Local recurrence for high-risk extremities/trunk soft tissue sarcoma (STS) after treatment can range from 15 to 30%. The modified Eilber protocol (MEP) using low-dose intravenous chemotherapy with a reduced dosage of radiation in the preoperative setting has demonstrated excellent local control and reduced wound complications in these patients. The aim of the current study was to assess long-term local control and overall survival in patients with STS treated with the MEP versus standard preoperative or postoperative radiotherapy.

Patients diagnosed with STS from 2004 to 2016 were identified using the Alberta Cancer Registry. Patients with STS treated with the MEP, preoperative or postoperative radiotherapy, were included. Patient and tumor characteristics, treatments and outcomes were abstracted from the registry and primary chart review. Characteristics were compared using one-way ANOVA for continuous variable and chi-square test and Fisher test for the categorical outcomes. Local recurrence-free survival and overall survival were analyzed using Kaplan-Meier Analysis with Log-rank test.

A total of 242 patients with STS were included, among which 100 (41.3%) received the MEP prior to surgery, 91 (37.6%) had preoperative radiation, and 51 (21.1%) had postoperative radiation. After a median follow up of 4.9 years, there were no significant differences in local recurrence or local recurrence-free survival between patients treated with the MEP vs. preoperative or postoperative radiotherapy (10 vs. 6.6% and 7.8%, respectively, p-value NS). There were also no significant differences between groups for recurrence-free survival and overall survival.

This study demonstrates that the use of the MEP has non-inferior oncologic outcomes compared to standard preoperative or postoperative radiation in a population-based analysis despite reducing the overall dosage of radiation administered. The modified Eilber preoperative chemoradiation protocol may be considered as an additional option for patients with STS.

Colorectal cancer (CRC) is the third most common malignancy worldwide and the second leading cause of cancer-related mortality in the United States. The incidence of early-onset colorectal cancer (EOCRC) has been increasing over the past several decades. While the etiologies for this rising incidence remain unclear, genetic factors likely play an important role. DNA polymerase epsilon (POLE) mutations occur at a higher rate than average-onset colorectal cancer (AOCRC). DNA polymerase epsilon (Pol ε) is a high-fidelity, processive polymerase that is a promising target for immune checkpoint inhibitors due to its association with various human malignancies, including colorectal cancer. EOCRC remains a major area of focus, and POLE mutations leading to the high-TMB subtype constitute a potential therapeutic target.

Cancer treatments can result in subfertility or infertility in female adult childhood cancer survivors (ACCSs). While ACCSs may utilize assisted reproductive technology (ART) or other family-building options, the limited evidence describing their experiences remains a hindrance to developing and implementing appropriate patient-centered supports. The study's aim is to describe the challenges female ACCSs experienced while navigating ART and family-building options, to inform improvements in clinical practice in a western Canadian province.

In this qualitative Interpretive Description study, interviews were conducted with 15 female ACCSs and data were analyzed using an interpretive thematic approach and constant comparative techniques.

ACCSs' narratives suggest they experienced five prominent challenges while navigating ART and family-building options, including (1) confronting unexpected, impaired fertility, (2) grieving loss and redefining identity, (3) encountering unsupportive healthcare, (4) exploring alternative paths of adoption and international family-building, and (5) facing financial strain.

This exploratory study provides initial insights into the significant and multifaceted challenges female ACCSs experience related to family building and highlights gaps in healthcare services. Further research is warranted to articulate these challenges across contexts and the development and implementation of mitigating approaches.

The integration of comprehensive informational, psychosocial, and financial supports into existing cancer survivor and family-building services is vital to meeting female ACCSs' unmet needs.

Non-small cell lung cancer (NSCLC) remains a major contributor to cancer-related deaths worldwide, with therapeutic resistance presenting a critical clinical hurdle. The DNA damage response (DDR) constitutes a sophisticated cellular framework that detects, signals, and repairs genetic lesions to preserve genomic stability. While the DDR plays a crucial role in determining the efficacy of radiotherapy and chemotherapy, current research primarily focuses on direct DDR inhibitors, often overlooking the broader regulatory networks that modulate DDR activity. This review aims to comprehensively analyze the upstream and downstream pathways governing DDR in NSCLC, highlighting key molecular regulators, signaling interactions, and potential feedback mechanisms contributing to therapy resistance. By identifying novel regulatory targets and clinically relevant biomarkers, we propose innovative therapeutic strategies to enhance treatment efficacy. Our approach seeks to bridge the gap between DDR dysregulation and precision oncology, offering new perspectives on overcoming resistance and improving patient outcomes in NSCLC.

In clinical applications of surface-enhanced Raman spectroscopy (SERS) immunosensors, accurately determining analyte biomarker concentrations is essential. This study presents a non-invasive approach for quantifying various breast cancer biomarkers-including human epidermal growth factor receptor II (HER-II) (2+, 3+ (I), 3+ (II), 3+ (III), and positive IV) and CA 15-3-using a directional, plasmonically active, label-free SERS sensor. Each stage of sensor functionalization, conjugation, and biomarker interaction was verified by UV-Vis spectroscopy. Atomic force microscopy (AFM) characterized the morphology of gold nanourchin (GNU)-immobilized printed circuit board (PCB) substrates. An enhancement factor of ≈ 0.5 × 10⁵ was achieved using Rhodamine 6G as the probe molecule. Calibration curves were initially established using standard HER-II solutions at concentrations ranging from 1 to 100 ng/mL and CA 15-3 at concentrations from 10 to 100 U/mL. The SERS signal intensities in the 620-720 nm region were plotted against concentration, yielding linear sensitivity with R² values of 0.942 and 0.800 for HER-II and CA15-3, respectively. The same procedure was applied to breast cancer serum (BCS) samples, allowing unknown biomarker concentrations to be determined based on the corresponding calibration curves. SERS data were processed using the filtfilt filter from scipy.signal for smoothing and then baseline-corrected with the Improved Asymmetric Least Squares (IASLS) algorithm from the pybaselines.Whittaker library. Principal Component Analysis (PCA) effectively distinguished the sample groups and revealed spectral differences before and after biomarker interactions. Key Raman peaks were attributed to functional groups including N-H (primary and secondary amines), C-H antisymmetric stretching, C-N (amines), C=O antisymmetric stretching, NH₃⁺ (amines), carbohydrates, glycine, alanine, amides III, C=N stretches, and NH₂ in primary amides.

Traditional imaging modalities for the planning of Gamma Knife radiosurgery (GKRS) are non-specific and do not accurately delineate intracranial neoplasms. This study aimed to evaluate the utility of positron emission tomography (PET) for the planning of GKRS for intracranial neoplasms (ICNs) and the post-GKRS applications of PET for patient care.

PubMed, Scopus, and ScienceDirect were searched in order to assemble relevant studies regarding the uses of PET in conjunction with GKRS for ICN treatment. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to identify relevant studies on the use of PET in conjunction with GKRS. Particular emphasis was placed on review articles and medical research investigating tumor delineation and post-operative care. Relevant studies were selected and assessed based on quality measures, including study design, sample size, and significance. Inclusion and exclusion criteria were used to examine the yield of the initial search (n = 105). After a secondary review, the included results were identified (n = 50).

This study revealed that PET imaging is highly accurate for the planning of GKRS. In fact, many cases indicate that it is more specific than traditional imaging modalities. PET is also capable of complementing traditional imaging techniques through combination imaging. This showed significant efficacy for the planning of GKRS for ICNs.

While PET shows a multitude of applications for the treatment of ICNs with GKRS, further research is necessary to assemble a complete set of clinical guidelines for treatment specifications. Importantly, future studies need a greater standardization of methods and expanded trials with a multitude of radiotracers.

Endometriosis is a clinical entity affecting up to 10% of women of reproductive age, characterized by ectopic endometrial tissue outside the uterine cavity. While extrapelvic endometriosis has been documented, pancreatic endometriosis remains extremely rare and poses significant diagnostic challenges due to its similarity to other pancreatic diseases. At the same time, splenic mesothelial cysts are also rare and typically benign. This report presents a unique case of pancreatic endometriosis coexisting with a splenic mesothelial cyst in a 31-year-old woman. The patient presented to the emergency department with complaints of persistent epigastric and low back pain. She noted having similar symptoms approximately a year prior. Her past medical history was otherwise unremarkable, and there was no known family history of pancreatic disease or neoplasms. Initial imaging revealed a 3.8 cm cystic lesion in the pancreatic tail, with features suggestive of mucinous cystadenoma. Following clinical evaluation and confirmation of the cyst's nature through endoscopic ultrasound-guided biopsy, the patient subsequently underwent laparoscopic distal pancreatectomy and splenectomy due to worsening symptoms. Gross examination revealed a multilocular pancreatic cyst with a smooth, hemorrhagic wall. Microscopic analysis showed the cyst to be lined by cuboidal to columnar epithelium, consistent with pancreatic endometriosis, confirmed by immunohistochemical staining. The spleen showed cystic formations, diagnosed as a multifaceted mesothelial cyst. In conclusion, this report is the first to document the coexistence of pancreatic endometriosis and splenic mesothelial cysts, highlighting the importance of accurate imaging and pathologic evaluation in the diagnosis of these rare conditions. Early diagnosis and surgical intervention lead to favorable outcomes, reinforcing the importance of comprehensive diagnostic strategies.

Background: The aim was to explore the association between coping strategies (CSs) and health-related quality of life (HRQoL) in breast cancer (BC) survivors and to analyze the role of relevant sociodemographic and clinical variables. Methods: A cross-sectional study involving 305 women under follow-up for surgically treated BC in Spain. CSs were measured using the Brief Coping Orientation to Problems Experienced Scale and the HRQoL with the Short-Form Health Survey (SF-12). Results: The mean age at BC diagnosis for participants was 57.4 years, with 60.3% of diagnoses at the local stage. Most frequent complementary treatments were radiotherapy (53.4%) and chemotherapy (33.1%). Adaptative CS scores were positively associated both with higher physical HRQoL (adjusted regression coefficient: 2.19; 95% confidence interval: 0.11; 4.27, p-value: 0.039) and mental HRQoL scores (coef.: 2.65: 95%CI: 0.25; 5.04, p-value: 0.030). Maladaptive CS scores were inversely associated with mental HRQoL scores (coef.: -3.92; 95%CI: -6.62; -1.22, p-value: 0.005). The effects were stronger among women with a favorable BC prognosis. Conclusions: Adaptive CSs positively affected the physical and mental HRQoL, while maladaptive CSs negatively affected the mental HRQoL. Therefore, psychosocial interventions that promote adaptive CSs and avoid maladaptive ones could improve the well-being of women with a favorable BC prognosis.

Black-blood (BB) magnetic resonance images (MRI) offer superior image contrast for the detection and segmentation of brain metastases (BMs). This study investigated the efficacy and accuracy of deep learning (DL) architectures and post-processing for BMs detection and segmentation with BB images.

The BB images of 50 patients were collect to train (40) and test (10) the DL model. To ensure consistency, we implemented piecewise linear histogram matching for intensity normalization and resampling. Modified U-Net, including combination with generative adversarial network (GAN), was applied to enhance the segmentation performance. The U-Net-based networks generated bounding boxes indicating regions of interest, which were then processed in a post-processing using the Segment Anything Model (SAM). We quantitatively assessed the three U-Net-based models and their post-processed counterparts in terms of lesion-wise sensitivity (LWS), patient-wise dice similarity coefficient (DSC), and average false-positive rate (FPR).

The modified U-Net with GAN yielded a patient-wise DSC of 0.853 and a LWS of 89.19%, which outperformed the standard U-Net (patient-wise DSC of 0.815) and modified U-Net only (patient-wise DSC of 0.846). Combining GAN architecture with modified U-Net also reduced the FPR, less than 1 on average. Post-processing with SAM further did not affect LWS and FPR, but effectively enhanced the patient-wise DSC by 2%-3% for the U-Net-based models.

The modifications to standard U-Net notably improves the detection and segmentation of BMs in BB images, and applying SAM as post-processing can further enhance the precision of segmentation results.

Photodynamic therapy (PDT) is an emerging cancer treatment that relies on photosensitizers (PS) activated by specific light wavelengths to produce reactive oxygen species (ROS), effectively targeting malignant cells. However, ROS can also harm surrounding healthy tissues, necessitating strategies to reduce unintended DNA damage. Recent attention has turned to dietary antioxidants as potential agents to protect genome integrity and enhance DNA repair mechanisms during PDT.

This review explores the complementary roles of PDT and dietary antioxidants in modulating oxidative stress and DNA repair pathways. Key DNA repair systems such as base excision repair (BER), nucleotide excision repair (NER), mismatch repair (MMR), homologous recombination (HR), and non-homologous end joining (NHEJ) are discussed in the context of their response to PDT-induced damage. The regulatory role of dietary compounds such as vitamins, polyphenols, flavonoids, phenolic acids, and alkaloids are also examined. Evidence suggests that specific dietary antioxidants can reduce ROS-induced genomic instability by enhancing the efficiency of DNA repair pathways and modulating gene expression related to repair mechanisms. The combination of PDT with antioxidant intake might reduce mutation risk in healthy cells while preserving the cellular toxicity on cancerous tissue.

Integrating dietary antioxidants with PDT offers a promising dual strategy maximizing tumor destruction while protecting normal cells through enhanced genome maintenance. Continued investigation is necessary to improve this synergistic approach and develop targeted protocols for clinical application, with the aim of enhancing therapeutic outcomes and patient safety.