Objective: To investigate the expression of insulin-like growth factor 1 receptor (IGF-1R) in desmoplastic small round cell tumor (DSRCT) and evaluate the inhibitory efficacy of OSI-906, an IGF-1R selective inhibitor, on the growth of DSRCT cells.

Methods: The clinical and pathological data of 8 cases of DSRCT diagnosed at Renji Hospital, Shanghai Jiao Tong University School of Medicine from 2012 to 2024 were collected and analyzed. The expression of IGF-1R in DSRCT tissues was detected using immunohistochemistry (IHC), and its distribution features were analyzed. Alamar-Blue and CCK8 assays were performed to detect the half maximal inhibitory concentration (IC₅₀) of OSI-906 in three DSRCT cell lines, and Western blotting was used to detect the expression of key proteins in the IGF-1R kinase receptor-related signaling pathway.

Results: IGF-1R protein expression was localized at the cell membrane or cytoplasm, a moderate-to-strong positive expression rate of 75% was found in all 8 DSRCT tissue samples. Alamar-Blue and CCK8 assays revealed that the IC₅₀ of OSI-906 for JN-DSRCT-1, DSRCT-B1Z and DSRCT-B3OD cell lines were 6.942, 60.440 and 3.487 µmol/L, respectively, and OSI-906 inhibited the viability of DSRCT-B3OD cell line in a dose-dependent manner. Western blotting analysis demonstrated that the expression level of phosphorylated AMPK was significantly upregulated, while the expression level of phosphorylated mTOR was significantly downregulated.

Conclusion: IGF-1R is highly expressed in DSRCT cells. In vitro, the OSI-906 shows a certain inhibitory effect on the growth of DSRCT cells, possibly by regulating the AMPK/mTOR pathway. These findings highlight the significance of IGF-1R as a potential therapeutic target in DSRCT.

Objective: This study aims to evaluate the correction effect of adaptive radiotherapy (ART) based on fan beam CT (FBCT) and image-guided radiotherapy (IGRT) using the uLinac HalosTx medical linear accelerator on the setup errors of tumor patients. It also analyzes the impact of the planning duration of ART on body position stability, with the intention of providing a reference for clinical optimization of ART procedures.

Methods: Using a retrospective cohort analysis, 27 patients with malignant tumors (5 patients with esophageal cancer, 13 patients with cervical cancer, and 9 patients with prostate cancer) admitted to Renji Hospital, Shanghai Jiao Tong University School of Medicine from September 2024 to March 2025 were included. Through FBCT three-dimensional registration technology, the setup errors in the X (Lat), Y (Lng), and Z (Vrt) directions were measured before and after the ART plan was formulated, and the impact of different durations of ART planning (0-20 min, >20-25 min, >25 min) on the setup errors was analyzed.

Results: The setup errors in the X (Lat), Y (Lng), and Z (Vrt) directions in patients with esophageal cancer decreased from 0.190±0.131 cm, 0.197±0.152 cm and 0.267±0.208 cm, respectively, to 0.098±0.062 cm, 0.094±0.092 cm and 0.074±0.057 cm (P<0.001); the setup errors in patients with cervical cancer decreased from 0.185±0.131 cm, 0.331±0.270 cm and 0.244±0.209 cm, respectively, to 0.066±0.085 cm, 0.133±0.096 cm and 0.087±0.073 cm (P<0.001); the setup errors in the patients with prostate cancer decreased from 0.169±0.137 cm, 0.294±0.221 cm and 0.279±0.177 cm, respectively, to 0.052±0.067 cm, 0.132±0.125 cm and 0.084±0.079 cm (P<0.001). The relationship between the duration of ART planning and setup errors showed that there were no significant differences in the setup errors in the X (Lat), Y (Lng) and Z (Vrt) directions in patients with esophageal cancer among different duration groups (P>0.05); however, there were significant differences in the setup errors in patients with pelvic malignancies among different duration groups (P<0.05), with increase in the setup errors in the three-dimensional directions as the duration of planning increased.

Conclusion: ART can effectively improve setup accuracy and significantly reduce the setup errors in patients with esophageal, cervical or prostate cancer. However, for patients with pelvic malignancies, it is recommended to strictly control the duration of ART planning to avoid the accumulation of setup errors caused by prolonged time.

Objective: To investigate the impact of different radiotherapy doses on the concurrent chemoradiotherapy efficacy and prognosis in patients with stage Ⅱ-Ⅳa esophageal squamous cell carcinoma (ESCC) receiving S-1 (Tegafur-gimeracil-oteracil potassium) chemotherapy.

Methods: Based on inclusion and exclusion criteria, 154 eligible patients with ESCC were selected from those treated at the Department of Radiation Oncology of the First Affiliated Hospital of Bengbu Medical University between January 2019 and January 2023. According to prescribed radiation dose, these patients were divided into a standard-dose radiotherapy (SD-RT) group (n = 75, total radiation dose: 50-54 Gy) and a high-dose radiotherapy (HD-RT) group (n = 79, total radiation dose: 60 Gy). Since a relatively high proportion of the enrolled patients were elderly (age > 75 years, accounting for > 70%) with poor physical condition, and some patients declined standard intravenous chemotherapy due to personal reasons, all enrolled patients received oral S-1 concurrent chemotherapy during radiotherapy. Follow-up evaluations were conducted 1 - 3 months after concurrent chemoradiotherapy. The short-term clinical efficacy and the incidence of acute radiotherapy-related adverse reactions were evaluated for both the SD-RT and HD-RT groups according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Long-term survival was analyzed using Kaplan-Meier curves. Log-rank test and multivariate COX regression analysis were used to identify independent prognostic factors affecting progression-free survival (PFS) and overall survival (OS) of ESCC patients.

Results: Among the 154 ESCC patients, the objective response rate (ORR) and disease control rate (DCR) were 88.0% and 97.3% in the SD-RT group, respectively, while those of the HD-RT group were 93.7% and 100%. There was no statistically significant difference in the short-term clinical efficacy between the two groups (P=0.516, χ²=2.369), but significant differences were observed in both PFS and OS (PFS^{SD-RT vs HD-RT}: 20.0 months vs 26.0 months, P=0.009; OS^{SD-RT vs HD-RT}: 26.0 months vs 34.0 months, P=0.047). Subgroup analysis based on clinical stage demonstrated that HD-RT can improve the long-term survival in patients with stage Ⅲ-Ⅳa ESCC (PFS^{SD-RT vs HD-RT}: 15.0 months vs 20.0 months, P=0.002; OS^{SD-RT vs HD-RT}: 17.0 months vs 22.0 months, P=0.006), but did not significantly benefit patients with stage Ⅱ ESCC. Additionally, the subgroup analysis according to median gross tumor volume (GTV) showed that ESCC patients with smaller tumor volumes (≤43.39 cm^³) exhibited greater sensitivity to HD-RT compared to those with larger tumors (>43.39 cm³) (PFS^{SD-RT vs HD-RT}: 18.0 months vs 26.0 months, P = 0.028; OS^{SD-RT vs HD-RT}: 22.0 months vs 32.0 months, P = 0.025). In terms of radiation-related toxicity, there were no significant statistical differences between the SD-RT and HD-RT groups in the incidence of myelosuppression (P = 0.539), radiation esophagitis (P = 0.882), or radiation pneumonitis (P=0.636). Log-rank test and multivariate COX regression analysis identified radiation dose, T stage, and clinical stage as independent prognostic factors for PFS of ESCC patients (all P < 0.05), while radiation dose and clinical stage were independent prognostic factors for OS of ESCC patients (both P < 0.05).

Conclusion: For ESCC patients treated with S-1-based concurrent chemoradiotherapy, increasing the total radiation dose to 60 Gy can improve their long-term survival outcomes without increasing the risk of radiation-related adverse events. This survival benefit was particularly pronounced in ESCC patients with advanced-stage disease (Ⅲ-Ⅳa) and smaller tumor volumes (≤43.39 cm³).

Objective: To establish normal or specific gene-deficient gallbladder epithelial organoids and gallbladder cancer organoids for investigating the molecular mechanisms driving gallbladder cancer progression.

Methods: Gallbladder and gallbladder cancer tissues were enzymatically digested with collagenase Ⅳ, followed by neutralization, filtration, and centrifugation to isolate epithelial cell pellets. The isolated epithelial cells were embedded in Matrigel and cultured in a three-dimensional system. Gene editing technologies, including the Cre-loxP transgenic mouse and CRISPR-Cas9 system, were employed to generate gallbladder epithelial organoids with specific gene knock-outs or mutations. The gene editing efficiency was verified using flow cytometry, puromycin selection, and Sanger sequencing. The growth behavior and functional features of the organoids under different culture conditions were observed, and the effects of small pharmaceutical molecules (such as Wnt agonists and inhibitors) on the growth of the organoids were further assessed.

Results: Murine gallbladder epithelial organoids and human gallbladder cancer organoids were successfully generated and stably propagated in the long term under optimized organoid culture conditions. A gallbladder epithelial organoid model with specific gene knock-outs was successfully established, providing a robust platform for molecular mechanism research in gallbladder cancer. Further research demonstrated that the Wnt signaling pathway was highly activated in gallbladder cancer organoids, with growth dynamics significantly modulated by Wnt agonists or inhibitors.

Conclusion: Normal murine gallbladder epithelial organoids and human gallbladder cancer organoids, combined with advanced gene-editing technologies, serve as powerful tools for deciphering the molecular mechanism and developing targeted therapeutic strategies through building disease models with high efficiency and accuracy. Wnt signaling is one of the critical regulatory signaling pathways in gallbladder progression, highlighting its potential as a therapeutic target.

Bispecific antibody (BsAb) refers to a large class of novel immunotherapeutic drugs that can recognize two different epitopes or antigens, combining the ability to activate the patient’s immune system and target tumor target cells. Several clinical trial studies on oncology have shown that BsAb has become an important strategy for the treatment of advanced solid tumors such as advanced lung and gastric cancers. Compared to the combination of two kinds of monoclonal antibodies, BsAb has shown specific biological activity and lower resistance when applied to the treatment of advanced solid tumors. This paper provides an overview of the development history, mechanism of action, classification, and clinical applications of BsAb in advanced solid tumors, and discusses the possible biomarkers for the clinical efficacy.

Primary bone lymphoma (PBL) is a rare malignancy characterized by lymphoma cells primarily invading bone tissue. Unlike other lymphoma subtypes, PBL usually remains confined to bone at diagnosis without involving lymph nodes or other organs. It affects individuals of all ages, generally showing a better prognosis than secondary bone lymphoma. However, the low incidence of PBL has led to limited large-scale studies, with most researches relying on case reports or small retrospective analyses, causing challenges in diagnosis and delays in treatment. This review summarizes the clinical manifestations, diagnostic methods, treatment strategies, and prognostic outcomes of PBL to enhance understanding of its management and improve patients’ outcomes and quality of life.

Objective: To describe an effective chemotherapy regimen for metastatic sclerosing epithelioid fibrosarcoma (SEF).

Methods: The diagnosis and treatment of one SEF case were reported.

Results: The patient with primary left-sided colon SEF underwent radical left hemicolectomy. Two months later, multiple metastases in the abdominal and pelvic cavity were found. The patient received first-line chemotherapy with FOLFIRI. Disease progression was observed after 17 months, while no relevant treatment was performed due to the epidemic. After the next 19 months, the abdominal and pelvic tumor progressed significantly, then a secondary cytoreductive surgery was underwent. A CT scan conducted three weeks after surgery revealed multiple metastases within the abdominal and pelvic cavities. Second-line chemotherapy with single-agent Epirubicin was administered, the tumor increased significantly after two cycles. Subsequently, the patient received third-line GT chemotherapy, achieved partial response (PR) after 2 cycles, and completed 7 cycles in total. With regular follow-up, treatment efficacy was assessed as a sustained PR. The patient has achieved a progression-free survival (PFS) exceeding 19 months to date.

Conclusion: SEF is an exceptionally aggressive malignancy characterized by high invasiveness and poor prognosis. Here, we report a case, the GT regimen chemotherapy demonstrated remarkable efficacy in treating SEF, providing valuable insights for future therapeutic approaches.