Body composition has gained increasing attention in oncology in recent years due to fact that sarcopenia has been revealed to be a strong prognostic indicator for survival across multiple stages and cancer types and a predictive factor for toxicity and surgery complications. Accumulating evidence over the last decade has unraveled the "pharmacology" of sarcopenia. Lean body mass may be more relevant to define drug dosing than the "classical" body surface area or flat-fixed dosing in patients with cancer. Since sarcopenia has a major impact on patient survival and quality of life, therapeutic interventions aiming at reducing muscle loss have been developed and are being prospectively evaluated in randomized controlled trials. It is now acknowledged that this supportive care dimension of oncological management is essential to ensure the success of any anticancer treatment. The field of sarcopenia and body composition in cancer is developing quickly, with (i) the newly identified concept of sarcopenic obesity defined as a specific pathophysiological entity, (ii) unsolved issues regarding the best evaluation modalities and cutoff for definition of sarcopenia on imaging, (iii) first results from clinical trials evaluating physical activity, and (iv) emerging body-compositiontailored drug administration schemes. In this context, we propose a comprehensive review providing a panoramic approach of the clinical, pharmacological and therapeutic implications of sarcopenia and body composition in oncology.
The infective stages, or ‘zoites, of coccidian parasites possess an organized network of spirally arranged microtubules that closely follow the helical body shape of these vermiform cells. These subpellicular microtubules are anchored anteriorly by insertion into a highly structured circular microtubule-organizing centre (MTOC) known as the polar ring. This MTOC has been examined both in situ and in isolated, critical-point-dried whole cytoskeletons. The 24 microtubules attach laterally to the MTOC through shallow depressions on the inner face of the ring: the ends do not appear to be physically capped. The polar ring has no obvious or regular substructure, although it has a faintly fibrous appearance. The polarity of the microtubules, determined by ‘hook decoration’, is such that the plus or fast-growing end is distal to the MTOC. The coccidian ‘zoite MTOC is unique both in its highly defined structure and in the degree of organization it confers upon the developing cell in terms of the number, spacing, orientation and polarity of the subpellicular microtubules.
Hematoporphyrin derivative-photoradiation therapy (HPD-PRT) of human malignancy has been performed on 267 tumor sites in 50 patients. Tumor response has been assayed at 24 hours and one month following treatment with 625-635 nm light from an argon laser-pumped dye laser. The majority of tumors treated were dermal breast cancer recurrences (21 cases), local recurrence of ENT squamous cell carcinomas (16 cases), and ENT cutaneous metastases of squamous cell carcinomas (9 cases). A 30-day favorable response was judged to be either complete regression of the tumor or reduction of tumor diameter by greater than 50%. The above categories of tumors had a combined favorable response of 81%. Appropriate dosimetry is discussed.
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