cancer treatment

癌症治疗
  • 文章类型: Journal Article
    背景:乳腺癌治疗通常会对生育能力产生负面影响,这对将来想成为父母的患者构成了挑战。这项研究旨在检查卵母细胞冷冻保存的功效,胚胎冷冻保存,和卵巢组织冷冻保存在乳腺癌患者。
    方法:这项回顾性研究评估了2012年1月至2022年12月在我们中心接受生育能力保留的42例乳腺癌患者。这篇综述涵盖了患者的人口统计学特征,癌症阶段,治疗细节,以及生育力保存程序的类型及其结果。
    结果:疾病诊断的平均年龄为33.4岁。约90.4%的患者出现早期癌症(≤2)。42名患者中,26例进行了卵母细胞冷冻保存;17,胚胎冷冻保存;和2,卵巢组织冷冻保存。Further,3例患者接受混合治疗.总体活产率为63.2%。胚胎冷冻保存组中活产较多。成功妊娠组比未成功妊娠组显着年轻,并且保存的卵母细胞/胚胎数量显着高于未成功妊娠组。冷冻保存的卵母细胞和胚胎利用率分别为7.69%和52.94%,分别。这些发现强调了迅速,关于生育力保护选项的知情讨论。
    结论:保留乳腺癌患者的生育力具有良好的生殖结局,胚胎冷冻保存特别有效。及时的咨询和个性化的生育保护策略对于提高治疗后妊娠的可能性很重要。然而,未来必须对不同生育力保存方法的长期心理和情绪影响进行研究。
    BACKGROUND: Breast cancer treatments often have negative effects on fertility, which pose challenges among patients who want to be parents in the future. This study aimed to examine the efficacy of oocyte cryopreservation, embryo cryopreservation, and ovarian tissue cryopreservation in patients with breast cancer.
    METHODS: This retrospective review evaluated 42 patients with breast cancer who underwent fertility preservation at our center from January 2012 to December 2022. This review encompassed the demographic characteristics of the patients, cancer stages, treatment details, and types of fertility preservation procedures and their outcomes.
    RESULTS: The average age at disease diagnosis was 33.4 years. Approximately 90.4% of patients presented with early-stage cancer (≤2). Of 42 patients, 26 underwent oocyte cryopreservation; 17, embryo cryopreservation; and 2, ovarian tissue cryopreservation. Further, three patients received mixed treatment. The overall live birth rate was 63.2%. There are more live births in embryo cryopreservation group. The successful pregnancy group was significantly younger and had a remarkably higher quantity of preserved oocytes/embryos than the nonsuccessful pregnancy group. The oocyte and embryo utilization rates in cryopreservation were 7.69% and 52.94%, respectively. These findings underscored the importance of prompt, informed discussions about fertility preservation options.
    CONCLUSIONS: Fertility preservation in patients with breast cancer have promising reproductive outcomes, with embryo cryopreservation being particularly effective. Prompt counseling and individualized fertility preservation strategies are important for improving the likelihood of posttreatment pregnancy. Nevertheless, future research on the long-term psychological and emotional effects of different fertility preservation methods must be performed.
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  • 文章类型: Journal Article
    背景:远程医疗有利于提高癌症患者的治疗效率和降低医疗费用。这项研究的重点是癌症患者通过中国的区域远程医疗平台参与远程会诊,分析咨询过程,为远程医疗的临床应用提供参考。
    方法:我们收集了2015年至2022年通过区域远程医疗平台进行的癌症患者远程咨询的信息。利用SPSS23.0软件,我们进行了描述性分析,总结了患者性别的分布,年龄,区域,和疾病类型。采用有序logistic回归分析影响远程会诊等待时间和会诊时间的因素。
    结果:从2015年到2022年,通过区域远程医疗平台为癌症患者进行了23,060次远程咨询,平均增长率为11.09%。主要的会诊类型是肺癌,肝癌,和乳腺癌,占18.14%,10.49%,和9.46%。57.05%的远程会诊等待时间少于24小时,而患者年龄,咨询专家级,和疾病类型是影响等待时间的主要因素。50.06%的远程会诊持续时间超过20分钟,邀请医院级别和邀请顾问职称是影响咨询持续时间的主要因素。
    结论:在中国,远程医疗已广泛应用于癌症的临床诊断和治疗,涵盖各种类型的肿瘤疾病。然而,电话会诊的等待时间一般在12小时以上,指出需要加强咨询安排和分配更多专家资源,以进一步优化远程咨询的效率。此外,院外癌症门诊患者的远程健康管理需要进一步探索。
    BACKGROUND: Telemedicine is beneficial for improving treatment efficiency and reducing medical expenses of cancer patients. This study focuses on cancer patients participating in teleconsultations through a regional telemedicine platform in China, analyzes the consultation process, and provides references for the clinical application of telemedicine.
    METHODS: We collected information on teleconsultations of cancer patients conducted from 2015 to 2022 through the regional telemedicine platform. Utilizing SPSS 23.0 software, we conducted descriptive analysis to summarize the distribution of patient gender, age, region, and disease types. The ordinal logistic regression analysis was adopted to analyze the factors influencing the waiting time and consultation duration for teleconsultations.
    RESULTS: From 2015 to 2022, a total of 23,060 teleconsultations were conducted for cancer patients via regional telemedicine platform, with an average growth rate of 11.09%. The main types of consultations were for lung cancer, liver cancer, and breast cancer, accounting for 18.14%, 10.49%, and 9.46% respectively. 57.05% of teleconsultations had a waiting time of less than 24 h, while patient age, consultation expert level, and disease type were the main factors influencing the waiting time. 50.06% of teleconsultations had a duration of more than 20 min, and the inviting hospital level and the title of invited consultant were the main factors influencing the consultation duration.
    CONCLUSIONS: In China, telemedicine has been widely employed in the clinical diagnosis and treatment of cancers, covering various types of oncological diseases. However, the waiting time for teleconsultations was generally more than 12 h, indicating the need to enhance consultation scheduling and allocate more expert resources to further optimize the efficiency of teleconsultations. Additionally, further exploration is required for remote health management of outpatients with cancers outside the hospital.
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  • 文章类型: Journal Article
    UNASSIGNED: Cisplatin (Cis) is potent chemotherapy used to treating already many different types of cancer; however, it is found to correlate with nephrotoxicity and other adverse health consequences. Thymoquinone (TQ) is an antioxidant and anti-inflammatory molecule that may defend against the consequences of different chemotherapies. Thymoquinone uses, although, are negatively impacted by its weak solubility and inadequate biological availability.
    UNASSIGNED: This investigation examined the efficacy of a new nanoparticle (NP) absorbing TQ in an Ehrlich Ascites Carcinoma (EAC) mice model to address its low solubility, enhance its bioavailability, and protect against Cis-induced nephrotoxicity.
    UNASSIGNED: Following 4 treatment groups were included in this research: (1) control, (2) EAC, (3) EAC + Cis + Thymoquinone nanoparticle (TQ-NP) treated, and (4) EAC + Cis-treated.
    UNASSIGNED: The study revealed that TQ-NP was efficacious in avoiding Cis-induced kidney problems in EAC mice, as well as restoring kidney function and pathology. Thymoquinone nanoparticle considerably reduced Cis-induced oxidative damage in renal tissue by augmenting antioxidant levels. According to tumor weight and histological investigation results, TQ-NP did not impair Cis\'s anticancer efficacy.
    UNASSIGNED: Thymoquinone nanoparticle might be used as a potential drug along with Cis anticancer therapy to reduce nephrotoxicity and other side effects while maintaining Cis anticancer properties.
    UNASSIGNED: Le cisplatine (CIS) est un puissant agent chimiothérapeutique utilisé pour le traitement de nombreux types de cancers. Le cisplatine est cependant corrélé à de la néphrotoxicité et à d’autres conséquences néfastes pour la santé. La thymoquinone (TQ) est une molécule antioxydante et anti-inflammatoire qui peut protéger contre les effets néfastes de différents agents chimiothérapeutiques. Les faibles solubilité et biodisponibilité de la TQ limitent toutefois son utilisation.
    UNASSIGNED: Un modèle de souris atteintes d’un carcinome ascitique d’Ehrlich (souris EAC) a servi à vérifier l’efficacité d’une nouvelle nanoparticule (NP) absorbant la TQ pour remédier aux faibles solubilité et biodisponibilité de la TQ et protéger contre la néphrotoxicité induite par le CIS.
    UNASSIGNED: Les quatre groupes suivants ont été examinés: i) témoin; ii) souris EAC; iii) souris EAC traitées par CIS + TQ-NP (thymoquinone-nanoparticule); iv) souris EAC traitées par CIS.
    UNASSIGNED: L’étude a révélé que la TQ-NP était efficace pour éviter les problèmes rénaux induits par le CIS chez les souris EAC, de même que pour restaurer la fonction rénale et soigner la pathologie. En augmentant les niveaux d’antioxydants, la TQ-NP a considérablement réduit les dommages oxydatifs induits par le CIS dans le tissu rénal. Selon le poids des tumeurs et les résultats de l’étude histologique, la TQ-NP n’a pas altéré l’efficacité anticancéreuse du CIS.
    UNASSIGNED: La TQ-NP pourrait potentiellement être utilisée avec le traitement anticancéreux par CIS afin de réduire la néphrotoxicité et les autres effets secondaires, sans altérer les propriétés anticancer du CIS.
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  • 文章类型: Journal Article
    直肠癌几乎影响个人日常生活的方方面面。然而,在理解从诊断到康复的完整经验方面存在差距。因此,这项研究的目的是探索诊断为直肠癌的个体的治疗轨迹。采用解释性现象学方法,采用目的性抽样方法招募了7名参与者.数据是使用半结构化、以数字方式记录的深度采访,使用主题分析进行转录和分析。遵循可信度的四个维度标准建立了研究的严谨性,可靠性,可转移性和可确认性。参与者接受直肠癌治疗的经历中出现了四个突出的主题:发现内心的战斗;驾驭身体挑战;支持和征服峰会的锚。这些发现通过强调为考虑到直肠癌治疗的身体和心理情绪影响的个人提供全面和个性化治疗计划的重要性,为知识和实践做出了贡献。
    Rectal cancer affects almost every aspect of an individual\'s daily life. However, there are gaps in understanding the complete spectrum of experiences spanning from diagnosis to recovery. Therefore, the aim of this study was to explore the treatment trajectories of individuals diagnosed with rectal cancer. Adopting an interpretative phenomenological approach, seven participants were recruited using purposive sampling. Data were collected using semi-structured, in-depth interviews that were digitally recorded, transcribed and analysed using thematic analysis. Study rigour was established following the four-dimension criteria of credibility, dependability, transferability and confirmability. Four prominent themes emerged from the participants\' experiences of undergoing rectal cancer treatment: uncovering the inner battles; navigating the physical challenges; anchors of support and conquering the summit. These findings contribute to knowledge and practice by highlighting the importance of providing a comprehensive and individualised treatment plan for individuals that takes account of the physical and psycho-emotional implications of rectal cancer treatment.
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  • 文章类型: Journal Article
    目的:癌症治疗中的治疗路线(LOT)的概念通常被考虑用于肿瘤委员会和临床管理的决策。但缺乏跨医学专业的共同定义。恶性肿瘤和治疗方式的复杂性和异质性导致医生对LOT的理解不一致。这项研究评估了对LOT概念理解的异质性,它的主要尺寸,从德国肿瘤学重点不同专科医师的角度和标准。对9名医生进行了半结构化专家访谈,并使用定性内容分析进行了评估。
    结果:大多数受访者都认为LOT没有单一的定义,并且很难解释他们的理解。大多数专家表示,他们已经遇到了同事对LOT的误解,并且他们在从患者的医疗记录中破译LOT时遇到了问题。关于以下在LOT概念中的作用出现了分歧:维持治疗,治疗意向,不同的治疗方式,改变药剂,和治疗中断。受访者主要认为对于LOT的定义和LOT的变化具有决定性的相同标准(例如,进展事件或肿瘤复发的发生)。
    OBJECTIVE: The concept of lines of therapy (LOT) in cancer treatment is often considered for decision making in tumor boards and clinical management, but lacks a common definition across medical specialties. The complexity and heterogeneity of malignancies and treatment modalities contribute to an inconsistent understanding of LOT among physicians. This study assesses the heterogeneity of understandings of the LOT concept, its major dimensions, and criteria from the perspective of physicians of different specialties with an oncological focus in Germany. Semi-structured expert interviews with nine physicians were conducted and evaluated using qualitative content analysis.
    RESULTS: Most interviewees agreed that there is no single definition for LOT and found it difficult to explicate their understanding. A majority of experts stated that they had already encountered misunderstandings with colleagues regarding LOT and that they had problems with deciphering LOT from the medical records of their patients. Disagreement emerged about the roles of the following within the LOT concept: maintenance therapy, treatment intention, different therapy modalities, changing pharmaceutical agents, and therapy breaks. Respondents predominantly considered the same criteria as decisive for the definition of LOT as for a change in LOT (e.g., the occurrence of a progression event or tumor recurrence).
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    文章类型: Journal Article
    多浊度,除了癌症之外,还有慢性病的存在,对癌症幸存者特别重要。它对进展有影响,诊断阶段,预后,和癌症患者的治疗。关于不同癌症幸存者中特定合并症的患病率的证据很少,无法为多发病的预防和管理提供信息。这项研究的目的是通过使用来自多个链接的英国医疗保健数据库的大规模电子健康数据来检查28个癌症部位的多发病率患病率,从而解决这一证据差距。对于这项基于人群的横断面研究,我们将来自英国临床研究实践数据链(CPRD)GOLD数据集和医院事件统计(HES)的一级和二级医疗保健数据联系起来.我们确定了28名诊断时年龄在18岁或以上的常见癌症的幸存者,他们在癌症中存活了2年,并将他们的多发病率与没有癌症史的匹配对照进行了比较。为了比较个体合并症的患病率,多变量逻辑回归模型,使用混杂因素校正。在2010年1月1日至2020年12月31日之间,我们确定了347,028名癌症幸存者和804,299名年龄匹配的对照。性和一般实践。与所有癌症部位的非癌症对照相比,癌症幸存者的多发病率更高。高血压(56.2%),痛苦的状况(39.8%),骨关节炎(38.0%),抑郁症(31.8%)和便秘(31.4%)是报告的五种最常见的慢性疾病。与对照相比,在28个癌症部位中的25个幸存者中发现便秘的几率较高,在23个癌症部位中发现贫血的几率较高。便秘的患病率,与诊断前相比,癌症诊断后的贫血和疼痛状况更高。由于这些合并症没有被统一评估为任何合并症量表的一部分,它们在癌症幸存者中往往被低估。癌症幸存者中某些合并症的风险升高表明,在该人群中进行预防努力以降低疾病负担并改善生活质量的潜力。长期状况不应被视为癌症诊断和治疗的必然结果。我们需要考虑针对特定癌症的慢性病的综合管理,以改善癌症生存率。
    Multimorbidity, the presence of a chronic condition in addition to cancer, is of particular importance to cancer survivors. It has an impact on the progression, stage at diagnosis, prognosis, and treatment of cancer patients. Evidence is scarce on the prevalence of specific comorbidities in survivors of different cancers to inform prevention and management of multimorbidity. The objective of this study is to address this evidence gap by using large scale electronic health data from multiple linked UK healthcare databases to examine the prevalence of multimorbidity in 28 cancer sites. For this population-based cross-sectional study, we linked primary and secondary healthcare data from the UK Clinical Research Practice Datalink (CPRD) GOLD dataset and Hospital Episode Statistics (HES). We identified survivors of 28 common cancers aged 18 years or older at diagnosis who survived 2 years of cancer and compared their multimorbidity with matched controls without a history of cancer. To compare prevalence of individual comorbidity, multivariable logistic regression models, adjusted for confounding factors were used. Between January 1, 2010 and December 31, 2020, we identified 347,028 cancer survivors and 804,299 controls matched on age, sex and general practice. Cancer survivors had a higher prevalence of multimorbidity compared to non-cancer controls across all the cancer sites. Hypertension (56.2%), painful conditions (39.8%), osteoarthritis (38.0%), depression (31.8%) and constipation (31.4%) were the five most frequent chronic conditions reported. Compared to the controls, higher odds of constipation were found in survivors of 25 of the 28 cancer sites and higher odds of anaemia were found in 23 cancer sites. Prevalence of constipation, anaemia and painful conditions were higher after cancer diagnosis compared to before diagnosis. Since these comorbidities are not uniformly assessed as part of any of the comorbidity scales, they tend to be underreported among cancer survivors. The elevated risk of certain comorbidities in cancer survivors suggests the potential for preventative efforts in this population to lower disease burden and improve quality of life. Long-term conditions should not be viewed as the inevitable result of cancer diagnosis and treatment. We need to consider integrated management of chronic conditions tailored to specific cancers to improve cancer survivorship.
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  • 文章类型: Journal Article
    目的:检查并比较完成治疗的癌症幸存者和仍在接受治疗的癌症幸存者之间与癌症相关的关注水平和影响因素。
    方法:本研究采用横断面比较设计。
    方法:采用便利抽样方法,该研究包括350名土耳其癌症幸存者。数据是在2022年3月至6月之间在线收集的,具有描述性特征表格和幸存者担忧评估。获得的数据用数字进行了分析,百分比,平均值,t检验和多元线性回归分析。
    结果:完成治疗的癌症幸存者比仍在接受治疗的幸存者有更高的担忧水平。女性癌症幸存者,诊断后时间少于5年的癌症幸存者和完成癌症治疗的妇科癌症幸存者也可能有更高水平的癌症相关问题.
    结论:已完成治疗的癌症幸存者比仍在接受治疗的幸存者有更高的关注水平。性别,诊断后的时间流逝和癌症类型会影响患者的关注程度.
    护士除了身体护理外,还应评估癌症幸存者的心理社会护理和需求。提高对癌症幸存者的担忧的认识,除了那些仍在接受治疗和提供整体护理的癌症幸存者之外,还可以减少他们的担忧。
    结论:了解在癌症治疗期间和之后可能增加癌症相关问题的因素非常重要。这项研究确定了已完成或仍在接受治疗的癌症幸存者中与癌症相关的问题,并与文献中的其他研究进行了比较。
    我们坚持使用STROBE清单进行横断面研究。
    没有患者或公众参与。
    OBJECTIVE: To examine and compare the level of cancer-related concerns and affecting factors between cancer survivors who completed their treatment and those still receiving treatment.
    METHODS: The study has a cross-sectional comparative design.
    METHODS: Convenience sampling was used and the study included 350 Turkish cancer survivors. Data were collected between March and June 2022 online with a descriptive characteristics form and the Assessment of Survivor Concerns. Obtained data were analysed with numbers, percentages, mean values, t-test and multiple linear regression analysis.
    RESULTS: The cancer survivors who completed their treatment had a significantly higher level of concerns than those who were still on treatment. Female cancer survivors, cancer survivors with less than 5-year time elapsing after diagnosis and gynaecological cancer survivors with completed cancer treatment can also have a higher level of cancer-related concerns.
    CONCLUSIONS: Cancer survivors who have completed their treatment have a higher level of concerns than those who still receive treatment. Gender, time elapsing after diagnosis and type of cancer affect the level of concerns.
    UNASSIGNED: Nurses should evaluate psychosocial care and needs of cancer survivors in addition to their physical care. Raising awareness about the concerns of the cancer survivors with completed treatment in addition to those still receiving treatment and providing holistic care to them can reduce their concerns.
    CONCLUSIONS: It is of great importance to be aware of the factors likely to increase cancer-related concerns during and after cancer treatment. This study identifies cancer-related concerns in cancer survivors who completed or were still receiving treatment and provides a comparison with other studies in the literature.
    UNASSIGNED: We have adhered to STROBE statement using STROBE checklist for cross-sectional studies.
    UNASSIGNED: There was no patient or public involvement.
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  • 文章类型: Journal Article
    Envafolimab,PD-L1抑制剂,已证明在治疗晚期恶性实体瘤(AMST)方面具有潜力。为了研究其在AMST中的有效性和安全性,我们的回顾性研究招募了64名患有各种AMST的患者,并用Envafolimab(每3周400mg)治疗。我们将患者分为两组:队列1(25名患者)接受Envafolimab作为一线治疗,和队列2(39名患者)接受它作为二线或后续治疗。我们的分析重点是Envafolimab的疗效和安全性。中位随访时间为7.1个月,队列I报告疾病控制率(DCR)为72.0%,客观缓解率(ORR)为12.0%,而队列II的DCR为51.3%,ORR为5.1%。值得注意的是,与周期较少患者相比,4个以上治疗周期的患者表现出更高的DCR和更长的无进展生存期(PFS).68.8%的患者发生不良事件,严重事件(CTCAE3/4级)占14.1%。大多数不良事件是轻微的,导致只有3.1%的患者停止治疗,没有报告危及生命的事件。总之,Envafolimab是AMST的安全有效治疗方法,在初始和后期治疗阶段,特别是随着治疗持续时间的延长,值得进一步的临床试验。
    Envafolimab, a PD-L1 inhibitor, has demonstrated potential in treating advanced malignant solid tumors (AMST). To study its\' efficacy and safety in AMST, our retrospective study recruited 64 patients with various AMST, and treated with Envafolimab (400 mg every 3 weeks). We divided the patients into two cohorts: Cohort 1 (25 patients) receiving Envafolimab as first-line therapy, and Cohort 2 (39 patients) receiving it as second-line or subsequent therapy. Our analysis focused on Envafolimab\'s efficacy and safety. Over a median follow-up of 7.1 months, Cohort I reported a Disease Control Rate (DCR) of 72.0% and an Objective response rate (ORR) of 12.0%, while Cohort II had a DCR of 51.3% and an ORR of 5.1%. Notably, patients with more than four treatment cycles showed higher DCR and longer Progression-Free Survival (PFS) than those with fewer cycles. Adverse events were observed in 68.8% of patients, with severe events (CTCAE grade 3/4) in 14.1%. Most adverse events were mild, leading to treatment discontinuation in only 3.1% of patients, with no life-threatening events reported. In summary, Envafolimab is a safe and effective treatment for AMST, in both initial and later therapy stages, particularly with extended treatment duration, meriting further clinical trials.
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  • 文章类型: Observational Study
    背景:蛋白尿是抗血管内皮生长因子(VEGF)抗体治疗期间观察到的常见不良事件。蛋白尿是慢性肾脏病患者肾功能不全和心血管并发症的危险因素。然而,抗VEGF抗体诱导的蛋白尿与肾功能障碍或心血管并发症之间的关联尚不清楚.
    方法:本回顾性研究,观察性研究包括在京都大学医院接受贝伐单抗(BV)治疗的癌症患者(京都,日本)2006年1月至2018年3月。比较出现定性≥2+蛋白尿的患者和出现<1+蛋白尿的患者的不良事件发生率。不良事件被定义为肾功能不全(即,eGFR下降≥57%,与初始治疗时的发生率相比)和由于BV相关的心血管并发症和其他不良事件导致的住院率。
    结果:总计,734名患者被纳入本分析。肾功能障碍在≥2+蛋白尿患者中比在<1+蛋白尿患者中更常见(13/199,6.5%vs.12/535,2.3%)。这13例蛋白尿≥2+的患者中有7例有短暂的可逆性肾功能不全。只有四名(2.0%)患者患有BV相关的肾功能不全。在734名患者中,六个病人,16名患者,13例患者因心血管并发症的不良事件而住院,血栓栓塞,和脑血管并发症,分别。未观察到这些不良事件与蛋白尿之间的关系。
    结论:BV治疗诱导的蛋白尿与肾功能障碍或其他不良事件无关。谨慎继续BV是一种可能的治疗选择,即使在蛋白尿发展后,在癌症患者和有限的预后。
    BACKGROUND: Proteinuria is a common adverse event observed during treatment with antivascular endothelial growth factor (VEGF) antibodies. Proteinuria is a risk factor for renal dysfunction and cardiovascular complications in patients with chronic kidney disease. However, the association between anti-VEGF antibody-induced proteinuria and renal dysfunction or cardiovascular complications remains unclear.
    METHODS: This retrospective, observational study included patients with cancer that were treated with bevacizumab (BV) at Kyoto University Hospital (Kyoto, Japan) between January 2006 and March 2018. Adverse event rates were compared between patients who developed qualitative ≥ 2 + proteinuria and those who developed < 1 + proteinuria. Adverse events were defined as renal dysfunction (i.e., ≥ 57% decrease in the eGFR, compared to the rate at the initial treatment) and hospitalization due to BV-associated cardiovascular complications and other adverse events.
    RESULTS: In total, 734 patients were included in this analysis. Renal dysfunction was more common in patients with ≥ 2 + proteinuria than in those with < 1 + proteinuria (13/199, 6.5% vs. 12/535, 2.3%). Seven of these 13 patients with ≥ 2 + proteinuria had transient reversible renal dysfunction. Only four (2.0%) patients had BV-associated renal dysfunction. Of the 734 patients, six patients, 16 patients, and 13 patients were hospitalized because of the adverse events of cardiovascular complications, thromboembolisms, and cerebrovascular complications, respectively. No relationship was observed between these adverse events and proteinuria.
    CONCLUSIONS: BV treatment-induced proteinuria was not associated with renal dysfunction or other adverse events. Continuing BV with caution is a possible treatment option, even after proteinuria develops, in patients with cancer and a limited prognosis.
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  • 文章类型: Journal Article
    全球,越来越多的癌症女性在化疗期间接受促性腺激素释放激素激动剂(GnRHa)联合治疗,以保护卵巢.准则之间存在分歧,有些人建议GnRHa联合治疗乳腺癌患者,然而,GnRHa对未来生育率的影响是不确定的。
    在这项基于人群的队列研究中,我们纳入了瑞典2005年7月至2017年3月期间所有15-45岁被诊断患有癌症的女性。在瑞典癌症登记册中确定。使用规定的药物登记册捕获GnRHa共同治疗的暴露。癌症分娩后,从医学出生登记册中提取,是主要结果。次要结果包括通过自然受孕(NC)实现的分娩,不孕症诊断和癌症死亡率。对于每个结果,使用延迟进入Cox模型估计调整后的风险比(AHR)和95%置信区间(CI),按年龄和癌症部位分层。
    在24,922名被诊断患有癌症的女性中,1.5%接受了GnRHa联合治疗。在80.2%的GnRHa暴露妇女中发现了乳腺癌诊断,GnRHa暴露与更高的分娩率无关(aHR1.23,95%CI0.80-1.89)。或NC分娩(AHR1.02,95%CI0.62-1.67),而不孕症的发生率明显较高(aHR2.42,95%CI1.44-4.08)。在患有淋巴瘤和其他癌症的女性中,GnRHa暴露与较高的分娩率无关,NC分娩或不孕症。GnRHa暴露与任何癌症类型的较高癌症死亡率无关。
    我们没有发现生育能力改善或维持的证据,估计癌症后的分娩率,在癌症治疗期间接受GnRHa的女性中。
    这项研究由瑞典癌症协会的研究资助(CAN2017/704;190249Pj,200170F),瑞典研究委员会(DNR2019-00446),北欧癌症联盟NCU(赠款2017),瑞典儿童癌症基金会(KP2016-0031)福斯金斯方德(Dnr:201313),斯德哥尔摩县议会(FoUI-953912)和卡罗林斯卡学院(Dnr2020-01963)。
    UNASSIGNED: Worldwide, an increasing number of women with cancer are receiving Gonadotropin Releasing Hormone agonist (GnRHa) co-treatment during chemotherapy aiming at ovarian protection. There is divergence among guidelines, and some have recommended GnRHa co-treatment for women with breast cancer, however, the effect of GnRHa on future fertility is uncertain.
    UNASSIGNED: In this population-based cohort study we included all women diagnosed with cancer at ages 15-45 between July 2005 and March 2017 in Sweden, identified in the Swedish Cancer Register. Exposure to GnRHa co-treatment was captured using the Prescribed Drug Register. Post-cancer childbirth, extracted from the Medical Birth Register, was the main outcome. Secondary outcomes included childbirths achieved through natural conception (NC), infertility diagnosis and cancer mortality. For each outcome, adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were estimated using delayed-entry Cox models, stratified by age and cancer site.
    UNASSIGNED: Among 24,922 women diagnosed with cancer, 1.5% had GnRHa co-treatment. Breast cancer diagnoses were found in 80.2% of GnRHa exposed women and the GnRHa exposure was not associated with higher rates of childbirth (aHR 1.23, 95% CI 0.80-1.89), or NC childbirth (aHR 1.02, 95% CI 0.62-1.67), whereas the rate of infertility was significantly higher (aHR 2.42, 95% CI 1.44-4.08). In women with lymphoma and other cancers, GnRHa exposure was not associated with higher rates of childbirth, NC childbirth or infertility. GnRHa exposure was not associated with higher cancer mortality for any cancer type.
    UNASSIGNED: We did not find evidence of improved or maintained fertility, estimated as childbirth rates post-cancer, in women who received GnRHa during cancer treatment.
    UNASSIGNED: This study was financed by research grants from The Swedish Cancer Society (CAN 2017/704; 190249Pj, 200170F), The Swedish Research Council (Dnr 2019-00446), the Nordic Cancer Union NCU (Grant 2017), The Swedish Childhood Cancer Fund (KP2016-0031), Radiumhemmets Forskningsfonder (Dnr: 201313), Stockholm County Council (FoUI-953912) and Karolinska Institutet (Dnr 2020-01963).
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