patient treatment clinical follow progression

The gap

Supporting evidence — 5 representative gaps

• Intensity-Modulated Radiotherapy versus Volumetric Modulated Arc Therapy in Post-operative Carcinoma Tongue: A Systematic Review of Dosimetric Parameters, Treatment Efficiency, and Clinical Outcomes (2026) · doi

  This review has several strengths. The comprehensive search strategy across multiple databases minimizes the risk of missing relevant studies. The restriction to post- operative tongue carcinoma provides homogeneity and clinical applicability. The inclusion of RCTs alongside well-designed observational studies balances internal validity with representativeness. The assessment of multiple outcome domains (dosimetric, efficiency, clinical) provides a holistic comparison. Several limitations warrant acknowledgment. First, despite efforts to identify all relevant studies, the majority of included studies were observational, introducing potential for selection bias and confounding. While our sensitivity analyses restricted to RCTs yielded similar results, the relatively small number of randomized trials limits estimates. Second, heterogeneity in radiation dose-fractionation schemes, concurrent chemotherapy regimens, and outcome definitions across studies precluded formal meta-analysis for some outcomes and may limit generalizability. Third, most included studies had relatively short follow-up (median 24-36 months), limiting assessment of late toxicity and long-term survival. Fourth, the majority of studies originated from high-volume academic centers, potentially to community practice settings. Fifth, detailed information on treatment planning objectives, optimization algorithms, and quality assurance protocols was inconsistently reported, limiting our ability to identify technical factors that might influence comparative performance. Additionally, our review did not address cost- effectiveness formally, though the efficiency advantages of VMAT would likely translate to favorable economic profiles in most healthcare systems. Patient-reported outcome data, while supportive of VMAT benefits for xerostomia, were available in only a subset of studies, and standardized QoL assessment was not universal. Finally, subgroup analyses to identify patient populations who might derive particular benefit from VMAT were limited by inconsistent reporting of relevant baseline characteristics across studies. CONCLUSION This systematic review provides robust evidence that VMAT offers significant advantages over IMRT for post-operative radiotherapy in tongue carcinoma. The limiting generalizability IJDDT, Volume 16 Issue 7s, 2026 338 Intensity-Modulated Radiotherapy versus Volumetric Modulated Arc Therapy in Post-operative Carcinoma Tongue: A Systematic Review of Dosimetric Parameters, Treatment Efficiency, and Clinical Outcomes in 67% reduction in treatment delivery time and 35% represent substantial in monitor units reduction improvements efficiency without treatment compromising target coverage or oncological outcomes. The superior sparing of parotid glands and oral cavity translates to modest but clinically meaningful reductions in xerostomia and improved quality of life. Acute toxicity profiles are comparable, while late xerostomia shows favorable trends with VMAT. Based on the current evidence, VMAT should be considered the preferred radiation delivery technique for technical post-operative expertise and quality assurance infrastructure are available. The benefits are particularly compelling in high-volume centers where workflow efficiency gains can substantially improve patient access and resource utilization.

  Keywords: vmat efficiency review post operative treatment across relevant tongue carcinoma provides clinical assessment outcome identify
• The mechanism of the PI3K-AKT-mTOR signaling pathway in renal cell carcinoma: current developments and future prospects (2026) · doi

  Can Zou 1, Yuxia Wang 2, Qiuyan Chen 1, Jianyou Shi 3*, Xianbo Wu 1* and Quan Luo 4* 1School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China, 2Department of Pharmacy, Sichuan Academy of Medical Sciences&Sichuan Provincial People’s Hospital, Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China, 3Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China, 4West China School of Medicine, Sichuan University, The Second People’s Hospital of Chengdu Affiliated to Sichuan University, Chengdu Second People’s Hospital, Chengdu, Sichuan, China Renal cell carcinoma (RCC) is a type of solid tumor with one of the highest incidences among urinary system malignancies, and its incidence continues to increase worldwide. The PI3K-AKT-mTOR signaling pathway, as a central signaling hub that regulates biological processes such as cell survival, proliferation, metabolism, and metastasis, often exhibits abnormal and sustained activation during the pathological progression of RCC. Dysregulation of this pathway synergistically promotes tumor progression through multiple mechanisms, including enhancing the survival and clonal expansion of tumor cells, inducing angiogenesis, driving metabolic reprogramming of the tumor microenvironment, and mediating treatment resistance. These pathological changes are closely associated with poor patient prognosis. Given the central role of the PI3K-AKT-mTOR signaling pathway in the pathogenesis of RCC, it has become a key target for targeted therapeutic intervention. Although multiple small-molecule inhibitors targeting this pathway have demonstrated potential for inhibiting tumor growth in preclinical studies and early-phase clinical trials, their clinical application still faces numerous challenges. Against this backdrop, combination therapy strategies offer a new approach to overcome the limitations of single-agent therapy, not only enhancing treatment efficacy but also potentially reducing the risk of drug resistance. Notably, natural products and their derivatives, due to their low toxicity, ability to modulate multiple targets, and specific inhibitory effects on cancer stem cells, are regarded as promising sensitizers in combination therapy. This article systematically reviews the pathological features of RCC and current clinical treatment strategies, with a focus on exploring the molecular regulatory mechanisms of the PI3K-AKT-mTOR signaling pathway in tumor progression, while highlighting the latest research

  Keywords: sichuan chengdu china tumor university therapy pathway school medicine people hospital signaling drug mtor pathological
• Integrated multi-omics and machine learning identify EFNA3 as a key biomarker of tumor invasion (2026) · doi

  The association between EFNA3 expression, clinical staging, and survival outcomes was demonstrated in multi-omics cohorts and public datasets; however, prospective clinical studies with longitudinal follow-up are needed to establish EFNA3 as a predictive biomarker for gastric cancer prognosis, treatment response, and progression-free survival in patient populations stratified by molecular subtype.

  Keywords: EFNA3 biomarker prognostic stratification clinical outcomes prospective gastric cancer
• Clinical Validity and Utility of Whole-Genome Sequencing In Rare Mendelian Disorders: Lessons for Population Screening and Policy (2026) · doi

  Patient and specimen registries with longitudinal follow-up data are needed to study clinical progression and treatment outcomes for rare Mendelian disorders evaluated with WGS, yet current frameworks for formal assessment of genomic test clinical effectiveness vary significantly across countries, requiring harmonization to support population-wide trials.

  Keywords: patient registries specimen registries whole-genome sequencing rare Mendelian disorders longitudinal follow-up
• TdT Negativity and ETP Phenotype in Young Patients with Acute T- Lymphoid Leukemia: A Case Report (2021) · doi

  The paper does not provide long-term follow-up data or treatment outcomes for this patient, limiting understanding of clinical progression and therapeutic response.

  Keywords: provide long term follow treatment outcomes patient limiting understanding clinical progression therapeutic response