Hypofractionated simultaneous integrated boost (IMRT-SIB) with pelvic nodal irradiation and concurrent androgen deprivation therapy for high-risk prostate cancer: results of a prospective phase II trial

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AIRO Breast Cancer Group Best Clinical Practice 2022 Update

Introduction: Breast cancer is the most common tumor in women and represents the leading cause of cancer death. Radiation therapy plays a key-role in the treatment of all breast cancer stages. Therefore, the adoption of evidence-based treatments is warranted, to ensure equity of access and standardization of care in clinical practice.Method: This national document on the highest evidence-based available data was developed and endorsed by the Italian Association of Radiation and Clinical Oncology (AIRO) Breast Cancer Group.We analyzed literature data regarding breast radiation therapy, using the SIGN (Scottish Intercollegiate Guidelines Network) methodology (www.sign.ac.uk). Updated findings from the literature were examined, including the highest levels of evidence (meta-analyses, randomized trials, and international guidelines) with a significant impact on clinical practice. The document deals with the role of radiation therapy in the treatment of primary breast cancer, local relapse, and metastatic disease, with focus on diagnosis, staging, local and systemic therapies, and follow up. Information is given on indications, techniques, total doses, and fractionations.Results: An extensive literature review from 2013 to 2021 was performed. The work was organized according to a general index of different topics and most chapters included individual questions and, when possible, synoptic and summary tables. Indications for radiation therapy in breast cancer were examined and integrated with other oncological treatments. A total of 50 questions were analyzed and answered.Four large areas of interest were investigated: (1) general strategy (multidisciplinary approach, contraindications, preliminary assessments, staging and management of patients with electronic devices); (2) systemic therapy (primary, adjuvant, in metastatic setting); (3) clinical aspects (invasive, non-invasive and micro-invasive carcinoma; particular situations such as young and elderly patients, breast cancer in males and cancer during pregnancy; follow up with possible acute and late toxicities; loco-regional relapse and metastatic disease); (4) technical aspects (radiation after conservative surgery or mastectomy, indications for boost, lymph node radiotherapy and partial breast irradiation).Appendixes about tumor bed boost and breast and lymph nodes contouring were implemented, including a dedicated web application. The scientific work was reviewed and validated by an expert group of breast cancer key-opinion leaders.Conclusions: Optimal breast cancer management requires a multidisciplinary approach sharing therapeutic strategies with the other involved specialists and the patient, within a coordinated and dedicated clinical path. In recent years, the high-level quality radiation therapy has shown a significant impact on local control and survival of breast cancer patients. Therefore, it is necessary to offer and guarantee accurate treatments according to the best standards of evidence-based medicine

Cellular localization of PACAP and its receptors in the ovary of the spotted ray Torpedo marmorata Risso 1880 (Elasmobranchii: Torpediniformes).

The pituitary adenylate cyclase-activating polypeptide (PACAP) is a member of the glucagon-related family and occurs in two amidated forms, PACAP38 and PACAP27, with 38 and 27 amino acids, respectively. PACAP acts by binding to three different receptors, that are classified by their binding affinity for PACAP and VIP (vasoactive intestinal polypeptide): PAC(1) R (PACAP-specific receptor) exclusively binds PACAP, while VPAC(1) R (VIP/PACAP receptor, subtype 1) and VPAC(2) R (VIP/PACAP receptor, subtype 2) bind both PACAP and VIP. PACAP, first discovered in the brain, was then localized in several peripheral tissues of mammals, including the ovary. Besides mammals, PACAP and its receptors have been reported in fish too; however, less is known about the presence of PACAP in the fish ovary and the studies are limited to teleosts. The aim of our work was to study the distribution of the PACAP/PACAP-Rs system in the ovary of the cartilaginous fish Torpedo marmorata. Using in situ hybridization (ISH) and immunohistochemistry techniques, we demonstrated that PACAP and its receptors are widely represented in the Torpedo ovary in a stage-dependent manner. Moreover, our findings suggest an involvement of this peptide in the whole follicologenesis, probably influencing steroidogenesis, follicle development, and oocyte growt

EXISTING BRIDGES IN ITALY: A REINFORCED CONCRETE MID-CENTURY CASE STUDY

In the framework of an ongoing research project which involved the Politecnico di Milano and the Lombardy region, the paper presents the preliminary investigations conducted on a reinforced concrete post-World War II bridge. The discussed infrastructure was selected, among others, as a pilot case for the development of novel guidelines aimed at: i) defining a first-level methodology for the priority-setting of maintenance operations on existing bridges belonging to the regional road network; and ii) establishing harmonized rules for the structural monitoring of bridge infrastructures. The results presented in the paper confirm the importance of historical investigations and highlight the conflict between economically-constrained diagnostic campaigns and the requirement to maximize the knowledge level of a structure that, after 70 years of operation and a minor maintenance, still carries increasing volumes of traffic loads

The expression of estrogen receptors during the Mytilus galloprovincialis ovarian cycle

The aim of this paper is to assess, by real-time polymerase chain reaction and in situ hybridization, the expression of estrogen receptors ER1 and ER2 during the ovarian cycle of Mytilus galloprovincialis. By considering four phases of the reproductive cycle, that is stasis and previtellogenic stage (Stage 0), early vitellogenesis (Stage I), vitellogenesis (Stage II), full-grown oocyte (Stage III), our investigation demonstrates that the two receptors are differently expressed during the phases investigated of the ovarian cycle: ER1 reaches the highest level at Stage III, whereas ER2 reaches the highest level at Stage II, with ER2 always present at higher levels than ER1. The stage-dependent receptor expression was recorded within oocytes, follicle cells, and adipogranular cells. No ER1 and ER2 messenger RNAs (mRNAs) were found within vesicular cells. It is to be noted that the ER1 and ER2 expression within the growing oocytes, the follicular, and adipogranular cells overlaps with that of the mRNA for vitellogenin in the same cells, strongly suggesting that in Mytilus, as in vertebrates studied so far, the vitellogenin expression is under the control of estrogen

Pituitary adenylate cyclase-activating polypeptide in the testis of the quail Coturnix coturnix: Expression, localization, and phylogenetic analysis

To evaluate the involvement of pituitary adenylate cyclase-activating polypeptide (PACAP)/receptors system in the control of testis activity, we have investigated the expression and localization of PACAP and the distribution of its receptors in the testis of mature samples of quail Coturnix coturnix, and we have performed a phylogenetic analysis of PACAP in birds. Using histological, molecular, and bioinformatics tools, we demonstrated that (a) PACAP messenger RNA shows a high sequence identity with that reported in other birds studied so far and in other vertebrates. Furthermore, we showed that purifying selection acts on PACAP; (b) the PACAP peptide is present only in Leydig cells, whereas its receptors are localized within both Leydig and germ cells; (c) the synthesis of PACAP does not take place in seminiferous tubules. The role of PACAP in the control of spermatogenesis and steroidogenesis in birds is discussed. Finally, we talk about the phylogenetic and evolutionary relationships between PACAP in birds and in other vertebrate