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Piccolo C, Vigorito S, Rondi E, Piperno G, Ferrari A, Pepa M, Conte E, Catto V, Andreini D, Carbucicchio C, Jereczek-Fossa B, Cattani F. Phantom study of stereotactic radioablation treatments for ventricular tachycardia (STRA-MI-VT) using Cyberknife synchrony respiratory tracking system with a single fiducial marker. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00164-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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la Fauci F, Marvaso G, Augugliaro M, Comi S, Pepa M, Zaffaroni M, Corrao G, Mistretta F, Gandini S, Petralia G, Cattani F, de Cobelli O, Orecchia R, Jereczek-Fossa B. Evaluation of effect on dose due to displacement of bowel and target volume in SBRT treatment for oligorecurrent crastation sensitive prostate cancer patients. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00425-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Jereczek-Fossa B. SP-0461 The role of EBRT: Can we give second chances? Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08595-9] [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: 10/20/2022]
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Navarria P, Clerici E, Comito T, Cozzi S, Pinzi V, Ciammella P, Scoccianti S, Borzillo V, Anselmo P, Maranzano E, Dell'acqua V, Jereczek-Fossa B, Levra NG, Minniti G, Podlesko A, Giudice E, di Monale e Bastia MB, Pedretti S, Bruni A, Zanetti IB, Borgesi S, Busato F, Scorsetti M. PO-0880: SRS in brain metastases from colorectalcancer. A Radiation Oncology Italian Association study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00897-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
We present a case of small cell esophageal carcinoma (SCEC) treated with alternated chemotherapy (including cisplatin, etoposide, vincristine, cyclophosphamide and doxorubicin) and irradiation (36 Gy) followed by surgery. Despite a pathological complete response, the patient died of regional disease recurrence 29 months after the diagnosis. We reviewed the available literature on SCEC with regard to the incidence, clinical symptoms, radiological signs, diagnostic workup, therapeutic modalities and prognosis of this malignancy.
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Affiliation(s)
- B Jereczek-Fossa
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
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Dicuonzo S, Leonardi M, Radice D, Morra A, Dell'Acqua V, Gerardi M, Rojas D, Surgo A, Cattani F, Cambria R, Fodor C, De Lorenzi F, Galimberti V, Orecchia R, Jereczek-Fossa B. EP-1344: Long-term reconstruction failure after postmastectomy RT to temporary expander or permanent implant. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31653-0] [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]
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Gerardi M, Morra A, Dicuonzo S, Arculeo S, Patti F, Ricotti R, Dell'Acqua V, Augugliaro M, Arrobbio C, Viola A, Rojas D, Fodor C, Emiro F, Cattani F, Raimondi S, Galimberti V, Orecchia R, Leonardi M, Jereczek-Fossa B. EP-1323: Dosimetry results and toxicity of a 3-week schedule RT with SIB in breast cancer, with TomoDirect. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31633-5] [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]
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Marvaso G, Riva G, Bassi C, Fodor C, Ciardo D, Zerini D, Timon G, Surgo A, Maucieri A, Pansini F, De Marco P, Cattani F, De Cobelli O, Orecchia R, Jereczek-Fossa B. EP-1339: Feasibility and efficacy of moderately hypofractionated radiotherapy in high risk prostate cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31774-7] [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: 10/19/2022]
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Luraschi R, Lazzari R, Galimberti V, Bazani A, Rondi E, Leonardi M, Corso G, Colombo N, Jereczek-Fossa B, Cattani F. EP-1596: Intraoperative radiotherapy with electrons in breast cancer patients with cardiac devices. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32846-8] [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: 10/21/2022]
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Giandini T, Carrara M, Pignoli E, Bedini N, Morlino S, Bosetti D, Avuzzi B, Villa S, Hasegawa A, Russo S, Vischioni B, Ciocca M, Valvo F, Jereczek-Fossa B, Ciardo D, Zerini D, Colangione S, Fodor C, Cattani F, Valdagni R, Orecchia R. EP-1374: Contouring guideline optimisation for prostate pts undergoing carbon ions/photons combined treatment. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32624-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: 12/01/2022]
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Jereczek-Fossa B, Piperno G, Ronchi S, Catalano G, Fodor C, Cambria R, Fossati P, Zerini D, Garibaldi C, Orecchia R. OC-0042 STEREOTACTIC BODY RADIOTHERAPY FOR OLIGOMETASTATIC PATIENTS WITH SINGLE ABDOMINAL LYMPH NODE RECURRENT CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70381-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Pedicini P, Jereczek-Fossa B, Vischioni B, Alterio D, Fusco V, Orecchia R. 53 COMBINATION OF RADIATION AND MONOCLONAL ANTIBODY EGFR INHIBITORS IN THE HEAD AND NECK TUMORS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70036-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Curigliano G, Spitaleri G, Magni E, Lorizzo K, De Cobelli O, Locatelli M, Fumagalli L, Adamoli L, Cossu Rocca M, Verri E, De Pas T, Jereczek-Fossa B, Martinelli G, Goldhirsch A, Nolè F. Cisplatin, etoposide and continuous infusion bleomycin in patients with testicular germ cell tumors: efficacy and toxicity data from a retrospective study. J Chemother 2010; 21:687-92. [PMID: 20071294 DOI: 10.1179/joc.2009.21.6.687] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We retrospectively reviewed medical charts of 54 patients who underwent orchidectomy for germ cell tumors (GCT) and received a regimen, given every 3 weeks, consisting of cisplatin 100 mg/m2 day 4 intravenous (i.v.), bleomycin 15 Units (U) day 1 i.v. push; bleomycin 10 U days 1-3 24 h i.v. continuous infusion (c.i.) and etoposide 100 mg/m2 days 1-5/i.v. (PEB). 53 of 54 patients achieved a complete remission without adjunctive surgery. At a median follow-up of 48.2 months (95%CI 41.7 - 54.8 months) all patients but one are alive with no evidence of disease recurrence. Patients receiving PEB experienced no pulmonary toxicity, nephrotoxicity nor neurological adverse events. PEB with c.i.bleomycin is an active regimen with a low rate of acute and late toxicity. The main limitations of our study are related to the retrospective analysis, the limited number of patients and the restricted follow-up time. A prolonged follow-up is necessary to evaluate long term toxicity and outcome.
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Affiliation(s)
- G Curigliano
- Division of Medical Oncology, Università di Milano, Milan, Italy.
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Rogowski W, Jereczek-Fossa B, Tomczak-Hałaburda J, Wełnicka-Jaśkiewicz M, Badzio A, Jassem J. 173. Does the correlation between chemotherapy-induced leukopenia with response in locally advanced breast cancer exist? Rep Pract Oncol Radiother 2003. [DOI: 10.1016/s1507-1367(03)70657-9] [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: 11/27/2022] Open
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Serkies K, Badzio A, Jereczek-Fossa B, Tarnawska Z, Nowak R, Szewczyk P, Jassem J. Rectal doses in intracavitary brachytherapy of gynecological malignancies: comparison of two dosimetric methods. Radiother Oncol 2001; 58:37-41. [PMID: 11165680 DOI: 10.1016/s0167-8140(00)00325-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To compare calculated rectal doses obtained by two dosimetric methods in intracavitary brachytherapy of gynecological malignancies. MATERIALS AND METHODS This analysis included 124 intracavitary applications performed in 102 patients with cervical or endometrial cancer. The pelvic dose distribution based on orthogonal intracavitary placement films was calculated with the computer planning system. In each application the rectal dose was defined in the specific rectal point determined by both the use of a wire marker inserted into the rectum (R1) and by packing the vagina with radio-opaque gauze - the method recommended by the ICRU Report 38 (R2). The comparison included R1 and R2 doses as well as the respective radiobiological equivalent doses determined by the linear-quadratic model (r1 and r2). RESULTS In 83% of applications the absolute value of R1 was lower than R2. The mean difference between R1 and R2 was 3.7 Gy (95% CI 3.03-4.41 Gy) and between r1 and r2 7.2 Gy (95% CI 5.77-8.56 Gy). These differences were significant (P<0.001 for both comparisons). The difference between the doses was not influenced by the type of applicator and remained significant even when a systemic+/-10% error of method was assumed. CONCLUSION The rectal point dose determined with the use of rectal wire marker may be underestimated, therefore this method should be discouraged in gynecological brachytherapy.
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Affiliation(s)
- K Serkies
- Department of Oncology and Radiotherapy, Medical University of Gdansk, 7 Debinki Street, 80-211, Gdansk, Poland
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Badzio A, Jereczek-Fossa B, Senkus-Konefka E, Adamska K, Fajndt I, Tesmer-Laskowska I, Janus-Kowalska E, Jassem J. 34. A multicenter randomized study of two regimens in paliative radiotherapy of bone metastases. Rep Pract Oncol Radiother 2001. [DOI: 10.1016/s1507-1367(01)70404-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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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17
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Serkies K, Badzio A, Jereczek-Fossa B, Nowak R, Szewczyk P, Tarnawska Z, Jassem J. 2 Ocena porównawcza dawki w odbytnicy obliczonej dwiema metodami w brachyterapii śródjamowej chorych na raka szyjki i trzonu macicy. Rep Pract Oncol Radiother 2000. [DOI: 10.1016/s1507-1367(00)70320-8] [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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de Pas T, Catalano G, Pastorino U, de Braud F, Jereczek-Fossa B, Spaggiari L, Orecchi R. Very low acute toxicity of three fractions per day accelerated radiotherapy given after induction chemotherapy and surgery in stage III non-small cell lung cancer. Lung Cancer 2000; 30:149-50. [PMID: 11185476 DOI: 10.1016/s0169-5002(00)00143-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
PURPOSE Postoperative irradiation of endometrial cancer patients decreases the risk of local recurrence but is associated with a number of long-term sequelae. In a proportion of patients, no immediate postoperative radiotherapy is applied and this treatment is introduced only at relapse. The aim of our study was to assess the long-term results of salvage radiotherapy in previously nonirradiated endometrial cancer patients who developed local recurrence, and to evaluate the impact of patient- and treatment-related factors on treatment efficacy. METHODS AND MATERIALS We performed a detailed retrospective analysis of 73 endometrial cancer patients given radiotherapy for local recurrence after the initial surgery only. The mean age at diagnosis of the recurrence was 63 years (range, 39-78 years). Median time to recurrence was 11 months (range, 1-19 months). All recurrences were staged with the use of Perez modification of the International Federation of Gynecology and Obstetrics (FIGO) staging system for primary vaginal carcinoma. There were five (7%) Stage I patients, 43 (59%) Stage II patients, and 25 (34%) Stage III patients. Forty-four patients (60%) received both external beam irradiation (EBRT) and endovaginal brachytherapy (BRT), 17 (23%) received only BRT, and 12 (17%) received only EBRT. The mean total physical radiation dose was 75.9 Gy (range, 8-130 Gy), and the mean normalized total dose (NTD) calculated on the base of the linear-quadratic model was 86.6 Gy (range, 8.5-171.9 Gy). Median follow-up for alive patients was 8.8 years (range, 3-21 years). The impact of patient-, tumor-, and therapy-related factors on the treatment outcome was evaluated with the use of uni- and multivariate analyses. RESULTS Three- and 5-year overall survival rates were 33% and 25%, respectively. In the univariate analysis, lower stage of recurrent disease (p < 0.0005), combined EBRT and BRT (p = 0.027), higher total radiation dose (p = 0.031), and higher NTD (p = 0.006) were significantly correlated with better survival. In the multivariate analysis, only stage of recurrent disease (p < 0.005) and high total dose (p = 0.047) were independently correlated with better survival. Lower FIGO stage of recurrence (p = 0.023) and higher total dose (p = 0.005) were also independently correlated with longer time to progression, whereas higher radiotherapy dose was the only factor correlated with better local control (p = 0.029). CONCLUSIONS The efficacy of salvage radiotherapy in endometrial cancer patients with local failure after previous surgery is limited. Factors determining treatment outcome include advancement of the tumor at relapse and radiotherapy dose.
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Affiliation(s)
- B Jereczek-Fossa
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland.
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Serkies K, Jereczek-Fossa B, Badzio A, Jassem J. Clodronate in the management of bone metastases: a clinical study of 91 patients. Neoplasma 2000; 46:317-22. [PMID: 10665850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The aim of our study was to evaluate the efficacy of oral clodronate supplementing systemic therapy and/or palliative irradiation in 91 patients with painful bone metastases. Clodronate was administered at a daily dose of 1600-3200 mg for a median of 11 months (range 3--36 months). Partial or complete pain relief was achieved in 61 of 88 evaluable patients (69%). Response rate to clodronate in patients who additionally received palliative bone radiation was similar to that in patients who did not receive irradiation (68 and 71%, respectively). Eleven out of 12 bed-ridden patients with metastatic bone pain regained the ability of walking after the treatment with clodronate. Bone pain relief lasted from 1.5 to 36 months (mean 9.3 months). Clodronate was well tolerated in all but three cases (3%) in whom the treatment was discontinued due to intensive adverse gastrointestinal effects. In conclusion, we observed satisfactory symptomatic effect and low rate of adverse reactions in patients with metastatic bone lesions treated with oral clodronate. Further large controlled studies with thorough patient monitoring are warranted to evaluate the real benefit of clodronate, and to define its optimal scheduling.
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Affiliation(s)
- K Serkies
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Poland
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Orecchia R, Redda MG, Ragona R, Nassisi D, Jereczek-Fossa B, Zurrida S, Bussi M, Succo G, Sannazzari G. Results of hypofractionated stereotactic re-irradiation on 13 locally recurrent nasopharyngeal carcinomas. Radiother Oncol 1999; 53:23-8. [PMID: 10624849 DOI: 10.1016/s0167-8140(99)00130-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Thirteen patients with locally recurrent, previously-irradiated nasopharyngeal carcinoma were treated with linac-based hypofractionated stereotactic radiotherapy (24 Gy in two or four fractions). One- and 3-year overall survival were 54 and 31%. Three patients were free of disease at 30, 34 and 65 months. No severe acute or late complications were seen.
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Affiliation(s)
- R Orecchia
- Division of Radiotherapy, European Institute of Oncology and University of Milan, Italy
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Jereczek-Fossa B, Jassem J, Badzio A, Kobierska A, Serkies K. Recurrent endometrial cancer (EC) after surgery alone: Results of salvage radiotherapy (RT). Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81341-0] [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: 10/27/2022]
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Jereczek-Fossa B, Badzio A, Jassem J. Surgery followed by radiotherapy in endometrial cancer: analysis of survival and patterns of failure. Int J Gynecol Cancer 1999; 9:285-294. [PMID: 11240781 DOI: 10.1046/j.1525-1438.1999.99038.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We performed a retrospective evaluation of survival and patterns of failure in 317 consecutive endometrial cancer patients treated between 1974 and 1991 with surgery and adjuvant radiotherapy. Two hundred and forty seven patients (78%) had FIGO stage I disease, 30 (9%) - stage II, 35 (11%) - stage III and 5 (2%) - stage IV. Both low dose rate brachytherapy (BRT) and external beam radiation (EBRT) were applied in 247 patients (78%), only BRT in 49 (15%), and only EBRT in 21 (7%). Median follow-up was 7.3 years. Five-year overall survival was 75%, and five-year disease free survival was 81%. Both overall and disease free survival rates were correlated with stage (P = 0.001 and P = 0.000, respectively). Recurrence occurred in 70 patients (22%): 11 (3.5%) in the pelvis, 51 (16%) outside the pelvis and 6 (2%) both in- and outside the pelvis. Independent risk factors for local recurrence included older age (P = 0.03) and variant histologic subtypes (P = 0.039), whereas independent risk factors for distant spread were stage (P = 0.000) and older age (P = 0.011). Normalized Total Dose (the sum of EBRT and BRT doses, based on linear-quadratic equation), type of radiotherapy regimen, overall radiotherapy time and surgery-to-radiotherapy interval did not correlate with the risk of relapse. Severe early and late radiotherapy complications were observed in 21 (7%) and 35 patients (11%), respectively. In view of the relatively low risk of exclusive pelvic recurrences and the high rate of severe late radiotherapy complications, indications for postoperative radiotherapy and its scheme should be verified. A relatively high rate of extrapelvic recurrences calls for effective systemic adjuvants to surgery. Further definition of high risk patients is warranted in order to tailor postoperative therapy to the prognostic factors and to increase the therapeutic index of management of endometrial cancer.
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Affiliation(s)
- B. Jereczek-Fossa
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Poland and Department of Radiotherapy, European Institute of Oncology, Milan, Italy
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Jereczek-Fossa B, Airoldi M, Gribaudo S, Ruo Redda MG, Valente G, Orecchia R. Small cell carcinoma of the esophagus. Neoplasma 1999; 46:7-11. [PMID: 10355527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Small cell carcinoma of the esophagus (SCEC) is a rare tumor with its particular biologic features, distinct from squamous and glandular carcinoma of esophagus. Although initial symptoms can be similar (with metastatic dissemination and paraneoplastic syndromes at presentation more frequent in SCEC), differences in age and sex distribution, tumor location, radiological and endoscopic findings, clinical course and prognosis have been observed between SCEC and other esophageal malignancies. SCEC should be considered a systemic disease, and by analogy to bronchogenic small cell carcinoma, multimodality approach including chemotherapy is recommended. In patients with limited disease, irradiation or surgery should be offered after induction chemotherapy to manage local disease. However, optimal treatment schedule has not yet been defined. In the future, registration of all SCEC cases and careful analysis of prognostic factors in the larger multi-institutional series could contribute to further progress in treatment outcome.
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Affiliation(s)
- B Jereczek-Fossa
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
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Paganelli G, Orecchia R, Jereczek-Fossa B, Grana C, Cremonesi M, De Braud F, Tradati N, Chinol M. Combined treatment of advanced oropharyngeal cancer with external radiotherapy and three-step radioimmunotherapy. Eur J Nucl Med 1998; 25:1336-9. [PMID: 9724386 DOI: 10.1007/s002590050305] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The prognosis of patients with locally advanced head and neck cancer remains grim due to poor locoregional tumour control. In the attempt to eradicate residual disease, various novel modalities have been tested, among which radioimmunotherapy (RIT) has shown some potential. We present a case of locally advanced oropharyngeal carcinoma successfully treated with a combination of various treatments including surgery, radio-chemotherapy and three-step RIT, with the avidin-biotin pretargeting system. A partial tumour response was achieved after surgery and radio-chemotherapy; persistent disease was documented at computed tomography (CT), ultrasound (US) and immunoscintigraphy (ISG) 10 weeks after the end of chemo-radiotherapy. The good correlation between the tracer localization in the scintigraphic images and residual mass visualized at CT suggested the application of three-step RIT using systemic administration of yttrium-90 (py) biotin. At present, 17 months after RIT, the patient is alive with no evidence of disease as documented by magnetic resonance imaging (MRI) and US. This is the first case of complete clinical remission of a head and neck carcinoma induced by combined treatment including pretargeted RIT with 90Y-biotin.
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Affiliation(s)
- G Paganelli
- Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy
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Jereczek-Fossa B, De Braud F, Gasparetto M, De Pas T, Tradati N, Leonardi MC, Marsiglia HR, Orecchia R. Induction chemotherapy followed by simultaneous hyperfractionated radiochemotherapy in advanced head and neck cancer. A pilot study. Strahlenther Onkol 1998; 174:457-61. [PMID: 9765686 DOI: 10.1007/bf03038623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the feasibility of induction chemotherapy followed by concomitant chemotherapy and hyperfractionated irradiation in locally advanced, inoperable head and neck cancer. METHODS A pilot study was undertaken comprising 3 cycles of cisplatinum (100 mg/m2, day 1) and 5-fluorouracil (1000 mg/m2 in continuous intravenous infusion over the first 120 h) followed by bifractionated radiotherapy applied to tumor/involved lymph nodes up to the dose of 74.4 Gy given in 2 fractions of 1.2 Gy daily for 5 days a week combined with concomitant weekly cisplatinum infusion (50 mg/m2). RESULTS Six patients were enrolled in the study. All of them completed the protocol therapy. Severe mucositis and myelotoxicity were the most common acute side effects observed in all and in 5 of the patients, respectively. Acute toxicity required interruption of concomitant chemotherapy in 5 cases and in 2 interruption of radiotherapy was necessary. Opioid analgesic parenteral therapy was administered in 4 patients. Three of them had to be hospitalized. One patient experienced cerebral stroke 1 day after the completion of therapy and died 7 days later. Due to high acute toxicity, patient accrual was terminated after 6 patients. At the mean follow-up of 17 months, 4 patients are alive, 3 of them are free of disease and in 1 local progression has been diagnosed. CONCLUSIONS High acute toxicity of induction cisplatinum and 5-fluorouracil followed by concomitant cisplatinum and hyperfractionated irradiation calls for less toxic treatment schedules in locally advanced inoperable head and neck cancer.
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Affiliation(s)
- B Jereczek-Fossa
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Poland.
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Jereczek-Fossa B, Jassem J, Karnicka-Młodkowska H, Badzio A, Moś-Antkowaik R, Krawczyk K, Kowal E, Pilarska-Machowicz A, Radzikowska E, Malak K. Does chemotherapy-induced leukopenia predict a response in small-cell lung cancer? J Cancer Res Clin Oncol 1998; 124:106-12. [PMID: 9654193 DOI: 10.1007/s004320050141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The correlation between chemotherapy-induced toxicity and treatment outcome in cancer patients has not been studied thoroughly. Our aim was to evaluate whether there is any relationship between chemotherapy-induced leukopenia and response to treatment in small-cell lung cancer (SCLC). Data derived from records of 228 patients treated within two prospective multicentre phase II studies were analysed. In the first study (101 patients) chemotherapy included vincristine, epirubicin and cyclophosphamide and, in the second (127 patients), cyclophosphamide, etoposide and epirubicin; both regimens were given every 3 weeks. In the present analysis, the correlation between treatment outcome (response rate and survival) and highest scores of leukopenia within the first two and up to the fourth chemotherapy cycle, respectively, was evaluated. The objective response rate for the entire group was 66%; 53% in patients whose white blood cells remained normal and 85% in those who developed leukopenia within the first two cycles (P = 0.000). In multifactorial analysis, also including other treatment- and patient-related factors, independent correlation with response to chemotherapy was found for leukopenia (P = 0.001), chemotherapy regimen (P = 0.002) and the combined relative dose intensity (P = 0.018), but not for patient sex, age, performance status, pre-study weight loss, extent of disease and initial white blood cell count. Leukopenia within the first two cycles of chemotherapy was not correlated with survival, whereas such correlation for leukopenia occurring up to the fourth cycle was at the borderline level (P = 0.06). These findings suggest a relationship between chemotherapy-induced leukopenia and tumour response in SCLC.
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Affiliation(s)
- B Jereczek-Fossa
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Poland.
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Jereczek-Fossa B, Jassem J, Nowak R, Badzio A. Late complications after postoperative radiotherapy in endometrial cancer: analysis of 317 consecutive cases with application of linear-quadratic model. Int J Radiat Oncol Biol Phys 1998; 41:329-38. [PMID: 9607348 DOI: 10.1016/s0360-3016(98)00050-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the incidence and risk factors for late complications after postoperative radiotherapy in endometrial cancer patients. METHODS AND MATERIAL We performed a detailed retrospective analysis of 317 endometrial cancer patients given postoperative radiotherapy. A total of 247 patients (78%) received both intracavitary (BRT) and external beam irradiation (XRT); 49 patients (15%) received only BRT, and 21 (7%) only XRT. BRT included radium (Ra) and cesium (Cs). The mean dose rate for both isotopes at 0.5 cm from the applicator surface was 0.47 +/- 0.06 and 1.42 +/- 0.41 Gy/h, and the mean total dose was 50.5 +/- 10.3 and 48.4 +/- 15.0 Gy, respectively. Mean BRT dose at 0.5 cm was 50.1 +/- 11.7 Gy (range 14.5-71.0). Mean XRT dose in the International Commission on Radiation Units and Measurements (ICRU) reference point was 49.0 +/- 3.7 Gy (range 22.0-66.0) given in fractions of 1.54-2.49 Gy (mean 2.0 +/- 0.17) with a two- or four-field technique. Follow-up ranged from 4 to 21 years (median 7.3). Normalized total dose (NTD) including XRT and BRT doses was calculated based on a linear quadratic equation. RESULTS Five-year overall survival rate was 75%, and 5-year disease-free survival (censored for noncancer deaths) was 81%. Late radiotherapy complications of any grade occurred in 158 patients (51%), including bowel complications in 41% and urinary bladder complications in 21%. A total of 37 grade 3 or 4 complications were observed in 33 patients (11%), of whom 32 were treated with both XRT and BRT. Severe bowel and/or urinary bladder complications occurred in 24 patients: in 14 of 72 patients (19.4%) who received XRT and Cs BRT, and in 10 of 172 patients (6.0%) applied XRT and Ra BRT. The higher proportion of severe bowel and/or bladder complications in the former group was due to the particularly frequent rate of these events (30.0%) in a subset of 47 patients who received XRT combined with Cs BRT at the dose rate of 1.7 Gy/h and the total BRT dose of 60 Gy. Higher NTD, XRT fraction dose, BRT dose rate, Cs BRT, two-field XRT technique, short overall radiotherapy time, and older age were correlated with increased late-event risk in univariate analysis. Multivariate Cox analysis demonstrated that the independent risk factors for late bowel complications were NTD (p = 0.000) and BRT dose rate (p = 0.036), whereas for bladder complications they were BRT dose rate (p = 0.005) and XRT fraction dose (p = 0.041). Neither clinical factor (age, parity, prior abdominal surgery, FIGO stage, diabetes mellitus, or hypertension) nor the surgery-to-radiotherapy interval, nor overall radiotherapy time was independently associated with the risk of late bladder or bowel complications. CONCLUSIONS The risk of late complications after postoperative radiotherapy in endometrial cancer depends mainly on treatment-related factors: NTD, BRT dose rate, and XRT fraction dose. The use of combined XRT and BRT increases the risk of late effects. NTD calculations including BRT dose rate and XRT fraction dose enable estimation of radiobiologically equivalent dose and can decrease the risk of mistakes when the radiotherapy regimen is changed.
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Affiliation(s)
- B Jereczek-Fossa
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Poland
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Negri E, Ghilezan M, Marsiglia H, Robertson C, Ivaldi G, Leonardi MC, Krengli M, Vavassori A, Gatti GM, Brambilla MG, Cattani F, Jereczek-Fossa B, Orecchia R. Analysis of tumor control probability (TCP) and normal tissue complication probability (NTCP) in 40 prostate cancer patients treated with 2 different techniques of 3D-conformal radiation therapy (3D-CRT). Int J Radiat Oncol Biol Phys 1998. [DOI: 10.1016/s0360-3016(98)80610-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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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Ghilezan M, Greco C, Cattani F, Brambilla MG, Negri L, Krengli M, Marsiglia H, Gatti GM, Ivaldi G, Jereczek-Fossa B, Orecchia R. Radiothérapie de conformation dans le cancer de la prostate. Protocole technique et résultats préliminaires à propos de 41 patients traités à l'Institut européen d'oncologie. Cancer Radiother 1997. [DOI: 10.1016/s1278-3218(97)89568-6] [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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Jereczek-Fossa B, Jassem J, Badzio A, Serkies K, Kobierska A. Factors determining late complications following postoperative radiotherapy in endometrial carcinoma. Eur J Cancer 1997. [DOI: 10.1016/s0959-8049(97)84885-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: 10/18/2022]
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Jassem J, Jereczek-Fossa B, Badzio A, Karnicka-Maodkowska H. 70 Chemotherapy-induced leukopenia as a predictor of treatment outcome in small cell lung cancer (SCLC). Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)89349-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: 10/18/2022]
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