Integrative Oncology (IO) in France aligns with the definition proposed by the Society for Integrative Oncology, combining conventional cancer treatments with evidence-based complementary therapies within an interdisciplinary, patient-centered framework. Unlike alternative approaches, integrative therapies are used alongside standard oncological care. In France, a wide range of complementary therapies are implemented, with some-such as homeopathy and acupuncture-more widely integrated, reflecting historical use and favorable safety profiles.Over the past decade, IO has developed through diverse organizational models, including hospital-based day care programs, dedicated consultations in cancer centers, and community-based structures. These models provide access to personalized and coordinated care pathways, with no out-of-pocket cost for patients, supported by the national health insurance system or alternative funding sources. In 2023, the French Society for Integrative Oncology was established to structure and promote this approach nationwide and to foster connections with the European branch of the Society for Integrative Oncology.Compared with international models, the French approach appears distinctive in combining hospital-based and community-based structures, thereby facilitating broader accessibility while maintaining coordination with conventional care. This hybrid organization contrasts with predominantly academic models in the United States and more systematically integrated hospital-based systems in countries such as Israel.Available data and patient-reported outcomes suggest improvements in quality of life and treatment adherence. However, marked heterogeneity across programs and a predominantly observational evidence base highlight the need for controlled trials specifically designed to evaluate the particularities of integrative oncology.Overall, integrative oncology in France represents a pragmatic and evolving model that may contribute to reshaping supportive cancer care by combining accessibility, coordination, and patient-centered approaches.
Acupuncture is increasingly integrated into oncology care as a nonpharmacologic strategy for managing cancer- and treatment-related symptoms. However, specific symptom responses remain incompletely characterized. This study retrospectively evaluated changes in individual symptoms following completion of a structured group acupuncture regimen at an NCI-designated comprehensive cancer center. Patients treated at our Integrative Oncology and Survivorship Program between 2023 and 2025 who completed ≥8 acupuncture sessions and pre- and post-treatment Measure Yourself Concerns and Wellbeing (MYCaW) questionnaires were included. Patients identified and rated their two most bothersome symptoms on a 0–6 Likert scale. Symptoms were categorized into 20 domains. Pre-to-post changes were assessed using Wilcoxon signed-rank tests. Among 723 patients (median age 60 years; 78.8% female; 36.0% Black), breast cancer was the most common diagnosis (52.8%). Reported symptoms included peripheral neuropathy (n=293), generalized pain (n=245), fatigue (n=120), hot flashes (n=96), and insomnia (n=83), with a median severity score of 5. Significant improvements were observed across all domains (p<0.05) except depression and urinary incontinence (p = 0.057). Large effect sizes ( r ≥0.8) were noted for upper gastrointestinal symptoms (r = −0.86), radiation-related changes (r = −0.80), lower gastrointestinal symptoms (r = −0.79), and oral–salivary gland symptoms (r = −0.79). High-prevalence symptoms, including neuropathy ( Mdn : 5 vs 4, p<0.001), pain (5 vs 3, p<0.001), fatigue (5 vs 3, p<0.001), hot flashes (5 vs 3, p<0.001), and insomnia (5 vs 4, p<0.001), demonstrated substantial improvement. Completion of a structured group acupuncture regimen was associated with broad improvements in all but two patient-identified symptoms. Controlled studies are warranted to further define acupuncture’s role in comprehensive oncology symptom management.
Objective: Complementary and alternative medicine (CAM) is widely used by patients with chronic diseases, including cancer, but many physicians still have little knowledge about these medical methods and/or do not believe in their efficacy. This leads to inadequate doctor-patient communication and self-prescription of CAM with a high risk of interaction with standard cancer treatments. Information about CAM should be planned at all levels of medical education, starting from university, to promote the use of CAM among specialists. The primary objective of this study, conducted between October 2023 and February 2024, was to assess the opinion and impact of learning about CAM in future graduating physicians. Methods: One hundred and sixty medical students attended a 2-hour CAM academic training course; they also completed an anonymous 35-item questionnaire divided into 2 sections. The items included in the first section investigated their attitudes toward CAM. The second part of the survey investigated the students’ opinion about the course they had attended and re-evaluated their knowledge of CAM. Results: Of the 160 participants, 79.4% were aware of the existence of other forms of medicine besides conventional medicine, and the most well-known CAM were Oriental and Chinese medicine (48.8%), homeopathy (8.1%), and acupuncture (5%). About 58.4% percent of participants agreed that universities should teach CAM, 51.3% believed that different medical approaches can coexist, and 78.1% did not consider Western medicine to be the only therapeutic option. One hundred percent found the teaching of CAM useful, 88.8% agreed that CAM should be taught in all medical/health/biological degrees, and 88.1% would propose an integrative approach. Conclusion: Clinical practice can be significantly improved by introducing CAM into university training programs. This will meet the educational needs of modern and innovative medicine, with the hope that in the future, physicians will be able to provide patients with tailored treatments choosing their options from both conventional and alternative medicine and will discourage patients from seeking treatment and medical advice from non-medical practitioners.
IntroductionFirst-generation EGFR-TKIs in NSCLC frequently lose efficacy as a result of the secondary EGFR-T790M mutation and a "persistent-STAT3" prosurvival pathway that sustains STAT3-survivin signaling in the face of EGFR inhibition. Preclinical evidence demonstrates that phytochemicals in the JI017 herbal formulation (2:1:1, Angelica gigas: processed Aconitum carmichaeli: Zingiber officinale) can reinstate erlotinib sensitivity in T790M-positive NSCLC, and relevant molecular mechanisms have been examined.MethodsAnti-proliferative activities were evaluated in A549 (EGFR-WT), HCC827 (EGFR Δ19), and H1975 (EGFR L858R/T790M) cells utilizing MTT assays, colony formation, and Annexin V/7-AAD flow cytometry. Mechanistic analyses included immunoblotting for p-EGFR (Tyr1068/1173), p-JAK2, p-STAT3 (Tyr705), PARP, Bcl-2, survivin, and AXL, complemented by RT-qPCR for BIRC5 and AXL transcripts. Drug interaction effects were determined using the Chou-Talalay combination index (CompuSyn). Anti-tumor efficacy was assessed in H1975 xenografts treated for 14 days with vehicle, JI017, erlotinib, or combination therapy; tumors underwent H&E staining and IHC for p-STAT3, survivin, and Ki-67.ResultsJI017 inhibited proliferation in all NSCLC cell lines tested, showing greatest effectiveness in H1975, where it triggered PARP cleavage and suppression of Bcl-2 and survivin expression. In H1975, co-treatment with JI017 and erlotinib led to synergistic growth inhibition, eradicated colony growth, and significantly elevated apoptotic cell populations compared to single treatments. While erlotinib alone reduced p-EGFR and p-JAK2, it left p-STAT3 largely unaltered, reflecting persistent-STAT3 activity. The combination regimen abrogated p-STAT3, further lowered p-EGFR and p-JAK2 levels, diminished BIRC5 mRNA, and decreased both AXL protein and transcript levels. In vivo, the drug combination achieved sustained tumor stasis relative to controls or monotherapy; combination group tumors displayed widespread necrosis and substantial decreases in p-STAT3, survivin, and Ki-67.DiscussionThese data support the suppression of STAT3-survivin as the primary mechanism by which JI017 sensitizes EGFR-T790M models to erlotinib. The consistent down-regulation of AXL indicates the inhibition of an AXL-mediated bypass that may maintain STAT3 signaling during EGFR blockade, although causality has yet to be confirmed. The marked in-vivo tumor inhibition without observable toxicity underscores the translational promise as a low-toxicity therapeutic adjunct.ConclusionsJI017 restores erlotinib sensitivity in EGFR-T790M NSCLC by inhibiting STAT3-survivin signaling and possibly reducing AXL-mediated resistance, resulting in durable antitumor effects both in vitro and in vivo. Additional preclinical studies and early-phase clinical assessment of JI017 in combination with erlotinib are justified.
Caregivers play a central role in managing the nutrition challenges that arise during pediatric cancer treatment, yet many report insufficient knowledge, low confidence, and limited support for preparing foods that address treatment-related side effects. Culinary medicine, integrating nutrition education with hands-on cooking, may help caregivers navigate these challenges, but caregiver-centered programs in pediatric oncology are scarce. Caregiver’s Kitchen is an eight-week, remotely delivered culinary medicine and coaching intervention designed to strengthen caregiver nutrition knowledge, cooking skills, and confidence in managing their child’s symptoms. This mixed-methods feasibility study evaluated program feasibility and acceptability and explored caregiver experiences to inform refinement of a future trial. Ten caregiver–child dyads were enrolled. Caregivers participated in four live virtual culinary workshops and four individualized telephone coaching sessions. Feasibility outcomes included recruitment, retention, assessment completion, engagement, and acceptability, assessed against predefined progression criteria. Qualitative feedback was collected through post-intervention open-ended survey questions and analyzed using rapid content analysis. Three of five feasibility criteria were met. Recruitment targets were achieved (2–3 dyads/week), and engagement was high, with 80% attending ≥3 workshops and 90% completing ≥2 coaching calls. Acceptability was strong (mean ratings 4.35/5). Assessment completion declined at later time points. Qualitative findings highlighted the usefulness of practical culinary guidance, accessible recipes, and individualized coaching, while identifying scheduling constraints and lengthy assessments as barriers. Caregiver insights informed refinements to enhance feasibility, including transitioning to self-paced modules and streamlining assessments. Findings support progression to a larger pilot trial.
Background: To develop and validate a clinically applicable nomogram (NUTRISCORE) predicting severe neutropenia (Grade 3/4) across cycles 2 to 8 of adjuvant chemotherapy in gastric cancer. Methods: This retrospective cohort study analyzed 391 patients receiving postoperative adjuvant chemotherapy (CAPEOX/XELOX/SOX) following curative laparoscopic D2 gastrectomy. Cohorts were stratified into derivation (n = 318; 1518 cycles) and validation (n = 73; 356 cycles) sets. Generalized Estimating Equations (GEE) were used to account for within-patient correlation of multiple cycles. Multivariable logistic regression identified independent predictors, with subsequent nomogram construction using R. Model performance was quantified through AUC-ROC and decision curve analysis (DCA). Results: Four predictors emerged: age > 60 years (OR = 2.1, P < .01), prealbumin ≤ 180 mg/L (OR = 3.4, P = .002), PNI < 45 (OR = 2.8, P = .008), and prior cycle neutropenia (OR =4.7, P < .001). The nomogram achieved AUCs of 0.825 (95% CI 0.789-0.860) and 0.810 (0.783-0.835) in derivation and validation cohorts, with DCA confirming clinical utility across threshold probabilities (4%-65% in derivation, 3%-63% in validation), supporting its use for guiding G-CSF prophylaxis at clinically relevant risk thresholds (>15%). Conclusions: We establish a nutrition-centric predictive tool for severe neutropenia, demonstrating robust accuracy in stratifying chemotherapy toxicity risk. This model directly informs personalized prophylactic strategies, warranting prospective multicenter validation.
Background Traditional, complementary, and integrative medicine (TCIM) is an evolving field in oncology focused on managing cancer symptoms. Hydrogen water (HW) has gained attention for its antioxidant and anti-inflammatory properties, yet its clinical effectiveness needs further exploration. This randomized controlled trial aimed to assess the impact of gargling with HW on oral mucositis severity, pain levels, oral frailty, and quality of life in head and neck cancer patients undergoing radiotherapy or concurrent chemo-radiotherapy. Methods In this single-center, single-blind, parallel-group randomized controlled trial, patients were randomly assigned to receive either HW or distilled water (DW) for gargling. Oral mucositis (OM) severity, pain, oral frailty, and quality of life (QoL) were assessed using the World Health Organization Oral Mucositis Grading Criteria (WHO-OMGC), the Brief Pain Inventory-Taiwan (BPI-T), the Oral Frailty Checklist (OFC), and the EORTC QLQ-H&N35 questionnaire. Assessments were conducted at baseline (T0) and on Days 1 (T1), 3 (T2), 7 (T3), and 14 (T4) post-treatment. Results The HW group showed significant OM improvement at Day 7 (p = 0.04) and Day 14 (p = 0.002). Pain decreased significantly in the HW group at Day 14 (p = 0.02). QoL improved in the HW group (p = 0.03), while OFC scores showed no significant difference between groups (p = 0.74). Conclusion HW gargling significantly alleviated OM severity and pain and improved QoL in head and neck cancer (HNC) patients undergoing radiotherapy or CCRT. HW gargling may serve as a simple, well-tolerated, and effective complementary and integrative therapy during cancer treatment.
Consolidated Standards of Reporting Trials (CONSORT) 2025 Statement was issued in April 2025, however, no dedicated CONSORT extension currently exists for integrative oncology. It is therefore essential to provide practical recommendations, grounded in the CONSORT 2025 Statement and in an analysis of randomized controlled trials (RCT) reporting quality against CONSORT 2010, to guide future RCTs. This study presents a literature-based analysis of RCTs published in Integrative Cancer Therapies between 2010 and 2025, describing study characteristics and overall weighted adherence to CONSORT 2010 of 72 included RCTs. The annual number of publications exhibited an overall upward trend over the past 15 years; overall weighted adherence to CONSORT 2010 across the 72 studies was 67.9%, and the mean per-manuscript adherence was 67.2%. Drawing on this analysis and the CONSORT 2025 update, several specific measures are proposed to improve the reporting quality of RCTs in integrative oncology.
Consolidated Standards of Reporting Trials (CONSORT) 2025 Statement was issued in April 2025, however, no dedicated CONSORT extension currently exists for integrative oncology. It is therefore essential to provide practical recommendations, grounded in the CONSORT 2025 Statement and in an analysis of randomized controlled trials (RCT) reporting quality against CONSORT 2010, to guide future RCTs. This study presents a literature-based analysis of RCTs published in Integrative Cancer Therapies between 2010 and 2025, describing study characteristics and overall weighted adherence to CONSORT 2010 of 72 included RCTs. The annual number of publications exhibited an overall upward trend over the past 15 years; overall weighted adherence to CONSORT 2010 across the 72 studies was 67.9%, and the mean per-manuscript adherence was 67.2%. Drawing on this analysis and the CONSORT 2025 update, several specific measures are proposed to improve the reporting quality of RCTs in integrative oncology.
Background: Lung metastasis is the primary cause of mortality in aggressive breast cancers, particularly triple-negative breast cancer (TNBC), underscoring the urgent need for effective antimetastatic strategies. Objective: This study aimed to evaluate the efficacy, safety, and molecular mechanisms of Scutellaria barbata water extract (SBW) against breast cancer lung metastasis, with a focus on ferroptosis induction and epithelial-mesenchymal transition (EMT) inhibition. Methods: In vitro and in vivo experiments to evaluate the antitumor and antimetastatic activities of SBW. Proteomic and metabolomic analyses were performed to identify key pathways and bioactive components. Ferroptosis markers and EMT-related proteins were measured by biochemical assays and Western blotting. Arachidonic acid (AA) was validated using in vitro and in vivo functional experiments. Results: SBW dose-dependently reduced breast cancer cell viability, migration, and invasion in vitro. In vivo, SBW suppressed tumor growth and lung metastasis in 4T1 tumor-bearing mice without systemic toxicity. Proteomic analysis revealed that SBW induced ferroptosis, characterized by increased Fe 2 + , ROS, LPO levels, and upregulation of HO-1/NCOA4, concomitant with downregulation of GPX4. SBW also inhibited EMT by reducing Twist and N-cadherin expression without affecting E-cadherin. Metabolomic profiling identified AA as a critical bioactive component. Functional validation confirmed that AA induced ferroptosis in vitro and inhibited tumor growth/metastasis in vivo. Conclusions: SBW exerts potent antimetastatic effects through dual mechanisms: induction of ferroptosis via GPX4 inhibition and suppression of EMT via Twist/N-cadherin downregulation. Arachidonic acid plays a central role in mediating ferroptosis.
Background: Triple-negative breast cancer (TNBC) is a major cause of mortality worldwide. Chinese herbal medicine (CHM) is often used as adjunctive therapy, but its long-term impact on TNBC remains unclear. Materials and methods: This study analyzed a multi-institutional cohort from the Chang Gung Research Database, investigating long-term outcomes of integrative CHM use in TNBC patients newly diagnosed between January 1, 2011, and December 31, 2021. Patients were followed for up to 10 years or until death. Overall survival rate (OS) and disease-specific survival rates were assessed using Kaplan–Meier estimation with overlap weighting and landmark analysis to reduce bias. Core CHMs were identified through network pharmacology analysis on prescriptions made for TNBC patients. Results: The analysis included 2174 TNBC patients, with 464 using CHM. CHM use was associated with a significantly higher 10-year OS compared to non-users (77.7% vs 70.2%, P = .007). In stages 1 to 3, the OS among CHM users was 6.6% higher (80.7% vs 74.1%, P = .018). After adjusting for demographic factors, CHM use reduced the risk of all-cause mortality (adjusted hazard ratio [aHR]: 0.71, P = .044). Lower disease-specific survival rates were observed among CHM users. Core CHMs, such as Hedyotis diffusa Willd. , may have potential anti-cancer effects, while combinations like Jia-Wei-Xiao-Yao-San, Scutellaria barbata D. Don. and Suan-Zao-Ren-Tang may have a complementary role to standard treatments for TNBC. Conclusion: Use of CHM may improve 10-year OS in TNBC patients, and core CHMs provided crucial references for further studies.
Background: Radiation-induced quantitative deficiency of T helper 1 (Th1) cells accelerates lung tumor development. Here, we evaluated IL-7R–STAT5 signaling in Th1 recovery after irradiation and examined how catalpol contributes to Th1 reconstitution by targeting this signaling axis in mice. Methods: The recovery characteristics of irradiated Th1 cells, compared with other IFN-γ-producing (IFN-γ + ) cells, were analyzed in local radiotherapy (LRT) mice challenged with lung melanoma and single low-dose total body irradiation (SLTBI) mice without tumor. IL-7R–STAT5 signaling of Th1 from LRT mice, treated with or without catalpol, was evaluated using flow cytometry and RT-qPCR. The role of IL-7–IL-7R–STAT5 signaling in irradiated Th1 cells was further confirmed in irradiated EL4 cells following administration of IL-7 or catalpol. Results: Th1 subsets showed delayed recovery in both LRT and SLTBI mice compared with other IFN-γ + cells, and irradiated Th1 cells exhibited decreased activation of IL-7R–STAT5 signaling. Quantitative reduction of Th1 cells increased lung metastasis of B16 melanoma in irradiated mice. Irradiated EL4 cells also displayed decreased IL-7R–STAT5 signaling and reduced IFN-γ production in vitro. Treatment with catalpol could restore IL-7R–STAT5 signaling and promote Th1 recovery following irradiation both in vivo and in vitro. Catalpol-mediated restoration of IL-7R–STAT5 signaling in Th1 provided superior protection against B16 melanoma metastasis to the lung. Conclusions: IL-7R–STAT5 signaling is required for Th1 recovery after irradiation. Catalpol effectively promotes Th1 cell reconstitution and decreases B16 melanoma metastasis to the lung by enhancing IL-7R–STAT5 signaling. These findings provide new strategies for improving radiotherapy and immunotherapy outcomes in cancer.
Irinotecan (IRI), a clinically used anticancer drug, is effective against various solid tumors, including colorectal cancer, but its use is limited by side effects. Triptolide (TP), an alkaloid from Tripterygium wilfordii, has been used to treat malignancies in China, though its combined effects with IRI on colon cancer cells are not well-documented. In vitro, human colon cancer HT-29 cells were treated with IRI, TP, or both combinations. Results showed that the combination of IRI and TP significantly decreased viable cell numbers more than IRI or TP alone. IRI combined with TP also led to higher Bax and lower Bcl-2 levels, as well as increased cleaved caspase-8, -9, and -3. These findings suggest that TP enhances apoptosis in HT-29 cells and may potentiate the anticancer effects of IRI by disrupting the balance of pro- and anti-apoptotic proteins, which plays a crucial role in controlling tumor cell survival. In vivo, HT-29 cell-xenograft nude mice were treated with IRI, TP, or both combinations for 30 days. Tumor volume and body weight were measured every 2 days, and liver and kidney functions (ALT, AST, CREA, GGT) were assessed. H&E staining of tissues revealed no significant toxicity in the heart, lungs, liver, kidneys, spleen, or small intestine, suggesting that the combination therapy does not induce major organ damage. Immunohistochemical (IHC) analysis showed that IRI combined with TP resulted in higher expression of cleaved-caspase-3, -8, and -9 compared to IRI or TP alone, indicating enhanced tumor cell apoptosis. These results suggest that TP enhances IRI's anti-cancer effects by promoting apoptosis in colon cancer cells. TP may thus serve as a potential enhancer for IRI in future colon cancer treatments, offering a novel strategy to improve therapeutic outcomes, enhance drug efficacy, and minimize side effects.
Background: Lung cancer represents a frequently seen respiratory system malignancy. Sini Decoction combined with cyclophosphamide is demonstrated to remarkably extend survival and improve quality of life of these patients; however, the associated anti-tumor mechanisms are largely unexplored. Objective: The present work focused on investigating the inhibition of tumor cells by Sini Decoction plus cyclophosphamide within the orthotopic lung cancer model and exploring the mechanisms in terms of exosome-based tumor hypoxic microenvironment modulation. Methods: A549-luc2-tdT-2 cells were implanted in left lung of nude mice for establishing the orthotopic lung cancer xenograft model. After 5 days, bioluminescence imaging was conducted for model validation. Mice were later randomized as 4 groups: model, Sini Decoction , cyclophosphamide, as well as Sini Decoction plus cyclophosphamide. Bioluminescence imaging was conducted to assess anti-tumor effects. Enzyme-linked immunosorbent assay (ELISA) was performed for measuring liver and kidney function indicators (ALT, AST, Cr) in serum. Additionally, RT-qPCR and immunohistochemistry were carried out for detecting hypoxia-related factor levels (HIF-1α, VEGF, PDGF-β) within lung tissue. Additionally, characterizations of the separated exosomes were completed with transmission electron microscopy, BCA protein assay, nanoparticle tracking analysis, and Western blotting. Exosomal miR-20a-5p was chosen based on TargetScan database for analysis, while RT-qPCR was completed for validation. Results: Sini Decoction plus cyclophosphamide dramatically suppressed tumor growth within the orthotopic lung cancer model while ameliorating hepatorenal toxicities, as evidenced by serum liver and kidney function indicators and bioluminescence imaging. Meanwhile, immunohistochemistry showed that the combination therapy markedly downregulated HIF-1α expression in lung tissue and suppressed the expression of its downstream target genes VEGF and PDGF-β, which was also confirmed by RT-qPCR. Additionally, bioinformatic analysis suggested that tumor-derived exosomal miR-20a-5p could target HIF-1α. Isolation and RT-qPCR analysis of lung tissue-derived exosomes demonstrated that the combination therapy significantly downregulated the expression of exosomal miR-20a-5p. Conclusion: This study indicates that the combination of Sini Decoction and cyclophosphamide can effectively inhibit lung cancer growth and alleviate hepatorenal toxicity. The mechanism may be associated with the amelioration of the tumor hypoxic microenvironment, inhibition of the HIF-1α-mediated tumor hypoxia signaling pathway, and regulation of exosomal miR-20a-5p expression.
The immunosuppressive tumor microenvironment and vascular abnormalities are important factors affecting the anticancer effects of chemotherapeutic drugs. Previous studies have shown that moxibustion combined with cisplatin can improve tumor immunity and vascular normalization. The aim is to further explore the pathways and molecular mechanisms by which moxibustion combined with cisplatin exerts anti-tumor effects through regulating the tumor immune-vascular microenvironment. Through RNA sequencing and bioinformatics analysis, we identified related signaling pathways and key molecules, which were subsequently validated at both cellular and molecular levels. The combination of moxibustion and cisplatin enhanced the infiltration of CD4 + T cells and myeloid dendritic cells in tumor tissues. Moreover, it elevated the M1/M2 and Th1/Th2 ratios along with enhanced Th1 cell polarization. This therapeutic approach modulated immune-related molecules through upregulation of Il2 and downregulation of Il1β at the mRNA level, accompanied by decreased protein expression of CXCL1, IL-13, CCL3, and CCL4. Furthermore, moxibustion upregulated Ifnγ and Pf4 mRNA levels and downregulated Vegfa and Flt1 . Thus, the imbalance between pro-angiogenic and anti-angiogenic factors in the tumor microenvironment can be corrected. Notably, the anti-tumor effects of moxibustion combined with cisplatin were abrogated upon intratumoral injection of the IFN-γ neutralizing antibody, suggesting the critical role of IFN-γ. The findings demonstrate that the combination of moxibustion and cisplatin can enhance tumor immunity, inhibit tumor angiogenesis. This therapeutic effect is potentially mediated through the upregulation of IFN-γ.
Objective: To determine the safety of semi-permanent needles alone or combined with filiform needles in patients treated within a pediatric oncology unit during antineoplastic therapy. Methods: A retrospective review of electronic medical records at the Pediatric Cancer Center Barcelona of Hospital Sant Joan de Déu, Spain. Data were collected from September 1, 2019, to September 30, 2021, including all oncology patients treated with semi-permanent needles at the integrative pediatric oncology unit. The primary outcome was the safety of acupuncture in pediatric cancer patients, specifically assessing infection and bleeding risks, considering sequential levels of neutropenia and thrombocytopenia. Results: A total of 196 patients (59.2% boys, 40.8% girls) underwent acupuncture. The median age at first treatment was 11.82 years (range: 0.2-34.0 years). The median number of treatments per patient was 4 (range: 1-44), totaling 1107 acupuncture sessions. Of these, 370 (33.4%) were performed in patients with neutropenia and 305 (27.6%) in patients with thrombocytopenia. A total of 9360 semi-permanent needles and 5125 filiform needles were used. No cases of sepsis, local infections, or skin irritation were reported within 72 hours post-removal. One self-limited adverse event—a superficial ear hematoma in a patient with grade 4 thrombocytopenia—was observed, which resolved spontaneously without complications. Conclusion: Semi-permanent needle therapy, alone or combined with filiform needles, is a safe acupuncture modality when used within pediatric oncology settings, including care contexts that encompass a small number of adolescents and young adults. This study supports the feasibility of incorporating semi-permanent needles into integrative oncology protocols within pediatric oncology practice. Registration number: ClinicalTrials.gov (NCT05585463).
Purpose: To evaluate the feasibility and the preliminary estimate of effect of a 12-week Guolin Qigong (GQ) intervention, a mind-body exercise, on the fatigue-sleep disturbance-depression symptoms among breast, lung and colon cancer survivors. Methods: Forty-one breast, lung, and colon cancer survivors with moderate to severe fatigue as measured by the Brief Fatigue Index were randomised to a GQ intervention (n = 21) or a waitlist control (n = 20). Outcome measures were assessed at baseline, 6, 12 weeks (post-intervention), and 16 weeks (4 weeks post-intervention). The primary feasibility was assessed using recruitment, retention, class attendance, home practice, safety and quantum of missing data. Secondary outcomes of symptom differences across timepoints in fatigue, sleep, and depression were assessed using a Generalised Estimating Equations (GEE) model with a Gaussian family, independent link, exchangeable correlation structure, and robust variance estimation. Results: Forty-one cancer survivors were successfully recruited with a recruitment rate of 72%. Retention was 95% (GQ) and 80% (control) at Week-12 and Week-16. GQ intervention class attendance was 86% for the 12-weeks duration with home practice averaging 5 day/week and 394 minutes/week. Missing data were less than 10%. There were no intervention-related serious adverse events. From baseline to Week 12 or Week 16, the average decreases in fatigue, sleep quality, and depression were 0.66, 0.11, and 1.79 respectively, after adjusting for gender and cancer-type imbalances. Conclusion: GQ was feasible and safe for cancer survivors with fatigue-sleep disturbance-depression symptoms, within the defined small sample size. A larger randomised trial is needed for statistical validation.
Background: Chronic lymphedema is a common late effect after completion of head and neck cancer (HNC) treatment, contributing to substantial symptom burden and negatively impacting quality of life. No effective approaches are available to treat this progressive condition. This study aimed to evaluate the preliminary efficacy of photobiomodulation (PBM) therapy for chronic lymphedema in HNC survivors. Methods: This was a pilot, randomized, wait-list controlled trial. Eligible HNC survivors included those with chronic lymphedema after completion of complete decongestive therapy. Participants were randomized (1:1) to 1 of 2 arms: intervention group (active) or wait-list control group (control). The active group received 12 PBM therapy sessions (twice a week for 6 weeks). The control group completed the study assessments and was then offered the same dose of PBM therapy as the active group. Lymphedema and fibrosis (LEF), symptom burden, jaw range of motion, and neck range of motion were measured at baseline, end-of-intervention, 4-week, and 8-week post-intervention. Results: Twenty five HNC survivors were randomized to the active group (n = 12) and the control group (n = 13). About 91.7% planned PBM treatment sessions were completed. No adverse events were reported. Compared to the control group, the active group demonstrated improvements at 8-week post-intervention in the severity of external LEF ( P < .001), symptom burden (eg, Soft Tissue and Neurologic Toxicity subscale, Cohen’s d = − 0.47), and neck range of motion (eg, extension, Cohen’s d = 0.65). Conclusion: PBM therapy may improve chronic lymphedema-associated outcomes. Future large randomized controlled trials are warranted to examine the efficacy of PBM therapy for HNC-related chronic lymphedema.
Apoptosis is a regulated process of programed cell death that removes damaged ells. GO-Y078, a new curcumin analog, has been studied in the oncology field and shown to exert anti-proliferative and anti-angiogenic effects in multiple tumor types. However, its detailed signaling mechanisms and functional effects in human cervical cancer have not been clarified. Herein, GO-Y078 was employed to examine the anti-cancer mechanism in cervical cancer cells. GO-Y078 reduced the cell viability and elicited chromatin condensation and apoptotic cells of human cervical SiHa and HeLa cancer cells. Active PARP and active caspase-9, -8, and -3 were involved in GO-Y078-stimulated apoptosis. GO-Y078 also elevated phosphorylation of mitogen-activated protein kinase (MAPK) pathway. Co-treatment with GO-Y078 and either the ERK inhibitor U0126 or the p38 inhibitor SB203580 significantly reduced GO-Y078-induced activation of caspase-9, -8, and -3. In conclusion, GO-Y078 is a potential therapeutic candidate that induces apoptotic cell death in cervical cancer cells through phosphorylation-dependent activation of MAPK signaling followed by caspase activation.
