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Rigo M, Giaj-Levra N, Mazzola R, Nicosia L, Ricchetti F, Pastorello E, Ravelli P, D'alessandro S, Ruggieri R, Alongi F. 1.5T MR-Guided Daily Adaptive Radiotherapy: Preliminary Clinical Report of the First 5000 Fractions. Int J Radiat Oncol Biol Phys 2023; 117:e712-e713. [PMID: 37786084 DOI: 10.1016/j.ijrobp.2023.06.2212] [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) 1.5T MR-Linac improves target volume and adjacent OARs visualization, ensuring high precision in radiation treatment delivery. Daily MR-imaging allows on-table adapted planning and real-time intra-fraction imaging without additional exposure to radiation. Our department implemented the first high field MRgRT system in Italy and herein we present the preliminary report of the first 5000 fractions delivered. We aim to describe the clinical implementation, feasibility, toxicity and patient tolerability of daily adapted RT. MATERIALS/METHODS Since October 2019, 1.5T MR-Linac has been available in our department. A prospective observational study for the clinical use of 1.5T MR-Linac is currently ongoing in our department: patients affected by prostate adenocarcinoma, pancreatic cancer, oligometastases and patients requiring retreatments were included. Two different workflows were used depending on the OARs daily anatomy: Adapt To Position (ATP) where the reference plan position is adjusted rigidly to match the position of the targets and OARs, and Adapt To Shape (ATS) where a new plan is created to better match the anatomy of the day. Toxicity and quality of life were assessed at baseline and after treatment using the CTCAE v5.0. Patient-reported outcomes of prostate cancer patients were investigated by means IPSS, ICIQ-SF, IIEF-5, EPIC-26, EORTC-QLQ-C30 and PR-25 questionnaires. RESULTS Between October 2019 and June 2022, 590 patients with 675 target sites were treated with MR-guided radiation therapy in 5000 total fractions. Median patient age was 70 years (39-86). Among 675 tumor sites, the most frequently treated region was pelvis (n = 549, 81%). The most common diagnosis was prostate cancer (n = 326). On-table adaptive radiation therapy was used at every treatment session: ATP workflow in 63 fractions (1%) and ATS workflow in 4937 fractions (99%), respectively. Median prescribed dose was 35 Gy (20-67.5 Gy) in median 5 fractions (5-30). Mean total treatment time was 43 minutes (20-56). Treatments were well-tolerated and no acute G>3 toxicities were reported. Concerning the PROMS, all questionnaires showed no relevant deterioration between the pre-, post-RT and follow-up evaluations. CONCLUSION MR-guided radiation treatment using 1.5T MR-Linac has been successfully implemented into clinical routine at our department. The data reported support an optimal profile of tolerability of daily on-table adaptive radiation therapy in acceptable time slots. These results are confirmed by PROMs.
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Affiliation(s)
- M Rigo
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella (VR), Italy
| | - N Giaj-Levra
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella (VR), Italy
| | - R Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella (VR), Italy
| | - L Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella (VR), Italy
| | - F Ricchetti
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella (VR), Italy
| | - E Pastorello
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella (VR), Italy
| | - P Ravelli
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella (VR), Italy
| | - S D'alessandro
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella (VR), Italy
| | - R Ruggieri
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella (VR), Italy
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Cuccia F, Mazzola R, Pastorello E, Figlia V, Giaj-Levra N, Nicosia L, Ricchetti F, Rigo M, Vitale C, Attinà G, Ruggieri R, Alongi F. PO-1463 SBRT for over 80years oligometastatic patients: report of feasibility and clinical outcomes. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03427-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cuccia F, Pastorello E, Vitale C, Figlia V, Giaj-Levra N, Nicosia L, Ricchetti F, Rigo M, Mazzola R, Ceccaroni M, Ruggieri R, Alongi F. PO-1353 SBRT for gynecological oligometastases: mono-institutional report of toxicity and clinical outcomes. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03317-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nicosia L, Giaj-Levra N, Sicignano G, Cuccia F, Figlia V, Mazzola R, Ricchetti F, Rigo M, Vitale C, Attinà G, De Simone A, Gurrera D, Ruggeri R, Molon G, Alongi F. PO-1452 Stereotactic ablative radiotherapy in patients with refractory ventricular tachyarrhythmia. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03416-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nicosia L, Vitale C, Cuccia F, Rigo M, Figlia V, Mazzola R, Giaj-Levra N, Ricchetti F, Ruggeri R, Alongi F. PD-0574 1.5T MR-guided RT versus linac-based VMAT SBRT in localized prostate cancer: a toxicity comparison. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02889-4] [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: 11/28/2022]
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Cuccia F, Mazzola R, Pastorello E, Ingrosso G, Franzese C, Scorsetti M, Figlia V, Giaj-Levra N, Nicosia L, Rigo M, Ricchetti F, Vitale C, Attinà G, Ruggieri R, Alongi F. PD-0086 PSMA-PET guided stereotactic body radiotherapy for bone oligorecurrent prostate cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02756-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nicosia L, Figlia V, Ricottone N, Cuccia F, Mazzola R, Giaj-Levra N, Ricchetti F, Rigo M, Girlando A, Alongi F. PO-1188 Stereotactic body RT (SBRT) and concomitant systemic therapy in oligoprogressive breast cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03152-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nicosia L, Vitale C, Cuccia F, Figlia V, Giaj-Levra N, Mazzola R, Ricchetti F, Rigo M, Ruggero R, Cavalleri S, Alongi F. PO-1407 Postoperative hypofractionated RT: toxicity and efficacy in a series of 304 prostate adenocarcinoma. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03371-0] [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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Cuccia F, Mazzola R, Sicignano G, Vitale C, Rigo M, Giaj-Levra N, Nicosia L, Figlia V, Ricchetti F, Attinà G, Pastorello E, De Simone A, Gurrera D, Naccarato S, Ruggieri R, Alongi F. Impact of hydrogel peri-rectal spacer insertion on seminal vesicles intra-fraction motion during 1.5 t-MRI-guided adaptive stereotactic body radiotherapy for localized prostate cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02741-5] [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: 11/17/2022] Open
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Cuccia F, Rigo M, Gurrera D, Nicosia L, Figlia V, Giaj-Levra N, Mazzola R, Ricchetti F, Attinà G, De Simone A, Naccarato S, Sicignano G, Ruggieri R, Alongi F. Preliminary Dosimetric Analysis of the First 150 Sessions of 1.5-T MR-Guided Daily-Adaptive Radiotherapy for Abdomino-Pelvic Lymph-Nodal Oligometastases. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1495] [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: 11/28/2022]
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Cuccia F, Mazzola R, Pastorello E, Rigo M, Giaj-Levra N, Nicosia L, Figlia V, Ricchetti F, Attinà G, Vitale C, De Simone A, Gurrera D, Naccarato S, Sicignano G, Ruggieri R, Alongi F. PSMA-guided SBRT for bone oligometastatic prostate cancer: a monoinstitutional report of preliminary outcomes and toxicity. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02743-9] [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: 10/19/2022] Open
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Cuccia F, Nicosia L, Mazzola R, Figlia V, Giaj-Levra N, Ricchetti F, Rigo M, Vitale C, Attinà G, Pastorello E, Corradini S, Ruggieri R, Alongi F. PO-1376 Preliminary mono-institutional report of prostate/prostate bed SBRT re-irradiation. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07827-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rigo M, Cuccia F, Figlia V, Giaj-Levra N, Mazzola R, Nicosia L, Ricchetti F, Gurrera D, De Simone A, Naccarato S, Sicignano G, Ruggieri R, Alongi F. PO-1499 1.5T MR-guided daily adaptive radiotherapy: preliminary clinical report of the first 2000 fractions. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07950-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cuccia F, Mazzola R, Figlia V, Rigo M, Nicosia L, Giaj-Levra N, Ricchetti F, Vitale C, Attinà G, Pastorello E, Di Paola G, De Simone A, Gurrera D, Naccarato S, Sicignano G, Ruggieri R, Alongi F. PO-1388 1.5 T MR-guided SBRT for oligorecurrent prostate cancer: preliminary report of feasibility and PROMs. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07839-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nicosia L, Vitale C, Cuccia F, Figlia V, Giaj-Levra N, Mazzola R, Ricchetti F, Rigo M, Ruggieri R, Cavalleri S, Alongi F. PO-1353 Postoperative hypofractionated RT for prostate adenocarcinoma: results from a large series. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07804-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Figlia V, Giaj-Levra N, Mazzola R, Rigo M, Cuccia F, Nicosia L, Ricchetti F, Attinà G, Pastorello E, Sicignano G, De Simone A, Naccarato S, Gurrera D, Ruggieri R, Alongi F. PO-1439 Clinical results of SBRT for spinal metastases using dedicated contouring/planning system. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07890-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cuccia F, Mazzola R, Attinà G, Figlia V, Giaj-Levra N, Nicosia L, Ricchetti F, Rigo M, Pastorello E, Alongi F. PO-1153 Preliminary mono-institutional report of stereotactic body radiotherapy for lung oligometastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07604-0] [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: 11/15/2022]
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Rigo M, Cuccia F, Figlia V, Giaj-Levra N, Mazzola R, Nicosia L, Ricchetti F, Gurrera D, De Simone A, Naccarato S, Sicignano G, Ruggieri R, Alongi F. PO-1512 Daily adaptive MR-guided SBRT for oligometastatic lymph-nodes:feasibility and preliminary experience. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07963-9] [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: 11/26/2022]
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Alongi F, Nicosia L, Figlia V, De Sanctis V, Mazzola R, Giaj-Levra N, Reverberi C, Valeriani M, Osti MF. A multi-institutional analysis of fractionated versus single-fraction stereotactic body radiotherapy (SBRT) in the treatment of primary lung tumors: a comparison between two antipodal fractionations. Clin Transl Oncol 2021; 23:2133-2140. [PMID: 33840047 DOI: 10.1007/s12094-021-02619-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/06/2021] [Accepted: 04/01/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Stereotactic body radiotherapy (SBRT) is a consolidate treatment for inoperable early-stage lung tumors, usually delivered in single or multi-fraction regimens. We aimed to compare these two approaches in terms of local effectiveness, safety and survival. MATERIALS AND METHODS Patients affected by medically inoperable early-stage lung tumor were treated at two Institutions with two different schedules: 70 Gy in ten fractions (TF) (BED10: 119 Gy) or 30 Gy in single fraction (SF) (BED10: 120 Gy). RESULTS 73 patients were treated with SBRT delivered with two biological equivalent schedules: SF (44) and TF (29). The median follow-up was 34 months (range 3-81 months). Three-year Overall survival (OS) was 57.9%, 3-year cancer-specific survival (CSS) was 77.2%, with no difference between treatment groups. Three-year progression-free survival (LPFS) was 88.9% and did not differs between SF and TF. Overall, four cases (5.4%) of acute grade ≥ 3 pneumonitis occurred. No differences in acute and late toxicity between the two groups were detected. CONCLUSION SF and TF seems to be equally safe and effective in the treatment of primary inoperable lung tumors especially for smaller lesion. The SF may be preferentially offered to reduce patient access to hospital with no negative impact on tumor control and survival.
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Affiliation(s)
- F Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
- University of Brescia, Brescia, Italy
| | - L Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy.
| | - V Figlia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - V De Sanctis
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - R Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - N Giaj-Levra
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - C Reverberi
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - M Valeriani
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - M F Osti
- Department of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
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Alongi F, Nicosia L, Figlia V, Giaj-Levra N, Cuccia F, Mazzola R, Ricchetti F, Rigo M, Vitale C, De Simone A, Naccarato S, Sicignano G, Gurrera D, Corradini S, Ruggeri R. Long-term disease outcome and volume-based decision strategy in a large cohort of multiple brain metastases treated with a mono-isocentric linac-based Stereotactic Radiosurgery technique. Clin Transl Oncol 2021; 23:1561-1570. [PMID: 33570720 DOI: 10.1007/s12094-020-02550-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Radiosurgery (SRS) is an effective treatment option for brain metastases (BMs). Long-term results of the first worldwide experience with a mono-isocentric, non-coplanar, linac-based stereotactic technique in the treatment of multiple BMs are reported. METHODS patients with multiple BMs, life expectancy > 3 months, and good performance status (≤ 2) were treated with simultaneous SRS with volumetric modulated arc technique. Data were retrospectively evaluated. RESULTS 172 patients accounting for 1079 BMs were treated at our institution from 2017 to 2020. The median number of treated metastases was 4 (range 2-22). Primary tumor histology was: lung (44.8%), breast (32%), and melanoma (9.4%). The 2-year LPFS was 71.6%, respectively. A biological effective dose (BED) ≥ 51.3 Gy10 correlated with higher local control. Uncontrolled systemic disease and melanoma histology were independent prognostic factors correlated with decreased iPFS. Patients with > 10 BMs had a trend towards shorter iPFS (p = 0.055). 31 patients received multiple SRS courses (2-7) in case of intracranial progression. The median iOS was 22.4 months. Brainstem metastases and total PTV > 7.1 cc correlated with shorter iOS. The 1- and 2-year WBRT-free survival was 83.2% and 61.1%, respectively. CONCLUSION Long-term results in a large patient population treated with a mono-isocentric, dedicated technique demonstrated its effectiveness and safety also in the case of multiple courses. The shortened treatment time and the possibility to safely spare healthy brain tissue allows the safe treatment of patients with a large number of metastases and to deliver multiple courses of SRS. In selected cases, the administration of WBRT can be delayed.
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Affiliation(s)
- F Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy.,University of Brescia, Brescia, Italy
| | - L Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy.
| | - V Figlia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - N Giaj-Levra
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - F Cuccia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - R Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - F Ricchetti
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - M Rigo
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - C Vitale
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - A De Simone
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - S Naccarato
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - G Sicignano
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - D Gurrera
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - S Corradini
- Radiation Oncology Department, University Hospital, LMU Munich, Munich, Germany
| | - R Ruggeri
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
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Frassinelli L, Borghetti P, Giaj-Levra N, D'Angelo E, Bonù M, Salvestrini V, Costantino G, Mariotti M, Alongi F, Lohr F, Scotti V, Bruni A. PO-1000: Multicentric restrospective analysis of safety of SBRT to centrally located lesion of the lung. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01017-3] [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: 10/22/2022]
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Rigo M, Mazzola R, Figlia V, Nicosia L, Giaj-Levra N, Ricchetti F, Francesco C, Alongi F. PO-1163: 68Ga-PSMA PET-Guided metastases directed stereotactic body radiotherapy in prostatic cancer patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01181-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mazzola R, Figlia V, Rigo M, Cuccia F, Nicosia L, Giaj-Levra N, Ricchetti F, Vitale C, De Simone A, Sicignano G, Naccarato S, Ruggieri R, Alongi F. Geriatric assessment tools and preliminary patient-reported outcomes in a cohort of elderly patients treated with 1.5T MR-guided and daily adapted abdominal-pelvic SBRT. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36210-8] [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: 11/25/2022] Open
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Nicosia L, Cuccia F, Rigo M, Figlia V, Giaj-Levra N, Mazzola R, Ricchetti F, Tomasini D, Alongi F. PO-1027: Disease natural history of lung oligometastatic colo-rectal cancer patients treated with SBRT. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01044-6] [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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Rigo M, Mazzola R, Napoli G, Giaj-Levra N, Figlia V, Nicosia L, Ricchetti F, Bellorofonte C, Cuccia F, Alongi F. PO-1162: Post hifu salvage radiotherapy in locally relapsed prostate carcinoma: a mono-institutional analysis. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01180-4] [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: 11/25/2022]
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Olmetto E, Scoccianti S, Di Franco R, Anselmo P, Beltramo G, Mantovani C, Osti M, Pinzi V, Giaj-Levra N, Bruni A, Matteucci P, Pedretti S, Giudice E, Tini P, Krengli M, Ciammella P, Pasqualetti F, Trignani M, Merlotti A, Borzillo V, Franceschini D, Maranzano E, Umberto R, Pierina N, Scotti V. PD-0175: TTIRS trial:a retrospective analysis of the association between TT or IT and RS for BM from NSCLC. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00199-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nicosia L, Cuccia F, Figlia V, Giaj-Levra N, Mazzola R, Ricchetti F, Rigo M, Bonù M, Alongi F. PO-1062: Stereotactic body radiotherapy can delay polymetastatic conversion in liver oligometastatic patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01079-3] [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: 11/30/2022]
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Alongi F, Figlia V, Giaj-Levra N, Cuccia F, Mazzola R, Ricchetti F, Rigo M, Vitale C, Corradini S, Ruggieri R, Nicosia L. Non-Coplanar Mono-Isocenter Stereotactic Radiotherapy For Multiple Brain Metastases From Solid Tumors: Results From The First 1000 Metastases. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2065] [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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Cuccia F, Nicosia L, Mazzola R, Figlia V, Giaj-Levra N, Ricchetti F, Rigo M, Vitale C, Corradini S, Ruggieri R, Alongi F. Linac-based SBRT for local recurrent prostate cancer after previous radiotherapy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36196-6] [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] Open
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Nicosia L, Mazzola R, Francolini G, Triggiani L, Napoli G, Cuccia F, Figlia V, Giaj-Levra N, Ricchetti F, Rigo M, Vitale C, Livi L, Magrini S, Salgarello M, Alongi F. 678P Metastasis-directed stereotactic body radiotherapy (SBRT)-guided by PET-CT 18F-choline versus PET-CT 68Ga-PSMA in castration sensitive oligorecurrent prostate cancer: A comparative effectiveness analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Mazzola R, Figlia V, Rigo M, Cuccia F, Ricchetti F, Giaj-Levra N, Nicosia L, Vitale C, Sicignano G, De Simone A, Naccarato S, Ruggieri R, Alongi F. 1862P Geriatric assessment tools and preliminary patient-reported outcomes in a cohort of elderly patients treated with 1.5T MR guided abdominal-pelvic SBRT. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1509] [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] Open
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Osti M, Figlia V, Rigo M, Mazzola R, Ricchetti F, Giaj-Levra N, Valeriani M, Reverberi C, Nicosia L, Alongi F. Fractionated Stereotactic Body Radiotherapy (SBRT) Versus Single Dose Stereotactic Body Radiotherapy in the Treatment of Primary Lung Tumors: Early Results from a Multi-Institutional Analysis. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2425] [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: 11/28/2022]
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Rigo M, Giaj-Levra N, Figlia V, Mazzola R, Nicosia L, Ricchetti F, Ruggieri R, Alongi F. EP-1347 "Risk adapative" dose prescription in central NSCLC lesions in early stage NSCLC and lung metastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31767-0] [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: 11/27/2022]
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Alongi F, Gregucci F, Fiorentino A, Mazzola R, Figlia V, Ricchetti F, Sicignano G, Giaj-Levra N, Naccarato S, Massocco A, Corradini S, Ruggieri R. PV-0047 IMRT versus VMAT for elderly patients with breast cancer: comparison of acute and late toxicities. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30467-0] [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: 11/25/2022]
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Giaj-Levra N, Trovo M, Muraro E, Fersino S, Fiorentino A, Mazzola R, Ricchetti F, Filippi A, Ricardi U, Alongi F. Report of a Pilot Study on IL-13 As Prognostic Biomarker in Patients with Early Stage Lung Cancer Treated with Stereotactic Ablative Radiation Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1842] [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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Alongi F, Fiorentino A, Gregucci F, Giaj-Levra N, Mazzola R, Ricchetti F, Fersino S, Ruggieri R. Stereotactic Intracranial Ablative Radiation Therapy for Brain Metastases with a Mono-Isocenter No-Coplanar Dedicated System: A Preliminary Dosimetric and Clinical Report. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.717] [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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Mazzola R, Giaj-Levra N, Fiorentino A, Fersino S, Figlia V, Gregucci F, Ricchetti F, Ruggieri R, Alongi F. Can Stereotactic Body Radiation Therapy for Lung Oligometastases Impact on Delaying the Administration of Systemic Therapies? A Cohort Study of 70 Patients with 140 Lung Metastases. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dingemans A, Hendriks L, Berghmans T, Levy A, Hasan B, Faivre-Finn C, Giaj Levra M, Giaj-Levra N, Girard N, Greillier L, Lantuejoul S, Edwards J, O'Brien M, Reck M, Smit E, Van Schil P, Postmus P, Ramella S, Lievens Y, Gaga M, Peled N, Scagliotti G, Senan S, Paz-Ares L, Guckenberger M, Mcdonald F, Ekman S, Cufer T, Gietema H, Infante M, Dziadziuszko R, Besse B, Novello S. MA25.02 Searching for a Definition of Synchronous Oligometastatic (sOMD)-NSCLC: A Consensus from Thoracic Oncology Experts. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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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Levy A, Hendriks L, Berghmans T, Faivre-Finn C, Giaj Levra M, Giaj-Levra N, Hasan B, Girard N, Greillier L, Lantuejoul S, Edwards J, O’Brien M, Reck M, Besse B, Novello S, Dingemans A. MA25.01 EORTC Lung Cancer Group Survey to Define Synchronous Oligometastatic Disease in NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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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Fiorentino A, Mazzola R, Fersino S, Ricchetti F, Giaj-Levra N, Gregucci F, Alongi F. PO-0861: Stereotactic Ablative Radiotherapy For Oligometastatic Patients With Isolated/Limited Lymphnodes. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31171-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Fersino S, Mazzola R, Aiello D, Gregucci F, Giaj-Levra N, Fiorentino A, Ricchetti F, Ruggieri R, Alongi F. EP-1417: SBRT for liver oligometastases:predictive factors of local responce response by 18F-FDG-PET/CT. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31726-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tebano U, Fiorentino A, Sicignano G, Giaj-Levra N, Fersino S, Mazzola R, Ricchetti F, Naccarato S, Ruggieri R, Alongi F. EP-1103: Are hippocampi considered organs at risks during stereotactic radiotherapy for brain metastases? Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31539-6] [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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Alongi F, Fersino S, Mazzola R, Fiorentino A, Giaj-Levra N, Ricchetti F, Ruggieri R, Di Paola G, Cirillo M, Gori S, Salgarello M, Zamboni G, Ruffo G. Radiation dose intensification in pre-operative chemo-radiotherapy for locally advanced rectal cancer. Clin Transl Oncol 2017; 19:189-196. [PMID: 27271749 DOI: 10.1007/s12094-016-1522-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 03/16/2016] [Accepted: 05/28/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND To assess the role of radiation dose intensification with simultaneous integrated boost guided by 18-FDG-PET/CT in pre-operative chemo-radiotherapy (ChT-RT) for locally advanced rectal cancer. METHODS A prospective study was approved by the Internal Review Board. Inclusion criteria were: age >18 years old, World Health Organization performance status of 0-1, locally advanced histologically proven adenocarcinoma of the rectum within 10 cm of the anal verge, signed specific informed consent. High-dose volumes were defined including the hyper-metabolic areas of 18-FDG-PET/CT of primary tumor and the corresponding mesorectum and/or pelvic nodes with at least a standardized uptake values (SUV) of 5. A dose of 60 Gy/30 fractions was delivered. A total dose of 54 Gy/30 fractions was delivered to prophylactic areas. Capecitabine was administered concomitantly with RT for a dose of 825 mg/mq twice daily for 5 days/every week. RESULTS Between September 2011 and July 2015 fortypatients were recruited. At the time of the analysis, median follow up was 20 months (range 5-51). The median interval from the end of ChT-RT to surgery was 9 weeks (range 8-12). Thirty-seven patients (92.5 %) were submitted to sphincter preservation. Tumor Regression Grade (Mandard scale) was recorded as follows: grade 1 in 7 (17.5 %), grade 2 in 17 (42.5 %), grade 3 in 15 (37.5 %) and grade 4 in 1 (2.5 %). Post-surgical circumferential resection margin was negative in all patients. A tumor downstaging was reported in 62.5 % (95 % CI: 0.78-0.47). A nodes downstaging was registered in 85 % (95 % CI: 0.55-0.25). 18-FDG-PET/CT was not able to predict pCR. No correlation was found between pre-treatment SUV-max values and pCR. A metabolic tumor volume >127 cc was related to ypT ≥2 (p 0.01). Patients with TRG >2 had higher tumor lesion glycolysis values (p 0.05). CONCLUSION Preliminary results did not confirm some advantages in terms of primary tumor downstaging/downsizing compared to conventional schedules reported in historical series. The role of 18-FDG-PET/CT in neoadjuvant rectal cancer management needs to be confirmed in further investigations. Long terms results are necessary.
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Affiliation(s)
- F Alongi
- Radiation Oncology Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - S Fersino
- Radiation Oncology Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - R Mazzola
- Radiation Oncology Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy.
| | - A Fiorentino
- Radiation Oncology Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - N Giaj-Levra
- Radiation Oncology Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - F Ricchetti
- Radiation Oncology Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - R Ruggieri
- Radiation Oncology Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - G Di Paola
- Statistic Science Faculty, University of Palermo, Palermo, Italy
| | - M Cirillo
- Medical Oncology Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - S Gori
- Medical Oncology Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - M Salgarello
- Nuclear Medicine Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - G Zamboni
- Pathology Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
| | - G Ruffo
- Surgery Division, Sacro Cuore Don Calabria Cancer Care Center, Negrar, Verona, Italy
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Mazzola R, Ricchetti F, Fiorentino A, Giaj-Levra N, Fersino S, Tebano U, Albanese S, Gori S, Alongi F. Fentanyl pectin nasal spray for painful mucositis in head and neck cancers during intensity-modulated radiation therapy with or without chemotherapy. Clin Transl Oncol 2016; 19:593-598. [DOI: 10.1007/s12094-016-1570-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 10/31/2016] [Indexed: 12/14/2022]
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Giaj-Levra N, Fiorentino A, Mazzola R, Fersino S, Ricchetti F, Sicignano G, Naccarato S, Ruggieri R, Alongi F. EP-1153: Hypofractionated radiotherapy and simultaneous boost in breast cancer: preliminary result in elderly. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32403-3] [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: 11/25/2022]
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