Objective:The EF-14 trial established the survival benefit of adding Tumor Treating Fields (TTFields) to maintenance temozolomide (TMZ) following standard radiochemotherapy in glioblastoma (GBM). Whether this benefit is reproducible in Chinese grade 4 glioma patients in real-world practice-and what biomarkers predict response-remains unknown. This study evaluates TTFields efficacy in a Chinese cohort and explores predictive biomarkers. Methods:We conducted a retrospective analysis of Chinese patients with grade 4 gliomas who underwent surgery and postoperative radiochemotherapy, followed by maintenance TMZ with or without TTFields treatment at Tongji Hospital, Huazhong University of Science and Technology, between November 2019 and November 2024. The Kaplan-Meier method was used to plot survival curves for overall survival (OS) and progression-free survival (PFS), and the log-rank test was applied for group comparisons. Univariate Cox proportional hazards regression analysis was performed to identify factors associated with PFS and OS. Subgroup analyses were conducted, and results were visualized using forest plots. Results:A comprehensive dataset of 64 postoperative grade 4 glioma patient records was compiled in the study. Among them, 22 patients (34.4%) were administered TTFields treatment. The TTFields-treated group demonstrated a significant improvement in OS compared to the non-TTFields-treated group (median OS: 15 months vs. 11 months, P = .047). Univariate Cox analysis identified the chromosome 7 gain and chromosome 10 loss as a significant risk factor for shortened PFS (HR = 2.294; 95% CI, 1.268-4.150; P = .006) and OS (HR = 2.831; 95% CI, 1.507-5.316; P = .001). Subgroup analysis revealed that TTFields treatment resulted in better PFS for O6-methylguanine DNA methyltranferase (MGMT)-unmethylated patients (HR [95% CI] = 2.269 [1.066-4.83], P = .033) and isocitrate dehydrogenase (IDH) wild-type patients (HR [95% CI] = 2.101 [1.029-4.291], P = .042). In terms of OS, TTFields treatment was associated with improved OS in patients with multiple surgical sites (HR [95% CI] = 4.148 [1.073-16.033], P = .039), MGMT-unmethylated patients (HR [95% CI] = 2.421 [1.113-5.263], P = .026), IDH wild-type patients (HR [95% CI] = 2.169 [1.039-4.526], P = .039), and those with Ki-67 < 20% (HR [95% CI] = 9.398 [1.122-78.75], P = .039). Conclusion:In this retrospective cohort of Chinese patients with grade 4 glioma, adding TTFields to maintenance TMZ therapy following standard postoperative radiochemotherapy was associated with improved OS compared with maintenance TMZ alone, whereas the improvement in PFS did not reach statistical significance. The co-occurrence of chromosome 7 gain and chromosome 10 loss was identified as a significant risk factor for shorter PFS and OS. Exploratory subgroup analyses suggested greater potential benefit in patients with MGMT-unmethylated tumors, IDH wild-type tumors, multiple surgical sites, or Ki-67 < 20%. Given the small sample size, retrospective non-randomized design, and wide confidence intervals in some subgroup estimates, these findings should be interpreted cautiously and validated in larger prospective multicenter studies.

OBJECTIVE:To explore the connection between TGF-β1 expression and the survival of patients with head and neck squamous cell carcinoma (HNSCC), as well as whether non-invasive CT-based Radiomics can predict TGF-β1 expression in HNSCC patients. METHODS:Data on transcriptional profiling and clinical information were acquired from the TCGA database and subsequently categorized based on the TGF-β1 expression cutoff value. Based on the completeness of enhanced arterial phase CT scans, 139 HNSCC patients were selected. The PyRadiomics package was used to extract radiomic features, and the 3D Slicer software was used for image segmentation. Using the mRMR_RFE and Repeat LASSO algorithms, the optimal features for establishing the corresponding gradient enhancement prediction models were identified. RESULTS:A survival analysis was performed on 483 patients, who were divided into two groups based on the TGF-β1 expression cut-off. The Kaplan-Meier curve indicated that TGF-β1 was a significant independent risk factor that reduced patient survival. To construct gradient enhancement prediction models, we used the mRMR_RFE algorithm and the Repeat_LASSO algorithm to obtain two features (glrlm and ngtdm) and three radiation features (glrlm, first order_10percentile, and gldm). In both the training and validation cohorts, the two established models demonstrated strong predictive potential. Furthermore, there was no statistically significant difference in the calibration curve, DCA diagram, or AUC values between the mRMR_RFE_GBM model and the LASSO_GBM model, suggesting that both models fit well. CONCLUSION:Based on these findings, TGF-β1 was shown to be significantly associated with a poor prognosis and to be a potential risk factor for HNSCC. Furthermore, by employing the mRMR_RFE_GBM and Repeat_LASSO_GBM models, we were able to effectively predict TGF-β1 expression levels in HNSCC through non-invasive CT-based Radiomics.

e21050 Background: Pre-clinical mouse models have suggested that gut microbiota in immune relates with inflammation and modulates tumor response, while it remains uncertain in lung cancer patients with EGFR mutation. We aimed to evaluate the relationship between gut microbiota and early tumor response after EGFR-TKI treatment in metastatic non-small cell lung cancer (NSCLC) patients. Methods: NSCLC patients haboring EGFR exon 19del or 21L858R mutation were enrolled in this study in Tongji Hospital, Wuhan, China. Early response was assessed at 12 weeks after EGFR-TKI initiation per RECIST 1.1, and patients were categorized as responders (CR+PR) and non-responders (SD+PD). Stool sample was collected prior to EGFR-TKI treatment. The V3–V4 region of the 16S rRNA gene was amplified for the characterization of the gut microbiota profiling. Data were analyzed on the online tool of Majorbio Cloud Platform to compare microbiota community structure and abundance at α- and β-diversity levels. Linear discriminant analysis with effect size (LEfSe) was used to to identify biomarkers using a taxonomic bar chart. PICRUSt2 was used to predict the functional profiling of microbial communities. P-values < 0.05 were considered statistically significant. Results: From June 2020 to Sep 2022, 24 patients were included. CR, PR, SD and PD were recorded in 2 (8.3%), 14(58.3%), 6(25%) and 2(8.3%) patients, respectively. The four most abundant bacteria at phylum level were Firmicutes (64.4%), Bacteroidota (15.1%), Proteobacteria(14.7%), and Actinobacteriota (4.6%). The relative abundance of Actinobacteriota counts were significantly higher in responders than those with no-responders ( p= 0.032). There was a significant difference in the Sob index (α-diversity) between responders and no-responders (60.062 vs. 86.250, p= 0.043). β-diversity was similar between the two groups ( p= 0.087). Differential analysis using LEfSe identified that genus Rothia was significantly enriched in responders; phyla Actinobacteria and Deinococcota, genera Ruminococcus, Collinsella, Holdemanella were significantly enriched in non-responders. PICRUSt2 based on KEGG prediction identified that Transketolase and Carbamoyl-phosphate synthase were significantly enriched enzymes in non-responders compared with responders, the p values were 0.019 and 0.022, respectively. Conclusions: The early response of EGFR-TKI was associated with alteration of specific genera and metabolic function of gut microbiota. Further research with larger cohorts is needed to validate this pilot study. [Table: see text]

Objective This study aimed to assess anxiety,depression,and stress among inpatients with cancer.Methods Two hundred thirty-five hospitalized patients with cancer were surveyed with the Depression Anxiety Stress Scales （simplified Chinese Version）.The software program SPSS 25.0 was used for statistical analysis of the survey data.Results The average scores of depression,anxiety,and stress of inpatients with cancer were 12.17,11.84,and 13.98 respectively,which were higher than the normal range.The scores of anxiety and stress of inpatients with different caregivers were statistically different （P=0.024/0.036）.The anxiety and stress scores of inpatients with spouses as caregivers were higher than those of inpatients with children as caregivers.There was a statistically significant difference in the incidence of stress between inpatients with cancer with religious beliefs and inpatients with cancer without religious beliefs （P=0.026）,and those with religious beliefs had greater incidence of stress.The score of anxiety was significantly higher for inpatients with children than for inpatients without children （P=0.040）.Conclusion The anxiety,depression,and stress levels of inpatients with cancer are relatively high.It is necessary to pay special attention to the psychological status of these patients during clinical diagnosis and treatment to improve their quality of life.

Many studies pointed out that psychological pain is not limited to the cancer patients themselves,but their caregivers also experience different levels of psychological problems such as depression,anxiety,and stress.This article attempts to review the mental health status,assessment tools,and psychological interventions of the caregivers of cancer patients,and calls on social and medical workers to pay attention to the mental and physical health status of the caregivers of cancer patients.

Medical Psychology Department, Peking University Health Science Center, Beijing 100191, China; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China; Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China

Mental distress is prevalent among cancer patients. Many measurements have been developed to screen and evaluate such distress. About one-third of the persons with cancer will experience significant levels of distress, requiring targeted psychosocial intervention. Mental distress has been endorsed as the sixth vital sign by the International Psycho-Oncology Society (IPOS) in 2009. The need for effective screening and psychological interventions is well recognized as a necessary, integral part of oncology care. This systematic review examines the psychometric properties of the existing tools used to screen patients for emotional distress and the applicable intervention methods.

e22008 Background: Determining prognosis in advanced cancer is of key importance. Various prognostic scores have been developed. However, they are often very complex, and physicians still do not accurately estimate survival time according to these tools. In this study, we dynamically evaluated the feasibility of clinical routine examination including blood cells and biochemistry as indices to estimate survival in end-stage cancer patients. Methods: From January 2016 to December 2017, the clinical data of 556 patients with advanced cancer in Xinfeng County People's Hospital and Tongji Hospital were collected. 201 cases among them died, we retrospectively analyzed clinical data of these 201 patients within 6 months before death, The clinical symptoms and blood biochemical changes in 1 week, 1 month, 3 months and 6 months before the death were observed. Results: 201 cases of death among the 556 cases included 72 cases of liver cancer, 53 cases of lung cancer, 42 cases of digestive system tumor (excluding liver cancer), 18 cases of head and neck squamous cell carcinoma, 11 cases of urogenital tumors, and 5 cases of others. The incidence of symptoms was fatigue (94.5%), pain (90.0%), constipation (89.1%), dysphagia (27.9%) and dyspnea (20.9%) in 1 week prior to death. Multivariate Logistic regression analysis showed that white blood cell count (P= 0.012) and neutrophil count (P= 0.008), alanine aminotransferase (P= 0.003), albumin (P= 0.000), urea nitrogen (P= 0.035), serum sodium (P= 0.002), lactate dehydrogenase (P= 0.038) and C reactive protein (P= 0.000) were independent prognostic factors of end-stage tumor death. The hematological indices of 201 patients in 6 months before death were dynamically analyzed, the results of 1 week before death were compared with those of 1 month, 3 months and 6 months before death (P< 0.03). The trends of these independent prognostic factors were more obvious between 1 week and 6 months before death. Conclusions: Dynamic changes in clinical routine hematological indices of end-stage cancer patients within 6 months prior to death can obviously predict the prognosis, which is helpful for the accurate judgement of patients' survival and palliative care.

OBJECTIVE:This study investigated miR-422a and PLP2 expressions in breast cancer cells and breast cancer stem cells (BCSCs). Besides, their influences on polymorphism changes were observed.METHODS:Flow cytometry and fluorescence-activated cell sorting was performed and CD24-/CD44+ cells were sorted from breast cancer cells and recognized as BCSCs. Microarray was applied to search for the differentially expressed miRNAs and mRNAs between MCF7 and BCSCs. The aberrant expression of miR-422a and PLP2 was further confirmed by RT-qPCR and the direct targeted relationship was verified by dual-luciferase reporter assay. After in vitro transfection, the expression of miR-422a and PLP2 were manipulated and biological functions of BMSCs were compared with CCK-8, colony formation and sphere formation assay. The tumorigenesis ability of transfected BMSCs was also investigated in NOD/SCID tumor mice models.RESULTS:BMSCs were successfully established from MCF7 cells and miR-422a expression was downregulated while PLP2 level decreased in BMSCs. MiR-422a directly targets the 3'UTR of PLP2 and suppressed its expression. Besides, the up-regulation of miR-422a contributed to weakened ability of proliferation and microsphere formation of BMSCs, while PLP2 overexpression facilitated those biological abilities. Tumorigenesis of BMSCs in mice models was impaired by either overexpression of miR-442a or silencing of PLP2.CONCLUSION:Up-regulation of miR-422a attenuated microsphere formation, proliferation and tumor formation of breast cancer stem cells via suppressing the PLP2 expression.

Object: This study aimed to investigate the role of lncRNA OIP5-AS1 in regulating radioresistance of colorectal cancer (CRC) cells. Methods: Microarray analysis was used to screen out lncRNAs differentially expressed in radio-resistant CRC cell lines. Expression levels of OIP5-AS1, miR-369-3p and DYRK1A in CRC cell lines were measured by qRT-PCR. Protein expression of DYRK1A was determined by western blot. The target relationships among OIP5-AS1, miR-369-3p and DYRK1A were validated by dual luciferase reporter assay. Impacts of OIP5-AS1 or DYRK1A on CRC cellular activity and apoptosis were investigated by MTT assay, clonogenic survival assay and flow cytometry to analyze OIP5-AS1 or DYRK1A’s effect on radioresistance of CRC cells. Results: LncRNA OIP5-AS1 and DYRK1A were down-regulated in radio-resistant CRC cell lines. OIP5-AS1 suppressed the expression of miR-369-3p, thus up-regulating DYRK1A, the downstream gene of miR-369-3p. OIP5-AS1 and DYRK1A impaired cell clonogenic survival and promoted cell apoptosis after irradiation, improving radiosensitivity of CRC cells. Conclusion: LncRNA OIP5-AS1 suppressed cell viability, promoted radio-induced apoptosis, and enhanced the radiosensitivity of CRC cells by regulating DYRK1A expression through miR-369-3p.

Purpose: To investigate the treatments of patients with cancer in their last 6 months of life in intensive care unit (ICU) and Cancer Center. Method: A prospective study was conducted on patients with cancer who died between January 2010 and July 2013 in the ICU and the Cancer Center (55 and 161 cases, respectively) of Tongji Hospital, Wuhan, China. The differences were compared by Chi-square test or Fisher test. Results: The differences in the treatments of patients with cancer between 2 groups were statistically significant. The proportion of patients with cancer who accepted blood transfusion (except albumin) was significantly higher in the ICU than in the Cancer Center. Conclusion: Patients with cancer in the ICU were more likely to receive active treatments and less palliative and hospice care at the end of life than patients in the Cancer Center.

Objectives: To elaborate the expression of MTA3 in colon cancer and correlation with prognosis as well as clinical index. Methods: We chose a colon cancer tissue microarray with follow-up information (containing 90 colon cancer specimens). Immunohistochemistry was applied to investigate the expression level of MTA3. The relationship between MTA3 expression and clinical index as well as the prognosis of colon cancer were statistically analyzed by SPSS software respectively. Results: MTA3 was specifically expressed in the nucleus of colon cancer tissue and para-carcinoma tissue, and there was a significant positive correlation between them (r=0.278, P=0.008). The clinical indexes correlation analysis showed that: the expression of MTA3 in colon cancer tissue was not correlated with clinical indexes (P>0.05); the expression of MTA3 in para-carcinoma tissue was significant positive correlated with M staging, clinical staging (r=0.264, P=0.013; r=0.222, P=0.039). Further survival analysis showed that the expression of MTA3 in colon cancer tissue was significant negative correlated with overall survival time of patients (35.7% VS 54.2%, P=0.030), and it was an independent predict factor (P=0.045); the expression of MTA3 in paracarcinoma tissue was not correlated with overall survival time (P=0.576). In addition, age, N staging and M staging were all independent predict factors of colon cancer patients, and they were significant negative correlated with prognosis (P<0.05). Conclusion: We hypothesized that: MTA3 was a clear oncogene in colon cancer. There may be multiple genes involve in the cancer promoting gene network of MTA3 in both cancer tissue and para-carcinoma tissue, they all increased the migration ability of cancer cell and reduced the survival time of patients. Next step, in order to further understand the molecular mechanism of MTA3 in colon cancer, we will carry out cytology research.

Objective To investigate the cancer patients?? view of death and its related factors. Methods A questionnaire survey was designed by ourselves and conducted on cancer patients. Results One hundred questionnaires were sent out, receiving 99 efficient questionnaires. The patients who minded talking about death related issues were 27?? 27%. Whether patients minded talking a?bout death was related with their education degree(P= 0?? 005), dwelling environment(P= 0?? 009), the contact with critically ill or dy?ing patients(P= 0?? 001), the contact with deaths(P= 0?? 003), whether witnessed relatives at the end of life(P= 0?? 042), and the feel of attending funeral(P= 0?? 001). In the patients who didn??t mind talking about death, more than half of them thought that death should let nature take its course; for dying person the patients who chose should “rescue as far as possible” and “depend on the state of ill?ness” were similar in the proportions(44?? 44% vs. 50?? 00%); the most concerns when majority of patients met death were “unfinished family responsibilities”(63?? 89%) and “friends and relatives will be sad” (11?? 11%); for place of death, two?thirds of the patients chose at home, only 18?? 06% chose in hospital. Conclusion It will be great importance of implementing palliative and hospice care, as well as enhancing cancer patients?? quality of life.

Objective To find out the change trend of LDH values in cancer patients' last 6 months of life, and to evaluate whether LDH level was a predictor for on patients' prognosis and survival time. Method A retrospec-tive analysis including 216 patients was conducted to assess the correlation between their demographic characteris-tics, disease characteristics and the level of LDH. Results Patients that were closer to death had higher LDH level. In addition, the correlation between patients' gender, age, tumor type, tumor stage and LDH levels was insignificant (P > 0.05). Conclusion The increase of LDH level indicates poorer prognosis and limited survival time in cancer patients.

在接受化疗或免疫治疗的HBsAg阳性癌症患者中，HBV的再激活风险很高，尤其是给予利妥昔单抗或类固醇治疗时。HBV再激活的机制分为HBV复制增加，HBV破坏肝脏细胞，以及HBV下降的恢复期这三个阶段。对高风险患者应在化疗前进行HBV标志物的筛查（包括HBsAg、anti-HBc和/或anti-HBs）和/或HBV DNA的检测，但检测项目的数目目前还存在争议。对达到预防性抗HBV治疗标准的患者尽早进行抗HBV治疗，并根据患者的治疗计划以及合并症情况选择合适的抗病毒药物，通常在免疫抑制性治疗结束后还要进行6个月甚至更长时间的抗HBV治疗。

Chemotherapy-induced neuropathy is a serious clinical problem for patients receiving cancer treatment. The aim of this study was to investigate the potential efficacy of pregabalin in chemotherapy-induced neuropathy in rats. A total of 35 male Sprague-Dawley rats were randomly divided into 5 groups: group 1, naive control; group 2, treated with pregabalin (30 mg/kg p.o., for 8 days); group 3, docetaxel was given by single intravenous infusion at 10 mg/kg; groups 4 and 5, pregabalin at 10 mg/kg and 30 mg/kg respectively was orally administered for 8 days after the docetaxel treatment. On day 8, behavioral test was performed, and substance P and CGRP release in dorsal root ganglion (DRG) and sciatic nerve were analyzed by electron microscope. Our results showed that docetaxel induced mechanical allodynia, mechanical hyperalgesia, heat hypoalgesia, cold allodynia, and sciatic nerve impairment and substance P and CGRP release in DRG. However, oral administration of pregabalin (10 mg/kg and 30 mg/kg) for 8 consecutive days significantly attenuated docetaxel-induced neuropathy by ameliorating heat hypoalgesia, cold allodynia, impairment of sciatic nerve and reducing the release of substance P and CGRP. The findings in the present study reveal that pregabalin may be a potential treatment agent against chemotherapy-induced neuropathy.

OBJECTIVE:To study the potential role of pregabalin in taxol-induced neuropathic pain in rats.METHODS:Forty male SD rats were randomly divided into five groups:normel control,pregabalin group(30 mg/kg p.o.) for 16 days,taxol group(2 mg/kg i.p.for 4 alternate days),and pregabalin followed by taxol for 16 days(10 and 30 mg/kg p.o.).On day 16,mechanical threshold,heat threshold,cold allodynia were examined,and sciatic nerve was analyzed by electron microscope.RESULTS:Taxol could arouse mechanical allodynia((32.5±3.7)% vs(7.5±3.1)%,P0.01),mechanical hyperalgesia((52.5±7.5)% vs(12.5±3.7)%,P0.01),cold allodynia((2.9±0.5) s vs(0.5±0.3)s,P0.01),and sciatic nerve impairment,without thermo hyperalgesia((9.1±0.6) s vs(11.0±0.8) s,P0.05).However,oral administration of pregabalin(30 mg/kg) for consecutive 16 days significantly alleviated taxol-induced neuropathy by ameliorating mechanical allodynia((12.5±3.7)% vs(32.5±3.7)%,P0.01),mechanical hyperalgesia((30.0±3.8)% vs(52.5±7.5)%,P0.05),cold allodynia((1.4±0.3) s vs(2.9±0.5) s,P0.05) and impairment of sciatic nerve.CONCLUSION:Pregabalin attenuates the neuropathic pain induced by taxol,and it may be an effective candidate agent for chemotherapy-induced neuropathic pain.