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Fiorino C, Gori C. 9th Congress of the Associazione Italiana di Fisica Medica, Perugia 25–28 February 2016, “ Continuity and evolution in medical physics ”. Phys Med 2016; 32:1634-1636. [DOI: 10.1016/j.ejmp.2016.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2016] [Indexed: 11/16/2022] Open
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202
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Cicchetti A, Rancati T, Ebert M, Fiorino C, Palorini F, Kennedy A, Joseph DJ, Denham JW, Vavassori V, Fellin G, Avuzzi B, Stucchi C, Valdagni R. Modelling late stool frequency and rectal pain after radical radiotherapy in prostate cancer patients: Results from a large pooled population. Phys Med 2016; 32:1690-1697. [PMID: 27720692 DOI: 10.1016/j.ejmp.2016.09.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/30/2016] [Accepted: 09/22/2016] [Indexed: 11/27/2022] Open
Abstract
AIM To investigate late gastrointestinal toxicity in a large pooled population of prostate cancer patients treated with radical radiotherapy. Normal tissue complication probability models were developed for late stool frequency and late rectal pain. METHODS AND MATERIALS Population included 1336 patients, 3-year minimum follow-up, treated with 66-80Gy. Toxicity was scored with LENT-SOMA-scale. Two toxicity endpoints were considered: grade ⩾2 rectal pain and mean grade (average score during follow-up) in stool frequency >1. DVHs of anorectum were reduced to equivalent uniform dose (EUD). The best-value of the volume parameter n was determined through numerical optimization. Association between EUD/clinical factors and the endpoints was investigated by logistic analyses. Likelihood, Brier-score and calibration were used to evaluate models. External calibration was also carried out. RESULTS 4% of patients (45/1122) reported mean stool frequency grade >1; grade ⩾2 rectal pain was present in the TROG 03.04 RADAR population only (21/677, 3.1%): for this endpoint, the analysis was limited to this population. Analysis of DVHs highlighted the importance of mid-range doses (30-50Gy) for both endpoints. EUDs calculated with n=1 (OR=1.04) and n=0.35 (OR=1.06) were the most suitable dosimetric descriptors for stool frequency and rectal pain respectively. The final models included EUD and cardiovascular diseases (OR=1.78) for stool frequency and EUD and presence of acute gastrointestinal toxicity (OR=4.2) for rectal pain. CONCLUSION Best predictors of stool frequency and rectal pain are consistent with findings previously reported for late faecal incontinence, indicating an important role in optimization of mid-range dose region to minimize these symptoms highly impacting the quality-of-life of long surviving patients.
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Fiorino C, Broggi S, Fossati N, Cozzarini C, Goldner G, Wiegel T, Hinkelbein W, Karnes RJ, Boorjian SA, Haustermans K, Joniau S, Palorini F, Shariat S, Montorsi F, Van Poppel H, Di Muzio N, Calandrino R, Briganti A. Predicting the 5-Year Risk of Biochemical Relapse After Postprostatectomy Radiation Therapy in ≥PT2, pN0 Patients With a Comprehensive Tumor Control Probability Model. Int J Radiat Oncol Biol Phys 2016; 96:333-340. [DOI: 10.1016/j.ijrobp.2016.06.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 05/23/2016] [Accepted: 06/10/2016] [Indexed: 11/26/2022]
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204
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Rancati T, Improta I, Palorini F, Cozzarini C, Esposti CD, Franco P, Garibaldi E, Girelli G, Iotti C, Vavassori V, Valdagni R, Fiorino C. Local Dose Descriptors Correlated With Late Urinary Toxicity at 6 to 24 Months After Radiation Therapy for Prostate Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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205
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Avuzzi B, Cozzarini C, Rancati T, Improta I, Palorini F, Badenchini F, Iotti C, Vavassori V, Girelli G, Esposti CD, Valdagni R, Fiorino C. What Happens to Testosterone Levels After Radical Radiation Therapy for Prostate Cancer? Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1325] [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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206
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Gigliotti C, Vecchio AD, Perna L, Fiorino C, Modorati G, Nicola MD, Mortini P, Picozzi P, Franzin A, Bolognesi A, Calandrino R. Dose-volume predictors of radio-induced complications after radiosurgery for uveal melanoma. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Fiorino C, Cozzarini C, Passoni P. The promise of adaptive radiotherapy for pelvic tumors: "too high cost for too little result" or "a low cost for a significant result"? Acta Oncol 2016; 55:939-42. [PMID: 27367444 DOI: 10.1080/0284186x.2016.1203460] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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208
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Perna L, Sini C, Cozzarini C, Agnello G, Cattaneo G, Hysing L, Muren L, Fiorino C, Calandrino R. Deformable registration-based segmentation of the bowel on Megavoltage CT during pelvic radiotherapy. Phys Med 2016; 32:898-904. [DOI: 10.1016/j.ejmp.2016.06.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 05/24/2016] [Accepted: 06/17/2016] [Indexed: 11/15/2022] Open
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209
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Cozzarini C, Noris Chiorda B, Sini C, Fiorino C, Briganti A, Montorsi F, Di Muzio N. Hematologic Toxicity in Patients Treated With Postprostatectomy Whole-Pelvis Irradiation With Different Intensity Modulated Radiation Therapy Techniques Is Not Negligible and Is Prolonged: Preliminary Results of a Longitudinal, Observational Study. Int J Radiat Oncol Biol Phys 2016; 95:690-5. [DOI: 10.1016/j.ijrobp.2016.01.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 01/12/2016] [Accepted: 01/14/2016] [Indexed: 10/22/2022]
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210
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Fodor A, Berardi G, Fiorino C, Picchio M, Busnardo E, Kirienko M, Incerti E, Dell'Oca I, Cozzarini C, Mangili P, Pasetti M, Calandrino R, Gianolli L, Di Muzio NG. Toxicity and efficacy of salvage carbon 11-choline positron emission tomography/computed tomography-guided radiation therapy in patients with lymph node recurrence of prostate cancer. BJU Int 2016; 119:406-413. [DOI: 10.1111/bju.13510] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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211
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Cozzarini C, Briganti A, Fossati N, Montorsi F, Di Muzio N, Fiorino C. Dose Escalation in Salvage Radiation Therapy and Urinary Toxicity: A Small Price to Pay for a Significant Prospective Benefit. J Clin Oncol 2016; 34:1704-5. [PMID: 26951317 DOI: 10.1200/jco.2016.66.7139] [Citation(s) in RCA: 1] [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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Landoni V, Fiorino C, Cozzarini C, Sanguineti G, Valdagni R, Rancati T. Predicting toxicity in radiotherapy for prostate cancer. Phys Med 2016; 32:521-32. [PMID: 27068274 DOI: 10.1016/j.ejmp.2016.03.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 02/15/2016] [Accepted: 03/02/2016] [Indexed: 02/08/2023] Open
Abstract
This comprehensive review addresses most organs at risk involved in planning optimization for prostate cancer. It can be considered an update of a previous educational review that was published in 2009 (Fiorino et al., 2009). The literature was reviewed based on PubMed and MEDLINE database searches (from January 2009 up to September 2015), including papers in press; for each section/subsection, key title words were used and possibly combined with other more general key-words (such as radiotherapy, dose-volume effects, NTCP, DVH, and predictive model). Publications generally dealing with toxicity without any association with dose-volume effects or correlations with clinical risk factors were disregarded, being outside the aim of the review. A focus was on external beam radiotherapy, including post-prostatectomy, with conventional fractionation or moderate hypofractionation (<4Gy/fraction); extreme hypofractionation is the topic of another paper in this special issue. Gastrointestinal and urinary toxicity are the most investigated endpoints, with quantitative data published in the last 5years suggesting both a dose-response relationship and the existence of a number of clinical/patient related risk factors acting as dose-response modifiers. Some results on erectile dysfunction, bowel toxicity and hematological toxicity are also presented.
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Palorini F, Botti A, Carillo V, Gianolini S, Improta I, Iotti C, Rancati T, Cozzarini C, Fiorino C. Bladder dose-surface maps and urinary toxicity: Robustness with respect to motion in assessing local dose effects. Phys Med 2016; 32:506-11. [PMID: 27053449 DOI: 10.1016/j.ejmp.2016.03.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/29/2016] [Accepted: 03/03/2016] [Indexed: 11/28/2022] Open
Abstract
The purpose of this study was to quantify the impact of inter-fraction modifications of bladder during RT of prostate cancer on bladder dose surface maps (DSM). Eighteen patients treated with daily image-guided Tomotherapy and moderate hypofractionation (70-72.8Gy at 2.5-2.6Gy/fr in 28 fractions and full bladder) were considered. Bladder contours were delineated on co-registered daily Megavoltage CT (MVCT) by a single observer and copied on the planning CT to generate dose-volume/surface histograms (DVH/DSH) and bladder DSMs. Discrepancies between planned and daily absorbed doses were analyzed through the average of individual systematic errors, the population systematic errors and the population random errors for the DVH/DSHs and DSMs. In total, 477 DVH/DSH and 472 DSM were available. DSH and DVH showed small population systematic errors of absolute surfaces (<3.4cm(2)) and volumes (<8.4cm(3)) at the highest doses. The dose to the posterior bladder base assessed on DSMs showed a mean systematic error below 1Gy, with population systematic and random errors within 4 and 3Gy, respectively. The region surrounding this area shows higher mean systematic errors (1-3Gy), population systematic (8-11Gy) and random (5-7Gy) errors. In conclusion, DVH/DSH and DSMs are quite stable with respect to inter-fraction variations in the high-dose region, within about 2cm from bladder base. Larger systematic variations occur in the anterior portion and cranially 2.5-3.5cm from the base. Results suggest that dose predictors related to the high dose area (including the trigone dose) are likely to be sufficiently reliable with respect to the expected variations due to variable bladder filling.
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Fossati N, Karnes JR, Morlacco A, Moschini M, Boorjian SA, Seisen T, Bossi A, Cozzarini C, Fiorino C, Noris Chiorda B, Gandaglia G, Tosco L, De Ridder D, Joniau S, Goldner G, Shariat SF, Hinkelbein W, Haustermans K, Tombal B, Montorsi F, Van Poppel H, Wiegel T, Briganti A. MP14-07 PATTERNS AND PREDICTORS OF CLINICAL RECURRENCE FOLLOWING EARLY SALVAGE RADIATION THERAPY IN PATIENTS WITH PSA RISE AFTER RADICAL PROSTATECTOMY: A LONG TERM MULTI-INSTITUTIONAL ANALYSIS. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.2510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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215
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Chiorda BN, Sini C, Fiorino C, Badenchini F, Briganti A, Chiara A, Deantoni C, Slim N, Suardi N, Montorsi F, Di Muzio N, Cozzarini C. PO-0749: Factors predicting late severe urinary incontinence after postprostatectomy RT: a longitudinal study. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31999-5] [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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216
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Fiorino C. SP-0383: How to bring QUANTEC into the 21st century? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31632-2] [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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217
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Sini C, Fiorino C, Perna L, Noris Chiorda B, Sacco V, Pasetti M, Chiara A, Calandrino R, Di Muzio N, Cozzarini C. EP-1725: Predictors of diarrhea after whole-pelvis post-prostatectomy radiotherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32976-0] [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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218
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Cozzarini C, Badenchini F, Rancati T, Girelli G, Gabriele P, Degli Esposti C, Franco P, Vavassori V, Galeandro M, Bianconi C, Improta C, Palorini F, Valdagni R, Fiorino C. OC-0535: How patient-reported urinary symptoms predict impairment of urinary QoL from RT for prostate cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31785-6] [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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219
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Deantoni C, Cozzarini C, Fodor A, Noris Chiorda B, Mangili P, Picchio M, Incerti E, Dell'Oca I, Passoni P, Fiorino C, Calandrino R, Di Muzio N. EP-1347: Could “radical” RT be a reasonable choice in bone oligometastatic prostate cancer patients? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32597-x] [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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220
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Badenchini F, Cozzarini C, Avuzzi B, Sini C, Fodor A, Rancati T, Valdagni R, Di Muzio N, Fiorino C. PO-0753: Prospective evaluation of urinary function in patients with prostate cancer treated with RT. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32003-5] [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]
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221
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Benigni F, Cozzarini C, Sini C, Spinelli A, Venturini M, Perani L, Sacco V, Viale A, Capelli A, Mondino A, Briganti A, Bellone M, Fiorino C, Calandrino R, Di Muzio N. EP-2053: In-vivo imaging of rat leukocytes redistribution after pelvic irradiation. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33304-7] [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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222
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Branchini M, Broggi S, Belli M, Fiorino C, Cattaneo G, Perna L, Calandrino R. EP-1815: Towards adaptive Tomotherapy: planning CT to MVCT deformable image registration for dose calculation. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33066-3] [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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223
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Cicchetti A, Rancati T, Ebert M, Fiorino C, Kennedy A, Joseph D, Denham J, Vavassori V, Fellin G, Valdagni R. PO-0873: Modelling severe late rectal bleeding in a large pooled population of prostate cancer patients. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32123-5] [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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224
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Palorini F, Rancati T, Cicchetti A, Improta I, Cozzarini C, Casanova Borca V, Degli Esposti C, Franco P, Garibaldi E, Girelli G, Maggio A, Micera R, Palombarini M, Pierelli A, Pignoli E, Simoni N, Vavassori V, Villa S, Valdagni R, Fiorino C. PO-0875: Multivariable models for urinary symptoms at 6-24 months after radical RT of prostate cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32125-9] [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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225
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Cozzarini C, Noris Chiorda B, Deantoni CL, Briganti A, Fiorino C, Gandaglia G, Fossati N, Freschi M, Sini C, Montironi R, Montorsi F, Di Muzio N. MP14-10 DETRIMENTAL ROLE OF PRE-PROSTATECTOMY NEOADJUVANT ANDROGEN DEPRIVATION IN NODE-NEGATIVE PATIENTS TREATED WITH ADJUVANT RT. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.2513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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