The sacral chordoma margin

[Objective]: Aim of the manuscript is to discuss how to improve margins in sacral chordoma. [Background]: Chordoma is a rare neoplasm, arising in half cases from the sacrum, with reported local failure in >50% after surgery. [Methods]: A multidisciplinary meeting of the “Chordoma Global Consensus Group” was held in Milan in 2017, focusing on challenges in defining and achieving optimal margins in chordoma with respect to surgery, definitive particle radiation therapy (RT) and medical therapies. This review aims to report on the outcome of the consensus meeting and to provide a summary of the most recent evidence in this field. Possible new ways forward, including on-going international clinical studies, are discussed. [Results]: En-bloc tumor-sacrum resection is the cornerstone of treatment of primary sacral chordoma, aiming to achieve negative microscopic margins. Radical definitive particle therapy seems to offer a similar outcome compared to surgery, although confirmation in comparative trials is lacking; besides there is still a certain degree of technical variability across institutions, corresponding to different fields of treatment and different tumor coverage. To address some of these questions, a prospective, randomized international study comparing surgery versus definitive high-dose RT is ongoing. Available data do not support the routine use of any medical therapy as (neo)adjuvant/cytoreductive treatment. [Conclusion]: Given the significant influence of margins status on local control in patients with primary localized sacral chordoma, the clear definition of adequate margins and a standard local approach across institutions for both surgery and particle RT is vital for improving the management of these patients

A software defined radio architecture for a regenerative on-board processor

The possibility to adapt in-flight the behaviour of a space-based equipment to different operating conditions and/or new functional requirements is of paramount importance in the field of the commercial multimedia communications.Infact, in a satellite lifetime of 15 years, new standards may arise, the existing one may be upgraded, or the opportunity to introduce new addedvalue services may be considered by a satellite operator. The in-flight adaptability is particularly significant for an On-Board Processor (OBP) based on the signal regeneration: such kind of equipments, though offering excellent performances in terms of BER/PER, require an access protocol to exploit the communication resources and this condition is an heavy limitation to the OBP flexibility, usually perceived as a risk factor by a commercial satellite operator. The present paper describes a Regenerative OBP architecture which makes use of the SRAM-based FPGA technology to obtain a fully reconfigurable platform, where any functional block of the signal processing chain may be completely modified in-flight. Together with the OBP architecture, a procedure to perform an efficient and reliable payload reconfiguration is described. A prototype of the proposed OBP architecture, based on COTS devices, will be realized in the frame of an ESA/ESTEC contract. © 2008 IEEE

Consolidative active scanning proton therapy for mediastinal lymphoma: selection criteria, treatment implementation and clinical feasibility

aims proton therapy (PT) represents an advanced form of radiotherapy with unique physical properties which could be of great advantage in reducing long-term radiation morbidity for cancer survivors. here, we aim to describe the whole process leading to the clinical implementation of consolidative active scanning proton therapy treatment (PT) for mediastinal lymphoma. methods the process included administrative, technical and clinical issues. authorization of PT is required in all cases as mediastinal lymphoma is currently not on the list of diseases reimbursable by the Italian national health service. technically, active scanning PT treatment for mediastinal lymphoma is complex, due to the interaction between actively scanned protons and the usually irregular and large volumes to be irradiated, the nearby healthy tissues and the target motion caused by breathing. a road map to implement the technical procedures was prepared. the clinical selection of patients was of utmost importance and took into account both patient and tumor characteristics. results the first mediastinal lymphoma was treated at our PT center in 2018, four years after the start of the clinical activities. The treatment technique implementation included mechanical deep inspiration breath-hold simulation computed tomography (CT), clinical target volume (CTV)-based multifield optimization planning and plan robustness analysis. the ultimate authorization rate was 93%. In 4 cases a proton-photon plan comparison was required. between may 2018 and february, 2021, 14 patients were treated with consolidative PT. The main clinical reasons for choosing PT over photons was a bulky disease in 8 patients (57%), patient's age in 11 patients (78%) and the proximity of the lymphoma to cardiac structures in 10 patients (71%). With a median follow-up of 15 months (range, 1-33 months) all patients but one (out-of-field relapse) are without evidence of disease, all are alive and no late toxicities were observed during the follow-up period. conclusions the clinical implementation of consolidative active scanning PT for mediastinal lymphoma required specific technical procedures and a prolonged experience with PT treatments. an accurate selection of patients for which PT could be of advantage in comparison with photons is mandatory

The sacral chordoma margin

Aim of the manuscript is to discuss how to improve margins in sacral chordoma

Proposal to change the conserved type of Ipomoea, nom. cons. (Convolvulaceae)

Ipomoea L. is the largest (650–900 species, depending on the concept adopted) and most iconic genus in Convolvulaceae, a family of c. 1880 species (data from Staples, Convolvulaceae Unlimited, 2012 at: http//convolvulaceae.myspecies.info), including the important crop sweetpotato, Ipomoea batatas (L.) Lam. (Tabl. Encycl. 1: 465. 1793), and several ornamental species commonly known as “bindweeds” or “morning glories” (Wilkin in Kew Bull. 54: 853–876. 1999; Mabberley, Mabberley's Plant‐book. 2008). The genus has a long history of taxonomic and nomenclatural problems, mainly for the lack of a clear morphological circumscription and overlap with other genera. In his Species plantarum (1753), Linnaeus distinguished two genera, Convolvulus L. and Ipomoea, whose species suffered numerous re‐arrangements, between Ipomoea and Convolvulus, but especially into numerous more recently described genera, which amount today to a total of 60 (Staples in World Checklist of Vascular Plants, v.2.0. 2020, http://wcvp.science.kew.org/ retrieved 2 Apr 2020)