Cancers最新文献

{"title":"A Chronobiological Prognostic Model for Resected Stage I Non-Small-Cell Lung Cancer.","authors":"Giovanni Leuzzi, Pamela Minicozzi, Paolo Verderio, Chiara Maura Ciniselli, Michele Ferrari, Alessandro Pardolesi, Alessia Stanzi, Jury Brandolini, Luigi Rolli, Matteo Calderoni, Clarissa Uslenghi, Ugo Pastorino, Giuseppe Lo Russo, Claudia Proto, Arsela Prelaj, Teresa Beninato, Daniele Lorenzini, Piergiorgio Solli","doi":"10.3390/cancers18193208","DOIUrl":"10.3390/cancers18193208","url":null,"abstract":"<p><strong>Objectives: </strong>Chronobiology may influence outcomes in non-small-cell lung cancer (NSCLC), but its prognostic role in early-stage disease remains unclear. We evaluated the association between perioperative chronobiological variables, systemic inflammation, and long-term outcomes after complete resection for stage I NSCLC.</p><p><strong>Methods: </strong>587 patients who underwent curative-intent resection for pathological stage I NSCLC between 2009 and 2018 were retrospectively reviewed. Chronobiological and inflammatory variables included season of surgery (spring/summer [21st March-22nd September], autumn/winter [23rd September-20th March]), time of day, day of week, and preoperative (CRP0 levels: low ≤ 3 mg/L, high > 3 mg/L) and postoperative day-3 (CRP3 levels: low ≤ 126 mg/L, high > 126 mg/L) C-reactive protein levels. The cohort was randomly divided into training (70%) and testing (30%) sets to develop and validate a prognostic model for overall survival (OS), taking into consideration the follow-up time. Disease-free survival (DFS) was analyzed as a secondary endpoint.</p><p><strong>Results: </strong>Median follow-up was 6.7 years, with 80 deaths and 108 recurrences recorded. In the training set, older age (<i>p</i> = 0.0049), stage IB disease (<i>p</i> = 0.0301), high CRP0 (<i>p</i> = 0.0049), and high CRP3 (<i>p</i> = 0.0280) were associated with worse OS, while surgery performed during autumn/winter was associated with improved OS (<i>p</i> = 0.0312). The multivariate Cox model including age, stage, and season of surgery showed the best prognostic performance (C-index 0.67, 95% Bonferroni-adjusted CI 0.50-0.83) and was internally validated in the testing cohort (C-index 0.69, 95%CI 0.52-0.86). The resulting linear predictor remained associated with both OS and DFS in the overall population.</p><p><strong>Conclusions: </strong>A simple model integrating age, pathological stage, and season of surgery was associated with long-term outcomes after surgery in stage I NSCLC. This model provides an exploratory framework integrating host-, tumor-, and chronobiological dimensions of prognosis. These findings require external validation and further investigation of the biological mechanisms underlying seasonal variation.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive Care in Patients with Solid Tumours: A Practical Framework for Integrated Onco-Critical Care.","authors":"Alicia Castelo-Loureiro, Amanda Lesmes González de Aledo, Mateo Bover Larroya, Zaira Molina Collado, Cristina Serrano Gómez, Isaías Martín Badía, Jesús González Olmedo, Santiago Terán, Marcos Valiente Fernández, Carlos Heredia-Mena, Joseph Exebio-Jara, Lidia Orejón García, María Carnevali Frías, Carlos Gómez Martín, María Cruz Martín Delgado, Luis Paz-Ares","doi":"10.3390/cancers18193210","DOIUrl":"10.3390/cancers18193210","url":null,"abstract":"<p><p>The number of patients with solid tumours requiring intensive care is increasing as cancer survival improves and oncological treatments become more complex. Intensive care unit (ICU) admission decisions should not be based on cancer diagnosis, metastatic status or palliative treatment intent alone. This narrative review presents a practical, multidisciplinary framework for assessing critically ill patients with solid tumours. It integrates acute illness severity and reversibility, organ failure, baseline performance status and frailty, cancer trajectory, remaining treatment options, expected functional recovery and patient preferences. We discuss contemporary anticancer treatment toxicities, cancer-associated thromboembolic disease, older adults, palliative care, communication and ethical decision-making. We also propose an algorithm ranging from full ICU support to a time-limited ICU trial with predefined reassessment or comfort-focused care. Early joint assessment by oncology and intensive care teams, followed by dynamic reassessment, may reduce both inappropriate escalation and premature exclusion from potentially beneficial organ support. Future research should prioritize structured pathways, improved prognostic tools and outcomes beyond survival, including functional recovery, quality of life and the ability to resume meaningful cancer treatment.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chk1/2 Inhibition by AZD7762 Enhances Andrographolide-Induced DNA Damage, Impairs DNA Repair, and Promotes Apoptosis in Head and Neck Squamous Cell Carcinoma CAL-33 Cells.","authors":"Sakshi Singh, Anitha Kartha, Aishwarya Jaiswal, Dhanir Tailor, Sivanandhan Dhanalakshmi","doi":"10.3390/cancers18193199","DOIUrl":"10.3390/cancers18193199","url":null,"abstract":"<p><p><b>Background</b>: Andrographolide (AG), a diterpenoid lactone and a major constituent of <i>Andrographis paniculata</i>, has shown promising antiproliferative effect on diverse cancer cell lines, including head and neck cancer. However, a significant anti-proliferative effect is observed only at high micromolar concentrations. Further, AG has been shown to have poor oral bioavailability. Therefore, it is essential to consider mechanism-based combinations that could synergistically enhance the therapeutic potential of this compound so that efficacy can be achieved in concentrations that are systemically achievable. <b>Objective</b>: The present study is aimed to evaluate the anticancer effects and associated molecular alterations of an AG and Chk1/2 inhibitor combination in head and neck squamous cell carcinoma (CAL-33) cells since the earlier studies have suggested ATM/ATR/Chk1/2-mediated activation of DNA damage checkpoints. <b>Methods</b>: Normal FHs74int cells and HNSCC cells (CAL-33 and FaDu) were used to assess cell proliferation and cell death. Cell cycle distribution and apoptosis were analyzed by flow cytometry and Acridine orange/EtBr, respectively, in CAL-33 cells. DNA damage in CAL-33 and FaDu cells was assessed by comet assay. Changes in the expression of proteins implicated in apoptosis, cell cycle progression, and DNA damage signaling were examined using Western blotting. <b>Results</b>: While AG did not show any significant changes in the growth or cell death of normal FHs74int cells, it strongly inhibited proliferation of HNSCC cells, concomitant with G2/M arrest and apoptosis. AG and AZD7762 showed an IC50 of 2.743 μM and 0.02600 μM, respectively, on cell proliferation in CAL-33 cells. Furthermore, AG caused an accumulation of intracellular ROS, which was inhibited by treatment with N-acetylcysteine. Chk1, Chk2 and γH2AX phosphorylation were induced in a dose-dependent manner by treatment with AG. The combination of AG with Chk1/2 inhibitor AZD7762 showed a synergistic effect in inhibiting cell proliferation with a CI of 0.4 through inhibition of DNA repair and premature mitotic entry, ultimately resulting in programmed cell death. <b>Conclusions</b>: These findings provide evidence that AG selectively targets DNA damage and repair in HNSCC CAL-33 cells via cell cycle arrest and apoptosis. Further, the anticancer potential of AG can be significantly enhanced by combination with the Chk1/2 inhibitor AZD7762, preventing repair of AG-induced DNA damage and amplifying checkpoint stress responses, resulting in enhanced apoptotic cell death. Together, these findings support the therapeutic potential of AG and highlight checkpoint kinase inhibition as a rational combination strategy for HNSCC treatment.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Mitophagy-Associated Factors and Their Associations with Metastasis and Prognosis in Oral Squamous Cell Carcinoma.","authors":"Yudai Matsuzoe, Daisuke Takeda, Izumi Saito, Yuki Murakami, Aki Murakami, Yoshiaki Tadokoro, Junya Hirota, Yasumasa Kakei, Masaya Akashi, Takumi Hasegawa","doi":"10.3390/cancers18193194","DOIUrl":"10.3390/cancers18193194","url":null,"abstract":"<p><strong>Background/objectives: </strong>Mitophagy-associated factors have been implicated in tumor behavior and patient outcomes; however, their clinical significance depends on tumor type, stage, and microenvironmental context, and consistent conclusions remain lacking. We aimed to comprehensively assess the expression of mitophagy-associated factors in a moderate-sized cohort of patients with oral squamous cell carcinoma (OSCC) and clarify their prognostic significance.</p><p><strong>Methods: </strong>A retrospective cohort study included 197 patients with OSCC who underwent primary surgical resection between August 2013 and October 2018. Immunohistochemical expression of mitophagy-associated factors, including transcription factor EB (TFEB), nuclear factor erythroid 2-related factor 2 (NRF2), activating transcription factor 4 (ATF4), Parkin, PTEN-induced kinase 1 (PINK1), and mitochondrial ubiquitin ligase (MITOL), was evaluated. Associations between protein expression and clinicopathological parameters, local control, 5-year disease-specific survival (DSS), regional control, and distant metastasis were analyzed.</p><p><strong>Results: </strong>High expression of NRF2 and TFEB was significantly related with decreased DSS, poor regional control, and increased distant metastasis. High ATF4 expression was associated with distant metastasis and showed no association with DSS. Parkin, PINK1, and MITOL showed no significant association with patient outcomes. Explanatory multivariable analysis showed associations between high TFEB expression, vascular invasion, extranodal extension, and disease-specific mortality.</p><p><strong>Conclusions: </strong>TFEB expression showed an exploratory association with aggressive tumor behavior and poor prognosis in OSCC, warranting further investigation. However, because immunohistochemical evaluation measures protein expression rather than mitophagy flux or mitochondrial turnover, these findings represent associations between mitophagy-associated factor expression and clinical outcomes and do not directly demonstrate altered mitophagy activity.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MedNeXt-Based Automated Tumor Segmentation and TMTV Prognostication in Hodgkin Lymphoma PET Images: A Retrospective Study.","authors":"Haoan Zhang, Fuming Sun, Hang Yu, Xinyuan Chen, Yixuan Shi, Yue Teng, Wenze He, Yu Jin, Shangdong Liu, Chongyang Ding, Chong Jiang, Jingyan Xu","doi":"10.3390/cancers18193196","DOIUrl":"10.3390/cancers18193196","url":null,"abstract":"<p><p><b>Background/Objectives</b>: To evaluate a deep learning-based method for automatic segmentation of Hodgkin lymphoma (HL) on PET images and to explore the prognostic value of total metabolic tumor volume (TMTV) derived from segmentation. <b>Methods</b>: PET datasets from two independent institutions were retrospectively collected and divided into training and validation cohorts. MedNeXt was trained for HL PET segmentation and benchmarked against five representative segmentation architectures under the same data split, preprocessing pipeline, and evaluation framework. Segmentation performance was assessed using the Dice similarity coefficient (DSC), Jaccard index (JSC), 95th percentile Hausdorff distance (HD95), and average symmetric surface distance (ASSD). Bland-Altman and linear regression analyses evaluated agreement between ground-truth TMTV (gtTMTV) and predicted TMTV (pTMTV). Cox proportional hazards regression analysis was applied to assess the prognostic value of pTMTV. <b>Results</b>: In the validation cohort, the mean values (±standard deviation) of DSC, HD95, JSC, and ASSD were 0.702 ± 0.191, 67.998 ± 99.220, 0.561 ± 0.203, and 16.992 ± 31.659, respectively. Among the evaluated segmentation models, MedNeXt showed the best segmentation performance. Mean gtTMTV and pTMTV were 424.681 ± 498.811 cm³ and 405.871 ± 466.984 cm³, showing good agreement. pTMTV was significantly associated with progression-free survival (PFS) (<i>p</i> = 0.048), but not overall survival (OS) (<i>p</i> = 0.163). <b>Conclusions</b>: MedNeXt achieved reliable HL segmentation, although tumor boundary delineation requires further improvement. The derived pTMTV may serve as a prognostic indicator for PFS but showed no significant association with OS. Further validation in larger cohorts is warranted.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Reprogramming in Bladder Cancer: Molecular Drivers, Immune Regulation and Therapeutic Opportunities.","authors":"Shaolin Li, Minghui Li, Yinglang Zhang, Jie Pu, Jiaao Sun, Chunsheng Li, Changgang Guo","doi":"10.3390/cancers18193202","DOIUrl":"10.3390/cancers18193202","url":null,"abstract":"<p><p>Metabolic reprogramming is increasingly recognised as a central determinant of bladder cancer heterogeneity, immune regulation and treatment response. This review integrates genetic, epigenetic, microenvironmental and therapeutic evidence to explain how bladder cancer redistributes carbon and nitrogen across glycolysis, lipid synthesis and oxidation, amino-acid metabolism and mitochondrial respiration. Alterations in <i>FGFR3</i>, <i>PIK3CA</i>, <i>MYC</i>, <i>TP53</i>/<i>RB1</i> and <i>KDM6A</i> establish distinct, context-dependent metabolic dependencies, while hypoxia, extracellular-matrix mechanics and treatment selection reinforce metabolic plasticity. These programmes influence not only energy production and biosynthesis but also ferroptosis, genome stability and chromatin or RNA regulation. Lactate, adenosine, kynurenine and asparagine further connect tumour metabolism to regulatory T cells, myeloid cells, innate immune sensing and CD8-positive T cell function, thereby shaping resistance to chemotherapy and immune-checkpoint blockade. Therapeutic opportunities include targeting glycolysis, fatty-acid and cholesterol metabolism, glutamine and proline metabolism, arginine auxotrophy and metabolite-mediated immune suppression. However, pathway redundancy, cellular heterogeneity and shared metabolic requirements between tumour and immune cells constrain unselected treatment. Urine, tissue, blood and imaging metabolomics offer complementary routes to diagnosis, prognostication and real-time response monitoring, but require harmonised sampling, functional flux measurements and prospective validation. A clinically useful strategy will therefore depend on defining metabolic vulnerabilities by genotype, cell type, spatial context and treatment stage, and on pairing pharmacodynamic biomarkers with rational combinations and local delivery where appropriate.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GammaTile^® Brachytherapy as Spatially Fractionated Radiation Therapy for Postoperative Brain Cancer: A Paradigm for Precision Intracranial Radiotherapy.","authors":"Hualin Zhang, Nguyen Phuong Dang, Jason C Ye, Adam Garsa, Aram S Modrek, Zhilei Liu Shen, Salim Balik, Zhengzheng Xu, Kaley Woods, Adam C Turner, David G Brachman, Thomas Chen, Gabriel Zada, Eric L Chang","doi":"10.3390/cancers18193201","DOIUrl":"10.3390/cancers18193201","url":null,"abstract":"<p><p><b>Purpose:</b> Tile-based radiation therapy (TBRT) delivers adjuvant radiation to brain tumor beds using evenly spaced cesium-131 (Cs-131) sources in collagen tiles. This study evaluated TBRT as spatially fractionated radiation therapy (SFRT) across tumor sizes and source counts. <b>Methods and Materials:</b> Dose distributions were generated from postoperative CT scans for 18 patients treated with TBRT, using 10-32 implanted Cs-131 sources per case (median, 20). The resection cavity (RC) was contoured on CT with registered postoperative T1-weighted MRI guidance. CTV_5mm was defined as the RC plus a 5 mm expansion excluding skull and surgical tract, and CTV_5mm_Eval as CTV_5mm minus the RC. Both volumes were analyzed using SFRT dose metrics from the Radiosurgery Society SFRT/Flash working group white paper, and planar high-dose core number density (HCND_A) was used to characterize TBRT spatial fractionation. <b>Results</b>: The mean dose indices of D5 (dose covering 5% of the target volume), D10, D50, D90, D95 and D100 were 175.8 ± 43.3, 148.8 ± 35.1, 86.7 ± 18.5, 56.1 ± 10.5, 50.2 ± 9.0 and 33.4 ± 7.2 Gy for the CTV_5mm_Eval, respectively. The heterogeneity indices, represented by the ratio of D5/D95 and D10/D90, were 3.5 ± 0.6 and 2.7 ± 0.4, respectively, which were in the range of the linac-based Lattice therapy. HCND_A was a constant, TBRT delivered one high dose core for every 1 cm² of tumor bed. All dose metrics in both the CTV_5mm and CTV_5mm_Eval were largely consistent across all plans. <b>Conclusions</b>: TBRT produced heterogeneous dose distributions comparable to conventional SFRT. A 60 Gy TBRT nominal prescription dose approximated the SFRT D90, or valley dose of the 5 mm expansion target volume, suggesting TBRT may provide an SFRT platform for tile-accessible cancers.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second Primary Malignancies in Gastrointestinal Cancer Survivors: Epidemiology, Risk Factors, and Future Prediction Models.","authors":"Jyoti Yadav, Thomas Balizzakiwa, Hemant Goyal","doi":"10.3390/cancers18193195","DOIUrl":"10.3390/cancers18193195","url":null,"abstract":"<p><p>Advances in gastrointestinal (GI) cancer care have produced a growing population of long-term survivors at risk of second primary malignancies (SPMs). SPM definitions vary across studies, and SPMs remain underrepresented in cancer forecasting and prediction tools for GI cancer survivors. We conducted a narrative review across major GI cancer subtypes, summarizing site-specific SPM risk, key etiological pathways, and available prediction tools. Approximately one in ten colorectal cancer (CRC) survivors develops an SPM at ten years (pooled SIR ~1.15), a figure specific to CRC that does not generalize to other GI sites. Gastric cancer survivors carry excess risk of thyroid (O/E 2.00), esophageal, small intestinal, and pancreatic (O/E 1.60) malignancy, amplified by radiotherapy. Esophageal squamous cell carcinoma survivors show markedly elevated risk of upper aerodigestive tract tumors, consistent with field cancerization. Lynch syndrome (~16% second CRC risk at 10 years) and familial adenomatous polyposis (near-100% lifetime CRC risk without colectomy) confer some of the highest lifetime risks of metachronous GI malignancy reported to date. Most forecasting frameworks treat cancer incidence as a single event and do not adequately capture survivor-specific transitions, competing mortality, or germline susceptibility. GI cancer survivors form a distinct group whose risk is often overlooked. Harmonizing SPM definitions, extending multistate and competing-risk modeling, and integrating hereditary-risk stratification are near-term priorities for individualized surveillance.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Evaluation of Feature Selection Algorithms for Predicting Radiation-Induced Complications in Head and Neck Cancer Using Multimodal CT and MRI Radiomics.","authors":"Benyamin Khajetash, Mohammad Reza Deevband, William A Stokes, Meysam Tavakoli","doi":"10.3390/cancers18193200","DOIUrl":"10.3390/cancers18193200","url":null,"abstract":"<p><p>Head and neck cancer (HNC) presents a significant challenge due to its anatomic complexity and treatment-related complications such as sticky saliva and xerostomia, which critically impair patients' quality of life. Recent advancements in imaging technologies, using the concept of radiomics, offer promising approaches for predicting these complications and ultimately reducing their incidence. In this regard, robust feature selection is critical in radiomics-based predictive modeling due to the high dimensionality, redundancy, and instability of extracted imaging biomarkers. This study aims to evaluate nine distinct feature selection algorithms-Boruta, Kruskal, Recursive Maximum Relevance minimum redundancy (R-MRmr), Relief, Recursive Feature Elimination (RFE), Forward Selection (FS), Backward Elimination (BE), Least Absolute Shrinkage and Selection Operator (LASSO), and Principal Component Analysis (PCA)-as a feature-transformation comparator for predicting sticky saliva and xerostomia in HNC patients using clinical, dosimetric, MRI and CT radiomics data. The study involved 250 HNC patients who underwent radiotherapy from three different institutions. From MRI and CT images, a total of 321 radiomic features (107 from each CT, T1, and T2-weighted MRI) along with 20 clinical and dosimetric features were extracted. The predictive robustness of feature selection methods was further evaluated across five machine-learning classifiers, including K-nearest neighbors (KNN), support vector machine (SVM), random forest (RF), logistic regression (LR), and eXtreme Gradient Boosting (XGBoost), were initially benchmarked using a common feature selection procedure, after which SVM was selected as the reference classifier for systematic comparison of the feature-reduction approaches. Model performance was assessed using metrics objectives such as Area Under the Curve (AUC), accuracy, sensitivity, and specificity. Among the evaluated feature selection approaches, R-MRmr and Relief generally yielded better discrimination, although performance varied according to toxicity endpoint and imaging modality. The highest AUCs were 0.85 for early sticky saliva (R-MRmr, T1-weighted MRI), 0.96 for early xerostomia (R-MRmr, T1-weighted MRI), 0.65 for late sticky saliva (Relief, combined CT+T1+T2), and 0.88 for late xerostomia (Relief, T1-weighted MRI). T1-weighted MRI frequently provided better individual-modality performance, whereas combining all three imaging modalities did not consistently improve discrimination. These findings demonstrate that the choice of feature selection strategy and imaging modality can materially influence radiomics-based toxicity prediction.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Use of Savi Scout and Magtrace for Non-Palpable Breast Cancer: A Retrospective Study.","authors":"Claire Lloyd-Davies, Abdul Kasem","doi":"10.3390/cancers18193197","DOIUrl":"10.3390/cancers18193197","url":null,"abstract":"<p><strong>Background: </strong>Non-palpable breast cancer management has become less invasive and more efficient, driven by advances in tumor localization and sentinel lymph node (SLN) identification. Savi Scout, using a radar-based localization system, can be implanted into the tumor before neoadjuvant systemic therapy (NST). Magtrace, a superparamagnetic iron oxide nanoparticle for SLN detection, can be administered preoperatively. This study evaluated combining Savi Scout and Magtrace for breast-conserving surgery and SLN biopsy in non-palpable breast cancer.</p><p><strong>Methods: </strong>Patients who underwent breast-conserving surgery and SLN biopsy for non-palpable breast cancer using Savi Scout and Magtrace between December 2022 and June 2026 at HCA Healthcare London Bridge Hospital were retrospectively identified. Outcomes included successful tumor localization, SLN identification, intraoperative signal detection failure, margin status, re-excision rate and staining.</p><p><strong>Results: </strong>72 patients were identified (mean age 52 years, standard deviation ± 10), with a total of 78 breast lesions and 73 SLN biopsies. A total of 27.8% (20/72) underwent neo-adjuvant therapy with Savi Scout in situ. SLNs were identified using Magtrace in 95.9% (70/73) of SLN biopsies, with a mean of 2.7 (standard deviation ± 0.7) SLNs identified per procedure. A total of 78 Savi Scout devices were implanted, one for each lesion. Of these, 97.4% (76/78) were localizable intraoperatively, 100.0% (78/78) were retrieved and none migrated. One patient required re-excision for margin involvement.</p><p><strong>Conclusions: </strong>Combined use of Savi Scout and Magtrace is feasible, demonstrates high technical success, and offers pre-operative imaging flexibility in primary surgery for non-palpable breast cancers and post-NST patients. This study evaluates the combination of Savi Scout and Magtrace and demonstrates a practical approach for simultaneous tumor localization and SLN identification.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}