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Di Brina L, D'agostino G, Franzese C, Franceschini D, Comito T, De Rose F, Navarria P, Tozzi A, Iftode C, Ascolese A, Clerici E, Pasini L, Benetti A, Scorsetti M. EP-1337: High hypofractionation using beacon transponders in intermediate-risk prostate cancer: first results. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31772-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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102
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Mancosu P, Nicollini G, De Rose F, Lobefalo F, Franceschini D, Scorsetti M, Tomatis S. EP-1637: Critical appraisal of deep inspiration breath hold CBCT for left breast using VMAT. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32072-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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103
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Ascolese A, Navarria P, Mancosu P, Tomatis S, Fogliata A, Colombo P, De Sanctis R, Marrari A, Franceschini D, D'Agostino G, Santoro A, Quagliuolo V, Scorsetti M. EP-1375: Volumetric-modulated-arc-therapy versus 3D-conformal-radiotherapy for sarcoma of extremities. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31810-8] [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]
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104
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Clerici E, Navarria P, Ascolese A, Pessina F, Tomatis S, Cozzi L, Simonelli M, Santoro A, Franzese C, Bello L, Scorsetti M. EP-1409: Prospective study of hypofractionated radiotherapy for elderly patients with High Grade Glioma. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31844-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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105
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Cozzi L, Reggiori G, Franzese C, Lobefalo F, Scorsetti M, Fogliata A. EP-1528: RapidPlan Head and Neck model: the objectives and possible clinical benefits. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31963-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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106
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Fogliata A, Seppala J, Reggiori G, Lobefalo F, Palumbo V, De Rose F, Franceschini D, Scorsetti M, Cozzi L. EP-1560: Left breast cancer planning with VMAT technique: the dosimetric trade-offs. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31995-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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107
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Fogliata A, Reggiori G, Stravato A, Lobefalo F, Franzese C, Franceschini D, Tomatis S, Mancosu P, Scorsetti M, Cozzi L. RapidPlan head and neck model: the objectives and possible clinical benefit. Radiat Oncol 2017; 12:73. [PMID: 28449704 PMCID: PMC5408433 DOI: 10.1186/s13014-017-0808-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 04/14/2017] [Indexed: 11/27/2022] Open
Abstract
Background To evaluate a knowledge based planning model for RapidPlan (RP) generated for advanced head and neck cancer (HNC) patient treatments, as well its ability to possibly improve the clinical plan quality. The stability of the model was assessed also for a different beam geometry, different dose fractionation and different management of bilateral structures (parotids). Methods Dosimetric and geometric data from plans of 83 patients presenting HNC were selected for the model training. All the plans used volumetric modulated arc therapy (VMAT, RapidArc) to treat two targets at dose levels of 69.96 and 54.45 Gy in 33 fractions with simultaneous integrated boost. Two models were generated, the first separating the ipsi- and contra-lateral parotids, while the second associating the two parotids to a single structure for training. The optimization objectives were adjusted to the final model to better translate the institutional planning and dosimetric strategies and trade-offs. The models were validated on 20 HNC patients, comparing the RP generated plans and the clinical plans. RP generated plans were also compared between the clinical beam arrangement and a simpler geometry, as well as for a different fractionation scheme. Results RP improved significantly the clinical plan quality, with a reduction of 2 Gy, 5 Gy, and 10 Gy of the mean parotid, oral cavity and laryngeal doses, respectively. A simpler beam geometry was deteriorating the plan quality, but in a small amount, keeping a significant improvement relative to the clinical plan. The two models, with one or two parotid structures, showed very similar results. NTCP evaluations indicated the possibility of improving (NTCP decreasing of about 7%) the toxicity profile when using the RP solution. Conclusions The HNC RP model showed improved plan quality and planning stability for beam geometry and fractionation. An adequate choice of the objectives in the model is necessary for the trade-offs strategies.
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108
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Navarria P, Pessina F, Toschi L, Santoro A, Ascolese A, Clerici E, Franceschini D, Bello L, Scorsetti M. P14.17 What is the optimal therapeutic strategy for limited brain metastases (BMs) from non small cell lung cancer (NSCLC)? Prognostic factors conditioning brain control and patients outcome. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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109
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Navarria P, Pessina F, Tomatis S, Simonelli M, Santoro A, Ascolese A, Clerici E, Rossi M, Bello L, Scorsetti M. P09.36 A new therapeutic strategy for newly diagnosed glioblastoma patients: hypofractionated stereotactic radiation therapy (HSRT) delivered in 15 fractions respect to standard fractionation in 30 fractions, with concomitant temozolomide chemotherapy - A phase II study. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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110
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De Rose F, Fogliata A, Franceschini D, Iftode C, Masci G, Torrisi R, Gatzemeier W, Testori A, Tinterri C, Scorsetti M. Skin toxicity and cosmetic outcomes in early stage breast cancer patients treated with hypofractionation and simultaneous integrated boost using VMAT: results in 1,000 patients. Breast 2017. [DOI: 10.1016/s0960-9776(17)30238-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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111
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Masci G, Santarpia L, Bottai G, Giordano L, Zuradelli M, Torrisi R, Di Tommaso L, Sagona A, Errico V, Gatzemeier W, Testori A, Navarria P, Bello L, Tinterri C, Scorsetti M, Santoro A. HER2 positive breast cancer with central nervous system metastases: Pathological features and clinical outcome. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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112
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De Rose F, Franceschini D, Cozzi L, Comito T, D'Agostino G, Navarria P, Ascolese A, Tozzi A, Iftode C, Franzese C, Clerici E, Tomatis S, Fogliata A, Scorsetti M. Is There a Role for Stereotactic Body Radiation Therapy (SBRT) in Oligometastatic Breast Cancer? Results From an Observational Study. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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113
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Pessina F, Navarria P, Ascolese A, Cozzi L, Tomatis S, Riva M, Rossi M, Scorsetti M, Bello L. P08.27 The role of supramarginal resection for single large brain metastases: feasibility, morbidity and local control evaluation. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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114
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Navarria P, Ascolese A, Cozzi L, Tomatis S, Picozzi P, Pecchioli G, Attuati L, Clerici E, Maggi G, Scorsetti M. P19.03 Randomized double arm phase III study to evaluate feasibility and safety of Gamma Knife radiosurgery versus Linac Based (Edge) radiosurgery in brain metastatic patients. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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115
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Navarria P, Pessina F, Ascolese A, Cozzi L, Tomatis S, Riva M, Bello L, Clerici E, Lobefalo F, Scorsetti M. P13.11 Outcome evaluation of oligometastatic patients with single, large brain metastases treated with gross total resection (GTR) followed by hypofractionated stereotactic radiosurgery (HSRS) on the tumor bed. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Franzese C, Cozzi L, Clerici E, D'Agostino G, Navarria P, Comito T, De Rose F, Ascolese A, Franceschini D, Mancosu P, Tomatis S, Scorsetti M. Role of Stereotactic Body Radiation Therapy With Volumetric Modulated Arc Therapy Technique and FFF Beams for Abdomino-Pelvic Lymph Node Metastases in Oligometastatic Patients. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pessina F, Navarria P, Ascolese A, Cozzi L, Tomatis S, Riva M, Simonelli M, Scorsetti M, Bello L. P08.28 Role of surgical resection in recurrent glioblastoma: prognostic factors and outcome evaluation. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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118
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Navarria P, Pessina F, Ascolese A, Tomatis S, Bello L, Simonelli M, Riva M, Lopci E, Santoro A, Scorsetti M. P08.44 Phase II study of hypofractionated radiation therapy with concomitant and adjuvant temozolomide following surgical resection for patients with newly diagnosed glioblastoma: preliminary evaluation. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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119
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Franceschini D, Franzese C, Navarria P, Ascolese AM, De Rose F, Del Vecchio M, Santoro A, Scorsetti M. Radiotherapy and immunotherapy: Can this combination change the prognosis of patients with melanoma brain metastases? Cancer Treat Rev 2016; 50:1-8. [PMID: 27566962 DOI: 10.1016/j.ctrv.2016.08.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 11/30/2022]
Abstract
Brain metastases are a common occurrence in patients with melanoma. Prognosis is poor. Radiotherapy is the main local treatment for brain metastases. Recently, immunotherapy (i.e. immune checkpoints inhibitors) showed a significant impact on the prognosis of patients with metastatic melanoma, also in the setting of patients with brain metastases. Despite various possible treatments, survival of patients with melanoma brain metastases is still unsatisfactory; new treatment modalities or combination of therapies need to be explored. Being immunotherapy and radiotherapy alone both efficient in the treatment of melanoma brain metastases, the combination of these two therapies seems logical. Moreover radiotherapy can improve the efficacy of immunotherapy and the immune system plays a relevant role in the action of radiotherapy. Preclinical data support this combination. Clinical data are more contradictory. In this review, we will discuss available therapies for melanoma brain metastases, focusing on the preclinical and clinical available data supporting the possible synergism between radiotherapy and immunotherapy.
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D'Agostino G, Franzese C, De Rose F, Franceschini D, Comito T, Villa E, Alongi F, Liardo R, Tomatis S, Navarria P, Mancosu P, Reggiori G, Cozzi L, Scorsetti M. High-quality Linac-based Stereotactic Body Radiation Therapy with Flattening Filter Free Beams and Volumetric Modulated Arc Therapy for Low-Intermediate Risk Prostate Cancer. A Mono-institutional Experience with 90 Patients. Clin Oncol (R Coll Radiol) 2016; 28:e173-e178. [PMID: 27389021 DOI: 10.1016/j.clon.2016.06.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 12/29/2022]
Abstract
AIMS The aim of this phase II study was to evaluate the efficacy and toxicity of stereotactic body radiotherapy in patients with low or intermediate risk prostate cancer. MATERIALS AND METHODS Biopsy-confirmed prostate cancer patients were enrolled, provided that they had the following characteristics: initial prostate-specific antigen (PSA) ≤ 20 ng/ml, Gleason Score < 7, International Prostate Symptom Score < 7. The treatment schedule was 35 Gy in five fractions, delivered with volumetric modulated arcs with flattening filter free beams. Toxicity was recorded according to CTCAE criteria v4.0. Biochemical failure was calculated according to the Phoenix definition. The Expanded Prostate Cancer Index Composite questionnaire was used to record health-related quality of life. RESULTS Between December 2011 and March 2015, 90 patients were enrolled (53 low risk, 37 intermediate risk). The median age was 71 years (range 48-82). In total, 58 (64.5%) of the patients had Gleason Score=6, the remaining had Gleason Score=7.The median initial PSA was 6.9 ng/ml (range 2.7-17.0). Acute toxicity was mild, with 32.2 patients presenting grade 1 urinary toxicity and 32.2% of patients presenting grade 2 urinary toxicity, mainly represented by urgency, dysuria and stranguria. Rectal grade 1 toxicity was found in 15.5% of patients, whereas grade 2 toxicity was recorded in 6.6% of patients. Regarding late toxicity, grade 1 proctitis was recorded in 11.1% of patients and grade 1 urinary in 38.8%; only two events of grade 2 urinary toxicity were observed (transient urethral stenosis, resolved by a 24 h catheterisation). At a median follow-up of 27 months (6-62 months) only two intermediate risk patients experienced a biochemical failure. Health-related quality of life revealed a slight worsening in all the domains during treatment, with a return to baseline 3 months after treatment. CONCLUSIONS Stereotactic body radiotherapy delivered using linac-based flattening filter free volumetric modulated arc radiotherapy in low and intermediate risk prostate cancer patients is associated with mild toxicity profiles and good patient-reported quality of life.
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Navarria P, Ascolese A, D'agostino G, Villa E, Clerici E, Tozzi A, Iftode C, De Rose F, Liardo L, Comito T, Franzese C, Franceschini D, Pessina F, Riva M, Bello L, Reggiori G, Scorsetti M. PO-0654: Hypofractionated StereotaticRS for patients with brain metastases. Outcome evaluation and toxicity. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31904-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ascolese A, Franceschini D, De rose F, Cozzi L, Navarria P, Tozzi A, Iftode C, Villa E, Franzese C, Comito T, D'agostino G, Tomatis S, Liardo L, Scorsetti M. EP-1443: Radical hypofractionated VMAT-RA for stage III NSCLC in the elderly: feasibility and toxicity. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32693-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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123
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Iftode C, De Rose F, Franceschini D, Fogliata A, Villa E, Ascolese A, Navarria P, D'Agostino G, Franzese C, Comito T, Tozzi A, Clerici E, Liardo R, Stravato A, Scorsetti M. PV-0511: Hypofractionated VMAT for early stage breast cancer: acute toxicity and cosmesis in 840 patients. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31761-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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124
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Reggiori G, Mancosu P, Stravato A, Lobefalo F, Paganini L, Zucconi F, Palumbo V, Suchowerska N, Tomatis S, Scorsetti M. EP-1517: Characterization of a new stereotactic diode under flattening filter free beams down to small fields. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32767-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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125
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Villa E, Franzese C, Fogliata A, Franceschini D, D'Agostino G, Clerici E, Navarria P, Comito T, De Rose F, Iftode C, Ascolese A, Tozzi A, Liardo R, Mancosu P, Scorsetti M. EP-1053: Toxicity and clinical outcome for patients treated for advanced head and neck cancer with VMAT-SIB. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32303-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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