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Nature Communications May 2024Minimally invasive thermal therapy is a successful alternative treatment to surgery in solid tumors with high complete ablation rates, however, tumor recurrence remains...
Minimally invasive thermal therapy is a successful alternative treatment to surgery in solid tumors with high complete ablation rates, however, tumor recurrence remains a concern. Central memory CD8 T cells (T) play important roles in protection from chronic infection and cancer. Here we find, by single-cell RNA analysis of human breast cancer samples, that although the memory phenotype of peripheral CD8 T cells increases slightly after microwave ablation (MWA), the metabolism of peripheral CD8 T cells remains unfavorable for memory phenotype. In mouse models, glycolysis inhibition by 2-deoxy-D-glucose (2DG) in combination with MWA results in long-term anti-tumor effect via enhancing differentiation of tumor-specific CD44CD62LCD8 T cells. Enhancement of CD8 T cell differentiation determined by Stat-1, is dependent on the tumor-draining lymph nodes (TDLN) but takes place in peripheral blood, with metabolic remodeling of CD8 T cells lasting the entire course of the the combination therapy. Importantly, in-vitro glycolysis inhibition in peripheral CD8 T cells of patients with breast or liver tumors having been treated with MWA thrice leads to their differentiation into CD8 T cells. Our work thus offers a potential strategy to avoid tumor recurrence following MWA therapy and lays down the proof-of-principle for future clinical trials.
Topics: Glycolysis; Animals; CD8-Positive T-Lymphocytes; Humans; Cell Differentiation; Mice; Female; Breast Neoplasms; Microwaves; Immunologic Memory; Deoxyglucose; Cell Line, Tumor; Liver Neoplasms; Memory T Cells
PubMed: 38821965
DOI: 10.1038/s41467-024-49059-6 -
Clinics in Chest Medicine Jun 2024The clinical role and use of percutaneous transthoracic needle biopsy (TTNB) and ablation of lung tumors are evolving. Here we discuss important considerations for... (Review)
Review
The clinical role and use of percutaneous transthoracic needle biopsy (TTNB) and ablation of lung tumors are evolving. Here we discuss important considerations for referring providers, including current and emerging indications supported by guidelines, critical aspects of pre and postprocedure patient management, and expected postprocedure imaging findings.
Topics: Humans; Lung Neoplasms; Biopsy, Needle; Lung; Ablation Techniques; Tomography, X-Ray Computed
PubMed: 38816090
DOI: 10.1016/j.ccm.2024.02.005 -
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 -
International Journal of Surgery... May 2024
A commentary on "a multicenter case-controlled study on laparoscopic hepatectomy versus microwave ablation as first-line therapy for 3-5 cm hepatocellular carcinoma in patients aged 60 and older".
PubMed: 38814261
DOI: 10.1097/JS9.0000000000001526 -
[Application of process analysis technology in traditional Chinese medicine manufacturing industry].Zhongguo Zhong Yao Za Zhi = Zhongguo... May 2024In the traditional Chinese medicine(TCM) manufacturing industry, quality control determines the safety, effectiveness, and quality stability of the final product. The... (Review)
Review
In the traditional Chinese medicine(TCM) manufacturing industry, quality control determines the safety, effectiveness, and quality stability of the final product. The traditional quality control method generally carries out sampling off-line testing of drugs after the end of the batch production, which is incomprehensive, and it fails to find the problems in the production process in time. Process analysis technology(PAT) uses process testing, mathematical modeling, data analysis, and other technologies to collect, analyze, feedback, control, and continuously improve the critical quality attributes(CQA) in all aspects of the production of TCM preparations in real time. The application of PAT in the TCM manufacturing industry is one of the research hotspots in recent years, which has the advantages of real-time, systematic, non-destructive, green, and rapid detection for the production quality control of TCM preparations. It can effectively ensure the stability of the quality of TCM preparations, improve production efficiency, and play a key role in the study of the quantity and quality transfer law of TCM. Commonly used PAT includes near-infrared spectroscopy, Raman spectroscopy, online microwave, etc. In addition, the establishment of an online detection model by PAT is the key basic work to realize intelligent manufacturing in TCM production. Obtaining real-time online detection data through PAT and establishing a closed-loop control model on this basis are a key common technical difficulty in the industry. This paper adopted systematic literature analysis to summarize the relevant Chinese and foreign literature, policies and regulations, and production applications, and it introduced the development trend and practical application of PAT, so as to provide references for accelerating the application of PAT in the TCM manufacturing industry, the intelligent transformation and upgrading, and high-quality development of the TCM industry.
Topics: Medicine, Chinese Traditional; Quality Control; Drugs, Chinese Herbal; Technology, Pharmaceutical; Drug Industry
PubMed: 38812130
DOI: 10.19540/j.cnki.cjcmm.20231223.303 -
Oncology Letters Jul 2024The purpose of the present study was to assess and compare the efficacy of microwave ablation (MWA) and stereotactic body radiotherapy (SBRT) in the treatment of lung...
The purpose of the present study was to assess and compare the efficacy of microwave ablation (MWA) and stereotactic body radiotherapy (SBRT) in the treatment of lung metastases from patients with colorectal cancer (CRC) and to identify the preferable treatment modality based on patient and tumor characteristics. Records of 118 patients with CRC with a total of 307 lung metastases who underwent SBRT or MWA between January 2015 and December 2022 were retrospectively analyzed, including the essential clinicopathological information on patients (age, sex and underlying diseases), diagnosis and treatment information [primary tumor site, levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9], imaging data [diameter of lung metastasis, location of the metastasis (i.e., whether or not the tumor was adjacent to the vessel or bronchus) and internal features] and follow-up data (postoperative therapy, complications or adverse effects and survival outcomes). For statistical analysis of the local tumor progression (LTP), disease-free survival and overall survival (OS) rates, Cox regression analysis, along with the Kaplan-Meier method adjusted using inverse probability of treatment weighting (IPTW), were performed. The median follow-up duration in the present study was 31.5 months. Multivariable Cox regression analysis revealed that the CEA level, metastasis diameter and internal features were independent predictors of OS. In the IPTW-adjusted analysis, no significant difference in the 1-year OS rate was observed between the SBRT and MWA groups (92.9 vs. 93.9%; P=0.483); however, a notable discrepancy in the treatment modalities was noted, leading to significant differences in the 2- and 3-year OS rates (65.9 vs. 57.6%, P=0.001, and 44.7 vs. 36.4%, P<0.001, respectively). A significant interaction effect for the treatment modality was observed for LTP (P=0.021). In conclusion, the present study revealed that SBRT and MWA have similar therapeutic effects in terms of prolonging the survival of patients with CRC with lung metastases; however, regarding the local control of lung metastases, MWA is associated with a number of significant advantages.
PubMed: 38807676
DOI: 10.3892/ol.2024.14455 -
BMJ Open May 2024First-generation and second-generation endometrial ablation (EA) techniques, along with medical treatment and invasive surgery, are considered successful lines of... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
First-generation and second-generation endometrial ablation (EA) techniques, along with medical treatment and invasive surgery, are considered successful lines of management for abnormal uterine bleeding (AUB). We set out to determine the efficacy of first and second-generation ablation techniques compared with medical treatment, invasive surgery and different modalities of the EA techniques themselves.
DESIGN
Systematic review and network meta-analysis using a frequentist network.
DATA SOURCES
We searched Medline (Ovid), PubMed, ClinicalTrials.gov, Cochrane CENTRAL, Web of Science, EBSCO and Scopus for all published studies up to 1 March 2021 using relevant keywords.
ELIGIBILITY CRITERIA
We included all randomised controlled trials (RCTs) that compared premenopausal women with AUB receiving the intervention of second-generation EA techniques.
DATA EXTRACTION AND SYNTHESIS
49 high-quality RCTs with 8038 women were included. We extracted and pooled the data and then analysed to estimate the network meta-analysis models within a frequentist framework. We used the random-effects model of the netmeta package in R (V.3.6.1) and the 'Meta-Insight' website.
RESULTS
Our network meta-analysis showed many varying results according to specific outcomes. The uterine balloon ablation had significantly higher amenorrhoea rates than other techniques in both short (hydrothermal ablation (risk ratio (RR)=0.51, 95% CI 0.37; 0.72), microwave ablation (RR=0.43, 95% CI 0.31; 0.59), first-generation techniques (RR=0.44, 95% CI 0.33; 0.59), endometrial laser intrauterine therapy (RR=0.18, 95% CI 0.10; 0.32) and bipolar radio frequency treatments (RR=0.22, 95% CI 0.15; 0.31)) and long-term follow-up (microwave ablation (RR=0.11, 95% CI 0.01; 0.86), bipolar radio frequency ablation (RR=0.12, 95% CI 0.02; 0.90), first generation (RR=0.12, 95% CI 0.02; 0.90) and endometrial laser intrauterine thermal therapy (RR=0.04, 95% CI 0.01; 0.36)). When calculating efficacy based only on calculated bleeding scores, the highest scores were achieved by cryoablation systems (p-score=0.98).
CONCLUSION
Most second-generation EA systems were superior to first-generation systems, and statistical superiority between devices depended on which characteristic was measured (secondary amenorrhoea rate, treatment of AUB, patient satisfaction or treatment of dysmenorrhoea). Although our study was limited by a paucity of data comparing large numbers of devices, we conclude that there is no evidence at this time that any one of the examined second-generation systems is clearly superior to all others.
Topics: Humans; Female; Endometrial Ablation Techniques; Network Meta-Analysis; Uterine Hemorrhage; Randomized Controlled Trials as Topic
PubMed: 38806429
DOI: 10.1136/bmjopen-2022-065966 -
International Journal of Biological... Jun 2024Gums are high-molecular-weight compounds with hydrophobic or hydrophilic characteristics, which are mainly comprised of complex carbohydrates called polysaccharides,... (Review)
Review
Gums are high-molecular-weight compounds with hydrophobic or hydrophilic characteristics, which are mainly comprised of complex carbohydrates called polysaccharides, often associated with proteins and minerals. Various innovative modification techniques are utilized, including ultrasound-assisted and microwave-assisted techniques, enzymatic alterations, electrospinning, irradiation, and amalgamation process. These methods advance the process, reducing processing times and energy consumption while maintaining the quality of the modified gums. Enzymes like xanthan lyases, xanthanase, and cellulase can selectively modify exudate gums, altering their structure to enhance their properties. This precise enzymatic approach allows for the use of exudate gums for specific applications. Exudate gums have been employed in nanotechnology applications through techniques like electrospinning. This enables the production of nanoparticles and nanofibers with improved properties, making them suitable for the drug delivery system, tissue engineering, active and intelligient food packaging. The resulting modified exudate gums exhibit improved rheological, emulsifying, gelling, and other functional properties, which expand their potential applications. This paper discusses novel applications of these modified gums in the pharmaceutical, food, and industrial sectors. The ever-evolving field presents diverse opportunities for sustainable innovation across these sectors.
Topics: Plant Gums; Drug Delivery Systems; Humans
PubMed: 38806080
DOI: 10.1016/j.ijbiomac.2024.132688 -
Supportive Care in Cancer : Official... May 2024To explore symptom clusters and interrelationships using a network analysis approach among symptoms in patients with lung tumors who underwent computed tomography...
PURPOSE
To explore symptom clusters and interrelationships using a network analysis approach among symptoms in patients with lung tumors who underwent computed tomography (CT)-guided microwave ablation (MWA).
METHODS
A longitudinal study was conducted, and 196 lung tumor patients undergoing MWA were recruited and were measured at 24 h, 48 h, and 72 h after MWA. The Chinese version of the MD Anderson Symptom Inventory and the Revised Lung Cancer Module were used to evaluate symptoms. Network analyses were performed to explore the symptom clusters and interrelationships among symptoms.
RESULTS
Four stable symptom communities were identified within the networks. Distress, weight loss, and chest tightness were the central symptoms. Distress, and weight loss were also the most key bridge symptoms, followed by cough. Three symptom networks were temporally stable in terms of symptom centrality, global connectivity, and network structure.
CONCLUSION
Our findings identified the central symptoms, bridge symptoms, and the stability of symptom networks of patients with lung tumors after MWA. These network results will have important implications for future targeted symptom management intervention development. Future research should focus on developing precise interventions for targeting central symptoms and bridge symptoms to promote patients' health.
Topics: Humans; Lung Neoplasms; Male; Female; Middle Aged; Tomography, X-Ray Computed; Longitudinal Studies; Microwaves; Aged; Adult; Ablation Techniques
PubMed: 38780815
DOI: 10.1007/s00520-024-08560-w -
Radiologie (Heidelberg, Germany) Jun 2024The aim of this article is to provide an overview on the most frequently applied image-guided, percutaneous, local ablative techniques for treatment of primary and... (Review)
Review
The aim of this article is to provide an overview on the most frequently applied image-guided, percutaneous, local ablative techniques for treatment of primary and secondary liver tumors. The technical procedures of microwave ablation (MWA) and radiofrequency ablation (RFA) are presented. The pre-interventional diagnostics, indications and feasibility are also discussed, taking the current national guidelines into consideration. Finally, treatment outcomes and recommendations on post-interventional imaging following local tumor ablation are presented.
Topics: Humans; Liver Neoplasms; Microwaves; Catheter Ablation; Radiofrequency Ablation; Surgery, Computer-Assisted; Ablation Techniques; Preoperative Care; Treatment Outcome
PubMed: 38780657
DOI: 10.1007/s00117-024-01308-x