Objective:To evaluate the feasibility of using the domestic ArcherQA system for fast and simplified independent verification of CyberKnife (CK) stereotactic radiotherapy (SRT) plans.Methods:SRT plans of 57 patients treated with CK at Tianjin Medical University Cancer Institute and Hospital from August 2021 to August 2022 were retrospectively analyzed, including 15 intracranial, 30 pulmonary, and 12 abdominal tumors cases. Point-dose and planar-dose verifications were performed using an ionization chamber and radiochromic films embedded in a homogeneous phantom, and the results were compared with those calculated by the treatment planning system (TPS). The localization CT images and corresponding SRT plans were imported into the ArcherQA system for independent dose verification and analysis. The correlation between ArcherQA results and phantom measurements was analyzed, with comparisons of target mean dose differences and γ pass rates.Results:Phantom measurement results showed, the measured point-dose differences for intracranial, lung, and abdominal plans were -0.94% ± 3.22%, 1.92% ± 2.05%, and 2.12% ± 0.77%, respectively. The mean dose differences in target dose calculation between ArcherQA and TPS: intracranial in the gross tumor volume (GTV) regions were 0.34% ± 2.21%, lung tumor GTV were -2.47% ± 2.46%, and abdominal tumor GTV were 0.80% ± 2.61%, respectively. Among them, the abdominal GTV region showed the highest correlation between ArcherQA and measured results ( r=0.78). The average two-dimensional γ pass rates (2 mm/2%, threshold=10%) measured using phantom films were 95.92% ± 2.35% for intracranial, 95.70% ± 2.74% for lung, and 96.74% ± 3.41% for abdominal tumors plans, respectively. The three-dimensional ArcherQA results showed comparable γ pass rates (1 mm/2%, threshold=10%) for lung and abdominal GTV and PTV regions, with similar medians and data dispersion to film measurements. Conclusions:The ArcherQA system enables rapid and efficient independent dose verification of CK SRT plans without the need for additional hardware. The verification results show good correlation with phantom measurements, supporting its potential as an auxiliary quality assurance tool in clinical CK SRT implementation.

Since cemiplimab was approved by United States Food and Drug Administration in 2018, anti-programmed cell death receptor-1 antibodies have been considered as the first-line systemic therapy for advanced cutaneous squamous cell carcinoma. This review focuses on current clinical application of targeted therapy, immunotherapy, targeted immunotherapy and gene therapy for cutaneous squamous cell carcinoma.

Many nail changes have been found to be associated with systemic diseases, such as acropachy, koilonychia, splinter hemorrhages, leukonychia, yellow nail syndrome, Beau's lines, etc., so they may provide clues for the diagnosis of systemic disorders. However, studies on nail damages secondary to systemic diseases are rare, and their pathogenesis is still unclear. This review summarizes the progress in the pathogenesis of nail damages in systemic diseases, so as to improve their diagnosis and treatment.

Cutaneous squamous cell carcinoma (cSCC) is the second most common skin tumor, and metastatic cSCC usually has a poor prognosis. Many factors influence the metastasis of cSCC, including primary lesion diameter, anatomical location, immunosuppression, clinical types, depth of tumor invasion, degree of differentiation, and vascular, perineural, and lymphatic invasion. Multiple intracellular signaling pathways drive tumor metastasis, such as Wnt/β-catenin, transforming growth factor β, and the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin pathway. This review discusses the factors influencing cSCC metastasis and the role of the above signaling pathways in the metastatic mechanisms of cSCC, providing new insights for the treatment of metastatic cSCC.

Cutaneous squamous cell carcinoma (cSCC) is the second most common skin tumor, and metastatic cSCC usually has a poor prognosis. Many factors influence the metastasis of cSCC, including primary lesion diameter, anatomical location, immunosuppression, clinical types, depth of tumor invasion, degree of differentiation, and vascular, perineural, and lymphatic invasion. Multiple intracellular signaling pathways drive tumor metastasis, such as Wnt/β-catenin, transforming growth factor β, and the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin pathway. This review discusses the factors influencing cSCC metastasis and the role of the above signaling pathways in the metastatic mechanisms of cSCC, providing new insights for the treatment of metastatic cSCC.

Objective:To evaluate the feasibility of using the domestic ArcherQA system for fast and simplified independent verification of CyberKnife (CK) stereotactic radiotherapy (SRT) plans.Methods:SRT plans of 57 patients treated with CK at Tianjin Medical University Cancer Institute and Hospital from August 2021 to August 2022 were retrospectively analyzed, including 15 intracranial, 30 pulmonary, and 12 abdominal tumors cases. Point-dose and planar-dose verifications were performed using an ionization chamber and radiochromic films embedded in a homogeneous phantom, and the results were compared with those calculated by the treatment planning system (TPS). The localization CT images and corresponding SRT plans were imported into the ArcherQA system for independent dose verification and analysis. The correlation between ArcherQA results and phantom measurements was analyzed, with comparisons of target mean dose differences and γ pass rates.Results:Phantom measurement results showed, the measured point-dose differences for intracranial, lung, and abdominal plans were -0.94% ± 3.22%, 1.92% ± 2.05%, and 2.12% ± 0.77%, respectively. The mean dose differences in target dose calculation between ArcherQA and TPS: intracranial in the gross tumor volume (GTV) regions were 0.34% ± 2.21%, lung tumor GTV were -2.47% ± 2.46%, and abdominal tumor GTV were 0.80% ± 2.61%, respectively. Among them, the abdominal GTV region showed the highest correlation between ArcherQA and measured results ( r=0.78). The average two-dimensional γ pass rates (2 mm/2%, threshold=10%) measured using phantom films were 95.92% ± 2.35% for intracranial, 95.70% ± 2.74% for lung, and 96.74% ± 3.41% for abdominal tumors plans, respectively. The three-dimensional ArcherQA results showed comparable γ pass rates (1 mm/2%, threshold=10%) for lung and abdominal GTV and PTV regions, with similar medians and data dispersion to film measurements. Conclusions:The ArcherQA system enables rapid and efficient independent dose verification of CK SRT plans without the need for additional hardware. The verification results show good correlation with phantom measurements, supporting its potential as an auxiliary quality assurance tool in clinical CK SRT implementation.

Since cemiplimab was approved by United States Food and Drug Administration in 2018, anti-programmed cell death receptor-1 antibodies have been considered as the first-line systemic therapy for advanced cutaneous squamous cell carcinoma. This review focuses on current clinical application of targeted therapy, immunotherapy, targeted immunotherapy and gene therapy for cutaneous squamous cell carcinoma.

Many nail changes have been found to be associated with systemic diseases, such as acropachy, koilonychia, splinter hemorrhages, leukonychia, yellow nail syndrome, Beau's lines, etc., so they may provide clues for the diagnosis of systemic disorders. However, studies on nail damages secondary to systemic diseases are rare, and their pathogenesis is still unclear. This review summarizes the progress in the pathogenesis of nail damages in systemic diseases, so as to improve their diagnosis and treatment.

Nail dystrophy is a group of non-specific nail plate diseases with various clinical manifestations caused by multiple factors. Appropriate surgical approaches could be chosen according to different causes of nail dystrophy to improve the nail plate shape and relieve clinical symptoms. This review summarizes the progress in surgical treatment of pachyonychia congenita, congenital malalignment of the great toenail, congenital hypertrophy of the lateral nail folds of the hallux, chronic paronychia and other nail dystrophies, including resection of the nail matrix and nail bed, nail unit rotation surgery combined with wedge-shaped skin flap excision and repair, nail fold reconstruction, Swiss roll technique, etc., in order to provide a reference for clinicians to choose appropriate surgical approaches.

Skin imaging techniques can markedly improve the accuracy of diagnosis of nail diseases, and can be used to evaluate therapeutic effects. This review mainly summarizes the application of reflectance confocal microscopy, optical coherence tomography, high-frequency ultrasound, and nailfold capillaroscopy in nail diseases, and evaluates their advantages and limitations in clinical practice.