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dos Santos PV, Scoczynski Ribeiro Martins M, Amorim Nogueira S, Gonçalves C, Maffei Loureiro R, Pacheco Calixto W. Unsupervised model for structure segmentation applied to brain computed tomography. PLoS One 2024; 19:e0304017. [PMID: 38870119 PMCID: PMC11175403 DOI: 10.1371/journal.pone.0304017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/03/2024] [Indexed: 06/15/2024] Open
Abstract
This article presents an unsupervised method for segmenting brain computed tomography scans. The proposed methodology involves image feature extraction and application of similarity and continuity constraints to generate segmentation maps of the anatomical head structures. Specifically designed for real-world datasets, this approach applies a spatial continuity scoring function tailored to the desired number of structures. The primary objective is to assist medical experts in diagnosis by identifying regions with specific abnormalities. Results indicate a simplified and accessible solution, reducing computational effort, training time, and financial costs. Moreover, the method presents potential for expediting the interpretation of abnormal scans, thereby impacting clinical practice. This proposed approach might serve as a practical tool for segmenting brain computed tomography scans, and make a significant contribution to the analysis of medical images in both research and clinical settings.
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Affiliation(s)
- Paulo Victor dos Santos
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Department of Radiology, Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil
- Technology Research and Development Center (GCITE), Federal Institute of Goias, Goiania, Brazil
| | - Marcella Scoczynski Ribeiro Martins
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Federal University of Technology - Parana, Ponta Grossa, Parana, Brazil
| | - Solange Amorim Nogueira
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Department of Radiology, Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil
| | | | - Rafael Maffei Loureiro
- Department of Radiology, Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil
| | - Wesley Pacheco Calixto
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Technology Research and Development Center (GCITE), Federal Institute of Goias, Goiania, Brazil
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Kamal MV, Damerla RR, Parida P, Chakrabarty S, Rao M, Kumar NAN. Antiapoptotic PON2 expression and its clinical implications in locally advanced oral squamous cell carcinoma. Cancer Sci 2024; 115:2012-2022. [PMID: 38602182 PMCID: PMC11145147 DOI: 10.1111/cas.16170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/07/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024] Open
Abstract
Locally advanced oral squamous cell carcinoma poses a significant challenge in oncology due to its rising incidence and mortality rates. Despite therapeutic progress, understanding molecular intricacies is essential. This study explored the role of PON2, a multifunctional enzyme implicated in antiapoptotic mechanisms. Aberrant PON2 expression in oral cancers raises questions regarding its involvement in evading programmed cell death and treatment resistance. Patients with locally advanced disease were enrolled, and molecular analyses were undertaken on the collected tumor and normal tissues. Utilizing computational datasets, this study used in silico gene expression analysis, differential gene expression analysis in our patient cohort, survival analysis, and gene set enrichment analysis to unravel role of PON2 in disease prognosis. The results showed elevated PON2 levels in advanced tumor stages, correlating with factors such as tobacco exposure, higher tumor grade, and nodal metastasis. Survival analysis revealed prognostic relevance of PON2, with lower expression linked to extended survival rates. Gene set enrichment analysis identified pathways aiding in cancer metastasis influenced by PON2. This study underscores the significance of PON2 expression as a prognostic marker for oral malignancies, with increased expression associated with advanced disease stages. Understanding the molecular profile of the PON2 gene suggests its potential as a valuable biomarker for the management of cancer.
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Affiliation(s)
- Mehta Vedant Kamal
- Department of Surgical OncologyManipal Comprehensive Cancer Care Centre, Kasturba Medical College, Manipal, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Rama Rao Damerla
- Department of Medical GeneticsKasturba Medical College, Manipal, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Preetiparna Parida
- Department of Medical GeneticsKasturba Medical College, Manipal, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Sanjiban Chakrabarty
- Department of Public Health and GenomicsManipal School of Life Sciences, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Mahadev Rao
- Department of Pharmacy Practice, Centre for Translational ResearchManipal College of Pharmaceutical Sciences, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Naveena AN Kumar
- Department of Surgical OncologyManipal Comprehensive Cancer Care Centre, Kasturba Medical College, Manipal, Manipal Academy of Higher EducationManipalKarnatakaIndia
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Sun K, Zhang H, Wang C, Gong S, Pan Y, Han X, Li J, Liu K, Yu Z. Surgical Management Strategies for Carotid Artery Invasion by Head and Neck Cancer: Ligation Versus Reconstruction. Otolaryngol Head Neck Surg 2024. [PMID: 38796730 DOI: 10.1002/ohn.824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/15/2024] [Accepted: 05/04/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE Whether ligation or reconstruction should be performed after radical resection of the tumor and carotid artery in patients with head and neck cancers invading the carotid artery (HNC-CA) has been controversial. This paper provides a review and meta-analysis of the efficacy of these 2 modalities. DATA SOURCES PubMed, Cochrane, Web of Science, Scopus, and Ovid databases were searched through August 2023. REVIEW METHODS Descriptive, graphical, tabular, and quantitative data were extracted. The statistical outcomes (risk difference, RD) were synthesized under a random-effects model. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. RESULTS A total of 22 papers and 337 patients met the inclusion criteria for the literature review. Statistical analysis showed that the RD of overall survival (OS) rate at 1-year was 32% (95% confidence interval [CI]: 21%-42%) for ligation and 70% (95% CI: 65%-76%) for reconstruction (P < .05). The RD for OS rate at 2-year was 16% (95% CI: 7%-26%) for ligation and 39% (95% CI: 30%-47%) for reconstruction (P < .05). The RD for disease-free survival rate at 1-year was 27% (95% CI: 17%-38%) for ligation and 60% (95% CI: 51%-70%) for reconstruction (P < .05). There were no statistically significant differences (P > .05) between the 2 surgical modalities in terms of locoregional recurrence rate, carotid blowout rate, surgery-related complications rate, neurological complications rate, and perioperative mortality rate. CONCLUSION This review demonstrates the significant advantage of carotid artery reconstruction surgery in short-term patient survival, thus making it a recommended option for HNC-CA patients undergoing radical surgery.
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Affiliation(s)
- Kai Sun
- Department of Otolaryngology Head and Neck Surgery, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- The Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm, Nanjing, Jiangsu, China
| | - Haidong Zhang
- The Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm, Nanjing, Jiangsu, China
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Chao Wang
- The Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm, Nanjing, Jiangsu, China
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Shanchun Gong
- Department of Otolaryngology Head and Neck Surgery, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- The Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm, Nanjing, Jiangsu, China
| | - Yufei Pan
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Xiao Han
- Department of Otolaryngology Head and Neck Surgery, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- The Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm, Nanjing, Jiangsu, China
| | - Jing Li
- Department of Otolaryngology Head and Neck Surgery, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- The Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm, Nanjing, Jiangsu, China
| | - Kai Liu
- Department of Otolaryngology Head and Neck Surgery, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- The Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm, Nanjing, Jiangsu, China
| | - Zhenkun Yu
- Department of Otolaryngology Head and Neck Surgery, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- The Nanjing Medical Key Laboratory of Laryngopharynx and Head and Neck Neoplasm, Nanjing, Jiangsu, China
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
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Alter IL, Chan K, Lechien J, Rameau A. An introduction to machine learning and generative artificial intelligence for otolaryngologists-head and neck surgeons: a narrative review. Eur Arch Otorhinolaryngol 2024; 281:2723-2731. [PMID: 38393353 DOI: 10.1007/s00405-024-08512-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE Despite the robust expansion of research surrounding artificial intelligence (AI) and machine learning (ML) and their applications to medicine, these methodologies often remain opaque and inaccessible to many otolaryngologists. Especially, with the increasing ubiquity of large-language models (LLMs), such as ChatGPT and their potential implementation in clinical practice, clinicians may benefit from a baseline understanding of some aspects of AI. In this narrative review, we seek to clarify underlying concepts, illustrate applications to otolaryngology, and highlight future directions and limitations of these tools. METHODS Recent literature regarding AI principles and otolaryngologic applications of ML and LLMs was reviewed via search in PubMed and Google Scholar. RESULTS Significant recent strides have been made in otolaryngology research utilizing AI and ML, across all subspecialties, including neurotology, head and neck oncology, laryngology, rhinology, and sleep surgery. Potential applications suggested by recent publications include screening and diagnosis, predictive tools, clinical decision support, and clinical workflow improvement via LLMs. Ongoing concerns regarding AI in medicine include ethical concerns around bias and data sharing, as well as the "black box" problem and limitations in explainability. CONCLUSIONS Potential implementations of AI in otolaryngology are rapidly expanding. While implementation in clinical practice remains theoretical for most of these tools, their potential power to influence the practice of otolaryngology is substantial. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Isaac L Alter
- Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medical College, 240 E 59 St, New York, NY, 10022, USA
| | - Karly Chan
- Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medical College, 240 E 59 St, New York, NY, 10022, USA
| | - Jérome Lechien
- Department of Otorhinolaryngology, Head and Neck Surgery, Hôpital Foch, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health and Sciences Technology, University of Mons (UMons), Mons, Belgium
| | - Anaïs Rameau
- Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medical College, 240 E 59 St, New York, NY, 10022, USA.
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Gobbo M, Joy J, Guedes H, Shazib MA, Anderson C, Abdalla-Aslan R, Peechatanan K, Lajolo C, Nasir KS, Gueiros LA, Nagarajan N, Hafezi Motlagh K, Kandwal A, Rupe C, Xu Y, Ehrenpreis ED, Tonkaboni A, Epstein JB, Bossi P, Wardill HR, Graff SL. Emerging pharmacotherapy trends in preventing and managing oral mucositis induced by chemoradiotherapy and targeted agents. Expert Opin Pharmacother 2024; 25:727-742. [PMID: 38808634 DOI: 10.1080/14656566.2024.2354451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/08/2024] [Indexed: 05/30/2024]
Abstract
INTRODUCTION The introduction of targeted therapy and immunotherapy has tremendously changed the clinical outcomes and prognosis of cancer patients. Despite innovative pharmacological therapies and improved radiotherapy (RT) techniques, patients continue to suffer from side effects, of which oral mucositis (OM) is still the most impactful, especially for quality of life. AREAS COVERED We provide an overview of current advances in cancer pharmacotherapy and RT, in relation to their potential to cause OM, and of the less explored and more recent literature reports related to the best management of OM. We have analyzed natural/antioxidant agents, probiotics, mucosal protectants and healing coadjuvants, pharmacotherapies, immunomodulatory and anticancer agents, photobiomodulation and the impact of technology. EXPERT OPINION The discovery of more precise pathophysiologic mechanisms of CT and RT-induced OM has outlined that OM has a multifactorial origin, including direct effects, oxidative damage, upregulation of immunologic factors, and effects on oral flora. A persistent upregulated immune response, associated with factors related to patients' characteristics, may contribute to more severe and long-lasting OM. The goal is strategies to conjugate individual patient, disease, and therapy-related factors to guide OM prevention or treatment. Despite further high-quality research is warranted, the issue of prevention is paramount in future strategies.
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Affiliation(s)
- Margherita Gobbo
- Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, Piazzale Ospedale, Treviso, Italy
| | - Jamie Joy
- Department of Pharmacy, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Helena Guedes
- Medical Oncology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Porto, Portugal
| | - Muhammad Ali Shazib
- Workman School of Dental Medicine, High Point University, High Point, NC, USA
| | - Carryn Anderson
- Department of Radiation Oncology, University of Iowa Hospitals & Clinics, Iowa City, USA
| | - Ragda Abdalla-Aslan
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Khunthong Peechatanan
- Supportive and Palliative Care Unit, Monash Health, Clayton, VIC, Australia
- Department of Medicine, Division of Medical Oncology, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Carlo Lajolo
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli-IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Khawaja Shehryar Nasir
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Luiz Alcino Gueiros
- Department of Clinic and Preventive Dentistry & Oral Medicine Unit, Health Sciences Center, Hospital das Clínicas, Federal University of Pernambuco, Recife, Brazil
| | - Nivethitha Nagarajan
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, California, USA
| | - Kimia Hafezi Motlagh
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abhishek Kandwal
- Himalayan Institute of Medical Sciences Cancer Research Institute Swami Rama Himalayan University, Uttarakhand, India
| | - Cosimo Rupe
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli-IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Yuanming Xu
- Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Eli D Ehrenpreis
- Department of Medicine, Advocate Lutheran General Hospital, Park Ridge, IL, USA
- E2Bio Life Sciences, Skokie, IL, USA
| | - Arghavan Tonkaboni
- Oral Medicine Department, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
| | - Joel B Epstein
- Department of Surgery, City of Hope National Cancer Center, Duarte, CA, USA
| | - Paolo Bossi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Hannah R Wardill
- School of Biomedicine, The University of Adelaide, Adelaide, Australia
- Supportive Oncology Research Group, Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Stephanie L Graff
- Lifespan Cancer Institute, Providence, RI, USA
- Legorreta Cancer Center, Brown University, Providence, RI, USA
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Singh P, Rajput M, Pandey M. Tumor hypoxia and role of hypoxia-inducible factor in oral cancer. World J Surg Oncol 2024; 22:18. [PMID: 38200568 PMCID: PMC10782715 DOI: 10.1186/s12957-023-03284-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Head and neck cancer (HNC) is one of the most frequent malignancies in Asian males with a poor prognosis. Apart from well-known prognostic indicators, markers of tumor hypoxia can help us predict response to treatment and survival. METHODS A review of the literature on the present evidence and potential clinical importance of tumor hypoxia in head and neck cancer was carried out. The data obtained from the literature search is presented as a narrative review. RESULTS The literature shows possible associations between prognosis and low tumor oxygenation. Intermediate hypoxia biomarkers like HIF-1, GLUT-1, miRNA, and lactate, can help in predicting the response to therapy and survival as their altered expression is related to prognosis. CONCLUSIONS Hypoxia is common in HNC and can be detected by use of biomarkers. The tumors that show expression of hypoxia biomarkers have poor prognosis except for patients with human papilloma virus-associated or VHL-associated cancers. Therapeutic targeting of hypoxia is emerging; however, it is still in its nascent stage, with increasing clinical trials hypoxia is set to emerge as an attractive therapeutic target in HNC.
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Affiliation(s)
- Pooja Singh
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
| | - Monika Rajput
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Manoj Pandey
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
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Ma X, Zhao Q. Application of artificial intelligence in oncology. Semin Cancer Biol 2023; 97:68-69. [PMID: 37977345 DOI: 10.1016/j.semcancer.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Xuelei Ma
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Qi Zhao
- Institute of Translational Medicine, Cancer Centre, Faculty of Health Sciences, University of Macau, Taipa, Macau Special Administrative region of China; MoE Frontiers Science Center for Precision Oncology, University of Macau, Taipa, Macau Special Administrative region of China.
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Wang Z, Sun P, Li Z, Xiao S. Clinical Advances and Future Directions of Oncolytic Virotherapy for Head and Neck Cancer. Cancers (Basel) 2023; 15:5291. [PMID: 37958464 PMCID: PMC10650136 DOI: 10.3390/cancers15215291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Oncolytic viruses (OVs), without harming normal tissues, selectively infect and replicate within tumor cells, to release immune molecules and tumor antigens, achieving immune-mediated destruction of tumors and making them one of the most promising immunotherapies for cancer. Many clinical studies have demonstrated that OVs can provide clinical benefits for patients with different types of tumors, at various stages, including metastatic and previously untreatable cases. When OVs are used in combination with chemotherapy, radiotherapy, immunotherapy, and other treatments, they can synergistically enhance the therapeutic effects. The concept of oncolytic virotherapy (OVT) was proposed in the early 20th century. With advancements in genetic engineering, genetically modified viruses can further enhance the efficacy of cancer immunotherapy. In recent years, global research on OV treatment of malignant tumors has increased dramatically. This article comprehensively reviews the findings from relevant research and clinical trials, providing an overview of the development of OVT and its application in the clinical treatment of head and neck cancer. The aim is to offer insights for future clinical and fundamental research on OVT.
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Affiliation(s)
- Zhan Wang
- Department of Stomatology, Wenzhou Medical University Renji College, Wenzhou 325000, China
| | - Peng Sun
- School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou 325000, China; (P.S.); (Z.L.)
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo 315000, China
| | - Zhiyong Li
- School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou 325000, China; (P.S.); (Z.L.)
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo 315000, China
| | - Shaowen Xiao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
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