Liposomal Doxorubicin, Vinblastine and Dacarbazine Plus Consolidation Radiotherapy of Residual Nodal Masses for Frontline Treatment in Older Adults With Advanced Stage Classic Hodgkin Lymphoma: Improved Outcome in a Multi-Center Real-Life Study

: In elderly patients with high-risk classic Hodgkin lymphoma (c-HL), we evaluated the impact of a new modality treatment without bleomycin, that is, liposomal doxorubicin (NPLD)-based regimen plus consolidation radiotherapy of residual nodal masses (RNMs), on overall survival (OS) and progression free survival (PFS). In this retrospective study (2013-2023) conducted in tertiary hospitals in the bay of Naples (Italy), 50 older adults (median age, 69 years; range, 60-89) with advanced stage c-HL received frontline treatment with MVD ± irradiation. MVD consisted of 25 mg/m2 of NPLD along with standard Vinblastine and Dacarbazine for a total of 6 cycles (twelve iv administrations, every 2 weeks) followed by radiation of RNMs with size ≥ 2.5 cm at computed tomography. Patients underwent MVD with a median dose intensity of 92%. At 2-deoxy-2[F-18] fluoro-D-glucose positron emission tomography (FDG-PET), 90% of patients (45/50 patients; one failed to perform final FDG-PET due to early death) reached complete responses. Altogether, 17 patients (34%) received consolidation radiotherapy of RNMs with Deauville score ≥ 3. At 5-year median follow-up, the OS and PFS of the entire population were 87.5% (95% confidence interval [CI], 78.7-97.4) and 81.6% (95% CI, 71.4-93.2), respectively. Eleven patients (22%) experienced grade ≥ 3 adverse events, and 4 of them required hospitalization. Our data suggest that in older adults with high-risk c-HL NPLD-driven strategy (without bleomycin) plus consolidation radiotherapy (if needed) may be a promising up-front option, to test in phase II clinical trials for improving survival incidence

Turismo internazionale ed effetto “made in”. L’influenza dell’immagine Paese sulla soddisfazione turistica e le intenzioni post-visita

Questo studio propone un modello di ricerca finalizzato ad indagare la relazione esistente tra le diverse componenti dell’immagine Paese–valutate a livello generale (general country image) e con riferimento agli attributi turistici (tourism destination image) e alle produzioni nazionali (product-countryimage) – la soddisfazione turistica e le intenzioni post-visita in termini di fedeltà attesa e propensione all’acquisto delle produzioni nazionali. Il framework analitico è stato testato su un campione di turisti internazionali intercettati al termine della propria visita in Italia. Sulla base dei risultati, vengono discusse le principali implicazioni di ricerca e fornite indicazioni utili per la gestione dell’immagine Paese da parte degli enti pubblici che si occupano di promozione turistica e delle imprese del made in