To examine the prevalence of depressive symptoms and its relationship with quality-of-life domains in home-care cancer patients at an advanced stage of illness, 86 patients were given psychological tests for depression (Hospital Anxiety Depression Scale) (HAD) and quality of life (EORTC-QLQ-C30) 1 week after admission to the home-care program. Using a proper cut-off score on the HAD-Depression subscale, depressive symptoms were reported by 45% of the patients. The quality of life of depressed patients was more affected than non-depressed patients in the social, emotional, cognitive, and physical domains. Significant correlations were found between depression scores and impairment in most quality-of-life areas. These findings support the importance of depression and quality-of-life evaluation in patients with advanced cancer who are followed in a home-care setting. This evaluation is needed to provide patients, their families, and caregivers with appropriate psychosocial interventions.
The Neogene–Quaternary alkali-basalt–hawaiite lavas of the Gharyan volcanic field (NW Libya) contain mantle xenoliths. These mostly consist of protogranular spinel lherzolites with superimposed metasomatic textures represented by reaction patches where primary orthopyroxene (opx), clinopyroxene (cpx) and spinel (sp) are the main reacting phases. The secondary parageneses include clinopyroxene (cpx2), olivine (ol2) and feldspar (feld) as reaction rims around opx, spongy-textured clinopyroxene with recrystallized portions (cpx2±feldspar), and brown spinel destabilized in a higher Cr/(Cr+Al) black vermicular aggregate (sp2) generally associated with feldspar microlites. Cpx2 are typically depleted in Na2O and Al2O3 relative to cpx; feldspar includes both alkali-feldspar (Or 17–51) and plagioclase (An 23–64). Bulk rocks have flat heavy rare earth element (HREE) patterns (1.2–2.3 times chondrite) and are variably enriched in light REE (LREE; LaN/YbN up to 6.6). The constituent clinopyroxenes are characterized by flat HREE distributions (8–14.5 times chondrite) and variable LREE enrichment with LaN/YbN up to seven, which generally conform to the bulk-rock chemistry. Samples relatively unaffected by metasomatism have clinopyroxene Sr–Nd isotopic composition (87Sr/86Sr down to 0.7023, 143Nd/144Nd up to 0.5139) that approaches the depleted mantle (DM), suggesting that the lithospheric mantle beneath the area underwent a long-term depletion probably by pre-Palaeozoic extraction of basic melts. The remaining samples approach 87Sr/86Sr c. 0.7030, 143Nd/144Nd c. 0.5130, with 206Pb/204Pb up to 19.66. These data imply that the causative agents of metasomatism were Na-alkali silicate melts with a clear HIMU affinity, in accordance with the isotopic signature of the host lavas (87Sr/86Sr=0.7032, 143Nd/144Nd=0.5130, 206Pb/204Pb=19.60). This prevalent HIMU geochemical signature is comparable with that recorded in Cenozoic alkaline basic lavas and associated mantle xenoliths from other occurrences of the northern–central African lithosphere, suggesting a common regional sub-lithospheric component. The relatively low 3He/4He of the Gharyan xenoliths (5.3–6.5 Ra) indicates that this component originates within the upper mantle and is unrelated to the deep-seated mantle plume source of the Ethiopian–Yemen plateau basalts. Therefore, the Cenozoic volcanic districts of the Saharan belt could be related to smaller-scale shallow mantle upwellings (also referred to as ‘hot fingers’) triggered by intraplate reactivation of regional tectonic lineaments within the Pan-African cratonic basement, as a foreland reaction of the African–Europe collisional system.
Several drugs have been proposed for chemoprevention from cisplatin (CDDP)‐induced neurotoxicity. For the purpose of this study the effectiveness of reduced glutathione (GSH) during CDDP‐based first‐line treatment was evaluated in a series of 54 patients affected by epithelial ovarian cancer. Neurotoxicity was assessed by clinical examination, vibrametry and neurophysiology before, during and after chemotherapy. First of all, it is noteworthy that GSH cotreatment did not impair CDDP antineoplastic effectiveness. Non‐neurological side effects were similar in the two groups, with the exclusion of oliguria which occured more frequently in CDDP alone‐treated patients. From a neurological point of view, the comparison between CDDP alone and CDDP+GSH treated groups at the end of treatment (CDDP total dose 500–675 mg m−2) constantly evidenced a trend toward less severe neurotoxicity after cotreatment with all methods. Although neuroprotection was not complete, these findings are in agreement with previous preclinical and clinical data and further support the view that chemoprevention with GSH should be considered in CDDP‐treated patients.
LBA3513 Background: The combination of capecitabine plus long course radiotherapy (RT) is the standard preoperative therapy in cT3-4 cN+ rectal cancer. pathologic complete remission (pCR) can be considered as surrogate endpoint of efficacy of treatment in terms of disease-free survival (DFS). Preclinical data points heavily toward a strong synergy between RT and immune treatments. Methods: This is a prospective phase II, open label, single arm, multicentre study in patient with locally advanced rectal cancer who receive standard concomitant CT/RT therapy (825 mg/m2 twice daily capecitabine every day and 5040 cGy radiotherapy for 5 days per week for 5 weeks) followed by durvalumab (1500 mg Q4W for 3 administrations). Surgery is performed after 10-12 weeks from neoadjuvant therapy. The primary endpoint is the proportion of pCRs after at least 1 cycle of durvalumab; secondary endpoints are the proportion of clinical complete remissions (cCRs) after at least 1 cycle of durvalumab, the proportion of adverse and serious adverse events (NCI CTCAE v5.0). The sample size has been estimated by using the optimal Simon’s two-stage design assuming a null pCR proportion of 0.15 and an alternative pCR percentage of 0.30 (alpha = 0.05, power = 0.80). If more than 4 pCRs were observed in the first 19 enrolled patients, 36 additional patients were to be accrued for a total of 55 evaluable patients. The null hypothesis is rejected if ≥ 13 pCRs are observed in 55 patients. Results: Between November 2019 and August 2021, 60 patients were accrued, of which 55 were evaluable for study objectives. Fifty-two of 55 treated patients received all 3 infusions of durvalumab. After treatment, a clinical response percentage of 81.8% was observed; 3 patients had progression of disease due to local and/or metastases before surgical intervention. Eighteen patients achieved complete pathological response (32.7%), confirmed by central revision. Near complete regression, moderate and minimal regression were observed in 14 (25.5%), 9 (16.4%) and 11 (20.0%) patients respectively. Regarding toxicity, 23 patients (41.8%) had adverse events (AEs) related to durvalumab treatment. Two patients (1.8%) discontinued durvalumab for toxicity. Grade 3 AEs occurred in 4 (7.3%) patients (diarrhea, skin toxicity, transaminase increase, lipase increase and pancolitis). No Grade 4 toxicity was observed. In 20 patients (36.4%) G1-2 AEs related to durvalumab were observed. The most common were endocrine toxicity (hyper/hypo-thyroidism), dermatologic toxicity (skin rash) and gastrointestinal toxicity (transaminase increase, nausea, diarrhea, constipation). Conclusions: This study met its primary endpoint showing a promising activity of neoadjuvant chemo-radiotherapy plus durvalumab in terms of pCR rate and a safe toxicity profile. Clinical trial information: NCT04083365.
In this trial the schedules used showed no statistically significant differences in terms of disease-free survival or overall survival in the treatment of colorectal cancer.
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