Wuzhou Red Cross Hospital

This aim of the study was to compare the outcomes of radiation-induced hepatic toxicity (RIHT) of hepatocellular carcinoma (HCC) patients treated with radiotherapy (RT) combined with immune checkpoint inhibitors (ICIs) and targeted therapy with those of RT alone or RT combined with ICIs. A total of 146 patients with HCC who received RT between January 2017, and May 2023 were enrolled in the study; 50 and 96 patients received a combination of RT with ICIs plus targeted therapy (triple therapy), and RT alone or RT plus ICIs (RT/RT+ICIs), respectively. Propensity-score matched (PSM) analyses were performed to compare the hepatotoxicity, dosimetric, and clinical parameters between the groups. Non-classical radiation-induced liver disease (ncRILD) was evaluated using univariate and multivariate analyses. After matching, 50 patients were included per group. The ncRILD rates were 16.0% in the triple therapy group and 18.0% in the RT/RT+ICIs group, respectively (p = 0.790). Increased Child-Pugh (CP) scores ≥ 2 were observed in 16.0% each of the triple therapy and RT/RT+ICIs groups (p = 1.000). Increased CP scores ≥ 1 were observed in 38.0% and 40.0% of the triple therapy and RT/RT+ICIs groups, respectively (p = 0.838). The groups did not differ significantly in all hepatotoxicity metrics after PSM (p > 0.05). Normal liver volume (Vliver) was an independent predictor of ncRILD in the matched cohort. RT in combination with ICIs and targeted therapy is a seemingly safe treatment modality and achieves comparable RIHT with RT/RT+ICIs in HCC patients. Higher Vliver values indicate lower risks of developing ncRILD.

Objective:To compare the clinical outcomes of reconstruction of oral and maxillofacial soft tissue defects using superficial circumflex iliac artery perforator flap （SCIA PF） and radial forearm free flap （RFF）. Methods:A retrospective analysis was conducted on 90 patients with head, neck, and maxillofacial tumors who were treated in our department from June 2019 to January 2024. Patients were divided into two groups based on the surgical method used: the SCIA group（n=45）, who underwent reconstruction with SCIA PF, and the RFF group（n=45）, who received RFF reconstruction. Six months postoperatively, clinical efficacy was evaluated by comparing flap swelling, flap survival rate, and patient satisfaction. Oral function was assessed using standardized scoring systems before surgery, at 1 week, 3 months, and 6 months post-surgery. Hemorheological parameters, including high-shear viscosity（shear rate 200/s）, low-shear viscosity（shear rate 30/s）, plasma viscosity, erythrocyte aggregation index, and erythrocyte sedimentation rate（ESR）, were also measured at each time point. Results:Compared with the RFF group, the SCIA group showed significantly larger flap size, longer flap harvesting and reconstruction times, earlier nasogastric tube removal and oral intake initiation, higher scores in all aspects of oral function, reduced flap edema and faster resolution, higher flap survival rates, and greater overall satisfaction （all P<0.05）. During the follow-up period （preoperative, 1 week, 3 months, and 6 months post-surgery）, hemorheological indices including high-and low-shear viscosity, plasma viscosity, erythrocyte aggregation index, and ESR progressively decreased in the SCIA group （P<0.05）. In the RFF group, these parameters improved significantly by 6 months postoperatively compared with preoperatively and 1-week postoperatively, with a notable decrease in erythrocyte aggregation index at 6 months （P<0.05）. Conclusion:Compared with RFF, SCIA PF provides larger flaps, better functional recovery, higher patient satisfaction, improved flap survival, fewer complications, and more favorable hemorheological profiles following reconstructive surgery for oral and maxillofacial defects.

The influence of COVID-19 vaccination before chemoradiotherapy on nonmetastatic nasopharyngeal carcinoma (NPC) is not known. Propensity score matching was used to minimize potential selection bias between groups. Primary endpoints were treatment-related adverse events (TRAEs). The Kaplan-Meier method and Cox proportional hazards models were performed to conduct survival analysis. The Benjamini-Hochberg false discovery rate control procedure was used to adjust for multiple comparisons. Eight hundred ninety-three patients with newly diagnosed nonmetastatic NPC were enrolled. On propensity score matching analysis, vaccinated group exhibited higher prevalence of neutropenia (p = 0.049), fatigue (p = 0.011) during induction chemotherapy, and higher prevalence of fatigue (p =0.016) during radiotherapy after adjustment for multiple comparisons. [Correction added after first online publication on 20 March 2025. P values have been updated in this sentence.] No significant differences were observed in 2-year OS, PFS, DMFS, and LRRFS in matched groups. Additionally, vaccinated patients exhibited a high and comparable absolute lymphocyte count. COVID-19 vaccination before chemoradiotherapy increases the prevalence of acute TRAEs, while no significant influence is observed on the oncologic outcomes of patients with nonmetastatic NPC.

[This corrects the article DOI: 10.1515/tnsci-2020-0127.].

Growing research proves gut microbiota and thyroid autoimmunity are linked. Graves’ disease (GD), as an autoimmune thyroid disease (AITD), is attributed to the production of thyroid-stimulating hormone receptor (TSHR) autoantibodies that bind to the thyroid follicular endothelial cells. It is well known that genetic factors, environmental factors, and immune disorders count for much in the development of GD. So far, the pathogenesis of GD is not elucidated. Emerging research reveals that the change in gut microbiota composition and its metabolites are related to GD. The gut microbial diversity is reduced in GDs compared with healthy controls (HCs). Firmicutes and Bacteroidetes account for a large proportion at the genus level. It is found that phyla Bacteroidetes increased while phyla Firmicutes decreased in Graves’ Disease patients (GD patients). Moreover, gut microbiota modulates the immune system to produce cytokines through bacterial metabolites. This article aims to find out the relation between gut microbiota dysbiosis and the development of GD. As more molecular pathways of bacterial metabolites are revealed, targeting microbiota is expected to the treatment of GD.

ABSTRACT Objective To describe cytokine release syndrome (CRS) associated with immune checkpoint inhibitors (ICIs) reported in the FDA Adverse Event Reporting System (FAERS). Methods We obtained ICIs adverse event (AE) reports from January 2011 to September 2023 from the FAERS database. The preferred term (PT) ‘cytokine release syndrome’ from the Medical Dictionary for Regulatory Activities (MedDRA) 26.1 was used to identify cases with ICIs-related CRS. The reporting odds ratio (ROR) of the disproportionality method was performed to quantify the association between CRS and ICIs treatment strategy. Results Three hundred and ninety-five cases were gathered. 42.03% of the patients were aged 18 to 65. Male patients outnumbered female patients (53.67% vs. 34.94%). The prevalent potential cancer types were lung cancer (33.42%) and skin cancer (20.51%). Japanese were responsible for the majority of ICIs-related CRS cases (176 cases). The combination of nivolumab and ipilimumab resulted in the most CRS cases (138 cases), and the ICIs combination therapy had the highest ROR signal value (ROR = 11.95 [10.14–14.06]). ICIs-related CRS had a median time to onset of 14 days (interquartile range [IQR] 7–43.25). Conclusions ICIs-related CRS is an increasingly important immune-related AE. Our study provided helpful information to help medical professionals learn more about ICIs-related CRS.

Abstract Background: The influence of COVID-19 vaccination on treatment of non-metastatic nasopharyngeal carcinoma (NPC) who were newly diagnosed after the widespread vaccination against COVID-19 and subsequently treated withchemoradiotherapy is not known. Methods: We performed a retrospective cohort study, patients in the vaccinated group had received at least one COVID-19 vaccination before chemoradiotherapy and those in the control group had not. Propensity score matching was used to minimize potential selection bias between groups. Primary endpoints were acute and late treatment-relatedadverse events (TRAEs). Secondary endpoints included overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRRFS) at 2 years. Results: Our study enrolled 893 patients with newly diagnosed non-metastatic NPC between May 2020 and December 2021. At last follow-up on December 31, 2023, the median follow-up was 31.6 months (interquartile range [IQR], 28 to 35.5 months). On propensity score matching analysis, vaccinated group had higher prevalence of grade-3–4 neutropenia (24.2% vs. 18.0%, P=0.048), grade-1–2 fatigue (41.9% vs. 23.9%, P＜0.001), grade-1–2 nausea/vomiting (66.7% vs. 58.4%, P=0.026) during induction chemotherapy, and grade-1–2 fatigue (58.4% vs. 43.1%, P＜0.001) during radiotherapy. No significant differences were observed in OS (97.6% vs. 98.5%, P=0.401), PFS (91.7% vs. 87.9%, P=0.097), DMFS (93.2% vs. 91.4%, P=0.385), or LRRFS (95.3% vs. 94.1%, P=0.494) at 2 years in matched groups. Conclusions: COVID-19 vaccination is associated with higher prevalence of acute TRAEs, while no significant influence is observed on the oncologic outcomes of patients with non-metastatic NPC.

Induction chemotherapy plus concurrent chemoradiotherapy is recommended for locoregionally advanced nasopharyngeal carcinoma but is associated with higher rates of acute toxic effects and low compliance. Evidence on de-escalating treatment intensity after induction chemotherapy is limited. To assess if radiotherapy was noninferior to chemoradiotherapy after induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma. From April 2015 to March 2018, a multicenter, open-label, randomized, noninferiority, phase 3 trial was conducted at 5 Chinese hospitals. A total of 383 patients aged 18 to 70 years with an untreated histologically confirmed nonkeratinizing tumor, Karnofsky performance status score not worse than 70, proper organ function, and stage III to IVB nasopharyngeal cancer were enrolled. Data were analyzed from April 2023 to June 2023. Patients were assigned randomly. Both groups received 3 cycles of induction chemotherapy consisting of intravenous administration (on day 1) of cisplatin at 60 mg/m2 and docetaxel at 60 mg/m2 and continuous intravenous infusion (from day 1 to day 5) of daily fluorouracil (600 mg/m2), repeated every 21 days. Subsequently, the patients received radiotherapy alone (induction chemotherapy in combination with radiotherapy [IC-RT] group) or concomitant cisplatin (30 mg/m2/week) with radiotherapy for 6 to 7 weeks (induction chemotherapy combined with chemoradiotherapy [IC-CCRT] group). The primary end point was 3-year progression-free survival (time from the initiation of therapy until the first indication of disease progression or death), with a noninferiority margin of 10%. The secondary end points included overall survival, locoregional failure-free survival, distant metastasis-free survival, response rate, and toxic effects. A total of 383 patients (median [range] age, 48 [19-70] years; 100 women [26%]). Median follow-up time was 76 months (IQR, 70-89 months). The 3-year progression-free survival was 76.2% and 76.8% in the IC-RT (n = 193) and IC-CCRT groups (n = 190), respectively, in the intention-to-treat population, showing a difference of 0.6% (95% CI, -7.9% to 9.1%; P = .01 for noninferiority). Identical outcomes were reported in the per-protocol population. The incidence of grade 3 to 4 short-term toxic effects in the IC-RT group was less than the IC-CCRT group. No differences were observed in late toxic effects. The results of this randomized clinical trial suggest that after induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma, radiotherapy alone was noninferior to chemoradiotherapy in terms of 3-year progression-free survival. ClinicalTrials.gov Identifier: NCT02434614.