LAPC

LAPC
  • 文章类型: Journal Article
    背景:了解利益相关者对前列腺癌(PC)治愈的看法对于准备有关具有治愈意图的新兴治疗方法的有效沟通至关重要。本研究使用人工智能(AI)进行景观评价和定义的语言分析,PC利益相关者之间治愈的背景和价值。
    方法:主题专家(SME)使用Elicit,语义文献搜索引擎,从Medline中提取包含关键词的点击,Sermo和Overton,代表学术研究人员,医疗保健提供者(HCP)和政策制定者,分别。NetBaseQuid,社交媒体分析和自然语言处理工具,用于在社交媒体(代表公众)中进行关键字搜索。NetBaseQuid分析了针对关键字计数的特定关键字命中集的语言学,地理位置和情感。中小企业定性总结了针对关键词的见解。识别并量化了与关键词频繁出现的上下文术语。
    结果:中小企业在四个平台上确定了适用于PC的七个关键字(获得的点击量):Cure(12429),幸存者(6063),Remission(1904),幸存者(1179),治疗意图(432),无疾病证据(381)和完全缓解(83)。最常用的关键词是公众和HCP的Cure(11815和224次点击),学术研究人员的幸存者和政策制定者的幸存者(378命中)。所有利益相关者主要在早期PC中讨论了与治愈和治愈相关的关键词,并将其与积极情绪联系起来。所有利益相关者对治愈的定义都不同,但与疾病测量(例如前列腺特异性抗原)或手术有关。利益相关者在PC中讨论治愈时更喜欢不同的术语:治愈(学术研究人员),治愈率(HCPs),潜在治愈和幸存者/幸存者(政策制定者)和治愈和幸存者(一般公众)。
    结论:这个人类主导的,人工智能辅助的大规模定性基于语言的研究表明,治疗方法通常是由学术研究人员讨论的,HCP,决策者和公众,尤其是在早期PC。利益相关者在他们的沟通中不同地定义和情境化治疗,并将其与积极价值相关联。
    BACKGROUND: Understanding stakeholders\' perception of cure in prostate cancer (PC) is essential to preparing for effective communication about emerging treatments with curative intent. This study used artificial intelligence (AI) for landscape review and linguistic analysis of definition, context and value of cure among stakeholders in PC.
    METHODS: Subject-matter experts (SMEs) selected cure-related key words using Elicit, a semantic literature search engine, and extracted hits containing the key words from Medline, Sermo and Overton, representing academic researchers, health care providers (HCPs) and policymakers, respectively. NetBase Quid, a social media analytics and natural language processing tool, was used to carry out key word searches in social media (representing the general public). NetBase Quid analysed linguistics of key word-specific hit sets for key word count, geolocation and sentiments. SMEs qualitatively summarised key word-specific insights. Contextual terms frequently occurring with key words were identified and quantified.
    RESULTS: SMEs identified seven key words applicable to PC (number of acquired hits) across four platforms: Cure (12429), Survivor (6063), Remission (1904), Survivorship (1179), Curative intent (432), No evidence of disease (381) and Complete remission (83). Most commonly used key words were Cure by the general public and HCPs (11815 and 224 hits), Survivorship by academic researchers and Survivor by policymakers (378 hits each). All stakeholders discussed Cure and cure-related key words primarily in early-stage PC and associated them with positive sentiments. All stakeholders defined cure differently but communicated about it in relation to disease measurements (e.g. prostate-specific antigen) or surgery. Stakeholders preferred different terms when discussing cure in PC: Cure (academic researchers), Cure rates (HCPs), Potential cure and Survivor/Survivorship (policymakers) and Cure and Survivor (general public).
    CONCLUSIONS: This human-led, AI-assisted large-scale qualitative language-based research revealed that cure was commonly discussed by academic researchers, HCPs, policymakers and the general public, especially in early-stage PC. Stakeholders defined and contextualised cure in their communications differently and associated it with positive value.
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  • 文章类型: Journal Article
    本系统综述旨在全面总结当前关于立体定向放射治疗(SBRT)在各种胰腺癌临床环境中的前瞻性证据,包括将其用作临界可切除胰腺癌(BRPC)的新辅助治疗。局部晚期胰腺癌(LAPC)的诱导治疗,孤立性局部复发(ILR)的挽救治疗,根治性切除术后的辅助治疗,作为一种姑息治疗。特别注意磁共振引导放射治疗(MRgRT)的应用。
    遵循PRISMA准则,我们通过PubMed对Medline数据库进行了系统评价,重点关注过去10年发表的前瞻性研究.提取有关研究特征的数据,结果衡量标准,毒性概况,SBRT剂量和分级方案,以及其他系统疗法。
    本综述共纳入了1,571例患者的31项研究,包括14项LAPC研究,9用于新辅助治疗,2用于辅助治疗,2用于ILR,另有4项研究评估MRgRT。在LAPC,SBRT展示了令人鼓舞的结果,以有利的局部控制率为特征。一些研究甚至报告转化为可切除的疾病,切除率达到39%。MRgRT的采用可以为挑战提供解决方案,以递送消融剂量,同时最小化严重毒性。在BRPC中,选择的前瞻性研究将术前消融剂量SBRT与现代诱导全身治疗相结合,已取得了高达80%的显著切除率.MRgRT在这种情况下也具有潜力。辅助SBRT似乎没有赋予化疗的相关优势。虽然SBRT在ILR和姑息性疼痛缓解方面的前瞻性数据有限,他们证实了回顾性研究的积极结果。
    UNASSIGNED: This systematic review aims to comprehensively summarize the current prospective evidence regarding Stereotactic Body Radiotherapy (SBRT) in various clinical contexts for pancreatic cancer including its use as neoadjuvant therapy for borderline resectable pancreatic cancer (BRPC), induction therapy for locally advanced pancreatic cancer (LAPC), salvage therapy for isolated local recurrence (ILR), adjuvant therapy after radical resection, and as a palliative treatment. Special attention is given to the application of magnetic resonance-guided radiotherapy (MRgRT).
    UNASSIGNED: Following PRISMA guidelines, a systematic review of the Medline database via PubMed was conducted focusing on prospective studies published within the past decade. Data were extracted concerning study characteristics, outcome measures, toxicity profiles, SBRT dosage and fractionation regimens, as well as additional systemic therapies.
    UNASSIGNED: 31 studies with in total 1,571 patients were included in this review encompassing 14 studies for LAPC, 9 for neoadjuvant treatment, 2 for adjuvant treatment, 2 for ILR, with an additional 4 studies evaluating MRgRT. In LAPC, SBRT demonstrates encouraging results, characterized by favorable local control rates. Several studies even report conversion to resectable disease with substantial resection rates reaching 39%. The adoption of MRgRT may provide a solution to the challenge to deliver ablative doses while minimizing severe toxicities. In BRPC, select prospective studies combining preoperative ablative-dose SBRT with modern induction systemic therapies have achieved remarkable resection rates of up to 80%. MRgRT also holds potential in this context. Adjuvant SBRT does not appear to confer relevant advantages over chemotherapy. While prospective data for SBRT in ILR and for palliative pain relief are limited, they corroborate positive findings from retrospective studies.
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  • 文章类型: Journal Article
    局部晚期胰腺癌患者(LAPC)的最佳治疗策略尚未建立。我们的目的是评估FOLFIRINOX(FFN)或吉西他滨-纳巴紫杉醇(GemNab)新辅助治疗后的手术如何影响这些患者的临床结局。回顾性分析在我们机构治疗的LAPC患者以达到这一目标。该组特征相似:35例患者接受FOLFIRINOX方案治疗,21例患者接受吉西他滨Nab-紫杉醇治疗。接受手术的患者人数在FFN组为14(40%),在GemNab组为6(28.6%)。FFN组的中位无病生存期(DFS)为77.10周,GemNab组为58.65周(p=0.625),而未切除组的中位PFS在FFN组为49.4周,在GemNab组为30.9周(p=0.0029,95%CI0.138-0.862,HR0.345).切除人群的总生存期(OS)需要更长的随访才能完全评估,而在未切除的人群中,FFN组的中位总生存期(mOS)分别为72.10周和GemNab组的53.30周(p=0.06)。手术是LAPC患者的有价值的选择,并且能够诱导相关的生存优势。FOLFIRINOX和Gem-Nab紫杉醇应作为局部晚期胰腺癌患者的首选选择。
    The optimal therapeutic strategy for locally advanced pancreatic cancer patients (LAPC) has not yet been established. Our aim is to evaluate how surgery after neoadjuvant treatment with either FOLFIRINOX (FFN) or Gemcitabine-NabPaclitaxel (GemNab) affects the clinical outcome in these patients. LAPC patients treated at our institution were retrospectively analysed to reach this goal. The group characteristics were similar: 35 patients were treated with the FOLFIRINOX regimen and 21 patients with Gemcitabine Nab-Paclitaxel. The number of patients undergoing surgery was 14 in the FFN group (40%) and six in the GemNab group (28.6%). The median Disease-Free Survival (DFS) was 77.10 weeks in the FFN group and 58.65 weeks in the Gem Nab group (p = 0.625), while the median PFS in the unresected group was 49.4 weeks in the FFN group and 30.9 in the GemNab group (p = 0.0029, 95% CI 0.138-0.862, HR 0.345). The overall survival (OS) in the resected population needs a longer follow up to be completely assessed, while the median overall survival (mOS) in the FFN group was 72.10 weeks and 53.30 weeks for the GemNab group (p = 0.06) in the unresected population. Surgery is a valuable option for LAPC patients and it is able to induce a relevant survival advantage. FOLFIRINOX and Gem-NabPaclitaxel should be offered as first options to pancreatic cancer patients in the locally advanced setting.
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