The use of patient reported outcome measures (PROMs) in palliative radiotherapy: A topical review.

Radiotherapy (RT) can be used to palliate cancer-related symptoms and improve quality of life (QoL). Patient Reported Outcome Measures (PROMs) could be a reliable, minimally invasive method to monitor patients after palliative radiotherapy. This review was performed to provide an overview of the way PROMs are currently used in follow-up after palliative RT, regarding the goal of the PROM, the type of PROMs, PROM selection, PROM completion as well as the follow-up schemes and patient adherence and attrition. Pubmed, EMBASE and the Cochrane Library were systematically searched for articles published between 2008 and 2020. Titles and abstracts were reviewed to find relevant studies, which were advanced to full-text review. The reference lists of review articles were screened for correctness of the search and additional studies. No meta-analysis was performed. This search strategy identified 5733 studies, with 94 ultimately selected for inclusion in this topical review. We discovered a great variety of studies that used PROMs after palliative RT. We found no articles describing PROMs in routine clinical care. PROMs were exclusively used as a benchmarking tool and never to improve symptom control or QoL for individual patients. The selection process for the questionnaires, completion method and/or follow-up scheme was seldom described. We did not find any studies referencing patients' experience on PROMs. Although clear guidelines on the use of PROMs in palliative RT may be difficult to establish, more attention should be paid to the PROM aspect when writing study protocols. Furthermore, efforts should be made to introduce PROMs in routine clinical care in the context of palliative RT.

Does 11C-choline PET-CT contribute to multiparametric MRI for prostate cancer localisation?

BACKGROUND AND PURPOSE: The aim of this work was to determine whether 11C-choline positron emission tomography (PET)-computed tomography (CT) makes a positive contribution to multiparametric magnetic resonance imaging (MRI) for localisation of intraprostatic tumour nodules. PATIENTS AND METHODS: A total of 73 patients with biopsy-proven intermediate- and high-risk prostate cancer were enrolled in a prospective imaging study consisting of T2-weighted (T2w), dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) MRI and 11C-choline PET-CT before radical prostatectomy. Cancerous regions were delineated on the whole-mount prostatectomy sections and on the different MRI modalities and analysed in 24 segments per patient (3 sections, 8 segments each). To analyse PET-CT images, standardized uptake values (SUV) were calculated per segment. RESULTS: In total, 1,752 segments were analyzed of which 708 (40.4%) were found to be malignant. A high specificity (94.7, 93.6 and 92.2%) but relatively low sensitivity (31.2, 24.9 and 44.1%) for tumour localisation was obtained with T2w, DCE and DW MRI, respectively. Sensitivity values significantly increased when combining all MRI modalities (57.2%). For PET-CT, mean SUVmax of malignant octants was significantly higher than mean SUVmax of benign octants (3.68±1.30 vs. 3.12±1.02, p<0.0001). In terms of accuracy, the benefit of adding PET-CT to (multiparametric) MRI was less than 1%. CONCLUSION: The additional value of 11C-choline PET-CT to MRI in localising intraprostatic tumour nodules is limited, especially when multiparametric MRI is used.

Predicting the likelihood of developing boar taint: early physical indicators in entire male pigs.

Three potential early-age predictors of which boars are likely to develop boar taint (testes volume, skin lesions and dirtiness) were measured on 102 boars every fortnight from 10 weeks of age until slaughter. These predictors were correlated with the level of boar taint according to the hot iron method and the concentrations of skatole and androstenone as determined by chemical analysis. The chance of no/low boar taint according to the hot iron method decreased with higher testes volume (weeks 22 and 24) and increased with skin lesion score (weeks 12, 16 and 18). For the concentrations of androstenone and skatole, the strongest correlation was found with testes volume in week 12. Skin lesions in week 16 were negatively correlated with skatole levels. Dirtiness was negatively correlated with skatole concentrations (week 18) but positively correlated with androstenone concentrations (weeks 20 and 22). Testes volume has the greatest potential for predicting the likelihood of developing boar taint.

Evaluating a decision aid for patients with localized prostate cancer in clinical practice.

AIM: The aim of the study was to evaluate the usefulness of a decision aid regarding treatment options for patients with early-stage localized prostate cancer. METHODS: 50 patients with newly diagnosed localized prostate cancer received the decision aid and were interviewed twice: before the decision-making consultation with the physicians and before treatment or, in case of watchful waiting, before the follow-up consultation. The physicians (radiation oncologists and urologists) were interviewed after the consultation. RESULTS: The patients became more active partners in the decision-making process: They were better prepared for the consultation, asked more direct information, and were able to make a more deliberative choice. Generally, the use of the decision aid improved the quality of the consultation and resulted in a treatment decision agreed upon by both parties. Sometimes the consultation turned out to be more time-consuming. The decision aid did not only improve the patient-physician interaction but also helped patients to discuss the disease with their partner and family members. CONCLUSION: The use of the decision aid has a positive impact on the consultation and the decision-making process. The policy of involving patients more actively in the decision process should be further implemented in daily practice.

The efficiency of adjuvants combined with flupyrsulfuron-methyl plus metsulfuron-methyl (Lexus XPE) on weed control.

This paper presents the results of laboratory tests on a selection of weeds (Viola arvensis, Polygonum persicaria, Chamomilla recutita, Chenopodium album, Veronica persicaria, Alopecurus myosusroides) to investigate the efficiency of flupyrsulfuron-methyl plus metsutfuronmethyl (Lexus XPE) in combination with different adjuvants. The efficiency of the herbicide improved in combination of adjuvants. The level of phytotoxicity of the adjuvants-herbicide treatments appllied varied among the different weed species.

Fusarium spp. and Fusarium mycotoxins in maize: a problem for Flanders?

Fusarium species cause not only root, stem and ear rot with severe reductions in crop yield, they produce also toxic secondary metabolites (mycotoxins) such as deoxynivalenol (DON) and zearalenone (ZEA). During several growing seasons the presence of Fusarium spp was followed up. DON and ZEA were determined and related to infection levels. The distribution of DON and ZEA in the different plant parts was studied as well as the influence of the ensiling process on the mycotoxin content. More or less important varietal differences in susceptibility for Fusarium spp. could be detected. DON and ZEA were clearly present in most of the analysed samples. No clear relationship could be detected between visual disease symptoms and mycotoxin content. The accumulation of DON and ZEA was different for the analysed aerial plant parts. The ensiling process gave no reduction of the mycotoxin content.

Differences in susceptibility of winter wheat varieties for Fusarium species under Belgian growing conditions.

Fusarium head blight is an important disease of cereal crops caused by Fusarium species. It causes not only a reduction in yield, but most Fusarium species (F. graminearum. F. culmorum, F. avenaceum. F. poae) produce also a range of toxic metabolites such as deoxynivalenol (DON) and zearalenone (ZEA). The evaluation of Fusarium species was followed up under natural infection conditions during the growing seasons 2001--2002 and 2002--2003 in two varietal winter wheat experiments on the experimental farm of the Hogeschool Gent at Bottelare. Disease pressure, DON and ZEA content, different Fusarium species as well as growth and yield parameters were determined. In both years there were significant differences between the varieties concerning the susceptibility to Fusarium and the DON content. ZEA was not found in the kernels. The mean deoxynivalenol (DON) content was in 2002 (1,126 mg/kg) higher than in 2003 (0.879 mg/kg) although the mean disease severity was bigger in 2003 than in 2002 what means that the DON content was not always correlated with the disease severity. The Fusarium species most frequently identified in our two field trials (Bottelare) were F. graminearum and F. culmorum Varietal differences in susceptibility to Fusarium species and DON contamination could be detected.

Disease control by means of induced resistance.

The biological control of fungal diseases in agriculture and horticulture based on induced resistance can become an attractive alternative to traditional fungicides. The principle is that all plants have genetic information about resistance mechanisms against pathogens such as fungi, viruses, and bacteria. The purpose of our research is to activate these resistance factors that are latent present in the plant, by treating the plants with abiotic and biotic agents (elicitors) to activate defence responses. The resistance inducing products used in the experiments are based on non-pathogenic rhizobacteria, and metabolites of micro-organisms and plants. In our experiments the different products and organisms were tested against powdery mildew on tomato. Good results are obtained with Milsana, Elexa and Serenade, especially Milsana showed a strong reduction of the disease symptoms of O. lycopersicum. These products could contribute to an environmentally more acceptable crop protection and suits in the aim to durable production techniques in agriculture and horticulture.