As breast cancer survival rates improve, attention is shifting toward long-term health outcomes, including oral health. This study evaluated the dental prosthesis needs of breast cancer survivors using a nationally representative sample and examined variations by menopausal status at diagnosis.

This nationwide cross-sectional study analyzed data from 14,886 Korean women aged ≥ 19 years who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2016 to 2021. Among these, 214 participants reported a history of breast cancer. Multivariable logistic regression was used to compare prosthetic needs and dental care utilization between breast cancer survivors and non-cancer controls, with subgroup analyses stratified by menopausal status at diagnosis.

Breast cancer survivors had significantly greater needs for fixed prostheses than the non-breast cancer controls (OR 1.102, 95% CI 1.018-1.194). Postmenopausal survivors were more likely to require fixed prostheses (OR 1.56, p < 0.001), while premenopausal survivors had greater partial denture needs (OR 5.549, p = 0.009) than the non-breast cancer controls. No significant differences in dental visit frequency or self-perceived oral health were observed between groups.

Breast cancer diagnosis was significantly associated with higher prosthetic needs, though survivors did not perceive their oral health as worse and demonstrated dental care behaviors comparable to non-cancer individuals. These findings highlight a potential gap in survivor awareness and underscore the need for integrating oral health assessment into survivorship care planning. Targeted dental interventions and awareness programs may improve quality of life for breast cancer survivors.

Acupuncture is a method of traditional Chinese medicine that has been adapted in the Western world. The objective of this study was to critically assess the evidence presented in randomized controlled trials (RCTs) about the effectiveness of acupuncture on fatigue in cancer patients.

In April 2024 a systematic search was conducted searching five electronic databases to find studies concerning the use, effectiveness and potential harm of acupuncture therapy on cancer patients.

From all (1599) search results, 15 studies with 1346 patients were included. Acupuncture methods varied (e.g., traditional-, electro-, mind-regulating and ATAS-acupuncture) and were compared to sham acupuncture, usual care, or other controls. Studies comparing acupuncture to sham acupuncture reported mixed results: while some found significant effects on cancer-related fatigue, others found no advantages. Studies comparing acupuncture to usual care or waitlist controls often reported positive effects. However, the reliability of these findings is limited, as 14 of 15 studies were rated as "high risk of bias" by the RoB-2 tool due to issues like insufficient blinding and incomplete data analysis. Only one study, with low risk of bias, showed a significant reduction in fatigue with acupuncture compared to sham acupuncture (p < 0.001). GRADE evaluation also showed very low certainty of evidence.

The heterogenous results and methodological limitations of the existing studies prevent us from drawing definitive conclusions about the effectiveness of acupuncture in the treatment of cancer-related fatigue. Despite the inclusion of 15 studies, the overall evidence remains insufficient due to widespread problems in study design and inconsistent results. This analysis highlights the need to use more rigorous designs and more comprehensive assessment tools in future studies to better understand the role of acupuncture in the management of fatigue after cancer treatment.

Emotional engagement, family support and personal beliefs can influence how patients and healthcare professionals (HCPs) perceive cancer differently. This study examined the extent to which the views of patients and HCPs on cancer care align, and identified factors that may underlie disparities.

Participants with colorectal cancer (CRC) were asked to describe their perception of their disease (i.e. whether they felt it was under control (DC), was progressing (PD), or was of an unknown status) and to complete psychometric assessments of anxiety, depression, PTSD and well-being. Two HCPs, who were blinded to the patients' responses, examined the case files to determine the stage of treatment at which the patients were enrolled in the study. The concordance of perceptions between patients and HCPs was examined, along with associations with clinical variables and psychometric health outcomes, using both univariate and multivariate analyses.

A total of 205 patients with CRC were included in the study. The mean age was 65 years, with 58% of patients being male. Overall, a significant difference in perception was observed between HCPs and patients (p < 0.001), particularly for patients identified by HCPs as having PD. Significant discrepancies were observed among patients receiving palliative care (p < 0.001), whereas those in the adjuvant or neo-adjuvant pathway appeared to align more closely with HCPs' perceptions (p = 0.99). Neither demographic nor psychological factors were significant determinants of concordance between HCPs and patients' understanding of cancer status in this population. In multivariate analysis, patients perceiving PD or expressing uncertainty were found to have significantly higher levels of depression than those with DC (OR 6.42, p = 0.001 and OR 3.86, p = 0.009, respectively).

This study reveals significant differences in how cancer is perceived by HCPs and patients, particularly among those without disease control or undergoing palliative care. This highlights the importance of effective communication in addressing patients' needs and their psychological well-being.

Diverting ileostomies are routinely created during low rectal cancer surgery, yet 15-30% remain permanent. Understanding predictors of non-reversal is essential for informed patient counseling. This study investigated factors preventing ileostomy closure following colorectal surgery, primarily for rectal malignancy.

This retrospective cohort study analyzed prospectively collected data from patients undergoing diverting ileostomy creation (January 2015-December 2020). Exclusions included early postoperative mortality (within 30 days), follow-up less than 6 months, or missing primary outcome data. Demographics, surgical details, and reversal outcomes were analyzed. Multivariable logistic regression identified independent predictors of non-reversal.

Of 508 patients, 456 met inclusion criteria (mean age 58.9 ± 13.2 years, 63.8% male). Malignancy accounted for 96.7% of cases, with low anterior resection performed in 83.8%. Ileostomy closure was achieved in 364 patients (79.8%) at a median of 6 months (mean 7.4 ± 5.3). The non-reversal rate was 20.2% (92 patients). Main reasons included mortality (35.8%), metastatic disease (23.9%), and anastomotic complications (22.8%). Multivariable analysis identified ASA score 3-4 (OR 2.68, 95% CI 1.58-4.54, p < 0.001) and malignant pathology (OR 5.12, 95% CI 1.23-21.3, p = 0.025) as independent predictors of non-reversal. Age showed statistical but limited clinical significance.

One in five patients with diverting ileostomies will not undergo reversal. High ASA scores, malignant disease, mortality, metastatic progression, and anastomotic complications are primary barriers. These findings emphasize the need for realistic preoperative counseling regarding permanent stoma risk.

To develop clinically relevant test cases for commissioning Model-Based Dose Calculation Algorithms (MBDCAs) for ¹⁹²Ir High Dose Rate (HDR) gynecologic brachytherapy following the workflow proposed by the TG-186 report and the WGDCAB report 372.

Two cervical cancer intracavitary HDR brachytherapy models were developed based on a real patient, using either uniformly structured regions or realistic segmentation. The patient's computed tomography (CT) images were processed, converted to a series of digital imaging and communications in medicine (DICOM) CT images, and imported into two treatment planning systems (TPSs), the Oncentra Brachy and BrachyVision. The original segmentation of the clinical case was augmented to enable a thorough dosimetric analysis. The actual clinical treatment plan was generally maintained, with the source replaced by a generic ¹⁹²Ir HDR source. Dose to medium in medium calculations were performed using the MBDCA option of each TPS, and three different Monte Carlo (MC) simulation codes. MC results demonstrated agreement within statistical uncertainty, while comparisons between the commercial TPS MBDCAs and a general-purpose MC code highlighted both the advantages and limitations of the studied MBDCAs, suggesting potential approaches to overcome the challenges.

The datasets for the developed cases are available online at https://doi.org/10.5281/zenodo.15720996. The DICOM files include the treatment plan for each case, TPS, and the corresponding reference MC dose data. The package also contains a TPS- and case-specific user guide for commissioning the MBDCAs, as well as files necessary to replicate the MC simulations.

The provided datasets and proposed methodology can serve as a commissioning framework for TPSs that employ MBDCAs, as well as a benchmark for brachytherapy researchers using MC methods and MBDCA developers. They also facilitate intercomparisons of MBDCA performance and provide a quality assurance resource for evaluating future TPS software updates.

Background/Purpose: We explored the complex relationship between the presence of metastatic cancer and undergoing cancer chemotherapy in adults with moderate to severe trauma and risk of reported physical abuse/assault-related trauma as defined in the American College of Surgeons Trauma Quality Programs Participant (ACS-TQP) dataset. We analyzed how these specific health conditions are associated with vulnerability to assault-related trauma, addressing a significant knowledge gap in existing literature.Methods: We utilized retrospective data from the ACS-TQP from 2017-2019 (N=27,531). The outcome was the report of physical abuse/assault-related trauma (no/yes). We focused on adults (aged ≥ 18 years) diagnosed with moderate to severe physical trauma (Injury Severity Scale: 9-75) who either had metastatic cancer (exposure) or were currently receiving chemotherapy (intervention), adjusting for predisposing factors and need for care factors based on Anderson's Model of Health Service Utilization. We used descriptive statistics, Fisher's exact test, chi-square analysis, and logistic regression using Stata.v18, with a statistical significance of P≤0.05.Results: We found 0.19% of 27,531 overall patients reported assault-related trauma, with 16,261 (0.16%) among those with moderate to severe trauma. Among these, a substantial majority with metastatic cancer reported assault-related trauma compared to those without metastatic cancer (84.62% vs. 15.38%; P value: 0.040). Patients receiving chemotherapy reported less frequent assault-related trauma than those not receiving it (26.92% vs. 73.08%; P value = 0.045). In the adjusted model, patients with metastatic cancer had significantly higher odds of reporting assault-related trauma than those without metastatic cancer (OR:7.847; 95% CI: 1.021-60.337; P<0.05). Chemotherapy was associated with a lower adjusted odds of assault-related trauma (OR 0.31, 95% CI: 0.08-1.14), but this did not reach statistical significance.Conclusion: In this large trauma cohort, metastatic cancer was associated with higher odds of assault-related trauma, while chemotherapy showed a reduced risk only in unadjusted analyses. Our findings highlight the higher vulnerability of patients with metastatic cancer and support further investigation into potential protective associations with active treatment.

Objective: To determine whether serum squamous cell carcinoma antigen (SCC-Ag) is predictive of treatment response in patients with squamous cell cervical carcinoma (SCC) undergoing chemoradiation therapy, and to establish the mean normal serum SCC-Ag level in age-matched, apparently healthy female controls.Methods: Patients with histologically confirmed cervical SCC scheduled for concurrent chemoradiation were recruited (75 cases, alongside 75 age-matched apparently healthy controls, N = 150). Blood samples were collected before treatment and 6 weeks post-external beam radiotherapy to assess serum SCC-Ag levels, which were correlated with tumor stage and grade. Age-matched apparently healthy controls were also phlebotomized at baseline and 12 weeks later to determine normal SCC-Ag levels. Serum SCC-Ag was analyzed using Alinity i SCC reagent and analyzer (Abbott Laboratories, Chicago, IL, USA). The manufacturer's reference value for SCC-Ag is ≤1.5 ng/ml. Treatment response was assessed via pre- and post-treatment abdominopelvic computed tomography scans and classified as either complete or partial response. Data analysis was performed using SPSS v22.0, and logistic regression was used to evaluate predictors of treatment response. A P value <0.05 was considered statistically significant.Results: The mean age was 55.1 ± 11.6 years for cases and 55.5 ± 11.4 years for controls. Among cervical cancer patients, the median pre-treatment SCC-Ag level was 7.4 ng/ml, and post-treatment was 1.2 ng/ml, both significantly higher than in controls (0.4 ng/ml and 0.5 ng/ml, respectively). Vaginal bleeding was the most common symptom (94.7%), and 68% presented with locally advanced disease. SCC histology was confirmed in 94.7% of cases, and 61% showed either complete or partial treatment response. Median SCC-Ag levels were significantly associated with disease stage (P<0.001) but not with tumor grade (P=0.159). Logistic regression identified tumor size as a significant predictor of treatment response, while pre-treatment SCC-Ag and SCC-Ag reduction rate were not.Conclusion: Serum SCC-Ag levels were normal among all healthy controls and some patients with prior treatment. SCC-Ag correlated with disease stage but was not predictive of treatment response in patients undergoing chemoradiation. Tumor size was the only significant predictor of treatment response.

Chemotherapy is the standard second-line treatment option for advanced biliary tract cancer (BTC), but its therapeutic efficacy is suboptimal. Disitamab vedotin (RC48) and lenvatinib have demonstrated promising efficacy in human epidermal growth factor receptor 2 (HER2)-positive BTC and other malignancies. In this study, we aim to evaluate the efficacy and safety of RC48 in combination with lenvatinib in second-line or above treatment for HER2-positive advanced BTC.

This is a single-centre, single-arm, open-label, exploratory phase II clinical study in patients with HER2-positive unresectable locally advanced or metastatic BTC who have failed prior therapy. 31 patients will be enrolled in this study to receive the combination of RC48 and lenvatinib. The primary study endpoint is objective response rate, and the secondary study endpoints are disease control rate, duration of response, progression-free survival and overall survival.

The study has received approval from the Medical Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (approval No. (2023)0367-01). Results will be disseminated through publication in peer-reviewed journals and through other appropriate media channels.

ChiCTR2300076406.

Accurate identification of adverse events after colonoscopy is essential for quality assurance in colorectal cancer (CRC) screening. Review of medical records is labour intensive as adverse events are infrequent. The object of this study was to investigate the accuracy of claims data in identifying adverse events after colonoscopy in CRC screening.

Cross-sectional, retrospective.

Males and females aged 50-74 years were randomised to once-only sigmoidoscopy or biennial faecal immunochemical test in a CRC screening trial at two screening centres in Norway. Participants in the present study underwent follow-up colonoscopy from 2012 to April 2020 after initial positive screening test. We reviewed medical records for adverse events within 30 days following 11 205 colonoscopies.

The primary outcome of the study was to assess the sensitivity of claims data from the Norwegian Patient Registry to identify lower gastrointestinal bleeding using emergency contact International Statistical Classification of Diseases and Related Health Problems 10th Revision diagnostic code sets under two definitions: a stringent definition (codes explicitly identifying bleeding) and a broad definition (including suggestive codes). Secondary outcome measures included the sensitivity to identify perforation using a stringent and a broad definition. Additionally, we assessed whether incorporating procedure codes and non-emergency contacts improved accuracy.

87 cases of lower gastrointestinal bleeding and eight perforations were confirmed. Sensitivity for bleeding differed between the centres (p<0.001). At centre 1, sensitivity was 48.6% (95% CI 31.9% to 65.6%) using the stringent and 89.2% (95% CI 74.6% to 97.0%) using the broad definition. At centre 2, sensitivity was 36.0% (95% CI 22.9% to 50.8%) and 50.0% (95% CI 35.5% to 64.5%), respectively. Combined sensitivity for perforation was 37.5% (95% CI 8.5% to 75.5%) using the stringent and 62.5% (95% CI 24.5% to 91.5%) using the broad definition. Adding procedure codes and non-emergency contacts slightly increased sensitivity but increased false positives.

Use of claims data underestimated adverse event rates following colonoscopy. Difference in coding practice across hospitals underscores the need for standardised reporting in screening programmes.

NCT01538550.

Human papillomavirus (HPV) vaccines have been introduced in the Chinese market since 2016. However, the HPV vaccine coverage is still remarkably low among adolescent girls in China. This study will employ discrete choice experiments (DCEs) to elicit the preferences of Chinese caregivers for HPV vaccine-related profile characteristics and service delivery methods for adolescent girls.

Two DCEs will be conducted with caregivers of girls aged 9-18 in China. The first DCE will focus on caregivers' preferences regarding the HPV vaccine-related profile for girls aged 9-18, with potential attributes including level of protection against cervical cancer, level of protection against genital warts, risk of severe side effects, number of dose(s), place of manufacture, waiting time and cost for one dose. The second DCE will assess Chinese caregivers' preferences for vaccination service delivery methods, with the potential attributes including source of recommendation, information channel, message framing, how to make an appointment, location for receiving the vaccine and incentives. A total of 300 participants will be recruited to complete the DCEs. We will summarise the key socio-demographic characteristics of participants and use latent class and mixed logit models to assess preferences and preference heterogeneity in HPV vaccination services.

Ethical approval was obtained from the Research and Ethics Committee at Nanjing Medical University. Findings from this study will be disseminated widely to relevant stakeholders via scheduled meetings, webinars, presentations at conferences and in peer-reviewed journal manuscripts.