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Keller R, Costa T, Imperiale D, Bianco A, Rondini E, Hassiotis A, Bertelli MO. Stereotypies in the Autism Spectrum Disorder: Can We Rely on an Ethological Model? Brain Sci 2021; 11:762. [PMID: 34201177 PMCID: PMC8230333 DOI: 10.3390/brainsci11060762] [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: 04/16/2021] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Stereotypic behaviour can be defined as a clear behavioural pattern where a specific function or target cannot be identified, although it delays on time. Nonetheless, repetitive and stereotypical behaviours play a key role in both animal and human behaviour. Similar behaviours are observed across species, in typical human developmental phases, and in some neuropsychiatric conditions, such as Autism Spectrum Disorder (ASD) and Intellectual Disability. This evidence led to the spread of animal models of repetitive behaviours to better understand the neurobiological mechanisms underlying these dysfunctional behaviours and to gain better insight into their role and origin within ASD and other disorders. This, in turn, could lead to new treatments of those disorders in humans. METHOD This paper maps the literature on repetitive behaviours in animal models of ASD, in order to improve understanding of stereotypies in persons with ASD in terms of characterization, pathophysiology, genomic and anatomical factors. RESULTS Literature mapping confirmed that phylogenic approach and animal models may help to improve understanding and differentiation of stereotypies in ASD. Some repetitive behaviours appear to be interconnected and mediated by common genomic and anatomical factors across species, mainly by alterations of basal ganglia circuitry. A new distinction between stereotypies and autotypies should be considered. CONCLUSIONS Phylogenic approach and studies on animal models may support clinical issues related to stereotypies in persons with ASD and provide new insights in classification, pathogenesis, and management.
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Affiliation(s)
- Roberto Keller
- Adult Autism Centre, Mental Health Department, ASL Città di Torino, 10138 Turin, Italy; (R.K.); (T.C.)
| | - Tatiana Costa
- Adult Autism Centre, Mental Health Department, ASL Città di Torino, 10138 Turin, Italy; (R.K.); (T.C.)
| | - Daniele Imperiale
- Neurology Unit, Maria Vittoria Hospital, ASL Città di Torino, 10144 Turin, Italy;
| | - Annamaria Bianco
- CREA (Research and Clinical Centre), San Sebastiano Foundation, Misericordia di Firenze, 50142 Florence, Italy; (A.B.); (E.R.)
| | - Elisa Rondini
- CREA (Research and Clinical Centre), San Sebastiano Foundation, Misericordia di Firenze, 50142 Florence, Italy; (A.B.); (E.R.)
| | - Angela Hassiotis
- Division of Psychiatry, University College London, London W1T 7NF, UK;
| | - Marco O. Bertelli
- CREA (Research and Clinical Centre), San Sebastiano Foundation, Misericordia di Firenze, 50142 Florence, Italy; (A.B.); (E.R.)
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Bertelli MO, Del Furia C, Bonadiman M, Rondini E, Banks R, Lassi S. The Relationship Between Spiritual Life and Quality of Life in People with Intellectual Disability and/or Low-Functioning Autism Spectrum Disorders. J Relig Health 2020; 59:1996-2018. [PMID: 31602541 DOI: 10.1007/s10943-019-00891-x] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Spirituality seems to represent a relevant domain in the person-centred care planning and outcome assessment for persons with intellectual disability and low-functioning autism spectrum disorder. Despite this, the impact of spirituality on subjective well-being and quality of life (QoL) has been scarcely investigated. The aim of the present study was to map the international scientific literature in order to identify the reasons of such misconsideration and the key points for future research and practice implementation. The relationship between spirituality and QoL depends on a complexity of factors, ranging from QoL theoretical models to services' organisation. Personal attitude, family members, health and social-care personnel, training, faith and life communities, and even different religions seem to deserve an in-depth analysis.
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Affiliation(s)
- Marco O Bertelli
- CREA (Centro Ricerca E Ambulatori), Fondazione San Sebastiano, Via del Sansovino, 176, 50142, Florence, Italy.
| | - Chiara Del Furia
- CREA (Centro Ricerca E Ambulatori), Fondazione San Sebastiano, Via del Sansovino, 176, 50142, Florence, Italy
- Istituto Don Orione, Florence, Italy
| | | | - Elisa Rondini
- CREA (Centro Ricerca E Ambulatori), Fondazione San Sebastiano, Via del Sansovino, 176, 50142, Florence, Italy
- Istituto Don Orione, Florence, Italy
- Dipartimento di Filosofia, Scienze Sociali, Umane e della Formazione, Università di Perugia, Perugia, Italy
| | - Roger Banks
- National Senior Psychiatry Lead, NHS England, Leeds, UK
| | - Stefano Lassi
- Associazione Trisomia 21 Onlus, Florence, Italy
- Facoltà Teologica dell'Italia Centrale, Florence, Italy
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Boni C, Moretti G, Savoldi L, Armaroli L, Barbieri W, Bisagni G, Caroggio A, Iotti C, Pedroni C, Manenti AL, Rondini E, Sassi M, Zadro A. Neoadjuvant Chemotherapy with Continuous Infusion of Cisplatin and Fluorouracil in Stage II-IV, M0 Squamous Cell Carcinoma of the Head and Neck. Tumori 2018; 82:567-72. [PMID: 9061065 DOI: 10.1177/030089169608200610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and Background The aim of the study was to assess the activity and the toxicity of cisplatin (DDP) and fluorouracil (FU) administered by continuous infusion as neoadjuvant chemotherapy for patients with stage II-IV, MO squamous cell carcinoma of the head and neck. Methods Thirty previously untreated patients were submitted to chemotherapy with DDP (20 mg/m2) and FU (1000 mg/m2), both in continuous infusion for 5 days, repeated every 21 days, for a maximum of 5 cycles. Following completion of chemotherapy, the patients underwent radiotherapy; in some patients surgery was performed immediately after chemotherapy. All patients were monitored for response, time to failure, survival, treatment-related events and toxicity. Results All patients were evaluated for response; after chemotherapy the complete response rate was 27% and the partial response rate 33%. Twenty-four patients underwent radiotherapy: the overall response rate was 83% (complete response 79%). After a median follow-up of 34 months, the median survival time was 22 months with a median time to failure of 15 months. Acute vascular accidents were the main and unexpected adverse events, with 2 deaths for pulmonary embolism and 1 for stroke. The response rate to the regimen does not seem to be better than that obtained with the standard combination of cisplatin bolus and fluorouracil continuous infusion. The disadvantage of the regimen is that it causes more discomfort for the patient in that it requires hospitalization. Conclusions For this reason, we believe that there are no elements for recommending the schedule as neoadjuvant treatment of patients with squamous cell carcinoma of the head and neck or as an experimental arm in a randomized trial.
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Affiliation(s)
- C Boni
- Servizio di Oncologia Medica, Azienda Ospedaliera di Reggio Emilia, Italy
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Bisagni G, Boni C, Manenti AL, Moretti G, Rondini E, Sassi M, Zadro A, Savoldi L. Ifosfamide Bolus Followed by Five Days Continuous Infusion in Extensively Pretreated Patients with Advanced Breast Cancer: A Phase II Study. Tumori 2018; 84:659-61. [PMID: 10080671 DOI: 10.1177/030089169808400608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE A phase II study with ifosfamide in pretreated patients with advanced breast cancer was performed to determine the objective response rate, the toxicity and the feasibility of the regimen. METHODS & STUDY DESIGN Patients enrolled had advanced breast cancer pretreated with at least one previous regimen of chemotherapy for advanced disease. Treatment consisted of ifosfamide infused at a dose of 2 g/m2 iv in 4 hrs followed by ifosfamide, 8 g/m2 iv in 120 hrs in ambulatory treatment, using a portable external pump system. The total dose of ifosfamide was 10 g/m2; mesna (4 g/m2 iv) was administered mixed with ifosfamide in 120 hrs Cycles were repeated every 3 weeks. Three patients were pretreated with neoadjuvant and 15 with adjuvant chemotherapy. All patients were treated for advanced disease (median number of regimens, 1; range, 1-3): 21 with the cyclophosphamide-containing regimen and 15 with adryamicin. Sixteen patients received one or more lines of endocrine therapy. Fifteen patients had dominant site in viscera, 6 in bone, and only one in soft tissue; 17 patients had more than one site of disease. RESULTS Twenty-two patients were enrolled and all were assessable for response and toxicity. A partial response was reached in 5 patients (23%; 95% confidence limits 5% to 60%). Hematologic toxicity was the dose-limiting side effect; grade 4 leukopenia occurred in 10 patients (46%). CONCLUSIONS Considering the response rate obtained in our series of intensively pretreated patients, the results seem to indicate that the regimen is active and could be included among the possible options in the treatment of patients with refractory, poor-prognosis, advanced breast carcinoma.
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Affiliation(s)
- G Bisagni
- Medical Oncology Service, General Hospital, Reggio Emilia, Italy
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Larocca M, Damato A, Rondini E, Allegri E, Lince M, Pinto C. The impact of social factors on oncology: The experience of the Reggio Emilia Clinical Cancer Center. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx436.011] [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: 11/15/2022] Open
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Rondini E, Bertelli M, Scuticchio D. The Relation Between Socio-environmental Factors and Intellectual Disability: Unraveling the Knot. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background and aimThe current literature indicates that people with intellectual disabilities (ID) present quantitative and qualitative peculiarities of various socio-environmental factors than the general population. Although the identification of such peculiarities would have very important implications for the development of preventive, rehabilitative and inclusive procedures, valuable data are still lacking. The aim of the present paper was to assess the significance of the relationship between socio-environmental variables in person with ID, with particular reference to individual history and life contexts.MethodsA consecutively recruited sample of 112 participants with ID attending residential or clinic/rehabilitative services across Italy was evaluated by the administration of ISTORIA (Historiographical organized interview for adult intellectual retard), a semi-structured questionnaire designed to investigate clinical and personal history of the person. A considerable percentage of the samples have co-occurent psychiatric disorder. Scores obtained were statistically processed through frequency analysis and calculation of correlation indexes.ResultsSignificant correlations were found between the family, the educational/professional environments, and the inclusion in society. Further associations concerned social relationships within and outside the family, the changes of living accommodation, and the level of environmental stimulation received.ConclusionsBoth findings from previous research and the ones of this work confirm the importance of investigating the mechanisms involved in the acquisition of social skills by persons with ID, through family dynamics and participation in community life, as protective factor against the worsening of disabilities and potentially of psychopathological vulnerability that affects this population.
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Rondini E, Bertelli M. Urban Spaces and psychic disease: A case series from Florence. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
People with schizophrenia or other psychoses present alterations of multi-sensory processing and impairments in cognitive functions. They seem to be more sensitive to external stimuli than the general population, which can negatively impact on their emotional state. The purpose of the study was to assess how elements of urban milieu combine with spatial experiences of people with these disorders, affecting their spatial perceptions and social interactions. The group of participants consisted of 10 patients aged between 20 and 40 years, with schizophrenia or other psychoses. We used qualitative methods to assess behaviours in different urban routes, including a period of participant observation and a series of semi-structured interviews. Pathways within the city were recorded using a Global Position System (GPS), in order to link perceptual and behavioural data to specific urban spaces. The data analysis has revealed positive interactions between most of participants and the city. Different places have been differently perceived in terms of stress and comfort. The wide squares and the art-rich sites of the city center, as well as public parks and gardens, have been connected with positive feelings and senses of pleasure. Conversely, the presence of a high number of people and the movement experiences through public transport services have emerged to be associated with negative emotions. A deeper understanding of mechanisms and processes that interest the link between urban space and psychological disease can contribute to show new directions for the improvement of urban life quality and to progress both in psychiatry and in urban planning.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Giommoni E, Maiello E, Tortora G, Vaccaro V, Rondini E, Toppo L, Giordano G, Latiano T, Calvetti L, Antonuzzo L, Lamperini C, Boni L, Di Costanzo F. Nab-paclitaxel in substitution of oxaliplatin and irinotecan in folfirinox schedule as first-line therapy in patients with metastatic pancreatic cancer: results of phase I dose finding of NabucCO study by GOIRC. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.74] [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: 11/14/2022] Open
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Baldi L, Panebianco M, Giorgi Rossi P, Di Felice E, Cassetti T, Sassatelli R, Rondini E, Boni C, Pinto C. Second-line chemotherapy in advanced pancreatic cancer patients before nab-paclitaxel introduction. Retrospective study in Reggio Emilia Clinical Cancer Centre. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.20] [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: 11/12/2022] Open
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Passalacqua R, Lazzarelli S, Montironi R, Pignata S, De Giorgi U, Bernardo A, Ceresoli G, Delconte G, Donini M, Iezzi E, Maiello E, Nolè F, Panni S, Perrucci B, Rondini E, Sabbatini R, Sequino M, Tonini G, Zucali P, Caminiti C. Retrospective observational study of Vinflunine (VFL) in patients (pts) with transitional cell carcinoma of the urothelial tract (TCCU): final results of a real world population study (MOVIE-GOIRC01/2014 trial). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw334.14] [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: 11/14/2022] Open
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Hjermstad MJ, Aass N, Aielli F, Bennett M, Brunelli C, Caraceni A, Cavanna L, Fassbender K, Feio M, Haugen DF, Jakobsen G, Laird B, Løhre ET, Martinez M, Nabal M, Noguera-Tejedor A, Pardon K, Pigni A, Piva L, Porta-Sales J, Rizzi F, Rondini E, Sjøgren P, Strasser F, Turriziani A, Kaasa S. Characteristics of the case mix, organisation and delivery in cancer palliative care: a challenge for good-quality research. BMJ Support Palliat Care 2016; 8:456-467. [PMID: 27246166 DOI: 10.1136/bmjspcare-2015-000997] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 08/07/2015] [Revised: 02/05/2016] [Accepted: 05/10/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Palliative care (PC) services and patients differ across countries. Data on PC delivery paired with medical and self-reported data are seldom reported. Aims were to describe (1) PC organisation and services in participating centres and (2) characteristics of patients in PC programmes. METHODS This was an international prospective multicentre study with a single web-based survey on PC organisation, services and academics and patients' self-reported symptoms collected at baseline and monthly thereafter, with concurrent registrations of medical data by healthcare providers. Participants were patients ≥18 enrolled in a PC programme. RESULTS 30 centres in 12 countries participated; 24 hospitals, 4 hospices, 1 nursing home, 1 home-care service. 22 centres (73%) had PC in-house teams and inpatient and outpatient services. 20 centres (67%) had integral chemotherapy/radiotherapy services, and most (28/30) had access to general medical or oncology inpatient units. Physicians or nurses were present 24 hours/7 days in 50% and 60% of centres, respectively. 50 centres (50%) had professorships, and 12 centres (40%) had full-time/part-time research staff. Data were available on 1698 patients: 50% females; median age 66 (range 21-97); median Karnofsky score 70 (10-100); 1409 patients (83%) had metastatic/disseminated disease; tiredness and pain in the past 24 hours were most prominent. During follow-up, 1060 patients (62%) died; 450 (44%) <3 months from inclusion and 701 (68%) within 6 months. ANOVA and χ2 tests showed that hospice/nursing home patients were significantly older, had poorer performance status and had shorter survival compared with hospital-patients (p<.0.001). CONCLUSIONS There is a wide variation in PC services and patients across Europe. Detailed characterisation is the first step in improving PC services and research. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT01362816.
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Affiliation(s)
- M J Hjermstad
- Department of Oncology, Regional Centre for Excellence in Palliative Care, Oslo University Hospital, Ullevål, Oslo, Norway.,Department of Cancer Research and Molecular Medicine, Faculty of Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - N Aass
- Department of Oncology, Regional Centre for Excellence in Palliative Care, Oslo University Hospital, Ullevål, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - F Aielli
- Medical Oncology Department, University of L'Aquila, L'Aquila, Italy
| | - M Bennett
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - C Brunelli
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Pain Therapy and Rehabilitation Unit, Department of Palliative Care, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Caraceni
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Pain Therapy and Rehabilitation Unit, Department of Palliative Care, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Cavanna
- Oncology-Hematology Department, Hospital of Piacenza, Piacenza, Italy
| | - K Fassbender
- Cross Cancer Institute, Regional Cancer Centre Northern Alberta, Edmonton, Alberta, Canada
| | - M Feio
- Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Lisbon, Portugal
| | - D F Haugen
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Regional Centre of Excellence for Palliative Care, Western Norway, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine K1, University of Bergen, Bergen, Norway
| | - G Jakobsen
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - B Laird
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - E T Løhre
- Cancer Clinic, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - M Martinez
- Clínica Universidad de Navarra, Pamplona, Spain
| | - M Nabal
- Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | | | - K Pardon
- End-of-Life Care Research Group, Ghent University & Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - A Pigni
- Pain Therapy and Rehabilitation Unit, Department of Palliative Care, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Piva
- Unità di Cure Palliative Azienda Ospedaliera San Paolo, Milan, Italy
| | - J Porta-Sales
- Palliative Care Service, Catalan Institute of Oncology (ICO), Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), WeCare Chair: end of life care, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain
| | - F Rizzi
- U.O. Complessa Cure Palliative e Terapia del Dolore Istituti Clinici di Perfezionamento, Milan, Italy
| | - E Rondini
- Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - P Sjøgren
- Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - F Strasser
- Oncological Palliative Medicine, Oncology Department, Internal Medicine & Palliative Centre Cantonal Hospital, St. Gallen, Switzerland
| | - A Turriziani
- Hospice Villa Speranza, Università Cattolica S. Cuore, Rome, Italy
| | - S Kaasa
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Cancer Clinic, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Donini M, Passalacqua R, Montironi R, Lazzarelli S, Perrucci B, Nole' F, Ceresoli G, Pignata S, Torriccelli F, Tonini G, Doni L, Bernardo A, Marcomini B, Necchi A, Betri E, Degiorgi U, Sabbatini R, Rondini E, Maiello E, Caminiti C. Effectiveness and possible molecular factors predictive of clinical outcomes in patients with transitional cell carcinoma of the urothelial tract (TCCU) treated with VInfluninE: a multicenter retrospective study (MOVIE) of the Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv341.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Passalacqua R, Montironi R, Lazzarelli S, Donini M, Perrucci B, Nolè F, Ceresoli G, Pignata S, Torricelli F, Giannatempo P, Doni L, Ungari M, Panni S, Necchi A, Betri E, De Giorgi U, Sabbatini R, Rondini E, Sequino M, Caminiti C. 2639 Effectiveness and possible Molecular factors predictive of clinical Outcomes in patients with transitional cell carcinoma of the urothelial tract (TCCU) treated with VInfluninE: A multicenter retrospective study (MOVIE) of the Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31456-3] [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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Tinterri C, Gatzemeier W, Costa A, Gentilini MA, Zanini V, Regolo L, Pedrazzoli C, Rondini E, Amanti C, Gentile G, Taffurelli M, Fenaroli P, Tondini C, Sacchetto G, Sismondi P, Murgo R, Orlandi M, Cianchetti E, Andreoli C. Breast-conservative surgery with and without radiotherapy in patients aged 55-75 years with early-stage breast cancer: a prospective, randomized, multicenter trial analysis after 108 months of median follow-up. Ann Surg Oncol 2013; 21:408-15. [PMID: 24197757 DOI: 10.1245/s10434-013-3233-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Breast-conserving therapy (BCT), including postoperative whole breast irradiation (WBI), is generally accepted as the treatment of choice for most patients with early-stage breast cancer. The question whether WBI is mandatory in all patients remains one of the most controversial issues in BCT. To answer this question, a randomized, prospective, multicentre study was launched in January 2001. Primary endpoints of the study were to assess the cumulative incidence of in-breast-recurrences (IBR) and overall survival (OAS) after conservative surgery (BCS) with or without WBI. METHODS From January 2001 until December 2005, 749 patients with unifocal infiltrating breast cancer up to 25 mm, 0-3 positive axillary lymph nodes, no extensive intraductal component or lymphvascular invasion from 11 centres in Italy, were randomly assigned to BCS+WBI (arm 1:373 patients) or BCS alone (arm 2:376 patients). Treatment arms were well balanced in terms of baseline characteristics. Systemic adjuvant therapy was administered according to the institutional policies. Kaplan-Meier method was used for survival analysis and log-rank test to evaluate the difference between the two arms. RESULTS (Last analysis 31.12.2012): After median follow-up of 108 months, 12 (3.4%) IBR were observed in arm 1 and 16 (4.4%) in arm 2. OAS was 81.4% in arm 1 and 83.7% in arm 2. There was no statistically significant difference regarding IBR and death in the two treatment groups. CONCLUSIONS These data are promising and suggest that WBI after BCS can be omitted in selected patients with early stage breast cancer without exposing them to an increased risk of local recurrence and death. Longer follow-up is needed to further consolidate these results.
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Affiliation(s)
- C Tinterri
- Breast Unit, Istituto Clinico Humanitas, Rozzano, Milan, Italy,
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Montanari M, Fabbri F, Frassineti L, Rondini E, Mattioli R, Luzi Fedeli S, Turci D, Carloni S, Amadori D, Cruciani G. Phase II trial of nonpegylated liposomal doxorubicin and low-dose prednisone in second-line chemotherapy for hormone-refractory prostate cancer: A translational study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tinterri C, Gatzemeier W, Zanini V, Regolo L, Pedrazzoli C, Rondini E, Amanti C, Gentile G, Taffurelli M, Fenaroli P, Tondini C, Sacchetto G, Sismondi P, Murgo R, Orlandi M, Cianchetti E, Andreoli C. Conservative surgery with and without radiotherapy in elderly patients with early-stage breast cancer: a prospective randomised multicentre trial. Breast 2009; 18:373-7. [PMID: 19910194 DOI: 10.1016/j.breast.2009.09.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 09/17/2009] [Indexed: 11/26/2022] Open
Abstract
Breast conserving therapy (BCT) including postoperative irradiation of the remaining breast tissue is generally accepted as the best treatment for the majority of patients with early-stage breast cancer. The question is whether there is a necessity for irradiating all patients. Between 2001 and 2005, 749 women aged 55-75 years with infiltrating breast carcinoma were randomly assigned to breast conservative surgery, with or without radiotherapy (RT), to evaluate the incidence of in-breast recurrence (IBR). After 5 years of median follow-up, the cumulative incidence of IBR was 2.5% in the surgery-only arm and 0.7% in the surgery plus RT arm. There are no differences in terms of overall survival and distant disease-free survival. The preliminary evaluation suggests that breast irradiation after conservative surgery can be avoided without exposing these patients to an increased risk of distant-disease recurrence. Prolonged follow-up will further clarify the possible risks and late sequelae potentially induced by breast RT.
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Affiliation(s)
- C Tinterri
- Breast Unit, Istituto Clinico Humanitas, via Manzoni 56, 20089 Rozzano, Milano, Italy
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Passalacqua R, Buzio C, Buti S, Labianca R, Porta C, Boni C, Rondini E, Camisa R, Sabbatini R, Artioli F, Caminiti C. Adjuvant low-dose interleukin-2 (IL2) plus interferone-alpha (IFN) in operable renal cell cancer (RCC). A phase III, randomized, multicenter, independent trial of the Italian Oncology Group for Clinical Research (GOIRC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.lba5028] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA5028 Background: For pts with non-metastatic RCC, no standard adjuvant treatment exists. Immunotherapy (IT) using IFN and/or IL2 is effective in metastatic disease setting. Low and chronically repeated doses of IL2 plus IFN induce a persistent stimulation of the immune system with no relevant toxicity. Methods: From July1994 to March 2006, surgically treated RCC pts were randomized to the following arms: A) low-dose IT; B) control arm. IT consisted of a 4-week cycle of s.c. IL2 (5 days/wk, 1 million UI/sqm bid d 1,2 and 1 million UI/sqm × 1 d 3,4,5) + IFN (1,8 million UI/sqm d 3,5 of each week). Cycles were repeated every 4 months for the first 2 years and every 6 months for the remaining 3 years. Each patient received 12 cycles in 5 years. Inclusion criteria were as follows: histological diagnosis of RCC, age <75 yrs, radical or partial nephrectomy within the past 3 months, pT1 (diameter of T > 2,5 cm), T2, T3 a-b-c; pN0-pN3, M0; good cardiac and renal function and no autoimmune disease. Based on a planned sample size of 320 pts, the trial was designed to have a 80% power to detect a 15% improvement in 5-year survival. Results: A total of 310 pts were randomized: 157 on arm A, 153 on arm B. Pts characteristics were well balanced between the two arms. At a median follow-up of 52 months, 77 pts relapsed: 35 in arm A and 42 in arm B. In the first 5 years of observation, disease free survival (DFS) curves were similar in the two arms, but diverged thereafter. DFS at 5 and 10 years was 0.73 and 0.73 in arm A vs 0.73 and 0.60 in arm B with an estimated Hazard Ratio (HR) of 0.84 (95% CI: 0.54–1.33 p=0.47). Efficacy of IT was more evident in patients with good PS (HR 0.78; 0.47–1.30 p=0.35); age<60 yrs (HR 0.61; 0.31–1.19 p=0.15), and low tumor grade (HR 0.70; 0.38–1.27 p=0.24). As for overall survival, 59 deaths were observed with no differences between the two arms. Toxicity was mild and limited to WHO grade 1 or 2 in the majority of cases. Conclusions: Low-dose adjuvant IL2+IFN is feasible in RCC and seems to reduce the risk of recurrence after 5 years from diagnosis. Follow-up update is still ongoing. No significant financial relationships to disclose.
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Affiliation(s)
- R. Passalacqua
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
| | - C. Buzio
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
| | - S. Buti
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
| | - R. Labianca
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
| | - C. Porta
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
| | - C. Boni
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
| | - E. Rondini
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
| | - R. Camisa
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
| | - R. Sabbatini
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
| | - F. Artioli
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
| | - C. Caminiti
- Istituti Ospitalieri, Cremona, Italy; University of Parma, Parma, Italy; Bergamo Hospital, Bergamo, Italy; Policlinico S. Matteo, Pavia, Italy; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; University Hospital, Parma, Italy; University Hospital, Modena, Italy; Hospital, Carpi (MO), Italy
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Cocconi G, Di Blasio B, Boni C, Bisagni G, Rondini E, Bella MA, Leonardi F, Savoldi L, Vallisneri C, Camisa R, Bruzzi P. Primary chemotherapy in operable breast carcinoma comparing CMF (cyclophosphamide, methotrexate, 5-fluorouracil) with an anthracycline-containing regimen: short-term responses translated into long-term outcomes. Ann Oncol 2005; 16:1469-76. [PMID: 15956038 DOI: 10.1093/annonc/mdi278] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The role of anthracyclines has been extensively studied in adjuvant chemotherapy, but much less in the primary chemotherapy of early breast carcinoma. This study, comparing CMF (cyclophosphamide, methotrexate, 5-fluorouracil) with the rotational anthracycline-containing regimen CMFEV (CMF plus epirubicin and vincristine) administered as primary chemotherapy, demonstrated a significant increase in clinical complete response in premenopausal women. We report the long-term results. PATIENTS AND METHODS Two hundred and eleven patients with stage I or II palpable breast carcinoma and a tumour diameter of >2.5 cm were randomised to receive CMF or CMFEV for four cycles before surgery. After surgery, the patients in both arms received adjuvant CMF for three cycles. RESULTS In the study population as a whole, there was a non-significant 20% reduction in mortality and relapse rates in the CMFEV arm. However, the effect of the experimental regimen was only found in premenopausal patients, especially in terms of relapse-free survival (P=0.07) and locoregional relapse-free survival (P=0.0009), thus mirroring the effect on response rates. After 10 years, the proportions of premenopausal patients free from locoregional relapse as a first event in the CMF and CMFEV groups were 68% and 97%, respectively. No relevant differences were found in postmenopausal patients. CONCLUSION The overall results of this study showed that the greater activity of the experimental anthracycline-containing combination over CMF as primary chemotherapy in premenopausal patients translated into long-term effects in the same subgroup.
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Affiliation(s)
- G Cocconi
- Medical Oncology Division, Azienda Ospedaliera Universitaria of Parma, Italy.
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Colozza M, Bisagni G, Mosconi AM, Gori S, Boni C, Sabbatini R, Frassoldati A, Passalacqua R, Bian AR, Rodinò C, Rondini E, Algeri R, Di Sarra S, De Angelis V, Cocconi G, Tonato M. Epirubicin versus CMF as adjuvant therapy for stage I and II breast cancer: a prospective randomised study. Eur J Cancer 2002; 38:2279-88. [PMID: 12441265 DOI: 10.1016/s0959-8049(02)00452-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We compared a relatively short regimen of monochemotherapy with epirubicin versus polychemotherapy with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) as adjuvant treatment for stage I and II breast cancer patients. 348 patients with oestrogen receptor negative (ER-) node negative and ER- or ER+ node-positive with <10 nodes were accrued. CMF was given intravenously (i.v.) on days 1 and 8, every 4 weeks, for six courses; epirubicin was given weekly for 4 months. Postmenopausal patients received tamoxifen for 3 years. The primary endpoints were overall survival (OS), relapse-free survival (RFS) and event-free survival (EFS). Outcome evaluation was performed both in eligible patients and in all randomised patients according to the intention-to-treat principle. 8 randomised patients were considered ineligible. At a median follow-up of 8 years, there was no difference in OS (Hazard Ratio (HR)=1.11, 95% Confidence Interval (CI): 0.77-1.61, P=0.58), EFS (HR=1.14, 95% CI: 0.78-1.64, P=0.48), and RFS (HR=1.14, 95% CI: 0.8-1.64, P=0.48) between the two arms for all of the patients. At 8 years, the RFS percentages (+/-Standard Error (S.E.)) were 65.4% (+/-4%) in the CMF arm and 62.7% (+/-4%) in the epirubicin arm; for EFS these were 64.2% (+/-4%) for CMF and 60.8% (+/-4%) for epirubicin, respectively. A significant difference in RFS (P=0.015) was observed in patients with 4-9 positive nodes in favour of the CMF arm. Toxicity in the two arms was superimposable except for more frequent grade 3 alopecia in the epirubicin-treated patients (P=0.001). Overall, at a median follow-up of 8 years, there were no differences between the two arms in terms of OS, EFS and RFS.
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Affiliation(s)
- M Colozza
- Medical Oncology Division, Policlinico Hospital, Via Brunamonti, 51-06122, Perugia, Italy.
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Diedhiou A, Cazals-Hatem D, Rondini E, Sterkers O, Degott C, Wassef M. [Sebaceous carcinoma of the submandibular gland: a case report]. Ann Pathol 2001; 21:348-51. [PMID: 11685135] [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: 02/22/2023]
Abstract
Primary sebaceous carcinoma of the major salivary glands is very rare, arising mainly in the parotid. The submandibular gland localization is exceptional and only two cases have been reported in the literature. We report a third case diagnosed in Beaujon's Hospital in a 80 year old woman. Histologically, the tumor was poorly differentiated and lobules contained clear cells, foam cells or adipocyte-like cells, containing lipids stained with Oil Red O. We report the clinical, histological and prognostic features of this rare entity. We also discuss the differential diagnoses that pathologists should discard.
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Affiliation(s)
- A Diedhiou
- Service d'Anatomie Pathologique, 100, boulevard du General Leclerc, 92118 Clichy Cedex, France
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Boni C, Bisagni G, Savoldi L, Moretti G, Rondini E, Sassi M, Zadro A, De Pas T, Franciosi V, Pazzola A, Vignoli R, Banzi MC, Pajetta V. Gemcitabine, ifosfamide, cisplatin (GIP) for the treatment of advanced non-small cell lung cancer: a phase II study of the italian oncology group for clinical research (GOIRC). Int J Cancer 2000; 87:724-7. [PMID: 10925367] [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: 02/17/2023]
Abstract
The purpose of this study was to evaluate the activity and the toxicity of the combination of gemcitabine with ifosfamide and cisplatin (GIP) in chemonaive patients with advanced non small cell lung cancer (NSCLC). Eighty chemonaive patients with Stage IIIB-IV NSCLC were treated with the combination of gemcitabine 1 g/m(2) on Days 1 and 8, ifosfamide 2 g/m(2) on Day 1 and cisplatin 80 mg/m(2) on Day 2. Cycles were administered on an outpatient basis every 3 weeks. Hematologic toxicity was the main side effect; Grade III-IV thrombocytopenia was observed in 54 (67%) patients and Grade III-IV leucopenia in 44 (55%) patients, with 4 episodes of febrile neutropenia and 1 toxic death. Thirteen patients received platelet transfusions and 38 were transfused with packed red cells. All patients were evaluable for response. The overall response rate was 54% (95% confidence interval 43 to 65%) with 1 complete response. In patients with Stage IIIB and IV disease, response rates were 58% and 52%, respectively. Median time to progression was 40 weeks (range 0-114) and median overall survival was 12 months (16.6 months for stage IIIB and 10.4 months for stage IV). Median and minimum follow-up were 19 and 12 months, respectively. The GIP combination shows a response rate and overall survival of clinical interest. Hematologic toxicity was the main toxic effect, especially in patients with low performance status. This regimen will be tested in a Phase III randomized trial.
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Affiliation(s)
- C Boni
- Medical Oncology Service, Arcispedale S. Maria Nuova, Reggio Emilia, Italy.
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Boni C, Bisagni G, Savoldi L, Moretti G, Rondini E, Sassi M, Zadro A, De Pas T, Franciosi V, Pazzola A, Vignoli R, Banzi M, Pajetta V. Gemcitabine, ifosfamide, cisplatin (GIP) for the treatment of advanced non-small cell lung cancer: A phase II study of the Italian oncology group for clinical research (goirc). Int J Cancer 2000. [DOI: 10.1002/1097-0215(20000901)87:5<724::aid-ijc15>3.0.co;2-n] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Boni C, Savoldi L, Bisagni G, Ceci G, Crinò L, De Lisi V, Di Costanzo F, Lasagni L, Manenti AL, Moretti G, Rondini E, Sassi M, Zadro A. Bolus versus 5-day continuous infusion of cisplatin with mitomycin and vindesine in the treatment of advanced non-small cell lung cancer (NSCLC): a phase III prospective randomised trial of the Italian Oncology Group for Clinical Research (GOIRC). Eur J Cancer 1998; 34:1974-6. [PMID: 10023325 DOI: 10.1016/s0959-8049(98)00231-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this randomised trial was to compare the efficacy of bolus versus continuous infusion cisplatin combined with mitomycin C and vindesine (MVP) for chemotherapy-naive patients with stage IIIB-IV non-small cell lung cancer (NSCLC). 97 patients (49 given bolus cisplatin-arm A and 48 given continuous infusion cisplatin--arm B) were evaluable for response. In arm A, 2 patients achieved a complete response (CR), 21 achieved a partial response (PR), whilst in arm B, 14 patients achieved a PR (29%) (P = 0.07). Median survival was 8 months in both arms. Myelosuppression was the most frequent and severe toxicity, with a higher incidence of grade 3-4 leucopenia in arm A when compared with arm B (44% versus 25%). In conclusion, there is no advantage for a cisplatin 5 day infusion in the MVP regimen.
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Affiliation(s)
- C Boni
- Medical Oncology Service, Arcispedale S. Maria Nuova, Reggio Emilia, Italy
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Colozza M, Bisagni G, Mosconi A, Gori S, Boni C, Rosa Bian A, Sabbatini R, Frassoldati A, Passalacqua R, Rodinò C, Rondini E, Algeri R, Di Sarra S, Bacchi M, Tonato M, Cocconi G. P86 Epirubicin as a single agent in comparison to CMF in adjuvant therapy of stage I and II breast cancer. Eur J Cancer 1998. [DOI: 10.1016/s0959-8049(97)89303-3] [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: 10/18/2022]
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