While lung cancer remains a lethal disease despite treatment advances, some parasitic infections can demonstrate cancer-modulating roles and exhibit anti-tumor effects. The emergence of hydatid cysts as a potential anti-cancer treatment has sparked optimism for the development of more successful therapies. This research examines the effect of hydatic cysts on the growth and proliferation of lung tumor cells, as well as the underlying molecular mechanisms involved. The laminated layer (LL) of the hydatid cyst antigens was administered to lung cancer cells with varying dosages and durations. The MTT assay was applied to evaluate cell viability. After exposure to different concentrations of LL antigens, the apoptosis, necrosis, cell cycle, and intracellular reactive oxygen species (ROS) of the cell culture were measured using flow cytometry. The expression levels of SOX-9, β-catenin, CD133, and CD44 genes were assessed using Real-Time PCR. Treating A549 cells with varying concentrations of LL antigens resulted in a decrease in viable cells, which depended on both time and dosage. Treatment with cysts led to apoptosis induction and a reduction in necrosis percentage in a dose-dependent manner. The induction of apoptosis correlated with elevated ROS production and a notable decrease in the expression of invasion-related genes (β-catenin, CD133, and CD44) (P < 0.05). However, this reduction in expression was not statistically significant for SOX-9. Exposing lung cancer cells to precise amounts of crude LL antigens resulted in cell death, apoptosis, increased intracellular ROS levels, and reduced expression of genes linked to cancer cell growth and invasion. These results lay the groundwork for further exploring purified Echinococcus granulosus parasite antigens as potential drug targets in cancer treatment.

BackgroundSpatially fractionated radiotherapy (SFRT) intentionally creates spatially-modulated peak-valley dose patterns for improving the tumor control or/and the sparing of organs at risk, compared to conventional radiotherapy (CONV). Evaluating non-uniform dose distributions using conventional physical dose does not fully account for the biological effectiveness of SFRT. In this study, we adopt the equivalent uniform dose (EUD) as a surrogate metric to evaluate non-uniform dose distributions.PurposeThis work will develop a SFRT treatment planning method with EUD optimization, which is the first-of-its-kind to the best of our knowledge.MethodsThe SFRT scenario of proton GRID with uniform target dose is considered in this work for dose-only optimization (DO) and joint dose and peak-valley-dose-ratio (PVDR) optimization (JDPO) respectively. In addition to dose and PVDR optimization, SFRT treatment planning also optimizes the EUD. The EUD used in this work is based on cell survival as modeled by the linear-quadratic model. The EUD optimization problem is solved by: (1) iterative convex relaxation to decouple the nonconvex dose-volume-histogram constraint; (2) linearized alternating direction method of multiplier to efficiently handle the nonconvex minimum-monitor-unit constraint and nonlinear EUD objective.ResultsEUD optimization reduced the EUD and increased survival fraction. For example, for a head-and-neck patient, EUD optimization decreased the brainstem EUD from 5.52% to 3.86% for DO, and from 5.78% to 4.82% for JDPO, and increased the brainstem survival fraction from 72.9% to 81.6% for DO, and from 71.5% to 76.6% for JDPO. Furthermore, EUD optimization preserved PVDR from DO or JDPO.ConclusionsA novel EUD optimization method is proposed for SFRT that can reduce the EUD and increase the survival fraction.

Radionuclide therapy, such as with iodine-131 or lutetium-177-labeled substances, is used to treat thyroid cancer and neuroendocrine tumors. Due to the incorporated radioactivity, patients must remain hospitalized until radiation levels are deemed safe, according to national regulations. This is particularly problematic for patients who require hemodialysis (HD). While contamination of dialysis waste after radionuclide therapy is generally well recognized, a critical gap remains regarding its duration and extent. This poses risks for patient management and outpatient staff.

This study aims to demonstrate the problems with classifying residual waste and provides arguments for appropriate regulation. It evaluates if the radioactivity of the dialysate and residuals at discharge, based on whole-body measurements, complies with relevant limits. If not, the waste is classified as radioactive and treated accordingly.

We studied four patients treated by radionuclide therapy who required dialysis: three received [¹³¹I]I for thyroid disease and one [¹⁷⁷Lu]Lu-DOTATATE for neuroendocrine neoplasia. Dialysis was performed in the nuclear medicine ward, and patients were discharged once the local dose rate limits were met. Subsequent dialysis sessions were conducted in a radiation protection area until the activity concentration in the dialysate dropped below the specific limit.

Patient 1 ([¹³¹I]I, thyroid cancer) showed the highest extraction rate and was discharged after 9 days, requiring nine additional dialysis sessions over 21 days. Patients 2 and 3 ([¹³¹I]I, benign thyroid disease) were discharged after 8 and 4 days, with dialysis continued for 31 and 18 days under supervision, respectively. Patient 4 ([¹⁷⁷Lu]Lu-DOTATATE) lost 4.9% of the total body radioactivity per dialysis session and was discharged after 9 days; supervised dialysis continued for 17 days.

This study highlights the need for refined monitoring and the limitations of standard discharge strategies for patients requiring dialysis during radionuclide therapy. Even if dose limits are met, dialysate and residuals may still require regulated handling and storage.

The normal tissue objective (NTO) is an inverse planning approach in radiosurgery, also available for the CyberKnife system. By employing a model function, it aims to achieve precise control over the global dose fall-off in healthy tissue. As a novel technique, NTO can serve as an alternative to the established method, which utilizes layered contours around the target to shape dose gradients and enhance conformity, referred to as Auto-shells in CyberKnife systems.

This study compares the dose distribution achieved with NTO and Auto-shells to evaluate their respective advantages in CyberKnife treatment planning.

A total of 45 patients with brain tumors-including 15 vestibular schwannomas, 15 meningiomas, and 15 metastases, all of whom had previously been treated using an Auto-shells-generated plan, were analyzed. For each case, an alternative NTO-based plan was generated and compared with its Auto-shells counterpart. Key treatment parameters-including nodes, beams, total monitor units (MU), treatment time, new conformity index (nCI), gradient index (GI), and dose exposure volumes to healthy brain tissue (V12Gy and V5Gy)-were evaluated.

Both methods resulted in comparable plans across many indices. Significant differences were particularly in terms of healthy brain tissue dose exposure. With the NTO method, V12Gy and V5Gy were reduced by up to 14%, and in the case of meningiomas and metastases, the GI was reduced by up to 7%. The conformity, described by the nCI, was within 2%. No significant difference was observed in MU.

NTO optimization presents a viable option to the Auto-shells method for CyberKnife treatment of brain tumors. By reducing healthy brain tissue exposure without increasing monitor units, it enhances dose-sparing efficiency. However, maintaining optimal conformity remains an important issue, highlighting the trade-offs between precision and tissue preservation.

Glioblastoma (GBM), the most aggressive type of primary brain tumor in adults, is characterized by a poor prognosis and considerable resistance to current therapies. Traditional treatment approaches-surgery, radiation, and chemotherapy-offer few clinical benefits and are often linked to increased recurrence rates and significant adverse effects. This underscores the urgent need for novel therapeutic strategies. Targeting the transforming growth factor-beta (TGF-β) signaling pathway is a viable strategy. TGF-β acts as a tumor suppressor during the first stages of cancer but promotes tumor progression, angiogenesis, immune evasion, and the creation of an immunosuppressive tumor microenvironment in GBM. The deregulation of TGF-β signaling has been shown to interact with essential carcinogenic pathways, including the Wnt/β-catenin, PI3K/AKT, and Notch pathways, therefore aggravating GBM pathogenesis. TGF-β plays a pivotal role in controlling glioma stem cells and influencing the permeability of the blood-brain barrier, making it an attractive target for therapeutic intervention. Novel treatment approaches, including small-molecule inhibitors and monoclonal antibodies, as well as the use of phytochemicals such as flavonoids, quercetin, and other phytochemicals targeting specific elements of the TGF-β signaling pathway, have shown encouraging results in preclinical investigations and early-stage clinical trials. These novel strategies may enhance clinical outcomes and mitigate treatment limitations in GBM therapy by leveraging this system's combined tumor-suppressive and immune-regulatory properties.

This review examines the role of specific probiotic strains in modulating oral biofilms and immune pathways implicated in the prevention of oral squamous cell carcinoma (OSCC). Evidence indicates that Lactobacillus fermentum, L. salivarius, Bifidobacterium animalis, and Streptococcus salivarius effectively disrupt carcinogenic biofilms through multiple mechanisms. These include competitive exclusion, nutrient competition, and the production of antimicrobial peptides and biosurfactants. In addition, they contribute to cancer prevention by detoxifying mutagens such as acetaldehyde and nitrosamines. These probiotics also influence OSCC-relevant immunity by enhancing natural killer cell cytotoxicity, promoting CD8⁺ T-cell activity, and inducing TRAIL-mediated apoptosis, while strengthening epithelial defenses via upregulation of tight junction proteins. Multi-strain formulations frequently demonstrate superior efficacy compared to single strains, reflecting potential synergistic mechanisms. Nonetheless, outcomes remain highly strain-dependent and context-specific. Overall, current evidence suggests a promising yet preliminary role for probiotics in OSCC prevention, underscoring the need for rigorously designed, strain-specific clinical trials and optimized delivery systems tailored to the oral environment.

Invasive fungal infections (IFIs) are life-threatening complications in immunocompromised patients, particularly those with hematologic malignancies or undergoing transplantation. Despite advances in diagnostic methods and antifungal therapy, IFI-related mortality remains unacceptably high. Evidence from Latin America is scarce, limiting the understanding of regional epidemiology and outcomes. Our work aimed to analyze the epidemiological and clinical profiles of pediatric hemato-oncologic patients diagnosed with proven IFIs. We conducted a retrospective, cross-sectional study by reviewing medical records of patients diagnosed with proven IFIs according to the 2020 criteria of the European Organization for Research and Treatment of Cancer and the Mycoses Study Group, at the Hospital Universitario "Dr. José Eleuterio González" in northeast Mexico, between 2018 and 2024. Statistical analysis included descriptive and inferential methods. A p-value < 0.05 was considered statistically significant. Thirty-three patients were included (mean age 6 years; 54.5% male). Most (91%) were classified as high risk for IFIs, and acute lymphoblastic leukemia was the most frequent underlying malignancy (72.7%). Mold infections accounted for 69.7% of cases, mainly Aspergillus spp. and Fusarium spp., while Candida tropicalis was the most common yeast. The sinonasal region was the predominant site of mold disease. Prophylaxis was administered in 69.7% of patients, most commonly with itraconazole. Amphotericin B was the primary therapeutic agent, alone or in combination with voriconazole, and 42.4% required surgical intervention. Overall mortality was 21.2%, higher in yeast infections (30%) compared with molds (17.4%). Intensive care unit admission was the only independent predictor of death (OR 35.4; p = 0.019). In pediatric hemato-oncologic patients, IFIs were predominantly associated with acute lymphoblastic leukemia, neutropenia, and induction chemotherapy. Mold infections accounted for most cases, and mortality remained high despite prophylaxis. These findings provide novel data from Latin America, where studies on pediatric IFIs are limited, and underscore the need for improved diagnostic and preventive strategies in high-risk populations.

Diagnosing salivary gland tumors remains challenging due to their clinical and biological complexity, histopathologic diversity, and overlapping morphology. Over the last few years, molecular profiling has emerged as a key tool for improving tumor classification, shedding light on the cellular and molecular mechanisms underlying tumors pathogenesis. This review provides a comprehensive exploration of the clinical application of molecular profiling in the decision to indicate targeted therapy for salivary gland neoplasm. The increasing adoption of innovative biological markers associated with Next-Generation Sequencing highlights the potential of molecular diagnostic approaches as well as the prediction of therapeutic response. While immunohistochemistry remains a reliable and widely accessible ancillary tool for characterizing specific salivary gland tumors subtypes, additional validation using in situ hybridization, reverse transcription polymerase chain reaction or Next-Generation Sequencing may enhance diagnostic accuracy and facilitate the identification of actionable molecular alterations in the appropriate clinical and morphological context. This integrated diagnostic approach strengthens clinical decision-making and opens new avenues for precision-targeted therapy in the management of salivary gland tumors. As molecular insights continue to expand, the integration of traditional and modern tools will be critical to improving diagnostic accuracy, prognostic stratification, and treatment outcomes for patients with salivary gland tumors.

Radiolabeled somatostatin receptor (SSTR) analogues are widely utilized for both imaging (PET or scintigraphy) and peptide receptor radionuclide therapy (PRRT) in the management of neuroendocrine neoplasms (NENs). These approaches have been extensively validated in low- to intermediate-grade gastroenteropancreatic neuroendocrine tumors (NET G1 - G2). However, data on the use of SSTR imaging - particularly SSTR PET imaging - in patients with high-grade NETs (G3) and neuroendocrine carcinomas (NECs) remain limited. This study aimed to evaluate the diagnostic performance of ¹⁸F-AlF-NOTA-octreotide (¹⁸F-AlF-OC) PET/CT in patients with high-grade NENs and assess its complementarity with ¹⁸F-FDG PET/CT.

Out of 426 patients who underwent ¹⁸F-AlF-OC PET/CT between January 2023 and October 2024, 42 patients with histologically confirmed high-grade NENs (28 with G3 NETs and 14 with NECs) were retrospectively analyzed. 36 patients also underwent ¹⁸F-FDG PET/CT. Lesions were classified as positive on PET/CT if their uptake exceeded organ background activity and could not be explained by physiologic biodistribution. Tumor uptake higher than normal liver was considered high uptake.

On a per-patient basis, ¹⁸F-AlF-OC PET/CT was positive in 39 of 42 patients, yielding a detection rate of 92.9%. Among all patients, 28 (66.7%, 28/42) exhibited high ¹⁸F-AlF-OC uptake, and 19 (45.2%, 19/42) demonstrated positivity in all lesions. Of the 36 patients who underwent both scans, detection rates were 91.7% (33/36) for ¹⁸F-AlF-OC and 88.9% (32/36) for ¹⁸F-FDG PET/CT. Discordant findings were observed in 11 patients (30.6%) with¹⁸F-AlF-OC-negative/¹⁸F-FDG-positive lesions and in 13 patients (36.1%) with ¹⁸F-AlF-OC-positive/¹⁸F-FDG-negative lesions. On a per-lesion basis, ¹⁸F-AlF-OC PET/CT showed a higher detection rate than ¹⁸F-FDG PET/CT (80.7% [547/678] vs. 72.9% [494/678]). Specifically, ¹⁸F-AlF-OC identified 109 lesions missed by ¹⁸F-FDG, while ¹⁸F-FDG identified 56 lesions missed by ¹⁸F-AlF-OC. The combined use of both tracers improved the detection rate to 89.1% (604/678), surpassing either modality alone.

¹⁸F-AlF-OC PET/CT demonstrated high detection rates in patients with high-grade NENs, with a substantial proportion showing strong SSTR expression and lesion-wide positivity, supporting its potential role in guiding PRRT eligibility. The complementary nature of ¹⁸F-AlF-OC and ¹⁸F-FDG PET/CT enhances overall diagnostic accuracy, making dual-tracer imaging a valuable approach in this setting.

The gut microbiome plays a pivotal role in cancer development, progression, and treatment response, driving interest in microbiome-based interventions. This review examines probiotics, prebiotics, synbiotics, and postbiotics (PPSPs) as precision tools in oncology, highlighting their mechanisms, clinical applications, and challenges. Gut microbiota influence cancer through immune modulation, metabolic regulation, and inflammatory control, while also shaping chemotherapy pharmacokinetics and immunotherapy efficacy. PPSPs demonstrate antitumor effects via: (1) immune activation, (2) intestinal barrier reinforcement, (3) pathogen suppression, and (4) carcinogen neutralization. Clinically, probiotics/postbiotics reduce chemotherapy-induced mucositis and enhance checkpoint inhibitor responses, while synbiotics/prebiotics selectively nourish beneficial microbes. Despite promise, hurdles like strain-specific variability, dosing optimization, and individual microbiome differences hinder translation. By integrating preclinical and clinical data, this review underscores PPSPs' potential to bridge gut ecology with antitumor immunity, advancing precision oncology. Future priorities include large-scale trials, standardized protocols, and mechanistic insights into host-microbiome-cancer crosstalk. Personalized microbiota therapies, engineered consortia, and combination regimens represent promising frontiers. With robust evidence, PPSPs may emerge as essential adjuvants, improving outcomes while minimizing toxicity in cancer care.