The prognosis of prostate cancer (PC) is generally favorable but the incidence of metastases is relatively high after the treatment of the primary tumor, especially in high-risk patients. ...Fractionated stereotactic body radiotherapy (SBRT) or single fraction stereotactic body radiosurgery (SRS) are emerging treatment options in this setting. However, data on SBRT/SRS in patients with metastatic castration-resistant PC (mCRPC) are largely lacking, particularly in subjects with nodal lesions. Therefore, we evaluated outcomes and toxicity recorded in mCRPC patients with nodal oligoprogression. Patients included in this analysis had ≤ 5 metastatic sites without visceral lesions and underwent SBRT/SRS on nodal metastases. Thirty-eight patients carrying out 61 nodal metastases were analyzed. The median SRS dose was 20 Gy (range 12–24 Gy) and the most common schedule was 20 Gy (44.8%). The median SBRT dose was 45 Gy (range 20–50 Gy) and the most common regimen was 45 Gy in 5 fractions (37.9%). Thirty-seven patients (97.4%) showed only grade 0–1 acute toxicity while one patient reported grade 2 dysphagia. In terms of late toxicity, one grade 2 laryngeal, one grade 1 skin and one grade 1 gastrointestinal toxicities were recorded. Two-year actuarial local control (LC), distant progression-free survival, progression-free survival (PFS) and overall survival were 94.0, 47.2, 47.2, and 90.2%, respectively. Two-year next line systemic therapy-free survival (NEST-FS) was 67.7%. In conclusion, the efficacy in terms of LC of SBRT/SRS in patients with nodal metastases from PC was confirmed. Moreover, this analysis suggests the efficacy in terms of PFS and NEST-FS also in the setting of oligoprogressive PC. In fact, about one-third of patients were free from progressive disease and two-third of subjects did not require hormonal therapy switch or discontinuation three years after treatment.
An assembly line for the construction of ultra-radio-pure detectors Buccheri, E.; Capodiferro, M.; Morganti, S. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
12/2014, Letnik:
768
Journal Article
Recenzirano
Odprti dostop
The 19 towers constituting the CUORE detector are an assembly of ultra-radio-pure components made of copper and PTFE plus tellurium dioxide crystals for a total of more than 10,000 pieces. A ...dedicated assembly line is mandatory to handle and assemble those parts and to minimize the risk of recontamination induced by external agents both during their construction and during their storage prior to installation inside the cryostat. The assembly strategy and the tool design proposed in this paper and developed for CUORE offer solutions that can be extended to the construction of similar-size detectors with strict requirements regarding contamination.
We use deep optical, infrared and radio observations to explore the symbiosis between nuclear activity and galaxy evolution in the southern compact radio source PKS 1549−79 (z= 0.1523). The optical ...imaging observations reveal the presence of tidal tail features which provide strong evidence that the host galaxy has undergone a major merger in the recent past. The merger hypothesis is further supported by the detection of a young stellar population (YSP), which, on the basis of spectral synthesis modelling of our deep Very Large Telescope (VLT) optical spectra, was formed 50-250 Myr ago and makes up a significant fraction of the total stellar mass (1-30 per cent). Despite the core-jet structure of the radio source, which is consistent with the idea that the jet is pointing close to our line of sight, our H i 21-cm observations reveal significant H i absorption associated with both the core and the jet. Moreover, the luminous, quasar-like active galactic nucleus (AGN) (MV
< −23.5) is highly extinguished (A
v
> 6.4) at optical wavelengths and show many properties in common with narrow-line Seyfert 1 galaxies (NLS1), including relatively narrow permitted lines full width at half-maximum (FWHM) ∼ 1940 km s−1, highly blueshifted O iiiλλ5007,4959 lines (ΔV∼ 680 km s−1) and evidence that the putative supermassive black hole is accreting at a high Eddington ratio (0.3 < L
bol/L
edd < 11). The results suggest that accretion at high Eddington ratio does not prevent the formation of powerful relativistic jets.
Together, the observations lend strong support to the predictions of some recent numerical simulations of galaxy mergers in which the black hole grows rapidly through merger-induced accretion following the coalescence of the nuclei of two merging galaxies, and the major growth phase is largely hidden at optical wavelengths by the natal gas and dust. Although the models also predict that AGN-driven outflows will eventually remove the gas from the bulge of the host galaxy, the visible warm outflow in PKS 1549−79 is not currently capable of doing so. However, much of the outflow may be hidden by the material obscuring the quasar and/or tied up in hotter or cooler phases of the interstellar medium.
By combining our estimates of the reddening of the quasar with the H i column derived from the 21-cm radio observations, we have also made the first direct estimate of the H i spin temperature in the vicinity of a luminous AGN: T
spin > 3000 K.
The existence of double-double radio galaxies (DDRGs) is evidence for recurrent jet activity in active galactic nuclei (AGN), as expected from standard accretion models. A detailed study of these ...rare sources provides new perspectives for investigating the AGN duty cycle, AGN-galaxy feedback, and accretion mechanisms. Using wide-field imaging with the LOFAR telescope, we study both a well-known DDRG as well as a large number of radio sources in the field of view. We present a high resolution image of the DDRG B1834+620 obtained at 144 MHz using LOFAR commissioning data. The spectral fit of the four components is consistent with a scenario in which the outer lobes are still active or the jets recently switched off, while emission of the inner lobes is the result of a mix-up of new and old jet activity. Finally, we show that the significant challenges of wide-field imaging can be solved using LOFAR commissioning data, thus demonstrating the potential of the full LOFAR telescope to discover millions of powerful AGN at redshift z ~ 1.
The influence of ultrasonic treatment parameters of chitin nanofibrils aqueous suspension on structure, strength and deformation properties of chitosan-based composite films and fibers was ...investigated. Model calculations of ultrasound-induced cavitation parameters in the aqueous suspension of the chitin nanofibrils showed that an increase in the field power up to 630 W led to destruction of the cavity, to an increase in the temperature in the vicinity of cavitation area (up to 507 °C) and, as a consequence, to destruction of chitin glycoside ring (which is confirmed by the IR data). The results of light scattering, IR spectroscopy, and electron microscopy investigations indicated that the optimal duration of ultrasonic treatment of the chitin nanofibrils aqueous solution was 4–10 min (depending on oriented state of the scaffold). Tensile strength of the composites was 130 ± 11 MPa (films), 226 ± 4.8 MPa (fibers); deformation at break was 43 ± 7.5% (films), 10 ± 0.6% (fibers).
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Introduction
The oncoplastic conservative surgery was developed as a natural evolution of traditional surgery, attempting to improve the therapeutic and aesthetic outcomes where tumor resection could ...be followed by not-adequate results. Our primary aim is to evaluate how patient satisfaction and quality-of-life after conservative oncoplastic surgery, using BREAST-Q (BCT Module), change pre- and post-operatively. The secondary aim is to compare patient-reported outcome after oncoplastic or traditional conservative surgery.
Patients and methods
We enrolled 647 patients who underwent traditional conservative surgery or oncoplastic surgery from January 2020 to December 2022. Only 232 women (35.9%) completed the BREAST-Q questionnaire on a web-based platform, at the preoperative phase and 3 months after treatment.
Results
The average score of “Psychosocial well-being” and “Satisfaction with Breasts” 3 months after surgery showed a statistically significant improvement, while the average score for “Physical well-being: Chest” at 3 months showed a worsening compared to the baseline. “Sexual well-being” did not show statistically significant change. A significant difference between the post-operative outcome of oncoplastic surgery and traditional surgery was observed only for Physical well-being (better for traditional surgery).
Conclusions
The study showed significant improvement in patient-reported outcomes 3 months after the surgery, except for physical discomfort that increases especially after oncoplastic surgery. Furthermore, our data, as well as many others, point to the appropriateness of using OCS where there is an effective indication, while the perspective of patients cannot find significant superiority over TCS in any of the areas analyzed.
Abstract Using the Karl G. Jansky Very Large Array, we have detected absorption lines due to carbon monoxide, CO( J = 0 → 1), and the cyano radical, CN( N = 0 → 1), associated with radio galaxy B2 ...0902+34 at redshift z = 3.4. The detection of millimeter-band absorption observed 1.5 Gyr after the Big Bang facilitates studying molecular clouds down to gas masses inaccessible to emission-line observations. The CO absorption in B2 0902+34 has a peak optical depth of τ ≥ 8.6% and consists of two components, one of which has the same redshift as previously detected 21 cm absorption of neutral hydrogen (H i ) gas. Each CO component traces an integrated H 2 column density of N H 2 ≳ 3 × 10 20 cm −2 . CN absorption is detected for both CO components, as well as for a blueshifted component not detected in CO, with CO/CN line ratios ranging from ≲0.4 to 2.4. We discuss the scenario that the absorption components originate from collections of small and dense molecular clouds that are embedded in a region with more diffuse gas and high turbulence, possibly within the influence of the central active galactic nucleus or a starburst region. The degree of reddening in B2 0902+34, with rest-frame color B − K ∼ 4.2, is lower than the very red colors ( B − K > 6) found among other known redshifted CO absorption systems at z < 1. Nevertheless, when including the many nondetections from the literature, a potential correlation between the absorption-line strength and B − K color is evident, giving weight to the argument that the red colors of CO absorbers are due to a high dust content.
Purpose
: To evaluate the impact of tumor response; tumor and nodal downstaging; and cTNM, yTNM (clinical stage after chemoradiation, based on preoperative imaging), and pTNM classifications on ...long-term outcome in patients with rectal cancer treated with preoperative 5-fluorouracil (5-FU)-based concurrent chemoradiation.
Methods and Materials
: Between January 1990 and March 1998, 165 consecutive patients with locally advanced extraperitoneal cancer of the rectum were treated with preoperative chemoradiation. Four patients had a cT2 lesion (2.5%), 120 had a cT3 lesion (74.5%), and 41 had a cT4 lesion (23%). The nodal involvement at combined imaging was cN0 in 21%, cN1 in 41%, cN2 in 34%, and cN3 in 4%. Preoperative chemoradiation was delivered according to 1 of 3 schedules: (
1) FUMIR-T3 (from 1990 to 1995) for patients with cT3N0-2 or cT2N1-2 rectal carcinoma (82 patients): 37.8 Gy (1.8 Gy/fraction) plus 5-FU, 1 g/m
2/d on Days 1–4, continuous infusion, and mitomycin-C, 10 mg/m
2/d on Day 1; (
2) FUMIR-T4 (from 1990 to 1999) for patients with cT4N0-3 or cT3-4N3 rectal carcinoma (40 patients): 45 Gy (1.8 Gy/fraction) plus 5-FU, 1 g/m
2/d on Days 1–4 and 29–32, continuous infusion, and mitomycin-C, 10 mg/m
2/d on Days 1 and 29; and (
3) PLAFUR-4 (from 1995 to 1998) for patients with cT3N0-2 or cT2N1-2 rectal carcinoma (42 patients): 50.4 Gy (1.8 Gy/fraction) plus 5-FU, 1 g/m
2/d on Days 1–4 and 29–32, continuous infusion, and cisplatin, 60 mg/m
2/d on Days 1 and 29. Four to five weeks after chemoradiation, patients were reevaluated for clinical response by imaging studies (CT scan, transrectal ultrasonography, barium enema, liver ultrasonography, chest X-rays) and restaged (yTNM). Surgery was performed 6–8 weeks after chemoradiation. Adjuvant chemotherapy (5-FU + l-folinic acid) was delivered to 26 patients in the FUMIR-T4 protocol group. Local control (LC), freedom from distant metastases (FDM), disease-free survival, and overall survival (OS) were evaluated according to the clinical response and cTNM, yTNM, and pTNM classification. The median follow-up was 67 months.
Results
: The 5-year survival rate was 100% for cT2, 77% for cT3, and 62% for cT4 (
p = 0.0497); after chemoradiation, it ranged between 81% and 91% for pT0-pT2 and dropped to 66% for pT3 and 47% for pT4 (
p = 0.014). The 5-year local control rate was, at the first staging, 84% for cT3 and 72% for cT4; after chemoradiation, the pT stage correlated significantly with LC (
p = 0.0012): 100% for pT0, 83% for pT1, 88% for pT2, 79% for pT3, and 46% for pT4. N stage was statistically significant in predicting FDM and OS at any staging step. A significant impact of tumor response, tumor downstaging, and nodal downstaging on LC, FDM, disease-free survival, and OS was also recorded. If the residual tumor, before surgery, had a tumor index <30 (i.e., width less than one-quarter of rectal circumference and length in its caudocranial axis ≤30 mm), the 5-year LC, FDM, disease-free survival, and OS rates were significantly higher at both the univariate and the multivariate analyses. The surgical procedure was tailored according to tumor downstaging, and thus the choice of sphincter-preserving surgery was based on the distance between the lower pole of the tumor and the anorectal ring “after” chemoradiation. In 36 patients with the lower pole of the lesion in the range of 0–30 mm from the anorectal ring, 16 patients (44%) underwent a sphincter-saving procedure. All clinical outcomes were similar compared with 20 patients with tumor located at the same rectum level who received an abdominoperineal resection.
Conclusion
: After preoperative chemoradiation, clinical response and tumor/nodal pathologic downstaging showed a close correlation with improved outcomes. The better 5-year survival and local control in pT0-2 patients regardless of their initial stage seems to confirm a heterogeneity in rectal cancer patients. The responder population showed a behavior similar to rectal cancer diagnosed at Stage cT1-2 and treated with conservative surgery alone. Additional studies aimed at improving local tumor response seem justified. Trials of sphincter-saving surgery after a major response are warranted.
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