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Borghetti P, Volpi G, Facheris G, Cossali G, Mataj E, La Mattina S, Singh N, Imbrescia J, Bonù ML, Tomasini D, Vitali P, Greco D, Bezzi M, Melotti F, Benvenuti M, Borghesi A, Grisanti S, Buglione di Monale e Bastia M. Unresectable stage III non-small cell lung cancer: could durvalumab be safe and effective in real-life clinical scenarios? Results of a single-center experience. Front Oncol 2023; 13:1208204. [PMID: 37469420 PMCID: PMC10352832 DOI: 10.3389/fonc.2023.1208204] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/09/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction The standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC) is chemoradiotherapy (CRT) followed by consolidation durvalumab as shown in the PACIFIC trial. The purpose of this study is to evaluate clinical outcomes and toxicities regarding the use of durvalumab in a real clinical scenario. Methods A single-center retrospective study was conducted on patients with a diagnosis of unresectable stage III NSCLC who underwent radical CRT followed or not by durvalumab. Tumor response after CRT, pattern of relapse, overall survival (OS) and progression-free survival (PFS), and toxicity profile were investigated. Results Eighty-five patients met the inclusion criteria. The median age was 67 years (range 45-82 years). Fifty-two patients (61.2%) started sequential therapy with durvalumab. The main reason for excluding patients from the durvalumab treatment was the expression of PD-L1 < 1%. Only two patients presented a grade 4 or 5 pneumonitis. A median follow-up (FU) of 20 months has been reached. Forty-five patients (52.9%) had disease progression, and 21 (24.7%) had a distant progression. The addition of maintenance immunotherapy confirmed a clinical benefit in terms of OS and PFS. Two-year OS and PFS were respectively 69.4% and 54.4% in the durvalumab group and 47.9% and 24.2% in the no-durvalumab group (p = 0.015, p = 0.007). Conclusion In this real-world study, patients treated with CRT plus durvalumab showed clinical outcomes and toxicities similar to the PACIFIC results. Maintenance immunotherapy after CRT has been shown to be safe and has increased the survival of patients in clinical practice.
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Affiliation(s)
- Paolo Borghetti
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Giulia Volpi
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Giorgio Facheris
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Gianluca Cossali
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Eneida Mataj
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Salvatore La Mattina
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Navdeep Singh
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Jessica Imbrescia
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Marco Lorenzo Bonù
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Davide Tomasini
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Paola Vitali
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Diana Greco
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Michela Bezzi
- Division of Pneumology, University Hospital Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Flavia Melotti
- Institute of Pathology, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Mauro Benvenuti
- Thoracic Surgery, Department of Cardio-Thoracic Surgery, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Andrea Borghesi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Salvatore Grisanti
- Medical Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
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Bonù ML, La Mattina S, Singh N, Toraci C, Spiazzi L, Terraneo F, Barbera F, Vitali P, Frassine F, Guerini A, Triggiani L, Tomasini D, Morelli V, Imbrescia J, Andreuccetti J, Frittoli B, Pittiani F, Grazioli L, Portolani N, Nicosia L, Albano D, Bertagna F, Magrini SM, Buglione M. Anal squamous cell carcinoma: Impact of radiochemotherapy evolution over years and an explorative analysis of MRI prediction of tumor response in a mono-institutional series of 131 patients. Front Oncol 2022; 12:973223. [PMID: 36353538 PMCID: PMC9639749 DOI: 10.3389/fonc.2022.973223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 09/27/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Radiochemotherapy (RCHT) for the treatment of anal squamous cell carcinoma (ASCC) has evolved dramatically, also thanks to intensity-modulated RT (IMRT) and 3D image guidance (3D IGRT). Despite most patients presenting fair outcomes, unmet needs still exist. Predictors of poor tumor response are lacking; acute toxicity remains challenging; and local relapse remains the main pattern of failure. Patients and methods Between 2010 and 2020, ASCC stages I–III treated with 3D conformal radiotherapy or IMRT and CDDP-5FU or Mytomicine-5FU CHT were identified. Image guidance accepted included 2D IGRT or 3D IGRT. The study endpoints included freedom from locoregional recurrence (FFLR), colostomy free survival (CFS), freedom from distant metastasis (FFDM), overall survival (OS), and acute and late toxicity as measured by common terminology criteria for adverse events (CTCAE) version 5.0. An exploratory analysis was performed to identify possible radiomic predictors of tumor response. Feature extraction and data analysis were performed in Python™, while other statistics were performed using SPSS® v.26.0 software (IBM®). Results A total of 131 patients were identified. After a median FU of 52 months, 83 patients (63.4%) were alive. A total of 35 patients (26.7%) experienced locoregional failure, while 31 patients (23.7%) relapsed with distant metastasis. Five year FFLR, CFS, DMFS and PS resulted 72.3%, 80.1%, 74.5% and 64.6%. In multivariate analysis, 2D IGRT was associated with poorer FFLR, OS, and CFS (HR 4.5, 4.1, and 5.6, respectively); 3DcRT was associated with poorer OS and CFS (HR 3.1 and 6.6, respectively). IMRT reduced severe acute gastro-intestinal (GI) and severe skin acute toxicity in comparison with 3DcRT. In the exploratory analysis, the risk of relapse depended on a combination of three parameters: Total Energy, Gray Level Size Zone Matrix’s Large Area High Gray Level Emphasis (GLSZM’s LAHGLE), and GTV volume. Conclusions Advances in radiotherapy have independently improved the prognosis of ASCC patients over years while decreasing acute GI and skin toxicity. IMRT and daily 3D image guidance may be considered standard of care in the management of ASCC. A combination of three pre-treatment MRI parameters such as low signal intensity (SI), high GLSZM’s LAHGLE, and GTV volume could be integrated in risk stratification to identify candidates for RT dose-escalation to be enrolled in clinical trials.
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Affiliation(s)
- Marco Lorenzo Bonù
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Salvatore La Mattina
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Navdeep Singh
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Cristian Toraci
- Department of Medical Physics, Spedali Civili Hospital, Brescia, Italy
| | - Luigi Spiazzi
- Department of Medical Physics, Spedali Civili Hospital, Brescia, Italy
| | - Fabrizia Terraneo
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Fernando Barbera
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Paola Vitali
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Francesco Frassine
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Andrea Guerini
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Vittorio Morelli
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Jessica Imbrescia
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | | | - Barbara Frittoli
- Department of Radiology, Spedali Civili Hospital, Brescia, Italy
| | - Frida Pittiani
- Department of Radiology, Spedali Civili Hospital, Brescia, Italy
| | - Luigi Grazioli
- Department of Radiology, Spedali Civili Hospital, Brescia, Italy
| | - Nazario Portolani
- Department of General Surgery, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Luca Nicosia
- Advanced Radiation Oncology Department, Cancer Care Centre, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Domenico Albano
- Department of Nuclear Medicine, ASST Spedali Civili di Brescia and Brescia University, Brescia, Italy
| | - Francesco Bertagna
- Department of Nuclear Medicine, ASST Spedali Civili di Brescia and Brescia University, Brescia, Italy
| | - Stefano Maria Magrini
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Michela Buglione
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
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Borghetti P, Imbrescia J, Volpi G, Scotti V, Aquilano M, Bruni A, Franceschini D, Ursino S, Ciammella P, Piperno G, Taraborrelli M, Magrini SM. Chemo-radiotherapy plus durvalumab for loco-regional relapse of resected NSCLC. Radiat Oncol 2022; 17:124. [PMID: 35842660 PMCID: PMC9288672 DOI: 10.1186/s13014-022-02084-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND tumor recurrence after NSCLC surgical resection is the most common cause of treatment failure that sharply reduces the patient's life expectancy. The optimal treatment strategy for loco-regional recurrences developing after surgical resection in patients with non-small-cell lung cancer (NSCLC) is not established yet. This report aims to describe the pattern of relapse, PFS, and OS in patients treated with radio-chemotherapy and durvalumab for loco-regional relapse after surgery. METHODS We conducted a multicenter, retrospective study including subjects who underwent surgical resection for NSCLC and were treated with Pacific protocol after loco-regional relapse. RESULTS Twenty-four patients met the inclusion criteria. At the time of diagnosis mean age was 65 years (range 47-78), the majority being male (58.3%). The 12-month progression-free survival rate was 68.7%, the 18-month progression-free survival rate was 45.8%, and the 24-month progression-free survival rate was 34.3%. There were three deaths: the 12-month survival rate was 91%, and the 18-month survival rate was 82.8%. CONCLUSIONS In this article, we propose a treatment strategy that might prolong post recurrence survival in patients with good performance status experiencing loco-regional relapse after surgery.
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Affiliation(s)
- Paolo Borghetti
- Radiation Oncology Department, ASST Spedali Civili and Brescia University, Brescia, Italy.
| | - Jessica Imbrescia
- Radiation Oncology Department, ASST Spedali Civili and Brescia University, Brescia, Italy
| | - Giulia Volpi
- Radiation Oncology Department, ASST Spedali Civili and Brescia University, Brescia, Italy
| | - Vieri Scotti
- Radiation Oncology Unit, Oncology Department AOU Careggi Firenze, Firenze, Italy
| | - Michele Aquilano
- Radiation Oncology Unit, Oncology Department AOU Careggi Firenze, Firenze, Italy
| | - Alessio Bruni
- Radiotherapy Unit, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Davide Franceschini
- IRCCS Humanitas Research Hospital - Radiotherapy and Radiosurgery Department, Milan, Italy
| | - Stefano Ursino
- Radiation Oncology Unit, University Hospital Santa Chiara Pisa, Pisa, Italy
| | - Patrizia Ciammella
- Radiotherapy Unit, Department of Oncology and Advanced Technologies, AUSL-IRCCS, Reggio Emilia, Italy
| | - Gaia Piperno
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Maria Taraborrelli
- Radiation Oncology Unit, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Stefano Maria Magrini
- Radiation Oncology Department, ASST Spedali Civili and Brescia University, Brescia, Italy
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Guerini AE, Tucci A, Alongi F, Mataj E, Belotti A, Borghetti P, Triggiani L, Pegurri L, Pedretti S, Bonù M, Tomasini D, Imbrescia J, Donofrio A, Facheris G, Singh N, Volpi G, Tomasi C, Magrini SM, Spiazzi L, Buglione M. RR Myelo POINT: A Retrospective Single-Center Study Assessing the Role of Radiotherapy in the Management of Multiple Myeloma and Possible Interactions with Concurrent Systemic Treatment. Cancers (Basel) 2022; 14:cancers14092273. [PMID: 35565401 PMCID: PMC9099690 DOI: 10.3390/cancers14092273] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 02/04/2023] Open
Abstract
Background and purpose: Although chemotherapy, biological agents, and radiotherapy (RT) are cornerstones of the treatment of multiple myeloma (MM), the literature regarding the possible interactions of concurrent systemic treatment (CST) and RT is limited, and the optimal RT dose is still unclear. Materials and methods: We retrospectively analyzed the records of patients who underwent RT for MM at our institution from 1 January 2005 to 30 June 2020. The data of 312 patients and 577 lesions (treated in 411 accesses) were retrieved. Results: Most of the treated lesions involved the vertebrae (60%) or extremities (18.9%). Radiotherapy was completed in 96.6% of the accesses and, although biologically effective doses assuming an α/β ratio of 10 (BED 10) > 38 Gy and CST were significantly associated with higher rates of toxicity, the safety profile was excellent, with side effects grade ≥2 reported only for 4.1% of the accesses; CST and BED 10 had no impact on the toxicity at one and three months. Radiotherapy resulted in significant improvements in performance status and in a pain control rate of 87.4% at the end of treatment, which further increased to 96.9% at three months and remained at 94% at six months. The radiological response rate at six months (data available for 181 lesions) was 79%, with only 4.4% of lesions in progression. Progression was significantly more frequent in the lesions treated without CST or BED 10 < 15 Gy, while concurrent biological therapy resulted in significantly lower rates of progression. Conclusion: Radiotherapy resulted in optimal pain control rates and fair toxicity, regardless of BED 10 and CST; the treatments with higher BED 10 and CST (remarkably biological agents) improved the already excellent radiological disease control.
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Affiliation(s)
- Andrea Emanuele Guerini
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Alessandra Tucci
- Department of Haematology, ASST-Spedali Civili Hospital, 25123 Brescia, Italy; (A.T.); (A.B.)
| | - Filippo Alongi
- Advanced Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar Di Valpolicella, Italy;
| | - Eneida Mataj
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Angelo Belotti
- Department of Haematology, ASST-Spedali Civili Hospital, 25123 Brescia, Italy; (A.T.); (A.B.)
| | - Paolo Borghetti
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
- Correspondence: ; Tel.: +39-0303995272
| | - Luca Triggiani
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Ludovica Pegurri
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Sara Pedretti
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Marco Bonù
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Davide Tomasini
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Jessica Imbrescia
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Alessandra Donofrio
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Giorgio Facheris
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Navdeep Singh
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Giulia Volpi
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Cesare Tomasi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, 25123 Brescia, Italy;
| | - Stefano Maria Magrini
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Luigi Spiazzi
- Medical Physics Department, ASST Spedali Civili Hospital, 25123 Brescia, Italy;
| | - Michela Buglione
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
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Bruni A, Bertolini F, D'Angelo E, Barbieri F, Imbrescia J, Trudu L, Cappelli A, Lohr F, Dominici M, Guaitoli G. 147P Chemo-immunotherapy with or without consolidative radiotherapy in extensive-stage small cell lung cancer: An initial report of clinical outcome and safety. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.178] [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] Open
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Borghetti P, Costantino G, Santoro V, Sepulcri M, Maddalo M, Greco D, Frassine F, Vitali P, Pastorello E, La Mattina S, Volpi G, Imbrescia J, Magrini S. PO-1194 A predictive model for OS in patients treated with Stereotactic Radiotherapy for early-stage NSCLC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07645-3] [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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Guerini A, Magrini S, Borghetti P, Volpi G, Luca T, Costa L, Pegurri L, Guaineri A, Imbrescia J, Ranghetti E, Premi A, Donofrio A, Spiazzi L, Buglione M. PO-1494 Universal testing for SARS-Cov-2 in patients undergoing anticancer treatment. Radiother Oncol 2021. [PMCID: PMC8479304 DOI: 10.1016/s0167-8140(21)07945-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Borghetti P, Imbrescia J, Volpi G, Costantino G, Cossali G, Greco D, Pastorello E, La Mattina S, Bonù ML, Tomasini D, Buglione M. Prevention and management of acute esophageal toxicity during concomitant chemoradiotherapy for locally advanced lung cancer. Tumori 2021; 108:470-476. [PMID: 34165018 DOI: 10.1177/03008916211025609] [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: 11/15/2022]
Abstract
BACKGROUND Standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC) is concomitant chemoradiotherapy. The survival benefit of combined treatment is partially counterbalanced by an increased rate of acute esophageal toxicity. Several pharmaceutical products are available for prevention and management of esophagitis, including Faringel Plus. AIM To assess the incidence and the grade, identify the correlations with clinical, dosimetric, and therapeutic variables, and analyse the role of Faringel Plus as a pharmaceutical preventive measure against acute esophageal toxicity. METHODS Patients with LA-NSCLC treated with concomitant radiochemotherapy were retrospectively reviewed. Acute esophagitis and dysphagia were graded according to Common Terminology Criteria for Adverse Events version 5.0. Clinical, dosimetric, and therapeutic correlations were investigated using χ2 test. RESULTS Among the 23 analysed patients, 18 (78.3%) and 1 (4.3%) developed G2 and G3 esophagitis, respectively; G1-2 dysphagia were reported in 11 cases (47.8%). No statistically significant correlation between the variables considered and acute esophageal toxicity was identified. In the group of patients who received Faringel Plus as preventive treatment (10 subjects, 43.5%), dysphagia presentation time was significantly longer (p = 0.038); esophagitis onset time was longer and symptoms duration was shorter. Faringel Plus allowed a reduction in the use of analgesic drugs. CONCLUSIONS Acute mild esophageal toxicity was confirmed to be a common side effect in this setting. No clinical-dosimetric parameter has been demonstrated to be effective in predicting acute esophageal toxicity. The use of Faringel Plus appears effective as a therapeutic and prophylactic tool to manage acute esophageal toxicity.
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Affiliation(s)
- Paolo Borghetti
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Jessica Imbrescia
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Giulia Volpi
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Gianluca Costantino
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Gianluca Cossali
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Diana Greco
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Edoardo Pastorello
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Salvatore La Mattina
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Marco Lorenzo Bonù
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Davide Tomasini
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Michela Buglione
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
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9
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Guaineri A, Triggiani L, Frassine F, Imbrescia J, Barbera F, Vitali P, Terraneo F, Pegurri L, Ranghetti E, Taddeo A, Magrini S, Buglione M. PO-1115: What's the role of tumor regression grade (TRG) in rectal cancer: an istututional experience. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01132-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Borghetti P, Volpi G, Imbrescia J, Bonù M, Guerini A, Turla O, Maddalo M, Vitali P, Triggiani L, Donofrio A, Buglione M, Magrini S. PO-1028: Consolidation therapy with Durvalumab after radical CRT in stage IIII NSCLC: a preliminar analysis. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01045-8] [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: 11/26/2022]
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11
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Guerini AE, Borghetti P, Filippi AR, Bonù ML, Tomasini D, Greco D, Imbrescia J, Volpi G, Triggiani L, Borghesi A, Maroldi R, Pasinetti N, Buglione M, Magrini SM. Differential Diagnosis and Clinical Management of a Case of COVID-19 in a Patient With Stage III Lung Cancer Treated With Radio-chemotherapy and Durvalumab. Clin Lung Cancer 2020; 21:e547-e550. [PMID: 32527714 PMCID: PMC7265852 DOI: 10.1016/j.cllc.2020.05.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/17/2020] [Accepted: 05/26/2020] [Indexed: 12/19/2022]
Affiliation(s)
| | - Paolo Borghetti
- Radiation Oncology Department, ASST Spedali Civili of Brescia, Brescia, Italy
| | | | - Marco Lorenzo Bonù
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy
| | - Davide Tomasini
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy.
| | - Diana Greco
- Radiation Oncology Department, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Jessica Imbrescia
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy
| | - Giulia Volpi
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy
| | - Luca Triggiani
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy
| | - Andrea Borghesi
- Department of Radiology, University and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Roberto Maroldi
- Department of Radiology, University and ASST Spedali Civili of Brescia, Brescia, Italy
| | | | - Michela Buglione
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy
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