The relationship and mechanisms among weathering processes, cation fluxes, clay mineralogy, organic matter composition and stability were studied in soils developing on basaltic material in southern ...Italy (Sicily). The soils were transitions between Phaeozems and Vertisols. Intense losses of the elements Na, Ca and Mg were measured indicating that weathering has occurred over a long period of time. The main weathering processes followed the sequence: amphibole, mica, volcanic glass or if ash was the primary source → smectite → interstratified smectite–kaolinite → kaolinite. Kaolinite formation was strongly related to high Al, Mg and Na losses. The good correlation between oxyhydroxides and kaolinite in the soils suggests that (macro)aggregates have formed due to physical or electrostatic interactions between the 1:1 clay minerals and oxides. The stability of organic matter was investigated with a H
2O
2-treatment that assumes that chemical oxidation mimics the natural oxidative processes. The ratio of C after the H
2O
2 treatment to the total organic C ranged from 1–28%. No correlation between clay content and organic matter (labile or stable fraction) was found. The refractory organic fraction was enriched in aliphatic compounds and did not greatly interact with the kaolinite, smectite or poorly crystalline Fe or Al phases. A part of this fraction (most probably proteins) was bound to crystalline Fe-oxides. In contrast, the oxidisable fraction showed a strong relationship with poorly crystalline oxyhydroxides and kaolinite. Surprisingly, smectite did not contribute to the stabilisation of any of the organic C fractions. The stabilisation of organic matter in the soils has, therefore, two main mechanisms: 1) the protection of labile (oxidisable with H
2O
2) organic matter, including also aromatic-rich compounds such as charcoal, by the formation of aggregates with oxyhydroxides and kaolinite and 2) the formation of a refractory fraction enriched in aliphatic compounds.
This work investigated the effects of land cover and land-use change (LUC) on the ability of a soil to store carbon (C) and reduce carbon dioxide (CO
2) emissions, in a Mediterranean area. Using a ...paired-site approach, we estimated the effect of land-cover change on the C stock from 1972 to 2008 in a natural reserve (Grotta di Santa Ninfa) in western Sicily. We selected 15 paired sites representative of five LUCs. We studied the effect of land use on soil organic C (SOC) content in bulk soil and in different particle-size fractions (2000–1000
μm, 1000–500
μm, 500–250
μm, 250–63
μm, 63–25
μm, and <
25
μm). Laboratory incubation of the soil samples was conducted to measure CO
2 evolution in bulk soil collected at two different depths from each paired site. We found that the conversion of natural vegetation to orchards (vineyards and olive groves) resulted in SOC decreases ranging from 27% to 50%. The conversion from vineyards to arable land led to a 9% decrease in SOC, whereas the opposite caused a 105% gain. When arable land was replaced by
Eucalyptus afforestation, a 40% increase in SOC was observed. SOC decline occurred mainly in coarser soil fractions, whereas the finest fractions were not influenced by land use. We calculated an overall SOC reduction of 63% in the study area, corresponding to a 58
Mg
ha
−
1
SOC loss in less than 30
years. Our results indicate that land-use conversion, vegetation type, and management practices that control the biogeochemical and physical properties of soil could help reduce CO
2 emissions and sequester SOC.
► The SOC content is strongly affected by land cover and land use change. ► SOC losses are mainly associated with coarser fractions. ► OC content in bulk soil shows a significant negative linear relationship with CO
2 flux.
To study the prognostic value for overall survival of baseline assessment of functional status, comorbidity, and quality of life (QoL) in elderly patients with advanced non-small-cell lung cancer ...treated with chemotherapy.
Data from 566 patients enrolled onto the phase III randomized Multicenter Italian Lung Cancer in the Elderly Study (MILES) study were analyzed. Functional status was measured as activities of daily living (ADL) and instrumental ADL (IADL). The presence of comorbidity was assessed with a checklist of 33 items; items 29 and 30 of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30 (EORTC QLQ-C30) were used to estimate QoL. ADL was dichotomized as none versus one or more dependency. For IADL and QoL, three categories were defined using first and third quartiles as cut points. Comorbidity was summarized using the Charlson scale. Analysis was performed by Cox model, and stratified by treatment arm.
Better values of baseline QoL (P = .0003) and IADL (P = .04) were significantly associated with better prognosis, whereas ADL (P = .44) and Charlson score (P = .66) had no prognostic value. Performance status 2 (P = .006) and a higher number of metastatic sites (P = .02) also predicted shorter overall survival.
Pretreatment global QoL and IADL scores, but not ADL and comorbidity, have significant prognostic value for survival of elderly patients with advanced non-small-cell lung cancer who were treated with chemotherapy. Using these scores in clinical practice might improve prognostic prediction for treatment planning.
Chemotherapy is the standard treatment for advanced non-small-cell lung cancer, and myelosuppression is a common side-effect. We aimed to assess whether haematological toxic effects could be a ...biological measure of drug activity and a marker of efficacy.
We analysed data for 1265 patients who received chemotherapy (vinorelbine, gemcitabine, gemcitabine and vinorelbine, cisplatin and vinorelbine, or cisplatin and gemcitabine) within three randomised trials. Primary landmark analyses were restricted to 436 patients who received all six planned chemotherapy cycles and who were alive 180 days after randomisation. Neutropenia was categorised on the basis of worst WHO grade during chemotherapy: absent (grade 0), mild (grade 1–2), or severe (grade 3–4). All statistical analyses were stratified by treatment allocation. Analyses were repeated in the out-of-landmark group (829 patients), stratifying by treatment allocation and number of chemotherapy cycles. The primary endpoint was overall survival.
In the landmark group, hazard ratios of death were 0·65 (0·46–0·93) for patients with severe neutropenia and 0·74 (0·56–0·98) for those with mild neutropenia. Median survival after the landmark time of 180 days was 31·4 weeks (95% CI 25·7–39·6) for patients without neutropenia compared with 42·0 weeks (32·7–59·7) for patients with severe neutropenia, and with 43·7 weeks (36·6–66·0) for those with mild neutropenia (severe
vs mild
vs no neutropenia p=0·0118). Findings were much the same for the out-of-landmark group.
Neutropenia during chemotherapy is associated with increased survival of patients with advanced non-small-cell lung cancer, and its absence might be a result of underdosing. Prospective trials are needed to assess whether drug dosing guided by the occurrence of toxic effects could improve efficacy of standard regimens.
Highlights • Chemo-radiotherapy is standard of care in the unresectable stage III NSCLC. • We performed a multicenter phase III trial and a literature-based meta-analysis. • Addition of taxane to ...thoracic radiotherapy after induction chemotherapy was studied. • The results do not support a clinically meaningful benefit on survival
Abstract Background Socioeconomic status can potentially affect prognosis of cancer patients. Our aim was to describe potential differences in demographic and clinical characteristics, treatment, and ...survival by education level in patients with advanced non-small cell lung cancer (NSCLC) enrolled in clinical trials of first-line treatment. Methods Individual data of Italian patients with advanced NSCLC (stage IV, or IIIB with supraclavicular nodes or malignant pleural effusion), ECOG performance status (PS) 0–2, enrolled in four phase III randomized trials conducted between 1996 and 2005 were pooled. Information about education was available for 1680 of 1709 patients (98.3%). Patients were divided in two groups according to education level: high (patients with at least high school diploma) or low (those with less than high school diploma). Survival analyses were stratified by treatment arm within trial. Results There were 312 (19%) and 1368 (81%) patients with high and low education, respectively. Education level was significantly different among birth cohorts, with a time-trend toward higher education level. Patients with high education were significantly younger (median age 65 vs. 70), were less frequently unfit at diagnosis (ECOG PS2 5% vs. 16%), and their tumor type was more frequently adenocarcinoma (47% vs. 37%). Number of treatment cycles received was not significantly different between education groups. Median survival was 9.4 and 7.6 months in high and low education, respectively ( p = 0.012). At multivariable analysis, female sex, better PS and high education level (Hazard Ratio 0.85, 95%CI 0.73–0.99, p = 0.03) were independently associated with longer survival. Conclusions In Italian patients enrolled in four randomized trials of first-line chemotherapy for advanced NSCLC, high education was significantly more frequent among younger patients, and was associated with lower proportion of PS2 patients. Education level did not significantly affect number of chemotherapy cycles received. Overall survival was longer in patients with high education, after adjustment for PS and other prognostic factors. The exact underlying mechanisms of the independent prognostic role of education level are substantially unknown, but lead-time bias (anticipation in diagnosis and time to inclusion in the trial), differences in adherence to care outside the trial procedures, differences in comorbidities and life-style factors may all contribute.
Abstract Lung cancer is the most common cancer in the world today, in terms of both incidence and mortality. Non-small cell lung cancer (NSCLC) accounts for about 85% of all lung cancers, and the ...majority of people diagnosed with NSCLC have locally advanced or metastatic disease. Treatment algorithms have rapidly changed in the last 10 years because of the introduction of new chemotherapeutic and targeted agents in clinical practice. SUN is a 1-year longitudinal observational multicenter study that has consecutively enrolled patients affected by stage IIIB or IV NSCLC with the aim to describe the pattern of care and evolving approaches in the treatment of advanced NSCLC. 987 consecutive NSCLC patients were enrolled between January 2007 and March 2008 at the 74 participating centers throughout Italy and a 12-month follow-up was performed. Cyto-histological diagnosis was performed mainly by broncoscopy with only 24% by CT-scan guided fine-needle aspiration biopsy. 91.4% of the patients received a first-line medical treatment and 8.6% supportive care only. Median age of patients receiving first-line treatment was 66 years. First-line chemotherapy consisted of a single agent in 20% of patients and combination chemotherapy in 80%. The most frequently used chemotherapy regimens were cisplatin plus gemcitabine and carboplatin plus gemcitabine. Median survival of patients receiving first-line chemotherapy was 9.1 months. 32% percent of patients received a second-line treatment that consisted of chemotherapy in 71% of cases and erlotinib in 29%. Overall third-line treatment was given to 7.3% of patients. These results showed a pattern of care for advanced NSCLC that reflects the current clinical practice in Italy at the study time with a high adherence to the International guidelines by the Italian Oncologists.
PDF
