A Case of Radiation-Induced Aortitis in a Patient With Cervical Cancer.

Radiation-induced aortitis is a rare but potentially serious complication of radiotherapy. We report the case of a 46-year-old female with a history of cervical cancer who developed radiation-induced aortitis following two courses of concurrent chemoradiation. The patient was asymptomatic, and the condition was detected during a routine follow-up positron emission tomography (PET) scan. The patient was referred to rheumatology for differential diagnosis, which ruled out non-radiation-induced aortitis. The condition was managed conservatively, and a follow-up computed tomography (CT) scan showed resolution of the aortitis but the progression of aorto-iliac fibrosis. The patient was then started on prednisone, which led to a regression of the aorto-iliac vessel thickening.

Change of the Neutrophil-to-Lymphocyte Ratio during Treatment: A Potential Prognostic Biomarker in Metastatic Prostate Cancer Treated with Radium-223 Dichloride.

The neutrophil to lymphocyte ratio (NLR) at baseline has been shown to have prognostic value in metastatic prostate cancer. Little is known about the importance of a change in the NLR during treatment in patients treated with Radium-223 (223Ra). We investigated the prognostic value of the NLR at baseline and during therapy in patients with metastatic prostate cancer treated with 223Ra and also in patients treated with Docetaxel. We reviewed all patients treated with 223Ra in our center and randomly chosen patients treated with Docetaxel. Patients were stratified according to NLR ≤ 5 and >5 at baseline and at 12 weeks of therapy. The relationship between NLR measured at baseline and at 12 weeks and overall survival (OS) were evaluated. A total of 149 patients treated with 223Ra and 170 with Docetaxel were evaluated. For patients treated with 223Ra, overall survival was significantly better in patients that had both an NLR ≤ 5 at baseline and at 12 weeks. No such effect of NLR was found in patients treated with Docetaxel. In the present study, NLR at baseline and after 12 weeks of therapy was found to be prognostic factor in patients treated with 223Ra but not in those treated with Docetaxel.

Biochemical failure-rate and preservation of erectile function after prostate seed brachytherapy in early-onset prostate cancer.

INTRODUCTION: To analyze biochemical failure-free survival and erectile dysfunction (ED) in younger men treated with prostate seed brachytherapy (PB). MATERIALS AND METHODS: Included were patients ≤ 55 years treated with PB. Erectile function at baseline and after treatment were assessed using the physician-reported CTCAE version 4.0. Biochemical failure (BF) was defined according to the Phoenix Consensus definition (PSA nadir + 2 ng/mL). The log-rank test (Kaplan-Meier method) and cox-regression analysis was used to calculate BF-free survival. RESULTS: Between July 2005 and November 2020, a total of 137 patients ≤ 55 years (range 44-55 years old) were treated with PB. Median follow up was 72 months. Twenty percent had Gleason 3+4 disease and 6% a PSA >10 ng/mL. Median prostate volume was 34 cc. Actuarial biochemical failure free survival at 5, 7, and 10 years, were 98%, 95% and 89%, respectively. Five patients received local salvage treatment. On multivariate analysis, CAPRA-score (HR 4.46, 95%CI 1.76-11.33, p = 0.002) and the dosimetric measure D90 > 130 Gy (p = 0.03) were predictive of BF. Five deaths occurred in our cohort, two due to cardiovascular reasons and three due to another malignancy. At baseline, all patients were able to have erections with or without medication. At 5 years and 7 years after PB, 80% and 64% of patients had little or no ED (erections without the need for medication) respectively. CONCLUSION: In young-onset patients treated with PB, failure rates are similar to their older counterparts. Sexual function decreases with time, even in patients with good sexual function.

A single-center, multidisciplinary experience with radium-223 dichloride in men with metastatic castrate-resistant prostate cancer.

INTRODUCTION: We aimed to investigate several clinical and biochemical parameters, including palliative external beam radiation therapy (EBRT) to predict survival in patients with metastatic castrate-resistant prostate cancer (mCRPC) treated with radium-223 (223Ra). METHODS: We tested known and possible prognostic parameters, including palliative EBRT, both prior and concurrent to 223Ra. Logrank test (Kaplan-Meier method) and Cox regression analysis were used to predict overall survival (OS). RESULTS: A total of 133 patients were treated with 223Ra; median age was 72 years. Median OS was 9.0 (95% confidence interval [CI] 7.4-10.6) months. By univariate analysis (log-rank test), baseline Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1 (p=0.001), ≥5 cycles of 223Ra (p<0.001), baseline hemoglobin (Hb) ≥120 g/L (p <0.001), baseline total alkaline phosphatase (tALP) <110 U/L (p=0.001), and any prostate-specific antigen (PSA) decline at week 12 (p=0.013) were associated with increased OS. EBRT prior and/or concurrent to 223Ra showed a trend (p=0.051) towards inferior OS by univariate analysis only. By multivariate analysis, significant factors were PS 0-1 (hazard ratio [HR] 1.94, 95% CI 1.3-2.9, p=0.001), Hb ≥120 g/L (HR 0.5, 95% CI 0.3-0.9, p=0.011), and absence of docetaxel use prior to 223Ra (HR 1.86, 95% CI 1.08-3.22, p=0.026). With baseline Hb, tALP, and ECOG PS, we were able to divide patients into three groups with different median OS (months): 23.0 (95% CI 12.8-33.2), 8.0 (95% CI 6.7-9.3), and 5.0 (95% CI 3.1-6.9) for low-, intermediate-, and high-risk, respectively (p<0.001). CONCLUSIONS: We found that 223Ra therapy can result in an OS of close to two years in carefully selected patients. Earlier administration of 223Ra therapy to fitter patients with mCRPC should be tested.

Characterisation of road sediments near Bordeaux with emphasis on phosphorus.

Road sediments from the region of Bordeaux (France) were analysed for trace metals, hydrocarbons (including Polycyclic Aromatic Hydrocarbons, PAHs) and phosphorus. The aim of the study was to assess their potential risk for the environment. The sediments were collected by means of a sweeper. The particles are mostly sandy clay loam and silty clay loam with 5.6-8.3% CaO. Heavy metal concentrations are generally below the French and Dutch standards for polluted soils, but a few samples have higher concentrations, e.g., 547 mg kg(-1) for Zn, and 222 mg kg(-1) for Pb. PAH concentrations are above the Dutch target value for polluted soils, and could be a threat to the environment: pyrene (2600 microg kg(-1)) and fluoranthene (1400 microg kg(-1)) have the highest concentrations, whereas chrysene (340 microg kg(-1)) has the lowest. Consequently, these sediments must be considered as waste according to the French circular no 2001-39 from 18 June 2001 and cannot be disposed of anywhere. The Standards Measurements and Testing (SMT) protocol for sequential extraction of phosphorus in sediments was used to determine the forms of phosphorus in the samples. Total phosphorus concentration is 620 mg kg(-1) on average, with a maximum of 933 mg kg(-1); organic phosphorus content is low (36 mg kg(-1) on average). The protocol could be slightly amended, especially with regards to organic phosphorus at low concentrations and could then be used for the determination of phosphorus in other materials such as sludge from detention ponds.