Search

Objective: We aimed to assess disease-free survival (DFS), overall survival (OS) and treatment-related toxicity of two therapeutic strategies for treating bulky lymph nodes on imaging in patients with locally advanced cervical cancer (LACC): radiotherapy boost versus surgical debulking followed by radiotherapy., Methods: We performed a systematic review of studies published up to October 2023. We selected studies including patients with LACC treated by external beam radiotherapy (EBRT) boost or lymph node debulking followed by EBRT (with or without boost)., Results: We included two comparative (included in the meta-analysis) and nine non-comparative studies. The estimated 3-year recurrence rate was 28.2% (95%CI:18.3-38.0) in the EBRT group and 39.9% (95%CI:22.1-57.6) in the surgical debulking plus EBRT group. The estimated 3-year DFS was 71.8% and 60.1%, respectively (p = 0.19). The estimated 3-year death rate was 22.2% (95%CI:11.2-33.2) in the EBRT boost group and 31.9% (95%CI:23.3-40.5) in the surgical debulking plus EBRT group. The estimated 3-year OS was 77.8% and 68.1%, respectively (p = 0.04). No difference in lymph node recurrence between the two comparative studies (p = 0.36). The meta-analysis of the two comparative studies showed no DFS difference (p = 0.13) but better OS in the radiotherapy boost group (p = 0.006). The incidence of grade≥3 toxicities (ranging 0-50%) was not different between the two approaches in the two comparative studies (p = 0.31)., Conclusion: No DFS and toxicity difference when comparing EBRT boost with surgical debulking of enlarged lymph nodes and EBRT in patients with cervical cancer was evident. Radiotherapy boost had better OS. Further investigation is required to better understand the prognostic role of surgical lymph node debulking in light of radiotherapy developments., Competing Interests: Declaration of competing interest None., (© 2024 Published by Elsevier Ltd.)

Innovative solid-phase microextraction coatings synthesized by sol-gel technology were developed for the determination of environmental pollutants, i.e. polycyclic aromatic hydrocarbons at trace level in water. The fibers obtained, based on the use of (3-aminopropyl)triethoxysilane and diethoxydiphenylsilane were characterised in terms of film thickness, porosity, thermal stability and pH resistance. An excellent thermal stability was obtained in the case of diethoxydiphenylsilane-based coating, with a negligible weight loss until 400 degrees C. A very good fiber-to-fiber and batch-to-batch repeatability was also obtained with RSD lower than 6% using a mixture of aromatic hydrocarbons in the low ng/l range. Finally, the capabilities of the developed coating for sampling polycyclic aromatic hydrocarbons in water at trace levels were proved obtaining limits of detection about twofold lower than those achieved by using the commercially available polydimethylsiloxane 7 microm fiber.