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Nicosia L, Franceschini D, Perrone Congedi F, Casamassima F, Gerardi M, Rigo M, Mazzola R, Perna M, Scotti V, Fodor A, Iurato A, Pasqualetti F, Gadducci G, Chiesa S, Niespolo R, Bruni A, Alicino G, Frassinelli L, Borghetti P, Di Marzo A, Ravasio A, De Bari B, Sepulcri M, Aiello D, Mortellaro G, Sangalli C, Franceschini M, Montesi G, Aquilanti F, Lunardi G, Valdagni R, Fazio I, Corti L, Vavassori V, Maranzano E, Magrini S, Arcangeli S, Valentini V, Paiar F, Ramella S, Di Muzio N, Livi L, Jereczek- Fossa B, Osti M, Scorsetti M, Alongi F. OC-0602 A pREDictive model of polymetastatic disease on oligometastatic colorectal cancer: the RED LaIT-SABR. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02624-x] [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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Nicosia L, Franceschini D, Perrone-Congedi F, Casamassima F, Gerardi MA, Rigo M, Mazzola R, Perna M, Scotti V, Fodor A, Iurato A, Pasqualetti F, Gadducci G, Chiesa S, Niespolo RM, Bruni A, Alicino G, Frassinelli L, Borghetti P, Di Marzo A, Ravasio A, De Bari B, Sepulcri M, Aiello D, Mortellaro G, Sangalli C, Franceschini M, Montesi G, Aquilanti FM, Lunardi G, Valdagni R, Fazio I, Corti L, Vavassori V, Maranzano E, Magrini SM, Arcangeli S, Valentini V, Paiar F, Ramella S, Di Muzio NG, Livi L, Jereczek-Fossa BA, Osti MF, Scorsetti M, Alongi F. A multicenter LArge retrospectIve daTabase on the personalization of Stereotactic ABlative Radiotherapy use in lung metastases from colon-rectal cancer: the LaIT-SABR study. Radiother Oncol 2021; 166:92-99. [PMID: 34748855 DOI: 10.1016/j.radonc.2021.10.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 08/27/2021] [Revised: 10/14/2021] [Accepted: 10/31/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION stereotactic ablative radiotherapy (SABR) has been shown to increase survival in oligometastatic disease, but local control of colorectal metastases remains poor. We aimed to identify potential predictive factors of SBRT response through a multicenter large retrospective database and to investigate the progression to the polymetastatic disease (PMD). MATERIAL AND METHODS the study involved 23 centers, and was approved by the Ethical Committee (Prot. Negrar 2019-ZT). 1033 lung metastases were reported. Clinical and biological parameters were evaluated as predictive for local progression-free survival (FLP). Secondary end-point was the time to the polymetastatic conversion (tPMC). RESULTS Two-year FLP was 75.4%. Two-year FLP for lesions treated with a BED <100 Gy, 100-124 Gy, and ≥125 Gy was 76.1%, 70.6%, and 94% (p=0.000). Two-year FLP for lesion measuring ≤10 mm, 10-20 mm, and >20 mm was 79.7%, 77.1%, and 66.6% (p=0.027). At the multivariate analysis a BED ≥125 Gy significantly reduced the risk of local progression (HR 0.24, 95%CI 0.11-0.51; p=0.000). Median tPMC was 26.8 months. Lesions treated with BED ≥125 Gy reported a significantly longer tPMC as compared to lower BED. The median tPMC for patients treated to 1, 2-3 or 4-5 simultaneous oligometastases was 28.5, 25.4, and 9.8 months (p=0.035). CONCLUSION The present is the largest series of lung colorectal metastases treated with SABR. The results support the use of SBRT in lung oligometastatic colorectal cancer patients as it might delay the transition to PMD or offer relatively long disease-free period in selected cases. Predictive factors were identified for treatment personalization.
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Affiliation(s)
- L Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center.
| | - D Franceschini
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - F Perrone-Congedi
- Department of Radiation Oncology, "Sapienza" University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | | | - M A Gerardi
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - M Rigo
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center
| | - R Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center
| | - M Perna
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - V Scotti
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - A Fodor
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Iurato
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128, Rome, Italy
| | - F Pasqualetti
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - G Gadducci
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - S Chiesa
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - R M Niespolo
- Department of Radiation Oncology, Azienda Ospedaliera S. Gerardo, Monza, Italy
| | - A Bruni
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - G Alicino
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - L Frassinelli
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
| | - P Borghetti
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - A Di Marzo
- Radiation Oncology Centre, S. Maria Hospital, Terni, Italy
| | - A Ravasio
- Radiotherapy Unit, Humanitas Gavazzeni, Bergamo
| | - B De Bari
- Radiation Oncology Department, University Hospital of Besançon, Besançon, France; Radiation Oncology Department, Neuchâtel Hospital Network, la Chaux-de-Fonds, Switzerland
| | - M Sepulcri
- Radiation Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - D Aiello
- Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
| | - G Mortellaro
- Department of Radiation Oncology, ARNAS Ospedale Civico, Palermo, Italy
| | - C Sangalli
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Franceschini
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Montesi
- Radiotherapy Unit ULSS5, Rovigo, Italy
| | - F M Aquilanti
- Radiotherapy Marrelli Hospital, Marrelli Hospital, Crotone, Italy
| | - G Lunardi
- Medical Analysis Laboratory, IRCCS Sacro Cuore Don Calabria Hospital
| | - R Valdagni
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Haematology-Oncology, University of Milan
| | - I Fazio
- Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
| | - L Corti
- Radiation Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - V Vavassori
- Radiotherapy Unit, Humanitas Gavazzeni, Bergamo
| | - E Maranzano
- Radiation Oncology Centre, S. Maria Hospital, Terni, Italy
| | - S M Magrini
- Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
| | - S Arcangeli
- Department of Radiation Oncology, Azienda Ospedaliera S. Gerardo, Monza, Italy
| | - V Valentini
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Paiar
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123, Pisa, Italy
| | - S Ramella
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128, Rome, Italy
| | - N G Di Muzio
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - L Livi
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - B A Jereczek-Fossa
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - M F Osti
- Department of Radiation Oncology, "Sapienza" University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - M Scorsetti
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University Pieve Emanuele, Milan, Italy
| | - F Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center; University of Brescia, Brescia, Italy
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Nicosia L, Franceschini D, Perrone Congedi F, Casamassima F, Gerardi M, Perna M, Scotti V, Fodor A, Mazzola R, Rigo M, Iurato A, Pasqualetti F, Gadducci G, Chiesa S, Niespolo R, Bruni A, Frassinelli L, Borghetti P, Di Marzo A, Ravasio A, De Bari B, Sepulcri M, Aiello D, Mortellaro G, Sangalli C, Franceschini M, Montesi G, Aquilanti F, Valdagni R, Fazio I, Corti L, Vavassori L, Maranzano E, Magrini S, Lohr F, Arcangeli S, Valentini V, Paiar F, Ramella S, Di Muzio N, Livi L, Jereczek-Fossa B, Osti M, Scorsetti M, Alongi F. PH-0112 Multicenter large retrospectIve database on SBRT for colorectal lung metastases: the LaIT-SABR study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07246-7] [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: 11/30/2022]
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Delli Paoli C, Esposito M, Grilli Leonulli B, Laghai I, Muscas G, Betti M, Perna M, Baldazzi V, Konze A, Della Puppa A, Sestini S, Russo S, Scoccianti S. PO-1048 FluorEthyl-l-Tyrosine PET in glioma radiotherapy planning: an isotoxic dose prescription approach. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07499-5] [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: 11/30/2022]
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Camerini A, Del Conte A, Pezzuto A, Scotti V, Facchinetti F, Ciccone L, Perna M, Sartori G, Puccetti C, Ricci A, Santo A, Tiseo M, Amoroso D. 412P Treatment patterns and selection criteria for advanced non-small cell lung cancer (NSCLC) patients unfit for platinum-based first-line therapy: Results of the MOON-OSS observational trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.406] [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] Open
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Meattini I, Ciccone L, Lucidi S, Desideri I, Visani L, Perna M, Peruzzi A, Scotti V, Simontacchi G, Livi L. Comparison Between Accelerated Partial Breast Irradiation and Whole Breast Irradiation: APBI IMRT Florence Retrospective Analysis of Subjective, Objective and Patient-reported Cosmetic Outcomes. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.907] [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: 11/24/2022]
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Milner-Watts C, Perna M, O’Brien M. Frequency of follow-up brain imaging in non-small cell lung cancer (NSCLC) patients with previously treated brain metastases (BrMs). Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30077-5] [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: 10/25/2022]
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Zanotto L, Dan M, Toigo V, Ferrari F, Zella D, Gutierrez D, Huart M, Decamps H, Perna M, Merli E, Finotti C, Guarda F, Panizza C. Acceleration grid power supply conversion system of the MITICA neutral beam injector: On site integration activities and tests. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.03.161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Olmetto E, Paoli CD, Ciccone L, Perna M, Grassi R, Erika S, Scoccianti S, Greto D, Desideri I, Simontacchi G, Marrazzo L, Arilli C, Casati M, Compagnucci A, Pecchioli G, Pallotta S, Livi L. OC-0276 Stereotactic radiosurgery plus immunotherapy or targeted therapy for brain metastases from NSCLC. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30696-6] [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: 10/26/2022]
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Desideri I, Meattini I, Becherini C, Francolini G, Scotti V, Olmetto E, Perna M, Topulli J, Livi L. Abstract P3-12-09: Dosimetric analysis of the pattern of local recurrence in breast cancer patients undergoing breast reconstruction and post-mastectomy radiotherapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-12-09] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Background
This study aims to identify spatial and dosimetric patterns of breast cancer relapse in a mono-institutional large series of patients treated with mastectomy and various forms of breast reconstruction.
Material and Methods
We retrospectively reviewed 196 patients with Stage II-III breast cancer treated with modified radical mastectomy between 1995 and 2016 at the Radiotherapy Department of Careggi Hospital, Florence. All patients performed Skin-sparing mastectomy or nipple-sparing mastectomy with immediate or delayed breast reconstruction and subsequently received post-mastectomy radiotherapy (PMRT). Systemic therapy was prescribed as per local and international guidelines both in neoadjuvant and adjuvant setting. All patients were treated with 3DCRT technique. Diagnostic imaging (e.g. CT, MRI) obtained at recurrence were registered with the original planning computed tomography (pCT) for the dosimetric analysis. Recurrence gross tumor volume (rGTV) were delineated and co-registered with pCT. All rGTV were compared dosimetrically to planned dose and spatially with planning target volumes. Locoregional recurrence (LR) were divided in three categories relative to the high dose region, 95% of prescription dose (D95%). We defined “in field LR” those with more than 90% of their volume within D95% region,“marginal LR” when recurrence volume was between 20 and 90% within D95% and “outfield LR” those with less than 20% of their volume D95%.
Results
The median age was 49 years (range, 26 - 83 years).163 women (83 %) were classified as stage III; 118 women (60 %) had more than three positive axillary nodes. The majority of lesions were estrogen receptor positive ( 75 %), grade 3 (52%) ,with the presence of LVI (60 %). Adjuvant RT at chest wall were performed in all patients, most of whom underwent a RT of chest wall +infra- supraclavicular nodes (71%).Prescribed RT dose was 50 Gy in 25 fractions. With a median follow-up of 60 months (range, 12-240 months), 22 (11%) patients experienced a locoregional relapse: 10 patients in the chest wall; 7 in ipsilateral axillary region +/- chest wall; 3 in internal mammary nodes -/+ chest wall; one locoregional relapse was observed in the supraclavicular nodes. Most of relapses were G3 (75%) with documented LVI (79%). The topographic analysis of the local failure patterns showed: thirteen (59 %) were “in-field LR”; 9 (41%) were “out-field LR” . For the spatial analysis, all relapses on the chest wall were observed above the breast tissue expander or mammary prosthesis. Free time from recurrence disease was 30 months (range 5-86 months).
Conclusion
This study suggests that chest wall recurrences are rare after PMRT and are related to biologic aggressiveness of the disease than to inadequate irradiation of target volumes. Prospective studies are warranted to evaluate the relationship between treatment volumes and patterns of recurrences in order to refine new delineation guidelines for women undergoing PMRT and breast reconstruction.
Citation Format: Desideri I, Meattini I, Becherini C, Francolini G, Scotti V, Olmetto E, Perna M, Topulli J, Livi L. Dosimetric analysis of the pattern of local recurrence in breast cancer patients undergoing breast reconstruction and post-mastectomy radiotherapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-12-09.
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Affiliation(s)
| | | | | | | | - V Scotti
- University of Florence, Florence, Italy
| | - E Olmetto
- University of Florence, Florence, Italy
| | - M Perna
- University of Florence, Florence, Italy
| | - J Topulli
- University of Florence, Florence, Italy
| | - L Livi
- University of Florence, Florence, Italy
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Scabini S, Trunfio M, Pirriatore V, Imperiale D, Audagnotto S, Bertucci R, Ghisetti V, Cinnirella G, Cistaro A, Perna M, Calcagno A, Di Perri G. Antiviral activity of maraviroc plus mirtazapine in a low-risk HIV-negative patient with progressive multifocal leukoencephalopathy. Infez Med 2018; 26:160-163. [PMID: 29932090] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A case of progressive multifocal leukoencephalopathy (PML) is described in an HIV-negative patient with mixed connective-tissue disease (MCTD) on a minimally immunosuppressive treatment with hydroxychloroquine. The patient presented with right-sided weakness, episodes of disorientation and loss of short-term memory and of vision in her right eye. PML was diagnosed by JCV DNA on cerebrospinal fluid and radiological criteria. She was treated with off-label maraviroc and mirtazapine but died two months after hospital admission, despite a surprising decrease in the viral load of cerebrospinal fluid three weeks after starting therapy. Prompt diagnosis and antiviral treatment of PML even in low-risk patients are warranted. Future studies are required to define the therapeutic role of maraviroc (MVC) and mirtazapine in this setting.
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Affiliation(s)
- Silvia Scabini
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Italy
| | - Mattia Trunfio
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Italy
| | - Veronica Pirriatore
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Italy
| | - Daniele Imperiale
- Department of Neurology, Maria Vittoria Hospital, ASLTO2, Torino, Italy
| | - Sabrina Audagnotto
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Italy
| | - Roberto Bertucci
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Italy
| | - Valeria Ghisetti
- Laboratory of Microbiology and Molecular Biology, Amedeo di Savoia Hospital, ASLTO2, Torino, Italy
| | | | - Angelina Cistaro
- Positron Emission Tomography Centre IRMET, Affidea, Torino, Italy, Neuroimaging Steering Committee of AIMN, Italy
| | - Mariaelena Perna
- Department of Radiology, Giovanni Bosco Hospital, ASLTO2, Torino, Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Italy
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Borghetti P, Bruni A, Bonù M, Giaj Levra N, Perna M, Taraborelli M, Giubbolini R, Triggiani L, Franceschini D, Greco C, Scotti V. OC-0496: Concomitant radiotherapy and TKI in EGFR or ALK positive stage IV NSCLC: a multicentric analisys. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30806-5] [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: 11/24/2022]
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Desideri I, Scotti V, Topulli J, Baki M, Moroni C, Perna M, Muntoni C, Meacci F, Agresti B, Francolini G, Miele V, Livi L. PO-0868: Nivolumab in association with Radiation Therapy in patients with lung and kidney cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31178-2] [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: 11/15/2022]
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Affiliation(s)
- Fabrizio Elia
- High Dependency Unit, San Giovanni Bosco Hospital, Turin, Italy.
| | - Michele Covella
- Department of Medical Sciences, Città della Salute e della Scienza, Turin, Italy
| | | | - Franco Aprà
- High Dependency Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Vincenzo Crupi
- Department of Philosophy and Education, Center for Logic, Language and Cognition, University of Turini, Turin, Italy
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Meattini I, Pezzulla D, Carta GA, Becherini C, Perna M, Grassi R, Garlatti P, Desideri I, Scotti V, Bernini M, Sanchez LJ, Orzalesi L, Nori J, Bianchi S, Livi L. Abstract P6-09-07: Triple negative apocrine carcinomas as a distinct subtype of triple negative breast cancer: A case-control study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-09-07] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction. Invasive apocrine carcinoma of the breast is a rare type of breast cancer (BC), pure apocrine carcinoma constitutes <1% of all BC. Mammary apocrine epithelium has a characteristic steroid receptor profile that is negative for full length estrogen receptor-alpha and progesterone receptor and is androgen receptor positive. Conflicting data are available on the outcome of this type of disease: few studies reported significantly different prognosis of triple negative (TN) apocrine carcinomas when compared to most non-apocrine triple negative (NA-TN) tumors. The aim of this study is to report our long-term experience in a single-center series of TN apocrine tumors.
Methods. We analyzed clinical and pathological features of a series of TN apocrine carcinomas treated at our Centre in a 15-year period. Clinical and pathological characteristics and outcomes have been compared with a control series of NA-TN tumors treated during the same follow up period. Local relapse-free survival (LRFS), distant metastases-free survival (DMFS), and overall survival (OS) have been evaluated and compared between groups of patients.
Results. Forty-five TN apocrine carcinomas were analyzed. The mean age at diagnosis was 60 years (range 34-83 years). The proportions of apocrine tumor grades varied, with G1 being seen in 6.8% of patients, G2 in 51.1%, and G3 in 40.1%. The majority of apocrine carcinomas had small tumor size (T1: 72.7%; T2: 27.3%), and negative axillary nodal status (66.7%). The series was compared to a homogenous control group of 45 NA-TN patients. The mean age was 54 years (range 32-79 years), affected by high grade (G3: 53.7%), small tumor size (T1: 87.5%; T2: 12.5%), and mostly negative axillary nodal status (82.9%). LRFS in the apocrine group was 85% and 78% at 5- and 10-year, respectively. LRFS in the NA-TN group was 90% and 79% at 5- and 10-year, respectively. No difference was evidenced between groups (HR 1.44 95%CI 0.62-3.79; p=0.39). DMFS in the apocrine group was 85% and 85% at 5- and 10-years, respectively. DMFS in the NA-TN group was 85% and 75% at 5- and 10-year, respectively. DMFS was significantly better in the apocrine group (HR 0.69 95%CI 0.28-1.62). OS in the apocrine group was 86% and 83% at 5- and 10-year, respectively. OS in the NA-TN group was 86% and 63% at 5- and 10-years, respectively. OS was significantly better in the apocrine group (HR 0.57 95%CI 0.26-1.18).
Conclusions. Apocrine carcinomas represent a clinic-pathological distinct group of triple-negative BC, characterized by significantly more favorable clinical prognosis in terms of long-term disease-related morbidity or mortality when compared to NA-TN tumors.
Citation Format: Meattini I, Pezzulla D, Carta GA, Becherini C, Perna M, Grassi R, Garlatti P, Desideri I, Scotti V, Bernini M, Sanchez LJ, Orzalesi L, Nori J, Bianchi S, Livi L. Triple negative apocrine carcinomas as a distinct subtype of triple negative breast cancer: A case-control study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-09-07.
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Affiliation(s)
- I Meattini
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - D Pezzulla
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - GA Carta
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - C Becherini
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - M Perna
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - R Grassi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - P Garlatti
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - I Desideri
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - V Scotti
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - M Bernini
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - LJ Sanchez
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - L Orzalesi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - J Nori
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - S Bianchi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
| | - L Livi
- Azienda Ospedaliero Universitaria Careggi - University of Florence, Florence, Italy
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Loi M, Di Cataldo V, Simontacchi G, Detti B, Bonomo P, Masi L, Desideri I, Greto D, Francolini G, Carfora V, Pezzulla D, Perna M, Carta G, Livi L. Robotic Stereotactic Retreatment for Biochemical Control in Previously Irradiated Patients Affected by Recurrent Prostate Cancer. Clin Oncol (R Coll Radiol) 2018; 30:93-100. [DOI: 10.1016/j.clon.2017.11.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/28/2017] [Accepted: 11/06/2017] [Indexed: 12/31/2022]
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17
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Papalia R, Tecame A, Vadalà G, Russo F, Perna M, Papalia G, Bressi F, Sterzi S, Denaro V. The use of hyaluronic acid in the treatment of shoulder capsulitis: a systematic review. J BIOL REG HOMEOS AG 2017; 31:23-32. [PMID: 29202560] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Adhesive capsulitis (AC) is a common pathological condition of the shoulder characterized by painful restriction of range of motion (ROM) of the glenohumeral joint. Currently, no consensus has been reached regarding the best treatment. Hyaluronic acid (HA) injection is a safe procedure that can result in significant improvement in active and passive ROM, alleviating pain and improving shoulder function. We systematically reviewed current literature in order to evaluate the best evidence about the effectiveness of intra-articular HA injection for the treatment of primary AC. We searched Medline, CINAHL, Embase, Google Scholar and Cochrane Library. We selected studies comparing clinical outcomes of patients treated with HA in association or not with conventional therapy. Seven studies were evaluated: 2 uncontrolled randomized studies and 5 prospective randomized clinical trials with level of evidence I. Clinical outcome measures used included, among other, ROM, Visual Analogic Scale (VAS) pain scores, Constant score, Activity of daily living, Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) and Japanese Orthopedic Association Score (JOA score). Improvement was noted in terms of ROM, constant scores and pain in patients affected by AC treated with intra-articular HA injections. When compared with cortisone intra-articular injection, HA has equivalent clinical outcomes and ROM. The heterogeneity of treatments used in the studies reviewed, makes it difficult to draw a definite conclusion on the subject. HA injections do not seem to determine the final outcomes directly compared with conventional treatments. However, they could play an important role for early mobilization in the initial stages, during which, due to pain and inflammation, the patient keeps the shoulder immobilized for a long time, determining the direct cause of AC. Numerous variables, including use of lidocaine, different HA and AC stages, could influence the results and deserve to be accounted for in future investigations.
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Affiliation(s)
- R Papalia
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
| | - A Tecame
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
| | - G Vadalà
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
| | - F Russo
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
| | - M Perna
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
| | - G Papalia
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
| | - F Bressi
- University Campus Bio-Medico of Rome, Physical and Rehabilitation Medicine
| | - S Sterzi
- University Campus Bio-Medico of Rome, Physical and Rehabilitation Medicine
| | - V Denaro
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
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Vannini A, Meattini I, Grassi R, Carta G, Perna M, Becherini C, Garlatti P, Scotti V, Desideri I, Bonomo P, Livi L. First-line bevacizumab in combination with weekly paclitaxel for metastatic breast cancer: efficacy and safety results from a routine oncology practice analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.036] [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: 11/13/2022] Open
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19
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Meattini I, Salvadori B, Coltelli L, Perna M, Carta G, Becherini C, Grassi R, Garlatti P, Cappelli S, Desideri I, Vannini A, Fontana A, Landucci E, Michelotti A, Ricci S, Allegrini G, Falcone A, Livi L. Efficacy and safety of everolimus and exemestane for metastatic breast cancer patients: a real-life experience of three Oncology Departments. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.062] [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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20
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Papalia R, Vadalà G, Torre G, Perna M, Saccone L, Cannata F, Denaro V. The cytokinome in osteoarthritis, a new paradigm in diagnosis and prognosis of cartilage disease. J BIOL REG HOMEOS AG 2016; 30:77-83. [PMID: 28002903] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
At present, diagnosis and progression monitoring of osteoarthritis (OA) is made through radiological and clinical assessment. Several studies investigated the role of synovial fluid analysis, to find out whether joint disease could be characterized by the pattern of cytokines, which acts during the pathogenic process or in specific stages of it. Online PubMed-Medline search was performed in order to retrieve evidence concerning synovial fluid analysis of cytokines involved in OA degenerative process. Concerning pro-inflammatory cytokines, it has been shown that interleukin (IL)-6, TNF-α and IL-17 are mainly over-expressed in the synovial fluid of OA joints, as well as anti-inflammatory cytokine IL-10. Variations of cytokines levels occur with radiological and clinical progression. It was also reported that metalloproteinases are involved. Synovial fluid analysis may be helpful in defining stage and type of OA, but more research is needed, especially focusing on the variation of sets of cytokines during OA stages and correlating these patterns with clinical features.
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Affiliation(s)
- R Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - G Vadalà
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - G Torre
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - M Perna
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - L Saccone
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - F Cannata
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - V Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
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Scotti V, Bruni A, Simontacchi G, Furfaro I, Loi M, Scartoni D, Gonfiotti A, Viggiano D, De Luca Cardillo C, Agresti B, Poggesi L, Olmetto E, Ferrari K, Perna M, Bastiani P, Paoletti L, Lastrucci L, Pernici P, Carta G, Borghesi S, Bertocci S, Giacobazzi P, Voltolini L, Livi L. PO-0695: Lobectomy vs Stereotactic Ablative Radiotherapy in NSCLC:a multicentric series in four centers. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31945-4] [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: 11/26/2022]
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Gaio E, Maistrello A, Barp M, Perna M, Coffetti A, Soso F, Novello L, Matsukawa M, Yamauchi K. Full scale prototype of the JT-60SA Quench Protection Circuits. Fusion Engineering and Design 2013. [DOI: 10.1016/j.fusengdes.2013.02.083] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Su EP, Perna M, Boettner F, Mayman DJ, Gerlinger T, Barsoum W, Randolph J, Lee G. A prospective, multi-center, randomised trial to evaluate the efficacy of a cryopneumatic device on total knee arthroplasty recovery. ACTA ACUST UNITED AC 2013; 94:153-6. [PMID: 23118406 DOI: 10.1302/0301-620x.94b11.30832] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pain, swelling and inflammation are expected during the recovery from total knee arthroplasty (TKA) surgery. The severity of these factors and how a patient copes with them may determine the ultimate outcome of a TKA. Cryotherapy and compression are frequently used modalities to mitigate these commonly experienced sequelae. However, their effect on range of motion, functional testing, and narcotic consumption has not been well-studied. A prospective, multi-center, randomised trial was conducted to evaluate the effect of a cryopneumatic device on post-operative TKA recovery. Patients were randomised to treatment with a cryopneumatic device or ice with static compression. A total of 280 patients were enrolled at 11 international sites. Both treatments were initiated within three hours post-operation and used at least four times per day for two weeks. The cryopneumatic device was titrated for cooling and pressure by the patient to their comfort level. Patients were evaluated by physical therapists blinded to the treatment arm. Range of motion (ROM), knee girth, six minute walk test (6MWT) and timed up and go test (TUG) were measured pre-operatively, two- and six-weeks post-operatively. A visual analog pain score and narcotic consumption was also measured post-operatively. At two weeks post-operatively, both the treatment and control groups had diminished ROM and function compared to pre-operatively. Both groups had increased knee girth compared to pre- operatively. There was no significant difference in ROM, 6MWT, TUG, or knee girth between the 2 groups. We did find a significantly lower amount of narcotic consumption (509 mg morphine equivalents) in the treatment group compared with the control group (680 mg morphine equivalents) at up to two weeks postop, when the cryopneumatic device was being used (p < 0.05). Between two and six weeks, there was no difference in the total amount of narcotics consumed between the two groups. At six weeks, there was a trend toward a greater distance walked in the 6MWT in the treatment group (29.4 meters versus 7.9 meters, p = 0.13). There was a significant difference in the satisfaction scores of patients with their cooling regimen, with greater satisfaction in the treatment group (p < 0.0001). There was no difference in ROM, TUG, VAS, or knee girth at six weeks. There was no difference in adverse events or compliance between the two groups. A cryopneumatic device used after TKA appeared to decrease the need for narcotic medication from hospital discharge to 2 weeks post-operatively. There was also a trend toward a greater distance walked in the 6MWT. Patient satisfaction with the cryopneumatic cooling regimen was significantly higher than with the control treatment.
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Affiliation(s)
- E P Su
- Hospital for Special Surgery, 535 East 70th Street, New York, New York 10021, USA.
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Abstract
Background: Although pulmonary involvement is common in systemic lupus erythematosus (SLE), its effects on healthy lifestyle physical activity and its association with fatigue have not been well characterized. The goals of this study were to describe pulmonary function measured by office-based spirometry in patients with SLE and to compare spirometry with physical activity and systemic fatigue. Methods: During an office visit, 49 patients with SLE completed spirometry assessing: a) forced expiratory volume in 1 s (FEV1, a measure of airway patency and responsiveness); b) forced vital capacity (FVC, a measure of lung volume); and c) maximum voluntary ventilation (MVV, a measure of volume of air moved during rapid breathing) which has been hypothesized to be decreased in SLE due to muscle fatigue. Patients also performed a 2-min corridor walking test and completed self-reported questionnaires measuring weekly physical activity and systemic fatigue. Results: Mean age was 45 years, 45 (92%) were women, mean SLEDAI and SLICC scores were 2.8 and 1.0, respectively. Some 24 patients had a smoking history, and 15 had a history of SLE-related pleuritis, which was not active at enrollment. FEV1 and FVC were 96% of predicted, but MVV was only 55% of predicted. The distance walked during the corridor test was similar to that of patients with other chronic diseases; however, self-reported physical activity was less than recommended by national guidelines. There were no associations between spirometry values and history of pleuritis, other pulmonary diagnoses, or smoking ( p > .10 for all comparisons), however, better FEV1 ( p = .04) and better FVC ( p = .04) were associated with more self-reported activity and better FEV1 ( p = .03) was associated with longer distance walked during the corridor test. Most patients reported marked systemic fatigue; however, there were no associations between spirometry values and fatigue scores ( p > .10 for all comparisons). Conclusions: MVV was markedly diminished, which supports the hypothesis that SLE may be associated with respiratory muscle fatigue during rapid breathing. MVV was not associated with mild-to-moderate patient-directed physical activity; however, lower FEV1 and FVC were associated with less self-reported and performance-based physical activity.
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Affiliation(s)
- CA Mancuso
- Research Division, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
- Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
| | - M Perna
- Research Division, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
| | - AB Sargent
- Research Division, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
| | - JE Salmon
- Research Division, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
- Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
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Abstract
Promoting physical activity should be a priority for patients with systemic lupus erythematosus (SLE) because a sedentary lifestyle compounds patients’ already disproportionately high risk for cardiovascular events and other adverse health outcomes. The objectives of this pilot study were to assess physical activity in 50 patients with SLE and to compare activity levels with clinical and psychosocial variables, such as fatigue, depressive symptoms, and social support and stress. Patients were asked open-ended questions about physical activity, and responses were coded according to Grounded Theory. Patients then completed the Paffenbarger Physical Activity and Exercise Index, a survey of lifestyle energy expenditure reported in kilocalories/week, performed a 2-minute walk test according to a standard protocol, and completed questionnaires measuring fatigue, depressive symptoms and social support and stress. Most patients (92%) were women, had a mean age of 45 years, and did not have extensive SLE. In response to open-ended questions, patients reported they avoided physical activity because they did not want to exacerbate SLE in the short term. However, if they could overcome initial hurdles, 46 patients (92%) thought physical activity ultimately would improve SLE symptoms. Walking was the preferred activity and 45 (90%) thought they could walk more. According to the Paffenbarger Index, mean energy expenditure was 1466 ± 1366 kilocalories/week and mean time spent in moderate-intensity activity was 132 ± 222 min/week. In total, 18 patients (36%) and 14 patients (28%) met physical activity goals for these values, respectively. Mean distance walked during the 2-minute test was 149 ± 28 m, equivalent to two blocks, which is similar to reports for stable patients with other chronic diseases. Patients with more social stress and more fatigue reported less physical activity. We conclude that the proportion of patients meeting physical activity goals was low; however, patients performed well on a standard walking test. Most patients believed physical activity provided long-term benefits for SLE and that they could be more physically active.
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Affiliation(s)
- CA Mancuso
- Research Division and Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
| | - M Perna
- Research Division, Hospital for Special Surgery, New York, USA
| | - AB Sargent
- Research Division, Hospital for Special Surgery, New York, USA
| | - JE Salmon
- Research Division and Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
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Cardinale L, Cortese G, Familiari U, Perna M, Solitro F, Fava C. Fibrous tumor of the pleura (SFTP): a proteiform disease. Clinical, histological and atypical radiological patterns selected among our cases. Clin Imaging 2009. [DOI: 10.1016/j.clinimag.2009.06.007] [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: 10/20/2022]
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27
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Cardinale L, Ardissone F, Familiari U, Perna M, Fava C. A case of intermittent lumbar pain radiating to the right shoulder in a 76-year-old woman. Eur Radiol 2009; 19:2315-9. [PMID: 19626327 DOI: 10.1007/s00330-008-1221-5] [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: 07/22/2008] [Revised: 09/05/2008] [Accepted: 10/12/2008] [Indexed: 10/20/2022]
Abstract
Malignant fibrous histiocytoma (MFH) is a pleomorphic sarcoma, occurring most frequently in the deep soft tissues of the extremities, and it is most frequently seen in elderly patients. A primary MFH of the diaphragm is very rare, and to the best of our knowledge, a multi-phased spiral CT appearance of this tumour has not been previously reported. In this report, we describe the clinical and multi-phase CT features of a primary MFH of the diaphragm.
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Affiliation(s)
- Luciano Cardinale
- Department of Radiology, S. Luigi Hospital, University of Turin, Turin, Italy.
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Cardinale L, Cortese G, Familiari U, Perna M, Solitro F, Fava C. Fibrous tumour of the pleura (SFTP): a proteiform disease. Clinical, histological and atypical radiological patterns selected among our cases. Radiol Med 2008; 114:204-15. [DOI: 10.1007/s11547-008-0345-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Accepted: 09/10/2008] [Indexed: 01/23/2023]
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29
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De Pascale A, Garofalo G, Perna M, Priola S, Fava C. Contrast-enhanced ultrasonography in Crohn's disease. Radiol Med 2006; 111:539-50. [PMID: 16779540 DOI: 10.1007/s11547-006-0049-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2005] [Accepted: 11/30/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to demonstrate the diagnostic efficacy of contrast-enhanced power Doppler (CEPD) after ultrasound (US) with colour power Doppler (CPD) in defining disease activity in patients with ileal Crohn's disease in the acute phase and during treatment follow-up. MATERIALS AND METHODS The study included 15 patients with ileal Crohn's disease, 12 of whom were examined in the acute phase of their illness and then 30-60 days after treatment. Three patients were studied during clinical quiescence. All patients were examined prior to treatment with US-CPD study and then with contrast-enhanced power Doppler (CEPD) examination (CEPD) with the use of US contrast agent (SonoVue, Bracco), together with clinical assessment and laboratory tests. Disease activity was defined by the Crohn's Disease Activity Index (CDAI) and some of the most sensitive biohumoural markers. After initial US, CPD and CEPD were performed to assess enhancement of the thickened bowel wall with the use of a reference box and a semiquantitative scoring system. RESULTS The CEPD study is more reliable then US-CPD in the diagnosis of Crohn's disease and statistically agrees significantly with clinical and laboratory indices for disease activity. CONCLUSIONS This study demonstrates the importance of US-CPD in the follow-up of patients with Crohn's disease and suggests systematic use of the US contrast agent, which can improve diagnostic performance of abdominal US study. It also provides more information about patients both in the acute phase and during follow-up, thus improving treatment planning and better monitoring of treatment efficacy.
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Affiliation(s)
- A De Pascale
- S.C.D.U. Radiologia, Ospedale Universitario S. Luigi, Via Reg. Gondole 10, I-10043, Orbassano (TO), Italy.
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Frank E, Landgrebe M, Perna M, Langguth B, Hajak G, Eichhammer P. Altered motor cortex excitability by colour perception as a hint for cross-modal plasticity. KLIN NEUROPHYSIOL 2006. [DOI: 10.1055/s-2006-939142] [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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Sand P, Langguth B, Hajak G, Perna M, Prikryl R, Kucerova H, Ceskova E, Kick C, Stoertebecker P, Eichhammer P. Screening for Neuroligin 4 (NLGN4) truncating and transmembrane domain mutations in schizophrenia. Schizophr Res 2006; 82:277-8. [PMID: 16377159 DOI: 10.1016/j.schres.2005.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2005] [Accepted: 11/05/2005] [Indexed: 10/25/2022]
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Langguth B, Perna M, Eichhammer P, Sand P, Hajak G. Affect and colour perception – a neurophysiological approach. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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33
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Comella P, Palmieri G, Lorusso V, Catalano G, Nicollela D, Ianniello GP, Casaretti R, Montella M, Frasci G, Perna M, Comella G. Double biochemical modulation of 5-fluorouracil by methotrexate and levo-folinic acid in the treatment of advanced digestive tract malignancies. Eur J Cancer 1996; 32A:1719-26. [PMID: 8983280 DOI: 10.1016/0959-8049(96)00155-4] [Citation(s) in RCA: 7] [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: 02/03/2023]
Abstract
The aim of this study was to evaluate the activity and toxicity of a double biochemical modulation of 5-fluorouracil (5-FU) by means of methotrexate (MTX) and levo-folinic acid (LFA) in patients with advanced carcinoma of the digestive tract, and to assess the prognostic significance of MTX serum concentrations achieved in these patients. 94 patients affected by advanced carcinoma of the colon-rectum, stomach or biliary tract (47 of them previously untreated) received a regimen consisting of MTX 500 mg/m2 as a 2-h i.v. infusion on day 1, followed by LFA 250 mg/m2 as a 2-h i.v. infusion and 5-FU 600 mg/m2 as an i.v. bolus on day 2. Cycles were repeated every 2 weeks. Treatment was administered until tumour progression or for a maximum of 24 courses. MTX serum level was assessed soon after and 24 h (24-h MTXs) after its infusion in 61 patients. One complete and 22 partial responses were obtained, giving an overall activity of 24% (95% confidence interval, 16-34%). Response rate was 30% in chemotherapy-naive patients (colorectal, 26%; gastric, 37%; and biliary-tract, 22%) and 19% in those previously treated (all with fluoropyrimidines). A poor performance status adversely affected the response and survival of patients. The toxicity of treatment was very mild, and occurrence of severe diarrhoea (11% of patients) and mucositis (3%) was lower than that reported with other modulations of 5-FU. A cut-off value of 24-h MTXs was identified as a strong prognostic indicator. Patients with 24-h MTXs > or = 2 microM had a significantly better probability of response (37% versus 5%; P = 0.032), longer progression-free survival (5.3 versus 2.3 months; P = 0.023) and overall survival (10.8 versus 8.3 months; P = 0.045) on multivariate analysis. In chemotherapy-naive colorectal cancer patients, those with 24-h MTXs > or = 2 microM had a response rate of 38% (3/8), with a 19.6-month median survival time, as compared to no responses (0/4) and a 9.9-month median survival in the group with a lower serum concentration. The achievement of such MTX serum levels yielded a 31% (4/13) response rate even in colorectal patients who had previously received a 5-FU-FA treatment.
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Affiliation(s)
- P Comella
- National Cancer Institute, Naples, Italy
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Comella P, Beneduce G, Casaretti R, Daponte A, Iamiello G, Perna M, Nicolella D, Catalano G, Palmjeri G, Cannada Bartoili G, Comella G. Double biochemical modulation of 5-fluorouracil (5FU) with methotrexate (MTX) and levo-folinic acid (LFA) in the treatment of patients with advanced digestive mailgnancies. Eur J Cancer 1993. [DOI: 10.1016/0959-8049(93)91147-d] [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: 10/26/2022]
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Affiliation(s)
- A Marfella
- Lab. Clinical Pathology, National Cancer Institute Fondaz. G. Pascale, Italy
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36
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Marfella A, Satriano RA, Polese C, Perna M, Pisani M. Urinary neopterin and kynurenine in herpes gestationis. Dermatology 1991; 183:56. [PMID: 1769421 DOI: 10.1159/000247636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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37
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Apice G, Beneduce G, Bruni GS, D'Aprile M, Perna M, Silvestro P, Villari P, Pergola M. [Bacterial infections in cancer patients without neutropenia. Comparison between 2 antibiotic combinations (aztreonam and oxacillin versus cefoxitin and tobramycin)]. Clin Ter 1989; 131:177-82. [PMID: 2533029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In the treatment of infections arisen in neoplastic patients without neutropenia, 2 antibiotic combinations (aztreonam + oxacillin vs tobramycin + cefoxitin), have been compared with regard to therapeutic effectiveness and tolerability. Twenty patients (age: 30-75) have been studied. Tolerability of both combinations was excellent. Results of this study showed a lower percentage of superinfections and a higher percentage of cure in patients treated with the combination aztreonam + oxacillin, even if the data were not statistically significant.
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Marfella A, Ruocco V, Capobianco A, Perna M, Santelli G, Frigione G, Kyalwazi SK, Mugerwa RD, Serwadda D, Beth-Giraldo E. Neopterin and alpha-interferon in patients affected by Kaposi's sarcoma from Africa. Eur J Cancer Clin Oncol 1989; 25:1145-50. [PMID: 2767104 DOI: 10.1016/0277-5379(89)90407-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 01/02/2023]
Abstract
The presence of circulating alpha-interferon and neopterin was investigated in sera of 47 patients affected by African Kaposi's sarcoma, both HIV-seropositive (13 patients) and HIV-seronegative (34 patients). For comparison, analyses were also performed in 20 HIV-seropositive symptomatic African subjects as well as in 20 African and 20 Italian healthy individuals. Alpha-interferon and neopterin levels appeared significantly higher in comparison with healthy control groups (P less than 0.001) but not with HIV-seropositve African individuals without Kaposi's sarcoma. Moreover, alpha-interferon and neopterin levels were significantly higher in progressive Kaposi's sarcoma (27 patients) than in regressive Kaposi's sarcoma (20 patients) (P less than 0.001). A significant correlation between alpha-interferon and neopterin was observed (r = 0.57; P less than 0.01). Furthermore, alpha-interferon levels of HIV-seropositive Kaposi's sarcoma patients resulted significantly higher in comparison with the seronegative ones (P less than 0.05). It is concluded that alpha-interferon and neopterin may be reliable prognostic markers in Kaposi's sarcoma patients.
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Affiliation(s)
- A Marfella
- Laboratory of Clinical Pathology, National Cancer Institute Fondaz. Sen. G. Pascale, Naples, Italy
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Abstract
Neopterin excretion levels were assessed in 66 consecutive patients affected by non-Hodgkin's lymphomas (NHL). The logarithm of the mean value of the whole series was 2.71 (log [mumol neopterin/mol creatinine]), significantly higher (P less than 0.001) than the control value (2.12). Fifty-six of 66 patients had a raised excretion of neopterin in amounts statistically related to the stage of disease. The mean value (2.51) of patients in Stages I-II was lower than the mean value (2.86) of patients in Stage III-IV (P less than 0.001). The 2-year probability of survival was 64% for patients in Stages I-II and 34% for patients in Stages III-IV. However, patients with lower neopterin excretion (less than 2.65) fared better than patients with higher neopterin excretion, regardless of the stage. Longitudinal analysis showed a trend toward a correlation between response to therapy and neopterin excretion. In NHL, the raised neopterin excretion appears to be a consequence of activation of the host immune system rather than a product of the malignant cells. But this excessive activation of the monocytes-macrophages, as reflected by urinary neopterin levels, is not accompanied by a better outcome. In conclusion, although neopterin cannot be considered a typical tumor marker, nevertheless it is an useful prognostic marker in NHL.
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Affiliation(s)
- G Abate
- Division of Hematology and Medical Oncology, National Tumor Institute, Naples, Italy
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Santelli G, Melillo G, Marfella A, Napolitano M, D'Alessio V, Satriano RA, Beth-Giraldo E, Giraldo G, Perna M, Castello G. Urinary neopterin and immunological features in patients with Kaposi's sarcoma. Eur J Cancer Clin Oncol 1988; 24:1391-6. [PMID: 3263274 DOI: 10.1016/0277-5379(88)90327-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We studied neopterin excretion levels and immunological features of 20 patients affected by Kaposi's sarcoma (KS), compared to 30 normal controls. Eighteen patients had the classic form of Kaposi's sarcoma (CKS), while two patients were anti-human immunodeficiency virus (HIV) seropositive and affected by the epidemic form associated with the acquired immunodeficiency syndrome (AIDS). In CKS patients, a trend of an increase of neopterin levels with more advanced stages appeared from our data whereas a significant reduction in CD3+ and CD4+ lymphocytes subsets was observed already at early stages (P less than 0.01). CD8+ cells did not show significant variations. A significant increase in serum IgA immunoglobulins (P less than 0.05) was also observed. Comparative analysis of the two patients affected by AIDS/KS showed the profound deficit in T-cell immunity but also the prognostic value of neopterin monitoring. Furthermore these findings seem to confirm Kaposi's sarcoma as an 'opportunistic neoplasia' and indicate neopterin as a useful prognostic marker.
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Affiliation(s)
- G Santelli
- Sezione di Farmaco e Chemioterapia Sperimentale, Istituto Nazionale dei Tumori, Napoli, Italy
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Beth-Giraldo E, Giraldo G, De Biasi R, Miraglia E, Castello G, Monaco M, Perna M, Zarrilli D, Piazza M, Tullio Cataldo P. Human immunodeficiency virus infection in hemophilia patients: a 4-year prospective study. Antibiot Chemother (1971) 1987; 38:66-79. [PMID: 3499114 DOI: 10.1159/000414222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- E Beth-Giraldo
- Division of Viral Oncology, Instituto Nazionale Tumori, Fondazione G. Pascale, Naples, Italy
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Abstract
We studied urinary excretion levels of neopterin in 30 cancer patients affected by non-Hodgkin's lymphomas, Hodgkin's disease and multiple myeloma compared to 30 healthy subjects. Mean value of neopterin excretion in cancer patients (576.01 +/- 620.37) appeared significantly increased (p less than 0.001) compared to normal controls (134.40 +/- 41.65). A neopterin excretion above the upper normal limit was observed in 23/28 (82%) patients with active disease. A trend to an increased urinary level of neopterin with more advanced stage was observed, namely in patients with bone marrow involvement and constitutional symptoms. We suggest that the evaluation of urinary neopterin levels may be of value in the diagnosis and follow-up of hematologic malignancies.
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Perna M, Nitsch F, Santelli G, Marfella A, Giraldo G, Beth-Giraldo E, Levy JA, Piazza M, De Mercato R, Chirianni A. Urinary neopterin, a useful marker for AIDS? Lancet 1985; 1:1048. [PMID: 2859500 DOI: 10.1016/s0140-6736(85)91652-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Ruggiero M, Perna M, Morelli S, Monaco A, Salvia F, Cantore R, Mangoni di S Stefano C. Diurnal variations in plasma aminoacid concentrations. I) Effect of dietary protein intake on rhythm of neutral aminoacids. Boll Soc Ital Biol Sper 1981; 57:2116-22. [PMID: 7337732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The effect of dietary protein content on the diurnal variations in plasma neutral amino acid levels was studied in normal human subjects. For 3 consecutive 5-day periods, subjects consumed diet containing 0-or 75 or 150 g of protein per day. Blood samples were drawn at 4-hr intervals on the 4th and 5th days of each period. Consumption of the protein-free diet caused plasma concentration of all amino acids in the late morning and afternoon, while the 150 g protein diet elicited increases in these levels during the daytime. Ingestion of the diet containing 75 g protein tended to diminish the amplitude the daily rhythms.
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Ruggiero M, Perna M, Morelli S, Salvia PF, Monaco A, Cantore R, Mangoni di S Stefano C. Diurnal variations in plasma concentrations of neutral amino acids. 2) Effect of dietary protein intake on amino acid ratios. Boll Soc Ital Biol Sper 1981; 57:2123-9. [PMID: 7337733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The ratios of plasma tryptophan, tyrosine and phenilanine levels to the sum of other large neutral amino acids are reported. They tended to fall as the protein content of the diet was increased. The isoleucine ratios were not correlated with dietary protein content. Since diet-induced changes in plasma tryptophan and tyrosine ratios in animal are known to cause parallel alterations in brain tryptophan and tyrosine and levels, and thus in the rates of brain serotonin and catecholamines synthesis, out data suggest that the ingestion of carbohydrates and protein may also normally affect brain monoamine synthesis in humans.
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