76
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Kozloski G, Trevisan L, Bonnecarrère L, Härter C, Fiorentini G, Galvani D, Pires C. Níveis de fibra em detergente neutro na dieta de cordeiros: consumo, digestibilidade e fermentação ruminal. ARQ BRAS MED VET ZOO 2006. [DOI: 10.1590/s0102-09352006000500027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Foram utilizados oito cordeiros castrados (35,0±6,0kg peso vivo) em um delineamento duplo quadrado latino 4 <FONT FACE=Symbol>´</FONT> 4 para avaliar o efeito de quatro níveis de fibra em detergente neutro (FDN) na dieta (25, 31, 37 e 43% da matéria seca (MS)) sobre o consumo e parâmetros digestivos. O consumo de nitrogênio (N) variou de forma quadrática; o de MS, matéria orgânica (MO) e energia diminuíram (P<0,05) e de FDN aumentou (P<0,01) linearmente com o aumento de fibra na dieta. A digestibilidade da FDN e do N, assim como o pH e as concentrações de peptídeos no fluído ruminal foram similares em todos os tratamentos. A digestibilidade aparente da MS, da MO e da energia, assim como as concentrações ruminais de açúcares diminuíram linearmente (P<0,01) e a síntese de proteína microbiana ruminal, as concentrações ruminais de amônia e de aminoácidos variaram quadraticamente (P<0,05) com o aumento do teor de FDN das dietas. A redução do consumo e da digestibilidade foram mais evidentes somente pela inclusão do nível mais alto de FDN (43%) e, sob o aspecto nutricional, a inclusão em torno de 30% de FDN representa o nível mais adequado para formulação de dietas a base de silagem de sorgo e concentrado oferecido a cordeiros confinados.
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Aliberti C, Tilli M, Benea G, Fiorentini G. Trans-arterial chemoembolization (TACE) of liver metastases from colorectal cancer using irinotecan-eluting beads: preliminary results. Anticancer Res 2006; 26:3793-5. [PMID: 17094403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE The purpose of the study was to evalutate the feasibility of irinotecan drug-eluting beads (DC Bead) administered as trans-arterial chemoembolization (TACE) in patients with liver metastases from colorectal cancer (CRC). PATIENTS AND METHODS Ten patients with liver metastases from CRC were treated with TACE adopting irinotecan-eluting beads at a dose of 100 mg every 3 weeks. Computed Tomography (CT) was performed 24h before and after TACE. RESULTS TACE with irinotecan eluting beads was found to be feasible and well-tolerated. Right upper quadrant pain (RUQP) lasting 4 days (range 2-7) was reported by all the patients. After 30 days, a reduction >50% of CEA levels and of the lesional contrast enhancement was observed in all the patients. CONCLUSION Irinotecan drug-eluting beads administered as TACE were shown to be active and safe in patients with liver metastases from CRC.
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Chrysos E, Athanasakis E, Vrekousis T, Almarashdah S, Fiorentini G, Xynos E, Zoras O. Abdominal and pelvic stop-flow chemotherapy. Effect of chemotherapeutic agents and tissue ischemia on rectoanal pressures. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2006; 25:303-8. [PMID: 17167968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
In hypoxic stop-flow chemoperfusion high doses of chemotherapeutic agents are almost directly administered to locally advanced tumors without risking significant systemic toxicity, although chemotherapy-induced neurotoxicity is still a problem. The aim of the study was to assess rectoanal motility and sensation before, during and after abdominal and pelvic stop-flow chemotherapy using the methods of stationary and ambulatory manometry. Stationary rectoanal manometry was performed within 24 hrs before and repeated 48 hrs after stop-flow chemotherapy in 7 consecutive patients with a history of locally advanced or recurrent abdominal and pelvic tumors. Anal sphincter resting and squeeze pressures, rectal sensitivity, rectoanal inhibitory reflex and rectal volumes at which temporary and permanent urge to defecate were reported were examined. Rectal volume associated with leak of rectal contents and rectal compliance were also assessed. Intraoperatively, changes in rectal and anal resting pressures before, during and after occlusion of the vessels and after administration of chemotherapeutic agent were as well recorded, analyzed and interpreted using ambulatory manometry. Induction of anesthesia reduced distal and proximal anal resting pressures. Vascular occlusion further and dramatically decreased resting pressures at all levels, which were fully recovered after re-establishing local blood circulation and for the rest of the recording period. Intraoperative administration of chemotherapy did not further affect anal resting pressures during or after hypoxia. No significant changes in rectoanal motility and sensation were detected on the 48 hrs postoperative assessment as compared to the preoperative state. Tissue hypoxia induced by vascular occlusion during stop-flow chemotherapy procedure, seems to be the only factor leading to a dramatic drop of anal pressures. Anal pressures fully recover after reperfusion of the isolated area. Furthermore, anorectal motility and sensation are not affected by any direct or indirect toxic action of the chemotherapeutic agents.
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79
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Peters S, Voelter V, Zografos L, Pampallona S, Popescu R, Gillet M, Bosshard W, Fiorentini G, Lotem M, Weitzen R, Keilholz U, Humblet Y, Piperno-Neumann S, Stupp R, Leyvraz S. Intra-arterial hepatic fotemustine for the treatment of liver metastases from uveal melanoma: experience in 101 patients. Ann Oncol 2006; 17:578-83. [PMID: 16469752 DOI: 10.1093/annonc/mdl009] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Exclusive liver metastases occur in up to 40% of patients with uveal melanoma associated with a median survival of 2-7 months. Single agent response rates with commonly available chemotherapy are below 10%. We have investigated the use of fotemustine via direct intra-arterial hepatic (i.a.h.) administration in patients with uveal melanoma metastases. PATIENTS AND METHODS A total of 101 patients from seven centers were treated with i.a.h. fotemustine, administered intra-arterially weekly for a 4-week induction period, and then as a maintenance treatment every 3 weeks until disease progression, unacceptable toxicity or patient refusal. RESULTS A median of eight fotemustine infusions per patient were delivered (range 1-26). Catheter related complications occurred in 23% of patients; however, this required treatment discontinuation in only 10% of the patients. The overall response rate was 36% with a median overall survival of 15 months and a 2-year survival rate of 29%. LDH, time between diagnosis and treatment start and gender were significant predictors of survival. CONCLUSIONS Locoregional treatment with fotemustine is well tolerated and seems to improve outcome of this poor prognosis patient population. Median survival rates are among the longest reported and one-third of the patients are still alive at 2 years.
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Mambrini A, Bondavalli C, Caudana R, Amoroso V, Pacetti P, Fiorentini G, Cantore M. Intra-arterial chemotherapy in elderly patients with invasive bladder cancer. Clin Oncol (R Coll Radiol) 2005; 17:663-4. [PMID: 16372497 DOI: 10.1016/j.clon.2005.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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81
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Antonioli E, Nozzoli C, Gianfaldoni G, Mannelli F, Rossi S, Betti S, Bernardeschi P, Fiorentini G, Bosi A. Pulmonary hypertension related to thalidomide therapy in refractory multiple myeloma. Ann Oncol 2005; 16:1849-50. [PMID: 16012178 DOI: 10.1093/annonc/mdi357] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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82
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Fiorentini G, Dentico P, Cantore M, Rossi S, Pacetti P, Bernardeschi P, Della Seta R, Tumolo S, de Giorgi U. Capecitabine (XE) plus Irinotecan (IRI) as second-line treatment (XELIRI) for metastatic colorectal cancer (MCRC) in elderly patients: Feasibility and safety results from a Phase II study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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83
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De Simone M, Vaira M, Scuderi S, Costamagna D, Caponi A, Caponi C, Ciaccio B, Fiorentini G, Bolieraki A, Camassa M, Parma E, Scarcello E, Taddei P, Zappelli I. [Complications of cytoreductive surgery associated with intraperitoneal chemohyperthermia: prevention and treatment]. I SUPPLEMENTI DI TUMORI : OFFICIAL JOURNAL OF SOCIETA ITALIANA DI CANCEROLOGIA ... [ET AL.] 2005; 4:S115. [PMID: 16437940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
New approach to peritoneal carcinomatosis combining cytoreductive surgery and hypertermic intraperitoneal chemotherapy suggest improved survival when it is possible to achieve a complete cytoreduction. In this study we consider the major complications related to this procedure and purpose our approach for their prevention and treatment.
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De Giorgi U, Pupi A, Fiorentini G, Rosti G, Marangolo M. FDG-PET in the management of germ cell tumor. Ann Oncol 2005; 16 Suppl 4:iv90-94. [PMID: 15923438 DOI: 10.1093/annonc/mdi915] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Germ cell tumor is the most common malignancy in young men. The cure rate of these patients has tremendously increased in the cisplatin era, and recent results have indicated that the management of patients with GCT is still improving. The use of FDG-PET in the management of patients with GCT has been recently investigated. This report attempts to comprehensively review new advances and delineate the potential applications of FDG-PET in GCT.
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85
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Vaira M, Scuderi S, Costamagna D, Caponi A, Caponi C, Ciaccio B, Fiorentini G, Bolieraki A, Camassa M, Parma E, Scarcello E, Taddei P, Zappelli I, De Simone M. [Cytoreduction and intraoperative peritoneal chemohyperthermia in carcinomatosis from colonic carcinoma and in peritoneal pseudomyxoma]. I SUPPLEMENTI DI TUMORI : OFFICIAL JOURNAL OF SOCIETA ITALIANA DI CANCEROLOGIA ... [ET AL.] 2005; 4:S116. [PMID: 16437941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
New approach in treatment of peritoneal carcinomatosis combining cytoreductive surgery and intraperitoneal chemotherapy suggests improved survival when it is possible to achieve a complete cytoreduction. In this study we consider the carcinomatosis from colorectal and appendiceal adenocarcinoma. In all cases, patients in whom cytoreductive surgery was complete had a median survival much longer compared with patients in whom was not possible and, as perfusion works on minimal residual disease, peritonectomy is the only surgical technique that aim at total removal of parietal and visceral peritoneal lesions.
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86
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Mura G, Vagliasindi A, Solfrini G, Fiorentini G, Galassi R, Ricci E, Casadei A, Saragoni L, Dubini A, Verdecchia GM. [Sentinel lymph nodes in early gastric cancer: preliminary feasibility study]. I SUPPLEMENTI DI TUMORI : OFFICIAL JOURNAL OF SOCIETA ITALIANA DI CANCEROLOGIA ... [ET AL.] 2005; 4:S79-80. [PMID: 16437916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
From January to December 2004, 8 patients with pre-operative diagnosis of early gastric cancer (EGC) and no nodal involvement were submitted to sentinel node biopsy using the dual mapping procedure with endoscopic blue dye and 99mTc radio-colloid injection. All the patients underwent standard radical gastrectomy and D2 lymphadenectomy. The resected nodes were evaluated by routine (hematoxylin-eosin) histopathological examination; the sentinel (blue or hot) nodes in addition were evaluated with immunohistochemistry for cytokeratin. The preliminary results and perspectives for feasibility of sentinel node biopsy and its accuracy in predicting the nodal status in EGC are discussed.
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Fiorentini G, Rossi S, Bernardeschi P, Cantore M, Guadagni S. Is there a new drug beyond floxuridine for intra-arterial hepatic chemotherapy in liver metastases from colorectal cancer? J Clin Oncol 2005; 23:2105; author reply 2106. [PMID: 15774801 DOI: 10.1200/jco.2005.99.297] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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88
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Fiorentini G, Poddie DB, Cantore M, Rossi S, Tumolo S, Dentico P, Bernardeschi P, Guadagni S, Rossi G, Valori VM, De Simone M. Hepatic intra-arterial chemotherapy (HIAC) of high dose mitomycin and epirubicin combined with caval chemofiltration versus prolonged low doses in liver metastases from colorectal cancer: a prospective randomized clinical study. J Chemother 2005; 16 Suppl 5:51-4. [PMID: 15675479 DOI: 10.1080/1120009x.2004.11782385] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A multicenter randomized study comparing high dose of mitomycin and epirubicin given as hepatic intra-arterial chemotherapy (HIAC) combined with caval chemofiltration (CF) versus low doses of the same drugs in unresectable liver metastases from colorectal cancer showed a significant improvement in the survival rate of the 20 patients treated with high dose compared to the 22 patients treated with low doses with a 1 year survival of 69% vs 39%. The median survival was 17 vs 11 months and the responses were 65% vs 33%. Toxicity was colangitis in 50% of patients considered. The extrahepatic progression was similar in the two groups (7/20 vs 8/22).
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Gadaleta C, Catino A, Ranieri G, Armenise F, Colucci G, Lorusso V, Cramarossa A, Fiorentini G, Mattioli V. Radiofrequency thermal ablation of 69 lung neoplasms. J Chemother 2005; 16 Suppl 5:86-9. [PMID: 15675488 DOI: 10.1080/1120009x.2004.11782394] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Radiofrequency thermal ablation (RFA) is a new, minimally invasive technique offered in the treatment of various neoplasms. RFA produces ionic agitation within the area to be treated, resulting in the heating of neoplastic tissue using a radiofrequency generator. Well defined areas of coagulative necrosis are formed, thereby destroying the tumor. Percutaneous CT-guided RFA was performed in 34 patients with 69 lung neoplasms. Six patients were affected by primary Non-Small Cell Lung Cancer (NSCLC), and 28 patients presented with metastatic lung nodules originating in various solid tumors. Patients were considered ineligible for surgery for the following reasons: medical comorbidities; technical reasons; severe respiratory insufficiency; refusal of surgery. Adequacy of treatment was assessed by CT-Scan and Nuclear Magnetic Resonance (NMR) with gadolinium. A median follow-up of 9 months (3-25 months) resulted in 30 patients evaluable for response with a total of 63 nodules to be treated, 58 of which achieved complete necrotic response. Relapse occurred in 5/63 treated nodules. In 2 of these patients, relapse occurred exclusively in the treated nodules, whereas in the other 3 patients, relapse occurred in the treated nodules as well as at distant sites. 9 patients are alive and disease free. Pneumothorax requiring pleural drainage was the main complication, observed in 16% of the treatment sessions. Lung RFA has shown itself to be a safe and feasible option in the treatment of lung neoplasms in patients otherwise ineligible for surgery. The high rate of complete responses obtained in our study (92%) suggests that further investigation of lung RFA, combined with chemotherapy and/or radiation therapy is warranted with the objective of improving local disease control and survival rates.
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Mambrini A, Caudana R, Zamagni D, Rabbi C, Del Freo A, Sanguinetti F, Fiorentini G, Cantore M. Intra-arterial hepatic chemotherapy in heavily pretreated patients with epithelial ovarian cancer. Ann Oncol 2005; 16:334-5. [PMID: 15668294 DOI: 10.1093/annonc/mdi052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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91
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Cantore M, Rabbi C, Fiorentini G, Oliani C, Zamagni D, Iacono C, Mambrini A, Del Freo A, Manni A. Combined irinotecan and oxaliplatin in patients with advanced pre-treated pancreatic cancer. Oncology 2004; 67:93-7. [PMID: 15539911 DOI: 10.1159/000080993] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2003] [Accepted: 02/06/2004] [Indexed: 01/06/2023]
Abstract
OBJECTIVES This study evaluated the clinical activity and toxicity of combination chemotherapy with irinotecan and oxaliplatin in patients with advanced pancreatic cancer that had progressed despite > or =1 course of a gemcitabine-containing regimen. METHODS Thirty patients with metastatic pancreatic cancer and Karnofsky performance status > or =70 received oxaliplatin 60 mg/m2 on days 1 + 15 and irinotecan 60 mg/m2 on days 1 + 8 + 15 every 4 weeks. Patients were assessed on the basis of clinical benefit response, changes in serum tumour marker CA 19-9, objective tumour response, time to progressive disease (TTP), and survival. RESULTS Six patients (20%) had clinical benefit response (median duration of 7.2 months). CA 19-9 levels were reduced > or =50% from baseline in 8 patients (26%) and remained stable in 8 patients. CT scans revealed that 3 patients (10%) had a partial response and 7 (23%) had stable disease. Two patients (7%) were down-staged and underwent surgery. Median TTP was 4.1 months, median survival was 5.9 months and the 1-year survival rate was 23.3%. The most serious adverse events were grade 3-4 leukopenia in 2 patients (6%), grade 3 neuropathy in 2 (6%) and grade 3 diarrhoea in 1 (3%). CONCLUSION Chemotherapy with irinotecan and oxaliplatin is an active and well-tolerated combination in patients with advanced pre-treated pancreatic cancer.
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92
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Aliberti C, Soriani M, Tilli M, Benea G, De Giorgi U, Fiorentini G. Radiofrequency Ablation of Liver Malignancies: MRI for Evaluation of Response. J Chemother 2004; 16 Suppl 5:79-81. [PMID: 15675486 DOI: 10.1080/1120009x.2004.11782392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of this study was to investigate the role of magnetic resonance imaging (MRI) in the evaluation of response to radiofrequency ablation (RFA) and detect residual or recurrent tumor. After RFA, the target lesion shows a hyperintensive signal without increased T1-weighted, low on T2-weighted, non enhancing in gadolinium-enhanced MRI. In the long term follow-up the successfully treated lesions decrease in size. Signs of recurrence include new enhancement areas, the lesion's size increase, and development of T1-weighted hypointense and T2 weighted hyperintense areas. The MRI is a reliable method to evaluate the effectiveness of RFA and detect residual tumor.
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93
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Bernardeschi P, Fiorentini G, Rossi S, Dentico P, Simi P, Guidi S. Trisomy 8 in Philadelphia-negative cells during imatinib therapy. Am J Hematol 2004; 77:88-9. [PMID: 15307114 DOI: 10.1002/ajh.20133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Targeted therapy with imatinib selectively suppresses Philadelphia-positive cells in chronic myeloid leukemia cells, with reappearance of apparently normal hemopoiesis in a considerable number of patients. Recently, clonal abnormalities have been observed in Philadelphia-negative cells during imatinib therapy, the biologic and prognostic significance of which is actually unknown. A case of trisomy 8 occurring in Philadelphia-negative cells, which was treated by bone marrow transplantation, is reported. Chromosomal abnormalities in Philadelphia-negative cells do not seem to herald disease transformation, but the long-term prognosis may be influenced by an increased incidence of myelodysplasia in younger patients.
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MESH Headings
- Benzamides
- Bone Marrow Transplantation
- Chromosome Aberrations/drug effects
- Chromosomes, Human, Pair 8
- Clone Cells/pathology
- Female
- Humans
- Imatinib Mesylate
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/drug therapy
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/genetics
- Middle Aged
- Piperazines/adverse effects
- Piperazines/therapeutic use
- Prognosis
- Pyrimidines/adverse effects
- Pyrimidines/therapeutic use
- Trisomy
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Mambrini A, Fiorentini G, Pennucci C, Muttini MP, Manni A, Del Freo A, Zamagni D, Rabbi C, Sanguinetti F, Cantore M. Intra-arterial hepatic chemotherapy combined with systemic infusion of 5-FU in patients with advanced biliary tract cancers. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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95
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Piga A, Nortilli R, Cetto GL, Cardarelli N, Fedeli SL, Fiorentini G, D'Aprile M, Giorgi F, Parziale AP, Contu A, Montironi R, Gesuita R, Carle F, Cellerino R. Carboplatin, doxorubicin and etoposide in the treatment of tumours of unknown primary site. Br J Cancer 2004; 90:1898-904. [PMID: 15138469 PMCID: PMC2409455 DOI: 10.1038/sj.bjc.6601785] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The aim of this study was to assess the activity and toxicity of a platinum-based treatment on a group of patients with unknown primary tumours (UPTs). Patients with a diagnosis of UPT underwent a standard diagnostic procedure. Treatment was started within 2 weeks from diagnosis and consisted of carboplatin 400 mg m(-2) day 1, doxorubicin 50 mg m(-2) day 1, etoposide 100 mg m(-2) days 1-3, every 21 days. Response was evaluated after three courses and treatment continued in case of objective response (OR) or symptom control. A total of 102 patients were eligible. The median age was 59 years, sex male/female 54/48, histology was mainly adenocarcinoma or poorly differentiated carcinoma. Nodes, bone, liver and lung were the most frequently involved sites. In all, 79 patients received at least three courses of treatment; 26 patients received six courses or more. Six complete responses and 21 partial responses were observed, for a total of 27 of 102 ORs or 26.5% (95% confidence interval 18.2-36.1%). The median survival was 9 months and median progression-free survival was 4 months. Toxicity was moderate to severe, with 57.8% of patients experiencing grade III-IV haematological toxicity, mainly leucopenia. The regimen employed has shown activity in tumours of unknown primary site, but was associated with significant toxicity. Such toxicity may be considered unjustified, given the large proportion of patients with tumours not likely to respond. Efforts should therefore be addressed to identify predictors of response to chemotherapy, thus limiting aggressive treatment to those patients who could benefit from it.
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96
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Romi R, Pontuale G, CIufolini MG, Fiorentini G, Marchi A, Nicoletti L, Cocchi M, Tamburro A. Potential vectors of West Nile virus following an equine disease outbreak in Italy. MEDICAL AND VETERINARY ENTOMOLOGY 2004; 18:14-19. [PMID: 15009441 DOI: 10.1111/j.1365-2915.2004.0478.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In the late summer of 1998, an outbreak of equine encephalomyelitis due to West Nile virus (WNV) occurred in the Tuscany region of central Italy. The disease was detected in 14 race horses from nine localities in four Provinces: Firenze, Lucca, Pisa and Pistoia. The outbreak area included Fucecchio wetlands (1800 ha), the largest inland marsh in Italy, and the adjacent hilly Cerbaie woodlands with farms breeding horses. To detect potential vectors of WNV, entomological surveys of Fucecchio and Cerbaie were undertaken during 1999-2002 by collecting mosquito larvae from breeding sites and adult mosquitoes by several methods of sampling. Among 6023 mosquitoes (Diptera: Culicidae) collected, 11 species were identified: Aedes albopictus (Skuse), Ae. vexans (Meigen), Anopheles atroparvus Van Thiel, An. maculipennis Meigen s.s., An. plumbeus Stephens, Culex impudicus Ficalbi, Cx. pipiens L., Culiseta longiareolata Macquart), Ochlerotatus caspius (Pallas), Oc. detritus (Haliday) and Oc. geniculatus (Olivier). In Fucecchio marshes, Cx. impudicus predominated with seasonal peak densities in spring and autumn: its greatest abundance during early spring coincides with arrival of migratory birds from Africa. In Cerbaie hills, Cx. pipiens predominated with peak population density in late summer. No viruses were isolated from 665 mosquitoes processed. These findings, plus other data on Italian mosquito bionomics, suggest a possible mode of WNV transmission involving the most abundant Culex in the Fucecchio-Cerbaie areas. Culex impudicus, being partly ornithophilic, might transmit WNV from migratory to non-migratory birds during springtime; Cx. pipiens, having a broader host range, would be more likely to transmit WNV from birds to horses and, perhaps, to humans by late summer.
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97
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Riccobon A, Ridolfi R, Galassi R, Petrini M, Stefanelli M, Fiammenghi L, Giorgetti G, Moretti A, Ridolfi L, Fiorentini G. Cancer Cell Int 2004; 4:S15. [DOI: 10.1186/1475-2867-4-s1-s15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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98
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Rossi S, Fiorentini G, Porcu G, Dentico P, Giustarini G, Bernardeschi P. Thyroid metastases from colon cancer case report in a long term survivor. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2003; 22:243-5. [PMID: 16767939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Colon cancer usually has an hematogenous spread to liver and lung: rarely, or in the case of most advanced disease, also brain and bone can be involved. Thyroid metastasis is generally thought to be infrequent, breast and kidney cancer being the most frequent causes. Herein we present the case of a man affected by liver metastasis from colon cancer, who developed unusual metastasis to thyroid.
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Cantore M, Fiorentini G, Mambrini A, Rabbi C, Zamagni D, Carlone N, Manni A, Caudana R, Torri T. Regional combined with systemic chemotherapy in unresectable biliary tract cancers: a phase II study. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2003; 22:59-64. [PMID: 16767908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Unresectable biliary tract cancers have a very poor prognosis. No good systemic chemotherapeutic regimen is available. This study aimed to evaluated the activity and toxicity of a novel approach of combined loco-regional and systemic chemotherapy. Twenty four patients with advanced or metastatic biliary tumors were treated with epiadriamycin 50 mg/m2 and cisplatin 60 mg/m2 administered bolus in proper hepatic artery on day 1, combined with systemic continuous infusion of 5-fluorouracil 200 mg/m2/day, from day 1 to day 14, every 3 weeks. The overall response rate was 8/24 (33%), including one complete response and 7 partial responses (stable disease 46%, progression 21%). The treatment was well tolerated with a minimal hematological toxicity; the major clinical problem was the deep venous thrombosis related to central venous catheter, that occurred in 5 patients (21%). Median overall survival was 14,6 months and 1-year and 2-year survival were 54% and 38% respectively. Performance status improved in 33% of patients and weight gain more than 7% was observed in 17%. This novel combined loco-regional and systemic chemotherapeutic regimen is active and safe for advanced biliary tract cancer patients.
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Cantore M, Fiorentini G, Luppi G, Rosati G, Caudana R, Piazza E, Comella G, Ceravolo C, Miserocchi L, Mambrini A, Del Freo A, Zamagni D, Aitini E, Marangolo M. Randomised trial of gemcitabine versus flec regimen given intra-arterially for patients with unresectable pancreatic cancer. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2003; 22:51-7. [PMID: 16767907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Gemcitabine is considered the golden standard treatment for unresectable pancreatic adenocarcinoma. Intra-arte-rial drug administration had shown a deep rationale with some interesting results. In a multicenter phase III trial, we compared gemcitabine given weekly with a combination of 5-fluoruracil, leucovorin, epirubicin, carboplatin (FLEC) administered intra-arteriously as first-line therapy in unresectable pancreatic adenocarcinoma. Patients were randomly assigned to receive gemcitabine at a dose of 1,000 mg/m2 over 30 minutes intravenously weekly for 7 weeks, followed by 1 week of rest, then weekly for 3 weeks every 4 weeks or 5-fluoruracil 1,000 mg/m2, leucovorin 100 mg/m2, epirubicin 60 mg/m2, carboplatin 300 mg/m2 infused bolus intra-arteriously at three-weekly interval for 3 times. The primary end point was overall survival, while time to treatment failure, response rate, clinical benefit response were secondary endpoints. Sixty-seven patients were randomly allocated gemcitabine and 71 were allocated FLEC intra-arterially. Patients treated with FLEC lived for significantly longer than patients on gemcitabine (p=.036). Survival at 1 year was increased from 21% in the gemcitabine group to 35% in the FLEC group. Median survival was 7.9 months in the FLEC group and 5.8 months in the gemcitabine group. Median time to treatment failure was longer with FLEC (5.3 vs 4.2 months for FLEC vs gemcitabine respectively; p=.013). Clinical benefit was similar in both groups (17.9% for gemcitabine and 26.7% for FLEC; p=NS). CT-scan partial response was similar in both group (5.9% for gemcitabine and 14% for FLEC; p=NS). Toxicity profiles were different. Compared with gemcitabine, FLEC regimen given intra-arteriously, improved survival in patient with unresectable pancreatic adenocarcinoma.
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