Approximately 30%-40% of prostate cancer patients undergoing surgical treatment will experience biochemical recurrence. However, this proportion will be increased to 50%-70% among those with locally advanced, high-risk disease. In contrast to the approach of active surveillance, adjuvant radiotherapy (ART) administered after prostate surgery has demonstrated a substantial reduction of approximately 50% in the risk of biochemical recurrence among high-risk patients exhibiting adverse pathological characteristics such as extraprostatic extension, seminal vesicle invasion, a high Gleason score, or positive surgical margins. This conclusion is firmly supported by the results of three prior randomized controlled trials. In three recently published comparative studies, salvage radiation therapy (SRT) and ART were rigorously compared among patients with high-risk prostate cancer who had undergone surgical treatment. The results revealed that the early SRT cohort exhibited comparable rates of event-free survival, clinical outcomes, and radiological progression to those observed in the ART group. Notably, the SRT group reported significantly fewer adverse effects related to urinary and bowel functions, suggesting a more favorable safety profile compared to the ART group. However, there is substantial heterogeneity among the enrolled patient populations across these studies, exhibiting unfavorable characteristics. In real-world settings, we frequently encounter patients with multiple high-risk characteristics and those who have developed pelvic lymph node metastasis postoperatively. Given this, it is imperative to undertake an individualized analysis of these adverse features, which will enable us to precisely identify patients who are most responsive to postoperative ART while effectively mitigating radiotherapy-related adverse effects. Consequently, an improvement can be obtained in patient survival rates while also ensuring their quality of life.

Patients with oligometastatic prostate cancer based on accurate diagnosis should be given active treatment. We should optimize the benefit through tailored approaches encompassing systemic treatment, local therapy, and metastasis-directed therapy. The optimal combination and duration of systemic treatment are currently undefined. Combining new hormonal agents with androgen deprivation therapy is recommended. Most experts advocate a duration of hormonal therapy ranging from 18 to 36 months. Local therapy for the primary lesion, surgery or radiotherapy, has been clinically validated for its feasibility and effectiveness in oligometastatic prostate cancer patients. Stereotactic ablative radiation therapy for metastatic lesions ensures safe and reliable local control. In summary, maximal eradication of all visible active lesions may confer a survival benefit to these patients. We provide a comprehensive review for the treatment of oligometastatic hormone-sensitive prostate cancer, aiming to contribute insights for clinical diagnosis and treatment.

Hepatic metastasis is the most common in rectal cancer, and patients with resectable hepatic metastasis have better survival. Pelvic radiotherapy has become a key component of multidisciplinary management of rectal cancer with hepatic metastasis. For patients with unresectable hepatic metastasis, palliative radiotherapy to the primary lesion can reduce the risk of bleeding and obstruction and thus improve the quality of life. For patients with resectable hepatic metastasis, pelvic radiotherapy can effectively reduce the local recurrence rate, help some patients avoid surgery and improve their quality of life, and even improve the overall survival. At present, there is no consensus on the standardized treatment mode of pelvic radiotherapy for rectal cancer patients with hepatic metastasis, and it has become a hotspot for research on how to select the population benefiting from radiotherapy, how to optimize multidisciplinary collaboration and radiotherapy plans (long-course radiotherapy versus short-course radiotherapy) and how to preserve organs. This article reviews the research progress in pelvic radiotherapy for rectal cancer with hepatic metastasis in recent years, and provides ideas for individualized pelvic radiotherapy for rectal cancer with hepatic metastasis.

Hepatic metastasis is the most common in rectal cancer, and patients with resectable hepatic metastasis have better survival. Pelvic radiotherapy has become a key component of multidisciplinary management of rectal cancer with hepatic metastasis. For patients with unresectable hepatic metastasis, palliative radiotherapy to the primary lesion can reduce the risk of bleeding and obstruction and thus improve the quality of life. For patients with resectable hepatic metastasis, pelvic radiotherapy can effectively reduce the local recurrence rate, help some patients avoid surgery and improve their quality of life, and even improve the overall survival. At present, there is no consensus on the standardized treatment mode of pelvic radiotherapy for rectal cancer patients with hepatic metastasis, and it has become a hotspot for research on how to select the population benefiting from radiotherapy, how to optimize multidisciplinary collaboration and radiotherapy plans (long-course radiotherapy versus short-course radiotherapy) and how to preserve organs. This article reviews the research progress in pelvic radiotherapy for rectal cancer with hepatic metastasis in recent years, and provides ideas for individualized pelvic radiotherapy for rectal cancer with hepatic metastasis.

Research in abdominal wall mechanics is progressively overcoming the limitations of traditional assessment methods with the application of machine learning and artificial intelligence technologies.By leveraging deep learning algorithms and big data analytics,precise mechanical and predictive models are being established to analyze the stress distribution in abdominal wall muscles under various conditions,facilitating the development of personalized treatment strategies.This approach not only aids in optimizing hernia repair strategies and reducing recurrence risks,but also has the potential to improve patient outcomes.Looking ahead,the continued integration of multidimensional data will further drive systematic research and clinical application in the field of abdominal wall mechanics.

Objective To investigate the influencing factors of unplanned rehospitalization within one year after surgery among adult renal transplant recipients. Methods The clinical data of 299 recipients who underwent renal transplant surgery in the Department of Organ Transplantation of the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2022 were retrospectively analyzed. The recipients were divided into unplanned rehospitalization group and non-rehospitalization group based on whether they experienced unplanned rehospitalization within one year after surgery. Univariate analysis and binary Logistic regression analysis were performed to explore the influencing factors of unplanned rehospitalization within one year after renal transplantation. Results Among the 299 recipients, 102 experienced unplanned rehospitalization, with an incidence rate of 34.11%. Univariate analysis revealedstatistically significant differences were noted between the two groups in terms of gender, occupational status, preoperative underlying disease, rejection reactions, nosocomial infections, immunosuppressive medication regimens, serum creatinine, cystatin C, serum phosphorus, serum potassium, and initial hospitalization duration (P < 0.05). Binary Logistic regression analysis showed that having ≥3 kinds of preoperative underlying disease (OR=2.122, 95%CI, 1.198 to 3.759) and experiencing rejection reactions (OR=3.162, 95%CI, 1.217 to 8.218) were independent risk factors for unplanned rehospitalization within one year after renal transplantation (P < 0.05). Conclusion The rate of unplanned rehospitalization within one year after surgery is relatively high among adult renal transplant recipients. Having ≥3 preoperative underlying disease and experiencing rejection reactions are independent risk factors for unplanned rehospitalization within one year after surgery. Transplantation healthcare teams can develop corresponding strategies targeting these risk factors to reduce the rate of unplanned rehospitalization and alleviate the burden of disease.

Distant metastasis, peritoneal recurrence and locoregional recurrence are the three major patterns of gastric cancer (GC) recurrence after surgery and the causes of patients'death. Among them, distant organ metastasis or peritoneal recurrence after surgery is more common and occurs earlier, while locoregional failure alone occurs later with a relatively lower incidence. Several studies have confirmed that preoperative radiotherapy can shrink tumors and increase R0 resection rates, and postoperative radiotherapy helps reduce local recurrence. However, whether perioperative radiotherapy can further improve patient survival is still controversial.. We believe that this is partly due to the characteristics of recurrence and metastasis. As a local treatment, radiotherapy is complement to the inadequacy of surgery. Thus, we believe that perioperative radiotherapy is not recommended for patients with standard R0 surgery and adequate lymph node dissection, but rather requires accurate prediction of their recurrence and metastasis patterns based on accurate clinical and pathological staging, and thus screening of those who may benefit from radiotherapy.

Distant metastasis, peritoneal recurrence and locoregional recurrence are the three major patterns of gastric cancer (GC) recurrence after surgery and the causes of patients'death. Among them, distant organ metastasis or peritoneal recurrence after surgery is more common and occurs earlier, while locoregional failure alone occurs later with a relatively lower incidence. Several studies have confirmed that preoperative radiotherapy can shrink tumors and increase R0 resection rates, and postoperative radiotherapy helps reduce local recurrence. However, whether perioperative radiotherapy can further improve patient survival is still controversial.. We believe that this is partly due to the characteristics of recurrence and metastasis. As a local treatment, radiotherapy is complement to the inadequacy of surgery. Thus, we believe that perioperative radiotherapy is not recommended for patients with standard R0 surgery and adequate lymph node dissection, but rather requires accurate prediction of their recurrence and metastasis patterns based on accurate clinical and pathological staging, and thus screening of those who may benefit from radiotherapy.

Radiotherapy is a pivotal method in cancer treatment harbouring immunomodulatory effects. Radiotherapy combined with immunotherapy has been proven to yield promising preliminary results in certain types of tumors. Most studies have concentrated on the dose fractionation of radiotherapy and timing of radiotherapy and immunotherapy. With the development of related studies, attention has been gradually paid to the influence of target volume upon circulating lymphocytes and tumor microenvironment. The interaction between target volume and immunotherapy has been valued. For tumors not suitable for hypofractionated radiotherapy, such as advanced esophageal cancer, conventional fractionated radiotherapy has been adopted. The volume and planning of target volume play a pivotal role in radiotherapy combined with immunotherapy. This article illustrates the feasibility of radiotherapy combined with immunotherapy, theory and conception of optimizing target volume.

The glymphatic system plays a pivotal role in maintaining cerebral homeostasis. Chronic cerebral hypoperfusion, arising from small vessel disease or carotid stenosis, results in cerebrometabolic disturbances ultimately manifesting in white matter injury and cognitive dysfunction. However, whether the glymphatic system serves as a potential therapeutic target for white matter injury and cognitive decline during hypoperfusion remains unknown. Here, we established a mouse model of chronic cerebral hypoperfusion via bilateral common carotid artery stenosis. We found that the hypoperfusion model was associated with significant white matter injury and initial cognitive impairment in conjunction with impaired glymphatic system function. The glymphatic dysfunction was associated with altered cerebral perfusion and loss of aquaporin 4 polarization. Treatment of digoxin rescued changes in glymphatic transport, white matter structure, and cognitive function. Suppression of glymphatic functions by treatment with the AQP4 inhibitor TGN-020 abolished this protective effect of digoxin from hypoperfusion injury. Our research yields new insight into the relationship between hemodynamics, glymphatic transport, white matter injury, and cognitive changes after chronic cerebral hypoperfusion.
Animals ; Brain Ischemia ; Carotid Stenosis/drug therapy* ; Cognitive Dysfunction/etiology* ; Digoxin ; Disease Models, Animal ; Mice ; Mice, Inbred C57BL ; White Matter