ALBERESE (GROSSETO), POGGIO DI SPACCASASSO. STATO DELL’ARTE DELLE RICERCHE DI ARCHEOLOGIA PREISTORICA

The paper describes the investigations undertaken at Spaccasasso, a hill placed in the Regional Park of Maremma (Alberese, GR). Excavations at the site uncovered a Copper Age cemetery on the plan facing the Spaccasasso shelter, and a Neolithic cinnabar mine. Layers attesting the extraction of cinnabar have been excavated under the funerary layers. Survey investigations on the NW slope of the hill have individuated other mining areas that can date also to later phases

Combining abiraterone and radiotherapy in metastatic castration-resistant prostate cancer: a review of current evidence

Prostate cancer is the second most frequent cancer worldwide, with a very high rate of progression despite treatment. The most aggressive form of the disease is known as castration-resistant prostate cancer, which carries a poor prognosis. We reviewed available literature regarding the combination of abiraterone acetate antihormonal drug and ablative radiation therapy for the treatment of metastatic castration-resistant prostate cancer. This dual treatment may enhance the effects of second-line hormonal therapy, as radiotherapy renders cancer cells more prone to immune-mediated cytotoxicity. Moreover, radiotherapy exerts its effect both on directly irradiated cells and on other distant tissues, with an abscopal effect, already demonstrated in other solid tumors. This combination treatment is safe and effective, with few adverse events. Moreover, it is of paramount importance in patients with oligoprogression of the primary disease, when current guidelines recommend continuing abiraterone treatment. Ablative radiation therapy is a noninvasive, nontoxic treatment with very high efficacy on local tumor growth control. In the available literature, the combination of radiation therapy and abiraterone acetate has prolonged both overall survival and progression-free survival, with a positive impact also on locoregional recurrence and distant metastases

Combining abiraterone and radiotherapy in metastatic castration-resistant prostate cancer: a review of current evidence

Prostate cancer is the second most frequent cancer worldwide, with a very high rate of progression despite treatment. The most aggressive form of the disease is known as castration-resistant prostate cancer, which carries a poor prognosis. We reviewed available literature regarding the combination of abiraterone acetate antihormonal drug and ablative radiation therapy for the treatment of metastatic castration-resistant prostate cancer. This dual treatment may enhance the effects of second-line hormonal therapy, as radiotherapy renders cancer cells more prone to immune-mediated cytotoxicity. Moreover, radiotherapy exerts its effect both on directly irradiated cells and on other distant tissues, with an abscopal effect, already demonstrated in other solid tumors. This combination treatment is safe and effective, with few adverse events. Moreover, it is of paramount importance in patients with oligoprogression of the primary disease, when current guidelines recommend continuing abiraterone treatment. Ablative radiation therapy is a noninvasive, nontoxic treatment with very high efficacy on local tumor growth control. In the available literature, the combination of radiation therapy and abiraterone acetate has prolonged both overall survival and progression-free survival, with a positive impact also on locoregional recurrence and distant metastases

SAFE trial: an ongoing randomized clinical study to assess the role of cardiotoxicity prevention in breast cancer patients treated with anthracyclines with or without trastuzumab

Over the years, thanks to the addition of new generation systemic agents, as well as the use of more advanced and precise radiotherapy techniques, it was able to obtain a high curability rate for breast cancer. Anthracyclines play a key role in the treatment of breast disease, with a well-known benefit on disease-free survival of patients with positive nodal status. Trastuzumab have shown a significant outcome advantage after 1-year administration in case of HER2-positive disease. Unfortunately, significant increase in cardiotoxicity has been observed after anthracyclines and trastuzumab therapies. Even though the cardiology and oncology community strongly recommend a cardiotoxicity prevention strategy for this subset of patients, there is still no consensus on the optimal patient’s approach. We aimed to review the published and ongoing researches on cardioprevention strategies and to present the SAFE trial (CT registry ID: NCT2236806; EudraCT number: 2015-000914-23). It is a randomized phase 3, four-arm, single-blind, placebo-controlled study that aims to evaluate the effect of bisoprolol, ramipril or both drugs, compared to placebo, on subclinical heart damage evaluated by speckle tracking cardiac ultrasound in non-metastatic breast cancer patients

Treatment of first tonic-clonic seizure does not affect mortality: long-term follow-up of a randomised clinical trial.

BACKGROUND: Information on the effects of early treatment of seizures on mortality is scarce. The authors assessed the survival of patients with a first generalised tonic-clonic seizure, randomised to immediate treatment (treated) versus treatment only in the event of seizure recurrence (untreated), over a 20-year period. METHODS: The authors followed 419 patients. The median follow-up was 19.7 years (range 0.2-21.5) for a total of 7867 person-years. RESULTS: 40 persons (9.6%) died during follow-up, 19 (8.9%) treated and 21 (10.3.%) untreated. The probability of surviving was 100% at 1 year, 97% (95% CI 95% to 99%) at 5 years, 94% (91-97) at 10 years and 91% (87-95) at 20 years in treated patients and 100%, 98% (95-100), 97% (94-99) and 89% (85-94), respectively, in untreated patients (p=0.7). After adjustment for treatment of first seizure and putative risk factors (gender, age, seizure type, previous uncertain seizures, family history of seizures, pre-, peri- and postnatal risk factors, remote aetiological factors for epilepsy, abnormal neurological examination, CT or MRI abnormalities, EEG abnormalities and acute treatment), only the presence of aetiological factors for epilepsy predicted a higher mortality (HR 3.4, 95% CI 2.5 to 4.3%; p<0.01). Patients with remote aetiological factors and who did not achieve 5-year remission had the poorest survival. CONCLUSION: Starting antiepileptic treatment immediately after the first generalised tonic-clonic seizure or only after seizure recurrence did not affect survival over the following 20 years