This presentation of two cases and literature review discusses the epidemiology, clinical manifestations, pathogenesis, diagnosis, treatment, and prognosis of high-grade glioma with extracranial metastases. A retrospective analysis of the clinical features of two cases of malignant glioma, including metastatic sites, pathological data, and treatment methods, and a literature review was performed. Two patients developed extracranial metastases within 1 year after surgery for primary glioma. One patient developed cervical lymph node and bone metastases while the other developed bone metastases, and both patients died within 2 months after the diagnosis of the extracranial metastasis. Extracranial metastases may develop from malignant gliomas. According to the literature, the most common extracranial site is intraspinal (along the neural axis), followed by the vertebrae, lungs, liver, and lymph nodes. The complex metastatic mechanism remains unclear, and the prognosis is very poor, with a survival duration of less than 6 months.

The technological advancement heralded the arrival of precision radiotherapy (RT), thereby increasing the therapeutic ratio and decreasing the side effects from treatment. Contour of target volumes (TV) and organs at risk (OARs) in RT is a complicated process. In recent years, automatic contouring of TV and OARs has rapidly developed due to the advances in deep learning (DL). This technology has the potential to save time and to reduce intra- or inter-observer variability. In this paper, the authors provide an overview of RT, introduce the concept of DL, summarize the data characteristics of the included literature, summarize the possible challenges for DL in the future, and discuss the possible research directions.

Central giant cell granuloma (CGCG) is a rare, non-neoplastic, benign lesion that exhibits expansive and osteolytic biological behavior. CGCG treatment and management is challenging for clinicians. This report presents the treatment and management of recurrent, aggressive CGCG after surgical resection. After informed consent was obtained, the patient underwent radiotherapy. The lesion size was reduced significantly, with no evidence of recurrence or malignant transformation. This treatment experience indicates that radiotherapy can be used as a rescue treatment for complicated CGCG involving vital neurovascular structures of the cranial base.

Background: Sarcopenia is a common indicator of systemic nutritional status in patients with cancer progression. This study investigated the impacts of sarcopenia on adverse effects and prognosis of sarcopenia on patients with esophageal cancer receiving chemoradiotherapy.Methods: The clinical data of 158 patients with initially diagnosed esophageal cancer who received chemoradiotherapy were collected, and nutritional indexes and inflammatory markers were calculated. The cross-sectional areas of the skeletal muscle, subcutaneous fat and visceral fat were calculated using computed tomography (CT) images of the midpoint of the third lumbar (L3) vertebra. The incidence of adverse events, response evaluation, 1-year and 3-year overall survival (OS) and progression-free survival (PFS) were compared between sarcopenia group and non-sarcopenia groups.Results: This study included 158 patients, 103 (71.5%) in the sarcopenia group and 45 (28.5%) in the non-sarcopenia group. The last follow-up date was January 31, 2024. The median follow-up time was 36 months for all patients. The chi-square test revealed no significant difference in the incidence of serious adverse events between the two groups. The complete response rates (CR) of patients in the sarcopenia and non-sarcopenia groups 1 month after chemoradiotherapy were 2.7 and 13.3%, respectively, p = 0.017, and the difference was statistically significant. Moreover, the objective response rates (ORR) were 38.9 and 60.0%, respectively (χ² = 5.770, p = 0.016). The median survival time for all patients was 36 months [95% Confidence Interval CI 24–48]. Univariate analysis (Cox proportional risk model) showed that sarcopenia, KPS score, albumin level, T stage, and N stage were correlated with patients’ OS. Multivariate analysis showed that sarcopenia (Hazard Ratio HR 2.84, 95%CI [1.45–5.57], p = 0.002), KPS score, albumin level and N stage were independent prognostic factors for OS.Conclusion: Sarcopenia reduced OS in patients with EC treated with chemoradiotherapy. It can be used as an independent indicator to predict the OS of such patients, which may help in developing optimal treatment strategies.

Lung cancer has a poor prognosis with traditional treatments. Realgar (AS4S4), a traditional Chinese medicine, exhibits chemotherapeutic efficacy. However, its low solubility, complex dosage form, and limited therapeutic efficacy hinder its further application in lung cancer. In this study, AS4S4 was chemically synthesized using hydrochloric acid to disrupt the bonding between AS and NH2, producing realgar nanoclusters that improved solubility and reduced side effects. Simultaneously, Fe3O4 nanoparticles were introduced, and intelligent temperature-sensitive hydrogels were utilized to combine these two performance nanomaterials, developing a local injection nano-diagnosis and treatment unit (AS4S4/Fe3O4@Gel) that integrates chemotherapy with alternating current magnetic field (ACMF) induction hyperthermia. The morphological characteristics, thermal stability, and controlled release of AS4S4/Fe3O4@Gel were assessed. After processing the Lewis cells, the CCK-8 method, hemolysis test, EdU method, cell apoptosis test, reactive oxygen species detection, and cellular ultrastructure analysis were used to evaluate the biological effects. Western blot was employed to detect Bcl-2, BAX, GPX4, and HO-1 protein expression in cells. After injecting the gel system into the transplanted tumor, in vivo imaging, near-infrared thermography, and the antitumor effect were studied. AS4S4/Fe3O4@Gel, which exhibits fluorescence and magnetic inductive hyperthermia, was successfully developed. The gel system, which has good hemocompatibility, possesses ideal temperature sensitivity. It can transform from liquid to solid within a specific temperature range, and the drug release rate about 80% within 3 h at 42 °C. Cell experiments showed that the combination of AS4S4/Fe3O4@Gel and ACMF induced the highest levels of apoptosis and ferroptosis. AS4S4/Fe3O4@Gel in vivo displayed good fluorescence characteristics and a magnetocaloric effect. The combination therapy group significantly decreased the expression levels of Ki-67, CD31, E-cadherin, Bcl-2, and GPX4 proteins, indicating that combination therapy can better exert antitumor effects. At the same time, AS4S4/Fe3O4@Gel had no damage to normal organs. The prepared AS4S4/Fe3O4@Gel in this study can exert synergistic antitumor activity in combination with ACMF under bimodal imaging guidance and represents a potential clinical treatment for lung cancer.

Primary cardiac tumors are extremely rare, with an incidence rate ranging from only 0.17% to 0.33%. Clinically, their diagnosis is often delayed due to nonspecific clinical symptoms. This paper reports a case of primary cardiac angiosarcoma (PCAS) pathologically confirmed via surgery, presenting with recurrent palpitations during exertion as the initial symptom. The patient subsequently developed bilateral lung and liver metastases and received chemotherapy. Through a comprehensive review of the literature, this report explores the diagnostic and therapeutic strategies for PCAS, with a focus on analyzing the mechanisms underlying the atypical disease course, the rationale for treatment decisions, and the key clinical insights.