The problem of lung cancer poses a great threat to the health of people all over the world. This threat is mainly associated with resistance to treatment. There is evidence that shows that ferroptosis fails to take place in lung cancer. There is a high degree of suppression in those that have become resistant to treatment. There seems to be a link between resistance to treatment and suppression of ferroptosis. This led to the development of a strategy to induce ferroptosis. In this review, the mechanisms of ferroptosis in drug-resistant non-small lung cancer cells will be discussed, along with a synopsis of recent studies analyzing combination therapies that involve the pharmacological induction of ferroptosis, thus further validating the notion that the prevention of ferroptosis plays an important role in drug resistance. Based on these principles, we will assess the inadequacies in current ferroptosisinducing agents regarding their use in the treatment of lung cancer, focusing mainly on the suboptimal targeting of cancer cells and drug delivery efficiency. Conversely, these inadequacies have triggered new approaches in cancer therapy, which include using nanomedicine for improved drug delivery, functional nanomaterials for directly triggering ferroptosis, among others. In addition, we evaluate the validity of nanomaterials for precision medicine in cancer therapy, in addition to utilizing bioactive compounds. Lastly, we discuss the integration with artificial intelligence in single-cell sequence analysis for the development of modeling systems for ferroptosis control.

AIM:This updated systematic review and meta-analysis aimed to evaluate the effectiveness of mindfulness-based interventions (MBIs) in reducing stress, anxiety, depression and improving mindfulness among nursing students. BACKGROUND:Nursing students often experience significant psychological distress due to the demanding academic and clinical environments of nursing education. MBIs have been increasingly used to reduce distress and enhance well-being. However, the strength and certainty of the available evidence remain variable, warranting an updated synthesis. DESIGN:Systematic review and meta-analysis. METHODS:Following PRISMA 2020 guidelines, five databases were searched up to September 2025 for randomized controlled trials (RCTs) on MBIs in nursing students. Two reviewers independently extracted data and assessed risk of bias using RoB2. Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using Stata 17.0 software. Subgroup, sensitivity and meta-regression analyses explored heterogeneity. Evidence certainty was assessed using the GRADE approach. RESULTS:Eighteen RCTs were included. MBIs were associated with reductions in anxiety (SMD = -0.49), depression (SMD = -0.43), stress (SMD = -0.54) and with an improvement in mindfulness (SMD = 0.40). Subgroup analyses showed no significant differences between face-to-face and online delivery modes across outcomes. A significant stage-based difference was observed for stress, with larger pooled effects in clinical-phase students. CONCLUSIONS:This meta-analysis provides moderate certainty evidence suggesting that MBIs are associated with improvements in psychological well-being among nursing students. However, given methodological limitations, further well-designed RCTs with longer follow-up are needed to strengthen the evidence base.

PURPOSE:Double-lumen endobronchial tube (DLT) is a widely used anesthetic technique in lung surgery; however, it often leads to laryngeal complications that negatively impact postoperative recovery. This study aims to thoroughly investigate the efficacy of thermal softening technology in reducing the incidence of postoperative sore throat (POST), hoarseness, vocal cord injuries, and intubation resistance. DESIGN:A systematic review and meta-analysis of randomized controlled trials. METHODS:As of September 2024, two independent reviewers systematically searched PubMed, EMBASE, and the Cochrane Library, employing Review Manager 5.4 for meta-analysis and subgroup analysis. Potential publication bias was evaluated through Egger's and Begg's tests. Additionally, the of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was utilized to assess the certainty of the evidence collected. FINDINGS:A total of 1257 relevant articles were identified, of which 4 were included in the comprehensive analysis. Statistical results indicate high-quality evidence supporting that thermal softening of DLTs can significantly reduce intubation resistance (RR = 0.36, CI = 0.22-0.61, I² = 68%, P = .0001) and subsequently decrease the incidence of POST (RR = 0.59, CI = 0.47-0.75, I² = 38%, P < .0001), hoarseness (RR = 0.73, CI = 0.54-0.98, I² = 19%, P = .04), and vocal cord injuries (RR = 0.51, CI = 0.41-0.64, I² = 20%, P < .00001). CONCLUSIONS:This research supports the use of thermal softening technology as a non-pharmacological approach to mitigate laryngeal complications associated with double-lumen tracheal intubation.

BackgroundSurgery plays a critical role in managing radio-recurrent prostate cancer (PCa). This study aims to comprehensively review its effectiveness and associated severe complications.MethodsA thorough review of PubMed and EMBASE databases up to July 2024 was conducted, focusing on recurrence-free survival (RFS) with salvage surgery across various subgroups. Severe complications were also assessed using the Clavien-Dindo Scale (CDS). Survival curves were reconstructed using WebPlotDigitizer and a newly developed shiny application.ResultsForty-four studies were included, with 17 papers (2056 patients) contributing to survival curve reconstruction. Among 1654 patients treated with salvage surgery after eliminating duplicate cases, the median RFS was 63.9 months, with 2-, 3-, and 5-year rates of 65.6%, 59.3%, and 51.2%, respectively. Factors associated with better RFS included robot-assisted surgery [hazard ratio (HR):1.49, p < 0.001], lower rates of seminal vesicle invasion (SVI) (HR: 0.75, p = 0.006) and lymph node involvement (LNI) (HR: 0.74, p = 0.006), higher proportion of adjuvant androgen deprivation therapy (ADT) (HR: 2.96, p < 0.001), and higher values of pathological Gleason scores (GS) (≤7/≥8) (HR:1.30, p < 0.001). Severe complications (grade ≥ IIIa) occurred in 404 out of 2537 patients (15.9%, 95% CI: 14.5 to 17.4).ConclusionsThis study comprehensively assesses complications and conducts a pooled analysis of RFS for salvage surgery in radio-recurrent PCa. Robot-assisted surgery, lower rates of SVI and LNI, adjuvant ADT, and higher proportions of pathological GS ≤7 appear promising as prognostic factors for RFS. However, confirming these findings will necessitate randomized controlled trials due to low levels of evidence and study heterogeneity.

INTRODUCTION:To evaluate the effectiveness of transcranial direct current stimulation (tDCS) on acute postoperative orthopedic pain and opioid depletion following arthroplasty. EVIDENCE ACQUISITION:Two independent researchers searched PubMed, EMBASE, and the Cochrane Library databases from inception to May 2024 to identify eligible randomized controlled trials (RCTs). The methodological quality and potential biases of the included studies were assessed using the Cochrane risk of bias assessment tool, and the risk of bias and robustness of the literature were evaluated through funnel plots and sensitivity analyses. Additionally, statistical analysis of relevant outcome measures was conducted using STATA 17.0. EVIDENCE SYNTHESIS:Preliminary screening yielded 417 articles, from which eight were selected for comprehensive analysis. Statistical analysis revealed that tDCS effectively alleviated acute postoperative pain following arthroplasty, whether during rest or movement. Additionally, tDCS was observed to reduce the consumption of opioid analgesics among patients, particularly in cases where the primary motor cortex (M1) was targeted for tDCS application. CONCLUSIONS:Based on low-level evidence, tDCS shows promise in alleviating acute postoperative pain following arthroplasty and reducing the consumption of opioid analgesics in patients after surgery. These findings suggest that tDCS could potentially serve as a valuable adjunctive therapy for managing postoperative pain in orthopedic patients, providing a possible alternative or complement to traditional analgesic methods. However, it is important to note that further research, including more RCTs, is needed to confirm and extend these findings.

BACKGROUND:This study addresses the lack of a comprehensive meta-analysis comparing the efficacy and safety of first-line anti-blocking the programmed cell death 1 (PD-1) and anti-programmed death ligand 1 (PD-L1) therapies in patients with extensive-stage small-cell lung cancer, using reconstructed individual patient data. METHODS:Through systematic review, we extracted relevant studies from PubMed and EMBASE databases, spanning January 1, 2010 to November 28, 2024. Only phase III randomized controlled trials assessing anti-PD-1 inhibitors plus chemotherapy (CT) versus anti-PD-L1 inhibitors plus CT were selected. To compare survival outcomes, we employed WebPlotDigitizer and R software for survival curve reconstruction, aiming to elucidate the comparative effectiveness and safety of the 2 therapies. RESULTS:Our analysis of 7 randomized controlled trials, involving 3339 patients, revealed no significant difference in progression-free survival (PFS) or overall survival (OS) between anti-PD-1 inhibitors plus CT and anti-PD-L1 inhibitors plus CT. The combined 6-, 12-, and 18-month PFS rates were 42.4% versus 43.3%, 19.9% versus 17.0%, and 14.6% versus 13.6% for the anti-PD-1 and anti-PD-L1 groups, respectively (hazard ratio: 0.98, 95% confidence interval: 0.88-1.09, P = .691). The combined 6-, 12-, 18-, and 24-month OS rates were 86.6% versus 85.5%, 58.7% versus 56.9%, 38.8% versus 36.8%, and 28.9% versus 25.4% for the anti-PD-1 and anti-PD-L1 groups, respectively (hazard ratio: 0.94, 95% confidence interval: 0.84-1.06, P = .305). The analysis showed a slightly lower incidence of grade ≥3 adverse events (AEs), serious AEs, any-grade immune-related adverse events, grade ≥3 immune-related adverse events, and events leading to death or treatment discontinuation in the anti-PD-L1 group compared to the anti-PD-1 group (P < .001). However, no significant differences were observed in the risk of any-grade AEs. CONCLUSION:This research provides detailed analyses of PFS, OS, and treatment safety for these 2 treatment regimens, making it a valuable resource for clinicians in routine care. Our results demonstrate that both anti-PD-1 and anti-PD-L1 therapies, when combined with chemotherapy, are equally effective. However, anti-PD-L1 therapies appear to offer a safer first-line treatment option for extensive-stage small-cell lung cancer.

The effect of Meaning-Centered Interventions (MCI) in advanced cancer patients requires further comprehensive research. Two researchers independently searched the PubMed, EMBASE, SCOPUS, Cochrane, and PsycINFO databases to investigate the impact of MCI on anxiety and depressive symptoms, sense of meaning, and quality of life (QoL) in patients with advanced cancer from inception to April 2024. Statistical analyses were conducted using standardized mean difference (SMD) as the effect size with Stata 17.0 software for analysis, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was employed to assess the certainty of evidence. Data from 12 eligible studies, involving a total of 1,459 participants, were included in the review. The analysis found that 3 studies with 321 participants reported an improvement in the quality of life (QoL) of patients with advanced cancer within one month after the intervention, compared to the control group (SMD, 0.27; 95

BackgroundCryotherapy plays a crucial role in managing radio-recurrent prostate cancer (PCa) after initial treatment. This study aims to provide a comprehensive review of its effectiveness and associated complications.MethodsA systematic review was conducted using PubMed and EMBASE databases up to June 2024, focusing on recurrence-free survival (RFS) with salvage cryotherapy across various subgroups. Severe complications were also assessed. Survival curves were reconstructed using WebPlotDigitizer and a newly developed Shiny application. The incidence of complications was summarized with a 95% confidence interval (CI) using a random-effects model. Complications were evaluated using the Clavien-Dindo Scale (CDS).ResultsThirty-six studies were included, with 15 papers (3174 patients) contributing to survival curve reconstruction. Among 1593 patients treated with salvage cryotherapy, the median RFS was 56.7 months, with 2-, 3-, and 5-year rates of 67.6%, 59.5%, and 47.3%, respectively. Factors associated with better RFS included a longer time from primary treatment to salvage therapy (TRS) [> 70 months vs. < 70 months, hazard ratio (HR) (95% CI):0.75(0.58-0.97), p=0.031], lower pre-salvage prostate-specific antigen (PSA) levels [< 5 ng/mL vs. > 5 ng/mL, HR (95% CI):0.78 (0.65-0.93), p=0.005], salvage whole-gland cryotherapy (SWC) [whole vs. focal, HR (95% CI):0.45 (0.37-0.56), p < 0.001], neoadjuvant androgen deprivation therapy (ADT) [Yes vs. No, HR (95% CI):0.79 (0.69-0.89), p < 0.001], and higher adjuvant ADT usage [16.5-34.2% vs. 0-10.5%, HR (95% CI):0.47(0.39-0.56), p < 0.001]. Concerning severe complications, 78 out of 876 patients (8.9%, 95% CI: 7-11) experienced genitourinary (GU) events, 53 out of 633 patients (8.5%, 95% CI: 6-11) suffered from urinary incontinence, 15 out of 493 patients (3.0%, 95% CI: 2-5) had urethral sloughing/stenosis, and 6 out of 522 patients (1.1%, 95% CI: 0-2) developed recto-urethral/vesical fistula. No cases of severe haematuria, urinary tract infection, or urinary retention were reported.ConclusionsCryotherapy demonstrates a favorable safety profile and significant RFS benefits for salvage treatment of radio-recurrent PCa. Longer TRS, lower pre-salvage PSA, SWC, and peri-salvage ADT usage appear to be promising prognostic factors for RFS. However, confirmation of these findings requires randomized controlled trials (RCTs) due to the low evidence levels and study heterogeneity.

Objective To summarise the efficacy and toxicity of salvage low‐dose‐rate brachytherapy (LDR‐BT) and compare these findings with the published data on salvage high‐dose‐rate brachytherapy (HDR‐BT). Methods We reviewed PubMed and EMBASE for studies published up to May 2024, mainly focusing on recurrence‐free survival (RFS) with salvage LDR‐BT across subgroups. We also compared RFS and adverse events with HDR‐BT as a secondary objective. We reconstructed survival curves using a semi‐automated tool called WebPlotDigitizer, along with a new shiny application integrated with R. Results A total of 31 studies (891 patients) met the inclusion criteria for salvage LDR‐BT. The median RFS of patients treated with salvage LDR‐BT was 131.6 months, with 2‐, 3‐ and 5‐year rates of 84.6%, 74.3% and 63.5%. Lower median age (65–70 years vs 72.3–75 years, hazard ratio [HR] 0.50, 95% confidence interval [CI] 0.35–0.70; P < 0.0001) and higher adjuvant androgen deprivation therapy (ADT) proportion (83.8%–100% vs 0%–47%, HR 0.60, 95% CI 0.55–0.65; P = 0.036) were positive RFS factors. Compared to HDR‐BT, salvage LDR‐BT demonstrated improved RFS for all patients (HR 0.67, 95% CI 0.55–0.81; P < 0.0001). Specifically, salvage LDR‐BT exhibited superior RFS ( P < 0.05) for patients with a median age ≤70 years at recurrence, a median time from primary treatment to salvage therapy (TPTS) of ≥70 months, a median pre‐salvage prostate‐specific antigen level of ≥5 ng/mL, and a proportion of adjuvant ADT of ≥53%, compared to HDR‐BT. However, LDR‐BT was associated with a higher rate of severe gastrointestinal (GI; 3.5% vs 0.3%, odds ratio [OR] 0.08, 95% CI 0.03–0.28; P < 0.0001) and genitourinary (GU) toxicities (12.7% vs 5.8%, OR 0.42, 95% CI 0.30–0.60; P < 0.001) compared to HDR‐BT. Conclusions In specific cohorts, salvage LDR‐BT appears to yield superior RFS but entails a higher incidence of severe GI/GU toxicities compared to HDR‐BT.

Colorectal cancer (CRC) is the third most common cause of death worldwide and has high mortality and a poor prognosis. Long non-coding RNAs (lncRNAs) are non-coding RNAs longer than 200 nucleotides that play roles in cancer through multiple mechanisms. TMEM51-AS1 is a newly discovered 40,650 bp lncRNA. Our results showed that TMEM51-AS1 expression was significantly downregulated in CRC tissues (fold change = 0.74, P < 0.0001). This finding was confirmed in 20 pairs of CRC carcinoma and paracancerous tissues (fold change = 0.5, P < 0.001). Additionally, TMEM51-AS1 expression was found to be significantly reduced in CRC cell lines compared to normal human intestinal epithelial cells (P < 0.001). Bioinformatic analysis revealed that TMEM51-AS1 expression was associated with immune escape, RNA methylation, and DNA damage and repair. TMEM51-AS1 may also activate energy metabolism pathways to participate in cancer development. Drug sensitivity analysis confirmed that several drugs are more effective in CRC patients with high expression of TMEM51-AS1. In conclusion, our study demonstrates that TMEM51-AS1 can suppress the progression of CRC.

Background: To date, no meta-analysis has been conducted to compare the effectiveness and safety of adjuvant tyrosine kinase inhibitors (TKIs) and adjuvant immunotherapies (IMTs) in renal cell carcinoma (RCC) patients using reconstructed individual patient data (IPD). This study aims to fill that gap by assessing the efficacy and safety profiles of these treatments in such patients. Methods: This study employed a systematic approach for identifying relevant literature from the PubMed and EMBASE databases. We included articles published in English from the inception of these databases until November 11, 2023, focusing specifically on appropriate phase III randomized controlled trials (RCTs). To reconstruct survival curves, we utilized a semiautomated tool, WebPlotDigitizer, in conjunction with a novel shiny application integrated with R software. For adverse events (AEs), the summary measures were incidences, expressed as a 95% confidence interval (CI), calculated using a random-effects model with a logit transformation. Results: The analysis included 8 RCTs with a total of 9119 patients. Compared to adjuvant TKIs, adjuvant IMTs showed a similar disease-free survival (DFS) (hazard ratio [HR] 1.03, 95% CI [0.98–1.09], P = .281). However, the overall survival (OS) rates between the 2 groups couldn’t be directly compared due to unmatched control groups in the IMT and TKI studies. Against placebo, adjuvant IMTs demonstrated superior DFS (HR 0.82, 95% CI [0.71–0.94], P = .004) but comparable OS (HR 0.79, 95% CI [0.59–1.06], P = .120). Against placebo, adjuvant TKIs showed superior DFS (HR 0.85, 95% CI [0.79–0.92], P < .0001) and marginally better OS (HR 0.89, 95% CI [0.80–0.996], P = .042). Regarding severe AEs and discontinuation rates due to AEs, adjuvant IMTs had a significantly lower incidence of severe AEs (25% [320/1282] vs 59% [2192/3716], odds ratio [OR] 0.23, 95% CI [0.20–0.27], P < .0001) and a markedly better discontinuation rate (39% [499/1282] vs 52% [2068/4018], OR 0.60, 95% CI [0.53–0.68], P < .0001) compared to TKIs. Conclusion: This paper presents a thorough analysis of DFS, OS, and treatment-related AEs across various groups in RCC patients, offering a valuable resource for clinicians in everyday practice. Our findings indicate that while adjuvant IMTs and adjuvant TKIs demonstrate similar DFS, IMTs are notably superior in terms of safety and compliance.

This study explores the impact of family dignity interventions (FDI) on palliative patients and their family caregivers through a systematic review and meta-analysis of randomized controlled trials (RCTs). A systematic search was conducted in PubMed, Embase, and Cochrane databases for RCTs related to family-centered dignity interventions, with the search period extending from the inception of the databases up to July 2024. Statistical analyses were conducted using standardized mean difference (SMD) as the effect size with Stata 17.0 software for analysis, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was employed to assess the certainty of evidence. A total of 7 RCTs involving 556 pairs of palliative patients and their caregivers were included. Compared to the control group, palliative patients who received FDI demonstrated greater improvements in dignity (SMD, − 0.27; 95

BACKGROUND:Stereotactic body radiotherapy (SBRT) is pivotal in managing radio-recurrent prostate cancer (PCa). This study aims to comprehensively review its efficacy and associated severe toxicities. METHODS:A thorough review of PubMed and EMBASE databases up to July 2024 was conducted to assess recurrence-free survival (RFS) with salvage SBRT across various subgroups. Survival curves were reconstructed using WebPlotDigitizer and a newly developed shiny application. RESULTS:Thirty-six studies were analyzed, with 15 papers (682 patients) contributing to survival curve reconstruction. Median RFS was 36.2 months, with 2-, 3-, and 5-year rates of 64.8%, 50.7%, and 40.6%, respectively. Factors associated with improved RFS included whole-gland irradiation [focal vs. whole, hazard ratio (HR) 1.83 (95% CI: 1.16-2.87), p = 0.008], and higher biologically effective dose (BED) [120-138.1 Gy vs. 144-167.7 Gy, HR 1.40 (95% CI: 1.07-1.83), p = 0.015]. Severe (grade ≥ 3) acute and late genitourinary (GU) toxicities occurred in 1.4% (95% CI: 0.8-2.3) and 3.7% (95% CI: 2.6-4.9) of patients, respectively. Severe acute and late gastrointestinal (GI) toxicities were reported in 0.5% (95% CI: 0.2-1.1) and 0.4% (95% CI: 0.1-1.0) of patients, respectively. Combined severe GU and GI toxicities were observed in 5.8% (95% CI: 4.5-7.4) and 1.3% (95% CI: 0.7-2.2) of patients, respectively. CONCLUSIONS:This study provides a comprehensive assessment of toxicities and conducts a pooled analysis of RFS for salvage SBRT in radio-recurrent PCa. Factors such as whole-gland irradiation, and higher BED show promise as prognostic indicators for RFS. However, confirmation through randomized controlled trials is essential due to the low levels of evidence and study heterogeneity.

High-dose-rate brachytherapy (HDR-BT) plays an important role in the treatment of locally recurrent prostate cancer after definitive treatment. The objective of this study is to summarize the efficacy and toxicity of HDR-BT in these patients. We performed a systematic review of PubMed and EMBASE from inception to July 2023. The primary endpoint was relapse-free survival (RFS) in different subgroups, and the secondary endpoint was gastrointestinal (GI) and genitourinary (GU) toxicity. A semi-automated tool (WebPlotDigitizer) and a new Shiny application combined with R software (R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria; https://www.R-project.org/ ) helped to reconstruct survival curves. Twenty-six studies met the inclusion criteria for quantitative analysis, including 1447 patients. A total of 761 patients from 13 studies were included in survival reconstruction, and the median RFS time was 61.2 months (57.6–72.0 months). The estimated 2‑, 3‑, and 5‑year rates were 75.9

Numerous studies have examined the effectiveness of photobiomodulation therapy (PBMT) in reducing chemoradiotherapy (CRT)-induced oral mucositis (OM) in patients with head and neck cancer (HNC). Despite this, there is an urgent need to update the meta-analyses on this topic. This meta-analysis aims to explore the impact of PBMT on CRT-induced OM in these patients. We conducted a systematic search in PubMed, Embase, Cochrane, LILACS, and Web of Science from January 2000 to October 2023. This search focused on randomized controlled trials (RCTs) that assessed the effects of PBMT on CRT-induced OM. The study included a total of 14 RCTs encompassing 869 patients with HNC. The incidence of OM in the PBMT group was significantly lower from the second week onwards compared to the control group (RR = 0.49, CI = 0.25-0.97, I2  = 71%, p = 0.04), and this was present until the seventh week (RR = 0.77, CI = 0.61-0.99, I2  = 89%, p = 0.04). Furthermore, the occurrence of severe mucositis in the PBMT group decreased from the third week (RR = 0.51, CI = 0.29-0.90, I2  = 12%, p = 0.02) until the conclusion of the intervention (RR = 0.45, CI = 0.24-0.85, I2  = 80%, p = 0.01). Additionally, PBMT showed beneficial effects in alleviating OM-related pain (WMD = -1.09, 95% CI = -1.38 to -0.880, I2  = 13%, p < 0.00001). The use of He-Ne or InGaAlP lasers with a power range of 10-25 mW demonstrated the most favorable outcomes in preventing and treating OM. PBMT has shown considerable efficacy in reducing the incidence, severity, and pain associated with OM in patients with HNC. Future studies are encouraged to further investigate the most effective parameters for PBMT in the management of OM.

Abstract Introduction Small cell lung cancer (SCLC) is a highly aggressive lung cancer variant known for its elevated risk of brain metastases (BM). While earlier meta‐analyses supported the use of prophylactic cranial irradiation (PCI) to reduce BM incidence and enhance overall survival, modern MRI capabilities raise questions about PCI's universal benefit for limited‐stage SCLC (LS‐SCLC) patients. As a response, we have created a predictive model for BM, aiming to identify low‐risk individuals who may not require PCI. Methods A total of 194 LS‐SCLC patients without PCI treated between 2009 and 2021 were included. We conducted both univariate and multivariate analyses to pinpoint the factors associated with the development of BM. A nomogram for predicting the 2‐ and 3‐year probabilities of BM was then constructed. Results Univariate and multivariate analyses revealed several significant independent risk factors for the development of BM. These factors include TNM stage, the number of chemotherapy (ChT) cycles, Ki‐67 expression level, pretreatment serum lactate dehydrogenase (LDH) levels, and haemoglobin (HGB) levels. These findings underscore their respective roles as independent predictors of BM. Based on the results of the final multivariable analysis, a nomogram model was created. In the training cohort, the nomogram yielded an area under the receiver operating characteristic curve (AUC) of 0.870 at 2 years and 0.828 at 3 years. In the validation cohort, the AUC values were 0.897 at 2 years and 0.789 at 3 years. The calibration curve demonstrated good agreement between the predicted and observed probabilities of BM. Conclusions A novel nomogram has been developed to forecast the likelihood of BM in patients diagnosed with LS‐SCLC. This tool holds the potential to assist healthcare professionals in formulating more informed and tailored treatment plans.

BackgroundThe use of adjuvant first-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKIs) in patients with resected EGFR-mutant non-small cell lung cancer (NSCLC) remains controversial. Therefore, we performed a systematic review with meta-analysis to investigate the overall survival (OS) in patients with resected NSCLC.MethodsRelevant studies were identified from the PubMed and EMBASE databases, and pooled hazard risks were obtained by random-effects models.ResultsThree prospective phase III and one phase II randomized controlled trials were identified, including a total of 839 patients who had undergone resection of EGFR-sensitive mutation in our analysis, 429 of whom received adjuvant first-generation TKIs therapy. For all patients with complete resection, adjuvant first-generation TKIs therapy was associated with improved disease-free survival (DFS) [hazard ratio (HR): 0.50, 95% confidence interval (CI): 0.30-0. 82] but not OS (HR: 0.78, 95% CI: 0.48-1.27) compared with adjuvant chemotherapy. In addition, we reconstructed the OS curves of the ADJUVANT and IMPACT studies, and the pooled 3- and 5-year OS rates of stage II-III patients in the TKI group and chemotherapy group were 80% vs. 79% and 66% vs. 64%, respectively. We also reconstructed the DFS curves based on the ADJUVANT, IMPACT, and EVIDENCE studies, and the pooled 1-, 3- and 5-year DFS rates of stage II-III patients in the TKI group and chemotherapy group were 87% vs. 70%, 49% vs. 37% and 28% vs. 29%, respectively.ConclusionsIn patients with completely resected EGFR-mutant NSCLC, adjuvant first-generation TKIs may delay disease progression but still fail to improve long-term survival compared with conventional chemotherapy.

Aim: This study aimed to investigate the functions of ZNF582-AS1 and ZNF582 in esophageal cancer (EC). Materials & methods: Bioinformatics analysis, qRT-PCR and western blot were used to analyze the expression levels. Biological functions were evaluated using cell-counting kit 8, colony formation, Transwell assays and flow cytometry. FISH was used to detect subcellular localization, and methylation-specific PCR determined gene methylation levels. Animal experiments validated the impact on tumor progression. Results: ZNF582-AS1 and ZNF582 were highly methylated and downregulated in EC. Overexpression of ZNF582-AS1 up-regulated the expression of ZNF582, thereby inhibiting EC cell viability and metastasis, promoting apoptosis and inhibiting tumor growth. Conclusion: Low expression of ZNF582-AS1/ZNF582 mediated by DNA hypermethylation facilitates the malignant progression of EC.

BACKGROUND:Recent advancements in magnetic resonance imaging (MRI) for staging have highlighted the critical question of the need for prophylactic cranial irradiation (PCI) in managing early to mid-stage small cell lung cancer (SCLC). This study assesses the impact of PCI on overall survival (OS) and intracranial control among patients with stage I-IIB SCLC. METHODS:Data from 148 stage I-IIB SCLC patients treated with thoracic radiation therapy (TRT) at two centers were examined. Patients were categorized based on PCI administration: 63 received PCI, while 85 did not. All underwent pretreatment MRI, achieving at least a partial response to therapy. A 1:1 propensity score matching analysis corrected for potential biases. RESULTS:Propensity scores were generated to 116 patients, considering patient demographics, disease progression, and treatment methods. Death was included as a competing risk. The 3-year brain metastases (BM) occurrence rate was significantly higher in patients who did not receive PCI (30.0%) compared to those who did (14.8%), however, the difference was not statistically significant (No PCI vs. PCI, hazard ratio [HR]: 2.08, 95% CI [0.93-4.55], P = .07). No significant effect of PCI on OS was observed [PCI vs. No PCI, HR: 0.80, 95% CI (0.45-1.43), P = .45]. A subgroup analysis of stage IIB patients showed a significant increase in BM risk and mortality for those not receiving PCI (No PCI vs. PCI, BM risk HR: 5.85, 95% CI: 1.83-18.87, P = .003; mortality HR: 2.78, 95% CI: 1.14-6.67, P = .02), with less pronounced effects in stages I-IIA. CONCLUSION:With modern MRI-based screening, PCI may markedly benefit stage IIB SCLC patients by reducing BM and improving OS after initial sensitive treatment. This benefit does not appear to extend to stage I-IIA patients.