Cancers最新文献

{"title":"Clinician Recommendation for Hereditary Genetic Testing in Participants at Increased Risk for Hereditary Cancer.","authors":"Emerson Delacroix, Sarah Austin, John D Rice, Elena Martinez Stoffel, Erika Koeppe, Jennifer J Griggs, Ken Resnicow","doi":"10.3390/cancers17121994","DOIUrl":"10.3390/cancers17121994","url":null,"abstract":"<p><p><b>Background:</b> Despite clinical utility in managing hereditary cancers, genetic testing (GT) remains underutilized. While barriers include knowledge gaps and cost, clinician recommendation is a major driver of GT uptake, with rates varying by cancer type and family cancer history documentation. <b>Methods:</b> Adult participants (≥18 years) were recruited through multiple sources to complete a cancer family history survey for a larger intervention trial. Participants with personal or family history indicating increased hereditary cancer risk who had not undergone GT (N = 3001) were invited to complete a baseline survey. Multivariable logistic regression was used to analyze associations between demographics and cancer history by receipt of a clinician recommendation for GT. <b>Results:</b> Among 784 respondents, most were White (84.6%), female (58.4%), and over age 51 (75.3%), with 58.2% reporting a diagnosis of cancer. Only 14.0% reported receiving a clinician recommendation for GT, with lower recommendation rates among younger adults (20.1%), those reporting no financial stress (10.7%), and those with higher education (12.0%). Multivariate analysis showed participants who did not report financial stress (<i>p</i> = 0.049) were less likely to receive a recommendation. <b>Discussion:</b> These findings highlight disparities in GT recommendation by clinicians. Increased clinician education about indications for GT, the implementation of electronic medical record tools to facilitate the identification of patients with guideline-concordant personal and/or biological-relative cancer history, and patient-facing interventions could standardize the dissemination of recommendations for GT. <b>Conclusions:</b> Future efforts that focus on increasing clinician education and electronic decision support should identify individuals with personal and/or biological-relative cancer history meeting criteria for GT.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494716","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":"Evofosfamide Enhances Sensitivity of Breast Cancer Cells to Apoptosis and Natural-Killer-Cell-Mediated Cytotoxicity Under Hypoxic Conditions.","authors":"Shubhankar Das, Goutham Hassan Venkatesh, Walid Shaaban Moustafa Elsayed, Raefa Abou Khouzam, Ayda Shah Mahmood, Husam Hussein Nawafleh, Nagwa Ahmed Zeinelabdin, Rania Faouzi Zaarour, Salem Chouaib","doi":"10.3390/cancers17121988","DOIUrl":"10.3390/cancers17121988","url":null,"abstract":"<p><p><b>Background/objectives:</b> Hypoxia in the tumor microenvironment is linked to aggressiveness, epithelial-mesenchymal transition, metastasis, and therapy resistance. Targeting hypoxia to enhance antitumor immunity is crucial for overcoming therapeutic resistance. Here, we investigated the ability of Evofosfamide, a prodrug that gets activated under hypoxic conditions, to sensitize breast cancer cells to cell death. Evofosfamide is converted into bromo-isophosphoramide mustard, a potent DNA cross-linking agent that is expected to enhance the killing of cancer cells under hypoxic conditions, where these cells typically exhibit resistance. <b>Methods:</b> Representative breast cancer cell lines, MCF-7 and MDA-MB-231, were treated with Evofosfamide under normoxia and hypoxia. Changes in cell viability and the mechanism of cell death were measured using neutral red dye uptake, Annexin-FITC/propidium iodide staining, and Western blot analysis of markers-PARP1 and caspase 3/7. We tested Evofosfamide's ability to counteract hypoxic suppression of type I Interferon signaling genes using quantitative PCR (qPCR), as well as its capacity to trigger natural killer (NK)-cell-mediated cytotoxicity. <b>Results:</b> Evofosfamide enhanced cell killing in both MCF-7 and MDA-MB-231 cells under hypoxic conditions compared to normoxic conditions. Cell killing was accompanied by increased cellular reactive oxygen species (ROS), diminished mitochondrial membrane potential, and induction of apoptosis, as demonstrated by the fragmentation or laddering of genomic DNA, the activation of caspase 3/7, and the cleavage of PARP. qPCR analysis revealed that Evofosfamide was capable of restoring type I interferon signaling in hypoxic breast cancer cells, leading to the subsequent cytolytic activity of NK cells against the tumor cells. <b>Conclusions:</b> Thus, conditioning the breast cancer cells with Evofosfamide resulted in enhanced cell killing under hypoxia, further underscoring its potential as a sensitizer to target hypoxia-driven tumors.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494791","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":"Immune-Related Cutaneous Adverse Events Display Distinct Clinical and Molecular Characteristics, Depending on Immune Checkpoints Targeted.","authors":"Lukas Kraehenbuehl, Nicola Winkelbeiner, Patrick Turko, Ramon Staeger, Adhideb Ghosh, Vivienn Kaiser, Pia-Charlotte Stadler, Thierry M Nordmann, Marie-Charlotte Brüggen, Mitchell P Levesque, Emmanuel Contassot, Lars E French, Reinhard Dummer, Barbara Meier-Schiesser","doi":"10.3390/cancers17121992","DOIUrl":"10.3390/cancers17121992","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Immune-related cutaneous adverse events (ircAEs) are common complications of cancer immunotherapy and provide insight into immune-related adverse events (irAEs) more broadly. To enhance our molecular understanding, we characterized ircAEs resulting from single-agent (PD1) and combined immunotherapy regimens (P+C). Clinically, maculopapular rash (MPR) and toxic epidermal necrolysis (TEN) resemble ircAEs, providing a valuable basis for investigations. <b>Methods</b>: To investigate the transcriptome and immune infiltrates in ircAEs, we conducted transcriptomic analyses and multiplexed immunohistochemistry on skin biopsies from patients receiving PD1 and P+C, as well as those with MPR, TEN, and healthy controls. <b>Results</b>: Principal component analysis revealed distinct transcriptomic clustering between ircAEs, MPR, and TEN. Specifically, PD1 ircAEs exhibited a gene expression profile similar to TEN, with upregulation of Type-I-response-related genes (e.g., CXCL9 Log2FC 5.34, <i>p</i> < 0.0001, CXCL10 Log2FC 6.03, <i>p</i> < 0.0001), while P+C ircAEs more closely resembled MPR. Immune infiltrates differed significantly between all groups (<i>p</i> = 0.002 by PERMANOVA for all groups). CD4 T-cells were abundant in the dermis of ircAEs from any type of immunotherapy. However, PD1 stained positive in 1.07% of CD4 cells with PD1 monotherapy, compared to 0.3%, 0.4%, and 0.08% in P+C, MPR, and TEN, respectively. <b>Conclusions</b>: This study identified distinct molecular and cellular signatures in ircAEs depending on the type of immune checkpoint blockade. aPD1-associated ircAEs share similarities with the cytotoxic profile of TEN, while P+C more closely mirrored MPR. These findings support the need for tailored management strategies for ircAEs, emphasizing personalized therapeutic approaches to minimize treatment interruptions while preserving the efficacy of cancer immunotherapy.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494813","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":"Application of the Deep Inspiration Breath-Hold Technique in Proton Therapy for Mediastinal Lymphomas: Initial Experience.","authors":"Magdalena Garbacz, Tomasz Skóra, Anna Cepiga, Gabriela Foltyńska, Jan Gajewski, Eleonora Góra, Dominika Kędzierska-Pardel, Wiktor Komenda, Dawid Krzempek, Emilia Krzywonos, Tomasz Mikołajski, Antoni Ruciński, Karolina Sobkowicz, Urszula Sowa, Agnieszka Wochnik, Kamil Kisielewicz, Renata Kopeć","doi":"10.3390/cancers17121985","DOIUrl":"10.3390/cancers17121985","url":null,"abstract":"<p><p><b>Background:</b> This work presents the procedures and application of the deep inspiration breath-hold (DIBH) technique for mediastinal lymphoma patients at a proton therapy (PT) center. It also discusses the implementation and validation of the surface-guided radiotherapy (SGRT) protocol in terms of positioning accuracy. <b>Methods:</b> This study included six lymphoma patients. Dedicated computed tomography (CT) protocols and a treatment workflow based on international guidelines were developed. Clinical data from the treatment planning system (TPS) were used to assess the difference between DIBH and free-breathing irradiation. Additionally, data from an optical patient positioning system and kilovoltage (kV) imaging system were used to estimate positioning shifts. The new CT protocol reduced the volume CT dose index by over six times compared with the standard protocol. <b>Results</b>: The DIBH method decreased the mean dose to the heart and lungs by up to 7.02 Gy(RBE) and 0.83 Gy(RBE), respectively. The median magnitude of patient setup errors and repeatability in DIBH positioning was 0.4 cm and 0.18 cm (mean for males and females) for the SGRT protocol. The kV imaging showed a setup error of over 0.3 cm for both groups. <b>Conclusions</b>: Despite the small size of the patient cohort, the relatively large number of individual positioning sessions enabled the detection of statistically significant differences (<i>p</i> < 0.05) in certain areas between male and female patients; however, no significant difference in the displacement vector magnitude was observed. DIBH treatment with SGRT offers high reproducibility for patient positioning.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494768","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":"The Role of Viruses in the Glioma Tumor Microenvironment: Immunosuppressors or Primers for Anti-Tumor Immunity?","authors":"Anna J Hudson, Jay Chandar, Muhammet Enes Gurses, Thomas Malek, Ashish H Shah","doi":"10.3390/cancers17121984","DOIUrl":"10.3390/cancers17121984","url":null,"abstract":"<p><p>The WHO estimates that nearly 10-15% of cancers have a known viral etiology, although this number is likely an underestimate. In glioblastoma (GBM), the most common primary brain malignancy, viral associations have been proposed and investigated without a definitive etiology. Viral-host interactions are known to alter cellular growth and stem cell programming, as well as modulate innate immune signaling. However, in GBM, the multifaceted role of endogenous or exogenous viral expression remains unclear. Here, we provide a review of common viral associations in GBM and discuss how these viruses modulate intrinsic cellular processes to enhance anti-viral immune response or suppress anti-tumor immunity.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494827","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":"MRI-Based Radiomics Ensemble Model for Predicting Radiation Necrosis in Brain Metastasis Patients Treated with Stereotactic Radiosurgery and Immunotherapy.","authors":"Yijun Chen, Corbin Helis, Christina Cramer, Michael Munley, Ariel Raimundo Choi, Josh Tan, Fei Xing, Qing Lyu, Christopher Whitlow, Jeffrey Willey, Michael Chan, Yuming Jiang","doi":"10.3390/cancers17121974","DOIUrl":"10.3390/cancers17121974","url":null,"abstract":"<p><p><b>Background:</b> Radiation therapy is a primary and cornerstone treatment modality for brain metastasis. However, it can result in complications like necrosis, which may lead to significant neurological deficits. This study aims to develop and validate an ensemble model with radiomics to predict radiation necrosis. <b>Method:</b> This study retrospectively collected and analyzed MRI images and clinical information from 209 stereotactic radiosurgery sessions involving 130 patients with brain metastasis. An ensemble model integrating gradient boosting, random forest, decision tree, and support vector machine was developed and validated using selected radiomic features and clinical factors to predict the likelihood of necrosis. The model performance was evaluated and compared with other machine learning algorithms using metrics, including the area under the curve (AUC), sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). SHapley Additive exPlanations (SHAP) analysis and local interpretable model-agnostic explanations (LIME) analysis were applied to explain the model's prediction. <b>Results:</b> The ensemble model achieved strong performance in the validation cohort, with the highest AUC. Compared to individual models and the stacking ensemble model, it consistently outperformed. The model demonstrated superior accuracy, generalizability, and reliability in predicting radiation necrosis. SHAP and LIME were used to interpret a complex predictive model for radiation necrosis. Both analyses highlighted similar significant factors, enhancing our understanding of prediction dynamics. <b>Conclusions:</b> The ensemble model using radiomic features exhibited high accuracy and robustness in predicting the occurrence of radiation necrosis. It could serve as a novel and valuable tool to facilitate radiotherapy for patients with brain metastasis.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494789","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":"Functional and Oncologic Outcomes in Single-Kidney Patients Treated with Robot-Assisted Partial Nephrectomy for Renal Tumors: Results from a Prospectively Maintained Dataset of a Single Tertiary Referral Center.","authors":"Antonio Andrea Grosso, Luca Lambertini, Fabrizio Di Maida, Giulia Carli, Pedro Ramos, Alessandro Sandulli, Vincenzo Salamone, Francesca Conte, Filippo Lipparini, Elena Ciaralli, Daniele Paganelli, Sofia Giudici, Rino Oriti, Riccardo Fantechi, Matteo Salvi, Gianni Vittori, Maria Rosaria Raspollini, Gabriella Nesi, Andrea Minervini, Andrea Mari","doi":"10.3390/cancers17121978","DOIUrl":"10.3390/cancers17121978","url":null,"abstract":"<p><p><b>Background</b>: Renal tumors in solitary kidneys require treatments that optimize both oncological and functional outcomes. Robot-assisted partial nephrectomy (RAPN) offers a balance between these needs and reduced morbidity. This study investigates the oncologic and functional outcomes of RAPN in solitary-kidney patients. <b>Methods</b>: We analyzed data from 1852 patients with cT1-T4N0M0 renal cell carcinoma treated by RAPN from January 2018 to June 2022. The cohort included patients with solitary kidneys based on preoperative characteristics, tumor staging and perioperative outcomes using the Trifecta criteria. <b>Results</b>: Of the study participants, 39 had solitary kidneys. Fifteen patients (38.6%) had an ASA score > 2, indicating a higher preoperative risk. The median PADUA score was 7 (IQR 8-9). Moreover, 28 (71.8%) patients had a chronic kidney disease stage > 2. Trifecta success was achieved in 26 (66.6%) of the cases. During a median follow-up of 36 months, tumor recurrence was observed in 12 patients (30.7%), with local recurrences in 4 (10.2%) and systemic recurrences in 8 (20.5%). A higher ASA score and global ischemic clamping were independent predictors of renal function decline at the third postoperative day and Trifecta failure. Only a higher ASA score significantly predicted a significant long-term decline in renal function. Nucleolar grade at pathological stage was the only factor significantly associated with tumor recurrence. <b>Conclusions</b>: RAPN is as an effective treatment for renal tumors in solitary kidneys, balancing oncological control and renal function preservation. Global ischemia and patient physical status are the most important factors influencing outcomes and highlight the importance of patient selection and tailored surgical strategies.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494796","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":"Inhibition of PCSK9 Attenuates Liver Endothelial Cell Activation Induced by Colorectal Cancer Stem Cells During Liver Metastasis.","authors":"Ander Martin, Daniela Gerovska, Marcos J Arauzo-Bravo, Maitane Duarte García-Escudero, Helena García García, Iratxe Bañares, Naroa Fontal, Geraldine Siegfried, Serge Evrad, Simon Pernot, Abdel-Majid Khatib, Iker Badiola","doi":"10.3390/cancers17121977","DOIUrl":"10.3390/cancers17121977","url":null,"abstract":"<p><p><b>Background:</b> Colorectal cancer (CRC) is among the most prevalent and lethal cancers globally, with liver metastasis representing the leading cause of CRC-related mortality. Proprotein convertase subtilisin/kexin type 9 (PCSK9) has recently gained attention due to its overexpression in colorectal tumor tissues and its potential role in driving metastatic progression. This aims to investigate the involvement of PCSK9 in the liver metastatic niche, focusing on its effects on liver sinusoidal endothelial cells (LSECs), key components of the liver microenvironment. <b>Methods:</b> LSECs were stimulated with conditioned media derived from differentiated colorectal cancer cells and cancer stem cells (CSCs), the latter generated by reprogramming SW620 and CT26 cell lines. RNA sequencing was used to profile gene expression in LSECs. PCSK9 mRNA and protein levels were quantified by qPCR and Western blotting, respectively. PCSK9 expression in CRC liver metastases was evaluated by immunofluorescent staining. <b>Results</b>: PCSK9 was detected in both human and murine LSECs and significantly upregulated following exposure to CSC-conditioned media. Immunofluorescent staining confirmed PCSK9 expression in LSECs within CRC liver metastases. Total RNA sequencing revealed that a pre-treatment of LSECs with the PCSK9 inhibitor PF-06446864 prior to CSC stimulation seems to reduce the expression of microRNAs linked to cell migration and proliferation. Functional assays demonstrated that CSC-conditioned media enhanced LSEC proliferation and migration, effects reversed by PCSK9 inhibition. <b>Conclusions:</b> PCSK9 promotes the activation of LSECs in response to colorectal CSCs, contributing to a pro-metastatic phenotype. These findings highlight PCSK9 as a potential therapeutic target in colorectal liver metastasis.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494833","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":"Cognitive Decline in Nasopharyngeal Carcinoma Survivors with Post-Radiation Epilepsy: A Prospective Cohort Study.","authors":"Kejia Liu, Yaxuan Pi, Yingying Zhu, Dong Pan, Zongwei Yue, Yanting Chen, Lianhong Yang, Yituan Xie, Yuhua Huang, Yamei Tang, Yongteng Xu, Xiaoming Rong","doi":"10.3390/cancers17121976","DOIUrl":"10.3390/cancers17121976","url":null,"abstract":"<p><p><b>Purpose:</b> Cognitive decline is a major concern for nasopharyngeal carcinoma (NPC) survivors after radiotherapy (RT). We assessed whether the rates of cognitive decline in NPC survivors differed depending on the presence of epilepsy. <b>Methods:</b> Based on an ongoing prospective cohort study (NCT03908502), we included consecutive NPC patients with a history of radiotherapy who underwent a baseline and follow-up cognition assessment between January 2005 and December 2023. Patients who had a confirmed diagnosis of epilepsy before radiotherapy, had intracranial brain metastasis during follow-up, lacked baseline major clinical data, or lacked follow-up cognitive assessment of longer than six months were excluded. The outcome was cognitive function assessed by the Chinese version of the Montreal Cognitive Assessment (MoCA), with assessments being performed every 6 months through face-to-face interviews. Linear mixed-effect models were used to analyze the progression rate of MoCA scores by epilepsy status (incident, prevalent, or no epilepsy). <b>Results:</b> A total of 521 patients with a median follow-up period of 3.96 years were included in our study. The rate of decline in MoCA was significantly faster in patients with prevalent epilepsy compared with no epilepsy after adjusting for demographics, health behaviors, tumor-related history, complications, anti-seizure medication, and inflammatory blood index (estimate: -1.407; 95%CI: -2.419, -0.412; <i>p</i> = 0.007). However, the cognitive decline rate was similar in the incident epilepsy group compared with that in the non-epilepsy group (<i>p</i> = 0.126). Subgroup analysis showed that there was no significant difference in the effect of epilepsy status on cognitive deterioration among subgroups stratified by the pre-planned covariates. <b>Conclusions:</b> Global cognitive function declined more rapidly in NPC patients with prevalent epilepsy. The control of seizure attacks may be valuable to mitigate cognitive decline.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494718","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":"New Approaches in Radiotherapy.","authors":"Matthew Webster, Alexander Podgorsak, Fiona Li, Yuwei Zhou, Hyunuk Jung, Jihyung Yoon, Olga Dona Lemus, Dandan Zheng","doi":"10.3390/cancers17121980","DOIUrl":"10.3390/cancers17121980","url":null,"abstract":"<p><p>Radiotherapy (RT) has undergone transformative advancements since its inception over a century ago. This review highlights the most promising and impactful innovations shaping the current and future landscape of RT. Key technological advances include adaptive radiotherapy (ART), which tailors treatment to daily anatomical changes using integrated imaging and artificial intelligence (AI), and advanced image guidance systems, such as MR-LINACs, PET-LINACs, and surface-guided radiotherapy (SGRT), which enhance targeting precision and minimize collateral damage. AI and data science further support RT through automation, improved segmentation, dose prediction, and treatment planning. Emerging biological and targeted therapies, including boron neutron capture therapy (BNCT), radioimmunotherapy, and theranostics, represent the convergence of molecular targeting and radiotherapy, offering personalized treatment strategies. Particle therapies, notably proton and heavy ion RT, exploit the Bragg peak for precise tumor targeting while reducing normal tissue exposure. FLASH RT, delivering ultra-high dose rates, demonstrates promise in sparing normal tissue while maintaining tumor control, though clinical validation is ongoing. Spatially fractionated RT (SFRT), stereotactic techniques and brachytherapy are evolving to treat challenging tumor types with enhanced conformality and efficacy. Innovations such as 3D printing, Auger therapy, and hyperthermia are also contributing to individualized and site-specific solutions. Across these modalities, the integration of imaging, AI, and novel physics and biology-driven approaches is redefining the possibilities of cancer treatment. This review underscores the multidisciplinary and translational nature of modern RT, where physics, engineering, biology, and informatics intersect to improve patient outcomes. While many approaches are in various stages of clinical adoption and investigation, their collective impact promises to redefine the therapeutic boundaries of radiation oncology in the coming decade.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494859","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}