Tag: pubmed

ESMO Open. 2026 Jun 8;11(6):107730. doi: 10.1016/j.esmoop.2026.107730. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with glioblastoma (GBM) often have disease progression after standard temozolomide-based chemoradiation. The benefits and optimal use of re-irradiation (re-RT) following re-operation (re-OP) in recurrent GBM (rGBM) remain uncertain. In this study, we assessed the efficacy and safety of post-operative re-RT in patients with isocitrate dehydrogenase-wild-type rGBM, aiming to identify survival benefits and determine clinicogenetic criteria for patient selection.

PATIENTS AND METHODS: Data from the Korean Radiation Oncology Group 21-02 retrospective study were evaluated, including 531 patients with rGBM from 2013 to 2019. A subset of 164 patients undergoing re-OP were analyzed for survival and benefits of post-operative re-RT. Additionally, 206 patients receiving re-RT, irrespective of re-OP, were evaluated for risks of radiation necrosis. The overall survival (OS) after re-OP was the primary endpoint. Statistical analyses included the Kaplan-Meier method and log-rank test for OS, Cox proportional hazards regression model for univariate and multivariate analyses, and the Fine-Gray competing risk model for assessing the risk of brain necrosis.

RESULTS: The median OS after re-OP was 13.4 months. Kaplan-Meier analysis revealed significantly better OS for those who received re-RT (17.6 months) than for those who did not (11.0 months; P = 0.002). Factors associated with improved OS included higher Karnofsky performance status scores, post-operative re-RT, and additional systemic therapy after re-OP. Factors associated with adverse outcomes included recurrence outside the initial RT field and homozygous deletion of CDKN2A/B. The incidence of grade 2 or higher RT necrosis was 5.8% among those undergoing both re-OP and post-operative re-RT.

CONCLUSION: Post-operative re-RT appears to be associated with enhanced survival and minimal toxicity in patients with rGBM following temozolomide chemoradiation. Our study suggests a novel clinicogenetic criterion for re-RT after re-OP in rGBM, which requires further validation.

PMID:42258967 | DOI:10.1016/j.esmoop.2026.107730

ESMO Open. 2026 Jun 8;11(6):107769. doi: 10.1016/j.esmoop.2026.107769. Online ahead of print.

ABSTRACT

BACKGROUND: Trastuzumab deruxtecan (T-DXd) has improved outcomes for many patients with metastatic breast cancer (MBC). T-DXd is associated with alopecia, yet limited data exist describing the efficacy of scalp cooling (SC) in preventing alopecia among patients receiving T-DXd.

PATIENTS AND METHODS: This prospective, phase II trial evaluated the efficacy of SC among patients with MBC receiving T-DXd. Conducted at Dana-Farber Cancer Institute, the trial enrolled patients with MBC without alopecia at baseline, initiating treatment with T-DXd. Participants elected either the SC arm, using the Paxman Scalp Cooling System, or the non-SC arm. The primary endpoint was hair loss rate, defined as locally assessed Common Terminology Criteria for Adverse Events (version 5.0) grade ≥1 alopecia occurring at cycle 3, day 1; cycle 5, day 1; or end of treatment, whichever occurred first.

RESULTS: Among 40 enrolled evaluable patients, 33 (82.5%) patients [18 (90%) in the SC arm and 15 (75%) in the non-SC arm] experienced grade ≥1 alopecia. The difference in rates between arms was not statistically significant (P = 0.41). Grade 2 alopecia rates were the same in both arms (55%). Centralized image review revealed no significant differences in grade ≥1 (P = 1.00) or grade 2 alopecia (P = 0.33) between treatment arms. Grade 2 alopecia was the primary reason for SC discontinuation (45%). The median time to grade 2 alopecia was 2.76 months [95% confidence interval (CI), 1.64-NA] in the SC arm; 4.60 months (95% CI, 2.53-NA) in the non-SC arm (P = 0.7).

CONCLUSIONS: SC with T-DXd did not reduce alopecia rates. Small sample size and lack of randomization may have limited the interpretation. Further studies are crucial to improve SC’s efficacy with antibody-drug conjugate therapy.

PMID:42258966 | DOI:10.1016/j.esmoop.2026.107769

Cancer Treat Res Commun. 2026 Jun 8;48:101279. doi: 10.1016/j.ctarc.2026.101279. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity is increasingly recognized as a risk factor for several malignancies, including cervical cancer. Women with obesity participate less frequently in screening and may have higher rates of unsatisfactory cytology, potentially affecting cervical lesion detection. This study evaluated the association between BMI and high-grade cervical intraepithelial neoplasia (CIN) in a referral cohort.

METHODS: In this single-center retrospective study, clinical and histopathological data from 257 women referred to the dysplasia unit clinic of Hannover Medical School (Germany) between January 2021 and December 2025 were analyzed. BMI was categorized as normal (<25 kg/m²), overweight (25-29.9 kg/m²), and obese (≥30 kg/m²). The primary outcome was high-grade cervical lesions (CIN 2/3/AIS). Logistic regression assessed associations between BMI and high-grade lesions, adjusting for age, gravidity, and smoking.

RESULTS: Overall, the distribution of histological findings showed numerically higher proportions of CIN 3 with increasing BMI, although this difference did not reach statistical significance (p = 0.055). Increasing BMI was significantly associated with high-grade lesions (OR 1.61, 95% CI 1.02-2.52, p = 0.040), remaining significant after adjustment (OR 1.74, 95% CI 1.01-3.00, p = 0.048). HPV genotype distribution (p = 0.784) and cytological findings (p = 0.34) were comparable across BMI groups.

CONCLUSION: Higher BMI was associated with an increased likelihood of high-grade cervical intraepithelial neoplasia in women referred for dysplasia evaluation. Similar HPV and cytology distributions suggest that this association may reflect differences in timing of diagnosis or clinical detection rather than underlying HPV patterns.

PMID:42258959 | DOI:10.1016/j.ctarc.2026.101279

Cancer Treat Res Commun. 2026 May 29;48:101267. doi: 10.1016/j.ctarc.2026.101267. Online ahead of print.

ABSTRACT

BACKGROUND: Cancer is the second leading cause of death worldwide, including in Georgia. This study aimed to evaluate the number of new cancer cases, identify the most common cancer sites, analyze sex differences, and evaluate age-standardized rates (ASR) and age-specific rates from 2015 to 2019 in Georgia.

METHODS: We used the Georgia National Cancer Registry data for all registered cancer cases, excluding non-melanoma of skin, and the National Statistics Office of Georgia population data. ASRs per 100,000 population were calculated using the direct standardization method, with the WHO’s world standard population as a reference.

RESULTS: Between 2015 and 2019, 50,098 cancer cases (ICD-10 codes C00-96 exc. C44) were diagnosed in Georgia, including 21,802 in men (ASR 175.5/100,000) and 28,296 in women (ASR 192.8/100,000). Among men, the most common cancer sites were lung (16%, ASR 28.0/100,000); prostate (14%, ASR 22.0/100,000); bladder (10%, ASR 16.3/100,000); colorectal (10%, ASR 16.2/100,0000); and larynx (6%, ASR 10.9/100,000). Among women, the most common cancer sites were breast (34%, ASR 64.5/100,000), thyroid (14%, ASR 34.3/100,000), colorectal (7%, 10.3/100,000), cervix (6%, ASR 12.6/100,000) and corpus uteri (6%, ASR 11.4/100,000), respectively.

CONCLUSION: This is the first comprehensive evaluation of cancer incidence in Georgia. Beyond sex-specific cancers such as breast and prostate, lung cancer was more common in men, while thyroid cancer was more common in women. The overall cancer incidence in Georgia was lower than the 2022 GLOBOCAN-estimated ASR for the 27 EU countries. Differences in healthcare infrastructure, screening uptake, or reporting accuracy may explain these disparities.

PMID:42258958 | DOI:10.1016/j.ctarc.2026.101267

Talanta. 2026 Jun 2;310:130077. doi: 10.1016/j.talanta.2026.130077. Online ahead of print.

ABSTRACT

The limit of detection (LOD) is a key parameter for determining the lowest measurable analyte concentration. Despite the widespread use of theoretical equations to estimate LOD, significant discrepancies are often observed between calculated and empirically achievable values. This study critically examines these discrepancies by applying multiple calculation approaches – including blank signal statistics, error propagation, and graphical methods – to square-wave voltammetry (SWV) and differential pulse voltammetry (DPV) measurements of [Fe(CN)₆]^3-/4- at a gold electrode. The results reveal that commonly used equations can yield LOD values that differ from experimental observations by up to an order of magnitude, depending on the technique and calculation method. Critically, we demonstrate that numerous literature reports incorrectly equate the limit of detection with the limit of quantification (LOQ), leading to overoptimistic sensitivity claims. Furthermore, we revisit the mechanistic understanding of the [Fe(CN)₆]^3-/4-/Au system, showing that the gold electrode is not inert but participates via Au(CN)₂^– formation, which contributes to signal instability at low concentrations. Based on these findings, we propose a statistically rigorous experimental framework for empirical LOD determination that accounts for matrix effects and electrode stability, thereby improving the reliability of electroanalytical methods for real-world applications.

PMID:42258921 | DOI:10.1016/j.talanta.2026.130077

Eur J Radiol. 2026 Jun 5;203:112964. doi: 10.1016/j.ejrad.2026.112964. Online ahead of print.

ABSTRACT

PURPOSE: To determine whether QP-Prostate, a commercially available artificial intelligence (AI) decision-support system, improves Prostate Imaging Reporting and Data System (PI-RADS)-based detection of clinically significant prostate cancer (csPCa) using prostate MRI by readers with different levels of experience, without loss of specificity.

METHODS: This single-center retrospective study included 52 men with pathologically confirmed csPCa who underwent preoperative 3.0-T multiparametric magnetic resonance imaging (mpMRI) and radical prostatectomy between 2021 and 2023. To match AI inputs, four radiologists (1-25 years of experience) interpreted the PI-RADS findings using only biparametric components (T2WI and DWI) under three scenarios: reader-alone, reader + AI, and AI-alone. Per-case (evaluating sensitivity only) and per-lesion analyses were conducted, setting PI-RADS ≥ 3 as positive. The primary endpoint was the within-reader per-lesion AUC difference evaluated via DeLong’s test with Holm adjustment; secondary metrics were assessed using DeLong and McNemar tests.

RESULTS: In the per-case (index-lesion) analysis, AI assistance significantly increased sensitivity only for the least-experienced reader, from 0.73 to 0.87 (p = 0.046), whereas higher point estimates for the other readers were not statistically significant. In the per-lesion analysis, AI assistance significantly improved sensitivity for 3/4 readers and increased AUC for all readers (p-values ranging 0.002-0.027; within-reader ΔAUC, +0.013 to + 0.037; all 95% CIs excluded zero), with no statistically significant change in specificity (all p ≥ 0.061). AI-alone showed high specificity (0.94) and low sensitivity (0.34) in the per-lesion analysis, with a per-lesion AUC (0.64) closest to that of the least-experienced reader.

CONCLUSION: In this small prostatectomy-enriched cohort, AI assistance was associated with improved lesion-level discrimination and increased sensitivity, with the greatest apparent benefit observed among less-experienced readers. These findings should be interpreted as proof-of-concept/feasibility data rather than as evidence of improved reader agreement or immediate clinical generalizability.

PMID:42258918 | DOI:10.1016/j.ejrad.2026.112964

Appl Radiat Isot. 2026 Jun 4;236:112749. doi: 10.1016/j.apradiso.2026.112749. Online ahead of print.

ABSTRACT

PURPOSE: This study systematically compares the dose prediction performance of three knowledge-based RapidPlan models-Broad-Spectrum Model (Model-BS), K-means Clustering-Based Classification Model (Model-CA), and Volume Stratification Model (Model-V)-in volumetric modulated arc therapy (VMAT) planning for multiple brain metastases (multi-BM).

METHODS: A total of 138 multi-BM patients (with 2 to 16 lesions) treated between 2021 and 2024 were retrospectively included. Among these, 122 patients were randomly selected to construct Model-BS (general knowledge-based), Model-CA (unsupervised clustering based on lesion count and total volume features), and Model-V (volume stratification based on total volume thresholds). The remaining 16 patients were designated as the test group and received automated plans (BS-plans, CA-plans, and V-plans) as well as manual plans (MP-plans). All plans used single-isocenter technique, with a prescription dose of 30 Gy/5Fr. Dose metric parameters, including conformity index (CI), gradient index (GI), and organ-at-risk (OAR) doses, were compared.

RESULTS: All knowledge-based plans (RP-plans) showed comparable or slightly improved target coverage compared to MP-plans. Compared to Model-BS, both Model-CA and Model-V significantly reduced high-dose volumes (V₂₄ Gy-V₁₂ Gy) in the Brain and normal brain tissue (Brain-PTV) (p < 0.05). Model-V plans had the lowest gradient index (GI = 5.55), significantly outperforming CA-plans (GI = 5.81) and BS-plans (GI = 5.61); however, the difference compared to MP-plans (GI = 5.89) did not reach statistical significance (p = 0.134). Model-V also demonstrated the highest conformity index (CI = 0.924). However, Model-V was slightly less effective in protecting some OARs, such as the optic nerve Dmax, compared to Model-CA.

CONCLUSION: The classification knowledge-based model, built on tumor lesion count and total volume, significantly improves the dose distribution in multi-BM VMAT planning. Among the models, Model-V achieved the optimal dose gradient (GI), while Model-CA offered the best overall balance between target conformity, dose gradient fall-off, and OAR sparing.

PMID:42258912 | DOI:10.1016/j.apradiso.2026.112749

Geriatr Nurs. 2026 Jun 8;71:104124. doi: 10.1016/j.gerinurse.2026.104124. Online ahead of print.

ABSTRACT

AIM: The aim of the study was to evaluate effectiveness of nurse-led preoperative education in reducing kinesiophobia and improving mobilization indicators among older adult patients undergoing total knee arthroplasty.

METHODS: This randomized controlled study was conducted with a total of 120 participants. Patients were randomly assigned to either the control group, which received standard hospital-based health education, or the experimental group, which received nurse-led preoperative education. Baseline data were collected at the first clinical encounter. Following the intervention, kinesiophobia levels and secondary outcomes measures were assessed at four subsequent time points: (1) on the morning of surgery, (2) 24 h after surgery, (3) 24 h after mobilization, and (4) at the time of discharge. Data collection was performed using structured questionnaires, validated scales, and smart bracelet. All statistical analyses were conducted using R software.

RESULTS: The experimental group showed significantly lower kinesiophobia 24 h after mobilization than the control group (3.8 ± 0.2 vs. 4.0 ± 0.3, p < 0.001). Anxiety scores on the morning of surgery were also lower in the experimental group than in the control group (44.0 ± 4.9 vs. 50.4 ± 6.6, p < 0.001). Following surgery, patients in experimental group initiated mobilization earlier and recorded a higher number of steps compared to the control group (p = 0.001). No significant differences were observed between the groups in postoperative pain intensity and length of hospital stay.

CONCLUSION: Nurse-led preoperative education was found to be effective in reducing kinesiophobia and preoperative anxiety while promoting earlier mobilization and greater physical activity among older adult patients undergoing total knee arthroplasty.

TRIAL REGISTRATION NUMBER: ClinicalTrials.gov; NCT05950217.

PMID:42258910 | DOI:10.1016/j.gerinurse.2026.104124

Am J Health Promot. 2026 Jun 8:8901171261458119. doi: 10.1177/08901171261458119. Online ahead of print.

ABSTRACT

PurposeThe study aimed to evaluate the effectiveness of a school-based health promotion program in reducing key risk factors for NCDs in Nepal.DesignA repeated cross-sectional, quasi-experimental study design.SettingSchool.SampleThe sample size for each of the intervention and control arms was 209.InterventionHealth education intervention.MeasuresMeasurement of change in metabolic equivalent of task (MET), body mass index, body fat percentage, fruit and vegetable servings per day, and other risk factors of non-communicable diseases.AnalysisData for both groups were summarized as frequencies and percentages at baseline (T0), after the first intervention (T1), and after the second intervention (T2). Intervention and control groups were compared using the Chi-square test, Mann-Whitney U test, independent-samples t-test, Mood’s median test, and Cluster-level Difference-in-Difference (DiD) analysis.ResultsA total of 423, 366, and 270 adolescents (intervention: 214, 176, 135; control: 209, 190, 125) from 9 schools (5 intervention, 4 control) participated at baseline, T1, and T2. Cluster-level DiD analysis to assess the effectiveness of the intervention found improvements in BMI, body fat percentage, fruit and vegetable purchase frequency, and school canteen fruit availability, but none were statistically significant.ConclusionAlthough not statistically significant, the intervention produced directionally favorable changes in physical activity, anthropometric measures, and dietary behaviors, suggesting potential public health benefits at the school level.

PMID:42258891 | DOI:10.1177/08901171261458119

West J Emerg Med. 2026 Apr 14;27(3):644-650. doi: 10.5811/westjem.48916.

ABSTRACT

INTRODUCTION: In-situ simulation offers a realistic training environment with a higher level of fidelity compared to other simulation models. It is associated with enhanced knowledge retention and a higher level of composure during real clinical encounters. One common barrier to undertaking in-situ simulation is the concern that it contributes to a delay in providing patient care. In this study we gave patients in the waiting room seven hypothetical emergency medical scenarios, two of which were training simulation scenarios, and we asked them how long they would be willing to delay their care if the different scenarios were actually occurring in the emergency department (ED). Our objective was to investigate whether patients in the ED waiting room would be willing to delay their care if they knew that there were simulation training scenarios occurring.

METHODS: This was a prospective convenience sample of participants conducted at a Level 1 trauma centre. Participants completed a survey that presented seven hypothetical scenarios, including two in-situ simulation scenarios. They were then asked to indicate the amount of additional wait time they would deem acceptable for each scenario.

RESULTS: Responses to the two in-situ simulation scenarios indicated that 342 (40%) and 335 (40.5%) of the 827 study participants, respectively, were willing to wait > 40 minutes for these to occur. In contrast, and after controlling for age, sex, waiting time, and time of recruitment, subjects reported they would tolerate shorter wait times for simulation scenarios than for real patient-care scenarios. [Willingness to wait > 40 minutes for the five real scenarios ranged from 70.5-79.9%, P < .05).

CONCLUSION: While patients demonstrated lower tolerance for simulation-related delays than for routine clinical care, our results showed that most were still willing to wait up to an additional hour to allow in-situ simulation to proceed. These findings indicate that in-situ simulation is broadly acceptable to patients and supports its continued use in clinical settings.

PMID:42258882 | DOI:10.5811/westjem.48916