Xiao-Hong Wang

Purpose: The objective of this study was retrospectively to compare the efficacy and safety of hypofractionated radiotherapy (HFRT) with a simultaneous integrated boost (SIB) or with a sequential boost (SB) after breast‐conserving surgery in patients diagnosed with early breast cancer.Methods: This study enrolled a total of 343 patients diagnosed with T1‐2N0‐1 breast cancer who had undergone breast‐conserving surgery followed by whole‐breast irradiation (WBI) without nodal irradiation, between March 2018 and April 2021. Out of 343 patients, 176 (51.3%) received HFRT‐SIB treatment, totaling 15 sessions, while the remaining 167 (48.7%) received HFRT‐SB treatment, totaling 18 sessions. Demographic characteristics, skin toxicity, radiation pneumonia, and myelosuppression, were compared in the two groups. Three‐year local progression free survival (LPFS) rates were determined using the Kaplan–Meier method and compared using the log‐rank test.Results: The median follow‐up time was 39.7 months (range 24.3–61.3 months). Toxicities rates did not differ significantly in the HFRT‐SIB and HFRT‐SB groups, including rates of grade 2 skin toxicity (14.8% vs. 13.8%, p = 0.721), Grade 2 radiation pneumonia (2.8% vs. 3.6%, p = 0.355), grades 1, 2 and 3 myelosuppression (12.5%, 5.7% and 1.1%, respectively, vs. 9.6%, 7.8%, and 1.2%, respectively; p = 0.744). Three‐year cumulative LPFS rates were similar in the HFRT‐SIB and HFRT‐SB groups (99.3% vs. 98.6%, p = 0.52). Regional nodal recurrences were observed in one patient in the HFRT‐SIB group (after 27.4 months) and in two patients in the HFRT‐SB group (after 29.4 and 56.4 months), and a local recurrence was observed in one patient in the latter group after 36.0 months. One patient in the HFRT‐SIB group was diagnosed with distant metastases to bone, and one patient in the HFRT‐SB group was diagnosed with distant metastases to the liver.Conclusion: Similar efficacy and safety of HFRT‐SIB and HFRT‐SB after breast‐conserving surgery in patients with early‐stage (T1‐2N0‐1) breast cancer. Longer‐term follow‐up is required to further compare their efficacy.

Immune checkpoint inhibitors, a type of immunotherapy, have demonstrated optimal treatment efficacy in inducing durable antitumor responses in various cancers. Cytokine-release syndrome is a rare i... Plain language summary Immune checkpoint inhibitors (ICIs) have shown revolutionary efficacy in the treatment of multiple cancers. Cytokine-release syndrome (CRS) is a common and lethally adverse e...

Rationale: Vulvar melanoma is a rare and aggressive tumor with a high risk of local recurrence and distant metastasis. The prognosis is poor with a 5-year overall survival rate of only 46.6%. Management of vulvar melanoma remains a clinical challenge. Recent evidences have shown that immune checkpoint inhibitors are effective in the treatment of vulvar melanoma. Patient concerns and diagnoses: A 63-year-old woman with vulvar malignant melanoma suffered inguinal lymph node metastasis after vulvectomy and chemotherapy. She underwent inguinal lymph node dissection and inguinal radiotherapy. The tumor progressed again and she received immunotherapy. Interventions: The tumor progressed again, and she was admitted to our hospital and received toripalimab combined with apatinib and abraxane. Outcomes: After 6 cycles of immunotherapy, the efficacy achieved partial remission. And with toripalimab as maintenance therapy, the patient achieved durable antitumor efficacy and good safety. Lessons: In this rare case, the patient with metastatic vulvar malignant melanoma had durable antitumor efficacy and good safety when receiving toripalimab.

The treatment of advanced triple-negative breast cancer, which failed in first-line or second-line therapy, is a significant challenge. We conducted this retrospective study to explore the efficacy and safety of apatinib and capecitabine as the third-line treatment for advanced triple-negative breast cancer. This retrospective study involved 44 advanced triple-negative breast cancer patients who failed in first-line or second-line therapy in Tangshan People's Hospital from January 2016 to February 2017. Twenty-two patients received apatinib and capecitabine, while 22 patients were treated with capecitabine monotherapy as third-line therapy. The progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events were compared between 2 groups. The apatinib and capecitabine group exhibited a higher PFS than capecitabine group (P = .001). Meanwhile, ORR and DCR in apatinib and capecitabine group were better than in capecitabine group (P = .042; .016). The 2 groups showed no significant difference in adverse events except degree I-II bleeding (P = .021). Both the apatinib and capecitabine and the capecitabine regimens revealed good tolerability. The apatinib and capecitabine regimen can achieve a better efficacy and similar serious adverse events compared with capecitabine regimen as the third-line treatment for advanced triple-negative breast cancer.