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Ciardo D, Pisani P, Lombardi FA, Franchini R, Conversano F, Casciaro S. POS0163 INCIDENT FRACTURE RISK PREDICTION USING THE FRAGILITY SCORE CALCULATED BY LUMBAR SPINE RADIOFREQUENCY ECHOGRAPHIC MULTI SPECTROMETRY (REMS) SCANS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The main consequence of osteoporosis is the occurrence of fractures due to bone fragility, with important sequelae in terms of disability and mortality. It has been already demonstrated that the information about bone mass density (BMD) alone is not sufficient to predict the risk of fragility fractures, since several fractures occur in patients with normal BMD [1].The Fragility Score is a parameter that allows to estimate skeletal fragility thanks to a trans-abdominal ultrasound scan performed with Radiofrequency Echographic Multi Spectrometry (REMS) technology. It is calculated by comparing the results of the spectral analysis of the patient’s raw ultrasound signals with reference models representative of fragile and non-fragile bones [2]. It is a dimensionless parameter, which can vary from 0 to 100, in proportion to the degree of fragility, independently from BMD.Objectives:This study aims to evaluate the effectiveness of Fragility Score, measured during a bone densitometry exam performed with REMS technology at lumbar spine, in identifying patients at risk of incident osteoporotic fractures at a follow-up period of 5 years.Methods:Caucasian women with age between 30 and 90 were scanned with spinal REMS and DXA. The incidence of osteoporotic fractures was assessed during a follow-up period of 5 years. The ability of the Fragility Score to discriminate between patients with and without incident fragility fractures was subsequently evaluated and compared with the discriminatory ability of the T-score calculated with DXA and with REMS.Results:Overall, 533 women (median age: 60 years; interquartile range [IQR]: 54-66 years) completed the follow-up (median 42 months; IQR: 35-56 months), during which 73 patients had sustained an incident fracture.Both median REMS and DXA measured T-score values were significantly lower in fractured patients than for non-fractured ones, conversely, REMS Fragility Score was significantly higher (Table 1).Table 1.Analysis of T-score values calculated with REMS and DXA and Fragility Score calculated with REMS. Median values and interquartile ranges (IQR) are reported. The p-value is derived from the Mann-Whitney test.Patients without incident fragility fracturePatients with incident fragility fracturep-valueT-score DXA[median (IQR)]-1.9 (-2.7 to -1.0)-2.6 (-3.3 to -1.7)0.0001T-score REMS[median (IQR)]-2.0 (-2.8 to -1.1)-2.7 (-3.5 to -1.9)<0.0001Fragility Score[median (IQR)]29.9 (25.7 to 36.2)53.0 (34.2 to 62.5)<0.0001By evaluating the capability to discriminate patients with/without fragility fractures, the Fragility Score obtained a value of the ROC area under the curve (AUC) of 0.80, higher than the AUC of the REMS T-score (0.66) and of the T-score DXA (0.64), and the difference was statistically significant (Figure 1).Figure 1.ROC curve comparison of Fragility Score, REMS and DXA T-score values in the classification of patients with incident fragility fractures.Furthermore, the correlation between the Fragility Score and the T-score values was low, with Pearson correlation coefficient r=-0.19 between Fragility Score and DXA T-score and -0.18 between the Fragility Score and the REMS T-score.Conclusion:The Fragility Score was found to be an effective tool for the prediction of fracture risk in a population of Caucasian women, with performances superior to those of the T-score values. Therefore, this tool presents a high potential as an effective diagnostic tool for the early identification and subsequent early treatment of bone fragility.References:[1]Diez Perez A et al. Aging Clin Exp Res 2019; 31(10):1375-1389.[2]Pisani P et al. Measurement 2017; 101:243–249.Disclosure of Interests:None declared
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Leonardi M, Cattani F, Pepa M, Luraschi R, Vigorito S, Gugliandolo S, Ciardo D, Orecchia R, Jereczek-Fossa B. PO-0979: Variability of axillary nodal CTV contouring in breast cancer (PART I - geometric evaluation). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00997-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Leonardi M, Cattani F, Pepa M, Luraschi R, Vigorito S, Gugliandolo S, Ciardo D, Orecchia R, Jereczek-Fossa B. PO-0981: Variability of axillary nodal CTV contouring in breast cancer (PART II – dosimetric impact). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00999-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Marvaso G, Gugliandolo S, Comi S, Pepa M, Russo S, Vischioni B, Valvo F, Giandini T, Avuzzi B, Valdagni R, Ciardo D, Jereczek-Fossa B, Cattani F, Orecchia R. PO-1748: Carbon-ion boost followed by photon IMRT for PCa: dosimetric and geometric evaluations, AIRCIG. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01766-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pepa M, Gugliandolo S, Isaksson L, Marvaso G, Raimondi S, Botta F, Gandini S, Ciardo D, Volpe S, Riva G, Rojas D, Zerini D, Pricolo P, Alessi S, Petralia G, Summers P, Mistretta A, Luzzago S, Cattani F, De Cobelli O, Cassano E, Cremonesi M, Bellomi M, Orecchia R, Jereczek-Fossa B. PO-1576: Assessment of mpMRI-based radiomics tools in PCa for cancer aggressiveness prediction, AIRC IG-. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01594-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Giannitto C, Marvaso G, Botta F, Raimondi S, Alterio D, Ciardo D, Volpe S, De Piano F, Ancona E, Tagliabue M, Origgi D, Chiocca S, Maffini FA, Ansarin M, Bagnardi V, Cattani F, Nolè F, Preda L, Orecchia R, Cassano E, Cremonesi M, Starzyńska A, Bellomi M, Jereczek-Fossa BA. Association of quantitative MRI-based radiomic features with prognostic factors and recurrence rate in oropharyngeal squamous cell carcinoma. Neoplasma 2020; 67:1437-1446. [PMID: 32787435 DOI: 10.4149/neo_2020_200310n249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/24/2020] [Indexed: 11/08/2022]
Abstract
Radiomics focuses on extracting a large number of quantitative imaging features and testing both their correlation with clinical characteristics and their prognostic and predictive values. We propose a radiomic approach using magnetic resonance imaging (MRI) to decode the tumor phenotype and local recurrence in oropharyngeal squamous cell carcinoma (OPSCC). The contrast-enhanced T1-weighted sequences from baseline MRI examinations of OPSCC patients treated between 2008 and 2016 were retrospectively selected. Radiomic features were extracted using the IBEX software, and hiegrarchical clustering was applied to reduce features redundancy. The association of each radiomic feature with tumor grading and stage, HPV status, loco-regional recurrence within 2 years, considered as main endpoints, was assessed by univariate analysis and then corrected for multiple testing. Statistical analysis was performed with SAS/STAT® software. Thirty-two eligible cases were identified. For each patient, 1286 radiomic features were extracted, subsequently grouped into 16 clusters. Higher grading (G3 vs. G1/G2) was associated with lower values of GOH/65Percentile and GOH/85Percentile features (p=0.04 and 0.01, respectively). Positive HPV status was associated with higher values of GOH/10Percentile (p=0.03) and lower values of GOH/90Percentile (p=0.03). Loco-regional recurrence within 2 years was associated with higher values of GLCM3/4-7Correlation (p=0.04) and lower values of GLCM3/2-1InformationMeasureCorr1 (p=0.04). Results lost the statistical significance after correction for multiple testing. T stage was significantly correlated with 9 features, 4 of which (GLCM25/180-4InformationMeasureCorr2, Shape/MeanBreadth, GLCM25/90-1InverseDiffMomentNorm, and GLCM3/6-1InformationMeasureCorr1) retained statistical significance after False Discovery Rate correction. MRI-based radiomics is a feasible and promising approach for the prediction of tumor phenotype and local recurrence in OPSCC. Some radiomic features seem to be correlated with tumor characteristics and oncologic outcome however, larger collaborative studies are warranted in order to increase the statistical power and to obtain robust and validated results.
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Affiliation(s)
- C Giannitto
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - G Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - F Botta
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Raimondi
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - D Alterio
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - D Ciardo
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Volpe
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - F De Piano
- Postgraduation School in Radiodiagnostics, University of Milan, Milan, Italy
| | - E Ancona
- Postgraduation School in Radiodiagnostics, University of Milan, Milan, Italy
| | - M Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - D Origgi
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - F Antonio Maffini
- Department of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Ansarin
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - V Bagnardi
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - F Cattani
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - F Nolè
- Department of Medical Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - L Preda
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,National Centre of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - R Orecchia
- Scientific Directorate, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Medical Imaging and Radiation Sciences, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - E Cassano
- Breast Imaging Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Cremonesi
- Radiation Research Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Starzyńska
- Department of Oral Surgery, Medical University of Gdansk, Gdansk, Poland
| | - M Bellomi
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - B Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
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Quarta E, Ciardo D, Ciccarese M, Conversano F, DI Paola M, Forcignanò R, Grimaldi A, Lombardi FA, Muratore M, Pisani P, Casciaro S. SAT0461 SHORT-TERM MONITORING OF DENOSUMAB EFFECT IN BREAST CANCER PATIENTS RECEIVING AROMATASE INHIBITORS USING REMS TECHNOLOGY ON LUMBAR SPINE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Aromatase inhibitor (AI) therapy in women with estrogen receptor-positive (ER+) breast cancer (BC) causes accelerated bone loss and increased risk of osteoporosis and fractures as side effects. Denosumab (i.e. 60 mg twice a year) is a viable therapy against bone resorption, but the short-term monitoring of bone mineral density (BMD) change with time is still an unmet clinical need, since the current techniques (including dual-energy X-ray absorptiometry, DXA) require 1-2 years between two consecutive measurements [1]. Radiofrequency Echographic Multi Spectrometry (REMS), with high performance in terms of precision and repeatability [2], might be used in this setting of patients for short-term monitoring of bone health-related parameters.Objectives:The objective is the short-term monitoring of the effect of AIs with/without denosumab on bone health in BC patients using REMS and DXA scans at lumbar spine.Methods:Post-menopausal ER+ BC patients treated with adjuvant AIs were recruited. Two subgroups were identified, whether receiving also 60 mg of denosumab therapy every 6 months or not (named Group A and Group B, respectively). All patients underwent baseline DXA and REMS lumbar spine scans at time T0, previous to the first AI therapy, and after 12 months (time T1). REMS scan only was repeated also at 18 months (T2), since a 6-month interval between two consecutive scans is not recommended for DXA. The bone mineral density (BMD) was measured with both techniques.Results:Overall, 254 ER+ BC patients were enrolled (127 per group). The effect of denosumab on BMD is reported in Table. The BMD values obtained by DXA and REMS were not significantly different at T0 and T1, whereas the difference between Group A and B at T1 was statistically significant (p<0.001) both for REMS and DXA. At T2, REMS confirmed the increasing trend of BMD for Group A and the decreasing one for Group B, and the difference between groups was statistically significant (p<0.001). For each time point and each group, there were not statistically significant differences between DXA and REMS.Conclusion:Several studies have shown the effect of denosumab on BMD over a period not less than 2 years from the start of treatment. This study showed the feasibility of short-term follow-up using REMS lumbar spine scans at 6-month time steps.References:[1]Diez-Perez A et al, Aging Clin Exp Res 2019;31(10):1375–89[2]Di Paola M et al, Osteoporos Int 2018;30:391–402Table 1.BMD values, expressed as g/cm2, measured by DXA and REMS for Group A (patients receiving AIs only) and Group B (patients receiving AIs and denosumab) at baseline (T0), 12 months (T1) and 18 months (T2) from the start of therapy. Results are presented as median values with 25thand 75thpercentiles. P-values are obtained with a Mann-Whitney test.DXAREMSScan timeGroup AGroup BpGroup AGroup BpT00.840 (0.719-0.959)0.867 (0.723-0.958)0.990.833 (0.708-0.949)0.855 (0.714-0.973)0.77T10.823 (0.702-0.944)0.889 (0.749-0.990)0.0030.819 (0.691-0.927)0.887 (0.740-1.018)<0.001T2---0.801 (0.679-0.909)0.899 (0.754-1.020)<0.001Note:The authorsD. Ciardo, M. Ciccarese, F. Conversano, M. Di Paola, R. Forcignanò, A. Grimaldi, F.A. Lombardi, M. Muratore and P. Pisaniare listed in alphabetical orderDisclosure of Interests:None declared
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Caffarelli C, Adami G, Arioli G, Bianchi G, Brandi ML, Casciaro S, Cianferotti L, Ciardo D, Conversano F, Gatti D, Girasole G, Manfedini M, Muratore M, Pisani P, Quarta E, Quarta L, Gonnelli S. AB1082 INFLUENCE OF THE VARIATION OF THE OPERATOR, PATIENT POSITION AND DEVICE ON THE MEASUREMENT PERFORMANCE OF RADIOFREQUENCY ECHOGRAPHIC MULTI SPECTROMETRY (REMS). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The monitoring of bone mineral density (BMD) is a key aspect for patients undergoing pharmacological treatments that might cause BMD changes at non-physiological rates. At present, the short-term follow-up of patients under treatment in terms of BMD change with time remains an unmet clinical need, since the current techniques, including the gold standard dual X-ray absorptiometry (DXA), require at least 1 year between two consecutive measurements [1]. Therefore, an effective strategy for the assessment of BMD should guarantee high accuracy, precision and repeatability of the measurements.Objectives:The aim is to assess the influence of the variation 1) in patient position, 2) operator (both intra- and inter-) and 3) device on the REMS performance at lumbar spine and femoral neck.Methods:210 women were enrolled, divided in 7 groups of 30-patient each for the assessment of the parameters of interest, i.e. inter-device, intra- and inter-operator repeatability for lumbar spine scans and inter-patient position, inter-device, intra- and inter-operator repeatability for femoral neck scans.All patients underwent 2 REMS scans at lumbar spine or femoral neck, performed by the same operator or by 2 different operators or by the same operator using 2 different devices or in different patient position (i.e. supine without constraints or with a constrained 25°-rotation of the leg). The percentage coefficient of variation (CV%) with 95% confidence interval and least significant change for a 95% confidence level (LSC) have been calculated.Results:For lumbar spine, intra-operator repeatability resulted in CV%=0.37% (95%CI: 0.26%-0.48%), with LSC=1.02%, inter-operator repeatability resulted in CV%=0.55% (95% CI: 0.42%-0.68%), with LSC=1.52%, inter-device repeatability resulted in CV%=0.53% (95% CI: 0.40%-0.66%), with LSC=1.47%.For femoral neck, intra-operator repeatability resulted in CV%=0.33% (95%CI: 0.23%-0.43%), with LSC=0.91%, inter-operator repeatability resulted in CV%=0.47% (95% CI: 0.35%-0.59%), with LSC=1.30%, inter-device repeatability resulted in CV%=0.42% (95% CI: 0.30%-0.51%), with LSC=1.16%, inter-patient position repeatability resulted in CV%=0.24% (95% CI: 0.18%-0.30%), with LSC=0.66%.Conclusion:REMS densitometry is highly precise for both anatomical sites, showing high performance in repeatability. These results suggest that REMS might be a suitable technology for short-term monitoring. Moreover, thanks to its ionizing radiation-free approach, it might be applied for population mass investigations and prevention programs also in paediatric patients and pregnant women.References:Note:Carla Caffarelli, Giovanni Adami§, Giovanni Arioli§, Gerolamo Bianchi§, Maria Luisa Brandi§, Sergio Casciaro§, Luisella Cianferotti§, Delia Ciardo§, Francesco Conversano§, Davide Gatti§, Giuseppe Girasole§, Monica Manfredini§, Maurizio Muratore§, Paola Pisani§, Eugenio Quarta§, Laura Quarta§, Stefano Gonnelli§Equal contributors listed in alphabetical orderDisclosure of Interests:Carla Caffarelli: None declared, Giovanni Adami: None declared, Giovanni Arioli *: None declared, Gerolamo Bianchi Grant/research support from: Celgene, Consultant of: Amgen, Janssen, Merck Sharp & Dohme, Novartis, UCB, Speakers bureau: Abbvie, Abiogen, Alfa-Sigma, Amgen, BMS, Celgene, Chiesi, Eli Lilly, GSK, Janssen, Medac, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sanofi Genzyme, Servier, UCB, Maria Luisa Brandi: None declared, Sergio Casciaro: None declared, Luisella Cianferotti: None declared, Delia Ciardo: None declared, Francesco Conversano: None declared, Davide Gatti Speakers bureau: Davide Gatti reports personal fees from Abiogen, Amgen, Janssen-Cilag, Mundipharma, outside the submitted work., Giuseppe Girasole: None declared, Monica Manfedini: None declared, Maurizio Muratore: None declared, Paola Pisani: None declared, Eugenio Quarta: None declared, Laura Quarta: None declared, Stefano Gonnelli: None declared
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Francia CM, Marvaso G, Piperno G, Gandini S, Ferrari A, Zerella MA, Arculeo S, Sibio D, Fodor C, Pepa M, Trivellato S, Rondi E, Vigorito S, Cattani F, Spaggiari L, De Marinis F, Orecchia R, Ciardo D, Jereczek-Fossa BA. Lung optimized treatment with CyberKnife® in inoperable lung cancer patients: feasibility analysis of a mono-institutional 115 patient series. Neoplasma 2020; 67:684-691. [PMID: 32182088 DOI: 10.4149/neo_2020_190717n645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/29/2019] [Indexed: 11/08/2022]
Abstract
CyberKnife® Lung Optimized Treatment (LOT) allows the treatment of lung cancer without invasive fiducial implantation. The aim of this retrospective analysis was to evaluate the feasibility, toxicity and clinical outcome. One hundred fifteen patients (124 lesions) were treated with CyberKnife® using LOT. The median age was 72.6 years (range 31.8-90.3). From 124 treated lesions, 52 were with histopathological confirmation (41 primitive pulmonary cancers, 8 pulmonary metastases) and 72 as untyped tumors. For 5 patients (6 lesions) treatment was an in-field re-irradiation. Concomitant therapy was administered in 7 patients. Zero-View tracking was applied in 69 patients, 1-View in 33 patients, 2-View in 22 patients. The median total dose was 45 Gy (range 18-54), median dose/fraction was 15 Gy (range 4-18) with a median prescription isodose of 80% (range 68-85). The median planning target volume (PTV) was 25 cm3 (range 3-195). The median follow-up was 20 months (range 7-47). Thirty-seven patients (32%) were alive with no evidence of disease, 39 patients (34%) were alive with clinically evident disease, and 38 patients (33%) died of the disease. The 1- and 2-year overall survival (OS) rate was 83% and 61%. The median time to progression was 19 months (95% confidence interval: 11-19 months), 1- and 2-year progression-free survival (PFS) rates were 62% and 41%, respectively. Smaller PTV was significantly associated with better OS, PFS and in-field PFS in univariate and multivariate analyses. Acute toxicity was observed in 36 patients (41%). Late toxicity was registered in 25 patients (29%). G3 late toxicity was observed in one patient (1.1%). Our data suggest that fiducial less-stereotactic body radiation therapy (SBRT) is a feasible, well-tolerated and potentially effective treatment with high compliance in the setting of inoperable patients due to concomitant disease or previous treatments.
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Affiliation(s)
- C Maria Francia
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - G Marvaso
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - G Piperno
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - S Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - A Ferrari
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - M Alessia Zerella
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - S Arculeo
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - D Sibio
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - C Fodor
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - M Pepa
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - S Trivellato
- Unit of Medical Physics, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - E Rondi
- Unit of Medical Physics, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - S Vigorito
- Unit of Medical Physics, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - F Cattani
- Unit of Medical Physics, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - L Spaggiari
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.,Division of Thoracic Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - F De Marinis
- Division of Thoracic Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - R Orecchia
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.,Scientific Directorate, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - D Ciardo
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - B Alicja Jereczek-Fossa
- Department of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
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Riva G, Andrea V, Spoto R, Durante S, Ciardo D, Comi S, Cattani F, Lazzari R, Jereczek-Fossa B. EP-2131 Venezia: New Advanced Brachytherapy Gynecological Applicator in cervical cancer. Our preliminary data. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32551-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Romanò C, Trivellato S, De Marco P, Comi S, Bazani A, Marvaso G, Ciardo D, Jereczek-Fossa B, Orecchia R, Cattani F. EP-2066 Evaluation of ANACONDA performances varying the exploited subset of controlling ROIs (AIRC IG-14300). Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32486-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Marvaso G, Ciardo D, Gandini S, Riva G, Frigo E, Zerini D, Comi S, Cambria R, De Cobelli O, Orecchia R, Jereczek-Fossa B. PO-0854 Extreme vs moderate hypofractionation for localized Pca: a Propensity Score Matching Analisys. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31274-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Riva G, Ferrari A, Durante S, Ciardo D, Piperno G, Leonardi M, Vigorito S, Rondi E, Orecchia R, Jereczek-Fossa B. EP-1212 Clinical outcome in brain metastases from breast cancer treated with stereotactic radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31632-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Ciardo D, Marvaso G, Gandini S, Mambretti M, Fodor C, Zerini D, Volpe S, Riva G, Rojas D, Petralia G, Cambria R, Orecchia R, Jereczek-Fossa B. EP-1550 Give-me-five trial: toxicity assessment in ultra-hypofractionated prostate cancer radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31970-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Augugliaro M, Marvaso G, Ciardo D, Zerini D, Riva G, Rondi E, Vigorito S, Comi S, Cobelli OD, Orecchia R, Jereczek-Fossa BA. Recurrent oligometastatic transitional cell bladder carcinoma: is there room for radiotherapy? Neoplasma 2019; 66:160-165. [DOI: 10.4149/neo_2018_180522n333] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/24/2018] [Indexed: 11/08/2022]
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16
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Jereczek-Fossa BA, Maucieri A, Marvaso G, Gandini S, Fodor C, Zerini D, Riva G, Alessandro O, Surgo A, Volpe S, Fanetti G, Arculeo S, Zerella MA, Parisi S, Maisonneuve P, Vavassori A, Cattani F, Cambria R, Garibaldi C, Starzyńska A, Musi G, De Cobelli O, Ferro M, Nolè F, Ciardo D, Orecchia R. Impact of image guidance on toxicity and tumour outcome in moderately hypofractionated external-beam radiotherapy for prostate cancer. Med Oncol 2018; 36:9. [PMID: 30483899 DOI: 10.1007/s12032-018-1233-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 11/22/2018] [Indexed: 02/07/2023]
Abstract
To report toxicity and efficacy outcome of moderately hypofractionated image-guided external-beam radiotherapy in a large series of patients treated for prostate cancer (PCa). Between 10/2006 and 12/2015, 572 T1-T3N0M0 PCa patients received 70.2 Gy in 26 fractions at 2.7 Gy/fraction: 344 patients (60%) with three-dimensional conformal radiotherapy (3D-CRT) and 228 (40%) with intensity-modulated radiotherapy (IMRT). Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria and Houston definition (nadir + 2) were used for toxicity and biochemical failure evaluation, respectively. Median age was 74 years (interquartile range 69-77). Compared with 3D-CRT, in IMRT group more high-risk patients (29% vs 18%; P = 0.002) and more high-volume target (75% vs 60%; P < 0.001) were included. Acute gastro-intestinal (GI) toxicity G > 1 were registered in 8% and in 11% IMRT and 3D-CRT patients, respectively, whereas late GI G > 1 were observed in 2% and 16% IMRT and 3D-CRT patients, respectively. Acute genito-urinary (GU) toxicity G > 1 were registered in 26% and 40% IMRT and 3D-CRT patients, respectively, whereas late GU G > 1 occurred in 5% IMRT and 15% 3D-CRT patients. Multivariate proportional hazard Cox models confirmed significantly greater risk of late toxicity with 3D-CRT compared to IMRT for GU > 1 (P = 0.004) and for GI > 1 (P < 0.001). With a median 4-year follow-up, overall survival (OS), clinical progression-free survival (cPFS) and biochemical PFS (bPFS) for the whole series were 91%, 92% and 91%, respectively. cPFS and bPFS were significantly different by risk groups. Multivariate Cox models for bPFS and cPFS showed no difference between irradiation techniques and a significant impact of risk group and initial PSA. Moderately hypofractionated radiotherapy is a viable treatment option for localized PCa with excellent tumour control and satisfactory toxicity profile. IMRT seems associated with a reduction in toxicity, whereas tumour control was equal between IMRT and 3D-CRT patients and depended mainly on the risk category.
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Affiliation(s)
- B A Jereczek-Fossa
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - A Maucieri
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - G Marvaso
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - S Gandini
- Department of Experimental Oncology, European Institute of Oncology, Via Adamello 16, 20139, Milan, Italy
| | - C Fodor
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - D Zerini
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - G Riva
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - O Alessandro
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - A Surgo
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Volpe
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - G Fanetti
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Arculeo
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - M A Zerella
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - S Parisi
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - P Maisonneuve
- Division of Epidemiology and Biostatistics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Vavassori
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - F Cattani
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - R Cambria
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - C Garibaldi
- Radiation Research Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - G Musi
- Department of Urology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - O De Cobelli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Department of Urology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Ferro
- Department of Urology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - F Nolè
- Medical Oncology Division of Urogenital and Head and Neck Tumours, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - D Ciardo
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - R Orecchia
- Scientific Directorate, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Kobiela J, Spychalski P, Marvaso G, Ciardo D, Dell'Acqua V, Kraja F, Błażyńska-Spychalska A, Łachiński AJ, Surgo A, Glynne-Jones R, Jereczek-Fossa BA. Ablative stereotactic radiotherapy for oligometastatic colorectal cancer: Systematic review. Crit Rev Oncol Hematol 2018; 129:91-101. [PMID: 30097241 DOI: 10.1016/j.critrevonc.2018.06.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 06/13/2018] [Accepted: 06/13/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND SBRT is a novel modality in treatment for oligometastatic colorectal cancer. We aimed to perform a systematic review of results of SBRT in maintaining LC (local control) for CRC liver and lung oligometastases. MATERIALS AND METHODS The review was performed according to PRISMA and PICO guidelines. Database search using keywords: stereotactic, colon, colorectal, cancer, sbrt, sabr returned 457 results. 15 were included in the study. Only cohorts with CRC histology and reported LC were included. RESULTS For liver LC rates ranged from 50% to 100% after 1 year and 32% to 91% after 2 years. BED range 40.5-262.5 Gy (Gray). For lung LC rates ranged from 62% to 92% after 1 one year and from 53% to 92% after 2 years. BED range 51.3-262.5 Gy. CONCLUSIONS SBRT of oligometastatic CRC offers high LC with low morbidity and toxicity. It requires more observational studies and randomized trials but available data on clinical efficacy is promising, however not yet matured.
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Affiliation(s)
- J Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - P Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
| | - G Marvaso
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - D Ciardo
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - V Dell'Acqua
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - F Kraja
- Department of Oncology, University Hospital Centre "Mother Theresa", Tirana, Albania
| | - A Błażyńska-Spychalska
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - A J Łachiński
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - A Surgo
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - R Glynne-Jones
- Mount Vernon Centre for Cancer Treatment, Northwood, Middlesex, HA6 2RN, UK
| | - B A Jereczek-Fossa
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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18
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Marvaso G, Fanetti G, Fodor C, Ricotti R, Ciardo D, Riva G, Volpe S, Rojas D, Zerini D, Romanelli P, Cambria R, Pansini F, Jereczek-Fossa B. PO-1084: Short-term RT for early PCa with concomitant boost to the DIL : QoL after the end of the accrual. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31394-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Monti S, Palma G, D'Avino V, Gerardi M, Ciardo D, Alterio D, Jereczek-Fossa B, Quarantelli M, Pacelli R, Cella L. Regional Dose Differences Associated with Radiation-Induced Acute Severe Dysphagia. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Alterio D, Gerardi MA, Cella L, Spoto R, Zurlo V, Sabbatini A, Fodor C, D'Avino V, Conson M, Valoriani F, Ciardo D, Pacelli R, Ferrari A, Maisonneuve P, Preda L, Bruschini R, Cossu Rocca M, Rondi E, Colangione S, Palma G, Dicuonzo S, Orecchia R, Sanguineti G, Jereczek-Fossa BA. Radiation-induced acute dysphagia : Prospective observational study on 42 head and neck cancer patients. Strahlenther Onkol 2017; 193:971-981. [PMID: 28884310 DOI: 10.1007/s00066-017-1206-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 08/17/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Acute toxicity in head and neck (H&N) cancer patients treated with definitive radiotherapy (RT) has a crucial role in compliance to treatments. The aim of this study was to correlate doses to swallowing-associated structures and acute dysphagia. METHODS We prospectively analyzed 42 H&N cancer patients treated with RT. Dysphagia (grade ≥ 3) and indication for percutaneous endoscopic gastrostomy (PEG) insertion were classified as acute toxicity. Ten swallowing-related structures were considered for the dosimetric analysis. The correlation between clinical information and the dose absorbed by the contoured structures was analyzed. Multivariate logistic regression method using resampling methods (bootstrapping) was applied to select model order and parameters for normal tissue complication probability (NTCP) modelling. RESULTS A strong multiple correlation between dosimetric parameters was found. A two-variable model was suggested as the optimal order by bootstrap method. The optimal model (Rs = 0.452, p < 0.001) includes V45 of the cervical esophagus (odds ratio [OR] = 1.016) and Dmean of the cricopharyngeal muscle (OR = 1.057). The model area under the curve was 0.82 (95% confidence interval 0.69-0.95). CONCLUSION Our results suggested that the absorbed dose to the cricopharyngeal muscle and cervical esophagus might play a relevant role in the development of acute RT-related dysphagia.
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Affiliation(s)
- D Alterio
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
| | - M A Gerardi
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - L Cella
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - R Spoto
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - V Zurlo
- Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - A Sabbatini
- Dietetic and Clinical Nutrition Unit, European Institute of Oncology, Milan, Italy
| | - C Fodor
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - V D'Avino
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - M Conson
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - F Valoriani
- Dietetic and Clinical Nutrition Unit, European Institute of Oncology, Milan, Italy
| | - D Ciardo
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - R Pacelli
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy.,Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy
| | - A Ferrari
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - P Maisonneuve
- Department of Epidemiology and Statistics, European Institute of Oncology, Milan, Italy
| | - L Preda
- Department of Radiology, European Institute of Oncology, Milan, Italy
| | - R Bruschini
- Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - M Cossu Rocca
- Division of Urogenital and Head and Neck Tumors, Department of Medical Oncology, European Institute of Oncology, Milan, Italy
| | - E Rondi
- Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - S Colangione
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - G Palma
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - S Dicuonzo
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - R Orecchia
- Scientific Directorate, European Institute of Oncology, Milan, Italy
| | | | - B A Jereczek-Fossa
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
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Riva G, Timon G, Ciardo D, Bazani A, Maestri D, De Lorenzo D, Pansini F, Cambria R, Cattani F, Marvaso G, Zerini D, Rojas D, Volpe S, Golino F, Scroffi V, Fodor C, Petralia G, De Cobelli O, Orecchia R, Jereczek-Fossa B. EP-1338: High precision radiotherapy for early prostate cancer with concomitant boost to the dominant lesion. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31773-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Alterio D, Gerardi M, Cella L, D’Avino V, Palma G, Ciardo D, Rondi E, Ferrari A, Muto M, Spoto R, Pacelli R, Orecchia R, Jereczek B. EP-1077: Predictive modeling for radiation-induced acute dysphagia in head and neck cancer patients. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31513-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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23
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Marvaso G, Riva G, Bassi C, Fodor C, Ciardo D, Zerini D, Timon G, Surgo A, Maucieri A, Pansini F, De Marco P, Cattani F, De Cobelli O, Orecchia R, Jereczek-Fossa B. EP-1339: Feasibility and efficacy of moderately hypofractionated radiotherapy in high risk prostate cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31774-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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24
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Gerardi M, Rojas D, Ricotti R, Leonardi M, Riva G, Ciardo D, Francia C, Cambria R, Luraschi R, Cattani F, Fodor C, De Lorenzi F, Rietjens M, Veronesi P, Morra A, Dell’Acqua V, Orecchia R, Jereczek-Fossa B. EP-1191: Postmastectomy locoregional irradiation to temporary tissue-expander or permanent breast implant. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31627-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Belfatto A, Ciardo D, Vidal Urbinati A, Cattani F, Lazzari R, Jereczek-Fossa B, Franchi D, Orecchia R, Baroni G, Cerveri P. SP-0595: Modeling the interplay among volume, vascularization and radio-sensitivity in cervical cancer exploiting 3D-Doppler data. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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26
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Orecchia R, Surgo A, Muto M, Ferrari A, Piperno G, Gerardi MA, Comi S, Garibaldi C, Ciardo D, Bazani A, Golino F, Pansini F, Fodor C, Romanelli P, Maestri D, Scroffi V, Mazza S, Jereczek-Fossa BA. VERO® radiotherapy for low burden cancer: 789 patients with 957 lesions. Ecancermedicalscience 2016; 10:677. [PMID: 27729942 PMCID: PMC5045299 DOI: 10.3332/ecancer.2016.677] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Indexed: 12/04/2022] Open
Abstract
Purpose The aim of this retrospective study is to evaluate patient profile, feasibility, and acute toxicity of RadioTherapy (RT) delivered by VERO® in the first 20 months of clinical activity. Methods Inclusion criteria: 1) adult patients; 2) limited volume cancer (M0 or oligometastatic); 3) small extracranial lesions; 4) treatment between April 2012 and December 2013 and 5) written informed consent. Two techniques were employed: intensity modulated radiotherapy (IMRT) and stereotactic body radiotherapy (SBRT). Toxicity was evaluated using Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer (RTOG/EORTC) criteria. Results Between April 2012 and December 2013, 789 consecutive patients (957 lesions) were treated. In 84% of them one lesion was treated and in 16% more than one lesion were treated synchronously/metachronously; first radiotherapy course in 85%, re-irradiation in 13%, and boost in 2% of cases. The treated region included pelvis 46%, thorax 38%, upper abdomen 15%, and neck 1%. Radiotherapy schedules included <5 and >5 fractions in 75% and 25% respectively. All patients completed the planned treatment and an acceptable acute toxicity was observed. Conclusions RT delivered by VERO® was administrated predominantly to thoracic and pelvic lesions (lung and urologic tumours) using hypofractionation. It is a feasible approach for limited burden cancer offering short and well accepted treatment with favourable acute toxicity profile. Further investigation including dose escalation and other available VERO® functionalities such as real-time dynamic tumour tracking is warranted in order to fully evaluate this innovative radiotherapy system.
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Affiliation(s)
- R Orecchia
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy; Department of Oncology and Haemato-oncology, University of Milan, Milan, Italy; Equally contributed to the article
| | - A Surgo
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy; Equally contributed to the article; Affiliation at the time of the study
| | - M Muto
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy; Affiliation at the time of the study
| | - A Ferrari
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - G Piperno
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - M A Gerardi
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - S Comi
- Department of Medical Physics, European Institute of Oncology, Milan, Italy
| | - C Garibaldi
- Unit of Radiation Research, European Institute of Oncology, Milan, Italy
| | - D Ciardo
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - A Bazani
- Department of Medical Physics, European Institute of Oncology, Milan, Italy
| | - F Golino
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - F Pansini
- Department of Medical Physics, European Institute of Oncology, Milan, Italy
| | - C Fodor
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - P Romanelli
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - D Maestri
- University of Milan, Milan, Italy; Department of Medical Physics, European Institute of Oncology, Milan, Italy
| | - V Scroffi
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - S Mazza
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - B A Jereczek-Fossa
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy; Department of Oncology and Haemato-oncology, University of Milan, Milan, Italy
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Vavassori A, Ricotti R, Bazani A, Pansini F, Spoto R, Ciardo D, Sammarco V, Cattani F, Orecchia R, Jereczek-Fossa B. PV-0036: Dosimetric evaluation of 3D printed applicators for High Dose Rate brachytherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31285-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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28
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Ciardo D, Ricotti R, Jereczek-Fossa B, Breast Cancer Working Group A. OC-0051: Variability in lymph node delineation for breast cancer radiotherapy: an AIRO multicenter study. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31300-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cremonesi M, Gilardi L, Garibaldi C, Travaini L, Ferrari M, Ronchi S, Ciardo D, Botta F, Baroni G, Grana C, Jereczek-Fossa B, Orecchia R. EP-1232: Interim 18F-FDG-PET/CT for early outcome prediction during chemoradiotherapy of thorax malignancies. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32482-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Giandini T, Carrara M, Pignoli E, Bedini N, Morlino S, Bosetti D, Avuzzi B, Villa S, Hasegawa A, Russo S, Vischioni B, Ciocca M, Valvo F, Jereczek-Fossa B, Ciardo D, Zerini D, Colangione S, Fodor C, Cattani F, Valdagni R, Orecchia R. EP-1374: Contouring guideline optimisation for prostate pts undergoing carbon ions/photons combined treatment. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32624-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Jereczek-Fossa B, Ciardo D, Petralia G, Bellomi M, De Cobelli O, Orecchia R. EP-1380: Primary focal prostate radiotherapy: do all patients really need whole-prostate irradiation? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32630-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cassetta Junior F, Ciardo D, Fattori G, Riboldi M, Orecchia R, Jereczek-Fossa B, Baroni G. EP-1904: Virtual CT for adaptive prostate radiotherapy based on CTCBCT deformable image registration. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33155-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Jereczek-Fossa B, Ciardo D, Colangione S, Fodor C, Zerini D, Cecconi A, Surgo A, Gerardi M, Muto M, Timon G, Comi S, Pansini F, Bazani A, Maestri D, Garioni M, Scroffi V, Cattani F, Cambria R, De Cobelli O, Orecchia R. OC-0448: Give me five: extreme hypofractionated IG-IMRT for organ confined prostate cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ricotti R, Vavassori A, Spoto R, Ciardo D, Pansini F, Bazani A, Noris S, Cattani F, Orecchia R, Jereczek-Fossa B. Dosimetric properties of 3D-printed flat bolus for external radiotherapy. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Garibaldi C, Bazani A, Pansini F, Ricotti R, Ciardo D, Comi S, Piperno G, Ferrari A, Cremonesi M, Jereczek-Fossa B, Orecchia R. Impact of auto beam-off and 4D model automatic update on tracking accuracy of the VERO system. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Belfatto A, Riboldi M, Ciardo D, Cecconi A, Lazzari R, Jereczek-Fossa BA, Orecchia R, Baroni G, Cerveri P. Adaptive Mathematical Model of Tumor Response to Radiotherapy Based on CBCT Data. IEEE J Biomed Health Inform 2015; 20:802-809. [PMID: 26173223 DOI: 10.1109/jbhi.2015.2453437] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Mathematical modeling of tumor response to radiotherapy has the potential of enhancing the quality of the treatment plan, which can be even tailored on an individual basis. Lack of extensive in vivo validation has prevented, however, reliable clinical translation of modeling outcomes. Image-guided radiotherapy is a consolidated treatment modality based on computed tomographic (CT) imaging for tumor delineation and volumetric cone beam CT data for periodic checks during treatment. In this study, a macroscopic model of tumor growth and radiation response is proposed, being able to adapt along the treatment course as volumetric tumor data become available. Model parameter learning was based on cone beam CT images in 13 uterine cervical cancer patients, subdivided into three groups (G1, G2, G3) according to tumor type and treatment. Three group-specific parameter sets (PS1, PS2, and PS3) on one general parameter set (PSa) were applied. The corresponding average model fitting errors were 14%, 18%, 13%, and 21%, respectively. The model adaptation testing was performed using volume data of three patients, other than the ones involved in the parameter learning. The extrapolation performance of the general model was improved, while comparable prediction errors were found for the group-specific approach. This suggests that an online parameter tuning can overcome the limitations of a suboptimal patient stratification, which appeared otherwise a critical issue.
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Zaffino P, Ciardo D, Piperno G, Travaini LL, Comi S, Ferrari A, Alterio D, Jereczek-Fossa BA, Orecchia R, Baroni G, Spadea MF. Radiotherapy of Hodgkin and Non-Hodgkin Lymphoma. Technol Cancer Res Treat 2015; 15:355-64. [DOI: 10.1177/1533034615582290] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 03/19/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose: To improve the contouring of clinical target volume for the radiotherapy of neck Hodgkin/non-Hodgkin lymphoma by localizing the prechemotherapy gross target volume onto the simulation computed tomography using [18F]-fluorodeoxyglucose positron emission tomography/computed tomography. Material and Methods: The gross target volume delineated on prechemotherapy [18F]-fluorodeoxyglucose positron emission tomography/computed tomography images was warped onto simulation computed tomography using deformable image registration. Fifteen patients with neck Hodgkin/non-Hodgkin lymphoma were analyzed. Quality of image registration was measured by computing the Dice similarity coefficient on warped organs at risk. Five radiation oncologists visually scored the localization of automatic gross target volume, ranking it from 1 (wrong) to 5 (excellent). Deformable registration was compared to rigid registration by computing the overlap index between the automatic gross target volume and the planned clinical target volume and quantifying the V95 coverage. Results: The Dice similarity coefficient was 0.80 ± 0.07 (median ± quartiles). The physicians’ survey had a median score equal to 4 (good). By comparing the rigid versus deformable registration, the overlap index increased from a factor of about 4 and the V95 (percentage of volume receiving the 95% of the prescribed dose) went from 0.84 ± 0.38 to 0.99 ± 0.10 (median ± quartiles). Conclusion: This study demonstrates the impact of using deformable registration between prechemotherapy [18F]-fluorodeoxyglucose positron emission tomography/computed tomography and simulation computed tomography, in order to automatically localize the gross target volume for radiotherapy treatment of patients with Hodgkin/non-Hodgkin lymphoma.
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Affiliation(s)
- P. Zaffino
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
| | - D. Ciardo
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
| | - G. Piperno
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
| | - L. L. Travaini
- Nuclear Medicine Division, European Institute of Oncology, Milan, Italy
| | - S. Comi
- Medical Physics Unit, European Institute of Oncology, Milano, Italy
| | - A. Ferrari
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
| | - D. Alterio
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
| | - B. A. Jereczek-Fossa
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | - R. Orecchia
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
- Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - G. Baroni
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
- Bioengineering Unit, Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - M. F. Spadea
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
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Ciardo D, Bazani A, Pansini F, Russo S, Molinelli S, Comi S, Cambria R, Cattani F, Petralia G, Vischioni B, Zerini D, Baroni G, Valvo F, Orecchia R, Jereczek-Fossa B. PO-0995: Evaluation of VMAT-RapidArc, IMRT-VERO and proton-RT for a hypofractionated scheme of prostate cancer treatment. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40987-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Ricotti R, Fattori G, Ciardo D, Leonardi M, Morra A, Pansini F, Cattani F, Riboldi M, Jereczek B, Baroni G, Orecchia R. EP-1494: Evaluation of intra-fraction breathing pattern variability in Helical Tomotherapy by means of optical tracking. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41486-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fassi A, Ciardo D, Riboldi M, Sarrut D, Baroni G. OC-0549: Improving the clinical applicability of markerless lung tumour tracking with contrast-enhanced kV imaging. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40544-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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41
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Cambria R, Cattani F, Jereczek-Fossa BA, Pansini F, Ciardo D, Vigorito S, Russo S, Zerini D, Cozzi L, Orecchia R. Planning study to compare dynamic and rapid arc techniques for postprostatectomy radiotherapy of prostate cancer. Strahlenther Onkol 2014; 190:569-74. [PMID: 24557057 DOI: 10.1007/s00066-014-0601-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/18/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE To compare our standard technique for postprostatectomy radiotherapy of prostate cancer, i.e. using two lateral conformal dynamic arcs with volumetric-modulated arc therapy (VMAT) performed with the RapidArc(®) (Varian Medical Systems, Palo Alto, CA, USA). The plans were referred to as DA and RA, respectively. MATERIALS AND METHODS The treatment plans of 44 patients receiving adjuvant/salvage radiotherapy in the first months of 2010 were compared. In all cases, the prescribed total dose was 66-68.2 Gy (2.2 Gy per fraction). Both DA and RA plans were optimized in terms of dose coverage and constraints. RESULTS Small differences between the techniques were observed for planning target volume (PTV) dose distribution, whereas significant differences in sparing of organs at risk (OARs) were recorded (p < 0.0001). The OAR values (median; 95 % confidence interval, CI) were: rectum: D30 % = 60.7 Gy (59.40-62.04 Gy) and 48.2 Gy (46.40-52.72 Gy), D60 % = 34.1 Gy (28.50-38.92 Gy) and 27.7 Gy (21.80-31.51 Gy); bladder: D30 % = 57.3 Gy (45.83-64.53 Gy) and 46.4 Gy (33.23-61.48 Gy), D50 % = 16.4 Gy (11.89-42.38 Gy) and 17.2 Gy (10.97-27.90 Gy), for DA and RA, respectively. Treatment times were very similar, whereas the monitor units (MU) were 550 ± 29 versus 277 ± 3 for RA and DA, respectively. CONCLUSION Dose-volume histograms (DVHs) show improvements in OAR sparing with RA. However, the RA technique is associated with almost double the number of MUs compared to DA. Regarding the PTV, DA is slightly superior in terms of D2 % and dose homogeneity. On the whole, the results suggest that RA be the favorable technique.
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Affiliation(s)
- R Cambria
- Department of Medical Physics, Istituto Europeo di Oncologia, via Ripamonti 435, 20141, Milan, Italy,
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Ciardo D, Jereczek-Fossa B, Zerini D, Petralia G, Cambria R, Rondi E, Cattani F, Fodor C, Baroni G, Orecchia R. EP-1695: Multimodal image registration to identify the dominant intraprostatic lesion in radiotherapy - AIRC grant IG 13218. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31813-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ciardo D, Peroni M, Riboldi M, Alterio D, Baroni G, Orecchia R. The role of regularization in deformable image registration for head and neck adaptive radiotherapy. Technol Cancer Res Treat 2013; 12:323-31. [PMID: 23448576 DOI: 10.7785/tcrt.2012.500327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Deformable image registration provides a robust mathematical framework to quantify morphological changes that occur along the course of external beam radiotherapy treatments. As clinical reliability of deformable image registration is not always guaranteed, algorithm regularization is commonly introduced to prevent sharp discontinuities in the quantified deformation and achieve anatomically consistent results. In this work we analyzed the influence of regularization on two different registration methods, i.e. B-Splines and Log Domain Diffeomorphic Demons, implemented in an open-source platform. We retrospectively analyzed the simulation computed tomography (CTsim) and the corresponding re-planning computed tomography (CTrepl) scans in 30 head and neck cancer patients. First, we investigated the influence of regularization levels on hounsfield units (HU) information in 10 test patients for each considered method. Then, we compared the registration results of the open-source implementation at selected best performing regularization levels with a clinical commercial software on the remaining 20 patients in terms of mean volume overlap, surface and center of mass distances between manual outlines and propagated structures. The regularized B-Splines method was not statistically different from the commercial software. The tuning of the regularization parameters allowed open-source algorithms to achieve better results in deformable image registration for head and neck patients, with the additional benefit of a framework where regularization can be tuned on a patient specific basis.
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Affiliation(s)
- D Ciardo
- Advanced Radiotherapy Center, Division of Radiotherapy, European Institute of Oncology, via Ripamonti 435, 20141 Milano, Italy.
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Babouee B, Widmer AF, Dubuis O, Ciardo D, Droz S, Betsch BY, Garzoni C, Führer U, Battegay M, Frei R, Goldenberger D. Emergence of four cases of KPC-2 and KPC-3-carrying Klebsiella pneumoniae introduced to Switzerland, 2009–10. Euro Surveill 2011; 16. [DOI: 10.2807/ese.16.11.19817-en] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- B Babouee
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - A F Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | | | | | - S Droz
- Institute for Infectious Diseases, University of Berne, Berne, Switzerland
| | - B Y Betsch
- University Clinic for Infectious Diseases, University Hospital and University of Berne, Inselspital, Berne, Switzerland
| | - C Garzoni
- University Clinic for Infectious Diseases, University Hospital and University of Berne, Inselspital, Berne, Switzerland
| | - U Führer
- University Clinic for Infectious Diseases, University Hospital and University of Berne, Inselspital, Berne, Switzerland
| | - M Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - R Frei
- Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland
| | - D Goldenberger
- Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland
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Janovsky M, Gröne A, Ciardo D, Völlm J, Burnens A, Fatzer R, Bacciarini LN. Phaeohyphomycosis in a snow leopard (Uncia uncia) due to Cladophialophora bantiana. J Comp Pathol 2006; 134:245-8. [PMID: 16542676 DOI: 10.1016/j.jcpa.2005.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2005] [Accepted: 09/27/2005] [Indexed: 11/17/2022]
Abstract
Phaeohyphomycosis caused by Cladophialophora bantiana was diagnosed in a 5-month-old snow leopard with spastic paralysis of the hind legs and inability to defaecate or urinate. At post-mortem examination, a greenish soft mass resembling an abscess was found on one side of the epidural space at the fourth lumbar vertebral body. Histological examination revealed a purulent meningitis with myelomalacia. Dematiaceous fungal hyphae, present within the inflammatory infiltrate, were identified as C. bantiana by culture and sequence analysis of the 18S ribosomal RNA gene. This neurotropic fungus rarely affects organs other than the brain in human beings and cats, and has been reported only occasionally in Europe. The case described suggests that phaeohyphomycosis due to C. bantiana infection may be recognized more frequently in the future and the possible involvement of organs other than the brain should be borne in mind.
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Affiliation(s)
- M Janovsky
- Zentrum für Fisch- und Wildtiermedizin, Universität Bern, Länggassstr. 122, 3001 Bern, Switzerland
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