11 research outputs found
The Giant Dipole Resonance as a quantitative constraint on the symmetry energy
The possible constraints on the poorly determined symmetry part of the
effective nuclear Hamiltonians or effective energy functionals, i.e., the
so-called symmetry energy S(rho), are very much under debate. In the present
work, we show that the value of the symmetry energy associated with Skyrme
functionals, at densities rho around 0.1 fm^{-3}, is strongly correlated with
the value of the centroid of the Giant Dipole Resonance (GDR) in spherical
nuclei. Consequently, the experimental value of the GDR in, e.g., 208Pb can be
used as a constraint on the symmetry energy, leading to 23.3 MeV < S(rho=0.1
fm^{-3}) < 24.9 MeV.Comment: 5 pages, 2 figures, submitte
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
Exploring all avenues for radiotherapy in oligorecurrent prostate cancer disease limited to lymph nodes : a systematic review of the role of stereotactic body radiotherapy
Stereotactic body radiotherapy (SBRT) is emerging as a treatment option in patients affected by oligorecurrent prostate cancer disease limited to lymph nodes, a subgroup of patients who would otherwise be treated only with androgen deprivation therapy (ADT)
Metastasis-directed stereotactic radiotherapy for oligoprogressive castration-resistant prostate cancer: a multicenter study
PURPOSE:
Herein, we report the clinical outcomes of a multicenter study evaluating the role of SBRT in a cohort of patients affected by oligoprogressive castration-resistant prostate cancer (CRPC).
MATERIALS AND METHODS:
This is a retrospective multicenter observational study including eleven centers. Inclusion criteria of the current study were: (a) Karnofsky performance status > 80, (b) histologically proven diagnosis of PC, (c) 1-5 oligoprogressive metastases, defined as progressive disease at bone or nodes levels (detected by means of choline PET/CT or CT plus bone scan) during ADT, (d) serum testosterone level under 50 ng/ml during ADT, (e) controlled primary tumor, (f) patients treated with SBRT with a dose of at least 5 Gy per fraction to a biologically effective dose (BED) of at least 80 Gy using an alpha-to-beta ratio of 3 Gy, (g) at least 6 months of follow-up post-SBRT.
RESULTS:
Eighty-six patients for a total of 117 lesions were treated with SBRT. The median follow-up was 30.7 months (range 4-91 months). The median new metastasis-free survival after SBRT was 12.3 months (95% CI 5.5-19.1 months). One- and two-year distant progression-free survival was 52.3% and 33.7%, respectively. Twenty-six out of 86 patients underwent a second course of SBRT due to further oligoprogressive disease: This resulted in a median systemic treatment-free survival of 21.8 months (95% CI 17.8-25.8 months). One-year systemic treatment-free survival was 72.1%.
CONCLUSION:
SBRT appears to be a promising approach in oligoprogressive castration-resistant prostate cancer. Further investigations are warranted
Política de saúde e de cuidados continuados integrados em Portugal: O planeamento da alta em Serviço Social
This paper presents the construction of the policy for integrated and continued, social assistance and healthcare in the realm of healthcare policy in Portugal, highlighting the planning for release in Social Work. Since 2006, when continued care was recognized as a right and integrated into policy and the healthcare system, the Social Work profession has been highlighted in this process of planning for release and in the development of procedures that are implicit in the relation of assistance, particularly in the reception and diagnosis, meetings and reports, action plans, accompaniment and evaluation of the process and integration in the community. The technical-operative dimension of Social Work in planning for release highlights the role of the profession within the healthcare system, improving access to the benefits of care, the well-being of the ill and of families, and consolidates the Social Work profession in society.Este texto pretende evidenciar a construção da política de cuidados continuados integrados, social e de saúde, no âmbito da política de saúde em Portugal, destacando o planeamento da alta em Serviço Social. Desde 2006 que os cuidados continuados são assumidos como direitos e integrados na política e no sistema de saúde. A profissão do Serviço Social tem recebido destaque no processo de planeamento das altas e no desenvolvimento de procedimentos implícitos na relação de ajuda, nomeadamente no acolhimento e diagnóstico, reuniões e pareceres, planos de ação, acompanhamento e avaliação do processo e integração na comunidade. A dimensão técnico-operativa do Serviço Social no planeamento da alta contribui para destacar a profissão no sistema de saúde, potenciar o usufruto de cuidados, melhorar o bem-estar dos doentes e das famílias, assim como consolidar a profissão de Serviço Social na sociedade
Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study
BACKGROUND: The aim of the present study is to evaluate the impact of metastases-directed stereotactic body radiotherapy in two groups of oligometastatic prostate cancer (PC) patients: oligorecurrent PC and oligoprogressive castration-resistant PC (oligo-CRPC).
METHODS: Inclusion criteria of the present multicentre retrospective analysis were: (1) oligorecurrent PC, defined as the presence of 1-3 lesions (bone or nodes) detected with choline positron emission tomography or CT plus bone scan following biochemical recurrence; (2) oligo-CRPC, defined as metastases (bone or nodes) detected after a prostatic-specific antigen rise during androgen deprivation therapy (ADT). Primary end points were: distant progression-free survival (DPFS) and ADT-free survival in oligorecurrent PC patients; DPFS and second-line systemic treatment-free survival in oligo-CRPC patients.
RESULTS: About 100 patients with oligorecurrent PC (139 lesions) and 41 with oligo-CRPC (70 lesions), treated between March 2010 and April 2016, were analysed. After a median follow-up of 20.4 months, in the oligorecurrent group 1- and 2-year DPFS were 64.4 and 43%. The rate of LC was 92.8% at 2 years. At a median follow-up of 23.4 months, in the oligo-CRPC group 1- and 2-year DPFS were 43.2 and 21.6%. Limitations include the retrospective design.
CONCLUSIONS: Stereotactic body radiotherapy seems to be a useful treatment both for oligorecurrent and oligo-CRP