Local treatment with deep percutaneous electrochemotherapy of different tumor lesions: pain relief and objective response results from an observational study.

OBJECTIVE: The aim of this investigation focuses on the evaluation of the efficacy of deep-seated Electrochemotherapy (ECT) in terms of pain relief and local objective response, in pre-treated patients with neither further available pharmacological treatments nor eligible for surgery. PATIENTS AND METHODS: Deep percutaneous ECT has been performed in 20 patients subjected to systemic anaesthesia. Bleomycin was administrated intravenously before the application of the electrical pulses on the target area, employing multiple single needles depending on the size and location of the target tumor. RESULTS: Pain assessment based on Visual Analogue Scale showed significant pain relief one month after treatment in all patients, reducing from 7.5 to 3 as a median value (p-value at Wilcoxon test <0.001). Local symptom-free survival median value was 5.5 months. At the first follow-up (1-2 months), a local disease control rate (LDCR) was observed in 19/20 (95%) patients: complete responses in 2 (10%), partial responses in 8 (40%) and stable disease in 9 (45%). Local progression-free survival median value was 5.7 months. Overall, no major adverse effects were observed. CONCLUSIONS: Our study indicates that deep percutaneous ECT can produce a significant pain reduction and a high LDCR in different tumor lesions, for anatomical site or histotype. In particular, ECT has demonstrated to be effective in various histotypes and deep-seated tumor lesions never treated before by this approach giving a new chance to physicians for reducing oncological pain in patients not eligible to other therapeutic routes. The innovative peculiarity of our study was the successful application of deep percutaneous ECT on adrenal metastasis, malignant pleural mesothelioma, uterine leiomyosarcoma and the uncommon case of a male müllerian tumor.

Angle-Resolved Electron Scattering from H_{2}O near 0°.

An electron beam, characterized by a high-angular discrimination (≃0.7°), has been used to measure the total (elastic plus inelastic) cross section of H_{2}O in the energy range 3-100 eV. Broad coincidence is found with recent experiments, including a pronounced shoulder in the 6-12 eV region. However, at energies ≲6 eV, the present cross sections are ≃30% higher. Furthermore, forward scattering has been probed in the angular range 0°-3.5° and measures of the average (rotationally and vibrationally summed) differential elastic cross sections for incident energies ≤12 eV are obtained at a scattering angle ≃1^{∘}. The measurements, which provide the first test of theoretical predictions in an angular region experimentally unexplored until now, are found to be within 1 standard deviation of corresponding ab initio R-matrix calculations.

A statistical description of scattering at the quantum level.

Quantum physics is undoubtedly the most successful theory of the microscopic world, yet the complexities which arise in applying it even to simple atomic and molecular systems render the description of basic collision probabilities a formidable task. For this reason, approximations are often employed, the validity of which may be restricted to given energy regimes and/or targets and/or projectiles. Now we have found that the lognormal function, widely used for the probability distribution of macroscopic stochastic events (as diverse as periods of incubation of and recovery from diseases, size of grains, abundance of species, fluctuations in economic quantities, etc.) may also be employed to describe the energy dependence of inelastic collisions at the quantum level (including ionization, electron capture and excitation by electrons, positrons, protons, antiprotons, etc.), by allowing for the relevant threshold energy. A physical interpretation is discussed in this article by analogy with the heat capacity of few-level systems in solid state physics. We find the generality of the analysis to extend also to nuclear reactions. As well as aiding the description of collision probabilities for quantum systems, this finding is expected to impact also on the fundamental understanding of the interface between the classical and quantum domains.

High-Resolution Measurements of e

Using a purely electrostatic positron beam, the total cross section of positrons scattering from H_{2}O has been measured for the first time with a high angular discrimination (≃1°) against forward scattered projectiles. Results are presented in the energy range (10-300) eV. Significant deviations from previous measurements are found which are, if ascribed entirely to the angular acceptances of various experimental systems, in quantitative accord with ab initio theoretical predictions of the differential elastic scattering cross section.

Positronium Production and Scattering below Its Breakup Threshold.

Recent findings on the similarity between electron and positronium scattering at the same velocity [Brawley et al., Science 330, 789 (2010)] have guided us towards the realization of a detectable flux of positronium atoms at beam energies five times lower than previously obtained, enabling total cross sections to be measured in the energy range ∼(1-7) eV for the first time. In collision with Ar and Xe, the total cross sections of positronium are found to be smallest at the lowest energy probed, approaching those of the Ramsauer-Townsend minima for electron projectiles. Additional structure has been observed in the case of positronium scattering at incident energies around 5 eV.

Absolute Differential Positronium-Formation Cross Sections.

The first absolute experimental determinations of the differential cross sections for the formation of ground-state positronium are presented for He, Ar, H2, and CO2 near 0°. Results are compared with available theories. The ratio of the differential and integrated cross sections for the targets exposes the higher propensity for forward emission of positronium formed from He and H2.

Electron-like scattering of positronium.

Positronium (Ps), a hydrogen-like atom composed of an electron and its antimatter partner, the positron, is formed in considerable quantities whenever positrons interact with matter. It has unexpectedly been found to scatter from a wide variety of atoms and molecules in a way very similar to that of a bare electron moving at the same velocity, despite Ps being neutral and twice the mass.

Simultaneous ionization and excitation of molecules by positron impact.

Cross sections for ionization excitation of molecules by positron impact have been measured for the first time by scattering a positron beam from CO2 and N2. The cross sections have been observed to exceed those for electron impact by up to a factor of approximately 3 for CO2 and approximately 5 for N2. The enhancement arises primarily via positronium formation. The cross sections account for up to approximately 12% and 20% of the total cross sections for positron scattering from N2 and CO2, respectively.

Resonant scattering of positronium in collision with CO2.

The total cross sections of positronium (Ps) scattering from a carbon-dioxide molecule have been measured over the range (7-400) eV incident-Ps energy. For the first time in Ps collisions, a resonantlike structure is observed. For the present target, it occurs around 9.5 eV followed by a broader peak at ∼60 eV. Following Brawley et al. [Science 330, 789 (2010)] who have observed similarities between the total cross sections of positronium and of electrons incident upon a given target at the same velocity, a corresponding comparison is made for CO2. The comparison suggests that the former peak corresponds to the well-known 2Π(u) shape resonance which occurs for electrons at an incident velocity of 0.5 a.u. Further features are discussed and theoretical input is sought.

Excited-state positronium formation from helium, argon, and xenon.

The cross sections for the formation of positronium in the 2P state in collisions of positrons with He, Ar, and Xe atoms have been determined by measuring coincidences between the remnant ion and the Lyman-alpha photon from positronium. The maximum fractional contributions of these to the total Ps formation cross sections increase from approximately 0.06+/-0.01 in He to 0.12+/-0.04 in Ar and 0.26+/-0.09 in Xe. In the case of He, good agreement is found with a coupled-state calculation; for Ar and Xe, measurements are compared with a distorted-wave Born approximation.

Energy-sharing asymmetries in ionization by positron impact.

The triply differential cross section of molecular hydrogen for ionization by 50 eV positrons has been determined, for the first time, for both the ejected electron in coincidence with the remnant ion and for the scattered projectile. Asymmetries in the energy sharing between the two light particles in the final state are observed, with the electron spectrum being shifted to significantly lower (and the scattered positron to correspondingly higher) energies than expected. A similar shape is observed in the case of the ejected electron spectrum from a helium target at the same excess energy.

Fragmentation of positronium in collision with He atoms.

The absolute cross section for the fragmentation of positronium in collision with He atoms has been measured. The results are compared with available theories. The longitudinal energy distributions of positrons resulting from fragmentation have also been determined and are found to display a peak situated just below half the residual energy. This is suggestive of the occurrence of "electron loss to the continuum" in which the two residual charged particles lie in a low relative-velocity Coulomb-continuum state.