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Gemelli M, Albini A, Catalano G, Incarbone M, Cannone M, Balladore E, Ricotta R, Pelosi G. Navigating resistance to ALK inhibitors in the lorlatinib era: a comprehensive perspective on NSCLC. Expert Rev Anticancer Ther 2024:1-15. [PMID: 38630549 DOI: 10.1080/14737140.2024.2344648] [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: 10/19/2023] [Accepted: 04/15/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION The emergence of anaplastic lymphoma kinase (ALK) rearrangements in non-small cell lung cancer (NSCLC) has revolutionized targeted therapy. This dynamic landscape, featuring novel ALK inhibitors and combination therapies, necessitates a profound understanding of resistance mechanisms for effective treatment strategies. Recognizing two primary categories - on-target and off-target resistance - underscores the need for comprehensive assessment. AREAS COVERED This review delves into the intricacies of resistance to ALK inhibitors, exploring complexities in identification and management. Molecular testing, pivotal for early detection and accurate diagnosis, forms the foundation for patient stratification and resistance management. The literature search methodology involved comprehensive exploration of Pubmed and Embase. The multifaceted perspective encompasses new therapeutic horizons, ongoing clinical trials, and their clinical implications post the recent approval of lorlatinib. EXPERT OPINION Our expert opinion encapsulates the critical importance of understanding resistance mechanisms in the context of ALK inhibitors for shaping successful treatment approaches. With a focus on molecular testing and comprehensive assessment, this review contributes valuable insights to the evolving landscape of NSCLC therapy.
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Affiliation(s)
- Maria Gemelli
- Medical Oncology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
| | - Adriana Albini
- Departement of Scientific Directorate, European Institute of Oncology (IEO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Gianpiero Catalano
- Radiation Oncology Center, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
| | - Matteo Incarbone
- Department of Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
| | - Maria Cannone
- Inter-Hospital Division of Pathology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
| | - Emanuela Balladore
- Inter-Hospital Division of Pathology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
| | - Riccardo Ricotta
- Medical Oncology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
| | - Giuseppe Pelosi
- Inter-Hospital Division of Pathology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Leonardi MC, Pepa M, Zaffaroni M, Vincini MG, Luraschi R, Vigorito S, Morra A, Dicuonzo S, Mazzola GC, Gerardi MA, Zerella MA, Cante D, Petrucci E, Borzì G, Marrocco M, Chieregato M, Iadanza L, Lobefalo F, Valenti M, Cavallo A, Russo S, Guernieri M, Malatesta T, Meaglia I, Liotta M, Palumbo I, Marcantonini M, Mezzenga E, Falivene S, Arrichiello C, Barbero MP, Ivaldi GB, Catalano G, Vidali C, Giannitto C, Ciabattoni A, Meattini I, Aristei C, Orecchia R, Cattani F, Jereczek-Fossa BA. Impact of inter-observer variability on first axillary level dosimetry in breast cancer radiotherapy: An AIRO multi-institutional study. Tumori 2023; 109:570-575. [PMID: 37688419 DOI: 10.1177/03008916231196801] [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] [Indexed: 09/10/2023]
Abstract
This study quantified the incidental dose to the first axillary level (L1) in locoregional treatment plan for breast cancer. Eighteen radiotherapy centres contoured L1-L4 on three different patients (P1,2,3), created the L2-L4 planning target volume (single centre planning target volume, SC-PTV) and elaborated a locoregional treatment plan. The L2-L4 gold standard clinical target volume (CTV) along with the gold standard L1 contour (GS-L1) were created by an expert consensus. The SC-PTV was then replaced by the GS-PTV and the incidental dose to GS-L1 was measured. Dosimetric data were analysed with Kruskal-Wallis test. Plans were intensity modulated radiotherapy (IMRT)-based. P3 with 90° arm setup had statistically significant higher L1 dose across the board than P1 and P2, with the mean dose (Dmean) reaching clinical significance. Dmean of P1 and P2 was consistent with the literature (77.4% and 74.7%, respectively). The incidental dose depended mostly on L1 proportion included in the breast fields, underlining the importance of the setup, even in case of IMRT.
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Affiliation(s)
| | - Matteo Pepa
- Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
| | | | - Rosa Luraschi
- Unit of Medical Physics, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
| | - Sabrina Vigorito
- Unit of Medical Physics, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
| | - Anna Morra
- Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
| | - Samantha Dicuonzo
- Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
| | | | | | | | - Domenico Cante
- Radiotherapy Department, ASL TO4 Ivrea Community Hospital, Ivrea, Italy
| | - Edoardo Petrucci
- Unit of Medical Physics, ASL TO4 Ivrea Community Hospital, Ivrea, Italy
| | | | | | | | - Luciano Iadanza
- Unit of Medical Physics, Azienda Ospedaliera di Rilievo Nazionale San Pio, Benevento, Italy
| | - Francesca Lobefalo
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Centre IRCCS, Milano, Italy
| | - Marco Valenti
- Unit of Medical Physics, Ospedali Riuniti Umberto I, G.M. Lancisi, G. Salesi, Ancona, Italy
| | - Anna Cavallo
- Unit of Medical Physics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Serenella Russo
- Unit of Medical Physics, AUSL Toscana Centro, Ospedale Santa Maria Annunziata, Firenze, Italy
| | - Marika Guernieri
- Medical Physics Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Tiziana Malatesta
- Unit of Medical Physics, Ospedale Fatebenefratelli Isola Tiberina - Gemelli Isola, Roma, Italy
| | - Ilaria Meaglia
- Department of Radiation Oncology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Marco Liotta
- Unit of Medical Physics, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Isabella Palumbo
- Radiation Oncology section, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Marta Marcantonini
- Medical Physics Unit, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Emilio Mezzenga
- Medical Physics Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori", Meldola, Italy
| | - Sara Falivene
- Department of Radiotherapy, ASL Napoli1 Centro - Ospedale del Mare, Napoli, Italy
| | - Cecilia Arrichiello
- Unit of Radiotherapy, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italy
| | - Maria Paola Barbero
- Unit of Medical Physics, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Gianpiero Catalano
- Department of Radiotherapy, IRCCS MultiMedica, Sesto San Giovanni, Italy
| | - Cristiana Vidali
- Department of Radiation Oncology, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Caterina Giannitto
- Division of Radiology, Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | | | - Icro Meattini
- Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy
- Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Firenze, Italy
| | - Cynthia Aristei
- Radiation Oncology section, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Roberto Orecchia
- Scientific Direction, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
| | - Federica Cattani
- Unit of Medical Physics, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
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Morelli F, Balzarotti N, Guarischi M, Cappagli G, Maviglia A, Crepaldi M, Orciari L, Parmiggiani A, Catalano G, Signorini S, Gori M. A novel multisensory device for the assessment and rehabilitation of perceptual and attentional competencies. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083635 DOI: 10.1109/embc40787.2023.10340824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The present study aims to assess a novel technological device suitable for investigating perceptual and attentional competencies in people with or without sensory impairment. The TechPAD is a cabled system including embedded sensors and actuators to enable visual, auditory, and tactile interactions and a capacitive surface receiving inputs from the user. The system is conceived to create multisensory environments, using multiple units controlled separately and simultaneously. We assessed the device by adapting a spatial attention task comparing performances in different cognitive load conditions (high or low) and stimulation (unimodal, bimodal, or trimodal). 28 sighted adults were asked to monitor both the central and peripheral parts of the device and to tap a target stimulus (either visual, auditory, haptic, or multimodal) as fast as they could. Our results suggest that this new device can provide congruent and incongruent multimodal stimuli and quantitatively measure parameters such as reaction time and accuracy, allowing to investigate perceptual mechanisms in multisensory environments.Clinical Relevance-The TechPad is a reliable tool for the assessment of spatial attention during interactive tasks. its application in clinical trials will pave the way to its role in multisensory rehabilitation.
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Franco P, Porreca A, Mantello G, Valvo F, Gasparini L, Slim N, Manfrida S, De Felice F, Gerardi MA, Vagge S, Krengli M, Palazzari E, Osti MF, Gonnelli A, Catalano G, Pittoni P, Ivaldi GB, Lupattelli M, Rosetto ME, Niespolo RM, Guido A, Durante O, Macchia G, Munoz F, El Khouzai B, Lucido MR, Arcadipane F, Casadei Gardini A, Maria D'Angelillo R, Gambacorta MA, Genovesi D, Di Nicola M, Caravatta L. External validation of a composite bio-humoral index in anal cancer patients undergoing concurrent chemoradiation. Radiother Oncol 2022; 177:9-15. [PMID: 36273737 DOI: 10.1016/j.radonc.2022.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/24/2022] [Revised: 09/25/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND PURPOSE A prognostic scoring system based on laboratory inflammation parameters, [Hemo-Eosinophils-Inflammation (HEI) index], including baseline hemoglobin level, the systemic inflammatory index and eosinophil count was recently proposed in patients with squamous cell carcinoma of the anus (ASCC). HEI was shown to discriminate disease-free (DFS) and overall (OS) survival in ASCC patients treated with concurrent chemoradiation (CRT). We tested the accuracy of the model on a multicentric cohort for external validation. MATERIALS AND METHODS Patients treated with CRT were enrolled. The Kaplan-Meier curves for DFS and OS based on HEI risk group were calculated and the log-rank test was used. Cox proportional hazards models were used to assess the prognostic factors for DFS and OS. The exponential of the regression coefficients provided an estimate of the hazard ratio (HR). For model discrimination, we determined Harrell's C-index, Gönen & Heller K Index and the explained variation on the log relative hazard scale. RESULTS A total of 877 patients was available. Proportional hazards were adjusted for age, gender, tumor-stage, and chemotherapy. Two-year DFS was 77 %(95 %CI:72.0-82.4) and 88.3 %(95 %CI:84.8-92.0 %) in the HEI high- and low- risk groups. Two-year OS was 87.8 %(95 %CI:83.7-92.0) and 94.2 %(95 %CI:91.5-97). Multivariate Cox proportional hazards model showed a HR = 2.02(95 %CI:1.25-3.26; p = 0.004) for the HEI high-risk group with respect to OS and a HR = 1.53(95 %CI:1.04-2.24; p = 0.029) for DFS. Harrel C-indexes were 0.68 and 0.66 in the validation dataset, for OS and DFS. Gonen-Heller K indexes were 0.67 and 0.71, respectively. CONCLUSION The HEI index proved to be a prognosticator in ASCC patients treated with CRT. Model discrimination in the external validation cohort was acceptable.
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Affiliation(s)
- Pierfrancesco Franco
- Division of Radiation Oncology, Department of Translational Medicine, University of Eastern Piedmont, and University Hospital "Maggiore della Carità", Novara, Italy.
| | - Annamaria Porreca
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
| | - Giovanna Mantello
- Department of Oncology and Radiotherapy, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy.
| | - Francesca Valvo
- Radiotherapy Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, Pavia, Italy.
| | - Lucrezia Gasparini
- Radiation Oncology Unit, "SS Annunziata" Hospital, "G. d'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy.
| | - Najla Slim
- Department of Radiotherapy, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Stefania Manfrida
- "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario, 00168 Roma, Italy.
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
| | - Marianna A Gerardi
- Department of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy.
| | - Stefano Vagge
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Marco Krengli
- Division of Radiation Oncology, Department of Translational Medicine, University of Eastern Piedmont, and University Hospital "Maggiore della Carità", Novara, Italy.
| | - Elisa Palazzari
- Radiation Oncology Department, Oncological Referral Center, Aviano, Italy.
| | - Mattia Falchetto Osti
- Unit of Radiation Oncology, Sant'Andrea Hospital, Sapienza University of Rome, 00100 Rome, Italy.
| | - Alessandra Gonnelli
- Department of Radiotherapy, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
| | - Gianpiero Catalano
- Radiation Oncology Center, IRCCS Multimedica, Sesto San Giovanni, Italy.
| | - Patrizia Pittoni
- Radiation Oncology Unit, Asst Lariana, Ospedale di Como, Como, Italy.
| | | | - Marco Lupattelli
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, 06156, Perugia, Italy.
| | | | | | - Alessandra Guido
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| | - Oreste Durante
- Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
| | - Gabriella Macchia
- Radiation Oncology Unit, Gemelli Molise Hospital - Università Cattolica del Sacro Cuore, Campobasso, Italy.
| | - Fernando Munoz
- Department of Radiotherapy, Azienda U. S. L. della Valle d'Aosta, 11100, Aosta, Italy.
| | - Badr El Khouzai
- Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology-IRCCS, Padova, Italy.
| | | | - Francesca Arcadipane
- Radiation Oncology, AOU Citta' della Salute e della Scienza, Presidio San Giovanni Antica Sede, Torino, Italy.
| | - Andrea Casadei Gardini
- Department of Medical Oncology, Università Vita-Salute, San Raffaele Hospital IRCCS, 20019 Milan, Italy.
| | - Rolando Maria D'Angelillo
- Radiation Oncology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Maria Antonietta Gambacorta
- "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario, 00168 Roma, Italy.
| | - Domenico Genovesi
- Radiation Oncology Unit, "SS Annunziata" Hospital, "G. d'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy; Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
| | - Luciana Caravatta
- Radiation Oncology Unit, "SS Annunziata" Hospital, "G. d'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy.
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Noguera NI, Catalano G, Zaza A, Banella C, Ottone T, Pelosi E, Travaglini S, Divona M, Del Principe MI, Buccisano F, Maurillo L, Amatuna E, Testa U, Venditti A, Voso MT. P434: MITOCONDRIAL MCL1 REGULATES LEUKEMIC CELLS METABOLISM VIA DIRECT INTERACTION WITH HEXOKINASE II. METABOLIC SIGNATURE AT ONSET PREDICTS OVERALL SURVIVAL IN AMLS’ PATIENTS. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000844624.54003.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Franco P, Porreca A, Di Nicola M, Mantello G, Valvo F, Slim N, Manfrida S, Gambacorta M, De Felice F, Vagge S, Krengli M, Palazzari E, Osti M, Gonelli A, Catalano G, Pittoni P, Lupattelli M, Niespolo M, Rosetto M, Macchia G, Durante O, Munoz F, D'Angelillo R, Genovesi D, Caravatta L. OC-0272 External validation of the Hemo-Eosinophils-Inflammation index as a prognosticator in anal cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02530-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Leonardi MC, Pepa M, Gugliandolo SG, Luraschi R, Vigorito S, Rojas DP, La Porta MR, Cante D, Petrucci E, Marino L, Borzì G, Ippolito E, Marrocco M, Huscher A, Chieregato M, Argenone A, Iadanza L, De Rose F, Lobefalo F, Cucciarelli F, Valenti M, De Santis MC, Cavallo A, Rossi F, Russo S, Prisco A, Guernieri M, Guarnaccia R, Malatesta T, Meaglia I, Liotta M, Tabarelli de Fatis P, Palumbo I, Marcantonini M, Colangione SP, Mezzenga E, Falivene S, Mormile M, Ravo V, Arrichiello C, Fozza A, Barbero MP, Ivaldi GB, Catalano G, Vidali C, Aristei C, Giannitto C, Miglietta E, Ciabattoni A, Meattini I, Orecchia R, Cattani F, Jereczek-Fossa BA. Geometric contour variation in clinical target volume of axillary lymph nodes in breast cancer radiotherapy: an AIRO multi-institutional study. Br J Radiol 2021; 94:20201177. [PMID: 33882239 PMCID: PMC8248216 DOI: 10.1259/bjr.20201177] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/23/2020] [Accepted: 01/25/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To determine interobserver variability in axillary nodal contouring in breast cancer (BC) radiotherapy (RT) by comparing the clinical target volume of participating single centres (SC-CTV) with a gold-standard CTV (GS-CTV). METHODS The GS-CTV of three patients (P1, P2, P3) with increasing complexity was created in DICOM format from the median contour of axillary CTVs drawn by BC experts, validated using the simultaneous truth and performance-level estimation and peer-reviewed. GS-CTVs were compared with the correspondent SC-CTVs drawn by radiation oncologists, using validated metrics and a total score (TS) integrating all of them. RESULTS Eighteen RT centres participated in the study. Comparative analyses revealed that, on average, the SC-CTVs were smaller than GS-CTV for P1 and P2 (by -29.25% and -27.83%, respectively) and larger for P3 (by +12.53%). The mean Jaccard index was greater for P1 and P2 compared to P3, but the overlap extent value was around 0.50 or less. Regarding nodal levels, L4 showed the highest concordance with the GS. In the intra-patient comparison, L2 and L3 achieved lower TS than L4. Nodal levels showed discrepancy with GS, which was not statistically significant for P1, and negligible for P2, while P3 had the worst agreement. DICE similarity coefficient did not exceed the minimum threshold for agreement of 0.70 in all the measurements. CONCLUSIONS Substantial differences were observed between SC- and GS-CTV, especially for P3 with altered arm setup. L2 and L3 were the most critical levels. The study highlighted these key points to address. ADVANCES IN KNOWLEDGE The present study compares, by means of validated geometric indexes, manual segmentations of axillary lymph nodes in breast cancer from different observers and different institutions made on radiotherapy planning CT images. Assessing such variability is of paramount importance, as geometric uncertainties might lead to incorrect dosimetry and compromise oncological outcome.
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Affiliation(s)
| | - Matteo Pepa
- Division of Radiation Oncology, IEO Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | | | - Rosa Luraschi
- Unit of Medical Physics, IEO Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | - Sabrina Vigorito
- Unit of Medical Physics, IEO Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | | | | | - Domenico Cante
- Radiotherapy Department, ASL TO4 Ivrea Community Hospital, Ivrea, Italy
| | - Edoardo Petrucci
- Unit of Medical Physics, ASL TO4 Ivrea Community Hospital, Ivrea, Italy
| | - Lorenza Marino
- Radiotherapy Unit, REM Radioterapia, Viagrande (CT), Italy
| | - Giuseppina Borzì
- Unit of Medical Physics, REM Radioterapia, Viagrande (CT), Italy
| | - Edy Ippolito
- Department of Radiotherapy, Campus Bio-Medico University, Roma, Italy
| | | | | | | | - Angela Argenone
- Division of Radiation Oncology, Azienda Ospedaliera di Rilievo Nazionale San Pio, Benevento, Italy
| | - Luciano Iadanza
- Unit of Medical Physics, Azienda Ospedaliera di Rilievo Nazionale San Pio, Benevento, italy
| | - Fiorenza De Rose
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Centre IRCCS, Milano, Italy
| | - Francesca Lobefalo
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Centre IRCCS, Milano, Italy
| | - Francesca Cucciarelli
- Department of Internal Medicine, Radiotherapy Institute, Ospedali Riuniti Umberto I, G.M. Lancisi, G. Salesi, Ancona, Italy
| | - Marco Valenti
- Unit of Medical Physics, Ospedali Riuniti Umberto I, G.M. Lancisi, G. Salesi, Ancona, Italy
| | | | - Anna Cavallo
- Unit of Medical Physics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Francesca Rossi
- Radiotherapy Unit, Usl Toscana Centro, Ospedale Santa Maria Annunziata, Firenze, Italy
| | - Serenella Russo
- Unit of Medical Physics, Usl Toscana Centro, Ospedale Santa Maria Annunziata, Firenze, Italy
| | - Agnese Prisco
- Department of Radiotherapy, ASUFC - P.O. “ Santa Maria della Misericordia” di Udine, Udine, Italy
| | - Marika Guernieri
- Unit of Medical Physics, ASUFC - P.O. “ Santa Maria della Misericordia” di Udine, Udine, Italy
| | - Roberta Guarnaccia
- Radiotherapy Unit, Ospedale Fatebenefratelli Isola Tiberina, Roma, Italy
| | - Tiziana Malatesta
- Unit of Medical Physics, Ospedale Fatebenefratelli Isola Tiberina, Roma, Italy
| | - Ilaria Meaglia
- Radiation Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Marco Liotta
- Medical Physics Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | | | - Isabella Palumbo
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy
| | | | - Sarah Pia Colangione
- Radiotherapy Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Emilio Mezzenga
- Medical Physics Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) "Dino Amadori", Meldola (FC), Italy
| | - Sara Falivene
- Department of Radiotherapy, ASL Napoli 1 Centro - Ospedale del Mare, Napoli, Italy
| | - Maria Mormile
- Unit of Medical Physics, ASL Napoli 1 Centro - Ospedale del Mare, Napoli, Italy
| | - Vincenzo Ravo
- Unit of Radiotherapy, Istituto Nazionale Tumori – IRCCS - Fondazione G. Pascale, Napoli, Italy
| | - Cecilia Arrichiello
- Unit of Radiotherapy, Istituto Nazionale Tumori – IRCCS - Fondazione G. Pascale, Napoli, Italy
| | - Alessandra Fozza
- Division of Radiation Oncology, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Maria Paola Barbero
- Unit of Medical Physics, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Gianpiero Catalano
- Department of Radiotherapy, IRCCS MultiMedica, Sesto San Giovanni (MI), Italy
| | - Cristiana Vidali
- Department of Radiation Oncology, Azienda Sanitaria Universitaria Integrata di Trieste (ASUI-TS), Trieste, Italy
| | - Cynthia Aristei
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Caterina Giannitto
- Division of Radiology, IEO Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | - Eleonora Miglietta
- Division of Radiation Oncology, IEO Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | | | | | - Roberto Orecchia
- Scientific Direction, IEO Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | - Federica Cattani
- Unit of Medical Physics, IEO Istituto Europeo di Oncologia IRCCS, Milano, Italy
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8
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Jereczek-Fossa BA, Palazzi MF, Tonoli S, Zaffaroni M, Marvaso G, Ivaldi GB, Amadori M, Antognoni P, Arcangeli S, Buffoli A, Beltramo G, Bignardi M, Bracelli S, De Stefani A, Castiglioni S, Catalano G, Di Muzio N, Cerrotta A, Fariselli L, Filippi AR, Gramaglia A, Italia C, Massaro P, Magrini SM, Nava S, Orlandi E, Pasinetti N, Sbicego EL, Scandolaro L, Scorsetti M, Barbonetti C, Tortini R, Valdagni R, Vavassori V, Pepa M, Cazzaniga LF, Soatti CP. Almost one year of COVID-19 pandemic: how radiotherapy centers have counteracted its impact on cancer treatment in Lombardy, Italy. CODRAL/AIRO-L study. Tumori 2021; 108:177-181. [PMID: 33885350 DOI: 10.1177/03008916211009974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lombardy has represented the Italian and European epicenter of the coronavirus disease 2019 (COVID-19) pandemic. Although most clinical efforts within hospitals were diverted towards the care of virally infected patients, therapies for patients with cancer, including radiotherapy (RT), have continued. During both the first and second pandemic waves, several national and regional organizations provided Italian and Lombardian RT departments with detailed guidelines aimed at ensuring safe treatments during the pandemic. The spread of infection among patients and personnel was limited by adopting strict measures, including triage procedures, interpersonal distance, and adequate implementation of personal protective equipment (PPE). Screening procedures addressed to both the healthcare workforce and patients, such as periodic nasopharyngeal swabs, have allowed the early identification of asymptomatic or pauci-symptomatic COVID-19 cases, thus reducing the spread of the infection. Prevention of infection was deemed of paramount importance to protect both patients and personnel and to ensure the availability of a minimum number of staff members to maintain clinical activity. The choice of treating COVID-19-positive patients has represented a matter of debate, and the risk of oncologic progression has been weighted against the risk of infection of personnel and other patients. Such risk was minimized by creating dedicated paths, reserving time slots, applying intensified cleaning procedures, and supplying personnel and staff with appropriate PPE. Remote working of research staff, medical physicists, and, in some cases, radiation oncologists has prevented overcrowding of shared spaces, reducing infection spread.
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Affiliation(s)
- Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | | | - Sandro Tonoli
- Radiation Oncology Centre, ASST Cremona, Cremona, Lombardia, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | | | | | - Paolo Antognoni
- Radiation Oncology Centre, Ospedale di Circolo e Fondazione Macchi, ASST dei Sette Laghi, Varese, Italy
| | - Stefano Arcangeli
- Department of Radiation Oncology, Ospedale S. Gerardo and University of Milan Bicocca, Monza, Italy
| | - Alberto Buffoli
- Radiation Oncology Centre, Istituto Clinico S. Anna, Brescia, Italy
| | - Giancarlo Beltramo
- Radiation Oncology Centre, Centro Diagnostico Italiano (CDI), Milano, Italy
| | - Mario Bignardi
- Radiation Oncology Centre, Fondazione Poliambulanza, Brescia, Italy
| | | | - Agostina De Stefani
- Division of Radiation Oncology, Ospedale di Treviglio, Caravaggio di Treviglio, Italy
| | | | - Gianpiero Catalano
- Radiation Oncology Centre, IRCCS Multimedica, Sesto San Giovanni/Castellanza, Italy
| | - Nadia Di Muzio
- Radiation Oncology Centre, IRCCS Ospedale S. Raffaele and University Vita Salute, Milano, Italy
| | - Annamaria Cerrotta
- Division of Radiation Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Laura Fariselli
- Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Andrea Riccardo Filippi
- Division of Radiotherapy, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | | | - Corrado Italia
- Radiation Oncology Centre, Istituti Ospedalieri Bergamaschi, Ponte S. Pietro-Zingonia, Italy
| | - Patrizia Massaro
- Radiotherapy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Stefano Maria Magrini
- Radiation Oncology Centre, Brescia University Radiation Oncology Department, O. Alberti Radium Institute, Spedali Civili Hospital, Brescia, Italy
| | - Simonetta Nava
- Radiation Oncology Centre, Istituti Clinici di Pavia e Vigevano, Vigevano, Italy
| | - Ester Orlandi
- Radiation Oncology Unit, Clinical Department, National Centre for Oncological Hadrontherapy, Fondazione CNAO, Pavia, Italy
| | - Nadia Pasinetti
- Radiation Oncology Department, Esine and University of Brescia, Esine, Italy
| | - Elena Lara Sbicego
- Radiation Oncology Centre, Istituto Clinico Sant'Ambrogio, Milano, Italy
| | - Luciano Scandolaro
- Radiation Oncology Centre, Ospedale Sant'Anna, ASST Lariana, Como, Italy
| | - Marta Scorsetti
- IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Center, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Claudio Barbonetti
- Radiation Oncology Centre, Ospedale di Sondrio, ASST Valtellina e Alto Lario, Sondrio, Italy
| | - Roberto Tortini
- Ospedale di Casalpusterlengo, Azienda Ospedaliera della Provincia di Lodi, Casalpusterlengo, Italy
| | - Riccardo Valdagni
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy.,Division of Radiation Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | | | - Matteo Pepa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy
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9
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Jereczek-Fossa BA, Pepa M, Zaffaroni M, Marvaso G, Bruni A, Buglione di Monale E Bastia M, Catalano G, Filippi AR, Franco P, Gambacorta MA, Genovesi D, Iatì G, Magli A, Marafioti L, Meattini I, Merlotti A, Mignogna M, Musio D, Pacelli R, Pergolizzi S, Tombolini V, Trovo M, Leonardi MC, Ricardi U, Magrini SM, Corvò R, Donato V. COVID-19 safe and fully operational radiotherapy: An AIRO survey depicting the Italian landscape at the dawn of phase 2. Radiother Oncol 2021; 155:120-122. [PMID: 33065185 PMCID: PMC7553860 DOI: 10.1016/j.radonc.2020.09.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/18/2020] [Accepted: 09/27/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - Matteo Pepa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy.
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - Alessio Bruni
- Radiotherapy Unit, Department of Oncology and Haematology, University Hospital of Modena, Italy
| | | | - Gianpiero Catalano
- Radiation Oncology Centre, IRCCS Ospedale Multimedica, Sesto San Giovanni/Castellanza, Italy
| | - Andrea Riccardo Filippi
- Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Italy
| | | | | | - Domenico Genovesi
- Radiation Oncology Unit, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Giuseppe Iatì
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Italy
| | | | - Luigi Marafioti
- Division of Radiotherapy, Azienda Ospedaliera di Cosenza, Italy
| | - Icro Meattini
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy; Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Firenze, Italy
| | - Anna Merlotti
- Department of Radiation Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Marcello Mignogna
- Radiation Oncology Unit, S. Luca Hospital, Healthcare Company Tuscany Nord Ovest, Lucca, Italy
| | - Daniela Musio
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Roma, Italy
| | - Roberto Pacelli
- Department of Advanced Biomedical Sciences, Federico II University, Napoli, Italy
| | - Stefano Pergolizzi
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Italy
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Roma, Italy
| | - Marco Trovo
- Department of Radiation Oncology, Udine General Hospital, Italy
| | | | | | - Stefano Maria Magrini
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Renzo Corvò
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Health Science Department (DISSAL), University of Genoa, Genova, Italy
| | - Vittorio Donato
- Radiation Oncology Division, Oncology and Specialty Medicine Department, San Camillo-Forlanini Hospital, Roma; President of AIRO (Italian Association of Radiotherapy and Clinical Oncology), Italy
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10
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Jereczek-Fossa BA, Pepa M, Marvaso G, Bruni A, Buglione di Monale E Bastia M, Catalano G, Filippi AR, Franco P, Gambacorta MA, Genovesi D, Iatì G, Magli A, Marafioti L, Meattini I, Merlotti A, Mignogna M, Musio D, Pacelli R, Pergolizzi S, Tombolini V, Trovò M, Ricardi U, Magrini SM, Corvò R, Donato V. COVID-19 outbreak and cancer radiotherapy disruption in Italy: Survey endorsed by the Italian Association of Radiotherapy and Clinical Oncology (AIRO). Radiother Oncol 2020; 149:89-93. [PMID: 32413527 PMCID: PMC7215158 DOI: 10.1016/j.radonc.2020.04.061] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 12/11/2022]
Abstract
Italy experienced one of the world's deadliest COVID-19 outbreaks and healthcare systems had to instantly reorganise activity. The Italian Radiation Oncology Departments adapted numerous solutions to minimize the disruptions. Information technologies, treatment prioritization and implementation of hypofractionation and protection procedures allowed balancing between cancer patient care and patient/healthcare workers safety.
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Affiliation(s)
- Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - Matteo Pepa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy.
| | - Alessio Bruni
- Radiotherapy Unit, Department of Oncology and Haematology, University Hospital of Modena, Modena, Italy
| | | | - Gianpiero Catalano
- Radiation Oncology Center, IRCCS Ospedale Multimedica, Sesto San Giovanni/Castellanza, Italy
| | - Andrea Riccardo Filippi
- Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | | | | | - Domenico Genovesi
- Radiation Oncology Unit, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Giuseppe Iatì
- Radiation Oncology Unit - Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Alessandro Magli
- Department of Radiation Oncology, Udine General Hospital, Udine, Italy
| | - Luigi Marafioti
- Division of Radiotherapy, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - Icro Meattini
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy; Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Firenze, Italy
| | - Anna Merlotti
- Department of Radiation Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Marcello Mignogna
- Radiation Oncology Unit, S. Luca Hospital, Healthcare Company Tuscany Nord Ovest, Lucca, Italy
| | - Daniela Musio
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Roma, Italy
| | - Roberto Pacelli
- Department of Advanced Biomedical Sciences, Federico II University, Napoli, Italy
| | - Stefano Pergolizzi
- Radiation Oncology Unit - Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Roma, Italy
| | - Marco Trovò
- Department of Radiation Oncology, Udine General Hospital, Udine, Italy
| | | | - Stefano Maria Magrini
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Renzo Corvò
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Health Science Department (DISSAL), University of Genoa, Genova, Italy
| | - Vittorio Donato
- Radiation Oncology Division, Oncology and Speciality Medicine Department, San Camillo-Forlanini Hospital, Roma, Italy; President of AIRO (Italian Association of Radiotherapy and Clinical Oncology), Italy
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11
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Jereczek-Fossa BA, Palazzi MF, Soatti CP, Cazzaniga LF, Ivaldi GB, Pepa M, Amadori M, Antognoni P, Arcangeli S, Buffoli A, Beltramo G, Berlinghieri S, Bignardi M, Bracelli S, Bruschieri L, Castiglioni S, Catalano G, Di Muzio N, Fallai C, Fariselli L, Filippi AR, Gramaglia A, Italia C, Lombardi F, Magrini SM, Nava S, Orlandi E, Pasinetti N, Sbicego EL, Scandolaro L, Scorsetti M, Stiglich F, Tonoli S, Tortini R, Valdagni R, Vavassori V, Marvaso G. COVID-19 Outbreak and Cancer Radiotherapy Disruption in Lombardy, Northern Italy. Clin Oncol (R Coll Radiol) 2020; 32:e160-e161. [PMID: 32354669 PMCID: PMC7177150 DOI: 10.1016/j.clon.2020.04.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/17/2020] [Indexed: 11/18/2022]
Affiliation(s)
- B A Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - M F Palazzi
- Radiotherapy Unit, ASST Ospedale Niguarda, Milano, Italy
| | - C P Soatti
- Radiation Oncology Center, Ospedale Manzoni, Lecco, Italy
| | - L F Cazzaniga
- Radiation Oncology Center, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - G B Ivaldi
- Radiation Oncology Center, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - M Pepa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - M Amadori
- Radiation Oncology Center, Ospedale C. Poma, Mantova, Italy
| | - P Antognoni
- Radiation Oncology Center, Ospedale di Circolo e Fondazione Macchi, ASST dei Sette Laghi, Varese, Italy
| | - S Arcangeli
- Department of Radiation Oncology, Policlinico S. Gerardo and University of Milan "Bicocca", Milano, Italy
| | - A Buffoli
- Radiation Oncology Center, Istituto Clinico S. Anna, Brescia, Italy
| | - G Beltramo
- Radiation Oncology Center, Centro Diagnostico Italiano (CDI), Milano, Italy
| | - S Berlinghieri
- Unit of Radiotherapy, Ospedale di Esine - ASL Vallecamonica-Sebino, Esine, Italy
| | - M Bignardi
- Radiation Oncology Center, Fondazione Poliambulanza, Brescia, Italy
| | - S Bracelli
- Radiation Oncology Center, Ospedale, Busto Arsizio, Italy
| | - L Bruschieri
- Division of Radiation Oncology, Ospedale di Treviglio, Caravaggio di Treviglio, Italy
| | - S Castiglioni
- Radiation Oncology Center, S. Pio X-Humanitas, Milano, Italy
| | - G Catalano
- Radiation Oncology Center, IRCCS Ospedale Multimedica, Sesto San Giovanni/Castellanza, Italy
| | - N Di Muzio
- Radiation Oncology Center, IRCCS Ospedale S. Raffaele and University Vita Salute, Milano, Italy
| | - C Fallai
- Division of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - L Fariselli
- Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - A R Filippi
- Radiation Oncology Department, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - A Gramaglia
- Radiation Oncology Center, Policlinico, Monza, Italy
| | - C Italia
- Radiation Oncology Center, Istituti Ospedalieri Bergamaschi, Ponte S. Pietro-Zingonia, Italy
| | - F Lombardi
- Radiotherapy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - S M Magrini
- Radiation Oncology Center, Brescia University Radiation Oncology Department, O. Alberti Radium Institute, Spedali Civili Hospital, Brescia, Italy
| | - S Nava
- Radiation Oncology Center, Istituti Clinici di Pavia e Vigevano, Vigevano, Italy
| | - E Orlandi
- Radiation Oncology Center, National Center of Oncological Hadrontherapy, CNAO, Pavia, Italy
| | - N Pasinetti
- Radiation Oncology Department, Esine and University of Brescia, Esine, Italy
| | - E L Sbicego
- Radiation Oncology Center, Istituto Clinico Sant'Ambrogio, Milano, Italy
| | - L Scandolaro
- Radiation Oncology Center, Ospedale Sant'Anna, ASST Lariana, Como, Italy
| | - M Scorsetti
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Hospital - IRCCS, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
| | - F Stiglich
- Radiation Oncology Center, Ospedale, Sondrio, Italy
| | - S Tonoli
- Radiation Oncology Center, Ospedale, Cremona, Italy
| | - R Tortini
- Ospedale di Casalpusterlengo, Azienda Ospedaliera della Provincia di Lodi, Casalpusterlengo, Italy
| | - R Valdagni
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy; Division of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - V Vavassori
- Unit of Radiotherapy, Cliniche Gavezzeni SPA, Bergamo, Italy
| | - G Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
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12
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Banella C, Ginevrino M, Catalano G, Fabiani E, Falconi G, Divona M, Curzi P, Panetta P, Voso MT, Noguera NI. Absence of FGFR3-TACC3 rearrangement in hematological malignancies with numerical chromosomal alteration. Hematol Oncol Stem Cell Ther 2020; 14:163-168. [PMID: 32199932 DOI: 10.1016/j.hemonc.2020.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/10/2019] [Revised: 01/29/2020] [Accepted: 02/07/2020] [Indexed: 10/24/2022] Open
Abstract
FGFR-TACC, found in different tumor types, is characterized by the fusion of a member of fibroblast grown factor receptor (FGFR) tyrosine kinase (TK) family to a member of the transforming acidic coiled-coil (TACC) proteins. Because chromosome numerical alterations, hallmarks of FGFR-TACC fusions are present in many hematological disorders and there are no data on the prevalence, we studied a series of patients with acute myeloid leukemia and myelodysplastic syndrome who presented numerical alterations using cytogenetic traditional analysis. None of the analyzed samples showed FGFR3-TACC3 gene fusion, so screening for this mutation at diagnosis is not recommended.
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Affiliation(s)
- C Banella
- Neuro-oncohematology Unit, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M Ginevrino
- Neurogenetics Unit, IRCCS Santa Lucia Foundation, Rome, Italy; Deparment of Molecular Medicine, University of Pavia, Pavia, Italy
| | - G Catalano
- Neuro-oncohematology Unit, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - E Fabiani
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - G Falconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M Divona
- Policlinico Tor Vergata, Rome, Italy
| | - P Curzi
- Policlinico Tor Vergata, Rome, Italy
| | - P Panetta
- Policlinico Tor Vergata, Rome, Italy
| | - M T Voso
- Neuro-oncohematology Unit, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - N I Noguera
- Neuro-oncohematology Unit, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
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13
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Santacroce R, Bennasar CR, Jaraiz JS, Montemitro C, Baroni G, Corbo M, Pasquini A, Sarchione F, Angelini F, Catalano G, Carenti M, Di Taranto C, Tenuta S, Lecciso U, De Angelis M, Rondoni A, Di Giannantonio M, Martinotti G. Party Hard: Drug-related Fatalities in Ibiza from 2010 to 2016. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2017.01.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionIllicit drug use is well known as an important contributor to the global burden of diseases, but the physical and psychopathological risks of recreational drugs misuse are often underestimated and drug-related fatalities in specific settings are under-investigated.Objectives and methodsIn the framework of the EU-funded project “EU-Madness”, we collected and analysed all the reports of drug-related fatalities in Ibiza from January 2010 to September 2016, with the aim of characterising the sample, and identifying the involved substances and the nature of deaths associated with their consumption.ResultsOverall, 58 drug-related fatalities were registered from 2010 to September 2016 (87.9% males, 12.1% females, mean age 33.16; females were significantly younger than males). Most of the deceased were Britons (36.2%), followed by Spanish (22.4%), Italians (6.9%) and Germans (5.2%). In half the cases, the substance identified in post-mortem analyses was a stimulant; in 24.1% of the sample it was a depressor a prescription drug or more than two substances in 22.4%. Most of the fatalities were due to cardiovascular accidents (62%); 22.4% were deaths by drowning, 12% by fall from heights and 3.4% were due to mechanical asphyxia.ConclusionsAccording to the results from our sample, stimulants (mainly MDMA and cocaine) are the substances of abuse involved in most drug-caused fatalities. The number of fatalities per year has been steadily increasing, but the growing diffusion of novel psychoactive substances (NPS) does not seem to be a direct cause (although better methods of their analysis in post-mortem samples should be designed).Disclosure of interestThe authors have not supplied their declaration of competing interest.
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14
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Noguera NI, Catalano G, Banella C, Divona M, Faraoni I, Ottone T, Arcese W, Voso MT. Acute Promyelocytic Leukemia: Update on the Mechanisms of Leukemogenesis, Resistance and on Innovative Treatment Strategies. Cancers (Basel) 2019; 11:cancers11101591. [PMID: 31635329 PMCID: PMC6826966 DOI: 10.3390/cancers11101591] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [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: 09/16/2019] [Revised: 10/04/2019] [Accepted: 10/10/2019] [Indexed: 12/15/2022] Open
Abstract
This review highlights new findings that have deepened our understanding of the mechanisms of leukemogenesis, therapy and resistance in acute promyelocytic leukemia (APL). Promyelocytic leukemia-retinoic acid receptor α (PML-RARa) sets the cellular landscape of acute promyelocytic leukemia (APL) by repressing the transcription of RARa target genes and disrupting PML-NBs. The RAR receptors control the homeostasis of tissue growth, modeling and regeneration, and PML-NBs are involved in self-renewal of normal and cancer stem cells, DNA damage response, senescence and stress response. The additional somatic mutations in APL mainly involve FLT3, WT1, NRAS, KRAS, ARID1B and ARID1A genes. The treatment outcomes in patients with newly diagnosed APL improved dramatically since the advent of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). ATRA activates the transcription of blocked genes and degrades PML-RARα, while ATO degrades PML-RARa by promoting apoptosis and has a pro-oxidant effect. The resistance to ATRA and ATO may derive from the mutations in the RARa ligand binding domain (LBD) and in the PML-B2 domain of PML-RARa, but such mutations cannot explain the majority of resistances experienced in the clinic, globally accounting for 5-10% of cases. Several studies are ongoing to unravel clonal evolution and resistance, suggesting the therapeutic potential of new retinoid molecules and combinatorial treatments of ATRA or ATO with different drugs acting through alternative mechanisms of action, which may lead to synergistic effects on growth control or the induction of apoptosis in APL cells.
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Affiliation(s)
- N I Noguera
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy.
- Santa Lucia Foundation, Unit of Neuro-Oncoematologia, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), 00143 Rome, Italy.
| | - G Catalano
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy.
- Santa Lucia Foundation, Unit of Neuro-Oncoematologia, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), 00143 Rome, Italy.
| | - C Banella
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy.
- Santa Lucia Foundation, Unit of Neuro-Oncoematologia, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), 00143 Rome, Italy.
| | - M Divona
- Policlinico Tor vergata, 00133 Rome, Italy.
| | - I Faraoni
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - T Ottone
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy.
- Santa Lucia Foundation, Unit of Neuro-Oncoematologia, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), 00143 Rome, Italy.
| | - W Arcese
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy.
| | - M T Voso
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy.
- Santa Lucia Foundation, Unit of Neuro-Oncoematologia, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), 00143 Rome, Italy.
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15
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Roila F, Ruggeri B, Ballatori E, Patoia L, Palazzo S, Colucci G, Di Costanzo F, Cascinu S, Labianca R, Sobrero A, Cortesi E, Bressi C, Ferraldeschi R, Mazzoli M, Evangelista M, Di Fonzo C, Cigolari S, Angelini V, Cioffi A, Guardasole V, Zarra E, Tonato M, Betti M, Marrocolo F, Bon-ciarelli V, Cetto G, Silingardi V, Cognetti F, Beretta G, Pessi A, Mosconi S, Milesi L, Bertetto O, Malacarne P, Marzola M, Margutti G, Modenesi C, Manente P, Comandone A, Oliva C, Berniolo P, Cutin SC, Luporini G, Colucci G, Recaldin E, Nicodemo M, Picece V, Turaz-za M, Ferrazzi E, Solina G, Rosati G, Rossi A, Manzione L, Sozzi P, Fornarini G, Lavarello A, Catalano G, Giordani P, Alessandroni P, Troccoli G, Ramus GV, Tonda L, Sirgiovanni M, Iannello GP, Tinessa V, Ruggiero A, Palazzo S, Barni S, Mandalà M, Cremonesi M, Porcile G, Destefanis M, Testore F, Carteni G, Daniele B, Volta C, Ferraù F, Zaniboni A, Marchetti P, Citone G, Cefaro GA, Iacono C, Musi M, Mozzicafreddo A, Imperiale FN, Filippelli G, Sciacca V, D'Aprile M, Isa L, Recchia F, Spada S, Cascinu S, Carroccio R, Mustacchi G, Ceccherini R, Chetrì M, Rizzo P, Botturi M, Marchei P, Bretti S, Montalbetti L, Reguzzoni G, Massidda B, Ionta M, Cruciani G, Prosperi A, Mantovani G, Sidoti V, Peta A, Greco E, Cicero G, Sobrero A, Marsilio P, Vigevani E, Rimondi G, Gebbia V, Nuzzo A, Biondi E, Caroti C, D'Amico M, Tuveri G, Pieri G, Enrici RM, Tonini G, Santini D, Iannone T, Pizza C, Belli M, Del Prete S, Pizza C, Trevisonne R, Serlenga M, Laricchiuta R, Lacava V, Bumma C, Roselli M, Verderame F, Mascia V, Perrone D, Prantera T, Venuta S, Nastasi G, Bortolussi V, Lembo A. Adjuvant Systemic Therapies in Patients with Colorectal Cancer: An Audit on Clinical Practice in Italy. Tumori 2019; 91:472-6. [PMID: 16457144 DOI: 10.1177/030089160509100605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background Rarely are conclusions from clinical trials summarized in international consensus conferences and promptly transferred to patient care. The adjuvant therapy for colorectal cancer used in daily clinical practice in Italy is described and compared with the recommendations of the 1990 NIH Consensus Conference. Patients and Methods We audited prescriptions of adjuvant systemic therapies for Italian colorectal cancer patients in 82 centers during a fixed one-week period. Results Among 434 patients receiving adjuvant chemotherapy there were 139 (42.5%) colon cancer patients with N- and 169 (51.7%) with N+ regional nodal involvement. Treatment at academic centers, a young age, T4 and a low total number of lymph nodes removed at surgery were the factors potentially justifying the decision for adjuvant chemotherapy in stage II colon cancer patients. The most common chemotherapy used was a bolus of 5-fluorouracil/folinic acid for 6 months (75.8%). Adjuvant radiotherapy was not administered to 37 (38.5%) of 96 patients with stage II and III rectal cancer. Conclusions The study shows that a substantial proportion of patients on adjuvant treatment at a certain time point in a large enough sample of Italian centers are stage II (potential over-treatment) and that an under-treatment of stage II and III rectal cancer patients (lack of radiotherapy) occurs too often in daily clinical practice in this country.
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Affiliation(s)
| | - Fausto Roila
- Divisione Oncologia Medica, Ospedale Policlinico, Perugia
| | | | - Enzo Ballatori
- Unità di Statistica Medica, Dip. Medicina Interna e Sanità Pubblica, Università, L'Aquila
| | - Lucio Patoia
- Dip. Medicina Interna e Scienze Oncologiche, Università, Perugia
| | | | - Giuseppe Colucci
- Oncologia Medica e Sperimentale, Istituto Nazionale Tumori, Bari
| | | | | | | | | | - E. Cortesi
- D.H. Oncologico Policlinico Umberto I, Roma
| | - C. Bressi
- D.H. Oncologico Policlinico Umberto I, Roma
| | | | - M. Mazzoli
- D.H. Oncologico Policlinico Umberto I, Roma
| | | | | | - S. Cigolari
- III Medicina Interna, Università Federico II, Napoli
| | - V. Angelini
- III Medicina Interna, Università Federico II, Napoli
| | - A. Cioffi
- III Medicina Interna, Università Federico II, Napoli
| | - V. Guardasole
- III Medicina Interna, Università Federico II, Napoli
| | - E. Zarra
- III Medicina Interna, Università Federico II, Napoli
| | - M. Tonato
- Divisione Oncologia Medica, Policlinico, Perugia
| | - M. Betti
- Divisione Oncologia Medica, Policlinico, Perugia
| | - F. Marrocolo
- Divisione Oncologia Medica, Policlinico, Perugia
| | | | - G. Cetto
- Divisione Clinicizzata Oncologia Medica, Ospedale Maggiore, Verona
| | | | - F. Cognetti
- Divisione Oncologia Medica, Istituto Nazionale dei Tumori, Roma
| | - G. Beretta
- Divisione Oncologia Medica, Ospedali Riuniti, Bergamo
| | - A. Pessi
- Divisione Oncologia Medica, Ospedali Riuniti, Bergamo
| | - S. Mosconi
- Divisione Oncologia Medica, Ospedali Riuniti, Bergamo
| | - L. Milesi
- Divisione Oncologia Medica, Ospedali Riuniti, Bergamo
| | - O. Bertetto
- Divisione Oncologia Medica, Ospedale S. Giovanni Molinette, Torino
| | - P. Malacarne
- Divisione Oncologia Clinica, Ospedale S. Anna, Ferrara
| | - M. Marzola
- Divisione Oncologia Clinica, Ospedale S. Anna, Ferrara
| | - G. Margutti
- Divisione Oncologia Clinica, Ospedale S. Anna, Ferrara
| | - C. Modenesi
- Divisione Oncologia Clinica, Ospedale S. Anna, Ferrara
| | - P. Manente
- Divisione Oncologia Medica, Ospedale Civile, Castelfranco Veneto
| | - A. Comandone
- Divisione Oncologia Medica, Ospedale Gradenigo, Torino
| | - C. Oliva
- Divisione Oncologia Medica, Ospedale Gradenigo, Torino
| | - P. Berniolo
- Divisione Oncologia Medica, Ospedale Gradenigo, Torino
| | | | - G. Luporini
- Divisione Oncologia Medica, Ospedale S. Carlo Borromeo, Milano
| | - G. Colucci
- Divisione Oncologia Medica e Sperimentale, Istituto Nazionale Tumori, Bari
| | - E. Recaldin
- Divisione Oncologia Medica, Ospedale S. Cuore, Negrar, Verona
| | - M. Nicodemo
- Divisione Oncologia Medica, Ospedale S. Cuore, Negrar, Verona
| | - V. Picece
- Divisione Oncologia Medica, Ospedale S. Cuore, Negrar, Verona
| | - M. Turaz-za
- Divisione Oncologia Medica, Ospedale S. Cuore, Negrar, Verona
| | - E. Ferrazzi
- Divisione Oncologia Medica, Ospedale Civile, Rovigo
| | - G. Solina
- Divisione Chirurgia Oncologica, Ospedale Cervello, Palermo
| | - G. Rosati
- Divisione Oncologia Medica, Ospedale Civile, Potenza
| | - A. Rossi
- Divisione Oncologia Medica, Ospedale Civile, Potenza
| | - L. Manzione
- Divisione Oncologia Medica, Ospedale Civile, Potenza
| | - P. Sozzi
- Divisione Oncologia Medica, Ospedale degli Infermi, Biella
| | - G. Fornarini
- Divisione Oncologia Medica, Ospedale degli Infermi, Biella
| | - A. Lavarello
- Divisione Oncologia Medica, Ospedale Civile, Sestri Levante
| | - G. Catalano
- Divisione Oncologia Medica, Ospedale S. Salvatore, Pesaro
| | - P. Giordani
- Divisione Oncologia Medica, Ospedale S. Salvatore, Pesaro
| | | | - G. Troccoli
- Divisione Oncologia Medica, Policlinico Universitario, Bari
| | - G. Vietti Ramus
- UO di Oncologia, Ospedale S. Giovanni Bosco, ASL Torino 4, Torino
| | - L. Tonda
- UO di Oncologia, Ospedale S. Giovanni Bosco, ASL Torino 4, Torino
| | - M.P. Sirgiovanni
- UO di Oncologia, Ospedale S. Giovanni Bosco, ASL Torino 4, Torino
| | | | - V. Tinessa
- Divisione Oncologia Medica, Ospedale Civile, Benevento
| | - A Ruggiero
- Divisione Oncologia Medica, Ospedale Civile, Benevento
| | - S. Palazzo
- Divisione Oncologia Medica, Ospedale Mariano Santo, Cosenza
| | - S. Barni
- UO di Oncologia Medica, Azienda Ospedaliera, Treviglio
| | - M. Mandalà
- UO di Oncologia Medica, Azienda Ospedaliera, Treviglio
| | - M. Cremonesi
- UO di Oncologia Medica, Azienda Ospedaliera, Treviglio
| | - G. Porcile
- Divisione Oncologia Medica, Ospedale Civile, Alba
| | | | - F. Testore
- Divisione Oncologia Medica, Ospedale Civile, Asti
| | - G. Carteni
- Divisione Oncologia Medica, Ospedale Cardarelli, Napoli
| | - B. Daniele
- Divisione Oncologia Medica, Istituto Nazionale Tumori, Napoli
| | - C. Volta
- Divisione Oncologia Medica, Ospedale Maggiore della Carità, Novara
| | - F. Ferraù
- Divisione Oncologia Medica, Ospedale Civile, Taormina
| | - A. Zaniboni
- Divisione Oncologia Medica, C. Cura Poliambulanza, Brescia
| | - P. Marchetti
- Divisione Oncologia Medica, Ospedale S. Salvatore, L'Aquila
| | - G. Citone
- Divisione Oncologia Medica, Ospedale S. Salvatore, L'Aquila
| | | | - C. Iacono
- Divisione Oncologia Medica, Ospedale Civile, Ragusa
| | - M. Musi
- Divisione Oncologia Medica, Ospedale Generale, Aosta
| | | | | | | | - V. Sciacca
- Divisione Oncologia Medica, Ospedale S. Maria Goretti, Latina
| | - M. D'Aprile
- Divisione Oncologia Medica, Ospedale S. Maria Goretti, Latina
| | - L. Isa
- Divisione Oncologia Medica, Ospedale Civile, Gorgonzola
| | - F. Recchia
- Divisione Oncologia Medica, Ospedale Civile, Avezzano
| | - S. Spada
- D.H. Oncologico, Ospedale Umberto I, Siracusa
| | - S. Cascinu
- Divisione Oncologia Medica, Ospedale Civile, Parma
| | - R. Carroccio
- Unità Operativa Complessa di Oncologia Medica, Ospedale Umberto I, Enna
| | | | | | - M. Chetrì
- D.H. Oncologico, Ospedale di Summa, Brindisi
| | - P. Rizzo
- D.H. Oncologico, Ospedale di Summa, Brindisi
| | - M. Botturi
- UO Radioterapia, Ospedale Niguarda, Milano
| | - P. Marchei
- Divisione Oncologia Medica, Università La Sapienza, Roma
| | - S. Bretti
- Divisione Oncologia Medica, Ospedale Civile, Ivrea
| | | | - G. Reguzzoni
- D. H. Oncologico, Ospedale Civile, Busto Arsizio
| | - B. Massidda
- Oncologia Medica, Policlinico Universitario, Monserrato, Cagliari
| | - M.T. Ionta
- Oncologia Medica, Policlinico Universitario, Monserrato, Cagliari
| | - G. Cruciani
- Divisione Oncologia Medica, Ospedale Civile, Lugo
| | | | - G. Mantovani
- Divisione Oncologia Medica, Università, Cagliari
| | - V. Sidoti
- Divisione Oncologia Medica, Ospedale Civile, Pinerolo
| | - A. Peta
- Divisione Ematologia Oncologica, Ospedale Pugliese, Catanzaro
| | - E. Greco
- Divisione Oncologia Medica, Ospedale Civile, Lamezia Terme
| | - G. Cicero
- Divisione Oncologia Medica, Ospedale Civile, Castrovillari
| | - A. Sobrero
- Divisione Oncologia Medica, Policlinico Universitario, Udine
| | - P. Marsilio
- Divisione Oncologia Medica, Ospedale Civile, Udine
| | - E. Vigevani
- Divisione Oncologia Medica, Ospedale Civile, Tolmezzo
| | - G. Rimondi
- Divisione Oncologia Medica, Ospedale Civile, Tolmezzo
| | - V. Gebbia
- Divisione Oncologia Medica, Policlinico Universitario, Palermo
| | - A. Nuzzo
- UO di Oncologia Medica, Ospedale Renzetti, Lanciano
| | - E. Biondi
- UO di Oncologia Medica, Ospedale Renzetti, Lanciano
| | - C. Caroti
- Divisione Oncologia Medica, Ospedale Galliera, Genova
| | - M. D'Amico
- Divisione Oncologia Medica, Ospedale Galliera, Genova
| | - G. Tuveri
- Divisione Oncologia Medica, Ospedale della Pietà, Trieste
| | - G. Pieri
- Divisione Oncologia Medica, Ospedale della Pietà, Trieste
| | | | - G. Tonini
- Oncologia Medica, Università Campus Biomedico, Roma
| | - D. Santini
- Oncologia Medica, Università Campus Biomedico, Roma
| | - T. Iannone
- Unità di Radioterapia Oncologica, Ospedale civile, Belluno
| | - C. Pizza
- Divisione Oncologia Medica, Ospedale S. Maria della Pietà, Nola
| | | | - S. Del Prete
- Divisione Oncologia Medica, Ospedale Civile, Frattamaggiore
| | - C. Pizza
- Divisione Oncologia Medica, Ospedale S. Maria della Pietà, Nola
| | - R. Trevisonne
- Divisione Oncologia Medica e Radioterapia, Ospedale Civile, Ascoli Piceno
| | - M. Serlenga
- Oncologia Radioterapica, Ospedale Civile, Barletta
| | | | - V. Lacava
- D.H. Oncologia, Università La Sapienza, Roma
| | - C. Bumma
- Divisione Oncologia Medica, Ospedale S. Giovanni Vecchio, Torino
| | - M. Roselli
- Oncologia Medica, Università di Roma “Tor Vergata”, Roma
| | | | - V. Mascia
- Divisione Oncologia Medica, Policlinico Universitario, Cagliari
| | - D. Perrone
- Divisione Oncologia Medica, Ospedale Civile, Saluzzo, Cuneo
| | - T. Prantera
- Divisione Oncologia Medica, Ospedale S. Giovanni di Dio, Crotone
| | - S. Venuta
- Divisione Oncologia Medica, Policlinico Universitario, Catanzaro
| | - G. Nastasi
- Divisione Medicina Oncologica, Ospedale Civile, Alzano Lombardo
| | | | - A. Lembo
- Servizio Oncologia Medica, Casa di Cura M. Polo, Roma
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16
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Palazzi MF, Soatti C, Jereczek-Fossa BA, Cazzaniga LF, Antognoni P, Gardani G, Amadori M, Baio A, Beltramo G, Bignardi M, Bracelli S, Buffoli A, Castiglioni S, Catalano G, Di Muzio N, Fallai C, Fariselli L, Frata P, Gramaglia A, Italia C, Ivaldi G, Lombardi F, Magrini SM, Nava S, Sarti E, Scandolaro L, Scorsetti M, Stiglich F, Tortini R, Valdagni R, Valvo F, Vavassori V, Sbicego EL, Tonoli S, Orecchia R. Equipment, staffing, and provision of radiotherapy in Lombardy, Italy: Results of three surveys performed between 2012 and 2016. Tumori 2018; 104:352-360. [PMID: 29986637 DOI: 10.1177/0300891618784800] [Citation(s) in RCA: 8] [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] [Indexed: 11/16/2022]
Abstract
INTRODUCTION: Several efforts are being implemented at the European level to measure provision of up-to-date radiation treatments across the continent. METHODS: A snapshot survey involving all radiation oncology centers within Lombardy, Italy, was performed in 2012 and repeated in 2014 and 2016, in cooperation with regional governmental officers. Centers were asked to provide detailed information concerning all individual patients being treated on the index day, and to report data on available local resources. RESULTS: We observed an increase in the number of centers and of megavoltage units (MVU) (from 76 to 87, i.e., 8.7 MVU per million inhabitants in 2016). Mean number of MVU per center was 2.5. Average age of MVU increased from 5.3 to 7.5 years and patients on the waiting list also increased. Conformal 3D radiotherapy (RT) treatments decreased from 56% to 42% and were progressively replaced by intensity-modulated RT treatments (from 39% to 49%). Waiting times were overall satisfactory. Radiation oncologists treated on average 152 and radiation therapists 100 RT courses per year. Average reimbursement per course was €4,879 (range €2,476-€8,014). CONCLUSIONS: The methodology of snapshot survey proved feasible and provided valuable information about radiation oncology provision and accessibility in Lombardy.
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Affiliation(s)
- Mauro F Palazzi
- 1 Radiation Oncology Center, Grande Ospedale Metropolitano Niguarda Milan, Italy
| | - Carlo Soatti
- 2 Radiation Oncology Center, Ospedale Manzoni, Lecco, Italy
| | - Barbara A Jereczek-Fossa
- 3 Department of Oncology and Hemato‑oncology, University of Milan, and Division of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - Luigi F Cazzaniga
- 4 Radiation Oncology Center, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Paolo Antognoni
- 5 Radiation Oncology Center, Ospedale di Circolo e Fondazione Macchi, ASST dei Sette Laghi, Varese, Italy
| | | | | | - Ambrogia Baio
- 8 Radiation Oncology Center, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Giancarlo Beltramo
- 9 Radiation Oncology Center, Centro Diagnostico Italiano (CDI), Milan, Italy
| | - Mario Bignardi
- 10 Radiation Oncology Center, Fondazione Poliambulanza, Brescia, Italy
| | | | - Alberto Buffoli
- 12 Radiation Oncology Center, Istituto Clinico S. Anna, Brescia, Italy
| | | | - Gianpiero Catalano
- 14 Radiation Oncology Center, IRCCS Ospedale Multimedica, Sesto San Giovanni/Castellanza, Italy
| | - Nadia Di Muzio
- 15 Radiation Oncology Center, IRCCS Ospedale S. Raffaele, Milano, Italy
| | - Carlo Fallai
- 16 Radiation Oncology Center, Istituto Nazionale Tumori, Milan, Italy
| | - Laura Fariselli
- 17 Radiation Oncology Center, Fondazione Istituto Neurologico Besta, Milan, Italy
| | - Paolo Frata
- 18 Radiation Oncology Center, Ospedale di Esine, ASST di Valcamonica, Esine, Italy
| | | | - Corrado Italia
- 20 Radiation Oncology Center, Istituti Ospedalieri Bergamaschi, Ponte S. Pietro, Zingonia (BG), Italy
| | - Giovanni Ivaldi
- 21 Radiation Oncology Center, Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | - Fabrizio Lombardi
- 22 Radiation Oncology Center, Ospedale San Donato, San Donato Milanese, Italy
| | - Stefano M Magrini
- 23 Radiation Oncology Center, Brescia University Radiation Oncology Department, O. Alberti Radium Institute, Spedali Civili Hospital, Brescia, Italy
| | - Simonetta Nava
- 24 Radiation Oncology Center, Istituti Clinici di Pavia e Vigevano, Vigevano, Italy
| | - Enrico Sarti
- 25 Radiation Oncology Center, Ospedale, Treviglio, Italy
| | - Luciano Scandolaro
- 26 Radiation Oncology Center, Ospedale Sant'Anna, ASST Lariana, Como, Italy
| | - Marta Scorsetti
- 27 Radiation Oncology Center, Humanitas Clinical and Research Center and Humanitas University, Milano-Rozzano, Italy
| | | | - Roberto Tortini
- 29 Radiation Oncology Center, Presidio di Casalpusterlengo, ASST Lodi, Italy
| | - Riccardo Valdagni
- 30 Radiation Oncology Center, Istituto Nazionale Tumori and Università degli Studi di Milano, Milan, Italy
| | | | - Vittorio Vavassori
- 32 Radiation Oncology Center, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Elena L Sbicego
- 33 Radiation Oncology Center, Istituto Clinico S. Ambrogio, Milan, Italy
| | - Sandro Tonoli
- 34 Radiation Oncology Center, Ospedale, Cremona, Italy
| | - Roberto Orecchia
- 35 Radiation Oncology Center, IEO Scientific Direction, Milan, Italy
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17
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Cascinu S, Veraldi A, Foglietti GP, Ghiselli R, Saba V, Lungarotti F, Babini L, Catalano G. A Pilot Clinical Trial of Surgical Adjuvant Treatment with High-Dose 6S-Leucovorin/5-Fluorouracil and Radiation Therapy for High-Risk Rectal Carcinoma. Tumori 2018; 80:335-8. [PMID: 7839461 DOI: 10.1177/030089169408000504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background The study was performed to evaluate the feasibility of combining leucovorin (LV) with 5-fluorouracil (5FU) and radiation therapy as adjuvant treatment for high-risk rectal carcinoma. Methods Twenty-five patients with histologically proven adenocarcinoma of the rectum, at high-risk of recurrence after potentially curative resection (T3 NO, T any N1-2; MO), received 5FU (370 mg/m2) and 6S-LV (100 mg/m2) on days 1-5, 4 and 8 weeks after surgery. On treatment day 64, radiotherapy on the pelvis (50 Gy) was initiated. Finally, three further courses of 5FU/LV were given at intervals of 4 weeks beginning 28 days after the completion of radiotherapy. Results The treatment was generally well tolerated. We observed only 2 cases of grade III toxicity (diarrhea) during the third cycle of chemotherapy. No severe complications were recorded following the use of radiotherapy. The mean overall 5FU dose intensity was 92%. After a median follow-up of 24 months, 4 patients had relapsed (liver, lung, and pelvis, 2 cases). Conclusions The association of LV to 5FU and radiation therapy seems to be feasible, with acceptable toxicity. The advantage of this combination, in terms of recurrence rate and survival with respect to 5FU/radiotherapy alone, will have to be evaluated in randomized trials.
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Affiliation(s)
- S Cascinu
- Servizio di Oncologia, Ospedali Riuniti, Pesaro, Italy
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18
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Abstract
Until recently, chemotherapy was considered ineffective in pancreatic cancer and these patients received best supportive care only. Now, there is evidence that chemotherapy may influence the natural history of the disease by prolonging survival and there are data on its role as an effective tool for the improvement of physical conditions in patients with advanced disease. The results are far from conclusive, and only partially satisfying but they represent a step forward.
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Affiliation(s)
- F Graziano
- Sezione di Oncologia Sperimentale, Azienda Ospedaliera Ospedale S. Salvatore, Pesaro, Italy
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19
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Abstract
Aims and background Until recently radiotherapy of hepatic malignancies has played a limited role due to the well-known limited radiotolerance of the liver. The aim of this paper is to review the available data on the risk of radiation-induced liver disease (RILD) and to define the modern role of radiotherapy in the management of patients with metastatic or primary liver malignancies. Methods The advent of three-dimensional conformal treatment planning with dose-volume histogram analysis has made the study of partial liver irradiation possible. Limited portions of the liver may withstand high doses of radiation with minimal risk of RILD. Patients with solitary unresectable liver tumors may be treated with high-dose radiotherapy with curative intent. Recently, the feasibility of stereotactically guided treatment techniques with a single fraction or few treatment sessions has been explored in numerous institutions. Results The radiation tolerance of the whole liver found by several investigations is in the order of approximately 30 Gy, which seriously restricts its clinical application. The role of whole liver irradiation therefore appears of limited benefit in the palliation of patients with multiple liver metastases. The use of three-dimensional conformal techniques has made partial liver irradiation possible to doses in the 70–80 Gy range with conventional fractionation. At least two published series have reported improved local control and survival rates with dose escalation with three-dimensional conformal radiotherapy in patients with unresectable liver metastases. Similar outcomes have been recently reported with single dose (or hypofractionated) stereotactic radiotherapy both in metastatic and primary hepatic malignancies with minimal morbidity. Accurate target delineation and treatment reproducibility are the key to the success of this novel treatment approach, and specific treatment planning techniques and patient setup procedures must be developed to implement it. Conclusions Stereotactic high-dose radiotherapy is technically feasible for the treatment of inoperable liver malignancies, with the potential of high local control and low morbidity. Definitive evidence on the clinical advantages of this technique over other more established treatments can only be gathered from well-designed clinical studies.
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Affiliation(s)
- Carlo Greco
- Division of Radiation Oncology, European Institute of Oncology, Milan, Italy.
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20
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De Lucia D, De Vita F, Orditura M, Renis V, Belli A, Conte M, di Grazia M, Iacoviello L, Donati MB, Catalano G. Hypercoagulable State in Patients with Advanced Gastrointestinal Cancer: Evidence for an Acquired Resistance to Activated Protein C. Tumori 2018; 83:948-52. [PMID: 9526590 DOI: 10.1177/030089169708300615] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background Thromboembolic complications are common in patients with cancer and represent the second cause of death in patients with overt malignant disease. The aim of this study was to investigate the activated protein C pathway in cancer. Methods We studied the coagulation cascade, natural clotting inhibitors, fibrinolytic proteins and resistance to activated protein C in 20 patients with advanced gastrointestinal cancer and 84 volunteers by measuring PT, APTT, fibrinogen, AT III, PC, PS, APC resistance, fibrinolytic system (PLG, ANPL, PAI-1 and t-PA) and activation peptides (D-Dimers, prothrombin 0 fragment 1+2/F1+2). Results Laboratory tests confirmed coagulation abnormalities in cancer patients. Fibrinogen, D-Dimers and F1+2 were increased, while t-PA activity was significantly lower than that of controls. APC resistance was higher in cancer patients compared to the control group (55% vs 2%; P < 0.0001). Excess thrombin generation was manifested by increased F1+2 plasma levels in APC-resistant cancer patients. Genetic analyses showed that only one patient with a poor response to APC carried a factor V R506Q mutation in exon 10. Conclusions Our findings show a high prevalence of APC resistance in cancer, compatible with an acquired defect in the APC pathway.
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Affiliation(s)
- D De Lucia
- Institute of General Pathology and Oncology, II University of Naples, Italy
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21
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Graziano F, Cardarelli N, Marcellini M, Menichetti ET, Catalano G, Cascinu S. A Pilot Clinical Trial of Postoperative Intensive Weekly Chemotherapy Using Cisplatin, Epi-Doxorubicin, 5-Fluorouracil, 6S-Leucovorin, Glutathione and Filgrastim in Patients with Resected Gastric Cancer. Tumori 2018; 84:368-71. [PMID: 9678619 DOI: 10.1177/030089169808400311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background The study was performed to assess the feasibility and activity of an intensive chemotherapeutic regimen as adjuvant treatment for patients with resected gastric cancer at high risk of recurrence (PT2N1-2; pT3-4Nany M0). Patients and methods Starting 21 to 28 days after potentially curative surgery for primary gastric cancer, 25 patients received 8 weekly cycles of cisplatin 40 mg/m2, 5-fluorouracil 500 mg/m2, epidoxorubicin 35 mg/m2, 6S-stereoisomer of leucovorin at a dose of 250 mg/m2, and glutathione at a dose of 1.5 g/m2. From the day after to the day before each cycle of chemotherapy, filgrastim was administered by subcutaneous injection at a dose of 5 μg/kg. Results After a median follow-up of 33 months, 80% of the patients were alive and disease-free. Five patients had relapsed: three in the liver, one in the peritoneum and one in the lymph nodes. Toxicity was mild: five patients experienced WHO grade III toxicity (three leukopenia, two thrombocytopenia); no toxic deaths occurred. Conclusion Intensive weekly chemotherapy is a feasible postoperative treatment option for patients with resected gastric cancer at high risk of relapse. These data, together with recent results in advanced disease, make this approach of interest for the development of new programs of adjuvant therapy in this setting.
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Affiliation(s)
- F Graziano
- Section of Experimental Oncology, Ospedale S. Salvatore, Pesaro, Italy
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22
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Cascinu S, Valentini G, Catalano G. A Pilot Clinical Trial of Postoperative Adjuvant Intraperitoneal Cisplatin, 5-Fluorouracil, 6S-Leucovorin and Interferon Alpha 2b in Patients with Resected Gastric Cancer. Tumori 2018; 79:331-5. [PMID: 8116076 DOI: 10.1177/030089169307900509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background The study was performed to assess the toxicity and impact on relapse pattern of postoperative intraperitoneal cisplatin, 5-fluorouracil, leucovorin and interferon therapy as adjuvant treatment for gastric cancer patients who are at high risk for recurrence after potentially curative resection (T2 N1-2; T3-4 N any Mo). Patients and Methods Starting 14 to 21 days after potentially curative resection of primary gastric cancers, 22 patients were given intraperitoneal cisplatin, 60 mg/m2; 5-fluorouracil, 1000 mg/m2; 6S-leucovorin, 250 mg/m2; interferon alpha 2b, 10 MU/m2; every other week for six times. Results After a median follow-up of 24 months, 63 % of patients were alive and free of disease. Eight patients had recurred; five had an intraabdominal component, and 3 had extraabdominal failure. Toxicity was mild: no grade III-IV WHO toxicity was observed. Conclusions Intraperitoneal cisplatin, 5-fluorouracil, 6S-leucovorin and interferon is a tolerable therapy in the postoperative setting for patients with resected gastric cancer. These data make this approach interesting for the development of new programs of adjuvant therapy of high-risk gastric cancer.
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Affiliation(s)
- S Cascinu
- Servizio di Oncologia, Ospedali Riuniti, Pesaro, Italy
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23
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De Vita F, Turitto G, di Grazia M, Frattolillo A, Catalano G. Analysis of Interleukin-2/Interleukin-2 Receptor System in Advanced Non-Small-Cell Lung Cancer. Tumori 2018; 84:33-8. [PMID: 9619711 DOI: 10.1177/030089169808400107] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background The purpose of the study was to investigate the IL-2/IL-2 receptor system in patients with advanced non-small-cell lung cancer (NSCLC). Patients and methods Sera from 40 subjects and 80 patients with stage III and IV NSCLC were assayed for soluble interleukin-2 receptor (sIL-2R) and interleukin-2 (IL-2) by the enzyme-linked immunosorbent assay. Circulating CD25+ cells were analyzed by flow cytoflorimetry. The data were related to clinical status by comparing the levels of slL-2R and IL-2 at diagnosis and during the treatment. Results The mean slL-2R concentrations of the NSCLC patients were significantly higher than the control population (P=0.0001); the patients with metastatic disease had significantly higher levels than those with locally advanced disease (P=0.02). No correlation was seen between circulating CD25+ cells and slL-2R levels. Disease progression was associated with an increase in slL-2R levels and a decline in IL-2; the sIL-2R/IL-2 ratio showed a gradual increase with tumor progression. Conclusions Our study demonstrates in a large series of patients that in advanced NSCLC there is an imbalance of the IL-2/IL-2 receptor system. Furthermore, circulating slL-2R levels and the sIL-2R/IL-2 ratio may be useful as markers of disease activity and treatment response, suggesting a potential prognostic value.
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Affiliation(s)
- F De Vita
- Department of Internal and Experimental Medicine F. Magrassi, II University of Naples, Italy
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24
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Cascinu S, Isidori PP, Fedeli A, Fedeli SL, Raspugli M, Rossi A, Ugolini M, Catalano G. Experience with Intrapleural Natural Beta Interferon in the Treatment of Malignant Pleural Effusions. Tumori 2018; 77:237-8. [PMID: 1862552 DOI: 10.1177/030089169107700310] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Malignant pleural effusion is a common complication of cancer. Intrapleural beta interferon has been recently tested, and responses were obtained in about 1/3 of the patients without considerable side effects. We treated 22 patients with recurrent symptomatic malignant pleural effusions with intrapleural beta interferon at increasing doses (5–15 million units) for a maximum of three courses and obtained only two responses. In our opinion, this schedule cannot be recommended for routine use.
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Affiliation(s)
- S Cascinu
- Servizio di Oncologia, Ospedali Riuniti, Pesaro, Italy
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25
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Abstract
We describe a case of a 50 year old woman with a secondary involvement of the stomach from breast carcinoma. She complained of nausea, vomiting and epigastric pain resistant to gastroprotective drugs. Initially symptoms were attributed to the side effects of chemotherapeutic agents. Correct diagnosis led to effective treatment of gastrointestinal symptoms with consequent improvement in her quality of life.
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Affiliation(s)
- S Cascinu
- Servizio di Oncologia, Ospedali Riuniti Pesaro, Italy
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26
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Cascinu S, Catalano G. Intensive Weekly Chemotherapy for Elderly Gastric Cancer Patients, Using 5-Fluorouracil, Cisplatin, Epi-Doxorubicin, 6S-Leucovorin and Glutathione with the Support of G-CSF. Tumori 2018; 81:32-5. [PMID: 7538704 DOI: 10.1177/030089169508100107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Elderly patients constitute the largest group of advanced gastric cancer patients. Since there is a widespread misconception that the elderly are poorly tolerant of chemotherapy, most of them are untreated or receive a less aggressive but also less efficacious chemotherapy. However, because tolerance and response to cancer seem to vary more with physiologic age than chronologic age, we evaluated the feasibility and activity of an intensive weekly chemotherapy in elderly gastric cancer patients. Methods 23 advanced gastric cancer patients (13 males and 10 females), older than 70 years, received weekly: cisplatin, 40 mg/m2 iv; epi-doxorubicin, 35 mg/m2 iv; 6S-leucovorin, 250 mg/m2 iv; 5-fluorouracil, 500 mg/m2 iv; and glutathione, 1.5 g/m2 G-CSF, at the dose of 5 μg/kg, was administered daily from the day after to the day before each chemotherapy administration. Results Toxicity was mild. The most common adverse effects were leukopenia (grade 3 in 2 patients); thrombocytopenia (grade 3 in 1 patient) and anemia (grade 3 in 3 patients). Five patients (20%) achieved a complete response and 9 (39%) a partial response, resulting in an overall response rate of 59% (95% CI, 40% to 78%). The median survival time was 13 months for all the patients and 15 months for patients with objective responses. Conclusions This regimen appears feasible also in elderly gastric cancer patients and, because of its activity, suitable for further studies.
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Affiliation(s)
- S Cascinu
- Servizio di Oncologia Medica, Ospedali Riuniti, Pesaro, Italy
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27
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Micheletti E, La Face B, Huscher A, Catalano G, Ambrosi E, Marini G, Simoncini E. Postmastectomy Radiotherapy and Concomitant Adjuvant Chemotherapy Versus Adjuvant Chemotherapy Alone in Premenopausal Breast Cancer Patients with Positive Axillary Nodes. Tumori 2018; 84:652-8. [PMID: 10080670 DOI: 10.1177/030089169808400607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS To evaluate the efficacy of postmastectomy radiotherapy (RT) combined with adjuvant chemotherapy compared to adjuvant chemotherapy alone as regards overall survival (OS), overall disease-free survival (ODFS), local disease-free survival (LDFS) and distant disease-free survival (DDFS). METHODS We reviewed retrospectively two non-randomized groups of premenopausal high-risk breast cancer patients treated from 1985 to 1990 in the following Institutions: Department of Radiation Oncology of Brescia University, "Istituto del Radio O. Alberti" (IRA), and Department of Oncology of Brescia Hospital "Beretta Foundation" (BF). A total of 163 patients was found to satisfy the criteria of the current analysis: 81 patients received adjuvant chemotherapy alone [6 cycles CMF(1-8)] at BF and 82 patients received postoperative radiotherapy and chemotherapy [8 cycles CMF(1-21)] at IRA. A modified CMF schedule was chosen at IRA to avoid the feared increase in toxicity due to the association with RT. Primary surgical treatment was modified radical mastectomy with axillary node dissection in both cases. RESULTS A statistically significant improvement in OS was found in systemic adjuvant therapy patients compared to those also given RT (77.6% vs 59%; P = 0.0025). No statistically significant improvement in ODFS was found in the CMF(1-8) arm compared to the RT and CMF(1-21) stm: 51.6% vs 43.6%; P = 0.46. A statistically significant improvement in LDFS at 5 years was found in irradiated patients (89.3% vs 76.2%; P <0.05). The DDFS was also improved, although without evidence of statistical significance, in the CMF(1-8) group: at 5 years 65% vs 44% (P = 0.059). CONCLUSIONS The study confirmed that RT reduces the risk of local recurrence but without a statistically significant reduction in mortality. The lack of a survival benefit may somehow reflect the dose reduction in CMF(1-21). The evidence that CMF(1-8) offers undoubtable advantages over the CMF(1-21) regimen in OS and, perhaps, in distant control suggests that the dose intensity of CMF in this setting may also be important. In fact, although many CMF(1-8) patients received a dose intensity lower than 100%, 95% of them received a dose intensity higher than the maximum one of the CMF(1-21) patients. Although our results should be interpreted with caution, they seem to provide further rationale for testing the association of postoperative radiotherapy and the CMF(1-8) regimen in stage II breast cancer with positive nodes and treated with demolitive surgery, as already done in the conservative management of breast cancer, also in view of the new support therapies now available (i.e. hematologic growth factors).
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Affiliation(s)
- E Micheletti
- Department of Radiation Oncology of Brescia University Istituto del Radio O. Alberti, Italy
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28
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De Cicco L, Vavassori A, Jereczek-Fossa BA, Pruneri G, Catalano G, Ferrari AM, Orecchia R. Lymph Node Metastases of Merkel Cell Carcinoma from Unknown Primary Site: Report of Three Cases. Tumori 2018; 94:758-61. [DOI: 10.1177/030089160809400522] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Merkel cell carcinoma (MCC) is an uncommon aggressive neuroendocrine skin carcinoma. It usually affects sun-exposed skin of white elderly people. MCC is characterized by a high incidence of early locoregional relapse and distant metastases. Because of its rarity and the resulting lack of prospective randomized trials, data regarding the optimal treatment of MCC are limited. Despite aggressive multimodality treatment, the prognosis of patients bearing MCC is often poor. We report three cases of lymph node metastases of MCC with unknown primary sites. Two patients died 17 and 28 months after diagnosis due to brain and pancreatic metastases, respectively, without evidence of cutaneous disease. The third patient is alive and free of tumor at 16 months from the diagnosis. After an accurate diagnosis of lymph node metastases from MCC, the absence of a primary tumor at complete initial evaluation and during adequate follow-up can confirm this particular clinical scenario. The prognosis seems to be analogous to that of cases with similar disease stage (lymph node involvement) but a known primary site.
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Affiliation(s)
- Luigi De Cicco
- Division of Radiotherapy, European Institute of Oncology, Milan, Italy
- Department of Diagnostic Imaging and Radiation, Federico II University of Naples, Naples, Italy
| | - Andrea Vavassori
- Division of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - Barbara A Jereczek-Fossa
- Division of Radiotherapy, European Institute of Oncology, Milan, Italy
- Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Giancarlo Pruneri
- Faculty of Medicine and Surgery, University of Milan, Milan, Italy
- Division of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy
| | | | | | - Roberto Orecchia
- Division of Radiotherapy, European Institute of Oncology, Milan, Italy
- Faculty of Medicine and Surgery, University of Milan, Milan, Italy
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29
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van Dam P, Tomatis M, Marotti L, Heil J, Mansel R, Rosselli del Turco M, van Dam P, Casella D, Bassani L, Danei M, Denk A, Egle D, Emons G, Friedrichs K, Harbeck N, Kiechle M, Kimmig R, Koehler U, Kuemmel S, Maass N, Mayr C, Prové A, Rageth C, Regolo L, Lorenz-Salehi F, Sarlos D, Singer C, Sohn C, Staelens G, Tinterri C, Audisio R, Ponti A, Badbanchi F, Catalano G, Cretella E, Daniaux M, Emons A, van Eygen K, Ettl J, Gatzemeier W, Kern P, Schneeweiss A, Stoeblen F, Van As A, Wuerstlein R, Zanini V. Time trends (2006–2015) of quality indicators in EUSOMA-certified breast centres. Eur J Cancer 2017; 85:15-22. [DOI: 10.1016/j.ejca.2017.07.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/31/2017] [Accepted: 07/25/2017] [Indexed: 12/21/2022]
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30
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Mazzoni A, Giampietro C, Bianco I, Grazzini T, Nencini C, Pileggi C, Scatena F, Filipponi F, Ghinolfi D, Catalano G, Biancofiore G, Bindi M, Urbani L. Extracorporeal photopheresis and liver transplantation: Our experience and preliminary data. Transfus Apher Sci 2017; 56:515-519. [DOI: 10.1016/j.transci.2017.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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31
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Leonardi M, Ivaldi G, Alessandro M, Catalano G, Ciabattoni A, Fillini C, Guenzi M, Tomio L, Rojas D, Augugliaro M, Fodor C, Sangalli C, Rossetto F, Jereczek-Fossa B, Orecchia R, AIRO IORT Working Group. PO-0661: Intraoperative partial breast re-irradiation: a multicenter study of the AIRO IORT Working Group. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31098-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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32
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Leonardi M, Tomio L, Ivaldi G, Catalano G, Alessandro M, Fillini C, Ciabattoni A, Guenzi M, Francia C, Fodor C, Rossetto F, Jereczek-Fossa B, Orecchia R, AIRO IORT Working Group. PV-0237: Management and outcome of local failure after intraoperative partial breast irradiation. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30680-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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33
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Krengli M, Calvo F, Sedlmayer F, Schumacher C, Cazzaniga F, Alessandro M, De Paoli A, Russi E, Kruszyna M, Corvò R, Wenz F, Mazzarotto R, Fusconi F, Ciabattoni A, Weytjens R, Ivaldi G, Baldissera A, Pisani C, Morillo V, Osti M, Bese N, Catalano G, Stefanelli A, Iotti C, Tomio L. PO-0754: ISIORT pooled analysis 2016: characteristics of intraoperative radiotherapy in 11,025 patients. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31191-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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34
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Catalano G, Tandoi F, Mazza E, Simonato F, Tognarelli G, Biancone L, Lupo F, Romagnoli R, Salizzoni M. Simultaneous Liver-Kidney Transplantation in Adults: A Single-center Experience Comparing Results With Isolated Liver Transplantation. Transplant Proc 2016; 47:2156-8. [PMID: 26361666 DOI: 10.1016/j.transproceed.2014.11.073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 11/08/2014] [Accepted: 11/19/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND After introduction of the Model for End-Stage Liver Disease (MELD) score in 2002, a worldwide increasing number of simultaneous liver-kidney transplantations (SLKTx) has been observed. However, organ shortage puts into question the allocation of 2 grafts to 1 recipient. This retrospective, single-center study compared SLKTx results with isolated liver transplantation (LTx). METHODS Between 1995 and 2013, 37 SLKTx were performed in adult recipients. Every SLKTx was matched by donor age (±5 years) and transplantation date with 2 LTx (n = 74). Pretransplant, intraoperative, and post-transplant variables were collected; liver graft and patient survivals were calculated. RESULTS As expected, donor age was similar in the 2 groups (median, 39.7 years), whereas serum creatinine level, glomerular filtration rate, and MELD and D-MELD (donor age*MELD) scores were significantly higher in the SLKTx group. SLKTx had longer waiting list time (P = .0034) as well as higher surgical difficulty, testified by more blood transfusions (P = .0083), increased use of classic caval reconstruction (P = .0024), and more frequent need of abdominal packing for bleeding control (P = .0003). In addition, duration of hospital stay (P < .0001), second-look surgery (P = .0082), post-transplant dialysis (P < .0001), and post-transplant infections (P = .04) were significantly greater in SLKTx group. Acute rejection episodes involving the liver were significantly less in SLKTx than in LTx (14% vs 41%; P = .0045). Liver graft and patient survival at 10 years after transplantation was similar in the 2 groups (liver graft: SLKTx, 80% vs LTx, 77% [P = .85]; patient: SLKTx, 86% vs LTx, 79% [P = .56]). CONCLUSIONS Despite being technically challenging, SLKTx provided excellent long-term results and was shown to be an effective use of liver grafts.
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Affiliation(s)
- G Catalano
- Liver Transplant Center and General Surgery, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy.
| | - F Tandoi
- Liver Transplant Center and General Surgery, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - E Mazza
- Liver Transplant Center and General Surgery, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - F Simonato
- Kidney Transplant Center and Nephrology, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - G Tognarelli
- Kidney Transplant Center and Nephrology, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - L Biancone
- Kidney Transplant Center and Nephrology, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - F Lupo
- Liver Transplant Center and General Surgery, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - R Romagnoli
- Liver Transplant Center and General Surgery, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - M Salizzoni
- Liver Transplant Center and General Surgery, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
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35
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Marselli L, De Simone P, Morganti R, Coletti L, Carrai P, Catalano G, Tincani G, Ghinolfi D, Occhipinti M, Filipponi F, Marchetti P. Frequency and characteristics of diabetes in 300 pre-liver transplant patients. Nutr Metab Cardiovasc Dis 2016; 26:441-442. [PMID: 27089979 DOI: 10.1016/j.numecd.2016.02.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/24/2016] [Accepted: 02/26/2016] [Indexed: 11/16/2022]
Affiliation(s)
- L Marselli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - P De Simone
- Department of Oncology, Transplants and Advances in Medicine, University of Pisa, Pisa, Italy
| | - R Morganti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Coletti
- Department of Oncology, Transplants and Advances in Medicine, University of Pisa, Pisa, Italy
| | - P Carrai
- Department of Oncology, Transplants and Advances in Medicine, University of Pisa, Pisa, Italy
| | - G Catalano
- Department of Oncology, Transplants and Advances in Medicine, University of Pisa, Pisa, Italy
| | - G Tincani
- Department of Oncology, Transplants and Advances in Medicine, University of Pisa, Pisa, Italy
| | - D Ghinolfi
- Department of Oncology, Transplants and Advances in Medicine, University of Pisa, Pisa, Italy
| | - M Occhipinti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - F Filipponi
- Department of Oncology, Transplants and Advances in Medicine, University of Pisa, Pisa, Italy
| | - P Marchetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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van Dam P, Tomatis M, Marotti L, Heil J, Wilson R, Rosselli del Turco M, Mayr C, Costa A, Danei M, Denk A, Emons G, Friedrichs K, Harbeck N, Kiechle M, Koheler U, Kuemmel S, Maass N, Marth C, Prové A, Kimmig R, Rageth C, Regolo L, Salehi L, Sarlos D, Singer C, Sohn C, Staelens G, Tinterri C, Ponti A, Cretella E, Kern P, Stoeblen F, Emons A, van Eygen K, Ettl J, Zanini V, Van As A, Daniaux M, Gatzemeier W, Catalano G, Schneeweiss A, Wuerstlein R. The effect of EUSOMA certification on quality of breast cancer care. Eur J Surg Oncol 2015; 41:1423-9. [DOI: 10.1016/j.ejso.2015.06.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/04/2015] [Accepted: 06/12/2015] [Indexed: 12/12/2022] Open
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Krengli M, Sedlmayer F, Calvo F, Wenz F, Alessandro M, Mazzarotto R, Corvò R, Adamczyk S, Fillini C, Fusconi F, Osti M, Tomio L, Azinovic I, Ciabattoni A, Polkowski W, Di Grazia A, Gava A, Abdach L, Iotti C, Dubois J, Catalano G, Cazzaniga F, Schumacher C, Weytjens R, Pisani C. OC-0473: Intraoperative radiotherapy (IORT) in breast cancer: analysis of 6,816 cases from ISIORT database. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40468-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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De Simone P, Precisi A, Petruccelli S, Balzano E, Carrai P, Catalano G, Campani D, Filipponi F. The impact of everolimus on renal function in maintenance liver transplantation. Transplant Proc 2014; 41:1300-2. [PMID: 19460545 DOI: 10.1016/j.transproceed.2009.03.051] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We retrospectively investigated the impact on renal function (RF) of conversion from calcineurin inhibitors (CNI) to everolimus (EVL) monotherapy in orthotopic liver transplant (OLT) recipients. Between January 2006 and July 2007, 70 deceased donor OLT recipients including 51 men and 19 women of overall mean age of 55.9 +/- 11 years were enrolled into a program of conversion to EVL monotherapy at a mean interval of 45 +/- 35.9 months from transplantation (range, 7-192 months). The indication for conversion was deteriorating RF in 64 (91.4%). Efficacy failure was defined as the persistence of CNI, EVL discontinuation, death, graft loss, loss to follow-up, or need for dialysis at 12 months. Twelve months after switching, 53 patients (75.7%) were on EVL monotherapy. Their mean change in creatinine clearance (CrCl) from baseline (day 1 before EVL introduction) to endpoint (12 months) was 5.8 +/- 13.1 mL/min. On univariate and multivariate analyses, the clinical variable correlated with the greatest probability of improvement was the baseline CrCl (P < .0001). Conversion from CNI to EVL monotherapy was successful in 75.7% of cases with improvement in RF correlated with baseline CrCl. These data supported preemptive minimization of CNI in the posttransplant course, seeking to delay the decline in RF.
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Affiliation(s)
- P De Simone
- Unità Operativa Chirurgia Generale e Trapianti di Fegato, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
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Jereczek-Fossa BA, Piperno G, Ronchi S, Catalano G, Fodor C, Cambria R, Fossati Ing P, Gherardi F, Alterio D, Zerini D, Garibaldi C, Baroni G, De Cobelli O, Orecchia R. Linac-based stereotactic body radiotherapy for oligometastatic patients with single abdominal lymph node recurrent cancer. Am J Clin Oncol 2014; 37:227-33. [PMID: 22992626 DOI: 10.1097/coc.0b013e3182610878] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate stereotactic body radiotherapy (SBRT) for single abdominal lymph node cancer recurrence. METHODS Inclusion criteria for this retrospective study were as follows: adult oligometastatic cancer patients with single abdominal lymph node recurrence that underwent SBRT but not other local therapy, written informed consent for treatment. Previous radiotherapy or concomitant systemic therapy were allowed. Toxicity and tumor response were evaluated using Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Scale and Response Evaluation Criteria in Solid Tumors. RESULTS Sixty-nine patients (94 lesions) underwent SBRT (median 24 Gy/3 fractions). Primary diagnosis included urological, gastrointestinal, gynecologic, and other malignancies. Concomitant systemic therapy was performed in 35 cases. Median follow-up was 20 months. Two grade 3 acute and 1 grade 4 late toxicity events were registered. Complete radiologic response, partial response, stabilization, and progressive disease were observed in 36 (44%), 21 (26%), 20 (25%), and 4 (5%) lesions, respectively, out of 81 evaluable lesions. Response rates were similar when analysis was restricted to lesions treated with exclusive SBRT (no concomitant therapy). Actuarial 3-year in-field progression-free interval, progression-free survival and overall-survival rates were 64.3%, 11.7%, and 49.9%, respectively. Overall-survival rates were significantly higher in favorable histology cases (prostate and kidney tumors). Pattern of failure was predominantly out-field. CONCLUSIONS SBRT is a feasible approach for single abdominal lymph node recurrence, offering excellent in-field tumor control with low-toxicity profile. Future studies are warranted to identify the patients that benefit most from this treatment. The optimal combination with systemic treatment should also be defined.
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Affiliation(s)
- Barbara A Jereczek-Fossa
- Departments of *Radiotherapy §Medical Physics #Urology, European Institute of Oncology ∥CNAO Foundation, National Center for Oncological Hadrontherapy †University of Milan ¶Department of Bioengineering, Politecnico di Milano, Milan ‡Division of Radiotherapy, IRCCS Multimedia. Sesto S. Giovanni and Multimedica Holding, Castellanza, Italy
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Ghinolfi D, Marti J, De Simone P, Lai Q, Pezzati D, Coletti L, Tartaglia D, Catalano G, Tincani G, Carrai P, Campani D, Miccoli M, Biancofiore G, Filipponi F. Use of octogenarian donors for liver transplantation: a survival analysis. Am J Transplant 2014; 14:2062-71. [PMID: 25307037 DOI: 10.1111/ajt.12843] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 01/25/2023]
Abstract
Use of very old donors in liver transplantation (LT) is controversial because advanced donor age is associated with a higher risk for graft dysfunction and worse long-term results, especially for hepatitis C virus (HCV)-positive recipients. This was a retrospective, single-center review of primary, ABO-compatible LT performed between 2001 and 2010. Recipients were stratified in four groups based on donor age (<60 years; 60-69 years; 70-79 years and ≥80 years) and their outcomes were compared. A total of 842 patients were included: 348 (41.3%) with donors <60 years; 176 (20.9%) with donors 60-69 years; 233 (27.7%) with donors 70-79 years and 85 (10.1%) with donors ≥80 years. There was no difference across groups in terms of early (≤30 days) graft loss, and graft survival at 1 and 5 years was 90.5% and 78.6% for grafts <60 years; 88.6% and 81.3% for grafts 60-69 years; 87.6% and 75.1% for grafts 70-79 years and 84.7% and 77.1% for grafts ≥80 years (p = 0.065). In the group ≥80 years, the 5-year graft survival was lower for HCV-positive versus HCV-negative recipients (62.4% vs. 85.6%, p = 0.034). Based on our experience, grafts from donors ≥80 years may provide favorable results but require appropriate selection and allocation policies.
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Affiliation(s)
- D Ghinolfi
- Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
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Steiling W, Bascompta M, Carthew P, Catalano G, Corea N, D’Haese A, Jackson P, Kromidas L, Meurice P, Rothe H, Singal M. Principle considerations for the risk assessment of sprayed consumer products. Toxicol Lett 2014; 227:41-9. [DOI: 10.1016/j.toxlet.2014.03.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 03/10/2014] [Accepted: 03/11/2014] [Indexed: 11/24/2022]
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Tascini C, Urbani L, Doria R, Catalano G, Leonildi A, Filipponi F, Menichetti F. BreakthroughFusariumspp Fungemia During Caspofungin Therapy in an ABO-Incompatible Orthotopic Liver Transplant Patient. J Chemother 2013; 21:236-8. [DOI: 10.1179/joc.2009.21.2.236] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Garibaldi C, Catalano G, Baroni G, Tagaste B, Riboldi M, Spadea MF, Ciocca M, Cambria R, Serafini F, Orecchia R. Deep inspiration breath-hold technique guided by an opto- electronic system for extracranial stereotactic treatments. J Appl Clin Med Phys 2013; 14:4087. [PMID: 23835375 PMCID: PMC5714523 DOI: 10.1120/jacmp.v14i4.4087] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [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: 06/15/2012] [Revised: 02/19/2013] [Accepted: 02/13/2013] [Indexed: 11/23/2022] Open
Abstract
The purpose of this work was to evaluate the intrapatient tumor position reproducibility in a deep inspiration breath‐hold (DIBH) technique based on two infrared optical tracking systems, ExacTrac and ELITETM, in stereotactic treatment of lung and liver lesions. After a feasibility study, the technique was applied to 15 patients. Each patient, provided with a real‐time visual feedback of external optical marker displacements, underwent a full DIBH, a free‐breathing (FB), and three consecutive DIBH CT‐scans centered on the lesion to evaluate the tumor position reproducibility. The mean reproducibility of tumor position during repeated DIBH was 0.5±0.3mm in laterolateral (LL), 1.0±0.9mm in anteroposterior (AP), and 1.4±0.9mm in craniocaudal (CC) direction for lung lesions, and 1.0±0.6mm in LL, 1.1±0.5mm in AP, and 1.2±0.4mm in CC direction for liver lesions. Intra‐and interbreath‐hold reproducibility during treatment, as determined by optical markers displacements, was below 1 mm and 3 mm, respectively, in all directions for all patients. Optically‐guided DIBH technique provides a simple noninvasive method to minimize breathing motion for collaborative patients. For each patient, it is important to ensure that the tumor position is reproducible with respect to the external markers configuration. PACS numbers: 87.53.Ly, 87.55.km
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Niscola P, Tendas A, Fratoni S, Giovannini M, Scaramucci L, Catalano G, De Fabritiis P. P-045 Chronic myelomonocytic leukemia evolved from refractory anemia: The unusual course of a myelodysplastic syndrome. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70094-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Niscola P, Tendas A, Palombi M, Trawinska M, Cupelli L, Giovannini M, Scaramucci L, Catalano G, Perrotti A, De Fabritiis P. P-176 Hypomethylating therapy in the management of an old older patient with myelodysplastic syndrome followed in a home care program. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70224-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Niscola P, Tendas A, Catalano G, Fratoni S, Piccioni D, Giovannini M, Perrotti A, De Fabritiis P. P-046 Atypical myelodysplastic/myeloproliferative neoplasm rapidly transformed to chronic myelomonocytic leukemia and acute myeloid leukemia in a laryngeal cancer patients. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70095-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Niscola P, Tendas A, Catalano G, Fratoni S, Piccioni D, Giovannini M, Perrotti A, De Fabritiis P. P-271 Atypical myelodysplastic/myeloproliferative neoplasm rapidly transformed to chronic myelomonocytic leukemia and acute myeloid leukemia in a laryngeal cancer patients. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70318-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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48
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Niscola P, Tendas A, Fratoni S, Giovannini M, Scaramucci L, Catalano G, De Fabritiis P. P-270 Chronic myelomonocytic leukemia evolved from refractory anemia: The unusual course of a myelodysplastic syndrome. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70317-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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49
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Tendas A, Cupelli L, Giovannini M, Catalano G, Scaramucci L, Perrotti A, Niscola P, De fabritiis P. P-166 Disability and disease burden in outpatient myelodisplastic syndromes. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70214-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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50
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Niscola P, Tendas A, Giovannini M, Scaramucci L, Cupelli L, Piccioni D, Catalano G, Perrotti A, De Fabritiis P. P-177 Long-lasting erythroid response after discontinuation of human recombinant erythropoietin in MDS patients: Report of three cases. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70225-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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