Timing of cranial reconstruction after cranioplasty infections: are we ready for a re-thinking? A comparative analysis of delayed versus immediate cranioplasty after debridement in a series of 48 patients

Neurosurgical Review - The optimal management of cranioplasty infections remains a matter of debate. Most authors have suggested that the infected bone/implant removal is mandatory, combined with...     

Impact of docetaxel-based chemotherapy on quality of life of patients with castration-resistant prostate cancer: results from a prospective phase II randomized trial

Study Type – Therapy (RCT) Level of Evidence 1b What’s known on the subject? and What does the study add? Data on quality of life during docetaxel treatment in castration resistant prostate cancer was mainly provided by SWOG and TAX327 trials. In the TAX327 trial biochemical response and pain predicted survival, whereas quality of life outcomes did not. In the present study, there were no statistically significant changes in the quality of life scales during treatment except in the case of patients receiving docetaxel and estramustine, who experienced a significant decrease in pain. Our data seem to suggest that patients with a better baseline quality of life (and consequently with fewer symptoms) are more likely to achieve a biochemical response.

OBJECTIVES

? To assess quality of life (QoL) outcomes and pain changes in patients affected by castration‐resistant prostate cancer enrolled in a phase II randomized trial of 3‐week docetaxel (DOC)‐based chemotherapy. ? To provide further data to clarify the conflicting published data concerning the impact of DOC on the patients’ QoL.

PATIENTS AND METHODS

? QoL outcomes were assessed using the European Organisation for the Research and Treatment of Cancer QLQ‐C30 questionnaire. ? Pain changes were evaluated by means of the Brief Pain Inventory at baseline and after every two DOC courses. ? The patients completing at least two questionnaires (at baseline and before the third course) were considered evaluable.

RESULTS

? In all, 59 patients were evaluable. ? Asymptomatic patients and responders had a better baseline QoL than symptomatic patients and non‐responders. ? There were no statistically significant changes in the QLQ‐C30 scales during treatment except in the case of patients receiving DOC and estramustine, who experienced a significant decrease in pain. ? There was a progressive improvement in the mean intensity and interference scores of the Brief Pain Inventory.

CONCLUSIONS

? Our data confirm that QoL is generally maintained during chemotherapy. ? There is a substantial reduction in pain. ? Our results also suggest that baseline QoL may predict treatment response.