1,720,958 research outputs found
Efficacia e Sicurezza del trattamento con microsfere a rilascio di farmaco nel colangiocarcinoma (CCA) in stadio avanzato: risultati in 124 pazienti
No full textScopo: Le opzioni terapeutiche nei colangiocarcinomi avanzati sono oggi limitate. Scopo dello studio è
determinare efficacia e sicurezza della chemioembolizzazione intraarteriosa con microsfere a rilascio
di Doxorubicina (DEBDOX) nei CCA intraepatici non operabili.
Materiali e metodi:
Tra Febbraio 2006 e Settembre 2013, 104 pz con CCA istologicamente documentato sono stati
trattati con DEBDOX dopo essere stati giudicati inoperabili da un team di chirurghi, oncologi e
radiologi oncologici. Sono stati eseguiti 328 trattamenti (in media 3/pz) con intervallo minimo di 4
settimane (in media 7). Ogni trattamento prevede l’infusione di 2-4 ml di microsfere (70-150 ?m in
226 pz, 100-300 ?m in 102 pz) precaricate con doxorubicina (50-150 mg) nei vasi afferenti alla
lesione. La prima TC di controllo è stata eseguita ad 1 mese ed in seguito ogni 3 mesi.
Risultati:
La chemioembolizzazione con DEBDOX è risultata fattibile in tutti i pz. I giorni di degenza
post-procedura sono stati in media 1,8. Il trattamento è stato ben tollerato senza casi di tossicità
sistemica; si sono sviluppati 6 ascessi epatici post-trattamento. Si è osservata stabilità di malattia in
94 su 104 pz (90,4%), risposta parziale in 7 pz (6,7%) e 3 casi (2,8%) di malattia in progressione
(criteri di Choi). In 4 casi, dopo il trattamento, la neoplasia è divenuta operabile ed è stata eseguita
una resezione epatica. Ad un follow-up medio di 14 mesi (range 1-26), 68 pz sono in vita (65,3%), 36
deceduti (34,7%). I dati sono ancora in fase di raccolta perciò è presto per effettuare un’analisi della
sopravvivenza.
Conclusioni:
DEBDOX è una procedura semplice ed efficace con alta percentuale di controllo di malattia nei CCA.
DEBDOX potrebbe migliorare l’outcome di questi pz ma dati ulteriori sono necessari per confermare
questi risultati preliminari
Ruolo della chemioembolizzazione intra-arteriosa (TACE) con microsfere a rilascio di Irinotecano (DEBIRI) nel trattamento delle metastasi epatiche da melanoma dell’uvea
No full textScopo:
Il 50% circa dei pazienti con melanoma dell’uvea (UV) svilupperà metastasi, in prevalenza epatiche.
La prognosi dei melanomi uveali metastatici (mUM) è severa e, ad oggi, non vi è una terapia
standard.
Materiali e metodi:
Sono stati analizzati in modo prospettico i dati di 141 pazienti con mUM sottoposti, come approccio
iniziale, a TACE con DEBIRI (12,1%), terapia sistemica (39,7%), entrambe (33,3%) o nessuna delle
due (14,9%) da Settembre 1990 a Settembre 2013.
Risultati:
Il tempo medio libero da malattia è stato di 23,1 mesi, la sopravvivenza media dei pazienti in IV
stadio è stata di 18,1 mesi. La percentuale di coinvolgimento epatico (RR 1.3), la presenza di
malattia multi organo (RR 2.0), l’incremento dei livelli di LDH (RR 1.8) ed un performance status
secondo i criteri WHO pari a 1 (RR 1.6) o 2-3 (RR 4,7) sono stati associati ad una prognosi peggiore.
In presenza di lunghi intervalli liberi da malattia (RR 0.9), il ricorso a TACE con DEBIRI nel
trattamento delle metastasi epatiche ha determinato un incremento della sopravvivenza (22,6 mesi)
rispetto alle sole chemioterapie sistemiche (14.4 mesi). In particolare la combinazione di DEBIRI
TACE con fotemustina per via sistemica ha determinato il maggiore incremento della sopravvivenza
(RR 0,5).
Conclusioni:
La prognosi dei melanomi uveali metastatici è influenzata da: percentuale di coinvolgimento epatico,
presenza di malattia multiorgano, livelli di LDH, performance status, intervallo libero da malattia e
dalla terapia loco regionale con DEBIRI
Liver Metastases of Unknown Primary Renal Cell Carcinoma Treated With Immune Checkpoint Inhibitors Plus Tyrosine Kinase Inhibitors: A Case Report and Literature Review
Full text linkBackground/Aim: Renal cell carcinoma (RCC) constitutes approximately 3% of all cancers. More than 60% of RCCs are detected incidentally; one-third of patients present with regional or distant metastases, and another 20-40% of patients develop metastases after radical nephrectomy. RCC can metastasize to any organ. In contrast, metastatic RCC (mRCC) without evidence of a primary tumor is extremely rare, with only a few reported cases. Case Report: We present a case of mRCC that initially presented with multiple liver and lymph node metastases but no primary renal lesion. An impressive response to treatment was achieved with a combination of immune checkpoint inhibitors and tyrosine kinase inhibitors. A clinical, radiological, and pathological diagnostic strategy, particularly in the context of a multidisciplinary team, are crucial for reaching a definitive diagnosis. This approach allows to select the appropriate treatment, making a huge difference for a mRCC due to its resistance to standard chemotherapy. Conclusion: There are currently no guidelines available for mRCC without primary tumor. Nevertheless, a combination of TKI and immunotherapy could be the optimal first-line treatment if systemic therapy is required
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Diagnostic value of contrast-enhanced CT combined with 18-FDG PET in patients selected for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC)
No full textPURPOSE:
Aim of the study is to assess the reliability and correlation with surgical peritoneal cancer index (PCI) of combined PET/CT and ceCT scans (PET/ceCT) performed in a session in patients with peritoneal carcinomatosis candidates for cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
METHODS:
We retrospectively analyzed data collected from 27 patients with different types of peritoneal carcinomatosis candidates to CS + HIPEC who underwent FDG PET/ceCT in a single session. Two nuclear medicine physicians and two radiologists independently and blindly evaluated PET/CT and ceCT imaging, respectively. In the case of discordance, the consensus was reached by a discussion between the specialists. Moreover, the combined images were evaluated by all the specialists in consensus. The PCIs obtained from surgical look, PET/CT, ceCT, and PET/ceCT were compared with each other. The coefficients of correlation (r) were calculated. The study was conducted after approval of local ethics committee.
RESULTS:
Surgical PCI was available in 21 patients. The coefficient of correlation between PCI of PET/CT and surgery was 0.528, while it resulted higher between PET/ceCT and surgery (r = 0.878), very similar to ceCT and surgery (r = 0.876). The r coefficient between surgical PCI and PET/CT was higher in patients with a non-mucinous cancer (n = 12) than the counterpart (0.601 vs. 0.303) and the addition of ceCT significantly increases the correlation (r = 0.863), which is anyway similar to ceCT alone (r = 0.856).
CONCLUSIONS:
PET/ceCT as single examination is more accurate than PET/CT but not than ceCT alone for the definition of PCI in a selected group of patients candidates to CS + HIPEC
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
- …
