Asian Oncology Research Journal

Unveiling the Awareness Gap: A Community-Based Cross-Sectional Study to Assess Knowledge and Attitude on Cervical Cancer among the Female Population

2026-01-14T13:12:14+00:00

Cervical cancer continues to be a significant public health issue in India, standing as the second most prevalent cancer among women. Despite being largely preventable through regular screening and human papillomavirus (HPV) vaccination, awareness remains inadequate and negative attitudes toward prevention and early detection persist.

Aims: This study aimed to assess the knowledge and attitudes regarding cervical cancer among women attending community pharmacies.

Study Design: Cross-sectional Study

Place and Duration of Study: The study was conducted among women visiting selected community pharmacies over a period of four months.

Methodology: A cross-sectional survey was conducted among 502 women aged 18 years and above who visited selected community pharmacies. Data on socio-demographics, knowledge and attitudes regarding cervical cancer were collected using a pre-validated questionnaire. Descriptive statistics were used to analyze the responses.

Results: Among 502 participants, 73.71% were aware of cervical cancer, with 57.29% healthcare professionals being the most common source of primary information. However, only 28.08% recognized it as a leading cause of cancer-related mortality among women and 44.82% had heard of HPV. While 64.34% believed screening is preventive and 60.75% were willing to be screened, 39.24% were unwilling, due to a lack of awareness and financial constraints.

Conclusion: The study revealed moderate awareness but significant gaps in knowledge of cervical cancer risk factors, symptoms and prevention. Generally positive attitudes toward screening, misconceptions and structural barriers continue to limit participation. There is a need for strengthened community-based educational interventions and accessible screening services to improve women’s participation in cervical cancer prevention programs.

Patterns of Peripheral Cytopenia in Hematological Malignancies: A Single-Center Retrospective Study from Aden, Yemen

2026-01-19T10:23:56+00:00

Background: Peripheral cytopenias, including anemia, thrombocytopenia, bicytopenia, and pancytopenia, are common findings in patients with hematological malignancies (HMs) and often necessitate bone marrow evaluation for definitive diagnosis. This study aimed to determine the spectrum of HMs and their association with various patterns of peripheral cytopenia at a major oncology center in Aden, Yemen.

Methods: This descriptive, retrospective study included 70 patients diagnosed with HMs at the Hematology Department of the National Oncology Center, Aden, between January 2019 and December 2020. All patients underwent comprehensive assessment including history, physical examination, full blood count, and bone marrow aspiration/biopsy. Data were analyzed using SPSS version 26, with a p-value < 0.05 considered statistically significant.

Results: Peripheral cytopenia was present in 84.3% (n=59) of HM patients. The median age was 50 years, with a male-to-female ratio of 1.5:1. Bicytopenia was the most common pattern (52.5%), followed by isolated anemia (27.1%), pancytopenia (10.2%), and isolated thrombocytopenia (10.2%). Acute leukemias constituted 61.0% of cases among cytopenic patients, with Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid Leukemia (AML) being the most frequent subtypes. A significant association was found between AML and both pancytopenia (83.3% of pancytopenic cases) and isolated thrombocytopenia (50.0% of isolated thrombocytopenic cases) (p<0.05). Conversely, Multiple Myeloma (MM) was significantly associated with normal peripheral blood counts (36.4% of non-cytopenic cases) (p<0.05). Bone marrow examination in cytopenic patients frequently revealed hypercellularity, decreased erythrocyte precursors, and decreased megakaryocytes, indicative of ineffective hematopoiesis and marrow infiltration.

Conclusion: Peripheral cytopenia is highly prevalent among HM patients in Aden, with bicytopenia being the dominant pattern. The strong association between acute leukemias and severe cytopenias underscores the aggressive nature and advanced presentation of these malignancies in this population. These findings are crucial for guiding diagnostic strategies and clinical management in resource-limited settings and emphasize the importance of prompt bone marrow examination in patients with unexplained multi-lineage cytopenia.

A Statistical Framework for Modelling Breast Cancer Disease Pathways with Multistate and Competing Risks Approaches

2026-02-12T13:05:18+00:00

Background: Breast cancer is one of the leading causes of mortality in women in Ghana; prognostic studies are still dominated by single endpoint Kaplan-Meier and Cox models, which do not consider recurrence, progression, and competing mortality. The study aimed to come up with a robust multistate competing risks survival model to define disease processes in Ghanaian breast cancer patients and provide dynamic prognostic profiles.

Objectives: To measure transition-specific hazards between diagnosis and progression, breast cancer event with competing risk death; to obtain the cumulative probability of breast cancer event in the presence of competing mortality; and to obtain state occupation probabilities over follow-up time.

Methods: A retrospective cohort of 558 patients was analysed using cause-specific Cox multistate models, Fine-Gray sub-distribution hazards, nonparametric cumulative incidence functions, and Aalen-Johansen estimators. The baseline predictors were age, stage, grade, lymph node involvement, tumour size, molecular subtype and hormone receptor status in determining the Hazard Ratio (HR) and the Sub-distribution Hazard Ratio (SHR).

Findings: After five years of follow-up with a median of about five years, 241 incidences of breast cancer and 40 competing risks deaths were verified. The advanced stage was a strong predictor of transition adverse outcomes (HR = 1.55, 95% CI: 1.192.01, p = 0.001), whereas lymph node involvement was a strong predictor of adverse outcomes (HR = 1.23, 95% CI: 1.051.44, p = 0.012). The cumulative incidence of breast cancer events was strongly increased by stage (SHR = 2.12, 95% CI: 1.48-3.04, p < 0.001) and lymph node status (SHR = 1.49, 95% CI: 1.25-1.78, p < 0.001), as observed in the Fine-Grey model.

Conclusion: This research integrates progression and competing mortality into a multistate survival model in Ghana to overcome the statistical limitations of single-endpoint models. The evidence supports early diagnosis, expanded molecular profiling, and the implementation of state-based prognostic instruments to strengthen precision oncology and cancer control policy.

Integrative Structural and Network Analysis Identifies CDK9 as a Candidate Therapeutic Target in Short-Term Survivor High-Grade Serous Ovarian Cancer

2026-02-24T09:22:08+00:00

Background: High-grade serous ovarian cancer (HGSC) exhibits marked clinical heterogeneity, with Short-Term (ST) survivors demonstrating intrinsic resistance to standard chemotherapy and poor outcomes. Understanding tumor-intrinsic transcriptional vulnerabilities in ST-HGSC represents a critical unmet need for precision therapeutic development. This study integrates structural bioinformatics, network topology analysis, and pharmacogenomics to identify druggable master regulators sustaining the aggressive ST phenotype.

Methods: We analyzed transcriptomic data from Kotnik et al. (2023) comparing ST and Long-Term (LT) HGSC survivors, identifying 325 significantly upregulated differentially expressed genes (DEGs) in the ST cohort (log₂FC >1.5, adjusted P<0.05). The ESR1-CCDC170 fusion protein structure was predicted using AlphaFold2 v2.3.1 to assess ligand-binding domain integrity. A protein-protein interaction (PPI) network was constructed from ST-specific DEGs using STRING (confidence >0.4), and master regulatory hubs were identified using the Maximal Clique Centrality (MCC) algorithm in CytoHubba. Survival analysis was performed using Kaplan-Meier Plotter (n=1,435 serous ovarian cancer patients). Functional enrichment of hub neighborhoods was conducted using NetworkSuite v2.1 (Sequensolutions), integrating Gene Ontology, Reactome, WikiPathways, and KEGG databases. Pharmacogenomic repurposing was performed using L1000CDS2, and drug-target interactions were validated through structural analysis.

Results: AlphaFold2 modeling demonstrated that ESR1-CCDC170 retains the DNA-binding domain (pLDDT >85) but completely lacks the C-terminal ligand-binding domain, providing structural evidence for endocrine therapy resistance. Network analysis identified Cyclin-Dependent Kinase 9 (CDK9) as the top-ranked hub (degree=17, highest MCC score), exhibiting both high connectivity and betweenness centrality. Survival analysis confirmed that high CDK9 expression significantly predicted poor overall survival (median OS: 42.5 vs 51.2 months; HR=1.28, 95% CI: 1.10-1.51; log-rank P=0.0088). Functional enrichment of CDK9's 17 first-degree interactors revealed profound overrepresentation in RNA Polymerase II transcriptional elongation pathways (FDR<10⁻¹⁰), supporting a model of elongation-dependent transcriptional addiction. Network stability analysis across multiple STRING confidence thresholds (0.4-0.9) confirmed CDK9's robust central position. Pharmacogenomic analysis identified transcriptional inhibitors as signature-reversing compounds, and structural validation confirmed stable CDK9-alvocidib interaction.

Conclusion: Our integrative computational analysis identifies CDK9 as a candidate master regulator sustaining transcriptional addiction in ST-HGSC, potentially driven by fusion-mediated constitutive transcriptional activation. These findings support CDK9 inhibition as a rational precision therapeutic strategy for this high-risk patient subgroup. Experimental validation through functional studies, including CDK9 knockdown experiments, drug sensitivity assays in HGSC cell lines, and patient-derived xenograft models, is essential to confirm these computational predictions and advance toward clinical translation.

Disparities in Targeted Therapy Access and Survival by Molecular Subtype in Breast Cancer: Evidence from Yemen

2026-02-28T12:30:38+00:00

Background: Breast cancer management has evolved toward precision medicine based on molecular subtypes. In low-resource settings like Yemen, access to targeted therapies is limited, potentially exacerbating survival disparities. This study examines treatment patterns and survival outcomes across molecular subtypes in a large Yemeni cohort from a conflict-affected setting.

Methods: A retrospective analysis of 1,167 breast cancer patients at the National Oncology Center in Aden, Yemen (2017-2024) was conducted. Patients were classified into four molecular subtypes: Luminal A-like (HR+/HER2-), Luminal B-like (HR+/HER2+), HER2-enriched (HR-/HER2+), and Triple-Negative (TNBC). Treatment patterns (surgery, chemotherapy, endocrine therapy, anti-HER2 therapy) and mortality at last follow-up were compared across subtypes using chi-square tests and multivariate logistic regression. Due to 41.9% loss to follow-up, survival analysis was restricted to 678 patients with documented outcomes.

Results: The cohort comprised 611 (52.4%) Luminal A-like, 168 (14.4%) Luminal B-like, 139 (11.9%) HER2-enriched, and 284 (24.3%) TNBC cases. Significant disparities in treatment access were observed: only (66.2%) of eligible HR+ patients received endocrine therapy; only (61.2%) of HER2+ patients received anti-HER2 therapy. TNBC patients had the highest rate of mastectomy (78.2%) and chemotherapy (98.2%). Mortality at last follow-up varied significantly by subtype: Luminal A-like (61.7% alive), Luminal B-like (54.8% alive), HER2-enriched (48.9% alive), and TNBC (42.6% alive; p<0.001). On multivariate analysis, TNBC subtype (OR 2.8, 95% CI 1.6-4.9) and lack of minimum subtype-specific systemic therapy (OR 3.1, 95% CI 1.8-5.4) were independent predictors of mortality. Median follow-up duration was 24 months (range 1-84 months).

Conclusion: Profound disparities exist in access to precision therapy for breast cancer in Yemen, particularly affecting HER2+ and TNBC patients. The survival disadvantage of TNBC patients persists even in this late-presenting cohort, highlighting the urgent need for equitable access to essential cancer medicines and clinical trial inclusion for aggressive subtypes in conflict settings. These findings provide actionable evidence for global oncology policy and humanitarian cancer care strategies.

Survival and Prognostic Factors in Ewing Sarcoma: Evaluating the Role of Radiotherapy in Multimodality Management

2026-03-21T10:54:51+00:00

Background: Ewing sarcoma is an aggressive small round blue cell malignancy that predominantly affects children and young adults. Radiotherapy plays a central role in local control, particularly in anatomically complex or unresectable disease.

Methods: A retrospective cohort study of 51 patients with histologically confirmed Ewing sarcoma treated between January 2022 and December 2024 at a tertiary care centre was conducted. All patients received multi-agent chemotherapy, and radiotherapy was delivered with curative (adjuvant or definitive) or palliative intent. Advanced conformal techniques, including volumetric modulated arc therapy (VMAT) and three-dimensional conformal radiotherapy (3DCRT), were used according to clinical indication. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan–Meier method. DFS was defined as the time from completion of primary treatment to recurrence or last follow-up. Prognostic factors were explored using univariate Cox proportional hazards regression.

Results: The median age was 21 years (IQR 14.5–28.0), and 43.1% of patients were in the paediatric age group. Metastatic disease at diagnosis was present in 27.5% of patients. Radiotherapy was delivered using conformal techniques in 68.6% of cases, most commonly VMAT. The median radiotherapy dose was 45 Gy. With a median follow-up of 28 months, the median OS and DFS were both 25 months. The 2-year OS rate was 75%. Higher radiotherapy dose and use of advanced conformal techniques were associated with improved survival outcomes in univariate analyses. No grade ≥3 acute toxicities were observed.

Conclusion: Radiotherapy contributes significantly to local control and survival in Ewing sarcoma within a multimodality treatment framework. Metastatic disease at diagnosis remains the dominant adverse prognostic factor. Optimisation of local therapy through appropriate dose and modern conformal techniques may improve outcomes; however, larger prospective studies are required to validate these associations.

Assessment of the Outcomes of a Modified Version of the Reverse Hockey Stick Incision (mRHSI): A single Institutional Ambispective Longitudinal Study

2026-04-03T11:45:34+00:00

Background: Neck dissection is a cornerstone of head and neck cancer management, requiring an incision design that balances surgical exposure with skin viability and cosmesis. Traditional designs, such as the Y-shaped incision, often suffer from poor blood supply at trifurcation points, leading to vessel exposure and wound breakdown.

Objectives: This study aimed to assess the outcomes of a modified version of the Reverse Hockey Stick Incision (mRHSI). The primary objective was to evaluate its usability and feasibility in a large clinical sample, focusing on intraoperative accessibility and postoperative complications.

Methods: An ambispective longitudinal study was conducted from May 2018 to March 2022, involving 451 patients with oral, oropharyngeal, or parotid malignancies. The mRHSI utilizes a gentle curve 3–4 cm below the angle of the mandible along the skin crease, extending longitudinally toward the mid-clavicle. Parameters assessed included dissection duration, marginal necrosis, wound dehiscence, and long-term cosmesis using the Vancouver Scar Scale (VSS).

Results: The mean dissection time was 22.49 +/- 1.69 minutes, significantly shorter than historical rates for MacFee or Schobinger incisions (p < 0.001). Complication rates remained low, with marginal necrosis at 3.1% and wound dehiscence requiring re-suturing at 2.4%. Scar assessment showed significant longitudinal improvement, with mean VSS scores decreasing from 11.43 at discharge to 2.81 at the three-year follow-up (p < 0.001). Approximately 85.6% of patients reported "good" or "satisfactory" cosmetic feedback.

Conclusion: The mRHSI provides excellent surgical exposure and accessibility while minimizing operative time and flap-related complications. By avoiding acute angles and three-point junctions, the modification ensures superior healing and favorable cosmetic outcomes without compromising oncological radicality.

Institution-specific Validation of CTV-PTV Margins in Head and Neck Radiotherapy using Daily Cone Beam Computed Tomography on Halcyon Elite: A Population - Based Study

2026-03-27T12:48:59+00:00

Aims: To quantitatively evaluate setup errors in head and neck cancer radiotherapy using Cone Beam Computed Tomography (CBCT) and determine whether the institutional Clinical Target Volume (CTV)–Planning Target Volume (PTV) margin adequately compensates for these uncertainties.

Study Design: Retrospective observational study.

Place and Duration of Study: Sample: Department of Radiation Oncology, Father Muller Medical College Hospital, Mangalore, India, conducted over a period of six months.

Methodology: Twenty patients with head and neck malignancies treated using Intensity‑Modulated Radiotherapy (IMRT) or Volumetric Modulated Arc Therapy (VMAT) were retrospectively analyzed. All patients were immobilized with thermoplastic head and neck masks. Daily setup verification was performed using kV cone‑beam CT on the Halcyon Elite linear accelerator. Translational setup deviations in vertical, longitudinal and lateral directions were recorded. Population systematic (Σ) and random (σ) errors were calculated using individual patient mean and standard deviation values. The CTV–PTV margins were derived using the Van Herk margin formula.

Results: Population systematic errors (Σ) were 0.041 cm, 0.072 cm and 0.076 cm in vertical, longitudinal and lateral directions respectively. Random errors (σ) were 0.148 cm, 0.154 cm and 0.213 cm respectively. The calculated CTV–PTV margins were 0.21 cm (vertical), 0.29 cm (longitudinal) and 0.34 cm (lateral), all smaller than the institutional margin of 3 mm.

Conclusion: Daily CBCT‑based image guidance combined with thermoplastic immobilization provides high setup reproducibility in head and neck radiotherapy. The institutional 3 mm margin remains adequate as it accounts for additional clinical uncertainties beyond setup errors.

Unmasking Renal Cell Carcinoma: A Comprehensive Review of Histological Signatures and Subtypes

2026-01-12T07:13:32+00:00

Renal cell carcinoma (RCC) is the most common type of kidney cancer, accounting for over 90% of adult renal cancers. This review aimed to explore renal cell carcinomas, classifications and histological identifications. RCC is a diverse group of kidney tumors and accounts for most adult kidney cancers. A combination of factors, including age, sex, lifestyle, and genetic changes, shapes its development. RCC is subtyped as clear cell, papillary, chromophobe, and the rare collecting duct carcinoma, each with its own unique. Accurate diagnosis depends on careful examination of tissue samples, both under the microscope and through immunohistochemical testing. Common stains, such as H&E, PAS, Masson’s trichrome, and Feulgen, help highlight key structures and cellular details. Immunohistochemical markers such as CK18, vimentin, PAX2, PAX8, and RCC antigen are critical tools for distinguishing RCC from other tumors. However, because some markers can appear in multiple tumor types, interpretation requires experience and caution, particularly when working with small or difficult biopsy samples.

Advancements in Precision Medicine for Myelodysplastic Neoplasms and Acute Myeloid Leukemia: A Review on Genomics to Targeted Therapies

2026-01-16T12:15:15+00:00

Myelodysplastic neoplasms (MDS) and acute myeloid leukemia (AML) are clonal hematopoietic disorders characterized by ineffective hematopoiesis and rapid proliferation of abnormal myeloid cells, respectively. Recent advances in molecular biology have significantly enhanced our understanding of the pathogenesis of MDS and AML, leading to improved diagnostic methods and novel therapeutic strategies. This review highlights the latest developments in genetic and epigenetic alterations, the role of the bone marrow microenvironment, advancements in diagnostics, targeted therapies, immunotherapies, and personalized medicine approaches in MDS and AML. Challenges and future directions are also discussed to provide a comprehensive overview of the current landscape and potential advancements in the management of these hematologic malignancies.

Precision Neuro-oncology: A Comprehensive Review of Molecular Diagnostics and Therapies in Glioma Care

2026-01-27T12:42:12+00:00

Cancer is the uncontrolled proliferation of abnormal cells that invades adjacent tissues and metastasizes in the lymphatic or bloodstream. Central Nervous System (CNS) tumors, and most notably gliomas are formidable to treat because of their aggressiveness, molecular heterogeneity, and resistance to standard therapy. Gliomas are the most prevalent primary malignant brain tumors and have a poor prognosis due to the limited choices of treatment. The 2021 World Health Organization Classification of CNS Tumors (WHO CNS5) has transformed glioma diagnosis with the inclusion of certain molecular markers like isocitrate dehydrogenase (IDH) mutations, 1p/19q co-deletion, loss of Alpha Thalassemia/Mental Retardation Syndrome X-linked (ATRX), and Tumor Protein 53 (TP53) mutations, in addition to the classic histopathological features. Next generation sequencing (NGS) has also revolutionized neuro-oncology by enabling the specific detection of genetic alterations responsible for tumor formation. NGS makes it possible to detect mutations, amplifications, and gene fusions with increased specificity, opening the door to more personalized and possibly efficacious treatment. In India, the increasing rate of CNS tumors emphasizes the imperative need for better diagnosis and treatment infrastructure. This review summarizes international and Indian trends in cancer epidemiology, developments in glioma classification, current diagnostic challenges, and the emerging roles of targeted sequencing and treatments in CNS tumor precision medicine. These molecular advances enable precise risk stratification and many different targeted therapies like IDH inhibitors and MGMT, which can help the clinicians to integrate NGS with other gold standard diagnostic methods and provide precise treatment and enhance progression free survival.

A Comprehensive Analysis of the Vascular Endothelial Growth Factor (VEGF) Family in Oral Carcinoma: From Molecular Mechanisms to Clinical Translation

2026-02-05T12:52:18+00:00

Oral squamous cell carcinoma has created a major health burden in developing countries. High incidence of tobacco addiction and limited awareness in the general population leads to its usual presentation in the advanced stage. Angiogenesis, being one of the important factors associated with carcinogenesis, has emerged as a topic of interest for better understanding of the molecular micromechanisms responsible for carcinoma growth and progression. The Vascular Endothelial Growth Factor (VEGF) family acts as a primary regulator of this process. The molecular biology of the VEGF family along with its association with development and progression of oral carcinoma has been explored in this review. Further potential of VEGF as a diagnostic, therapeutic and prognostic marker has also been analysed.

Epigenetic Modifiers as Therapeutic Targets at the Interface of Infectious Diseases and Cancer Progression

2026-02-06T08:04:16+00:00

Epigenetic regulation plays a central role in controlling gene expression programs that govern cellular identity, immune responses, and adaptation to environmental stress. Increasing evidence demonstrates that dysregulation of epigenetic mechanisms is a shared hallmark of both infectious diseases and cancer progression, enabling pathogen persistence, immune evasion, malignant transformation, and therapeutic resistance. Epigenetic modifiers—including DNA methyltransferases, histone-modifying enzymes, chromatin remodelers, and non-coding RNAs—mediate reversible yet stable transcriptional changes that bridge genetic predisposition and environmental influence. In infectious diseases, pathogens actively exploit host epigenetic machinery to suppress antimicrobial responses and establish chronic or latent infections, while host-directed epigenetic reprogramming can shape immune memory and disease outcomes. In cancer, aberrant epigenetic landscapes drive silencing of tumor suppressor genes, maintenance of cancer stem cell plasticity, and resistance to cytotoxic and immune-based therapies. Importantly, the reversibility of epigenetic alterations has enabled the clinical development of epigenetic drugs, particularly in oncology, and has opened new avenues for therapeutic repurposing in infectious diseases, although challenges related to target specificity, context-dependent effects, and potential toxicity continue to limit their broader clinical application. This review provides an integrative overview of epigenetic regulation in health and disease, examines the role of epigenetic modifiers in host–pathogen interactions and cancer progression, and highlights emerging translational strategies, including combination therapies and epigenome editing technologies. By bridging insights from infectious disease biology and cancer research, this work underscores the potential of epigenetic modifiers as unifying and versatile therapeutic targets in complex human diseases.

Oral Mucositis in Cancer Patients: Prevention and Treatment

2026-02-17T11:07:29+00:00

Oral mucositis is a common and potentially severe complication of cancer therapy, particularly affecting high-risk populations such as pediatric patients, hematopoietic stem cell transplant recipients, and individuals with head and neck cancer. The incidence and severity of oral mucositis vary depending on cancer type, treatment modality, dose intensity, and patient-related factors, with the highest burden observed in head and neck cancer patients undergoing chemoradiotherapy. The pathogenesis of oral mucositis is complex and involves a multistep biological process characterized by epithelial injury, generation of reactive oxygen species, activation of pro-inflammatory cytokines, signal amplification, ulceration, and subsequent healing. These pathological changes compromise oral mucosal integrity and contribute to secondary infections and nutritional difficulties. Various preventive and therapeutic strategies have been investigated to mitigate oral mucositis. Evidence from randomized controlled trials and systematic reviews supports the use of preventive measures such as oral cryotherapy, low-level laser therapy (photobiomodulation), benzydamine mouthwash, and keratinocyte growth factor (palifermin) in selected patient populations. In addition, nutritional supplements and natural agents, including honey, glutamine, zinc, aloe vera, and probiotics, have demonstrated potential benefits, although clinical outcomes remain heterogeneous. Management of established oral mucositis is primarily supportive and focuses on pain control, maintenance of oral hygiene, prevention of infection, and preservation of nutritional status. Current international guidelines emphasize a multidisciplinary, evidence-based approach for optimal prevention and management. Despite advances in supportive care, oral mucositis continues to pose a significant clinical challenge, highlighting the need for standardized assessment tools, personalized interventions, and further high-quality research to improve patient outcomes.

CBX2-Mediated Epigenetic Modulation Drives Proliferation in Gliomas: A Narrative Review

2026-05-19T08:05:49+00:00

Gliomas represent some of the most biologically heterogeneous and therapeutically recalcitrant primary brain tumours in human oncology. Despite decades of intensive research effort, the molecular mechanisms underpinning their aggressive proliferative behaviour remain incompletely characterised, and median overall survival for patients with glioblastoma—the most malignant grade—remains dismal even under optimally delivered multimodal therapy. Epigenetic dysregulation has emerged as a central theme in glioma pathogenesis, with Polycomb group proteins occupying a particularly prominent position in this landscape. Chromobox protein homologue 2 (CBX2) is a chromodomain-containing component of Polycomb Repressive Complex 1 (PRC1) that mediates transcriptional silencing through recognition of the repressive histone mark H3K27me3 and facilitation of histone H2A monoubiquitination at lysine 119. Accumulating evidence from pan-cancer transcriptomic analyses and molecular cell biology indicates that CBX2 is aberrantly overexpressed in multiple solid malignancies and that its oncogenic activity encompasses the repression of senescence-associated tumour suppressors, dysregulation of cell cycle progression, and maintenance of stem-like cellular states. Within the glioma context, CBX2 overexpression intersects with established epigenetic drivers—including IDH mutation-associated methylation phenotypes and H3K27M oncohistone mechanisms—to sustain unchecked proliferation and confer resistance to standard therapeutic interventions. This article provides a comprehensive narrative review of the molecular architecture and canonical biology of CBX2, synthesises current evidence concerning its dysregulation and functional consequences in gliomas, examines its interactions with downstream proliferative signalling networks, and considers its emerging potential as a therapeutic target. Whilst the direct experimental evidence specifically linking CBX2 to glioma proliferation remains in relatively early development compared to its better-characterised roles in other cancers, convergent data from epigenomic, transcriptomic, and functional studies make a compelling case for deeper investigation of this Polycomb subunit in neuro-oncological research.

Clinical Utility of Multiple Blood Transfusion Products and the Management of Hematological Complications, Implications and Preventive Strategies among Oncological Patients: A Systematic Review

2026-04-25T11:59:18+00:00

Background: Patients with solid tumors and hematological malignancies frequently develop transfusion-dependent anemia from marrow infiltration and cytotoxic therapy. Multiple blood transfusions (MBT) sustain oxygen delivery but increase alloimmunization, iron overload, transfusion-related immunomodulation (TRIM), and thrombosis/bleeding shifts. Practice variation persists on haemoglobin (Hb) triggers, component ratios, and mitigation (phenotyping, chelation).

Objective: To critically appraise the clinical utility of MBT in oncological populations and synthesize hematological implications (alloimmunization, iron metrics, TRIM, survival) and formulate the best management strategies for Haematological complications and prevention.

Methodology: PRISMA-guided critical review (2010–2025).

Search engines (10): PubMed/MEDLINE, Embase, Cochrane Library, Scopus, Web of Science, African Index Medicus, IMEMR, LILACS, WHO Global Index Medicus, Google Scholar were used.

Search terms (sample): ("multiple blood transfusion" OR "repeated transfusion" OR "chronic transfusion") and (oncology OR cancer OR leukaemi OR lymphoma) AND (alloimmun_ OR "iron overload" OR ferritin OR TRIM OR thrombosis OR "hemoglobin trigger")—adapted per engine (MeSH/Emtree; title/abstract).

Selection:350 records → 240 studies included (adult oncology; ≥2 transfusion episodes; report Hb thresholds, alloantibodies, ferritin/MRI iron, Venous Thromboembolism (VTE) occurrence is independently associated with shorter Overall Survival (OS) and Progression-Free Survival (OS/PFS). Appraised via SANRA & Newcastle–Ottawa; thematic synthesis by tumour type/intent.

Results: 240 studies (n≈102,400) and restrictive Hb (70–80 g/L) non-inferior in solid tumours; liberal use retained in Acute Myeloid Leukemia (AML)/Myelodysplastic Syndromes (MDS) induction. Alloimmunization: 14–26% after ≥10 units (↓ ∼38% with leukoreduced & Rh/Kell matching). Iron overload (ferritin>1000 µg/L) in 28% after ≥20 units, associated with higher non-relapse mortality post-HSCT. Transfusion Related Immunomodulation signal bacterial sepsis (RR≈1.18); RBC:plasma >1.5 modestly raised Venous Thromboembolism(VTE).

Main Finding: Management of blood transfusion (MBT) are life-saving in acute settings but show diminishing hematological utility beyond ∼10–12 episodes without Patient Blood Managenent /chelation; alloimmunization and iron loading drive late morbidity more than incremental Hb gain.

Conclusion: Restrictive strategies, extended phenotyping, and early iron monitoring optimize utility. Routine liberal Management of blood transfusion in stable oncology patients is not supported; Curative-intent subgroups often require personalized approaches because patients' responses to treatment can vary widely. Tailored thresholds help identify the most effective treatment strategies for specific groups. Factors influencing these thresholds include: Biomarker profiles, Cancer stage and aggressiveness, Patient overall health and Genetic factors.

Managing Persistent Cervical Aneurysmal Bone Cyst with Salvage Radiotherapy: A Case Report

2026-03-28T09:40:17+00:00

Aims: Aneurysmal bone cyst (ABC) is a benign yet locally aggressive bone lesion that can lead to significant morbidity when it involves the spine. Cervical spine involvement is particularly rare and poses significant management challenges because of its proximity to the spinal cord and major neurovascular structures, often limiting complete surgical excision. This report aims to highlight the role of salvage radiotherapy in managing residual cervical spine ABC following surgery.

Presentation of Case: A 17-year-old girl presented with progressive swelling in the left side of the neck associated with pain and recent onset weakness in both lower limbs. Imaging revealed a large expansile multiloculated lesion involving the C2–C3 vertebrae, causing spinal cord compression. She underwent C2–C3 laminectomy with excision of the lesion and posterior fixation. Histopathology confirmed aneurysmal bone cyst. Postoperative imaging showed residual disease at the operative site. Considering the anatomical constraints and surgical morbidity, salvage external beam radiotherapy was delivered using three-dimensional conformal radiotherapy to a dose of 30 Gy in 15 fractions. The treatment was well tolerated, with gradual relief of pain and improvement in motor strength. Follow-up imaging demonstrated partial regression of the lesion.

Discussion: Although surgery remains the cornerstone of treatment for ABC, residual or recurrent disease can occur when complete excision is not feasible. In such situations, carefully planned radiotherapy can provide effective local control and symptomatic relief while minimizing risks to the spinal cord.

Conclusion: This case illustrates that moderate-dose conformal radiotherapy may serve as a valuable salvage option for persistent cervical spine ABC, particularly in anatomically complex regions where further surgery carries substantial risk.

Pleural Metastases from Primary Femoral Sarcoma in a Child: A Rare Case Report

2026-05-26T10:30:02+00:00

Background: Primary malignant bone sarcomas are rare but aggressive pediatric tumors with a strong tendency for pulmonary metastasis, while pleural spread is exceptionally uncommon and diagnostically challenging.

Aims: To report a rare case of pleural metastatic dissemination from a primary femoral sarcoma in a pediatric patient and to describe its computed tomography features.

Study Design: Case report.

Presentation of Case: An 8-year-old girl previously treated for malignant sarcoma of the distal femur presented seven months later with acute respiratory distress. Chest computed tomography revealed extensive heterogeneous pleural masses with internal calcifications, peripheral enhancement, and significant compressive effect on the right lung, causing near-complete pulmonary collapse and mediastinal shift. Associated pulmonary nodules were also identified. The imaging findings were consistent with extensive pleural metastatic involvement.

Discussion: Pleural metastases from primary bone sarcomas are extremely uncommon in children. Their radiological appearance may mimic primary pleural malignancies or other thoracic neoplasms, making diagnosis challenging. Recognition of calcified pleural metastatic lesions in patients with known primary bone tumors is essential for accurate diagnosis and appropriate management.

Conclusion: Pleural metastatic dissemination should be considered in pediatric patients with primary bone sarcoma presenting with new thoracic symptoms, particularly when imaging demonstrates calcified pleural masses.