1
|
Mazzola G, Bergamaschi L, Pedone C, Vincini M, Pepa M, Zaffaroni M, Volpe S, Rombi B, Doyen J, Fossati P, Haustermans K, Høyer M, Langendijk J, Matute R, Orlandi E, Rylander H, Troost E, Orecchia R, Alterio D, Jereczek-Fossa B. Patients' needs in proton therapy: A survey among ten European facilities. Clin Transl Radiat Oncol 2023; 43:100670. [PMID: 37736140 PMCID: PMC10509656 DOI: 10.1016/j.ctro.2023.100670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/30/2023] [Accepted: 08/19/2023] [Indexed: 09/23/2023] Open
Abstract
Aims The number of Proton Therapy (PT) facilities is still limited worldwide, and the access to treatment could be characterized by patients' logistic and economic challenges. Aim of the present survey is to assess the support provided to patients undergoing PT across Europe. Methods Through a personnel contact, an online questionnaire (62 multiple-choice and open-ended questions) via Microsoft Forms was administered to 10 European PT centers. The questionnaire consisted of 62 questions divided into 6 sections: i) personal data; ii) general information on clinical activity; iii) fractionation, concurrent systemic treatments and technical aspects of PT facility; iv) indication to PT and reimbursement policies; v) economic and/ or logistic support to patients vi) participants agreement on statements related to the possible limitation of access to PT. A qualitative analysis was performed and reported. Results From March to May 2022 all ten involved centers filled the survey. Nine centers treat from 100 to 500 patients per year. Paediatric patients accounted for 10-30%, 30-50% and 50-70% of the entire cohort for 7, 2 and 1 center, respectively. The most frequent tumours treated in adult population were brain tumours, sarcomas and head and neck carcinomas; in all centers, the mean duration of PT is longer than 3 weeks. In 80% of cases, the treatment reimbursement for PT is supplied by the respective country's Health National System (HNS). HNS also provides economic support to patients in 70% of centers, while logistic and meal support is provided in 20% and 40% of centers, respectively. PT facilities offer economic and/or logistic support in 90% of the cases. Logistic support for parents of pediatric patients is provided by HNS only in one-third of centers. Overall, 70% of respondents agree that geographic challenges could limit a patient's access to proton facilities and 60% believe that additional support should be given to patients referred for PT care. Conclusions Relevant differences exist among European countries in supporting patients referred to PT in their logistic and economic challenges. Further efforts should be made by HNSs and PT facilities to reduce the risk of inequities in access to cancer care with protons.
Collapse
Affiliation(s)
- G.C. Mazzola
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - L. Bergamaschi
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - C. Pedone
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - M.G. Vincini
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - M. Pepa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - M. Zaffaroni
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - S. Volpe
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - B. Rombi
- Proton Therapy Center, Trento, Italy
| | - J. Doyen
- Centre Antoine Lacassagne, Nice, France
| | - P. Fossati
- MedAustron Ion Therapy Center, Wiener Neustadt, Austria
| | | | - M. Høyer
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - J.A. Langendijk
- University Medical Center Groningen, Groningen, The Netherlands
| | - R. Matute
- Centro de Protonterapia Quironsalud, Madrid, Spain
| | - E. Orlandi
- CNAO National Center for Oncological Hadrontherapy, Pavia, Italy
| | | | - E.G.C. Troost
- Faculty of Medicine and University Hospital Carl Gustav Carus, Department of Radiotherapy and Radiation Oncology, Dresden, Germany
- OncoRay - National Center for Radiation Research in Oncology: Faculty of Medicine and University Hospital Carl Gustav Carus, Dresden; Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
- Institute of Radiooncology - OncoRay, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - R. Orecchia
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - D. Alterio
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - B.A. Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| |
Collapse
|
2
|
Alterio D, Vigorito S, Emiro F, Vincini M, Ferrari A, Marani S, Pepa M, Zaffaroni M, Fodor C, Volpe S, Marvaso G, Bergamaschi L, Pedone C, Franzetti J, Zorzi S, Tagliabue M, Ansarin M, Jereczek-Fossa B. PO-1114 Intensity Modulated Radiotherapy (IMRT) after conservative surgery for supraglottic tumours. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03078-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
3
|
Pepa M, Gugliandolo S, Pansini F, Vavassori A, Vincini M, Zaffaroni M, Alterio D, Rajendran S, Pillai S, Volpe S, Marvaso G, Corrao G, Cattani F, Colosimo B, Jereczek-Fossa B. PO-1546 Dosimetric characterization of PLA 3D printed boluses for external beam radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03510-1] [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: 10/18/2022]
|
4
|
Bonomo P, Merlotti A, Morbelli S, Berti V, Saieva C, Bergesio F, Bacigalupo A, Belgioia L, Franzese C, Lopci E, Casolo A, D'Angelo E, Alterio D, Travaini L, Berretta L, Pirro V, Ursino S, Volterrani D, Roncali M, Vigo F, Desideri I, Russi E, Livi L, Bianchi A. PH-0040: A 6-point scale approach to 18F-FDG PET-CT for response assessment in HNSCC: a multicenter study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00066-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
5
|
Giannitto C, Marvaso G, Botta F, Raimondi S, Alterio D, Ciardo D, Volpe S, De Piano F, Ancona E, Tagliabue M, Origgi D, Chiocca S, Maffini FA, Ansarin M, Bagnardi V, Cattani F, Nolè F, Preda L, Orecchia R, Cassano E, Cremonesi M, Starzyńska A, Bellomi M, Jereczek-Fossa BA. Association of quantitative MRI-based radiomic features with prognostic factors and recurrence rate in oropharyngeal squamous cell carcinoma. Neoplasma 2020; 67:1437-1446. [PMID: 32787435 DOI: 10.4149/neo_2020_200310n249] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/24/2020] [Indexed: 11/08/2022]
Abstract
Radiomics focuses on extracting a large number of quantitative imaging features and testing both their correlation with clinical characteristics and their prognostic and predictive values. We propose a radiomic approach using magnetic resonance imaging (MRI) to decode the tumor phenotype and local recurrence in oropharyngeal squamous cell carcinoma (OPSCC). The contrast-enhanced T1-weighted sequences from baseline MRI examinations of OPSCC patients treated between 2008 and 2016 were retrospectively selected. Radiomic features were extracted using the IBEX software, and hiegrarchical clustering was applied to reduce features redundancy. The association of each radiomic feature with tumor grading and stage, HPV status, loco-regional recurrence within 2 years, considered as main endpoints, was assessed by univariate analysis and then corrected for multiple testing. Statistical analysis was performed with SAS/STAT® software. Thirty-two eligible cases were identified. For each patient, 1286 radiomic features were extracted, subsequently grouped into 16 clusters. Higher grading (G3 vs. G1/G2) was associated with lower values of GOH/65Percentile and GOH/85Percentile features (p=0.04 and 0.01, respectively). Positive HPV status was associated with higher values of GOH/10Percentile (p=0.03) and lower values of GOH/90Percentile (p=0.03). Loco-regional recurrence within 2 years was associated with higher values of GLCM3/4-7Correlation (p=0.04) and lower values of GLCM3/2-1InformationMeasureCorr1 (p=0.04). Results lost the statistical significance after correction for multiple testing. T stage was significantly correlated with 9 features, 4 of which (GLCM25/180-4InformationMeasureCorr2, Shape/MeanBreadth, GLCM25/90-1InverseDiffMomentNorm, and GLCM3/6-1InformationMeasureCorr1) retained statistical significance after False Discovery Rate correction. MRI-based radiomics is a feasible and promising approach for the prediction of tumor phenotype and local recurrence in OPSCC. Some radiomic features seem to be correlated with tumor characteristics and oncologic outcome however, larger collaborative studies are warranted in order to increase the statistical power and to obtain robust and validated results.
Collapse
Affiliation(s)
- C Giannitto
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - G Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - F Botta
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Raimondi
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - D Alterio
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - D Ciardo
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Volpe
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - F De Piano
- Postgraduation School in Radiodiagnostics, University of Milan, Milan, Italy
| | - E Ancona
- Postgraduation School in Radiodiagnostics, University of Milan, Milan, Italy
| | - M Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - D Origgi
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - S Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - F Antonio Maffini
- Department of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Ansarin
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - V Bagnardi
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - F Cattani
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - F Nolè
- Department of Medical Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - L Preda
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,National Centre of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - R Orecchia
- Scientific Directorate, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Medical Imaging and Radiation Sciences, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - E Cassano
- Breast Imaging Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Cremonesi
- Radiation Research Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Starzyńska
- Department of Oral Surgery, Medical University of Gdansk, Gdansk, Poland
| | - M Bellomi
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - B Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| |
Collapse
|
6
|
Andreano A, Ansarin M, Alterio D, Bruschini R, Valsecchi MG, Russo AG. Cancer of the head and neck: a set of indicators based on register and administrative data. Acta Otorhinolaryngol Ital 2019; 38:13-23. [PMID: 29756612 DOI: 10.14639/0392-100x-1934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 12/17/2017] [Indexed: 11/23/2022]
Abstract
SUMMARY Head and neck (H&N) tumours are a heterogeneous group of neoplasms with 5-year relative survival ranging from about 25% for the hypopharynx to 60% for the larynx in Europe. To improve survival rates, along with therapeutic improvements, it is important to standardise and optimise care received by patients with H&N tumours across different healthcare providers. To reach this goal, it is necessary to evaluate adherence to standards of received care at a population level. Published guidelines can serve as the basis to develop indicators, which can be computed from administrative health databases, measuring the adherence to specific recommendations at the individual level in unselected H&N cancer patients, identified from a population cancer register. We developed a set of indicators and calculated them in a cohort of 2007-2012 incident cases of H&N tumours in the cancer register of the Milan province (n = 1441 cases). The study cohort was mainly composed of men (77%) and patients older than 50 years (89%). Surgery was the most frequently employed treatment (66%). Ten percent of patients had no recorded treatment. Timing between cyto-histological assessment and first therapy for those having a recorded microscopic verification procedure was ≤ 60 days for 90.4% of patients undergoing surgery, 86.3% of those undergoing radiotherapy, and 90.7% of patients receiving chemotherapy. Eighty-three percent of patients underwent cyto-histological assessment in the 180 days before the first treatment. Evaluation by a pain therapist, opioid therapy or hospitalisation for palliative therapy in the 90 days before death was performed in 51% of patients who eventually died of cancer. This is the first Italian study defining and calculating quality indicators to monitor adherence to standards of care received by H&N cancer patients at a population level.
Collapse
Affiliation(s)
- A Andreano
- Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milan Biococca, Monza, Italy; Epidemiology Unit, Agency for Health Protection of Milan, Italy
| | - M Ansarin
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - D Alterio
- Division of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - R Bruschini
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - M G Valsecchi
- Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milan Biococca, Monza, Italy
| | - A G Russo
- Epidemiology Unit, Agency for Health Protection of Milan, Italy
| |
Collapse
|
7
|
Alterio D, Preda L, Volpe S, Giannitto C, Riva G, Pounou Kamga A, Atac M, Giugliano G, Ferrari A, Marvaso G, Durante S, Arculeo S, Turturici I, Cossu Rocca M, Ansarin M, Bellomi M, Jereczek-Fossa B, Orecchia R. EP-1160 Quantifying the impact of radiologic revision in head and neck cancer: monoinstitutional experience. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31580-4] [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: 10/26/2022]
|
8
|
Marvaso G, Delia C, Alterio D, Botta F, Giannitto C, Volpe S, Maffini F, Raimondi S, Ansarin M, Bellomi M, Jereczek-Fossa B. EP-1925 Association of MRI-based radiomic features with prognostic factors in oropharyngeal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32345-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
9
|
Gerardi M, Buglione M, Alterio D, Maddalo M, Greco D, Augugliaro M, Alghisi A, Bonù M, Costa L, Ferrari A, Marvaso G, Tomasini D, Rocca MC, Orecchia R, Magrini S, Jereczek-Fossa B. PO-078 Radio-chemotherapy for Heand and Neck cancer: retrospective comparison between weekly and three-weekly CDDP. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30244-0] [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]
|
10
|
Volpe S, Bagicalupo A, Alterio D, Belgioia L, Ferrari A, Zurlo V, Santomauro V, Marvaso G, Montesano M, Augugliaro M, Turturici I, Vigorito S, Corvò R, Jereczek-Fossa B. PO-147 Functional outcome of postoperative IMRT after laryngeal conservative surgery. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30313-5] [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: 11/27/2022]
|
11
|
Ghi MG, Paccagnella A, Ferrari D, Foa P, Alterio D, Codecà C, Nolè F, Verri E, Orecchia R, Morelli F, Parisi S, Mastromauro C, Mione CA, Rossetto C, Polsinelli M, Koussis H, Loreggian L, Bonetti A, Campostrini F, Azzarello G, D'Ambrosio C, Bertoni F, Casanova C, Emiliani E, Guaraldi M, Bunkheila F, Bidoli P, Niespolo RM, Gava A, Massa E, Frattegiani A, Valduga F, Pieri G, Cipani T, Da Corte D, Chiappa F, Rulli E. Induction TPF followed by concomitant treatment versus concomitant treatment alone in locally advanced head and neck cancer. A phase II-III trial. Ann Oncol 2018; 28:2206-2212. [PMID: 28911070 DOI: 10.1093/annonc/mdx299] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [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: 11/12/2022] Open
Abstract
Background Platinum-based chemoradiation (CCRT) is the standard treatment for Locally Advanced Head and Neck Squamous-Cell Carcinoma (LAHNSCC). Cetuximab/RT (CET/RT) is an alternative treatment option to CCRT. The efficacy of induction chemotherapy (IC) followed by chemoradiation compared to chemoradiation alone has not been demonstrated in randomized clinical trials. The goals of this phase II-III trial were to assess: (i) the overall survival (OS) of IC versus no-induction (no-IC) and (ii) the Grade 3-4 in-field mucosal toxicity of CCRT versus CET/RT. The present paper focuses on the analysis of efficacy. Materials and methods Patients with LAHNSCC were randomized to receive concomitant treatment alone [CCRT (Arm A1) or CET/RT (Arm A2)], or three cycles of induction docetaxel/cisplatin/5 fluorouracil (TPF) followed by CCRT (Arm B1) or followed by CET/RT (Arm B2). The superiority hypothesis of OS comparison of IC versus no-IC (Arms B1 + B2 versus A1 + A2) required 204 deaths to detect an absolute 3-year OS difference of 12% (HR 0.675, with 80% power at two-sided 5% significance level). Results 414 out of 421 patients were finally analyzed: 206 in the IC and 208 in the no-IC arm. Six patients were excluded because of major violation and one because of metastatic disease at diagnosis. With a median follow-up of 44.8 months, OS was significantly higher in the IC arm (HR 0.74; 95% CI 0.56-0.97; P = 0.031). Complete Responses (P = 0.0028), Progression Free Survival (P = 0.013) and the Loco-regional Control (P = 0.036) were also significantly higher in the IC arm. Compliance to concomitant treatments was not affected by induction TPF. Conclusions IC followed by concomitant treatment improved the outcome of patients with LAHNSCC without compromising compliance to the concomitant treatments. The degree of the benefit of IC could be different according to the type of the subsequent concomitant strategy. Clinical Trial Number NCT01086826, www.clinicaltrials.gov.
Collapse
Affiliation(s)
- M G Ghi
- Medical Oncology Department, Ospedale dell'Angelo, Venezia
| | - A Paccagnella
- Medical Oncology Department, Ospedale dell'Angelo, Venezia
| | - D Ferrari
- Medical Oncology Unit, Ospedale San Paolo, Milano
| | - P Foa
- Medical Oncology Unit, Ospedale San Paolo, Milano
| | | | - C Codecà
- Medical Oncology Unit, Ospedale San Paolo, Milano
| | - F Nolè
- Unit of Urogenital and Head and Neck Oncology, Istituto Europeo di Oncologia, Milano
| | - E Verri
- Unit of Urogenital and Head and Neck Oncology, Istituto Europeo di Oncologia, Milano
| | | | | | - S Parisi
- U.O.C. Radiation Oncology, IRCCS Casa Sollievo della Sofferenza, San Giovanni, Rotondo
| | - C Mastromauro
- Medical Oncology Department, Ospedale dell'Angelo, Venezia
| | - C A Mione
- Radiotherapy Department, Ospedale SS Giovanni e Paolo, Venezia
| | | | - M Polsinelli
- S.O.C. Radiation Oncology, Azienda Ospedaliero-Universitaria S.Maria della Misericordia, Udine
| | - H Koussis
- Medical Oncology Department 2, Istituto Oncologico Veneto- IRCCS, Padova
| | - L Loreggian
- Radiotherapy Department, Istituto Oncologico Veneto - IRCCS, Padova
| | - A Bonetti
- Medical Oncology Department, Ospedale Mater Salutis, Legnago
| | - F Campostrini
- Radiotherapy Department, Ospedale Mater Salutis, Legnago
| | - G Azzarello
- Oncology Unit, Department of Internal Medical Sciences, Mirano
| | | | - F Bertoni
- Radiotherapy Department, Azienda Ospedaliero Universitaria, Modena
| | | | - E Emiliani
- Radiotherapy Department, Azienda USL, Ravenna
| | - M Guaraldi
- Medical Oncology Department, Policlinico Sant'Orsola-Malpighi, Bologna
| | - F Bunkheila
- Radiotherapy Department, Policlinico Sant'Orsola-Malpighi, Bologna
| | - P Bidoli
- Medical Oncology Department, Ospedale San Gerardo, Monza
| | - R M Niespolo
- Radiotherapy Department, Ospedale San Gerardo, Monza, Ospedale San Gerardo, Monza
| | - A Gava
- Radiotherapy Department, Ospedale Ca' Foncello, Treviso
| | - E Massa
- Department of Medical Science, Università degli Studi di Cagliari, Cagliari
| | - A Frattegiani
- Radiation Oncology Department, Ospedale S. Maria della Misericordia, Perugia
| | - F Valduga
- Medical Oncology Department, Ospedale S. Chiara, Trento
| | - G Pieri
- Medical Oncology Department, AO Triestina, Trieste
| | - T Cipani
- Niguarda Cancer Center, Ospedale Niguarda Cà Granda, Milano
| | - D Da Corte
- Oncology Department, Ospedale S. Martino, Belluno
| | - F Chiappa
- Laboratory of Clinical Research, Istituto di Ricerche Farmacologiche "Mario Negri," Milano, Italy
| | - E Rulli
- Laboratory of Clinical Research, Istituto di Ricerche Farmacologiche "Mario Negri," Milano, Italy
| | | |
Collapse
|
12
|
Fanetti G, Bazzani F, Ferrari A, Alterio D, Donghi S, Pounou Kamga F, Orecchia R, Jereczek-Fossa B. Bronchiolitis obliterans organizing pneumonia after stereotactic ablative radiation therapy for lung cancer: A case report. Cancer Radiother 2018; 22:57-61. [DOI: 10.1016/j.canrad.2017.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/21/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
|
13
|
Monti S, Palma G, D'Avino V, Gerardi M, Ciardo D, Alterio D, Jereczek-Fossa B, Quarantelli M, Pacelli R, Cella L. Regional Dose Differences Associated with Radiation-Induced Acute Severe Dysphagia. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.127] [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]
|
14
|
Alterio D, Gerardi MA, Cella L, Spoto R, Zurlo V, Sabbatini A, Fodor C, D'Avino V, Conson M, Valoriani F, Ciardo D, Pacelli R, Ferrari A, Maisonneuve P, Preda L, Bruschini R, Cossu Rocca M, Rondi E, Colangione S, Palma G, Dicuonzo S, Orecchia R, Sanguineti G, Jereczek-Fossa BA. Radiation-induced acute dysphagia : Prospective observational study on 42 head and neck cancer patients. Strahlenther Onkol 2017; 193:971-981. [PMID: 28884310 DOI: 10.1007/s00066-017-1206-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 05/05/2017] [Accepted: 08/17/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Acute toxicity in head and neck (H&N) cancer patients treated with definitive radiotherapy (RT) has a crucial role in compliance to treatments. The aim of this study was to correlate doses to swallowing-associated structures and acute dysphagia. METHODS We prospectively analyzed 42 H&N cancer patients treated with RT. Dysphagia (grade ≥ 3) and indication for percutaneous endoscopic gastrostomy (PEG) insertion were classified as acute toxicity. Ten swallowing-related structures were considered for the dosimetric analysis. The correlation between clinical information and the dose absorbed by the contoured structures was analyzed. Multivariate logistic regression method using resampling methods (bootstrapping) was applied to select model order and parameters for normal tissue complication probability (NTCP) modelling. RESULTS A strong multiple correlation between dosimetric parameters was found. A two-variable model was suggested as the optimal order by bootstrap method. The optimal model (Rs = 0.452, p < 0.001) includes V45 of the cervical esophagus (odds ratio [OR] = 1.016) and Dmean of the cricopharyngeal muscle (OR = 1.057). The model area under the curve was 0.82 (95% confidence interval 0.69-0.95). CONCLUSION Our results suggested that the absorbed dose to the cricopharyngeal muscle and cervical esophagus might play a relevant role in the development of acute RT-related dysphagia.
Collapse
Affiliation(s)
- D Alterio
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
| | - M A Gerardi
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - L Cella
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - R Spoto
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - V Zurlo
- Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - A Sabbatini
- Dietetic and Clinical Nutrition Unit, European Institute of Oncology, Milan, Italy
| | - C Fodor
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - V D'Avino
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - M Conson
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - F Valoriani
- Dietetic and Clinical Nutrition Unit, European Institute of Oncology, Milan, Italy
| | - D Ciardo
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - R Pacelli
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy.,Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy
| | - A Ferrari
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - P Maisonneuve
- Department of Epidemiology and Statistics, European Institute of Oncology, Milan, Italy
| | - L Preda
- Department of Radiology, European Institute of Oncology, Milan, Italy
| | - R Bruschini
- Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - M Cossu Rocca
- Division of Urogenital and Head and Neck Tumors, Department of Medical Oncology, European Institute of Oncology, Milan, Italy
| | - E Rondi
- Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - S Colangione
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy
| | - G Palma
- Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy
| | - S Dicuonzo
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - R Orecchia
- Scientific Directorate, European Institute of Oncology, Milan, Italy
| | | | - B A Jereczek-Fossa
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| |
Collapse
|
15
|
Alterio D, Gerardi M, Cella L, D’Avino V, Palma G, Ciardo D, Rondi E, Ferrari A, Muto M, Spoto R, Pacelli R, Orecchia R, Jereczek B. EP-1077: Predictive modeling for radiation-induced acute dysphagia in head and neck cancer patients. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31513-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
16
|
Alterio D, Cossu Rocca M, Russell-Edu W, Dicuonzo S, Fanetti G, Marvaso G, Preda L, Zorzi S, Verri E, Nole' F, Jereczek-Fossa BA. Feasibility of concurrent chemoradiotherapy with high-dose cisplatin after induction TPF chemotherapy in head and neck cancer: a critical review of the literature and the experience of the European Institute of Oncology. Med Oncol 2017; 34:86. [PMID: 28391578 DOI: 10.1007/s12032-017-0952-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 04/04/2017] [Indexed: 11/30/2022]
Abstract
Many concerns are related to the idea that the acute toxicity of induction chemotherapy (IC) performed with TPF (docetaxel, cisplatin, 5-fluorouracil) could reduce the ability to deliver the subsequent standard concurrent chemoradiotherapy (CRT) in head and neck cancer patients. We performed a critical review of the literature on the toxicity profile of the standard CRT administered after the IC with TPF. A total of 13 papers (including 950 patients) were selected. Results showed that most patients were treated with an adequate radiation total dose although a significant proportion of them (from 15 to 30%) completed the planned treatment with a delay of more than 5 days. A minority of patients were able to be treated with three cycles of concurrent cisplatin, but only few papers reported how many of patients reached the cumulative total dose of almost 200 mg/m2 cisplatin. The rate of deaths due to treatment-related toxicity varied from 0 to 9% (median and mean 2%). Two prospective trials stopped patient enrollment due to acute treatment-related toxicity and because a low number of patients were able to undergo the planned full schedule of cisplatin during the CRT, respectively. Retrospective analysis of 45 patients treated at our institute showed that this schedule was feasible with manageable side effects. In conclusion, the literature data did not provide homogeneous information on the feasibility of the standard CRT after induction TPF. A more uniform data collection of treatment-related toxicity will be helpful in better selecting the patients who might adequately tolerate this multimodality strategy.
Collapse
Affiliation(s)
- D Alterio
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy.
| | - M Cossu Rocca
- Medical Oncology Division of Urogenital and Head and Neck Tumours, European Institute of Oncology, Milan, Italy
| | - W Russell-Edu
- Library of European Institute of Oncology, Milan, Italy
| | - S Dicuonzo
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - G Fanetti
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - G Marvaso
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy
| | - L Preda
- Particle Therapy Cancer Research Institute, CNAO Foundation, Pavia, Italy.,University of Pavia, Pavia, Italy
| | - S Zorzi
- Department of Otolaryngology - Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - E Verri
- Medical Oncology Division of Urogenital and Head and Neck Tumours, European Institute of Oncology, Milan, Italy
| | - F Nole'
- Medical Oncology Division of Urogenital and Head and Neck Tumours, European Institute of Oncology, Milan, Italy
| | - B A Jereczek-Fossa
- Department of Radiotherapy, European Institute of Oncology, Via Ripamonti, 435, 20141, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| |
Collapse
|
17
|
Alterio D, Marvaso G, Zorzi S, Preda L, Ferrari A, Rappa A, Giugliano G, Maffini F, Sibio D, Francia C, Cossu Rocca M, Jereczek-Fossa B, Ansarin M. PO-133: Occult lymphnode metastasis in early stage OPC treated with TORS without neck lymphnodes dissection. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30267-0] [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: 10/19/2022]
|
18
|
Tonoli S, Alterio D, Caspiani O, Bacigalupo A, Bunkheila F, Cianciulli M, Merlotti A, Podhradska A, Rampino M, Cante D, Bruschieri L, Gatta R, Magrini SM. Nasopharyngeal carcinoma in a low incidence European area : A prospective observational analysis from the Head and Neck Study Group of the Italian Society of Radiation Oncology (AIRO). Strahlenther Onkol 2016; 192:931-943. [PMID: 27761611 DOI: 10.1007/s00066-016-1052-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 04/12/2016] [Accepted: 09/19/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the outcomes with respect to long-term survival and toxicity in patients with nasopharyngeal carcinoma (NPC) treated in a European country with low incidence. MATERIALS AND METHODS A prospective observational study carried out by the AIRO Head and Neck group in 12 Italian institutions included 136 consecutive patients treated with radiotherapy (RT) ± chemotherapy (CHT) for NPC (without distant metastasis) between January 1, 2008 and December 31, 2010. RESULTS The disease-specific survival (DSS), overall survival (OS), and disease-free survival (DFS) at 5 years were 92 (±2), 91 (±3), and 69 % (±5 %), respectively. Distant failure was the most frequent modality of relapse. The local, regional, and locoregional control at 5 years were 89 (±3), 93 (±3), and 84 % (±4 %), respectively. The incidence of acute and late toxicity and the correlations with different clinical/technical variables were analyzed. Neoadjuvant CHT prolongs radiotherapy overall treatment time (OTT) and decreases treatment adherence during concomitant chemoradiotherapy. An adequate minimum dose coverage to PTV(T) is a predictive variable well related to outcome. CONCLUSION Our data do not substantially differ in terms of survival and toxicity outcomes from those reported in larger series of patients treated in countries with higher incidences of NPC. The T stage (TNM 2002 UICC classification) is predictive of DSS and OS. The GTV volume (T ± N) and an adequate minimum PTV(T) coverage dose (D95 %) were also identified as potential predictive variables. Sophisticated technologies of dose delivery (IMRT) with image-guided radiotherapy could help to obtain better minimum PTV(T) coverage dose with increased DFS; distant metastasis after treatment still remains an unresolved issue.
Collapse
Affiliation(s)
- S Tonoli
- Istituto del Radio, Brescia University, A.O. Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy.
| | - D Alterio
- Milan-European Institute of Oncology, Milan, Italy
| | - O Caspiani
- Roma-Isola Tiberina Hospital, Rome, Italy
| | - A Bacigalupo
- IRCCS A.O.U. San Martino IST Genoa, Genoa, Italy
| | | | | | - A Merlotti
- Busto Arsizio Hospital, Busto Arsizio, Italy
| | - A Podhradska
- Milan University - Monza S. Gerardo Hospital, Milan, Italy
| | | | | | | | - R Gatta
- Istituto del Radio, Brescia University, A.O. Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - S M Magrini
- Istituto del Radio, Brescia University, A.O. Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy.,Prato Hospital, Prato, Italy
| |
Collapse
|
19
|
Alterio D, Ferrari A, Maffini F, Marvaso G, Santoro L, Fodor C, Cossu Rocca M, Ansarin M, Dicuonzo S, Muto M, Zerini D, Chiocca S, Orecchia R, Jereczek-Fossal B. EP-1085: EGFR expression in head and neck cancer : does it have a role as prognostic factor in radiotherapy? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32335-0] [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: 11/28/2022]
|
20
|
Cremonesi M, Alterio D, Garibaldi C, Ferrari A, Botta F, Ferrari M, Vigorito S, Rondi E, Cattani F, Rocca MC, Strigari L, Pedicini P, Jereczek-Fosa B, Orecchia R. Combined RT and epidermal growth factor receptor inhibitor monoclonal antibody-MoAb-EGFr treatment of head and neck cancer (HNC): Radiobiological model for FAMOSO. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.055] [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: 11/25/2022] Open
|
21
|
Zaffino P, Ciardo D, Piperno G, Travaini LL, Comi S, Ferrari A, Alterio D, Jereczek-Fossa BA, Orecchia R, Baroni G, Spadea MF. Radiotherapy of Hodgkin and Non-Hodgkin Lymphoma. Technol Cancer Res Treat 2015; 15:355-64. [DOI: 10.1177/1533034615582290] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 03/19/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose: To improve the contouring of clinical target volume for the radiotherapy of neck Hodgkin/non-Hodgkin lymphoma by localizing the prechemotherapy gross target volume onto the simulation computed tomography using [18F]-fluorodeoxyglucose positron emission tomography/computed tomography. Material and Methods: The gross target volume delineated on prechemotherapy [18F]-fluorodeoxyglucose positron emission tomography/computed tomography images was warped onto simulation computed tomography using deformable image registration. Fifteen patients with neck Hodgkin/non-Hodgkin lymphoma were analyzed. Quality of image registration was measured by computing the Dice similarity coefficient on warped organs at risk. Five radiation oncologists visually scored the localization of automatic gross target volume, ranking it from 1 (wrong) to 5 (excellent). Deformable registration was compared to rigid registration by computing the overlap index between the automatic gross target volume and the planned clinical target volume and quantifying the V95 coverage. Results: The Dice similarity coefficient was 0.80 ± 0.07 (median ± quartiles). The physicians’ survey had a median score equal to 4 (good). By comparing the rigid versus deformable registration, the overlap index increased from a factor of about 4 and the V95 (percentage of volume receiving the 95% of the prescribed dose) went from 0.84 ± 0.38 to 0.99 ± 0.10 (median ± quartiles). Conclusion: This study demonstrates the impact of using deformable registration between prechemotherapy [18F]-fluorodeoxyglucose positron emission tomography/computed tomography and simulation computed tomography, in order to automatically localize the gross target volume for radiotherapy treatment of patients with Hodgkin/non-Hodgkin lymphoma.
Collapse
Affiliation(s)
- P. Zaffino
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
| | - D. Ciardo
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
| | - G. Piperno
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
| | - L. L. Travaini
- Nuclear Medicine Division, European Institute of Oncology, Milan, Italy
| | - S. Comi
- Medical Physics Unit, European Institute of Oncology, Milano, Italy
| | - A. Ferrari
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
| | - D. Alterio
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
| | - B. A. Jereczek-Fossa
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | - R. Orecchia
- Department of Radiation Oncology, European Institute of Oncology, Milano, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
- Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - G. Baroni
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
- Bioengineering Unit, Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - M. F. Spadea
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
| |
Collapse
|
22
|
Cossu Rocca M, Maffini F, Santoro L, Chiocca S, Massaro M, Preda L, Cattaneo A, Verri E, Alterio D, Ansarin M. PO-058: Primary chemotherapy followed by Transoral Laser Microsurgery and early laryngeal squamous cell carcinoma. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34818-0] [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: 10/23/2022]
|
23
|
Mazzola R, Ricchetti F, Fiorentino A, Fersino S, Giaj Levra N, Naccarato S, Sicignano G, Albanese S, Di Paola G, Alterio D, Ruggieri R, Alongi F. Dose-volume-related dysphagia after constrictor muscles definition in head and neck cancer intensity-modulated radiation treatment. Br J Radiol 2014; 87:20140543. [PMID: 25348370 DOI: 10.1259/bjr.20140543] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Dysphagia remains a side effect influencing the quality of life of patients with head and neck cancer (HNC) after radiotherapy. We evaluated the relationship between planned dose involvement and acute and late dysphagia in patients with HNC treated with intensity-modulated radiation therapy (IMRT), after a recontouring of constrictor muscles (PCs) and the cricopharyngeal muscle (CM). METHODS Between December 2011 and December 2013, 56 patients with histologically proven HNC were treated with IMRT or volumetric-modulated arc therapy. The PCs and CM were recontoured. Correlations between acute and late toxicity and dosimetric parameters were evaluated. End points were analysed using univariate logistic regression. RESULTS An increasing risk to develop acute dysphagia was observed when constraints to the middle PCs were not respected [mean dose (Dmean) ≥50 Gy, maximum dose (Dmax) >60 Gy, V50 >70% with a p = 0.05]. The superior PC was not correlated with acute toxicity but only with late dysphagia. The inferior PC was not correlated with dysphagia; for the CM only, Dmax >60 Gy was correlated with acute dysphagia ≥ grade 2. CONCLUSION According to our analysis, the superior PC has a major role, being correlated with dysphagia at 3 and 6 months after treatments; the middle PC maintains this correlation only at 3 months from the beginning of radiotherapy, but it does not have influence on late dysphagia. The inferior PC and CM have a minimum impact on swallowing symptoms. ADVANCES IN KNOWLEDGE We used recent guidelines to define dose constraints of the PCs and CM. Two results emerge in the present analysis: the superior PC influences late dysphagia, while the middle PC influences acute dysphagia.
Collapse
Affiliation(s)
- R Mazzola
- 1 Radiation Oncology, Sacro Cuore-Don Calabria Hospital, Negrar-Verona, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Ciardo D, Peroni M, Riboldi M, Alterio D, Baroni G, Orecchia R. The role of regularization in deformable image registration for head and neck adaptive radiotherapy. Technol Cancer Res Treat 2013; 12:323-31. [PMID: 23448576 DOI: 10.7785/tcrt.2012.500327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Deformable image registration provides a robust mathematical framework to quantify morphological changes that occur along the course of external beam radiotherapy treatments. As clinical reliability of deformable image registration is not always guaranteed, algorithm regularization is commonly introduced to prevent sharp discontinuities in the quantified deformation and achieve anatomically consistent results. In this work we analyzed the influence of regularization on two different registration methods, i.e. B-Splines and Log Domain Diffeomorphic Demons, implemented in an open-source platform. We retrospectively analyzed the simulation computed tomography (CTsim) and the corresponding re-planning computed tomography (CTrepl) scans in 30 head and neck cancer patients. First, we investigated the influence of regularization levels on hounsfield units (HU) information in 10 test patients for each considered method. Then, we compared the registration results of the open-source implementation at selected best performing regularization levels with a clinical commercial software on the remaining 20 patients in terms of mean volume overlap, surface and center of mass distances between manual outlines and propagated structures. The regularized B-Splines method was not statistically different from the commercial software. The tuning of the regularization parameters allowed open-source algorithms to achieve better results in deformable image registration for head and neck patients, with the additional benefit of a framework where regularization can be tuned on a patient specific basis.
Collapse
Affiliation(s)
- D Ciardo
- Advanced Radiotherapy Center, Division of Radiotherapy, European Institute of Oncology, via Ripamonti 435, 20141 Milano, Italy.
| | | | | | | | | | | |
Collapse
|
25
|
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]
|
26
|
Peroni M, Paganelli C, Spadea M, Riboldi M, Comi S, Alterio D, Seco J, Sharp G, Orecchia R, Baroni G. 1192 poster GENERATION OF VIRTUAL DAILY PLANNING CT FOR ADAPTIVE RADIOTHERAPY IN HEAD AND NECK CANCER. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71314-7] [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: 10/18/2022]
|
27
|
Peroni M, Spadea M, Riboldi M, Seco J, Sharp G, Comi S, Rondi E, Zerini D, Alterio D, Orecchia R, Baroni G. SU-GG-T-19 Automatic Contour Propagation between Planning Computed Tomography (CT) and Cone Beam CT (CBCT) Scan for In-Room Adaptive Planning: A Feasibility Study on Nasopharyngeal Cancer Patients. Med Phys 2010. [DOI: 10.1118/1.3468405] [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: 11/07/2022] Open
|
28
|
Peroni M, Riboldi M, Spadea M, Baroni G, Tagaste B, Preve E, Rondi E, Comi S, Garibaldi C, Alterio D, Zerini D, Pedotti A, Orecchia R. MERGING AND NON-RIGID REGISTRATION OF CBCTS FOR LARGE FIELD ADAPTIVE RADIOTHERAPY IN NASOPHARYNGEAL CANCER. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)73020-7] [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: 10/27/2022]
|
29
|
Garibaldi C, Rondi E, Comi S, Alterio D, Jereczek-Fossa B, Ferrari A, Zerini D, Pedroli G, Orecchia R. REPEAT COMPUTER TOMOGRAPHY IMAGING TO DETECT DOSIMETRIC CHANGES FOR HEAD AND NECK IMRT PLANS. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72815-3] [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: 10/27/2022]
|
30
|
Lazzari R, De Cicco L, Vavassori A, Cattani F, Ciocca M, Alterio D, Jereczek-Fossa B, Orecchia R. 132 poster: HDR BRachytherapy in Early Stage Oral Cavity and LIP Cancer: the Experience of the European Institute of Oncology. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(15)34389-9] [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]
|
31
|
Ferrari D, Chiesa F, Codecà C, Calabrese L, Jereczek-Fossa BA, Alterio D, Fiore J, Luciani A, Floriani I, Orecchia R, Foa P. Locoregionally advanced nasopharyngeal carcinoma: induction chemotherapy with cisplatin and 5-fluorouracil followed by radiotherapy and concurrent cisplatin: a phase II study. Oncology 2008; 74:158-66. [PMID: 18714164 DOI: 10.1159/000151363] [Citation(s) in RCA: 17] [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] [Received: 02/14/2008] [Accepted: 03/25/2008] [Indexed: 12/27/2022]
Abstract
BACKGROUND Chemoradiotherapy is the current standard of care for locoregionally advanced nasopharyngeal carcinoma. The purpose of this study was to assess the feasibility and efficacy of induction chemotherapy (CHT) followed by concomitant chemoradiotherapy in this patient population. PATIENTS AND METHODS In this single-arm, phase II study, patients with locoregionally advanced nasopharyngeal carcinoma were treated with 3 cycles of induction CHT with cisplatin (100 mg/m(2) on day 1) and 5-fluorouracil (1,000 mg/m(2) continuous infusion on days 1-4) followed by 3 cycles of cisplatin (100 mg/m(2) on days 1, 22 and 43) and concurrent radiotherapy up to 70 Gy. The primary endpoint was objective response. RESULTS Thirty-four patients were enrolled, and all completed both induction treatment and subsequent chemoradiotherapy. Objective response rates were 79.4% (95% CI 62.1-91.3) and 85.3% (95% CI 68.9-95.0) after induction CHT and chemoradiation, respectively. Treatment was well tolerated and toxicity was manageable. At a median follow-up of 29 months, 3-year overall survival and progression-free survival rates are 80.0% (95% CI 0.64-0.95) and 54.0% (95% CI 0.36-0.73), respectively. CONCLUSIONS Induction CHT with cisplatin and 5-fluorouracil followed by concomitant chemoradiotherapy is a feasible and active regimen for patients with stage IIB-IVB nasopharyngeal carcinoma. This regimen resulted in excellent locoregional disease control and overall survival.
Collapse
Affiliation(s)
- D Ferrari
- Division of Medical Oncology, San Paolo Hospital, Milan, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Veronesi R, Corrêa A, Alterio D. Single dose immunization against tetanus. Promising results in human trials. Rev Inst Med Trop Sao Paulo 1970; 12:46-54. [PMID: 4938470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
|