来源:Cancers 发布时间:2025/8/1 15:12:31
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论文选题灵感:“移植肿瘤学”方向 | MDPI Cancers

期刊名:Cancers

期刊主页:https://www.mdpi.com/journal/cancers

如何在现有研究领域内,找到一个合适的论文选题?本篇将为您提供更多论文选题灵感。

1. 中文标题: 免疫检查点抑制剂时代肝细胞癌的肝移植治疗

文章链接: https://doi.org/10.3390/cancers16132374

本综述提供了 LT 前后 ICI 治疗的当前证据的最新概述,并讨论了相关的缺陷和剩余的挑战。

选题方向参考

随着 ECD 移植物的使用率不断提高、Milan-out 标准的日益普及以及肝移植肿瘤适应症范围的不断扩大,在不久的将来,处理肝移植后肿瘤复发将变得越来越必要。在此背景下,引入机器灌注 (MP) 技术可能在两个方面发挥重要作用。一方面,MP 提供的 IRI 减少似乎可以降低 HCC 复发的发生率 [77],尽管这一假设仍有待验证 [78]。另一方面,长期MP[79]的开发可以为对移植物进行生物分子检测(例如PD-L1表达[68])提供理想的时间窗口,以便根据预期的AR概率进行分配。迫切需要开展临床前研究,阐明免疫检查点抑制剂(ICI)治疗背景下AR的分子机制,从而识别此类反应的生物标志物,同时开展共享注册库和多中心研究,以解决目前该领域临床数据的缺乏和分散问题。

对应英文原文部分

In contrast, the results of post-LT ICI therapy have been more disappointing, with an AR rate that currently makes this approach difficult to justify on a large scale, given the limited therapeutic benefit. However, the growing utilization of ECD grafts, the increasing adoption of Milan-out criteria, and the expanding range of oncological indications for LT will make it increasingly necessary to deal with post-LT tumor recurrence in the near future. In this context, the introduction of machine perfusion (MP) technology could be a valuable ally in two ways. On one hand, the reduction in IRI offered by MP appears to reduce the incidence of HCC recurrence [77], although this hypothesis is still to be validated [78]. On the other hand, the development of long-term MP [79] could offer an ideal time window to perform biomolecular tests on the graft, such as PD-L1 expression [68], to base the allocation on anticipated probabilities of AR. Preclinical studies to clarify the molecular mechanisms underlying AR in the context of ICI therapy and, thus, identify such response biomarkers are urgently needed, along with shared registries and multicenter studies to address the current lack and dispersion of clinical data on the topic.

2.中文标题: 肝移植术后复发性肝细胞癌的全身治疗:一项多中心试验

文章链接: https://doi.org/10.3390/cancers16132442

本文是一项来自德国和奥地利四个移植中心的回顾性多中心研究,收集了 2007 至 2020 年间 46 例肝移植后肝细胞癌复发且接受酪氨酸激酶抑制剂(索拉非尼或仑伐替尼等)治疗患者的数据,分析其基础肝病、复发时间、转移情况、治疗方式等,得出整个队列中位总生存期 10.9 个月、中位无进展生存期 5.7 个月的结果,且指出因肝移植病史是免疫治疗禁忌症,此类患者预后仍差。

选题方向参考

迄今为止,mTOR 抑制剂作为肝移植后复发性肝癌的免疫抑制剂,尚未对肿瘤进展和总生存期产生积极影响。这方面仍需进一步研究:前瞻性研究或许有助于更好地评估 mTOR 抑制剂在预防肝移植后复发性肝癌以及治疗肝移植后复发性肝癌方面的益处。

肝移植后不可切除的复发性肝细胞癌的预后仍然不佳,仍然需要进行样本量更大的前瞻性研究。TKI通常作为一线全身治疗。然而,关于TKI替代治疗方案或TKI后二线治疗方案的数据稀缺。

对应英文原文部分

So far, no positive effect on tumor progression and overall survival could be achieved for mTOR inhibitors as immunosuppression in recurrent HCC after liver transplantation. Further investigations are needed here: prospective studies could probably help to better assess the benefits mTOR inhibitors in the prevention of HCC recurrence after LT, but also in the treatment of recurrent HCC after transplant.

The prognosis for non-resectable recurrent HCC after liver transplantation remains poor. In our study, we could not demonstrate any significant benefit of mTOR inhibitors with regard to overall survival. However, prospective studies with larger sample sizes are still required. TKIs are usually administered as first-line systemic treatment. However, data on further treatment options as alternative to TKIs or second-line therapy after TKIs is scarce.

3.中文标题: 既往自体造血细胞移植后复发的浆细胞骨髓瘤患者中使用不同剂量阿糖胞苷进行干细胞动员 —— 波兰骨髓瘤研究小组的多中心报告

文章链接: https://doi.org/10.3390/cancers16142588

本文研究了对先前自体造血干细胞移植后浆细胞骨髓瘤复发进行挽救性自体造血干细胞移植时,不同剂量阿糖胞苷(800、1600、2400mg/m²)用于造血干细胞再动员的疗效和安全性。

选题方向参考

关于自体造血细胞移植后干细胞再动员疗效的研究数据非常有限。仍然需要进行样本量更大的前瞻性研究。并考虑一线治疗方案的变化、维持治疗的可及性以及用于治疗复发的新型药物的可用性。以及进行基因/突变研究来检查克隆性造血。

对应英文原文部分

It may, however, occur that there is either no or an insufficient stem cell dose in storage to proceed to transplantation. Remobilization to procure new cells is then required. There are very limited data in the literature concerning the efficacy of stem cell remobilization after previous auto-HCT. In our previous report, we showed that remobilization with cytarabine was associated with a lower risk of remobilization failure in comparison to etoposide or cyclophosphamide. In the current study, we analyze the efficacy and safety of different doses of cytarabine (800, 1600, and 2400 mg/m2), showing that all doses are efficacious but that the dose of 2400 mg/m2 is associated with the most toxicity. Therefore, lower doses of cytarabine seem to be preferable, with plerixafor rescue when needed.

There are some important limitations to our study. First, it is a retrospective study, and the number of patients is limited. Secondly, the changing first-line treatment regimens, the availability of maintenance, and the availability of novel drugs to treat relapse were not considered in this analysis. Third, we did not perform genetic/ mutational studies to check for clonal hematopoiesis. Nevertheless, we provide robust data to demonstrate that remobilization with cytarabine is very effective.

To conclude, remobilization with cytarabine is effective, regardless of the dose. Higher doses of cytarabine are, however, associated with greater toxicity and both hematological and infectious complications. Therefore, it is reasonable to conclude that either a dose of 1600 m/m2 or 800 mg/m2 total is preferable, with plerixafor rescue when needed.

4. 中文标题: 造血干细胞移植患者亚临床癌症治疗相关心脏功能障碍的评估:一项超声心动图研究

文章链接: https://doi.org/10.3390/cancers16223808

本文旨在确定造血干细胞移植(HSCT)患者移植 12 个月后亚临床癌症治疗相关心脏功能障碍(CTRCD)的患病率及评估临床因素影响。

选题方向参考

Bootstrap 分析显示,BEAM 预处理方案作为 CTRCD 发生的独立因素具有良好的结果。因此,需要对更多患者进行进一步研究才能得出有意义的结论。此外,心血管危险因素对 CTRCD 发生的影响可能被低估。进一步,由于本研究中接受异基因造血干细胞移植 (HSCT) 的患者数量较少,其对 CTRCD 发生的影响可能被低估——尚未获得具有统计学意义的结果。

对应英文原文部分

The main limitation of this study is its relatively small sample size. Bootstrap analysis shows promising results regarding the BEAM conditioning regimen as an independent factor contributing to the development of CTRCD. Therefore, further investigation with a larger number of patients is needed to draw significant conclusions. Also, the impact of cardiovascular risk factors on the development of CTRCD could have been underestimated.

Moreover, due to a small number of patients undergoing allogeneic HSCT in our study, its effects on the development of CTRCD could have been underscored—we did not obtain statistically significant results.

5.中文标题: 接受自体和异基因造血细胞移植或 CAR - T 治疗患者的营养状况演变:一项回顾性观察研究

文章链接: https://doi.org/10.3390/cancers17010079

本回顾性观察研究,在四个时间点用 BMI、MUST 和 GLIM 标准评估了 365 名接受造血细胞移植(HCT)(含异基因、自体移植及 CAR-T 疗法)的患者的营养状况和非复发相关并发症情况。

选题方向参考

该研究的回顾性设计限制了包括所有所需参数的能力,特别是在随访期间。由于各种疾病相关或后勤因素,并非所有患者都完成了完整的治疗途径,导致某些时间点的数据不完整。其次,该研究在一家医院进行,这限制了结果的地域多样性和普遍性。此外,这项研究没有考虑导致各种造血干细胞移植(HCT)的不同血液学状况,也没有考虑所使用的具体治疗方案。这些因素可能影响了结果,未来的研究应旨在包括更广泛的状况和治疗方法,以获得更全面的结果。另一个限制是在研究期间缺乏标准化的营养治疗方案,这可能导致为参与者提供的营养干预措施有所不同。此外,虽然选择了相当大的时间点进行营养状况评估,但它们与治疗程序过于接近;因此,延长随访时间本应有益,但由于数据的回顾性,很难在不丢失大量数据的情况下获得随访结果。最后,虽然记录了非复发相关并发症,但其分类受限于患者病历中的信息。尤其是感染,一种重要的非复发相关并发症,由于数据不足而未进行详细分析,但将其纳入未来的前瞻性研究可以提供有价值的信息。

对应英文原文部分

This study has several limitations that should be considered when interpreting its findings. First, the retrospective design of the study restricted the ability to include all desired parameters, especially during the follow-up period. Not all patients completed the full treatment pathway due to various disease-related or logistical factors, leading to incomplete data for some time points. Second, the research was conducted at a single hospital, which limits the geographical diversity and generalizability of the results. Furthermore, this study did not account for the different hematological conditions that led to various HCTs, nor did it consider the specific therapeutic regimens used. These factors may have influenced the outcomes, and future studies should aim to include a broader range of conditions and treatments for more comprehensive results. Another limitation is the lack of a standardized nutritional treatment protocol during the study period, which could have led to variability in the nutritional interventions provided to participants. Furthermore, the time points selected for nutritional status assessment, although chosen with considerable effort, were too close to therapeutic procedures; therefore, a longer follow-up would have been beneficial, but the retrospective nature of the data made it difficult to obtain this without losing substantial amounts of data over time. Finally, while non-recurrence-related complications were documented, their classification was limited by the information available in the patients’ medical records. In particular, infections, a significant non-recurrence-related complication, were not analyzed in detail due to insufficient data, but their inclusion in future prospective studies could provide valuable information.

推文:https://mp.weixin.qq.com/s/QyW-EeobVE8p8qmCPXxGDw

 
 
 
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