecting overall survival or event-free survival. This adaptation offering a more tailored cancer management while preventing functional impact of treatment due to toxicity and improving patient quality of life.</p><p><strong>Trial registration: </strong>The study was registered as (number's register: F20240123102237) and MR004 (CNIL number: 23RDUROL01).</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"642"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810530","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":"Intensity-modulated proton therapy for hippocampal-sparing prophylactic cranial irradiation: a planning comparison with photon therapy.","authors":"Xiaoyan Yin, Xiutong Lin, Guifang Zhang, Yong Yin, Tao Sun","doi":"10.1186/s12885-025-14039-6","DOIUrl":"https://doi.org/10.1186/s12885-025-14039-6","url":null,"abstract":"<p><strong>Background: </strong>The purpose of the study was to evaluate the dosimetric characteristics of volumetric modulated arc therapy (VMAT), helical tomotherapy (HT), and intensity-modulated proton therapy (IMPT) and to compare the dosimetric differences between the two IMPT plans with coplanar and non-coplanar beams in prophylactic cranial irradiation (PCI) with hippocampal-sparing for small cell lung cancer (SCLC).</p><p><strong>Methods: </strong>Twenty-five patients diagnosed with limited-stage SCLC and received PCI were enrolled in the study. Four treatment plans were designed: VMAT, HT, and two IMPT plans with coplanar and non-coplanar beams (referred to as IMPT-cop and IMPT-noncop, respectively). The prescription dose was 25 Gy in 2.5 Gy(RBE) fractions. The PTV was optimized in both the VMAT and HT plans. In IMPT plans, multifield optimization and CTV robust optimization with a 3-mm setup uncertainty and 3.5% range uncertainty were used. According to the RTOG 0933 protocol, the dose limits for the hippocampus were the dose received by 100% volume (D₁₀₀) ≤ 9 Gy and the maximum dose (D_max) ≤ 16 Gy.</p><p><strong>Results: </strong>For the target, the two IMPT plans significantly improved the V₁₀₀, D₉₈, the homogeneity index (HI) and gradient index (GI) compared with VMAT and HT plans. The HT plans showed the highest conformity index (CI) compared to the other three plans. The two IMPT plans significantly reduced the D₁₀₀, D_max and D_mean of the hippocampus, the mean dose of bilateral eyeballs and parotids, the maximum dose of bilateral lenses and lenses PRV compared to the VMAT and HT plans. For D₁₀₀ in hippocampus, the IMPT-cop and IMPT-noncop plans reduced by 43.23%, 42.55%, 41.14%, and 40.43%, respectively, relative to VMAT and HT plans. For D_max in hippocampus, the IMPT-cop and IMPT-noncop plans decreased by 8.22%, 8.29%, 7.86%, and 7.93%, respectively, relative to VMAT and HT plans. For hippocampal D_mean, IMPT-cop and IMPT-noncop plans decreased by 23.1%, 22.48%, 20.55%, and 19.91% compared with VMAT and HT plans, respectively. VMAT plans showed the lowest values for the maximum dose to the bilateral eyeballs among the four plans. When comparing the two IMPT plans, IMPT-cop plans significantly reduced the mean dose to the hippocampus, and increased the D_mean and D_max of bilateral eyeballs, and the D_max of bilateral lenses and lenses PRV compared to IMPT-noncop plans.</p><p><strong>Conclusions: </strong>Compared with photon plans, proton plans significantly reduce the dose to the hippocampus, lenses, eyeballs and parotids in hippocampal-sparing PCI. Compared to IMPT plans with coplanar beams, IMPT plans with non-coplanar beams have shown dosimetric advantages in eyeballs and lenses, with no benefit for dose sparing in the hippocampus.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"639"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810537","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}