Radiation-induced intestinal injury (RIII) is a major factor limiting the dose in abdominal and pelvic radiotherapy. This review summarizes our current understanding of RIII, focusing on its mechanisms, biomarkers, and potential treatment targets. Radiation directly induces DNA damage in intestinal epithelial cells and contributes to excessive reactive oxygen species (ROS), which together lead to increased apoptosis and decreased regeneration of intestinal stem cells (ISCs). An impaired antioxidant system also contributes to excessive ROS levels. Damage to ISCs results in decreased mucus production and compromised tight junctions, causing damage to the intestinal barrier. Epithelial cells impairment triggers ongoing inflammation, which promotes fibrogenesis and angiogenesis, processes involved in excessive wound healing during this damage. Endothelial cells experience DNA damage and ROS injury similar to that of epithelial cells. Intestinal vascular dysfunction, including increased permeability, ischemia, and angiogenesis, is involved throughout all stages of RIII. Additionally, dysbiosis of intestinal flora is characterized by reduced diversity, an overgrowth of conditional pathogens, and a decrease in probiotics. Current treatments for RIII include anti-inflammatory drugs, antibiotics, mucosal protective agents, and probiotics. Other therapies, such as anti-ferroptosis agents and targeted drugs, are still in preclinical studies. Traditional Chinese medicine, including decoctions, single herbs, or extracts, shows potential in treating RIII. The pathophysiology of RIII involves multiple dynamic steps, each with both harmful and protective aspects. Future research should delve deeper into these dual aspects of radiation-induced damage and its associated complications.

Background: Leukopenia is one of most common types of myelosuppression secondary to chemotherapy. The main methods used to treat leukopenia after chemotherapy have various limitations. Several studies have reported the role of acupuncture in the prevention and treatment of leukopenia, but the quality of the study is uneven. Here, we used a systematic review and meta-analysis to evaluate the efficacy and safety of acupuncture in the treatment of leukopenia after chemotherapy. Methods: We searched the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Library, Medline (via PubMed), EMBASE (via embase.com), the China National Knowledge Infrastructure Database (CNKI), the Chinese Biomedical Literature Database (CBM), the Chinese Scientific Journal Database (VIP database) and the Wanfang database to collect randomized clinical trials (RCTs) on acupuncture in the treatment of leukopenia after chemotherapy. Cochrane systematic reviewer manual 5.2 was used for bias risk assessment. RevMan5.3 statistical software was applied for statistical analysis. Results: Fifteen RCTs were included in this study, with a total of 1130 patients. Meta-analysis results showed that acupuncture can increase white blood cell (WBC) count after chemotherapy [MD = 1.18, 95% CI (0.80, 1.57), P < .00001], reduce the incidence of myelosuppression [RR = 0.38, 95% CI (0.23, 0.63), P = .0002], and improve the clinical treatment effectiveness [RR = 1.20, 95% CI (1.00, 1.43), P = .05]. The differences were statistically significant. Conclusion: It is recommended to use acupuncture in the treatment of leukocytopenia after chemotherapy, but this result needs further research for verification.

Treatment options for advanced colon cancer are mainly combinations of chemotherapy and targeted drugs. However, poor physical health and medication intolerance limit the choice of anticancer drugs. Colon cancer with cirrhosis is a particular patient group that poses a challenge to clinical treatment. This article presents a case of a patient in the decompensated stage of cirrhosis who was diagnosed with advanced colon cancer. The initial presentation was a nodule on his navel named the Sister Mary Joseph’s nodule, which was later confirmed by biopsy and PET-CT as one of the metastases of colon cancer. The patient was treated with cetuximab and 5-fluorouracil at a below-guideline dose; however, portal vein thrombosis developed and led to death. This entire process, from diagnosis to death, occurred within a span of three months. Cancers with cirrhosis are a special group that deserves more attention. There is no unified treatment guideline for these patients, especially those with extrahepatic primary tumors. We should be more cautious when choosing treatment for such patients in the future. Both chemotherapy and targeted treatment may potentially induce portal vein thrombosis, which appears to have a higher incidence and worse prognosis than cancers without cirrhosis.

Background Treatment options for advanced colon cancer are mainly combinations of chemotherapy and targeted drugs. However, poor physical health and medication intolerance limit the choice of anticancer drugs. Colon cancer with cirrhosisis a particular patient group that poses a challenge to clinical treatment. Case presentation This article presents a case of a patient in the decompensated stage of cirrhosis who was diagnosed with advanced colon cancer. The initial presentation was a nodule on his navel named the Sister Mary Joseph’s nodule, which was later confirmed by biopsy and PET-CT as one of the metastases of colon cancer. The patient was treated with Cetuximab and 5-Fluorouracil at a below-guideline dose, however, portal vein thrombosis developed and led to death. This entire process, from diagnosis to death, occurred within a span of three months. Conclusion Cancers with cirrhosis are a special group that deserves more attention. There is no unified treatment guideline for these patients, especially those with extrahepatic primary tumors. We should be more cautious when choosing treatment for such patients in the future. Both chemotherapy and targeting may potentially induce portal vein thrombosis, which appears to have a higher incidence and worse prognosis than other diseases.