Cancer Management and Research最新文献

{"title":"Development and Cross-Institutional Validation of a Comprehensive Machine Learning Model Predicting Response to Neoadjuvant Therapy for Rectal Cancer.","authors":"Sha Li, Zhengxian Li, Shuai Li, Ping Jiang, Hongbin Han, Yibao Zhang, Yanye Lu","doi":"10.2147/CMAR.S517949","DOIUrl":"10.2147/CMAR.S517949","url":null,"abstract":"<p><strong>Objective: </strong>Accurately identifying patients achieving pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) for locally advanced rectal cancer (LARC) not only ensures treatment efficacy but also helps avoid surgical risks. We developed a comprehensive multi-omics model to predict pCR before surgery.</p><p><strong>Methods: </strong>Clinical data, CT, MRI-T1WI and MRI-T2WI, and radiotherapy dose were collected from 183 LARC patients who underwent preoperative nCRT. Backward stepwise selection, logistic regression, and five-fold cross-validation were employed for the development and validation of a non-imaging model, three radiomics-based models and a dosiomics-based model. These were integrated into a final model, and its performance was tested on multi-center sets.</p><p><strong>Results: </strong>C_model, based on clinical characteristics, achieved an AUC of 0.85 in the validation set. Radiomics models (CT_model, T1_model, T2_model) exhibited AUCs of 0.66, 0.67, and 0.64, respectively. Dosiomics-based model, D_model, achieved an AUC of 0.75 in validation. The mean AUCs for F_model in the training sets, validation sets, internal and external test sets were 0.90, 0.88, 0.77, and 0.74, respectively.</p><p><strong>Conclusion: </strong>To assess the efficacy of nCRT in LARC patients, it is crucial to consider clinical characteristics, followed by dosiomics. While T1_model, T2_model and CT_model demonstrate relatively comparable performance, each contributes unique value to the final prediction model.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"1563-1575"},"PeriodicalIF":2.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Oncolytic Virotherapy for Malignant Glioma: From Bench to Bedside.","authors":"Weihua Jiang, Yeqing Tian, Huafen Gu, Wenqing Guan","doi":"10.2147/CMAR.S528875","DOIUrl":"10.2147/CMAR.S528875","url":null,"abstract":"<p><p>Malignant glioma is a highly aggressive brain tumor characterized by frequent recurrence, poor prognosis, and limited responsiveness to standard therapies. Glioblastoma multiforme, the most common and aggressive subtype, further complicates treatment due to its infiltrative nature, genetic heterogeneity, the protective blood-brain barrier, and an immunosuppressive microenvironment. Despite aggressive treatment strategies such as surgical resection combined with chemoradiotherapy, the median survival for malignant glioma patients remains low, highlighting the urgent need for more effective therapeutic approaches. Oncolytic virotherapy (OVT), a dual-modality approach that combines immunotherapy and biotherapy, has emerged as a promising alternative. Oncolytic viruses (OVs) can replicate continuously, disseminate within the tumor, and stimulate anti-tumor immunity, offering distinct advantages in targeting invasive and immunologically \"cold\" malignant glioma. However, the efficacy of OVT in clinical trials remains unsatisfactory, particularly in single-agent regimens. This limitation is primarily attributed to the viruses' limited replication efficiency, suboptimal immune induction, premature clearance by antiviral immune responses, and the blood-brain barrier, which impedes effective intracranial delivery. Thus, further optimization of viral modifications, delivery systems, and treatment regimens is critical to enhancing therapeutic potency before OVT can become a standard therapy for malignant glioma. This review systematically summarizes current strategies for enhancing OVs, including genetic engineering, chemical functionalization, and carrier-based delivery. Furthermore, it highlights combination therapies that aim to synergistically enhance therapeutic efficacy through chemotherapy, radiotherapy, and immunotherapy. Finally, the review emphasizes recent clinical trials leveraging these enhancement strategies, aiming to offer novel insights for translating OVs from research to clinical practice.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"1537-1554"},"PeriodicalIF":2.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-6 as a Predictive Marker for Lymph Node and Distant Metastasis in Colorectal Cancer: A Retrospective Cohort Study.","authors":"Jianjun Xiao, Muyou Tian, Guoyu Chen, Huifen Li","doi":"10.2147/CMAR.S527441","DOIUrl":"10.2147/CMAR.S527441","url":null,"abstract":"<p><strong>Background: </strong>Metastasis is the leading cause of death in colorectal cancer (CRC). While interleukin-6 (IL-6), a key inflammatory cytokine, is implicated in tumor metastasis, its specific association with lymph node metastasis (LNM) and distant metastasis (DM) in CRC remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed clinical data and serum levels of carcinoembryonic antigen (CEA) and cytokines (including IL-6) in 427 CRC patients, stratified by metastatic status. Statistical analyses assessed the predictive value of IL-6 for metastasis.</p><p><strong>Results: </strong>Elevated serum IL-6 levels were significantly associated with both LNM and DM (P<0.05). IL-6 positively correlated with CEA levels (Spearman correlation). Although IL-6 alone showed modest predictive power for LNM (AUC=0.555), it outperformed CEA (AUC=0.525). Combining IL-6 and CEA improved diagnostic accuracy for LNM (AUC=0.583). Notably, IL-6 demonstrated greater sensitivity than CEA in predicting DM (77.30% vs 67.40% at optimal cutoff).</p><p><strong>Conclusion: </strong>These findings demonstrate that IL-6 holds significant predictive value for metastasis in CRC, particularly excelling in the prediction of LNM. The detection of IL-6 offers a valuable complementary approach to the existing clinical prediction paradigm for CRC metastasis risk.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"1525-1535"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypopharyngeal Squamous Cell Carcinoma in Elderly Patients Aged ≥70 Years: Surgery and Postoperative Radiotherapy Improves Outcomes in Selected Patients.","authors":"Ru Wang, Ahmad A Hariri, Hengmin Tao, Yumei Wei, Zhenghua Lyu","doi":"10.2147/CMAR.S529332","DOIUrl":"10.2147/CMAR.S529332","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the efficacy of surgery plus postoperative radiotherapy as initial treatment in elderly patients aged ≥70 years with advanced hypopharyngeal cancer and to analyze prognostic factors.</p><p><strong>Methods: </strong>Retrospective analysis of 77 elderly patients aged ≥70 years with stage III-IV hypopharyngeal squamous cell carcinoma who underwent surgery as initial treatment at Shandong Provincial ENT Hospital between 2006-2020. Treatment completion rate and prognostic factors were summarized and analyzed, with comparisons made to non-surgical treatments in published literature. SPSS 26.0 was used for analysis. Univariate Cox regression analysis was applied to identify potential predictors of overall survival (OS) and disease-free survival (DFS). Kaplan-Meier method with Log rank test was used to calculate and compare survival rates. Multivariate analysis employed the Cox proportional hazards regression model, with <i>P</i> < 0.05 considered statistically significant.</p><p><strong>Results: </strong>The study achieved 100% follow-up with a median duration of 62 months. Among the cohort, 26 patients received surgery only whilst 51 received surgery plus radiotherapy, seven patients failed to complete radiotherapy resulting in a completion rate of 86.27%. Survival analysis revealed significant intergroup differences: at 1 year, OS/DFS rates were 76.9%/73.1% in Group A versus 93.2%/81.8% in Group B (both <i>P</i> < 0.05). By 3 years, OS/DFS rates were 61.5%/57.7% in Group A versus 77.3%/70.5% in Group B. The overall 3-year and 5-year OS rates for the cohort were 68.8% and 52.3%, respectively. Univariate analysis showed no significant differences in gender, age, T/N staging, comorbidities, or second primary malignancies (all *<i>P</i>* > 0.05), but treatment modality was a significant predictor of both OS (<i>P</i> = 0.002) and DFS (<i>P</i> = 0.001). Multivariate COX regression analysis confirmed N staging and treatment modality as independent prognostic factors for OS (<i>P</i> = 0.007 and 0.002, respectively) and DFS (P = 0.009 and 0.002, respectively).</p><p><strong>Conclusion: </strong>Elderly hypopharyngeal cancer patients tolerated surgery and postoperative radiotherapy well. Active pursuit of comprehensive treatment is recommended for fit stage III-IV patients aged ≥70 years to improve outcomes.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"1513-1523"},"PeriodicalIF":2.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ginseng-Derived Exosomes Attenuate Immune Evasion in NSCLC via PD-L1 Modulation.","authors":"Lin-Jia Zhu, Xiao-Qiang Chen, Qiu-Yan Lin, Jie-Ni Feng, Shao-Fei Yuan","doi":"10.2147/CMAR.S540462","DOIUrl":"10.2147/CMAR.S540462","url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) is a major cause of cancer-related death worldwide. While PD-1/PD-L1 immune checkpoint blockade has shown promise, its efficacy is often limited by tumor-induced immune evasion. Ginseng-derived exosomes (G-Exos), as natural plant-based nanocarriers, may offer a novel strategy for immunomodulation. This study investigated the potential of G-Exos to regulate PD-L1 expression and enhance anti-tumor immunity in NSCLC.</p><p><strong>Methods: </strong>Exosomes were isolated from ginseng cell cultures and characterized via transmission electron microscopy and nanoparticle tracking analysis. Uptake by NSCLC cells was confirmed using PKH26 labeling. In vitro, NSCLC cells were co-cultured with activated T cells to evaluate cytotoxicity (colony formation), cytokine secretion [enzyme-linked immunosorbent assay (ELISA)], and T-cell activation (flow cytometry). PD-L1 expression was assessed by quantitative polymerase chain reaction (qPCR) and Western blot. In vivo, C57BL/6 mice (n = 20) bearing Lewis lung carcinoma (LLC) tumors were randomized into four groups (n = 5/group): PBS, G-Exos (10 μg), anti-PD-L1 (8 μg), or combination therapy. Treatments were administered intravenously every other day for 20 days. Tumor growth was measured, and tissues were analyzed by immunohistochemistry and flow cytometry.</p><p><strong>Results: </strong>G-Exos were efficiently internalized by NSCLC cells and demonstrated immunostimulatory properties in vitro. They enhanced T-cell-mediated cytotoxicity, as reflected by reduced tumor colony formation, and promoted immune activation, evidenced by increased IL-2 and IFN-γ secretion and a higher proportion of CD8⁺ T cells expressing TNF-α and perforin. Mechanistically, G-Exos downregulated PD-L1 expression at both transcriptional and translational levels in NSCLC cells. In vivo, G-Exos treatment significantly inhibited tumor growth and, when combined with anti-PD-L1 monoclonal antibody, exhibited a synergistic effect characterized by greater tumor suppression and increased infiltration of cytotoxic CD8⁺ T cells in the tumor microenvironment.</p><p><strong>Conclusion: </strong>Ginseng-derived exosomes downregulate PD-L1 and enhance T-cell function, counteracting immune evasion in NSCLC. Their synergy with anti-PD-L1 therapy supports their potential as adjuvant nanotherapeutics in cancer immunotherapy.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"1503-1512"},"PeriodicalIF":2.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Xingxiao Pill Suppressed the Progression of Non-Small Cell Lung Cancer by Targeting SREBP1/FASN-Induced Fatty Acid Biosynthesis via PI3K/AKT/mTOR Signaling Pathway.","authors":"Xiangnan Zhou, Xiuhua Hu, Zhiying Zhang, Shicheng Lin, Ximing Lin, Tian Zhou, Yanping Bai, Kaiwen Hu","doi":"10.2147/CMAR.S510010","DOIUrl":"10.2147/CMAR.S510010","url":null,"abstract":"<p><strong>Introduction: </strong>Xingxiao Pill (XXP), a typical traditional Chinese medicine (TCM) prescription drug used to treat NSCLC in clinic. However, the mechanism underlying its regulatory effects remains unclear. This study aimed to evaluate the potential efficacy of XXP in treating NSCLC and to investigate how XXP regulates fatty acid biosynthesis in NSCLC.</p><p><strong>Methods: </strong>A lung carcinoma mouse model was created by transplanting Lewis lung carcinoma (LLC) cells into male C57BL/6 mice. Lung cancer cell models using LLC and A549 cells were also constructed. XXP's therapeutic efficacy on NSCLC was assessed via oral gavage. Bioinformatics analysis and transcriptome sequencing identified XXP's potential targets and mechanisms. These findings were verified by in vitro cell assays, Western blotting, immunofluorescence staining, and Oil Red O staining.</p><p><strong>Results: </strong>XXP inhibited lung tumor growth, suppressed cell proliferation and impeded cell migration. Additionally, it influenced the processes of apoptosis and cell cycle in both A549 and LLC cells. Bioinformatics analysis suggested that regulation of fatty acid biosynthesis and phosphoinositide-3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling pathway were crucial mechanisms underlying the antitumor effects of XXP in lung cancer. XXP reduced the levels of the fatty acid biosynthesis products, such as total cholesterol (TC), triglycerides (TG), lipids, and free fatty acids in A549 cells, and downregulated the expression of sterol regulatory element binding protein 1 (SREBP1) and fatty acid synthase (FASN). Furthermore, XXP decreased the expression level of PI3K, AKT, mTOR, phospho-PI3K, and phospho-AKT.</p><p><strong>Discussion: </strong>XXP exerts its inhibitory effect on lung cancer tumor growth by controlling the biosynthesis of fatty acids and the PI3K/AKT/mTOR signaling pathway. The research suggests that targeting this metabolic pathway could be a viable strategy for cancer therapy and emphasizes the value of TCM in providing a rich source of innovative pharmaceuticals for cancer treatment.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"1487-1501"},"PeriodicalIF":2.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Artificial Intelligence and Radiomics in the Management of Lymphomas by PET/CT: The Clairvoyance in Clinic.","authors":"Chong Ling Duan, Lin An, Yong Feng Yang, Lili Yuan, Yandong Zhu, Qian Han, Hongbing Ma, Fei Zhao, Qing-Qing Yu","doi":"10.2147/CMAR.S529589","DOIUrl":"10.2147/CMAR.S529589","url":null,"abstract":"<p><p>Lymphomas are a hematopoietic malignancies that encompass over 90 subtypes. Traditionally, they have been categorized into two main groups, non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). Based on morphology and immunohistochemistry, HL can be classified into nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) and classical HL (cHL). NHL represents the most common form of lymphoma, including more than 50 subtypes, such as mantle cell lymphoma (MCL), follicular lymphoma (FL), marginal zone lymphoma (MZL), and the most common, diffuse large B-cell lymphoma (DLBCL). Medical imaging plays a pivotal role in lymphoma management, with positron emission tomography/computed tomography (PET/CT) serving as an indispensable tool. 2-Deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) PET/CT is extensively utilized in lymphoma management, having demonstrated its value in providing crucial data for precise disease burden quantification, treatment response evaluation, and prognostic assessment. Radiomics is an innovative approach that entails the computer-aided extraction of quantitative, searchable data from medical images and its association with biological and clinical outcomes. The rapid advancement of radiomics research has opened new avenues for cancer diagnosis and therapy. Our findings indicate that artificial intelligence based PET/CT radiomics has demonstrated significant potential in lymphoma diagnosis, subtyping, staging, treatment selection, and survival prognosis assessment, offering clinicians powerful decision-support tools. However, challenges remain, such as the lack of standardized image quality in machine learning applications.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"1457-1475"},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Tumor ERCC1 Expression for Treatment Outcomes After Adjuvant Chemotherapy in Patients with Completely Resected Non-Small Cell Lung Cancer.","authors":"Masao Nakata, Shinsuke Saisho, Junichi Soh, Norihito Okumura, Hiroshige Nakamura, Motohiro Yamashita, Shinichi Toyooka, Hiroshi Date","doi":"10.2147/CMAR.S517916","DOIUrl":"10.2147/CMAR.S517916","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the predictive value of tumor expression of the excision repair cross-complementation group 1 gene (ERCC1) for the treatment outcomes after platinum-based adjuvant chemotherapy in patients with completely resected non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>In this study, we conducted immunohistochemical analysis using a mouse monoclonal anti-ERCC1 antibody (clone 8F1) of operative specimens obtained from 238 patients enrolled in the SLCG0401 study which compared paclitaxel plus carboplatin (CBDCA+PTX) with uracil-tegafur (UFT) as adjuvant chemotherapy for stage IB-IIIA NSCLC. The overall survival (OS) of the patients was compared according to the ERCC1 expression status and adjuvant chemotherapy employed.</p><p><strong>Results: </strong>Of the 238 specimens, 102 (42.9%) showed a positive result for ERCC1 expression. There were no significant differences in the patient characteristics or OS between the tumor ERCC1-positive and -negative patient groups. Among the patients with ERCC1-negative tumors, there was no significant difference in the survival between patient groups treated with CBDCA+PTX and UFT (HR=0.932, 95% CI: 0.52-1.67, p=0.814). However, among the patients with ERCC1-positive tumors, CBDCA+PTX treatment tended to yield an inferior outcome, in terms of the OS, as compared with UFT treatment (HR=1.852, 95% CI: 0.92-3.73, p=0.080). Multivariate analysis showed that ERCC1 expression was not an independent predictor of the OS following CBDCA+PTX treatment in completely resected NSCLC patients.</p><p><strong>Conclusion: </strong>In completely resected NSCLC patients with positive tumor ERCC1 expression, adjuvant CBDCA+PTX treatment tended to yield an inferior outcome as compared with UFT treatment in terms of the OS. However, immunohistochemical analysis with the 8F1 antibody cannot be used for clinical decision making at this point.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"1477-1486"},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Radiomics Nomogram Based on Magnetic Resonance Imaging and Clinicoradiological Factors to Predict HCC TACE Refractoriness.","authors":"YuHan Dong, Jihong Hu, Xuerou Meng, Bin Yang, Chao Peng, Wei Zhao","doi":"10.2147/CMAR.S486561","DOIUrl":"10.2147/CMAR.S486561","url":null,"abstract":"<p><strong>Purpose: </strong>This study constructs a predictive model for hepatocellular carcinoma (HCC) transarterial chemoembolization (TACE) refractoriness using a machine learning (ML) algorithm and verifies the predictive performance of different algorithms.</p><p><strong>Patients and methods: </strong>Clinical and magnetic resonance imaging (MRI) data of 131 patients (48 with TACE refractoriness) who underwent repeated TACE treatment for HCC were retrospectively collected. The training and validation cohorts comprised 104 and 27 cases, respectively, following an 8:2 ratio. Clinical imaging characteristics related to TACE refractoriness were identified through logistic regression analysis. HCC lesions on arterial phase, portal phase, delayed phase, and T2-weighted fat suppression MRI images before the first TACE were manually delineated as regions of interest. Dimension reduction was conducted using variance threshold, univariate selection, and least absolute shrinkage and selection operator methods. Relevant indices of TACE refractoriness were selected. ML algorithms, including a support vector machine, random forest, logistic regression and adaptive boosting, were used to construct the radiomics, clinical prediction, and combined models. The predictive performance of these models was evaluated using receiver operating characteristic curves. The optimal model was presented as a nomogram and verified through calibration and decision curve analyses.</p><p><strong>Results: </strong>In evaluating radiomics models for predicting TACE refractoriness in HCC, the LR-developed portal venous phase (VP) model achieved optimal single-sequence performance (training AUC: 0.896, 95% CI: 0.843-0.941; validation: 0.853, 0.727-0.965). Multisequence models significantly surpassed single-sequence counterparts, with the T2WI-FS+AP+VP+DP multisequence LR model demonstrating peak efficacy (training: 0.905, 0.853-0.949; validation: 0.876, 0.773-0.976). The integrated clinical-radiomics model demonstrated robust predictive performance, achieving a training cohort AUC of 0.955 (95% CI: 0.918-0.984) with 0.885 accuracy, 0.921 sensitivity, and 0.864 specificity, and maintained strong validation performance (AUC=0.941, 95% CI: 0.880-0.991).</p><p><strong>Conclusion: </strong>Multisequence clinical-radiomics model accurately predicts TACE refractoriness in hepatocellular carcinoma.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"1441-1455"},"PeriodicalIF":2.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pathogenesis and Prevention Strategies of Radiation-Induced Brain Injury.","authors":"Yong Wang, Jun Wu, Ya Wang, Weiyuan Song, Hongjian Ren, Xu Han, Xiaoqi Dong, Zhiqiang Guo","doi":"10.2147/CMAR.S525791","DOIUrl":"10.2147/CMAR.S525791","url":null,"abstract":"<p><p>Radiation-induced brain injury (RBI) encompasses the severe symptoms resulting from radiation-induced damage to the normal tissue surrounding tumors in patients undergoing radiotherapy for head and neck malignancies. The primary symptoms include skin erythema, pain, and may extend to headache, syncope, nausea, vomiting, memory impairment, alterations in mental status, visual disturbances, drowsiness, and other neurological abnormalities localized to the area of treatment. These side effects both limit the effectiveness of radiation therapy and reduce the patient's quality of life. During radiotherapy, while killing tumor cells, the radiation will damage the cerebral microvascular endothelial cells, cause cerebrovascular inflammatory response, destroy the blood-brain barrier, aggravate the cerebral oxidative stress response, and induce apoptosis of nerve cells. This review summarizes the mechanisms underlying the occurrence and progression of radiation-induced brain injury and discusses promising strategies for prevention and treatment that may be applicable to clinical patients suffering from this condition.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"1433-1440"},"PeriodicalIF":2.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}