| 1 | Neoadjuvant radiotherapy dose escalation for locally advanced rectal cancers in the new era of radiotherapy:A review of literature显示文摘BACKGROUND The standard treatment of locally advanced rectal cancers(LARC)consists on neoadjuvant chemoradiotherapy followed by total mesorectal excision.Different data in literature showed a benefit on tumor downstaging and pathological complete response(pCR)rate using radiotherapy dose escalation,however there is shortage of studies regarding dose escalation using the innovative techniques for LARC(T3-4 or N1-2).AIM To analyze the role of neoadjuvant radiotherapy dose escalation for LARC using innovative radiotherapy techniques.METHODS In December 2020,we conducted a comprehensive literature search of the following electronic databases:PubMed,Web of Science,Scopus and Cochrane library.The limit period of research included articles published from January 2009 to December 2020.Screening by title and abstract was carried out to identify only studies using radiation doses equivalent dose 2 Gy fraction(EQD2)≥54 Gy and Volumetric Modulated Arc Therapy(VMAT),intensity-modulated radiotherapy or image-guided radiotherapy(IGRT)techniques.The authors’searches generated a total of 2287 results and,according to PRISMA Group(2009)screening process,21 publications fulfil selection criteria and were included for the review.RESULTS The main radiotherapy technique used consisted in VMAT and IGRT modality.The mainly dose prescription was 55 Gy to high risk volume and 45 Gy as prophylactic volume in 25 fractions given with simultaneous integrated boosts technique(42.85%).The mean pCR was 28.2%with no correlation between dose prescribed and response rates(P value≥0.5).The R0 margins and sphincter preservation rates were 98.88%and 76.03%,respectively.After a mean follow-up of 35 months local control was 92.29%.G3 or higher toxicity was 11.06%with no correlation between dose prescription and toxicities.Patients receiving EQD2 dose>58.9 Gy and BED>70.7 Gy had higher surgical complications rates compared to other group(P value=0.047).CONCLUSION Dose escalation neoadjuvant radiotherapy using innovative techniques is safe for LARC achieving higher rates of pCR.EQD2 doses>58.9 Gy is associated with higher rate of surgical complications. | Durim Delishaj Ilaria Costanza Fumagalli Stefano Ursino Agostino Cristaudo Francesco Colangelo Antonio Stefanelli Alessandro Alghisi Giuseppe De Nobili Romerai D’Amico Alessandra Cocchi Antonio Ardizzoia Carlo Pietro | 2021 | World Journal of Clinical Cases2021，9，30： | 2 |
| 5 | Modeling fire ignition probability and frequency using Hurdle models: a crossregional study in Southern Europe显示文摘Background:Wildfires play a key role in shaping Mediterranean landscapes and ecosystems and in impacting species dynamics.Numerous studies have investigated the wildfire occurrences and the influence of their drivers in many countries of the Mediterranean Basin.However,in this regard,no studies have attempted to compare different Mediterranean regions,which may appear similar under many aspects.In response to this gap,climatic,topographic,anthropic,and landscape drivers were analyzed and compared to assess the patterns of fire ignition points in terms of fire occurrence and frequency in Catalonia(Spain),Sardinia,and Apulia(Italy).Therefore,the objectives of the study were to(1)assess fire ignition occurrence in terms of probability and frequency,(2)compare the main drivers affecting fire occurrence,and(3)produce fire probability and frequency maps for each region.Results:In pursuit of the above,the probability of fire ignition occurrence and frequency was mapped using Negative Binomial Hurdle models,while the models’performances were evaluated using several metrics(AUC,prediction accuracy,RMSE,and the Pearson correlation coefficient).The results showed an inverse correlation between distance from infrastructures(i.e.,urban roads and areas)and the occurrence of fires in all three study regions.This relationship became more significant when the frequency of fire ignition points was assessed.Moreover,a positive correlation was found between fire occurrence and landscape drivers according to region.The land cover classes more significantly affected were forest,agriculture,and grassland for Catalonia,Sardinia,and Apulia,respectively.Conclusions:Compared to the climatic,topographic,and landscape drivers,anthropic activity significantly influences fire ignition and frequency in all three regions.When the distance from urban roads and areas decreases,the probability of fire ignition occurrence and frequency increases.Consequently,it is essential to implement long-to medium-term intervention plans to reduce the proximity between potential ignition points and fuels.In this perspective,the present study provides an applicable decision-making tool to improve wildfire prevention strategies at the European level in an area like the Mediterranean Basin where a profuse number of wildfires take place. | Marina D’Este Antonio Ganga Mario Elia Raffaella Lovreglio Vincenzo Giannico Giuseppina Spano Giuseppe Colangelo Raffaele Lafortezza Giovanni Sanesi | 2020 | Ecological Processes2020，9，1： | 0 |
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