Abstract:OBJECTIVERenal cell carcinoma (RCC) frequently metastasizes to the spine, causing pain or neurological dysfunction, and is often resistant to standard therapies. Spinal surgery is frequently required, but may result in high morbidity rates. The authors sought to identify prognostic factors and determine clinical outcomes in patients undergoing surgery for RCC spinal metastases.METHODSThe authors searc… Show more
“…[1][2][3] For example, surgical resection may lead to organ failure and rapid tumor metastasis; radiotherapy has toxic effects on normal tissues, and non-specific chemotherapy leads to severe systemic toxicity. [4][5][6] As a result, modern medical research has focused on the urgent development of newer, less toxic treatment methods. In recent years, photothermal therapy (PTT) has been demonstrated as a highly effective cancer treatment by many scientists.…”
The aim of this study was to develop an "all-in-one" nanoplatform that integrates at the second near-infrared (NIR-II) region dye IR1061 and anticancer drug paclitaxel (PTX) into an apoferritin (AFN) nanocage (IR-AFN@PTX). Simultaneously, folic acid (FA), tumor target molecule, was conjugated onto IR-AFN@PTX to be IR-AFN@PTX-FA for tumortargeted and pH/NIR-II-triggered synergistic photothermal-chemotherapy. Methods: IR1061 was firstly reacted with PEG and then conjugated with AFN to be IR-AFN. Then, FA was conjugated onto the surface of IR-AFN to be IR-AFN-FA. At last, PTX was incorporated into IR-AFN-FA to fabricate a nanoplatform IR-AFN@PTX-FA. The NIR-II photothermal properties and pH/NIR-II triggered drug release were evaluated. The ability of IR-AFN@PTX-FA to target tumors was estimated using optical bioluminescence. In vitro and in vivo synergistic therapeutic effects of pH/NIR-II-triggered and tumor-targeted photothermal-chemotherapy were investigated in 4T1 tumor model. Results: IR-AFN@PTX-FA showed excellent water solubility and physiological stability, which significantly enhanced the solubility of both IR1061 and PTX. After 5 min of laser irradiation at 1064 nm, IR-AFN@PTX-FA exhibited an effective photothermal effect compared with laser irradiation at 808 nm, even when blocked with 0.6 cm thick chicken breast. Cellular uptake experiments showed IR-AFN@PTX-FA utilized clathrin-mediated and caveolae-mediated endocytosis pathways to enter 4T1 cells, and was then delivered by the endosome to the lysosome. NIR-II laser irradiation and pH could synergistically trigger PTX release, inducing significant tumor inhibition in vitro and in vivo. Conclusion: As a novel "all-in-one" nanoplatform, IR-AFN@PTX-FA was found to selectively target tumors and showed very efficient NIR-II photothermal effects and pH/NIR-II triggered drug release effects, showing a remarkable, synergistic photothermal-chemotherapy effect.
“…[1][2][3] For example, surgical resection may lead to organ failure and rapid tumor metastasis; radiotherapy has toxic effects on normal tissues, and non-specific chemotherapy leads to severe systemic toxicity. [4][5][6] As a result, modern medical research has focused on the urgent development of newer, less toxic treatment methods. In recent years, photothermal therapy (PTT) has been demonstrated as a highly effective cancer treatment by many scientists.…”
The aim of this study was to develop an "all-in-one" nanoplatform that integrates at the second near-infrared (NIR-II) region dye IR1061 and anticancer drug paclitaxel (PTX) into an apoferritin (AFN) nanocage (IR-AFN@PTX). Simultaneously, folic acid (FA), tumor target molecule, was conjugated onto IR-AFN@PTX to be IR-AFN@PTX-FA for tumortargeted and pH/NIR-II-triggered synergistic photothermal-chemotherapy. Methods: IR1061 was firstly reacted with PEG and then conjugated with AFN to be IR-AFN. Then, FA was conjugated onto the surface of IR-AFN to be IR-AFN-FA. At last, PTX was incorporated into IR-AFN-FA to fabricate a nanoplatform IR-AFN@PTX-FA. The NIR-II photothermal properties and pH/NIR-II triggered drug release were evaluated. The ability of IR-AFN@PTX-FA to target tumors was estimated using optical bioluminescence. In vitro and in vivo synergistic therapeutic effects of pH/NIR-II-triggered and tumor-targeted photothermal-chemotherapy were investigated in 4T1 tumor model. Results: IR-AFN@PTX-FA showed excellent water solubility and physiological stability, which significantly enhanced the solubility of both IR1061 and PTX. After 5 min of laser irradiation at 1064 nm, IR-AFN@PTX-FA exhibited an effective photothermal effect compared with laser irradiation at 808 nm, even when blocked with 0.6 cm thick chicken breast. Cellular uptake experiments showed IR-AFN@PTX-FA utilized clathrin-mediated and caveolae-mediated endocytosis pathways to enter 4T1 cells, and was then delivered by the endosome to the lysosome. NIR-II laser irradiation and pH could synergistically trigger PTX release, inducing significant tumor inhibition in vitro and in vivo. Conclusion: As a novel "all-in-one" nanoplatform, IR-AFN@PTX-FA was found to selectively target tumors and showed very efficient NIR-II photothermal effects and pH/NIR-II triggered drug release effects, showing a remarkable, synergistic photothermal-chemotherapy effect.
“…The 338 full texts were excluded with the following reason: 304 studies didn ’ t involve prognostic effect of the factors involved in Tokuhashi Score; 28 studies were literature or systematic reviews; 3 studies of Lei [16–18] used repeated patients cohort, thus only the one [18] identified primary tumor histology as non-small cell lung cancer(NSCLC) was included; and another 4 studies of Rades [19–22] were also excluded for using repeated patients cohorts with other studies. Finally, 63 studies [6, 8, 9, 18, 24–72, 74–82] with 10,411 participants and 38 studies [8, 9, 18, 26, 28–38, 40, 41, 43, 44, 46, 47, 49, 51–53, 56, 58, 60, 63, 64, 66, 69, 71, 76, 78–81] with 7462 participants were included in the qualitative and quantitative synthesis respectively.Fig. 1Flowchart of studies identification and selection…”
BackgroundCancer patients’ survival time has obviously improved, with the development of systemic treatment techniques. However, the probability of metastases to the vertebrae has also been increased which makes some adverse effects on patients’ quality of life. The prediction of survival plays a key role in choosing therapeutic modality, and Tokuhashi Score was established as one of the most commonly used predictive systems for spinal metastases. Thus, this study was conducted to identify the prognostic effect of factors involved in revised Tokuhashi Score (RTS).MethodsTwo investigators independently retrieved relevant literature on platforms of PubMed, Embase and Cochrane Library. We identified eligible studies through title/abstract and full-text perusing. Data was extracted including general information of studies, participants’ characteristics, therapeutic modality, overall survival and prognostic effect of factors. Hazard ratio (HR) for each factor was synthesized if available through fixed- or random-effect models as appropriate.ResultsA total of 63 eligible studies with 10,411 participants were identified. Overall, cases with thyroid cancer had the highest survival rate, while the ones with non-small cell lung cancer and hepatocellular carcinoma lived for the shorted survival time. Performance status, bone metastasis, number of involved vertebrae, visceral metastasis, primary tumor and neurological status were regarded as significant predictors in 71.4, 40.0, 18.2, 63.4, 73.1 and 44.7% of the involved studies respectively. Thirty-eight articles were included in meta-analysis, and prognostic effects of five factors (apart from primary tumor) were analyzed. Factors were all proved to be significant except comparisons between KPS (Karnofsky Performance Status) 10–40 VS. 50–70 and single VS. multiple spinal metastases.ConclusionAll factors of RTS were significant on prognosis predicting and should be considered when choosing therapeutic modality for spinal metastases. What’s more, we believe that more accurate prognosis may be obtained after removal of the cut-offs for KPS 10–40 VS. 50–70 and single VS. multiple involved vertebrae.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-5139-2) contains supplementary material, which is available to authorized users.
“…The literature search identified 1440 unique results, where 47 articles met the inclusion criteria with a total of 807 patients included in the data analysis ( Figure 1 ). 1 , 10 , 11 , 13 , 15 , 18 – 60 Demographics, presenting features, treatment, and survival information were compiled for those patients with known status. The majority of patients were male (75.5%), and the mean age at diagnosis of RCC spine metastasis was 56.7 years.…”
Study Design:Systematic review.Objectives:The objective of this systematic review was to answer 2 key questions: (1)
What is the clinical presentation and probability of symptomatic improvement
following treatment for patients with renal cell carcinoma (RCC) of the
spine? (2) What is the overall survival of patients diagnosed with spinal
metastases from RCC?Methods:A literature review was performed to identify articles that reported on
survival, clinical outcomes, and/or prognostic factors in the RCC population
with spinal metastases from 1986 to 2016.Results:Forty-eight articles (807 patients) were included. The Fuhrman Nuclear Grade
has been significantly associated with survival in previous studies but was
underpowered in the current study. The Memorial Sloan-Kettering Cancer
Center Score (MSKCC/Motzer) was also underpowered in the current study. From
the time of spinal metastasis, the mean and median survival for patients
with previously diagnosed primary RCC was 8.75 and 11.7 months,
respectively, whereas synchronously diagnosed patients (primary RCC and
spinal metastasis) had a mean and median survival of 6.75 and 11 months,
respectively. Patients with a “low” (0-8), “intermediate” (9-11), or “high”
(12-15) revised Tokuhashi score at initial presentation had a median
survival of 5.4, 11.7, and 32.9 months, respectively.Conclusion:Patients with either a synchronous or latent diagnosis of RCC survived
greater than 6 months from the time of presentation. Initial Furhman grade,
Tokuhashi score, and MSKCC/Motzer can be useful tools in informing
patient-specific prognosis for those with metastatic RCC of the spine.
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