1
|
Saldi S, Panizza B, Massei M, Capolsini I, Fulcheri C, Ingrosso G, Chierchini S, Mariucci C, Perrucci E, Caniglia M, Aristei C. PO-0921: Total Body Irradiation and adoptive immunotherapy in pediatric HLA-haploidentical transplantation. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00938-5] [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: 11/29/2022]
|
2
|
Falcinelli L, Mendichi M, Chierchini S, Tenti MV, Bellavita R, Saldi S, Ingrosso G, Reggioli V, Bini V, Aristei C. Pulmonary function in stereotactic body radiotherapy with helical tomotherapy for primary and metastatic lung lesions. Radiol Med 2020; 126:163-169. [PMID: 32415475 DOI: 10.1007/s11547-020-01223-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/27/2020] [Indexed: 11/29/2022]
Abstract
AIMS This retrospective study reports outcomes after stereotactic body radiation therapy (SBRT) as delivered by helical tomotherapy (HT) for lung lesions. It promotes a dose escalation program. METHODS Histological and/or radiological findings and/or case histories identified 41 primary and 15 metastatic lesions. Thirty patients received 40 Gy in 5 fractions (BED 72 Gy10Gy) and 26 50 Gy in 5 fractions (BED 100Gy10Gy). Primary end point was lung toxicity. Secondary end points were respiratory function, local control and local progression-free survival. RESULTS Acute toxicity developed in 18/56 patients and late toxicity in 8/54. Median FEV-1 variations versus baseline were - 0.5% (range - 16 to + 43%) at 6 months and - 4.00% (range - 42 to + 18%) at 24 months. Median DLCO variations versus baseline were - 1% (range - 38 to + 36%) at 6 months and - 12.2% (range - 48 to + 11%) at 24 months. At 6 months, a significant positive correlation emerged between FEV-1 change and KPS (p = 0.047). At 24 months, a significant negative correlation emerged between FEV-1 change and the ipsilateral lung V5 (p = 0.006). A low baseline DLCO correlated with more marked DLCO worsening at 6 months (p = 0.012). At 24 months, DLCO worsening correlated significantly with the median contralateral lung dose (p = 0.003). At the last checkup, 23 patients were in complete remission, 16 were in partial remission, 5 had stable disease, and 7 were in relapse. Median follow-up was 12 months (range 5-56). CONCLUSIONS In patients with lung disease, SBRT, as delivered by HT, was well tolerated and provided good local control.
Collapse
Affiliation(s)
| | - Monia Mendichi
- Radiation Oncology Unit, University of Perugia, Perugia, Italia
| | - Sara Chierchini
- Radiation Oncology Unit, University of Perugia, Perugia, Italia.
| | | | - Rita Bellavita
- Radiation Oncology Section, Perugia General Hospital, Perugia, Italia
| | - Simonetta Saldi
- Radiation Oncology Section, Perugia General Hospital, Perugia, Italia
| | - Gianluca Ingrosso
- Radiation Oncology Unit, University of Perugia and Perugia General Hospital, Perugia, Italia
| | | | - Vittorio Bini
- Endocrine and Metabolic Science Unit, University of Perugia, Perugia, Italia
| | - Cynthia Aristei
- Radiation Oncology Unit, University of Perugia and Perugia General Hospital, Perugia, Italia
| |
Collapse
|
3
|
Saldi S, Perrucci E, Fulcheri CPL, Mariucci C, Chierchini S, Ingrosso G, Falcinelli L, Podlesko AM, Merluzzi M, Bini V, Aristei C. Zinc-L-carnosine prevented dysphagia in breast cancer patients undergoing adjuvant radiotherapy: Results of a phase III randomized trial. Breast J 2020; 26:1882-1884. [PMID: 32383225 DOI: 10.1111/tbj.13855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/05/2020] [Accepted: 04/08/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Simonetta Saldi
- Radiation Oncology Section, Perugia General Hospital, Perugia, Italy
| | | | | | - Cristina Mariucci
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Sara Chierchini
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Gianluca Ingrosso
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy
| | | | - Anna Maria Podlesko
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Mara Merluzzi
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Vittorio Bini
- Internal Medicine, Endocrinology & Metabolism, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Cynthia Aristei
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy
| |
Collapse
|
4
|
Chierchini S, Ingrosso G, Saldi S, Stracci F, Aristei C. Physician And Patient Barriers To Radiotherapy Service Access: Treatment Referral Implications. Cancer Manag Res 2019; 11:8829-8833. [PMID: 31632142 PMCID: PMC6789154 DOI: 10.2147/cmar.s168941] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 06/18/2019] [Accepted: 09/14/2019] [Indexed: 12/24/2022] Open
Abstract
Radiotherapy is one of the mainstays of cancer treatment, and about 60% of cancer patients receive this type of treatment during their course of treatment. An evident gap between optimal and actual radiotherapy utilization proportions has recently been reported, which has been ascribed to lack of referral to radiation oncology. There are many factors influencing the radiotherapy referral, including patient anxiety about toxicity, wrong perception of efficacy and side effects by physicians and patients, insufficient knowledge of referral process. These factors, defined as barriers can be categorized in health system barriers, physician and patient barriers. In the present brief narrative review, we discussed barriers to radiotherapy referral focusing on physician and patient barriers.
Collapse
Affiliation(s)
- Sara Chierchini
- Radiation Oncology Section, Department of Surgical and Biomedical Sciences, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Gianluca Ingrosso
- Radiation Oncology Section, Department of Surgical and Biomedical Sciences, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Simonetta Saldi
- Radiation Oncology Section, Department of Surgical and Biomedical Sciences, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Fabrizio Stracci
- Department of Experimental Medicine, Section of Public Health, University of Perugia, Perugia, Italy
| | - Cynthia Aristei
- Radiation Oncology Section, Department of Surgical and Biomedical Sciences, University of Perugia and Perugia General Hospital, Perugia, Italy
| |
Collapse
|
5
|
Saldi S, Perrucci E, Lancellotta V, Palumbo I, Falcinelli L, Mariucci C, Chierchini S, Bini V, Aristei C. EP-1292 Zinc-L-Carnosine prevents dysphagia in breast cancer patients treated with adjuvant radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31712-8] [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: 11/15/2022]
|
6
|
Fiorentino A, Mazzola R, Lancellotta V, Saldi S, Chierchini S, Alitto A, Borghetti P, Gregucci F, Fiore M, Desideri I, Marino L, Greto D. EP-1653 Evaluation of Italian Radiotherapy research: preliminary analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32073-0] [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: 11/26/2022]
|
7
|
Lancellotta V, Chierchini S, Perrucci E, Saldi S, Falcinelli L, Iacco M, Zucchetti C, Palumbo I, Bini V, Aristei C. Skin toxicity after chest wall/breast plus level III-IV lymph nodes treatment with helical tomotherapy. Cancer Invest 2018; 36:504-511. [PMID: 30516084 DOI: 10.1080/07357907.2018.1545854] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION To evaluate the incidence of toxicity in breast cancer with helical tomotherapy (HT). MATERIALS AND METHODS 51 patients with breast cancer were assigned to postoperative radiotherapy by means of HT to the chest wall/breast plus draining nodes. During HT treatment, toxicity was monitored and were assessed using the Common Terminology Criteria for Adverse Events 4.0 scale. RESULTS Acute skin G3 toxicity observed in 1.9% cases. No acute or late G4 toxicity was observed. At a median follow-up of 21 months 2 patients have late G1 toxicity. CONCLUSIONS HT was associated with a low incidence of low-grade skin toxicity.
Collapse
Affiliation(s)
- Valentina Lancellotta
- a Radiation Oncology Section , Department of Surgical and Biomedical Sciences , University of Perugia and Perugia General Hospital , Italy
| | | | | | | | | | - Martina Iacco
- d Medical Physics Unit, Perugia General Hospital , Italy
| | | | - Isabella Palumbo
- a Radiation Oncology Section , Department of Surgical and Biomedical Sciences , University of Perugia and Perugia General Hospital , Italy
| | - Vittorio Bini
- e Internal Medicine, Endocrine and Metabolic Science Section , University of Perugia , Perugia , Italy
| | - Cynthia Aristei
- a Radiation Oncology Section , Department of Surgical and Biomedical Sciences , University of Perugia and Perugia General Hospital , Italy
| |
Collapse
|
8
|
Fiorentino A, Mazzola R, Lancellotta V, Saldi S, Chierchini S, Alitto AR, Borghetti P, Gregucci F, Fiore M, Desideri I, Marino L, Greto D, Tebala GD. Evaluation of Italian radiotherapy research from 1985 to 2005: preliminary analysis. Radiol Med 2018; 124:234-240. [PMID: 30430384 DOI: 10.1007/s11547-018-0960-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/02/2018] [Indexed: 01/26/2023]
Abstract
AIM The difficulty in conducting meaningful clinical research is a multifactorial issue, involving political, financial and cultural problems, which can lead to unexpected negative long-term consequences, in terms of knowledge advancement and impact on patient care. The aims of the present review were to evaluate the publications of Italian radiotherapy (RT) groups during a 20-year period and to verify whether research is still appealing to young radiation oncologists (ROs) in Italy. METHODS PubMed database was searched for English-language articles published by Italian groups from January 1985 to December 2005. Analyzed variables were: publication/year, kind of study, geographical area and age of the first author. RESULTS The systematic review identified 3291 articles: 1207 papers fulfilled the inclusion criteria. The number of Italian published papers increased during the examined period. Retrospective analyses, prospective phase I-II trials and literature reviews were 44, 20 and 14.5% of all published manuscripts, respectively. Randomized trials showed a mild increase from 2000 to 2005, but their absolute number remained low respect to other types of studies (4%). Northern Italy produced the very most of Italian research papers (58.7%). The age of the first/second author was evaluated on 716 papers: In more than 50% of cases, the first author was younger than 40. CONCLUSION Despite a general gradual improvement, RT clinical research suffers in Italy (as elsewhere) from insufficient funding, with a negative impact on evidence production. It is worth noting that clinical research is still appealing and accessible to junior Italian RO.
Collapse
Affiliation(s)
- Alba Fiorentino
- Radiotherapy Oncology Department, General Regional Hospital "F. Miulli", Strada Prov. 127 km 4, 70021, Acquaviva delle Fonti, Bari, Italy.
| | - Rosario Mazzola
- Radiotherapy Oncology Department, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | | | - Simonetta Saldi
- Radiation Oncology Section, University of Perugia, Perugia, Italy
| | - Sara Chierchini
- Radiation Oncology Section, University of Perugia, Perugia, Italy
| | - Anna Rita Alitto
- Radiotherapy Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Radioterapia, Rome, Italy
| | - Paolo Borghetti
- Radiation Oncology Department University and Spedali Civili, Brescia, Italy
| | - Fabiana Gregucci
- Radiotherapy Oncology Department, General Regional Hospital "F. Miulli", Strada Prov. 127 km 4, 70021, Acquaviva delle Fonti, Bari, Italy
| | - Michele Fiore
- Radiation Oncology, Campus Bio-Medico University, Rome, Italy
| | - Isacco Desideri
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", Section of Radiation Oncology, University of Florence, Florence, Italy
| | - Lorenza Marino
- Radiotherapy Oncology Department, REM, Viagrande, Catania, Italy
| | - Daniela Greto
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", Section of Radiation Oncology, University of Florence, Florence, Italy
| | | |
Collapse
|
9
|
Saldi S, Bellavita R, Lancellotta V, Palumbo I, Lupattelli M, Chierchini S, Falcinelli L, Zucchetti C, Bini V, Aristei C. Acute Toxicity Profiles of Hypofractionated Adjuvant and Salvage Radiation Therapy After Radical Prostatectomy: Results of a Prospective Study. Int J Radiat Oncol Biol Phys 2018; 103:105-111. [PMID: 30121233 DOI: 10.1016/j.ijrobp.2018.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 07/29/2018] [Accepted: 08/06/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE Hypofractionated radiation therapy (RT) is controversial after radical prostatectomy (RP). In this interim analysis, our prospective observational study assessed acute genitourinary (GU) and gastrointestinal (GI) toxicity after hypofractionated adjuvant and salvage RT, as delivered by helical tomotherapy (HT), in patients with prostate cancer. METHODS AND MATERIALS After undergoing RP with or without pelvic lymph node dissection, 112 patients were enrolled. Hypofractionated adjuvant RT (2.25 Gy daily for 29 fractions; total 65.25 Gy) was administered to 40 patients with high-risk features. Hypofractionated salvage RT (2.25 Gy daily for 32 or 33 fractions; total 72-74.25 Gy) was prescribed for 72 patients (24 with biochemical relapse, 48 with local relapse). Toxicity was graded according to the Common Terminology Criteria for Adverse Events version 4.02. The impact of RT on urinary flow was assessed by uroflowmetry. RESULTS Acute GU toxicity occurred in 41 of 112 patients (36%) (G1 31, G2 10). Acute GI toxicity was observed in 55 (49%) patients (G1 44, G2 11). Uroflowmetry showed that only salvage RT reduced maximum flow significantly (maximum, 68 vs 50 mL/s; P = .003), perhaps because a higher RT dose had been administered. CONCLUSIONS After RP, moderate hypofractionated adjuvant and salvage RT were associated with acceptable incidences of slight-to-moderate acute GU and GI toxicity and had little impact on urinary flow. Prospective trials are warranted with longer follow-up in larger cohorts to confirm these findings.
Collapse
Affiliation(s)
- Simonetta Saldi
- Section of Radiation Oncology, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy.
| | - Rita Bellavita
- Section of Radiation Oncology, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Valentina Lancellotta
- Section of Radiation Oncology, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Isabella Palumbo
- Section of Radiation Oncology, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Marco Lupattelli
- Section of Radiation Oncology, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Sara Chierchini
- Section of Radiation Oncology, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Lorenzo Falcinelli
- Section of Radiation Oncology, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Claudio Zucchetti
- Section of Medical Physics, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Vittorio Bini
- Department of Medicine, Section of Internal Medicine, Endocrinology & Metabolism, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Cynthia Aristei
- Section of Radiation Oncology, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| |
Collapse
|
10
|
Saldi S, Chierchini S, Mendichi M, Lancellotta V, Bellavita R, Palumbo I, Dipilato T, Bini V, Aristei C. EP-1594: Analysis of urinary toxicity by uroflowmetry in hypofractionated radiotherapy after prostatectomy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31903-0] [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: 10/14/2022]
|
11
|
Lancellotta V, Iacco M, Chierchini S, Perrucci E, Palumbo I, Falcinelli L, Saccia S, Nucciarelli S, Milletti A, Aristei C. EP-1176: Helical tomotherapy in chest wall/breast and draining node irradiation after breast cancer surgery. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31612-2] [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]
|