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Guckenberger M, Andratschke N, Belka C, Bellut D, Cuccia F, Dahele M, Guninski RS, Josipovic M, Mancosu P, Minniti G, Niyazi M, Ricardi U, Munck Af Rosenschold P, Sahgal A, Tsang Y, Verbakel W, Alongi F. ESTRO clinical practice guideline: Stereotactic body radiotherapy for spine metastases. Radiother Oncol 2024; 190:109966. [PMID: 37925107 DOI: 10.1016/j.radonc.2023.109966] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/18/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND AND PURPOSE Recent progress in diagnostics and treatment of metastatic cancer patients have improved survival substantially. These developments also affect local therapies, with treatment aims shifting from short-term palliation to long-term symptom or disease control. There is consequently a need to better define the value of stereotactic body radiotherapy (SBRT) for the treatment of spinal metastases. METHODS This ESTRO clinical practice guideline is based on a systematic literature review conducted according to PRISMA standards, which formed the basis for answering four key questions about the indication and practice of SBRT for spine metastases. RESULTS The analysis of the key questions based on current evidence yielded 22 recommendations and 5 statements with varying levels of endorsement, all achieving a consensus among experts of at least 75%. In the majority, the level of evidence supporting the recommendations and statements was moderate or expert opinion, only, indicating that spine SBRT is still an evolving field of clinical research. Recommendations were established concerning the selection of appropriate patients with painful spine metastases and oligometastatic disease. Recommendations about the practice of spinal SBRT covered technical planning aspects including dose and fractionation, patient positioning, immobilization and image-guided SBRT delivery. Finally, recommendations were developed regarding quality assurance protocols, including description of potential SBRT-related toxicity and risk mitigation strategies. CONCLUSIONS This ESTRO clinical practice guideline provides evidence-based recommendations and statements regarding the selection of patients with spinal metastases for SBRT and its safe implementation and practice. Enrollment of patients into well-designed prospective clinical trials addressing clinically relevant questions is considered important.
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Affiliation(s)
- M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - N Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - C Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany; German Cancer Consortium (DKTK), partner site Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - D Bellut
- University Hospital Zurich, University of Zurich, Department of Neurosurgery, Zurich, Switzerland
| | - F Cuccia
- ARNAS Civico Hospital, Radiation Oncology Unit, Palermo, Italy
| | - M Dahele
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Radiation Oncology and Cancer Center Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands
| | - R S Guninski
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - M Josipovic
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9 2100, Copenhagen, Denmark; Department of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B 2200, Copenhagen, Denmark
| | - P Mancosu
- IRCCS Humanitas Research Hospital, Medical Physics Unit, Radiation Oncology department, via Manzoni 56 I-20089, Rozzano, Milan, Italy
| | - G Minniti
- Department of Radiological Sciences, Oncology and Anatomical Pathology Sapienza University of Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | - M Niyazi
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
| | - U Ricardi
- University of Turin, Department of Oncology, Turin, Italy
| | | | - A Sahgal
- Odette Cancer Center of the Sunnybrook Health Sciences Center, Department of Radiation Oncology, Toronto, Canada
| | - Y Tsang
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Canada
| | - Wfar Verbakel
- Amsterdam University Medical Center, Department of Radiation Oncology, Amsterdam, the Netherlands
| | - F Alongi
- Advanced Radiation Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar-Verona, Italy; University of Brescia, Italy
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2
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Guninski RS, Cuccia F, Alongi F, Andratschke N, Belka C, Bellut D, Dahele M, Josipovic M, Kroese TE, Mancosu P, Minniti G, Niyazi M, Ricardi U, Munck Af Rosenschold P, Sahgal A, Tsang Y, Verbakel WFAR, Guckenberger M. Efficacy and safety of SBRT for spine metastases: A systematic review and meta-analysis for preparation of an ESTRO practice guideline. Radiother Oncol 2024; 190:109969. [PMID: 37922993 DOI: 10.1016/j.radonc.2023.109969] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND AND PURPOSE Advances in characterizing cancer biology and the growing availability of novel targeted agents and immune therapeutics have significantly changed the prognosis of many patients with metastatic disease. Palliative radiotherapy needs to adapt to these developments. In this study, we summarize the available evidence for stereotactic body radiotherapy (SBRT) in the treatment of spinal metastases. MATERIALS AND METHODS A systematic review and meta-analysis was performed using PRISMA methodology, including publications from January 2005 to September 2021, with the exception of the randomized phase III trial RTOG-0631 which was added in April 2023. Re-irradiation was excluded. For meta-analysis, a random-effects model was used to pool the data. Heterogeneity was assessed with the I2-test, assuming substantial and considerable as I2 > 50 % and I2 > 75 %, respectively. A p-value < 0.05 was considered statistically significant. RESULTS A total of 69 studies assessing the outcomes of 7236 metastases in 5736 patients were analyzed. SBRT for spine metastases showed high efficacy, with a pooled overall pain response rate of 83 % (95 % confidence interval [CI] 68 %-94 %), pooled complete pain response of 36 % (95 % CI: 20 %-53 %), and 1-year local control rate of 94 % (95 % CI: 86 %-99 %), although with high levels of heterogeneity among studies (I2 = 93 %, I2 = 86 %, and 86 %, respectively). Furthermore, SBRT was safe, with a pooled vertebral fracture rate of 9 % (95 % CI: 4 %-16 %), pooled radiation induced myelopathy rate of 0 % (95 % CI 0-2 %), and pooled pain flare rate of 6 % (95 % CI: 3 %-17 %), although with mixed levels of heterogeneity among the studies (I2 = 92 %, I2 = 0 %, and 95 %, respectively). Only 1.7 % of vertebral fractures required surgical stabilization. CONCLUSION Spine SBRT is characterized by a favorable efficacy and safety profile, providing durable results for pain control and disease control, which is particularly relevant for oligometastatic patients.
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Affiliation(s)
- R S Guninski
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - F Cuccia
- ARNAS Civico Hospital, Radiation Oncology Unit, Palermo, Italy
| | - F Alongi
- Advanced Radiation Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar-Verona, Italy. University of Brescia, Italy
| | - N Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - C Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany. German Cancer Consortium (DKTK), partner site Munich, Munich, Germany. Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - D Bellut
- University Hospital Zurich, University of Zurich, Department of Neurosurgery. Zurich, Switzerland
| | - M Dahele
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Radiation Oncology and Cancer Center Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands
| | - M Josipovic
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - T E Kroese
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - P Mancosu
- IRCCS Humanitas Research Hospital, Medical Physics Unit, Radiation Oncology department, via Manzoni 56, I-20089 Rozzano, Milan, Italy
| | - G Minniti
- Department of Radiological Sciences, Oncology and Anatomical PathologySapienza University of Rome, Rome; IRCCS Neuromed, Pozzilli, IS, Italy
| | - M Niyazi
- Department of Radiation Oncology, University hospital Tübingen, Tübingen, Germany
| | - U Ricardi
- University of Turin, Department of Oncology, Turin, Italy
| | - P Munck Af Rosenschold
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden; Medical Radiation Physics, Lund University, Lund, Sweden
| | - A Sahgal
- Odette Cancer Center of the Sunnybrook Health Sciences Center, Department of Radiation Oncology, Toronto, Canada
| | - Y Tsang
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Canada
| | - W F A R Verbakel
- Amsterdam University Medical Center, Department of Radiation Oncology, Amsterdam, The Netherlands
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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3
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Le Rhun E, Weller M, van den Bent M, Brandsma D, Furtner J, Rudà R, Schadendorf D, Seoane J, Tonn JC, Wesseling P, Wick W, Minniti G, Peters S, Curigliano G, Preusser M. Leptomeningeal metastasis from solid tumours: EANO-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO Open 2023; 8:101624. [PMID: 37863528 PMCID: PMC10619142 DOI: 10.1016/j.esmoop.2023.101624] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/03/2023] [Accepted: 07/28/2023] [Indexed: 10/22/2023] Open
Abstract
•This Clinical Practice Guideline provides recommendations for managing leptomeningeal metastases from solid tumours. •The guideline covers clinical, imaging and cytological diagnosis, staging and risk assessment, treatment and follow-up. •A treatment and management algorithm is provided. •The author panel encompasses a multidisciplinary group of experts from different institutions and countries in Europe. •Recommendations are based on available scientific data and the authors’ collective expert opinion.
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Affiliation(s)
- E Le Rhun
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland; Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - M Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - M van den Bent
- Department of The Brain Tumour Center at the Erasmus MC Cancer Institute, Rotterdam
| | - D Brandsma
- Department of Neuro-Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J Furtner
- Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - R Rudà
- Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Turin, Italy
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, Essen; University of Duisburg-Essen, Essen; German Cancer Consortium (DKTK), Partner Site Essen, Essen, Germany
| | - J Seoane
- Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona, Institució Catalana de Recerca i Estudis Avançats (ICREA), CIBERONC, Barcelona, Spain
| | - J-C Tonn
- Department of Neurosurgery, Ludwig-Maximilians-University School of Medicine, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - P Wesseling
- Department of Pathology, Amsterdam University Medical Centers/VUmc and Brain Tumour Center, Amsterdam; Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands
| | - W Wick
- Neurology Clinic, Heidelberg University Hospital, Heidelberg; Clinical Cooperation Unit Neuro-Oncology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - G Minniti
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Policlinico Umberto I, Rome; IRCCS Neuromed, Pozzilli IS, Italy
| | - S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University, Lausanne, Switzerland
| | - G Curigliano
- European Institute of Oncology, IRCCS, Milan; Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy
| | - M Preusser
- Division of Oncology, Department of Medicine 1, Medical University, Vienna, Austria
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Desideri I, Scartoni D, Morelli I, Banini M, Visani L, Greto D, Detti B, Perini Z, Zivelonghi E, Bulgarelli G, Pinzi V, Pierina N, Clerici E, Ascolese AM, Anselmo P, Amelio D, Osti MF, Minniti G, Livi L. Clinical Outcomes and Dosimetric Predictive Factors in Patients Undergoing Reirradiation for Recurrent Meningiomas. Int J Radiat Oncol Biol Phys 2023; 117:e106-e107. [PMID: 37784638 DOI: 10.1016/j.ijrobp.2023.06.881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Re-irradiation (reRT) of intracranial meningiomas is often limited by radiation tolerance of the surrounding normal tissue and the risk of side effects. Aim of this retrospective study is to report outcomes, toxicity and prognostic factors of reRT in a large cohort of patients with recurrent meningiomas (RM) treated with different RT techniques. MATERIALS/METHODS A multi-institutional database of intracranial meningioma patients who recurred after prior radiation treatment was collected. Patients underwent reRT with one of the following techniques: radiosurgery (SRS), multi-fraction stereotactic radiotherapy (f-SRT), proton therapy (PT), Intensity-Modulated radiotherapy (IMRT) and External Beam radiotherapy (EBRT). Biologically Equivalent Doses in 2 Gy-fractions (EQD2) and Biological Effective Dose (BED) for surrounding normal tissue and tumor were estimated for each RT course, assuming an a/b = 2 for brain tissue and a/b = 4 for meningioma. Progression-free survival (PFS) was the primary outcome measure. Secondary outcomes were overall survival (OS) and treatment-related toxicity, according to Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0). Kaplan-Meier curves were used to estimate the effect of several parameters on PFS and on OS; Cox regression models assessed predictors of PFS and OS. RESULTS Between 2003 and 2021, 181 patients (pts) were included. They were re-treated with SRS (n = 75; 41.4%), f-SRT (n = 63; 34.8%), PT (n = 31; 17.1%) and conventional radiotherapy (n = 12; 6.7%). 78 pts were identified with WHO Grade I disease, 65 pts with Grade II and 10 pts had Grade III disease. 28 pts without histologic sampling were included among Grade I patients for further analysis. Median age at re-irradiation was 62 (range 20-89) and median KPS 90 (range 60-100). After a median follow-up of 4.6 years (IQR 1.7-6.8), 3-year PFS was 51.6% and 3-year OS 72.5%. At univariate analysis Ki67 >5% (HR 2.81, 95% CI 1.48-5.34, p = 0.002) and WHO grade > I (HR 3.08, 95% CI 1.80-5.28, p< 0.001) were correlated with worse PFS, whereas f-SRT (HR 0.32, 95% CI 0.19-0.55, p<0.001), longer time to reRT (HR 0.37, 95% CI 0.21-0.67, p = 0.001) and higher tumor BED (HR 0.45 95% CI 0.27-0.76, p = 0.003) favorably correlated with PFS. At multivariate Cox analysis only f-SRT, time to reRT and tumor BED kept their statistically significant prognostic impact on PFS (HR 0.36, 95% CI 0.21-0.64, p<0.001; HR 0.38, 95% CI 0.20-0.72, p = 0.003 and HR 0.47 95% CI 0.26-0.83, p = 0.01, respectively). In addition, larger tumor GTV had a statistically significant higher risk of acute and late toxicity (p = .0.004 and p = 0.005, respectively). CONCLUSION Reirradiation of RM progressing after previous RT seems to be feasible, with encouraging outcomes and an acceptable toxicity profile. Prognostic factors in the treatment-algorithm have been identified and should be adopted in clinical daily practice.
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Affiliation(s)
- I Desideri
- Azienda Ospedaliero-Universitaria Careggi, Radiation Oncology Unit, Florence, Italy; Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - D Scartoni
- Proton Therapy Center, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - I Morelli
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - M Banini
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - L Visani
- Azienda Ospedaliero-Universitaria Careggi, Radiation Oncology Unit, Florence, Italy; Istituto Fiorentino di Cura e Assistenza (IFCA), CyberKnife Center, Florence, Italy
| | - D Greto
- Azienda Ospedaliero-Universitaria Careggi, Radiation Oncology Unit, Florence, Italy
| | - B Detti
- Azienda Ospedaliero-Universitaria Careggi, Radiation Oncology Unit, Florence, Italy
| | - Z Perini
- CyberKnife Unit, Ospedale s. Bortolo, Vicenza, Italy
| | - E Zivelonghi
- Unit of Stereotactic Neurosurgery, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy; Physic Department, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy
| | - G Bulgarelli
- Unit of Stereotactic Neurosurgery, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy; Physic Department, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy
| | - V Pinzi
- Radiotherapy Department, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - N Pierina
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy
| | - E Clerici
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy
| | - A M Ascolese
- Radiotherapy Department, St. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - P Anselmo
- Radiotherapy Oncology Centre, Santa Maria Hospital, Terni, Italy
| | - D Amelio
- Proton Therapy Unit, APSS, Trento, Italy
| | - M F Osti
- Radiotherapy Department, St. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - G Minniti
- Radiation Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - L Livi
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
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5
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Minniti G, Giraffa M, Capone L, Raza G, Russo I, Navarria P, Tini P, Romano A, Bozzao A, Paolini S, Esposito V. KS01.5.A Impact of reduced treatment volumes on pattern of tumor recurrence and radiation dose to normal brain parenchyma in glioblastoma. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
to analyze GBM recurrence pattern after standard chemoradiotherapy according to different target volume delineations. We hypothesized that reduced target volume margins may result in similar pattern of failure.
Material and Methods
207 patients with GBM who recurred after standard chemoradiation were evaluated. According to the Advisory Committee for Radiation Oncology Practice (ACROP) committee of the European Organisation for Research and Treatment of Cancer (EORTC) target volume delineation guideline, the clinical target volume (CTV) used for treatment planning consisted of residual tumor and resection cavity plus 2-cm margin. MRI scans showing tumor recurrences were fused with the planning computed tomography (CT), and the patterns of failure were analyzed dosimetrically using dose-volume histograms. The recurrent lesions were defined as in-field, marginal, or distant if >80%, 20-80%, or <20% of the intersecting volume was included in the 95% isodose line. For each patient a theoretical plan consisting of a reduced CTV using 1-cm margin was created and patterns of failure evaluated.
Results
The median overall survival and progression-free survival were 15.3 months and 7.8 months, respectively, from the date of surgery. Recurrences were in-field in 180 patients, marginal in 5 patients, and distant in 22 patients. Analysis of O6-methylguanine-DNA-methyltransferase (MGMT) promoter methylation status showed different recurrence patterns of GBMs in patients with MGMT methylated compared with patients with MGMT unmethylated status. Recurrences occurred in-field and distant in 75.6% and 18.6% of methylated patients and in 91.8% and 6% of unmethylated patients, respectively (p=0.0046). Patterns of failure were similar between the different treatment plans. Reduced target volumes were associated with significantly lower doses of 20-50 Gy to normal brain and hippocampi (p=0.0001).
Conclusion
Most of patients treated with standard chemioradiotherapy have in-field recurrences; however, an increased risk of distant recurrences occurs in methylated tumors. The use of target delineation using 1-cm CTV margin is associated with smaller volumes of normal brain and hippocampi irradiated to high doses, without significant changes in the pattern of failure. The impact of different target delineation in terms of efficacy and risk of late radiation-induced toxicity should be assessed prospectively.
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Affiliation(s)
- G Minniti
- Radiation Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte , Siena , Italy
- IRCCS Neuromed , Pozzilli (IS) , Italy
| | - M Giraffa
- UPMC Hillman Cancer Center San Pietro , Rome , Italy
| | - L Capone
- UPMC Hillman Cancer Center San Pietro , Rome , Italy
| | - G Raza
- UPMC Hillman Cancer Center San Pietro , Rome , Italy
| | - I Russo
- UPMC Hillman Cancer Center Villa Maria , Mirabella Eclano , Italy
| | - P Navarria
- Radiation Oncology Dept., IRCCS Istituto Clinico Humanitas, , Milano (Rozzano) , Italy
| | - P Tini
- Radiation Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte , Siena , Italy
| | - A Romano
- Neuroradiology Unit, Sant'Andrea Hospital , Rome , Italy
| | - A Bozzao
- Neuroradiology Unit, Sant'Andrea Hospital , Rome , Italy
| | - S Paolini
- Division of Neurosurgery, IRCCS Neuromed , Pozzilli (IS) , Italy
| | - V Esposito
- Division of Neurosurgery, IRCCS Neuromed , Pozzilli (IS) , Italy
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6
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Raza G, Minniti G, Trezza A, Capone L, Gentile P. Our first experiences with Hyper Arc and Elements Multi Brain Metastases techniques. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00170-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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7
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Le Rhun E, Guckenberger M, Smits M, Dummer R, Bachelot T, Sahm F, Galldiks N, de Azambuja E, Berghoff AS, Metellus P, Peters S, Hong YK, Winkler F, Schadendorf D, van den Bent M, Seoane J, Stahel R, Minniti G, Wesseling P, Weller M, Preusser M. EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with brain metastasis from solid tumours. Ann Oncol 2021; 32:1332-1347. [PMID: 34364998 DOI: 10.1016/j.annonc.2021.07.016] [Citation(s) in RCA: 199] [Impact Index Per Article: 66.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- E Le Rhun
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland; Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - M Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - R Dummer
- Department of Dermatology, University Hospital and University of Zurich, Zurich, Switzerland
| | - T Bachelot
- Département de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - F Sahm
- Department of Neuropathology, University of Heidelberg and Clinical Cooperation Unit Neuropathology, German Consortium for Transnational Cancer Research (DKTK), German Cancer Research Center (DKFZ) and Hopp Children's Cancer Center, Heidelberg, Germany
| | - N Galldiks
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany; Center of Integrated Oncology (CIO) Aachen, Bonn, Cologne and Duesseldorf, University of Cologne, Cologne, Germany
| | - E de Azambuja
- Medical Oncology Department, Institut Jules Bordet and L'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - A S Berghoff
- Division of Oncology, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
| | - P Metellus
- Ramsay Santé, Hôpital Privé Clairval, Department of Neurosurgery, Marseille; Aix-Marseille University, CNRS, INP, Neurophysiopathology Institute, Marseille, France
| | - S Peters
- Department of Oncology, University Hospital, Lausanne, Switzerland
| | - Y-K Hong
- Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - F Winkler
- Neurology Clinic, Heidelberg University Medical Center, Clinical Cooperation Unit, Neuro-oncology, German Cancer Research Center, Heidelberg, Germany
| | - D Schadendorf
- University Hospital Essen, Department of Dermatology, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site Essen, Essen, Germany
| | - M van den Bent
- The Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - J Seoane
- Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona. Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona; CIBERONC, Madrid, Spain
| | - R Stahel
- Department for Medical Oncology and Hematology, University Hospital Zürich, Zürich, Switzerland
| | - G Minniti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Siena, Italy; IRCCS Neuromed, Pozzilli, Italy
| | - P Wesseling
- Department of Pathology, Amsterdam University Medical Centers/VUmc and Brain Tumour Center, Amsterdam, the Netherlands; Laboratory for Childhood Cancer Pathology, Princess Máxima Center for Paediatric Oncology, Utrecht, the Netherlands
| | - M Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - M Preusser
- Division of Oncology, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
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8
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Minniti G. SP-0026 Primary and repeat radiosurgery for functioning and nonfunctioning pituitary adenoma. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08469-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Osti MF, Agolli L, Valeriani M, Reverberi C, Braccia S, Marinelli L, De Sanctis V, Cortesi E, Martelli M, De Dominicis C, Minniti G, Nicosia L. Erratum to "30 Gy single dose stereotactic body radiation therapy (SBRT): Report on outcome in a large series of patients with lung oligometastatic disease" [Lung Cancer 122 (2018) 165-170]. Lung Cancer 2021; 157:168. [PMID: 34030912 DOI: 10.1016/j.lungcan.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M F Osti
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - L Agolli
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - M Valeriani
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - C Reverberi
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - S Braccia
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - L Marinelli
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - V De Sanctis
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - E Cortesi
- Department of Radiology, Oncology and Human Pathology, Policlinico Umberto I "Sapienza" University of Rome, Italy
| | - M Martelli
- Thoracic Surgery Unit, Carlo Forlanini Hospital, Rome, Italy
| | - C De Dominicis
- Department of Radiology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - G Minniti
- Department of Neurological Sciences, IRCCS Neuromed, Via Atinense, Pozzilli, IS, Italy; UPMC San Pietro FBF, Radiotherapy Center, Rome, Italy.
| | - L Nicosia
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy.
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Capone L, Nardiello B, El Gawhary R, Raza G, Scaringi C, Bianciardi F, Tolu B, Rea F, Gentile P, Paolini S, Minniti G. PO-1873: SIDCA in patients with ≥ 10 brain mets: evaluation of neurological toxicity and treatment accuracy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01891-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Capone L, Nardiello B, El Gawhary R, Raza G, Scaringi C, Bianciardi F, Gentile P, Paolini S, Minniti G. PO-1838: Multiple Brain Mets: impact of patient positioning errors on optimal PTV margin strategy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01856-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Navarria P, Clerici E, Comito T, Cozzi S, Pinzi V, Ciammella P, Scoccianti S, Borzillo V, Anselmo P, Maranzano E, Dell'acqua V, Jereczek-Fossa B, Levra NG, Minniti G, Podlesko A, Giudice E, di Monale e Bastia MB, Pedretti S, Bruni A, Zanetti IB, Borgesi S, Busato F, Scorsetti M. PO-0880: SRS in brain metastases from colorectalcancer. A Radiation Oncology Italian Association study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00897-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Giaj Levra N, Niyazi M, Figlia V, Napoli G, Mazzola R, Nicosia L, Corradini S, Ruggieri R, Minniti G, Alongi F. PO-1256: Feasibility and initial results of Linac-based Stereotactic Body Radiotherapy in spinal metastases. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01274-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Villani V, Fabi A, Gaviani P, Rudà R, Lombardi G, Simonetti G, Silvani A, Pronello E, Minniti G, Pace A. P14.83 Adjuvant chemotherapy after severe myelotoxicity during temozolomide chemoradiation in gliomas. It is feasibile? The talian Multicentric Study (AINO). Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.318] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
Malignant gliomas are aggressive primitive brain tumor in adults. Today, the standard of care is Temozolomide (TMZ) administered daily with radiation therapy, followed by adjuvant TMZ. TMZ treatment has been considered to have a low toxicity profile. However, during concomitant treatment some patient may develop a severe myelosuppression. This toxicity may be in some cases prolonged and lead to treatment discontinuation.
MATERIAL AND METHODS
We have retrospectively collected data from 5 italian neuro-oncological centers, about glioma patients who developed severe and prolonged hematological toxicity during concomitant chemoradiotherapy with TMZ. The purpouse of this study is to evaluate: percentage of patients receiving adjuvant chemotherapy after severe myelotoxicity; rate of toxicity observed during adjuvant chemotherapy.
RESULTS
54 glioma patients who developed myelosuppression of grade 3 or 4 were considered. Hystology was Glioblastoma in 45 patients (83%); 63% of patients were female. Myelotoxicity during concomitant phase occurred at a median of 4 weeks (range 1–8) from the start of treatment.After recovery of myelotoxicity 19 patients did not received any treatment while 35 (65%) were treated with chemotherapy (28 received standard TMZ, one TMZ with metronomic schedule, 2 lomustine and 4 other agents). Among patients treated with TMZ, 13 patients presented hematological toxicity grade 3–4 which required treatment discontinuation in 7 cases (20%).
CONCLUSION
we observed that 80 % of glioma patients presenting severe myelotoxicity during concomitant radiochemotherapy may be treated with maintenance TMZ after blood value recovery.
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Affiliation(s)
| | | | - P Gaviani
- UO NEURO-ONCOLOGIA FONDAZIONE IRCCS ISTITUTO NEUROLOGICO CARLO BESTA, Milano, Italy
| | - R Rudà
- Department of Neuro-Oncology University of Turin and City of Health and Science Hospital, Torino, Italy
| | - G Lombardi
- Department of Experimental and Clinical Oncology Medical Oncology 1,Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - G Simonetti
- UO NEURO-ONCOLOGIA FONDAZIONE IRCCS ISTITUTO NEUROLOGICO CARLO BESTA, Milano, Italy
| | - A Silvani
- UO NEURO-ONCOLOGIA FONDAZIONE IRCCS ISTITUTO NEUROLOGICO CARLO BESTA, Milano, Italy
| | - E Pronello
- Department of Neuro-Oncology University of Turin and City of Health and Science Hospital, Torino, Italy
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15
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Minniti G, Rød Sandve S, Padra JT, Heldal Hagen L, Lindén S, Pope PB, Ø Arntzen M, Vaaje-Kolstad G. The Farmed Atlantic Salmon ( Salmo salar) Skin-Mucus Proteome and Its Nutrient Potential for the Resident Bacterial Community. Genes (Basel) 2019; 10:genes10070515. [PMID: 31284681 PMCID: PMC6678340 DOI: 10.3390/genes10070515] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 12/29/2022] Open
Abstract
Norway is the largest producer and exporter of farmed Atlantic salmon (Salmo salar) worldwide. Skin disorders correlated with bacterial infections represent an important challenge for fish farmers due to the economic losses caused. Little is known about this topic, thus studying the skin-mucus of Salmo salar and its bacterial community depict a step forward in understanding fish welfare in aquaculture. In this study, we used label free quantitative mass spectrometry to investigate the skin-mucus proteins associated with both Atlantic salmon and bacteria. In particular, the microbial temporal proteome dynamics during nine days of mucus incubation with sterilized seawater was investigated, in order to evaluate their capacity to utilize mucus components for growth in this environment. At the start of the incubation period, the largest proportion of proteins (~99%) belonged to the salmon and many of these proteins were assigned to protecting functions, confirming the defensive role of mucus. On the contrary, after nine days of incubation, most of the proteins detected were assigned to bacteria, mainly to the genera Vibrio and Pseudoalteromonas. Most of the predicted secreted proteins were affiliated with transport and metabolic processes. In particular, a large abundance and variety of bacterial proteases were observed, highlighting the capacity of bacteria to degrade the skin-mucus proteins of Atlantic salmon.
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Affiliation(s)
- Giusi Minniti
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), NO-1432 Ås, Norway
| | - Simen Rød Sandve
- Faculty of Biosciences, Norwegian University of Life Sciences (NMBU), NO-1432 Ås, Norway
| | - János Tamás Padra
- Department of Medical Biochemistry and Cell Biology, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden
| | - Live Heldal Hagen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), NO-1432 Ås, Norway
| | - Sara Lindén
- Department of Medical Biochemistry and Cell Biology, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden
| | - Phillip B Pope
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), NO-1432 Ås, Norway
| | - Magnus Ø Arntzen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), NO-1432 Ås, Norway.
| | - Gustav Vaaje-Kolstad
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), NO-1432 Ås, Norway.
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16
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Minniti G, Arzellini D, Reverberi C, Bianciardi F, Tolu B, Scaringi C, Osti M, Gentile P. PO-0744 Efficacy of single-fraction or fractionated SRS combined with CPIs in melanoma brain metastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31164-8] [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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17
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Minniti G, Scaring C, Arzellini D, Bianciardi F, Tolu B, Morace R, Osti M, Gentile P. PO-0745 Fractionated SRS (fSRS) or surgery plus fSRS to resection cavity for NSCLC large brain metastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31165-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: 11/15/2022]
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18
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Kunath BJ, Minniti G, Skaugen M, Hagen LH, Vaaje-Kolstad G, Eijsink VGH, Pope PB, Arntzen MØ. Metaproteomics: Sample Preparation and Methodological Considerations. Advances in Experimental Medicine and Biology 2019; 1073:187-215. [DOI: 10.1007/978-3-030-12298-0_8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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19
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Nardiello B, Aquilanti F, Tolu B, Raza G, Gawhary RE, D’ambrosio C, Bianciardi F, Rea F, Scaringi C, Capone L, Nicolini L, Lusini F, Minniti G, Gentile P. 170. Implementing single-isocenter volumetric modulated arc therapy radiosurgery treatment for multiple intracranial metastases. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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20
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Cappabianca G, Paparella D, D’Onofrio A, Caprili L, Minniti G, Lanzafame M, Parolari A, Musumeci F, Beghi C. OC46 MYCOBACTERIUM CHIMAERA INFECTIONS FOLLOWING CARDIAC SURGERY IN ITALY. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549874.10438.3d] [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: 11/05/2022]
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21
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Masat M, Pantaleo A, Calcara G, Minniti G, Camata A, Polesello L, Mondin F, Possamai M, Rivaben D, Antonini-Canterin F. OC85 TREATMENT OF AORTIC INSUFFICIENCY THROUGH AORTIC LEAFLETS REMODELLING. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549882.64627.ec] [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: 11/05/2022]
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22
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Nicosia L, Agolli L, Reverberi C, De Sanctis V, Marinelli L, Minniti G, Di Muzio J, Valeriani M, Osti MF. Salvage radiotherapy with simultaneous integrated boost in non small-cell lung cancer patients with mediastinal relapse after surgery: a pilot study. Radiat Oncol 2018; 13:207. [PMID: 30352607 PMCID: PMC6199747 DOI: 10.1186/s13014-018-1155-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 10/11/2018] [Indexed: 12/25/2022] Open
Abstract
Background The aim of our study was to evaluate feasibility, toxicity profile and local control of salvage intensity modulated radiotherapy (IMRT) delivered with simultaneous integrated boost (SIB) associated or not to concomitant weekly cisplatin in patients affected by NSCLC with mediastinal nodal recurrence after surgery. Patterns of recurrence, outcomes and prognostic factors were assessed. Methods Fourteen consecutive patients received 25 fractions of 50Gy/2Gy to the elective nodal stations and boost up to 62.5Gy/2.5Gy to the macroscopic lymph node metastases. Concomitant weekly cisplatin (40 mg/m2) was administered to 8 (57.1%) patients. Results Five (35.7%) patients experienced grade 2 pneumonitis and 5 (35.7%) patients had grade 2 esophagitis. One case of grade 3 pneumonitis occurred and was successfully treated with antibiotics and steroids with no sequelae. No patient recurred locally in the boost volume (local control 100%). Loco-regional control was 79% with 3 patients that developed nodal recurrence principally marginal to the elective volume. Seven patients developed distant metastases. Median PFS was 7 months. The nodal involvement of station 7 was associated to a significantly lower median metastasis-free survival (4 months vs. not reached, p = 0.036). Conclusions Salvage radiotherapy with IMRT-SIB is a feasible and a well-tolerated treatment option for mediastinal recurrent NSCLC after surgery. The role of more intensified radiation regimens and association to systemic therapy remain to be evaluated in larger cohorts.
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Affiliation(s)
- L Nicosia
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy.
| | - L Agolli
- Department of Radiation Oncology, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Reverberi
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - V De Sanctis
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - L Marinelli
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - G Minniti
- Radiation Oncology Unit, UPMC Hillman Cancer Center, San Pietro Hospital, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - J Di Muzio
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - M Valeriani
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - M F Osti
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
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23
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Bianciardi F, Chiesa S, Tolu B, Longo S, Minniti G, Nardiello B, Cellini F, Rea F, Gentile P, Valentini V. P05.82 Clinical decision making. The route from an ontology to a prediction model for stereotactic radiotherapy: PRE.M.I.S.E. (PREdiction Models in Stereotactic External Radiotherapy). Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - S Chiesa
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Dipartimento Scienze Rad, rome, Italy
| | - B Tolu
- UPMC San Pietro, rome, Italy
| | - S Longo
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Dipartimento Scienze Rad, rome, Italy
| | | | | | - F Cellini
- Fondazione Policlinico A. Gemelli IRCCS, Dipartimento Scienze Rad, rome, Italy
| | - F Rea
- UPMC San Pietro, rome, Italy
| | | | - V Valentini
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Dipartimento Scienze Rad, rome, Italy
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24
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Navarria P, Minniti G, Pinzi V, Draghini L, Borzillo V, Ciammella P, Scoccianti S, Amelio D, Krengli M, Buglione di Monale M. P01.069 Re-irradiation for recurrent glioma: outcome evaluation, toxicity and prognostic factors assessment. A multicenter retrospective study by the Brain-Study-Group of the Radiation Oncology Italian Association (AIRO). Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - V Pinzi
- Istituto Neurologico C.Besta, Milano, Italy
| | - L Draghini
- Azienda Ospedaliera S.Maria, Terni, Italy
| | - V Borzillo
- Istituto Nazionale per lo studio e la cura dei tumori, Napoli, Italy
| | - P Ciammella
- Arcispedale di S.M. Nuova azienda ospedaliera, Reggio Emila, Italy
| | | | - D Amelio
- Presidio Ospedaliero Santa Chiara, Trento, Italy
| | - M Krengli
- A.O.U. Maggiore della Carità, Novara, Italy
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25
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Bruno F, Silvani A, Ius T, Bello L, Minniti G, Pace A, Lombardi G, Soffietti R, Rudà R. OS3.1 IDH-wild type grade II gliomas: a retrospective series of AINO (Italian Association of Neuro-Oncology). Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F Bruno
- Dept. of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy
| | - A Silvani
- Dept. of Neuro-Oncology, Neurologic Institute Carlo Besta, Milan, Italy
| | - T Ius
- Dept. of Neurosurgery, University Hospital of Udine, Udine, Italy
| | - L Bello
- Dept. of Neurosurgery, University of Milan and Clinical Institute Humanitas, Milan, Italy
| | - G Minniti
- Dept. of Radiotherapy, University and Sant’Andrea Hospital, Rome, Italy
| | - A Pace
- Neurooncology Unit, IRCCS Regina Elena Cancer Institute, Rome, Italy
| | - G Lombardi
- Dept. of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - R Soffietti
- Dept. of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy
| | - R Rudà
- Dept. of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy
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26
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Osti MF, Agolli L, Valeriani M, Reverberi C, Bracci S, Marinelli L, De Sanctis V, Cortesi E, Martelli M, De Dominicis C, Minniti G, Nicosia L. 30 Gy single dose stereotactic body radiation therapy (SBRT): Report on outcome in a large series of patients with lung oligometastatic disease. Lung Cancer 2018; 122:165-170. [PMID: 30032826 DOI: 10.1016/j.lungcan.2018.06.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 03/20/2018] [Revised: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate the local control (LC) and long term adverse effects in a series of patients with lung metastases who received 30 Gy in single dose with stereotactic technique. MATERIALS AND METHODS Between December 2008 and April 2016, a total of 166 lung metastases in 129 patients affected by oligometastatic disease were treated at our Institution with stereotactic body radiotherapy (SBRT). Mainly, the primary tumors were non small-cell lung cancer and colorectal cancer (45.2% and 28.8%, respectively). Prognostic factors were also assessed. RESULTS The median follow-up was 38 months. Local progression occurred in 24 (14.4%) lesions in 21 patients. Intra-thoracic progression (new lung lesions or thoracic lymph node metastases) occurred in 59 (45.7%) patients. Forty-five (34.8%) patients had distant progression after a median time of 14 months. The 3- and 5-years local relapse-free survival (LPFS) were 80.1% and 79.2% (median not reached), respectively. One-hundred forty-eight patients were evaluated for late toxicity (follow-up >6 months): 51 (34.4%) patients had grade ≤2 fibrosis, 11 (7.4%) patients experienced grade 3 fibrosis. Two (1.3%) cases of rib fracture occurred. One case of toxic death (grade 5) has been reported. Median OS was 39 months. At the univariate analysis, lesion diameter ≤18 mm correlated significantly with a longer LPFS (p = 0.001). At the multivariate analysis, lesion diameter <18 mm was predictive for longer LPFS (p = 0.006). Also, oligometastases from primary colorectal cancer was a significant predictive factor for worse LPFS (p = 0.041) and progression-free survival (p = 0.04). CONCLUSIONS To our knowledge, the current study represents the largest series on the use of SBRT 30 Gy single dose for lung metastases. Our results confirm the effectiveness and safety of this schedule administered in selected oligometastatic patients. Further prospective series could better validate these results.
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Affiliation(s)
- M F Osti
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - L Agolli
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - M Valeriani
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - C Reverberi
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - S Bracci
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - L Marinelli
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - V De Sanctis
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - E Cortesi
- Department of Radiology, Oncology and Human Pathology, Policlinico Umberto I "Sapienza" University of Rome, Italy
| | - M Martelli
- Thoracic Surgery Unit, Carlo Forlanini Hospital, Rome, Italy
| | - C De Dominicis
- Department of Radiology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy
| | - G Minniti
- Department of Neurological Sciences, IRCCS Neuromed, Via Atinense, Pozzilli, IS, Italy; UPMC San Pietro FBF, Radiotherapy Center, Rome, Italy.
| | - L Nicosia
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Italy.
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27
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Minniti G, Hagen LH, Porcellato D, Jørgensen SM, Pope PB, Vaaje-Kolstad G. The Skin-Mucus Microbial Community of Farmed Atlantic Salmon ( Salmo salar). Front Microbiol 2017; 8:2043. [PMID: 29104567 PMCID: PMC5655796 DOI: 10.3389/fmicb.2017.02043] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [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: 06/22/2017] [Accepted: 10/06/2017] [Indexed: 01/07/2023] Open
Abstract
The skin of the teleost is a flexible and scaled structure that protects the fish toward the external environment. The outermost surface of the skin is coated with mucus, which is believed to be colonized by a diverse bacterial community (commensal and/or opportunistic). Little is known about such communities and their role in fish welfare. In aquaculture, fish seem to be more susceptible to pathogens compared to wild fish. Indeed common fish farming practices may play important roles in promoting their vulnerability, possibly by causing changes to their microbiomes. In the present study, 16S rRNA gene amplicon sequencing was employed to analyze the composition of the farmed Salmo salar skin-mucus microbiome before and after netting and transfer. The composition of the bacterial community present in the rearing water was also investigated in order to evaluate its correlation with the community present on the fish skin. Our results reveal variability of the skin-mucus microbiome among the biological replicates before fish handling. On the contrary, after fish handling, the skin-mucus community exhibited structural similarity among the biological replicates and significant changes were observed in the bacterial composition compared to the fish analyzed prior to netting and transfer. Limited correlation was revealed between the skin-mucus microbiome and the bacterial community present in the rearing water. Finally, analysis of skin-mucus bacterial biomasses indicated low abundance for some samples, highlighting the need of caution when interpreting community data due to the possible contamination of water-residing bacteria.
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Affiliation(s)
- Giusi Minniti
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), Ås, Norway
| | - Live Heldal Hagen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), Ås, Norway
| | - Davide Porcellato
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), Ås, Norway
| | - Sven Martin Jørgensen
- Nofima AS, Norwegian Institute of Food, Fisheries and Aquaculture Research, Ås, Norway
| | - Phillip B. Pope
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), Ås, Norway
| | - Gustav Vaaje-Kolstad
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), Ås, Norway
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Nicosia L, Reverberi C, Agolli L, Valeriani M, De Sanctis V, De Dominicis C, Minniti G, Cortesi E, Martelli M, Osti M. PO-0666: 30 Gy single-dose SBRT to lung lesions: outcome in a large series of patients. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31103-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Minniti G. P13.15 Multi-fraction stereotactic radiosurgery (MF-SRS) versus surgery plus MF-SRS for patients with large radioresistant brain metastases. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.259] [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: 11/13/2022] Open
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Bottini F, Celle ME, Calevo MG, Amato S, Minniti G, Montaldi L, Di Pasquale D, Cerone R, Veneselli E, Molinari AC. Metabolic and Genetic Risk Factors for Migraine in Children. Cephalalgia 2016; 26:731-7. [PMID: 16686913 DOI: 10.1111/j.1468-2982.2006.01107.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [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: 11/29/2022]
Abstract
Migraine can induce ischaemic stroke, and is considered an independent risk factor for stroke in the young. To date, the nature of the link between migraine and stroke is essentially unknown. Forty-five children were studied. Homocysteine levels (fasting and post methionine load), vitamin B12 and plasma folate levels, factor V Leiden, factor II G20210A, methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C mutations were examined. Compared with controls, patients with migraine had higher levels of post-methionine load homocysteine values (19.5 ± 4.9 vs. 16.9 ± 1.9; P = 0.025) and significantly lower folate levels (5.8 ± 2.6 vs. 7.5 ± 2.1; P = 0.002). We found a trend toward an increased risk of migraine in subjects carrying a homozygous mutant genotype for MTHFR C677T and MTHFR A1298C polymorphisms. Genetic prothrombotic conditions do not seem to be related to migraine in the young, whereas the biochemical differences between migrainous patients and controls are an appealing topic for further investigation.
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Affiliation(s)
- F Bottini
- Thrombosis and Haemostasis Unit, Department of Paediatric Haematology and Oncology, Giannina Gaslini Children's Hospital, Genoa, Italy
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Hatje E, Minniti G, Stewart MJ, Neuman C, Knibb W, Katouli M. First description of 'Chalky back' phenomenon in banana prawns (Fenneropenaeus merguiensis) and its possible association with Vibrio and Photobacterium species. FEMS Microbiol Lett 2016; 363:fnw019. [PMID: 26825678 DOI: 10.1093/femsle/fnw019] [Citation(s) in RCA: 2] [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] [Accepted: 01/21/2016] [Indexed: 11/13/2022] Open
Abstract
Here we report a newly identified 'Chalky back' phenomenon in banana prawns (Fenneropenaeus merguiensis) farmed in North Queensland, Australia. This was characterized by localized white discoloured segmentation of the cervical groove, moreover, after cooking the prawns exploded, making them unfit for commercial sale. Histological examination revealed breakdown of gut and abdominal muscle tissue in some moribund specimens. We selectively isolated Vibrio spp., which are known prawn pathogens, from healthy and Chalky back specimens. Isolated bacteria were identified, typed and tested for the presence of eight virulence genes (VGs), biofilm formation, adherence and cytotoxicity to fish cells. In all, 32 isolates were recovered and identified as Vibrio harveyi, V. owensii, V. sinaloensis-like, V. campbellii, V. shilonii, Vibrio sp. and Photobacterium damselae using 16S rRNA gene sequencing. All V. harveyi carried VGs coding for haemolysin, toxR and flagella; formed biofilm; and adhered to both cell lines. This was similar to the V. sinaloensis-like strains that were only isolated from Chalky back specimens. Our data suggest that Vibrio spp. may play a role in the pathogenesis of Chalky back. This study is the first report of Chalky back phenomenon in farmed banana prawns that needs to be closely monitored by the industry.
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Affiliation(s)
- Eva Hatje
- Genecology Research Centre, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia
| | - Giusi Minniti
- Genecology Research Centre, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia
| | - Michael J Stewart
- Genecology Research Centre, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia
| | - Christina Neuman
- Genecology Research Centre, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia
| | - Wayne Knibb
- Genecology Research Centre, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia
| | - Mohammad Katouli
- Genecology Research Centre, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia
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Nicosia L, Agolli L, Bracci S, Valeriani M, De Sanctis V, Minniti G, Osti M, Maurizi Enrici R. EP-1320: Feasibility and efficacy of stereotactic radiotherapy in lymph-node metastases. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41312-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: 11/16/2022]
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Bracci S, Agolli L, Nicosia L, Falco T, Valeriani M, Minniti G, De Sanctis V, Osti M, Maurizi Enrici R. EP-1181: SBRT in oligometastatic/oligorecurrent NSCLC cancer patients: a new therapeutic approach. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41173-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Salvador L, Cavarretta E, Minniti G, Di Angelantonio E, Salandin V, Frati G, Polesel E, Valfrè C. Autologous pericardium annuloplasty: a "physiological" mitral valve repair. J Cardiovasc Surg (Torino) 2014; 55:831-839. [PMID: 25268074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Autologous pericardium annuloplasty (APA) is an alternative to prosthetic ring implantation for mitral valve (MV) repair, avoiding the use of foreign material and preserving the mitral annulus' physiological motion. However, data on durability are questionable. Therefore, we analyzed long-term outcomes of treating degenerative mitral regurgitation (MR) with APA. METHODS Four hundred ninety patients (mean age, 54.3±11.3 years, [15-77 years]; N.=360 men [74.1%]) who had undergone APA and neochordae implantation between July 1988 and December 2006 were retrospectively studied. RESULTS MR was purely degenerative in 434 (89.3%) patients; endocarditis was present in 44 (9.1%) patients; an anterior, posterior, or bileaflet prolapse was present in 32 (6.6%), 241 (49.6%), and 213 (43.8%) patients, respectively. Clinical follow-up was 100% complete at a median of 6.5 years (5th percentile, 0.9; 95th percentile, 14.9) with an echocardiographic study in 92% of patients. In-hospital mortality was 1% (5 deaths); overall and late cardiac mortality were 7.6% and 3.9% (37 and 19 deaths), respectively. Kaplan-Meier curves for overall survival, late cardiac survival, and freedom from reoperation at 15 years (20 cases) were 86% (95%CI 80-91), 93% (95%CI 88-96), and 93% (95%CI 88-96), respectively. At 15 years, freedom from recurrent MR (28 patients) and endocarditis (6 events) were 86% (95%CI 76-91) and 97% (95%CI 92-99). Dehiscence, significant calcification of APA, and hemolysis never occurred. At reoperations, annular pericardium appeared covered by a smooth layer of tissue. CONCLUSION APA is feasible, safe, and cost-effective, providing long-term durability, high survival, and a low rate of valve-related complications.
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Affiliation(s)
- L Salvador
- Cardiac Surgery Division, Santa Maria dei Battuti Hospital, Treviso, Italy -
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Minniti G, Esposito V, Clarke E, Enrici RM. P08.18 * FRACTIONATED STEREOTACTIC RADIOSURGERY FOR PATIENTS WITH SKULL BASE METASTASES INVOLVING THE ANTERIOR VISUAL PATHWAY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.206] [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: 11/13/2022] Open
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Minniti G, Clarke E, Scaringi C, Falco T, Osti M, Enrici RM. P08.17 * REPEAT STEREOTACTIC RADIOSURGERY (SRS) FOR RECURRENT BRAIN METASTASES. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.205] [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: 11/13/2022] Open
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Minniti G, Scaringi C, Falco T, Lanzetta G, De Sanctis V, Enrici RM. P17.57 * COMBINED CHEMORADIATION IN ELDERLY PATIENTS WITH GLIOBLASTOMA: COMPARISON OF TWO RADIATION SCHEDULES. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.386] [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: 11/13/2022] Open
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Scaringi C, Cicone F, Papa A, Scopinaro F, Minniti G, Enrici RM. P16.30 * ROLE OF 18F-DOPA PET/CT IN NON-ENHANCING GLIOMAS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.325] [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: 11/13/2022] Open
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Purchiaroni F, Begini P, Minniti G, Gallina S, Delle Fave G, Marignani M. Glioblastoma multiforme and hepatitis B: do the right thing(s). Eur Rev Med Pharmacol Sci 2014; 18:3629-3631. [PMID: 25535132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Hepatitis B virus (HBV) reactivation is a well-known complication related to immunosuppression. Clinical manifestations of HBV relapse range from self-limiting anicteric hepatitis to acute hepatic failure. Temozolomide (TMZ) is an alkylating agent used for the treatment of glioblastoma multiforme (GBM), the most common and deadliest of malignant primary brain tumors. CASE REPORT We report the case of a 52-year old man with a history of serological positivity for hepatitis B surface antigen (HBsAg) who was diagnosed with GBM. Since the tumor was multifocal and thus inoperable, the patient received radiotherapy with concomitant TMZ and corticosteroids, without a prophylactic therapy for HBV infection. Acute hepatitis developed five months later the beginning of anticancer therapy. We started antiviral entecavir, which led to a decrease of HBV-DNA titer to 20 IU/ml, allowing the prosecution of the TMZ therapy. CONCLUSIONS Up to now only four other cases of HBV relapse during TMZ therapy have been reported in literature. These cases underline the need of HBV screening and antiviral prophylaxis before starting TMZ administration.
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Affiliation(s)
- F Purchiaroni
- Department of Digestive and Liver Disease, School of Medicine and Psychology, Sapienza University, Azienda Ospedaliera S. Andrea, Rome, Italy.
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Attramadal K, Øie G, Kjørsvik E, Minniti G, Skjermo J, Bakke I, Østensen MA, Olsen Y, Vadstein O. Control of the selective pressure on microbes of the incoming water increases survival of marine fish larvae. Commun Agric Appl Biol Sci 2013; 78:17-18. [PMID: 25141608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Osti MF, Agolli L, Scaringi C, Bracci S, Minniti G, Maurizi Enrici R. [Curative radiotherapy in patients with anal cancer: clinical outcomes and prognostic factors in a single-institution experience]. Radiol Med 2012. [PMID: 23184242 DOI: 10.1007/s11547-012-0900-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE Our aim was to retrospectively analyse a series of patients with anal cancer treated with curative intent at a single institute in terms of survival and local disease control. MATERIALS AND METHODS Forty-two patients with anal cancer were treated with primary radiotherapy with or without concurrent chemotherapy. The influence of the prognostic factors on overall (OS), disease-free (DFS), disease-specific (DSS), colostomy-free (CFS) and metastasis-free (MFS) survival was evaluated. RESULTS Nine patients had stage I, 15 stage II, four stage IIIA and 14 stage IIIB disease. Tumour progression/ persistence occurred in five patients (12%). The 5-year OS, DSS, DFS, CFS and MFS were 72.7%, 84.2%, 85.7%, 81.1% and 87.1%, respectively. On univariate analysis, T stage emerged as highly significant for OS, DSS, CFS and DFS, whereas N status was a significant prognostic factor for DSS. On multivariate analysis, T stage was a significant prognostic factor for OS and CFS. CONCLUSIONS Our data support the view that combined chemoradiation treatment of anal cancer is feasible and may provide survival benefits with an acceptable rate of adverse effects. We should consider T and N stages as important prognostic factors for survival.
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Affiliation(s)
- M F Osti
- Department of Radiation Oncology, Sant'Andrea Hospital, La Sapienza University, Rome, Italy
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Romano A, Calabria LF, Tavanti F, Minniti G, Rossi-Espagnet MC, Coppola V, Pugliese S, Guida D, Francione G, Colonnese C, Fantozzi LM, Bozzao A. Apparent diffusion coefficient obtained by magnetic resonance imaging as a prognostic marker in glioblastomas: correlation with MGMT promoter methylation status. Eur Radiol 2012; 23:513-20. [PMID: 22875158 DOI: 10.1007/s00330-012-2601-4] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 07/04/2012] [Accepted: 07/09/2012] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate whether apparent diffusion coefficient (ADC) values can predict the status of MGMT of glioblastoma multiforme (GBM) and correlate with overall survival (OS) and progression-free survival (PFS). METHODS This retrospective study included 47 patients with pathologically proven glioblastoma. All of them underwent MR DWI study before surgery (mean time 1 week) and the status of methylguanine-DNA-methyltransferase (MGMT) promoter methylation was searched for. Minimum apparent diffusion coefficient (ADC) values were evaluated. OS and PSF parameters were calculated, and Student's t-test, Kaplan-Meier curves, linear and Cox regression were performed. RESULTS Twenty-five patients showed positive methylation of the MGMT promoter. Patients showing MGMT promoter methylation had higher minimum ADC values, and they survived longer than those without MGMT promoter methylation. The median ADCmin value of 0.80 represents the cutoff value able to distinguish between methylated and un-methylated patients. Patients showing minimum ADC values higher than 0.80 survived longer than patients with minimum ADC values lower than 0.80. A linear correlation between minimum ADC values vs. the OS and PFS was observed. CONCLUSIONS Minimum ADC values in glioblastoma multiforme could be used as a preoperative parameter to estimate the status of MGMT promoter methylation and the survival of patients.
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Affiliation(s)
- Andrea Romano
- NESMOS, Department of Neuroradiology, S. Andrea Hospital, University Sapienza, Rome, Italy.
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Minniti G. SP-0581 TREATING BRAIN METASTASES: CURRENT APPROACHES AND CONTROVERSIES. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70919-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Minniti G, Scaringi C, Amelio D, Maurizi Enrici R. Stereotactic Irradiation of GH-Secreting Pituitary Adenomas. Int J Endocrinol 2012; 2012:482861. [PMID: 22518123 PMCID: PMC3296430 DOI: 10.1155/2012/482861] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 12/14/2011] [Indexed: 01/02/2023] Open
Abstract
Radiotherapy (RT) is often employed in patients with acromegaly refractory to medical and/or surgical interventions in order to prevent tumour regrowth and normalize elevated GH and IGF-I levels. It achieves tumour control and hormone normalization up to 90% and 70% of patients at 10-15 years. Despite the excellent tumour control, conventional RT is associated with a potential risk of developing late toxicity, especially hypopituitarism, and its role in the management of patients with GH-secreting pituitary adenomas remains a matter of debate. Stereotactic techniques have been developed with the aim to deliver more localized irradiation and minimize the long-term consequences of treatment, while improving its efficacy. Stereotactic irradiation can be given in a single dose as stereotactic radiosurgery (SRS) or in multiple doses as fractionated stereotactic radiotherapy (FSRT). We have reviewed the recent published literature on stereotactic techniques for GH-secreting pituitary tumors with the aim to define the efficacy and potential adverse effects of each of these techniques.
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Affiliation(s)
- G. Minniti
- Department of Neuroscience, Neuromed Institute, 86077 Pozzilli, Italy
- Department of Radiation Oncology, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy
- *G. Minniti:
| | - C. Scaringi
- Department of Radiation Oncology, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy
| | - D. Amelio
- ATreP, Agenzia Provinciale per la Protonterapia, 38122 Trento, Italy
| | - R. Maurizi Enrici
- Department of Radiation Oncology, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy
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Valeriani M, Muni R, Osti MF, De Sanctis V, Minniti G, Ardito F, Maurizi Enrici R. Acute toxicity in 14 patients with locally advanced head and neck squamous cell carcinoma treated with concurrent cetuximab and radiotherapy. Radiol Med 2011; 117:125-32. [DOI: 10.1007/s11547-011-0716-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 09/02/2010] [Indexed: 10/17/2022]
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Romano A, Rossi Espagnet MC, Calabria LF, Coppola V, Figà Talamanca L, Cipriani V, Minniti G, Pierallini A, Fantozzi LM, Bozzao A. Clinical applications of dynamic susceptibility contrast perfusion-weighted MR imaging in brain tumours. Radiol Med 2011; 117:445-60. [PMID: 21892719 DOI: 10.1007/s11547-011-0715-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 12/14/2010] [Indexed: 11/24/2022]
Abstract
Magnetic resonance imaging (MRI) with a dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) sequence to study brain tumours provides information on the haemodynamic characteristics of the neoplastic tissue. Brain perfusion maps and calculation of perfusion parameters, such as relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV) and mean transit time (MTT) allow assessment of vascularity and angiogenesis within tumours of the central nervous system (CNS), thus providing additional information to conventional MRI sequences. Although DSC-PWI has long been used, its clinical use in the study of brain tumours in daily clinical practice is still to be defined. The aim of this review was to analyse the application of perfusion MRI in the study of brain tumours by summarising our personal experience and the main results reported in the literature.
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Affiliation(s)
- A Romano
- NESMOS Department, Neuroradiology Faculty, Sant' Andrea Hospital, La Sapienza University, Via di Grottarossa 1035, 00189, Rome, Italy
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Minniti G, Armosini V, Salvati M, Lanzetta G, Caporello P, Mei M, Osti MF, Maurizi RE. Fractionated stereotactic reirradiation and concurrent temozolomide in patients with recurrent glioblastoma. J Neurooncol 2010; 103:683-91. [DOI: 10.1007/s11060-010-0446-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2010] [Accepted: 10/21/2010] [Indexed: 12/20/2022]
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Minniti G, Salvati M, Muni R, Lanzetta G, Osti MF, Clarke E, Costa A, Bozzao A, Trasimeni G, Enrici RM. Stereotactic radiosurgery plus whole-brain radiotherapy for treatment of multiple metastases from non-small cell lung cancer. Anticancer Res 2010; 30:3055-3061. [PMID: 20683055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND The aim of this study was to evaluate local control and survival rates after stereotactic radiosurgery (SRS) plus whole-brain radiotherapy (WBRT) for the treatment of multiple brain metastases from non-small cell lung cancer (NSCLC). PATIENTS AND METHODS Between June 2004 and September 2008, sixty-six patients with multiple brain metastases from NSCLC were enrolled in this prospective study. All patients were required to have 2-3 brain metastases and Karnofsky performance status (KPS) > or = 70. WBRT treatment dose was 30 Gy in 10 fractions followed by SRS. A matched control population treated with WBRT alone to a dose of 30 Gy in 10 fractions was used for comparison. RESULTS The median survival was 10.3 months in the WBRT plus SRS group and 7.2 months in the WBRT group (p=0.005). The 6-month and 12-month survival rates were 90% and 38% in the SRS plus WBRT group and 84% and 19% in the WBRT group (p=0.01). Stable extracranial disease and KPS were significant predictive factors of survival in both groups (p=0.001). Death due to neurological causes occurred in 18% and 35% of patients treated with WBRT plus SRS and WBRT (p=0.02), respectively. Disease control in the brain was 10 months in the SRS plus WBRT group and 7 months in the WBRT group (p=0.001); the 6-month and 12-month control rates were 82% and 42% for WBRT plus SRS, and 75% and 18% for WBRT (p=0.001), respectively. The 6-month and 12-month control rates of treated lesions (local control) were 90% and 47% in the WBRT group, and 100% and 93% in the WBRT plus SRS group (p=0.001). CONCLUSION WBRT plus SRS is a safe, minimally invasive and well-tolerated treatment for patients with up to three brain metastases from NSCLC. The treatment is associated with longer survival and better disease control in comparison with WBRT alone. Survival benefits need to be confirmed by large randomized studies.
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Affiliation(s)
- G Minniti
- Department of Radiotherapy Oncology, Sant' Andrea Hospital, University of Rome 'La Sapienza' Via di Grottarossa 1035, 00189 Rome, Italy.
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Giannattasio A, Calevo MG, Minniti G, Gianotti D, Cotellessa M, Napoli F, Lorini R, d'Annunzio G. Folic acid, vitamin B12, and homocysteine levels during fasting and after methionine load in patients with Type 1 diabetes mellitus. J Endocrinol Invest 2010; 33:297-9. [PMID: 19834315 DOI: 10.1007/bf03346589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS To assess plasma concentrations of folic acid, vitamin B12, and total plasma homocysteine (tHCY) during fasting and after methionine load in young patients with Type 1 diabetes mellitus (T1DM). METHODS We enrolled 41 young patients with T1DM without any sign of microvascular complications and 123 healthy controls in a 1:3 case-control study. Fasting and post-methionine load (PML) tHCY, folic acid, and vitamin B12 levels were measured in both groups. Data regarding chronological age, metabolic control (assessed by mean values of glycated hemoglobin in the last 12 months) and disease duration were also recorded. RESULTS Fasting and PML tHCY levels were significantly lower in patients than in controls: 7.3+/-2.7 micromol/l vs 8.3+/-2.5 micromol/l (p=0.01), and 16.7+/-5.8 micromol/l vs 17.3+/-4.3 micromol/l (p=0.01), respectively. No correlation was found between fasting and PML tHCY levels and chronological age, disease duration, metabolic control, and insulin requirement. Patients had significantly higher vitamin B12 levels compared to controls: 767+/-318 pg/ml vs 628+/-236 pg/ml (p=0.003), while folic acid turned out to be lower in patients than in controls: 5.3+/-1.9 nmol/l vs 7.5+/-2.6 nmol/l (p<0.0001). CONCLUSIONS Adolescents and young adults with T1DM without microvascular complications showed lower tHCY both during fasting and after methionine load. Lower folate concentrations in these patients might benefit from food fortification.
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Affiliation(s)
- A Giannattasio
- Department of Pediatrics, University of Genoa, IRCCS G. Gaslini, Italy
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Minniti G, Muni R, Lanzetta G, Marchetti P, Enrici RM. Chemotherapy for glioblastoma: current treatment and future perspectives for cytotoxic and targeted agents. Anticancer Res 2009; 29:5171-5184. [PMID: 20044633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Glioblastoma is the most frequent and devastating primary malignant brain tumor in adults. Surgery followed by standard radiotherapy with concomitant and adjuvant chemotherapy with temozolomide is the standard of care in patients with glioblastoma, however the prognosis remains poor with a median survival in the range of 12-15 months. Common genetic abnormalities in glioblastoma are associated with aberrant activation or suppression of cellular signal transduction pathways and resistance to radiation and chemotherapy. Special attention has been focused on targets such as epidermal growth factor receptor, vascular endothelial growth factor receptor, platelet-derived growth factor receptor, and on pathways such as the phosphatidylinositol-3kinase/Akt/mammalian target of rapamycin and Ras/Raf/mitogen-activated protein-kinase pathways. Several signal transduction inhibitors have been examined in preclinical and clinical malignant glioma trials, including antiangiogenic agents (bevacizumab, enzastaurin), and inhibitors of epidermal growth factor receptor tyrosine kinase (gefitinib and erlotinib), mammalian target of rapamycin (temsirolimus, everolimus) and integrin (cilengitide). Although preliminary clinical results of the use of targeted agents have not translated into significantly better survival, more recent phase II trials are exploring the combination of multitargeted drugs with cytotoxic chemotherapy and radiotherapy in order to overcome the resistance of tumors to single-agent targeted therapies. This review summarizes the current results with cytotoxic and targeted molecular agents in glioblastoma and the development of new chemoradiation strategies under evaluation to increase their effectiveness.
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Affiliation(s)
- G Minniti
- Sant' Andrea Hospital, Department of Radiotherapy Oncology, Via di Grottarossa 1035, 00189 Roma, Italy.
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