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Ghi M, Paccagnella A, Orecchia R, Parisi S, Bertoni F, Minguzzi N, Baggio V, Polsinelli M, Bunkheila F, Palazzi M. A Phase 2-3 Study Comparing Concomitant Chemoradiation Therapy (CRT) Versus Cetuximab/RT (CET/RT) With or Without Induction Docetaxel/Cisplatin/5-Fluorouracil (TPF) in Locally-Advanced Head and Neck Squamous Cell Carcinoma (LASCCHN) – Efficacy Results of the GSTTC Italian Study (NCT01086826). Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ghi M, Paccagnella A, Orecchia R, Parisi S, Bertoni F, Minguzzi N, Baggio V, Turcato G, Polsinelli M, Floriani I. Cetuximab/Radiation Therapy (CET + RT) Versus Concomitant Chemoradiation Therapy (cCHT + RT) With or Without Induction Docetaxel/Cisplatin/5Fluorouracil (TPF) in Locally Advanced Head-and-Neck Squamous Cell Carcinoma (LASCCHN) – Preliminary Results on Toxicity of a Randomized, 2x2 Factorial, Phase II-III Study (NCT01086826). Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ghi M, Paccagnella A, Ferrari D, Rocca MC, Verri E, Morelli F, Azzarello G, D'Ambrosio C, Casanova C, Floriani I. Concomitant Chemoradiotherapy (CT/RT) or CETUXIMAB/RT (CET/RT) with or Without Induction Docetaxel/Cisplatin/5-Fluorouracil (TPF) in Locally Advanced Head and Neck Cancer (LASCCHN). Preliminary Toxicity Results of a Randomized, 2x2 Factorial, Phase II-III Study. (NCT01086826). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33614-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Morassutti I, Giometto M, Baruffi C, Marcon ML, Michieletto S, Giometto B, Spinella N, Paccagnella A. Nutritional intervention for amyotrophic lateral sclerosis. MINERVA GASTROENTERO 2012; 58:253-260. [PMID: 22971635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The aim of the study was to assess the consequences of early and systematic nutritional intervention on the clinical conditions of amyotrophic lateral sclerosis (ALS) patients and on the opportunity to maintain a good nutritional status for as long as possible. METHODS Thirty-three subjects with ALS. Protocol Group: 12 subjects (9 M and 3 F) monitored according to a precise nutritional intervention protocol. CONTROL GROUP 21 subjects (10 M and 11 F) monitored before applying the protocol. RESULTS Data recorded at the time of initial assessment were compared and expressed as the mean ± standard deviation for the Protocol Group vs. the CONTROL GROUP BMI (kg/m2) 23.6 ± 4.1 vs. 21.6 ± 3.5; weight loss as a percentage of usual weight 6.6 ± 7.9 vs. 16.3 ± 8.8 (P=0.003). At six months: weight loss as a percentage of usual weight 4.9 ± 6.2 vs. 16.9 ± 10.2 (P=0.002). At 12 months: weight loss as a percentage of usual weight 7.3 ± 7.1 vs. 17.5 ± 11.1 (P=0.03). At the first follow-up visit, fewer patients in the Protocol Group were receiving enteral nutrition (25%) than patients in the CONTROL GROUP (60%). At six-month follow-up visit: 30% vs. 68%. Standard enteral nutrition formulas were used. One year after initial assessment, the mortality rate was 17% for the Protocol Group, whereas it was 24% at six months and 33% after one year for the CONTROL GROUP. CONCLUSION If patients are treated before any significant weight loss occurs, early and specific nutritional intervention allows good nutritional status to be maintained for a longer period; if artificial nutrition is required, standard diets are able to ensure adequate clinical results.
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Ferrario A, Scaramuzza M, Pasqualotto E, De Toni A, Paccagnella A. Development of a Disposable Gold Electrodes-Based Sensor for Electrochemical Measurements of cDNA Hybridization. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.proche.2012.10.128] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Paccagnella A, Ghi MG, Floriani I, Gava A, Buffoli A. Concomitant chemoradiation or RT/cetuximab versus induction TPF followed by chemoradiation or RT/cetuximab in locally advanced head and neck squamous cell carcinoma: A randomized phase III factorial study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rea F, Favaretto AG, Marulli G, Spaggiari L, De Pas TM, Ceribelli A, Paccagnella A, Crivellari G, Russo F, Ceccarelli M, Facciolo F. Phase II trial of neoadjuvant pemetrexed plus cisplatin followed by surgery and radiation in the treatment of malignant pleural mesothelioma (MPM). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ghi MG, Paccagnella A, Floriani I, Garavaglia D. Concomitant chemoradiation in locally advanced head and neck squamous cell carcinoma: A literature-based meta-analysis on the platinum concomitant chemotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5534] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Petit JC, Dran JC, Trotignon L, Casabonne JM, Paccagnella A, Della Mea G. Mechanism of Heavy Element Retention in Hydrated Layers Formed on Leached Silicate Glasses. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-127-33] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTWe have investigated the relationship between hydrated layer formation during aqueous corrosion of silicates and retention of heavy elements (Fe, REE, actinides). Our approach is based on the comparison of the dissolution behaviour of silicate glasses, silicate minerals implanted with increasing doses of lead ions (1×E+12 to 1×E+15 ions/cm2), sorption experiments on silica surfaces and direct precipitation of hydrosilicates. The characterization of reacted surfaces was performed by combining Rutherford backscattering spectrometry (RBS) for profiling heavy elements with Resonant Nuclear Reaction Analysis (RNRA) for hydrogen profilimetry. The accumulation of these elements does not necessarily imply a selective dissolution and can be explained by the “precipitation” of hydroxides or hydrosilicates.
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Blanchard P, Bourredjem A, Bourhis J, Hitt R, Posner M, Vermorken J, Calais G, Paccagnella A, Pignong J. TAXANE-CISPLATIN-5FU AS INDUCTION CHEMOTHERAPY IN LOCALLY ADVANCED HEAD AND NECK SQUAMOUS CELL CARCINOMA: AN INDIVIDUAL PATIENT DATA META-ANALYSIS OF THE MACH-NC GROUP. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70005-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Venturini M, Bighin C, Puglisi F, Olmeo N, Aitini E, Colucci G, Garrone O, Paccagnella A, Marini G, Crinò L, Mansutti M, Baconnet B, Barbato A, Del Mastro L. A multicentre Phase II study of non-pegylated liposomal doxorubicin in combination with trastuzumab and docetaxel as first-line therapy in metastatic breast cancer. Breast 2010; 19:333-8. [PMID: 20185313 DOI: 10.1016/j.breast.2010.01.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Revised: 12/23/2009] [Accepted: 01/22/2010] [Indexed: 01/07/2023] Open
Abstract
To evaluate the cardiotoxicity, general toxicity, and activity of non-pegylated liposomal doxorubicin, in combination with docetaxel and trastuzumab, as first-line therapy in metastatic breast cancer. Thirty-one patients with metastatic human epidermal growth factor receptor 2-overexpressing breast cancer, who had not previously received chemotherapy for metastatic disease, received non-pegylated liposomal doxorubicin (50 mg/m(2)), docetaxel (75 mg/m(2)) and trastuzumab (2 mg/kg/week) for up to eight cycles, followed by trastuzumab alone for up to 52 weeks. Cardiotoxicity was defined as a decrease in left ventricular ejection fraction (LVEF) to below 45%, or a decrease in LVEF of at least 20% from baseline. Mean LVEF was maintained at baseline level also in the subset of patients who had received anthracycline previously. Cardiotoxicity developed in three patients during the treatment cycles, and in two further patients after the end of the study. The most common adverse events were haematological toxicity, alopecia, asthenia and fever. The best overall response rate was 65.5%. Median time to progression was 13.0 months. The combination of non-pegylated liposomal doxorubicin, docetaxel and trastuzumab combines acceptable cardiac and general toxicity and promising activity as first-line therapy in metastatic breast cancer.
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Paccagnella A, Ghi MG, Loreggian L, Buffoli A, Koussis H, Mione CA, Bonetti A, Campostrini F, Gardani G, Ardizzoia A, Dondi D, Guaraldi M, Cavallo R, Tomio L, Gava A. Concomitant chemoradiotherapy versus induction docetaxel, cisplatin and 5 fluorouracil (TPF) followed by concomitant chemoradiotherapy in locally advanced head and neck cancer: a phase II randomized study. Ann Oncol 2009; 21:1515-1522. [PMID: 20032123 DOI: 10.1093/annonc/mdp573] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Concomitant chemoradiotherapy (CT/RT) is the standard treatment of locally advanced squamous cell carcinoma of the head and neck (SCCHN). We evaluated the efficacy of induction docetaxel (Taxotere), cisplatin, and 5-fluorouracil (TPF) before CT/RT versus CT/RT alone. PATIENTS AND METHODS Patients with stage III-IVM0 SCCHN, Eastern Cooperative Oncology Group performance status of zero to one, were randomly assigned to receive CT/RT alone (arm A: two cycles of cisplatin 20 mg/m(2), days1-4, plus 5-fluorouracil 800 mg/m(2)/day 96 h continuous infusion, during weeks 1 and 6 of radiotherapy) or three cycles of TPF (arm B: docetaxel 75 mg/m(2) and cisplatin 80 mg/m(2), day 1, and 5-fluorouracil 800 mg/m(2)/day 96 h continuous infusion, every 3 weeks) followed by the same CT/RT. The primary end point was the rate of radiologic complete response (CR) at 6-8 weeks after the end of CT/RT. RESULTS A total of 101 patients were randomly allocated to the study (51 arm A; 50 arm B). CR rates were 21.2% (arm A) versus 50% (arm B). Median progression-free survival and overall survival were, respectively, 19.7 and 33.3 months (arm A) and 30.4 and 39.6 months (arm B). Hematologic and non-hematologic toxic effects during CT/RT were similar in the two arms. CONCLUSION Induction TPF followed by CT/RT was associated with higher radiologic CR in patients with locally advanced SCCHN with no negative impact on CT/RT feasibility.
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Morello M, Marcon ML, Laviano A, Giometto M, Baruffi C, Zulian E, Cenerelli P, Faronato P, Tessarin M, Conte A, Paccagnella A. Enteral Nutrition in Nursing Home Residents. Nutr Clin Pract 2009; 24:635-41. [DOI: 10.1177/0884533609342439] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Anker S, Laviano A, Filippatos G, John M, Paccagnella A, Ponikowski P, Schols A. ESPEN Guidelines on Parenteral Nutrition: On Cardiology and Pneumology. Clin Nutr 2009; 28:455-60. [DOI: 10.1016/j.clnu.2009.04.023] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2009] [Accepted: 04/29/2009] [Indexed: 12/26/2022]
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Vanturini M, Bighin C, Puglisi F, Contu A, Aitini E, Colucci G, Merlano MC, Paccagnella A, Marini G, Crinò L, Djazouli K, Barbato A. A multicenter phase II study of non-pegylated liposomal doxorubicin (MYOCET®) in combination with trastuzumab and docetaxel as first line therapy in metastatic breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-3156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #3156
The objective of the phase II study is to evaluate the cardiotoxicity, general safety, and efficacy of non-pegylated liposomal doxorubicin, in combination with docetaxel and trastuzumab, as first line treatment of metastatic breast cancer.
 Patients and methods: Patients (n = 31) with metastatic HER2-overexpressing breast cancer, who had not previously received chemotherapy for metastatic disease, received non-pegylated liposomal doxorubicin (50 mg/m2), docetaxel (75 mg/m2) every 3 weeks and trastuzumab (2 mg/kg/week) for up to eight cycles, followed by trastuzumab alone for up to 52 weeks. Cardiotoxicity was defined as signs and/or symptoms of congestive heart failure (CHF) and/or an absolute decrease in left ventricular ejection fraction (LVEF) of ≥ 20 units or a decline to ≤ 45%. Patients were allowed to receive adjuvant doxorubicin or epirubicin to cumulative doses up to 240 mg/m2 or 450 mg/m2, respectively.
 Results: The mean LVEF at baseline was 62.8 ± 7.1% and decreased to 60.2 ± 6.5% at cycle 2, but did not change significantly during the rest of the study; mean values at cycle 8 and at the end of the study were 58.7 ± 7.0% and 57.3 ± 9.5% respectively. One case of symptomatic CHF occurred during the study.
 The most common adverse events were hematologic toxicities, alopecia, asthenia and fever. The Overall Response Rate was 65.5% (CR 31%, PR 34.5%).The median progression free survival was 15.5 months (95% CI 11-24 months). The average overall survival was 27.9 months.Conclusions: These results suggest that the combination of non-pegylated liposomal doxorubicin, docetaxel and trastuzumab has shown a good cardiac safety profile at a long term follow up, comparatively to recent published results data in HET study. A promising efficacy including CR and PFS has been noted in 1st line MBC.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3156.
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Monfardini S, Brunello A, Crivellari D, Puglisi F, Paccagnella A, Molino A, Mustacchi G, Beda M, Luciani A, Simoncini E, Pogliani C, Basso U. Activity and safety of trastuzumab in advanced breast cancer in elderly women (≥ 70 years) in italy. Crit Rev Oncol Hematol 2008. [DOI: 10.1016/s1040-8428(08)70104-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Paccagnella A, Buffoli A, Koussis H, Gava A, Franceschi T, Gardani G, Valduga F, Gaion F, Dondi D, Ghi MG. Concomitant chemoradiotherapy (CT/RT) vs neoadjuvant chemotherapy with docetaxel/cispaltin/5-fluorouracil (TPF) followed by CT/RT in locally advanced head and neck cancer. Final results of a phase II randomized study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.6000] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Vassanelli S, Bandiera L, Borgo M, Cellere G, Santoni L, Bersani C, Salamon M, Zaccolo M, Lorenzelli L, Girardi S, Maschietto M, Dal Maschio M, Paccagnella A. Space and time-resolved gene expression experiments on cultured mammalian cells by a single-cell electroporation microarray. N Biotechnol 2008; 25:55-67. [PMID: 18504020 DOI: 10.1016/j.nbt.2008.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2007] [Revised: 02/07/2008] [Accepted: 03/03/2008] [Indexed: 02/04/2023]
Abstract
Single-cell experiments represent the next frontier for biochemical and gene expression research. Although bulk-scale methods averaging populations of cells have been traditionally used to investigate cellular behavior, they mask individual cell features and can lead to misleading or insufficient biological results. We report on a single-cell electroporation microarray enabling the transfection of pre-selected individual cells at different sites within the same culture (space-resolved), at arbitrarily chosen time points and even sequentially to the same cells (time-resolved). Delivery of impermeant molecules by single-cell electroporation was first proven to be finely tunable by acting on the electroporation protocol and then optimized for transfection of nucleic acids into Chinese Hamster Ovary (CHO-K1) cells. We focused on DNA oligonucleotides (ODNs), short interfering RNAs (siRNAs), and DNA plasmid vectors, thus providing a versatile and easy-to-use platform for time-resolved gene expression experiments in single mammalian cells.
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Paccagnella A, Michieletto S, Pitassi I, Baruffi C, Pizzolato D, Marcon ML, Saia OS, Toscani P, Moretti G, Foscolo G. [Organisational aspects of a donated breast milk bank: experience of the Treviso hospital]. Minerva Pediatr 2007; 59:337-348. [PMID: 17947840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
AIM This study analyses the organisational aspects and the volume of milk managed by the donated breast milk bank (banca del latte umano donato, BLUD) in Treviso. METHODS The data gathered refer to the years 2003, 2004 and 2005. In particular the hygiene methodology is described in order to obtain a high-quality product from a clinical point of view which is in line with the recent norms regarding the management of food products. RESULTS During the three-year study 5,647 L of milk were collected (on average: 155 L/month; 5 L/day). Seventy-two percent of breast milk collected was from mothers for their own children; the remaining 28% of milk was from ''donors for the pool''. In the same period 5,053 L of milk was pasteurised and distributed (pool=31%; frozen breast milk=61%; chilled unpasteurized breast milk =8%). Microbiological data show total effectiveness of the methods of pasteurisation used (Holder method). The tracking of the product is possible through the BLUD organisation. CONCLUSION We propose: 1) that scientific organisations and legislators try to optimise the control of this important product by providing guidelines, indications, microbiological parameters and legal obligations for the correct continuation of the work carried out by BLUDs; 2) that BLUDs create a network for rapid communication, integration and possible collaboration; 3) that a study be carried out regarding BLUDs and population density in order to balance costs and benefits.
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Paccagnella A, Oniga F, Bearz A, Favaretto A, Barbieri F, Chella A, Ceresoli G, Biason R, D'Amanzo P, Ghi MG. Correlation of tumor response and survival in advanced NSCLC patients treated with paclitaxel plus carboplatin (PC) versus paclitaxel plus carboplatin plus gemcitabine (PCG). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7650 Background: We showed that PCG significantly increases both response rate (RR) (43.6% vs 20%) and median survival (10.8 mo vs 8.3 mo) over PC and that at Cox analysis, the only independent prognostic factors were PS and treatment (Paccagnella et al, J Clin Oncol 2006;24: 681–687). According to the Prentice criteria (Stat Med 1989;8: 431–440), to directly relate response and survival it is necessarily that responding patients (and non responding) of both arms have a similar survival and that the survival difference between the two arms disappear when the response factor is included in the multivariate analysis. Methods: Out of 324 pts included in the original analysis, 26 pts were not evaluable for response (early death, toxicity, refusal) before the planned response evaluation at two months and were excluded (15 pts from PC arm and 11 pts from PCG arm). The analysis however was also performed considering the non evaluable patients as non responders. Results: Overall, Responder patients had a median Survival that nearly doubled that of no responders: 14.73 mo vs 7.67 mo (HR: 0.49; CI: 0.31–0.54; P=0.000). No responder pts from PC and PCG arms had a similar survival (median 7.53 mo and 8.07 mo respectively; P= 0.96) as well as responder (CR + PR) patients (median 14.13 mo and 15.40 mo respectively; P=0.38). The principal difference between the two arms was that more than the double of patients in PCG arm responded (43.6% vs 20%) and consequently had a survival advantage of clinical relevance in comparison to patients in PC arm. When tumor response was introduced in the Cox model (as a four level variable), the difference in Overall Survival between PCG and PC changed from a significant level (HR=1.28; CI 1.00–1.63; P=0.049) to a not significant level (HR=0.99; CI: 0.76 - 1.28; P=0.97). Conclusions: To our knowledge this is the first report showing a significant direct correlation between response and survival in advanced NSCLC according to Prentice criteria. No significant financial relationships to disclose.
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Ghi MG, Paccagnella A, Stanta G, Murer B, Petrera F, Busato S, Bonin S, Medici M, Carnuccio R, Biason R. Retrospective analyses of m-RNA gene expression profile from formalin fixed paraffin embedded (FFPE) specimens in colorectal cancer (CRC) and correlation with chemoresponsiveness. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15039 Background: Patients with chemoresponsive tumors are more likely to have a survival advantage, consequently a great interest is being placed on the identification of predictive markers. Currently, the improving in the extraction techniques allow the detection of gene profile at the mRNA level from FFPE materials. The purpose of the study was to analyse the m-RNA level of specific genes from FFPE (Stanta et al, BioTechniques 1998), both primary tumor (T) and locoregional lymphnodes (N) in CRC patients treated with chemotherapy (CT), and to relate it with chemoresponsiveness. Material and Methods: RNA was extract from FFPE tumor specimen both in T and N. RNA was reversing transcribed to cDNA. From the cDNA sample, BRCA1, ERCC1, CES2 and TS gene transcripts were specifically amplified by PCR. ERCC1 and BRCA1 are involved in platinum-compound resistance; TS is involved in responses to 5Fluorouracil (5FU) and CES2 level expression was recently related to Irinotecan pro-drug activation. Eligible patients included metastatic CRC patients treated from March 2000 to December 2003 as first line CT with Oxaliplatin/5FU or Irinotecan/5FU or 5FU alone. Results: Forty-five consecutive patients were retrospectively analysed. 15 of them received Oxaliplatin/5FU, 15 Irinotecan/5FU and the other 15 5FU alone. Median age was 64 (range 46–75). 13 patients (28%) had received adjuvant CT. 32 patients (72%) had metastatic disease at the time of surgery. Global Response Rate was 44%. All 45 patients received 5FU and they were analysed for the level of TS expression. With Multiple Regression Analysis, no statistical significant relation between TS level expression and response to 5FU was observed (P=0.36). A strong relation was observed between ERCC1 and response to Oxaliplatin (P=0.006) and a possible correlation of BRCA1-exon11 level expression and response to Irinotecan (P=0.06). The analyses of CES2 and the relation between gene expression and survival are ongoing. Conclusions: The analyses of mRNA gene expression profile from FFPE could be use to predicting response to CT in CRC patients. To test this hypothesis, a randomized phase II-III prospective study of tailored therapy in metastatic CRC is planned. No significant financial relationships to disclose.
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Paccagnella A, Mauri A, Berto R, Falchero S, Baruffi C, Marcon ML, Faronato PP, Dal Ben G, Foscolo G. Biopsychosocial approach to home enteral nutrition: measure of subjective satisfaction and quality of life. Minerva Med 2007; 98:5-17. [PMID: 17372577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
AIM Home enteral nutrition (HEN) has become a therapeutic option used to prolong considerably the life of those patients who were previously doomed to malnutrition. The recent biopsychosocial suggests to consider the person in a global vision that takes into account not only the physiological but also the psychological and social implications of any treatment we use. In such a vision the wellness of the patients treated in HEN has to be considered in a more general view that considers the effect of the therapy related to quality of life of the person itself. In this study the effects of HEN on the quality of life of the patients and of their primary caregivers was assessed. METHODS Twenty patients, 12 males and 8 females, were included in the study. Twelve patients were excluded from the study due to their inability to give informed consent due to a decrease in consciousness and/or cognitive functioning. The 20 patients' mean age was 59.5+14 years with average of 7 years of school education. Twenty-nine caregivers, 25 females and 4 males (mean age = 55.3+/-9 years), were also considered. RESULTS The patients' condition was good since none showed symptoms related to the therapy. Of the 20 patients, 14 were hospitalized in the past 12 months and since their clinical conditions were stable they were sent back home, while 4 were hospitalized because of HEN issues. None of the patients showed gastro-enteric complications related to their disease state during the previous 12 months, although 5 patients had constipation, and 2 had temporary diarrhea (spontaneously receded) which reduced the infused caloric intake for 2-3 days from the symptom onset. CONCLUSIONS The biopsychosocial approach we used in this study shows that aspects traditionally treated as ''positive'' and desirable by health-care professionals (i.e. the possibility to provide home care) do not have a straightforward correspondence in the emotional sphere of the patient undergoing HEN. On the contrary, in some cases, the subjective perception of the health related quality of life tends to be lower than expected, since the patient endures a treatment which appears to be essentially ineffective in modifying the prognosis of the basal disease.
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Turcato G, Buffoli A, Loreggian L, Gava A, Campostrini F, Gardani G, Polsinelli M, Tomio L, Villa B, Paccagnella A. 1107. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Pagan V, Ceron L, Paccagnella A, Pizzi G. 5-year prospective results of trimodality treatment for malignant pleural mesothelioma. THE JOURNAL OF CARDIOVASCULAR SURGERY 2006; 47:595-601. [PMID: 17033611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
AIM Even though followed by a prolonged survival in highly selected patients, the promising results of Sugarbaker's trimodality treatment for malignant pleural mesothelioma (MPM) are debated and not yet uniformly replicated. The purpose of this study is to evaluate prospectively the reproducibility of the trimodality treatment results in a patient population with mesothelioma staged by the IMIG classification. METHODS Fifty-four patients with MPM have been judged candidable to extended pleuropneumonectomy (EPP), to be followed by chemotherapy (paclitaxel+carboplatin) and radiotherapy (50 Gy). RESULTS At thoracotomy, 44 of the 54 surgical candidates (81%) underwent EPP; 73% of the operated patients completed the entire adjuvant chemo-radiotherapy with no major toxicity. The 30-day or in-hospital operative mortality rate was 4.5% (2 deaths), the major morbidity 36%, and the overall complication rate 50%. At 5 years the projected survival of the 42 surgical survivors submitted to EPP is 19%; median survival is 20 months. The restricted group of patients with epithelial, N0-1, completely resected MPM (microscopic negative margins) exhibits a projected 50% 5-year survival. Clinical understaging has shown up to be noticeable both at the thoracotomy exploration and pathology examination. Most of the disease recurrences are loco-regional and the current insufficiency of intraoperative or postsurgical radicality needs improvement, along with earlier diagnosis, more accurate staging, and preoperative induction for the multimodality treatment of pleural mesothelioma to become an established curative option. CONCLUSIONS This series confirms the reproducibility of the trimodality treatment for MPM,which is associated with prolonged survival for early-stage tumors at the cost of a not prohibitive treatment-related mortality rate.
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Paccagnella A, Mauri A, Baruffi C, Berto R, Zago R, Marcon ML, Pizzolato D, Fontana F, Rizzo L, Bisetto M, Agostini S, Foscolo G. Application criteria of enteral nutrition in patients with anorexia nervosa: correlation between clinical and psychological data in a "lifesaving" treatment. JPEN J Parenter Enteral Nutr 2006; 30:231-9. [PMID: 16639070 DOI: 10.1177/0148607106030003231] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Data and research increasingly point to multiple factors in the genesis of eating-behavior disorders, but the lack of a clear etiological definition prevents a unique therapeutic or prognostic approach from being defined. Therapeutic approaches, as well as scientific research, have separately analyzed the psychological aspects and the clinical-nutrition aspects without integrating the variables or correlating clinical and psychological data. This work has several goals because it aims at considering the problem from the 2 different perspectives. Psychological and clinical variables are analyzed both separately and together in order to assess (a) the minimal criteria to define a cure as "lifesaving" and submit a patient to artificial nutrition; (b) the kind of implementation artificial nutrition should follow; (c) which indicators of the efficacy of artificial nutrition must be taken into account; (d) the results in nutrition terms that may be obtained during the follow-up; (e) if artificial nutrition may be used as a therapeutic tool; (f) if there are any psychological effects after artificial nutrition; (g) if there are any effects due to the patients' age; and (h) the correlation between the psychological profile of a patient and the acceptance of the nutrition treatment. METHODS Several psychological and pharmacologic variables, together with clinical and anthropometric data and blood chemical values, were all considered. CONCLUSIONS Besides defining minimal criteria for a "lifesaving" cure and proposing 2 ad hoc scales for the assessment of patients' subjective willingness toward feeding and for the objective measurement of feeding itself, clinical data and correlations with psychological data evidenced the importance of artificial nutrition and specifically of enteral nutrition as a therapeutic tool, allowing us to define the modalities of implementation of enteral nutrition. Results show that, because enteral nutrition did not deteriorate the psychological state of the patients, and was found to be accepted more positively than feeding orally in the most critical initial phase, it should be included in the therapy.
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