Colorectal cancer (CRC) has the second-highest tumor incidence and is a leading cause of death by cancer. Nearly 20% of patients with CRC will have metastases at the time of diagnosis, and more than 50% of patients with CRC develop metastatic disease during the course of their disease. A group of experts from Medicine and Molecular Imaging met to discuss and provide a multidisciplinary consensus on the management of liver metastases in patients with CRC. The group defined the different scenarios in which the disease can present: fit or unfit patients with resectable liver metastases, patients with potential resectable liver metastases, and patients with unresectable liver metastases. Within each scenario, the different strategies and therapeutic approaches are discussed.

Tumour-associated macrophages (TAMs) have been associated with survival in classic Hodgkin lymphoma (cHL) and other lymphoma types. The maturation and differentiation of tissue macrophages depends upon interactions between colony-stimulating factor 1 receptor (CSF1R) and its ligands. There remains, however, a lack of consistent information on CSF1R expression in TAMs. A new monoclonal antibody, FER216, was generated to investigate CSF1R protein distribution in formalin fixed tissue samples from 24 reactive lymphoid tissues and 187 different lymphoma types. We also analysed the distribution of CSF1R+, CD68+ and CD163+ macrophages by double immunostaining, and studied the relationship between CSF1R expression and survival in an independent series of 249 cHL patients. CSF1R+ TAMs were less frequent in B-cell lymphocytic leukaemia and lymphoblastic B-cell lymphoma than in diffuse large B-cell lymphoma, peripheral T-cell lymphoma, angioimmunoblastic T-cell lymphoma and cHL. HRS cells in cHL and, with the exception of three cases of anaplastic large cell lymphoma, the neoplastic cells in NHLs, lacked detectable CSF1R protein. A CSF1R+ enriched microenvironment in cHL was associated with shorter survival in an independent series of 249 cHL patients. CSF1R pathway activation was evident in the cHL and inactivation of this pathway could be a potential therapeutic target in cHL cases.

Currently, SBRT is mainly used when there is no other therapeutic alternative for the patient. This is due to the lack of randomized trials in these settings. However, the results shown in retrospective studies let us hope to impose SBRT as a new standard of care for many patients in the next few years.

The IMRT and integrated-boost chemoradiation scheme offered higher rates of ypCR and pT downstaging, without a significant increase in toxicity. The circumferential margins were free of tumors in the majority of patients. Primary tumor regression was associated with better disease-free survival.

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(Goldstone et al, 1993). Rates of morbidity and mortality have improved with better supportive measures and administration of HDC at an earlier phase in the course of the disease, but procedure-related mortality remains in the region of 10-20% in most published series using autologous bone marrow transplantation (ABMT) Jones et al, 1990;Reece et al, 1991;Bierman et al, 1993). Approximately 50% of these fatalities will be as a consequence of idiopathic pneumonia syndrome (IPS). This presents with dyspnoea, pulmonary infiltrates and fever, and the differential diagnosis is between infection (often with an uncommon or unusual organism), pulmonary involvement with HD, intrapulmonary haemorrhage or druginduced pneumonitis (Clark et al, 1993). The latter is most frequently associated with high-dose BCNU (carmustine), which induces interstitial fibrosis in a dose-dependent manner. (Litam et al, 1981;Pecego et al, 1986;Weaver et al, 1993). The mechanism is poorly understood but thought to involve toxic metabolites that react with sulphydryl compounds (including glutathione) resulting in neutralization. Depletion of such compounds and inhibition of glutathione reductase in alveolar Received 19April 1995 Revised 11 October 1996 Accepted 14 October 1996 Correspondence to: D Cunningham macrophages is postulated to increase the risk of oxidant injury (Arrick et al, 1984;Clark et al, 1993).Pulmonary toxicity may occur 9 days to 12 years after starting BCNU (Durant et al, 1979) and may present with the sudden onset of dyspnoea and progress rapidly to death, or be more insidious with a fatal outcome within 2 years (Phillips et al, 1983). In a dosefinding study published in 1990 using cyclophosphamide, etoposide and BCNU (Wheeler et al, 1990) 450 mg m-2 of BCNU was the maximum tolerated dose, with a 5% mortality rate compared with 22% observed following a dose of 600 mg ni-2. Another study using the same regimen and 600 mg m-2 BCNU, published the following year, reported a 16% incidence of IPS and a 12% mortality rate (Reece et al, 1991). A more recent series (Weaver et al, 1993) reported no IPS in patients who received BCNU 300 mg m-2 a rate of 23% in patients who received 600 mg m-2.The aim of our study was to quantify the risk and time of onset of IPS at our own institution and determine the risk factors for its development and prognostic factors for outcome. PATIENTS AND METHODS Using

Purpose To evaluate the efficacy and safety of lung low-dose radiation therapy (LD-RT) for pneumonia in patients with coronavirus disease 2019 (COVID-19). Materials and methods Inclusion criteria comprised patients with COVID-19-related moderate–severe pneumonia warranting hospitalization with supplemental O2 and not candidates for admission to the intensive care unit because of comorbidities or general status. All patients received single lung dose of 0.5 Gy. Respiratory and systemic inflammatory parameters were evaluated before irradiation, at 24 h and 1 week after LD-RT. Primary endpoint was increased in the ratio of arterial oxygen partial pressure (PaO2) or the pulse oximetry saturation (SpO2) to fractional inspired oxygen (FiO2) ratio of at least 20% at 24 h with respect to the preirradiation value. Results Between June and November 2020, 36 patients with COVID-19 pneumonia and a mean age of 84 years were enrolled. Seventeen were women and 19 were men and all of them had comorbidities. All patients had bilateral pulmonary infiltrates on chest X‑ray. All patients received dexamethasone treatment. Mean SpO2 pretreatment value was 94.28% and the SpO2/FiO2 ratio varied from 255 mm Hg to 283 mm Hg at 24 h and to 381 mm Hg at 1 week, respectively. In those who survived (23/36, 64%), a significant improvement was observed in the percentage of lung involvement in the CT scan at 1 week after LD-RT. No adverse effects related to radiation treatment have been reported. Conclusions LD-RT appears to be a feasible and safe option in a population with COVID-19 bilateral interstitial pneumonia in the presence of significant comorbidities.

Background:To present the 18 months results from a prospective multicenter phase II randomized trial of short vs protracted urethra-sparing stereotactic body radiotherapy (SBRT) for localized prostate cancer (PCa). Methods: Between 2012 and 2015, a total of 170 PCa patients were randomized to 36.25 Gy in 5 fractions (6.5 Gy × 5 to the urethra) delivered either every other day (EOD, arm A, n = 84) or once a week (QW, arm B, n = 86). Genitourinary (GU) and gastrointestinal (GI) toxicity (CTCAE v4.0 scale), IPSS, and QoL scores were assessed at baseline, at the 5th fraction (5fx), 12th weeks (12W), and every 6 months after SBRT. The primary endpoint was biochemical control at 18 months and grade ≥ 3 toxicity (including grade ≥ 2 for urinary obstruction/retention) during the first 3 months. Results: Among the 165 patients analyzed, the toxicity stopping rule was never activated during the acute phase. Maximum acute grade 2 GU toxicity rates at 5fx were 17% and 19% for arms A and B, respectively, with only 2 cases of grade 2 GI toxicity at 5fx in arm A. At month 18, grade ≥ 2 GU and GI toxicity decreased below 5% and 2% for both arms. No changes in EORTC QLQ-PR25 scores for GU, GI, and sexual domains were observed in both arms between baseline and month 18. Four biochemical failures were observed, 2 in each arm, rejecting the null hypothesis of an unfavorable response rate ≤ 85% in favor of an acceptable ≥ 95% rate. Conclusions: At 18 months, urethra-sparing SBRT showed a low toxicity profile, with minimal impact on QoL and favorable biochemical control rates, regardless of overall treatment time (EOD vs QW). K E Y W O R D Soverall treatment time, prostate cancer, quality of life, stereotactic body radiotherapy, urethra sparing 3098 | ZILLI et aL.