Territori partecipativi

Pubblicazione degli atti della IV Giornata di studio del Gruppo di ricerca A.Ge.I. (Associazione dei Geografi Italiani), a carattere internazionale, dal titolo "Territori partecipativi: prodromi e pratiche" (Roma, 22 settembre 2017)

Verso una geografia per la partecipazione

This article introduces the contributions collected in the special issue no. 1/2018 of “geotema” and presented at the 4th Study Day on Territorial Identities (Rome, September 22nd, 2017), promoted by the homonymous research group of the A.Ge.I. (Associations of Italian Geographers). The paper aims at discussing some basic questions on participatory processes, in order to pursue four objectives: 1) to recall some of the main issues that revolve around the topic of citizen participation in territorial decision-making processes; 2) to specify the ties between territorial identity (as intended by the research group) and participatory processes; 3) to highlight the questions raised by the contributions presented at the study day; 4) to propose an action for the professionalization of geographical skills in participation, with special reference to the Italian context

The impact of patient preference in the treatment algorithm for recurrent/metastatic head and neck squamous cell carcinoma

The advent of immune checkpoint inhibitors for recurrent/metastatic head and neck squamous cell carcinoma (RM-HNSCC) has revolutionized the standard of care approach in first-line treatment. The heterogeneity of disease presentation and treatment-related toxicities can be associated with suboptimal patient compliance to oncologic care. Hence, prioritizing quality of life and well-being are crucial aspects to be considered in tailoring the best treatment choice. The aim of our work is to present a short report on the topic of the patient’s preference in regard to treatment and its consequences on quality of life in the recurrent/metastatic setting. According to the literature, there’s an unmet need on how to assess patient attitude in respect to the choice of treatment. In view of the availability of different therapeutic strategies in first-line management of RM-HNSCC, increasing emphasis should be put on integrating patient preferences into the medical decision-making

Real-World Treatment Patterns and Survival Outcome in Advanced Anaplastic Lymphoma Kinase (ALK) Rearranged Non-Small-Cell Lung Cancer Patients

Introduction: Survival of ALK-rearranged NSCLC patients has dramatically improved by the use of multiple ALK-tyrosine kinase inhibitors (ALK-TKI). However, still little is known about the impact of drug sequencing and clinical features on survival in a real-world setting. Methods: Patients with stage IV ALK-rearranged NSCLC treated at six centers in Switzerland and Italy were identified and standard clinical variables collected. OS curves were constructed using the Kaplan-Meier method and compared with the log-rank test. Multivariate Cox proportional hazard analysis was applied to determine the correlations between clinical features and OS. In four patients, biopsies were subjected to NGS. Results: One-hundred and twenty-one patients with stage IV ALK-rearranged NSCLC diagnosed between 2011 and 2016 were included. With a median follow-up time of 39.5 months, the median OS from diagnosis of stage IV disease was 48.0 months. First-line treatment consisted of an ALK-TKI in 24% of patients, with crizotinib in 83% of them. Chemotherapy as first-line treatment did not influence OS (p = 0.955). The use of more than one ALK-TKI line positively correlated with OS (p = 0.016), as well as the use of alectinib or lorlatinib in any treatment line, as compared to the use of crizotinib ± ceritinib (p = 0.022). A never smoking history was an independent prognostic factor for OS (p = 0.032). Moreover, treatment with alectinib significantly improved OS. Conclusions: Targeted treatment for ALK-positive NSCLC patients lead to prolonged OS. Smoking status was a negative independent prognostic factor in a multi-variate analysis. The use of alectinib or lorlatinib in any treatment line improved overall outcome

Radiomic Analysis for Human Papillomavirus Assessment in Oropharyngeal Carcinoma: Lessons and Pitfalls for the Next Future

Background: Oropharyngeal Squamous Cell Carcinoma (OPSCC) is rapidly increasing due to the spread of Human Papillomavirus (HPV) infection. HPV-positive disease has unique characteristics, with better response to treatment and consequent better prognosis. HPV status is routinely assessed via p16 immunohistochemistry or HPV DNA Polymerase Chain Reaction. Radiomics is a quantitative approach to medical imaging which can overcome limitations due to its subjective interpretation and correlation with clinical data. The aim of this narrative review is to evaluate the impact of radiomic features on assessing HPV status in OPSCC patients. Methods: A narrative review was performed by synthesizing literature results from PUBMED. In the search strategy, Medical Subject Headings (MeSH) terms were used. Retrospective mono- or multicentric works assessing the correlation between radiomic features and HPV status prediction in OPSCC were included. Selected papers were in English and included studies on humans. The range of publication date was July 2015–April 2023. Results: Our research returned 23 published papers; the accuracy of radiomic models was evaluated by ROC curves and AUC values. MRI- and CT-based radiomic models proved of comparable efficacy. Also, metabolic imaging showed crucial importance in the determination of HPV status, albeit with lower AUC values. Conclusions: Radiomic features from conventional imaging can play a complementary role in the assessment of HPV status in OPSCC. Both primary tumor- and nodal-related features and multisequencing-based models demonstrated higher accuracy

Equity, Diversity, and Inclusion in Radiation Oncology: A Bibliometric Analysis and Critical Review

: The promotion of equity, diversity, and inclusion (EDI) is being increasingly pursued in health care, both in general and within radiation oncology. Because bibliometrics is a powerful tool to reveal the scientific literature on a specific topic during a certain timespan, a systematic bibliometric analysis of the documents published on EDI in radiation oncology was performed, aiming at exploring common patterns in research and emerging trends, tracking collaborations and networks, and anticipating future directions in clinical research. Standard descriptive statistics and bibliometric techniques were used in the analysis. A collaboration network and thematic map were generated from the data. Four domains were represented: (1) motor themes, including themes well developed and important for the structuring of the research field; (2) niche themes, representing the isolated topics that do not share important external links with other themes; (3) emerging themes, referring to still weakly developed topics; and (4) basic themes, including the essential topics. EDI in the profession of radiation oncology is essential to ensure that the workforce delivering radiation oncology care both draws from the full talent pool of human capital and delivers the highest quality science and clinical care to all patients. The burgeoning literature on EDI in radiation oncology suggests that a large and growing cohort of scholars within radiation oncology are dedicated to addressing these important challenges

Equity, Diversity, and Inclusion in Radiation Oncology: A Bibliometric Analysis and Critical Review.

The promotion of equity, diversity, and inclusion (EDI) is being increasingly pursued in health care, both in general and within radiation oncology. Because bibliometrics is a powerful tool to reveal the scientific literature on a specific topic during a certain timespan, a systematic bibliometric analysis of the documents published on EDI in radiation oncology was performed, aiming at exploring common patterns in research and emerging trends, tracking collaborations and networks, and anticipating future directions in clinical research. Standard descriptive statistics and bibliometric techniques were used in the analysis. A collaboration network and thematic map were generated from the data. Four domains were represented: (1) motor themes, including themes well developed and important for the structuring of the research field; (2) niche themes, representing the isolated topics that do not share important external links with other themes; (3) emerging themes, referring to still weakly developed topics; and (4) basic themes, including the essential topics. EDI in the profession of radiation oncology is essential to ensure that the workforce delivering radiation oncology care both draws from the full talent pool of human capital and delivers the highest quality science and clinical care to all patients. The burgeoning literature on EDI in radiation oncology suggests that a large and growing cohort of scholars within radiation oncology are dedicated to addressing these important challenges

Stereotactic Body Radiation Therapy and Abiraterone Acetate for Patients Affected by Oligometastatic Castrate-Resistant Prostate Cancer: A Randomized Phase II Trial (ARTO)

PURPOSEA RTO (clinical trials.gov identifier: NCT03449719) is a multicenter, phase II randomized clinical trial testing the benefit of adding stereotactic body radiation therapy (SBRT) to abiraterone acetate and prednisone (AAP) in patients with oligometastatic castrate-resistant prostate cancer (CRPC). materials and methods all patients were affected by oligometastatic CRPC as defined as three or less nonvisceral metastatic lesions. patients were randomly assigned 1:1 to receive either AAP alone (control arm) or AAP with concomitant SBRT to all the sites of disease (experimental arm). primary end point was the rate of biochemical response (BR), defined as a prostate-specific antigen (PSA) decrease >= 50% from baseline measured at 6 months from treatment start. complete BR (CBR), defined as PSA < 0.2 ng/mL at 6 months from treatment, and progression-free survival (PFS) were secondary end points. results one hundred and fifty-seven patients were enrolled between January 2019 and september 2022. BR was detected in 79.6% of patients (92% v 68.3% in the experimental v control arm, respectively), with an odds ratio (OR) of 5.34 (95% CI, 2.05 to 13.88; P = .001) in favor of the experimental arm. CBR was detected in 38.8% of patients (56% v 23.2% in the experimental v control arm, respectively), with an OR of 4.22 (95% CI, 2.12 to 8.38; P < .001). SBRT yielded a significant PFS improvement, with a hazard ratio for progression of 0.35 (95% CI, 0.21 to 0.57; P < .001) in the experimental versus control arm. conclusion the trial reached its primary end point of biochemical control and PFS, suggesting a clinical advantage for SBRT in addition to first-line AAP treatment in patients with metastatic castration-resistant prostate cancer