Oncology Practice Research Articles

PREVALENCE AND RISK FACTORS ASSOCIATED WITH HEPATITIS B VIRUS INFECTION AMONG ONCOLOGY PATIENTS

Background and aims: Hepatitis B virus (HBV) screening for patients with newly diagnosed solid cancer is not standard practice in oncology, and authorities disagree on whether complete screening should be carried out. Additionally, research on the risk factors for HBV infection in this patient population may differ from that in the general population. Therefore, estimating the prevalence of HBV and risk factors for HBV infection in individuals with recently diagnosed solid cancer was the study's goal. Subjects and methods: Newly diagnosed cancer patients at the oncology center of Al-Jumhori Hospital in Sana'a, are included in this cross-sectional study. A regular questionnaire created specifically for this study was used to gather data, which included demographic information, risk factors, cancer type, and test findings. Using an ELISA assays for HB surface antigen and HB Core IgG anti-antibodies were conducted. Results: The study analyzed 300 cancer patients with HBV testing, with a mean age of 42.9 years and a sex distribution of 37.6% men and 62.4% women. The crude HBV prevalence was 5%, with females having a higher prevalence. The study found no significant association between age, rural residency, married status, blood transfusion frequency, or blood sources with HBV risk. No association was found between under treatment chemotherapy and HBV infection. Conclusions: This study examines the frequency of HBV infections in patients with solid tumors for the first time in Yemen. Our study found that the nationwide prevalence of HBV was higher in cancer patients than in the broad population. Peer Review History: Received 15 October 2024; Reviewed 7 November; Accepted 21 December; Available online 15 January 2025 Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10

Return of Clinically Actionable Pharmacogenetic Results From Molecular Tumor Board DNA Sequencing Data: Workflow and Estimated Costs.

Pharmacogenetic testing can prevent severe toxicities from several oncology drug therapies; it also has the potential to improve the outcomes from supportive care drugs. Paired tumor and germline sequencing is increasingly common in oncology practice; these include sequencing of pharmacogenes, but the germline pharmacogenetic variants are rarely included in the clinical reports, despite many being clinically actionable. We established an informatics workflow to evaluate the clinical sequencing results for pharmacogenetic variants. We used the Aldy computational tool, which we have previously shown to determine the variant alleles in 14 pharmacogenes in clinical sequencing data with >99% accuracy, to identify pharmacogenetic variants in the clinical whole exome sequencing from our molecular tumor board. Patients with genetic variants that are clinically actionable for their individual therapy programs, including both treatment and supportive care, are referred to a clinical pharmacogenetics testing laboratory for confirmation. Through an evaluation of our weekly informatics workflow, we determined it took approximately 3.25 hours to complete the analysis of the sequencing data from approximately 20 patients. Using a United States pharmacist's median salary, we estimated the incremental added cost of the process to be only ~$15 per patient. This adds only a minor increase to the patient's cost of testing and has the potential to improve the safety and efficacy of their treatment.

Shared Local Oncology Care After Allogeneic Hematopoietic Cell Transplantation

Although sharing care with local oncologists after allogeneic hematopoietic cell transplantation (HCT) has been proposed for patients living far from HCT centers, it is not known whether a shared strategy is safe or improves patient quality of life (QOL). To determine the efficacy and safety of sharing follow-up care after HCT between the HCT specialty center and local oncologists. This was a multicenter collaborative randomized clinical trial of patients undergoing HCT at Dana-Farber Cancer Institute (DFCI)-a high volume HCT center in Boston (Massachusetts)-and 8 local oncology practices. Eligible patients were enrolled from December 2017 to December 2021 and were randomized 1:1 to shared vs usual care after neutrophil engraftment, stratified by local sites in Massachusetts, Rhode Island, New Hampshire, New York, and Maine. Data analyses were performed in January 2024. Shared care involved alternating post-HCT visits at DFCI and local oncology practices through day 100; for usual care, all post-HCT visits occurred only at DFCI. Coprimary outcomes were nonrelapse mortality (NRM) at day 100, and QOL measured by the FACT-BMT (Functional Assessment of Cancer Therapy-Bone Marrow Transplantation) instrument and the QLQ-C30 (European Organization for Research and Treatment of Cancer's Quality of Life Questionnaire) at day 180. Prespecified secondary outcomes included day 100 QOL and 1-year overall survival. A total of 302 participants (median [range] age, 63 [20-79] years; 117 [38.7%] females; 185 [61.3%] males) were included in the analysis; 152 were randomized to shared care and 150 to usual care. Day 100 NRM was noninferior for shared vs usual care (2.6% [95% CI, 0.7% to 6.6%] vs 2.7% [95% CI, 0.7% to 6.7%]; P = .98). There were no differences at day 180 for the FACT-BMT total score (mean difference, 3.8; 95% CI, -2.1 to 9.6; P = .20) or QLQ-C30 global score (1.9; 95% CI, -4.9 to 8.8; P = .58). At day 100, the FACT-BMT total score was better for shared care (mean difference, 6.6; 95% CI, 1.0 to 12.1; P = .02) as was the QLQ-C30 global score (8.8; 95% CI, 1.8 to 15.7; P = .02). This randomized clinical trial found that shared care resulted in noninferior NRM at day 100 but similar QOL at day 180, with improved QOL at day 100. These data suggest that shared care is safe, improves QOL early on, and has the potential to become a routine model for post-HCT care. ClinicalTrials.gov Identifier: NCT03244826.

Application value of multi-disciplinary collaborative diagnosis and treatment combined with CBL teaching model in gynecological oncology practice teaching

Application value of multi-disciplinary collaborative diagnosis and treatment combined with CBL teaching model in gynecological oncology practice teaching

The Effect of Pacemakers and Defibrillators on Distortion in 2 Magnetic Resonance Imaging (MRI) Sequences Commonly Used in Radiation Oncology Practice—3D True Fast Imaging with Steady State Precession (TrueFISP) at 0.35T MR-Linear Accelerator (LINAC) and 3D T1 at 3T MR Simulator

Background: We aimed to measure the pacemaker- and defibrillator-induced distortion at 0.35T and 3.0T magnetic fields. Methods: The pacemaker/defibrillator was placed at the top center of a water-filled/MagPhan phantom, followed by a T1 scan at 3T and a TrueFISP scan at 0.35T. The extent of distortion (i.e., the distance from the device to the furthest signal loss/void/rings) in the water-filled phantom was measured in MIM. For geometrical distortion (i.e., dislocation of geometrical structures), the spheres in the MagPhan phantom were contoured and their distortion was calculated based on their manufacturing coordinate positions. Results: The maximum extent of distortion caused by the defibrillator was 18.8 cm at 0.35T and 5.8 cm at 3.0T. Similarly, the maximum extent of distortion caused by the pacemaker was 9.28 cm at 0.35T and 2.8 cm at 3.0T. Geometrical distortion measurements using the MagPhan phantom showed that the maximum distortion caused by the defibrillator was 12.8 mm at 0.35T and 13.2 mm at 3.0T. Likewise, the maximum distortion caused by the pacemaker was 8.7 mm at 0.35T and 6.0 mm at 3.0T. Conclusions: Defibrillators cause larger distortions/signal voids than pacemakers, and require careful consideration when performing MRI-based treatment planning. To minimize distortion, sequences with lower sensitivity to magnetic field inhomogeneity should be used.

Progress and Challenges in Integrating Nutritional Care into Oncology Practice: Results from a National Survey on Behalf of the NutriOnc Research Group.

Nutritional care is a cornerstone of cancer treatment, with the potential to significantly improve patient outcomes by addressing malnutrition and enhancing recovery. Despite growing awareness, the integration of evidence-based nutritional strategies into oncology remains inconsistent. Following a 2020 survey that highlighted critical gaps, the NutriOnc Research Group launched targeted initiatives to raise awareness and improve practices. This study reassesses progress in integrating nutritional care and identifies persistent challenges. A 29-question survey was conducted in 2024 among 73 early-career oncologists, surgeons, radiation oncologists, and nutrition specialists across Italy. Respondents provided insights into clinical nutrition program availability, multidisciplinary team composition, screening practices, and educational needs. Encouraging advancements were noted, with 80.8% of respondents reporting the presence of clinical nutrition programs, compared to fewer structured efforts in 2020. However, only 26.0% included nutrition specialists in multidisciplinary teams, and barriers such as financial constraints, limited product availability, and the absence of trained professionals persisted. While 82.2% performed nutritional screening, variability in tools and practices highlighted the need for standardization. Strikingly, 98.6% expressed a strong demand for advanced education on clinical nutrition, emphasizing the need for innovative and accessible training programs. This study reveals a landscape of progress tempered by persistent inequities. To close the gap, oncology must embrace standardized protocols, expand access to trained nutrition specialists, and invest in educational initiatives. The findings offer actionable insights for transforming cancer care through nutrition, underscoring its potential to improve survival, quality of life, and overall treatment success.

An international survey on the knowledge, aTtitudes and clinical pAtternS of use of medical cannabis for caNcer care: the TASMAN study

BackgroundMedical cannabis (MC) has gained traction in oncology for managing cancer-related symptoms, but its integration faces challenges due to limited evidence, inconsistent guidelines, and varied legal frameworks. MethodsThe TASMAN study aimed to assess the knowledge, attitudes, and practices of oncologists and palliative care providers globally regarding MC use in cancer care. A survey of healthcare providers from diverse regions and income levels was conducted. Resultswe study included 179 participants (response rate: 51.1%), with an equal gender distribution (49.4% female) and a median age of 37 years. Participants were primarily oncologists (71.5%), practicing in university hospitals (40.2%) or cancer centres (32.4%), with over half from low- and middle-income countries. Most respondents (92.7%) were unaware of clinical guidelines for MC. A proportion of 44.1% were familiar with MC use, 78.8% recognized its role in cancer pain, and 34% identified its role in managing cachexia. Awareness of specific products was low, with only 10% familiar with specific cannabis products. Three-quarters of respondents (84.4%) did not prescribe MC routinely. Legal status and regulations were unclear for most participants; 40% noted cannabis as illegal. MC use and patient requests were more common in high-income countries and the EURO region, with palliative care providers demonstrating the highest awareness and prescription rates. ConclusionClearer regulations, standardized guidelines, and targeted education are essential to support the safe integration of MC into oncology and palliative care, ultimately improving the quality of life for cancer patients.

A training framework for multi-professional advanced level practice in non-surgical oncology: The journey through development and consultation to consensus.

The Non-Surgical Oncology (NSO) workforce, like many healthcare specialities, faces critical personnel shortages. With a 21% deficit in consultant oncologists anticipated by 2028, alongside vacancies in key roles such as therapeutic radiographers. To address these challenges, innovative workforce strategies are necessary, including the diversification of skills and the creation of advanced career pathways for healthcare professionals such as nurses, pharmacists, and allied health professionals. Advanced Clinical Practitioners (ACPs) and Advanced Practitioners (APs) have emerged as pivotal in bridging workforce gaps; however, their training lacks standardisation. This study utilised a multiphase design to gain consultation and consensus on the suitability of a newly developed NSO training framework adapted from the Royal College of Radiologists and Royal College of Physicians' joint curricula. Applying a modified Delphi approach, seen to be beneficial in curriculum design, and considering the diversity of professions and roles across the speciality, was used to develop an online survey which was distributed across the NSO healthcare sector. The survey aimed to gain consensus on the framework's alignment with clinical and educational needs and identify barriers to its implementation. On reviewing the NSO training framework, the majority of the panel members (n=46/51; 90.2%) felt the capabilities appropriately mapped to the 2017 MPF.7 When asked about the clarity of the overall introduction and the introduction to the CiPs an overall positive response rate was noted (n=50/51; 98%). There was a slightly lower level of consensus around the clarity of the generic and core oncology CiPs, and slightly less agreement in the speciality-specific capabilities. Following the first survey (round one), the responses were reviewed, and it was identified that overall, in eight out of ten of the questions agreement between panel members had exceeded the level of agreement established by the researchers. As a result, the decision was made to cease the surveys and analyse the results in full as a single round. Addressing the projected workforce shortages in oncologists and other key non-surgical oncology roles, this study contributes a framework adapted from established curricula, ensuring an equitable and high-standard educational pathway for trainees. The multi-phase process revealed consensus for the framework's alignment with clinical and educational standards, particularly its focus on capabilities in practice (CiPs), though highlighted inconsistencies in supervision and assessment. The NSO framework is essential for ensuring equitable training, improving workforce retention, and enhancing patient care outcomes.

Screening for Financial Toxicity in Oncology Research and Practice: A Narrative Review.

Financial toxicity (FT) is now a well-recognized issue affecting many patients with cancer and their families. The field is rapidly moving from a focus on describing this problem to efforts to optimize screening and identify management solutions. There are now multiple validated tools to study FT in the research setting. Although there is currently no standard tool for screening in the setting of routine clinical practice, many of the scales for FT were developed with clinical screening in mind, and there is emerging evidence regarding potential to screen with one or two questions to detect financial distress. This narrative review is intended to provide an update on validated scales that have been used to study FT in the research context and provide examples of tools of varying length that are being studied for implementation of screening in clinical practice. It is important for clinicians to seek to identify and assist patients who may be experiencing FT as a result of cancer or cancer therapy.

Interventions to Address Cancer-Related Financial Hardship: A Scoping Review and Call to Action.

As oncology practices implement routine screening for financial hardship (FH) and health-related social needs, interventions that address these needs must be implemented. A growing body of literature has reported on FH interventions. We conducted a scoping review of the literature using PubMed, EMBASE, PsychInfo, and CINAHL to identify key studies (2000-2024) reporting on interventions to address cancer-related FH. Full-length manuscripts were included in the review if they detailed a research, quality improvement, or community-based intervention to address at least one element of FH and drew association with an outcome of interest. Studies were categorized by intervention type and qualitatively analyzed to identify critical components, outcomes, and limitations. Forty-four publications reporting on 43 interventions were included in the final analysis and were categorized as research interventions (n = 20) and real-world programs (n = 20). Studies reporting on financial navigation programs (n = 17) and specialty pharmacy assistance programs (n = 11) were most common; enrolled patients received concrete assistance with direct medical costs and cost-of-living expenses (eg, transportation and food). In addition, several of these programs improved overall patient-reported financial toxicity, decreased appointment no-shows, and improved enrollment in clinical trials. Interventions to address FH are feasible and can address all domains of FH-material, behavioral, and psychosocial. Future research should address the uptake and implementation of these interventions across diverse cancer care delivery settings. Such programs will be an essential part of cancer care delivery until broad social and policy changes can address the underlying factors that contribute to FH in Americans with cancer.

Recommendations of the Brazilian Society of Surgical Oncology for the Treatment of Neoplastic Pericardial Effusion

ABSTRACTThis document presents guidelines to assist surgeons in the diagnosis and management of this condition, emphasizing a multidisciplinary approach. Recommendations described by a group of physicians members of the Brazilian Society of Oncological Surgery regarding the treatment of neoplastic pericardial effusion, developed to guide oncological surgeons, cardiothoracic surgeons and general surgeons in their clinical practice. Members of the Thoracic Neoplasms Committee carried out a literature review and discussion among expert peers to create a guideline that would help in managing this very serious clinical condition in our oncology practice: Neoplastic pericardial effusion.

Boron Neutron Capture Therapy with Boronophenylalanine in Experimental Oncology and Veterinary Practice

Neutron Capture Therapy (NCT) — highly selective method of binary radiotherapy of malignancies, which is based on physical phenomenon of thermal neutron radiation capture by atoms’ nuclei. Currently only 10B mediated NCT, known as boron neutron capture therapy (BNCT), is used in clinical practice. Boronophenylalanine — a modified amino acid is most widely used as 10B carrier. Despite of more than 70-years history of BCNT clinical application and promising results of curing patients with different tumors, this method of treatment is still under research and development. The most urgent issue is studying and prediction of radiation effects of healthy and tumor tissues after BNCT application. This task can be solved in experiments involving animals. The review contains results of BNCT studies both in laboratory animals with different tumor models and veterinary practice. Induced and transplanted models of central nervous system, oral cavity as well as subcutaneous and metastatic models are considered in the review. Obtained results of the studies show possible high antitumor efficacy of BPA mediated BNCT and fundamentally different mechanisms of BNCT effect on tumor and healthy tissues comparing to other known types of radiotherapy. Many issues still require addition research with modern methods of studies, such as in vivo preclinical imaging.

CT-Based Body Composition and Frailty as Predictors of Survival Among Older Adults With Gastrointestinal Malignancies.

Older adults with cancer are at an increased risk of treatment related toxicities and early death. Routinely collected clinico-demographic characteristics inadequately explain this increased risk limiting accurate prognostication. Prior studies have suggested that altered body composition and frailty are independently associated with worse survival among older adults with cancer; however, their combined influence remains unclear. We used data from a single-institution prospective cohort study of older adults (≥ 60 years) who underwent geriatric assessment (GA) at the time of initial consultation with a medical oncologist from September 2017 to December 2020 and available baseline abdominal computed tomography within 60 days of GA. Using multi-slice CT images from T12 to L5 level, we assessed volumetric measures of skeletal muscle (SMV), visceral adipose tissue (VATV), subcutaneous adipose tissue (SATV) and averaged skeletal muscle density (SMD), computing sex-specific z for each measure. Frailty was measured using a 44-item frailty index using the deficit accumulation approach. Primary outcome of interest was overall survival (OS) defined as time from GA to death or last follow up. We used multivariable Cox regression model to study the independent association between the above four body composition measurements and OS adjusted for baseline confounders and frailty. We included 459 patients with a mean age of 69.7 ± 7.5 years, 60% males and 77% non-Hispanic Whites. Most had colorectal (27%) or pancreatic cancer (20%) and 48% had stage IV disease. Over a median follow up of 39.4 months, 209 patients (46%) died. In multivariable Cox regression models adjusted for age, sex, race, cancer type, cancer stage and frailty, skeletal muscle volume (HR 0.74; 95% CI 0.58-0.96; p = 0.02, per 1 SD increment) was independently associated with OS. The addition of body composition variables to baseline clinico-demographic variables and frailty led to a slightly improved model discrimination. SMV is independently associated with OS among older adults with newly diagnosed gastrointestinal cancers. Capturing body composition measurements in oncology practice may provide additional prognostic information for older adults with cancer above and beyond what is captured in routine clinical assessment including frailty.

Deep multi-omics integration approach reveals new molecular features of uterine leiomyosarcoma.

Uterine leiomyosarcoma (uLMS) is a rare and aggressive cancer representing approximately 25 % of all uterine malignancies. The molecular heterogeneity and pathogenesis of uLMS are not well understood, and translational studies aimed at discovering the vulnerabilities of this tumor type are of high priority. We conducted an innovative comprehensive multi-omics integration study from DNA to protein using freshly frozen tumors. Here, we show that two tumors harbor actionable therapeutic targets, IDH1_p.Arg132Cys and KRAS_p.Gly12Cys, and homologous recombination deficiency (HRD) is the most predominant genomic signature. Additionally, 80 % of the samples presented a chromothripsis signature, reinforcing the aneuploidy phenotype of these tumors. Tumors with a high proliferation score and high Ki67 expression was associated with worse overall survival (OS). We observed a high frequency of balanced fusion events involving EEF1A1 with enrichment of the EGFR pathway. For the first time, uLMS proteomics analysis showed the enrichment of pathways associated with suppression of the innate immune system and ECM organization. Finally, our comprehensive multi-omics integration analysis identified amplification of the CTHRC1 gene from the matrisome, with a negative impact on OS. Interestingly, the expression of Ki67 and CTHRC1 exhibits a strong negative correlation, underscoring two distinct and mutually exclusive biological profiles in uLMS: (i) highly proliferative tumors, characterized by elevated Ki67 expression, and (ii) tumors driven by ECM remodeling, marked by high CTHRC1 levels. Taken together, this deep functional multi-omics approach contributes to the detection of new molecular features of uLMS and suggests that patients could benefit from precision oncology in clinical practice.

Standard requirements for clinical very high energy electron and ultra high dose rate medical devices

Very High-Energy Electrons (VHEE) present a promising innovation in radiation therapy (RT), particularly for the treatment of deep-seated tumors using Ultra High Dose Rate (UHDR) within the framework of FLASH-RT. VHEE offers significant advantages, such as improved tumor targeting, reduced treatment times, and potential utilization of the FLASH effect, which may minimize normal tissue toxicity. However, the lack of an international technical standard for VHEE systems, especially for UHDR applications, remains a critical challenge. Current standards for radiation therapy equipment, such as IEC 60601-2-1 and IEC 60601-2-64, do not encompass VHEE technology. This regulatory gap underscores the need for developing a structured international standard to ensure the basic safety and essential performance of VHEE medical devices. Addressing this challenge requires overcoming complex dose delivery issues, such as the interaction of multiple fields and beam conformality and incorporating novel techniques like broad beam or pencil beam scanning. Establishing comprehensive regulatory standards is essential to ensure patient safety, consistent treatment practices, and the successful clinical integration of VHEE systems. These standards must encompass design guidelines, radiation protection protocols, and integration with existing oncology practices. Collaborative research and development efforts are crucial to formulating evidence-based guidelines, fostering the safe and effective use of VHEE in clinical settings. By addressing these challenges, VHEE technology has the potential to revolutionize cancer therapy, particularly for deep-seated tumors, while enhancing therapeutic outcomes for patients.

Artificial intelligence in oncology: Revolutionizing cancer care

With the evolution of Artificial Intelligence (AI), even cancer care approaches are evolving as it is providing innovative solutions to some of the most complex challenges in oncology. This article delves into how AI is making a profound impact across the cancer care spectrum worldwide, from early detection and precise diagnosis to the personalization of treatment and improved patient management. By harnessing AI's ability to analyze massive datasets and identify patterns beyond human perception, healthcare professionals can offer more accurate diagnoses and more effective treatments tailored to individual patient needs. This review also highlights the most recent advancements in AI-driven technologies in oncology and looks toward the future, where AI's role is expected to expand further. By discussing the potential and challenges of AI in cancer care, this article offers insights into how it is reshaping oncology practice, with the ultimate goal of enhancing patient outcomes and revolutionizing cancer treatment. This article aims to explore the transformative role of Artificial Intelligence (AI) in oncology, focusing on its impact on early cancer detection, precise diagnosis, personalized treatment, and overall patient management. It seeks to provide insights into the recent advancements of AI in cancer care, the challenges associated with its integration, and the potential future directions in oncology.A comprehensive review of literature was conducted, focusing on AI applications in oncology, including diagnostic imaging, precision oncology, and clinical decision support systems. Recent studies were analyzed to understand the role of AI-driven technologies in cancer diagnosis, treatment, and management. Inclusion criteria: Peer-reviewed articles, case studies, and reviews published in the last five years that focus on the application of AI in oncology, including early cancer detection, diagnostic accuracy, personalized treatment, and clinical decision support systems. Exclusion criteria: Articles that did not focus on oncology, did not involve AI technologies, or were not peer-reviewed were excluded from this review. AI has shown significant improvements in cancer detection and diagnostic accuracy, particularly through advanced imaging techniques and personalized treatment strategies. AI-powered diagnostic tools have revolutionized imaging by enhancing detection rates and reducing diagnostic errors. Moreover, AI has played a crucial role in tailoring therapeutic interventions based on individual patient characteristics, thus contributing to precision oncology. AI is revolutionizing cancer care by improving diagnostic precision, personalizing treatments, and enhancing patient outcomes. However, challenges such as data privacy, algorithm bias, and regulatory complexities must be addressed. Future innovations in AI, along with collaborative efforts, will further enhance cancer care and pave the way for AI-driven oncology practices globally.

Anemia in oncological practice. Eralfon – the optimal opportunity for personalization of drug therapy

Anemia has a noticeable negative impact on the quality of life of cancer patients and determines the prognosis of the disease. The need to treat anemia is determined by its negative impact on life expectancy, since hypoxia caused by anemia can be associated with resistance to chemotherapy, radiation therapy, causes stimulation of genetic mutations and neoangiogenesis in the tumor, which makes it difficult to control it. The methods of correction of anemia are determined by the clinical picture and the antitumor treatment being carried out. The use of blood transfusions is limited and involves a number of risks. Erythropoiesis-stimulating drugs can reduce the need for blood transfusions. The article describes the mechanisms of action, indications and side effects of recombinant erythropoietin (rEPO) drugs. The analysis of the effectiveness of rEPO drugs in the treatment of anemia in oncology based on the historical experience of clinical trials is presented. The recommendations of the leading communities on the use of rEPO drugs in various categories of patients are presented, and the Russian experience of using epoetin alpha in patients receiving chemotherapy is reflected. The use of erythropoietins clearly in accordance with the indications can significantly improve the results of treatment of cancer patients.

Photobiomodulation therapy for the management of acute radiation dermatitis in head and neck cancer: A case report

To assess the effectiveness of photobiomodulation therapy (PBMT) for the management of acute radiation dermatitis (ARD) in a head and neck cancer (HNC) patient. This case study examines a patient who developed a severe radiation reaction during radiotherapy for squamous cell carcinoma of the alveolus, which was successfully managed with supportive care, including PBMT. PBMT significantly reduced grade IV ARD and grade III oral mucositis to grade zero within one week after the completion of radiotherapy. The patient completed treatment without interruption or hospitalization. PBMT appears to be a safe and effective method for managing severe ARD. The incidence of radiation dermatitis may be influenced by factors such as the type of radiation equipment used and whether concomitant chemotherapy was administered as an adjunct. More studies are needed to establish standardized PBMT protocols. This case study supports the implementation of PBMT in clinical oncology practice.

Circulating biomarkers in high-grade gliomas: current insights and future perspectives.

High-grade gliomas (HGG) represent a challenging subset of brain tumors characterized by aggressive nature and poor prognosis. Histopathology remains to be the standard for diagnosis, however, it is invasive, prone to sampling errors, and may not capture the full tumor heterogeneity and evolution over time. In recent years, there has been a growing interest in the potential utility of circulating biomarkers, obtained through minimally-invasive liquid biopsies, providing an opportunity for diagnosis, prognostication, monitoring treatment response and developing targeted therapies. We have reviewed the literature on circulating biomarkers for HGG, including circulating tumor cells (CTCs), circulating tumor-derived exosomes/extracellular vesicles (ctEVs), circulating tumor-derived DNA (ctDNA), circulating tumor-derived miRNA (ctmiRNA), and circulating tumor-derived proteins. CTCs provide real-time information about tumor characteristics for molecular profiling and monitoring treatment response, yet their low numbers in circulation makes detection challenging. ctEVs carry a range of biomolecules and are easily detectable. However, they are not exclusively released from tumor cells and heterogeneity in their content requires standardized isolation and analysis methods. ctDNA is another promising biomarker with its levels correlating with the disease stage. However, its low concentration in blood requires highly sensitive techniques for identification and differentiation from normal cell-free DNA. ctmiRNA and tumor-derived proteins show promise but are limited by their susceptibility to dilution and lack of specificity in current technology. This review highlights the transformative potential of circulating biomarkers in the management of HGG, with implications for improving patient outcomes, optimizing treatment strategies, and advancing precision oncology in neuro-oncology practice.

Experts of their own experience: adolescent and young adult cancer patients’ advice-giving as a coping mechanism

ABSTRACT Background To better understand informal coping strategies among adolescents and young adults (AYAs) with cancer, the current investigation asked AYA study participants to describe the ‘advice’ they would offer to hypothetical peers about coping following diagnosis. This study explores the utility of the single item ‘advice’ prompt for supportive oncology research and practice. Methods AYA cancer patients (n = 27) aged 12–25 years were recruited through electronic health record query at a single-institution health system. Participants completed semi-structured interviews. Inductive themes were described regarding advice about informal coping strategies following cancer diagnosis. The Institutional Review Board approved this study (HUM#00157267). Results Emergent advice themes included (1) attitude re/framing, (2) engage support network, and (3) self-advocacy. Participants advised cultivating a positive yet realistic attitude about the present and future. Reaching out to support network members and accepting help were advised, as was rebuffing unhelpful support. Participants also advocated for addressing medical information needs and building trusting relationships with clinicians. Conclusions Soliciting AYA advice serves to identify informal coping mechanisms in response to life-stage-specific concerns. Future research is called to substantiate the utility of ‘advice’ as a single item tool for research and clinical questionnaires. Practice implications call for creating opportunities for AYAs to impart their advice to others (e.g. anonymous community message board) as a means of personal catharsis, altruistic service, and legitimizing AYAs as ‘embodied’ experts of their own experiences.