Doxorubicin (Dox) is one of the most frequently used chemotherapeutic drugs in a variety of cancers, but Dox-induced cardiotoxicity diminishes its therapeutic efficacy. The underlying mechanisms of Dox-induced cardiotoxicity are still not fully understood. More significantly, there are no established therapeutic guidelines for Dox-induced cardiotoxicity. To date, Dox-induced cardiac inflammation is widely considered as one of the underlying mechanisms involved in Dox-induced cardiotoxicity. The Toll-like receptor 4 (TLR4) signaling pathway plays a key role in Dox-induced cardiac inflammation, and growing evidence reports that TLR4-induced cardiac inflammation is strongly linked to Dox-induced cardiotoxicity. In this review, we outline and address all the available evidence demonstrating the involvement of the TLR4 signaling pathway in different models of Dox-induced cardiotoxicity. This review also discusses the effect of the TLR4 signaling pathway on Dox-induced cardiotoxicity. Understanding the role of the TLR4 signaling pathway in Dox-induced cardiac inflammation might be beneficial for developing a potential therapeutic strategy for Dox-induced cardiotoxicity.

Breast cancer is a leading cause of mortality among women worldwide, necessitating surgical interventions like lumpectomy, mastectomy, or modified radical mastectomy. However, these procedures often lead to postoperative complications, such as frozen shoulder, significantly impacting patients’s quality of life. This review focuses on the challenges associated with frozen shoulder and other complications following breast cancer surgery. It proposes the integration of Artificial Intelligence (AI) in assessment and intervention as a cost- effective solution. Frozen shoulder, also known as adhesive capsulitis, affects around 22.2% of breast cancer patients, particularly those undergoing axillary approaches. It is frequently accompanied by Axillary Web Syndrome (AWS) and Post-Mastectomy Pain Syndrome (PMPS), resulting in pain, limited range of motion, and compromised functional abilities. Conservative treatments, including exercises and rehabilitation programs, have shown positive outcomes in managing these symptoms. Previous studies have demonstrated the effectiveness of exercises, joint mobilization techniques, and home-based exercise programs in improving muscle strength, range of motion, and functional ability in breast cancer survivors. Abnormal neuromuscular control and kinematic distortions in shoulder and spinal movements have also been identified, highlighting the significance of neuromuscular training for shoulder joint complex recovery. The integration of AI in the assessment and intervention of frozen shoulder can offer cost-effective solutions and reduce waiting times at healthcare centers in Thailand. AI technologies can enable precise evaluations and personalized treatment plans, optimizing patient outcomes and resource utilization. In conclusion, physical therapy plays a crucial role in managing frozen shoulder and other complications following breast cancer surgery. Evidence-based practices, including comprehensive patient education, tailored exercise programs, manual therapy techniques, and pain management strategies, are essential for effective treatment. Integrating AI in assessment and intervention can further enhance outcomes and alleviate the burden on healthcare resources.

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