Validation of the standardized index of shape tool to analyze DCE-MRI data in the assessment of neo-adjuvant therapy in locally advanced rectal cancer.

PURPOSE: Standardized index of shape (SIS) tool validation to examine dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) in preoperative chemo-radiation therapy (pCRT) assessment of locally advanced rectal cancer (LARC) in order to guide the surgeon versus more or less conservative treatment. MATERIALS AND METHODS: A total of 194 patients (January 2008-November 2020), with III-IV locally advanced rectal cancer and subjected to pCRT were included. Three expert radiologists performed DCE-MRI analysis using SIS tool. Degree of absolute agreement among measurements, degree of consistency among measurements, degree of reliability and level of variability were calculated. Patients with a pathological tumour regression grade (TRG) 1 or 2 were classified as major responders (complete responders have TRG 1). RESULTS: Good significant correlation was obtained between SIS measurements (range 0.97-0.99). The degree of absolute agreement ranges from 0.93 to 0.99, the degree of consistency from 0.81 to 0.9 and the reliability from 0.98 to 1.00 (p value < < 0.001). The variability coefficient ranges from 3.5% to 26%. SIS value obtained to discriminate responders by non-responders a sensitivity of 95.9%, a specificity of 84.7% and an accuracy of 91.8% while to detect complete responders, a sensitivity of 99.2%, a specificity of 63.9% and an accuracy of 86.1%. CONCLUSION: SIS tool is suitable to assess pCRT response both to identify major responders and complete responders in order to guide the surgeon versus more or less conservative treatment.

Beneficial Role of Fruits, Their Juices, and Freeze-Dried Powders on Inflammatory Bowel Disease and Related Dysbiosis.

Inflammatory bowel disease (IBD) is a group of complex chronic inflammatory conditions affecting the gastrointestinal tract. It is linked to a number of genetic and environmental factors able to perturb the immune-microbiome axis. Diet is the most investigated variable both for its role in the etiology of IBD and for its beneficial potential in the treatment of the symptoms. Dietary products may influence intestinal inflammation through different mechanisms of action, such as the modulation of inflammatory mediators, the alteration of gene expression, changes in gut permeability, and modifications in enteric flora composition. A consisting number of studies deal with the link between nutrition and microbial community, and particular attention is paid to plant-based foods. The effects of the dietary intake of different fruits have been investigated so far. This review aims to present the most recent studies concerning the beneficial potential of fruit consumption on human gut microbiota. Investigated plant species are described, and obtained results are presented and discussed in order to provide an overview of both in vitro and in vivo effects of fruits, their juices, and freeze-dried powders.

Integration of stereotactic radiotherapy in the treatment of metastatic colorectal cancer patients: a real practice study with long-term outcome and prognostic factors.

BACKGROUND: There are very few clinical or prognostic studies on the role of SRT (Stereotactic Radiation Therapy) in the continuum of care of metastatic colorectal cancer (mCRC) patients. PATIENTS AND METHODS: Patients affected by oligo-mCRC were treated with SRT before or after front-line standard treatments. SRT was delivered according to a risk-adapted protocol. Total body CT (Computed Tomography) scan was done before therapy and every three months thereafter. The radiologic responses to therapy were evaluated by RECIST (Response Evaluation Criteria In Solid Tumors). FDG-PET (FluoroDeoxyGlucose - Positron Emission Tomography) was done before and after SRT; metabolic responses were evaluated by using the EORTC (European Organization for Research and Treatment of Cancer) criteria. The Kaplan-Meier product limit method was applied to graph Overall Survival (OS) and Progression-Free Survival (PFS). RESULTS: Forty-seven patients were included. Twenty-one patients had disease limited to lungs, 9 to lung and liver, 7 only to liver, 10 to multiple sites. The median prescription SRT dose was 60 Gy per organ in 3 fractions (median biological effective dose of 180 Gy). The reduction of delta SUVmax (maximum Standardized Uptake Value) correlated with the local control (p<0.001) and two-years survival (p=0.003). At univariate analysis, localization of primary tumor, site of metastases, KRAS (Kirsten RAt Sarcoma) oncogene mutational status, response to first-line chemotherapy, response to SRT and number of treated lesions predicted both PFS and OS. DISCUSSION: This real practice experience suggests that further studies are needed to analyze the promising role of SRT in the multidisciplinary management of mCRC.

Limits and potential of targeted sequencing analysis of liquid biopsy in patients with lung and colon carcinoma.

The circulating free tumor DNA (ctDNA) represents an alternative, minimally invasive source of tumor DNA for molecular profiling. Targeted sequencing with next generation sequencing (NGS) can assess hundred mutations starting from a low DNA input. We performed NGS analysis of ctDNA from 44 patients with metastatic non-small-cell lung carcinoma (NSCLC) and 35 patients with metastatic colorectal carcinoma (CRC). NGS detected EGFR mutations in 17/22 plasma samples from EGFR-mutant NSCLC patients (sensitivity 77.3%). The concordance rate between tissue and plasma in NSCLC was much lower for other mutations such as KRAS that, based on the allelic frequency and the fraction of neoplastic cells, were likely to be sub-clonal. NGS also identified EGFR mutations in plasma samples from two patients with EGFR wild type tumor tissue. Both mutations were confirmed by droplet digital PCR (ddPCR) in both plasma and tissue samples. In CRC, the sensitivity of the NGS plasma analysis for RAS mutations was 100% (6/6) in patients that had not resection of the primary tumor before blood drawing, and 46.2% (6/13) in patients with primary tumor resected before enrollment. Our study showed that NGS is a suitable method for plasma testing. However, its clinical sensitivity is significantly affected by the presence of the primary tumor and by the heterogeneity of driver mutations.

Uretritis y conjuntivitis simultánea por adenovirus tipo 56 / Simultaneous urethritis and conjunctivitis caused by adenovirus type 56

No disponible

A phase I/II trial of gefitinib and radiotherapy in patients with locally advanced inoperable squamous cell carcinoma of the head and neck.

Two different doses of gefitinib, administered along with standard radiation therapy, were tested in locally advanced inoperable head and neck cancer with the aim of finding the maximum tolerated dose and assessing the toxicity and activity of the combination. The standard '3+3' design was used for the phase I study. Radiation therapy was given according to conventional dose and schedule. Gefitinib dose escalation was stopped if more than one-third of patients of a given cohort had dose-limiting toxicity. Dose-limiting toxicity was observed in three of four patients treated at the dose of 500 mg, and included grade 3 stomatitis in three patients and grade 3 liver toxicities in one patient. The dose level of 250 mg was recommended for the phase II study. Six confirmed objective responses were observed among 16 patients. Our results do not support further trials with gefitinib and radiation therapy, according to our schedule, in this patient population. Integration of gefitinib within chemoradiotherapy regimens and combination with other biological therapies may represent the next challenge.

Suplementación con micronutrientes resultados de la encuesta de consumo y nutrición 2005 / Supplementation with micronutrients results of the survey of consumption and nutrition 2005

El presente trabajo es el resultado de una encuesta aplicada a una muestra representativa nacional y departamental de los hogares de los municipios más vulnerables a la inseguridad alimentaria, reflejando la tipología de las organizaciones comunitarias, según su grado de vulnerabilidad