Treatment of osteolytic solitary painful osseous metastases with radiofrequency ablation or cryoablation: a retrospective study by propensity analysis

The present study aimed to measure the improvement in pain relief and quality of life in patients with osteolytic solitary painful bone metastasis treated by cryoablation (CA) or radiofrequency ablation (RFA). Fifty patients with solitary osteolytic painful bone metastases were retrospectively studied and selected by propensity analysis. Twenty-five patients underwent CA and the remaining twenty-five underwent RFA. Pain relief, in terms of complete response (CR), the number of patients requiring analgesia and the changes in self-rated quality of life (QoL) were measured following the two treatments. Thirty-two percent of patients treated by CA experienced a CR at 12 weeks versus 20% of patients treated by RFA. The rate of CR increased significantly with respect to baseline only in the group treated by CA. In both groups there was a significant change in the partial response with respect to baseline (36% in the CA group vs. 44% in the RFA group). The recurrence rate in the CA and RFA groups was 12% and 8%, respectively. The reduction in narcotic medication requirements with respect to baseline was only significant in the group treated by CA. A significant improvement in self-rated QoL was observed in both groups. The present study seems to suggest that CA only significantly improves the rate of CR and decreases the requirement of narcotic medications. Both CA and RFA led to an improvement in the self-rated QoL of patients after the treatments. However, the results of the present study should be considered as preliminary and to serve as a framework around which future trials may be designed

Treatment of Solitary Painful Osseous Metastases with Radiotherapy, Cryoablation or Combined Therapy: Propensity Matching Analysis in 175 Patients

aim of this study was to identify outcomes in pain relief and quality of life in patients with a solitary painful osseous metastasis treated by radiotherapy, cryoablation or the combination using a propensity score matching study design

The Lower Miocene volcaniclastic sedimentation in the Sicilian sector of the Maghrebian Flysch Basin: geodynamic implications

Abstract Volcaniclastic debris-rich formations, characterising the Troina–Tusa Unit in the Sicilian Maghrebian Chain, are examined. The Troina–Tusa Unit terrains sedimented in the Maghrebian Flysch Basin, which, from Jurassic to Early Miocene, constituted the southernmost branch of the Western Tethys, located between Africa and the Mesomediterranean Terrane margins. New field, biostratigraphic and petrographic data enable a reconstruction of the palaeogeographic and structural evolution of the Flysch Basin immediately before its deformation. All the studied formations transpired to be Burdigalian in age. The sandstone compositions, showing different source areas (magmatic arc, recycled orogen and continental block), indicate a provenance for the clastic material from a crystalline basement with an active volcanic arc, replaced by a remnant volcanic arc, which was rapidly completely eroded. The source area that has been considered is Sardinia, where Upper Oligocene–Aquitanian calc-alkaline volcanites are widespread, but the sedimentological characteristics and the Burdigalian age do not fit with this provenance. The Burdigalian calc-alkaline arc should be located on the internal side of the Troina–Tusa Basin, above the already stacked Peloritanian units. A migration of the volcanic activity, connected with the subduction plain roll-back, can be envisaged from the Sardinia Block to the Peloritanian Chain, this latter still docked to the Sardinia–Corsica massif

Radiotherapy at oligoprogression for metastatic castration-resistant prostate cancer patients: a multi-institutional analysis

Purpose To retrospectively estimate the impact of radiotherapy as a progression-directed therapy (PDT) in oligoprogressive metastatic castration-resistant prostate cancer (mCRPC) patients under androgen receptor-target therapy (ARTT). Materials and methods mCRPC patients are treated with PDT. End-points were time to next-line systemic treatment (NEST), radiological progression-free survival (r-PFS) and overall survival (OS). Toxicity was registered according to Common Terminology Criteria for Adverse Events v4.0. Survival analysis was performed using the Kaplan-Meier method; univariate and multivariate analyses were performed. Results Fifty-seven patients were analyzed. The median follow-up after PDT was 25.2 months (interquartile, 17.1-44.5). One-year NEST-free survival, r-PFS and OS were 49.8%, 50.4% and 82.1%, respectively. At multivariate analysis, polymetastatic condition at diagnosis of metastatic hormone-sensitive prostate cancer (mHSPC) (HR 2.82, p = 0.004) and PSA doubling time at diagnosis of mCRPC (HR 2.76, p = 0.006) were associated with NEST-free survival. The same variables were associated with r-PFS (HR 2.32, p = 0.021; HR 2.24, p = 0.021). One patient developed late grade >= 2 toxicity. Conclusion Our study shows that radiotherapy in oligoprogressive mCRPC is safe, is effective and seems to prolong the efficacy of ARTT in patients who otherwise would have gone systemic treatment switch, positively affecting disease progression. Prospective trials are needed

The Poggio del Carnaio Sandstones: age, petrography and importance for the reconstruction of the Northern Apennines evolution.

none5noneDI STASO A; S. PERROTTA; GUERRERA F; PERRONE V; TRAMONTANA MDI STASO, A; Perrotta, S.; Guerrera, F; Perrone, V; Tramontana, M

New biostratigraphic and petrographic data from the Poggio Carnaio Sandstone Fm (Val Marecchia Nappe): insights into the tectonic evolution of the Northern Apennines.

In the Northern Apennines, the Poggio Carnaio Sandstone Formation consists of sandy-clayey turbidites, cropping out in the northernmost corner of the Val Marecchia Nappe. The formation has been considered Oligocene in age and is commonly interpreted as an Epiligurian unit, unconformably deposited above the Val Marecchia Nappe during its transport towards the Adriatic foreland. The Poggio Carnaio Sandstone Fm rests on the Argille Varicolori Fm of the Val Marecchia Nappe, but field data do not allow it to be recognized wherever it abruptly replaces the pelagic sediments of the Argille Varicolori Fm, thus testifying to the foredeep evolution of the basin, or where it unconformably overlies this latter formation. Nannofossil assemblages are characterized by abundant reworked Cretaceous and Paleogene taxa and by some taxa, whose first occurrence is reported in the upper part of the NN4 Zone = upper part of the CN3 Zone. Therefore the formation must be considered not older than Langhian. Detrital modes of arenites revealed a quartz-feldspathic composition and the lithic component includes mainly metamorphic fragments and minor plutonic, sedimentary, ophiolithic and volcanic clasts. The presence of clasts of garnet, sillimanite, hornblende and glaucophane is significant. Biostratigraphic as well as petrographic data agree with the interpretation of the Poggio Carnaio Sandstone Fm as an Epiligurian succession. Rock fragments indicate source areas characterized by Ligurian-, Pennidic- and Australpine-type units. Sedimentary facies and textural features of arenites, revealing a rapid erosion and deposition of clasts in a basin close to the source area of the clastic supply, indicate that the Alps cannot be considered as the source area of these arenites, as frequently argued for many North-Apennine clastic formations. Ligurian-, Pennidic- and Australpine-type units were located close to the Poggio Carnaio Sandstone basin, probably representing the geometrically highest units of the Palaeo-Apennine Chain

The age of the oceanic accretionary wedge and onset of continental collision in the Sicilian Maghrebian Chain.

New biostratigraphic data from the formations unconformably lying above the tectonic units resulting from the Flysch Basin Domain (FBD) in the Sicilian Maghrebids are here reported. The FBD constituted a southern branch of the western Tethys, separating during the Jurassic to Paleogene a Mesomediterranean Microplate from the African Plate. The age of the youngest sediments involved in the nappes and that of the unconformable terrains deposited in thrust-top basins on these tectonic units, allow to define both the age of deformation of the oceanic realm and the onset of the continental collision. The deformation migrated from internal to external areas of FBD starting from the latest Burdigalian-Langhian to Serravallian. Therefore, the previously proposed Eocene-Oligocene mesoalpine deformation of the Maghrebian FBD cannot be supported. The continental collision started during the Serravallian and it was accomplished in the late Tortonian, when clastic deposits sealed the boundaries of the tectonic units originated from all the paleogeographic domains of the Maghrebian Chain. The steps of the tectonic evolution in the Sicilian Maghrebids are now very well constrained and the proposed tectonic evolution may be extended to the whole Maghrebian Chain, as far as to the western Betic Cordilleras and to the southern Apennines, where most of the tectonic events show highly similar features and ages

Stratigraphy and tectonics of an Internal Unit of the southern Apennines: implications for the geodynamic evolution of the peri-Tyrrhenian mountain belt

The Parasicilide succession is a key element of the southern Apennine orogen, being originally located in the distal portion of the Apulian palaeomargin, at the Neotethys ocean-continent transition. The succession, presently included in the upper nappe complex of the thrust belt, has been described elsewhere as a `broken formation'. However, detailed investigations carried out in the Sele Valley point out that there the Parasicilide Unit is characterized by a coherent stratigraphy. Therefore, in the study area, these rocks form a coherent sheet of distal continental margin/oceanic sedimentary cover material included within the peri-Tyrrhenian mountain belt. Stratigraphic and structural constraints obtained from both pre-and syn-orogenic deposits - the latter including both foredeep and thrust-top basin sediments - suggest that the pre-orogenic part of the Parasicilide succession subsided into the Apennine foredeep in the first part of the Burdigalian. The studied rocks were then involved in thrusting prior to late Burdigalian/early Langhian times

New data about the Piedimonte Formation (Monte Soro Unit): insights and constraints to the geodynamic evolution of the Sicilian Maghrebids.

A detailed study of the siliciclastic Piedimonte Fm (Sicilian Maghrebids), cropping out in north-eastern Sicily, between the Peloritani Mts. and the Etna Mt., has been carried out. The formation is tectonically covered by the Stilo-Capo d’Orlando Fm, which constitutes a siliciclastic succession unconformable above all the Internal Units of the Sicilian Maghrebids. The Piedimonte Fm resulted younger than the age previously considered in literature, being not older than late Oligocene (Late Chattian) at the base, and not older than early Miocene (Aquitanian) in the upper part. The Piedimonte Fm stratigraphically lies above the Variegated Clays Fm that, in turn, stratigraphically rests above the Monte Soro Fm. Therefore, the Piedimonte Fm constitutes the uppermost part of the Monte Soro Unit, which is re-defined in the present paper and which, from a paleogeographic point of view, is to ascribe to the innermost part (Mauretanian sub-domain) of the Maghrebian Flysch Domain. According to these results, the main phase of deformation of the most internal sector of the Sicilian Maghrebian Flysch Domain occurred not before than Aquitanian, in agreement with the Burdigalian age recognised in more external units