Response-adaptive designs have been proposed in randomized clinical trials to achieve ethical advantages by using sequential accrual information collected during the trial to update probabilities of treatment assignments. We propose the... more
Response-adaptive designs have been proposed in randomized clinical trials to achieve ethical advantages by using sequential accrual information collected during the trial to update probabilities of treatment assignments. We propose the use of a response adaptive design based on urn models in a simulation study on a randomized clinical trial on the efficacy of home enteral nutrition in cancer patients after major gastrointestinal surgery. We compare results with the adaptive design with those previously obtained with the non-adaptive approach. Abstract I disegni adattivi alla risposta sono stati proposti nell’ambito degli studi clinici per ottenere vantaggi etici utilizzando le informazioni sequenziali raccolte durante lo studio per aggiornare le probabilità di assegnazione ai trattamenti. In questo lavoro si propone l’uso di un disegno adattivo di risposta basato su modelli d’urna in uno studio di simulazione basato su uno studio clinico dell’efficacia della nutrizione enterale dom...
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ABSTRACT
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Research Interests: Endocrinology, Breast Cancer, Enzyme Inhibitors, Medicine, Multiple testing, and 15 morePostmenopausal Women, Humans, Internal Medicine, Nitriles, Female, Blood sampling, Aged, Middle Aged, Growth Factor, Aromatase Inhibitor, Biochemistry and cell biology, Insulin Like Growth Factor, Letrozole, aromatase, and postmenopause
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Research Interests: Gastroenterology, Cancer, Chemotherapy, Medicine, Humans, and 15 moreInternal Medicine, Female, Male, Aged, Middle Aged, Carcinoma, Adult, Neuroendocrine Tumor, Neuroendocrine Tumors, Combined Modality Therapy, Octreotide, Carcinoid tumor, Carcinoid Syndrome, Liver neoplasms, and Neoplasm metastasis
BACKGROUND.A series of patients with well differentiated (WD)/dedifferentiated (DD) retroperitoneal liposarcoma (RLS) was studied to evaluate the prognostic value of the presence, extension, and grade of the DD component.METHODS.Among 148... more
BACKGROUND.A series of patients with well differentiated (WD)/dedifferentiated (DD) retroperitoneal liposarcoma (RLS) was studied to evaluate the prognostic value of the presence, extension, and grade of the DD component.METHODS.Among 148 patients with RLS who underwent surgery over 20 years, the authors retrieved data on patients who had localized WD/DD RLS. For the current analysis, patients were included only if they had primary disease or a first recurrence at their initial presentation. The DD component, when present, was graded according to National Federation of Centers in the Fight Against Cancer (FNCLCC) criteria, and the extension of the DD component was described as a percentage. Univariate and multivariate analyses were carried out for local recurrence‐free survival (LRFS), event‐free survival (EFS), and disease‐specific survival (DSS).RESULTS.Of 93 patients who were identified, 36 patients (39%) had WD RLS, and 57 patients (61%) had DD RLS. The median follow‐up was 71 m...
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We sought to assess morbidity and mortality in primary retroperitoneal soft tissue sarcomas (RSTS) treated by a frontline aggressive surgical approach. A total of 249 consecutive patients with primary RSTS were treated by a frontline... more
We sought to assess morbidity and mortality in primary retroperitoneal soft tissue sarcomas (RSTS) treated by a frontline aggressive surgical approach. A total of 249 consecutive patients with primary RSTS were treated by a frontline aggressive surgical approach at two major European institutions. Multivariable models were used for exploring the relationship between postsurgical morbidity and the number of organs resected, with adjustment for clinical variables. The impact of morbidity on local and distant recurrence-free survival was explored by multivariable models, adjusting for the main known prognostic factors. Median follow-up was 37 months (interquartile [IQ] range, 16-61 months). Median tumor size was 17 cm (IQ range, 11-26 cm). The median number of organs resected en bloc with the tumor was 2 (IQ range, 1-3). Complete macroscopic resection was achieved in 232 cases (93%). At 5 years, overall survival was 65.4% (95% confidence interval [95% CI], 56.8-72.7); local and distant recurrence crude cumulative incidences were 22.3% (95% CI, 16.5-30.2) and 24.2% (95% CI, 18.4-31.9), respectively. Postsurgical morbidity requiring at least one invasive therapeutic procedure was observed in 45 patients (18%; 95% CI, 14-23). Surgical reintervention was necessary in 30 patients (12%; 95% CI, 8-17). Eight patients died of postoperative complications (3%; 95% CI, 1-6). No statistically significant association between postsurgical morbidity and any clinical variable was detected. For number of resected organs, we documented an increased risk of morbidity for more than three organs (P = 0.007). Postsurgical morbidity did not affect oncologic outcome. Frontline aggressive surgical approach to primary RSTS is safe when carried out at high-volume centers. It could be systematically considered in primary RSTS.
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Research Interests: Cancer, Risk assessment, Medicine, Linear models, Italy, and 15 moreMalnutrition, Prospective studies, Humans, Internal Medicine, Female, Male, Nutritional Status, Aged, Middle Aged, Outpatients, Risk Assessment, Severity of Illness Index, Psychology and Cognitive Sciences, Nutrition assessment, and Medical and Health Sciences
Purpose In this study on a series of 205 patients with rhabdomyosarcoma, we investigated whether the prognostic effect of tumor size, at diagnosis or in terms of tumor response after induction chemotherapy, differed when tumor diameter or... more
Purpose In this study on a series of 205 patients with rhabdomyosarcoma, we investigated whether the prognostic effect of tumor size, at diagnosis or in terms of tumor response after induction chemotherapy, differed when tumor diameter or tumor volume were considered. Patients and Methods Tumor size was assessed radiologically at diagnosis and, for the 108 patients with measurable disease, after three courses of chemotherapy. The analysis was based on multivariable models (linear for association between size and patient/tumor characteristics, Cox for association with survival). The predictive performance of the Cox model (estimated by V measure) was compared for the tumor's diameter and volume. Results Initial tumor size was significantly larger in male or older patients and in T2 or alveolar tumors, but was not associated with the achievement of complete surgical resection. Initial tumor size significantly influenced overall survival. The risk of death was comparable for tumors...
Research Interests: Magnetic Resonance Imaging, Chemotherapy, Survival Analysis, Adolescent, Medicine, and 15 moreMultivariate Analysis, Italy, Humans, Child, Female, Clinical, Male, Clinical oncology, Rhabdomyosarcoma, Proportional hazards model, Prognosis, Proportional Hazards Models, Predictive value of tests, Child preschool, and Decision Support Techniques
Home parenteral nutrition-quality of life (HPN-QOL) is a self-assessment tool for the measurement of QOL in patients on HPN. The aims of this study were: to re-assess the basic psychometric properties of the HPN-QOL in a multinational... more
Home parenteral nutrition-quality of life (HPN-QOL) is a self-assessment tool for the measurement of QOL in patients on HPN. The aims of this study were: to re-assess the basic psychometric properties of the HPN-QOL in a multinational sample of adult patients; to provide a description of QOL dimensions by short and long HPN treatment duration; to explore clinical factors potentially associated to QOL scores. Patients (n = 699) from 14 countries completed the HPN-QOL. The questionnaires were analysed to evaluate data completeness, convergent/discriminant validity and internal-consistency reliability. The association of overall QOL and HPN treatment duration as well as other clinical factors were investigated using multivariable linear regression models. The analysis of the multitrait-scaling and internal consistency indicates a good fit with the questionnaire structure for most items. Item discriminant validity correlation was satisfactory and psychometric evaluation of the HPN-QOL i...
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Purpose To determine the activity of pembrolizumab as neoadjuvant immunotherapy before radical cystectomy (RC) for muscle-invasive bladder carcinoma (MIBC) for which standard cisplatin-based chemotherapy is poorly used. Patients and... more
Purpose To determine the activity of pembrolizumab as neoadjuvant immunotherapy before radical cystectomy (RC) for muscle-invasive bladder carcinoma (MIBC) for which standard cisplatin-based chemotherapy is poorly used. Patients and Methods In the PURE-01 study, patients had a predominant urothelial carcinoma histology and clinical (c)T≤3bN0 stage tumor. They received three cycles of pembrolizumab 200 mg every 3 weeks before RC. The primary end point in the intention-to-treat population was pathologic complete response (pT0). Biomarker analyses included programmed death-ligand 1 (PD-L1) expression using the combined positive score (CPS; Dako 22C3 pharmDx assay), genomic sequencing (FoundationONE assay), and an immune gene expression assay. Results Fifty patients were enrolled from February 2017 to March 2018. Twenty-seven patients (54%) had cT3 tumor, 21 (42%) cT2 tumor, and two (4%) cT2-3N1 tumor. One patient (2%) experienced a grade 3 transaminase increase and discontinued pembrol...
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To evaluate the impact of number of cycles of platinum-based first-line chemotherapy <6 versus the conventional ≥6 on survival of metastatic urothelial carcinoma (UC). The Retrospective International Study of Invasive/Advanced Cancer... more
To evaluate the impact of number of cycles of platinum-based first-line chemotherapy <6 versus the conventional ≥6 on survival of metastatic urothelial carcinoma (UC). The Retrospective International Study of Invasive/Advanced Cancer of the Urothelium (RISC) database was employed. The association of the number of cycles of chemotherapy with overall survival (OS) was investigated by Cox multiple regression analysis after controlling for recognized prognostic factors. We excluded patients receiving <3 or >9 cycles of platinum chemotherapy to reduce confounding factors. The primary analysis was a comparison of OS with 3-5 cycles versus 6-9 cycles using 6-month landmark analysis when 281 death events were observed. Of 1,020 patients in RISC, 472 who received cisplatin (n=338) or carboplatin (n=134) were evaluable. A total of 157 patients received 3-5 cycles (median 4) and 315 received 6-9 cycles (median 6). There was no significant difference in OS between 3-5 and 6-9 cycles (H...
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Epithelioid sarcoma (ES) is an exceedingly rare malignant neoplasm with distinctive pathologic, molecular, and clinical features as well as the potential to respond to new targeted drugs. Little is known on the activity of... more
Epithelioid sarcoma (ES) is an exceedingly rare malignant neoplasm with distinctive pathologic, molecular, and clinical features as well as the potential to respond to new targeted drugs. Little is known on the activity of anthracycline-based regimens, gemcitabine-based regimens, and pazopanib in this disease. To report on the activity of anthracycline-based regimens, gemcitabine-based regimens, and pazopanib in patients with advanced ES. Seventeen sarcoma reference centers in Europe, the United States, and Japan contributed data to this retrospective analysis of patients with locally advanced/metastatic ES diagnosed between 1990 and 2016. Local pathological review was performed in all cases to confirm diagnosis according to most recent criteria. All patients included in the study received anthracycline-based regimens, gemcitabine-based regimens, or pazopanib. Response was assessed by RECIST. Progression-free survival (PFS) and overall survival (OS) were computed by Kaplan-Meier met...
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No validated prognostic tool is available for predicting overall survival (OS) of patients with well-differentiated neuroendocrine tumors (WDNETs). This study, conducted in three independent cohorts of patients from five different... more
No validated prognostic tool is available for predicting overall survival (OS) of patients with well-differentiated neuroendocrine tumors (WDNETs). This study, conducted in three independent cohorts of patients from five different European countries, aimed to develop and validate a classification prognostic score for OS in patients with stage IV WDNETs. We retrospectively collected data on 1387 patients: (i) patients treated at the Istituto Nazionale Tumori (Milan, Italy; n=515); (ii) European cohort of rare NET patients included in the European RARECAREnet database (n=457); (iii) Italian multicentric cohort of pancreatic NET (pNETs) patients treated at 24 Italian institutions (n=415). The score was developed using data from patients included in cohort (i) (training set); external validation was performed by applying the score to the data of the two independent cohorts (ii) and (iii) evaluating both calibration and discriminative ability (Harrell C statistic). We used data on age, p...
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We aimed to assess the incidence and risk factors of secondary malignancy (SM) in the young adult patients who received high-dose chemotherapy (HDCT) for germ cell tumors (GCT). The EBMT database was interrogated. Criteria for patient... more
We aimed to assess the incidence and risk factors of secondary malignancy (SM) in the young adult patients who received high-dose chemotherapy (HDCT) for germ cell tumors (GCT). The EBMT database was interrogated. Criteria for patient selection included adult male GCT and HDCT administered in any line of therapy. Cumulative incidence methods were used to estimate the time-to-SM diagnosis. Univariable Fine and Gray proportional hazard regression evaluated risk factors of SM occurrence. From 1981 to 2015, 9153 autografts were identified. Among 5295 patients, 59 cases of SM, developed after a median follow-up of 3.8 years, were registered. Of these patients, 23 (39%) developed hematologic SM, 34 (57.6%) solid SM (two patients had uncoded SM). Twenty-year cumulative incidence of solid versus hematologic SM was 4.17% (95% CI: 1.78-6.57) versus 1.37% (95% CI: 0.47-2.27). Median overall survival after SM was significantly shorter for patients who developed hematologic SM versus solid SM (8...
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The accurate prediction of prognosis in patients with soft tissue sarcoma (STS) is a challenging issue. Extreme variability in the clinical and pathological characteristics of this family of tumors hinders the simple stratification of... more
The accurate prediction of prognosis in patients with soft tissue sarcoma (STS) is a challenging issue. Extreme variability in the clinical and pathological characteristics of this family of tumors hinders the simple stratification of patients into meaningful prognostic cohorts. Precision medicine tools for the prediction of prognosis, such as nomograms, enable personalized computation of outcome based on clinical and pathological characteristics of both patient and tumor. The eighth edition of the American Joint Committee on Cancer staging manual moved from a "population-based" to a "personalized" approach endorsing high-quality nomograms to improve clinician prediction ability in definite patient subgroups. The first nomogram for STS was published in 2002, and this was followed by several prognostic predictors offered to clinicians. Focusing on a specific STS subgroup or site, nomograms can take into consideration highly specific factors relevant only in that p...
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The available prognostic models for overall survival (OS) in patients with metastatic urothelial carcinoma (UC) have been derived from clinical trial populations of cisplatin-treated patients. To develop a new model based on real-world... more
The available prognostic models for overall survival (OS) in patients with metastatic urothelial carcinoma (UC) have been derived from clinical trial populations of cisplatin-treated patients. To develop a new model based on real-world patients. Individual patient-level data from 29 centers were collected, including metastatic UC and first-line cisplatin- or carboplatin-based chemotherapy administered between January 2006 and January 2011. First-line, platinum-based, combination chemotherapy. The population was randomly split into a development and a validation cohort. Generalized boosted regression modelling was used to screen out irrelevant variables and address multivariable analyses. Two nomograms were built to estimate OS probability, the first based on baseline factors and platinum agent, the second incorporating objective response (OR). The performance of the above nomograms and that of other available models was assessed. We plotted decision curves to evaluate the clinical u...
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Background: adaptive clinical trial design has been proposed as a promising new approach to improve the drug discovery process. Among the many options available, adaptive sample size re-estimation is of great interest mainly because of... more
Background: adaptive clinical trial design has been proposed as a promising new approach to improve the drug discovery process. Among the many options available, adaptive sample size re-estimation is of great interest mainly because of its ability to avoid a large ‘up-front’ commitment of resources. In this simulation study, we investigate the statistical properties of two-stage sample size re-estimation designs in terms of type I error control, study power and sample size, in comparison with the fixed-sample study. Methods: we simulated a balanced two-arm trial aimed at comparing two means of normally distributed data, using the inverse normal method to combine the results of each stage, and considering scenarios jointly defined by the following factors: the sample size re-estimation method, the information fraction, the type of group sequential boundaries and the use of futility stopping. Calculations were performed using the statistical software SAS™ (version 9.2). Results: under the null hypothesis, any type of adaptive design considered maintained the prefixed type I error rate, but futility stopping was required to avoid the unwanted increase in sample size. When deviating from the null hypothesis, the gain in power usually achieved with the adaptive design and its performance in terms of sample size were influenced by the specific design options considered. Conclusions : we show that adaptive designs incorporating futility stopping, a sufficiently high information fraction (50-70%) and the conditional power method for sample size re-estimation have good statistical properties, which include a gain in power when trial results are less favourable than anticipated.
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To assess the diagnostic performance of the BLES as a biopsy tool in patients with ≤1cm clusters of BIRADS 4 microcalcifications, in order to possibly avoid surgical excision in selected patients. This is a retrospective study of 105... more
To assess the diagnostic performance of the BLES as a biopsy tool in patients with ≤1cm clusters of BIRADS 4 microcalcifications, in order to possibly avoid surgical excision in selected patients. This is a retrospective study of 105 patients undergone to stereotactic breast biopsy with the BLES. It excises a single specimen containing the whole mammographic target, allowing better histological assessment due to preserved architecture. Our case series consists of 41 carcinomas (39%) and 64 benign lesions (61%). Cancer involved the specimen margins in 20/41 cases (48.8%) or was close to them (≤1mm) in 14 cases (34.1%); margins were disease-free in only 7 DCIS (17.1%). At subsequent excision of 39/41 malignant cases, underestimation occurred for 5/32 DCIS (15.6%), residual disease was found in 15/39 cancers (38.5%) and no cancer in 19/39 cases (48.7%). For DCIS cases, no residual disease occurred for 66.7% G1-G2 cases and for 35.3% G3 cases (P=0.1556) as well as in 83.3%, 40.0% and 43.8% cases respectively for negative, close and positive BLES margins (P=0.2576). The BLES is a good option for removal of small clusters of breast microcalcifications, giving better histological interpretation, lower underestimation rates and possibly reducing the need of subsequent surgical excision in selected patients.
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Research Interests: Breast Cancer, Image Analysis, Medicine, Humans, Placebo, and 15 moreFemale, Chemoprevention, Breast, Morphometric Analysis, Clinical Sciences, Middle Aged, Biomarker, Combination drug therapy, Disease Progression, Estradiol, Fine needle aspiration, Hot Flashes, fenretinide, placebo controlled study, and postmenopause
Objective: Combination therapies of fluorouracil (FU) with irinotecan (CPT-11) and docetaxel plus cisplatin have been proven to be active in metastatic gastric cancer. In this paper, we present the results of a phase III trial in which... more
Objective: Combination therapies of fluorouracil (FU) with irinotecan (CPT-11) and docetaxel plus cisplatin have been proven to be active in metastatic gastric cancer. In this paper, we present the results of a phase III trial in which these two combinations given sequentially were compared to mitomycin C (MMC) monochemotherapy in an adjuvant setting. Methods: 169 patients with radically resected gastric cancer were randomized to receive CPT-11 (180 mg/m2 day 1), leucovorin (100 mg/m2 days 1–2), FU (400–600 mg/m2 days 1–2, q 14; for four cycles; FOLFIRI regimen), followed by docetaxel (85 mg/m2 day 1), cisplatin (75 mg/m2 day 1, q 21; for three cycles; arm A), or MMC (8 mg/m2 days 1–2 as 2-hour infusion, q 42; for four cycles; arm B). All patients had histologically confirmed gastric carcinoma with nodal positivity or pT3/4. A total of 166 patients (85 in arm A and 81 in arm B) were treated. Adjuvant treatment was completed in 76% of the patients in arm A and in 70% of the patients ...
Research Interests: Adolescent, Diarrhea, Humans, Female, Feasibility Studies, and 15 moreGastric Cancer, Cisplatin, Aged, Adult, Combination drug therapy, Camptothecin, Adjuvant Chemotherapy, Gastric Carcinoma, Adenocarcinoma, Docetaxel, Combination Therapy, FOLFIRI, Gastric Adenocarcinoma, Disease Free Survival, and fluorouracil
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We performed a phase II study to assess feasibility, pain relief, and toxicity of a tetracaine-based oral gel in the treatment of radiotherapy (RT)-induced mucositis. Fifty patients treated with RT for head-and-neck cancer with clinical... more
We performed a phase II study to assess feasibility, pain relief, and toxicity of a tetracaine-based oral gel in the treatment of radiotherapy (RT)-induced mucositis. Fifty patients treated with RT for head-and-neck cancer with clinical evidence of acute oral mucositis of grade&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=2 were scheduled to receive the tetracaine gel. A questionnaire evaluating the effect of the gel was given to all subjects. In 38 patients (79.2%), a reduction in oral cavity pain was reported. Thirty-four patients (82.9%) reported no side effect. Seventy-one percent of patients had no difficulties in gel application. Unpleasant taste of the gel and interference with food taste were noticed in 5 (12%) and 16 patients (39%), respectively. Planned RT course was interrupted less frequently in patients who reported benefit from gel application than in patients who did not (p=0.014). None of the patients who experienced pain relief needed a nasogastric tube, opposite to the patients who did not report any benefit from gel application (p=0.001). Tetracaine oral gel administration seemed feasible and safe while reducing RT-induced mucositis-related oral pain in a sizeable proportion of treated head-and-neck cancer patients. A trial designed to compare efficacy of this gel vs. standard treatment is warranted.
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Abstract DNA topoisomerases, nuclear enzymes that regulate DNA topology, are recognized as the primary targets of effective anti-tumor drugs. These enzymes may also have a role in the repair of DNA damage induced by alkylating agents and... more
Abstract DNA topoisomerases, nuclear enzymes that regulate DNA topology, are recognized as the primary targets of effective anti-tumor drugs. These enzymes may also have a role in the repair of DNA damage induced by alkylating agents and platinum compounds; ...
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Research Interests: Genetics, Computed Tomography, Cancer, Natural History, Medicine, and 15 moreLung Cancer, Humans, Female, Male, DNA methylation, Aged, Middle Aged, Early Detection, Sensitivity and Specificity, Case Control Study, Case Control Studies, Bronchoalveolar lavage, Lower respiratory tract, Peripheral blood, and lung neoplasms
Research Interests: Nutrition and Dietetics, Medicine, Multivariate Analysis, Malnutrition, Clinical Nutrition, and 15 moreHumans, Female, Male, Nutritional Status, Aged, Middle Aged, Immune system, Morbidity, Age Factors, Body Weight, Fluid Therapy, Gastrointestinal Cancer, Enteral Nutrition, Nutritional Support, and Colorectal Neoplasms
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Research Interests: Genetics, Computed Tomography, Lung Cancer, Prospective studies, Humans, and 15 moreFemale, Male, Cancer Diagnosis, American, Risk factors, Aged, Middle Aged, Longitudinal Study, Risk Factors, Case Control Study, Area Under Curve, Prospective Study, Non small Cell Lung Cancer, Medical and Health Sciences, and lung neoplasms
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We assessed the presence of salivary cytokines, their modulation during chemoradiation therapy (CTRT), and their association with oral mucositis severity in patients with head and neck cancer (HNC). The present prospective observational... more
We assessed the presence of salivary cytokines, their modulation during chemoradiation therapy (CTRT), and their association with oral mucositis severity in patients with head and neck cancer (HNC). The present prospective observational study enrolled 55 patients with locally advanced HNC requiring CTRT. We also studied 10 healthy volunteers and 10 patients with other cancers. The salivary levels of 13 cytokines were analyzed. We constructed a cytokine predictive score of oral mucositis severity. The baseline salivary cytokine levels were not associated with the severity of treatment-induced oral mucositis. The cytokine levels overall increased during treatment, especially in patients with worse mucositis. In particular, on univariable analysis, an increase of interleukin (IL)-1β (area under the curve [AUC] 0.733; P=.009), IL-6 (AUC 0.746; P=.005), and tumor necrosis factor-α (AUC 0.710; P=.005) at the third week of treatment was significantly associated with the development of severe oral mucositis. On multivariable analysis, the predictive score based on the IL-1β and IL-6 changes from baseline to week 3 was an early strong predictor of higher grade oral mucositis. The treatment of HNC patients with concurrent CTRT induces a significant increase in the salivary levels of IL-1β, IL-6, and tumor necrosis factor-α, all positively associated with the severity of mucosal toxicity. A greater increase of IL-1β and IL-6 3 weeks after treatment initiation is predictive of worse oral mucositis, representing a potential tool for the early identification of patients at risk.
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The analysis of yearly, seasonal and monthly frequency of north föhn in the Po valley was carried out considering some stations located in western Lombardy (Italy) and in Canton Ticino (Switzerland) and adopting synoptic, mesoscale and... more
The analysis of yearly, seasonal and monthly frequency of north föhn in the Po valley was carried out considering some stations located in western Lombardy (Italy) and in Canton Ticino (Switzerland) and adopting synoptic, mesoscale and punctual (single station's) recognition criteria. The results show a gradual reduction of föhn frequency with increasing dis- tance from the Alpine watershed but a
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A prognostic index (PI) is usually derived from a regression model as a weighted mean of the covariates, with weights (partial scores) proportional to the parameter estimates. When a PI is applied to patients other than those considered... more
A prognostic index (PI) is usually derived from a regression model as a weighted mean of the covariates, with weights (partial scores) proportional to the parameter estimates. When a PI is applied to patients other than those considered for its development, the issue of assessing its validity on the new case series is crucial. For this purpose, Van Houwelingen (2000)