Today's treatments cannot cure GBM patients but only extend their overall survival. The use of chemoradiation, immunotherapy, and radio sensitizers as an adjuvant therapy cannot reduce the high rates of recurrence within a few months after treatment. Radiotherapy will remain the backbone of the treatment but new treatment modalities must be developed.
BackgroundRadiation therapy (rt) is a longstanding treatment modality for cancer. In addition, immune checkpoint blockade has been a significant development in the field of immunotherapy, modifying key immunosuppressive pathways of cancer cells.MethodsThe aim of the present work was to review current concepts of rt and immunotherapy synergism, the abscopal effect, and the molecular effects of rt in the tumour microenvironment, its influence on immune stimulation, and potential clinical outcomes that might evolve from ongoing studies. We also discuss potential predictors of clinical response.ResultsUp-to-date literature concerning the mechanisms, interactions, and latest knowledge about rt and immunotherapy was reviewed and summarized, and is presented here.ConclusionsThe possibility of using hyperfractionated rt to combine an abscopal effect with the enhanced effect of immune treatment using checkpoint blockade is a very promising method for future tumour treatments.
Background:
Chemotherapy-induced peripheral neuropathy (CIPN) is considered
a severe side effect of therapeutic agents with limited treatment options. The incidence of
CIPN in cancer patients is approximately 3–7% in cytostatic monotherapy and as high as 38%
in cases of polychemotherapy. The prevalence of CIPN was found to be 68% within the first
month of chemotherapy treatment. In some cases, CIPN can resolve, partially or completely,
after completion of the treatment; in other cases, it can remain for a long time and affect the
patient's quality of life.
Objective:
The aim of this study is to present up-to-date data regarding available treatment
options for the management of CIPN.
Materials and Methods:
The up-to-date guidelines of ESMO (European Society for Medical
Oncology), ASCO (American Society of Clinical Oncology), ONS (Oncology Nursing Society),
NCI (National Cancer Institute), and NCCN (National Comprehensive Cancer Network)
were reviewed and included in the manuscript.
Results:
The use of tricyclic antidepressant (TCA), selective serotonin norepinephrine reuptake
inhibitor (SSNRI), pregabalin, and gabapentin are recommended as first-line treatment.
Other treatment options were offered as second and third lines of treatment (lidocaine patches,
capsaicin high-concentration patches, tramadol, and strong opioids, respectively); however,
lower significance was demonstrated. Inconclusive results were found in the use of cannabinoids,
drug combinations, antiepileptics, antidepressants, and topical drugs.
Conclusion:
TCA, other antidepressants, and opioids could be recommended as treatment.
Yet, we could not recommend an ideal therapeutic agent for the prevention or treatment of
CIPN. Therefore, CIPN continues to be a challenge to clinicians and our patients.
Vertical incision results in shorter scars but may be associated with increased incidence of haematomas. Meticulous closure of the subcutaneous tissue is recommended.
Background
Plate breakage is one form of construct failure after a clavicle fracture treated with an open reduction and plate fixation. A recent study evaluated construct failure after an open reduction and plate fixation and reported a construct failure rate of 6.9% of which 1.9% were related to broken plates. Plate breakage is rare, thus, there are insufficient data regarding risk factors, pathogenesis, or how to avoid it.
Case presentation
This case report presents an unusual case of a 35-year-old Caucasian man, 7 weeks after open reduction and internal plate fixation of a fracture in the middle third of his clavicle, who developed breakage of the implant. Surgery was advised, the implant was retrieved, the fracture was reduced, and a new bridging locking plate was implanted.
Conclusions
In the current case it seems that the use of a bridging plate, the fundamental anatomical structure of the clavicle and the forces that are applied on it, the lack of discipline in complying with the postoperative functional restrictions, and an unclear “patient expectation” process were the main reasons for the failure. These aspects should be carefully considered and addressed in clavicle fractures.
The use of the cannabis plant for various medical indications by cancer patients has been rising significantly in the past few years in several European countries, the US and Israel. The increase in use comes from public demand for the most part, and not due to a scientific basis. Cannabis chemistry is complex, and the isolation and extraction of the active ingredient remain difficult. The active agent in cannabis is unique among psychoactive plant materials, as it contains no nitrogen and, thus, is not an alkaloid. Alongside inconclusive evidence of increased risks of lung and head and neck cancers from prolonged smoking of the plant produce, laboratory evidence of the anti-cancer effects of plant components exists, but with no clinical research in this direction. The beneficial effects of treatment with the plant, or treatment with medicine produced from its components, are related to symptoms of the disease: pain, nausea and vomiting, loss of appetite and weight loss. The clinical evidence of the efficacy of cannabis for these indications is only partial. However, recent scientific data from studies with THC and cannabidiol combinations report the first clinical indication of cancer-related pain relief. The difficulties of performing research into products that are not medicinal, such as cannabis, have not allowed a true study of the cannabis plant extract although, from the public point of view, such studies are greatly desirable.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.