RESUMO
Additive manufacturing (AM) allows for optimized part design, reducing weight compared to conventional manufacturing. However, the microstructure, surface state, distribution, and size of internal defects (e.g., porosities) are very closely related to the AM fabrication process and post-treatment operations. All these parameters can have a strong impact on the corrosion and fatigue performance of the final component. Thus, the fatigue-corrosion behavior of the 3D-printed (L-PBF) AlSi10Mg aluminum alloy has been investigated. The influence of load sequence (sequential vs. combined) was explored using Wöhler diagrams. Surface roughness and defects in AM materials were examined, and surface treatment was applied to improve surface quality. The machined specimens showed the highest fatigue properties regardless of load sequence by improving both the roughness and removing the contour layer containing the highest density of defect. The impact of corrosion was more pronounced for as-printed specimens as slightly deeper pits were formed, which lowered the fatigue-corrosion life. As discussed, the corrosion, fatigue and fatigue-corrosion mechanisms were strongly related to the local microstructure and existing defects in the AM sample.
RESUMO
Brain metastases are a common and severe complication potentially leading to death in patients with metastatic melanoma. Immunotherapy and targeted therapy have significantly improved progression-free survival (PFS) and overall survival (OS) in patients with advanced melanoma. Few studies focus on patients with central nervous system (CNS) metastases, and these patients are often excluded and have a poor prognosis. It has been suggested that immunotherapy could reduce the incidence of brain metastases. We tested this hypothesis in a retrospective bicentric study. We performed a retrospective, bicentric descriptive analysis on a cohort of 293 patients treated for metastatic melanoma between May 2014 and October 2017 (Toulouse, N = 202; Limoges, N = 91). Patients with brain metastasis at diagnosis were excluded from the analysis. Patients were separated into two groups according to the first line of treatment: immunotherapy [immune checkpoint inhibitor (ICI)] vs other and anti-PD-1 vs other. The primary endpoint was the cumulative incidence of brain metastases, and secondary endpoints were OS and PFS. At 12 months, the cumulative incidence of brain metastases was 13.78% in the ICI group [95% confidence interval (CI) 9.14-19.36] and 27.26% in the other group (95% CI 19.38-35.71), P = 0.004. The cumulative incidence was 9.49% in the anti-PD-1 group (95% CI 5.43-14.90) vs 30.11% in the other group (95% CI 22.59-37.97), P < 0.0001. In multivariable analysis (model with 277 patients), anti-PD-1 reduced the risk of brain metastases by almost 70% (hazard ratio = 0.29, 95% CI 0.15-0.56, P < 0.0001). The use of ICI (anti-PD-1/PD-L1) in advanced melanomas without initial brain metastasis shows a protective effect and prevents their occurrence.