Objective:To compare the clinical efficacy and safety of bronchial artery chemoembolization (BACE) combined with anlotinib (BACE+A) versus BACE alone in patients with stage III-IV non-small cell lung cancer (NSCLC).Methods:A total of 94 patients with advanced NSCLC treated at six interventional centers between November 2020 and November 2021 were retrospectively enrolled. Patients were divided into the BACE+A group ( n=46) and the BACE alone group ( n=48) based on treatment regimen. Baseline and perioperative clinical data were collected and compared between the two groups. Treatment response was evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at 1, 6, and 12 months after the first BACE procedure. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (AEs) were recorded. Kaplan-Meier survival curves were plotted to compare median OS and PFS between groups. Cox proportional hazards regression analysis was used to identify factors influencing OS and PFS. Results:The Kaplan-Meier analysis showed that the median OS was significantly longer in the BACE+A group (18.8 months, 95% CI 16.3-21.3) than in the BACE group (13.4 months, 95% CI 11.6-15.2) ( P=0.001). The median PFS was also significantly longer in the BACE+A group (9.0 months, 95% CI 7.3-10.7) compared to the BACE group (6.1 months, 95% CI 4.9-7.3) ( P=0.001). At 6 and 12 months post-first BACE, the ORR (43.5%, 40.0%) and DCR (89.1%, 83.3%) were significantly higher in the BACE+A group than in the BACE group (ORR: 20.8%, 14.8%; DCR: 66.7%, 59.3%) (all P<0.05). Multivariate Cox regression identified treatment with BACE+A ( HR=0.42, 95% CI 0.27-0.72, P=0.002), tumor stage ( HR=1.80, 95% CI 1.05-3.07, P=0.031), presence of pre-existing complications requiring intervention ( HR=2.72, 95% CI 1.65-4.50, P<0.001), and >2 BACE procedures ( HR=0.32, 95% CI 0.15-0.68, P=0.003) as independent factors influencing OS. Treatment with BACE+A ( HR=0.49, 95% CI 0.32-0.76, P=0.001), tumor stage ( HR=1.72, 95% CI 1.07-2.77, P=0.025), multi-arterial tumor blood supply ( HR=2.76, 95% CI 1.76-4.31, P<0.001), and>2 BACE procedures ( HR=0.40, 95% CI 0.22-0.71, P=0.002) were independent factors influencing PFS. There was no significant difference in BACE-related adverse events between the two groups (all P>0.05). Hypertension, fatigue, hand-foot syndrome, and anorexia were common anlotinib-specific adverse reactions in the combination group, but no grade 4 or higher adverse reactions were observed. Conclusions:BACE combined with anlotinib demonstrates superior efficacy compared to BACE alone in treating advanced NSCLC, significantly prolonging OS and PFS. The safety profile is manageable, with adverse events remaining within tolerable limits.

Objective:To compare the clinical efficacy and safety of bronchial artery chemoembolization (BACE) combined with anlotinib (BACE+A) versus BACE alone in patients with stage III-IV non-small cell lung cancer (NSCLC).Methods:A total of 94 patients with advanced NSCLC treated at six interventional centers between November 2020 and November 2021 were retrospectively enrolled. Patients were divided into the BACE+A group ( n=46) and the BACE alone group ( n=48) based on treatment regimen. Baseline and perioperative clinical data were collected and compared between the two groups. Treatment response was evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at 1, 6, and 12 months after the first BACE procedure. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (AEs) were recorded. Kaplan-Meier survival curves were plotted to compare median OS and PFS between groups. Cox proportional hazards regression analysis was used to identify factors influencing OS and PFS. Results:The Kaplan-Meier analysis showed that the median OS was significantly longer in the BACE+A group (18.8 months, 95% CI 16.3-21.3) than in the BACE group (13.4 months, 95% CI 11.6-15.2) ( P=0.001). The median PFS was also significantly longer in the BACE+A group (9.0 months, 95% CI 7.3-10.7) compared to the BACE group (6.1 months, 95% CI 4.9-7.3) ( P=0.001). At 6 and 12 months post-first BACE, the ORR (43.5%, 40.0%) and DCR (89.1%, 83.3%) were significantly higher in the BACE+A group than in the BACE group (ORR: 20.8%, 14.8%; DCR: 66.7%, 59.3%) (all P<0.05). Multivariate Cox regression identified treatment with BACE+A ( HR=0.42, 95% CI 0.27-0.72, P=0.002), tumor stage ( HR=1.80, 95% CI 1.05-3.07, P=0.031), presence of pre-existing complications requiring intervention ( HR=2.72, 95% CI 1.65-4.50, P<0.001), and >2 BACE procedures ( HR=0.32, 95% CI 0.15-0.68, P=0.003) as independent factors influencing OS. Treatment with BACE+A ( HR=0.49, 95% CI 0.32-0.76, P=0.001), tumor stage ( HR=1.72, 95% CI 1.07-2.77, P=0.025), multi-arterial tumor blood supply ( HR=2.76, 95% CI 1.76-4.31, P<0.001), and>2 BACE procedures ( HR=0.40, 95% CI 0.22-0.71, P=0.002) were independent factors influencing PFS. There was no significant difference in BACE-related adverse events between the two groups (all P>0.05). Hypertension, fatigue, hand-foot syndrome, and anorexia were common anlotinib-specific adverse reactions in the combination group, but no grade 4 or higher adverse reactions were observed. Conclusions:BACE combined with anlotinib demonstrates superior efficacy compared to BACE alone in treating advanced NSCLC, significantly prolonging OS and PFS. The safety profile is manageable, with adverse events remaining within tolerable limits.

BACKGROUND: Neoadjuvant chemoradiotherapy followed by radical surgery has been a common practice for patients with locally advanced rectal cancer, but the response rate varies among patients. This study aimed to develop a ResNet-Vision Transformer based magnetic resonance imaging (MRI)-endoscopy fusion model to precisely predict treatment response and provide personalized treatment. METHODS: In this multicenter study, 366 eligible patients who had undergone neoadjuvant chemoradiotherapy followed by radical surgery at eight Chinese tertiary hospitals between January 2017 and June 2024 were recruited, with 2928 pretreatment colonic endoscopic images and 366 pelvic MRI images. An MRI-endoscopy fusion model was constructed based on the ResNet backbone and Transformer network using pretreatment MRI and endoscopic images. Treatment response was defined as good response or non-good response based on the tumor regression grade. The Delong test and the Hanley-McNeil test were utilized to compare prediction performance among different models and different subgroups, respectively. The predictive performance of the MRI-endoscopy fusion model was comprehensively validated in the test sets and was further compared to that of the single-modal MRI model and single-modal endoscopy model. RESULTS: The MRI-endoscopy fusion model demonstrated favorable prediction performance. In the internal validation set, the area under the curve (AUC) and accuracy were 0.852 (95% confidence interval [CI]: 0.744-0.940) and 0.737 (95% CI: 0.712-0.844), respectively. Moreover, the AUC and accuracy reached 0.769 (95% CI: 0.678-0.861) and 0.729 (95% CI: 0.628-0.821), respectively, in the external test set. In addition, the MRI-endoscopy fusion model outperformed the single-modal MRI model (AUC: 0.692 [95% CI: 0.609-0.783], accuracy: 0.659 [95% CI: 0.565-0.775]) and the single-modal endoscopy model (AUC: 0.720 [95% CI: 0.617-0.823], accuracy: 0.713 [95% CI: 0.612-0.809]) in the external test set. CONCLUSION The MRI-endoscopy fusion model based on ResNet-Vision Transformer achieved favorable performance in predicting treatment response to neoadjuvant chemoradiotherapy and holds tremendous potential for enabling personalized treatment regimens for locally advanced rectal cancer patients.
Humans ; Rectal Neoplasms/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Male ; Female ; Middle Aged ; Neoadjuvant Therapy/methods* ; Aged ; Adult ; Chemoradiotherapy/methods* ; Endoscopy/methods* ; Treatment Outcome

Primary hypotension is a common and frequently occurring blood vessel disease,characterized by insidious onset,lingering condition,complex etiology,and diverse symptoms.Its pathogenesis is primarily characterized by deficiency,and its onset involves multiple zang-fu organs.The"yang transforming qi and yin shaping up body"theory is derived from the Huangdi Neijing.This theory summarizes the fundamental laws of the movement and changes in yin and yang.From this perspective,the paper hypothesizes that the basic pathogenesis of primary hypotension stems from an insufficiency of yang in transforming qi and a malfunction of yin in shaping up body.The essence of the condition lies in an overall yang deficiency that fails to provide warmth and transformation,coupled with qi deficiency,which cannot control and regulate bodily functions.This leads to poor blood circulation and inadequate protection,causing yin to malfunction in forming the physical components of the body.As a result,normal physiological functions of the zang-fu organs are disrupted,the production of beneficial physiological substances is obstructed,and metabolic waste products accumulate.The primary therapeutic approach should be focused on tonifying qi and ascending yang;tonifying qi will provide the impetus for blood circulation,whereas ascending yang will facilitate yang transformation qi.The zang-fu organs should also be protected and nourished to ameliorate the internal environment of yang deficiency and yin excess,as well as to eliminate pathological product accumulation to dredge the channels of blood circulation.Using the"yang transforming qi and yin shaping up the body"theory to guide the treatment of primary hypotension can help deepen the understanding of the pathogenesis of this disease and broaden the clinical diagnosis and treatment strategies.

Primary hypotension is a common and frequently occurring blood vessel disease,characterized by insidious onset,lingering condition,complex etiology,and diverse symptoms.Its pathogenesis is primarily characterized by deficiency,and its onset involves multiple zang-fu organs.The"yang transforming qi and yin shaping up body"theory is derived from the Huangdi Neijing.This theory summarizes the fundamental laws of the movement and changes in yin and yang.From this perspective,the paper hypothesizes that the basic pathogenesis of primary hypotension stems from an insufficiency of yang in transforming qi and a malfunction of yin in shaping up body.The essence of the condition lies in an overall yang deficiency that fails to provide warmth and transformation,coupled with qi deficiency,which cannot control and regulate bodily functions.This leads to poor blood circulation and inadequate protection,causing yin to malfunction in forming the physical components of the body.As a result,normal physiological functions of the zang-fu organs are disrupted,the production of beneficial physiological substances is obstructed,and metabolic waste products accumulate.The primary therapeutic approach should be focused on tonifying qi and ascending yang;tonifying qi will provide the impetus for blood circulation,whereas ascending yang will facilitate yang transformation qi.The zang-fu organs should also be protected and nourished to ameliorate the internal environment of yang deficiency and yin excess,as well as to eliminate pathological product accumulation to dredge the channels of blood circulation.Using the"yang transforming qi and yin shaping up the body"theory to guide the treatment of primary hypotension can help deepen the understanding of the pathogenesis of this disease and broaden the clinical diagnosis and treatment strategies.

Primary hypotension is a common and frequently occurring blood vessel disease,characterized by insidious onset,lingering condition,complex etiology,and diverse symptoms.Its pathogenesis is primarily characterized by deficiency,and its onset involves multiple zang-fu organs.The"yang transforming qi and yin shaping up body"theory is derived from the Huangdi Neijing.This theory summarizes the fundamental laws of the movement and changes in yin and yang.From this perspective,the paper hypothesizes that the basic pathogenesis of primary hypotension stems from an insufficiency of yang in transforming qi and a malfunction of yin in shaping up body.The essence of the condition lies in an overall yang deficiency that fails to provide warmth and transformation,coupled with qi deficiency,which cannot control and regulate bodily functions.This leads to poor blood circulation and inadequate protection,causing yin to malfunction in forming the physical components of the body.As a result,normal physiological functions of the zang-fu organs are disrupted,the production of beneficial physiological substances is obstructed,and metabolic waste products accumulate.The primary therapeutic approach should be focused on tonifying qi and ascending yang;tonifying qi will provide the impetus for blood circulation,whereas ascending yang will facilitate yang transformation qi.The zang-fu organs should also be protected and nourished to ameliorate the internal environment of yang deficiency and yin excess,as well as to eliminate pathological product accumulation to dredge the channels of blood circulation.Using the"yang transforming qi and yin shaping up the body"theory to guide the treatment of primary hypotension can help deepen the understanding of the pathogenesis of this disease and broaden the clinical diagnosis and treatment strategies.

Primary hypotension is a common and frequently occurring blood vessel disease,characterized by insidious onset,lingering condition,complex etiology,and diverse symptoms.Its pathogenesis is primarily characterized by deficiency,and its onset involves multiple zang-fu organs.The"yang transforming qi and yin shaping up body"theory is derived from the Huangdi Neijing.This theory summarizes the fundamental laws of the movement and changes in yin and yang.From this perspective,the paper hypothesizes that the basic pathogenesis of primary hypotension stems from an insufficiency of yang in transforming qi and a malfunction of yin in shaping up body.The essence of the condition lies in an overall yang deficiency that fails to provide warmth and transformation,coupled with qi deficiency,which cannot control and regulate bodily functions.This leads to poor blood circulation and inadequate protection,causing yin to malfunction in forming the physical components of the body.As a result,normal physiological functions of the zang-fu organs are disrupted,the production of beneficial physiological substances is obstructed,and metabolic waste products accumulate.The primary therapeutic approach should be focused on tonifying qi and ascending yang;tonifying qi will provide the impetus for blood circulation,whereas ascending yang will facilitate yang transformation qi.The zang-fu organs should also be protected and nourished to ameliorate the internal environment of yang deficiency and yin excess,as well as to eliminate pathological product accumulation to dredge the channels of blood circulation.Using the"yang transforming qi and yin shaping up the body"theory to guide the treatment of primary hypotension can help deepen the understanding of the pathogenesis of this disease and broaden the clinical diagnosis and treatment strategies.

Primary hypotension is a common and frequently occurring blood vessel disease,characterized by insidious onset,lingering condition,complex etiology,and diverse symptoms.Its pathogenesis is primarily characterized by deficiency,and its onset involves multiple zang-fu organs.The"yang transforming qi and yin shaping up body"theory is derived from the Huangdi Neijing.This theory summarizes the fundamental laws of the movement and changes in yin and yang.From this perspective,the paper hypothesizes that the basic pathogenesis of primary hypotension stems from an insufficiency of yang in transforming qi and a malfunction of yin in shaping up body.The essence of the condition lies in an overall yang deficiency that fails to provide warmth and transformation,coupled with qi deficiency,which cannot control and regulate bodily functions.This leads to poor blood circulation and inadequate protection,causing yin to malfunction in forming the physical components of the body.As a result,normal physiological functions of the zang-fu organs are disrupted,the production of beneficial physiological substances is obstructed,and metabolic waste products accumulate.The primary therapeutic approach should be focused on tonifying qi and ascending yang;tonifying qi will provide the impetus for blood circulation,whereas ascending yang will facilitate yang transformation qi.The zang-fu organs should also be protected and nourished to ameliorate the internal environment of yang deficiency and yin excess,as well as to eliminate pathological product accumulation to dredge the channels of blood circulation.Using the"yang transforming qi and yin shaping up the body"theory to guide the treatment of primary hypotension can help deepen the understanding of the pathogenesis of this disease and broaden the clinical diagnosis and treatment strategies.

Primary hypotension is a common and frequently occurring blood vessel disease,characterized by insidious onset,lingering condition,complex etiology,and diverse symptoms.Its pathogenesis is primarily characterized by deficiency,and its onset involves multiple zang-fu organs.The"yang transforming qi and yin shaping up body"theory is derived from the Huangdi Neijing.This theory summarizes the fundamental laws of the movement and changes in yin and yang.From this perspective,the paper hypothesizes that the basic pathogenesis of primary hypotension stems from an insufficiency of yang in transforming qi and a malfunction of yin in shaping up body.The essence of the condition lies in an overall yang deficiency that fails to provide warmth and transformation,coupled with qi deficiency,which cannot control and regulate bodily functions.This leads to poor blood circulation and inadequate protection,causing yin to malfunction in forming the physical components of the body.As a result,normal physiological functions of the zang-fu organs are disrupted,the production of beneficial physiological substances is obstructed,and metabolic waste products accumulate.The primary therapeutic approach should be focused on tonifying qi and ascending yang;tonifying qi will provide the impetus for blood circulation,whereas ascending yang will facilitate yang transformation qi.The zang-fu organs should also be protected and nourished to ameliorate the internal environment of yang deficiency and yin excess,as well as to eliminate pathological product accumulation to dredge the channels of blood circulation.Using the"yang transforming qi and yin shaping up the body"theory to guide the treatment of primary hypotension can help deepen the understanding of the pathogenesis of this disease and broaden the clinical diagnosis and treatment strategies.

Primary hypotension is a common and frequently occurring blood vessel disease,characterized by insidious onset,lingering condition,complex etiology,and diverse symptoms.Its pathogenesis is primarily characterized by deficiency,and its onset involves multiple zang-fu organs.The"yang transforming qi and yin shaping up body"theory is derived from the Huangdi Neijing.This theory summarizes the fundamental laws of the movement and changes in yin and yang.From this perspective,the paper hypothesizes that the basic pathogenesis of primary hypotension stems from an insufficiency of yang in transforming qi and a malfunction of yin in shaping up body.The essence of the condition lies in an overall yang deficiency that fails to provide warmth and transformation,coupled with qi deficiency,which cannot control and regulate bodily functions.This leads to poor blood circulation and inadequate protection,causing yin to malfunction in forming the physical components of the body.As a result,normal physiological functions of the zang-fu organs are disrupted,the production of beneficial physiological substances is obstructed,and metabolic waste products accumulate.The primary therapeutic approach should be focused on tonifying qi and ascending yang;tonifying qi will provide the impetus for blood circulation,whereas ascending yang will facilitate yang transformation qi.The zang-fu organs should also be protected and nourished to ameliorate the internal environment of yang deficiency and yin excess,as well as to eliminate pathological product accumulation to dredge the channels of blood circulation.Using the"yang transforming qi and yin shaping up the body"theory to guide the treatment of primary hypotension can help deepen the understanding of the pathogenesis of this disease and broaden the clinical diagnosis and treatment strategies.