BackgroundRegarding concurrent chemoradiotherapy (CCRT), the combination of docetaxel and cisplatin (DP regimen) is a promising option for treating head and neck squamous cell carcinoma (HNSCC) with a relatively low dose of cisplatin; however, its non-inferiority to other chemotherapies in efficacy and tolerability remains unclear.MethodsIn this retrospective multi-institutional study, the efficacy and safety of the DP regimen were compared with those of other chemotherapy regimens in patients who underwent CCRT for HNSCC. Overall survival, progression-free survival, and adverse effects-including estimated glomerular filtration rate (eGFR)-were evaluated as outcome measures.ResultsStudy results showed that a total of 211 patients were included. The prevalence of oropharyngeal, hypopharyngeal, and laryngeal cancer was 44%, 33%, and 17%, respectively. Overall response and recurrence rates were comparable between the DP regimen and high-dose CDDP alone. Although overall and progression-free survival tended to be longer with the DP regimen than with high-dose CDDP, the differences were not statistically significant. Neutropenia was more frequently observed with the DP regimen, but the chemotherapy completion rate was comparable to that of high-dose CDDP alone. Regarding renal function, eGFR significantly decreased with high-dose CDDP but not with the DP regimen.ConclusionsA combination of docetaxel and cisplatin in concurrent chemoradiotherapy was a favorable option for treating HNSCC with acceptable efficacy and manageable toxicity.
BACKGROUND:Individuals with metabolic-associated steatotic liver disease (MASLD) have a worse prognosis compared to patients without steatosis, and its prevalence is increasing. However, detailed risk factors based on obesity and sex remain unclear. We aimed to investigate the impact of cardiometabolic risk factors (CMRFs) on the risk of MASLD in individuals without pre-existing SLD. METHODS:SLD was diagnosed by ultrasonography. Non-SLD individuals were followed 65,657 person-years. Incidence rates of MASLD were assessed by Kaplan-Meier analysis. Furthermore, independent factors associated with the development of MASLD were identified using Cox regression analysis, stratified by four groups: obese men, non-obese men, obese women, and non-obese women. RESULTS:The overall incidence rate of MASLD was 39.3/1,000 person-years. The cumulative incidence was highest in obese men, followed by obese women, non-obese men, and non-obese women. Two or more CMRFs increased the risk of MASLD in all groups. Low HDL cholesterol level was the strongest independent risk factor in both obese and non-obese women and hypertriglyceridemia for both obese and non-obese men. The impact of these CMRFs was stronger in non-obese individuals. (HR [95% CI]: women non-obese 1.9 [1.5-2.4], obese 1.4 [1.1-1.8]; men non-obese 2.3 [1.9-2.9], obese 1.5 [1.2-2.0]). CONCLUSIONS:Multiple CMRFs are important to MASLD development, regardless of sex and obesity. In this Japanese cohort, low HDL cholesterol in women and hypertriglyceridemia in men were the most significant risk factors, especially among the non-obese group. These findings suggest that sex-specific CMRFs may play a role in the development of MASLD.
Background/Objectives: BRAF mutations occur in 5–10% of metastatic colorectal cancer (mCRC) cases, but their implications for prognosis and optimal treatment remain unclear. Methods: This multicenter, prospective observational study analyzed 377 RAS wild-type cases from 511 patients across 32 centers, using PCR-based methods. Results: BRAF mutations were identified in 21% (79/377) of cases, predominantly V600E (89.9%) with a minority of non-V600E (10.1%). Microsatellite instability (MSI) testing revealed MSI-high in 11.3%, exclusively among V600E cases. V600E mutations were linked to right-sided tumors, poor differentiation, and elevated CA19-9 levels. Median survival was significantly lower in V600E cases compared to BRAF wild-type (12.4 vs. 37.5 months, HR 3.25, p < 0.001) and marginally lower non-V600E cases (12.4 vs. 34.7 months, HR 0.61, p = 0.057). Chemotherapy regimens (doublet vs. triplet) and targeted treatments (bevacizumab vs. anti-EGFR) showed no significant survival differences in V600E patients. Similarly, RAS/BRAF wild-type patients had comparable survival with bevacizumab versus anti-EGFR, even for left-sided tumors. Conclusions: These findings highlight distinct clinical and prognostic profiles for BRAF V600E and non-V600E mutations, while treatment choice appears to have limited impact on survival in these subgroups or RAS/BRAF wild-type cases.
Inflammatory bowel disease (IBD) significantly impacts employment and work productivity, necessitating support for balancing work and treatment (SBWT). While SBWT systems have been formalized in Japan, awareness among healthcare professionals remains low. This study aimed to evaluate the effectiveness of an educational program on SBWT for healthcare professionals in Hokkaido, Japan. A 2-year questionnaire-based study was conducted across eight medical facilities in Hokkaido, Japan, from November 2022 to November 2024. The educational program, comprising lecture-based and self-directed learning formats, addressed six key components of SBWT. Pre- and post-program surveys assessed changes in awareness, interest, and behaviors related to SBWT. Pre-program awareness of SBWT was low (36.7% among doctors, 28.2% among medical staff). Post-program, awareness increased significantly to 81.3% and 58.3%, respectively (p < 0.01). Interest in SBWT improved across several categories for both groups, with greater gains among medical staff. Behavioral changes, such as detailed employment-related consultations with IBD patients and improved reporting practices from medical staff to doctors, were observed but not statistically significant. Lecture-based learning was more effective than self-directed methods, in increasing awareness, interest, and engagement with SBWT, particularly for medical staff. The educational program successfully enhanced awareness and interest in SBWT, with lecture-based methods proving more effective for medical staff. These findings emphasize the need for tailored educational strategies based on baseline knowledge. Future initiatives should focus on sustaining knowledge acquisition, expanding programs nationwide, and assessing long-term impacts on healthcare practices and patient outcomes.
