ResearchPad - clinical-guideline https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[原发性肺癌外科手术临床路径(2013年版)]]> https://www.researchpad.co/article/5c052c87d5eed0c4848a83f4 <![CDATA[原发性肺癌诊疗规范(2011年版)]]> https://www.researchpad.co/article/5c052ad3d5eed0c4848a4d73 <![CDATA[Clinical diagnosis and treatment of immune checkpoint inhibitors‐related endocrine dysfunction]]> https://www.researchpad.co/article/N11841ab8-8264-46fc-9e07-8a5ac44b2257

As a new class of antitumor drugs, immune checkpoint inhibitors (ICIs) have shown remarkable efficacy toward the treatment of various malignant tumors. By virtue of their targets and mechanisms of action, ICIs can cause autoimmune and inflammatory effects, termed as immune‐related adverse events (irAEs) and unlike the adverse reactions of traditional therapies, irAEs are occult and not fixed, with some serious adverse reactions forcing patients to stop treatment which might even affect their survival. Therefore, with the wide clinical application of ICIs, clinicians need to fully understand the possible adverse reactions of these drugs and devise reasonable treatment strategies to improve the survival rate and therapeutic effects of patients receiving ICIs. In this article, we review the incidence, clinical manifestations, diagnosis and treatment of immune‐related endocrine events that may occur with the administration of ICIs.

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<![CDATA[Management of immune checkpoint inhibitor‐related dermatologic adverse events]]> https://www.researchpad.co/article/N26668f4c-eafe-4806-8a07-e16582b39151

Abstract

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment. The unique spectrum of immune‐related adverse events (IrAEs) may occur during treatment. Dermatologic toxicities appear to be one of the most prevalent immunotherapy‐related adverse events. The most common symptoms are maculopapular rash and pruritus. Serious dermatologic toxicities including Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reactions with eosinophilia and systemic symptoms are rare. In this review, we summarize guidelines of management of immunotherapy‐related toxicities, case reports, and proposed treatment recommendation.

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<![CDATA[Clinical manifestation and management of immune checkpoint inhibitor‐associated cardiotoxicity]]> https://www.researchpad.co/article/Nc4d22949-882b-4ee2-a4c9-600852871056

Abstract

Immune checkpoint inhibitors (ICIs) targeting programmed death‐1 (PD‐1), its ligand (PD‐L1), and cytotoxic T‐lymphocyte‐associated antigen 4 (CTLA4) have revolutionized cancer treatment by recovering the attack of T lymphocytes on the malignant cells. They have improved clinical outcomes dramatically in multiple types of advanced‐stage malignancies. Even though the tolerance and safety profiles are generally good, it has been widely reported that ICIs can cause severe or fatal immune‐related adverse events (irAEs), since the activated T lymphocytes are not specific for tumor cells. Cardiac irAEs appear to occur less frequently than irAEs in other organ systems but are notorious for high mortality. Here, we aim to identify and characterize the ICI‐associated cardiotoxicity and summarize the optional diagnosis and treatment strategies.

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<![CDATA[Clinical diagnosis and treatment recommendations for immune checkpoint inhibitor‐related adverse reactions in the nervous system]]> https://www.researchpad.co/article/N1f357579-2a9d-4a01-9592-67cc71f0dcec

Immune checkpoint inhibitors (ICIs) can cause adverse reactions in the nervous system. The incidence rate is 0.1%–12% and 80% of nervous system adverse reactions occur within the first four months of application. ICIs can cause diseases of various parts of the nervous system including central nervous system diseases such as aseptic meningitis, meningeal encephalitis, necrotizing encephalitis, brainstem encephalitis, transverse myelitis, etc., and peripheral neuropathy such as cranial nerve peripheral neuropathy, multifocal nerve root neuropathy, Guillain‐Barré syndrome, spinal nerve root neuropathy, myasthenia gravis, myopathy, etc. For these complications of the nervous system, diagnosis could be difficult. Physicians require a specific collection of nervous system symptoms and signs, combined with supplementary examinations including imaging, cerebrospinal fluid cytology, EEG or electromyography in order to exclude infection or malignant tumor before reaching a final diagnosis. With regard to treatment, ICIs should be discontinued in severe cases, and large doses of glucocorticoid or gamma globulin administered, and supportive treatment may be necessary. If severe adverse reactions of the nervous system occur, the prognosis could be poor.

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<![CDATA[Chinese Expert Consensus Workshop Report: Guideline for permanent iodine‐125 seed implantation of primary and metastatic lung tumors]]> https://www.researchpad.co/article/5c75646ed5eed0c484cbb5f3

Surgery remains the first choice of cure for early stage lung cancer. However, many patients are diagnosed at advanced stage, and thus miss the opportunity to undergo surgery. As such patients derive limited benefits from chemotherapy or radiotherapy, alternatives focusing on local control have emerged, including iodine‐125 seed implantation. The Interstitial Brachytherapy Society, Committee of Minimally Invasive Therapy in Oncology, Chinese Anti‐Cancer Association organized a group of multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim to standardize iodine‐125 seed implantation procedures, inclusion criteria, and outcome assessment to prevent and manage procedure‐related complications.

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