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Journal of Enzyme Inhibition and... Dec 2023Twenty-five azole compounds (-) were synthesised using regioselective base-metal catalysed and microwave-assisted approaches, fully characterised by high-resolution mass...
Twenty-five azole compounds (-) were synthesised using regioselective base-metal catalysed and microwave-assisted approaches, fully characterised by high-resolution mass spectrometry (HRMS), nuclear magnetic resonance (NMR), and infrared spectra (IR) analyses, and evaluated for anticancer, anti-tyrosinase, and anti-oxidant activities and . exhibited potent anticancer activity against cells of four skin cancer (SC) lines, with selectivity for melanoma (A375, SK-Mel-28) or non-melanoma (A431, SCC-12) SC cells over non-cancerous HaCaT-keratinocytes. Clonogenic, scratch-wound, and immunoblotting assay data were consistent with anti-proliferative results, expression profiling therewith implicating intrinsic and extrinsic apoptosis activation. In a mushroom tyrosinase inhibition assay, was most potent among the compounds (half-maximal inhibitory concentration where 50% of cells are dead, IC 15.9 μM), with activity greater than arbutin and kojic acid. Also, exhibited noteworthy free radical-scavenging activity. Furthermore, docking and absorption, distribution, metabolism, excretion, and toxicity (ADMET) simulations predicted prominent-phenotypic actives to engage diverse cancer/hyperpigmentation-related targets with relatively high affinities. Altogether, promising early-stage hits were identified - some with multiple activities - warranting further hit-to-lead optimisation chemistry with further biological evaluations, towards identifying new skin-cancer and skin-pigmentation renormalising agents.
Topics: Humans; Monophenol Monooxygenase; Antioxidants; Molecular Structure; Enzyme Inhibitors; Molecular Docking Simulation; Computer Simulation; Skin Neoplasms; Azoles; Pyrazoles
PubMed: 37184042
DOI: 10.1080/14756366.2023.2205042 -
Journal of Clinical Medicine Dec 2023We investigated the clinical outcomes of patients with hepatocellular carcinoma (HCC) who underwent next-generation microwave thermosphere ablation (MTA).
BACKGROUND AND AIM
We investigated the clinical outcomes of patients with hepatocellular carcinoma (HCC) who underwent next-generation microwave thermosphere ablation (MTA).
METHODS
A total of 429 patients with 607 HCCs (maximum tumor diameter ≤40 mm) were included. We defined the following areas of the liver as those where MTA therapy is difficult to perform: caudate lobe and areas near the primary and secondary branches of the intrahepatic portal vein, inferior vena cava, gallbladder, heart, duodenum, abdominal esophagus, collateral veins around the liver, and spleen. Factors which predisposed patients to local tumor recurrence in the context of tumor location and complications were examined.
RESULTS
The primary etiologies of HCC were hepatitis-related: 259 (60.4%) cases of HCV, 31 (7.3%) cases of HBV, and two instances of both. Median maximum tumor diameter was 15.0 (interquartile range, 10.0-21.0) mm. There were 86 tumors in areas of the liver where MTA is difficult. The most common area was near the primary and secondary branches of the intrahepatic portal vein (26 nodules). The cumulative local tumor recurrence rates at 1, 2, and 3 years were 4.4%, 8.0%, and 8.5%, respectively. The cumulative local tumor recurrence rate differed significantly by tumor size group: 6.6%, 13.8%, and 29.4% at three years in the ≤20 mm group ( = 483), 20-30 mm group ( = 107), and ≥30 mm group ( = 17), respectively ( < 0.001). The cumulative local tumor recurrence rate was similar despite difficult-to-treat status ( = 0.169). In the multivariable analysis, tumor size (>15 mm) (hazard ratio [HR], 2.15; 95% confidence interval [CI], 1.11-4.16; = 0.023) and ablative margin (<3 mm) (HR, 2.94; 95% CI, 1.52-5.71; = 0.001) were significantly associated with local tumor recurrence. Only tumor size (>15 mm) (odds ratio, 3.41 95% CI, 1.53-7.84; = 0.026) was significantly associated with complications.
CONCLUSIONS
MTA is a safe and effective local ablation therapy for HCC, even for tumors located in areas of the liver where local ablation therapy is difficult.
PubMed: 38137645
DOI: 10.3390/jcm12247577 -
Radiology. Imaging Cancer Mar 2024Purpose To determine if microwave ablation (MWA) of retroperitoneal tumors can safely provide high rates of local tumor control. Materials and Methods This retrospective...
Purpose To determine if microwave ablation (MWA) of retroperitoneal tumors can safely provide high rates of local tumor control. Materials and Methods This retrospective study included 19 patients (median age, 65 years [range = 46-78 years]; 13 [68.4%] men and six [31.6%] women) with 29 retroperitoneal tumors treated over 22 MWA procedures. Hydrodissection (0.9% saline with 2% iohexol) was injected in 17 of 22 (77.3%) procedures to protect nontarget anatomy. The primary outcomes evaluated were local tumor progression (LTP) and complication rates. Oncologic outcomes, including overall survival (OS), progression-free survival (PFS), and treatment-free interval (TFI), were examined as secondary outcome measures. Results Median follow-up was 18 months (range = 0.5-113). Hydrodissection was successful in displacing nontarget anatomy in 16 of 17 (94.1%) procedures. The LTP rate was 3.4% (one of 29; 95% CI: 0.1, 17.8) per tumor and 5.3% (one of 19; 95% CI: 0.1, 26.0) per patient. The overall complication rate per patient was 15.8% (three of 19), including two minor complications and one major complication. The OS rate at 1, 2, and 3 years was 81.8%, 81.8%, and 72.7%, respectively, with a median OS estimated at greater than 7 years. There was no evidence of a difference in OS ( = .34) and PFS ( = .56) between patients with renal cell carcinoma (six of 19 [31.6%]) versus other tumors (13 of 19 [68.4%]) and patients treated with no evidence of disease (15 of 22 [68.2%]) versus patients with residual tumors (seven of 22 [31.8%]). Median TFI was 18 months (range = 0.5-108). Conclusion Treatment of retroperitoneal tumors with MWA combined with hydrodissection provided high rates of local control, prolonged systemic therapy-free intervals, and few serious complications. Ablation Techniques (ie, Radiofrequency, Thermal, Chemical), Retroperitoneum, Microwave Ablation, Hydrodissection © RSNA, 2024.
Topics: Male; Humans; Female; Middle Aged; Aged; Retroperitoneal Neoplasms; Treatment Outcome; Microwaves; Retrospective Studies; Kidney Neoplasms
PubMed: 38334471
DOI: 10.1148/rycan.230080 -
Computers in Biology and Medicine Dec 2023Percutaneous microwave thermal ablation is based on electromagnetic waves that generate dielectric heating, and it is widely recognized as one of the mostly used...
BACKGROUND AND OBJECTIVES
Percutaneous microwave thermal ablation is based on electromagnetic waves that generate dielectric heating, and it is widely recognized as one of the mostly used techniques for tumor treatment. The aim of this work is to validate a predictive model capable of providing physicians with guidelines to be used during thermal ablation procedures avoiding collateral damage.
METHODS
A finite element commercial software, COMSOL Multiphysics, is employed to implement a tuning-parameter approach. Governing equations are written with reference to variable-porosity and Local Thermal Non-Equilibrium (LTNE) equations are employed. The simulations results are compared with available ex-vivo and in-vivo data with the help of regression analysis. For in-vivo data simulations, velocity vector modulus and direction are varied between 0.0007 and 0.0009 m/s and 90-270°, respectively, in order to use this parameter as a tuning one to simulate - and lately optimize with respect to the differences from experimental outcomes - all the possible directions of the blood flow with respect to the antenna, whose insertion angle is not registered in the dataset.
RESULTS
The model is validated using reference data provided by the manufacturer (AMICA), which is obtained from ex-vivo bovine liver. The model accurately predicts the size and shape of the ablated area, resulting in an overestimation lesser than 10 %. Additionally, predictive data are compared to an in-vivo dataset. The ablated volume is accurately predicted with a mean underestimation of 6 %. The sphericity index is calculated as 0.75 and 0.62 for the predictions and in-vivo data, respectively.
CONCLUSION
This study developed a predictive model for microwave ablation of liver tumors that showed good performance in predicting ablation dimensions and sphericity index for ex-vivo bovine liver and for in-vivo human liver data with the tuning technique. The study emphasizes the necessity for additional development and validation to enhance the accuracy and reliability of in-vivo application.
Topics: Animals; Cattle; Humans; Microwaves; Reproducibility of Results; Liver; Liver Neoplasms; Ablation Techniques; Catheter Ablation
PubMed: 37948968
DOI: 10.1016/j.compbiomed.2023.107669 -
RoFo : Fortschritte Auf Dem Gebiete Der... May 2024To compare the therapeutic response and clinical outcome of CT-guided percutaneous microwave (MWA) and radiofrequency ablation (RFA) for the treatment of small- and... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
PURPOSE
To compare the therapeutic response and clinical outcome of CT-guided percutaneous microwave (MWA) and radiofrequency ablation (RFA) for the treatment of small- and medium-sized HCC.
MATERIALS AND METHODS
In this prospective trial, 50 patients with HCC were randomly assigned to MWA or RFA treatment. MRI was performed 24 h before and after ablation and subsequently in 3-month intervals. Ablation volumes, ablation durations, adverse events (AE), technique efficacy, technical success, local tumor progression (LTP), disease-free survival (DFS), intrahepatic distant recurrence (IDR), and overall survival (OS) rates were evaluated.
RESULTS
The mean ablation volume was 66.5 cm³ for MWA and 29.2 cm³ for RFA ( < 0.01). The mean ablation durations for MWA and RFA were 11.2 ± 4.0 min and 16.3 ± 4.7 min, respectively ( < 0.01). Six mild AEs were documented ( > 0.05). All treatments had a technical success rate and a technique efficacy rate of 100 % (50/50, = 1.00). LTP within 2 years occurred in 1/25 (4 %) in the MWA group and in 4/25 (16 %) in the RFA group ( = 0.06). IDR within 2 years was 8/25 (32 %) for MWA and 14/25 (56 %) for RFA ( < 0.05). The median DFS was 24.5 months and 13.4 months for MWA and RFA, respectively ( = 0.02). The 1-, 2-, 3-year OS rates were 100 %, 80 %, 72 % in the MWA group and 72 %, 64 %, 60 % in the RFA group, respectively ( ≥ 0.14).
CONCLUSION
The clinical outcome after MWA or RFA for HCC treatment was very similar with no significant differences in LTP or OS. However, MWA shows a trend toward better DFS with fewer IDRs than RFA.
KEY POINTS
· MWA allows for larger ablation volumes and a shorter treatment duration compared to RFA in patients with HCC.. · MWA shows a trend toward better disease-free survival and fewer intrahepatic distant recurrences compared to RFA.. · The three-year survival rates show no significant difference between the two methods..
Topics: Humans; Liver Neoplasms; Carcinoma, Hepatocellular; Microwaves; Male; Female; Prospective Studies; Middle Aged; Aged; Radiofrequency Ablation; Tomography, X-Ray Computed; Treatment Outcome; Neoplasm Recurrence, Local; Survival Rate; Catheter Ablation; Magnetic Resonance Imaging; Surgery, Computer-Assisted
PubMed: 38065541
DOI: 10.1055/a-2203-2733 -
Cancers Feb 2024Focal therapy is a promising, minimally invasive method for the treatment of patients with localized prostate cancer. According to the existing literature, there is... (Review)
Review
BACKGROUND
Focal therapy is a promising, minimally invasive method for the treatment of patients with localized prostate cancer. According to the existing literature, there is growing evidence for positive functional outcomes and oncological effectiveness. The aim of this review is to evaluate the technical efficacy of three minimally invasive techniques (cryoablation, electroporation, and microwave ablation) and their impact on quality of life in patients with prostate cancer.
METHODS
Studies between January 2020 and July 2023 were selected using PubMed, Embase, and The Cochrane Library and analyzed following PRISMA guidelines; they have not been registered.
RESULTS
Twenty-three studies investigating three different sources of energy to deliver focal therapy were found. Thirteen studies evaluated the performance of the cryoablation therapy, seven studies of the irreversible electroporation, and three studies of microwave ablation option. The majority of studies were retrospective cohort studies. Cryoablation showed excellent oncological outcomes for low-grade prostate cancer, whether performed on the lesion, on the hemigland, or on the entire gland, with the best results obtained for patients with intermediate risk. Irreversible electroporation showed promising oncological outcomes with no significant changes in functional outcomes. Microwave ablation showed great early functional outcomes.
CONCLUSIONS
The oncological effectiveness of minimally invasive treatment in comparison to standard of care is still under investigation, despite encouraging results in terms of functional outcomes improvement and adverse events reduction. More comprehensive research is needed to fully understand the function of minimally invasive treatment in patients with localized PCa.
PubMed: 38398156
DOI: 10.3390/cancers16040765 -
Actas Dermo-sifiliograficas Apr 2024Hyperhidrosis, or excessive sweating, is characterized by overactivity of the eccrine sweat glands, usually associated with dysfunction of the autonomic nervous system.... (Review)
Review
Hyperhidrosis, or excessive sweating, is characterized by overactivity of the eccrine sweat glands, usually associated with dysfunction of the autonomic nervous system. Primary focal hyperhidrosis is the most common form and can affect the axillae, palms, soles, and/or face, often leading to significantly impaired quality of life and social functioning. Treatment is complex. Topical antiperspirants are normally recommended as the first-line treatment for mild hyperhidrosis. Multiple clinical trials and prospective studies support the efficacy and tolerability of oral and topical anticholinergics in the management of hyperhidrosis. Topical glycopyrronium, which has been investigated in at least 8 clinical trials enrolling more than 2000 patients, is probably the first-line pharmacological treatment for axillary hyperhidrosis in patients with moderate to severe disease poorly controlled with topical antiperspirants. Second-line treatments include botulinum toxin injections, microwave treatment, and oral anticholinergics. We review the use of topical anticholinergics in the management of focal hyperhidrosis in adults and children.
Topics: Adult; Child; Humans; Botulinum Toxins, Type A; Antiperspirants; Cholinergic Antagonists; Quality of Life; Prospective Studies; Sympathectomy; Hyperhidrosis
PubMed: 37714301
DOI: 10.1016/j.ad.2023.09.006 -
Journal of Clinical Medicine Jul 2023Renal cell carcinoma (RCC) is one of the most frequently diagnosed tumors and a leading cause of death. The high risk of local recurrence and distant metastases...
Renal cell carcinoma (RCC) is one of the most frequently diagnosed tumors and a leading cause of death. The high risk of local recurrence and distant metastases represent a significant clinical issue. Different image-guided ablation techniques can be applied for their treatment as an alternative to surgery, radiotherapy or systemic treatments. A retrospective analysis was conducted at our institution, including a total number of 34 RCC patients and 44 recurrent RCC tumors in different locations (kidney, lung, adrenal gland, liver, pancreas, pararenal and other) using microwave ablation, radiofrequency ablation, cryoablation and laser ablation. The estimated time to local and distant tumor progression after treatment were 22.53 ± 5.61 months and 24.23 ± 4.47 months, respectively. Systemic treatment was initiated in 10/34 (29%) treated patients with a mean time-to-systemic-therapy of 40.92 ± 23.98 months. Primary technical success was achieved in all cases and patients while the primary efficacy rate was achieved in 43/44 (98%) cases and 33/34 (97%) patients, respectively, with a secondary technical success and efficacy rate of 100%. At a mean follow-up of 57.52 months ± 27.86 months, local tumor progression occurred in 3/44 (7%) cases and distant progression in 25/34 (74%) patients. No significant complications occurred. Image-guided ablations can play a role in helping to better control recurrent disease, avoiding or delaying the administration of systemic therapies and their significant adverse effects.
PubMed: 37568303
DOI: 10.3390/jcm12154902 -
Annals of Palliative Medicine Mar 2024Hepatocellular carcinoma (HCC) is a common malignancy with many patients presenting with local disease. As of date, the use of radiation is not included in the commonly... (Randomized Controlled Trial)
Randomized Controlled Trial
Hepatocellular carcinoma (HCC) is a common malignancy with many patients presenting with local disease. As of date, the use of radiation is not included in the commonly utilized Barcelona Clinic Liver Cancer (BCLC) classification but is in the National Comprehensive Cancer Network guidelines. Radiation can volumetrically cover the entire tumor and with novel technologic advances can be administered non-invasively with excellent clinical outcomes with few adverse events. The gold standard for localized early HCC (such as BCLC-A) is resection or transplantation. In patients who are not candidates for surgical treatment, locoregional therapy should be considered as an optimal therapy for these patients. Tumor ablation techniques such as microwave ablation (MWA) and radiofrequency ablation (RFA) are excellent tools to control local disease or bridge to transplantation. Should these not be possible though then ablation with external beam radiation is also capable of yielding comparable local control and serve as a bridge to transplant without worse rates of adverse events. For tumors that meet Milan criteria for transplantation, in comparison to transarterial chemoembolization (TACE), there is considerable randomized evidence demonstrating better local control, less adverse events, better progression-free survival (PFS), and less costly. It can be utilized as a bridge in Barcelona liver class B. For larger localized tumors though (extrahepatic disease or vascular invasion like BCLC-C), stereotactic body radiation therapy (SBRT) is shown via a randomized clinical trial to have a survival benefit, local control benefit, and no worse adverse events compared to systemic therapy. In this setting, it should be considered the local consolidation standard of care.
Topics: Humans; Carcinoma, Hepatocellular; Liver Neoplasms; Neoplasm Staging; Retrospective Studies; Chemoembolization, Therapeutic; Treatment Outcome
PubMed: 38373778
DOI: 10.21037/apm-23-486 -
Journal of Vascular and Interventional... May 2024To analyze the effectiveness of image-guided energy ablation techniques with and without concurrent therapies in providing palliative pain relief in patients with bone... (Review)
Review
PURPOSE
To analyze the effectiveness of image-guided energy ablation techniques with and without concurrent therapies in providing palliative pain relief in patients with bone metastases.
MATERIALS AND METHODS
OVID Embase, OVID Medline, and Pubmed were searched from inception to April 14th, 2023 using search terms relating to bone lesions and MeSH terms regarding ablation therapy. English peer-reviewed primary articles were included that reported pain scores following image-guided energy-based ablation of bone metastases. Exclusion criteria included 1) non-palliative treatment, 2) pain scores associated with specific treatment modalities not reported, and 3) non-metastatic bone lesions. Mean percentage reduction in pain score was calculated.
RESULTS
1396 studies were screened and 54 were included. All but one study demonstrated decreased pain scores at final follow-up. Mean reduction in pain scores at final follow-up were 49% for radiofrequency ablation (RFA), 58% for radiofrequency ablation and adjunct (RFA-A), 54% for cryoablation (CA), 72% for cryoablation and adjunct (CA-A), 48% for microwave ablation (MWA), 81% for microwave ablation and adjunct (MWA-A), and 64% for high-intensity focused ultrasound (HIFU). Post-procedural adverse event rates were 4.9% for RFA, 34.8% for RFA-A, 9.6% for CA, 12.0% for CA-A, 48.9% for MWA, 33.5% for MWA-A and 17.0% for HIFU.
CONCLUSION
Image-guided energy ablation demonstrated consistently strong reduction in pain across all modalities, with variable post-procedural adverse event rates. Due to heterogeneity of included studies, quantitative analysis was not appropriate. Future primary research should focus on creating consistent prospective studies with established statistical power, explicit documentation and comparison to other techniques.
PubMed: 38815751
DOI: 10.1016/j.jvir.2024.05.011