Nicolae Ciufu

Background: Pancreatic neuroendocrine tumors (pNETs) represent a heterogeneous group of neoplasms characterized by variable biological behavior and clinical outcomes. Multiple therapeutic strategies have been investigated, including surgery, targeted therapies, peptide receptor radionuclide therapy, and systemic treatments. The present study aimed to summarize survival-related outcomes reported across studies investigating the management of pNETs. Methods: A systematic review of the literature was conducted including studies reporting clinical outcomes in patients with pancreatic neuroendocrine tumors. A total of 27 studies were included in the qualitative analysis. Survival-related outcomes, such as progression-free survival (PFS), recurrence-free survival (RFS), and recurrence rates, were extracted. Studies reporting quantitative survival values were included in the meta-analytical component. A random-effects model was applied, and a forest plot was generated to summarize the reported outcomes. Results: Reported survival outcomes varied substantially across studies. Median PFS values ranged from approximately 5.6 to 86.5 months, while several surgical series reported 5-year overall survival rates exceeding 90%. Recurrence rates following surgical resection ranged from approximately 12% to 26% in some cohorts. The pooled estimate derived from the meta-analytical model was 32.22 (95% CI: 15.65–48.80). Conclusions: The analysis summarizes survival-related outcomes reported in studies investigating pancreatic neuroendocrine tumors and provides a quantitative overview of the reported progression-related endpoints across the analyzed literature.

Background and Objectives: Low back pain (LBP) represents a major cause of disability worldwide, with a significant impact on quality of life and functional capacity. Standard physiotherapy is widely used for LBP, whereas comparative short-term evidence on balneotherapy and prolotherapy remains limited. This study aimed to compare clinical outcomes across therapeutic approaches in patients with LBP. Materials and Methods: This non-randomized, three-group interventional cohort study included adult patients diagnosed with LBP lasting more than three months and presenting a baseline Visual Analog Scale (VAS) score ≥ 4. 84 patients were allocated to one of three treatment groups: standard physiotherapy (CG) (25 patients), balneotherapy plus physiotherapy (BG) (28 patients), or prolotherapy (PG) (31 patients). Outcome measures included pain intensity, functional disability, lumbar mobility, quality of life, and psychological status. This clinical study has been officially registered on ClinicalTrials.gov under the identifier NCT07399145. Results: Statistical analyses were performed to assess within- and between-group differences over time. At the 4-week follow-up, all three treatment groups showed significant improvements compared to baseline in pain intensity (VAS; p < 0.001 for PG, BG, and CG) and lumbar mobility (Schober test; p < 0.001 for PG, BG, and CG), and functional disability (RMDQ; p < 0.001 for PG, p = 0.027 for BG, and p = 0.016 for CG). Between-group analyses at T1 revealed significant differences for RMDQ, ODI, Schober, and EQ-5D-5L. In contrast, no significant intergroup differences were observed for VAS, PPT-RS, PPT-LS, total PPT, HADS-A, HADS-D, BDI-II, or PHQ-9. Conclusions: All evaluated interventions improved clinical, functional, and psychological outcomes in patients with LBP. Prolotherapy showed a pattern of more consistent improvements, particularly in disability, spinal mobility, and health-related quality of life. These findings should be interpreted cautiously, given the non-randomized design and baseline differences between groups. Further randomized studies with larger samples and longer follow-up are warranted to confirm these results.

Background: Cancer rehabilitation represents a series of measures adopted for the recovery of psychological, emotional, social, and financial functioning in the case of cancer patients. The purpose of this study is to identify the main elements of therapeutic management in the field of medical rehabilitation, as well as integrative, complementary medicine and holistic approaches that can be performed on the oncological patient. Methods: This systematic literature review follows the methodology outlined in the “Preferred Reporting Items for Systematic Reviews and Meta-Analysis” (“PRISMA”) statement, which is an internationally recognized and widely accepted standard. Results: Active rehabilitative therapies offer therapeutic options for improving the functioning and quality of life of oncological patients; these therapies comprehensively address both the physical and psychological aspects of the disease. This review also includes the latest novelties and nanotechnologies applied in oncological rehabilitation, for example, drugs (or supplements) inspired by nature. Conclusions: Physical and rehabilitation medicine, mostly using stimulating therapeutic methods, was recently added to the list of contraindications in the management of oncological patients, both as an approach to the pathological concept itself and as an approach to the main clinical consequences and functional aspects of oncological therapies. Integrative, complementary medicine presents an important therapeutic resource in the case of oncological patients. Advanced studies are needed in the future to further ascertain the role of these therapies.