Interaction between deep and shallow groundwater systems in areas affected by Quaternary tectonics (Central Italy): a geochemical and isotope approach

Hydro- and isotope geochemistry are used to refine groundwater conceptual models in two areas of central Italy (Acque Albule Basin and Velino River Valley) affected by extensional Quaternary tectonics, where deep and shallow groundwater flow systems are interacting. The role of geology, of recent deposits filling the plains and of main tectonic features controlling groundwater flowpaths and deep-seated fluids emergences are investigated and discussed. Environmental isotopes ((2)H and (18)O) confirm recharge in the surrounding carbonate aquifers, and meteoric origin of both shallow and deep groundwater. Major ion chemistry indicates a mixing between shallow Ca-HCO(3) groundwater from carbonate aquifers and deep Ca-HCO(3)-SO(4) groundwater, characterised by higher salinity and temperature and high concentration in sulphates. Isotopic composition of dissolved sulphates (delta (34)S and delta (18)O) and dissolved inorganic carbon (delta (13)C), henceforth indicated as DIC, are used to verify the presence of different sources of groundwater, and to validate the mixing model suggested by the major ion analyses. Sulphate isotope composition suggests a marine origin for the groundwater characterised by elevated sulphate concentration, whose source is present in the deep buried sequences. Carbon isotope composition confirms the role of a DIC source associated to CO(2) degassing of a deep reservoir. Groundwater conceptual models are improved underlining the importance of Plio-Pleistocene sequences filling the tectonic depression. In the Acque Albule area, the travertine plateau represents a mixing stratified aquifer, where deep groundwater contribution is spread into the shallow aquifer. The alluvial-clastic-lacustrine leaky aquifer of Velino Valley enables a complete mixing of shallow and deep groundwater allowing spot-located discharge of deep groundwater along tectonic patterns and facilitating sulphate reduction in the lacustrine sediments, explaining locally the presence of H(2)S

Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study

PURPOSE: To study the prognostic value for overall survival of baseline assessment of functional status, comorbidity, and quality of life (QoL) in elderly patients with advanced non-small-cell lung cancer treated with chemotherapy. PATIENTS AND METHODS: Data from 566 patients enrolled onto the phase III randomized Multicenter Italian Lung Cancer in the Elderly Study (MILES) study were analyzed. Functional status was measured as activities of daily living (ADL) and instrumental ADL (IADL). The presence of comorbidity was assessed with a checklist of 33 items; items 29 and 30 of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30 (EORTC QLQ-C30) were used to estimate QoL. ADL was dichotomized as none versus one or more dependency. For IADL and QoL, three categories were defined using first and third quartiles as cut points. Comorbidity was summarized using the Charlson scale. Analysis was performed by Cox model, and stratified by treatment arm. RESULTS: Better values of baseline QoL (P = .0003) and IADL (P = .04) were significantly associated with better prognosis, whereas ADL (P = .44) and Charlson score (P = .66) had no prognostic value. Performance status 2 (P = .006) and a higher number of metastatic sites (P = .02) also predicted shorter overall survival. CONCLUSIONS: Pretreatment global QoL and IADL scores, but not ADL and comorbidity, have significant prognostic value for survival of elderly patients with advanced non-small-cell lung cancer who were treated with chemotherapy. Using these scores in clinical practice might improve prognostic prediction for treatment planning

Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study.

Purpose To study the prognostic value for overall survival of baseline assessment of functional status, comorbidity, and quality of life (QoL) in elderly patients with advanced non–small-cell lung cancer treated with chemotherapy. Patients and Methods Data from 566 patients enrolled onto the phase III randomized Multicenter Italian Lung Cancer in the Elderly Study (MILES) study were analyzed. Functional status was measured as activities of daily living (ADL) and instrumental ADL (IADL). The presence of comorbidity was assessed with a checklist of 33 items; items 29 and 30 of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30 (EORTC QLQ-C30) were used to estimate QoL. ADL was dichotomized as none versus one or more dependency. For IADL and QoL, three categories were defined using first and third quartiles as cut points. Comorbidity was summarized using the Charlson scale. Analysis was performed by Cox model, and stratified by treatment arm. Results Better values of baseline QoL (P .0003) and IADL (P .04) were significantly associated with better prognosis, whereas ADL (P .44) and Charlson score (P .66) had no prognostic value. Performance status 2 (P .006) and a higher number of metastatic sites (P .02) also predicted shorter overall survival. Conclusions Pretreatment global QoL and IADL scores, but not ADL and comorbidity, have significant prognostic value for survival of elderly patients with advanced non–small-cell lung cancer who were treated with chemotherapy. Using these scores in clinical practice might improve prognostic prediction for treatment planning