Cancers

Although standard chemotherapy for three to four cycles followed by surgery is considered safe and effective in the management of advanced ovarian cancer, the impact of extending treatment beyond this period remains uncertain. Some authors suggest that the number of neoadjuvant chemotherapy cycles does not directly affect prognosis and may reflect a confounding bias. Others, however, indicate that a prolonged exposure to chemotherapy can promote the selection of resistant tumor clones, negatively influencing patient survival and disease progression. This review aims to summarize the current evidence on the topic, evaluating the effect of prolonged chemotherapy on surgical cytoreduction and survival. To achieve this, we conducted an analysis of the English-language literature available in PubMed, focusing on treatment duration, achievement of complete surgical resection, survival outcomes, and prognostic factors.

Background: Despite clear evidence supporting low-dose computed tomography (LDCT) for lung cancer screening, the participation rate among eligible high-risk individuals remains low. Educational interventions that address gaps in knowledge, attitude, and beliefs may improve screening uptake. Objective: This study describes the systematic use of artificial intelligence to design and develop a series of online educational modules aimed at improving knowledge, attitudes, and beliefs toward lung cancer screening among high-risk individuals. Methods: Guided by the Health Belief Model and principles of digital health education, five interactive online modules were developed by artificial intelligence technology to address key topics: (1) lung cancer epidemiology, etiology, signs, and symptoms; (2) lung cancer treatment and care; (3) lung cancer prevention methods; (4) screening guidelines, benefits, and risks; and (5) screening procedures and results interpretation. The design process included literature review, individual cognitive interviews, expert consultation, and pilot testing among target users. Qualitative individual interviews were conducted with 12 high-risk individuals. Content validity was evaluated by an expert panel (n = 7) using a content validity index (CVI), and pilot usability testing was conducted with 25 high-risk individuals. Results: All five modules achieved high content validity (I-CVI range = 0.90–1.00; S-CVI = 0.96). Usability and satisfaction testing showed that participants rated the modules as clear, engaging, and relevant (mean System Usability Scale score = 88/100, mean satisfaction score = 18.32/20). Participants demonstrated significant improvements in knowledge (p < 0.001), lung cancer stigma (p < 0.001), and health beliefs (p < 0.001) after module completion. Of the 22 participants who completed the 3-month follow-up (88%), 13 (59.1%) reported obtaining LDCT screening. Conclusions: The developed online modules demonstrated strong content validity and usability, indicating their feasibility for use in future intervention studies to promote lung cancer screening knowledge, attitude, beliefs, and participation among high-risk individuals.

Background/Objectives: Radiation-induced dysphagia can cause life-threatening complications including aspiration pneumonia. Consequently, studies have attempted to limit the radiation dose to the swallowing muscles to prevent radiation-induced dysphagia. However, data identifying the specific swallowing muscles associated with post-radiation dysphagia are lacking. Therefore, this case–control study aimed to identify the swallowing muscles whose radiotherapy-related damage is likely to cause radiation-induced dysphagia. Methods: This retrospective study included 53 patients with head and neck cancer who received definitive radiotherapy and underwent post-radiotherapy swallowing function evaluation using videofluoroscopy or fiberoptic endoscopic evaluation of swallowing at least 3 months post-radiotherapy. Twenty-two patients with a Penetration-Aspiration Scale score ≥ 3 were defined as having laryngeal penetration or aspiration. Twenty-two controls matched for age and tumor site were selected using propensity score matching. The primary exposure variable was radiation dose to the swallowing muscles, including the floor of the mouth, thyrohyoid, posterior digastric/stylohyoid, longitudinal pharynx, hyoglossus, styloglossus, genioglossus, and intrinsic tongue muscles. A LASSO regression model was used to select the most predictive dosimetric parameter. Results: The percentage of genioglossus muscle receiving a radiation dose ≥70 Gy (GGS V70) was the only dosimetric variable predictive of radiation-induced dysphagia. After adjusting for the clinical variables, GGS V70 demonstrated a significant association with post-radiotherapy laryngeal penetration or aspiration (p = 0.003), with an adjusted odds ratio of 1.06 for each increasing radiation dose unit of GGS V70. Conclusions: The genioglossus muscle might be associated with radiation-induced dysphagia and, therefore, should be further investigated in prospective studies.