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Escudier B, Motzer R, Dyer M, May J, Ejzykowicz F, Kurt M, Lee CW, Wang P, Testa E, Sharpe D, George S, Tannir N. 1459P Analysis of long-term efficacy outcomes from the CheckMate 025 (CM 025) trial comparing nivolumab (NIVO) vs everolimus (EVE) based on ≥ 7 years (yrs) of follow-up in pre-treated patients (pts) with advanced renal cell carcinoma (aRCC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1562] [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] Open
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Fontana M, Ley JL, Dauvergne D, Freud N, Krimmer J, Letang JM, Maxim V, Richard MH, Rinaldi I, Testa E. Monitoring Ion Beam Therapy With a Compton Camera: Simulation Studies of the Clinical Feasibility. IEEE Trans Radiat Plasma Med Sci 2020. [DOI: 10.1109/trpms.2019.2933985] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Li WB, Belchior A, Beuve M, Chen YZ, Di Maria S, Friedland W, Gervais B, Heide B, Hocine N, Ipatov A, Klapproth AP, Li CY, Li JL, Multhoff G, Poignant F, Qiu R, Rabus H, Rudek B, Schuemann J, Stangl S, Testa E, Villagrasa C, Xie WZ, Zhang YB. Intercomparison of dose enhancement ratio and secondary electron spectra for gold nanoparticles irradiated by X-rays calculated using multiple Monte Carlo simulation codes. Phys Med 2020; 69:147-163. [PMID: 31918367 DOI: 10.1016/j.ejmp.2019.12.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 11/29/2019] [Accepted: 12/15/2019] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Targeted radiation therapy has seen an increased interest in the past decade. In vitro and in vivo experiments showed enhanced radiation doses due to gold nanoparticles (GNPs) to tumors in mice and demonstrated a high potential for clinical application. However, finding a functionalized molecular formulation for actively targeting GNPs in tumor cells is challenging. Furthermore, the enhanced energy deposition by secondary electrons around GNPs, particularly by short-ranged Auger electrons is difficult to measure. Computational models, such as Monte Carlo (MC) radiation transport codes, have been used to estimate the physical quantities and effects of GNPs. However, as these codes differ from one to another, the reliability of physical and dosimetric quantities needs to be established at cellular and molecular levels, so that the subsequent biological effects can be assessed quantitatively. METHODS In this work, irradiation of single GNPs of 50 nm and 100 nm diameter by X-ray spectra generated by 50 and 100 peak kilovoltages was simulated for a defined geometry setup, by applying multiple MC codes in the EURADOS framework. RESULTS The mean dose enhancement ratio of the first 10 nm-thick water shell around a 100 nm GNP ranges from 400 for 100 kVp X-rays to 600 for 50 kVp X-rays with large uncertainty factors up to 2.3. CONCLUSIONS It is concluded that the absolute dose enhancement effects have large uncertainties and need an inter-code intercomparison for a high quality assurance; relative properties may be a better measure until more experimental data is available to constrain the models.
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Affiliation(s)
- W B Li
- Institute of Radiation Medicine, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764 Neuherberg, Germany.
| | - A Belchior
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, 2695-066 Bobadela LRS, Portugal
| | - M Beuve
- Institut de Physique Nucléaire de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, CNRS/IN2P3 UMR 5822, Villeurbanne, France
| | - Y Z Chen
- Department of Engineering Physics, Tsinghua University, Beijing, China
| | - S Di Maria
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, 2695-066 Bobadela LRS, Portugal
| | - W Friedland
- Institute of Radiation Medicine, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
| | - B Gervais
- Normandie University, ENSICAEN, UNICAEN, CEA, CNRS, CIMAP, UMR 6252, BP 5133, F-14070 Caen Cedex 05, France
| | - B Heide
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - N Hocine
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-Aux-Roses, France
| | - A Ipatov
- Alferov Federal State Budgetary Institution of Higher Education and Science Saint Petersburg National Research Academic University of the Russian Academy of Sciences, St. Petersburg, Russia
| | - A P Klapproth
- Institute of Radiation Medicine, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764 Neuherberg, Germany; TranslaTUM, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - C Y Li
- Department of Engineering Physics, Tsinghua University, Beijing, China; Nuctech Company Limited, Beijing, China
| | - J L Li
- Department of Engineering Physics, Tsinghua University, Beijing, China
| | - G Multhoff
- TranslaTUM, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - F Poignant
- Institut de Physique Nucléaire de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, CNRS/IN2P3 UMR 5822, Villeurbanne, France
| | - R Qiu
- Department of Engineering Physics, Tsinghua University, Beijing, China
| | - H Rabus
- Physikalisch-Technische Bundesanstalt, Braunschweig, Germany
| | - B Rudek
- Physikalisch-Technische Bundesanstalt, Braunschweig, Germany; Massachusetts General Hospital & Harvard Medical School, Department of Radiation Oncology, Boston, MA, USA
| | - J Schuemann
- Massachusetts General Hospital & Harvard Medical School, Department of Radiation Oncology, Boston, MA, USA
| | - S Stangl
- TranslaTUM, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - E Testa
- Institut de Physique Nucléaire de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, CNRS/IN2P3 UMR 5822, Villeurbanne, France
| | - C Villagrasa
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-Aux-Roses, France
| | - W Z Xie
- Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Y B Zhang
- Peking University Cancer Hospital, Beijing, China
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Giannini E, Borro P, Botta F, Chiarbonello B, Fasoli A, Malfatti F, Romagnoli P, Testa E, Risso D, Lantieri PB, Antonucci A, Boccato M, Milone S, Testa R. Cholestasis is the Main Determinant of Abnormal CA 19–9 Levels in Patients with Liver Cirrhosis. Int J Biol Markers 2018; 15:226-30. [PMID: 11012098 DOI: 10.1177/172460080001500304] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background/Aims Altered CA19–9 levels are commonly found in patients with liver cirrhosis though a clear explanation for this finding has not yet been given. The aim of this study was to investigate whether CA19–9 levels might be related to alterations in biochemical parameters and/or to functional impairment in cirrhotic patients with and without hepatocellular carcinoma. Methods: We studied 126 patients with liver cirrhosis, 60 of whom also had hepatocellular carcinoma. CA19–9 values were related to clinical, biochemical and functional parameters. In half of the patients CA19–9 levels were related to the monoethylglycinexylidide test, which is a dynamic liver function test. Results In more than half the cases CA19–9 values were above the upper limit. Liver function worsening as assessed by Child-Pugh's score and monoethylglycinexylidide test did not seem to influence the alteration of the marker. By contrast, in univariate analysis CA19–9 correlated with aminotransferases, γ-glutamyltransferase and alkaline phosphatase. Multivariate analysis showed that besides alkaline phosphatase also the presence of hepatocellular carcinoma might influence the alteration of CA19–9, although the marker was of no use for the diagnosis of liver cancer in patients with altered though not diagnostic α-fetoprotein levels. Conclusions In our study we confirmed the correlation of CA19–9 levels with cholestasis and cytolysis parameters. Moreover, we found no association between CA19–9 levels and impaired liver function as assessed by means of the Child-Pugh's score and the monoethylglycinexylidide test, which is cholestasis-independent and explores liver metabolic and clearance activities. The cholestatic picture that characterizes liver cirrhosis might enhance the expression and passage of the marker from the bile to the blood. The addition of CA19–9 assessment is not useful for the diagnosis of hepatocellular carcinoma in patients with non-diagnostic levels of α-fetoprotein. Caution should therefore be used when evaluating CA19–9 in cirrhotic patients with cholestasis, since false positive results may occur.
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Affiliation(s)
- E Giannini
- Department of Internal Medicine, University of Genoa, Italy
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Finck C, Karakaya Y, Reithinger V, Rescigno R, Baudot J, Constanzo J, Juliani D, Krimmer J, Rinaldi I, Rousseau M, Testa E, Vanstalle M, Ray C. Study for online range monitoring with the interaction vertex imaging method. Phys Med Biol 2017; 62:9220-9239. [DOI: 10.1088/1361-6560/aa954e] [Citation(s) in RCA: 10] [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] [Indexed: 11/11/2022]
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Baldini E, Testa E, Cianfarani F, Voellenkle C, Martelli F, Ulisse S, Odorisio T. 673 Dysregulation of MicroRNA biogenesis in diabetic skin. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.350] [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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Poignant F, Gervais B, Ipatov A, Monini C, Cunha M, Lartaud P, Bacle T, Testa E, Beuve M. Abstract ID: 182 Biophysical modelisation of gold nanoparticles radiosensitizing effects. Phys Med 2017. [DOI: 10.1016/j.ejmp.2017.09.094] [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: 10/18/2022] Open
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Abstract
Particle therapy is increasingly attractive for the treatment of tumors and the number of facilities offering it is rising worldwide. Due to the well-known enhanced effectiveness of ions, it is of utmost importance to plan treatments with great care to ensure tumor killing and healthy tissues sparing. Hence, the accurate quantification of the relative biological effectiveness (RBE) of ions, used in the calculation of the biological dose, is critical. Nevertheless, the RBE is a complex function of many parameters and its determination requires modeling. The approaches currently used have allowed particle therapy to thrive, but still show some shortcomings. We present herein a short description of a new theoretical framework, NanOx, to calculate cell survival in the context of particle therapy. It gathers principles from existing approaches, while addressing some of their weaknesses. NanOx is a multiscale model that takes the stochastic nature of radiation at nanometric and micrometric scales fully into account, integrating also the chemical aspects of radiation-matter interaction. The latter are included in the model by means of a chemical specific energy, determined from the production of reactive chemical species induced by irradiation. Such a production represents the accumulation of oxidative stress and sublethal damage in the cell, potentially generating non-local lethal events in NanOx. The complementary local lethal events occur in a very localized region and can, alone, lead to cell death. Both these classes of events contribute to cell death. The comparison between experimental data and model predictions for the V79 cell line show a good agreement. In particular, the dependence of the typical shoulders of cell survival curves on linear energy transfer are well described, but also the effectiveness of different ions, including the overkill effect. These results required the adjustment of a number of parameters compatible with the application of the model in a clinical scenario thereby showing the potential of NanOx. Said parameters are discussed in detail in this paper.
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Affiliation(s)
- M Cunha
- Université de Lyon, F-69622, Lyon, France. Université de Lyon 1, Villeurbanne, France. CNRS/IN2P3, Institut de Physique Nucléaire de Lyon, France
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Berardi R, Pusceddu S, Spada F, Ibrahim T, Brizzi M, Antonuzzo L, Ferolla P, Rinzivillo M, Silvestris N, Freddari F, Testa E, Bongiovanni A, Zichi C, Di Costanzo F, Delle Fave G, Fazio N, de Braud F, Falconi M, Cascinu S. Prognostic impact of the cumulative dose and dose intensity of everolimus in patients with pancreatic neuroendocrine tumors (PNETs). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.17] [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: 11/14/2022] Open
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Cunha M, Monini C, Testa E, Beuve M. NanoxTM: A new multiscale theoretical framework to predict cell survival in the context of particle therapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30059-7] [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: 11/28/2022]
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Chaikh A, Cunha M, Testa E, Beuve M, Balosso J. Simulation Monte-Carlo pour évaluer l’impact de volume d’un nanodosimètre sur la dose mesurée en radiothérapie. Cancer Radiother 2015. [DOI: 10.1016/j.canrad.2015.07.144] [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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Del Re M, Tiseo M, D'Incecco A, Camerini A, Petrini I, Lucchesi M, Inno A, Spada D, Bordi P, Vasile E, Citi V, Malpeli G, Testa E, Gori S, Falcone A, Amoroso D, Chella A, Cappuzzo F, Ardizzoni A, Scarpa A, Danesi R. KRAS has a role in acquired resistance to EGFR-TKIs in NSCLC: an analysis on circulating tumor DNA. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv343.34] [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: 11/12/2022] Open
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Arbor N, Dauvergne D, Dedes G, Létang JM, Parodi K, Quiñones CT, Testa E, Rit S. Monte Carlo comparison of x-ray and proton CT for range calculations of proton therapy beams. Phys Med Biol 2015; 60:7585-99. [PMID: 26378805 DOI: 10.1088/0031-9155/60/19/7585] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Proton computed tomography (CT) has been described as a solution for imaging the proton stopping power of patient tissues, therefore reducing the uncertainty of the conversion of x-ray CT images to relative stopping power (RSP) maps and its associated margins. This study aimed to investigate this assertion under the assumption of ideal detection systems. We have developed a Monte Carlo framework to assess proton CT performances for the main steps of a proton therapy treatment planning, i.e. proton or x-ray CT imaging, conversion to RSP maps based on the calibration of a tissue phantom, and proton dose simulations. Irradiations of a computational phantom with pencil beams were simulated on various anatomical sites and the proton range was assessed on the reference, the proton CT-based and the x-ray CT-based material maps. Errors on the tissue's RSP reconstructed from proton CT were found to be significantly smaller and less dependent on the tissue distribution. The imaging dose was also found to be much more uniform and conformal to the primary beam. The mean absolute deviation for range calculations based on x-ray CT varies from 0.18 to 2.01 mm depending on the localization, while it is smaller than 0.1 mm for proton CT. Under the assumption of a perfect detection system, proton range predictions based on proton CT are therefore both more accurate and more uniform than those based on x-ray CT.
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Affiliation(s)
- N Arbor
- Institut de Physique Nucléaire de Lyon, CNRS/IN2P3 UMR5822, Université Lyon 1, 69622 Villeurbanne, France. Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Centre Léon Bérard, France
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Dedes G, Asano Y, Arbor N, Dauvergne D, Letang J, Testa E, Rit S, Parodi K. SU-E-J-147: Monte Carlo Study of the Precision and Accuracy of Proton CT Reconstructed Relative Stopping Power Maps. Med Phys 2015. [DOI: 10.1118/1.4924232] [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: 11/07/2022] Open
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Pinto M, De Rydt M, Dauvergne D, Dedes G, Freud N, Krimmer J, Létang JM, Ray C, Testa E, Testa M. Technical Note: Experimental carbon ion range verification in inhomogeneous phantoms using prompt gammas. Med Phys 2015; 42:2342-6. [DOI: 10.1118/1.4917225] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Pinto M, Bajard M, Brons S, Chevallier M, Dauvergne D, Dedes G, De Rydt M, Freud N, Krimmer J, La Tessa C, Létang JM, Parodi K, Pleskač R, Prieels D, Ray C, Rinaldi I, Roellinghoff F, Schardt D, Testa E, Testa M. Absolute prompt-gamma yield measurements for ion beam therapy monitoring. Phys Med Biol 2014; 60:565-94. [DOI: 10.1088/0031-9155/60/2/565] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Pinto M, Dauvergne D, Freud N, Krimmer J, Letang JM, Ray C, Roellinghoff F, Testa E. Design optimisation of a TOF-based collimated camera prototype for online hadrontherapy monitoring. Phys Med Biol 2014; 59:7653-74. [DOI: 10.1088/0031-9155/59/24/7653] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Spada D, Del Re M, Citi V, Guarino S, Ficarelli R, Testa E, Danesi R. Liquid Biopsy to Monitor the Evolution of Nsclc Egfr+During Treatment with Gefintinib. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu358.47] [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: 11/14/2022] Open
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Dedes G, Pinto M, Dauvergne D, Freud N, Krimmer J, Létang JM, Ray C, Testa E. Assessment and improvements of Geant4 hadronic models in the context of prompt-gamma hadrontherapy monitoring. Phys Med Biol 2014; 59:1747-72. [DOI: 10.1088/0031-9155/59/7/1747] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Roellinghoff F, Benilov A, Dauvergne D, Dedes G, Freud N, Janssens G, Krimmer J, Létang JM, Pinto M, Prieels D, Ray C, Smeets J, Stichelbaut F, Testa E. Real-time proton beam range monitoring by means of prompt-gamma detection with a collimated camera. Phys Med Biol 2014; 59:1327-38. [DOI: 10.1088/0031-9155/59/5/1327] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Maxim V, Dauvergne D, Hilaire E, Ley J, Lojacono X, Testa E. 134: Data models for the Compton camera acquisition and their influence on the reconstructed images. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34155-4] [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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Ley JL, Dahoumane M, Dauvergne D, Freud N, Joly B, Krimmer J, Létang J, Lestand L, Mathez H, Montarou G, Ray C, Richard M.H, Testa E, Zoccarato Y. 122: Development of a Time-Of-Flight Compton Camera for Online Control of Ion Therapy. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34143-8] [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: 10/23/2022]
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Dedes G, Pinto M, Dauvergne D, Freud N, Krimmer J, Michel Létang J, Ray C, Testa E. 52: Assessment and improvements of Geant4 models in the context of prompt-gamma hadrontherapy monitoring. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34073-1] [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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Krimmer J, Caponetto L, Chen X, Chevallier M, Dauvergne D, De Rydt M, Deng S, Ley JL, Mathez H, Ray C, Reithinger V, Testa E, Zoccarato Y. 111: Real-time monitoring of the ion range during hadrontherapy: An update on the beam tagging hodoscope. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34132-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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Rescigno R, Finck C, Juliani D, Baudot J, Dauvergne D, Dedes G, Krimmer J, Ray C, Reithinger V, Rousseau M, Testa E, Winter M. Simulation toolkit with CMOS detector in the framework of hadrontherapy. EPJ Web of Conferences 2014. [DOI: 10.1051/epjconf/20146610013] [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: 11/14/2022] Open
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Gueth P, Dauvergne D, Freud N, Létang JM, Ray C, Testa E, Sarrut D. Machine learning-based patient specific prompt-gamma dose monitoring in proton therapy. Phys Med Biol 2013; 58:4563-77. [DOI: 10.1088/0031-9155/58/13/4563] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Robert C, Dedes G, Battistoni G, Böhlen TT, Buvat I, Cerutti F, Chin MPW, Ferrari A, Gueth P, Kurz C, Lestand L, Mairani A, Montarou G, Nicolini R, Ortega PG, Parodi K, Prezado Y, Sala PR, Sarrut D, Testa E. Distributions of secondary particles in proton and carbon-ion therapy: a comparison between GATE/Geant4 and FLUKA Monte Carlo codes. Phys Med Biol 2013; 58:2879-99. [DOI: 10.1088/0031-9155/58/9/2879] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Henriquet P, Testa E, Chevallier M, Dauvergne D, Dedes G, Freud N, Krimmer J, Létang JM, Ray C, Richard MH, Sauli F. Interaction vertex imaging (IVI) for carbon ion therapy monitoring: a feasibility study. Phys Med Biol 2012; 57:4655-69. [DOI: 10.1088/0031-9155/57/14/4655] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Testa E, Chevallier M, Dauvergne D, Dedes G, De Rydt M, Freud N, Krimmer J, Henriquet P, Letang J, Ray C, Reithinger V, Richard M. 240 SPATIAL CORRELATIONS BETWEEN IMAGES DERIVED FROM DYNAMIC FDG-PET. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70207-4] [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: 10/28/2022]
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De Rydt M, Chevallier M, Dauvergne D, Deng S, Dedes G, Freud N, Krimmer J, Létang JM, Mattez H, Pinto M, Ray C, Richard MH, Roellinghoff F, Reithinger V, Testa E, Zoccaratto Y. 136 REAL-TIME MONITORING OF THE BRAGG PEAK DURING ION THERAPY: RECENT DEVELOPMENTS OF THE BEAM DETECTION SYSTEM. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70108-1] [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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Roellinghoff F, Benilov A, Dauvergne D, Dedes G, Freud N, Krimmer J, Létang J, Prieels D, Ray C, Richard M, Smeets J, Stichelbaut F, Testa E. 235 REAL-TIME PROTON BEAM RANGE MONITORING BY MEANS OF PROMPT-GAMMA DETECTION WITH A COLLIMATED CAMERA. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70203-7] [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: 11/17/2022]
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Krimmer J, Constanzo J, Dahoumane M, De Rydt M, Dauvergne D, Dedes G, Freud N, Létang J, Pinto M, Ray C, Richard M, Reithinger V, Roellinghoff F, Testa E, Walenta A. 155 PROGRESS IN USING PROMPT GAMMAS FOR ION RANGE MONITORING DURING HADRON-THERAPY. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70127-5] [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: 11/26/2022]
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Testa M, Bajard M, Chevallier M, Dauvergne D, Freud N, Henriquet P, Karkar S, Le Foulher F, Létang JM, Plescak R, Ray C, Richard MH, Schardt D, Testa E. Real-time monitoring of the Bragg-peak position in ion therapy by means of single photon detection. Radiat Environ Biophys 2010; 49:337-343. [PMID: 20352439 DOI: 10.1007/s00411-010-0276-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Accepted: 03/06/2010] [Indexed: 05/29/2023]
Abstract
For real-time monitoring of the longitudinal position of the Bragg-peak during an ion therapy treatment, a novel non-invasive technique has been recently proposed that exploits the detection of prompt gamma-rays issued from nuclear fragmentation. Two series of experiments have been performed at the GANIL and GSI facilities with 95 and 305 MeV/u (12)C(6+) ion beams stopped in PMMA and water phantoms. In both experiments, a clear correlation was obtained between the carbon ion range and the prompt photon profile. Additionally, an extensive study has been performed to investigate whether a prompt neutron component may be correlated with the carbon ion range. No such correlation was found. The present paper demonstrates that a collimated set-up can be used to detect single photons by means of time-of-flight measurements, at those high energies typical for ion therapy. Moreover, the applicability of the technique both at cyclotron and at synchrotron facilities is shown. It is concluded that the detected photon count rates provide sufficiently high statistics to allow real-time control of the longitudinal position of the Bragg-peak under clinical conditions.
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Affiliation(s)
- M Testa
- IPNL, Université de Lyon, 69003 Lyon, France.
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Cinnella P, Muratore M, Testa E, Bondente PG. The treatment of adolescent idiopathic scoliosis with Cheneau brace: long term outcome. Scoliosis 2009. [PMCID: PMC2793472 DOI: 10.1186/1748-7161-4-s2-o44] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Catalano V, Graziano F, Santini D, D'Emidio S, Baldelli AM, Rossi D, Vincenzi B, Giordani P, Alessandroni P, Testa E, Tonini G, Catalano G. Second-line chemotherapy for patients with advanced gastric cancer: who may benefit? Br J Cancer 2008; 99:1402-7. [PMID: 18971936 PMCID: PMC2579675 DOI: 10.1038/sj.bjc.6604732] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
No established second-line chemotherapy is available for patients with advanced gastric cancer failing to respond or progressing to first-line chemotherapy. However, 20–40% of these patients commonly receive second-line chemotherapy. We evaluated the influence of clinico-pathologic factors on the survival of 175 advanced gastric cancer patients, who received second-line chemotherapy at three oncology departments. Univariate and multivariate analyses found five factors which were independently associated with poor overall survival: performance status 2 (hazard ratio (HR), 1.79; 95% CI, 1.16–2.77; P=0.008), haemoglobin ⩽11.5 g l−1 (HR, 1.48; 95% CI, 1.06–2.05; P=0.019), CEA level >50 ng ml−1 (HR, 1.86; 95% CI, 1.21–2.88; P=0.004), the presence of greater than or equal to three metastatic sites of disease (HR, 1.72; 95% CI, 1.16–2.53; P=0.006), and time-to-progression under first-line chemotherapy ⩽6 months (HR, 1.97; 95% CI, 1.39–2.80; P<0.0001). A prognostic index was constructed dividing patients into low- (no risk factor), intermediate- (one to two risk factors), or high- (three to five risk factors) risk groups, and median survival times for each group were 12.7 months, 7.1 months, and 3.3 months, respectively (P<0.001). In the absence of data deriving from randomised trials, this analysis suggests that some easily available clinical factors may help to select patients with advanced gastric cancer who could derive more benefit from second-line chemotherapy.
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Affiliation(s)
- V Catalano
- Department of Medical Oncology, Azienda Ospedaliera 'Ospedale San Salvatore', Pesaro, Italy.
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Morjean M, Jacquet D, Charvet JL, L'Hoir A, Laget M, Parlog M, Chbihi A, Chevallier M, Cohen C, Dauvergne D, Dayras R, Drouart A, Escano-Rodriguez C, Frankland JD, Kirsch R, Lautesse P, Nalpas L, Ray C, Schmitt C, Stodel C, Tassan-Got L, Testa E, Volant C. Fission time measurements: a new probe into superheavy element stability. Phys Rev Lett 2008; 101:072701. [PMID: 18764526 DOI: 10.1103/physrevlett.101.072701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Indexed: 05/26/2023]
Abstract
Reaction mechanism analyses performed with a 4pi detector for the systems 208Pb + Ge, 238U + Ni and 238U + Ge, combined with analyses of the associated reaction time distributions, provide us with evidence for nuclei with Z=120 and 124 living longer than 10(-18) s and arising from highly excited compound nuclei. By contrast, the neutron deficient nuclei with Z=114 possibly formed in 208Pb + Ge reactions have shorter lifetimes, close to or below the sensitivity limit of the experiment.
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Affiliation(s)
- M Morjean
- GANIL, CEA-DSM, and IN2P3-CNRS, B.P. 55027, F-14076 Caen Cedex, France.
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Leotta G, Rabbia F, Canadè A, Testa E, Papotti G, Mulatero P, Veglio F. Characteristics of the patients referred to a Hypertension Unit between 1989 and 2003. J Hum Hypertens 2007; 22:119-21. [PMID: 17855800 DOI: 10.1038/sj.jhh.1002285] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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
The level of blood pressure, the type of antihypertensive treatment and the prevalence of resistant hypertension at the first examination were evaluated in 6254 patients referred to a hospital Hypertension Unit from 1989 to 2003. From 1989-1993 to 1999-2003, we observed a reduced prevalence of grade 2 and grade 3 hypertension, and an increase in the prevalence of grade 1 hypertension, the proportion of treated subjects, the average number of antihypertensive drugs per patient and the prevalence of resistant hypertension.
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Ruzzo A, Graziano F, Loupakis F, Santini D, Catalano V, Bisonni R, Ficarelli R, Fontana A, Andreoni F, Falcone A, Canestrari E, Tonini G, Mari D, Lippe P, Pizzagalli F, Schiavon G, Alessandroni P, Giustini L, Maltese P, Testa E, Menichetti ET, Magnani M. Pharmacogenetic profiling in patients with advanced colorectal cancer treated with first-line FOLFIRI chemotherapy. Pharmacogenomics J 2007; 8:278-88. [PMID: 17549067 DOI: 10.1038/sj.tpj.6500463] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The primary end point of the study was the analysis of associations between polymorphisms with putative influence on 5-fluorouracil/irinotecan activity and progression-free survival (PFS) of patients with advanced colorectal cancer treated with first-line FOLFIRI chemotherapy. Peripheral blood samples from 146 prospectively enrolled patients were used for genotyping polymorphisms in thymidylate synthase (TS), methylenetetrahydrofolate reductase (MTHFR), excision repair cross-complementation group-1 (ERCC 1) xeroderma pigmentosum group-D (XPD), X-ray cross-complementing-1 (XRCC 1), X-ray cross-complementing-3 (XRCC 3) and uridine diphosphate-glucuronosyltransferases-A1 (UGT1 A1). TS 3'-UTR 6+/6+ and XRCC3-241 C/C genotypes were associated with adverse PFS. Hazard ratio for PFS achieved 2.89 (95% confidence interval=1.56-5.80; P=0.002) in 30 patients (20%) with both risk genotypes. Risk for Grade III-IV neutropenia was significantly associated with UGT1A1*28 7/7 genotype. These promising findings deserve further investigations and their validation in independent prospective studies.
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Affiliation(s)
- A Ruzzo
- Institute of Biochemistry G Fornaini, University of Urbino, Urbino, Italy
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Leotta G, Rabbia F, Modica C, Testa E, Monticone S, Saglio E, Magnino C, Viola A, Tosello F, Papotti G, Paglieri C, Veglio F. Role of Trained Nurses in the Blood Pressure Control of Treated Essential Hypertensive Patients. High Blood Press Cardiovasc Prev 2007. [DOI: 10.2165/00151642-200714030-00017] [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: 11/02/2022] Open
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Maule S, Mulatero P, Monticone S, Saglio E, Testa E, Puglisi E, Magnino C, Veglio F. QT Interval in Patients with Primary Aldosteronism and Low-Renin Essential Hypertension. High Blood Press Cardiovasc Prev 2007. [DOI: 10.2165/00151642-200714030-00059] [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: 11/02/2022] Open
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Giannini EG, Zaman A, Kreil A, Floreani A, Dulbecco P, Testa E, Sohaey R, Verhey P, Peck-Radosavljevic M, Mansi C, Savarino V, Testa R. Platelet count/spleen diameter ratio for the noninvasive diagnosis of esophageal varices: results of a multicenter, prospective, validation study. Am J Gastroenterol 2006; 101:2511-9. [PMID: 17029607 DOI: 10.1111/j.1572-0241.2006.00874.x] [Citation(s) in RCA: 157] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Noninvasive assessment of esophageal varices (EV) may improve the management of patients with cirrhosis and decrease both the medical and financial burden related to screening. In this multicenter, international study, our aim was to prospectively validate the use of the platelet count/spleen diameter ratio for the noninvasive diagnosis of EV. METHODS A total of 218 cirrhotic patients underwent screening endoscopy for EV. Platelet count/spleen diameter ratio ((N/mm3)/mm) was assessed in all patients and its diagnostic accuracy was calculated. On the basis of previous results, a platelet count/spleen diameter ratio cutoff of 909 was applied to this population. The diagnostic accuracy of the platelet count/spleen diameter ratio was further evaluated for both severity and etiology of disease subgroups. RESULTS Prevalence of EV was 54.1%. The platelet count/spleen diameter ratio had 86.0% (95% CI, 80.7-90.4%) diagnostic accuracy for EV, which was significantly greater as compared with either accuracy of platelet count alone (83.6%, 95% CI 78.0-88.3%, P= 0.038) or spleen diameter alone (80.2%, 95% CI 74.3-85.3%, P= 0.018). The 909 cutoff had 91.5% sensitivity (95% CI 85.0-95.9%), 67.0% specificity (95% CI 56.9-76.1%), 76.6% positive predictive value, 87.0% negative predictive value, 2.77 positive likelihood ratio, and 0.13 negative likelihood ratio for the diagnosis of EV. Accuracy of the platelet count/spleen diameter ratio was maintained for both severity and etiology of disease subgroups. CONCLUSIONS The platelet count/spleen diameter ratio may be proposed as a safe and reproducible means to improve the management of cirrhotic patients who should undergo screening endoscopy for EV.
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Rabbia F, Del Colle S, Testa E, Naso D, Veglio F. Accuracy of the blood pressure measurement. Minerva Cardioangiol 2006; 54:399-416. [PMID: 17016412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Blood pressure measurement is the cornerstone for the diagnosis, the treatment and the research on arterial hypertension, and all of the decisions about one of these single aspects may be dramatically influenced by the accuracy of the measurement. Over the past 20 years or so, the accuracy of the conventional Riva-Rocci/Korotkoff technique of blood pressure measurement has been questioned and efforts have been made to improve the technique with automated devices. In the same period, recognition of the phenomenon of white coat hypertension, whereby some individuals with an apparent increase in blood pressure have normal, or reduced, blood pressures when measurement is repeated away from the medical environment, has focused attention on methods of measurement that provide profiles of blood pressure behavior rather than relying on isolated measurements under circumstances that may in themselves influence the level of blood pressure recorded. These methodologies have included repeated measurements of blood pressure using the traditional technique, self-measurement of blood pressure in the home or work place, and ambulatory blood pressure measurement using innovative automated devices. The purpose of this review to serve as a source of practical information about the commonly used methods for blood pressure measurement: the traditional Riva-Rocci method and the automated methods.
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Affiliation(s)
- F Rabbia
- Hypertension Center, Division of Internal Medicine, Department of Medicine and Experimental Oncology, S. Vito Hospital, University of Turin, Turin, Italy
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Testa R, Testa E, Giannini E, Borro P, Milazzo S, Isola L, Ceppa P, Lantieri PB, Risso D. Noninvasive ratio indexes to evaluate fibrosis staging in chronic hepatitis C: role of platelet count/spleen diameter ratio index. J Intern Med 2006; 260:142-50. [PMID: 16882278 DOI: 10.1111/j.1365-2796.2006.01673.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Noninvasive evaluation of fibrosis is an on-going effort in the management of chronic hepatitis C. This study was planned to noninvasively evaluate fibrosis staging. DESIGN We evaluated the biochemical, functional [aminopyrine breath test (ABT)] and ultrasonographic variables of 75 chronic hepatitis C patients. RESULTS Clinical [body mass index (BMI)], biochemical [aspartate aminotransferase (AST), alanine aminotransferase (ALT) and platelets (PLT)] and ratio indexes, together with the ABT, showed a higher relationship with fibrosis: initial (score<or=2) versus evident (score>2) fibrosis: BMI (24+/-2 vs. 26+/-2, P=0.0007), AST (56+/-36 vs. 88+/-65, P=0.0159), ALT (92+/-54 vs. 139+/-108, P=0.0290), PLT (220+/-64 vs. 173+/-61, P=0.0007), PLT/spleen diameter ratio (PLT/SPD) (2133+/-786 vs. 1540+/-681, P=0.0003), AST/platelet count ratio index (APRI) (0.80+/-0.87 vs. 1.51+/-1.47, P=0.0010), ABT%d/h30 min (10.8+/-4.5 vs. 7.6+/-3.8, P=0.0007), ABT%d/cum120 min (8.9+/-3.3 vs. 6.5+/-3.1, P=0.0007). Considering the differences between fibrosis score 2 and 3 patients, BMI, ABT and PLT/SPD ratio proved to be statistically significant. Multivariate stepwise analysis (with and without BMI) identified two models for distinguishing between initial and evident fibrosis: Model 1: -0.569+(BMIx0.107)+(APRIx0.169)-(PLT/SPDx0.304), and Model 2: 2.376+( APRIx0.152)-(ABTd/h30x0.043)-(PLT/SPDx0.249). These models showed concordance in identifying or ruling out evident fibrosis in 76% and 78.7% of the patients respectively. The PLT/SPD ratio also showed 78.7% concordance with the histological score. CONCLUSION These results suggest that noninvasive evaluation of fibrosis in chronic hepatitis C may be considered an effective tool thanks to the use of an inexpensive, reproducible ratio index.
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Affiliation(s)
- R Testa
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy.
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44
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Mulatero P, Bertello C, Verhovez A, Testa E, Puglisi E, Morello F, Monticone S, Fallo F, Veglio F. [Role of aldosterone in the metabolic syndrome]. G Ital Nefrol 2006; 23:406-14. [PMID: 17063441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The purpose of this review is to summarize the current knowledge regarding metabolic syndrome prevalence and features in primary aldosteronism. We will also discuss the link between aldosterone and the different metabolic changes typical of the metabolic syndrome. Hypertensive patients have a high prevalence of obesity, dyslipidemia and hyperglycaemia. These are risk factors for the metabolic syndrome, and are associated with an increased cardiovascular risk profile. In particular, insulin resistance seems to be the major alteration in patients affected by primary aldosteronism. We will then describe the experimental and clinical evidences of the role of aldosterone in the pathogenesis of insulin resistance. Higher rates of cardiovascular events have been recently reported in primary aldosteronism: they could be partly due to the increased prevalence of the metabolic syndrome in this disorder.
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Affiliation(s)
- P Mulatero
- Divisione di Medicina Interna e Ipertensione, Università di Torino, Torino.
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Santini D, Graziano F, Catalano V, Di Seri M, Testa E, Baldelli AM, Giordani P, La Cesa A, Spalletta B, Vincenzi B, Russo A, Caraglia M, Virzi V, Cascinu S, Tonini G. Weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF) as first-line chemotherapy for elderly patients with advanced gastric cancer: results of a phase II trial. BMC Cancer 2006; 6:125. [PMID: 16686939 PMCID: PMC1475875 DOI: 10.1186/1471-2407-6-125] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2005] [Accepted: 05/10/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Elderly patients have been often excluded from or underrepresented in the study populations of combination chemotherapy trials. The primary end point of this study was to determine the response rate and the toxicity of the weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF) regimen in elderly patients with advanced gastric cancer. The secondary objective was to measure the time to disease progression and the survival time. METHODS Chemotherapy-naive patients with advanced gastric cancer aged 70 or older were considered eligible for study entry. Patients received weekly oxaliplatin 40 mg/m2, fluorouracil 500 mg/m2 and folinic acid 250 mg/m2. All drugs were given intravenously on a day-1 schedule. RESULTS A total of 42 elderly patients were enrolled. Median age was 73 years and all patients had metastatic disease. The response rate according to RECIST criteria was 45.2% (95% CIs: 30%-56%) with two complete responses, 17 partial responses, 13 stable diseases and 10 progressions, for an overall tumor rate control of 76.2% (32 patients). Toxicity was generally mild and only three patients discontinued treatment because of treatment related adverse events. The most common treatment-related grade 3/4 adverse events were fatigue (7.1%), diarrhoea (4.8%), mucositis (2.4%), neurotoxicity (2.4%) and neutropenia (4.8%). The median response duration was 5.3 months (95% CIs: 2.13 - 7.34), the median time to disease progression was 5.0 months (95% CIs: 3.75 - 6.25) and the median survival time was 9.0 months (95% CIs: 6.18 - 11.82). CONCLUSION OXALF represents an active and well-tolerated treatment modality for elderly patients with locally advanced and metastatic gastric cancer.
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Affiliation(s)
- D Santini
- Medical Oncology, University Campus Bio-Medico, Rome, Italy
| | - F Graziano
- Medical Oncology, Civic Hospital, Urbino, Italy
| | - V Catalano
- Medical Oncology, Civic Hospital, Pesaro, Italy
| | - M Di Seri
- Medical Oncology, University La Sapienza, Rome, Italy
| | - E Testa
- Medical Oncology, Civic Hospital, Urbino, Italy
| | - AM Baldelli
- Medical Oncology, Civic Hospital, Pesaro, Italy
| | - P Giordani
- Medical Oncology, Civic Hospital, Pesaro, Italy
| | - A La Cesa
- Medical Oncology, University Campus Bio-Medico, Rome, Italy
| | - B Spalletta
- Medical Oncology, University La Sapienza, Rome, Italy
| | - B Vincenzi
- Medical Oncology, University Campus Bio-Medico, Rome, Italy
| | - A Russo
- Medical Oncology, University of Palermo, Italy
| | - M Caraglia
- National Cancer Institute Fondazione "G. Pascale", Experimental Oncology, Department, Experimental Pharmacology Unit, Naples, Italy
| | - V Virzi
- Medical Oncology, University Campus Bio-Medico, Rome, Italy
| | - S Cascinu
- Division of Medical Oncology, University of Ancona, Ancona, Italy
| | - G Tonini
- Medical Oncology, University Campus Bio-Medico, Rome, Italy
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Testa E, Malfatti F, Milazzo S, Cordiviola C, Cotellessa T, Marabotto E, Giannini E, Ceppa P, Mamone M, Risso D, Testa R. Hyaluronic acid and aspartate aminotransferase levels normalized by liver function can reflect sinusoidal impairment in chronic liver disease. Liver Int 2006; 26:439-44. [PMID: 16629647 DOI: 10.1111/j.1478-3231.2006.01251.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND/AIM To evaluate the relationship between hyaluronic acid/aminopyrine breath test (HA/ABT) ratio and fibrosis score in chronic hepatitis, and between HA/ABT and clinical staging (child-turcotte-pugh'score, CTP; and model for end stage liver disease, MELD) in cirrhosis, as well as to evaluate the aspartate aminotransferase (AST)/ABT in relation to the HA/ABT. METHODS We studied 48 patients with histologically proven chronic hepatitis C (CHC) and 35 patients with compensated cirrhosis (CIR). RESULTS HA/ABT and AST/ABT showed a more significant correlation with the fibrosis score than HA or ABT or AST alone in the 48 CHC patients: r=0.568 (P<0.0001), r=0.610 (P<0.0001), r=0.450 (P=0.0021), r=-0.449 (P=0.0021), and r=0.472(P=0.0012), respectively. Progressive liver damage (fibrosis 1-2 vs fibrosis 3-6 vs cirrhosis) was significantly (P<0.05) reflected by both HA/ABT (mean+/-SEM: 4.0+/-0.9 vs 18.1+/-4.2 vs 149.9+/-33.1) and AST/ABT (6.3+/-1.8 vs 12.7+/-1.6 vs 42.1+/-14.6). A strong relationship was found between HA/ABT and AST/ABT (r=0.755 P<0.0001). In cirrhotic patients, the most significant relationship was observed between HA/ABT and CTP r=0.483 and P=0.0049, and MELD r=0.523 and P=0.0023. CONCLUSION Considering that HA levels in chronic hepatitis depend on the progressive impairment of sinusoidal endothelial cells (SEC), related to progressive fibrosis, HA/ABT ratio would seem to be the most specific reflection of progressive impairment of the SEC. AST/ABT could be used as a possible surrogate of HA in identifying SEC impairment in chronic hepatitis.
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Affiliation(s)
- Emanuela Testa
- Gastroenterology Unit and Postgraduate School of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy.
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Giannini EG, Botta F, Borro P, Dulbecco P, Testa E, Mansi C, Savarino V, Testa R. Application of the platelet count/spleen diameter ratio to rule out the presence of oesophageal varices in patients with cirrhosis: a validation study based on follow-up. Dig Liver Dis 2005; 37:779-85. [PMID: 15996912 DOI: 10.1016/j.dld.2005.05.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2005] [Accepted: 05/15/2005] [Indexed: 12/11/2022]
Abstract
BACKGROUND Screening for oesophageal varices represents an important part of the diagnostic work-up of cirrhotic patients. We have previously shown that the platelet count/spleen diameter ratio is a parameter that can rule out the presence of oesophageal varices safely and in a cost-effective fashion. AIM To evaluate the prognostic and diagnostic accuracy of the platelet count/spleen diameter ratio for ruling out the presence of oesophageal varices in the follow-up of a cohort of cirrhotic patients without oesophageal varices at inclusion. METHODS After initial endoscopy, the 106 cirrhotic patients without oesophageal varices who participated in our previous study were followed-up with annual or biannual surveillance endoscopy. Patients were censored at the time of diagnosis of oesophageal varices or at their last visit, and at that time platelet count and spleen diameter were recorded. Sixty-eight patients made up the study cohort after excluding patients who were lost to follow-up or died before undergoing control endoscopy. RESULTS During the follow-up, 27 patients (40%) developed oesophageal varices. Patients with higher baseline platelet count/spleen diameter ratios (p<0.0001) as well as a ratio above 909 were less likely to develop oesophageal varices (p<0.0005). At follow-up, a platelet count/spleen diameter ratio < or = 909 had 100% negative predictive value and 84% efficiency in identifying the presence of oesophageal varices. CONCLUSIONS The use of the platelet count/spleen diameter ratio proved to be an effective means for ruling out the presence of oesophageal varices even in the longitudinal follow-up of patients.
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Affiliation(s)
- E G Giannini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Viale Benedetto XV, No. 6, 16132 Genoa, Italy.
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Giannini EG, Malfatti F, Botta F, Polegato S, Testa E, Fumagalli A, Mamone M, Savarino V, Testa R. Influence of 1-week Helicobacter pylori eradication therapy with rabeprazole, clarithromycin, and metronidazole on 13C-aminopyrine breath test. Dig Dis Sci 2005; 50:1207-13. [PMID: 16047461 DOI: 10.1007/s10620-005-2761-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Helicobacter pylori eradication therapy is commonly prescribed in the general population. Treatment consists of drugs that are mainly metabolized by the liver cytochrome P-450 (CYP) enzymatic pool. Most H. pylori-infected patients often take drugs for comorbid illnesses, therefore increasing the potential for drug-drug interactions. We aimed to evaluate the interactions of rabeprazole, clarithromycin, and metronidazole 1-week H. pylori eradication therapy with CYP-dependent liver metabolic function in clinical practice. Ten patients referred to our unit for H. pylori infection underwent 1-week eradication therapy with rabeprazole (20 mg, b.i.d.), clarithromycin (500 mg, b.i.d.), and metronidazole (500 mg, b.i.d.). We chose the 13C-aminopyrine breath test (13C-ABT) to evaluate CYP-dependent liver function since it is noninvasive and nonharmful. All patients underwent 13C-ABT at three time points: before therapy (to), at the end of therapy (t8), and after 1 month of follow-up (t38). Mean 13C-ABT dose/hr (t0 = 14.0 +/- 5.4, t8 = 13.5 +/- 4.0, t38 = 16.1 +/- 5.6) as well as 13C-ABT cumulative dose (t0 = 2.4 +/- 1.1, t8 = 2.4 +/- 0.8, t38 = 2.6 +/- 1.0) were not statistically different at the three time points of the study. These results did not seem to be influenced by drugs being administered concomitantly. In everyday clinical practice rabeprazole-based H. pylori eradication therapy does not seem to display any significant interactions with CYP-dependent liver function, even in patients on multiple drugs.
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Affiliation(s)
- Edoardo G Giannini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
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Scartozzi M, Galizia E, Graziano F, Catalano V, Berardi R, Baldelli AM, Testa E, Mari D, Silva RR, Cascinu S. Over-DI dissection may question the value of radiotherapy as a part of an adjuvant programme in high-risk radically resected gastric cancer patients. Br J Cancer 2005; 92:1051-4. [PMID: 15770210 PMCID: PMC2361942 DOI: 10.1038/sj.bjc.6602468] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The aim of our analysis was to assess retrospectively the effect on local relapse, overall survival (OS) and disease-free survival (DFS) of a limited or an extended lymphadenectomy in radically resected gastric cancer patients. This study was performed in order to identify a subgroup of patients possibly not benefiting from a therapeutic approach such as chemoradiation therapy. We divided our patients into two groups according to lymphadenectomy type: group A for limited (<25 resected lymph nodes) and group B for extended (>25 resected lymph nodes) lymph nodes resection. A total of 418 patients were analysed: tumour stage at diagnosis was pT2–3 pN1–3 M0 in 339 patients and pT3 N0 M0 in 79 patients. Median age at diagnosis was 68 years (range 30–92 years). A total of 306 patients (73.2%) were in group A and 112 (26.8%) in group B. The median survival time (OS) for patients in groups A and B was 58.8 and 84.8 months, respectively (P=0.0371); median DFS was 28.8 months in group A and 59.9 months in group B (P=0.0027). At multivariate analysis, extension within the gastric wall, nodal involvement and the number of resected lymph nodes appeared to affect both OS and DFS. An inadequate lymph nodes resection can affect survival and result in a higher incidence of local relapse, making the latter group of patients optimal candidates for adjuvant chemoradiation.
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Affiliation(s)
- M Scartozzi
- Department of Medical Oncology, Università Politecnica delle Marche-Azienda Ospedaliera Ospedali Riuniti, Ancona, Italy
| | - E Galizia
- Department of Medical Oncology, Università Politecnica delle Marche-Azienda Ospedaliera Ospedali Riuniti, Ancona, Italy
| | - F Graziano
- Department of Medical Oncology, Ospedale di Urbino, Italy
| | - V Catalano
- Department of Medical Oncology, Azienda Ospedaliera S Salvatore, Pesaro, Italy
| | - R Berardi
- Department of Medical Oncology, Università Politecnica delle Marche-Azienda Ospedaliera Ospedali Riuniti, Ancona, Italy
| | - A M Baldelli
- Department of Medical Oncology, Azienda Ospedaliera S Salvatore, Pesaro, Italy
| | - E Testa
- Department of Medical Oncology, Ospedale di Urbino, Italy
| | - D Mari
- Department of Medical Oncology, Ospedale di Fabriano, Italy
| | - R R Silva
- Department of Medical Oncology, Ospedale di Fabriano, Italy
| | - S Cascinu
- Department of Medical Oncology, Università Politecnica delle Marche-Azienda Ospedaliera Ospedali Riuniti, Ancona, Italy
- Clinica di Oncologia Medica, Università Politecnica delle Marche-Azienda Ospedaliera Umberto I, Via Conca, 60020 Ancona, Italy. E-mail:
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Ruzzo A, Graziano F, Pizzagalli F, Santini D, Battistelli V, Panunzi S, Canestrari E, Catalano V, Humar B, Ficarelli R, Bearzi I, Cascinu S, Naldi N, Testa E, Magnani M. Interleukin 1B gene (IL-1B) and interleukin 1 receptor antagonist gene (IL-1RN) polymorphisms in Helicobacter pylori-negative gastric cancer of intestinal and diffuse histotype. Ann Oncol 2005; 16:887-92. [PMID: 15851404 DOI: 10.1093/annonc/mdi184] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Polymorphisms in the interleukin 1beta gene (IL-1B-31T/C and IL-1B-511C/T single nucleotide changes) and in the interleukin 1 receptor anatagonist gene (IL-1RN2 variable number of tandem repeats) have been studied with respect to gastric cancer susceptibility. Available data support an aetiologic role of these genetic variants in the presence of concomitant Helicobacter pylori infection. Their contribution without H. pylori infection is still an open field of investigation. MATERIALS AND METHODS IL-1B and IL-1RN polymorphisms were investigated in 138 H. pylori-negative Italian patients with sporadic gastric cancer and 100 H. pylori-negative controls. Unconditional regression with odd ratios (OR) and 95% confidence intervals (CI), haplotype and linkage disequilibrium analyses were used to investigate the association of the polymorphisms with disease. RESULTS In all gastric cancer cases, carriers of the homozygous IL-1B-511T/T genotype showed a significant risk for the development of the disease (OR 3.2 with 95% CI 1.27-8.05). In cases with intestinal-type gastric cancer, however, both IL-1B-511T and IL-1RN2 alleles were associated with disease. In this subgroup, the odds ratio for carriers of both IL-1B-511T and IL-1RN2 was 6.49 (95% CI 2.07-20.4). Haplotype analysis supported the aetiologic contribution of these alleles in gastric cancer of the intestinal histotype. CONCLUSIONS In conclusion, IL-1B-511T and IL-1RN2 may contribute to intestinal gastric cancer risk in the absence of concomitant H. pylori infection. In this setting, future epidemiologic studies should consider dietary habits and exposure to carcinogens interacting with pro-inflammatory host genotypes.
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Affiliation(s)
- A Ruzzo
- Institute of Biochemistry 'G Fornaini', University of Urbino, Italy
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