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Miele E, Anghileri E, Calatozzolo C, Lazzarini E, Patrizi S, Ciolfi A, Pedace L, Patanè M, Abballe L, Paterra R, Maddaloni L, Barresi S, Mastronuzzi A, Petruzzi A, Tramacere I, Farinotti M, Gurrieri L, Pirola E, Scarpelli M, Lombardi G, Villani V, Simonelli M, Merli R, Salmaggi A, Tartaglia M, Silvani A, DiMeco F, Calistri D, Lamperti E, Locatelli F, Indraccolo S, Pollo B. Clinicopathological and molecular landscape of 5-year IDH-wild-type glioblastoma survivors: A multicentric retrospective study. Cancer Lett 2024; 588:216711. [PMID: 38423245 DOI: 10.1016/j.canlet.2024.216711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/19/2024] [Accepted: 02/05/2024] [Indexed: 03/02/2024]
Abstract
Five-year glioblastoma (GBM) survivors (LTS) are the minority of the isocitrate dehydrogenase (IDH)-wild-type GBM patients, and their molecular fingerprint is still largely unexplored. This multicenter retrospective study analyzed a large LTS-GBM cohort from nine Italian institutions and molecularly characterized a subgroup of patients by mutation, DNA methylation (DNAm) and copy number variation (CNV) profiling, comparing it to standard survival GBM. Mutation scan allowed the identification of pathogenic variants in most cases, showing a similar mutational spectrum in both groups, and highlighted TP53 as the most commonly mutated gene in the LTS group. We confirmed DNAm as a valuable tool for GBM classification with a diagnostic refinement by using brain tumor classifier v12.5. LTS were more heterogeneous with more cases classified as diffuse pediatric high-grade glioma subtypes and having peculiar CNVs. We observed a global higher methylation in CpG islands and in gene promoters of LTS with methylation levels of distinct gene promoters correlating with prognosis.
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Affiliation(s)
- Evelina Miele
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Elena Anghileri
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy.
| | - Chiara Calatozzolo
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Elisabetta Lazzarini
- Basic and Translational Oncology Unit, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy
| | - Sara Patrizi
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Ciolfi
- Molecular Genetics and Functional Genomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lucia Pedace
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Monica Patanè
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Luana Abballe
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rosina Paterra
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Luisa Maddaloni
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Sabina Barresi
- Pathology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Angela Mastronuzzi
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessandra Petruzzi
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Irene Tramacere
- Department of Research and Clinical Development, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mariangela Farinotti
- Neuroepidemiology-Brain Cancer Registry, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lorena Gurrieri
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori (IRST) Dino Amadori, Meldola, Italy
| | - Elena Pirola
- Department of Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mauro Scarpelli
- Neurology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Italy
| | - Giuseppe Lombardi
- Medical Oncology Unit 1, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy
| | - Veronica Villani
- Neuro-Oncology Unit, IRCCS Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - Matteo Simonelli
- Department of Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Rossella Merli
- Neurosurgery Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Marco Tartaglia
- Molecular Genetics and Functional Genomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonio Silvani
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Francesco DiMeco
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Department of Neurological Surgery, John Hopkins Medical School, Baltimore, MD, USA
| | - Daniele Calistri
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Elena Lamperti
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Franco Locatelli
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Stefano Indraccolo
- Basic and Translational Oncology Unit, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy; Department of Surgery Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Bianca Pollo
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Silvaggi F, Mariniello A, Leonardi M, Silvani A, Lamperti E, Di Cosimo S, Folli S, Trapani A, Schiavolin S. Psychosocial factors associated with workability after surgery in cancer survivors: An explorative study. J Health Psychol 2023; 28:999-1010. [PMID: 36800903 PMCID: PMC10492438 DOI: 10.1177/13591053231151286] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
This study aimed to evaluate the work ability and its associated factors in patients with glioma (II, III) and breast cancer after 6 (T0) and 12 (T1) months from surgery. A total of 99 patients were evaluated with self-reported questionnaires at T0 and T1. Correlation and Mann-Whitney tests were used to investigate the association between work ability and sociodemographic, clinical, and psychosocial factors. The Wilcoxon test was used to investigate the longitudinal change in work ability. Our sample showed a decrease in work ability level between T0 and T1. Work ability was associated with emotional distress, disability, resilience, and social support in glioma III patients at T0, and with fatigue, disability, and clinical treatments in patients with breast cancer at T0 and T1. Work ability levels decreased in patients with glioma and breast cancer and were associated with different psychosocial factors after surgery. Their investigation is suggested to facilitate the return to work.
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Affiliation(s)
- Fabiola Silvaggi
- Department of Neurology, Public Health, Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Italy
| | - Arianna Mariniello
- Department of Neurology, Public Health, Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Italy
| | - Matilde Leonardi
- Department of Neurology, Public Health, Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Italy
| | - Antonio Silvani
- UOC Neuro-Oncology Unit , Fondazione IRCCS Istituto Neurologico Carlo Besta, Italy
| | - Elena Lamperti
- UOC Neuro-Oncology Unit , Fondazione IRCCS Istituto Neurologico Carlo Besta, Italy
| | - Serena Di Cosimo
- Biomarkers Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Italy
| | - Secondo Folli
- Breast Cancer Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Italy
| | - Anna Trapani
- Breast Cancer Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Italy
| | - Silvia Schiavolin
- Department of Neurology, Public Health, Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Italy
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Leonardi M, Tagliavini F, Silvani A, Lamperti E, Schiavolin S, Silvaggi F. How long and how frequent follow-up care should be for lower-grade gliomas? Retrospective study on patients with LGGs at Neurological Institute Besta of Milan. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.118430] [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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Foppiani A, De Amicis R, Lessa C, Leone A, Ravella S, Ciusani E, Silvani A, Zuccoli G, Battezzati A, Lamperti E, Bertoli S. Isocaloric Ketogenic Diet in Adults with High-Grade Gliomas: A Prospective Metabolic Study. Nutr Cancer 2021; 73:1004-1014. [PMID: 33689522 DOI: 10.1080/01635581.2020.1779759] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The use of the ketogenic diet (KD) as an adjuvant therapy in high-grade gliomas (HGG) is supported by preclinical studies, but clinical data on its effects on metabolism are currently lacking. In this study, we describe the effects of a KD on glucose profile, ketonemia, energy metabolism, and nutritional status, in adults affected by HGG. This was a single-arm prospective study. An isocaloric 3:1 KD was administered for 1 mo. Glucose profile was assessed by using fasting glycemia, insulin, and glycated hemoglobin. To evaluate ketonemia changes, a hand-held ketone meter was used from home. Energy metabolism was assessed by indirect calorimetry. Nutritional status was evaluated through changes in body composition and in lipid and hepatic profile. No changes in fasting glycemia were observed; however, insulinemia dropped to half of baseline levels. The KD shifted the metabolism, rising ketonemia and decreasing glucose oxidation rate to a quarter of the initial values. Moreover, the KD was generally safe. One-month intervention with the KD was able to act upon key metabolic substrates potentially involved in HGG metabolism. The lack of a significant reduction in fasting glycemia should be investigated in future studies.
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Affiliation(s)
- Andrea Foppiani
- Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
| | - Ramona De Amicis
- Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
| | - Chiara Lessa
- Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
| | - Alessandro Leone
- Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
| | - Simone Ravella
- Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
| | - Emilio Ciusani
- UOC Neurologia 2-Neuroncologia Clinica, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Antonio Silvani
- UOC Neurologia 2-Neuroncologia Clinica, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giulio Zuccoli
- School of Medicine, Children Hospital at the University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alberto Battezzati
- Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
| | - Elena Lamperti
- UOC Neurologia 2-Neuroncologia Clinica, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Simona Bertoli
- Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy.,Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Obesity Unit and Laboratory of Nutrition and Obesity Research, Milan, Italy
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5
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Silvaggi F, Leonardi M, Raggi A, Eigenmann M, Mariniello A, Silvani A, Lamperti E, Schiavolin S. Employment and Work Ability of Persons With Brain Tumors: A Systematic Review. Front Hum Neurosci 2020; 14:571191. [PMID: 33192403 PMCID: PMC7658191 DOI: 10.3389/fnhum.2020.571191] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 06/10/2020] [Accepted: 09/28/2020] [Indexed: 01/21/2023] Open
Abstract
Brain tumors (BT) are between the eight most common cancers among persons aged 40 years, with an average survival time of 10 years for patients affected by non-malignant brain tumor. Some patients continue to work, reporting difficulties in work-related activities, or even job loss. The purpose of the present study was to review the existing information about the ability people with BT to return to work and to identify factors associated with job loss. We performed a systematic review on SCOPUS and EMBASE for peer-reviewed papers that reported studies assessing work ability in patients with BT that were published in the period from January 2010 to January 2020. Out of 800 identified records, 7 articles were selected for analysis, in which 1,507 participants with BT were enrolled overall. Three main themes emerged: the impact of neuropsychological functioning on work productivity, the change of employment status for long-term survivors and issues related to return to work processes. Based on the results of selected studies, it can be concluded that the impact of BT on workforce participation is determined by depressive symptoms and cognitive deficits, as well as by high short-term mortality but also on environmental barriers. Vocational Rehabilitation programs should be implemented to help patients wishing to return to or maintain their current work, as much as possible.
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Affiliation(s)
- Fabiola Silvaggi
- Unità Operativa Complessa Neurologia, Salute Pubblica, Disabilità, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Matilde Leonardi
- Unità Operativa Complessa Neurologia, Salute Pubblica, Disabilità, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alberto Raggi
- Unità Operativa Complessa Neurologia, Salute Pubblica, Disabilità, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Michela Eigenmann
- Unità Operativa Complessa Neurologia, Salute Pubblica, Disabilità, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Arianna Mariniello
- Unità Operativa Complessa Neurologia, Salute Pubblica, Disabilità, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Antonio Silvani
- Unità Operativa Complessa Neurologia 2 – Neuro-Oncologia Clinica, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Elena Lamperti
- Unità Operativa Complessa Neurologia 2 – Neuro-Oncologia Clinica, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvia Schiavolin
- Unità Operativa Complessa Neurologia, Salute Pubblica, Disabilità, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
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Di Pierro F, Simonetti G, Petruzzi A, Bertuccioli A, Botta L, Bruzzone MG, Cuccarini V, Fariselli L, Lamperti E. A novel lecithin-based delivery form of Boswellic acids as complementary treatment of radiochemotherapy-induced cerebral edema in patients with glioblastoma multiforme: a longitudinal pilot experience. J Neurosurg Sci 2019; 63:286-291. [DOI: 10.23736/s0390-5616.19.04662-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Simonetti G, Sommariva A, Basso Ricci C, Anghileri E, Botturi A, Eoli M, Gaviani P, Lamperti E, Moreschi C, Silvani A. P03.04 Observational, prospective study on complications and tolerability of PICC (central venous catheter with peripheral insertion) in neurooncological patients. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- G Simonetti
- IRCCS Neurologico Carlo Besta, milano, Italy
| | - A Sommariva
- IRCCS Neurologico Carlo Besta, milano, Italy
| | | | - E Anghileri
- IRCCS Neurologico Carlo Besta, milano, Italy
| | - A Botturi
- IRCCS Neurologico Carlo Besta, milano, Italy
| | - M Eoli
- IRCCS Neurologico Carlo Besta, milano, Italy
| | - P Gaviani
- IRCCS Neurologico Carlo Besta, milano, Italy
| | - E Lamperti
- IRCCS Neurologico Carlo Besta, milano, Italy
| | - C Moreschi
- IRCCS Neurologico Carlo Besta, milano, Italy
| | - A Silvani
- IRCCS Neurologico Carlo Besta, milano, Italy
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Bertoli S, Battezzati A, Petruzzi A, Leone A, De Amicis R, Tramacere E, Meda M, Foppiani A, Silvani A, Lamperti E. Anthropometrics and Body Composition in Adults with High-Grade Gliomas: Effects of Disease-Related Variables. Nutr Cancer 2018. [PMID: 29537900 DOI: 10.1080/01635581.2018.1446089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Nutritional status in adults with high-grade gliomas (HGGs) has been poorly investigated. We studied anthropometrics and fat mass (FM), fat free mass (FFM), and body water in HGGs patients also in relation to disease-related variables. Fifty-one patients (17 III and 34 IV-grade) and fifty-one control group (CG) matched for sex, age, and BMI were enrolled. Neurological scales, anthropometry, bioimpedance, and blood sampling were performed and analyzed according to grade, lesion location, extent of resection, phase of treatment, current steroids and antiepileptic therapy, and age of patient. 41.2% were overweight and 15.7% obese. Compared to the CG, HGGs had similar anthropometrics and body composition. IV-grade, compared to the III, had higher BMI, waist circumference, FM and lower FFM. Only patients during concomitant radio and chemotherapy showed a negative BMI variation from baseline. In conclusion, overnutrition occurs in almost 6 out of 10 HGGs patients and is more relevant in IV-grade. Throughout all the treatment phases, there is a higher risk of weight loss occurred only during concomitant radio and chemotherapy. Body composition showed no specific features compared to controls. These results may assist intervention studies directed towards neurometabolic dietary treatment. Nutritional screening is warranted during the time course of disease.
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Affiliation(s)
- Simona Bertoli
- a Department of Food Environmental and Nutritional Sciences (DeFENS) , International Center for the Assessment of Nutritional Status (ICANS), University of Milan , Milan , Italy
| | - Alberto Battezzati
- a Department of Food Environmental and Nutritional Sciences (DeFENS) , International Center for the Assessment of Nutritional Status (ICANS), University of Milan , Milan , Italy
| | - Alessandra Petruzzi
- b Clinical Neuro-oncology Unit, Neurological Institute Foundation Carlo Besta , Milan , Italy
| | - Alessandro Leone
- a Department of Food Environmental and Nutritional Sciences (DeFENS) , International Center for the Assessment of Nutritional Status (ICANS), University of Milan , Milan , Italy
| | - Ramona De Amicis
- a Department of Food Environmental and Nutritional Sciences (DeFENS) , International Center for the Assessment of Nutritional Status (ICANS), University of Milan , Milan , Italy
| | - Elena Tramacere
- a Department of Food Environmental and Nutritional Sciences (DeFENS) , International Center for the Assessment of Nutritional Status (ICANS), University of Milan , Milan , Italy.,b Clinical Neuro-oncology Unit, Neurological Institute Foundation Carlo Besta , Milan , Italy
| | - Maddalena Meda
- a Department of Food Environmental and Nutritional Sciences (DeFENS) , International Center for the Assessment of Nutritional Status (ICANS), University of Milan , Milan , Italy.,b Clinical Neuro-oncology Unit, Neurological Institute Foundation Carlo Besta , Milan , Italy
| | - Andrea Foppiani
- a Department of Food Environmental and Nutritional Sciences (DeFENS) , International Center for the Assessment of Nutritional Status (ICANS), University of Milan , Milan , Italy
| | - Antonio Silvani
- b Clinical Neuro-oncology Unit, Neurological Institute Foundation Carlo Besta , Milan , Italy
| | - Elena Lamperti
- b Clinical Neuro-oncology Unit, Neurological Institute Foundation Carlo Besta , Milan , Italy
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Petruzzi A, Finocchiaro CY, Rainoldi L, Silvani A, Farinotti M, Salmaggi A, Sarno L, Lamperti E. Caring for Brain Tumour Patients: Psychological Reactions After Bereavement. J Palliat Care 2017. [DOI: 10.1177/082585971503100205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim The aim of this study was to describe the changes in quality of life and in levels of anxiety and depression experienced by caregivers of patients with brain tumour 18 months after their bereavement. Methods This longitudinal study employed data from two time points: time 1, during the hospital stay of the caregiver's loved one; and time 2, approximately 18 months after the death of the patient. A total of 51 caregivers agreed to participate in the study at both time points. We used the Hospital Anxiety and Depression Scale and the 36-Item Short Form Health Survey; we compared the data obtained at the two time points using the paired-samples t-test. Results Caring for someone with a brain tumour had a greater impact on the caregivers’ mental health than on their physical well-being. At time 2, the caregivers’ levels of anxiety and depression and psychological burden were decreased, indicating that they were in a better emotional state than they had been in time 1. However, the mean values in the depression, vitality, and mental health subscales were lower than those in the normative data, indicating that these caregivers had a worse psychological status than members of the normative group. Conclusion Our study underscores the necessity of supporting caregivers and monitoring their suffering levels; such suffering can compromise their social and work lives, not only during the disease trajectory but also in bereavement. Providing psychological and emotional support for caregivers of patients with brain tumour during both periods could lessen the suffering and unhappiness of these caregivers.
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Affiliation(s)
- Alessandra Petruzzi
- Clinical Neurooncology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Via Celoria, 11, 20133 Milan, Italy
| | - Claudia Yvonne Finocchiaro
- Clinical Neurooncology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy; Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Rainoldi
- Clinical Neurooncology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Antonio Silvani
- Clinical Neurooncology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Mariangela Farinotti
- Neuroepidemiology–Brain Cancer Registry, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Andrea Salmaggi
- Clinical Neurooncology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Lucio Sarno
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Lamperti
- Clinical Neurooncology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
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Petruzzi A, Rigamonti A, Finocchiaro CY, Borelli P, Lamperti E, Silvani A, Regazzoni R, Stanzani L, Salmaggi A. Psychological features and quality of life in 50 adult patients with epilepsy and their caregivers from the Lecco epilepsy center, Italy. Epilepsy Behav 2017; 71:13-16. [PMID: 28441636 DOI: 10.1016/j.yebeh.2017.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/15/2017] [Accepted: 03/17/2017] [Indexed: 11/27/2022]
Abstract
Epilepsy is one of the most common neurological disorders. To the best of our knowledge, in Italy, the relationship between patients' and caregivers' psychological state has rarely been analyzed. Thus, we sought to evaluate both the psychological state of patients with epilepsy and that of their caregivers and the interrelationship between them. We also assessed the existing relation between psychological features and some clinical and demographic information, such as number of antiepileptic drugs (AEDs), epilepsy duration and education level of patients and their caregivers. We enrolled in the study 50 consecutive adult patients attending the epilepsy clinic of "A. Manzoni" Hospital and their caregivers. Both patients and their caregivers were administered Hospital Anxiety and Depression Scale (HADS) and 36-item Short-Form Health Survey (SF-36). Anxiety, depression and quality of life values of both patients and their caregivers did not differ significantly from the normative samples. No statistically significant correlation between epilepsy duration and patients' and caregivers' psychological features was found. Patients which took more than one AED reported lower values of "Vitality" (p <.05) and "Social Functioning" (p <.05) than their own caregivers. Caregivers with higher education level presented lower "Vitality" values than caregivers with lower education level (p <.05). Patients with pharmacoresistant seizures reported lower values of "Mental Health" than patients with non-pharmacoresistant seizures (p <.05). In this context, the role of coping mechanisms by patients and caregivers may explain apparently unexpected findings and suggests that strategies aimed at reinforcing them may be effective in selected cases. Therefore, while the severity of epilepsy may have an impact on the psychological state of adult patients with epilepsy and their caregivers, our results highlight the role of multidimensional determinants, including stigma. Further studies are needed to identify the factors related to epilepsy, patients, caregivers, treatments, and the environment that may be modifiable in order to improve self-perceived QoL.
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Affiliation(s)
- Alessandra Petruzzi
- Department of Neuroncology, Unit of Neurology II, Fondazione I.R.C.C.S. Istituto Neurologico "C. Besta", Milan, Italy; Department of Neurosciences - Unit of Neurology - Stroke Unit, "A. Manzoni" Hospital, Lecco, Italy.
| | - Andrea Rigamonti
- Department of Neurosciences - Unit of Neurology - Stroke Unit, "A. Manzoni" Hospital, Lecco, Italy
| | | | - Paolo Borelli
- Department of Neurosciences - Unit of Neurology - Stroke Unit, "A. Manzoni" Hospital, Lecco, Italy
| | - Elena Lamperti
- Department of Neuroncology, Unit of Neurology II, Fondazione I.R.C.C.S. Istituto Neurologico "C. Besta", Milan, Italy
| | - Antonio Silvani
- Department of Neuroncology, Unit of Neurology II, Fondazione I.R.C.C.S. Istituto Neurologico "C. Besta", Milan, Italy
| | - Rossana Regazzoni
- Department of Neurosciences - Unit of Neurology - Stroke Unit, "A. Manzoni" Hospital, Lecco, Italy
| | - Lorenzo Stanzani
- Department of Neurosciences - Unit of Neurology - Stroke Unit, "A. Manzoni" Hospital, Lecco, Italy
| | - Andrea Salmaggi
- Department of Neurosciences - Unit of Neurology - Stroke Unit, "A. Manzoni" Hospital, Lecco, Italy
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Simonetti G, Gaviani P, Botturi A, Fariselli L, Hottinger A, Lamperti E, Pesce G, Silvani A. P09.52 Extra central nervous system metastases from glioblastoma: a clinical case. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.308] [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: 11/14/2022] Open
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12
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Scaratti C, Leonardi M, Saladino A, Anghileri E, Broggi M, Lamperti E, Fariselli L, Ayadi R, Tringali G, Schiavolin S. Needs of neuro-oncological patients and their caregivers during the hospitalization and after discharge: results from a longitudinal study. Support Care Cancer 2017; 25:2137-2145. [PMID: 28204993 DOI: 10.1007/s00520-017-3619-6] [Citation(s) in RCA: 6] [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: 10/20/2016] [Accepted: 02/06/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE The aims of this study are to identify neuro-oncological patients' and their caregivers' needs during hospitalization (T0) and at 4 months after discharge (T1); to analyze the longitudinal changes in patients' and caregivers' needs and burden; to identify correlations between patients' needs and caregivers' burden and needs. METHODS A pilot observational longitudinal study was conducted on 94 neuro-oncological patients and their caregivers using NEQ to evaluate patients' needs, CNA, and FSQ for caregivers' needs and burden at T0 and T1. Descriptive statistics were performed to illustrate the distribution of questionnaires' scores. The longitudinal change of NEQ, FSQ, and CNA scores were investigated using Wilcoxon test. Spearman's correlation was used to measure the relation between NEQ and FSQ and CNA scores. RESULTS The most frequent patients and caregivers' needs were material and informative. Needs tend to decrease over time; in particular FSQ factor "need for knowledge about the disease", CNA factor "Information/communication needs" and CNA total score significantly decreased (p < 0.001). NEQ total score significantly correlated with FSQ factors "emotional burden" and "need for knowledge about the disease" and CNA total and factors scores at T0 and T1. At T0, NEQ correlated significantly with FSQ factor "thoughts about death", while at T1, it correlated with FSQ factor "problems in social involvement". CONCLUSIONS It is crucial to plan an assessment of patients' and caregivers' needs from the very beginning, in order to identify those individuals potentially at risk of developing high level of distress and to provide information and support following the illness trajectory of the brain tumor.
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Affiliation(s)
- C Scaratti
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Via Celoria 11, 20133, Milan, Italy
| | - M Leonardi
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Via Celoria 11, 20133, Milan, Italy
| | - A Saladino
- Department of Neurosurgery, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - E Anghileri
- Unit of Molecular Neuro-Oncology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - M Broggi
- Department of Neurosurgery, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - E Lamperti
- Department of Neuroncology, Unit of Neurology II, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - L Fariselli
- Neurosurgery Department, Radiotherapy Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - R Ayadi
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Via Celoria 11, 20133, Milan, Italy
| | - G Tringali
- Department of Neurosurgery, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - S Schiavolin
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Via Celoria 11, 20133, Milan, Italy.
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13
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Innocenti A, Simonetti G, Gaviani P, Botturi A, Lamperti E, Terreni M, Silvani A. P11.08 Even the good can be bad: malignant evolution of a “benign” WHO grade I meningioma. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.239] [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: 11/14/2022] Open
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14
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Finocchiaro CY, Petruzzi A, Fedeli G, Vistalli MG, Innocenti A, Silvani A, Lamperti E. Hidden reality: sexual sphere in brain tumor patients. PSYCHOL HEALTH MED 2016; 22:370-380. [DOI: 10.1080/13548506.2016.1210176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Gaviani P, Simonetti G, Innocenti A, Lamperti E, Botturi A, Silvani A. Safety and efficacy of primary central nervous system lymphoma treatment in elderly population. Neurol Sci 2015; 37:131-133. [PMID: 26292791 DOI: 10.1007/s10072-015-2371-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 08/14/2015] [Indexed: 11/25/2022]
Abstract
Elderly patients represent an important subgroup in primary central nervous system lymphoma (PCNSL) that accounts for approximately half the cases. Furthermore age represents one of the heaviest prognostic factors and in some cases it has more effect on survival than therapies. We performed a retrospective analysis to assess the toxicity and the efficacy of high-dose methotrexate (HDMTX) chemotherapy in a PCNSL population older than 70 years. Seventeen consecutive immunocompetent patients older than 70 years, with histologically confirmed PCNSL, without systemic involvement, treated with HDMTX at our institution between May 2005 and April 2013, were retrospectively evaluated. Main outcome measures were acute toxicity and tumour response. No evidence of haematological toxicity was recorded in 47 % of patients and no deaths related to toxicity grade were reported. Patients achieved a partial response after 3 cycles of chemotherapy in 53 % of cases. The median overall survival (m-OS) from diagnosis was 20.9 months (range 5.2-34 months), with OS-12 of 58.8 % and an OS-24 of 45.4 %. Since there is no standard of care in the treatment of PCNSL in elderly population, it should be taken into account that elderly patients not always can be considered "fragile" and the general tendency to less treat to avoid severe toxicity should not be the rule.
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Affiliation(s)
- Paola Gaviani
- Neuro Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via celoria, 11, 20133, Milan, Italy.
| | - G Simonetti
- Neuro Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via celoria, 11, 20133, Milan, Italy
| | - A Innocenti
- Neuro Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via celoria, 11, 20133, Milan, Italy
| | - E Lamperti
- Neuro Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via celoria, 11, 20133, Milan, Italy
| | - A Botturi
- Neuro Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via celoria, 11, 20133, Milan, Italy
| | - A Silvani
- Neuro Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via celoria, 11, 20133, Milan, Italy
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Abstract
Oligodendrogliomas represent the third most common type of glioma, comprising 4%-15% of all gliomas and can be classified by degree of malignancy into grade II and grade III, according to WHO classification. Only 30% of oligodendroglial tumors have anaplastic characteristics. Anaplastic oligodendroglioma (AO) is often localized as a single lesion in the white matter and in the cortex, rarely in brainstem or spinal cord. The management of AO is deeply changed in the recent years. Maximal safe surgical resection followed by radiotherapy (RT) was considered as the standard of care since paramount findings regarding molecular aspects, in particular co-deletion of the short arm of chromosome 1 and the long arm of chromosome 19, revealed that these subsets of AO, benefit in terms of overall survival (OS) and progression-free survival (PFS), from the addition of chemotherapy to RT. Allelic losses of chromosomes 1p and 19q occur in 50%-70% of both low-grade and anaplastic tumors, representing a strong prognostic factor and a powerful predictor of prolonged survival. Several other molecular markers have potential clinical significance as IDH1 mutations, confirming the strong prognostic role for OS. Malignant brain tumors negatively impacts on patients' quality of life. Seizures, visual impairment, headache, and cognitive disorders can be present. Moreover, chemotherapy and RT have important side effects. For these reasons, "health-related quality of life" is becoming a topic of growing interest, investigating on physical, mental, emotional, and social well-being. Understanding the impact of medical treatment on health-related quality of life will probably have a growing effect both on health care strategies and on patients.
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Affiliation(s)
- G Simonetti
- Neurooncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - P Gaviani
- Neurooncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A Botturi
- Neurooncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A Innocenti
- Neurooncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - E Lamperti
- Neurooncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A Silvani
- Neurooncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Salmaggi A, Venegoni E, Eoli M, Lamperti E, Dufour A, Ciusani E, Milanese C, Nespolo A, Novi C. Immunological monitoring in systemic lupus erythematosus. Contrib Nephrol 2015; 99:114-7. [PMID: 1458915 DOI: 10.1159/000421699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- A Salmaggi
- Istituto Neurologico C. Besta, Milano, Magenta, Italia
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18
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Ariano CC, Salmaggi A, Croci D, Lamperti E, Bottero P, Castiglione A, Venegoni E, La Mantia L, Eoli M. Lupus anticoagulants and antiphospholipid antibodies monitoring in systemic lupus erythematosus. Contrib Nephrol 2015; 99:118-22. [PMID: 1458916 DOI: 10.1159/000421700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- C C Ariano
- Istituto Neurologico C. Besta, Milano, Italia
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Botturi A, Gaviani P, Simonetti G, Innocenti A, Pollo B, Lamperti E, Legnani F, Silvani A. P17.10 * GEMISTOCYTIC ASTROCYTOMAS: MONO-INSTITUTIONAL EXPERIENCE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.340] [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: 11/13/2022] Open
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20
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Finocchiaro CY, Petruzzi A, Vistalli G, Innocenti A, Silvani A, Lamperti E. P15.05 * WHAT ABOUT BRAIN TUMOR PATIENTS' SEX LIFE? A PILOT STUDY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.284] [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: 11/14/2022] Open
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21
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Innocenti A, Simonetti G, Gaviani P, Botturi A, Lamperti E, Fariselli L, Silvani A. P06.05 * A CASE OF RADIATION-INDUCED MENINGIOMAS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.171] [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: 11/14/2022] Open
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22
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Gaviani P, Simonetti G, Lamperti E, Petruzzi A, Innocenti A, Botturi A, Fariselli L, Silvani A. P11.02 * PRIMARY CEREBRAL LYMPHOMA: TREATMENT WITH HIGH DOSE METHOTREXATE IN A MONO-INSTITUTIONAL EXPERIENCE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.225] [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: 11/12/2022] Open
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23
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Petruzzi A, Finocchiaro CY, Vistalli G, Botturi A, Milanesi I, Silvani A, Lamperti E. O9.04 * HIGH GRADE GLIOMAS AND CAREGIVERS' PSYCHOLOGICAL BURDEN. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.75] [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: 11/13/2022] Open
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24
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Simonetti G, Gaviani P, Innocenti A, Botturi A, Lamperti E, Silvani A. P17.80 * ANAPLASTIC GLIOMA: AN UPDATE ON TREATMENT STRATEGIES. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.409] [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: 11/14/2022] Open
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25
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Simonetti G, Gaviani P, Innocenti A, Botturi A, Pollo B, Marchetti M, Lamperti E, DiMeco F, Silvani A. P06.14 * MALIGNANT TRANSFORMATION OF MENINGIOMA WITH METASTASES IN YOUNG WOMAN. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.180] [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: 11/13/2022] Open
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26
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Petruzzi A, Finocchiaro CY, Simonetti G, Gaviani P, Casali C, Silvani A, Lamperti E. P17.69 * FOTEMUSTINE TRATMENT: WHAT ABOUT GLIOBLASTOMA PATIENTS' QUALITY OF LIFE? Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.398] [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: 11/12/2022] Open
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27
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Pensato V, Castellotti B, Gellera C, Pareyson D, Ciano C, Nanetti L, Salsano E, Piscosquito G, Sarto E, Eoli M, Moroni I, Soliveri P, Lamperti E, Chiapparini L, Di Bella D, Taroni F, Mariotti C. Overlapping phenotypes in complex spastic paraplegias SPG11, SPG15, SPG35 and SPG48. ACTA ACUST UNITED AC 2014; 137:1907-20. [PMID: 24833714 DOI: 10.1093/brain/awu121] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hereditary spastic paraplegias are a heterogeneous group of neurodegenerative disorders, clinically classified in pure and complex forms. Genetically, more than 70 different forms of spastic paraplegias have been characterized. A subgroup of complicate recessive forms has been distinguished for the presence of thin corpus callosum and white matter lesions at brain imaging. This group includes several genetic entities, but most of the cases are caused by mutations in the KIAA1840 (SPG11) and ZFYVE26 genes (SPG15). We studied a cohort of 61 consecutive patients with complicated spastic paraplegias, presenting at least one of the following features: mental retardation, thin corpus callosum and/or white matter lesions. DNA samples were screened for mutations in the SPG11/KIAA1840, SPG15/ZFYVE26, SPG21/ACP33, SPG35/FA2H, SPG48/AP5Z1 and SPG54/DDHD2 genes by direct sequencing. Sequence variants were found in 30 of 61 cases: 16 patients carried SPG11/KIAA1840 gene variants (26.2%), nine patients carried SPG15/ZFYVE26 variants (14.8%), three patients SPG35/FA2H (5%), and two patients carried SPG48/AP5Z1 gene variants (3%). Mean age at onset was similar in patients with SPG11 and with SPG15 (range 11-36), and the phenotype was mostly indistinguishable. Extrapyramidal signs were observed only in patients with SPG15, and epilepsy in three subjects with SPG11. Motor axonal neuropathy was found in 60% of cases with SPG11 and 70% of cases with SPG15. Subjects with SPG35 had intellectual impairment, spastic paraplegia, thin corpus callosum, white matter hyperintensities, and cerebellar atrophy. Two families had a late-onset presentation, and none had signs of brain iron accumulation. The patients with SPG48 were a 5-year-old child, homozygous for a missense SPG48/AP5Z1 variant, and a 51-year-old female, carrying two different nonsense variants. Both patients had intellectual deficits, thin corpus callosum and white matter lesions. None of the cases in our cohort carried mutations in the SPG21/ACP33 and SPG54/DDH2H genes. Our study confirms that the phenotype of patients with SPG11 and with SPG15 is homogeneous, whereas cases with SPG35 and with SPG48 cases present overlapping features, and a broader clinical spectrum. The large group of non-diagnosed subjects (51%) suggests further genetic heterogeneity. The observation of common clinical features in association with defects in different causative genes, suggest a general vulnerability of the corticospinal tract axons to a wide spectrum of cellular alterations.
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Affiliation(s)
- Viviana Pensato
- 1 Genetics of Neurodegenerative and Metabolic Diseases Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Barbara Castellotti
- 1 Genetics of Neurodegenerative and Metabolic Diseases Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Cinzia Gellera
- 1 Genetics of Neurodegenerative and Metabolic Diseases Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Davide Pareyson
- 2 Clinic of Central and Peripheral Degenerative Neuropathies Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Claudia Ciano
- 3 Clinical Neurophysiology Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Lorenzo Nanetti
- 1 Genetics of Neurodegenerative and Metabolic Diseases Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Ettore Salsano
- 2 Clinic of Central and Peripheral Degenerative Neuropathies Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Giuseppe Piscosquito
- 2 Clinic of Central and Peripheral Degenerative Neuropathies Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Elisa Sarto
- 1 Genetics of Neurodegenerative and Metabolic Diseases Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Marica Eoli
- 4 Molecular Neuro-Oncology Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Isabella Moroni
- 5 Paediatric Neurology Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Paola Soliveri
- 6 Movement Disorders Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Elena Lamperti
- 7 Neuro-Oncology Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Luisa Chiapparini
- 8 Neuroradiology Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Daniela Di Bella
- 1 Genetics of Neurodegenerative and Metabolic Diseases Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Franco Taroni
- 1 Genetics of Neurodegenerative and Metabolic Diseases Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
| | - Caterina Mariotti
- 1 Genetics of Neurodegenerative and Metabolic Diseases Unit, IRCCS-Fondazione Istituto Neurologico Carlo Besta, via Celoria 11, 20133 Milan, Italy
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Simonetti G, Trevisan E, Silvani A, Gaviani P, Botturi A, Lamperti E, Beecher D, Bertero L, Bosa C, Salmaggi A. Safety of bevacizumab in patients with malignant gliomas: a systematic review. Neurol Sci 2013; 35:83-9. [DOI: 10.1007/s10072-013-1583-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 11/12/2013] [Indexed: 01/01/2023]
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Simonetti G, Trevisan E, Gaviani P, Lamperti E, Salmaggi A, Silvani A. Safety of bevacizumab with or without anticoagulant treatment in neuro-oncological patients: A systematic review. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2101] [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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Petruzzi A, Finocchiaro C, Silvani A, Rainoldi L, Gaviani P, Lamperti E. Psychological burden of brain tumor patients and their caregivers. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2332] [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]
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31
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Finocchiaro C, Rainoldi L, Petruzzi A, Simonetti G, Silvani A, Lamperti E. Bereavement in brain tumor: Psychological reactions in caregivers. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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32
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Petruzzi A, Finocchiaro C, Silvani A, Botturi A, Lamperti E. Psychological patterns of patients with recurrent brain tumor. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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33
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Gaviani P, Simonetti G, Salmaggi A, Lamperti E, Silvani A. Safety of second-line chemotherapy with non-conventional fotemustine schedule in recurrent high grade gliomas: a single institution experience. J Neurooncol 2013; 113:527-9. [PMID: 23703296 PMCID: PMC3684713 DOI: 10.1007/s11060-013-1147-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 05/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
- P. Gaviani
- Neuro-Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - G. Simonetti
- Neuro-Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A. Salmaggi
- Neuro-Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- SC Neurologia Ospedale Manzoni Lecco, Lecco, Italy
| | - E. Lamperti
- Neuro-Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A. Silvani
- Neuro-Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Gaviani P, Corsini E, Salmaggi A, Lamperti E, Botturi A, Erbetta A, Milanesi I, Legnani F, Pollo B, Silvani A. Liposomal cytarabine in neoplastic meningitis from primary brain tumors: a single institutional experience. Neurol Sci 2013; 34:2151-7. [DOI: 10.1007/s10072-013-1358-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 03/08/2013] [Indexed: 11/29/2022]
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Finocchiaro CY, Botturi A, Lamperti E, Gauri S, Petruzzi A, Simonetti G, Sarno L, Salmaggi A. Privacy-solidarity conflict: the communication with the support group. Neurol Sci 2012; 32 Suppl 2:S225-7. [PMID: 22002118 DOI: 10.1007/s10072-011-0792-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Actually guidelines require that patient must be informed about his condition so that he can choose the persons he wants to share these information with. Nonetheless, the caregiver usually gets an intermediary role in doctor-patient communication thus becoming the doctor's main conversation partner and claiming to be given more information than the patient himself. A more complex situation is about brain tumours patients sometimes affected by cognitive deficiencies, compromising their comprehension skills or their capability of keeping the information they are being given. A preliminary study allowed to submit separately to brain tumour patients and their family members a semi-structured interview. Although doctors communicate diagnosis and therapeutic plans, patients and their family members often do not seem to remember the information they are given. An important percentage of patients and their carers cannot tell correctly what they was said by the doctors. Only a minor percentage of patients do not want to know all details of their disease. Instead, most of the family members, would rather their beloved were given just partial information on their conditions or even not given information at all. Communication with patients and their carers requires careful re-negotiation in a multiple time-points, rather than a one-off communication episode.
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Affiliation(s)
- C Y Finocchiaro
- Department of Neurooncology, Fondazione IRCCS Istituto Neurologico C. Besta, Neuro-Oncology Unit, Via Celoria, 11, 20133 Milan, Italy.
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Gaviani P, Silvani A, Lamperti E, Botturi A, Simonetti G, Ferrari D, Salmaggi A. Neuro-oncological diagnosis in patients without histological confirmation. Neurol Sci 2012; 32 Suppl 2:S213-5. [PMID: 21993830 DOI: 10.1007/s10072-011-0790-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The impossibility to conduct a histological diagnosis could be due to different reasons: (1) patient's refusal to undergo surgery/biopsy. (2) Technical difficulties: despite the advance in surgical procedures, the removal of lesions that are located either in critical or in deep areas represents a considerable risk for patients. (3) Quality/quantity of the sample. In rare cases even when the surgical sample is achieved it could be impossible to reach a histological confirmation, for example due to the small amount of tissue obtained. The lack of histology leads to suboptimal therapy, incorrect prognosis, and misinterpretation of clinical trials and furthermore undermines the possibility to perform most radiation and chemotherapy protocols. In this setting the morphological data obtained with conventional MR imaging may be integrated with the metabolic, structural and perfusional information provided by new MR and metabolic techniques (spectroscopy, SPECT, PET in particular).
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Affiliation(s)
- P Gaviani
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 11 Via Celoria, 20133 Milan, Italy.
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Abstract
Bevacizumab has been introduced in the management of high-grade gliomas after preliminary studies that showed an acceptable safety and a marked increase in clinico-radiological responses in comparison with second-line chemotherapy. The objective is to synthetically review the present use of bevacizumab--alone or in combination--in the context of recurrent high-grade glioma and highlight the future developments. The methodology of this study is to analyse and discuss relevant literature studies using bevacizumab in recurrent high-grade glioma. Bevacizumab may be used as single-agent therapy in recurrent high-grade glioma, with good clinico-radiological responses having little effect on survival. The open questions and developments include new MRI criteria for evaluation of response to anti-angiogenic agents, the identification of putative factors predicting response/failure of bevacizumab and the introduction of bevacizumab in first-line management of high-grade glioma.
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Affiliation(s)
- Andrea Salmaggi
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria, 11, 20133 Milan, Italy.
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Silvani A, Gaviani P, Lamperti E, Botturi A, Ferrari D, Simonetti G, Salmaggi A. Malignant gliomas: early diagnosis and clinical aspects. Neurol Sci 2012; 32 Suppl 2:S207-8. [PMID: 21993829 DOI: 10.1007/s10072-011-0788-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Brain tumor symptoms vary greatly from person to person because of two factors: location and size of tumors. The size of a tumor, however, does not necessarily affect the severity of symptoms. Manifestations depend on the cause of the symptoms: an increase in ICP, direct compression of gray or white matter, shifting of intracranial contents, or secondary cerebral ischemia. Symptoms may be non-specific and include headache, altered mental status, ataxia, nausea, vomiting, weakness, and gait disturbance. Left-sided weakness may be seen in a patient with a tumor pressing on the contra-lateral motor strip or speech difficulties may occur if a tumor is in the dominant hemisphere. Up to a third of people report having seizures prior to being diagnosed with a brain tumor. Rarely, brain tumor can present with psychiatric symptoms but without other neurological signs or symptoms. Evaluation for brain tumor is indicated in any patient with chronic, persistent headache associated with protracted nausea, vomiting, seizures, changes in headache pattern, neurologic symptoms, and change in personality.
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Affiliation(s)
- A Silvani
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy.
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Prithviraj GK, Sommers SR, Jump RL, Halmos B, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Hunter K, Chamberlain MC, Le EM, Lee ELT, Chamberlain MC, Sadighi ZS, Pearlman ML, Slopis JM, Vats TS, Khatua S, DeVito NC, Yu M, Chen R, Pan E, Cloughesy T, Raizer J, Drappatz J, Gerena-Lewis M, Rogerio J, Yacoub S, Desjardin A, Groves MD, DeGroot J, Loghin M, Conrad CA, Hess K, Ni J, Ictech S, Hunter K, Yung WA, Porter AB, Dueck AC, Karlin NJ, Chamberlain MC, Olson J, Silber J, Reiner AS, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Shiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Cachia D, Alderson L, Moser R, Smith T, Yunus S, Saito K, Mukasa A, Narita Y, Tabei Y, Shinoura N, Shibui S, Saito N, Flechl B, Ackerl M, Sax C, Dieckmann K, Crevenna R, Widhalm G, Preusser M, Marosi C, Marosi C, Ay C, Preusser M, Dunkler D, Widhalm G, Pabinger I, Dieckmann K, Zielinski C, Belongia M, Jogal S, Schlingensiepen KH, Bogdahn U, Stockhammer G, Mahapatra AK, Venkataramana NK, Oliushine V, Parfenov V, Poverennova I, Hau P, Jachimczak P, Heinrichs H, Mammoser AG, Shonka NA, de Groot JF, Shibahara I, Sonoda Y, Kumabe T, Saito R, Kanamori M, Yamashita Y, Watanabe M, Ishioka C, Tominaga T, Silvani A, Gaviani P, Lamperti E, Botturi A, DiMeco F, Broggi G, Fariselli L, Solero CL, Salmaggi A, Green RM, Woyshner EA, Cloughesy TF, Shu F, Oh YS, Iganej S, Singh G, Vemuri SL, Theeler BJ, Ellezam B, Gilbert MR, Aoki T, Kobayashi H, Takano S, Nishikawa R, Shinoura N, Nagane M, Narita Y, Muragaki Y, Sugiyama K, Kuratsu J, Matsutani M, Sadighi ZS, Khatua S, Langford LA, Puduvalli VK, Shen D, Chen ZP, Zhang JP, Chen ZP, Bedekar D, Rand S, Connelly J, Malkin M, Paulson E, Mueller W, Schmainda K, Gallego O, Benavides M, Segura PP, Balana C, Gil M, Berrocal A, Reynes G, Garcia JL, Murata P, Bague S, Quintana MJ, Vasishta VG, Nagane M, Kobayashi K, Tanaka M, Tsuchiya K, Shiokawa Y, Bavle AA, Ayyanar K, Puduvalli VK, Prado MP, Hess KR, Hunter K, Ictech S, Groves MD, Gilbert MR, Liu V, Conrad CA, de Groot J, Loghin ME, Colman H, Levin VA, Alfred Yung WK, Hackney JR, Palmer CA, Markert JM, Cure J, Riley KO, Fathallah-Shaykh H, Nabors LB, Saria MG, Corle C, Hu J, Rudnick J, Phuphanich S, Mrugala MM, Lee LK, Fu BD, Bota DA, Kim RY, Brown T, Feely H, Hu A, Drappatz J, Wen PY, Lee JW, Carter B, Kesari S, Fu BD, Kong XT, Bota DA, Fu BD, Bota DA, Sparagana S, Belousova E, Jozwiak S, Korf B, Frost M, Kuperman R, Kohrman M, Witt O, Wu J, Flamini R, Jansen A, Curtalolo P, Thiele E, Whittemore V, De Vries P, Ford J, Shah G, Cauwel H, Edrich P, Sahmoud T, Franz D, Khasraw M, Brown C, Ashley DM, Rosenthal MA, Jiang X, Mou YG, Chen ZP, Oh M, kim E, Chang J, Juratli TA, Kirsch M, Schackert G, Krex D, Gilbert MR, Wang M, Aldape KD, Stupp R, Hegi M, Jaeckle KA, Armstrong TS, Wefel JS, Won M, Blumenthal DT, Mahajan A, Schultz CJ, Erridge SC, Brown PD, Chakravarti A, Curran WJ, Mehta MP, Hofland KF, Hansen S, Sorensen M, Schultz H, Muhic A, Engelholm S, Ask A, Kristiansen C, Thomsen C, Poulsen HS, Lassen UN, Zalatimo O, Weston C, Zoccoli C, Glantz M, Rahmanuddin S, Shiroishi MS, Cen SY, Jones J, Chen T, Pagnini P, Go J, Lerner A, Gomez J, Law M, Ram Z, Wong ET, Gutin PH, Bobola MS, Alnoor M, Silbergeld DL, Rostomily RC, Chamberlain MC, Silber JR, Martha N, Jacqueline S, Thaddaus G, Daniel P, Hans M, Armin M, Eugen T, Gunther S, Hutterer M, Tseng HM, Zoccoli CM, Glantz M, Zalatimo O, Patel A, Rizzo K, Sheehan JM, Sumrall AL, Vredenburgh JJ, Desjardins A, Reardon DA, Friiedman HS, Peters KB, Taylor LP, Stewart M, Blondin NA, Baehring JM, Foote T, Laack N, Call J, Hamilton MG, Walling S, Eliasziw M, Easaw J, Shirsat NV, Kundar R, Gokhale A, Goel A, Moiyadi AA, Wang J, Mutlu E, Oyan A, Yan T, Tsinkalovsky O, Jacobsen HK, Talasila KM, Sleire L, Pettersen K, Miletic H, Andersen S, Mitra S, Weissman I, Li X, Kalland KH, Enger PO, Sepulveda J, Belda C, Balana C, Segura PP, Reynes G, Gil M, Gallego O, Berrocal A, Blumenthal DT, Sitt R, Phishniak L, Bokstein F, Philippe M, Carole C, Andre MDP, Marylin B, Olivier C, L'Houcine O, Dominique FB, Philippe M, Isabelle NM, Olivier C, Frederic F, Stephane F, Henry D, Marylin B, L'Houcine O, Dominique FB, Errico MA, Kunschner LJ, Errico MA, Kunschner LJ, Soffietti R, Trevisan E, Ruda R, Bertero L, Bosa C, Fabrini MG, Lolli I, Jalali R, Julka PK, Anand AK, Bhavsar D, Singhal N, Naik R, John S, Mathew BS, Thaipisuttikul I, Graber J, DeAngelis LM, Shirinian M, Fontebasso AM, Jacob K, Gerges N, Montpetit A, Nantel A, Albrecht S, Jabado N, Mammoser AG, Shah K, Conrad CA, Di K, Linskey M, Bota DA, Thon N, Eigenbrod S, Kreth S, Lutz J, Tonn JC, Kretzschmar H, Peraud A, Kreth FW, Muggeri AD, Alderuccio JP, Diez BD, Jiang P, Chao Y, Gallagher M, Kim R, Pastorino S, Fogal V, Kesari S, Rudnick JD, Bresee C, Rogatko A, Sakowsky S, Franco M, Hu J, Lim S, Lopez A, Yu L, Ryback K, Tsang V, Lill M, Steinberg A, Sheth R, Grimm S, Helenowski I, Rademaker A, Raizer J, Nunes FP, Merker V, Jennings D, Caruso P, Muzikansky A, Stemmer-Rachamimov A, Plotkin S, Spalding AC, Vitaz TW, Sun DA, Parsons S, Welch MR, Omuro A, DeAngelis LM, Omuro A, Beal K, Correa D, Chan T, DeAngelis L, Gavrilovic I, Nolan C, Hormigo A, Lassman AB, Kaley T, Mellinghoff I, Grommes C, Panageas K, Reiner A, Barradas R, Abrey L, Gutin P, Lee SY, Slagle-Webb B, Glantz MJ, Sheehan JM, Connor JR, Schlimper CA, Schlag H, Stoffels G, Weber F, Krueger DA, Care MM, Holland K, Agricola K, Tudor C, Byars A, Sahmoud T, Franz DN, Raizer J, Rice L, Rademaker A, Chandler J, Levy R, Muro K, Grimm S, Nayak L, Iwamoto FM, Rudnick JD, Norden AD, Omuro A, Kaley TJ, Thomas AA, Fadul CE, Meyer LP, Lallana EC, Colman H, Gilbert M, Alfred Yung WK, Aldape K, De Groot J, Conrad C, Levin V, Groves M, Loghin M, Chris P, Puduvalli V, Nagpal S, Feroze A, Recht L, Rangarajan HG, Kieran MW, Scott RM, Lew SM, Firat SY, Segura AD, Jogal SA, Kumthekar PU, Grimm SA, Avram M, Patel J, Kaklamani V, McCarthy K, Cianfrocca M, Gradishar W, Mulcahy M, Von Roenn J, Helenowski I, Rademaker A, Raizer J, Galanis E, Anderson SK, Lafky JM, Kaufmann TJ, Uhm JH, Giannini C, Kumar SK, Northfelt DW, Flynn PJ, Jaeckle KA, Buckner JC, Omar AI, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Schiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Delios A, Jakubowski A, DeAngelis L, Grommes C, Lassman AB, Theeler BJ, Melguizo-Gavilanes I, Shonka NA, Qiao W, Wang X, Mahajan A, Puduvalli V, Hashemi-Sadraei N, Bawa H, Rahmathulla G, Patel M, Elson P, Stevens G, Peereboom D, Vogelbaum M, Weil R, Barnett G, Ahluwalia MS, Alvord EC, Rockne RC, Rockhill JK, Mrugala MM, Rostomily R, Lai A, Cloughesy T, Wardlaw J, Spence AM, Swanson KR, Zadeh G, Alahmadi H, Wilson J, Gentili F, Lassman AB, Wang M, Gilbert MR, Aldape KD, Beumer JJ, Wright J, Takebe N, Puduvalli VK, Hormigo A, Gaur R, Werner-Wasik M, Mehta MP, Gupta AJ, Campos-Gines A, Le K, Arango C, Richards M, Landeros M, Juan H, Chang JH, Kim JS, Cho JH, Seo CO, Baldock AL, Rockne R, Canoll P, Born D, Yagle K, Swanson KR, Alexandru D, Bota D, Linskey ME, Nabeel S, Raval SN, Raizer J, Grimm S, Rice L, Rosenow J, Levy R, Bredel M, Chandler J, New PZ, Plotkin SR, Supko JG, Curry WT, Chi AS, Gerstner ER, Stemmer-Rachamimov A, Batchelor TT, Ahluwalia MS, Hashemi N, Rahmathulla G, Patel M, Chao ST, Peereboom D, Weil RJ, Suh JH, Vogelbaum MA, Stevens GH, Barnett GH, Corwin D, Holdsworth C, Stewart R, Rockne R, Swanson K, Graber JJ, Kaley T, Rockne RC, Anderson AR, Swanson KR, Jeyapalan S, Goldman M, Boxerman J, Donahue J, Elinzano H, Evans D, O'Connor B, Puthawala MY, Oyelese A, Cielo D, Blitstein M, Dargush M, Santaniello A, Constantinou M, DiPetrillo T, Safran H, Plotkin SR, Halpin C, Merker V, Barker FG, Maher EA, Ganji S, DeBerardinis R, Hatanpaa K, Rakheja D, Yang XL, Mashimo T, Raisanen J, Madden C, Mickey B, Malloy C, Bachoo R, Choi C, Ranjan T, Yono N, Zalatimo O, Zoccoli C, Glantz M, Han SJ, Sun M, Berger MS, Aghi M, Gupta N, Parsa AT. MEDICAL AND NEURO-ONCOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor152] [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: 11/14/2022] Open
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Botturi A, Lamperti E, Finocchiaro CY, Berrini FR, Ferrari D, Fariselli L, Salmaggi A. Consent and awareness: mental conditions at diagnosis. Neurol Sci 2011; 32 Suppl 2:S221-4. [DOI: 10.1007/s10072-011-0791-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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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Silvani A, Gaviani P, Lamperti E, Botturi A, Ferrari D, Simonetti G, Fariselli L, Salmaggi A. Metabolic, electrolytes disorders and tromboembolic risk in malignant glioma patients. Neurol Sci 2011; 32 Suppl 2:S229-31. [DOI: 10.1007/s10072-011-0793-z] [Citation(s) in RCA: 7] [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] [Indexed: 11/28/2022]
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Silvani A, Gaviani P, Lamperti E, Botturi A, Ferrari D, Simonetti G, Salmaggi A. Lecture: fotemustine in brain tumors. Neurol Sci 2011; 32 Suppl 2:S255-7. [DOI: 10.1007/s10072-011-0800-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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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Finocchiaro CY, Petruzzi A, Lamperti E, Botturi A, Gaviani P, Silvani A, Sarno L, Salmaggi A. The burden of brain tumor: a single-institution study on psychological patterns in caregivers. J Neurooncol 2011; 107:175-81. [PMID: 21968946 DOI: 10.1007/s11060-011-0726-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 09/17/2011] [Indexed: 11/25/2022]
Abstract
Quality of life and well-being in caregivers are usually partly neglected since all attention is focused on patients and the way they react to the illness. Carers also usually neglect their own needs, especially when the illness of the patient is as complex as a brain tumor. The aim of this study is to investigate how caregivers deal with a diagnosis of brain tumor in their relatives and how they manage their quality of life and psychosocial well-being. One hundred primary caregivers of patients with brain tumors were interviewed and were asked to fill in self-administered questionnaires detecting multidimensional levels of quality of life, anxiety, depression, and psychosocial reaction to the patient's illness. Data were related with some functional and psychosocial information collected about the patient's disease. Caregivers try to react to the illness of their relatives by mobilizing their physical reaction and growing their self-esteem, but they live with a clinically significant impairment of their quality of life, and experience a deep level of anxiety and depression. The caregivers' burden appears mainly in their ability to provide care and in financial strain. The length of disease and the functional status of patients significantly influence caregivers' psychosocial well-being. Despite the appearance they want to show their affected relatives, caregivers suffer from deep limitation in their quality of life. The relevance of caregivers' burden suggests the importance of psychological support to improve reaction to the illness.
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Affiliation(s)
- Claudia Yvonne Finocchiaro
- Department of Neurooncology, Fondazione I.R.C.C.S. Istituto Neurologico C. Besta, Via Celoria, 11, 20133 Milan, Italy.
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Silvani A, Fiumani A, Scaioli V, Lamperti E, Gaviani P, Eoli M, Falcone C, Salmaggi A, Boiardi A. A phase II study evaluating systemic sagopilone (ZK-EPO) treatment in patients with recurrent malignant gliomas. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.2083] [Citation(s) in RCA: 2] [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: 11/20/2022] Open
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Silvani A, Lamperti E, Gaviani P, Eoli M, Fiumani A, Salmaggi A, Falcone C, Filippini G, Botturi A, Boiardi A. Salvage chemotherapy with procarbazine and fotemustine combination in the treatment of temozolomide treated recurrent glioblastoma patients. J Neurooncol 2008. [DOI: 10.1007/s11060-008-9539-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Salmaggi A, Botturi A, Lamperti E, Grisoli M, Fischetto R, Ceccherini I, Caroli F, Boiardi A. A novel mutation in the GFAP gene in a familial adult onset Alexander disease. J Neurol 2007; 254:1278-80. [PMID: 17703343 DOI: 10.1007/s00415-006-0361-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2006] [Revised: 07/19/2006] [Accepted: 08/16/2006] [Indexed: 10/22/2022]
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Silvani A, Lamperti E, Gaviani P, Eoli M, Fiumani A, Salmaggi A, Falcone C, Filippini G, Botturi A, Boiardi A. Salvage chemotherapy with procarbazine and fotemustine combination in the treatment of temozolomide treated recurrent glioblastoma patients. J Neurooncol 2007; 87:143-51. [PMID: 17576523 DOI: 10.1007/s11060-007-9427-y] [Citation(s) in RCA: 25] [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] [Received: 04/04/2007] [Accepted: 05/29/2007] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to evaluate safety and efficacy of Procarbazine (PCB) and fotemustine (FTM) combination in the treatment of pre-temozolomide treated, recurrent GBM patients. The primary end-point was progression free survival at 6 months (PFS-6). Secondary end-points were overall survival, response rates (CR + PR) and toxicity. About 54 patients (41 men and 13 women) aged 26-68 years (median age, 53.5 years) with recurrent GBM were treated. PCB was administered as an oral dosage of 450 mg on days 1-2 and a total dose of 300 mg on day 3. FTM was administered on day 3, 3 h after the last PCB intake at a dose of 110 mg/mq/BSA. The treatment was repeated every 5 weeks. Treatment was continued for a maximum of six cycles or until disease progression. After two cycles of chemotherapy: 6 patients (11.2%) experienced a neuroradiographic partial response (PR), 29 patients (53.7%) had stable disease (SD), and 19 patients (35.1%) had progressive disease (PD). For the whole group of patients, the median PFS was 19.3 weeks (95% CI, 14.1-24.4 weeks), and PFS-6 was 26.7% (95% CI, 10.6-42.8%). Overall MST from the beginning of PCB + FTM chemotherapy was 28.7 weeks (95% CI, 24.8-32.7 weeks). At 6 and 12 months, 64.4% (95% CI, 51.5-77.3%) and 23.6% (95% CI, 10.1-37.1%) of patients were alive. The median survival time calculated from the first diagnosis was 20.8 months (95% CI, 16.7-24.8). We concluded that the PCB + FTM combination as done in the current trial for patients with recurrent GBM after treatment with TMZ showed some benefit with regards to increased survival and that a Phase III trial is warranted.
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Affiliation(s)
- Antonio Silvani
- Department of Neuro-Oncology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
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Silvani A, Salmaggi A, Eoli M, Lamperti E, Broggi G, Marras CE, Fariselli L, Milanesi I, Fiumani A, Gaviani P, Erbetta A, Giovagnoli AR, Pollo B, Botturi A, Boiardi A. Methotrexate based chemotherapy and deferred radiotherapy for primary central nervous system lymphoma (PCNSL): single institution experience. J Neurooncol 2006; 82:273-9. [PMID: 17111190 DOI: 10.1007/s11060-006-9276-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2006] [Accepted: 09/18/2006] [Indexed: 10/23/2022]
Abstract
In the following study, we present our experience in the treatment of PCNSL patients using a multi-step schedule combining chemotherapy and deferred radiotherapy. Patients were treated with two modified M-BACOD cycles and then differently according to radiological response For PR, SD and PD patients, chemotherapy was interrupted and radiotherapy initiated immediately (45 Gy Whole-brain RT). With CR patients, chemotherapy was continued with a combination of HMTX, VCZ, PCB and HD Ara-C up to a total of nine cycles. In 36 patients suitable for evaluation (2 patients had undergone tumour resection): 69.4% (25 of 36) had a complete response (CR), 19.4% (7 of 36) had a partial response(PR), 8.3% (3 of 36) had stable disease(SD), and 2.7% (one of 36) had progressive disease (PD). The PR, SD and PD patients were immediately treated by radiotherapy. In this cohort of patients, we observed 6 CR, 4 PR and 2 PD, respectively, following radiotherapy. At first relapse, a total of 16 CR patients were treated by radiotherapy for a total dose of 45 Gy. The OS was 42.1 months for the entire group of patients. In CR patients treated at the moment of recurrence by salvage radiotherapy, the TTP (time lasting from histological diagnosis until recurrence of disease before RT) was 28.3 months, with a 43.4% of disease free patients observed at 2 years. The median disease-free time observed after complete response to radiotherapy was 10.5 months. In 16 patients (34%), further progression of disease was observed following radiotherapy. Two patients developed extra-CNS disease in the breast and testis. When taking into account the patients with radiotherapy delayed at recurrence, the OS was 48 months and the survival rates were 70% and 60% at 2 years and 5 years, respectively.
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Affiliation(s)
- A Silvani
- Department of Neuro-oncology, Istituto Nazionale Neurologico Carlo Besta, via Celoria, 11, Milan 20133, Italy.
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Botturi A, Salmaggi A, Pollo B, Lamperti E, Erbetta A, Boiardi A. Meningitis following relapsing painful ophthalmoplegia in aspergillus sphenoidal sinusitis: a case report. Neurol Sci 2006; 27:284-7. [PMID: 16998735 DOI: 10.1007/s10072-006-0686-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2006] [Accepted: 07/19/2006] [Indexed: 10/24/2022]
Abstract
We report the case of a 58-year-old woman in whom relapsing painful ophthalmoplegia related to a mycetoma of the sphenoid sinus gave origin to meningitis with markedly depressed glucose levels in the cerebrospinal fluid. Surgical exeresis of the mycetoma allowed aetiological diagnosis (aspergillosis) and--together with antimycotic therapy--led to durable clinical response.
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Affiliation(s)
- A Botturi
- Istituto Nazionale Neurologico C. Besta, Via Celoria 11, I-20133, Milan, Italy
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Boiardi A, Eoli M, Salmaggi A, Lamperti E, Botturi A, Broggi G, Bissola L, Finocchiaro G, Silvani A. Systemic temozolomide combined with loco-regional mitoxantrone in treating recurrent glioblastoma. J Neurooncol 2006; 75:215-20. [PMID: 16283445 DOI: 10.1007/s11060-005-3030-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 10/25/2022]
Abstract
Twenty-two recurrent GBM patients were enrolled for second tumor debulking with local positioning of a Rickam reservoir, in order to locally deliver chemotherapy with the aim of controlling local tumor recurrence. We designed a protocol using systemic temozolomide (150 mg/sqm days 1-5 every 28) in association with mitoxantrone, delivered through the reservoir (4 mg/day 1-5 every 28) positioned into the area of tumor exeresis. After re-operation a residual tumor mass no larger than 2 cm was identified in 18/22 patients. The patients were treated with monthly cycles of chemotherapy until evolution of the tumor, but in no case for more than 10 cycles. Responses were evaluated by MRI scans performed every 2 months and images assessed according to MacDonald's criteria. Response rate: no complete responses (CR), 5 partial responses (PR), 13 stable disease (SD) and 4 progressive disease (PD) occurred. The median progression-free survival (PFS) and survival time (ST) of the whole group of treated patients was 7 and 11 months, respectively and more than a quarter of the patients survived over 18 months. During the study, the patients' compliance was complete and no dropouts occurred. Hematological toxicity was mild and after repeated local injections only minor neurological side-effects occurred. Despite some bias in patients' selection not excluded in this pilot study, results are interesting: the PFS was as long as the survival of recurrent GBM reported in the literature.
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Affiliation(s)
- A Boiardi
- Department of Neuro-Oncology, Istituto Nazionale Neurologico "Carlo Besta", Italy.
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