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Feasibility of cabazitaxel in octogenarian prostate cancer patients

Current Urology 2023年第3期17卷 153-158页

作者： Paolo Tralongo Sebastiano Bordonaro Giuseppe Di Lorenzo Ugo De Giorgi NicolòBorsellino Gaetano Facchini Sabrina Rossetti Giuseppe Fornarini Vito Longo Antonino Carmelo Tralongo Francesca Caspani Massimiliano Spada nicola calvani Paolo Carlini Medical Oncology Unit RAO-Umberto I HospitalSiracusa96100Italy Department of Medicine and Health Sciences‘Vincenzo Tiberio' University of MoliseCampobassoItaly Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori(IRST)IRCCS Meldola(FC)Italy Medical Oncology Unit Ospedale Buccheri La FerlaFatebenefratelliPalermoItaly Medical Oncology Unit Santa Maria delle Grazie di PozzuoliNapoliItaly Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology Istituto Nazionale TumoriIRCCSFondazione G.PascaleNapoliItaly Medical Oncology 1 IRCCSOspedale Policlinico San MartinoGenovaItaly Istituto Tumori Giovanni PaoloⅡI.R.C.C.S. BaOspedale di CircoloVareseItaly Medical Oncology Unit ASSTSETTE LAGHIOspedale di CircoloVareseItaly Medical Oncology Unit Fondazione Istituto G.Giglio di CefalùPalermoItaly Medical Oncology Division&Breast Unit Sen.A.Perrino HospitalBrindisiItaly Medical Oncology 1 Istituto Nazionale Tumori Regina ElenaRomaItaly

Background:To evaluate the effectiveness and safety of cabazitaxel in castration-resistant prostate cancer patients aged>80 years,we performed a retrospective study on a sample of patients from 11 Italian cancer *** and methods:Fifty-seven patients aged>80 years were treated with cabazitaxel after previous failure with docetaxel;39 completed a comprehensive geriatric assessment questionnaire(34 fit and 5 vulnerable)and 8 patients(14%)had an Eastern Cooperative Oncology Group performance status(PS)>2,while most had a PS of 0-1(86%).Cabazitaxel was administered at a dose of 25 mg/m^(2)in 30(52%)patients and 20 mg/m^(2)or adapted schedules in 27(48%)*** schedules were adopted mainly in patients>85 years(75%),with a PS>2(87.5%),and those classified as vulnerable(100%).Results:The duration of treatment was 4.8 months and was comparable in all subgroups;disease control rate was reported in 36 patients(63%);prostate-specific antigen response was recorded in 18 patients(31.5%).Median overall survival was 13.1 months regardless of age(85 years),but overall survival was reduced in vulnerable(7.2 months)and PS>2 patients(6.8 months).The most frequently documented grade 3-4 toxicities were neutropenia(14%)and diarrhea(10.5%).Six patients(10.5%)dropped out due to severe ***:Octogenarian patients can be treated with cabazitaxel with reduced doses or alternative schedules that are associated with less toxicity and fewer treatment *** geriatric assessment could facilitate more appropriate patient selection.

关键词： Cabazitaxel Cancer Octogenarian Prostate

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New obesity classification criteria as a tool for bariatricsurgery indication

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World Journal of Gastroenterology 2016年第2期22卷 681-703页

作者： Antonino De Lorenzo Laura Soldati Francesca Sarlo Menotti calvani nicola Di Lorenzo Laura Di Renzo Division of Clinical Nutrition and Nutrigenomic Department of Biomedicine and PreventionUniversity of Tor Vergata00133 RomeItaly Department of Internal Medicine UOSD Service of Clinical Nutritionparenteral therapy and anorexia nervosaPoliclinico Tor Vergata00133 RomeItaly Department of Health Sciences University of Milan20122 MilanItaly Department of Agriculture University of Naples“Federico II” 80055 Portici(NA)Italy Department of Surgical Sciences University of Tor VergataPoliclinico Tor Vergata00133 RomeItaly

Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic factors. Due to the role of adipose tissue in lipid and glucose metabolism, and low grade inflammation, it is necessary to classify obesity on the basis of body fat composition and distribution, rather than the simply increase of body weight, and the Body Mass Index. The new term of adiposopathy(‘‘sick fat'') clearly defines the pathogenic role of adipose tissue. Four phenotypes of obese individuals have been described:(1) normal weight obese(NWO);(2) metabolically obese normal weight;(3) metabolically healthy obese; and(4) metabolically unhealthy obese or "at risk" obese. Moreover, sarcopenic obesity has been related to all the phenotypes. The category of normal weight lean, represented by metabolically healthy normal weight has been classified to distinguish from NWO. It is crucial to recommend a bariatric surgery taking into account adiposopathy and sick fat that occurs with the expansion of fat mass, changing the inflammatory and metabolic profile of the patient. Body fat percentage and genetic polymorphism have to be evaluated to personalize the best bariatric surgery intervention.

关键词： Obesity Adiposopathy Normal weightlean Normal weight obese Metabolically obese normalweight Metabolically healthy obese Metabolicallyhealthy normal weight Metabolically unhealthy obese Laparoscopic gastric banding Fat mass

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