• 文章类型: Journal Article
    目的:本综述的目的是对鼻窦恶性肿瘤的诊断和治疗进行系统的文献综述。根据PRISMA指南对文献进行系统综述。
    结果:共分析5篇文献中的11,653例。3824例患者接受了适当的治疗。鼻窦恶性肿瘤组中最常见的组织型是鳞状细胞癌。鳞状细胞癌占54%。其他组织病理学亚型为美学神经母细胞瘤,占9.9%,黑色素瘤9.8%,腺癌7,5%,肉瘤7,3%,腺囊性癌7,1%,鼻窦未分化癌3,9%,鼻窦神经内分泌癌分别为2,8%。总共3824例中的772例仅通过手术治疗。3824例中62例,均未手术治疗。20例质子技术和SFUD,42例采用质子技术和IMRT。3824例中的其他2990例采用多模式治疗。鼻窦肿瘤的诊断和治疗需要跨学科的方法和多模式的治疗。
    OBJECTIVE: The purpose of this review is to analyze the diagnosis and treatments of the sinonasal malignant tumors throw systematic reviewed literature. The systematic review of the literature was performed according to PRISMA guidelines.
    RESULTS: Total 11,653 cases of five article were analyzed. The cohort of 3824 cases received appropriate treatment. The most frequent histotype of the group of sinonasal malignancies was squamous cell carcinoma. Squamous cell carcinoma was represented by 54%. The other histopathological subtypes were esthesioneuroblastoma with 9,9%, melanoma 9,8%, adenocarcinoma 7,5%, sarcoma 7,3%, adeno cystic carcinoma 7,1%, sinonasal undifferentiated carcinoma 3,9%, sinonasal neuroendocrine carcinoma 2,8% respectively. All 772 cases of total 3824 were treated only surgically. All 62 cases of total 3824 were treated without surgery, 20 cases with proton technique and SFUD, and 42 cases with proton technique and IMRT. The other 2990 cases of total 3824 were treated with multimodality treatment. The diagnosis and treatment of sinonasal cancers require a interdisciplinary approach and multimodality treatment.
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  • 文章类型: Journal Article
    在2023年,美国泌尿外科协会(AUA)要求进行更新文献综述(ULR),以纳入自本指南2019年发布以来产生的新证据。由此产生的2024年指南修正案提出了更新的建议,为前列腺治疗(IPT)后尿失禁患者的护理提供指导。
    2023年,IPT指南通过AUA修订过程进行了更新,在该过程中,对新发布的文献进行了审查,并将其整合到先前发布的指南中。最初在初步摘要综述中确定了82项感兴趣的研究。在全文审查之后,17项研究符合纳入标准,并最终告知了感兴趣的陈述。
    专家小组根据最新的综述制定了基于证据和共识的声明,为经历IPT的患者的护理提供指导。这些更新在这里详细介绍。
    随着前列腺治疗的完善,预计失禁的发生率会下降。随着IPT患者的诊断和治疗方案的不断发展,本指南将需要进一步审查。
    UNASSIGNED: In 2023 the American Urological Association (AUA) requested an Update Literature Review (ULR) to incorporate new evidence generated since the 2019 publication of this Guideline. The resulting 2024 Guideline Amendment addresses updated recommendations to provide guidance for the care of patients with incontinence after prostate treatment (IPT).
    UNASSIGNED: In 2023, the IPT Guideline was updated through the AUA amendment process in which newly published literature is reviewed and integrated into previously published guidelines. There were 82 studies of interest initially identified in preliminary abstract review. Following full-text review, 17 studies met inclusion criteria and ultimately informed the statements of interest.
    UNASSIGNED: The Panel developed evidence- and consensus-based statements based on an updated review to provide guidance for the care of patients who experience IPT. These updates are detailed herein.
    UNASSIGNED: As prostate treatments are refined, a decreasing incidence of incontinence is anticipated. This Guideline will require further review as the diagnostic and treatment options for patients with IPT continue to evolve.
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  • 文章类型: Case Reports
    甲状腺样滤泡性肾细胞癌(TLFRCC),也称为甲状腺样滤泡状癌或甲状腺滤泡状癌,是一种非常罕见的肾细胞癌变体,最近才被承认。这种肿瘤表现出与甲状腺相似的独特滤泡形态。免疫组织化学分析显示PAX8,波形蛋白,和EMA,而甲状腺特异性标志物TG和TTF1始终不存在。此外,在临床评估中,明显没有并发甲状腺病理.以前的报道表明,TLFRCC是一种惰性物质,生长缓慢的恶性肿瘤,具有罕见的转移潜力。在这份报告中,我们介绍了一个以显著骨化和广泛转移为特征的TLFRCC病例,包括多灶性肺部病变,腹壁受累,渗入腰大肌.据我们所知,这只是甲状腺滤泡性肾癌远处转移的第三例。目前的病例证明了一种将放疗与托里帕利马结合的治疗方法,程序性细胞死亡1(PD-1)受体抑制剂,还有帕唑帕尼.这种治疗方案是根据全面的基因组图谱定制的,鉴定了POLE(DNA聚合酶epsilon的催化亚基)和ATM(共济失调-毛细血管扩张症突变)基因的突变,两者都与各种恶性肿瘤的发病机理有关。这些发现代表了一个新的发现,这样的突变从未报道过与TLFRCC相关。到目前为止,这种治疗方法已被证明是治疗转移性TLFRCC最有效的选择,这也标志着首次提到放射治疗在治疗这种特殊亚型肾细胞癌方面的潜在益处。
    Thyroid-like follicular renal cell carcinoma (TLFRCC), also known as thyroid-like follicular carcinoma of the kidney or thyroid follicular carcinoma like renal tumor, is an exceedingly rare variant of renal cell carcinoma that has only recently been acknowledged. This neoplasm exhibits a distinct follicular morphology resembling that of the thyroid gland. Immunohistochemical analysis reveals positive expression of PAX8, Vimentin, and EMA, while thyroid-specific markers TG and TTF1 are consistently absent. Furthermore, there is a notable absence of any concurrent thyroid pathology on clinical evaluation. Previous reports have suggested that TLFRCC is an indolent, slow-growing malignancy with infrequent metastatic potential. In this report, we present a case of TLFRCC characterized by remarkable ossification and widespread metastasis, including multifocal pulmonary lesions, involvement of the abdominal wall, and infiltration into the psoas muscle. To our knowledge, this represents only the third documented instance of distant metastasis in thyroid follicular renal carcinoma. The current case demonstrates a therapeutic approach that combines radiotherapy with the utilization of toripalimab, a programmed cell death 1 (PD-1) receptor inhibitor, and pazopanib. This treatment regimen was tailored based on comprehensive genomic profiling, which identified mutations in the POLE (catalytic subunit of DNA polymerase epsilon) and ATM (ataxia-telangiectasia mutated) genes, both of which have been implicated in the pathogenesis of various malignant tumors. These findings represent a novel discovery, as such mutations have never been reported in association with TLFRCC. Thus far, this therapeutic approach has proven to be the most efficacious option for treating metastatic TLFRCC among previously reported, and it also marks the first mention of the potential benefits of radiotherapy in managing this particular subtype of renal cell carcinoma.
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  • 文章类型: Journal Article
    The simultaneous objectives of destroying tumor cells while protecting normal pelvic organs present a dual clinical and technical challenge within the realm of pelvic tumor radiotherapy. This article reviews the latest literatures, focusing on technological innovations in key aspects of radiotherapy such as positioning, planning, and delivery. These include positioning fixation techniques, organ-at-risk avoidance irradiation, non-coplanar irradiation techniques, as well as organ displacement protection and image-guided adaptive techniques. It summarizes and discusses the research progress made in the protection of critical organs during pelvic tumor radiotherapy. The paper emphasizes technological advancements in the protection of critical organs throughout the processes of radiotherapy positioning, planning, and implementation, aiming to provide references for further research on the protection of critical organs in the external irradiation treatment of pelvic tumors.
    如何在摧毁肿瘤细胞的同时保护盆腔内的正常器官,是盆腔肿瘤放射治疗领域在临床和技术上面临的双重挑战。本文通过评述最新文献,聚焦于放疗定位、计划设计、实施等关键环节中的技术创新,包括:摆位固定技术、危及器官避让照射技术和非共面照射技术,以及器官移位保护和图像引导的自适应技术等,总结并讨论了盆腔肿瘤放疗中危及器官保护的研究进展。本文重点关注放疗定位、计划设计、实施各环节中危及器官保护的技术进展,旨在为盆腔肿瘤外照射放疗中危及器官保护的进一步研究奠定基础。.
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  • 文章类型: Journal Article
    通过治疗方案抑制肿瘤微环境中的免疫应答可以阻碍肿瘤的根除,可能导致肿瘤转移。作为一种非侵入性的治疗方法,放射治疗用于肿瘤消融。在这项研究中,我们的目的是提高放疗的治疗效果和触发免疫反应,通过制定一个苯并噻唑(BTS)-亚磺酸酯(BTS)-负载融合脂质体(BFL)纳米平台,然后与放疗相结合进行抗癌治疗。血小板细胞膜,配备独特的表面受体,使BFL能够有效地靶向肿瘤,同时逃避免疫系统并粘附于肿瘤细胞。这有助于BFL被癌细胞吞噬,随后释放其中的BTS。发布后,BTS生产二氧化硫(SO2)用于气体治疗,启动细胞内谷胱甘肽(GSH)的氧化。这个过程证明了在放射治疗后修复损伤的有效性,从而实现有效的放射增敏。揭示了在BFL促进的增强的放射增敏作用后触发了免疫应答。这种方法促进了淋巴结内树突状细胞(DC)的成熟,导致远端肿瘤中T细胞比例增加。这导致原发性肿瘤的显著根除和远处肿瘤生长的抑制。总之,个性化BFL与放疗的整合显示出增强肿瘤免疫反应和消除肿瘤的潜力,包括转移。
    The inhibition of the immune response in the tumor microenvironment by therapy regimens can impede the eradication of tumors, potentially resulting in tumor metastasis. As a non-invasive therapeutic method, radiotherapy is utilized for tumor ablation. In this study, we aimed to improve the therapeutic impact of radiotherapy and trigger an immune response by formulating a benzothiazole sulfinate (BTS)-loaded fusion liposome (BFL) nanoplatform, which was then combined with radiotherapy for anti-cancer treatment. The platelet cell membrane, equipped with distinctive surface receptors, enables BFL to effectively target tumors while evading the immune system and adhering to tumor cells. This facilitates BFL\'s engulfment by cancer cells, subsequently releasing BTS within them. Following the release, the BTS produces sulfur dioxide (SO2) for gas therapy, initiating the oxidation of intracellular glutathione (GSH). This process demonstrates efficacy in repairing damage post-radiotherapy, thereby achieving effective radiosensitization. It was revealed that an immune response was triggered following the enhanced radiosensitization facilitated by BFL. This approach facilitated the maturation of dendritic cell (DC) within lymph nodes, leading to an increase in the proportion of T cells in distant tumors. This resulted in significant eradication of primary tumors and inhibition of growth in distant tumors. In summary, the integration of personalized BFL with radiotherapy shows potential in enhancing both tumor immune response and the elimination of tumors, including metastasis.
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  • 文章类型: Journal Article
    这项研究强调了将纳米技术与传统疗法结合在癌症治疗中的潜力,特别是对于像胰腺癌这样具有挑战性的病例。我们旨在通过研究金纳米颗粒(GNP)和多西他赛(DTX)作为潜在的放射增敏剂在体外和体内放疗(RT)中的协同作用来增强胰腺癌的治疗。利用MIAPaCa-2单培养球体模型和皮下植入MIAPaCa-2细胞的NRG小鼠,分别。用GNP(7.5μg/mL)处理球体,DTX(100nM),和使用6MV线性加速器的2GyRT。并行,小鼠接受GNP治疗(2mg/kg),DTX(6mg/kg),和5Gy的RT(6MV直线加速器)。体外结果表明,尽管RT和DTX减小了球状体大小并增加了DNADSB,DTX/RT/GNP的三重组合导致球体大小显着减少48%(p=0.05),DNADSB增加45%(p=0.05)。体内结果显示用(GNP/RT/DTX)治疗后20天肿瘤生长减少20%(p=0.05),并且小鼠中位存活增加。三联组合表现出协同效应,增强抗癌功效超越个体治疗,因此可用于改善放射治疗并潜在地减少不良反应。
    This research underscores the potential of combining nanotechnology with conventional therapies in cancer treatment, particularly for challenging cases like pancreatic cancer. We aimed to enhance pancreatic cancer treatment by investigating the synergistic effects of gold nanoparticles (GNPs) and docetaxel (DTX) as potential radiosensitizers in radiotherapy (RT) both in vitro and in vivo, utilizing a MIA PaCa-2 monoculture spheroid model and NRG mice subcutaneously implanted with MIA PaCa-2 cells, respectively. Spheroids were treated with GNPs (7.5 μg/mL), DTX (100 nM), and 2 Gy of RT using a 6 MV linear accelerator. In parallel, mice received treatments of GNPs (2 mg/kg), DTX (6 mg/kg), and 5 Gy of RT (6 MV linear accelerator). In vitro results showed that though RT and DTX reduced spheroid size and increased DNA DSBs, the triple combination of DTX/RT/GNPs led to a significant 48% (p = 0.05) decrease in spheroid size and a 45% (p = 0.05) increase in DNA DSBs. In vivo results showed a 20% (p = 0.05) reduction in tumor growth 20 days post-treatment with (GNPs/RT/DTX) and an increase in mice median survival. The triple combination exhibited a synergistic effect, enhancing anticancer efficacy beyond individual treatments, and thus could be employed to improve radiotherapy and potentially reduce adverse effects.
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  • 文章类型: Journal Article
    幸福感可以反映人们的心理状况,并与生理参数一起用于评估患者的身心健康。现代医疗环境越来越多地融入数字载体,人机交互设备,明智的空间,以及执行合适的算法。在健康的人机交互中,慢设计通常被用来反映人们对行为或对象的依赖或支持,促进行为的稳定性以及有意义和积极的变化。因此,在这项研究中,我们提出了一个慢感知模型,开发一个缓慢的福利园艺系统,并使用它来评估放射治疗患者在治疗和园艺治疗期间的行为数据。本研究基于SENS和慢速设计,将医院休息室设置为合理的空间并建立传感器系统。经过10天的检查,对该过程进行了评估和验证。最终,来自面部检测(微笑)和HRV的数据显示,实验组的患者的幸福感得到了显着改善,感觉比那些在正常治疗中保持最常见状态的对照组更好。因此,可以推断,慢幸福园艺模型确实是有效的,可以进一步发展。
    Well-being can reflect people\'s psychological conditions and be used alongside physiological parameters to evaluate patients\' physical and mental health. The modern medical environment increasingly incorporates digital carriers, human-computer interaction devices, sensible spaces, and the execution of suitable algorithms. Slow design in healthy human-computer interaction is often used to reflect people\'s dependence on or support from behaviors or objects, promoting the stability of behaviors as well as meaningful and positive changes. Therefore, in this study, we propose a slow sensing model, develop a Slow Well-Being Gardening system, and use it to evaluate behavioral data from radiation therapy patients during treatment sessions and horticultural therapy. This study is based on SENS and slow design, setting the hospital lounge as a sensible space and establishing a sensor system. After a 10-day inspection, the process was evaluated and verified. Ultimately, data from facial detection (smile) and HRV showed that the patients in the experimental group experienced a significant improvement in their well-being, feeling better than those in the control group who maintained the most common state in normal treatment. Therefore, it can be inferred that the Slow Well-Being Gardening model is indeed valid and can be further developed.
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  • 文章类型: Journal Article
    味觉障碍(TD)在全身治疗的癌症患者中很常见,会对他们的营养状况和生活质量产生负面影响。欧盟委员会(EFSA)批准的新型食品,干奇迹浆果(DMB),含有天然的调味蛋白miraculin。DMB,也可以作为补充,已经成为TDs的一种可能的替代疗法。本研究旨在评估习惯性DMB消耗在接受积极治疗的营养不良癌症患者中的疗效和安全性。进行了一项探索性临床试验,其中31名癌症患者被随机分为三组[标准剂量的DMB(150mgDMB/片),高剂量的DMB(300mgDMB/片)或安慰剂(300mg冻干草莓)]三个月。患者在每次主餐前每天服用DMB片剂或安慰剂(早餐,午餐,和晚餐)。在五次主要访问中,电化学味觉感知,营养状况,饮食摄入量,评价了生活质量和红细胞脂肪酸谱.服用标准剂量DMB的患者随着时间的推移表现出改善的味觉敏锐度(右/左侧变化百分比:-52.8±38.5/-58.7±69.2%)和咸味感(2.29±1.25vs.高剂量:2.17±1.84vs.安慰剂:1.57±1.51分,p<0.05)。他们还具有更高的能量摄入(p=0.075),并涵盖了更好的能量消耗(107±19%)。接受标准剂量DMB(便秘,p=0.048)。摄入DMB后,随着时间的推移,红细胞中花生四烯酸(13.1±1.8;14.0±2.8,12.0±2.0%;p=0.004)和二十二碳六烯酸(4.4±1.7;4.1±1.0;3.9±1.6%;p=0.014)的水平增加。DMB的标准剂量增加了无脂肪质量与安慰剂(47.4±9.3vs.44.1±4.7kg,p=0.007)。重要的是,患有DMB的习惯性患者没有经历任何不良事件,和代谢参数保持稳定并在正常范围内。总之,习惯食用标准的150毫克剂量的DMB改善电化学食物感知,营养状况(能量摄入,脂肪的数量和质量,无脂肪质量),接受抗肿瘤治疗的营养不良癌症患者的生活质量。此外,DMB消耗似乎是安全的,与健康状况相关的主要生化参数没有变化。临床试验注册(NCT05486260)。
    Taste disorders (TDs) are common among systemically treated cancer patients and negatively impact their nutritional status and quality of life. The novel food approved by the European Commission (EFSA), dried miracle berries (DMB), contains the natural taste-modifying protein miraculin. DMB, also available as a supplement, has emerged as a possible alternative treatment for TDs. The present study aimed to evaluate the efficacy and safety of habitual DMB consumption in malnourished cancer patients undergoing active treatment. An exploratory clinical trial was carried out in which 31 cancer patients were randomized into three arms [standard dose of DMB (150 mg DMB/tablet), high dose of DMB (300 mg DMB/tablet) or placebo (300 mg freeze-dried strawberry)] for three months. Patients consumed a DMB tablet or placebo daily before each main meal (breakfast, lunch, and dinner). Throughout the five main visits, electrochemical taste perception, nutritional status, dietary intake, quality of life and the fatty acid profile of erythrocytes were evaluated. Patients consuming a standard dose of DMB exhibited improved taste acuity over time (% change right/left side: -52.8 ± 38.5/-58.7 ± 69.2%) and salty taste perception (2.29 ± 1.25 vs. high dose: 2.17 ± 1.84 vs. placebo: 1.57 ± 1.51 points, p < 0.05). They also had higher energy intake (p = 0.075) and covered better energy expenditure (107 ± 19%). The quality of life evaluated by symptom scales improved in patients receiving the standard dose of DMB (constipation, p = 0.048). The levels of arachidonic (13.1 ± 1.8; 14.0 ± 2.8, 12.0 ± 2.0%; p = 0.004) and docosahexaenoic (4.4 ± 1.7; 4.1 ± 1.0; 3.9 ± 1.6%; p = 0.014) acids in erythrocytes increased over time after DMB intake. The standard dose of DMB increased fat-free mass vs. placebo (47.4 ± 9.3 vs. 44.1 ± 4.7 kg, p = 0.007). Importantly, habitual patients with DMB did not experience any adverse events, and metabolic parameters remained stable and within normal ranges. In conclusion, habitual consumption of a standard 150 mg dose of DMB improves electrochemical food perception, nutritional status (energy intake, fat quantity and quality, fat-free mass), and quality of life in malnourished cancer patients receiving antineoplastic treatment. Additionally, DMB consumption appears to be safe, with no changes in major biochemical parameters associated with health status. Clinical trial registered (NCT05486260).
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  • 文章类型: Journal Article
    背景/目的:髓母细胞瘤是儿童最常见的恶性脑肿瘤。近几十年来,治疗环境发生了重大变化,立体定向放射外科(SRS)成为复发病例的有希望的治疗方法。我们的研究提供了对SRS在单一机构中小儿和成人患者复发性髓母细胞瘤的长期疗效和安全性的全面分析。方法:我们回顾性回顾了1998年至2023年间在我们机构接受射波刀SRS治疗复发性颅髓母细胞瘤的患者的临床和影像学记录。10例患者的15例髓母细胞瘤的随访数据可用。该队列包括8名儿科患者(3-18岁)和2名成人患者(19-75岁)。SRS时的中位年龄为13岁,中位肿瘤体积占1.9cc,生物等效剂量中位数(BED)为126Gy,单部分等效剂量(SFED)为18Gy。SRS在中值等剂量线的75%处施用。结果:中位随访39个月(范围:6-78),53.3%的髓母细胞瘤进展,下降13.3%,33.3%保持稳定。所有髓母细胞瘤的3年局部肿瘤控制率(LTC)为65%,在成人队列中观察到较低的比率(50%),在儿科患者中观察到较高的比率(67%)。3年总生存率(OS)为70%,与成人患者(50%)相比,儿科患者(75%)的发病率明显更高。3年无进展生存率(PFS)为58.3%,与成人患者(50%)相比,儿科患者的发病率更高(60%)。两名儿科患者出现放射性水肿,虽然两名成年患者在最近的随访中出现了放射性坏死,两个成年病人都去世了.结论:我们的研究为CyberknifeSRS在儿童和成人人群中治疗复发性颅髓母细胞瘤的疗效和安全性提供了一个复杂的观点。罕见的不良辐射事件(ARE)强调了SRS的安全性,加强其在提高治疗效果方面的作用。复杂的症状结果,与年龄等因素交织在一起,肿瘤位置,和之前的手术,强调需要个性化的治疗方法。我们的发现强调了正在进行的研究和开发针对复发性髓母细胞瘤的更精细治疗策略的必要性。鉴于观察到的治疗结果差异,更细致的定制治疗方法变得至关重要。
    Background/Objectives: Medulloblastoma is the most common malignant brain tumor in children. In recent decades, the therapeutic landscape has undergone significant changes, with stereotactic radiosurgery (SRS) emerging as a promising treatment for recurrent cases. Our study provides a comprehensive analysis of the long-term efficacy and safety of SRS in recurrent medulloblastomas across both pediatric and adult patients at a single institution. Methods: We retrospectively reviewed the clinical and radiological records of patients who underwent CyberKnife SRS for recurrent cranial medulloblastomas at our institution between 1998 and 2023. Follow-up data were available for 15 medulloblastomas in 10 patients. The cohort comprised eight pediatric patients (ages 3-18) and two adult patients (ages 19-75). The median age at the time of SRS was 13 years, the median tumor volume accounted for 1.9 cc, the median biologically equivalent dose (BED) was 126 Gy, and the single-fraction equivalent dose (SFED) was 18 Gy. The SRS was administered at 75% of the median isodose line. Results: Following a median follow-up of 39 months (range: 6-78), 53.3% of the medulloblastomas progressed, 13.3% regressed, and 33.3% remained stable. The 3-year local tumor control (LTC) rate for all medulloblastomas was 65%, with lower rates observed in the adult cohort (50%) and higher rates in pediatric patients (67%). The 3-year overall survival (OS) rate was 70%, with significantly higher rates in pediatric patients (75%) compared to adult patients (50%). The 3-year progression-free survival (PFS) rate was 58.3%, with higher rates in pediatric patients (60%) compared to adult patients (50%). Two pediatric patients developed radiation-induced edema, while two adult patients experienced radiation necrosis at the latest follow-up, with both adult patients passing away. Conclusions: Our study provides a complex perspective on the efficacy and safety of CyberKnife SRS in treating recurrent cranial medulloblastomas across pediatric and adult populations. The rarity of adverse radiation events (AREs) underscores the safety profile of SRS, reinforcing its role in enhancing treatment outcomes. The intricacies of symptomatic outcomes, intertwined with factors such as age, tumor location, and prior surgeries, emphasize the need for personalized treatment approaches. Our findings underscore the imperative for ongoing research and the development of more refined treatment strategies for recurrent medulloblastomas. Given the observed disparities in treatment outcomes, a more meticulous tailoring of treatment approaches becomes crucial.
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  • 文章类型: Journal Article
    背景。药物相关的颌骨坏死(MRONJ)和放射性骨坏死(ORN)与严重的残疾和持续的疼痛有关,两者都很难控制。这项研究旨在评估MRONJ和ORN患者与碘仿纱布填塞和口腔粘膜初级缝合相比,富血小板纤维蛋白(PRF)治疗的结果。方法。从医院数据库中选择了最近10年在Cluj-Napoca口腔颌面外科诊所接受治疗的MRONJ和ORN患者进行这项研究。结果。PRF治疗被证明是帮助坏死骨部位愈合的可靠方法。ASA高危患者和免疫抑制患者更容易复发和持续的体征和症状。与口服施用相比,静脉内双膦酸盐产生更强烈的症状学。与其他部位相比,后下颌骨更难治疗。Conclusions.MRONJ和ORN患者的生活质量可以通过减少疼痛和住院的方案来改善。
    Background. Medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) are associated with severe disability and continuous pain, both of which are very difficult to control. This study aims to evaluate the outcome of platelet-rich fibrin (PRF) treatment compared to iodoform gauze packing and the primary suture of oral mucosa in patients with both MRONJ and ORN. Methods. Patients suffering from MRONJ and ORN who were treated in the Oral and Maxillofacial Surgery Clinic of Cluj-Napoca in the last 10 years were selected for this study from the hospital database. Results. PRF treatment proved to be a reliable method to help heal the necrotic bone sites. High-ASA risk patients and immunosuppressed patients are more prone to recurrence and persistent signs and symptoms. Intravenous bisphosphonates produce more intense symptomatology compared to oral administration. The posterior mandible is more difficult to treat compared to other sites. Conclusions. The quality of life of MRONJ and ORN patients may be improved by a protocol that reduces pain and hospitalization.
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