Is CT-based body composition associated with long-term chemotherapy-induced peripheral neuropathy in colorectal cancer survivors?

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect among colorectal cancer (CRC) survivors, and the severity is mainly dependent on the chemotherapy dose. Nowadays, chemotherapy dose is based on body surface area, while determination based on more accurate measures of body composition may be better. This study aimed to investigate the association between body composition and long-term CIPN among CRC survivors 2–11 years after diagnosis. METHODS: Data from CRC survivors from the population-based PROFILES registry were used. Survivors were included when they received chemotherapy, filled in the EORTC QLQ-CIPN20, and had a computed tomography (CT) scan at diagnosis (n = 202). Total, sensory, motor, and autonomic CIPN were based upon the EORTC QLQ-CIPN20. The abdominal CT scans were used to determine skeletal muscle index (SMI), skeletal muscle density (SMD), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and total adipose tissue (TAT). Logistic regression was used to analyze the association between CIPN outcomes and body composition variables. RESULTS: CIPN was experienced by 64% of the CRC survivors several years after chemotherapy. More SAT was associated with a higher odds of reporting total CIPN (OR = 1.01 95% CI 1.00–1.01, p = 0.01), motor CIPN (OR = 1.01 95% CI 1.00–1.01, p = 0.01), and sensory CIPN (OR = 1.01 95% CI 1.00–1.01, p = 0.04). No associations of other body composition parameters with CIPN were observed. CONCLUSION: Only SAT was associated with total, motor, and sensory CIPN. Based on these results, we cannot conclude that determining the chemotherapy dose based on body composition is preferred over determining the chemotherapy dose based on body surface to prevent CIPN. More research is needed to assess associations of body composition with CIPN, a common side effect of chemotherapy

Ecological management of cereal stemborers in African smallholder agriculture through behavioural manipulation

1. Africa faces serious challenges in feeding its rapidly growing human population owing to the poor productivity of maize and sorghum, the most important staple crops formillions of smallholder farmers in the continent,with yields being among the lowest in the world. 2. A complex of lepidopterous stemborers attack cereals in Africa. However, their effective control is difficult, largely as a result of the cryptic and nocturnal habits of moths, and protection provided by host stem for immature pest stages.Moreover, current control measures are uneconomical and impractical for resource-poor farmers. 3. An ecological approach, based on companion planting, known as ‘push–pull’, provides effective management of these pests, and involves combined use of inter- and trap cropping systems where stemborers are attracted and trapped on trap plants with added economic value (‘pull’), and are driven away from the cereal crop by antagonistic intercrops (‘push’). 4. Novel defence strategies inducible by stemborer oviposition have recently been discovered, leading to the attraction of egg and larval parasitoids, in locally adapted maize lines but not in elite hybrids. We also established that landscape complexity did not improve the ecosystem service of biological control, but rather provided a disservice by acting as a ‘source’ of stemborer pests colonising the crop. 5. Here we review and provide new data on the direct and indirect effects of the push–pull approach on stemborers and their natural enemies, including the mechanisms involved, and highlight opportunities for exploiting intrinsic plant defences and natural ecosystem services in pest management in smallholder farming systems in Africa

IMPACT OF SOLAR RADIATION, RAINFALL AND CANNIBALISM ON DISAPPEARANCE OF MAIZE STEMBORERS IN KENYA

The effect of solar radiation, rainfall and cannibalism on the disappearance of eggs and larvae of the cereal stemborer Chilo partellus (Swinhoe) were studied. Disappearance and nonviability of egg batches was higher on plants exposed to solar radiation than on shaded plants. Significantly fewer small larvae were recovered from plants exposed to rainfall than from shielded plants. Cannibalism among larvae of the same size was not common except at high larval densities. Contrary to the common belief that disappearance is the result of predation, these studies show that solar radiation and rainfall might also play an important role in the disappearance of stemborer eggs and small larvae. RÉSUMÉ Les effets des radiations solaires, de la pluie et du cannibalisme sur la disparition des oeufs et des larves du foreur des tiges de céréale Chilo partellus (Swinhoe) ont été étudiés. La disparition et la non-viabilité des pontes sont plus importantes sur les plantes exposées aux radiations solaires que sur celles situées à l'ombre. Le nombre de jeunes larves retrouvées sur les plantes exposées aux pluies est significativement plus faible que sur les plantes protégées. Le cannibalisme entre les larves de même taille n'est pas commun sauf si les densités de larves sont élevées. Contrairement à ce qui est communément admis, à savoir que la disparition est le résultat de la prédation, ces études montrent que les radiations solaires et la pluie peuvent aussi jouer un rôle important dans la disparition des oeufs et des jeunes larves de foreurs des tiges

Farmers perceptions of importance, control methods and natural enemies of maize stemborers at the Kenya coast

A survey among 240 resource-poor farmers at the Kenya coast indicated that insect pests were considered to be the main production constraint. Over 70% of respondents mentioned stemborers to be the most important insect pest. Unlike the eggs and adults, stemborer larvae and pupae were frequently seen by farmers. Alternative gramineous host plants for pests were common near maize fields and were often not destroyed until after the first rains. Nearly all farmers left dry stems and stubble in the field after harvest. Farmers knew of many methods for controlling stemborers, but only 32 and 56% of farmers in Kilifi and Kwale Districts, respectively, used any of the methods. Chemical control was the most popular control method, being applied regularly by 19 and 38% of farmers in Kilifi and Kwale Districts, respectively. Traditional methods and cultural control methods were seldom used. Approximately 50% of farmers had heard of beneficial insects, with farmers collectively mentioning 17 predators of stemborers. Cocoons of the parasitoids Cotesia flavipes, released in a biological control programme in the study area in 1993, and the indigenous Cotesia sesamiae had been seen by 33% of respondents, but none knew what these were. The results of the present study stress the need to educate farmers about the biology and ecology of stemborers and the role of natural enemies. Also, after effective control methods suitable for resource-poor farmers have been identified, both groups should be trained in pest management methods, for example through the Farmers Field School approach. RÉSUMÉ Une enquête couvrant 240 fermiers de la côte du Kenya a montré que les insectes ravageurs sont considérés comme les principaux facteurs limitants la production. Plus de 79% des personnes intérrogées ont cité les foreurs de tiges comme les insectes ravageurs les plus importants. Les fermiers ont fréquemment observé les larves et les pupes des foreurs de tiges et très peu les oeufs et les adults. D'autres graminés, plantes hôtes secondaires des foreurs de tiges, ont souvent été observées près des champs de maïs, et ces plantes n'étaient détruites qu'après les premières pluies. Presque tous les fermiers ont laissé des tiges séchées et des chaumes dans leurs champs après les récoltes. Les fermiers connaissaient plusieurs méthodes de lutte, toutefois, 32 et 56% seulement de fermiers dans les districts de Kilifi et Kwale, respectivement, ont utilisé l'une de ces méthodes. La lutte chimique était la plus fréquement utilisée. Elle était pratiquée régulièrement par 19 et 38% des fermiers des districts de Kilifi et de Kwale, respectivement. Les méthodes de luttes traditionelles et cuturales étaient très peu utilisées. Une cinquantaine de fermiers ont entendu parlé d'insectes bénéfiques. Les fermiers ont cité 17 prédateurs des foreurs de tiges. Les cocons du parasitoid, Cotesia flavipes qui a été lâché dans la région en 1993 lors d'un programme de lutte biologique, et ceux du parasitoid local, Cotesia sesamiae ont déjà été observés par 33% des fermiers mais aucun ne savait ce que c'était. Les résultats de cette étude souligne le besoin d'éduquer les paysans sur la biologie et l'écologie des foreurs de tiges ainsi que sur le rôle de leurs ennemis naturels. Aussi, lorsque des méthodes de luttes efficaces adaptées aux fermiers aux revenus faibles, sont identifiées, les paysans devraient être formés. Cette formation pourrait ce faire à travers "les écoles de fermiers"

Is CT-based body composition associated with long-term chemotherapy-induced peripheral neuropathy in colorectal cancer survivors?

Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect among colorectal cancer (CRC) survivors, and the severity is mainly dependent on the chemotherapy dose. Nowadays, chemotherapy dose is based on body surface area, while determination based on more accurate measures of body composition may be better. This study aimed to investigate the association between body composition and long-term CIPN among CRC survivors 2–11 years after diagnosis. Methods Data from CRC survivors from the population-based PROFILES registry were used. Survivors were included when they received chemotherapy, filled in the EORTC QLQ-CIPN20, and had a computed tomography (CT) scan at diagnosis (n = 202). Total, sensory, motor, and autonomic CIPN were based upon the EORTC QLQ-CIPN20. The abdominal CT scans were used to determine skeletal muscle index (SMI), skeletal muscle density (SMD), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and total adipose tissue (TAT). Logistic regression was used to analyze the association between CIPN outcomes and body composition variables. Results CIPN was experienced by 64% of the CRC survivors several years after chemotherapy. More SAT was associated with a higher odds of reporting total CIPN (OR = 1.01 95% CI 1.00–1.01, p = 0.01), motor CIPN (OR = 1.01 95% CI 1.00–1.01, p = 0.01), and sensory CIPN (OR = 1.01 95% CI 1.00–1.01, p = 0.04). No associations of other body composition parameters with CIPN were observed. Conclusion Only SAT was associated with total, motor, and sensory CIPN. Based on these results, we cannot conclude that determining the chemotherapy dose based on body composition is preferred over determining the chemotherapy dose based on body surface to prevent CIPN. More research is needed to assess associations of body composition with CIPN, a common side effect of chemotherapy

Perioperative Systemic Therapy Versus Cytoreductive Surgery and HIPEC Alone for Resectable Colorectal Peritoneal Metastases: Patient-Reported Outcomes of a Randomized Phase II Trial

BackgroundAs part of a randomized phase II trial in patients with isolated resectable colorectal peritoneal metastases (CPMs), the present study compared patient-reported outcomes (PROs) of patients treated with perioperative systemic therapy versus cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) alone. Also, PROs of patients receiving perioperative systemic therapy were explored.Patients and MethodsEligible patients were randomized to perioperative systemic therapy (experimental) or CRS-HIPEC alone (control). PROs were assessed using EORTC QLQ-C30, QLQ-CR29, and EQ-5D-5L questionnaires at baseline, after neoadjuvant treatment (experimental), and at 3 and 6 months postoperatively. Linear mixed modeling was used to compare five predefined PROs (visual analog scale, global health status, physical functioning, fatigue, C30 summary score) between arms and to longitudinally analyze PROs in the experimental arm.ResultsOf 79 analyzed patients, 37 (47%) received perioperative systemic therapy. All predefined PROs were comparable between arms at all timepoints and returned to baseline at 3 or 6 months postoperatively. The experimental arm had worsening of fatigue [mean difference (MD) + 14, p = 0.001], loss of appetite (MD + 15, p = 0.003), hair loss (MD + 18, p < 0.001), and loss of taste (MD + 27, p < 0.001) after neoadjuvant treatment. Except for loss of appetite, these PROs returned to baseline at 3 or 6 months postoperatively.ConclusionsIn patients with resectable CPM randomized to perioperative systemic therapy or CRS-HIPEC alone, PROs were comparable between arms and returned to baseline postoperatively. Together with the trial's previously reported feasibility and safety data, these findings show acceptable tolerability of perioperative systemic therapy in this setting