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Spinelli L, Martini S, Solla SD, Vigna Taglianti R, Olivero F, Gianello L, Reali A, Merlotti AM, Franco P. Nodal Elective Volume Selection and Definition during Radiation Therapy for Early Stage (T1-T2 N0 M0) Perianal Squamous Cell Carcinoma: A Narrative Clinical Review and Critical Appraisal. Cancers (Basel) 2023; 15:5833. [PMID: 38136378 PMCID: PMC10741760 DOI: 10.3390/cancers15245833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Distinction between anal canal and perianal squamous cell carcinomas (pSCCs) is essential, as these two subgroups have different anatomical, histological, and lymphatic drainage features. Early-stage true perianal tumors are very uncommon and have been rarely included in clinical trials. Perianal skin cancers and aCCs are included in the same tumor classification, even though they have different lymphatic drainage features. Furthermore, pSCCs are treated similarly to carcinomas originating from the anal canal. Radiation therapy (RT) is an essential treatment for anal canal tumors. Guidelines do not differentiate between treatment volumes for perianal tumors and anal cancers. So far, in pSCC, no study has considered modulating treatment volume selection according to the stage of the disease. We conducted a narrative literature review to describe the sites at higher risk for microscopic disease in patients with early-stage perianal cancers (T1-T2 N0 M0) to propose a well-thought selection of RT elective volumes.
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Affiliation(s)
- Lavinia Spinelli
- Radiation Oncology Department, Santa Croce and Carle Hospital, 12100 Cuneo, Italy; (L.S.); (S.M.); (S.D.S.); (R.V.T.); (F.O.); (L.G.); (A.M.M.)
| | - Stefania Martini
- Radiation Oncology Department, Santa Croce and Carle Hospital, 12100 Cuneo, Italy; (L.S.); (S.M.); (S.D.S.); (R.V.T.); (F.O.); (L.G.); (A.M.M.)
| | - Salvatore Dario Solla
- Radiation Oncology Department, Santa Croce and Carle Hospital, 12100 Cuneo, Italy; (L.S.); (S.M.); (S.D.S.); (R.V.T.); (F.O.); (L.G.); (A.M.M.)
| | - Riccardo Vigna Taglianti
- Radiation Oncology Department, Santa Croce and Carle Hospital, 12100 Cuneo, Italy; (L.S.); (S.M.); (S.D.S.); (R.V.T.); (F.O.); (L.G.); (A.M.M.)
| | - Francesco Olivero
- Radiation Oncology Department, Santa Croce and Carle Hospital, 12100 Cuneo, Italy; (L.S.); (S.M.); (S.D.S.); (R.V.T.); (F.O.); (L.G.); (A.M.M.)
| | - Luca Gianello
- Radiation Oncology Department, Santa Croce and Carle Hospital, 12100 Cuneo, Italy; (L.S.); (S.M.); (S.D.S.); (R.V.T.); (F.O.); (L.G.); (A.M.M.)
| | - Alessia Reali
- Radiation Oncology Department, Michele and Pietro Ferrero Hospital, 12060 Verduno, Italy;
| | - Anna Maria Merlotti
- Radiation Oncology Department, Santa Croce and Carle Hospital, 12100 Cuneo, Italy; (L.S.); (S.M.); (S.D.S.); (R.V.T.); (F.O.); (L.G.); (A.M.M.)
| | - Pierfrancesco Franco
- Department of Translational Medicine (DIMET), University of Eastern Piedmont, 28100 Novara, Italy
- Department of Radiation Oncology, ‘Maggiore della Carità’ University Hospital, 28100 Novara, Italy
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Merlotti A, Taglianti RV, Melano A, Gianello L, Reali A, Petrucci R, Russi EG. Letter to the editor regarding Wei W et al.: “Experience of the Hubei cancer hospital in Wuhan, China”. Radiother Oncol 2020; 150:183. [PMID: 32621831 PMCID: PMC7327443 DOI: 10.1016/j.radonc.2020.06.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/20/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Anna Merlotti
- Department of Radiation Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy.
| | | | - Antonella Melano
- Department of Radiation Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Luca Gianello
- Department of Radiation Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Alessia Reali
- Department of Radiation Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Rachele Petrucci
- Department of Radiation Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Elvio Grazioso Russi
- Department of Radiation Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
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Merlotti A, Bonomo P, Ragona R, Trovò M, Alongi F, Mazzola R, Vigna Taglianti R, Gianello L, Reali A, Bergesio F, Lucio F, Boriano A, De Maggi A, Russi E. Dose prescription in SBRT for early-stage non-small cell lung cancer: are we all speaking the same language? Tumori 2020; 107:182-187. [PMID: 32515301 DOI: 10.1177/0300891620929425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Stereotactic body radiation therapy is increasingly used in the treatment of early-stage lung cancers. Guidelines provide indications regarding the constraints to the organs at risk (OARs) and the minimum coverage of the planning target volume but do not suggest optimal dose distribution. Data on dose distribution from the different published series are not comparable due to different prescription modalities and reported dose parameters. METHODS We conducted a review of the published data on dose prescription, focusing on the role of homogeneity on local tumor control, and present suggestions on how to specify and report the prescriptions to permit comparisons between studies or between cases from different centers. CONCLUSIONS To identify the dose-prescription modality that better correlates with oncologic outcomes, future studies should guarantee a close uniformity of dose distribution between cases and complete dose parameters reporting for treatment volumes and OARs.
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Affiliation(s)
- Anna Merlotti
- Radiation Oncology, Santa Croce e Carle Hospital, Cuneo, Italy
| | | | | | - Marco Trovò
- Department of Radiation Oncology, Azienda Sanitaria Universitaria Integrata UD, Udine, Italy
| | - Filippo Alongi
- Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Rosario Mazzola
- Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | | | - Luca Gianello
- Radiation Oncology, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Alessia Reali
- Radiation Oncology, Santa Croce e Carle Hospital, Cuneo, Italy
| | | | | | | | | | - Elvio Russi
- Radiation Oncology, Santa Croce e Carle Hospital, Cuneo, Italy
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Palazzi M, Alterio D, Tonoli S, Caspiani O, Bolner A, Colombo S, Dall'Oglio S, Lastrucci L, Bunkheila F, Cianciulli M, Taglianti RV, Cante D, Merlotti A, Bianchi E, Rampino M, Podhradska A, Fontana A, Paiar F, Micciché F, Manzo R, Ursino S, Bruschieri L, Bacigalupo A, Iannone T, Barca R, Tomatis S. Patterns of Postoperative Radiotherapy for Head and Neck Cancer in Italy: A Prospective, Observational Study by the Head and Neck Group of the Italian Association for Radiation Oncology (AIRO). Tumori 2018; 97:170-6. [DOI: 10.1177/030089161109700207] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Our previous survey showed that the patterns of postoperative radiotherapy (PORT) for head and neck cancer (HNC) in Italy might be suboptimal. A prospective observational study was therefore designed to evaluate this issue in greater detail. Methods All radiotherapy centers involved in the HNC Working Group of the Italian Radiation Oncology Association were asked to enter into the study all patients treated with PORT during a 6-month period. Results A total of 200 patients were accrued by 24 centers from December 2008 to May 2009. Larynx (38%) and oral cavity (34%) were the most common primary sites. The median time between surgery and the start of radiotherapy was 69 days (range, 25–215 days). Seventy-nine percent of cases with no evidence of risk factors for local recurrence were treated with high-dose radiotherapy to the primary site. In about 75% of cases the pN0 neck was included in the target volume. Concomitant chemotherapy was delivered to about 60% of patients with major risk factors and 21% of patients with no risk factors. Conclusions Three issues emerged from our study as potential targets for future investigations: the impact on clinical outcome of the interval between surgery and the start of PORT; factors driving radiation oncologists to overtreat volumes at low risk of recurrence; and problems associated with the delivery of concomitant chemotherapy.
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Affiliation(s)
| | | | - Sandro Tonoli
- Istituto del Radio “O. Alberti”, University Hospital, Brescia
| | | | | | | | | | | | | | | | | | | | | | | | - Monica Rampino
- S. Giovanni Battista Le Molinette University Hospital, Torino
| | | | | | | | | | | | | | | | | | | | | | - Stefano Tomatis
- Medical Physics Unit, Istituto Nazionale Tumori, Milan, Italy
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Palazzi M, Alterio D, Tonoli S, Caspiani O, Bolner A, Colombo S, Dall'oglio S, Lastrucci L, Bunkheila F, Cianciulli M, Vigna Taglianti R, Cante D, Merlotti A, Bianchi E, Rampino M, Podhradska A, Fontana A, Paiar F, Miccichè F, Manzo R, Ursino S, Bruschieri L, Bacigalupo A, Iannone T, Barca R, Tomatis S. Patterns of postoperative radiotherapy for head and neck cancer in Italy: a prospective, observational study by the head and neck group of the Italian Association for Radiation Oncology (AIRO). Tumori 2011. [PMID: 21617711 DOI: 10.1700/667.7779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND Our previous survey showed that the patterns of postoperative radiotherapy (PORT) for head and neck cancer (HNC) in Italy might be suboptimal. A prospective observational study was therefore designed to evaluate this issue in greater detail. METHODS All radiotherapy centers involved in the HNC Working Group of the Italian Radiation Oncology Association were asked to enter into the study all patients treated with PORT during a 6-month period. RESULTS A total of 200 patients were accrued by 24 centers from December 2008 to May 2009. Larynx (38%) and oral cavity (34%) were the most common primary sites. The median time between surgery and the start of radiotherapy was 69 days (range, 25-215 days). Seventy-nine percent of cases with no evidence of risk factors for local recurrence were treated with high-dose radiotherapy to the primary site. In about 75% of cases the pN0 neck was included in the target volume. Concomitant chemotherapy was delivered to about 60% of patients with major risk factors and 21% of patients with no risk factors. CONCLUSIONS Three issues emerged from our study as potential targets for future investigations: the impact on clinical outcome of the interval between surgery and the start of PORT; factors driving radiation oncologists to overtreat volumes at low risk of recurrence; and problems associated with the delivery of concomitant chemotherapy.
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Affiliation(s)
- Mauro Palazzi
- Radiotherapy Units of the following institutions in Italy.
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Numico G, Russi EG, Vitiello R, Sorrentino R, Colantonio I, Cipolat M, Taglianti RV, Pelissero A, Fea E, Granetto C, Di Costanzo G, Gasco M, Garrone O, Occelli M, Merlano M. Gemcitabine and cisplatin in a concomitant alternating chemoradiotherapy program for locally advanced head-and-neck cancer: a pharmacology-guided schedule. Int J Radiat Oncol Biol Phys 2006; 66:731-7. [PMID: 17011449 DOI: 10.1016/j.ijrobp.2006.05.059] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2006] [Revised: 04/03/2006] [Accepted: 05/24/2006] [Indexed: 12/18/2022]
Abstract
PURPOSE Administration of gemcitabine together with cisplatin at cytotoxic doses in a chemoradiotherapy regimen is hampered by a high degree of local toxicity. Using the pharmacologic properties of the drug we designed a modified schedule aimed at reducing toxicity while preserving activity. METHODS AND MATERIALS Patients with squamous cell carcinomas of the oral cavity, pharynx and larynx, bulky T4, and/or N2 to N3 were eligible. Gemcitabine was administered at a dose of 800 mg/m2 on Days 1 and 12 and cisplatin at a dose of 20 mg/m2 on Days 2 to 5, every 21 days for 3 courses. Radiotherapy, delivered with standard fractionation, was given on Days 8 to 12 and 15 to 19 and was repeated 3 times up to a total dose of > or = 60 Gy. RESULTS A total of 28 patients were selected. Grade 3 to 4 stomatitis was recorded in 25 patients (89%). Thirteen patients (46%) experienced Grade 3 to 4 neutropenia. Febrile neutropenia occurred in 8 patients (29%) and in 2 was complicated by infection and death. The overall complete response rate was 79%. At a median follow up of 71 months, 11 patients had a locoregional relapse (3-year locoregional control, 64%); 6 patients had distant metastases, among whom only 2 were without locoregional recurrence. The 3-year progression-free survival is 39% and 3-year overall survival has been 43%. CONCLUSION The schedule modification did not attenuate local toxicity. Moreover, infections and especially pneumonia, were a major problem. The high activity of gemcitabine when combined with radiotherapy would most likely be better exploited in the context of modified radiation schemes.
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Mattei D, Mordini N, Vigna Taglianti R, Bruno B, Rapezzi D, Gallamini A. Bortezomib treatment followed by a second non-myeloablative allogeneic stem cell transplant in two previously autografted patients with multiple myeloma relapse. Haematologica 2005; 90:861-2. [PMID: 15951306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
We report two cases of multiple myeloma relapse and progression following a combination of autologous stem cell transplantation and non-myeloablative allogeneic stem cell transplantation. After failure of donor lymphocyte infusions and thalidomide salvage therapy, the patients were treated successfully with bortezomib and eventually underwent a second non-myeloablative allogeneic stem cell transplantation.
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Merlano M, Russi EG, Numico G, Colantonio I, Garrone O, Pelissero A, Granetto C, Gasco M, Di Costanzo G, Heouaine A, Vigna Taglianti R, Cipolat M. Paclitaxel, cisplatin, 5-fluorouracil and radiotherapy in the management of advanced squamous cell carcinoma of the head and neck. A phase II trial. Radiother Oncol 2005; 75:193-6. [PMID: 16086909 DOI: 10.1016/j.radonc.2004.11.007] [Citation(s) in RCA: 10] [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] [Received: 07/12/2004] [Revised: 11/08/2004] [Accepted: 11/18/2004] [Indexed: 10/26/2022]
Abstract
Aim of the present study was to test, activity and toxicity of a rapidly alternating chemoradiation (paclitaxel based) in 31 patients with unresectable, locally advanced or recurrent after surgery, head and neck cancer. Three-year overall survival and progression-free survival were 61.4 and 73.7%, respectively. Main side effects remain a major problem.
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Affiliation(s)
- Marco Merlano
- Department of Medical Oncology, S. Croce General Hospital, Cuneo, Italy.
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Russi EG, Taglianti RV, Airaldi C. Use of different urethrogram protocols can influence the definition of planning target volume inferior margin in prostate cancer radiotherapy. In regard to Liu et al.: Prostate movement during simulation resulting from retrograde urethrogram compared with “natural” prostate movement (INT J RADIAT ONCOL BIOL PHYS 2004;60:470–475). Int J Radiat Oncol Biol Phys 2005; 61:1278; author reply 1278-9. [PMID: 15752914 DOI: 10.1016/j.ijrobp.2004.11.035] [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: 10/25/2022]
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