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Ingrosso G, Ponti E, Francolini G, Caini S, Fondelli S, Santini R, Valeriani M, Rago L, Duroni G, Bruni A, Augurio A, Tramacere F, Trippa F, Russo D, Bottero M, Tamburo M, Parisi S, Borghesi S, Lancia A, Gomellini S, Scoccianti S, Stefanacci M, Vullo G, Statuto T, Miranda G, Santo B, Di Marzo A, Bellavita R, Vinciguerra A, Livi L, Aristei C, Bertini N, Orsatti C, Detti B. Image-guided moderately hypofractionated radiotherapy for localized prostate cancer: a multicentric retrospective study (IPOPROMISE). Radiol Med 2024; 129:643-652. [PMID: 38369638 PMCID: PMC11021246 DOI: 10.1007/s11547-024-01782-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/03/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Moderate hypofractionated radiotherapy is a treatment option for the cure of localized prostate cancer (PCa) patients based on the results of randomized prospective trials, but there is a clinical concern about the relatively short length of follow-up, and real-world results on outcome and toxicity based on cutting-edge techniques are lacking. The objective of this study is to present the long-term results of a large multicentric series. MATERIALS AND METHODS We retrospectively evaluated 1325 PCa patients treated with daily volumetric image-guided hypofractionated radiotherapy between 2007 and 2020 in 16 Centers. For survival endpoints, we used Kaplan-Meier survival curves and fitted univariate and multivariable Cox's proportional hazards regression models to study the association between the clinical variables and each survival type. RESULTS At the end of the follow-up, 11 patients died from PCa. The 15-year values of cancer-specific survival (CSS) and biochemical relapse-free survival (b-RFS) were 98.5% (95%CI 97.3-99.6%) and 85.5% (95%CI 81.9-89.4%), respectively. The multivariate analysis showed that baseline PSA, Gleason score, and the use of androgen deprivation therapy were significant variables for all the outcomes. Acute gastrointestinal (GI) and genitourinary (GU) toxicities of grade ≥ 2 were 7.0% and 16.98%, respectively. The 15-year late grade ≥ 2 GI and GU toxicities were 5% (95%CI 4-6%) and 6% (95%CI 4-8%), respectively. CONCLUSION Real-world long-term results of this multicentric study on cutting-edge techniques for the cure of localized PCa demonstrated an excellent biochemical-free survival rate of 85.5% at 15 years, and very low rates of ≥ G3 late GU and GI toxicity (1.6% and 0.9% respectively), strengthening the results of the available published trials.
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Affiliation(s)
- Gianluca Ingrosso
- Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Elisabetta Ponti
- Radiation Oncology Department, San Giovanni Addolorata Hospital, Rome, Italy
| | - Giulio Francolini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139, Florence, Italy
| | - Simona Fondelli
- Radiation Oncology Unit, Department of Oncology, Santa Maria Annunziata Hospital, Azienda USL Toscana Centro, Florence, Italy
| | - Roberto Santini
- Department of Radiation Oncology, Ospedale San Jacopo Pistoia, Pistoia, Italy
| | - Maurizio Valeriani
- Radiotherapy Oncology, Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy
| | - Luciana Rago
- Radiation Oncology Unit, IRCCS -CROB, Rionero in Vulture, Potenza, Italy
| | - Giacomo Duroni
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139, Florence, Italy
| | - Alessio Bruni
- Radiation Therapy Unit, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Antonietta Augurio
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Francesco Tramacere
- Department of Radiation Oncology, Azienda Sanitaria Locale, 72100, Brindisi, Italy
| | - Fabio Trippa
- Department of Radiotherapy, Saint Maria Hospital, Terni, Italy
| | | | - Marta Bottero
- Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Tamburo
- Radiotherapy Unit, Cannizzaro Hospital, Catania, Italy
| | - Silvana Parisi
- Radiation Oncology Unit - Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Simona Borghesi
- Radiation Oncology Unit of Arezzo-Valdarno, Azienda USL Toscana Sud Est, Arezzo, Italy
| | - Andrea Lancia
- Department of Radiation Oncology, Policlinico San Matteo Pavia Fondazione IRCCS, Pavia, Italy
| | - Sara Gomellini
- Radiation Oncology Department, San Giovanni Addolorata Hospital, Rome, Italy
| | - Silvia Scoccianti
- Radiation Oncology Unit, Department of Oncology, Santa Maria Annunziata Hospital, Azienda USL Toscana Centro, Florence, Italy
| | - Marco Stefanacci
- Department of Radiation Oncology, Ospedale San Jacopo Pistoia, Pistoia, Italy
| | - Gianluca Vullo
- Radiotherapy Oncology, Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy
| | - Teodora Statuto
- Radiation Oncology Unit, IRCCS -CROB, Rionero in Vulture, Potenza, Italy
| | - Giulia Miranda
- Radiation Therapy Unit, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Bianca Santo
- Radiotherapy Unit, Ospedale "Vito Fazzi", Lecce, Italy
| | | | - Rita Bellavita
- Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Annamaria Vinciguerra
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Lorenzo Livi
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Cynthia Aristei
- Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Niccolò Bertini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Carolina Orsatti
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Beatrice Detti
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
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Cepparulo P, Brancaccio P, Sirabella R, Anzilotti S, Guida N, Laudati G, Valsecchi V, Vinciguerra A, Viscardi V, D'Esposito L, Formisano L, Annunziato L, Pignataro G, Cuomo O. miR135a administration ameliorates brain ischemic damage by preventing TRPM7 activation during brain ischemia. CNS Neurosci Ther 2024; 30:e14448. [PMID: 37718696 PMCID: PMC10916440 DOI: 10.1111/cns.14448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/13/2023] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND miRNA-based strategies have recently emerged as a promising therapeutic approach in several neurodegenerative diseases. Unregulated cation influx is implicated in several cellular mechanisms underlying neural cell death during ischemia. The brain constitutively active isoform of transient receptor potential melastatin 7 (TRPM7) represents a glutamate excitotoxicity-independent pathway that significantly contributes to the pathological Ca2+ overload during ischemia. AIMS In the light of these premises, inhibition of TRPM7 may be a reasonable strategy to reduce ischemic injury. Since TRPM7 is a putative target of miRNA135a, the aim of the present paper was to evaluate the role played by miRNA135a in cerebral ischemia. Therefore, the specific objectives of the present paper were: (1) to evaluate miR135a expression in temporoparietal cortex of ischemic rats; (2) to investigate the effect of the intracerebroventricular (icv) infusion of miR135a on ischemic damage and neurological functions; and (3) to verify whether miR135a effects may be mediated by an alteration of TRPM7 expression. METHODS miR135a expression was evaluated by RT- PCR and FISH assay in temporoparietal cortex of ischemic rats. Ischemic volume and neurological functions were determined in rats subjected to transient middle cerebral artery occlusion (tMCAo) after miR135a intracerebroventricular perfusion. Target analysis was performed by Western blot. RESULTS Our results demonstrated that, in brain cortex, 72 h after ischemia, miR135a expression increased, while TRPM7 expression was parallelly downregulated. Interestingly, miR135a icv perfusion strongly ameliorated the ischemic damage and improved neurological functions, and downregulated TRPM7 protein levels. CONCLUSIONS The early prevention of TRPM7 activation is protective during brain ischemia.
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Affiliation(s)
- P. Cepparulo
- Division of Pharmacology, Department of Neuroscience, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - P. Brancaccio
- Division of Pharmacology, Department of Neuroscience, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - R. Sirabella
- Division of Pharmacology, Department of Neuroscience, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - S. Anzilotti
- Department of Science and TechnologyUniversity of SannioBeneventoItaly
| | - N. Guida
- Division of Pharmacology, Department of Neuroscience, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - G. Laudati
- Division of Pharmacology, Department of Neuroscience, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - V. Valsecchi
- Division of Pharmacology, Department of Neuroscience, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - A. Vinciguerra
- Department of Biomedical Sciences and Public HealthUniversity “Politecnica delle Marche”AnconaItaly
| | - V. Viscardi
- Division of Pharmacology, Department of Neuroscience, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - L. D'Esposito
- Veterinary Service CenterUniversity of Naples Federico IINaplesItaly
| | - L. Formisano
- Division of Pharmacology, Department of Neuroscience, School of MedicineUniversity of Naples Federico IINaplesItaly
| | | | - G. Pignataro
- Division of Pharmacology, Department of Neuroscience, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - O. Cuomo
- Division of Pharmacology, Department of Neuroscience, School of MedicineUniversity of Naples Federico IINaplesItaly
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Augurio A, Macchia G, Caravatta L, Lucarelli M, Di Gugliemo F, Vinciguerra A, Seccia B, De Sanctis V, Autorino R, Delle Curti C, Meregalli S, Perrucci E, Raspanti D, Cerrotta A. Contouring of emerging organs-at-risk (OARS) of the female pelvis and interobserver variability: A study by the Italian association of radiotherapy and clinical oncology (AIRO). Clin Transl Radiat Oncol 2023; 43:100688. [PMID: 37854671 PMCID: PMC10579954 DOI: 10.1016/j.ctro.2023.100688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/30/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023] Open
Abstract
Purpose To provide straightforward instructions for daily practice in delineating emerging organs-at-risk (OARs) of the female pelvis and to discuss the interobserver variability in a two-step multicenter study. Methods and materials A contouring atlas with anatomical boundaries for each emerging OAR was realized by radiation oncologists and radiologists who are experts in pelvic imaging, as per their knowledge and clinical practice. These contours were identified as quality benchmarks for the analysis subsequently carried out. Radiation oncologists not involved in setting the custom-built contouring atlas and interested in the treatment of gynecological cancer were invited to participate in this 2-step trial. In the first step all participants were supplied with a selected clinical case of locally advanced cervical cancer and had to identify emerging OARs (Levator ani muscle; Puborectalis muscle; Internal anal sphincter; External anal sphincter; Bladder base and trigone; Bladder neck; Iliac Bone Marrow; Lower Pelvis Bone Marrow; Lumbosacral Bone Marrow) based on their own personal knowledge of pelvic anatomy and experience. The suggested OARs and the contouring process were then presented at a subsequent webinar meeting with a contouring laboratory. Finally, in the second step, after the webinar meeting, each participant who had joined the study but was not involved in setting the benchmark received the custom-built contouring atlas with anatomical boundaries and was requested to delineate again the OARs using the tool provided. The Dice Similarity Coefficient (DSC) and the Jaccard Similarity Coefficient (JSC) were used to evaluate the spatial overlap accuracy of the different volume delineations and compared with the benchmark; the Hausdorff distance (HD) and the mean distance to agreement (MDA) to explore the distance between contours. All the results were reported as sample mean and standard deviation (SD). Results Fifteen radiation oncologists from different Institutions joined the study. The participants had a high agreement degree for pelvic bones sub-structures delineation according to DICE (IBM: 0.9 ± 0.02; LPBM: 0.91 ± 0.01). A moderate degree according to DICE was showed for ovaries (Right: 0.61 ± 0.16, Left: 0.72 ± 0.05), vagina (0.575 ± 0.13), bladder sub-structures (0.515 ± 0.08) and EAS (0.605 ± 0.05), whereas a low degree for the other sub-structures of the anal-rectal sphincter complex (LAM: 0.345 ± 0.07, PRM: 0.41 ± 0.10, and IAS: 0.4 ± 0.07). Conclusion This study found a moderate to low level of agreement in the delineation of the female pelvis emerging OARs, with a high degree of variability among observers. The development of delineation tools should be encouraged to improve the routine contouring of these OARs and increase the quality and consistency of radiotherapy planning.
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Affiliation(s)
- A. Augurio
- Department of Radiation Oncology, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - G. Macchia
- Radiation Oncology Unit, Gemelli Molise Hospital, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 1, 86100 Campobasso, Italy
| | - L. Caravatta
- Department of Radiation Oncology, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - M. Lucarelli
- Department od Radiotion Oncology, SS Annunziata Hospital, "G. D'Annunzio" University, Via dei Vestini, 66100 Chieti, Italy
| | - F. Di Gugliemo
- Department od Radiotion Oncology, SS Annunziata Hospital, "G. D'Annunzio" University, Via dei Vestini, 66100 Chieti, Italy
| | - A. Vinciguerra
- Department of Radiation Oncology, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - B. Seccia
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, Via Luigi Polacchi 11, 66100 Chieti, Italy
| | - V. De Sanctis
- Radiotherapy Oncology, Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, S. Andrea Hospital, Via di Grottarossa 1035, 00189 Rome, Italy
| | - R. Autorino
- Oncological Radiotherapy Unit, Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - C. Delle Curti
- Radioterapia Oncologica, Fondazione IRCS, Istituto Nazionale dei Tumori di Milano, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - S. Meregalli
- Radiotherapy Unit, Azienda Ospedaliera San Gerardo, Via G. B. Pergolesi, 33, 20900 Monza, Italy
| | - E. Perrucci
- Radiation Oncology Section, Perugia General Hospital, Piazzale Giorgio Menghini, 3, 06129 Perugia, Italy
| | - D. Raspanti
- Temasinergie S.p.A., Via Marcello Malpighi 120, Faenza, Italy
| | - A. Cerrotta
- Radioterapia Oncologica, Fondazione IRCS, Istituto Nazionale dei Tumori di Milano, Via Giacomo Venezian, 1, 20133 Milano, Italy
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Vinciguerra A, Mattavelli D, Turri-Zanoni M, Ferrari M, Schreiber A, Rampinelli V, Dohin I, Valentini M, Pontillo V, Gaudioso P, Karligkiotis A, Atallah S, Chatelet F, Saccardo T, Piazza C, Verillaud B, Nicolai P, Castelnuovo P, Herman P. Validation of modular endoscopic medial maxillectomies for inverted papilloma of the maxillary sinus. Rhinology 2023:3103. [PMID: 37515817 DOI: 10.4193/rhin23.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Abstract
BACKGROUND Treatment of inverted papilloma of the maxillary sinus (IPMS) has a lower success rate compared to other IPs. As such, its correct management generally needs trans-nasal endoscopic medial maxillectomy (EMMs) for adequate resection. The aim of this manuscript is to describe outcomes and major prognostic factors of a cohort of patients with IPMS who were treated with EMM. METHODOLOGY In this multicentric study, patients affected with IPMS and treated with EMMs were included. The site of origin of the IPMS were studied as well as the type of EMM performed. The histological features (IP vs dysplasia), type of mucosal resection (total vs. pedicle oriented), and post-operative complications were analyzed. RESULTS 310 patients were included (212 primary and 98 recurrent cases). After a mean follow-up of 45.4 months, 15 patients experienced recurrence (4.8%) due to the application of EMMs tailored to the surgical insertion point. Dysplasia was significantly associated with a higher risk of recurrence. The rates of early and late complications were 11.6% and 11.9%, respectively. CONCLUSIONS IPMS resection via tailored EMM is associated with excellent disease control, thus excluding the systematic use of extended EMMs, which can however be justified in case of dysplastic IPMS given its significant impact on recurrence.
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Affiliation(s)
- A Vinciguerra
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - D Mattavelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - M Turri-Zanoni
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - M Ferrari
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - A Schreiber
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - V Rampinelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - I Dohin
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - M Valentini
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - V Pontillo
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - P Gaudioso
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - A Karligkiotis
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - S Atallah
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - F Chatelet
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - T Saccardo
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - C Piazza
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - B Verillaud
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - P Nicolai
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - P Castelnuovo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - P Herman
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
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Brancaccio P, Anzilotti S, Cuomo O, Vinciguerra A, Campanile M, Herchuelz A, Amoroso S, Annunziato L, Pignataro G. Preconditioning in hypoxic-ischemic neonate mice triggers Na +-Ca 2+ exchanger-dependent neurogenesis. Cell Death Dis 2022; 8:318. [PMID: 35831286 PMCID: PMC9279453 DOI: 10.1038/s41420-022-01089-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 11/09/2022]
Abstract
To identify alternative interventions in neonatal hypoxic-ischemic encephalopathy, researchers’ attention has been focused to the study of endogenous neuroprotective strategies. Based on the preconditioning concept that a subthreshold insult may protect from a subsequent harmful event, we aimed at identifying a new preconditioning protocol able to enhance Ca2+-dependent neurogenesis in a mouse model of neonatal hypoxia ischemia (HI). To this purpose, we also investigated the role of the preconditioning-linked protein controlling ionic homeostasis, Na+/Ca2+ exchanger (NCX). Hypoxic Preconditioning (HPC) was reproduced by exposing P7 mice to 20’ hypoxia. HI was induced by isolating and cutting the right common carotid artery. A significant reduction in ischemic damage was observed in mice subjected to 20’ hypoxia followed,3 days later, by 60’ HI, thus suggesting that 20’ hypoxia functions as preconditioning stimulus. HPC promoted neuroblasts proliferation in the dentate gyrus mirrored by an increase of NCX1 and NCX3-positive cells and an improvement of behavioral motor performances in HI mice. An attenuation of HPC neuroprotection as well as a reduction in the expression of neurogenesis markers, including p57 and NeuroD1, was observed in preconditioned mice lacking NCX1 or NCX3. In summary, PC in neonatal mice triggers a neurogenic process linked to ionic homeostasis maintenance, regulated by NCX1 and NCX3.
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Affiliation(s)
- P Brancaccio
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples "Federico II", 80131, Naples, Italy
| | - S Anzilotti
- Department of Science and Technology, University of Sannio, 82100, Benevento, Italy
| | - O Cuomo
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples "Federico II", 80131, Naples, Italy
| | - A Vinciguerra
- Department of Biomedical Sciences and Public Health, School of Medicine, University "Politecnica delle Marche", 60126, Ancona, Italy
| | - M Campanile
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples "Federico II", 80131, Naples, Italy
| | - A Herchuelz
- Laboratoire de Pharmacodynamie et de Therapeutique-Faculté de Médecine Université Libre de Bruxelles, Bruxelles, Belgium
| | - S Amoroso
- Department of Biomedical Sciences and Public Health, School of Medicine, University "Politecnica delle Marche", 60126, Ancona, Italy
| | - L Annunziato
- IRCCS Synlab SDN S.p.A, via Gianturco 113, 80143, Naples, Italy
| | - G Pignataro
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples "Federico II", 80131, Naples, Italy.
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Lucarelli M, Caravatta L, Augurio A, Vinciguerra A, Di Tommaso M, Genovesi D. PO-1051 Analysis Of A Mono-Institutional Internal Procedure Protocol During Covid-19 Second Wave. Radiother Oncol 2022. [PMCID: PMC9153883 DOI: 10.1016/s0167-8140(22)03015-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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7
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Vinciguerra A, Augurio A, Rosa C, Fasciolo D, Borgia M, Milone V, Marchioni M, DI Nicola M, Genovesi D, Caravatta L. Lower Bladder Toxicity of Salvage Versus Adjuvant Modern Radiotherapy for Prostate Cancer Patients. In Vivo 2022; 36:1375-1382. [PMID: 35478143 DOI: 10.21873/invivo.12841] [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: 02/02/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM In prostate cancer, postoperative radiotherapy timing is debated to avoid overtreatments and toxicities. This study compared acute and late rectal and bladder toxicities in the adjuvant and salvage setting. PATIENTS AND METHODS In total, 129 patients were analyzed in two groups: adjuvant radiotherapy (aRT) and salvage radiotherapy (sRT). RESULTS In aRT and sRT, grade 1 (G1) acute bladder toxicities were detected in 40 and 30 patients, and grade 2 (G2) in 1 and 6; G1 late bladder toxicities were described in 30 and 20, and G2 in 6 and 2, respectively. In aRT and sRT, acute G1 rectal toxicities were reported in 18 and 27 patients, and G2 in 5 and 4, respectively. Late rectal G1 toxicities were observed in 10 patients, G2 in 6 and G3 in 1 in the aRT. In sRT, 8 patients and 1 developed G1 and G2 toxicities, respectively. Regarding bladder toxicity, a higher incidence occurred in aRT; late toxicity was lower in sRT. CONCLUSION Adjuvant and salvage RT in prostate cancer treatment resulted in acceptable toxicities.
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Affiliation(s)
- Annamaria Vinciguerra
- Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Antonietta Augurio
- Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Consuelo Rosa
- Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - David Fasciolo
- Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Marzia Borgia
- Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Valentina Milone
- Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Michele Marchioni
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Marta DI Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Domenico Genovesi
- Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Luciana Caravatta
- Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy
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Fasciolo D, Fasciolo D, Rosa C, Marchione M, Borgia M, Lucarelli M, Vinciguerra A, Augurio A, Caravatta L, Genovesi D. PO-1381 Toxicity outcomes of salvage versus adjuvant radiotherapy for prostate cancer using VMAT and IMRT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07832-4] [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: 11/28/2022]
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9
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Francolini G, Timon G, Matrone F, Marvaso G, Nicosia L, Ognibene L, Vinciguerra A, Trodella LE, Franzese C, Borghetti P, Jereczek-Fossa BA, Arcangeli S. Postoperative radiotherapy after upfront radical prostatectomy: debated issues at a turning point-a survey exploring management trends on behalf of AIRO (Italian Association of Radiotherapy and Clinical Oncology). Clin Transl Oncol 2021; 23:2568-2578. [PMID: 34286475 DOI: 10.1007/s12094-021-02665-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/07/2021] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Postoperative prostate cancer patients are a heterogeneous population, and many prognostic factors (e.g., local staging, PSA kinetics, margin status, histopathological features) may influence their clinical management. In this complex scenario, univocal recommendations are often lacking. For these reasons, the present survey was developed by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) to collect the opinion of Italian radiation oncologists and delineate a representation of current clinical practice in our country. METHODS A questionnaire was administered online to AIRO (Italian Association of Radiotherapy and Clinical Oncology) members registered in 2020 with a clinical interest in uro-oncological disease. RESULTS Sixty-one per cent of AIRO members answered the proposed survey. Explored topics included career and expertise, indications to adjuvant RT, additional imaging in biochemical recurrence setting, use of salvage radiotherapy (SRT), management of clinically evident locoregional recurrence and future considerations. CONCLUSIONS Overall, good level of agreement was found between participants for most of the topics. Most debated issues regarded, as expected, implementation of new imaging methods in this setting. Notably, trend in favour of early SRT vs. immediate adjuvant RT was underlined, and preference for global evaluation rather than isolated risk factors for RT indications was noticed.
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Affiliation(s)
- G Francolini
- Radiotherapy Department, University of Florence, Florence, Italy.
| | - G Timon
- Radioterapia Oncologica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - F Matrone
- Department of Radiation Oncology, Centro di Riferimento, Oncologico di Aviano CRO-IRCCS, Aviano, PN, Italy
| | - G Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - L Nicosia
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - L Ognibene
- Radiotheray Unit, San Gaetano Radiotherapy and Nuclear Medicine Center, Palermo, Italy
| | - A Vinciguerra
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
| | - L E Trodella
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128, Rome, Italy
| | - C Franzese
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Hospital-IRCCS, Via Manzoni 56, Rozzano, Milan, Italy
| | - P Borghetti
- Radiation Oncology Department, University and Spedali Civili of Brescia, Brescia, Italy
| | - B A Jereczek-Fossa
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - S Arcangeli
- Department of Radiation Oncology, School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
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10
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Francolini G, Trodella LE, Marvaso G, Matrone F, Nicosia L, Timon G, Ognibene L, Vinciguerra A, Franzese C, Borghetti P, Arcangeli S. Radiotherapy role in non-seminomatous germ cell tumors, radiobiological and technical issues of an unexplored scenario. Int J Clin Oncol 2021; 26:1777-1783. [PMID: 34273014 DOI: 10.1007/s10147-021-01989-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/07/2021] [Indexed: 12/01/2022]
Abstract
Historically, non-seminomatous germ cell tumor (NSGCT) has been considered a radio-resistant disease, excluding radiotherapy (RT) from curative strategies. However, case series exploring the use of radiation treatment in this setting are often outdated, and prospective ongoing studies testing new radiotherapeutic approaches in NSGCT are lacking. Considering that tremendous advances in radiotherapy technology have enabled improved precision in RT delivery as well as dose escalation while decreasing treatment-related morbidity, we overviewed the currently available literature to explore the radiobiological basis, the technical issues, and potential strategies for implementation of RT in the management of this clinical entity. The purpose of the present overview is to provide insight for future research in this unexplored scenario. In summary, the biological rationale for RT use and potential implementation with systemic therapies exist, especially considering the advantage of new technologies, which were unavailable in the era of early literature reports. The NSGCT radioresistance paradigm could be based only on the fact that effective treatment schedules were simply undeliverable with older RT techniques due to toxicity issues, but the availability of actual techniques may prompt further exploration to offer treatment alternatives to these patients. Ongoing trials on this issue are lacking, but potential areas of research are platinum-refractory disease and consolidation therapy for residual masses after PST.
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Affiliation(s)
- Giulio Francolini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy.
| | - Luca Eolo Trodella
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128, Rome, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Fabio Matrone
- Department of Radiation Oncology, Centro di Riferimento Oncologico di Aviano CRO-IRCCS, Aviano, Pordenone, Italy
| | - Luca Nicosia
- Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, via Don Sempreboni 5, 37034, Verona, Negrar, Italy
| | - Giorgia Timon
- Radioterapia Oncologica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Ognibene
- Radiotherapy Unit, San Gaetano Radiotherapy and Nuclear Medicine Center, Palermo, Italy
| | - Annamaria Vinciguerra
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
| | - Ciro Franzese
- Department of Biomedical Sciences, Humanitas University, Radiotherapy and Radiosurgery Department -Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy
| | - Paolo Borghetti
- Radiation Oncology Department, University and Spedali Civili of Brescia, Brescia, Italy
| | - Stefano Arcangeli
- Department of Radiation Oncology, School of Medicine and Surgery-University of Milan Bicocca, Milan, Italy
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11
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Vinciguerra A, Nanty I, Guillaumin C, Rusch E, Cornu L, Courtois R. Les déterminants du décrochage dans l’enseignement secondaire : une revue de littérature. Psychologie Française 2021. [DOI: 10.1016/j.psfr.2019.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Patani F, Fasciolo D, Allajbej A, Trignani M, Di Tommaso M, Augurio A, Vinciguerra A, Caravatta L, Genovesi D. PO-1183: Do we need sigma constraints in era of intensity-modulated radiation therapy for prostate cancer? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01201-9] [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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13
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Trimarchi M, Rampi A, Vinciguerra A, Polizzi E, Policaro NS, Gastaldi G. Palatal prosthetic rehabilitation in patients affected by cocaine-induced midline destructive lesions. J BIOL REG HOMEOS AG 2020; 34:59-68. [PMID: 33412781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Cocaine is one of the most popular illicit drugs in Europe and cocaine-induced midline destructive lesions (CIMDL) represent a rare but destructive consequence of its intranasal use. The extent of lesions can vary remarkably and may include palate perforations with consequent oronasal reflux and hypernasal speech. The therapeutic options encompass surgery, with local and distant flaps, and prosthetic rehabilitation with palatal obturators. We retrospectively reviewed a case series of 6 patients affected by palatal perforation as part of CIMDL, who were treated with a dental or implant-retained palatal obturator at San Raffaele Dentistry Department between 2015 and 2020. In addition, we reviewed the available literature on CIMDL and the prosthetic rehabilitation of palatal perforations in this context. The most frequent symptoms reported were hypernasal speech, oro-nasal reflux, halitosis, and difficulty in interpersonal relationships. Palatal obturators were always successful in the relief of the majority of symptoms, but the duration of the benefit was strongly related to progression of the lesion, and in some cases a close follow-up and continuous modifications of the prosthesis were necessary. In conclusion prosthetic approach is a valid option for the symptomatic relief in CIMDL-related palate perforation. Nevertheless, the short-lasting efficacy for patients with active disease can be the reason for unsatisfactory results.
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Affiliation(s)
- M Trimarchi
- Division of Head and Neck Department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - A Rampi
- Division of Head and Neck Department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - A Vinciguerra
- Division of Head and Neck Department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - E Polizzi
- Dental School, Vita-Salute San Raffaele University, Milan, Italy
- Department of Dentistry IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - N S Policaro
- Dental School, Vita-Salute San Raffaele University, Milan, Italy
| | - G Gastaldi
- Dental School, Vita-Salute San Raffaele University, Milan, Italy
- Department of Dentistry IRCCS San Raffaele Scientific Institute, Milan, Italy
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14
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Caravatta L, Rosa C, Di Sciascio MB, Tavella Scaringi A, Di Pilla A, Ursini LA, Taraborrelli M, Vinciguerra A, Augurio A, Di Tommaso M, Trignani M, Nuzzo M, Falco MD, De Nicola A, Adorante N, Patani F, Centofanti G, Gasparini L, Fasciolo D, Di Guglielmo FC, Bonfiglio C, Borgia M, Caravaggio G, Marcucci S, Turchi C, Mancinelli D, Sartori S, Schael T, Muraglia A, Caputi S, D'Amario C, Verì N, Genovesi D. COVID-19 and radiation oncology: the experience of a two-phase plan within a single institution in central Italy. Radiat Oncol 2020; 15:226. [PMID: 32993690 PMCID: PMC7522911 DOI: 10.1186/s13014-020-01670-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND COVID-19 in Italy has led to the need to reorganize hospital protocols with a significant risk of interruption to cancer treatment programs. In this report, we will focus on a management model covering the two phases of the COVID-19 emergency, namely lockdown-phase I and post-lockdown-phase II. METHODS The following steps were taken in the two phases: workload during visits and radiotherapy planning, use of dedicated routes, measures for triage areas, management of suspected and positive COVID-19 cases, personal protective equipment, hospital environments and intra-institutional meetings and tumor board management. Due to the guidelines set out by the Ministry of Health, oncological follow-up visits were interrupted during the lockdown-phase I; consequently, we set about contacting patients by telephone, with laboratory and instrumental exams being viewed via telematics. During the post-lockdown-phase II, the oncological follow-up clinic reopened, with two shifts operating daily. RESULTS By comparing our radiotherapy activity from March 9 to May 4 2019 with the same period in 2020 during full phase I of the COVID-19 emergency, similar results were achieved. First radiotherapy visits, Simulation Computed Tomography and Linear Accelerator treatments amounted to 123, 137 and 151 in 2019 compared with 121, 135 and 170 in 2020 respectively. There were no cases of COVID-19 positivity recorded either in patients or in healthcare professionals, who were all negative to the swab tests performed. CONCLUSION During both phases of the COVID-19 emergency, the planned model used in our own experience guaranteed both continuity in radiotherapy treatments whilst neither reducing workload nor interrupting treatment and, as such, it ensured the safety of cancer patients, hospital environments and staff.
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Affiliation(s)
- Luciana Caravatta
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy.
| | - Consuelo Rosa
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | | | | | - Angelo Di Pilla
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Lucia Anna Ursini
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Maria Taraborrelli
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Annamaria Vinciguerra
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Antonietta Augurio
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Monica Di Tommaso
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Marianna Trignani
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Marianna Nuzzo
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Maria Daniela Falco
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Andrea De Nicola
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Nico Adorante
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Fabiola Patani
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Giuseppe Centofanti
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Lucrezia Gasparini
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - David Fasciolo
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Fiorella Cristina Di Guglielmo
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Cecilia Bonfiglio
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Marzia Borgia
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Gabriella Caravaggio
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Stefano Marcucci
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Consalvo Turchi
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Domenico Mancinelli
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | - Stephanie Sartori
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy
| | | | | | | | | | - Nicoletta Verì
- Abruzzo Region Health Policy Department, L'Aquila, Italy
| | - Domenico Genovesi
- Department of Radiation Oncology, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via Dei Vestini, 66100, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
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Pianta L, Vinciguerra A, Bertazzoni G, Morello R, Mangiatordi F, Lund VJ, Trimarchi M. Acetic acid disinfection as a potential adjunctive therapy for non-severe COVID-19. Eur Arch Otorhinolaryngol 2020; 277:2921-2924. [PMID: 32449022 PMCID: PMC7245632 DOI: 10.1007/s00405-020-06067-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/25/2020] [Accepted: 05/18/2020] [Indexed: 11/29/2022]
Abstract
Purpose SARS-CoV-2 is a new pandemic influenza caused by a coronavirus which main route of transmission is through exhaled droplets that primarily infect the nose and the nasopharynx. The aim of this paper is to evaluate the effect of acetic acid, the active component of vinegar, as a potential disinfectant agent for upper airways. Methods Twenty-nine patients were enrolled and divided into two groups: group 1 (14 patients) was composed of patients treated with off-label hydroxychloroquine and lopinavir/ritonavir, whereas group 2 (15 patients) was composed of patients treated with hydroxychloroquine only, combined with the inhalation of acetic acid disinfectant at a 0.34% concentration. A questionnaire-based evaluation of symptoms was performed after 15 days in both groups. Results It appears that the number of patients treated with acetic acid (group 2) that experienced improvement in individual symptoms was double that of the other group of patients (group 1), although numbers are too small for robust statistical analysis. Conclusions Considering its potential benefits and high availability, acetic acid disinfection appears to be a promising adjunctive therapy in cases of non-severe COVID-19 and deserves further investigation.
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Affiliation(s)
- L Pianta
- Department of Otorhinolaryngology, ASST Cremona, Cremona, Italy
| | - A Vinciguerra
- Division of Head and Neck Department, Otorhinolaryngology Unit, San Raffaele Hospital, IRCCS San Raffaele Scientific Institute, Via Olgettina, 68, 20100, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milano, Italy
| | - G Bertazzoni
- Department of Otorhinolaryngology, ASST Cremona, Cremona, Italy
| | - R Morello
- Department of Otorhinolaryngology, ASST Cremona, Cremona, Italy
| | - F Mangiatordi
- Department of Emergency, ASST Cremona, Cremona, Italy
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, UCLH, London, UK
| | - M Trimarchi
- Division of Head and Neck Department, Otorhinolaryngology Unit, San Raffaele Hospital, IRCCS San Raffaele Scientific Institute, Via Olgettina, 68, 20100, Milan, Italy. .,School of Medicine, Vita-Salute San Raffaele University, Milano, Italy.
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16
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Pignataro G, Brancaccio P, Laudati G, Valsecchi V, Anzilotti S, Casamassa A, Cuomo O, Vinciguerra A. Sodium/calcium exchanger as main effector of endogenous neuroprotection elicited by ischemic tolerance. Cell Calcium 2020; 87:102183. [PMID: 32120196 DOI: 10.1016/j.ceca.2020.102183] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/12/2020] [Accepted: 02/16/2020] [Indexed: 12/13/2022]
Abstract
The ischemic tolerance (IT) paradigm represents a fundamental cell response to certain types or injury able to render an organ more "tolerant" to a subsequent, stronger, insult. During the 16th century, the toxicologist Paracelsus described for the first time the possibility that a noxious event might determine a state of tolerance. This finding was summarized in one of his most important mentions: "The dose makes the poison". In more recent years, ischemic tolerance in the brain was first described in 1991, when it was demonstrated by Kirino and collaborators that two minutes of subthreshold brain ischemia in gerbils produced tolerance against global brain ischemia. Based on the time in which the conditioning stimulus is applied, it is possible to define preconditioning, perconditioning and postconditioning, when the subthreshold insult is applied before, during or after the ischemic event, respectively. Furthermore, depending on the temporal delay from the ischemic event, two different modalities are distinguished: rapid or delayed preconditioning and postconditioning. Finally, the circumstance in which the conditioning stimulus is applied on an organ distant from the brain is referred as remote conditioning. Over the years the "conditioning" paradigm has been applied to several brain disorders and a number of molecular mechanisms taking part to these protective processes have been described. The mechanisms are usually classified in three distinct categories identified as triggers, mediators and effectors. As concerns the putative effectors, it has been hypothesized that brain cells appear to have the ability to adapt to hypoxia by reducing their energy demand through modulation of ion channels and transporters, which delays anoxic depolarization. The purpose of the present review is to summarize the role played by plasmamembrane proteins able to control ionic homeostasis in mediating protection elicited by brain conditioning, particular attention will be deserved to the role played by Na+/Ca2+ exchanger.
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Affiliation(s)
- G Pignataro
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy.
| | - P Brancaccio
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | - G Laudati
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | - V Valsecchi
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | | | - A Casamassa
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | - O Cuomo
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | - A Vinciguerra
- Division of Pharmacology, Department of Neuroscience, School of Medicine, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
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17
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Rosa C, Gasparini L, Di Biase S, Di Carlo C, Allajbej A, Patani F, Fasciolo D, Vinciguerra A, Caravatta L, Genovesi D. EP-1460 Internal Margin evaluation in prone or supine rectal cancer patients using CBCT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31880-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Allajbei A, Patani F, Trignani M, Di Pilla A, Bagalà P, Vinciguerra A, Augurio A, Caravaggio G, Falco M, Genovesi D. PO-129 Set-up errors in head and neck cancer patients undergoing IGRT. Relationship to BMI and weight loss. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30295-6] [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: 10/27/2022]
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Rosa C, Di Tommaso M, Caravatta L, Vinciguerra A, Augurio A, Perrotti F, Allajbej A, Regoli M, Zecca IA, Di Nicola M, Genovesi D. Assessment of bowel and anal sphincter function after neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Tumori 2018; 104:121-127. [PMID: 29714663 DOI: 10.1177/0300891618765580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To report long-term effects on anorectal function and bowel disorders and late toxicity rate of preoperative chemoradiotherapy in patients with locally advanced rectal cancer. METHODS Between 2000 and 2016, 201 patients treated with different neoadjuvant schedules of chemotherapy and radiotherapy doses were retrospectively analyzed. The Memorial Sloan-Kettering Cancer Center score was used for the evaluation of anal sphincter function. RESULTS The median follow-up time was 68 months (interquartile range 35-113 months). Radical resection was performed in 188 (93.5%) patients with a pathologic complete response rate of 26.4%. Overall sphincter function resulted excellent in 105 (52.2%) patients, good in 13 (6.5%), fair in 10 (5.0%), and poor (incontinence) in 40 (19.9%), with a persistent stoma rate of 16.4%. A further evaluation on 194 patients showed an improvement of sphincter function after 2 years in 11.9% of them. Seventy-three patients presenting stoma or poor sphincter function were re-evaluated for quality of life (QoL) indexes. Twenty-one (29%), 19 (26%), and 24 (33%) of them declared some variations concerning well-being, fatigue, and ability to perform daily activities. The 5-year overall survival, disease-free survival, and local recurrence rates were 88.0% ± 2.6%, 86.3% ± 2.5%, and 94.6% ± 1.9%, respectively. CONCLUSIONS In our study, neoadjuvant chemoradiotherapy was associated with good results in terms of sphincter function, late toxicities, and QoL indexes. A routine use of assessment scales could contribute to a better selection of patients with increased risk of developing functional disorders who could benefit from neoadjuvant therapy.
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Affiliation(s)
- Consuelo Rosa
- 1 Department of Radiation Oncology, SS Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Monica Di Tommaso
- 1 Department of Radiation Oncology, SS Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Luciana Caravatta
- 1 Department of Radiation Oncology, SS Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Annamaria Vinciguerra
- 1 Department of Radiation Oncology, SS Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Antonietta Augurio
- 1 Department of Radiation Oncology, SS Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Francesca Perrotti
- 1 Department of Radiation Oncology, SS Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Albina Allajbej
- 1 Department of Radiation Oncology, SS Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Marco Regoli
- 1 Department of Radiation Oncology, SS Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Isaia Al Zecca
- 2 Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti, Italy
| | - Marta Di Nicola
- 2 Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University, Chieti, Italy
| | - Domenico Genovesi
- 1 Department of Radiation Oncology, SS Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
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Falco M, Clemente S, Cagni E, Landoni V, Russo S, Talamonti C, Alparone A, Vinciguerra A, Fiandra C. EP-1946: Effect of small field (SF) output factor (OF) measurements on FSBRT VMAT plans. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32255-2] [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: 11/13/2022]
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21
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Rosa C, Caravatta L, Di Tommaso M, Cianci R, Delli Pizzi A, Vinciguerra A, Zecca I, Di Nicola M, Genovesi D. EP-1493: T2 and Diffusion weighted MRI for GTV delineation in rectal cancer: agreement between volumes. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31802-4] [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: 11/16/2022]
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Falco M, Giancaterino S, De Nicola A, Adorante N, Gimenez De Lorenzo R, Di Tommaso M, Vinciguerra A, Trignani M, Allajbej A, Greco F, Grusio M, Piermattei A, Genovesi D. EP-1755: In-Vivo Dosimetry: A Feasibility Study in Routine Clinical Practice. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32064-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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23
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Allajbej A, Patani F, Trignani M, Di Pilla A, Bagalà P, Vinciguerra A, Caravaggio G, Falco M, Genovesi D. EP-1156: Set-up errors in head and neck cancer patients undergoing IGRT. Relationship to BMI and weight loss. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31466-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: 10/14/2022]
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Di Biase S, Trignani M, Di Carlo C, Voicu I, Gentile L, Augurio A, Caulo M, Vinciguerra A, Genovesi D. EP-1643: Applicability of reference atlases to hippocampal contouring in paediatric radiotherapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31952-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Di Carlo C, Trignani M, Caravatta L, Vinciguerra A, Augurio A, Perrotti F, Di Tommaso M, Nuzzo M, Giancaterino S, Falco MD, Genovesi D. Hippocampal sparing in stereotactic radiotherapy for brain metastases: To contour or not contour the hippocampus? Cancer Radiother 2018; 22:120-125. [PMID: 29576492 DOI: 10.1016/j.canrad.2017.08.113] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/23/2017] [Accepted: 08/10/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of our study was to evaluate hippocampal irradiation in patients treated with fractionated stereotactic brain radiotherapy. PATIENTS AND METHODS Retrospective hippocampal dosimetric analysis performed on 22 patients with one to four brain metastases treated with fractionated stereotactic radiotherapy using volumetric intensity-modulated arc therapy. Original plans did not include hippocampus as avoidance structure in optimization criteria; hippocampus was retrospectively delineated on magnetic resonance coregistered with planning CT and using as reference the RTOG 0933 atlas. Hippocampus was defined both as a single and as pair organ. Constraints analysed were: Dmax<16Gy, D40%<7.3Gy, D100%=Dmin<9Gy. Assuming a α/β ratio of 2Gy, biologically equivalent dose in 2Gy fractions was calculated. Hippocampal-sparing plans were developed in cases where hippocampal constraints were not respected in the original plan. RESULTS Among constraints analysed Dmax and D40% have been exceeded in ten out of 22 cases. The constraints were not respected in patients with more than one metastatic lesion and in three patients with only one lesion. Considering all exceeded constraints values in non-hippocampal sparing plans, the 50% of them was respected after replanning. No significant differences were found among conformity and homogeneity index between non-hippocampal sparing and hippocampal sparing plans. CONCLUSION Volumetric intensity-modulated arc therapy hippocampal sparing plans significantly decreases dose to hippocampus assuring an equal target coverage and organs at risk avoiding.
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Affiliation(s)
- C Di Carlo
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - M Trignani
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - L Caravatta
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - A Vinciguerra
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - A Augurio
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - F Perrotti
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - M Di Tommaso
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - M Nuzzo
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - S Giancaterino
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - M D Falco
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy
| | - D Genovesi
- Department of Radiation Oncology, "G. D'Annunzio" University of Chieti, SS. Annunziata Hospital, Via Dei Vestini, 66100 Chieti, Italy.
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Cèfaro GA, Genovesi D, Vinciguerra A, Augurio A, Di Tommaso M, Marchese R, Borzillo V, Tasciotti L, Taraborrelli M, Innocenti P, Colecchia G, Di Nicola M. Effects of Preoperative Radiochemotherapy with Capecitabine for Resectable Locally Advanced Rectal Cancer in Elderly Patients. Tumori 2018; 98:622-9. [DOI: 10.1177/030089161209800513] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Aims and background Rectal cancer is a common disease of elderly people. However, patients over 70 years of age are often not included in clinical trials. There is a lack of data concerning the use of radiochemotherapy with capecitabine in elderly patients. The aim of this study was to retrospectively evaluate the impact of preoperative radiochemotherapy with capecitabine on downstaging and sphincter preservation and to assess treatment compliance and toxicity in elderly patients. Methods Twenty-six patients with resectable locally advanced rectal cancer (stage II-III/TNM) aged >70 years received preoperative radiotherapy and concurrent oral capecitabine 825 mg/m2 twice daily during the whole period of radiotherapy. Two patients who refused surgery after chemoradiation therapy were excluded from the analysis. Results Eighty-one percent of patients underwent anterior resection and 18.1% underwent abdominoperineal resection. Overall tumor downstaging, considering both T and N categories, was observed in 18/24 patients (75%). Treatment compliance was good and toxicity rates were similar to those of younger people. Conclusions Age is not a contraindication to any therapy and elderly patients who can tolerate radiochemotherapy should be treated like younger patients. Preoperative radiochemotherapy with capecitabine for patients aged >70 years has a good impact on tumor downstaging, increases the feasibility of sphincter-preserving surgery, and is also safe and well tolerated.
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Affiliation(s)
| | - Domenico Genovesi
- Radiation Oncology Department, G d'Annunzio University, Chieti, Italy
| | | | | | - Monica Di Tommaso
- Radiation Oncology Department, G d'Annunzio University, Chieti, Italy
| | - Rita Marchese
- Radiation Oncology Department, G d'Annunzio University, Chieti, Italy
| | | | - Lucia Tasciotti
- Radiation Oncology Department, G d'Annunzio University, Chieti, Italy
| | | | - Paolo Innocenti
- Surgery Department, G. d'Annunzio University, Chieti, G d'Annunzio University, Chieti, Italy
| | - Giuseppe Colecchia
- Surgery Department, Santo Spirito Hospital, Pescara, G d'Annunzio University, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Biomedical Science, G d'Annunzio University, Chieti, Italy
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Falco MD, Giancaterino S, De Nicola A, Adorante N, De Lorenzo RG, Di Tommaso M, Vinciguerra A, Trignani M, Perrotti F, Allajbej A, Fidanzio A, Greco F, Grusio M, Genovesi D, Piermattei A. A Feasibility Study for in vivo Dosimetry Procedure in Routine Clinical Practice. Technol Cancer Res Treat 2018; 17:1533033818779201. [PMID: 29871570 PMCID: PMC5992805 DOI: 10.1177/1533033818779201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: The aim of the in vivo dosimetry, during the fractionated radiation therapy, is the verification of the correct dose delivery to patient. Nowadays, in vivo dosimetry procedures for photon beams are based on the use of the electronic portal imaging device and dedicated software to elaborate electronic portal imaging device images. Methods: In total, 8474 in vivo dosimetry tests were carried out for 386 patients treated with 3-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and volumetric modulated arc therapy techniques, using the SOFTDISO. SOFTDISO is a dedicated software that uses electronic portal imaging device images in order to (1) calculate the R index, that is, the ratio between daily reconstructed dose and the planned one at isocenter and (2) perform a γ-like analysis between the signals, S, of a reference electronic portal imaging device image and that obtained in a daily fraction. It supplies 2 indexes, the percentage γ% of points with γ < 1 and the mean γ value, γmean. In γ-like analysis, the pass criteria for the signals agreement ΔS% and distance to agreement Δd have been selected based on the clinical experience and technology used. The adopted tolerance levels for the 3 indexes were fixed in 0.95 ≤ R ≤ 1.05, γ% ≥ 90%, and γmean ≤ 0.5. Results: The results of R ratio, γ-like, and a visual inspection of these data reported on a monitor screen permitted to individuate 2 classes of errors (1) class 1 that included errors due to inadequate standard quality controls and (2) class 2, due to patient morphological changes. Depending on the technique and anatomical site, a maximum of 18% of tests had at least 1 index out of tolerance; once removed the causes of class-1 errors, almost all patients (except patients with 4 lung and 2 breast cancer treated with 3-dimensional conformal radiotherapy) presented mean indexes values (R¯, γ¯%, and γ¯mean
) within tolerance at the end of treatment course. Class-2 errors were found in some patients. Conclusions: The in vivo dosimetry procedure with SOFTDISO resulted easily implementable, able to individuate errors with a limited workload.
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Affiliation(s)
- Maria D Falco
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Stefano Giancaterino
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Andrea De Nicola
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Nico Adorante
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Ramon Gimenez De Lorenzo
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Monica Di Tommaso
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Annamaria Vinciguerra
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Marianna Trignani
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Francesca Perrotti
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Albina Allajbej
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Andrea Fidanzio
- 2 Unità Operativa di Fisica Sanitaria; Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesca Greco
- 2 Unità Operativa di Fisica Sanitaria; Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Mattia Grusio
- 2 Unità Operativa di Fisica Sanitaria; Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Domenico Genovesi
- 1 Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Angelo Piermattei
- 2 Unità Operativa di Fisica Sanitaria; Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy
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Nuzzo M, Bisceglia A, Giordano M, Giaccherini L, Guido A, Macchia G, Vinciguerra A, Mantello G, Sallustio G, Cilla S, Cammelli S, Deodato F, Buwenge M, Genovesi D, Fuccio L, Morganti AG. Clinical Target Volume Definition in Preoperative Radiotherapy of Rectal Carcinoma: a Systematic Review. Curr Colorectal Cancer Rep 2017. [DOI: 10.1007/s11888-017-0375-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Di Biase S, Trignani M, Caravatta L, Voicu PI, Di Carlo C, Vinciguerra A, Augurio A, Perrotti F, Panara V, Genovesi D. Development of a contouring guide in three different head set-ups for hippocampal sparing radiotherapy: a practical approach. Radiol Med 2017; 122:683-689. [PMID: 28510808 DOI: 10.1007/s11547-017-0775-1] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 05/01/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUNDS Irradiation of the hippocampus plays a role in neurocognitive toxicity. Its delineation is complex and in practice different head position can vary hippocampus morphology on axial images; so atlas in a single standard position can result ineffective to describe different hippocampal morphologies in different head set-up. The purpose of our study was to develop a guide based on magnetic resonance imaging for hippocampus delineation in three different head set-ups. MATERIALS AND METHODS Three patients were selected to elaborate our guide. Patients were submitted to a planning computed tomography of the brain district in different head positions: 1° patient in neutral, 2° patient in over-extended and 3° patient in head hypo-extended position; axial images of 2-mm thickness were obtained. Computed tomography images were fused with diagnostic brain magnetic resonance images; then hippocampus was delineated according to RTOG atlas. Contours were revised by two neuro-radiologists with >5-year expertise in neuroimaging. RESULTS A guide was developed for each of three head positions considered. RTOG atlas provided an easy and reliable guide for hippocampus delineation in neutral position of the head. Discrepancies were observed in cranial and caudal limit in case of head over/hypo-extension, as well as in hippocampal morphology near the encephalic trunk where hippocampus takes an oblong shape in over-extended set-up, and short and stocky in hypo-extension. CONCLUSION Our guide can represent a useful tool for hippocampal delineation in clinical practice and for different anatomic variations due to different head positions. Certainly, it should be validated in practice.
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Affiliation(s)
- Saide Di Biase
- Department of Radiotherapy, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Marianna Trignani
- Department of Radiotherapy, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy.
| | - Luciana Caravatta
- Department of Radiotherapy, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Paul Ioan Voicu
- Section of Diagnostic Imaging and Therapy, Radiology Division, Department of Neuroscience and Imaging, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Clelia Di Carlo
- Department of Radiotherapy, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Annamaria Vinciguerra
- Department of Radiotherapy, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Antonietta Augurio
- Department of Radiotherapy, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Francesca Perrotti
- Department of Radiotherapy, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Valentina Panara
- Section of Diagnostic Imaging and Therapy, Radiology Division, Department of Neuroscience and Imaging, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Domenico Genovesi
- Department of Radiotherapy, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
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Di Carlo C, Di Biase S, Caravatta L, Caponigro G, Rosa C, Di Biase M, Perrotti F, Trignani M, Vinciguerra A, Augurio A, Giancaterino S, De Nicola A, Falco M, Genovesi D. EP-1123: To contour or not contour hippocampus in stereotactic brain radiotherapy? A dosimetric study. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31559-1] [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: 11/17/2022]
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Taraborrelli M, Nuzzo M, Vinciguerra A, Trignani M, Perrotti F, Di Carlo C, Di Biase S, Rosa C, Genovesi D. PUB113 Organs at Risk Contouring in Lung Cancer Radiation Therapy: An Anatomo-Radiological Atlas. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.2084] [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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Taraborrelli M, Nuzzo M, Trignani M, Vinciguerra A, Augurio A, Perrotti F, Caponigro G, Di Biase M, Genovesi D. PUB112 Comparison of Two Atlases to Delineate Organ at Risks Contouring in Lung Cancer Radiation Therapy. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.2083] [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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Taraborrelli M, Nuzzo M, Vinciguerra A, Augurio A, Perrotti F, Di Biase S, Di Carlo C, Genovesi D. PUB111 Delineating Mediastinal Lymph Nodal Clinical Target Volume: Comparison of Two Atlases and Practical Implications. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.2082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Callea M, Yavuz I, Clarich G, Gunay A, Vinciguerra A, Unal M, Sahbaz C, Sinan Dogan M, Cammarata-Scalisi F. A case of Beckwith-Wiedemann syndrome with peculiar dental findings. Eur J Paediatr Dent 2016; 17:315-317. [PMID: 28045321] [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: 06/06/2023]
Abstract
BACKGROUND Beckwith-Wiedemann syndrome (BWS, OMIM 130650) is a rare genetic disorder characterised by overgrowth, tumor predisposition and congenital malformations. Few systemic manifestations and oral features have been reported so far. CASE REPORT We report on a case of BWS, describing all features expanding the knowledge on oro-dento-facial phenotypes, along with a review of the literature.
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Affiliation(s)
- M Callea
- Unit of Dentistry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - I Yavuz
- Department of Paediatric Dentistry, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - G Clarich
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - A Gunay
- Department of Paediatric Dentistry, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - A Vinciguerra
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - M Unal
- Afyon Kocatepe University, Faculty of Dentistry, Department of Paediatric Dentistry, Afyon, Turkey
| | - C Sahbaz
- Afyon Kocatepe University, Faculty of Dentistry, Department of Restorative Dentistry, Afyon, Turkey
| | - M Sinan Dogan
- Department of Paediatric Dentistry, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - F Cammarata-Scalisi
- Unit of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of The Andes, Mérida, Venezuela
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Adorante N, Perrotti F, Giancaterino S, De Nicola A, Vinciguerra A, Bagalà P, Genovesi D, Falco M. Dosimetric comparison of 3D-conformal radiotherapy, intensity-modulated radiotherapy and volumetric-modulated ARC therapy for upper abdominal tumors. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gargiulo S, Anzilotti S, Coda ARD, Gramanzini M, Greco A, Panico M, Vinciguerra A, Zannetti A, Vicidomini C, Dollé F, Pignataro G, Quarantelli M, Annunziato L, Brunetti A, Salvatore M, Pappatà S. Imaging of brain TSPO expression in a mouse model of amyotrophic lateral sclerosis with (18)F-DPA-714 and micro-PET/CT. Eur J Nucl Med Mol Imaging 2016; 43:1348-59. [PMID: 26816193 DOI: 10.1007/s00259-016-3311-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 10/07/2015] [Accepted: 01/05/2016] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate the feasibility and sensitivity of (18)F-DPA-714 for the study of microglial activation in the brain and spinal cord of transgenic SOD1(G93A) mice using high-resolution PET/CT and to evaluate the Iba1 and TSPO expression with immunohistochemistry. METHODS Nine symptomatic SOD1(G93A) mice (aged 117 ± 12.7 days, clinical score range 1 - 4) and five WT SOD1 control mice (aged 108 ± 28.5 days) underwent (18)F-DPA-714 PET/CT. SUV ratios were calculated by normalizing the cerebellar (rCRB), brainstem (rBS), motor cortex (rMCX) and cervical spinal cord (rCSC) activities to that of the frontal association cortex. Two WT SOD1 and six symptomatic SOD1(G93A) mice were studied by immunohistochemistry. RESULTS In the symptomatic SOD1(G93A) mice, rCRB, rBS and rCSC were increased as compared to the values in WT SOD1 mice, with a statistically significantly difference in rBS (2.340 ± 0.784 vs 1.576 ± 0.287, p = 0.014). Immunofluorescence studies showed that TSPO expression was increased in the trigeminal, facial, ambiguus and hypoglossal nuclei, as well as in the spinal cord, of symptomatic SOD1(G93A) mice and was colocalized with increased Iba1 staining. CONCLUSION Increased (18)F-DPA-714 uptake can be detected with high-resolution PET/CT in the brainstem of transgenic SOD1(G93A) mice, a region known to be a site of degeneration and increased microglial activation in amyotrophic lateral sclerosis, in agreement with increased TSPO expression in the brainstem nuclei shown by immunostaining. Therefore, (18)F-DPA-714 PET/CT might be a suitable tool to evaluate microglial activation in the SOD1(G93A) mouse model.
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Affiliation(s)
- S Gargiulo
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145, Naples, Italy.,Ceinge Biotecnologie Avanzate s. c. a r. l., Via G. Salvatore 486, 80145, Naples, Italy
| | - S Anzilotti
- IRCCS SDN, Via E. Gianturco 113, 80143, Naples, Italy
| | - A R D Coda
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145, Naples, Italy
| | - M Gramanzini
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145, Naples, Italy.,Ceinge Biotecnologie Avanzate s. c. a r. l., Via G. Salvatore 486, 80145, Naples, Italy
| | - A Greco
- Ceinge Biotecnologie Avanzate s. c. a r. l., Via G. Salvatore 486, 80145, Naples, Italy.,Department of Advanced Biomedical Sciences, University "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - M Panico
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145, Naples, Italy
| | - A Vinciguerra
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, University "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - A Zannetti
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145, Naples, Italy
| | - C Vicidomini
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145, Naples, Italy
| | - F Dollé
- CEA, Institute for Biomedical Imaging, 4 Place du Général Leclerc, 91401, Orsay, France
| | - G Pignataro
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, University "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - M Quarantelli
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145, Naples, Italy
| | - L Annunziato
- IRCCS SDN, Via E. Gianturco 113, 80143, Naples, Italy.,Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, University "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - A Brunetti
- Ceinge Biotecnologie Avanzate s. c. a r. l., Via G. Salvatore 486, 80145, Naples, Italy.,Department of Advanced Biomedical Sciences, University "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - M Salvatore
- IRCCS SDN, Via E. Gianturco 113, 80143, Naples, Italy
| | - S Pappatà
- Institute of Biostructure and Bioimaging, National Research Council, Via T. De Amicis 95, 80145, Naples, Italy.
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Callea M, Nieminen P, Willoughby CE, Clarich G, Yavuz I, Vinciguerra A, Di Stazio M, Giglio S, Sani I, Maglione M, Pensiero S, Tadini G, Bellacchio E. A novel INDEL mutation in the EDA gene resulting in a distinct X- linked hypohidrotic ectodermal dysplasia phenotype in an Italian family. J Eur Acad Dermatol Venereol 2014; 30:341-3. [PMID: 25266272 DOI: 10.1111/jdv.12747] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Callea
- Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | - P Nieminen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Institute of Dentistry, Helsinki University Central Hospital, Helsinki, Finland
| | - C E Willoughby
- Department of Eye and Vision Science, University of Liverpool, Institute of Ageing and Chronic Disease, Liverpool, UK
| | - G Clarich
- Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | - I Yavuz
- Department of Pediatric Dentistry, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - A Vinciguerra
- Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | - M Di Stazio
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - S Giglio
- Medical Genetics Section, Department of Clinical Pathophysiology, University of Florence, Florence, Italy.,Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - I Sani
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - M Maglione
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - S Pensiero
- Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | - G Tadini
- Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico Milano, Milan, Italy.,Department of Pediatric Dermatology, University of Milan, Milan, Italy
| | - E Bellacchio
- Bambino Gesù Children's Hospital IRCCS, Research Laboratory, Rome, Italy
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Trignani M, Genovesi D, Vinciguerra A, Di Pilla A, Augurio A, Di Tommaso M, Cèfaro GA, Di Nicola M. Parotid glands in whole-brain radiotherapy: 2D versus 3D technique for no sparing or sparing. Radiol Med 2014; 120:324-8. [PMID: 25033946 DOI: 10.1007/s11547-014-0436-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 03/12/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE Whole-brain radiotherapy is performed as standard therapy in patients with multiple brain metastases and in patients with more favourable prognosis such as lymphoma and small-cell lung carcinoma in the prophylactic setting. Because of the prognosis and the total prescribed dose, the parotid glands are not usually regarded as an organ at risk in whole-brain radiotherapy. Long-term survival can be expected in some of these patients and late toxicity can be observed, becoming essential to evaluate organs at risk, particularly the parotid glands even in metastatic patients. We compared the 2D with 3D technique to evaluate parotid glands involvement and received dose, and coverage of the clinical target volume. MATERIALS AND METHODS Seven patients were considered. The prescribed dose was 30 Gy in ten fractions. On the same day and with the same set-up, all the treatment planning were performed using a 2D and 3D technique. A treatment plan was performed following same technical characteristics as the 2D technique. The parotid glands and whole brain were delineated. Dose-volume statistics were analysed. RESULTS Dose-volume histograms of the parotid glands showed that 2/7 patients (28 %) received a mean dose >20 Gy. We found a lack of coverage of the clinical target volume in 6/7 patients. CONCLUSIONS Planning whole-brain radiotherapy with only the 2D technique involves a risk of including parotid glands in the field and not covering the clinical target volume. The 3D technique should be systematically performed and the parotid glands should be regarded as an organ at risk in whole-brain radiotherapy.
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Affiliation(s)
- Marianna Trignani
- Department of Radiation Oncology, G. D'Annunzio University, SS. Annunziata Hospital, via dei Vestini, 66100, Chieti, Italy
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Callea M, Willoughby C, Nieminen P, Di Stazio M, Bellacchio E, Giglio S, Sani I, Vinciguerra A, Maglione M, Tadini G, Clarich G. Identification of a novel frameshift mutation in the EDAR
gene causing autosomal dominant hypohidrotic ectodermal dysplasia. J Eur Acad Dermatol Venereol 2014; 29:1032-4. [DOI: 10.1111/jdv.12457] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- M. Callea
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”- Trieste; Italy
| | - C.E. Willoughby
- Department of Eye and Vision Science; Institute of Ageing and Chronic Disease; University of Liverpool; Liverpool UK
| | - P. Nieminen
- Department of Oral and Maxillofacial Diseases; Institute of Dentistry; Helsinki University Central Hospital; University of Helsinki; Helsinki Finland
| | - M. Di Stazio
- Department of Medical, Surgical and Health Sciences; University of Trieste; Trieste Italy
| | - E. Bellacchio
- Research Laboratory; Bambino Gesù Children's Hospital IRCCS; Rome Italy
| | - S. Giglio
- Department of Clinical Pathophysiology; Medical Genetics Section; University of Florence; Florence Italy
- Medical Genetics Unit; Meyer Children's University Hospital; Florence Italy
| | - I. Sani
- Medical Genetics Unit; Meyer Children's University Hospital; Florence Italy
| | - A. Vinciguerra
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”- Trieste; Italy
| | - M. Maglione
- Department of Medical, Surgical and Health Sciences; University of Trieste; Trieste Italy
| | - G. Tadini
- Fondazione IRCCS Cà Granda; Ospedale Maggiore Policlinico Milano; Milan Italy
- Department of Pediatric Dermatology; University of Milan; Milan Italy
| | - G. Clarich
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”- Trieste; Italy
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Genovesi D, Ausili Cèfaro G, Trignani M, Vinciguerra A, Augurio A, Di Tommaso M, Perrotti F, De Paoli A, Olmi P, Valentini V, Di Nicola M. Interobserver variability of clinical target volume delineation in soft-tissue sarcomas. Cancer Radiother 2014; 18:89-96. [PMID: 24440683 DOI: 10.1016/j.canrad.2013.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 11/03/2013] [Accepted: 11/28/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE The present observational study reports the results of a multi-institutional dummy-run designed to estimate the consistency of interobserver variability in clinical target volume delineation in two different cases of soft-tissue sarcomas in which postoperative and preoperative radiotherapy were prescribed, respectively. The purpose of this work was to quantify interobserver variability in routine clinical practice. PATIENTS AND METHODS Two different cases of soft-tissues sarcomas were chosen: a case of postoperative and a case of preoperative radiation therapy. Participating centres were requested to delineate clinical target volumes according to their experience in both cases. Descriptive statistic was calculated for each variable (volume, diameters) separately for two cases. Box-whiskers plots were used for presentation of clinical target volume. A Shapiro-Wilk's test was performed to evaluate the departures from normality distribution for each variable. The comparison between relative variations of diameters was evaluated using the Student's t test. RESULTS Several variations affecting both volumes and diameters were observed. Main variations were observed in the craniocaudal and laterolateral diameters. Each case showed similar dispersion, indicating a lack of reproducibility in volumes definition. CONCLUSIONS This observational study highlighted that, in the absence of specific instructions or guidelines, the interobserver variability can be significant both in postoperative and preoperative radiotherapy of soft-tissue sarcomas.
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Affiliation(s)
- D Genovesi
- Department of Radiotherapy, SS. Annunziata Hospital, "G. D'Annunzio" University, via dei Vestini, 66100 Chieti, Italy.
| | - G Ausili Cèfaro
- Department of Radiotherapy, SS. Annunziata Hospital, "G. D'Annunzio" University, via dei Vestini, 66100 Chieti, Italy
| | - M Trignani
- Department of Radiotherapy, SS. Annunziata Hospital, "G. D'Annunzio" University, via dei Vestini, 66100 Chieti, Italy
| | - A Vinciguerra
- Department of Radiotherapy, SS. Annunziata Hospital, "G. D'Annunzio" University, via dei Vestini, 66100 Chieti, Italy
| | - A Augurio
- Department of Radiotherapy, SS. Annunziata Hospital, "G. D'Annunzio" University, via dei Vestini, 66100 Chieti, Italy
| | - M Di Tommaso
- Department of Radiotherapy, SS. Annunziata Hospital, "G. D'Annunzio" University, via dei Vestini, 66100 Chieti, Italy
| | - F Perrotti
- Department of Radiotherapy, SS. Annunziata Hospital, "G. D'Annunzio" University, via dei Vestini, 66100 Chieti, Italy
| | - A De Paoli
- Department of Radiotherapy C.R.O., Aviano, Italy
| | - P Olmi
- Department of Radiotherapy, Istituto Nazionale Tumori, Milano, Italy
| | - V Valentini
- Department of Radiotherapy "Cattolica Sacro Cuore" University, Roma, Italy
| | - M Di Nicola
- Department of Experimental and Clinical Sciences, Laboratory of Biostatistics, "G. D'Annunzio" University, Chieti, Italy
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Genovesi D, Myerson RJ, Cèfaro GA, Vinciguerra A, Augurio A, Trignani M, DI Tommaso M, Nuzzo M, Lupattelli M, Aristei C, Bellavita R, Scandolaro L, Cosentino D, Pani G, Ziccarelli L, Gambacorta MA, Barba MC, Maranzano E, Trippa F, Sciacero P, Niespolo R, Leonardi C, Iannone T, Rosetto ME, Fusco V, Sanpaolo P, Melano A, Valvo F, Capirci C, DE Paoli A, DI Nicola M, Mantello G, Valentini V. Postoperative 5-FU based radiochemotherapy in rectal cancer: retrospective long term results and prognostic factors of a pooled analysis on 1,338 patients. Anticancer Res 2013; 33:4557-4566. [PMID: 24123031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM To evaluate survival outcomes of patients in pStage II-III rectal cancer treated with adjuvant 5-fluorouracil-based radiochemotherapy and to retrospectively analyze the impact of prognostic variables on local control, metastasis-free survival and cause-specific survival. PATIENTS AND METHODS A total of 1,338 patients, treated between 1985-2005 for locally advanced rectal cancer, who underwent surgery and postoperative 5-fluorouracil-based chemoradiation, were selected. RESULTS The actuarial 5- and 10-year outcomes were: local control 87.0%-84.1%, disease-free survival 61.6%-52.1%, metastasis-free survival 72.0%-67.2%, cause-specific survival 70.4%-57.5%, and overall survival 63.8%-53.4%. Better outcomes were observed in patients with IIA, IIIA stage. Multivariate analyses showed that variables significantly affecting metastasis-free survival were pT4 and pN2, while for cancer-specific survival those variables were age >65 years, pT4, pN1, pN2, distal tumors and number of lymph nodes removed ≤ 12. CONCLUSION This study confirmed that among stage II-III rectal cancer patients there are subgroups of patients with different clinical outcomes.
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Affiliation(s)
- Domenico Genovesi
- Department of Radiotherapy, "SS Annunziata" Hospital, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy.
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Genovesi D, Filippone A, Ausili Cèfaro G, Trignani M, Vinciguerra A, Augurio A, Di Tommaso M, Borzillo V, Sabatino F, Innocenti P, Liberatore E, Colecchia G, Tartaro A, Cotroneo AR. Diffusion-weighted magnetic resonance for prediction of response after neoadjuvant chemoradiation therapy for locally advanced rectal cancer: preliminary results of a monoinstitutional prospective study. Eur J Surg Oncol 2013; 39:1071-8. [PMID: 23953231 DOI: 10.1016/j.ejso.2013.07.090] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 05/08/2013] [Accepted: 07/25/2013] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To evaluate diffusion-weighted imaging (DWI) for assessment of treatment response in locally advanced rectal cancer (LARC) 8 weeks after neoadjuvant chemoradiotherapy (CRT). METHODS AND MATERIALS A total of 28 patients with LARC underwent magnetic resonance imaging (MRI) prior to and 8 weeks after CRT. Tumor volume (TV) was calculated on T2-weighted MRI scans as well as the apparent diffusion coefficient (ADC) was calculated using Echo-planar DWI-sequences. All data were correlated to surgical results and histopathologic tumor regression grade (TRG), according to Mandard's classification. Post-treatment difference ADC (%ΔADC) and TV (%ΔTV) changes at 8 weeks were compared complete response (CR; TRG1) and non-complete response tumors (non-CR; TRG2-5). RESULTS The mean % ADC increase of CR group was significantly higher compared to non-CR group (77.2 ± 54.63% vs. 36.0 ± 29.44%; p = 0.05). Conversely, the mean % TV reduction did not significantly differ in CR group from non-CR group (73.7% vs. 63.77%; p = 0.21). Accordingly, the diagnostic accuracy of the mean % ADC increase to discriminate CR from non-CR group was significantly higher than that of the mean % TV reduction (0.913 vs. 0.658; p = 0.022). No correlation was found between mean % TV reduction and TRG (rho = 0.22; p = 0.3037), whereas a negative correlation between mean % ADC increase and TRG was recorded (r = -0.69; p = 0.006). CONCLUSION The mean % ADC increase appears to be a reliable tool to differentiate CR from non-CR after CRT in patients with LARC.
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Affiliation(s)
- D Genovesi
- Radiation Oncology Department, "G. d'Annunzio" University of Chieti, "SS. Annunziata" Hospital, Chieti, Italy.
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Pignataro G, Vinciguerra A, Cuomo O, Sirabella R, Di Renzo GF, Scorziello A. Conjunctival instillation of plasminogen eliminates ocular lesion in B6.129P2-Plg(tm1Jld) transgenic mice, a model of ligneous conjunctivitis. Pharmacol Res 2013; 74:45-8. [PMID: 23684723 DOI: 10.1016/j.phrs.2013.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 04/29/2013] [Accepted: 04/30/2013] [Indexed: 10/26/2022]
Abstract
Ligneous conjunctivitis is a severe and rare chronic "idiopathic membraneous" conjunctivitis, characterized by the formation of pseudomembranes mostly on the palpebral surfaces that progressively replace the normal mucosa. Evidence has been provided that ligneous conjunctivitis is caused by a severe systemic plasminogen deficiency with decreased plasminogen antigen and decreased plasminogen functional activities. Objective of the present study is to verify the hypothesis that a topical eye application of plasminogen is able to ameliorate the consequences of this disease. Here we report the results of pre-clinical studies performed to investigate the therapeutic effectiveness of an eye-drop plasminogen preparation in B6.129P2-Plg(tm1Jld) transgenic mice, a model of ligneous conjunctivitis. The entity of protection mediated by plasminogen was evaluated by measuring the extent of the eye lesion by means of a computerized system and dedicated software. The results of the present study clearly showed that the administration for six times a day of plasminogen eye-drop solution in the lesioned eye of animals knock-out for plasminogen gene and developing ligneous conjunctivitis caused a dose and time related reduction of the extent of the ocular lesion. These findings may pave the road for the pharmacological treatment of the ocular lesion associated to the ligneous conjunctivitis that at the present is surgically treated by removing the pseudomembranes generated on the eye.
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Affiliation(s)
- G Pignataro
- Division Pharmacology, Department of Neuroscience, School of Medicine, "Federico II" University of Naples, Via Pansini, 5, 80131 Naples, Italy
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Ausili Cèfaro G, Genovesi D, Vinciguerra A, Augurio A, Di Tommaso M, Marchese R, Borzillo V, Tasciotti L, Taraborrelli M, Innocenti P, Colecchia G, Di Nicola M. Effects of preoperative radiochemotherapy with capecitabine for resectable locally advanced rectal cancer in elderly patients. Tumori 2013. [PMID: 23235758 DOI: 10.1700/1190.13204] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS AND BACKGROUND Rectal cancer is a common disease of elderly people. However, patients over 70 years of age are often not included in clinical trials. There is a lack of data concerning the use of radiochemotherapy with capecitabine in elderly patients. The aim of this study was to retrospectively evaluate the impact of preoperative radiochemotherapy with capecitabine on downstaging and sphincter preservation and to assess treatment compliance and toxicity in elderly patients. METHODS Twenty-six patients with resectable locally advanced rectal cancer (stage II-III/TNM) aged >70 years received preoperative radiotherapy and concurrent oral capecitabine 825 mg/m² twice daily during the whole period of radiotherapy. Two patients who refused surgery after chemoradiation therapy were excluded from the analysis. Results. Eighty-one percent of patients underwent anterior resection and 18.1% underwent abdominoperineal resection. Overall tumor downstaging, considering both T and N categories, was observed in 18/24 patients (75%). Treatment compliance was good and toxicity rates were similar to those of younger people. CONCLUSIONS Age is not a contraindication to any therapy and elderly patients who can tolerate radiochemotherapy should be treated like younger patients. Preoperative radiochemotherapy with capecitabine for patients aged >70 years has a good impact on tumor downstaging, increases the feasibility of sphincter-preserving surgery, and is also safe and well tolerated.
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Affiliation(s)
- Giampiero Ausili Cèfaro
- Radiation Oncology Department, G d’Annunzio University, SSAnnunziata Hospital, Via dei Vestini, Chieti, Italy
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Céfaro GA, Genovesi D, Vinciguerra A, Trignani M, Taraborrelli M, Augurio A, Buonaguidi R, Galzio RJ, Di Nicola M. Prognostic impact of hemoglobin level and other factors in patients with high-grade gliomas treated with postoperative radiochemotherapy and sequential chemotherapy based on temozolomide: a 10-year experience at a single institution. Strahlenther Onkol 2011; 187:778-83. [PMID: 22127356 DOI: 10.1007/s00066-011-1129-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 09/15/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND AND PURPOSE To evaluate the influence of serum hemoglobin level prior to radiotherapy and other prognostic factors on survival in patients with high-grade gliomas. MATERIAL AND METHODS From 2001-2010, we retrospectively evaluated a total of 48 patients with malignant glioma treated with surgery and postoperative radiochemotherapy with temozolomide. A total of 37 of 48 patients received sequential temozolomide. Hemoglobin levels were assayed before radiotherapy in all patients. The Kaplan-Meier method was applied to estimate the overall survival, while the log-rank test was applied to evaluate the differences on survival probability between prognostic subgroups. RESULTS Results were assessed in 43 patients. The median overall survival time was 18 months (95% confidence interval: 12-40 months). The 1- and 2-year survival rates were 62.2% and 36.3%, respectively. The prognostic factors analyzed were gender, age, extent of surgery, performance status before and after radiotherapy, sequential chemotherapy, hemoglobin level, and methylation of the O-6-methylguanine-DNA methyltransferase gene (MGMT). In univariate analysis, the variables significantly related to survival were performance status before and after radiotherapy, sequential chemotherapy, and hemoglobin level. The median overall survival in patients with a hemoglobin level ≤ 12 g/dl was 12 months and 23 months in patients with a hemoglobin level > 12 g/dl. The 1- and 2-year survival rates were 46.7% and 20.0%, respectively, for patients with a hemoglobin level ≤ 12 mg/dl and 69.6% and 45.7%, respectively, for patients with a hemoglobin level > 12 g/dl. CONCLUSION Our results confirm the impact of well-known prognostic factors on survival. In this research, it was found that a low hemoglobin level before radiotherapy can adversely influence the prognosis of patients with malignant gliomas.
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Affiliation(s)
- Giampiero Ausili Céfaro
- Department of Radiation Oncology, G. d'Annunzio University of Chieti, SS. Annunziata Hospital, Chieti, Italy
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Genovesi D, Cèfaro GA, Vinciguerra A, Augurio A, D'alessandro M, Borzillo V, Marchese R, Di Nicola M. Retrospective Long-Term Results and Prognostic Factors of Postoperative Treatment for UICC Stages II and III Rectal Cancer. Tumori 2009; 95:675-82. [DOI: 10.1177/030089160909500606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
Aims To retrospectively evaluate 5-year local control, disease-free survival, cancer-specific survival and overall survival rates in patients with UICC stages II and III rectal cancer treated with adjuvant therapy and especially to analyze the impact of some prognostic factors on clinical outcome at univariate and multivariate analyses. Methods and Materials We retrospectively reviewed 306 patients treated with postoperative 5-fluorouracil-based chemoradiation (278 patients) or radiotherapy alone (28 patients) after curative surgery. The following prognostic factors were considered at univariate and multivariate analyses: age, sex, tumor location, surgery procedure, pathological stage, histology, tumor grade, surgical margins and radiotherapy technique. Results The 5-year actuarial rates for local control, disease-free survival, cancer-specific survival and overall survival were respectively 89.7%, 59.7%, 68.6% and 61.4% for the 278 patients (91%) treated with postoperative chemoradiation. Univariate analysis showed that abdominal-perineal resection impacted disease-free survival and that the T4 variable had an impact on cancer-specific survival and disease-free survival. Instead, age ≥70, N2, IIIB (p T3 p N1) and IIIC (pT3 p N2) stage impacted cancer-specific survival, disease-free survival and rate of distant metastases. Multivariate analysis showed as significant variables age ≥70 years, pN1 and pN2 and extraperitoneal tumor location. Conclusions Our retrospective study showed a good 5-year local control. Factors such as individual pT4, pN1, pN2, age ≥70 years, abdominal-perineal resection, stages IIIB-IIIC versus II-IIIA and extraperitoneal tumor location negatively influenced disease-free survival, distant metastases and cancer-specific survival. Differences exist between stages II and III rectal cancer and treatment modulation and intensification are required in order to offer the most appropriate and effective adjuvant treatment and to improve survival of rectal cancer patients.
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Affiliation(s)
- Domenico Genovesi
- Radiation Oncology Department, “G. d'Annunzio University”, Chieti, Italy
| | | | | | - Antonietta Augurio
- Radiation Oncology Department, “G. d'Annunzio University”, Chieti, Italy
| | - Marco D'alessandro
- Radiation Oncology Department, “G. d'Annunzio University”, Chieti, Italy
| | - Valentina Borzillo
- Radiation Oncology Department, “G. d'Annunzio University”, Chieti, Italy
| | - Rita Marchese
- Radiation Oncology Department, “G. d'Annunzio University”, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Biomedical Science, “G. d'Annunzio University”, Chieti, Italy
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Armellin G, Vinciguerra A, Bonato R, Pittarello D, Giron GP. Tranexamic acid in primary CABG surgery: high vs low dose. Minerva Anestesiol 2004; 70:97-107. [PMID: 14997082] [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: 04/29/2023]
Abstract
AIM Prophylactic administration of tranexamic acid decreases bleeding and transfusions after cardiac procedures but it is still unclear what the best dose and the most appropriate timing to get the best results are. METHODS We enrolled 250 patients scheduled for elective, primary coronary revascularization. They were randomly divided into 2 groups. Group H received tranexamic 30 mg x kg(-1) soon after the induction of anaesthesia and a further same dose was added to the prime solution of cardiopulmonary bypass (CPB). Group L received tranexamic acid 15 mg x kg(-1) after systemic heparinization followed by an infusion of 1 mg x kg(-1) h(-1) till the end of the operation. Transfusions of bank blood products, bleeding in the postoperative period and coagulation profile were recorded. RESULTS We did not find any difference between the groups either with respect to transfusion requirements or with respect to blood loss. CONCLUSION For elective, first time coronary artery bypass surgery, both dosages of tranexamic acid are equally effective. Theoretically, it seems safer to administer it when patients are protected from thrombus formation by full heparinization.
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Affiliation(s)
- G Armellin
- Department of Pharmacology and Anesthesiology Egidio Meneghetti, University of Padua, Padua, Italy.
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Vinciguerra A, Simpson PG, Kakiuti Y, Quagliano JV. Infrared Studies of 2,2'-Bipyridine N,N'-Dioxide and its Metal Complexes in the 3-38 μ Region. Inorg Chem 2002. [DOI: 10.1021/ic50006a010] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Affiliation(s)
- M L Salvetat
- Department of Ophthalmology, Children's Hospital, Trieste, Italy
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