Modulation of 5-fluorouracil as adjuvant systemic chemotherapy in colorectal cancer: the IGCS-COL multicentre, randomised, phase III study

The aims of this multicentre, randomised phase III trial were to evaluate: ( 1) the role of levamisol (LEV); and ( 2) the role of folinic acid ( FA), added to 5-fluorouracil (5FU) in the adjuvant treatment of colorectal cancer. Patients with histologically proven, radically resected stage II or III colon or rectal cancer were eligible. The study had a 2 x 2 factorial design with four treatment arms: ( a) 5FU alone, (b) 5FU+LEV, ( c) 5FU+FA, ( d) 5FU+LEV+FA, and two planned comparisons, testing the role of LEV and of FA, respectively. From March 1991, to September 1998, 1327 patients were randomised. None of the two comparisons resulted in a significant disease-free (DFS) or overall (OAS) survival advantage. The hazard ratio (HR) of relapse was 0.89 (95% confidence intervals (CI): 0.73 - 1.09) for patients receiving FA and 0.99 ( 95% CI 0.80 - 1.21) for those receiving LEV; corresponding HRs of death were 1.02 ( 95% CI: 0.80 - 1.30) and 0.94 ( 95% CI 0.73 - 1.20). Nonhaematological toxicity ( all grade vomiting, diarrhoea, mucositis, congiuntivitis, skin, fever and fatigue) was significantly worse with FA, while all other toxicities were similar. In the present trial, there was no evidence that the addition of FA or LEV significantly prolongs DFS and OAS of radically resected colorectal cancer patients

A Geological Itinerary Through the Southern Apennine Thrust-Belt (Basilicata—Southern Italy)

Open access via Springer Compact AgreementPeer reviewedPublisher PD

Sediment-cement relationships in a Pleistocene speleothem from Italy: a possible analogue for "replacement" cements and Archeolitoporella in ancient reefs

Ancient carbonate buildups may contain extraordinarily large amounts of early diagenetic precipitates. In some, host rock lamination may be traced into inclusion bands within the ‘cement’ crystals, suggesting that the crystals are replacive. By analogy with a Pleistocene speleothem from the Sorrento Peninsula, however, these relationships can be explained differently. In the speleothem, large, repeatedly split and dendritic calcite crystals occur within a laminated carbonate. Lamination consists of sub-mm alternations of micrite and microspar. Micritic laminae pass laterally into inclusion-rich growth bands in the dendritic calcite crystals, and have replaced an aragonitic cement, whereas the microspar laminae were primary calcite cements. Three types of inclusion-rich bands occur in the dendrite crystals: (1) with aragonite relicts, (2) ‘ribbon calcite’ and (3) with oriented micropores. When aragonite precipitated, the calcite dendrite branches were unable to keep growing as single crystals and split into crystallites (separated by micropores, some forming ribbon calcite), whereas during episodes of calcite lamina precipitation, the larger crystals were regenerated by crystallite coalescence. Calcite crystals are primary: they did not replace a micritic precursor. By analogy with the Italian speleothem, some ancient reefal sparry carbonates may not be replacements of earlier laminated sediments, but may have grown concurrently with them. It is also probable that some ancient laminated sediments were instead sea-floor precipitates, and that stromatolites containing cross-cutting crystal fabrics, and the alternating micrite-microspar laminae typical of Archaeolithoporella, could be largely abiotic crystal growths