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Meneghelli M, Peruzzo A, Priante E, Cavicchiolo ME, Bonadies L, Moschino L, De Terlizzi F, Verlato G. Bone Status and Early Nutrition in Preterm Newborns with and without Intrauterine Growth Restriction. Nutrients 2023; 15:4753. [PMID: 38004147 PMCID: PMC10675104 DOI: 10.3390/nu15224753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Intrauterine growth restriction (IUGR) together with preterm birth could be harmful to bone health. The aim of the study was to examine bone status in IUGR versus non-IUGR preterms and to analyze the nutritional management best correlated with its improvement. Newborns < 34 weeks of gestational age (wGA), 75 IUGR and 75 non-IUGR, admitted to the Neonatal Intensive Care Unit of the University Hospital of Padova were enrolled and monitored from birth until 36 wGA through anthropometry (weight, length, head circumference, lower limb length (LLL)), biochemistry, bone quantitative ultrasound assessment of bone status (metacarpus bone transmission time, mc-BTT, us) and nutritional intakes monitoring during parenteral nutrition. IUGR compared to non-IUGR showed lower mean mc-BTT (0.45 vs. 0.51, p = 0.0005) and plasmatic phosphate (1.45 vs. 1.79, p < 0.001) at birth. Mc-BTT at 36 wGA, though equal between groups, correlated in IUGR newborns with basal phosphate, mean total energy of the first week and month (positively) and days to reach full enteral feeding (negatively). Lower i.v. vitamin D intake, LLL and prolonged total parenteral nutrition predicted worse mc-BTT at 36 wGA in the enrolled infants. These results suggest that preterms and in particular IUGR newborns need special nutritional care to promote bone development.
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Affiliation(s)
- Marta Meneghelli
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | - Andrea Peruzzo
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | - Elena Priante
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | - Maria Elena Cavicchiolo
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | - Luca Bonadies
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | - Laura Moschino
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
| | | | - Giovanna Verlato
- Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy; (M.M.); (A.P.); (E.P.); (M.E.C.); (L.B.); (L.M.)
- Paediatric Nutrition Service, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy
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Cevolani L, Campanacci L, Staals EL, Dozza B, Bianchi G, De Terlizzi F, Donati DM. Is the association of electrochemotherapy and bone fixation rational in patients with bone metastasis? J Surg Oncol 2023. [PMID: 36966436 DOI: 10.1002/jso.27247] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/19/2023] [Revised: 02/19/2023] [Accepted: 03/07/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND Bone metastases are frequent in patients with cancer. Electrochemotherapy (ECT) is a minimally invasive treatment based on a high-voltage electric pulse combined with an anticancer drug. Preclinical and clinical studies supported the use of ECT in patients with metastatic bone disease, demonstrating that it does not damage the mineral structure of the bone and its regenerative capacity, and that is feasible and efficient for the treatment of bone metastases. Year 2014 saw the start of a registry of patients with bone metastases treated with ECT, whose data are recorded in a shared database. QUESTIONS/PURPOSES (1) Among patients who underwent ECT and internal fixation for bone metastasis, how many experienced a reduction of pain? (2) How many cases showed a radiological response? (3) How many patients presented local or systemic complication after ECT and fixation? PATIENTS AND METHODS Patients were treated in Bologna at Rizzoli Orthopaedic Institute between March 2014 and February 2022 and recorded in the REINBONE registry (a shared database protected by security passwords): clinical and radiological information, ECT session, adverse events, response, quality of life indicators, and duration of follow-up were registered. We consider only cases treated with ECT and intramedullary nail during the same surgical session. Patients included in the analysis were 32: 15 males and 17 females, mean age 65 ± 13 years (median 66, range 38-88 years), mean time since diagnosis of primary tumor 6.2 ± 7.0 years (median 2.9, range 0-22 years). Nail was indicated in 13 cases for a pathological fracture in, 19 for an impending fracture. Follow-up was available for 29 patients, as 2 patients were lost to follow-up and 1 was unable to return to controls. Mean follow-up time was 7.7 ± 6.5 months (median 5, range 1-24), and 16 patients (50%) had a follow-up longer than 6 months. RESULTS A significant decrease in pain intensity was observed at the mean Visual Numeric Scale after treatment. Bone recovery was observed in 13 patients. The other 16 patients remained without changes, and one presented disease progression. One patient presented a fracture occurrence during the ECT procedure. Among all patients, bone recovery was observed in 13 patients: complete recovery in 1 patient (3%) and partial recovery in 12 patients (41%). The other 16 patients remained without changes, and one presented disease progression. One patient presented a fracture occurrence during the ECT procedure. However, healing was possible with normal fracture callus quality and healing time. No other local or systemic complications were observed. CONCLUSION We found that pain levels decreased after treatment in 23 of the 29 cases for a pain relief rate of 79% at final follow-up. Pain is one of the most important indicators of quality of life in patients that undergo palliative treatments. Even if conventional external body radiotherapy is considered a noninvasive treatment, it presents a dose-dependent toxicity. ECT provides a chemical necrosis preserving osteogenic activity and structural integrity of bone trabeculae; this is a crucial difference with other local treatments and allows bone healing in case of pathological fracture. The risk of local progression in our patient population was small, and 44% experienced bone recovery while 53% of the cases remained unchanged. We observe intraoperative fracture in one case. This technique, in selected patients, improves outcome in bone metastatic patients combing both the efficacy of the ECT in the local control of the disease and the mechanical stability with the bone fixation to synergize their benefits. Moreover, the risk of complication is very low. Although encouraging data, comparative studies are required to quantify the real efficacy of the technique. Level of Evidence Level I, therapeutic study.
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Affiliation(s)
- Luca Cevolani
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Laura Campanacci
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Eric Lodewijk Staals
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Barbara Dozza
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Giuseppe Bianchi
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Davide Maria Donati
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Perrone AM, Corrado G, Coada CA, Garganese G, Fragomeni SM, Tagliaferri L, Di Costanzo S, De Crescenzo E, Morganti AG, Ferioli M, De Terlizzi F, Scambia G, De Iaco P. Electrochemotherapy with intravenous bleomycin for heavily pre-treated vulvar cancer patients. Int J Gynecol Cancer 2023; 33:473-481. [PMID: 36787933 DOI: 10.1136/ijgc-2022-004127] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE The management of vulvar cancer recurrences is complicated by patients' advanced age and comorbidities. Bleomycin-based electrochemotherapy is a potential treatment option in this setting. However, no data on long-term outcomes are available. Therefore, a multicenter observational study was designed to evaluate the 5-year results in these patients. METHODS Data about patients and tumor characteristics, electrochemotherapy cycles, clinical response, and follow-up were recorded. Treatment procedures were performed according to the European Standard Operating Procedures of Electrochemotherapy (ESOPE) guidelines. Response was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. RESULTS Fifty-one patients (mean age 82.31±7.28 years) with squamous cell vulvar cancer underwent electrochemotherapy (median number of sessions 1; range 1-4). 20 patients had complete response and 32% of these were disease-free after 2 years (median progression-free survival 16.8 months). In 13 patients with partial response the median progression-free survival was 15.36 months, while patients with stable or progressive disease showed tumor relapse after 6.95 and 3.26 months, respectively (p<0.001). Median overall survival was 18.77, 13.07, 6.73, and 11.13 months in patients with complete response, partial response, stable disease, and progressive disease, respectively (p=0.001). CONCLUSION Long-term follow-up of vulvar cancer patients showed reasonable tumor control after electrochemotherapy and improved progression-free survival and overall survival in responder subjects compared with non-responders. Further studies aimed at improving local response after electrochemotherapy are warranted. Thus, this approach represents a potential alternative for these patients.
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Affiliation(s)
- Anna Myriam Perrone
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giacomo Corrado
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | | | - Giorgia Garganese
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy.,Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Sezione di Ginecologia ed Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simona Maria Fragomeni
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Luca Tagliaferri
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Stella Di Costanzo
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
| | - Eugenia De Crescenzo
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alessio Giuseppe Morganti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Martina Ferioli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Giovanni Scambia
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Pierandrea De Iaco
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Claussen CS, Moir G, Bechara FG, Orlando A, Matteucci P, Mowatt D, Clover AJP, Mascherini M, Gehl J, Muir T, Sersa G, Groselj A, Odili J, Giorgione R, Campana LG, Bertino G, Curatolo P, Banerjee S, Kis E, Quaglino P, Pritchard-Jones R, De Terlizzi F, Grischke EM, Kunte C. Prospektive Kohortenstudie von InspECT zur Sicherheit und Wirksamkeit der Elektrochemotherapie bei Hauttumoren und Metastasen in Abhängigkeit von Ulzeration. J Dtsch Dermatol Ges 2022; 20:470-482. [PMID: 35446500 DOI: 10.1111/ddg.14699_g] [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: 03/29/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022]
Abstract
HINTERGRUND Elektrochemotherapie (ECT) ist eine wirksame lokale Behandlung von Hauttumoren. Ziel dieser Studie war es, die Wirksamkeit der ECT bei ulzerierten gegenüber nichtulzerierten Tumoren zu vergleichen und den Effekt auf tumorassoziierte Symptome zu untersuchen. METHODIK 20 Krebszentren des International Network for Sharing Practices on Electrochemotherapy (InspECT) sammelten prospektiv Daten. Die ECT wurde nach dem ESOPE-Protokoll durchgeführt. Das Therapieansprechen wurde anhand der Entwicklung der Läsionsgröße bewertet. Zusätzlich wurden Schmerzen, Symptome, Leistungsstatus (ECOG-Index) und Gesundheitszustand (EQ-5D-Fragebogen) untersucht. ERGEBNISSE 716 Patienten mit ulzerierten (n = 302) und nichtulzerierten (n = 414) Hauttumoren und Metastasen wurden eingeschlossen (Mindest-Nachsorge 45 Tage). Nicht-ulzerierte Läsionen sprachen besser auf die ECT an als ulzerierte Läsionen (vollständiges Ansprechen: 65 % gegenüber 51 %, p = 0,0061). Nur 38 % (115/302) der Patienten mit ulzerierten Läsionen vor der ECT wiesen bei der letzten Nachuntersuchung ulzerierte Läsionen auf. Patienten mit ulzerierten Läsionen berichteten über stärkere Schmerzen und schwerere Symptome im Vergleich zu Patienten mit nichtulzerierten Läsionen, die sich nach der ECT signifikant und kontinuierlich besserten. Bei Patienten mit nichtulzerierten Läsionen hingegen nahmen die Schmerzen während der Behandlung vorübergehend zu. Es wurden keine schwerwiegenden Nebenwirkungen beobachtet. SCHLUSSFOLGERUNGEN Die ECT ist eine sichere und wirksame lokale Behandlung von Hauttumoren. Während die ECT die Symptome insbesondere bei Patienten mit ulzerierten Läsionen verbessert, sollte auf Basis der Daten die Implementation eines perioperativen Schmerzmanagements besonders bei nichtulzerierten Läsionen während der ECT erwogen werden.
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Affiliation(s)
- Carla Sophie Claussen
- Department of Dermatosurgery and Dermatology, Artemed Clinic of Munich, Munich, Germany
| | - Graeme Moir
- The Royal London Hospital & QMUL, Bart's Health NHS Trust, Department of Cutaneous Medicine & Surgery, London, United Kingdom
| | - Falk G Bechara
- Department of Dermatologic Surgery, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Antonio Orlando
- Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Paolo Matteucci
- Department of Plastic surgery, Castle Hill Hospital, Cottingham, United Kingdom
| | - David Mowatt
- Plastic Surgery Department, The Christie Hospital NHS Foundation trust, Manchester, United Kingdom
| | - Anthony James P Clover
- Department of Plastic Surgery, Cork University Hospital, Cork, Ireland.,Cancer Research@UCC, Western Gateway Building, University College Cork, Cork, Ireland
| | - Matteo Mascherini
- Clinica Chirurgica 1 - Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tobian Muir
- Plastic Surgery Department, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Gregor Sersa
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Ales Groselj
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Joy Odili
- Department of Plastic Surgery, St. Georges University Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Luca Giovanni Campana
- Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.,Department of Surgery, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - Giulia Bertino
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Pietro Curatolo
- Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University of Roma "La Sapienza", Roma, Italy
| | - Shramana Banerjee
- Division of Surgery and interventional Science, University College London, London, United Kingdom
| | - Erika Kis
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Torino, Torino, Italy
| | | | | | - Eva-Maria Grischke
- Department of Gynecology, University Hospital of Tübingen, Tübingen, Germany
| | - Christian Kunte
- Department of Dermatosurgery and Dermatology, Artemed Clinic of Munich, Munich, Germany.,Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
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5
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Claussen CS, Moir G, Bechara FG, Orlando A, Matteucci P, Mowatt D, Clover AJP, Mascherini M, Gehl J, Muir T, Sersa G, Groselj A, Odili J, Giorgione R, Campana LG, Bertino G, Curatolo P, Banerjee S, Kis E, Quaglino P, Pritchard-Jones R, De Terlizzi F, Grischke EM, Kunte C. Prospective cohort study by InspECT on safety and efficacy of electrochemotherapy for cutaneous tumors and metastases depending on ulceration. J Dtsch Dermatol Ges 2022; 20:470-481. [PMID: 35384261 DOI: 10.1111/ddg.14699] [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: 03/29/2021] [Accepted: 11/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Electrochemotherapy (ECT) is an effective local treatment for cutaneous tumors. The aim of this study was to compare the effectiveness of ECT in ulcerated vs. non-ulcerated tumors and investigate the effect on tumor-associated symptoms. METHODS Twenty cancer centers in the International Network for Sharing Practices on Electrochemotherapy (InspECT) prospectively collected data. ECT was performed following ESOPE protocol. Response was evaluated by lesion size development. Pain, symptoms, performance status (ECOG-Index) and health status (EQ-5D questionnaire) were evaluated. RESULTS 716 patients with ulcerated (n = 302) and non-ulcerated (n = 414) cutaneous tumors and metastases were included (minimum follow-up of 45 days). Non-ulcerated lesions responded to ECT better than ulcerated lesions (complete response 65 % vs. 51 %, p = 0.0061). Only 38 % (115/302) with ulcerated lesions before ECT presented with ulcerated lesions at final follow-up. Patients with ulcerated lesions reported higher pain and more severe symptoms compared to non-ulcerated lesions, which significantly and continuously improved following ECT. In non-ulcerated lesions however, pain spiked during the treatment. No serious adverse events were reported. CONCLUSIONS ECT is a safe and effective local treatment for cutaneous tumors. While ECT improves symptoms especially in patients with ulcerated lesions, data suggest the implementation of a perioperative pain management in non-ulcerated lesions during ECT.
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Affiliation(s)
- Carla Sophie Claussen
- Department of Dermatosurgery and Dermatology, Artemed Clinic of Munich, Munich, Germany
| | - Graeme Moir
- The Royal London Hospital & QMUL, Barts Health NHS Trust, Department of Cutaneous Medicine & Surgery, London, United Kingdom
| | - Falk G Bechara
- Department of Dermatologic Surgery, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Antonio Orlando
- Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Paolo Matteucci
- Department of Plastic surgery, Castle Hill Hospital, Cottingham, United Kingdom
| | - David Mowatt
- Plastic Surgery Department, The Christie Hospital NHS Foundation trust, Manchester, United Kingdom
| | - Anthony James P Clover
- Department of Plastic Surgery, Cork University Hospital, Cork, Ireland.,Cancer Research@UCC, Western Gateway Building, University College Cork, Cork, Ireland
| | - Matteo Mascherini
- Clinica Chirurgica 1 - Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tobian Muir
- Plastic Surgery Department, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Gregor Sersa
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Ales Groselj
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Joy Odili
- Department of Plastic Surgery, St. Georges University Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Luca Giovanni Campana
- Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.,Department of Surgery, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - Giulia Bertino
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Pietro Curatolo
- Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University of Roma "La Sapienza", Roma, Italy
| | - Shramana Banerjee
- Division of Surgery and interventional Science, University College London, London, United Kingdom
| | - Erika Kis
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Torino, Torino, Italy
| | | | | | - Eva-Maria Grischke
- Department of Gynecology, University Hospital of Tübingen, Tübingen, Germany
| | - Christian Kunte
- Department of Dermatosurgery and Dermatology, Artemed Clinic of Munich, Munich, Germany.,Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
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Russano F, Del Fiore P, Di Prata C, Pasqual A, Marconato R, Campana LG, Spina R, Gianesini CM, Collodetto A, Tropea S, Dall’Olmo L, Carraro S, Parisi A, Galuppo S, Scarzello G, De Terlizzi F, Rastrelli M, Mocellin S. The Role of Electrochemotherapy in the Cutaneous and Subcutaneous Metastases From Breast Cancer: Analysis of Predictive Factors to Treatment From an Italian Cohort of Patients. Front Oncol 2021; 11:772144. [PMID: 34993137 PMCID: PMC8724516 DOI: 10.3389/fonc.2021.772144] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022] Open
Abstract
The treatment of cutaneous and subcutaneous localizations from breast cancer (BC) is still a therapeutic challenge. Electrochemotherapy (ECT) is one of the available options, and it is characterized by the association between the administration of a chemotherapic agent (Bleomycin) with the temporary raise of permeability of the cellular membrane induced by the local administration of electrical impulses (electroporation). ECT represents an effective therapy for loco-regional control of this disease. This study aimed to investigate the predictive factors of response in cutaneous and subcutaneous localizations from breast cancer treated with ECT. We decided to evaluate the response to this treatment in 55 patients who underwent ECT between January 2013 and March 2020 at our Institute. We performed a monocentric retrospective cohort study. ECT was administered following the ESOPE (European Standard Operative Procedure of Electrochemotherapy) guidelines, a set of criteria updated in 2018 by a panel of European experts on ECT who defined the indications for selecting the patients who can benefit from the ECT treatment and the ones for technically performing the procedure. The responses were evaluated with the RECIST criteria (Response Evaluation Criteria in Solid Tumor). We found after 12 weeks of treatment a complete response (CR) in 64% of our patients. From the analysis divided for subgroups of covariates is emerged that lower BMI, reduced body surface, and absence of previous radiation treatment could be predictive for a better complete response. This study suggests that the efficacy of the ECT treatment is related to the concurrent systemic therapies while administering ECT. The association between ECT and immunotherapy has offered better results than the association between ECT and chemotherapy (p-value = 0.0463). So, ECT is a valuable tool in the treatment of cutaneous and subcutaneous metastases from breast cancer and its efficacy in local control of these lesions improves when it is well planned in a therapeutic scenario.
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Affiliation(s)
- Francesco Russano
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Paolo Del Fiore
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
- *Correspondence: Paolo Del Fiore,
| | - Claudia Di Prata
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Andrea Pasqual
- Department of Medicine, University of Padua, Padua, Italy
| | - Roberto Marconato
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Luca Giovanni Campana
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Romina Spina
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Carlo Maria Gianesini
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Alessandra Collodetto
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Saveria Tropea
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Luigi Dall’Olmo
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Sabrina Carraro
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Alessandro Parisi
- Radiotherapy Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Sara Galuppo
- Radiotherapy Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Giovanni Scarzello
- Radiotherapy Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | | | - Marco Rastrelli
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Simone Mocellin
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
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7
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Campanacci L, Bianchi G, Cevolani L, Errani C, Ciani G, Facchini G, Spinnato P, Tognù A, Massari L, Cornelis FH, Mosconi M, Screpis D, Benazzo F, Rossi B, Bonicoli E, Fazioli F, Nicolosi M, Boffano M, Piana R, De Terlizzi F, Cadossi M, Donati DM. Operating procedures for electrochemotherapy in bone metastases: Results from a multicenter prospective study on 102 patients. Eur J Surg Oncol 2021; 47:2609-2617. [PMID: 34083080 DOI: 10.1016/j.ejso.2021.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 02/24/2021] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Bone metastases are frequent in patients with cancer. Electrochemotherapy (ECT) is a minimally invasive treatment. Preclinical and clinical studies supported the use of ECT in patients with metastatic bone disease (MBD). The purposes of this multicentre study are to confirm the safety and efficacy of ECT, and to identify appropriate operating procedures in different MBD conditions. MATERIALS AND METHODS 102 patients were treated in 11 Centres and recorded in the REINBONE registry (a shared database protected by security passwords): clinical and radiological information, ECT session, adverse events, response, quality of life indicators and duration of follow-up were registered. RESULTS 105 ECT sessions were performed (one ECT session in 99 patients, two ECT sessions in 3 patients). 24 patients (23.5%) received a programmed intramedullary nail after ECT, during the same surgical procedure. Mean follow-up was 5.9 ± 5.1 months (range 1.5-52). The response to treatment by RECIST criteria was 40.4% objective responses, 50.6% stable disease and 9% progressive disease. According to PERCIST criteria the response was: 31.4% OR; 51.7% SD, 16.9% PD with no significant differences between the 2 criteria. Diagnosis of breast cancer and ECOG values 0-1 were significantly associated to objective response. A significant decrease in pain intensity and significant better quality of life was observed after ECT session at follow-up. CONCLUSION The results are encouraging on pain and tumour local control. ECT proved to be an effective and safe treatment for MBD and it should be considered as an alternative treatment as well as in combination with radiation therapy.
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Affiliation(s)
- Laura Campanacci
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
| | - Giuseppe Bianchi
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
| | - Luca Cevolani
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
| | - Costantino Errani
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
| | - Giovanni Ciani
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
| | - Giancarlo Facchini
- Department of Radiology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
| | - Paolo Spinnato
- Department of Radiology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
| | - Andrea Tognù
- Department of Anaestesiology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
| | - Leo Massari
- Dipartimento di Neuroscienze e Riabilitazione, Università di Ferrara, U.O. di Clinica Ortopedica e Traumatologica, Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Italy.
| | - Francois H Cornelis
- Sorbonne Université, Department of Interventional Radiology, Hôpital Tenon 4 rue de la Chine, 75020, Paris, France.
| | - Mario Mosconi
- Fondazione IRCCS Policlinico San Matteo Pavia, UOC Ortopedia e Traumatologia, Italy.
| | - Daniele Screpis
- U.O. Ortopedia e Traumatologia - Ospedale Sacrocuore Don Calabria, Via don A. Sempreboni 5, Negrar di Valpolicella, 37024, Vr, Italy.
| | - Francesco Benazzo
- Sezione Universitaria di Chirurgia Protesica Ad Indirizzo Robotico, Unità di Traumatologia dello Sport Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
| | - Barbara Rossi
- UOC Oncologic Orthopaedics, IRCCS Regina Elena National Cancer Institute - Rome, Italy.
| | - Enrico Bonicoli
- U.O. Ortopedia e Traumatologia 1(a) Universitaria, Cisanello-Pisa, Italy.
| | - Flavio Fazioli
- Division of Oncological Orthopedics National Cancer Institute G. Pascale, Naples, Italy.
| | | | - Michele Boffano
- SC Chirurgia Oncologica Ortopedica, AOU Città della Salute e della Scienza di Torino, Presidio CTO - Via Zuretti 29, 10126, Torino, Italy.
| | - Raimondo Piana
- SC Chirurgia Oncologica Ortopedica, AOU Città della Salute e della Scienza di Torino, Presidio CTO - Via Zuretti 29, 10126, Torino, Italy.
| | | | - Matteo Cadossi
- IGEA Clinical Biophysics, Via Parmenide 10/A, 41012, Carpi, MO, Italy.
| | - Davide Maria Donati
- 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
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8
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Perrone AM, Ravegnini G, Miglietta S, Argnani L, Ferioli M, De Crescenzo E, Tesei M, Di Stanislao M, Girolimetti G, Gasparre G, Porcelli AM, De Terlizzi F, Zamagni C, Morganti AG, De Iaco P. Electrochemotherapy in Vulvar Cancer and Cisplatin Combined with Electroporation. Systematic Review and In Vitro Studies. Cancers (Basel) 2021; 13:cancers13091993. [PMID: 33919139 PMCID: PMC8122585 DOI: 10.3390/cancers13091993] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/24/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Electrochemotherapy (ECT) is an emerging treatment for solid tumors and an attracting research field due to its clinical results. ECT in association with bleomycin is an effective and safe treatment option in the vulvar cancer palliative setting. With regard to cisplatin (CSP)-based ECT, considering the clear evidence on its efficacy in gynecological tumors, the possibility to improve local control with CSP-based ECT is intriguing and a well-designed randomized clinical trial should be addressed to this issue. Abstract Electrochemotherapy (ECT) is an emerging treatment for solid tumors and an attractive research field due to its clinical results. This therapy represents an alternative local treatment to the standard ones and is based on the tumor-directed delivery of non-ablative electrical pulses to maximize the action of specific cytotoxic drugs such as cisplatin (CSP) and bleomycin (BLM) and to promote cancer cell death. Nowadays, ECT is mainly recommended as palliative treatment. However, it can be applied to a wide range of superficial cancers, having an impact in preventing or delaying tumor progression and therefore in improving quality of life. In addition, during the natural history of the tumor, early ECT may improve patient outcomes. Our group has extensive clinical and research experience on ECT in vulvar tumors in the palliative setting, with 70% overall response rate. So far, in most studies, ECT was based on BLM. However, the potential of CSP in this setting seems interesting due to some theoretical advantages. The purpose of this report is to: (i) compare the efficacy of CSP and BLM-based ECT through a systematic literature review; (ii) report the results of our studies on CSP-resistant squamous cell tumors cell lines and the possibility to overcome chemoresistance using ECT; (iii) discuss the future ECT role in gynecological tumors and in particular in vulvar carcinoma.
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Affiliation(s)
- Anna Myriam Perrone
- Division of Oncologic Gynecology, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.M.P.); (E.D.C.); (M.T.); (M.D.S.); (P.D.I.)
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (S.M.); (G.G.); (G.G.); (A.M.P.); (C.Z.); (A.G.M.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Gloria Ravegnini
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
- Correspondence:
| | - Stefano Miglietta
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (S.M.); (G.G.); (G.G.); (A.M.P.); (C.Z.); (A.G.M.)
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
- Center for Applied Biomedical Research, Alma Mater Studiorum-University of Bologna, 40138 Bologna, Italy
| | - Lisa Argnani
- Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy;
| | - Martina Ferioli
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Eugenia De Crescenzo
- Division of Oncologic Gynecology, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.M.P.); (E.D.C.); (M.T.); (M.D.S.); (P.D.I.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Marco Tesei
- Division of Oncologic Gynecology, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.M.P.); (E.D.C.); (M.T.); (M.D.S.); (P.D.I.)
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (S.M.); (G.G.); (G.G.); (A.M.P.); (C.Z.); (A.G.M.)
| | - Marco Di Stanislao
- Division of Oncologic Gynecology, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.M.P.); (E.D.C.); (M.T.); (M.D.S.); (P.D.I.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Giulia Girolimetti
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (S.M.); (G.G.); (G.G.); (A.M.P.); (C.Z.); (A.G.M.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
- Center for Applied Biomedical Research, Alma Mater Studiorum-University of Bologna, 40138 Bologna, Italy
| | - Giuseppe Gasparre
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (S.M.); (G.G.); (G.G.); (A.M.P.); (C.Z.); (A.G.M.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
- Center for Applied Biomedical Research, Alma Mater Studiorum-University of Bologna, 40138 Bologna, Italy
| | - Anna Maria Porcelli
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (S.M.); (G.G.); (G.G.); (A.M.P.); (C.Z.); (A.G.M.)
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
- Center for Applied Biomedical Research, Alma Mater Studiorum-University of Bologna, 40138 Bologna, Italy
- Interdepartmental Center for Industrial Research Life Sciences and Technologies for Health, Alma Mater Studiorum-University of Bologna, 40064 Ozzano dell’Emilia, Italy
| | | | - Claudio Zamagni
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (S.M.); (G.G.); (G.G.); (A.M.P.); (C.Z.); (A.G.M.)
- Oncologia Medica Addarii, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Alessio Giuseppe Morganti
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (S.M.); (G.G.); (G.G.); (A.M.P.); (C.Z.); (A.G.M.)
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Pierandrea De Iaco
- Division of Oncologic Gynecology, IRCCS—Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.M.P.); (E.D.C.); (M.T.); (M.D.S.); (P.D.I.)
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy; (S.M.); (G.G.); (G.G.); (A.M.P.); (C.Z.); (A.G.M.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
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9
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Ferioli M, Galuppi A, Buwenge M, Cammelli S, Perrone AM, Macchia G, Deodato F, Cilla S, Zamagni A, De Terlizzi F, Tagliaferri L, De Iaco P, Morganti AG. Electrochemotherapy in Kaposi sarcoma: A systematic review. Mol Clin Oncol 2021; 14:64. [PMID: 33680455 DOI: 10.3892/mco.2021.2226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 05/12/2020] [Accepted: 09/09/2020] [Indexed: 11/05/2022] Open
Abstract
Kaposi sarcoma (KS) is a rare angioproliferative disorder, which is usually associated with human herpesvirus-8 infection. Electrochemotherapy (ECT) may be an option in the treatment of KS skin lesions due to the high response rate noted in neoplastic lesions of different histological types. The aim of the present systematic review was to analyse the available evidence on using ECT in the treatment of KS skin lesions. Tumor response, local control and toxicity were analyzed. In the three included studies, the complete response rate was 65-100% and the overall response rate in all studies was 100%. The treatment was well tolerated with mild and transient toxicity. However, further studies are required to fully analyze long-term disease control and to compare ECT with other local therapies used for KS.
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Affiliation(s)
- Martina Ferioli
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
| | - Andrea Galuppi
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
| | - Milly Buwenge
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
| | - Silvia Cammelli
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
| | - Anna Myriam Perrone
- Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), University of Bologna, S. Orsola-Malpighi Hospital, I-40138 Bologna, Italy
| | - Gabriella Macchia
- Radiotherapy Unit, Gemelli Molise Hospital, Fondazione Policlinico Universitario A. Gemelli, IRCCS, I-86100 Campobasso, Italy
| | - Francesco Deodato
- Radiotherapy Unit, Gemelli Molise Hospital, Fondazione Policlinico Universitario A. Gemelli, IRCCS, I-86100 Campobasso, Italy
| | - Savino Cilla
- MedicalPhysic Unit, Gemelli Molise Hospital, Fondazione Policlinico Universitario A. Gemelli, IRCCS, I-86100 Campobasso, Italy
| | - Alice Zamagni
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
| | | | - Luca Tagliaferri
- Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, I-00168 Roma, Italy
| | - Pierandrea De Iaco
- Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), University of Bologna, S. Orsola-Malpighi Hospital, I-40138 Bologna, Italy
| | - Alessio Giuseppe Morganti
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
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10
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Ferioli M, Perrone AM, Buwenge M, Arcelli A, Zamagni A, Macchia G, Deodato F, Cilla S, Tagliaferri L, De Terlizzi F, De Iaco P, Zamagni C, Morganti AG. Electrochemotherapy of skin metastases from breast cancer: a systematic review. Clin Exp Metastasis 2020; 38:1-10. [PMID: 33180222 DOI: 10.1007/s10585-020-10063-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 07/10/2020] [Accepted: 11/08/2020] [Indexed: 12/11/2022]
Abstract
Skin metastases occur in 5-30% of breast cancer (BC) patients. Standard treatments include systemic therapies (chemotherapy, endocrine therapy, and immunotherapy) and local treatments (surgery and radiotherapy). Electrochemotherapy (ECT) could be another option in this setting based on preclinical and clinical studies. Aim of this review was to analyze the available evidence on ECT in skin metastases from BC. Studies reporting on ECT in skin metastases from BC were included in this review. Studies not reporting toxicity or tumor response or not reporting results separately from other primary cancers were excluded. The search was based on Medline, Scopus, and The Cochrane Library databases. Eleven studies including 464 patients were analyzed. ECT was performed using intravenous/intratumoral bleomycin (10 studies) or intratumoral cisplatin (one study). Complete and overall pooled response rates were 46.2% (95%CI 33.2-59.4 and 74.6% (95%CI 60.6-86.4) in studies reporting results on a per patient basis and 61.9% (95%CI 53.8-69.6) and 86.9% (95%CI 80.0-92.6) in studies reporting results on a per lesion basis, respectively. Worse response rates in larger lesions were observed in three studies. The incidence of toxicity was heterogeneous but adverse events were mild and manageable in all studies. One- and 3-year local progression-free survival was 86.2% and 81.0% in two studies, respectively. ECT is tolerable and effective in terms of response in BC skin metastases especially in less advanced lesions. Further studies are justified to compare ECT with other treatments in this setting.
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Affiliation(s)
- Martina Ferioli
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy.
| | - Anna Myriam Perrone
- Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Milly Buwenge
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy
| | - Alessandra Arcelli
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy
| | - Alice Zamagni
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy
| | - Gabriella Macchia
- Radiotherapy Unit, Gemelli Molise Hospital, Catholic University of Sacred Heart, Campobasso, Italy
| | - Francesco Deodato
- Radiotherapy Unit, Gemelli Molise Hospital, Catholic University of Sacred Heart, Campobasso, Italy
| | - Savino Cilla
- Medical Physic Unit, Gemelli Molise Hospital, Catholic University of Sacred Heart, Campobasso, Italy
| | - Luca Tagliaferri
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | | | - Pierandrea De Iaco
- Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Claudio Zamagni
- Department of Hematology and Oncology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Alessio Giuseppe Morganti
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy
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11
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Spigolon E, Cimolato I, Priante E, Bonadies L, Visentin S, De Terlizzi F, Cavicchiolo ME, Verlato G. Diet in pregnant women that delivered prematurely and preterm newborn's bone status. J Matern Fetal Neonatal Med 2020; 35:2859-2866. [PMID: 32814481 DOI: 10.1080/14767058.2020.1807507] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Inadequate maternal dietary pattern has been associated to negative pregnancy and fetal outcomes. With this study, we aimed to evaluate the adequacy of diet in pregnant women that delivered prematurely and its possible correlations with bone status of preterm newborns. STUDY DESIGN We prospectively enrolled women who delivered prematurely (≤than 34 gestational weeks) and their newborns (Neonatal Intensive Care, University Hospital of Padova) from January 2017 to May 2018. Maternal nutritional status and diet supplementations were assessed using a validated questionnaire. The preterm newborns were evaluated with anthropometric measurements and bone status by Quantitative Ultrasound of the second metacarpal bone within 72 h from birth. RESULTS One hundred and eighty mothers and 202 preterm newborns were evaluated. The mothers assumed more calories, proteins, total lipids and simple sugars compared to the revised National Guidelines. The intake of calcium, phosphorus and Vitamin D was inadequate despite the use of multivitamin supplements. The mothers assumption of vitamin D and zinc positively correlated with bone status and mothers with very low intake of vitamin D during gestation (<7 µg/die) had preterm newborns with a worst bone status at birth compared to those with a better intake (>7 µg/die). CONCLUSIONS Nutrition of pregnant women could be improved and maternal intakes of Vitamin D and zinc positively correlated with preterm newborn's bone status.
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Affiliation(s)
- Eleonora Spigolon
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Irene Cimolato
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Elena Priante
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Luca Bonadies
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Silvia Visentin
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | | | - Maria Elena Cavicchiolo
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Giovanna Verlato
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
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12
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Perrone AM, Ferioli M, Galuppi A, Coe M, De Terlizzi F, Tesei M, Dondi G, De Palma A, Morganti AG, De Iaco P. Palliative treatment with electrochemotherapy in recurrent or metastatic vaginal cancer. Int J Gynecol Cancer 2020; 30:939-946. [PMID: 32474450 DOI: 10.1136/ijgc-2020-001471] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/14/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Vaginal metastases are very rare events with a poor prognosis. To improve the quality of life, local treatments should be considered. The aim of this study was to evaluate the role of electrochemotherapy as palliative treatment in vaginal cancer not amenable to standard treatments due to poor performance status, previous treatments, or advanced disease. METHODS This is a prospective observational study on patients diagnosed with vaginal cancer and treated from January 2017 to December 2018 with palliative electrochemotherapy. We collected data on patients with vaginal cancer treated by electrochemotherapy with the aim of local control. Data regarding electrochemotherapy, hospital stay, adverse events, and patient outcomes were analyzed. Intravenous bleomycin was injected as a bolus in 2-3 min at a dose of 15 000 UI/m2 and electrical pulses started 8 min after chemotherapy. Electrochemotherapy response was defined according to the Response Evaluation Criteria in Solid Tumors. RESULTS Five patients with vaginal recurrence (two squamous, two melanomas, and one leiomyosarcoma) and one with vaginal metastasis from intestinal adenocarcinoma received one treatment and two patients were re-treated. Imaging reported nodal metastasis (inguinal or pelvic) in two patients, distant metastases in two, and both node and distant metastasis in two patients, respectively. Response Evaluation Criteria in Solid Tumors showed a complete response in one patient, partial response in three patients, stable disease in one patient, and progressive disease in one patient, with an overall response rate of 67% and a clinical benefit rate (complete response, partial response, stable disease) of 83%. Two patients were re-treated and had a new response (partial response and stable disease, respectively). At last follow-up, two patients had died of the disease, two were alive with stable disease, one was alive with progressive disease, and one was alive without disease. Median post-electrochemotherapy overall survival was 12.9 months (range 1.6-26.9) and 1-year overall survival was 66.7%. CONCLUSIONS This preliminary experience showed a tumor response or stabilization in 83% of patients requiring palliative management for vaginal cancer. Further studies are needed to evaluate treatment outcome in larger and prospective series.
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Affiliation(s)
- Anna Myriam Perrone
- Gynecologic Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy .,Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, Bologna, Italy
| | - Martina Ferioli
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine, DIMES Univerisity of Bologna, Bologna, Italy
| | - Andrea Galuppi
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, Bologna, Italy.,Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine, DIMES Univerisity of Bologna, Bologna, Italy
| | - Manuela Coe
- Department of Experimental, Diagnostic and Specialty Medicine, Unit of Radiology, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy
| | | | - Marco Tesei
- Gynecologic Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy.,Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, Bologna, Italy
| | - Giulia Dondi
- Gynecologic Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy.,Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, Bologna, Italy
| | - Alessandra De Palma
- Forensic Medicine and Integrated Risk Management Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy
| | - Alessio G Morganti
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, Bologna, Italy.,Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine, DIMES Univerisity of Bologna, Bologna, Italy
| | - Pierandrea De Iaco
- Gynecologic Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy.,Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, Bologna, Italy
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Fabrizio T, Cagiano L, De Terlizzi F, Grieco MP. Neoadjuvant treatment by ECT in cutaneous malignant neoplastic lesions. J Plast Reconstr Aesthet Surg 2020; 73:904-912. [DOI: 10.1016/j.bjps.2019.11.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/13/2019] [Accepted: 11/23/2019] [Indexed: 01/05/2023]
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Perrone AM, Galuppi A, Pirovano C, Borghese G, Covarelli P, De Terlizzi F, Ferioli M, Cara S, Morganti AG, De Iaco P. Palliative Electrochemotherapy in Vulvar Carcinoma: Preliminary Results of the ELECHTRA (Electrochemotherapy Vulvar Cancer) Multicenter Study. Cancers (Basel) 2019; 11:cancers11050657. [PMID: 31083599 PMCID: PMC6562538 DOI: 10.3390/cancers11050657] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 03/22/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 11/16/2022] Open
Abstract
Vulvar cancer (VC) is a rare disease of which recurrence poses management problems due to patients' advanced age and comorbidities, and to the localization of the disease. Palliative treatments, allowing local disease control in patients previously treated with multimodal therapies or with comorbidities, are lacking. In this study we tested electrochemotherapy (ECT) on recurrent VC refractory to standard therapies to assess the tumor response and to define the selection criteria for patient's candidate to ECT. This is a multicenter observational study carried out in five Italian centers. Data about patients and tumor characteristics, treatment, toxicity, and clinical response were recorded. In all procedures, intravenous bleomycin was administered according to European Standard Operative Procedure ECT (ESOPE) guidelines. Sixty-one patients, with a median age 79 years (range: 39-85) and mainly affected by squamous cellular carcinoma (91.8%), were treated with ECT. No serious adverse events were reported. Patients were discharged after three days (median, range: 0-8 days). Two months after ECT, the clinical response rate was 83.6% and was not related to age, body mass index, International Federation of Gynecology and Obstetrics (FIGO) stage, number of treated nodules, or previous treatments. ECT is a safe procedure with a favorable cost-effectiveness ratio and should be considered as a treatment option for local disease control in patients unsuitable for standard therapies.
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Affiliation(s)
- Anna Myriam Perrone
- Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy.
| | - Andrea Galuppi
- Radiation Oncology Centre, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy.
| | - Cecilia Pirovano
- Department of Obstetrics and Gynaecology, ASST Lecco Ospedale Manzoni, Via dell'Eremo 9/11, 23900 Lecco, Italy.
| | - Giulia Borghese
- Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy.
| | - Piero Covarelli
- General and Oncologic Surgery Unit, Department of Surgical and Biomedical sciences, Ospedale Santa Maria della Misericordia, University of Perugia, Piazza Menghini, 1, 06129 Perugia, Italy.
| | - Francesca De Terlizzi
- Scientific & Medical Department IGEA S.p.A. Via Parmenide 10/A, 41012 Carpi (Mo), Italy.
| | - Martina Ferioli
- Radiation Oncology Centre, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy.
| | - Silvia Cara
- Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy.
| | - Alessio Giuseppe Morganti
- Radiation Oncology Centre, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy.
| | - Pierandrea De Iaco
- Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy.
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15
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Massari L, Benazzo F, Falez F, Cadossi R, Perugia D, Pietrogrande L, Aloj DC, Capone A, D'Arienzo M, Cadossi M, Lorusso V, Caruso G, Ghiara M, Ciolli L, La Cava F, Guidi M, Castoldi F, Marongiu G, La Gattuta A, Dell'Omo D, Scaglione M, Giannini S, Fortina M, Riva A, De Palma PL, Gigante AP, Moretti B, Solarino G, Lijoi F, Giordano G, Londini PG, Castellano D, Sessa G, Costarella L, Barile A, Borrelli M, Rota A, Fontana R, Momoli A, Micaglio A, Bassi G, Cornacchia RS, Castelli C, Giudici M, Monesi M, Branca Vergano L, Maniscalco P, Bulabula M, Zottola V, Caraffa A, Antinolfi P, Catani F, Severino C, Castaman E, Scialabba C, Tovaglia V, Corsi P, Friemel P, Ranellucci M, Caiaffa V, Maraglino G, Rossi R, Pastrone A, Caldora P, Cusumano C, Squarzina PB, Baschieri U, Demattè E, Gherardi S, De Roberto C, Belluati A, Giannini A, Villani C, Persiani P, Demitri S, Di Maggio B, Abate G, De Terlizzi F, Setti S. Can Clinical and Surgical Parameters Be Combined to Predict How Long It Will Take a Tibia Fracture to Heal? A Prospective Multicentre Observational Study: The FRACTING Study. Biomed Res Int 2018; 2018:1809091. [PMID: 29854729 PMCID: PMC5952440 DOI: 10.1155/2018/1809091] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 02/22/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Healing of tibia fractures occurs over a wide time range of months, with a number of risk factors contributing to prolonged healing. In this prospective, multicentre, observational study, we investigated the capability of FRACTING (tibia FRACTure prediction healING days) score, calculated soon after tibia fracture treatment, to predict healing time. METHODS The study included 363 patients. Information on patient health, fracture morphology, and surgical treatment adopted were combined to calculate the FRACTING score. Fractures were considered healed when the patient was able to fully weight-bear without pain. RESULTS 319 fractures (88%) healed within 12 months from treatment. Forty-four fractures healed after 12 months or underwent a second surgery. FRACTING score positively correlated with days to healing: r = 0.63 (p < 0.0001). Average score value was 7.3 ± 2.5; ROC analysis showed strong reliability of the score in separating patients healing before versus after 6 months: AUC = 0.823. CONCLUSIONS This study shows that the FRACTING score can be employed both to predict months needed for fracture healing and to identify immediately after treatment patients at risk of prolonged healing. In patients with high score values, new pharmacological and nonpharmacological treatments to enhance osteogenesis could be tested selectively, which may finally result in reduced disability time and health cost savings.
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Affiliation(s)
- Leo Massari
- Orthopaedic and Traumatology Department, “S. Anna” Hospital, University of Ferrara, Ferrara, Italy
| | - Francesco Benazzo
- Orthopaedic and Traumatology Department, IRCCS Foundation “San Matteo” Hospital, University of Pavia, Pavia, Italy
| | - Francesco Falez
- Orthopaedic and Traumatology Department, “Santo Spirito in Sassia” Hospital, Rome, Italy
| | - Ruggero Cadossi
- Research and Development, IGEA Clinical Biophysics, Carpi, Modena, Italy
| | - Dario Perugia
- Orthopaedic and Traumatology Department, “Sant'Andrea” Hospital, Rome, Italy
| | - Luca Pietrogrande
- Health Sciences Department, Operative Unit of Orthopaedics and Traumatology, “San Paolo” Hospital, University of Milan, Milan, Italy
| | - Domenico Costantino Aloj
- Orthopaedic, Traumatology and Rehabilitation Department, II Orthopaedics Clinic, CTO Hospital, Torino, Italy
| | - Antonio Capone
- Orthopaedic Department, University of Cagliari, Cagliari, Italy
| | - Michele D'Arienzo
- Orthopaedic and Traumatology Department, “Paolo Giaccone” Hospital, University of Palermo, Palermo, Italy
| | - Matteo Cadossi
- Department of Orthopaedic Surgery, Rizzoli Orthopaedic Institute, University of Bologna, Bologna, Italy
| | - Vincenzo Lorusso
- Orthopaedic and Traumatology Department, “S. Anna” Hospital, University of Ferrara, Ferrara, Italy
| | - Gaetano Caruso
- Orthopaedic and Traumatology Department, “S. Anna” Hospital, University of Ferrara, Ferrara, Italy
| | - Matteo Ghiara
- Orthopaedic and Traumatology Department, IRCCS Foundation “San Matteo” Hospital, University of Pavia, Pavia, Italy
| | - Luigi Ciolli
- Orthopaedic and Traumatology Department, “Santo Spirito in Sassia” Hospital, Rome, Italy
| | - Filippo La Cava
- Orthopaedic and Traumatology Department, “Santo Spirito in Sassia” Hospital, Rome, Italy
| | - Marco Guidi
- Orthopaedic and Traumatology Department, “Sant'Andrea” Hospital, Rome, Italy
| | - Filippo Castoldi
- Orthopaedic, Traumatology and Rehabilitation Department, II Orthopaedics Clinic, CTO Hospital, Torino, Italy
| | | | - Alessandra La Gattuta
- Orthopaedic and Traumatology Department, “Paolo Giaccone” Hospital, University of Palermo, Palermo, Italy
| | - Dario Dell'Omo
- Translational Research on New Surgical and Medical Technologies Department, Orthopaedics and Traumatology II°, University of Pisa, Pisa, Italy
| | - Michelangelo Scaglione
- Translational Research on New Surgical and Medical Technologies Department, Orthopaedics and Traumatology II°, University of Pisa, Pisa, Italy
| | - Sandro Giannini
- Department of Orthopaedic Surgery, Rizzoli Orthopaedic Institute, University of Bologna, Bologna, Italy
| | - Mattia Fortina
- Orthopaedics and Traumatology Clinic, “S. M. alle Scotte” Hospital, University of Siena, Siena, Italy
| | - Alberto Riva
- Orthopaedics and Traumatology Clinic, “S. M. alle Scotte” Hospital, University of Siena, Siena, Italy
| | - Pier Luigi De Palma
- Clinical and Molecular Science Department, Faculty of Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Antonio Pompilio Gigante
- Clinical and Molecular Science Department, Faculty of Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Biagio Moretti
- Basic Medical Science, Neurosciences and Sensory Organs Department, University of Bari, Bari, Italy
| | - Giuseppe Solarino
- Basic Medical Science, Neurosciences and Sensory Organs Department, University of Bari, Bari, Italy
| | - Francesco Lijoi
- Orthopaedic and Trauma Department, “Morgagni-Pierantoni” Hospital, Forlì, Italy
| | - Giovanni Giordano
- Orthopaedic and Trauma Department, “Morgagni-Pierantoni” Hospital, Forlì, Italy
| | - Pier Giorgio Londini
- Orthopaedic and Traumatology Department, “Misericordia” Hospital ASL 9, Grosseto, Italy
| | - Danilo Castellano
- Orthopaedic and Traumatology Department, “Misericordia” Hospital ASL 9, Grosseto, Italy
| | - Giuseppe Sessa
- Surgery Department, “Vittorio Emanuele” Hospital, University of Catania, Catania, Italy
| | - Luciano Costarella
- Surgery Department, “Vittorio Emanuele” Hospital, University of Catania, Catania, Italy
| | - Antonio Barile
- Orthopaedic and Trauma Department, “San Michele” Nursing Home Hospital, Maddaloni, Caserta, Italy
| | - Mariano Borrelli
- Orthopaedic and Trauma Department, “San Michele” Nursing Home Hospital, Maddaloni, Caserta, Italy
| | - Attilio Rota
- Orthopaedic and Traumatology Department, “Sandro Pertini” Hospital, ASL RMB, Rome, Italy
| | - Raffaele Fontana
- Orthopaedic and Traumatology Department, “Sandro Pertini” Hospital, ASL RMB, Rome, Italy
| | - Alberto Momoli
- Orthopaedic and Traumatology Department, “San Bortolo” Hospital, Vicenza, Italy
| | - Andrea Micaglio
- Orthopaedic and Traumatology Department, “San Bortolo” Hospital, Vicenza, Italy
| | - Guido Bassi
- Orthopaedic and Traumatology Department, A.O. Pavia Voghera Hospital, Pavia, Italy
| | | | - Claudio Castelli
- Orthopaedics and Trauma Department, “Papa Giovanni XXIII” Hospital, Bergamo, Italy
| | - Michele Giudici
- Orthopaedics and Trauma Department, “Papa Giovanni XXIII” Hospital, Bergamo, Italy
| | - Mauro Monesi
- Orthopaedic and Traumatology Department, “M. Bufalini” Hospital, Cesena, Italy
| | | | - Pietro Maniscalco
- Orthopaedic and Traumatology Department, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
| | - M'Putu Bulabula
- Orthopaedic and Traumatology Department, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
| | - Vincenzo Zottola
- Traumatology and Reconstructive Surgery Functional Department, “S. Anna” Hospital, Como, Italy
| | - Auro Caraffa
- Orthopaedics and Traumatology Clinic, “S. M. Misericordia” Hospital, University of Perugia, Perugia, Italy
| | - Pierluigi Antinolfi
- Orthopaedics and Traumatology Clinic, “S. M. Misericordia” Hospital, University of Perugia, Perugia, Italy
| | - Fabio Catani
- Orthopaedic Surgery Department, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudio Severino
- Orthopaedic Surgery Department, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrico Castaman
- Orthopaedic and Traumatology Department, Montecchio Maggiore Hospital, Vicenza, Italy
| | - Carmelo Scialabba
- Orthopaedic and Traumatology Department, Montecchio Maggiore Hospital, Vicenza, Italy
| | - Venceslao Tovaglia
- Orthopaedic and Traumatology Department, CTO Hospital ASL RM “C”, Rome, Italy
| | - Pietro Corsi
- Orthopaedic and Traumatology Department, CTO Hospital ASL RM “C”, Rome, Italy
| | - Paolo Friemel
- Orthopaedic and Traumatology Department, Regione Veneto Azienda ULSS 18, Rovigo, Italy
| | - Marco Ranellucci
- Orthopaedic and Traumatology Department, Regione Veneto Azienda ULSS 18, Rovigo, Italy
| | - Vincenzo Caiaffa
- Orthopaedics and Traumatology Department, “Di Venere” Hospital, Bari, Italy
| | - Giovanni Maraglino
- Orthopaedics and Traumatology Department, “SS. Annunziata” Hospital, Taranto, Italy
| | - Roberto Rossi
- Orthopaedic and Traumatology SCDU Department, “Mauriziano Umberto I” Hospital, University of Torino, Torino, Italy
| | - Antonio Pastrone
- Orthopaedic and Traumatology SCDU Department, “Mauriziano Umberto I” Hospital, University of Torino, Torino, Italy
| | - Patrizio Caldora
- Orthopaedic and Traumatology Surgery Department, “San Donato” Hospital, Arezzo, Italy
| | - Claudio Cusumano
- Orthopaedic and Traumatology Surgery Department, “San Donato” Hospital, Arezzo, Italy
| | | | - Ugo Baschieri
- Orthopaedics Department, NOCSAE Hospital, Modena, Italy
| | - Ettore Demattè
- Orthopaedics and Traumatology Department, “Santa Chiara” Hospital, Trento, Italy
| | - Stefano Gherardi
- Orthopaedics and Traumatology Department, “Santa Chiara” Hospital, Trento, Italy
| | - Carlo De Roberto
- Orthopaedics Unit, “Santa Maria di Loreto Mare” Hospital, Loreto Mare, Napoli, Italy
| | - Alberto Belluati
- Specialized Surgery Department, “S. Maria delle Croci” Hospital, Ravenna, Italy
| | - Antonio Giannini
- Specialized Surgery Department, “S. Maria delle Croci” Hospital, Ravenna, Italy
| | - Ciro Villani
- Orthopaedic Department, Sapienza University of Rome, Rome, Italy
| | - Pietro Persiani
- Orthopaedic Department, Sapienza University of Rome, Rome, Italy
| | - Silvio Demitri
- Orthopaedic and Trauma Department, “Santa Maria della Misericordia” Hospital, AOUD Udine, Udine, Italy
| | - Bruno Di Maggio
- Orthopaedics and Traumatology Unit, Piedimonte Matese Hospital, Caserta, Italy
| | - Guglielmo Abate
- Orthopaedics and Traumatology Unit, Piedimonte Matese Hospital, Caserta, Italy
| | | | - Stefania Setti
- Research and Development, IGEA Clinical Biophysics, Carpi, Modena, Italy
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Plaschke CC, Bertino G, McCaul JA, Grau JJ, de Bree R, Sersa G, Occhini A, Groselj A, Langdon C, Heuveling DA, Cemazar M, Strojan P, Leemans CR, Benazzo M, De Terlizzi F, Wessel I, Gehl J. European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project: Results from the treatment of mucosal cancers. Eur J Cancer 2017; 87:172-181. [DOI: 10.1016/j.ejca.2017.10.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/04/2017] [Accepted: 10/16/2017] [Indexed: 12/13/2022]
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Bertino G, Sersa G, De Terlizzi F, Occhini A, Plaschke CC, Groselj A, Langdon C, Grau JJ, McCaul JA, Heuveling D, Cemazar M, Strojan P, de Bree R, Leemans CR, Wessel I, Gehl J, Benazzo M. European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project: Results of the treatment of skin cancer. Eur J Cancer 2016; 63:41-52. [DOI: 10.1016/j.ejca.2016.05.001] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/15/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
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Quaglino P, Matthiessen LW, Curatolo P, Muir T, Bertino G, Kunte C, Odili J, Rotunno R, Humphreys AC, Letulé V, Marenco F, Cuthbert C, Albret R, Benazzo M, De Terlizzi F, Gehl J. Predicting patients at risk for pain associated with electrochemotherapy. Acta Oncol 2015; 54:298-306. [PMID: 25591818 DOI: 10.3109/0284186x.2014.992546] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Electrochemotherapy describes the use of electric pulses to enhance chemotherapy uptake, and has proven highly efficient in treating cutaneous metastases. Patients referred for electrochemotherapy present with diverse clinical pictures, from multiple small lesions to large, ulcerated lesions. Post-electrochemotherapy pain has been observed in some patients. The objectives of this study were to evaluate pain scores before and after electrochemotherapy, and to investigate if patients at risk of post-procedure pain could be identified. METHODS Seven cancer centres in the International Network for Sharing Practices on Electrochemotherapy (INSPECT) consecutively and prospectively reported to a common database. Electrochemotherapy consisted of intratumoural or intravenous injection of bleomycin, followed by delivery of electric pulses in local or general anesthesia. RESULTS Of 121 patients 39% had metastatic melanoma, 18% squamous cell carcinoma, 16% breast cancer, 13% basal-cell carcinoma, and 14% other malignancies. Median size of the largest nodules was 2.3 cm (range 0.3-40 cm). A majority of patients presented with low pain scores, and this continued through follow-up (74%). A subset of patients had moderate (13%) or severe pain (13%) after treatment. Post-procedure pain was statistically significantly associated with: 1) moderate or severe pain before treatment (p<0.0001); 2) size of the largest treated lesion (p<0.01); 3) previous irradiation (p<0.02); and 4) high treatment current value (p<0.0001). CONCLUSION The majority of patients had no or mild pain after electrochemotherapy. Patients at risk for post-procedure pain could be identified at the pre-treatment visit, and/or at the time of treatment, enabling a pain management strategy for this group.
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Affiliation(s)
- Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Torino , Torino , Italy
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Guglielmi G, De Terlizzi F, Nasuto M, Sinibaldi L, Brancati F. Quantitative ultrasound at the phalanges in a cohort of monozygotic twins of different ages. Radiol Med 2014; 120:277-82. [PMID: 25091707 DOI: 10.1007/s11547-014-0440-x] [Citation(s) in RCA: 5] [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: 12/10/2013] [Accepted: 04/01/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of our study was to evaluate bone quality by quantitative ultrasound (QUS) at the phalanges in 129 monozygotic twin couples, outlining the differences between growing subjects and adults. MATERIALS AND METHODS A total of 129 healthy monozygotic twin couples (42 of children under 18 years of age and 87 of adults) were studied by phalangeal QUS, measuring amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT). Anthropometric data were also recorded. RESULTS In children AD-SoS and BTT were positively correlated with age (r = 0.91, r = 0.91), height (r = 0.88, r = 0.90) and weight (r = 0.81, r = 0.87); in adults AD-SoS was negatively related to age (r = -0.36), AD-SoS and BTT were positively related to height (r = 0.37, r = 0.58). Absolute value differences between twins for AD-SoS and BTT were significantly higher in adult twins (25.9 ± 21.9 for AD-SoS and 0.08 ± 0.08 for BTT) than in children (14.5 ± 12.4 for AD-SoS and 0.05 ± 0.04 for BTT). CONCLUSION Differentiation in bone tissue quality in twins increases with age, probably reflecting lifestyle, personal habits, likely acting through epigenetic mechanisms.
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Affiliation(s)
- Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71100, Foggia, Italy,
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Betto M, Gaio P, Ferrini I, De Terlizzi F, Zambolin M, Scattolin S, Pasinato A, Verlato G. Assessment of bone health in preterm infants through quantitative ultrasound and biochemical markers. J Matern Fetal Neonatal Med 2013; 27:1343-7. [PMID: 24215624 DOI: 10.3109/14767058.2013.858317] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess bone status in preterm infants with quantitative ultrasound and to search for biochemical markers of bone health. METHODS Metacarpus bone transmission time (mcBTT) was prospectively performed during hospitalization, together with biochemical and clinical outcomes analysis. RESULTS 154 patients were studied. At 3rd week of life mcBTT positively correlated with serum phosphate. Urinary excretion of calcium and phosphate were assessed in a subgroup of 55 patients: on day 21 mcBTT positively correlated with phosphaturia, negatively with calciuria. Gestational age (GA), weight and length at 3rd week and at 36 weeks of GA correlated positively with mcBTT. We found negative correlation between mcBTT at 3rd week and days of parenteral nutrition, mechanical ventilation period and days to reach 1800 g. CONCLUSIONS Serum phosphate, phosphaturia and calciuria correlate most with mcBTT. Further studies are necessary to verify the possible influence of early bone status on future bone health.
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Affiliation(s)
- Martina Betto
- Women's and Children's Health Department, University of Padova , Padova , Italy and
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21
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Prinapori R, Rosso R, Di Biagio A, Nicolini L, Giacobbe DR, De Hoffer L, Grignolo S, De Terlizzi F, Vignolo M, Borderi M, Martelli G, Calza L, Viale P, Vescini F, Viscoli C. Phalangeal quantitative ultrasound: cheaper methods for screening and follow-up of bone pathologies in HIV-infected women? New Microbiol 2013; 36:345-351. [PMID: 24177296] [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] [Received: 12/18/2012] [Accepted: 07/27/2013] [Indexed: 06/02/2023]
Abstract
This study estimated the prevalence of bone pathologies in a cohort of HIV-infected women in comparison with a cohort of HIV-negative women. Bone mineral density was measured by phalangeal quantitative ultrasound (AD-SoS: amplitude- dependent speed of sound; UBPI: ultrasound bone profile index). Risk of fracture, expressed by UBPI, was considered for value <0.39. Comparisons between groups and multivariate analyses were carried out using an ANOVA model. Correlations were evaluated using the Pearson correlation coefficient. Osteopenia and osteoporosis were present in 34.4% and 2% of patients, respectively. UBPI was pathologic in 5.7%. In a multivariate linear regression model significant correlations were found between AD-SoS z-score, duration of HIV-infection and BMI value. We also compared our cohort with 499 HIV-negative women as a historical control group of healthy subjects. AdSoS (2100 versus 2070 m/s) and UBPI (0.89 versus 0.74) were lower in HIV-infected women (p<0.001). Significant differences were also found in T-score values (p = 0.0013). These data show a high prevalence of bone diseases in women with HIV infection, correlated with duration of HIV-infection and BMI values. This non-invasive technique opens up new interesting perspectives, suggesting a possible use for bone mass screening in HIV-infected women.
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Affiliation(s)
- Roberta Prinapori
- Department of Internal Medicine and Infectious Diseases, IRCCS A.O.U. San Martino-IST, Genoa, Italy; 2Medical Office, IGEA s.r.l., Modena, Italy
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22
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Massari L, Falez F, Lorusso V, Zanon G, Ciolli L, La Cava F, Cadossi M, Chiarello E, De Terlizzi F, Setti S, Benazzo FM. Can a combination of different risk factors be correlated with leg fracture healing time? J Orthop Traumatol 2012. [PMID: 23179083 PMCID: PMC3585952 DOI: 10.1007/s10195-012-0218-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background A multicenter retrospective analysis of patients treated for leg fractures was conducted to develop a score that correlates with fracture healing time and to identify the risk gradient for delayed healing. Methods Fifty-three patients were analyzed and considered healed when full weight bearing was possible. Patients were divided into those who healed within 180 days and those who took longer to heal. Risk factors associated with delayed healing, fracture morphology, and orthopedic treatments were recorded. The available literature was used to weight the relative risk associated with each factor; values were combined into a score evaluating the risk of delayed healing: L-ARRCO (a literature-based score where the risk of delayed bone healing is calculated using a specific algorithm). Other risk factors associated with delayed healing were then considered in order to calculate a new score, ARRCO. Continuous variables were compared between groups using Student’s heteroschedastic two-tail t test. Receiver operating characteristic (ROC) curves and the areas under the curves were calculated to determine the ability of this score to discriminate subjects with delayed healing. Results The mean L-ARRCO scores of the patients who healed within and after 180 days were significantly different (5.78 ± 1.59 and 7.05 ± 2.46, respectively). The mean ARRCO scores of the patients who healed within and after 180 days were also significantly different (5.92 ± 1.78 and 9.03 ± 2.79, respectively). However, the area under the ROC curve was significantly smaller for L-ARRCO than for ARRCO (0.62 ± 0.09 versus 0.82 ± 0.07). Conclusions The ARRCO score is significantly associated with fracture healing time and could be used to identify “fractures at risk,” allowing early intervention to stimulate osteogenesis.
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Affiliation(s)
- Leo Massari
- Orthopaedic and Traumatology Department, Sant'Anna Hospital, University of Ferrara, Via Savonarola 9, 44121, Ferrara, Italy
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Moretti B, Notarnicola A, Moretti L, Setti S, De Terlizzi F, Pesce V, Patella V. I-ONE therapy in patients undergoing total knee arthroplasty: a prospective, randomized and controlled study. BMC Musculoskelet Disord 2012; 13:88. [PMID: 22672794 PMCID: PMC3476962 DOI: 10.1186/1471-2474-13-88] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 05/16/2012] [Indexed: 02/06/2023] Open
Abstract
Background Total knee arthroplasty (TKA) is often associated with a severe local inflammatory reaction which, unless controlled, leads to persistent pain up to one year after surgery. Standard and accelerated rehabilitation protocols are currently being implemented after TKA, but no consensus exists regarding the long-term effects. Biophysical stimulation with pulsed electromagnetic fields (PEMFs) has been demonstrated to exert an anti-inflammatory effect, to promote early functional recovery and to maintain a positive long-term effect in patients undergoing joint arthroscopy. The aim of this study was to evaluate whether PEMFs can be used to limit the pain and enhance patient recovery after TKA. Methods A prospective, randomized, controlled study in 30 patients undergoing TKA was conducted. Patients were randomized into experimental PEMFs or a control group. Patients in the experimental group were instructed to use I-ONE stimulator 4hours/day for 60days. Postoperatively, all patients received the same rehabilitation program. Treatment outcome was assessed using the Knee Society Score, SF-36 Health-Survey and VAS. Patients were evaluated pre-operatively and one, two, six and 12 months after TKA. Joint swelling and Non Steroidal Anti Inflammatory Drug (NSAID) consumption were recorded. Comparisons between the two groups were carried out using a two-tail heteroschedastic Student’s t-test. Analysis of variance for each individual subject during the study was performed using ANOVA for multiple comparisons, applied on each group, and a Dunnet post hoc test. A p value < 0.05 was considered statistically significant. Results Pre-operatively, no differences were observed between groups in terms of age, sex, weight, height, Knee-Score, VAS, SF-36 and joint swelling, with the exception of the Functional Score. The Knee-Score, SF-36 and VAS demonstrated significantly positive outcomes in the I-ONE stimulated group compared with the controls at follow-ups. In the I-ONE group, NSAID use was reduced and joint swelling resolution was more rapid than in controls. The effect of I-ONE therapy was maintained after use of the device was discontinued. Conclusions The results of the study show early functional recovery in the I-ONE group. I-ONE therapy should be considered after TKA to prevent the inflammatory reaction elicited by surgery, for pain relief and to speed functional recovery. Trial registration Current Controlled Trials ISRCTN10526056
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Rosso R, Parodi A, Torrisi C, De Terlizzi F, Viscoli C, Vignolo M. A tailored dose of tenofovir could reduce its impact on bone mass in HIV Type 1-infected children and adolescents: a report from 5 years of clinical experience. AIDS Res Hum Retroviruses 2010; 26:1265-6. [PMID: 20874420 DOI: 10.1089/aid.2010.0122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Raffaella Rosso
- Department Infectious Diseases, University of Genoa, San Martino Hospital, Genoa, Italy
| | - Arianna Parodi
- Pediatric Clinic, University of Genoa, G. Gaslini Institute, Genoa, Italy
| | - Chiara Torrisi
- Pediatric Clinic, University of Genoa, G. Gaslini Institute, Genoa, Italy
| | | | - Claudio Viscoli
- Department Infectious Diseases, University of Genoa, San Martino Hospital, Genoa, Italy
| | - Marina Vignolo
- Department Infectious Diseases, University of Genoa, San Martino Hospital, Genoa, Italy
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Valerio G, Spadaro R, Iafusco D, Lombardi F, Del Puente A, Esposito A, De Terlizzi F, Prisco F, Troncone R, Franzese A. The influence of gluten free diet on quantitative ultrasound of proximal phalanxes in children and adolescents with type 1 diabetes mellitus and celiac disease. Bone 2008; 43:322-326. [PMID: 18499552 DOI: 10.1016/j.bone.2008.04.004] [Citation(s) in RCA: 11] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2007] [Revised: 04/02/2008] [Accepted: 04/05/2008] [Indexed: 10/22/2022]
Abstract
A reduced bone mineral density has been reported in patients with untreated celiac disease (CD) as well as in patients with poorly controlled type 1 diabetes mellitus (T1DM). The aim of this study was to evaluate the bone mineral status by phalangeal quantitative ultrasound in 52 children and adolescents with both diseases (mean age 13.3+/-4.9 years). As a control group 50 patients with T1DM and no CD (age 12.2+/-4.0 years) were studied. The following bone parameters, amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) were considered and expressed as z score. Compliance to gluten free diet and long term glycemic control (mean of four determinations of HbA1c in the last year) were also assessed. The lowest mean AD-SoS z score values were found in patients with T1DM and CD, who reported transgressions to gluten free diet and exhibited positivity for serum anti-tissue transglutaminase antibodies (tTG) and/or endomysial antibodies (EmA), compared with patients with occasional transgressions but negative for anti-tTG and/or -EmA, patients strictly adherent to the diet, and patients who suffered only from diabetes (ANOVA p=0.021). No difference was found between patients with diabetes alone and patients with both diseases strictly adherent to gluten free diet. Prevalence of osteopenia (z AD-SoS values <-2 SD) was higher in patients with T1DM and CD and poor compliance to the diet (45.5%) compared with patients with T1DM (8%) or patients with both diseases strictly compliant to diet (12.9%) (p=0.015). A negative correlation between Ad-SoS z score and HbA1c (r -0.236, p=0.036) was found when patients with T1DM and patients with T1DM and CD, who strictly adhere to the diet, were pooled. In conclusion the quality of bone as assessed by phalangeal ultrasound in patients with T1DM and CD, who strictly adhere to gluten free diet, is similar to that found in T1DM patients. A higher prevalence of osteopenia is present in patients with both diseases who reported habitual transgressions to gluten free diet. The gluten free diet, as well as the optimization of glycemic control, plays an important role in preventing the osteopenic status caused by the clustering of these two chronic diseases.
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Affiliation(s)
- Giuliana Valerio
- School of Movement Sciences (DiSiST), Parthenope University, Naples, Italy.
| | | | - Dario Iafusco
- Department of Pediatrics, Seconda Università, Naples, Italy
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26
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Di Iorgi N, Muratori T, Secco A, Napoli F, Fratangeli N, De Terlizzi F, Giorgiani G, Locatelli F, Maghnie M. Quantitative ultrasound detects bone impairment after bone marrow transplantation in children and adolescents affected by hematological diseases. Bone 2008; 43:177-182. [PMID: 18487096 DOI: 10.1016/j.bone.2008.03.018] [Citation(s) in RCA: 8] [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] [Received: 01/17/2008] [Revised: 03/10/2008] [Accepted: 03/22/2008] [Indexed: 11/24/2022]
Abstract
PURPOSE Bone marrow transplantation (BMT) recipients are at risk of bone mass impairment and skeletal morbidity. We investigated bone status with quantitative ultrasound (QUS) technique in children and adolescents with hematological diseases before and after BMT. METHODS Phalangeal QUS measures for amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) were obtained in 144 hematological patients (81M, 63F; 11.6+/-5.2 years); forty two were evaluated before BMT and 102 after allogeneic or autologous BMT. Bone parameters were expressed as Z-scores based on age-sex-matched normal controls. RESULTS Mean BTT Z-score was reduced in subjects after BMT compared to patients before BMT (M, -0.35+/-1.04 vs. 0.70+/-1.11, P<0.001; F, -0.60+/-1.23 vs. 0.23+/-1.17, P<0.05). Females and males with hormone deficiencies showed reduced BTT Z-scores when compared with subjects without hormone defects (M, -0.52+/-1.0 vs. 0.05+/-1.17, P<0.05; F, -0.50+/-1.27 vs. -0.19+/-1.26; P=0.06). AD-SoS and BTT Z-scores were reduced in 15 subjects with fractures and/or avascular osteonecrosis compared to patients without bone events (-1.52+/-1.7 vs. -0.41+/-1.32 and -0.85+/-1.19 vs. -0.10+/-1.18; both Ps<0.05). Bone event cumulative incidence was 4 times greater in subjects who suffered from chronic GVHD. CONCLUSIONS Assessment of phalangeal QUS in young BMT survivors points towards impairment of bone status and endocrine dysfunction and chronic GVHD as risk factors of adverse bone events.
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Affiliation(s)
- Natascia Di Iorgi
- Department of Pediatrics, IRCCS G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy
| | - Tiziana Muratori
- Department of Pediatric Hematology/Oncology, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
| | - Andrea Secco
- Department of Pediatrics, IRCCS G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy
| | - Flavia Napoli
- Department of Pediatrics, IRCCS G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy
| | - Nadia Fratangeli
- Department of Pediatrics, IRCCS G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy
| | | | - Giovanna Giorgiani
- Department of Pediatric Hematology/Oncology, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology/Oncology, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
| | - Mohamad Maghnie
- Department of Pediatrics, IRCCS G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy.
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Mussa A, Porta F, Gianoglio B, Gaido M, Nicolosi MG, De Terlizzi F, de Sanctis C, Coppo R. Bone alterations in children and young adults with renal transplant assessed by phalangeal quantitative ultrasound. Am J Kidney Dis 2007; 50:441-9. [PMID: 17720523 DOI: 10.1053/j.ajkd.2007.06.002] [Citation(s) in RCA: 18] [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: 01/08/2007] [Accepted: 06/04/2007] [Indexed: 11/11/2022]
Abstract
BACKGROUND Bone alterations in young renal transplant recipients were investigated in several studies with conflicting results. Quantitative ultrasound of the phalanges is a recently developed noninvasive procedure to assess skeletal status. STUDY DESIGN Cross-sectional study at a single transplant center with values compared with previously studied healthy controls. SETTINGS & PARTICIPANTS 40 children and young adult recipients of renal grafts (15 females, 25 males; age, 20.0 +/- 8.4 years) studied 7.1 +/- 3.8 years after kidney transplantation. PREDICTOR Clinical, biochemical, and therapeutic features, including calcium, phosphate, and intact parathormone levels; and cumulative dosages of glucocorticoids and cyclosporine administered since transplantation. OUTCOME & MEASUREMENT Phalangeal quantitative ultrasound, including amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT), mainly dependent on mineral density and cortical thickness, respectively. Age- and sex-matched healthy controls were used to provide age-related z scores; sex- and height-matched healthy subjects, to provide z scores related to statural age. RESULTS Mean z scores of AD-SoS and BTT were -0.05 +/- 1.59 and -0.54 +/- 1.17, respectively (P > 0.05 and P < 0.001, respectively). Multivariate analysis showed that AD-SoS z score was associated significantly with body mass index, intact parathormone level, cumulative glucocorticoids administered in the first posttransplantation year, and cyclosporine administered since transplantation (model r(2) = 0.79; P < 0.001); BTT z score was associated significantly with glucocorticoid dosage in the first posttransplantation year and age (model r(2) = 0.55; P < 0.001). LIMITATIONS Absence of other measures of bone structure and longitudinal measures and comparison to a noncurrent control group. CONCLUSIONS Children and young adults may have decreased cortical thickness with maintained overall mineral density after renal transplantation. The findings of phalangeal quantitative ultrasound parallel observations using other imaging techniques. Phalangeal quantitative ultrasound may be a useful method to assess bone alternations after renal transplantation.
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Affiliation(s)
- Alessandro Mussa
- Department of Pediatric Endocrinology, Regina Margherita Children's Hospital, Torino, Italy.
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Camozzi V, De Terlizzi F, Zangari M, Luisetto G. Quantitative bone ultrasound at phalanges and calcaneus in osteoporotic postmenopausal women: influence of age and measurement site. Ultrasound Med Biol 2007; 33:1039-45. [PMID: 17445968 DOI: 10.1016/j.ultrasmedbio.2007.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Revised: 12/21/2006] [Accepted: 01/03/2007] [Indexed: 05/15/2023]
Abstract
Phalangeal and calcaneal quantitative ultrasound (QUS) measurements were tested in a postmenopausal osteoporotic population of a wide age range to assess their ability to identify subjects with vertebral fractures in a population of postmenopausal women with osteoporosis. A group of 127 osteoporotic women aged from 50 to 85 y, who had been postmenopausal for at least 5 y, were enrolled. All subjects underwent phalangeal and calcaneal QUS measurements, femoral neck and lumbar spine dual energy X-ray absorptiometry (DXA) measurements and lateral thoracic and lumbar spine radiography. Osteoporosis was defined on the basis of femoral neck or lumbar spine bone mineral density (BMD) T-score lower than -2.5 SD or of the presence of one or more vertebral atraumatic fractures, independently of BMD values. Fifty-two women had one or more vertebral fractures, while the remaining 75 had no evidence of previous fracture. Both QUS techniques were able to discriminate between fractured and nonfractured subjects in the whole group (p < 0.05). When patients aged <70 y (n = 43) and patients aged > or = 70 y (n = 84) were considered separately, phalangeal QUS and lumbar spine BMD were able to discriminate vertebral fractures in the younger group (p < 0.05), whereas calcaneal QUS was able to discriminate vertebral fractures in the older one (p < 0.05). The results of this study raise an issue of the optimal use of different QUS techniques and different skeletal sites in the management of osteoporosis in early or late postmenopausal life.
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Affiliation(s)
- Valentina Camozzi
- Department of Medical and Surgical Sciences, Division of Endocrinology, University of Padua, Padua, Italy
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Abstract
OBJECTIVE To evaluate the potential role of quantitative ultrasound (QUS) investigation in assessing the osteopenia of prematurity. DESIGN QUS parameters measured at the time of discharge were related to the anthropometric characteristics and age (postnatal and gestational) of 51 (34 female and 17 male) preterm infants fed fortified human milk. METHODS QUS evaluation was performed at the humerus (h) by measuring two parameters: ultrasound velocity (hSOS, in m/s) and bone transmission time (hBTT, in micros). A group of 43 term infants (29 female and 14 male) was also evaluated. RESULTS In preterm infants, significant correlations were found for hSOS and hBTT vs gestational age (r=0.504, 0.477, P<0.0001), length (r=0.641, 0.594, P<0.0001) and weight (r=0.580, 0.562, P<0.0001) at birth, and length (r=0.341, 0.332, P<0.05) and weight (r=0.331, r=0.362, P<0.05) at QUS measurement. In preterm infants, both QUS parameters were negatively correlated with age (r=-0.536, P<0.0001, r=-0.443, P<0.001) and were significantly lower than in the term infants (hSOS: 1664+/-42 m/s vs 1734+/-28 m/s, P<0.0001; hBTT: 0.58+/-0.24 micros vs 1.06+/-0.15 micros, P<0.0001) even when adjusted for body length (P<0.05). In preterm infants, hSOS was also negatively correlated with postconceptional age (r=-0.322, P<0.05). CONCLUSIONS This study suggests that bone mineral accrual is mainly determined by the development in utero, and that prematurity induces a halt in the bone development process in the early postnatal period. QUS parameters are correlated with the severity of prematurity and might therefore have clinical applications when bone maturation in early life needs to be determined.
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Affiliation(s)
- Alessandro Rubinacci
- Bone Metabolic Unit, Scientific Institute, San Raffaele Hospital, Via Olgettina 60, Milan 20132, Italy.
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Baroncelli GIGLI, Federico G, Bertelloni S, Sodini F, De Terlizzi F, Cadossi R, Saggese G. Assessment of bone quality by quantitative ultrasound of proximal phalanges of the hand and fracture rate in children and adolescents with bone and mineral disorders. Pediatr Res 2003; 54:125-36. [PMID: 12700367 DOI: 10.1203/01.pdr.0000069845.27657.eb] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.8] [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: 11/06/2022]
Abstract
Bone quality by quantitative ultrasound and fracture rate were assessed in 135 (64 males) children and adolescents aged 3-21 y with bone and mineral disorders such as chronic anticonvulsants or glucocorticoids treatment, juvenile rheumatoid arthritis, celiac disease, paucity of intrahepatic bile ducts, autoimmune hepatitis, genetic diseases, idiopathic juvenile osteoporosis, disuse osteoporosis, beta-thalassemia major, survivors of acute lymphoblastic leukemia, liver transplantation, calcium deficiency, and nutritional or X-linked hypophosphatemic rickets. Amplitude-dependent speed of sound through the distal end of the first phalangeal diaphysis of the last four fingers of the hand was measured by an ultrasound device. In the majority of patients cortical area to total area ratio by metacarpal radiogrammetry (n = 120) and lumbar bone mineral density (BMD) by dual-energy x-ray absorptiometry (n = 99) were also assessed. In patients with X-linked hypophosphatemic rickets radial BMD by single-photon absorptiometry instead of lumbar BMD was measured. Mean values of amplitude-dependent speed of sound, cortical area to total area ratio, lumbar BMDarea, or lumbar BMD corrected for bone sizes estimated by a mathematical model (BMDvolume), as well as mean values of radial BMD in patients with X-linked hypophosphatemic rickets, expressed as z score, were significantly reduced (p < 0.0001) in comparison with their reference values (-1.7 +/- 1.0, -2.0 +/- 0.9, -3.0 +/- 1.3, -1.9 +/- 1.0, -2.7 +/- 0.7, respectively). A positive relationship was found between amplitude-dependent speed of sound and cortical area to total area ratio (r = 0.90, p < 0.0001), lumbar BMDarea (r = 0.62, p < 0.0001), or lumbar BMDvolume (r = 0.66, p < 0.0001). Fifty-two patients (38.5%) had suffered fractures in the 6 mo preceding the bone measurements, the radial distal metaphysis being the most frequent fracture site (28.8%). Mean values of amplitude-dependent speed of sound, cortical area to total area ratio, lumbar BMDarea, or lumbar BMDvolume, expressed as z score, of fractured patients were significantly lower (p < 0.0001) than those of fracture-free patients (-2.2 +/- 1.0 and -1.4 +/- 0.8, -2.6 +/- 0.9 and -1.7 +/- 0.7, -3.5 +/- 1.2 and -2.5 +/- 1.0, -2.5 +/- 1.0 and -1.3 +/- 0.7, respectively). Phalangeal quantitative ultrasound may be a useful method to assess bone quality and fracture risk in children and adolescents with bone and mineral disorders.
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