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Background Radio-chemotherapy with CDDP is the standard for H&N squamous cell cancer. CDDP 100mg/m2/q3 is the standard; alternative schedules are used to reduce toxicity, mostly 40mg/m2/q1. Methods Patients were treated from 1/2010 to 1/2017 in two Radiation Oncology Centres. Propensity score analysis (PS) was retrospectively used to compare these two schedules. Results Patients analyzed were 166. Most (114/166) had 1w-CDDP while 52 had 3w-CDDP. In the 3w-CDDP group, patients were younger and with better performance status; disease extent was smaller and nodal involvement was more common than in the 1w-CDDP. Acute toxicity was similar in the groups. Treatment compliance was lower in the w-CCDP. OS before PS was better for female, for oropharyngeal disease and for 3w-CDDP group. After PS, survival was not related to the CDDP schedule. Conclusions 3w-CDDP remains the standard for fit patients, weekly schedule could be safely used in selected patients.

The coronavirus pandemic has become a huge global challenge medically, economically and psychologically. The COVID-19 pandemic shows that the population can experience general psychological distress. The sanitary regime in dental offices and lack of vaccine for coronavirus may have an impact on the level of dental anxiety among patients undergoing oral surgery procedures. A clinical study was conducted between November 2019 and September 2020. A total of 175 patients (n = 175) were enrolled in the research. The aim of the study was to assess the attitude of patients towards the new situation related to the reduced availability of dental offices providing oral surgery procedures. The level of anxiety associated with surgical intervention was measured using a self-made COVID-19 questionnaire and the MDAS scale. The ED-5Q questionnaire and EQ-VAS scale were also used in this research. The study showed that 21.9% of respondents presented with increased anxiety about a dental visit compared with the time before the pandemic. This epidemiological situation has led to an overwhelming increase in moderate dental anxiety (M: 11.4) among patients undergoing oral surgery procedures. The quality of patients&rsquo, health (EQ-VAS) related to the impact of the coronavirus pandemic and the quarantine decreased by 10 percentage points. Oral surgeons should be prepared for more anxious patients in dental offices during the pandemic.

A 22-year-old Camargue mare was referred for showing signs of discomfort during chewing, building up of food in the mouth, and foul odor from the mouth. On physical examination, the mare presented bilateral pigmented labial masses affecting the upper and lower lips, more in the form of plaques at the mucocutaneous junction as well as multiple perivulvar and perianal lumps. The skin lesions were biopsied for histopathologic examination and the clinical suspect of melanoma was confirmed. The owner elected the lesions to be treated with electrochemotherapy using the drug cisplatin. After two sessions, the nodules were shrunk by 50% and the horse’s ability to feed normally was restored: at that time, the owner had the treatment discontinued because of financial issues. The horse is still in partial remission after 1 year from the end of the treatment. Electrochemotherapy can be successfully used to palliate large melanomas in horses.

A study aiming to determine the prevalence of Chorioptes sp. mite infestation in the alpaca (Lama pacos) was carried out following confirmation of widespread skin disorders affecting South American camelids in the United Kingdom, and the isolation of this species of mange mite in conjunction with skin lesions from case material referred to the authors. A total of 209 alpaca in nine units in the south-west of England were included in the study. Every alpaca on the unit was clinically examined for the presence of skin lesions. All alpaca presenting with signs of skin disease, as well as approximately one in five clinically healthy, randomly selected, in-contact alpacas were included in the sampled population (n = 83). Superficial skin scrapings were taken from each animal included in the sampled population from six different sites, in addition to a dry swab taken from the ear canal. Of the 209 alpaca examined, 47 (47/209; 22.5%) showed signs of skin disease, ranging from mild alopecia, thickening, crusting and scaling of the skin of the pinnae, to severe and similar diffuse lesions affecting mostly ears, axilla, face and dorsum. Of the sampled population, 33 alpaca (33/83; 39.8%) were positive for Chorioptes sp. mite. Cumulatively, in 29 out of 33 positive cases (87.9%) Chorioptes sp. mites were detected in scrapings taken from the forefoot and/or the axilla. Thirteen out of the 47 alpacas affected by skin lesions (27.7%) were concurrently positive for Chorioptes sp. mite, 20 out of 36 (55%) un-affected sampled alpaca were positive for the mite, and 34 out of 47 affected alpacas (72.3%) presented skin lesions but were negative for Chorioptes sp. mite. Statistical test showed that affected animals tended not to be positive for the mite whilst un-affected animals tended to be positive for the mite. Additionally, there was a highly significant association between lesions, age and mite, in that an increase in the presence of skin lesions and a decrease in the presence of mites with increasing age was observed. Chorioptes sp. mites have been previously observed in the llama and the alpaca, but chorioptic mange was considered a rare condition in both host species. Findings from the present study indicate high prevalence of both the mite infestation and related clinical signs in alpaca in the south-west of England.

SummaryA Schmorl's node is the herniation of nucleus pulposus through the cartilaginous end plate of the vertebral disc into the body of the adjacent vertebra. Their formation is relatively common in people, and they may be symptomatic or asymptomatic. In contrast, there are few reported cases of Schmorl's nodes in non-human animals. This report describes a case of thoracic intervertebral disc degeneration, with Schmorl's node formation in a sheep.

Purpose To estimate the effects of heterogeneity on tumour cell sensitivity to radiotherapy combined with radiosensitizing agents attributable to differences in expression levels of Epidermal Growth Factor Receptor (EGFr). Materials and methods Differences in radiosensitivity are not limited to cells of different cancer histotypes but also occur within the same cancer, or appear during radiotherapy if radiosensitizing drugs are combined with ionizing radiation. A modified biologically effective dose (MBED), has been introduced to account for changes in radiosensitivity parameters (α and α/β) rather than changes in dose/fraction or total dose as normally done with standard biologically effective dose (BED). The MBED approach was applied to cases of EGFr over-expression and cases where EGFr inhibitors were combined with radiation. Representative examples in clinical practice were considered. Results Assuming membrane EGFr over-expression corresponds to reduced radiosensitivity (αH = 0.15 Gy-1 and αH/βH = 7.5 Gy) relative to normal radiosensitivity (α = 0.2 Gy-1 and α/β = 10 Gy), an increased dose per fraction of 2.42 Gy was obtained through the application of MBED, which is equivalent to the effect of a reference schedule with 30 fractions of 2 Gy. An equivalent hypo-fractionated regime with a dose per fraction of 2.80 Gy is obtained if 25 fractions are set. Dose fractionations modulated according to drug pharmacokinetics are estimated for combined treatments with biological drugs. Soft and strong modulated equivalent hypo-fractionations result from subtraction of 5 or 10 fractions, respectively. Conclusions During this computational study, a new radiobiological tool has been introduced. The MBED allows the required dose per fraction to be estimated when tumour radiosensitivity is reduced because EGFr is over-expressed. If radiotherapy treatment is combined with EGFr inhibitors, MBED suggests new treatment strategies, with schedules modulated according to drug pharmacokinetics.

Purpose: The purpose of this study is to demonstrate the substancial equivalence of deformable registered planning CTimages and propagated planning contours on CBCT dataset with replanning volume CT and manually adapted structures of interests. Method and Materials: The study includes two nasopharyngeal cancer patients, imaged with a helical mode CT scan before starting the therapy (CTsim). The patient also underwent CBCT scans on a Varian On‐Board Imager (OBI) after 40Gy dose delivery and a re‐planning CT scan (CTrepl). We performed a B‐Spline intensity based deformable registration between CTsim and CBCT with the in‐house software Plastimatch. The output deformation field was used to propagate the structures of interest on the CBCT volume. A rigid registration between CTrepl and CBCT was also necessary to obtain surrogate contours for the CBCT volume. The registered images were evaluated in terms of increment of Mutual Information(MI) and of mean overlap between the propagated structures by means of Dice coefficient (DSC). Results: The MI shared by the warped CTsim and CBCT in comparison with the MI shared by CTsim and CBCT before registration showed an increment of 35% and 33% for patient 1 and 2 respectively, quantitatively assessing the goodness of deformable registration as supposed after visual inspection. The rigid registration outputs showed residual anatomical discrepancies between the CTrepl and CBCT volumes. DSC value were well above 0.80 for all the structures of interests but right eye for patient 1, while difference in contouring, poor rigid registration and/or different image quality caused the DSC to be lower in most structures for patient 2. Conclusion: The developed algorithm is able to propagate contours to a CBCT dataset acquired either before or after a CTrepl. This method represents the first step towards a full in‐room adaptation of a previously calculated plan.

Background: Almost 30% of the sunitinib-treated patients for metastatic renal carcinoma (mRCC) do not receive a clinical benefit. Convincing evidences demonstrated a cross talk between the VEGF and CXCR4 pathways. It was hypothesized that CXCR4 expression in primary renal cancer could predict sunitinib responsiveness. Patients and Methods: In this exploratory study sixty-two mRCC patients receiving sunitinib as first-line treatment were evaluated for CXCR4 expression through immunohistochemistry (IHC). Correlations between CXCR4 expression, baseline patients and tumour characteristics were studied by contingency tables and the chi-square test. Univariable analysis was performed with the log-rank test, and the Cox model was applied for multivariable analysis. Results: The objective response rate of sunitinib first-line therapy was 35.5% (22/62) with a disease control rate (response and stable disease) of 62.9% (39/62). CXCR4 expression was absent/low in 30 (48.4%), moderate in 17 (27.4%), and high in 15 (24.2%) tumors respectively. Low or absent CXCR4 expression predicted response to sunitinib therapy. Moreover, Fuhrman grading and concomitant, CXCR4 and Fuhrman grading, strongly predicted sunitinib first line therapy responsiveness on progression-free survival and overall survival. Conclusions: High CXCR4 expression correlates with sunitinib poor response in metastatic renal cancer