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Bonù ML, Nicosia L, Turkaj A, Pastorello E, Vitali P, Frassine F, Toraci C, Spiazzi L, Lechiara M, Frittoli B, Grazioli L, Ghirardelli P, Costantino G, Barbera F, Borghetti P, Triggiani L, Portolani N, Buglione M, Dionisi F, Giacomelli I, Lancia A, Magrini SM, Tomasini D. High dose proton and photon-based radiation therapy for 213 liver lesions: a multi-institutional dosimetric comparison with a clinical perspective. Radiol Med 2024; 129:497-506. [PMID: 38345714 PMCID: PMC10942931 DOI: 10.1007/s11547-024-01788-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 01/15/2024] [Indexed: 03/16/2024]
Abstract
BACKGROUND Stereotactic radiotherapy (SRT) and Proton therapy (PT) are both options in the management of liver lesions. Limited clinical-dosimetric comparison are available. Moreover, dose-constraint routinely used in liver PT and SRT considers only the liver spared, while optimization strategies to limit the liver damaged are poorly reported. METHODS Primary endpoint was to assess and compare liver sparing of four contemporary RT techniques. Secondary endpoints were freedom from local recurrence (FFLR), overall survival (OS), acute and late toxicity. We hypothesize that Focal Liver Reaction (FLR) is determined by a similar biologic dose. FLR was delineated on follow-up MRI. Mean C.I. was computed for all the schedules used. A so-called Fall-off Volume (FOV) was defined as the area of healthy liver (liver-PTV) receiving more than the isotoxic dose. Fall-off Volume Ratio (FOVR) was defined as ratio between FOV and PTV. RESULTS 213 lesions were identified. Mean best fitting isodose (isotoxic doses) for FLR were 18Gy, 21.5 Gy and 28.5 Gy for 3, 5 and 15 fractions. Among photons, an advantage in terms of healthy liver sparing was found for Vmat FFF with 5mm jaws (p = 0.013) and Cyberknife (p = 0.03). FOV and FOVR resulted lower for PT (p < 0.001). Three years FFLR resulted 83%. Classic Radiation induced liver disease (RILD, any grade) affected 2 patients. CONCLUSIONS Cyberknife and V-MAT FFF with 5mm jaws spare more liver than V-MAT FF with 10 mm jaws. PT spare more liver compared to photons. FOV and FOVR allows a quantitative analysis of healthy tissue sparing performance showing also the quality of plan in terms of dose fall-off.
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Affiliation(s)
- Marco Lorenzo Bonù
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121, Brescia, Italy.
| | - Luca Nicosia
- Department of Radiation Oncology, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | | | - Edoardo Pastorello
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121, Brescia, Italy
| | - Paola Vitali
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121, Brescia, Italy
| | - Francesco Frassine
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121, Brescia, Italy
| | - Cristian Toraci
- Department of Medical Physics, Spedali Civili di Brescia, Brescia, Italy
| | - Luigi Spiazzi
- Department of Medical Physics, Spedali Civili di Brescia, Brescia, Italy
| | - Marco Lechiara
- Department of Radiology, Spedali Civili di Brescia, Brescia, Italy
| | - Barbara Frittoli
- Department of Radiology, Spedali Civili di Brescia, Brescia, Italy
| | - Luigi Grazioli
- Department of Radiology, Spedali Civili di Brescia, Brescia, Italy
| | - Paolo Ghirardelli
- Department of Radiation Oncology, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | - Gianluca Costantino
- Department of Radiation Oncology, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | - Fernando Barbera
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121, Brescia, Italy
| | - Paolo Borghetti
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121, Brescia, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121, Brescia, Italy
| | | | - Michela Buglione
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121, Brescia, Italy
| | | | | | - Andrea Lancia
- Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Maria Magrini
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121, Brescia, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121, Brescia, Italy
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Borghetti P, Volpi G, Facheris G, Cossali G, Mataj E, La Mattina S, Singh N, Imbrescia J, Bonù ML, Tomasini D, Vitali P, Greco D, Bezzi M, Melotti F, Benvenuti M, Borghesi A, Grisanti S, Buglione di Monale e Bastia M. Unresectable stage III non-small cell lung cancer: could durvalumab be safe and effective in real-life clinical scenarios? Results of a single-center experience. Front Oncol 2023; 13:1208204. [PMID: 37469420 PMCID: PMC10352832 DOI: 10.3389/fonc.2023.1208204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/09/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction The standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC) is chemoradiotherapy (CRT) followed by consolidation durvalumab as shown in the PACIFIC trial. The purpose of this study is to evaluate clinical outcomes and toxicities regarding the use of durvalumab in a real clinical scenario. Methods A single-center retrospective study was conducted on patients with a diagnosis of unresectable stage III NSCLC who underwent radical CRT followed or not by durvalumab. Tumor response after CRT, pattern of relapse, overall survival (OS) and progression-free survival (PFS), and toxicity profile were investigated. Results Eighty-five patients met the inclusion criteria. The median age was 67 years (range 45-82 years). Fifty-two patients (61.2%) started sequential therapy with durvalumab. The main reason for excluding patients from the durvalumab treatment was the expression of PD-L1 < 1%. Only two patients presented a grade 4 or 5 pneumonitis. A median follow-up (FU) of 20 months has been reached. Forty-five patients (52.9%) had disease progression, and 21 (24.7%) had a distant progression. The addition of maintenance immunotherapy confirmed a clinical benefit in terms of OS and PFS. Two-year OS and PFS were respectively 69.4% and 54.4% in the durvalumab group and 47.9% and 24.2% in the no-durvalumab group (p = 0.015, p = 0.007). Conclusion In this real-world study, patients treated with CRT plus durvalumab showed clinical outcomes and toxicities similar to the PACIFIC results. Maintenance immunotherapy after CRT has been shown to be safe and has increased the survival of patients in clinical practice.
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Affiliation(s)
- Paolo Borghetti
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Giulia Volpi
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Giorgio Facheris
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Gianluca Cossali
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Eneida Mataj
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Salvatore La Mattina
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Navdeep Singh
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Jessica Imbrescia
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Marco Lorenzo Bonù
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Davide Tomasini
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Paola Vitali
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Diana Greco
- Radiation Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Michela Bezzi
- Division of Pneumology, University Hospital Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Flavia Melotti
- Institute of Pathology, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Mauro Benvenuti
- Thoracic Surgery, Department of Cardio-Thoracic Surgery, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Andrea Borghesi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
| | - Salvatore Grisanti
- Medical Oncology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili and University of Brescia, Brescia, Italy
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Rampinelli V, Ferrari M, Mattavelli D, Bonomo P, Lambertoni A, Turri-Zanoni M, D’Angelo E, Alterio D, Cianchetti M, Vischioni B, Rosati R, Tomasoni M, Alparone M, Taboni S, Tomasini D, Maddalo M, Bastia MBDM, Iacovelli NA, Dionisi F, Bignami M, Battaglia P, Bossi P, Deganello A, Piazza C, Schreiber A, Nicolai P, Castelnuovo P, Orlandi E. Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogram. Front Oncol 2023; 13:1157584. [PMID: 37260976 PMCID: PMC10228821 DOI: 10.3389/fonc.2023.1157584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/02/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction The study assessed outcomes and toxicities of different treatment modalities for local and/or regional recurrent nasopharyngeal carcinoma (NPC) in a non-endemic area. Methods Patients treated with curative intent for recurrent NPC with salvage surgery, photon-based radiotherapy, proton therapy (PT), with or without chemotherapy, at different Italian referral centers between 1998 and 2020 were included. Adverse events and complications were classified according to the Common Terminology Criteria for Adverse Events. Characteristics of the patients, tumors, treatments, and complications are presented along with uni- and multivariate analysis of prognostic factors. A survival predictive nomogram is also provided. Results A total of 140 patients treated from 1998 to 2020 were retrospectively assessed. Cases with lower age, comorbidity rate, stage, and shorter disease-free interval (DFI) preferentially underwent endoscopic surgery. More advanced cases underwent re-irradiation, fairly distributed between photon-based radiotherapy and PT. Age and DFI were independent factors influencing overall survival. No independent prognostic effect of treatment modality was observed. No significant difference in the morbidity profile of treatments was observed, with 40% of patients experiencing at least one adverse event classified as G3 or higher. Conclusion Recurrent NPC in a non-endemic area has dissimilar aspects compared to its endemic counterpart, suggesting the need for further studies that can guide the choice of the best treatment modality.
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Affiliation(s)
- Vittorio Rampinelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Marco Ferrari
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Pierluigi Bonomo
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Alessia Lambertoni
- Unit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Mario Turri-Zanoni
- Unit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Elisa D’Angelo
- Radiotherapy Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Daniela Alterio
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Marco Cianchetti
- Proton Therapy Unit, Azienda Provinciale Per i Servizi Sanitari, Trento, Italy
| | - Barbara Vischioni
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Roberta Rosati
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Marco Alparone
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Stefano Taboni
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, Brescia University, Brescia, Italy
| | - Marta Maddalo
- Department of Radiation Oncology, Brescia University, Brescia, Italy
| | | | | | - Francesco Dionisi
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maurizio Bignami
- Unit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Paolo Battaglia
- Unit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Paolo Bossi
- Medical Oncology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Alberto Deganello
- Otolaryngology Head and Neck Surgery, IRCCS National Cancer Institute (INT), Milan, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Alberto Schreiber
- Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Paolo Castelnuovo
- Unit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Ester Orlandi
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
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Romani C, Lorini L, Bozzola A, Bignotti E, Tomasoni M, Ardighieri L, Bugatti M, Battocchio S, Ravaggi A, Tomasini D, Ravanelli M, Gurizzan C, Lombardi D, Mattavelli D, Calza S, Piazza C, Bossi P. Functional profiles of curatively treated adenoid cystic carcinoma unveil prognostic features and potentially targetable pathways. Sci Rep 2023; 13:1809. [PMID: 36720951 PMCID: PMC9889376 DOI: 10.1038/s41598-023-28901-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/27/2023] [Indexed: 02/02/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) of salivary gland is a slowly growing tumor showing a propensity for delayed recurrence, with decreased survival rates. The identification of poor prognosis patients may help in defining molecular-based targeted strategies in this rare disease orphan of new treatments. Through a gene expression microarray-based approach followed by GSE functional analysis the expression profile of 46 primary untreated ACC samples and of ACC (h-TERT) tumor cells was analyzed. Patients who experienced early relapse showed enrichment in proliferation-related gene sets, including the G2-M checkpoint, E2F and myc targets, and in gene sets related to IFN signaling and aberrant proteostasis (FDR < 0.1), indicating increased mitotic and transcriptional activity in aggressive ACC. Similar functions were enriched in ACC samples classified by immunohistochemical staining as p63-negative, which exhibited increased protein burden and activation of pro-survival stress response pathways compared to p63-positive tumors. Compared to ACC tissues, ACC (h-TERT) cells share transcriptional features of aggressive p63-negative tumors. These data suggest association of specific pathway alterations with histopathological features of ACC, as recapitulated by p63 testing in patient prognostic stratification, anticipating new avenues for therapeutic intervention.
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Affiliation(s)
- Chiara Romani
- Angelo Nocivelli Institute of Molecular Medicine, University of Brescia and ASST Spedali Civili di Brescia, Brescia, Italy.,Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Luigi Lorini
- Medical Oncology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Anna Bozzola
- Department of Pathology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Eliana Bignotti
- Angelo Nocivelli Institute of Molecular Medicine, University of Brescia and ASST Spedali Civili di Brescia, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Laura Ardighieri
- Department of Pathology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Mattia Bugatti
- Department of Pathology, ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Antonella Ravaggi
- Angelo Nocivelli Institute of Molecular Medicine, University of Brescia and ASST Spedali Civili di Brescia, Brescia, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Marco Ravanelli
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Cristina Gurizzan
- Medical Oncology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Davide Lombardi
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Davide Mattavelli
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.,Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Stefano Calza
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Cesare Piazza
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.,Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Paolo Bossi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. .,Medical Oncology Unit, ASST Spedali Civili di Brescia, Brescia, Italy.
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5
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Bonù ML, Magli A, Tomasini D, Frassine F, Albano D, Arcangeli S, Bruni A, Ciccarelli S, De Angeli M, Francolini G, Franzese C, Ghirardelli P, Grazioli L, Guerini A, Lancia A, Marvaso G, Sepulcri M, Trodella LE, Morelli V, Georgopulos A, Domina AO, Granello L, Mataj E, Barbera F, Triggiani L. Stereotactic prostate radiotherapy with or without androgen deprivation therapy, study protocol for a phase III, multi-institutional randomized-controlled trial. BJR Open 2022; 4:20220032. [PMID: 38525170 PMCID: PMC10958993 DOI: 10.1259/bjro.20220032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/14/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022] Open
Abstract
Objective The therapeutic landscape for localized prostate cancer (PC) is evolving. Stereotactic radiotherapy (SRT) has been reported to be at least not inferior to standard radiotherapy, but the effect of androgen deprivation therapy (ADT) in this setting is still unknown and its use is left to clinical judgment. There is therefore the need to clarify the role of ADT in association with SRT, which is the aim of the present study. Methods We present a study protocol for a randomized, multi-institutional, Phase III clinical trial, designed to study SRT in unfavorable intermediate and a subclass of high-risk localized PC. Patients (pts) will be randomized 1:1 to SRT + ADT or SRT alone. SRT will consists in 36.25 Gy in 5 fractions, ADT will be a single administration of Triptorelin 22.5 mg concurrent to SRT. Primary end point will be biochemical disease-free survival. Secondary end points will be disease-free survival, freedom from local recurrence, freedom from regional recurrence, freedom from distant metastasis and overall survival (OS); quality of life QoL and patient reported outcomes will be an exploratory end point and will be scored with EPIC-26, EORTC PR 25, IPSS, IIEF questionnaires in SRT + ADT and SRT alone arms. Moreover, clinician reported acute and late toxicity, assessed with CTCAE v. 5.0 scales will be safety end points. Results Sample size is estimated of 310 pts. For acute toxicity and quality of life results are awaited after 6 months since last patient in, whereas, for efficacy end points and late toxicity mature results will be available 3-5 years after last patient in. Conclusion Evidence is insufficient to guide decision making concerning ADT administration in the new scenario of prostate ultra-hypofractionation. Hence, the need to investigate the ADT role in SRT specific setting. Advances in knowledge The stereotactic prostate radiotherapy with or without ADT trial (SPA Trial) has been designed to establish a new standard of care for SRT in localized unfavorable intermediate and a subclass of localized high risk PC.
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Affiliation(s)
- Marco Lorenzo Bonù
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Alessandro Magli
- Department of Radiation Oncology, AULSS 1 Belluno, Belluno, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Francesco Frassine
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Domenico Albano
- Department of Nuclear Medicine, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Stefano Arcangeli
- Department of Radiation Oncology, ASST Monza Ospedale San Gerardo, Monza, Italy
| | - Alessio Bruni
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Policlinico di Modena, Modena, Italy
| | | | - Martina De Angeli
- Department of Radiation Oncology, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Giulio Francolini
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Ciro Franzese
- Department of Radiation Oncology, Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Paolo Ghirardelli
- Department of Radiation Oncology, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | - Luigi Grazioli
- Department of Radiology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Andrea Guerini
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Andrea Lancia
- Department of Radiation Oncology, Fondazione IRCCS Policlinico, San Matteo, Italy
| | - Giulia Marvaso
- Department of Radiation Oncology, Istituto Europeo di Oncologia (IEO), Milano, Italy
| | - Matteo Sepulcri
- Department of Radiation Oncology, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy
| | - Luca Eolo Trodella
- Department of Radiation Oncology, Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Vittorio Morelli
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Andrea Georgopulos
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Anastasiya Oleksandrivna Domina
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Lorenzo Granello
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Eneida Mataj
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Fernando Barbera
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, Istituto del Radio O.Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
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Bonù ML, La Mattina S, Singh N, Toraci C, Spiazzi L, Terraneo F, Barbera F, Vitali P, Frassine F, Guerini A, Triggiani L, Tomasini D, Morelli V, Imbrescia J, Andreuccetti J, Frittoli B, Pittiani F, Grazioli L, Portolani N, Nicosia L, Albano D, Bertagna F, Magrini SM, Buglione M. Anal squamous cell carcinoma: Impact of radiochemotherapy evolution over years and an explorative analysis of MRI prediction of tumor response in a mono-institutional series of 131 patients. Front Oncol 2022; 12:973223. [PMID: 36353538 PMCID: PMC9639749 DOI: 10.3389/fonc.2022.973223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 09/27/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Radiochemotherapy (RCHT) for the treatment of anal squamous cell carcinoma (ASCC) has evolved dramatically, also thanks to intensity-modulated RT (IMRT) and 3D image guidance (3D IGRT). Despite most patients presenting fair outcomes, unmet needs still exist. Predictors of poor tumor response are lacking; acute toxicity remains challenging; and local relapse remains the main pattern of failure. Patients and methods Between 2010 and 2020, ASCC stages I–III treated with 3D conformal radiotherapy or IMRT and CDDP-5FU or Mytomicine-5FU CHT were identified. Image guidance accepted included 2D IGRT or 3D IGRT. The study endpoints included freedom from locoregional recurrence (FFLR), colostomy free survival (CFS), freedom from distant metastasis (FFDM), overall survival (OS), and acute and late toxicity as measured by common terminology criteria for adverse events (CTCAE) version 5.0. An exploratory analysis was performed to identify possible radiomic predictors of tumor response. Feature extraction and data analysis were performed in Python™, while other statistics were performed using SPSS® v.26.0 software (IBM®). Results A total of 131 patients were identified. After a median FU of 52 months, 83 patients (63.4%) were alive. A total of 35 patients (26.7%) experienced locoregional failure, while 31 patients (23.7%) relapsed with distant metastasis. Five year FFLR, CFS, DMFS and PS resulted 72.3%, 80.1%, 74.5% and 64.6%. In multivariate analysis, 2D IGRT was associated with poorer FFLR, OS, and CFS (HR 4.5, 4.1, and 5.6, respectively); 3DcRT was associated with poorer OS and CFS (HR 3.1 and 6.6, respectively). IMRT reduced severe acute gastro-intestinal (GI) and severe skin acute toxicity in comparison with 3DcRT. In the exploratory analysis, the risk of relapse depended on a combination of three parameters: Total Energy, Gray Level Size Zone Matrix’s Large Area High Gray Level Emphasis (GLSZM’s LAHGLE), and GTV volume. Conclusions Advances in radiotherapy have independently improved the prognosis of ASCC patients over years while decreasing acute GI and skin toxicity. IMRT and daily 3D image guidance may be considered standard of care in the management of ASCC. A combination of three pre-treatment MRI parameters such as low signal intensity (SI), high GLSZM’s LAHGLE, and GTV volume could be integrated in risk stratification to identify candidates for RT dose-escalation to be enrolled in clinical trials.
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Affiliation(s)
- Marco Lorenzo Bonù
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Salvatore La Mattina
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Navdeep Singh
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Cristian Toraci
- Department of Medical Physics, Spedali Civili Hospital, Brescia, Italy
| | - Luigi Spiazzi
- Department of Medical Physics, Spedali Civili Hospital, Brescia, Italy
| | - Fabrizia Terraneo
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Fernando Barbera
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Paola Vitali
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Francesco Frassine
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Andrea Guerini
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Vittorio Morelli
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Jessica Imbrescia
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | | | - Barbara Frittoli
- Department of Radiology, Spedali Civili Hospital, Brescia, Italy
| | - Frida Pittiani
- Department of Radiology, Spedali Civili Hospital, Brescia, Italy
| | - Luigi Grazioli
- Department of Radiology, Spedali Civili Hospital, Brescia, Italy
| | - Nazario Portolani
- Department of General Surgery, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Luca Nicosia
- Advanced Radiation Oncology Department, Cancer Care Centre, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Domenico Albano
- Department of Nuclear Medicine, ASST Spedali Civili di Brescia and Brescia University, Brescia, Italy
| | - Francesco Bertagna
- Department of Nuclear Medicine, ASST Spedali Civili di Brescia and Brescia University, Brescia, Italy
| | - Stefano Maria Magrini
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Michela Buglione
- Department of Radiation Oncology, Istituto del Radio O. Alberti, University of Brescia and Spedali Civili Hospital, Brescia, Italy
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7
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Codenotti S, Zizioli D, Mignani L, Rezzola S, Tabellini G, Parolini S, Giacomini A, Asperti M, Poli M, Mandracchia D, Vezzoli M, Bernardi S, Russo D, Mitola S, Monti E, Triggiani L, Tomasini D, Gastaldello S, Cassandri M, Rota R, Marampon F, Fanzani A. Hyperactive Akt1 Signaling Increases Tumor Progression and DNA Repair in Embryonal Rhabdomyosarcoma RD Line and Confers Susceptibility to Glycolysis and Mevalonate Pathway Inhibitors. Cells 2022; 11:cells11182859. [PMID: 36139434 PMCID: PMC9497225 DOI: 10.3390/cells11182859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/18/2022] Open
Abstract
In pediatric rhabdomyosarcoma (RMS), elevated Akt signaling is associated with increased malignancy. Here, we report that expression of a constitutively active, myristoylated form of Akt1 (myrAkt1) in human RMS RD cells led to hyperactivation of the mammalian target of rapamycin (mTOR)/70-kDa ribosomal protein S6 kinase (p70S6K) pathway, resulting in the loss of both MyoD and myogenic capacity, and an increase of Ki67 expression due to high cell mitosis. MyrAkt1 signaling increased migratory and invasive cell traits, as detected by wound healing, zymography, and xenograft zebrafish assays, and promoted repair of DNA damage after radiotherapy and doxorubicin treatments, as revealed by nuclear detection of phosphorylated H2A histone family member X (γH2AX) through activation of DNA-dependent protein kinase (DNA-PK). Treatment with synthetic inhibitors of phosphatidylinositol-3-kinase (PI3K) and Akt was sufficient to completely revert the aggressive cell phenotype, while the mTOR inhibitor rapamycin failed to block cell dissemination. Furthermore, we found that pronounced Akt1 signaling increased the susceptibility to cell apoptosis after treatments with 2-deoxy-D-glucose (2-DG) and lovastatin, enzymatic inhibitors of hexokinase, and 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGCR), especially in combination with radiotherapy and doxorubicin. In conclusion, these data suggest that restriction of glucose metabolism and the mevalonate pathway, in combination with standard therapy, may increase therapy success in RMS tumors characterized by a dysregulated Akt signaling.
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Affiliation(s)
- Silvia Codenotti
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Daniela Zizioli
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Luca Mignani
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Sara Rezzola
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Giovanna Tabellini
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Silvia Parolini
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Arianna Giacomini
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Michela Asperti
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Maura Poli
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Delia Mandracchia
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Marika Vezzoli
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Simona Bernardi
- Department of Clinical and Experimental Sciences, ASST Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Domenico Russo
- Department of Clinical and Experimental Sciences, ASST Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Stefania Mitola
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Eugenio Monti
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Luca Triggiani
- Radiation Oncology Department, ASST Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Davide Tomasini
- Radiation Oncology Department, ASST Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Stefano Gastaldello
- Department of Physiology and Pharmacology, Karolinska Institutet, 17177 Stockholm, Sweden
- Precision Medicine Research Center, School of Pharmacy, Binzhou Medical University, Laishan District, Guanhai Road 346, Yantai 264003, China
| | - Matteo Cassandri
- Department of Hematology and Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
- Department of Radiotherapy, Policlinico Umberto I, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Rossella Rota
- Department of Hematology and Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Francesco Marampon
- Department of Radiotherapy, Policlinico Umberto I, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Alessandro Fanzani
- Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
- Correspondence: ; Tel.: +39-030-3717567
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8
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Savarese T, Abate A, Basnet RM, Lorini L, Gurizzan C, Tomasoni M, Lombardi D, Tomasini D, Zizioli D, Memo M, Berruti A, Bonini SA, Sigala S, Bossi P. Cytotoxic effects of targeted agent alone or with chemotherapy in the treatment of adenoid cystic carcinoma: a preclinical study. Sci Rep 2022; 12:9951. [PMID: 35705678 PMCID: PMC9200834 DOI: 10.1038/s41598-022-14197-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/02/2022] [Indexed: 11/24/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare malignancy characterized by high incidence of relapse. When relapsing, ACC has an indolent but relentless behaviour, thus leading to a poor long-term prognosis. The treatment of choice of relapsing ACC remains surgery followed by radiotherapy, whenever feasible. Therapeutic weapons are limited to systemic drugs. The most widely used chemotherapy regimen is the combination of cisplatin and doxorubicin, however with low response rate and not long lasting; there is also a lack of alternatives for second line therapies in case of disease progression. Therefore, a more comprehensive strategy aimed at identifying at preclinical level the most promising drugs or combination is clearly needed. In this study, the cytotoxic effects of two standard chemotherapy drugs, cisplatin and doxorubicin, and of five targeted therapy-drugs was tested in vitro, on an h-TERT immortalized ACC cell line, and in vivo, on zebrafish embryos with ACC tumoral cell xenograft. Then, combinations of one standard chemotherapy drug plus one targeted therapy drug were also evaluated, in order to find the best treatment strategy for ACC. Data obtained demonstrated that both vorinostat and olaparib significantly increased the standard chemotherapy cytotoxic effects, suggesting new interesting therapeutic options for ACC.
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Affiliation(s)
- Teresa Savarese
- Section of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Andrea Abate
- Section of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Ram Manohar Basnet
- Section of Biotechnology, Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Luigi Lorini
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia and ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Cristina Gurizzan
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia and ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Davide Lombardi
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Davide Tomasini
- Radiation Oncology Unit, Department of Medical and Surgical Specialties, Radiological Science and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Daniela Zizioli
- Section of Biotechnology, Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Maurizio Memo
- Section of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Alfredo Berruti
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia and ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Sara A Bonini
- Section of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy.
| | - Sandra Sigala
- Section of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Paolo Bossi
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia and ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
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9
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Guerini AE, Tucci A, Alongi F, Mataj E, Belotti A, Borghetti P, Triggiani L, Pegurri L, Pedretti S, Bonù M, Tomasini D, Imbrescia J, Donofrio A, Facheris G, Singh N, Volpi G, Tomasi C, Magrini SM, Spiazzi L, Buglione M. RR Myelo POINT: A Retrospective Single-Center Study Assessing the Role of Radiotherapy in the Management of Multiple Myeloma and Possible Interactions with Concurrent Systemic Treatment. Cancers (Basel) 2022; 14:cancers14092273. [PMID: 35565401 PMCID: PMC9099690 DOI: 10.3390/cancers14092273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 02/04/2023] Open
Abstract
Background and purpose: Although chemotherapy, biological agents, and radiotherapy (RT) are cornerstones of the treatment of multiple myeloma (MM), the literature regarding the possible interactions of concurrent systemic treatment (CST) and RT is limited, and the optimal RT dose is still unclear. Materials and methods: We retrospectively analyzed the records of patients who underwent RT for MM at our institution from 1 January 2005 to 30 June 2020. The data of 312 patients and 577 lesions (treated in 411 accesses) were retrieved. Results: Most of the treated lesions involved the vertebrae (60%) or extremities (18.9%). Radiotherapy was completed in 96.6% of the accesses and, although biologically effective doses assuming an α/β ratio of 10 (BED 10) > 38 Gy and CST were significantly associated with higher rates of toxicity, the safety profile was excellent, with side effects grade ≥2 reported only for 4.1% of the accesses; CST and BED 10 had no impact on the toxicity at one and three months. Radiotherapy resulted in significant improvements in performance status and in a pain control rate of 87.4% at the end of treatment, which further increased to 96.9% at three months and remained at 94% at six months. The radiological response rate at six months (data available for 181 lesions) was 79%, with only 4.4% of lesions in progression. Progression was significantly more frequent in the lesions treated without CST or BED 10 < 15 Gy, while concurrent biological therapy resulted in significantly lower rates of progression. Conclusion: Radiotherapy resulted in optimal pain control rates and fair toxicity, regardless of BED 10 and CST; the treatments with higher BED 10 and CST (remarkably biological agents) improved the already excellent radiological disease control.
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Affiliation(s)
- Andrea Emanuele Guerini
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Alessandra Tucci
- Department of Haematology, ASST-Spedali Civili Hospital, 25123 Brescia, Italy; (A.T.); (A.B.)
| | - Filippo Alongi
- Advanced Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar Di Valpolicella, Italy;
| | - Eneida Mataj
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Angelo Belotti
- Department of Haematology, ASST-Spedali Civili Hospital, 25123 Brescia, Italy; (A.T.); (A.B.)
| | - Paolo Borghetti
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
- Correspondence: ; Tel.: +39-0303995272
| | - Luca Triggiani
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Ludovica Pegurri
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Sara Pedretti
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Marco Bonù
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Davide Tomasini
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Jessica Imbrescia
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Alessandra Donofrio
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Giorgio Facheris
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Navdeep Singh
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Giulia Volpi
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Cesare Tomasi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, 25123 Brescia, Italy;
| | - Stefano Maria Magrini
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
| | - Luigi Spiazzi
- Medical Physics Department, ASST Spedali Civili Hospital, 25123 Brescia, Italy;
| | - Michela Buglione
- Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (A.E.G.); (E.M.); (L.T.); (L.P.); (S.P.); (M.B.); (D.T.); (J.I.); (A.D.); (G.F.); (N.S.); (G.V.); (S.M.M.); (M.B.)
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10
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Lombardi D, Tomasoni M, Lorini L, Gurizzan C, Tomasini D, Ardighieri L, Battocchio S, Bozzola A, Mattavelli D, Paderno A, Zamparini M, Farina D, Ravanelli M, Maroldi R, Maddalo M, Magrini S, Berruti A, Deganello A, Nicolai P, Bossi P, Piazza C. Baseline prognostic factors affecting survival in recurrent and/or metastatic salivary gland adenoid cystic carcinoma. Oral Oncol 2022; 126:105764. [DOI: 10.1016/j.oraloncology.2022.105764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/29/2022]
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11
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Magli A, Bonù ML, Tonetto F, Moretti E, DE Giorgi G, Spiazzi L, Trovò M, Tomasini D, Magrini SM, Triggiani L. Stereotactic Radiotherapy and Androgen Deprivation Therapy for Localized Prostate Cancer: A Retrospective Mono-institutional Experience. In Vivo 2022; 36:306-313. [PMID: 34972727 PMCID: PMC8765161 DOI: 10.21873/invivo.12703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/05/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Stereotactic radiotherapy (SRT) is an effective treatment for localized prostate cancer. However, is it not clear whether the addition of androgen deprivation therapy (ADT) to SRT is beneficial. The aim of this study was to analyze the outcomes of a series of patients treated with SRT plus ADT for localized prostate cancer. PATIENTS AND METHODS Patients were treated with SRT with 42 Gy in 7 fractions with volumetric-modulated arc therapy plus Image Guided Radiotherapy (V-MAT IGRT) technique. ADT was administered to patients with intermediate unfavorable- and high-risk disease. Study endpoints were biochemical disease-free survival (bDFS), overall survival (OS), acute and late toxicity and patient-reported outcomes (PROs) using international prostate cancer symptoms scale (IPSS) and international index of erectile function (IIEF). RESULTS A total of 170 consecutive patients were identified, of which 49 (28.8%) with low-risk, 15 (8.8%) with favorable intermediate-risk 76 (44.7%) with unfavorable intermediate-risk and 30 (17.6%) with high-risk class. All patients of unfavorable intermediate- and high-risk groups were administered LHRH analogue concurrently to SRT and for at least 6 months. Patients with unfavorable intermediate- and high-risk presented a 5-year bDFS of 81.7% and 76.9%, respectively. CONCLUSION SRT consisting of 42 Gy in seven fractions with short-term ADT represents a safe and effective treatment for unfavorable intermediate and high risk prostate cancer. Our results support the need of high quality studies to test the efficacy of ADT combined with SRT for unfavorable intermediate- and high-risk localized prostate cancer.
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Affiliation(s)
- Alessandro Magli
- Department of Radiation Oncology, University Hospital of Udine, Udine, Italy
| | - Marco Lorenzo Bonù
- Istituto del Radio O. Alberti, Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, Italy;
| | - Fabrizio Tonetto
- Department of Radiation Oncology, University Hospital of Udine, Udine, Italy
| | - Eugenia Moretti
- Department of Medical Physics, University Hospital of Udine, Udine, Italy
| | | | - Luigi Spiazzi
- Department of Medical Physics, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Marco Trovò
- Department of Radiation Oncology, University Hospital of Udine, Udine, Italy
| | - Davide Tomasini
- Istituto del Radio O. Alberti, Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Stefano Maria Magrini
- Istituto del Radio O. Alberti, Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Luca Triggiani
- Istituto del Radio O. Alberti, Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, Italy
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12
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Buglione M, Alterio D, Maddalo M, Greco D, Gerardi MA, Tomasini D, Pegurri L, Augugliaro M, Marvaso G, Turturici I, Guerini A, Ansarin M, Spiazzi L, Costa L, Cossu Rocca M, Magrini SM, Jereczek-Fossa BA. Three weekly versus weekly concurrent cisplatin: safety propensity score analysis on 166 head and neck cancer patients. Radiat Oncol 2021; 16:239. [PMID: 34930353 PMCID: PMC8686550 DOI: 10.1186/s13014-021-01966-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background Radio-chemotherapy with CDDP is the standard for H&N squamous cell cancer. CDDP 100 mg/m2/q3 is the standard; alternative schedules are used to reduce toxicity, mostly 40 mg/m2/q1.
Methods Patients were treated from 1/2010 to 1/2017 in two Radiation Oncology Centres. Propensity score analysis (PS) was retrospectively used to compare these two schedules. Results Patients analyzed were 166. Most (114/166) had 1w-CDDP while 52 had 3w-CDDP. In the 3w-CDDP group, patients were younger, with better performance status, smaller disease extent and a more common nodal involvement than in the 1w-CDDP. Acute toxicity was similar in the groups. Treatment compliance was lower in the w-CCDP. Overall survival before PS was better for female, for oropharyngeal disease and for 3w-CDDP group. After PS, survival was not related to the CDDP schedule. Conclusions 3w-CDDP remains the standard for fit patients, weekly schedule could be safely used in selected patients.
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Affiliation(s)
- Michela Buglione
- Radiation Oncology Department, University and ASST Spedali Civili, Brescia, Italy
| | - Daniela Alterio
- Division of Radiotherapy, Radiation Oncology Department, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Marta Maddalo
- Radiation Oncology Department, University and ASST Spedali Civili, Brescia, Italy
| | - Diana Greco
- Radiation Oncology Department, University and ASST Spedali Civili, Brescia, Italy
| | - Marianna Alessandra Gerardi
- Division of Radiotherapy, Radiation Oncology Department, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy.
| | - Davide Tomasini
- Radiation Oncology Department, University and ASST Spedali Civili, Brescia, Italy
| | - Ludovica Pegurri
- Radiation Oncology Department, University and ASST Spedali Civili, Brescia, Italy
| | - Matteo Augugliaro
- Division of Radiotherapy, Radiation Oncology Department, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Giulia Marvaso
- Division of Radiotherapy, Radiation Oncology Department, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Irene Turturici
- Division of Radiotherapy, Radiation Oncology Department, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Andrea Guerini
- Radiation Oncology Department, University and ASST Spedali Civili, Brescia, Italy
| | - Mohssen Ansarin
- Division of Head and Neck Surgery, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Luigi Spiazzi
- Medical Physics, ASST Spedali Civili, Brescia, Italy
| | - Loredana Costa
- Radiation Oncology Department, University and ASST Spedali Civili, Brescia, Italy
| | - Maria Cossu Rocca
- Division of Medical Oncology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | | | - Barbara Alicja Jereczek-Fossa
- Division of Radiotherapy, Radiation Oncology Department, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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13
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Bonù M, Magli A, Tonetto F, Moretti E, De Giorgi G, Spiazzi L, Trovò M, Tomasini D, Magrini S, Triggiani L. PO-1350 SBRT for localized prostate cancer: there is still a role for androgen deprivation therapy? Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07801-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Tomasini D, Triggiani L, Pedretti S, Bonù M, Costa L, Pegurri L, Romano L, Singh N, Lamattina S, Pastorello E, Facheris G, Turla O, Borghetti P, Buglione Di Monale E Bastia M, Magrini S. PO-1037 Hypofractionated Radiation Therapy For Non-Elderly Patients With Glioblastoma. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07488-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Borghetti P, Imbrescia J, Volpi G, Costantino G, Cossali G, Greco D, Pastorello E, La Mattina S, Bonù ML, Tomasini D, Buglione M. Prevention and management of acute esophageal toxicity during concomitant chemoradiotherapy for locally advanced lung cancer. Tumori 2021; 108:470-476. [PMID: 34165018 DOI: 10.1177/03008916211025609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC) is concomitant chemoradiotherapy. The survival benefit of combined treatment is partially counterbalanced by an increased rate of acute esophageal toxicity. Several pharmaceutical products are available for prevention and management of esophagitis, including Faringel Plus. AIM To assess the incidence and the grade, identify the correlations with clinical, dosimetric, and therapeutic variables, and analyse the role of Faringel Plus as a pharmaceutical preventive measure against acute esophageal toxicity. METHODS Patients with LA-NSCLC treated with concomitant radiochemotherapy were retrospectively reviewed. Acute esophagitis and dysphagia were graded according to Common Terminology Criteria for Adverse Events version 5.0. Clinical, dosimetric, and therapeutic correlations were investigated using χ2 test. RESULTS Among the 23 analysed patients, 18 (78.3%) and 1 (4.3%) developed G2 and G3 esophagitis, respectively; G1-2 dysphagia were reported in 11 cases (47.8%). No statistically significant correlation between the variables considered and acute esophageal toxicity was identified. In the group of patients who received Faringel Plus as preventive treatment (10 subjects, 43.5%), dysphagia presentation time was significantly longer (p = 0.038); esophagitis onset time was longer and symptoms duration was shorter. Faringel Plus allowed a reduction in the use of analgesic drugs. CONCLUSIONS Acute mild esophageal toxicity was confirmed to be a common side effect in this setting. No clinical-dosimetric parameter has been demonstrated to be effective in predicting acute esophageal toxicity. The use of Faringel Plus appears effective as a therapeutic and prophylactic tool to manage acute esophageal toxicity.
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Affiliation(s)
- Paolo Borghetti
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Jessica Imbrescia
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Giulia Volpi
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Gianluca Costantino
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Gianluca Cossali
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Diana Greco
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Edoardo Pastorello
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Salvatore La Mattina
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Marco Lorenzo Bonù
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Davide Tomasini
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Michela Buglione
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
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16
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Triggiani L, Mazzola R, Tomasini D, Bruni A, Alicino G, Matrone F, Bortolus R, Francolini G, Detti B, Magli A, Bonù ML, Ingrosso G, Lancia A, Trippa F, Maranzano E, Franzese C, Ghirardelli P, Vavassori V, Scorsetti M, Alongi F, Magrini SM. Upfront metastasis-directed therapy in oligorecurrent prostate cancer does not decrease the time from initiation of androgen deprivation therapy to castration resistance. Med Oncol 2021; 38:72. [PMID: 34008151 PMCID: PMC8131275 DOI: 10.1007/s12032-021-01518-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/29/2021] [Indexed: 01/16/2023]
Abstract
The aim of the present study was to explore the potential impact of upfront metastases-directed therapy (MDT) in terms of prolongation of castration-sensitive phase in a series of oligorecurrent castration-sensitive prostate cancer (PC) patients. The present article is a multicenter retrospective study. The population of interest was castrate-sensitive oligorecurrent PC, defined as the presence of 1–3 uptakes in non-visceral sites such as bones or nodes detected by means of 18F-Choline PET/CT or 68-Gallium PSMA PET/CT. Primary endpoint was the time to castration resistance. Secondary endpoints were ADT-free survival, local progression-free survival, and overall survival. Eighty-two patients and 118 lesions were analyzed. The median time to castration resistance for the entire population of the study was 49 months (95% CI 43.6–54.4 months). The 1- and 2-year TTCR-free survival rates were 94% and 82%, respectively. At the time of analysis, 52 patients were still in the castration-sensitive phase of the disease. In this cohort of patients, the median ADT-free survival was 20 months (range 3–69 months). On the other hand, during follow-up 30 patients switched to the castration-resistant phase of disease. In this last group of patients, the median ADT-free survival was 20 months (range 4–50 months). After the ADT administration, the median castration-sensitive phase was 29 months (range 5–71 months). Castration resistance generally occurs at a median follow-up of 24–36 months following ADT. In the current study, upfront MDT does not decrease the time from initiation of ADT to castration resistance.
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Affiliation(s)
- Luca Triggiani
- Department of Radiation Oncology, University and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Rosario Mazzola
- Department of Advanced Radiation Oncology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, University and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
| | - Alessio Bruni
- Department of Oncology and Hematology, Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - Giulia Alicino
- Department of Oncology and Hematology, Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - Fabio Matrone
- Department of Radiation Oncology, Centro Di Riferimento, Oncologico Di Aviano CRO-IRCCS, Aviano, Italy
| | - Roberto Bortolus
- Department of Radiation Oncology, Centro Di Riferimento, Oncologico Di Aviano CRO-IRCCS, Aviano, Italy
| | - Giulio Francolini
- Department of Radiation Oncology, University of Florence, A.O.U Careggi, Florence, Italy
| | - Beatrice Detti
- Department of Radiation Oncology, University of Florence, A.O.U Careggi, Florence, Italy
| | - Alessandro Magli
- Department of Radiation Oncology, University Hospital of Udine, ASUIUD, Udine, Italy
| | - Marco Lorenzo Bonù
- Department of Radiation Oncology, University and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Gianluca Ingrosso
- Radioterapia Oncologica, Dipartimento di Scienze Chirurgiche E Biomediche, Università degli Studi di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Andrea Lancia
- Radiation Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Fabio Trippa
- Department of Radiation Oncology, 'S. Maria' Hospital, Terni, Italy
| | | | - Ciro Franzese
- IRCCS, Radiotherapy and Radiosurgery Department, Humanitas University Hospital, Milan-Rozzano, Italy
| | | | | | - Marta Scorsetti
- IRCCS, Radiotherapy and Radiosurgery Department, Humanitas University Hospital, Milan-Rozzano, Italy
| | - Filippo Alongi
- Department of Advanced Radiation Oncology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy
| | - Stefano Maria Magrini
- Department of Radiation Oncology, University and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123, Brescia, Italy
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17
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Lancellotta V, Cellini F, Fionda B, De Sanctis V, Vidali C, Fusco V, Frassine F, Tomasini D, Vavassori A, Gambacorta MA, Franco P, Genovesi D, Corvò R, Tagliaferri L. The role of interventional radiotherapy (brachytherapy) in stage I esophageal cancer: an AIRO (Italian Association of Radiotherapy and Clinical Oncology) systematic review. Eur Rev Med Pharmacol Sci 2021; 24:7589-7597. [PMID: 32744685 DOI: 10.26355/eurrev_202007_22257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This review aimed at examining efficacy of interventional radiotherapy (brachytherapy-IRT) alone or combined with external beam radiotherapy (EBRT) in stage I esophageal cancer as exclusive treatment. MATERIALS AND METHODS A systematic research using PubMed, Scopus, and Cochrane library was performed. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. We analyzed only clinical study as full-text publication, reporting on patients with stage I esophageal cancer treated with IRT alone or in combination with other treatments (e.g., EBRT). Conference paper, survey, letter, editorial, book chapter, and review were excluded. Patients who underwent previous surgery were excluded. Time restriction (1990-2018) was applied for years of the publication. RESULTS Twelve studies have been selected. The number of evaluated patients was 514; the median age was 69 years. In the IRT group, the median: local control (LC) was 77% (range 63%-100%), disease-free survival (DFS) was 68.4% (range 49%-86.3%), the overall survival (OS) was 60% (range 31%-84%), the cancer specific survival (CSS) was 80% (range 55-100%), and grade 3-4 toxicity range was 0%-26%. CONCLUSIONS IRT alone or combined to EBRT is an effective and safe treatment option for patients with stage I esophageal cancer. Definitive radiation therapy could be an alternative to surgery in patients with superficial cancer.
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Affiliation(s)
- V Lancellotta
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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18
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Alghisi A, Borghetti P, Maddalo M, Roccaro AM, Tucci A, Mazzola R, Magrini SM, Lo Casto A, Bonù ML, Tomasini D, Pasinetti N, Peretto G, Bertagna F, Tomasi C, Buglione M, Triggiani L. Radiotherapy for the treatment of solitary plasmacytoma: 7-year outcomes by a mono-institutional experience. J Cancer Res Clin Oncol 2020; 147:1773-1779. [PMID: 33201300 DOI: 10.1007/s00432-020-03452-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/04/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Solitary plasmacytoma (SP) is characterized by a single mass of clonal plasma cells. Definitive RT can result in long-term local control of the SP. Due to the small number of patients and narrow range of doses, phase III randomized trials are lacking. The aim of this study is to further support the potential use of RT for the treatment of SP. METHODS Clinical data of all patients treated for SP at our Institution between 1992 and 2018 were reviewed. A total of 42 consecutive patients were analyzed. RESULTS The median follow-up was 84.8 months. Radiation dose did not differ significantly as a function of sex, type of SP (solitary bone plasmacytoma or as extramedullary plasmacytoma), tumor size; conversely differs significantly as a function of age (p = 0.04). The 5y-OS and 10y-OS were, respectively, 96 and 91%. Local recurrences developed in 21.4% of patients (9/42). 16 patients progressed to MM (38.1%). The 5y-progression to MM free survival (PMFS) and the 10y-PMFS were, respectively, 68.6 and 61.9%. CONCLUSIONS Our data confirm that good results are achievable with RT to treat SP, but they don't allow defining a dose-effect correlation; therefore, it remains uncertain which is the most effective dose and whether lower doses can guarantee adequate disease control.
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Affiliation(s)
- Alessandro Alghisi
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy.
| | - Paolo Borghetti
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Marta Maddalo
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Aldo Maria Roccaro
- Clinical Research Development and Phase I Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | | | - Rosario Mazzola
- Radiation Oncology Department, IRCCS, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy
| | - Stefano Maria Magrini
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Antonio Lo Casto
- Radiation Oncology School, University of Palermo, Palermo, Italy
| | - Marco Lorenzo Bonù
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Nadia Pasinetti
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Gloria Peretto
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | | | - Cesare Tomasi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Brescia, Italy
| | - Michela Buglione
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, Brescia University, Piazza Spedali Civili,1, 25100, Brescia, Italy
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Giaj Levra N, Figlia V, Mazzola R, Nicosia L, Ricchetti F, Rigo M, Tomasini D, Cuccia F, Agostinelli L, Ruggieri R, Alongi F. PO-1841: Efficacy of a new dedicated immobilization device for treatment of Central Nervous disease. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01859-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Nicosia L, Cuccia F, Rigo M, Figlia V, Giaj-Levra N, Mazzola R, Ricchetti F, Tomasini D, Alongi F. PO-1027: Disease natural history of lung oligometastatic colo-rectal cancer patients treated with SBRT. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01044-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Alghisi A, Borghetti P, Maddalo M, Roccaro A, Tucci A, Magrini S, Casto AL, Bonù M, Tomasini D, Baiguini A, Peretto G, Buglione M, Triggiani L. PO-0917: Radiotherapy-based approach for the treatment of solitary plasmacytoma. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00934-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Magrini SM, Katz MS, Tomasini D, Sasso G, Triggiani L, Buglione di Monale E Bastia M, Spiazzi L. Letter to the editor regarding "Lack of supporting data make the risks of a clinical trial of radiation therapy as a treatment for COVID-19 pneumonia unacceptable". Radiother Oncol 2020; 150:172-173. [PMID: 32621829 PMCID: PMC7327454 DOI: 10.1016/j.radonc.2020.06.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/20/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Stefano Maria Magrini
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Italy
| | - Matthew S Katz
- Department of Radiation Medicine, Lowell General Hospital, Lowell, USA
| | - Davide Tomasini
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Italy.
| | - Giuseppe Sasso
- Radiation Oncology Department, Auckland City Hospital, New Zealand; Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Luca Triggiani
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Italy
| | | | - Luigi Spiazzi
- Medical Physics Department, Spedali Civili Hospital, Brescia, Italy
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Ong CL, Giaj-Levra N, Nicosia L, Figlia V, Tomasini D, Franken EM, Alongi F. Intra-fraction and Inter-fraction analysis of a dedicated immobilization device for intracranial radiation treatment. Radiat Oncol 2020; 15:200. [PMID: 32811519 PMCID: PMC7437162 DOI: 10.1186/s13014-020-01639-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 08/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Immobilization devices are crucial to minimize patient positioning uncertainties in radiotherapy (RT) treatments. Accurate inter and intra-fraction motions is particularly important for intracranial and stereotactic radiation treatment which require high precision in dose delivery. Recently, a new immobilization device has been developed specifically for the radiation treatment of intracranial malignancies. To date, no data are available on the use of this device in daily clinical practice. The aim of this study is to investigate the intra and inter-fraction variations, patient comfort and radiographer confidence of the immobilization system from two distinct institutions: HagaZiekenhuis, Den Haag, Netherlands and IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy. Material and method Sixteen patients (10 diagnosed with brain metastases and 6 with primary central nervous systemic tumor) from IRCCS Ospedale Sacro Cuore Don Calabria and 17 patients (all diagnosed with brain metastases tumor) from HagaZiekenhuis were included in this study. The median target volume was 436 cc (range 3.2–1628 cc) and 4.58 cc (range 0.4–27.19 cc) for IRCCS and Haga, respectively. For patients treated in IRCCS Sacro Cuore Don Calabria, the median dose prescription was 30 Gy (range 27–60 Gy) and median number of fractions 10 (range 3–30). In Haga the median dose prescription was 21 Gy (range 8–21 Gy) and the median number of fraction was 1 (range 1–3). The immobilization device was assembled during CT simulation. A short interview to the patient regarding the device’s comfort level was conducted at the end of the simulation procedure. Additionally, simulation setup time and radiographer (RTT) procedures (i.e. mask preparation) were evaluated. Prior to radiation treatment delivery, an automatic rigid match on the cranial bones between cone beam computed tomography (CBCT) and planning-CT was performed. A couch shift was performed subsequently. An extra post-treatment CBCT was acquire after the treatment delivery. This post-treatment CBCT was matched with pre-treatment CBCT to identify any possible intra-fraction motion. All online matches were validated by experienced radiation oncologist or RTT. A total of 126 CBCT’s were analyzed offline by radiation oncologist/medical physicist. The data of the pre-treatment CBCT match was used to quantify inter-fraction motion. The post-treatment CBCT was matched with pre-treatment CBCT to identify any possible intra-fraction motion. Results During the molding of the mask, all patients responded positive to the comfort. Median time required by the RTTs to assemble the immobilization system was 9 min (range 6–12 min). In terms of comfort, all patients reported a good-to high level of satisfaction. The RTTs also respond positively towards the use of the locking mechanism and clips. Results of positioning uncertainties were comparable between the two institutes. The mean inter-fraction motion for all translational and rotational directions were < 2 mm (SD < 4 mm) and < 0.5°(SD < 1.5°), respectively, while the mean intra-fraction motions were < 0.4 mm (SD < 0.6 mm) and 0.3° (SD < 0.5°). Conclusions This study demonstrates the efficacy and feasibility of the immobilization device in the intracranial radiation treatment. Both patient comfort and preparation time by RTTs are considered adequate. In combination with online daily imaging procedure, this device can achieve submillimeter accuracy required for intracranial and stereotactic treatments.
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Affiliation(s)
- Chin Loon Ong
- Department of Radiotherapy, HagaZiekenhuis, Den Haag, The Netherlands
| | - Niccolò Giaj-Levra
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A.Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy.
| | - Luca Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A.Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Vanessa Figlia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A.Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Davide Tomasini
- Radiation Oncology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Eric M Franken
- Department of Radiotherapy, HagaZiekenhuis, Den Haag, The Netherlands
| | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A.Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy.,University of Brescia, Brescia, Italy
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24
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Bertagna F, Albano D, Cerudelli E, Gazzilli M, Tomasini D, Bonù M, Giubbini R, Treglia G. Radiolabelled PSMA PET/CT in breast cancer. A systematic review. Nucl Med Rev Cent East Eur 2020; 23:32-35. [PMID: 32779172 DOI: 10.5603/nmr.2020.0004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 01/08/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Radiolabelled prostate-specific membrane antigen (PSMA)-based PET/CT is a whole-body imaging technique currently performed for the detection of prostate cancer lesions. PSMA has been also demonstrated to be expressed by the neovasculature of many other solid tumours. The aim of this review is to evaluate the possible diagnostic role of radiolabelled PSMA PET/CT in breast cancer. MATERIAL AND METHODS A comprehensive literature search of the PubMed/MEDLINE, Scopus, Embase and Cochrane Library databases was conducted to find relevant published articles about the diagnostic performance of radiolabelled PSMA PET/CT in breast cancer. RESULTS The comprehensive computer literature search revealed 652 articles. On reviewing the titles and abstracts, 640 articles were excluded because the reported data were not within the field of interest of this review. Twelve articles were selected and retrieved in full-text version; no additional study was found when screening the references of these articles. In total, 12 articles were included in the systematic review. CONCLUSIONS Further studies enrolling a wider population are needed to clarify the.
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Affiliation(s)
- Francesco Bertagna
- University of Brescia and ASST Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia, Italy.
| | - Domenico Albano
- University of Brescia and ASST Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia, Italy
| | - Elisabetta Cerudelli
- University of Brescia and ASST Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia, Italy
| | - Maria Gazzilli
- University of Brescia and ASST Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, University of Brescia and ASST Spedali Civili di Brescia, Brescia, Italy
| | - Marco Bonù
- Department of Radiation Oncology, University of Brescia and ASST Spedali Civili di Brescia, Brescia, Italy
| | - Raffaele Giubbini
- University of Brescia and ASST Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia, Italy
| | - Giorgio Treglia
- Department of Nuclear Medicine and PET/CT Center, Imaging Institute of Southern Switzerland, Bellinzona and Lugano, Switzerland
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25
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Buglione M, Spiazzi L, Guerini AE, Barbera F, Pasinetti N, Pegurri L, Triggiani L, Tomasini D, Greco D, Costantino G, Bragaglio A, Bonometti N, Liccioli M, Mascaro L, Alongi F, Magrini SM. Two months of radiation oncology in the heart of Italian "red zone" during COVID-19 pandemic: paving a safe path over thin ice. Radiat Oncol 2020; 15:191. [PMID: 32778174 PMCID: PMC7416803 DOI: 10.1186/s13014-020-01631-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/04/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) pandemic had an overwhelming impact on healthcare worldwide. Outstandingly, the aftermath on neoplastic patients is still largely unknown, and only isolated cases of COVID-19 during radiotherapy have been published. We will report the two-months experience of our Department, set in Lombardy "red-zone". METHODS Data of 402 cancer patients undergoing active treatment from February 24 to April 24, 2020 were retrospectively reviewed; several indicators of the Department functioning were also analyzed. RESULTS Dedicated measures allowed an overall limited reduction of the workload. Decrease of radiotherapy treatment number reached 17%, while the number of administration of systemic treatment and follow up evaluations kept constant. Conversely, new treatment planning faced substantial decline. Considering the patients, infection rate was 3.23% (13/402) and mortality 1.24% (5/402). Median age of COVID-19 patients was 69.7 years, the large majority were male and smokers (84.6%); lung cancer was the most common tumor type (61.5%), 84.6% of subjects were stage III-IV and 92.3% had comorbidities. Remarkably, 92.3% of the cases were detected before March 24. Globally, only 2.5% of ongoing treatments were suspended due to suspect or confirmed COVID-19 and 46.2% of positive patients carried on radiotherapy without interruption. Considering only the last month, infection rate among patients undergoing treatment precipitated to 0.43% (1/232) and no new contagions were reported within our staff. CONCLUSIONS Although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during SARS-Cov-2 pandemic by endorsing consistent preventive measures.
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Affiliation(s)
- Michela Buglione
- Department of Radiation Oncology, Brescia University, Università degli Studi di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Luigi Spiazzi
- ASST Spedali Civili di Brescia, Department of Radiation Oncology, ASST Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Andrea Emanuele Guerini
- Department of Radiation Oncology, Brescia University, Università degli Studi di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Fernando Barbera
- ASST Spedali Civili di Brescia, Department of Radiation Oncology, ASST Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Nadia Pasinetti
- Department of Radiation Oncology, Brescia University, Università degli Studi di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Ludovica Pegurri
- ASST Spedali Civili di Brescia, Department of Radiation Oncology, ASST Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, Brescia University, Università degli Studi di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, Brescia University, Università degli Studi di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Diana Greco
- ASST Spedali Civili di Brescia, Department of Radiation Oncology, ASST Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Gianluca Costantino
- Department of Radiation Oncology, Brescia University, Università degli Studi di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Alessandra Bragaglio
- ASST Spedali Civili di Brescia, Department of Radiation Oncology, ASST Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Nadia Bonometti
- ASST Spedali Civili di Brescia, Department of Radiation Oncology, ASST Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Mara Liccioli
- ASST Spedali Civili di Brescia, Department of Radiation Oncology, ASST Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Lorella Mascaro
- ASST Spedali Civili di Brescia, Department of Radiation Oncology, ASST Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Filippo Alongi
- Department of Radiation Oncology, Brescia University, Università degli Studi di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Stefano Maria Magrini
- Department of Radiation Oncology, Brescia University, Università degli Studi di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
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Albano D, Bosio G, Tomasini D, Bonù M, Giubbini R, Bertagna F. Metabolic behavior and prognostic role of pretreatment 18F-FDG PET/CT in gist. Asia Pac J Clin Oncol 2020; 16:e207-e215. [PMID: 32762133 DOI: 10.1111/ajco.13366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/20/2020] [Indexed: 02/06/2023]
Abstract
AIM The metabolic behavior and the prognostic value of 18 F-FDG-PET/CT in gastrointestinal stromal tumor (GIST) is not well investigated. The aim of this study was to analyze the metabolic behavior of GIST and the prognostic role of pretreatment PET/CT features. METHODS In this retrospective study, we included 35 patients with a diagnosis of GIST who underwent a pretreatment 18 F-FDG-PET/CT scan. We analyzed PET images visually and semiquantitatively by measuring several metabolic parameters as the maximum standardized uptake value corrected for body weight (SUVbw), for lean body mass (SUVlbm), for body surface area (SUVbsa), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The Kaplan-Meier method was used to measure the progression free survival (PFS) and overall survival curves. RESULTS Twenty-nine (82%) patients showed a positive 18 F-FDG-PET/CT, whereas the remaining 6 had no hypermetabolic lesions. 18 F-FDG-avidity was significantly related with mitotic index, tumor stage and tumor risk group. Instead, semiquantitative PET/CT parameters correlated only with tumor risk group. Disease progression occurred in 16 patients whereas death in seven. 18 F-FDG-avidity, MTV and TLG were the only variables significantly associated with PFS. CONCLUSION An 82% rate of PET avidity in GIST was found and it was correlated with stage, tumor risk group and mitotic index. Only baseline 18 F-FDG-avidity, MTV and TLG were independently correlated with PFS.
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Affiliation(s)
- Domenico Albano
- Nuclear Medicine Department, University of Brescia and Spedali Civili of Brescia, Brescia, Italy
| | - Giovanni Bosio
- Nuclear Medicine Department, University of Brescia and Spedali Civili of Brescia, Brescia, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, University of Brescia and Spedali Civili of Brescia, Brescia, Italy
| | - Marco Bonù
- Department of Radiation Oncology, University of Brescia and Spedali Civili of Brescia, Brescia, Italy
| | - Raffaele Giubbini
- Nuclear Medicine Department, University of Brescia and Spedali Civili of Brescia, Brescia, Italy
| | - Francesco Bertagna
- Nuclear Medicine Department, University of Brescia and Spedali Civili of Brescia, Brescia, Italy
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Albano D, Tomasini D, Bonù M, Giubbini R, Bertagna F. 18F-FDG PET or PET/CT role in plasmacytoma: A systemicatic review. Rev Esp Med Nucl Imagen Mol 2020. [DOI: 10.1016/j.remnie.2019.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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28
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Albano D, Tomasini D, Bonù M, Giubbini R, Bertagna F. 18F-FDG PET or PET/CT role in plasmacytoma: A systematic review. Rev Esp Med Nucl Imagen Mol 2020; 39:220-224. [PMID: 32522411 DOI: 10.1016/j.remn.2019.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/04/2019] [Accepted: 12/12/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND The metabolic behavior of plasmacytoma at 18F-FDG PET/CT is not yet clear. OBJECTIVE The aim of this systematic review was to analyze published data about the role of 18F-FDG PET or PET/CT in patients affected by plasmacytoma. METHODS Acomprehensive computer literature search of the Scopus, PubMed/MEDLINE, Embase and Cochrane Library databases was conducted including articles up to July 2019 to find relevant published papers about the performance of 18F-FDG PET and PET/CT in plasmacytoma. RESULTS The comprehensive computer literature search revealed 371 articles. On reviewing the titles and abstracts, 363 articles were excluded because the reported data were not within the field of interest of this review. Eight articles were selected and retrieved in full-text version. From the analyses of the selected studies, the following main findings have been founded: 1) plasmacytoma generally is a 18F-FDG-avid tumor and PET/CT had good diagnostic performance with high sensitivity; 2) 18F-FDG PET/CT influenced patient management in most cases avoiding useless therapies and choosing the best therapeutic approach; 3) prognostic value of PET/CT qualitative and semiquantitative parameters is only suggested with controversial reports. CONCLUSION Despite several limitations affect this analysis, especially related to the low number of articles and patients studied, plasmacytoma looks to be an 18F-FDG-avid tumor in most of the cases; 18F-FDG PET or PET/CT had good diagnostic performance and had a significant clinical impact in change of therapeutic approach. Moreover, a possible prognostic role of PET/CT features is described.
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Affiliation(s)
- D Albano
- Nuclear Medicine, University of Brescia and Spedali Civili, Brescia, Italia.
| | - D Tomasini
- Department of Radiation Oncology, University of Brescia and Spedali Civili, Brescia, Italia
| | - M Bonù
- Department of Radiation Oncology, University of Brescia and Spedali Civili, Brescia, Italia
| | - R Giubbini
- Nuclear Medicine, University of Brescia and Spedali Civili, Brescia, Italia
| | - F Bertagna
- Nuclear Medicine, University of Brescia and Spedali Civili, Brescia, Italia
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29
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Guerini AE, Borghetti P, Filippi AR, Bonù ML, Tomasini D, Greco D, Imbrescia J, Volpi G, Triggiani L, Borghesi A, Maroldi R, Pasinetti N, Buglione M, Magrini SM. Differential Diagnosis and Clinical Management of a Case of COVID-19 in a Patient With Stage III Lung Cancer Treated With Radio-chemotherapy and Durvalumab. Clin Lung Cancer 2020; 21:e547-e550. [PMID: 32527714 PMCID: PMC7265852 DOI: 10.1016/j.cllc.2020.05.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/17/2020] [Accepted: 05/26/2020] [Indexed: 12/19/2022]
Affiliation(s)
| | - Paolo Borghetti
- Radiation Oncology Department, ASST Spedali Civili of Brescia, Brescia, Italy
| | | | - Marco Lorenzo Bonù
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy
| | - Davide Tomasini
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy.
| | - Diana Greco
- Radiation Oncology Department, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Jessica Imbrescia
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy
| | - Giulia Volpi
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy
| | - Luca Triggiani
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy
| | - Andrea Borghesi
- Department of Radiology, University and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Roberto Maroldi
- Department of Radiology, University and ASST Spedali Civili of Brescia, Brescia, Italy
| | | | - Michela Buglione
- Radiation Oncology Department, Università degli Studi di Brescia, Brescia, Italy
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30
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Nicosia L, Cuccia F, Mazzola R, Ricchetti F, Figlia V, Giaj-Levra N, Rigo M, Tomasini D, Pasinetti N, Corradini S, Ruggieri R, Alongi F. Disease course of lung oligometastatic colorectal cancer treated with stereotactic body radiotherapy. Strahlenther Onkol 2020; 196:813-820. [PMID: 32399637 DOI: 10.1007/s00066-020-01627-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/25/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Stereotactic body radiotherapy (SBRT) or stereotactic ablative radiotherapy (SABR) has been shown to increase survival rates in oligometastatic disease (OMD), but local control of colorectal metastases remains poor. We aimed to explore the natural course of oligometastatic colorectal cancer and to investigate how SBRT of lung metastases can delay the progression to polymetastatic disease (PMD). METHODS 107 lung oligometastases in 38 patients were treated with SBRT at a single institution. The median number of treated lesions was 2 (range 1-5). Time to PMD (ttPMD) was defined as the time from SBRT to the occurrence of >5 new metastases. Genetic biomarkers such as EGFR, KRAS, NRAS, BRAF, and microsatellite instability were investigated as predictive factors for response rates. RESULTS Median follow-up was 28 months. At median follow-up, 7 patients were free from disease and 31 had progression: 18 patients had sequential oligometastatic disease (SOMD) and 13 polymetastatic progression. All SOMD cases received a second SBRT course. Median progression-free survival (PFS) was 7 months (range 4-9 months); median ttPMD was 25.8 months (range 12-39 months) with 1‑ and 2‑year PFS rates of 62.5% and 53.4%, respectively. 1‑ and 2‑year local PFS (LPFS) rates were 91.5% and 80%, respectively. At univariate analysis, BRAF wildtype correlated with better LPFS (p = 0.003), SOMD after primary SBRT was associated with longer cancer-specific survival (p = 0.031). Median overall survival (OS) was 39.5 months (range 26-64 months) and 2‑year OS was 71.1%. CONCLUSION The present results support local ablative treatment of lung metastases using SBRT in oligometastatic colorectal cancer patients, as it can delay the transition to PMD. Patients who progressed as SOMD maintained a survival advantage compared to those who developed PMD.
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Affiliation(s)
- Luca Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy.
| | - Francesco Cuccia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Rosario Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Francesco Ricchetti
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Vanessa Figlia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Niccolò Giaj-Levra
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Michele Rigo
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Davide Tomasini
- Radiation Oncology Department, ASST Spedali Civili di Brescia, Brescia University, Brescia, Italy
| | - Nadia Pasinetti
- Department of Radiation Oncology, Ospedale di Esine, ASL Valle Camonica-Sebino Esine, Esine, Italy
| | - Stefanie Corradini
- Radiation Oncology Department, University Hospital, LMU Munich, Munich, Germany
| | - Ruggero Ruggieri
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy.,University of Brescia, Brescia, Italy
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31
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Maddalo M, Borghetti P, Tomasini D, Corvò R, Bonomo P, Petrucci A, Paiar F, Lastrucci L, Bonù ML, Greco D, Costa L, Pegurri L, Triggiani L, Belgioia L, Desideri I, Grisanti S, Buglione M, Magrini SM. Cetuximab and Radiation Therapy Versus Cisplatin and Radiation Therapy for Locally Advanced Head and Neck Cancer: Long-Term Survival and Toxicity Outcomes of a Randomized Phase 2 Trial. Int J Radiat Oncol Biol Phys 2020; 107:469-477. [PMID: 32184121 DOI: 10.1016/j.ijrobp.2020.02.637] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/03/2020] [Accepted: 02/17/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE This study describes the long-term survival and toxicity outcomes of a multicenter randomized phase 2 trial comparing radiation therapy (RT) plus cisplatin (CDDP) or cetuximab (CTX) as first line treatment in locally advanced head and neck cancer (LASCCHN). METHODS AND MATERIALS Between January 2011 and August 2014, 70 patients were enrolled and randomized to receive RT plus weekly CDDP (40 mg/m2) or CTX (250 mg/m2 plus a loading dose of 400 mg/m2). This updated series focuses on late toxicities (graded by using Common Terminology Criteria for Adverse Events version 4.0) and long-term survival outcomes in terms of local control, overall survival, cancer-specific survival, and metastasis-free survival (MFS). A supplementary analysis based on human papilloma virus (HPV) status was also performed. RESULTS No statistically significant difference was found in terms of late effects (xerostomia, fibrosis, mucosal atrophy, weight loss). In the CDDP arm and the CTX arm, 5-year local control rates were 67% and 48%; 5-year MFS rates were 83% and 97%; 5-year overall survival rates were 61% and 52%; and 5-year cancer-specific survival rates were 70% and 59%, respectively. None of these differences reached statistical significance. A subgroup analysis by HPV status and anatomic subsites revealed that in HPV+ oropharyngeal carcinoma, better survival was obtained in the CDDP arm (although statistical tests were not performed owing to the small sample size). Conversely, no statistically significant differences were observed in HPV- oropharyngeal carcinoma and other anatomic subsites, except for the confirmed better MFS rates of the CTX arm. CONCLUSIONS Long-term results are in line with current literature suggesting that RT + CTX is inferior to RT + CDDP for the definitive treatment of LASCCHN. However, if not as an alternative to CDDP, CTX might still play a role in LASCCHN, particularly in HPV- cases.
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Affiliation(s)
- Marta Maddalo
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - Paolo Borghetti
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - Davide Tomasini
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy.
| | - Renzo Corvò
- Health Science Department (DISSAL) University of Genova, Genova - Radiation Oncology Department IRCCS San Martino Hospital, Genova, Italy
| | - Pierluigi Bonomo
- Department of Radiation Oncology, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy
| | - Alessia Petrucci
- Pistoia Hospital, Azienda Unità Sanitaria Locale No. 3, Pistoia, Italy
| | - Fabiola Paiar
- Department of Radiation Oncology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Luciana Lastrucci
- S. Donato Hospital, Azienda Unità Sanitaria Locale No. 8, Arezzo, Italy
| | - Marco Lorenzo Bonù
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - Diana Greco
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - Loredana Costa
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - Ludovica Pegurri
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - Luca Triggiani
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - Liliana Belgioia
- Health Science Department (DISSAL) University of Genova, Genova - Radiation Oncology Department IRCCS San Martino Hospital, Genova, Italy
| | - Isacco Desideri
- Department of Radiation Oncology, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy
| | | | - Michela Buglione
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - Stefano Maria Magrini
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
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Rigo M, Mazzola R, Napoli G, Giaj-Levra N, Figlia V, Nicosia L, Ricchetti F, Tomasini D, Bonù ML, Cuccia F, Bellorofonte C, Alongi F. Post-HIFU locally relapsed prostate cancer: high-dose salvage radiotherapy guided by molecular imaging. Radiol Med 2020; 125:491-499. [PMID: 32077006 DOI: 10.1007/s11547-020-01148-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/06/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate tolerance and biochemical control rates of salvage external beam radiotherapy (EBRT) in patients with local relapse from prostate cancer (PC) after high-intensity focused ultrasound (HIFU) as primary treatment. METHODS Twenty-four patients presented biochemical failure of PC. Salvage EBRT to the residual prostate was performed with moderate hypofractionation schedule (MHRT) in 28 fractions (n = 16) or with extreme hypofractionation schedule (SBRT) in 5 fractions (n = 8) by means of image-guided volumetric modulation arc therapy. In case of MHRT, the median dose was 71.4 Gy, whereas in case of SBRT it was 32.5 Gy. RESULTS The median follow-up was 28 months. The median PSA nadir was 0.26 ng/mL. In case of MHRT, the median PSA nadir was 0.15 ng/mL and occurred within a median time of 19 months. In case of SBRT, the median PSA nadir was 0.64 ng/mL and occurred within a median time of 8 months. No G3 higher acute or late toxicity after EBRT was observed. Only three patients presented with G2 acute GI toxicity (actinic proctitis). Twelve patients experienced acute G1 GU toxicity: 8/16 of men treated with MHRT and 4/8 of men treated with SBRT. Complete local control of disease was achieved in 23/24 patients (96%). CONCLUSIONS Our data confirm the feasibility and the low toxicity of salvage EBRT with both schedules of treatment after HIFU failure. The findings of low acute toxicity and good biochemical control rates are encouraging, but a larger number of patients and a longer follow-up are needed to confirm these results.
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Affiliation(s)
- Michele Rigo
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, Via Don Sempreboni 5, 37034, Verona, Negrar, Italy.
| | - Rosario Mazzola
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, Via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Giuseppe Napoli
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, Via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Niccolò Giaj-Levra
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, Via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Vanessa Figlia
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, Via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Luca Nicosia
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, Via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Francesco Ricchetti
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, Via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Davide Tomasini
- Radiation Oncology Department, University of Brescia, Brescia, Italy
| | | | - Francesco Cuccia
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, Via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | | | - Filippo Alongi
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, Via Don Sempreboni 5, 37034, Verona, Negrar, Italy.,Radiation Oncology Department, University of Brescia, Brescia, Italy
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33
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Nicosia L, Figlia V, Mazzola R, Napoli G, Giaj-Levra N, Ricchetti F, Rigo M, Lunardi G, Tomasini D, Bonù ML, Corradini S, Ruggieri R, Alongi F. Repeated stereotactic radiosurgery (SRS) using a non-coplanar mono-isocenter (HyperArc™) technique versus upfront whole-brain radiotherapy (WBRT): a matched-pair analysis. Clin Exp Metastasis 2020; 37:77-83. [PMID: 31691873 DOI: 10.1007/s10585-019-10004-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 10/30/2019] [Indexed: 12/25/2022]
Abstract
Stereotactic radiosurgery (SRS) is an effective treatment option for multiple brain metastases (BMs). Modern mono-isocentric techniques allow the delivery of multiple stereotactic courses, in the event of intracranial failure. Nevertheless, limited data on effectiveness and toxicity have been reported in comparison to WBRT. Aim of this retrospective matched-pair analysis was to compare patients affected by limited BMs treated with multiple SRS courses using a mono-isocentric, non-coplanar technique (HyperArc™, Varian Medical System) to upfront WBRT. One hundred and two patients accounting for 677 BMs were treated with HyperArc™. In case of further intracranial progression, 44 treatment courses of 201 metastases in 19 patients, were treated by subsequent HyperArc™ courses. This population was matched with 38 patients treated with WBRT. The median BMs number was 4 (range 2-10) for HyperArc™ and 5 (range 2-10) for WBRT. Overall survival (OS) and toxicity were evaluated. The median follow-up was 9 months (range 3-40 months). The median OS was not reached (range 5-22 months) for HyperArc™ patients and 8 months (range 3-40 months) for WBRT patients, while the 1-year OS was 77% and 34.6% for HyperArc™ and WBRT, respectively (p = 0.001; HR 4.77, 95% CI 1.62-14.00). There was one case of radionecrosis. HyperArc™ is an effective and safe technique for the treatment of multiple BMs. In selected cases of intracranial oligorecurrence, further subsequent courses can be safely delivered with the same technical approach. Moreover, in patients with a limited number of BMs, SRS showed an improved survival outcome when compared to WBRT.
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Affiliation(s)
- Luca Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy.
| | - Vanessa Figlia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - Rosario Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - Giuseppe Napoli
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - Niccolò Giaj-Levra
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - Francesco Ricchetti
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - Michele Rigo
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - Gianluigi Lunardi
- Medical Analysis Laboratory, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar, Italy
| | - Davide Tomasini
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy.,University of Brescia, Brescia, Italy
| | - Marco L Bonù
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy.,University of Brescia, Brescia, Italy
| | - Stefanie Corradini
- Radiation Oncology Department, University Hospital, LMU Munich, Munich, Germany
| | - Ruggero Ruggieri
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy
| | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy.,University of Brescia, Brescia, Italy
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Albano D, Tomasini D, Bonù M, Giubbini R, Bertagna F. 18F-Fluciclovine ( 18F-FACBC) PET/CT or PET/MRI in gliomas/glioblastomas. Ann Nucl Med 2019; 34:81-86. [PMID: 31773466 DOI: 10.1007/s12149-019-01426-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/05/2019] [Indexed: 02/06/2023]
Abstract
18F-fluciclovine (18F-FACBC) is a radiotracer already studied for prostate cancer, and its potential role in brain tumors (such as glioma) is not yet well investigated despite promising results. The aim of this review is to evaluate the possible diagnostic role of 18F-FACBC PET/CT or PET/MRI in patients with gliomas and glioblastomas. A comprehensive literature search of the PubMed/MEDLINE, Scopus, Embase, and Cochrane library databases was conducted to find the relevant published articles about the diagnostic performance of FACBC PET/CT or PET/MRI in patients affected by glioma and/or glioblastoma. Seven papers were included in the systematic review. From the analyses of the selected studies, the following main findings were obtained: glioma and glioblastoma are FACBC-avid tumors with a detection rate of about 100%; FACBC PET has high-diagnostic accuracy in defining tumor extent, volumes, and satellite lesions better than MR; compared to methionine, FACBC has similar accuracy but better tumor-to-background contrast; FACBC uptake may help to discriminate between low-grade and high-grade glioma. Radiolabelled fluciclovine (18F-FACBC) imaging seems to be useful in analyzing glioma/glioblastoma. Further studies enrolling a wider population are needed to clarify the real clinical and diagnostic role of 18F-FACBC in this setting and its possible position in the diagnostic flowchart.
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Affiliation(s)
- Domenico Albano
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy.
| | - Davide Tomasini
- Department of Radiation Oncology, University of Brescia and ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Marco Bonù
- Department of Radiation Oncology, University of Brescia and ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Raffaele Giubbini
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy
| | - Francesco Bertagna
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy
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35
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Guerini AE, Triggiani L, Maddalo M, Bonù ML, Frassine F, Baiguini A, Alghisi A, Tomasini D, Borghetti P, Pasinetti N, Bresciani R, Magrini SM, Buglione M. Mebendazole as a Candidate for Drug Repurposing in Oncology: An Extensive Review of Current Literature. Cancers (Basel) 2019; 11:cancers11091284. [PMID: 31480477 PMCID: PMC6769799 DOI: 10.3390/cancers11091284] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 12/13/2022] Open
Abstract
Anticancer treatment efficacy is limited by the development of refractory tumor cells characterized by increased expression and activity of mechanisms promoting survival, proliferation, and metastatic spread. The present review summarizes the current literature regarding the use of the anthelmintic mebendazole (MBZ) as a repurposed drug in oncology with a focus on cells resistant to approved therapies, including so called “cancer stem cells”. Mebendazole meets many of the characteristics desirable for a repurposed drug: good and proven toxicity profile, pharmacokinetics allowing to reach therapeutic concentrations at disease site, ease of administration and low price. Several in vitro studies suggest that MBZ inhibits a wide range of factors involved in tumor progression such as tubulin polymerization, angiogenesis, pro-survival pathways, matrix metalloproteinases, and multi-drug resistance protein transporters. Mebendazole not only exhibits direct cytotoxic activity, but also synergizes with ionizing radiations and different chemotherapeutic agents and stimulates antitumoral immune response. In vivo, MBZ treatment as a single agent or in combination with chemotherapy led to the reduction or complete arrest of tumor growth, marked decrease of metastatic spread, and improvement of survival. Further investigations are warranted to confirm the clinical anti-neoplastic activity of MBZ and its safety in combination with other drugs in a clinical setting.
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Affiliation(s)
| | - Luca Triggiani
- Department of Radiation Oncology, Brescia University, 25123 Brescia, Italy
| | - Marta Maddalo
- Department of Radiation Oncology, ASST Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy.
| | - Marco Lorenzo Bonù
- Department of Radiation Oncology, Brescia University, 25123 Brescia, Italy
| | - Francesco Frassine
- Department of Radiation Oncology, Brescia University, 25123 Brescia, Italy
| | - Anna Baiguini
- Department of Radiation Oncology, Brescia University, 25123 Brescia, Italy
| | - Alessandro Alghisi
- Department of Radiation Oncology, Brescia University, 25123 Brescia, Italy
| | - Davide Tomasini
- Department of Radiation Oncology, Brescia University, 25123 Brescia, Italy.
| | - Paolo Borghetti
- Department of Radiation Oncology, Spedali Civili of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Nadia Pasinetti
- Radiation Oncology Service, ASST Valcamonica, 25040 Esine, Italy
| | - Roberto Bresciani
- Department of Molecular and Translational Medicine, Unit of Biotechnology, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | | | - Michela Buglione
- Department of Radiation Oncology, Brescia University, 25123 Brescia, Italy
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36
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Buglione M, Gerardi M, Greco D, Maddalo M, Daniela A, Bonù M, Augugliaro M, Alghisi A, Pegurri L, Ferrari A, Tomasini D, Marvaso G, Orecchia R, Jereczek B, Magrini S. EP-1156 Radical radio-chemotherapy in head and cancer: retrospective comparison between weekly and 3-weekly CDDP. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31576-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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37
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Gerardi M, Buglione M, Alterio D, Maddalo M, Greco D, Augugliaro M, Alghisi A, Bonù M, Costa L, Ferrari A, Marvaso G, Tomasini D, Rocca MC, Orecchia R, Magrini S, Jereczek-Fossa B. PO-078 Radio-chemotherapy for Heand and Neck cancer: retrospective comparison between weekly and three-weekly CDDP. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30244-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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38
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Tomasini D, Berti E. Angiocentric and intravascular lymphomas. GIORN ITAL DERMAT V 2015; 150:95-113. [PMID: 25531150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Under the generic diagnosis of angiocentric and intravascular lymphomas are included several subtypes of lymphomas histopathologically characterized either by the predominantly endovascular-endoluminal presence of neoplastic lymphocytes of B-T or NK/T cell origin, or by a pathologic process centered around a blood vessels secondarily infiltrated and invaded by the spreading infiltrate. This group of lymphoproliferative disorders is heterogeneous regarding phenotype, but they share common features that are multiorgan involvement, worse prognosis, and, frequently Ebstein-Barr virus (EBV) genomic integration. At onset, some of these rare lymphomas, e.g. intravascular large cell lymphoma or lymphomatoid granulomatosis (Liebow dieases), are misdiagnosed as inflammatory diseases. The actual treatments of these disorders are based upon chemotherapy and/or chemotherapy plus bone marrow transplantation with variable results. Therapeutic approaches for EBV related angiocentric and intravascular lymphomas, similarly to those employed for other viral induced lymphoproliferative disease would comprise the employment of chemotherapy together with drugs able to interfere with viral infection. Such an approach has been used in rare cases of EBV-positive diffuse large B-cell lymphoma of the elderly, a lymphoproliferative disorders which development is linked to immunosuppression due to senescence. The present review will focus on intravascular and angiocentric lymphomas providing histopathologic, immunophenotypical and molecular data useful to overcome to a specific diagnosis and to differentiate them from other lymphoproliferative disorders showing a secondary vascular engulfment and infiltration and some vasculitides showing overlapping histopathologic features.
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Affiliation(s)
- D Tomasini
- Unit of Dermatology, Busto Arsizio Hospital, Busto Arsizio, Varese, Italy -
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39
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Mitteldorf C, Bieri M, Wey N, Kerl K, Kamarachev J, Pfaltz M, Kutzner H, Roncador G, Tomasini D, Kempf W. Expression of programmed death-1 (CD279) in primary cutaneous B-cell lymphomas with correlation to lymphoma entities and biological behaviour. Br J Dermatol 2013; 169:1212-8. [DOI: 10.1111/bjd.12579] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2013] [Indexed: 12/12/2022]
Affiliation(s)
- C. Mitteldorf
- Department of Dermatology; Klinikum Hildesheim GmbH; Hildesheim Germany
| | - M. Bieri
- Department of Pathology; University Hospital Zürich; Zürich Switzerland
| | - N. Wey
- Department of Pathology; University Hospital Zürich; Zürich Switzerland
| | - K. Kerl
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
| | - J. Kamarachev
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
| | - M. Pfaltz
- Department of Psychiatry and Psychotherapy; University Hospital Zürich; Zürich Switzerland
- Kempf und Pfaltz; Histologische Diagnostik; Research Unit; Seminarstrasse 1 CH-8042 Zürich Switzerland
| | - H. Kutzner
- Dermatopathologie Friedrichshafen Bodensee; Friedrichshafen Germany
| | - G. Roncador
- Centro Nacional de Investigaciones Oncologicas; Madrid Spain
| | - D. Tomasini
- Department of Dermatology; Hospital of Busto Arsizio; Busto Arsizio Italy
| | - W. Kempf
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
- Kempf und Pfaltz; Histologische Diagnostik; Research Unit; Seminarstrasse 1 CH-8042 Zürich Switzerland
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40
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Tomasini D, Berti E. Subcutaneous panniculitis-like T-cell lymphoma. GIORN ITAL DERMAT V 2013; 148:395-411. [PMID: 23900161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Subcutaneous panniculitis like T-cell lymphoma derived from α/β T-cells (SPTCL-AB) belongs to the group of primary cutaneous T-cell lymphoma, and it represents less than the 1% of all primary cutaneous T-cell lymphomas. It affects patients in the 4th decade of life (median age of 36 years) with a female preference (male/female ratio 0.5) with 19% of patients being 20 years or younger. It can be sometime complicated by a hemophagocytic syndrome, and patients without hemophagocytic syndrome had a significantly better survival (5-year OS: 91% vs. 46%). Histopathologically, SPTCL-AB is characterized by a lobular lymphocytic panniculitis. Tumor cells distribute between individual adipose lobules, proliferating and forming "rim" and "capping" images, conferring a lace-like appearance at scanning magnification. This is not an entirely disease-specific feature, and can also be seen in other lobular lymphocytic panniculitis, either of inflammatory and neoplastic origin. Tumor cells are phenotypically CD45RO+, βF1+ (a monoclonal antibody able to identify the alpha/beta chain of TCR), CD3+, CD4-, CD8+, and express cytotoxic granules (TIA-1, granzyme and perforin), whereas they show variable deletion of T-cell restricted antigens like CD2, CD5 and CD7. The majority of cases show a monoclonal rearrangement for TCR beta and gamma genes and do not show genomic integration of EBV. The present review will focus on histopathologic, immunophenotypical and molecolare data useful to overcome to a specific diagnosis of SPTCL-AB and to differentiate SPTCL-AB from other lymphomas of T-cell or NK/T cell origin and with benign panniculitidis sharing with SPTCL-AB a predominant lobular lymphocytic pattern of involvement of subcutaneous tissue.
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MESH Headings
- Adult
- Age Distribution
- Antigens, CD/analysis
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Dermis/pathology
- Diagnosis, Differential
- Female
- Gene Rearrangement, beta-Chain T-Cell Antigen Receptor
- Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor
- Humans
- Immunophenotyping
- Immunosuppressive Agents/therapeutic use
- Lymphohistiocytosis, Hemophagocytic/etiology
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/drug therapy
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Male
- Neoplasm Staging
- Panniculitis/classification
- Panniculitis/diagnosis
- Prognosis
- Sex Distribution
- Subcutaneous Tissue/pathology
- T-Lymphocytes, Cytotoxic/pathology
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Affiliation(s)
- D Tomasini
- Dermatology Section, Busto Arsizio Hospital Busto Arsizio, Varese, Italy -
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41
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Berti E, Tomasini D, Vermeer MH, Meijer CJ, Alessi E, Willemze R. Primary cutaneous CD8-positive epidermotropic cytotoxic T cell lymphomas. A distinct clinicopathological entity with an aggressive clinical behavior. Am J Pathol 1999; 155:483-92. [PMID: 10433941 PMCID: PMC1866866 DOI: 10.1016/s0002-9440(10)65144-9] [Citation(s) in RCA: 344] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Cutaneous T cell lymphomas (CTCL) generally have the phenotype of CD3+, CD4+, CD45RO+ memory T cells. CTCL expressing a CD8+ T cell phenotype are extremely rare and ill-defined. To elucidate whether these CD8+ CTCL represent a distinct disease entity, the clinical, histological, and immunophenotypical features of 17 CD8+ CTCL were reviewed. None of the 17 cases expressed markers characteristic of natural killer cells or gamma/delta T cells. Nine of 17 cases showed the characteristic clinical and histological features as well as clinical behavior of well defined types of CTCL, such as mycosis fungoides (2 cases), pagetoid reticulosis (2 cases), lymphomatoid papulosis (2 cases), and CD30+ large T cell lymphoma (2 cases), all of which usually express a CD4+ T cell phenotype, and 1 case of subcutaneous panniculitis-like T cell lymphoma. The other 8 cases formed a homogeneous group showing a distinctive set of clinicopathological and immunophenotypical features, not consistent with that of other well defined types of CTCL. Clinical characteristics included presentation with generalized patches, plaques, papulonodules, and tumors mimicking disseminated pagetoid reticulosis; metastatic spread to unusual sites, such as the lung, testis, central nervous system, and oral cavity, but not to the lymph nodes; and an aggressive course (median survival, 32 months). Histologically, these lymphomas were characterized by band-like infiltrates consisting of pleomorphic T cells or immunoblasts, showing a diffuse infiltration of an acanthotic epidermis with variable degrees of spongiosis, intraepidermal blistering, and necrosis. The neoplastic cells showed a high Ki-67 proliferation index and expression of CD3, CD8, CD7, CD45RA, betaF1, and TIA-1 markers, whereas CD2 and CD5 were frequently lost. Expression of TIA-1 pointed out that these lymphomas are derived from a cytotoxic T cell subset. The results of this and other studies reviewed herein suggest that these strongly epidermotropic primary cutaneous CD8+ cytotoxic T cell lymphomas represent a distinct type of CTCL with an aggressive clinical behavior.
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Affiliation(s)
- E Berti
- Institute of Dermatologic Science, IRCCS Ospedale Maggiore, Milan, Italy.
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Tomasini D, Cerri A, Cozzani E, Berti E. Development of pemphigus foliaceus in a patient with psoriasis: a simple coincidence? Eur J Dermatol 1998; 8:56-9. [PMID: 9649683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Several cases of psoriasis associated with bullous diseases have been reported in the literature. Bullous pemphigoid is the most frequent association observed, while pemphigus-related disorders are less frequently described. The authors report a case of a patient with long-standing psoriasis who developed pemphigus foliaceous and discuss the possible relationship between the diseases.
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Affiliation(s)
- D Tomasini
- Department of Dermatology, Hospital of Busto Arsizio, Via A Da Brescia, Busto Arsizio (va), Italy
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Abstract
Oral hairy leukoplakia was first described in homosexual men infected with the human immunodeficiency virus. It is thought to be caused by infection with both the Epstein-Barr virus and human papillomavirus. We report 59 cases of oral hairy leukoplakia. The disease was diagnosed in patients in all risk groups and was categorized in all classes of the Walter Reed classification without significant differences in prevalence. Epstein-Barr virus could be demonstrated in all tissue samples examined; human papillomavirus was found in only a few specimens. In our series oral hairy leukoplakia had a chronic course, although temporary spontaneous healing occurred in some cases. Its appearance was a poor prognostic sign because acquired immunodeficiency syndrome developed in a significant proportion of patients within a few months of onset.
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Affiliation(s)
- E Alessi
- First Clinic of Dermatology, University of Milan, Italy
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