COVID-19 Outbreak and Cancer Radiotherapy Disruption in Lombardy, Northern Italy

none37nononeJereczek-Fossa B.A.; Palazzi M.F.; Soatti C.P.; Cazzaniga L.F.; Ivaldi G.B.; Pepa M.; Amadori M.; Antognoni P.; Arcangeli S.; Buffoli A.; Beltramo G.; Berlinghieri S.; Bignardi M.; Bracelli S.; Bruschieri L.; Castiglioni S.; Catalano G.; Di Muzio N.; Fallai C.; Fariselli L.; Filippi A.R.; Gramaglia A.; Italia C.; Lombardi F.; Magrini S.M.; Nava S.; Orlandi E.; Pasinetti N.; Sbicego E.L.; Scandolaro L.; Scorsetti M.; Stiglich F.; Tonoli S.; Tortini R.; Valdagni R.; Vavassori V.; Marvaso G.Jereczek-Fossa, B. A.; Palazzi, M. F.; Soatti, C. P.; Cazzaniga, L. F.; Ivaldi, G. B.; Pepa, M.; Amadori, M.; Antognoni, P.; Arcangeli, S.; Buffoli, A.; Beltramo, G.; Berlinghieri, S.; Bignardi, M.; Bracelli, S.; Bruschieri, L.; Castiglioni, S.; Catalano, G.; Di Muzio, N.; Fallai, C.; Fariselli, L.; Filippi, A. R.; Gramaglia, A.; Italia, C.; Lombardi, F.; Magrini, S. M.; Nava, S.; Orlandi, E.; Pasinetti, N.; Sbicego, E. L.; Scandolaro, L.; Scorsetti, M.; Stiglich, F.; Tonoli, S.; Tortini, R.; Valdagni, R.; Vavassori, V.; Marvaso, G

The effect of dietary coconut oil on reproductive traits and egg fatty acid composition in rainbow trout (Oncorhynchus mykiss)

Two hundred and twenty rainbow trouts (IBW: 700 g) were randomly allotted to four tanks, with a male/female ratio of 0.56. Fish were fed for 168 d with four experimental diets containing herring oil, cod liver oil and coconut oil with the following inclusion rates: diet A: 12-1-0% respectively; diet B: 6-1-6%; diet C: 0-1-12%; diet D: 0-0-13%. Irrespective of the dietary treatment, weight gains of broodstocks were high (> 3 g/d) and FCR below 2. No significant difference was observed concerning the total amount of eggs spawn, egg average weight (82.5 mg/egg) and lipid content (5.4 mg/egg). However, the fatty acid profile of eggs was significantly affected by the dietary treatments. The content of unsaturated fatty acids, particularly the n-3 fatty acid series (EPA and DHA) significantly decreased with increasing levels of coconut oil in the diet

. The effects of coconut oil on reproductive traits and fatty acid eggcomposition of rainbow Oncorhynchus mykiss, Walbaum)

Two hundred and twenty rainbow trouts (IBW: 700 g) were randomly allotted to four tanks, with a male/female ratio of 0.56. Fish were fed for 168 d with four experimental diets containing herring oil, cod liver oil and coconut oil with the following inclusion rates: diet A: 12-1-0% respectively; diet B: 6-1-6%; diet C: 0-1-12%; diet D: 0-0-13%. Irrespective of the dietary treatment, weight gains of broodstocks were high (> 3 g/d) and FCR below 2. No significant difference was observed concerning the total amount of eggs spawn, egg average weight (82.5 mg/egg) and lipid content (5.4 mg/egg). However, the fatty acid profile of eggs was significantly affected by the dietary treatments. The content of unsaturated fatty acids, particularly the n-3 fatty acid series (EPA and DHA) significantly decreased with increasing levels of coconut oil in the diet

Urinary bladder preservation for muscle-invasive bladder cancer: a survey among radiation oncologists of Lombardy, Italy

Aims and background: Bladder preservation is a treatment option in muscle-invasive bladder carcinoma. The most investigated approach is a trimodality schedule including maximum transurethral resection of bladder tumor (TURBT) followed by chemoradiotherapy. Our aim was to evaluate the use of bladder preservation by radiation oncologists of the Lombardy region in Italy. Methods and study design: A survey with 13 items regarding data of 2012 was sent to all 32 radiotherapy centers within the collaboration between the Lombardy Oncological Network and the Lombardy Section of the Italian Society of Oncological Radiotherapy. Results: Thirteen centers (41%) answered the survey; the presented data come from 11 active centers. In these centers, 11,748 patients were treated with external-beam radiotherapy in 2012, 100 of whom having bladder cancer (0.9%). 74/100 patients received radiotherapy as palliative treatment for T, N or M lesions. A further 9 and 5 patients received radiotherapy for oligometastatic disease (ablative doses to small volumes) and postoperatively, respectively. Bladder preservation was performed in 12 cases and included trimodality and other strategies (mainly TURBT followed by radiotherapy). A multidisciplinary urology tumor board met regularly in 5 of 11 centers. All responders declared their interest in the Lombardy multicenter collaboration on bladder preservation. Conclusions: Our survey showed that bladder preservation is rarely used in Lombardy despite the availability of the latest radiotherapy technologies and the presence of an urology tumor board in half of the centers. The initiative of multicenter and multidisciplinary collaboration was undertaken to prepare the platform for bladder preservation as a treatment option in selected patients

Equipment, staffing, and provision of radiotherapy in Lombardy, Italy: Results of three surveys performed between 2012 and 2016

Introduction: Several efforts are being implemented at the European level to measure provision of up-to-date radiation treatments across the continent. Methods: A snapshot survey involving all radiation oncology centers within Lombardy, Italy, was performed in 2012 and repeated in 2014 and 2016, in cooperation with regional governmental officers. Centers were asked to provide detailed information concerning all individual patients being treated on the index day, and to report data on available local resources. Results: We observed an increase in the number of centers and of megavoltage units (MVU) (from 76 to 87, i.e., 8.7 MVU per million inhabitants in 2016). Mean number of MVU per center was 2.5. Average age of MVU increased from 5.3 to 7.5 years and patients on the waiting list also increased. Conformal 3D radiotherapy (RT) treatments decreased from 56% to 42% and were progressively replaced by intensity-modulated RT treatments (from 39% to 49%). Waiting times were overall satisfactory. Radiation oncologists treated on average 152 and radiation therapists 100 RT courses per year. Average reimbursement per course was €4,879 (range €2,476-€8,014). Conclusions: The methodology of snapshot survey proved feasible and provided valuable information about radiation oncology provision and accessibility in Lombardy

Back to (new) normality—A CODRAL/AIRO-L survey on cancer radiotherapy in Lombardy during Italian COVID-19 phase 2

Background: Italy experienced one of the world’s severest COVID-19 outbreak, with Lombardy being the most afflicted region. However, the imposed safety measures allowed to flatten the epidemic curve and hence to ease the restrictions and inaugurate, on the 4th of May 2020, the Italian phase (P) 2 of the pandemic. The present survey study, endorsed by CODRAL and AIRO-L, aimed to assess how radiotherapy (RT) departments in Lombardy have dealt with the recovery. Materials and methods: A questionnaire dealing with the management of pandemic was developed online and sent to all CODRAL Directors on the 10th of June 2020. Answers were collected in full anonymity one week after. Results: All the 33 contacted RT facilities (100%) responded to the survey. Despite the scale of the pandemic, during P1 14 (42.4%) centres managed to safely continue the activity (≤ 10% reduction). During P2, 10 (30.3%) centres fully recovered and 14 (42.4%) reported an increase. Nonetheless, 6 (18.2%) declared no changes and, interestingly, 3 (9.1%) reduced activities. Overall, 21 centres (63.6%) reported suspected or positive cases within healthcare workforce since the beginning of the pandemic. Staff units were quarantined in 19 (57.6%) and 6 (18.2%) centres throughout P1 and P2, respectively. In the two phases, about two thirds centres registered positive or suspected cases amongst patients. Conclusion: The study revealed a particular attention to anti-contagion measures and a return to normal or even higher clinical workload in most RT centres in Lombardy, necessary to carry out current and previously deferred treatments