Mineralizzazione ossea e composizione corporea a 2, 5 e 7 anni dallo stop terapeutico in soggetti con pregresso tumore cerebrale in et\ue0 pediatrica

Background e obiettivi: Numerosi fattori di rischio influenzano la massa ossea nei sopravvissuti da tumore cerebrale pediatrico (CBCS), ma il loro impatto sulla densit\ue0 minerale ossea (BMD) e il potenziale recupero della massa ossea nel tempo non \ue8 ancora chiaro. Scopo dello studio \ue8 valutare la massa ossea, i suoi determinanti e la prevalenza di fratture nei CBCS dopo 2 (G+2), 5 (G+5) o 7 (G+7) anni dall\u2019off-therapy (OT). Metodi: 74(F=37, M=37, et\ue0 12,9\ub14,2anni), 95 (F=42, M=53, et\ue0 14,8\ub14,3 anni) e 77 (F=35, M=42, et\ue0 16,6\ub14,2 anni) CBCS sono stati valutati trasversalmente rispettivamente a G+2, G+5 e G+7. Le diagnosi erano: tumori astrocitari (G+2:n=25, G+5:n=29, G+7:n=25), embrionali (G+2:n=20, G+5:n=29, G+7:n=22), sellari (G+2:n=13, G+5:n=12, G+7:n=10), a cellule germinali (G+2:n=13, G+5:n=18, G+7:n=14), ependimali (G+2:n=3, G+5:n=7, G+7:n=6). La radioterapia era stata effettuata in 61, 85 e 70 pazienti (G+2, G+5 e G+7) e, in modo omogeneo nei 3 gruppi, il 44% dei pazienti irradiati erano stati sottoposti a radioterapia cranio-spinale (CSRT). Quaranta (G+2), n=69 (G+5) e n=55 (G+7) erano affetti da GHD, mentre n=15 (G+2), n=28 (G+5) e n=27 (G+5) da ipogonadismo. I pazienti sono stati valutati per altezza (cm, SDS), BMI (kg/m2, SDS), stadio puberale (Tanner) e, mediante DXA (LunarProdigy, GE), per densit\ue0 minerale ossea (BMD, g/cm2 e Z-score e BMD apparente-BMAD, g/cm3), contenuto minerale osseo (BMC,g) al rachide (L1\u2013L4=L) e al corpo intero (TB); da quest\u2019ultimo sono state derivate massa grassa (FM, % e Kg) e magra (LM, Kg). Risultati: Non vi era alcuna differenza tra i sessi e alle tre valutazioni in et\ue0 alla diagnosi, all\u2019OT, altezza, BMI, stadio di Tanner, numero di fratture. Una LBMD Z-score<-2 si riscontrava nel 18,9%, 11,6% e 16,4% (G+2vsG+5vsG+7) mentre una TBBMD Z-score<-2 nel 14,1%, 11,7% e 10,7% (G+2vsG+5vsG+7). Il gruppo G+7 confrontato con G+2 e G+5 mostrava significativamente migliore LBMD (p<0,0001 e p<0,005 rispettivamente per G+2 e G+5), BMAD (p<0,05), TBBMD (p<0,05 per G+2), LBMC (p<0,0001 per G+2) e TBBMC (p<0,05 per G+2, significativamente maggiore nei maschi); LBMD Z-score e TBBMD Z-score in G+7 erano maggiori rispetto a G+2 e G+5, anche se in modo non significativo. Soggetti sottoposti a CSRT presentavano TBBMD Z-score ridotta, in modo significativo in G+5 e G+7 (p=0,007 e 0,02); non differenze riguardo LBMD. Pazienti GHD o con ipogonadismo a G+2 mostravano ridotta LBMD Z-score (p=0,02 e p=0,001) e TBBMD Z-score (p=0,01 e p=0,065). Con analisi multivariata, la LBMD Z-score risultava predetta dall\u2019altezza e dalla condizione di ipogonadismo in G+2 e inversamente dall\u2019et\ue0 all\u2019OT nei 3 gruppi (R2=0,4); il TBBMD Z-score predetto direttamente dalla LM nei 3 gruppi e inversamente dall\u2019et\ue0 all\u2019OT nei 3 gruppi (R2=0,5), dopo correzione per numero di deficit ormonali, altezza SDS e FM. Il 6,8% (n=5/74) di G+2, il 2,1% (n=2/95) di G+5 e il 2,6% (n=2/77) di G+7 aveva presentato fratture. Conclusioni: Nella nostra popolazione pediatrica con storia di tumore cerebrale \ue8 stata rilevata un\u2019alta prevalenza di densit\ue0 minerale ossea ridotta, che interessava circa il 40% dei soggetti analizzati. Pazienti affetti da bassa statura, GHD e ipogonadismo sono risultati a rischio di ridotta massa ossea in particolare dopo 2 anni dall\u2019off therapy, che persiste anche a distanza di 5 e 7 anni; tuttavia, la prevalenza di frattura rimane bassa

Stereotactic ablative radiotherapy for oligometastatic prostate cancer

Background: The present study assessed clinical outcomes of stereotactic body radiotherapy (SBRT) in oligometastatic prostate cancer patients. Materials and methods: Between 2017 and 2020, 37 lesions (12 osseous and 25 nodal targets) detected with conventional and/or functional imaging, were treated in 29 patients (pts), in different clinical settings: de novo oligometastatic (2 pts), oligorecurrent castration-sensitive (19 pts), castration-resistant (6 pts) prostate cancers and oligoprogressive disease during systemic therapy (2 pts). SBRT was delivered with volumetric modulated arc therapy up to a total dose of 21 Gy given in 3 fractions for bone and 30 Gy in 5 fractions for nodal metastases. A total of 34% of pts received hormonal therapy. We evaluated biochemical control [prostate serum antigen (PSA) increase grade 2 was reported. Conclusions: SBRT for oligometastatic prostate cancer offers a good biochemical/local control and tangible delay of hormone/systemic therapy without major toxicities

Stereotactic ablative radiotherapy for oligometastatic prostate cancer

Background: The present study assessed clinical outcomes of stereotactic body radiotherapy (SBRT) in oligometastatic prostate cancer patients. Materials and methods: Between 2017 and 2020, 37 lesions (12 osseous and 25 nodal targets) detected with conventional and/or functional imaging, were treated in 29 patients (pts), in different clinical settings: de novo oligometastatic (2 pts), oligorecurrent castration-sensitive (19 pts), castration-resistant (6 pts) prostate cancers and oligoprogressive disease during systemic therapy (2 pts). SBRT was delivered with volumetric modulated arc therapy up to a total dose of 21 Gy given in 3 fractions for bone and 30 Gy in 5 fractions for nodal metastases. A total of 34% of pts received hormonal therapy. We evaluated biochemical control [prostate serum antigen (PSA) increase < 10%)], progression free-survival (PFS) (time from SBRT to biochemical progression), local control (LC) (time from SBRT to in-field radiologic progression), hormone/systemic therapy-free survival, acute and late toxicities. Results: At 3 months, biochemical response was observed in 20/29 pts (69%). At a median follow-up of 17 months (range 6-33), 8/20 (40%) of the 3-month responders remained free from progression. Two-year PFS and LC were 37% and 70%, respectively. In-field progression occurred in 3/37 (8%) lesions. Hormone/systemic therapy was delayed by an average of 11.6 months (range 3–28). No significant difference in PFS based on the type of lesion or concomitant endocrine therapy was observed and no toxicity > grade 2 was reported. Conclusions: SBRT for oligometastatic prostate cancer offers a good biochemical/local control and tangible delay of hormone/systemic therapy without major toxicities

Accuracy and limitations of the growth hormone (GH) releasing hormone-arginine retesting in young adults with childhood-onset GH deficiency

Background: Re-testing for GH secretion is needed to confirm the diagnosis of GH deficiency (GHD) after adult height achievement in childhood-onset GHD (COGHD). Aim: To define the cut-off of GH peak after retesting with GH-releasing hormone plus arginine (GHRHarg) in the diagnosis of permanent GHD in COGHD of different etiology. Patients and methods: Eighty-eight COGHD (median age 17.2 y), 29 idiopathic GHD (IGHD), 44 cancer survivors (TGHD) and 15 congenital GHD (CGHD) were enrolled in the study; 54 had isolated GHD (iGHD) and 34 had multiple pituitary hormone deficiencies (MPHD). All were tested with insulin tolerance test (ITT) and GHRHarg. IGHD with a GH response to ITT 656\ub5g/L were considered true negatives and served as the control group, and patients with a GH response <6\ub5g/L as true positives. Baseline IGF-I was also measured. The diagnostic accuracy of GHRHarg testing and of IGF-I SDS in patients with GHD of different etiologies was evaluated by ROC analysis. Results: Forty-six subjects with a GH peak to ITT 656\ub5g/L and 42 with GH peak <6 \ub5g/L showed a GH peak after GHRHarg between 8.8\u2013124\ub5g/L and 0.3\u201326.3\ub5g/L, respectively; 29 IGHD were true negatives, 42 were true positives and 17 with a high likelihood GHD showed a GH peak to ITT 656\ub5g/L. ROC analysis based on the etiology indicated the best diagnostic accuracy for peak GH cutoffs after GHRHarg of 25.3 \ub5g/L in CGHD, 15.7 in TGHD, and 13.8 in MPHD, and for IGF-1 SDS at 122.1 in CGHD, 121.5 in TGHD, and 121.9 in MPHD. Conclusions: Our findings indicate that the best cut-off for GH peak after retesting with GHRHarg changes according to the etiology of GHD during the transition age. Based on these results the diagnostic accuracy of GHRHarg remains questionable

Natural carriers in bioremediation: a review

Bioremediation of contaminated groundwater or soil is currently the cheapest and the least harmful method of removing xenobiotics from the environment. Immobilization of microorganisms capable of degrading specific contaminants significantly promotes bioremediation processes, reduces their costs, and also allows for the multiple use of biocatalysts. Among the developed methods of immobilization, adsorption on the surface is the most common method in bioremediation, due to the simplicity of the procedure and its non-toxicity. The choice of carrier is an essential element for successful bioremediation. It is also important to consider the type of process (in situ or ex situ), type of pollution, and properties of immobilized microorganisms. For these reasons, the article summarizes recent scientific reports about the use of natural carriers in bioremediation, including efficiency, the impact of the carrier on microorganisms and contamination, and the nature of the conducted research