Seasonal influenza vaccination among cancer patients: A systematic review and meta-analysis of the determinants

Cancer patients are among high-risk individuals for whom seasonal influenza vaccine (SIV) is recommended, but rates of vaccination in this subpopulation remain suboptimal; even in jurisdictions with universal influenza vaccination programs. We sought to summarize the evidence to better understand the determinants of SIV uptake (vaccine receipt) among cancer patients. We searched MEDLINE, Embase, and CINAHL from 2000 to February 12, 2020, focusing on articles on the determinants of seasonal influenza vaccination among cancer patients, published in English. Study selection was conducted independently by 2 reviewers. One reviewer extracted data from the included studies and another reviewer checked the extracted data for errors. Outcomes were sociodemographic and health-related factors. We pooled adjusted results from studies using the inverse variance, random-effects method, and reported the odds ratios (OR) and their 95% confidence intervals (CI). Out of 2664 citations, 10 studies (mostly from USA and South Korea) met our eligibility criteria. Overall, being older (OR 2.23, 95% CI 1.46-3.38; I² 92.3%, [6 studies]), a nonsmoker (1.43, 1.32-1.51; I² 0%, [4 studies]), having a chronic illness (1.18, 1.07-1.29; I² 15.7%, [5 studies]), having had a medical check-up in the past year (1.75, 1.65-1.86; I² 0%, [2 studies]), and having health insurance (1.39, 1.13-1.72; I² 21.8%, [3 studies]) were associated with increased SIV uptake. Compared with being African-American, being Caucasian was also associated with increased SIV uptake (1.79, 1.47-2.13; I² 10.7%, [3 studies]). Limited evidence suggests seasonal influenza vaccination among cancer patients may be determined by some sociodemographic and health-related factors.     

Experience of Interstitial Permanent I125 Brachytherapy for Extremity Soft Tissue Sarcomas

AimsSoft tissue sarcomas are uncommon, but relatively aggressive tumours. Although surgical resection remains the primary therapeutic modality for all localised tumours, brachytherapy combined with function-preserving excision is a popular treatment for extremity soft tissue sarcomas. The objective of this study was to evaluate the effect of interstitial permanent brachytherapy using I¹²⁵ seeds in patients undergoing the combined modality in the management of soft tissue sarcomas at our institution.Materials and methodsBetween January 2007 and January 2012, 110 adult patients aged 18–86 years (median = 44 years) with extremity soft tissue sarcomas and who underwent interstitial permanent brachytherapy as part of the local treatment were included in this study. Treatment included wide local excision of the tumour and brachytherapy using a permanent I¹²⁵ implantation. Complications were assessed in terms of wound complication and peripheral nerve damage.ResultsAfter a median follow-up of 43.7 months, the local control, disease-free survival and overall survival for the entire cohort studied were 74, 54 and 77%, respectively. The actual rates of wound complications requiring reoperation and nerve damage were 4.5 and 1.8%, respectively.ConclusionsWe conclude that interstitial permanent brachytherapy with I¹²⁵ after function-preserving surgery results in a satisfactory outcome in patients with extremity soft tissue sarcomas and the complication rate is low.     

TLR9 mediated regulatory B10 cell amplification following sub-total body irradiation: Implications in attenuating EAE

Autoimmunity and inflammation are controlled in part by regulatory B (Breg) cells, including the recently identified IL-10-competent B10 cell subset that represents 1%–3% of mouse spleen B cells. In this study, the influence of irradiation on Breg/B10 cell generation and IL-10 production mediated by TLR9 signaling pathways was investigated. Spleen and peritoneal cavity Breg/B10 cell frequencies were significantly expanded three weeks after sub-total body irradiation (sub-TBI, 5 Gy or 10 Gy) in adult male wild type (WT) C57BL/6(B6) mice but not in TLR9^−/− mice. TLR9 agonist ODN1826 stimulation in vitro for 5 h induced more B10 cells to express cytoplasmic IL-10 in sub-TBI WT mice than in TLR9^−/− mice. Prolonged ODN1826 stimulation (48 h) induced additional spleen CD19^hiCD5⁺CD1d^hi B cells to express IL-10. TLR9-dependent signaling molecules, MyD88, TRAF6 and IRF8 are involved in sub-TBI induced Breg/B10 cells development and expansion. Furthermore, using a mouse model for multiple sclerosis, we show here that sub-TBI induced Breg/B10 cells dramatically inhibit disease onset and severity when transferred into mice with established experimental autoimmune encephalomyelitis (EAE). Adoptively transferred sub-TBI induced Breg cells significantly suppress inflammatory T cell responses of TH17 and TH1 types in EAE mice. In conclusion, sub-TBI can drive Breg/B10 cell development and expansion, which could be used as a novel tool for suppressing undesirable immunity. The ex vivo expansion and reinfusion of autologous Breg/B10 cells may provide a novel and effective in vivo treatment for severe autoimmune diseases that are resistant to current therapies.     

PARP-1 inhibitor-AG14361 suppresses acute allograft rejection via stabilizing CD4+FoxP3+ regulatory T cells

Acute allograft rejection is the most common complication in organ transplantation leading to organ loss. Treg cells play an important role in preventing acute rejection, but they are unstable and easily lose function. Poly(ADP-ribose) polymerase 1(PARP-1) is involved in the differentiation stabilization of Treg cells, it has been suggested that PARP-1 inhibition could prevent acute rejection and prolong allograft survival. This study investigated AG14361 effects on acute allograft rejection. We used a fully MHC-mismatched murine heart transplantation model to compare the effect of PARP-1 inhibitor-AG14361 on alloimmunity to the control. Mice treated with PARP-1 inhibitors showed a longer median survival time of allografts (MS14 compared with the control group, MST was 8 days, and AG14361 was 6 days, P = 0.019). The combination of sirolimus and AG14361 significantly delayed allograft MST (AG14361 + sirolimus for 30 days, sirolimus for 16 days, P = 0.002). AG14361 markedly augmented the number of the CD25+FoxP3+ Treg cells in the graft and periphery. In addition, it could enhance the suppressive function of Treg cells by upregulating the level of CTLA-4, PD-1 and ICOS. In vivo, the Treg/Th17 ratio increased significantly in the AG14351 group compared to the control. In the combination with sirolimus treatment, AG14361 promoted the long-term allograft survival. Our results highlight novel effects of a PARP-1 inhibitor. PARP-1 inhibitor AG14361 may be a promising agent to attenuate acute allograft rejection as it can maintain the number and function of Treg cells in allografts.     

A multivariate analysis of prognostic factors for health-related quality of life in patients with surgically managed meningioma

The objective of this study was to examine the prognostic significance of health-related quality of life (HQOL) parameters combined with baseline clinical factors in patients undergoing neurosurgery for treatment of meningioma. A total of 147 patients (61 male, 86 female; mean age 43 years, range 5–77 years) who underwent resection of a meningioma between January 2002 and December 2004 were studied. HQOL was evaluated using a modified questionnaire based on the World Health Organization Quality of Life-100 Scale and the Karnofsky Performance Scale. The relationships between HQOL and clinical history, radiological findings, extent of resection, histological grade and recurrence were investigated using multivariate analysis. The mean HQOL score was 73.94 ± 1.79 for preoperative patients with meningioma, 84.88 ± 2.14 for postoperative patients, and 91.13 ± 1.61 for healthy controls. HQOL for patients with meningioma was significantly lower than that for normal controls (P < 0.001), and postoperative patients had a more satisfactory HQOL than preoperative (P < 0.05). Cox proportional hazards analysis showed that significant predictors of health-related quality of life were tumor size, extent of surgical excision, and histologic grade. Multivariate backward logistic regression yielded the regression equation HQOL = 119.1097 – 1.5002X₃ – 8.6650X₆ – 10.4210X₇ (R = 0.7466; where X₃ is tumor size, X₆ is extent of surgical excision, and X₇ is the histologic grade of the tumor). This equation can be used preoperatively to predict the HQOL of meningioma patients after neurosurgery. A specialized HQOL questionnaire for patients with meningioma provides useful information when planning the operative procedure, and may make it more likely that patients have a satisfactory HQOL after surgery.     

T1声门癌加大分割剂量放疗的随机对照研究

目的通过随机对照研究,分析比较每次分割剂量为2.3 Gy与常规分割2.0 Gy治疗T1声门癌的疗效及其毒副反应情况。方法 1995年1月至2005年12月我院首次接受单纯放射治疗的T1声门型喉鳞癌患者165例,男158例,女7例,抽烟患者占95.8%(158/165),随机分组研究,加大分割剂量组(LF组)83例,每次分割量2.3 Gy,原发灶靶区中心参考点剂量中位值为66.7 Gy(66.7～71.3 Gy),中位放疗时间为40 d(40～42 d);常规分割剂量组(CF组)82例,每次分割量2.0Gy,原发灶靶区中心参考点剂量中位值为70.0 Gy(70.0～74.0 Gy),中位放疗时间分别为49 d(49～51 d)。Kaplan-Meier法计算肿瘤专项生存率(CSSR)及肿瘤局部控制率(LCR),Log-rank法检验生存及肿瘤局部控制率差异,Cox比例风险模型进行多变量分析。结果 (1)LF组与CF组相比,5、10年肿瘤专项生存率分别为95.18%和95.12%、91.57%和91.46%,χ2=0.071,P=0.789,差异无显著性。(2)治疗结束后观察12周,LF与CF组的客观有效率均为100%,完全缓解率(CR)分别为100.0%(83/83)、97.6%(80/82)(χ2=0.518,P=0.471)。(3)LF组及CF组放疗后5年及10年局部控制率分别为95.18%和80.49%、92.77%和78.05%,差异具显著性(χ2=7.944,P=0.005)。(4)多变量分析结果显示,分割方式及前联合是否受侵是影响T1声门癌放疗长期局部控制率的预后因子,较大的放疗分割量与常规分割相比有较高的局部控制率(HR=0.35,95%CI=0.13～0.7,P=0.002),而前联合受侵局控率较低(HR=3.54,95%CI=1.74～8.32,P=0.01)。(5)LF组及CF组急性放疗副反应及远期并发症相仿。结论 (1)放疗治疗T1声门癌的5、10年肿瘤专项生存率很高,分别达95%及91%以上。(2)加大分割剂量及缩短放疗时间能显著提高5、10年的局控率,未见增加近期及远期毒副反应。(3)分割方式及前联合是否受侵影响T1声门癌放疗的局部控制率。     

放射治疗对直肠癌组织中肿瘤转移抑制基因Kiss-1表达的影响

目的：探讨放射治疗对直肠癌组织中Kiss-1基因表达的影响及意义。方法：应用免疫组化SP法检测29例放射治疗前、后直肠癌组织中Kiss-1基因的表达,通过图像分析系统（Image-Pro Plus 6.0）进行定量分析。结果：放射治疗前直肠癌组织中Kiss-1基因表达水平的图像分析灰度值为160.81±2.78,放疗后为158.04±3.24,差异无统计学意义（P〉0.05）。结论：放射治疗对直肠癌中肿瘤转移抑制基因Kiss-1的表达无明显影响,推测放射治疗不会增加直肠癌转移的风险。