Search Results (943)

Background/Objectives: Proton therapy provides superior dose conformity and better normal tissue sparing than conventional radiotherapy but is limited by its relatively low relative biological effectiveness (RBE). Nanoparticles have emerged as promising proton radiosensitizers capable of enhancing physical dose deposition and biological responses. Methods: A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar. Results: Gold nanoparticles were the most extensively studied radiosensitizers, while platinum, gadolinium, hafnium oxide, titanium dioxide, iron oxide, and other nanoparticles also demonstrated promising radiosensitizing effects. Evidence indicates that nanoparticles enhance local dose deposition, increase LET and ROS production, promote DNA damage, and improve tumor control. Conclusions: Nanoparticle-assisted proton therapy represents a promising strategy for improving cancer treatment by increasing therapeutic efficacy while preserving healthy tissues. Although preclinical studies demonstrate significant improvements in therapeutic efficacy, challenges related to tumor targeting, biodistribution, safety, and clinical validation remain. Further research is required to facilitate clinical implementation. Full article

Although robust observational data have long associated physical activity with improved colon cancer survival, the lack of randomized evidence has perpetuated a “causality gap,” confining exercise to supportive lifestyle advice and creating a clinical dilemma for surgeons. This paradigm has been fundamentally reshaped by the landmark phase III CHALLENGE trial. This review synthesizes the clinical, epidemiological, and translational evidence establishing exercise as a validated, disease-modifying intervention. In the CHALLENGE trial, a 3-year structured physical activity program significantly improved both disease-free survival (HR 0.72) and overall survival (HR 0.63) in patients with resected stage III or high-risk stage II colon cancer post-adjuvant chemotherapy, demonstrating a clinically meaningful additive benefit following completion of standard adjuvant chemotherapy. Mechanistically, exercise drives a multi-layered host–tumor reprogramming. Each acute exercise bout triggers transient surges of muscle-derived myokines (e.g., IL-6, SPARC) and immune-cell mobilization, enhancing natural killer and CD8⁺ T cell tumor infiltration. Cumulatively, these repeated acute pulses drive chronic adaptations, including downregulation of the pro-proliferative insulin/IGF-1 axis, attenuation of pro-tumor systemic inflammation, and microenvironmental remodeling at metastatic sites. To bridge the implementation gap, exercise oncology must transition from vague recommendations to structured, biomarker-driven clinical prescriptions defining type, dose, and duration. Mirroring the institutional success of Enhanced Recovery After Surgery (ERAS) protocols, physical activity should be systematically embedded into multidisciplinary, post-adjuvant oncologic care pathways. As the primary coordinators of colorectal cancer care, gastrointestinal surgeons must lead the transformation of exercise from optional supportive care into a validated, disease-modifying standard of care. Full article

Graphitic carbon nitrides (g-C₃N₄) are well-known fluorescent nanosheets that are photoactive under the UV–visible light range and could generate reactive oxygen species (ROS) upon appropriate light exposure. Therefore, these materials are generally favored in diagnostic applications for bioimaging and light-activated treatments simultaneously, e.g., theranostic applications in cancer treatments. Here, the natural polymer, hyaluronic acid (HA), was physically crosslinked with trivalent metal ions such as Gd(III) or Fe(III) ions in the presence of boron (B)- or sulfur (S)-doped graphitic carbon nitride (g-C₃N₄) nanosheets to attain spherical light-sensitive g-C₃N₄@HA-M(III) (M: G(III) or Fe(III) ions) composite microparticles. The g-C₃N₄@HA-M(III) particles were in the 0.5–20 μm size range, which is injectable for possible intravenous administration. No significant toxicity was determined for g-C₃N₄@HA-Gd(III) particles up to 500 μg/mL concentration on L929 fibroblast cells; for example, g-C₃N₄@HA-Fe(III) particles could be used in vivo applications safely up to 100 μg/mL concentration with no toxicity. The g-C₃N₄-based materials exhibited strong fluorescence at λ_ex 380 nm, and S-doped g-C₃N₄@HA-Gd(III) particles provided the highest emission intensity for possible cell imaging applications as a diagnostic tool material. Especially, S-doped g-C₃N₄@HA-M(III) particles delivered photoinduced anticancer activity on SKMEL 30 skin cancer cells after 30 min of UV-A treatment at 6.88 mW/cm² irradiance and 12.38 J/cm fluence via the reactive oxygen species (ROS) production capability. In addition to the targeting ability of HA-M(III) particles, the photoinduced anticancer activity of g-C₃N₄@HA-M(III) particles, e.g., on SKMEL 30 melanoma cells, offer great alternatives to toxic chemo- or radiotherapy. Furthermore, HA-Gd(III)-based particles show the highest signal intensity with better proton relaxation times and the highest proton longitudinal relaxivity. Overall, HA-Gd/Fe(III) particles with heteroatom-doped g-C₃N₄ revealed excellent assets with enhanced MRI capabilities in addition to specific targeted cancer treatments and photoinduced therapy for multifaceted theranostic applications. Full article

Background: Malnutrition is a significant clinical problem in patients with cancer, occurring not only during hospitalization but also throughout the recovery phase. It brings severe health and economic consequences, affecting patients on both physical and psychological levels. The American Society for Parenteral and Enteral Nutrition (ASPEN) and the European Society for Clinical Nutrition and Metabolism (ESPEN) emphasize the critical importance of early detection of nutritional disorders and timely intervention in oncology populations. The aim of this study was to determine the prevalence of malnutrition and factors associated with malnutrition among hospitalized Polish oncology patients and to draw attention to the need for early nutritional assessment in patients with cancer so as to ensure appropriate nutritional care. Methods: A multicenter cross-sectional study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines among adult patients diagnosed with cancer and undergoing oncological treatment. Data collection involved a structured survey questionnaire, anthropometric measurements, and validated screening tools: Mini Nutritional Assessment (MNA), Nutritional Risk Screening Score 2002 (NRS 2002), and Subjective Global Assessment (SGA). Results: The study group comprised 560 patients with a mean age of 55 ± 13.95 years, including 59% women and 41% men. The mean duration of illness was 3.37 years. Advanced-stage cancer was present in 43% of participants, and 66% were undergoing chemotherapy. The mean Body Mass Index (BMI) for the study group was 23.14 kg/m², with a mean MNA score of 16.23 points and a mean NRS 2002 score of 2.39 points. Based on Subjective Global Assessment, moderate malnutrition was identified in 45% of patients, whereas severe malnutrition was confirmed in 27% of the study population. Conclusions: The prevalence of malnutrition among oncology patients is high. Early screening and regular monitoring are essential for the prompt identification of patients at risk, enabling the implementation of appropriate nutritional therapy and the improvement of clinical outcomes. Full article

Vaginal drug delivery offers a critical route for local treatments but is limited by short formulation residence times. This study describes a thermosensitive in situ gel prepared by the cold-dissolution method from a ternary blend of Pluronic F127, Carbopol 940, and HPMC for localized vaginal therapy. We used ibuprofen as a model drug selected for its reported anti-inflammatory and antiproliferative activity. The hydrogels exhibited a constant gelation temperature of 28 °C and high viscosity under simulated physiological conditions; ibuprofen incorporation further reduced susceptibility to gravitational leakage. FTIR, XRD, and DSC analyses confirmed stable physical cross-linking of the polymer network and amorphous molecular dispersion of ibuprofen. Peppas–Sahlin modelling revealed a controlled, sustained release profile (>50% over 24 h) predominantly governed by Fickian diffusion (69%). The blank hydrogel exhibited high biocompatibility (>75% viability). In contrast, the ibuprofen-loaded matrix exhibited a concentration-dependent cytotoxic effect on HeLa cervical cancer cells, reducing cell viability to ~12% at the full extract concentration. Overall, this ternary hydrogel platform represents a stable, promising vehicle for sustained local administration of ibuprofen in the vaginal microenvironment. Full article

Background/Objectives: Obesity is a well-established risk factor for several cancers, yet few studies have explored survivorship outcomes among obesity-related cancer (ORC) survivors—a growing public health concern. Beyond cancer risk, obesity is associated with poorer health-related quality of life (HRQoL), greater comorbidity burden, and adverse lifestyle behaviors during survivorship. This study examined differences in these outcomes between ORC and non-ORC survivors living in Puerto Rico. Methods: We analyzed 569 cancer survivors aged ≥21 years actively undergoing treatment from the Impact of Social Determinants of Health on the Cancer Care Continuum in Cancer Survivors in Puerto Rico Study, with survey data collected between 2023 and 2025. ORC status was classified based on the presence of a primary ORC (n = 262); all others were classified as non-ORC (n = 307). Outcomes included: (1) HRQoL, assessed using the Functional Assessment of Cancer Therapy-General overall score and domains; (2) comorbidities; and (3) lifestyle behaviors (i.e., physical activity, alcohol use, and smoking status). Poisson regression models with robust standard errors estimated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for all outcomes except smoking status and comorbidity burden, which were analyzed using multinomial logistic regression models to estimate adjusted relative risk ratios (aRRRs). Results: ORC survivors had a higher relative risk of former smoking (vs. never smoking) than non-ORC survivors (aRRR: 1.74, 95% CI: 1.02–2.96). No other differences were observed between groups. Older ORC survivors reported better emotional (aPR = 0.59, 95% CI: 0.41–0.85) and physical (aPR = 0.74, 95% CI: 0.58–0.95) well-being than older non-ORC survivors. Among male participants, ORC survivors reported a lower prevalence of moderate/exceeded drinking than non-ORC survivors. Conclusions: Findings highlight a higher relative risk of former smoking (vs. never smoking) among ORC survivors compared with non-ORC survivors, with additional sex- and age-specific patterns in alcohol use and emotional/physical well-being. Full article

Background: Cardiovascular complications of cancer therapy may affect patients far beyond conventional measures of cardiac function, yet their relationship with health-related quality of life (HRQoL) remains incompletely defined. This review examined how cardiovascular status and cardiotoxicity-related interventions relate to HRQoL across cancer treatment and survivorship. Methods: Twenty-one studies were reviewed and reassessed according to four research questions: established cardiovascular disease or cardiac dysfunction and HRQoL; subclinical cardiovascular abnormalities and subsequent HRQoL; interventions targeting cardiotoxicity with HRQoL assessment; and supportive interventions improving HRQoL without demonstrated cardioprotection. Evidence was additionally considered across diagnostic, pharmacological/cardioprotective, exercise, and supportive-care domains. Results: The available evidence revealed a clinically relevant pattern. Established cardiovascular disease or cardiac dysfunction showed the clearest association with poorer HRQoL, particularly in physical domains, whereas evidence linking subclinical abnormalities to subsequent patient-reported deterioration was sparse. Most studies evaluated interventions, including cardioprotective pharmacological strategies and exercise-based approaches, but improvements in HRQoL were not consistently accompanied by, or attributable to, demonstrated cardioprotection. Exercise and supportive interventions were also associated with improvements in functional or patient-reported outcomes in some studies, independently of demonstrable cardiovascular benefit. Across domains, substantial heterogeneity in populations, cardiovascular measures, interventions, HRQoL instruments, and study designs limited direct comparison and causal interpretation. Conclusions: Cardiovascular health and HRQoL appear closely interconnected, but the available evidence does not establish a consistent link between cardiovascular injury and subsequent changes in HRQoL. The literature is richer in prevention and intervention studies than in longitudinal assessment of the patient-reported consequences of cardiovascular injury. Larger prospective studies incorporating standardized serial cardiovascular assessment and HRQoL as a predefined primary endpoint are needed to establish temporal relationships and clinically meaningful cardiovascular determinants of HRQoL. Full article

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality, and internal radionuclide therapy is an important locoregional option for unresectable disease. This review summarizes the current landscape of transarterial radionuclide therapy for HCC and, as a translational perspective, considers how the carrier, radionuclide, and dosimetry concepts established in HCC may extend to secondary liver tumors (liver metastases). It begins with established transarterial radioembolization (TARE/selective internal radiation therapy, SIRT) using yttrium-90 (⁹⁰Y) microspheres and the shift toward personalized dosimetry and combination with systemic and immune-based therapies. It then examines alternative radionuclides and carrier systems—including holmium-166 (¹⁶⁶Ho) microspheres, iodine-131 (¹³¹I) lipiodol, rhenium-188 (¹⁸⁸Re) lipiodol, and lutetium-177 emulsified in lipiodol (¹⁷⁷Lu-lipiodol)—from the standpoint of their physical properties, radiochemistry, theranostic potential, and preclinical and clinical evidence. Particular attention is given to ¹⁷⁷Lu-based approaches, including their favorable beta energy, the concurrent imageable gamma emission that enables single-photon emission computed tomography (SPECT)-based dosimetry, and the potential to address post-embolization hypoxia-related radioresistance, while noting that the clinical evidence for ¹⁷⁷Lu-lipiodol remains preclinical. The application of these platforms to colorectal and neuroendocrine liver metastases is then outlined. Finally, regulatory, radiation safety, and waste management considerations and the principal challenges to clinical translation are discussed. Full article

With immune checkpoint inhibitors becoming the mainstay of systemic therapy in both metastatic and early-stage settings across many cancer types, the management of immune-related adverse events has emerged as a central priority of modern oncological supportive care. These toxicities can substantially impair the quality of life of cancer patients, including those who achieve long-term survival. Consequently, there is a pressing need to develop reliable predictive biomarkers to better tailor immune checkpoint inhibitor treatment and optimize patient selection. This review summarizes several of the most promising predictive biomarkers currently under investigation, including genetic factors; peripheral blood parameters and their ratios; autoantibodies; cytokines and chemokines; cytomegalovirus serostatus; gut microbiome characteristics; body composition metrics; molecular imaging features; and tumour- and patient-related factors such as cancer type, gender, and physical activity. Because single biomarkers have limited predictive value, multi-omics prediction models and composite immune-cell scores are increasingly demonstrating greater potential. However, none of these candidate biomarkers have yet undergone sufficient validation to support their incorporation into routine clinical practice. Full article

Cancer cachexia is a multifactorial systemic syndrome characterized by progressive muscle loss, with or without adipose tissue depletion, that cannot be reversed by conventional nutritional support. It affects cancer patients and is associated with reduced treatment tolerance, impaired physical function, poor quality of life, and increased mortality. The understanding of cachexia has evolved recently, from the perception of a simple nutritional disorder to a complex immune–metabolic syndrome, based on tumor–host interactions, systemic inflammation, metabolic dysregulation, and multi-organ dysfunction. This review summarizes the progression of cachexia research, highlighting key findings involving inflammatory cytokines, proteolytic pathways, mitochondrial dysfunction, and immune dysregulation. The development of therapeutic strategies is examined, from early nutritional and appetite-stimulating interventions to contemporary targeted therapies, including ghrelin receptor agonists, cytokine inhibitors, and anabolic agents. Despite advances in mechanistic understanding, numerous trials targeting single pathways have failed to produce meaningful functional or survival benefits, underscoring the limitations of reductionist approaches. Emerging evidence supports a paradigm shift toward multimodal, biomarker-guided, and patient-centered interventions that address the interconnected biological mechanisms underlying cachexia. Particular emphasis is given to novel immunomodulatory strategies, including agents such as R-ketorolac, which may restore immune homeostasis and target the root causes of cachexia. It is hypothesized that future therapeutic success will likely depend on integrated approaches combining immunological, metabolic, nutritional, and rehabilitative interventions. Full article

Prostate cancer is among the most frequently diagnosed cancers in men globally, with metastatic disease contributing substantially to morbidity and mortality. While conventional therapies remain the standard of care, dietary and lifestyle behaviors are increasingly explored as potentially modifiable factors influencing clinical outcomes, although their role in advanced disease is not well established. We report a 60-year-old, physically active male, lifelong non-smoker without significant comorbidities, diagnosed with de novo metastatic prostate adenocarcinoma (Gleason score 9) and an initial prostate-specific antigen (PSA) of 808.3 µg/L. The patient received standard androgen deprivation therapy. By personal choice, he adopted a whole-food, low-fat (WFLF) vegan diet, structured physical activity, and periodic fasting-mimicking diet cycles. These interventions complemented, but did not replace or delay, conventional treatment. During the 14-month follow-up period, serial PSA measurements, laboratory tests, blood pressure monitoring, dietary assessment, body composition analysis, imaging, and germline genetic testing were performed. PSA declined from 808.3 µg/L to 1.7 µg/L (>99.8%), and remained suppressed throughout follow-up. Concurrent improvements were observed in body composition and metabolic biomarkers. The WFLF vegan diet increased fiber and micronutrient intake while reducing saturated fat and cholesterol. This case demonstrates the successful application and execution of an integrative oncology approach and highlights metastatic prostate cancer managed with standard therapy alongside patient-initiated lifestyle modifications. The findings should be interpreted as descriptive, exploratory, and hypothesis-generating. Given the single-patient design, the independent impact of lifestyle interventions cannot be determined. Controlled studies are warranted to clarify their potential role in advanced prostate cancer management. Full article

Purpose: Marking the one hundredth anniversary of quantum mechanics in 2025, quantum science has become foundational for the development of contemporary technologies, enabling advances in sensing, imaging, computing, and materials engineering. Cancer radiotherapy, although traditionally developed within the scope of classical dosimetric models and phenomenological biological frameworks, is fundamentally initiated by quantum-mechanical radiation-matter interactions. Radiation-induced DNA damage, which ultimately determines therapeutic effectiveness, originates from primary quantum-mechanical processes involving particle transport, electronic excitation and ionisation, followed by successive physicochemical and chemical stages including water radiolysis and radical formation. As scientific disciplines undergo a rapid “quantum transition,” radiation cancer treatment is increasingly positioned to benefit from deeper integration of quantum principles and emerging quantum technologies. Methods: This review examines how quantum mechanics governs the primary radiation-matter interactions that initiate the physical, physicochemical, chemical, and ultimately biological stages of radiation action at the (sub)cellular level, with particular emphasis on track structure, water radiolysis, DNA damage induction, and multiscale biological response. Contemporary approaches to DNA damage modeling are discussed, including track-structure Monte Carlo methods, nanodosimetric frameworks, and multi-scale simulation approaches that connect microscopic interaction events with biological outcomes. Key quantum concepts relevant to radiation therapy are outlined, together with emerging quantum technologies such as nanoscale quantum sensing, quantum lasers, quantum dots, and quantum computing, which are evaluated for their potential roles in dosimetry, imaging, treatment planning, and radiation transport simulations. In this context, artificial intelligence (AI) is considered a complementary tool to accelerate computation and integrate quantum-informed data across multiple scales. Results: The review highlights that quantum-informed modeling enables a more consistent description of radiation-induced processes across spatial and temporal scales, linking microscopic interaction mechanisms to DNA damage formation and macroscopic biological outcomes. Recent advances in track-structure and radiobiological modeling provide new opportunities for improving predictions of radiation effects and treatment response. Emerging quantum technologies show potential to enhance measurement sensitivity, improve simulation efficiency, and enable more precise control of radiation delivery. Furthermore, AI-assisted approaches facilitate the extraction of predictive patterns from complex datasets, supporting faster and more accurate estimation of biological endpoints such as DNA damage and cell survival. Conclusions: The quantum aspects of advanced treatment modalities, including proton and heavy-ion therapy, ultrafast radiation delivery, and the FLASH effect, as well as future concepts such as laser-plasma-driven and coherence-informed radiotherapy systems, indicate a promising direction for next-generation cancer treatment. By critically assessing both opportunities and limitations, this work provides a coherent framework for integrating DNA damage modeling, quantum principles, quantum-inspired techniques, emerging quantum technologies, and advanced computational tools to guide future developments in radiation oncology. Full article

Understanding tumor dynamics under chemotherapy is important for improving the prediction of cancer progression and assessing treatment effectiveness. This paper proposes a numerical modeling approach based on a fractal physics-informed neural network (fPINN) designed to solve nonlinear fractional-order differential equations describing the interaction of cell populations during cancer therapy. The mathematical model is formulated using the Atangana–Baleanu fractional operator in the Caputo sense, which makes it possible to capture both the fractal structure and hereditary properties of biological systems. The proposed architecture consists of four independent neural networks modeling the concentrations of stem cells, effector cells, tumor cells, and the chemotherapeutic agent. Model training is performed using a hybrid loss function that combines the residuals of the governing equations, initial conditions, and reference data generated by the Atangana–Toufik numerical method. The experimental results demonstrate high model accuracy, particularly for components with complex nonlinear dynamics. These findings indicate that the proposed fPINN framework is a promising tool for predicting tumor evolution and analyzing the impact of chemotherapy. Full article

Background/Objectives: Epithelial ovarian cancer (EOC) remains a gynecologic malignancy with a poor prognosis, with a 5-year survival of approximately 29% in advanced-stage disease. Despite cytoreductive surgery and platinum- and taxane-based chemotherapy, most patients relapse within 2 years. Major therapeutic barriers include chemoresistance, molecular heterogeneity, and an immunosuppressive peritoneal microenvironment. This review summarizes emerging therapeutic strategies for EOC, their mechanisms of action, and their potential to overcome treatment resistance. Methods: PubMed/MEDLINE was searched for preclinical studies, phase I–III clinical trials, systematic reviews, and meta-analyses addressing novel ovarian cancer therapies and resistance mechanisms. Results: The review covers molecularly targeted therapies, immunotherapies, metabolic and epigenetic approaches, cellular and gene therapies, targeted drug-delivery systems, and locoregional and physical modalities. Strategies include PARP inhibitors, antiangiogenic agents, antibody–drug conjugates, pathway inhibitors, immune checkpoint inhibitors, cancer vaccines, adoptive cell therapies, metabolic and epigenetic modulators, CAR-T, CAR-NK, CRISPR/Cas9, HIPEC, PIPAC, ablation, photodynamic therapy, and sonodynamic therapy. Conclusions: The clinical maturity of these approaches varies substantially. PARP inhibitors, antiangiogenic agents, selected antibody–drug conjugates, MAPK-directed therapy in LGSOC, and HIPEC in selected settings have the strongest clinical support. Most immune combinations, metabolic and epigenetic therapies, adoptive cell therapies, gene-editing approaches, and novel delivery or physical modalities remain early clinical or predominantly preclinical. Progress will depend on biomarker-guided patient selection, reassessment of evolving resistance mechanisms, and rational treatment sequencing and combinations. Full article

Background/Objectives: The advent of immune checkpoint inhibitors (ICIs) and targeted therapies has revolutionized advanced cutaneous melanoma care, shifting it from an acutely fatal illness to a chronic, manageable condition. While extending survival, these modern therapies introduce a new spectrum of persistent immune-related adverse events (irAEs) and long-term toxicities. This study aims to explore the “Toxicity-HRQoL Paradox” to comprehensively evaluate the true price of survival across the melanoma treatment continuum. Methods: This narrative review, based on a systematic database search, synthesizes quantitative patient-reported outcomes, health-related quality of life (HRQoL) trajectories, and health-economic data. It evaluates the impact of surgical, regional, and modern systemic therapies utilizing data derived from validated instruments, including the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), EuroQol 5 Dimensions (EQ-5D), Functional Assessment of Cancer Therapy-Melanoma (FACT-M), and comprehensive score for financial toxicity (COST). Results: Historically, extensive locoregional surgeries and high-dose interferons caused profound, debilitating drops in physical and overall QoL. Today, modern systemic therapies are associated with high rates of severe (Grade ≥ 3) acute toxicities and irreversible chronic conditions, such as permanent endocrinopathies. Despite this, global HRQoL frequently remains stable or even improves. This “toxicity-HRQoL paradox” occurs because the profound psychological relief of durable disease control effectively offsets the physical symptom burden. Furthermore, neoadjuvant ICI approaches demonstrate superior long-term HRQoL by enabling tailored surgical de-escalation. Ultimately, extended survivorship unmasks hidden burdens, revealing high prevalences of fear of cancer recurrence (FCR) (81–86%) and substantial financial toxicity. Conclusions: Despite the severe physical toxicities of modern melanoma treatments, the psychological benefit of survival largely preserves overall HRQoL. However, optimizing the modern survivorship experience requires the widespread adoption of melanoma-specific HRQoL tools and proactive, multidisciplinary care models to manage chronic toxicities, psychosocial distress, and financial burdens. Full article