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Moavero R, Voci A, Romigi A, Bisulli F, Luisi C, Vigevano F, Mazzone L, Valeriani M, Curatolo P, Bruni O. Sleep disorders in adults with tuberous sclerosis complex: a questionnaire-based study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.116] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bertino G, Muir T, Odili J, Groselj A, Marconato R, Curatolo P, Kis E, Lonkvist CK, Clover J, Quaglino P, Kunte C, Spina R, Seccia V, de Terlizzi F, Campana LG. Treatment of Basal Cell Carcinoma with Electrochemotherapy: Insights from the InspECT Registry (2008–2019). Curr Oncol 2022; 29:5324-5337. [PMID: 36005161 PMCID: PMC9406883 DOI: 10.3390/curroncol29080423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022] Open
Abstract
This prospective registry-based study aims to describe electrochemotherapy (ECT) modalities in basal cell carcinoma (BCC) patients and evaluate its efficacy, safety, and predictive factors. The International Network for Sharing Practices of Electrochemotherapy (InspECT) multicentre database was queried for BCC cases treated with bleomycin-ECT between 2008 and 2019 (n = 330 patients from seven countries, with 623 BCCs [median number: 1/patient; range: 1–7; size: 13 mm, range: 5–350; 85% were primary, and 80% located in the head and neck]). The procedure was carried out under local anaesthesia in 68% of cases, with the adjunct of mild sedation in the remaining 32%. Of 300 evaluable patients, 242 (81%) achieved a complete response (CR) after a single ECT course. Treatment naïvety (odds ratio [OR] 0.35, 95% confidence interval [C.I.] 0.19–0.67, p = 0.001) and coverage of deep tumour margin with electric pulses (O.R. 5.55, 95% C.I. 1.37–21.69, p = 0.016) predicted CR, whereas previous radiation was inversely correlated (O.R. 0.25, p = 0.0051). Toxicity included skin ulceration (overall, 16%; G3, 1%) and hyperpigmentation (overall, 8.1%; G3, 2.5%). At a 17-month follow-up, 28 (9.3%) patients experienced local recurrence/progression. Despite no convincing evidence that ECT confers improved outcomes compared with standard surgical excision, it can still be considered an opportunity to avoid major resection in patients unsuitable for more demanding treatment. Treatment naïvety and coverage of the deep margin predict tumour clearance and may inform current patient selection and management.
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Affiliation(s)
- Giulia Bertino
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy;
| | - Tobian Muir
- South Tees NHS Foundation Trust, Middlesbrough TS4 3BW, UK;
| | - Joy Odili
- Department of Plastic Surgery, St. George’s University Hospitals NHS Foundation Trust, London SW17 0QT, UK;
| | - Ales Groselj
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia;
| | | | - Pietro Curatolo
- Dermatology Unit, Department of Internal Medicine and Medical Specialties, University “La Sapienza”, 00042 Rome, Italy;
| | - Erika Kis
- Department of Dermatology and Allergology, Albert Szent-Györgyi Clinical Centre, University of Szeged, 6700 Szeged, Hungary;
| | - Camilla Kjaer Lonkvist
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, 2730 Herlev, Denmark;
| | - James Clover
- Cork Cancer Research Centre, University College Cork, T12 YN60 Cork, Ireland;
- Department of Plastic Surgery, Cork University Hospital, T12 DC4A Cork, Ireland
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, 10094 Turin, Italy;
| | - Christian Kunte
- Department of Dermatologic Surgery and Dermatology, Artemed Fachklinik München, 81379 Munich, Germany;
- Department of Dermatology and Allergology, Ludwig-Maximillian University, 80539 Munich, Germany
| | - Romina Spina
- Psychology Unit, University Hospital of Padova, 35100 Padova, Italy;
| | - Veronica Seccia
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Pisa University Hospital, Via Paradisa 2, 56124 Pisa, Italy;
| | - Francesca de Terlizzi
- IGEA Clinical Biophysics Department, Via Parmenide 10/A, Carpi, 41012 Modena, Italy;
| | - Luca Giovanni Campana
- Department of Surgery, Manchester University NHS Foundation Trust, Manchester Royal Infirmary, Oxford Rd, Manchester M13 9WL, UK
- Correspondence:
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Claussen CS, Moir G, Bechara FG, Orlando A, Matteucci P, Mowatt D, Clover AJP, Mascherini M, Gehl J, Muir T, Sersa G, Groselj A, Odili J, Giorgione R, Campana LG, Bertino G, Curatolo P, Banerjee S, Kis E, Quaglino P, Pritchard-Jones R, De Terlizzi F, Grischke EM, Kunte C. Prospektive Kohortenstudie von InspECT zur Sicherheit und Wirksamkeit der Elektrochemotherapie bei Hauttumoren und Metastasen in Abhängigkeit von Ulzeration. J Dtsch Dermatol Ges 2022; 20:470-482. [PMID: 35446500 DOI: 10.1111/ddg.14699_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022]
Abstract
HINTERGRUND Elektrochemotherapie (ECT) ist eine wirksame lokale Behandlung von Hauttumoren. Ziel dieser Studie war es, die Wirksamkeit der ECT bei ulzerierten gegenüber nichtulzerierten Tumoren zu vergleichen und den Effekt auf tumorassoziierte Symptome zu untersuchen. METHODIK 20 Krebszentren des International Network for Sharing Practices on Electrochemotherapy (InspECT) sammelten prospektiv Daten. Die ECT wurde nach dem ESOPE-Protokoll durchgeführt. Das Therapieansprechen wurde anhand der Entwicklung der Läsionsgröße bewertet. Zusätzlich wurden Schmerzen, Symptome, Leistungsstatus (ECOG-Index) und Gesundheitszustand (EQ-5D-Fragebogen) untersucht. ERGEBNISSE 716 Patienten mit ulzerierten (n = 302) und nichtulzerierten (n = 414) Hauttumoren und Metastasen wurden eingeschlossen (Mindest-Nachsorge 45 Tage). Nicht-ulzerierte Läsionen sprachen besser auf die ECT an als ulzerierte Läsionen (vollständiges Ansprechen: 65 % gegenüber 51 %, p = 0,0061). Nur 38 % (115/302) der Patienten mit ulzerierten Läsionen vor der ECT wiesen bei der letzten Nachuntersuchung ulzerierte Läsionen auf. Patienten mit ulzerierten Läsionen berichteten über stärkere Schmerzen und schwerere Symptome im Vergleich zu Patienten mit nichtulzerierten Läsionen, die sich nach der ECT signifikant und kontinuierlich besserten. Bei Patienten mit nichtulzerierten Läsionen hingegen nahmen die Schmerzen während der Behandlung vorübergehend zu. Es wurden keine schwerwiegenden Nebenwirkungen beobachtet. SCHLUSSFOLGERUNGEN Die ECT ist eine sichere und wirksame lokale Behandlung von Hauttumoren. Während die ECT die Symptome insbesondere bei Patienten mit ulzerierten Läsionen verbessert, sollte auf Basis der Daten die Implementation eines perioperativen Schmerzmanagements besonders bei nichtulzerierten Läsionen während der ECT erwogen werden.
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Affiliation(s)
- Carla Sophie Claussen
- Department of Dermatosurgery and Dermatology, Artemed Clinic of Munich, Munich, Germany
| | - Graeme Moir
- The Royal London Hospital & QMUL, Bart's Health NHS Trust, Department of Cutaneous Medicine & Surgery, London, United Kingdom
| | - Falk G Bechara
- Department of Dermatologic Surgery, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Antonio Orlando
- Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Paolo Matteucci
- Department of Plastic surgery, Castle Hill Hospital, Cottingham, United Kingdom
| | - David Mowatt
- Plastic Surgery Department, The Christie Hospital NHS Foundation trust, Manchester, United Kingdom
| | - Anthony James P Clover
- Department of Plastic Surgery, Cork University Hospital, Cork, Ireland.,Cancer Research@UCC, Western Gateway Building, University College Cork, Cork, Ireland
| | - Matteo Mascherini
- Clinica Chirurgica 1 - Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tobian Muir
- Plastic Surgery Department, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Gregor Sersa
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Ales Groselj
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Joy Odili
- Department of Plastic Surgery, St. Georges University Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Luca Giovanni Campana
- Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.,Department of Surgery, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - Giulia Bertino
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Pietro Curatolo
- Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University of Roma "La Sapienza", Roma, Italy
| | - Shramana Banerjee
- Division of Surgery and interventional Science, University College London, London, United Kingdom
| | - Erika Kis
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Torino, Torino, Italy
| | | | | | - Eva-Maria Grischke
- Department of Gynecology, University Hospital of Tübingen, Tübingen, Germany
| | - Christian Kunte
- Department of Dermatosurgery and Dermatology, Artemed Clinic of Munich, Munich, Germany.,Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
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Claussen CS, Moir G, Bechara FG, Orlando A, Matteucci P, Mowatt D, Clover AJP, Mascherini M, Gehl J, Muir T, Sersa G, Groselj A, Odili J, Giorgione R, Campana LG, Bertino G, Curatolo P, Banerjee S, Kis E, Quaglino P, Pritchard-Jones R, De Terlizzi F, Grischke EM, Kunte C. Prospective cohort study by InspECT on safety and efficacy of electrochemotherapy for cutaneous tumors and metastases depending on ulceration. J Dtsch Dermatol Ges 2022; 20:470-481. [PMID: 35384261 DOI: 10.1111/ddg.14699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 11/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Electrochemotherapy (ECT) is an effective local treatment for cutaneous tumors. The aim of this study was to compare the effectiveness of ECT in ulcerated vs. non-ulcerated tumors and investigate the effect on tumor-associated symptoms. METHODS Twenty cancer centers in the International Network for Sharing Practices on Electrochemotherapy (InspECT) prospectively collected data. ECT was performed following ESOPE protocol. Response was evaluated by lesion size development. Pain, symptoms, performance status (ECOG-Index) and health status (EQ-5D questionnaire) were evaluated. RESULTS 716 patients with ulcerated (n = 302) and non-ulcerated (n = 414) cutaneous tumors and metastases were included (minimum follow-up of 45 days). Non-ulcerated lesions responded to ECT better than ulcerated lesions (complete response 65 % vs. 51 %, p = 0.0061). Only 38 % (115/302) with ulcerated lesions before ECT presented with ulcerated lesions at final follow-up. Patients with ulcerated lesions reported higher pain and more severe symptoms compared to non-ulcerated lesions, which significantly and continuously improved following ECT. In non-ulcerated lesions however, pain spiked during the treatment. No serious adverse events were reported. CONCLUSIONS ECT is a safe and effective local treatment for cutaneous tumors. While ECT improves symptoms especially in patients with ulcerated lesions, data suggest the implementation of a perioperative pain management in non-ulcerated lesions during ECT.
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Affiliation(s)
- Carla Sophie Claussen
- Department of Dermatosurgery and Dermatology, Artemed Clinic of Munich, Munich, Germany
| | - Graeme Moir
- The Royal London Hospital & QMUL, Barts Health NHS Trust, Department of Cutaneous Medicine & Surgery, London, United Kingdom
| | - Falk G Bechara
- Department of Dermatologic Surgery, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Antonio Orlando
- Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Paolo Matteucci
- Department of Plastic surgery, Castle Hill Hospital, Cottingham, United Kingdom
| | - David Mowatt
- Plastic Surgery Department, The Christie Hospital NHS Foundation trust, Manchester, United Kingdom
| | - Anthony James P Clover
- Department of Plastic Surgery, Cork University Hospital, Cork, Ireland.,Cancer Research@UCC, Western Gateway Building, University College Cork, Cork, Ireland
| | - Matteo Mascherini
- Clinica Chirurgica 1 - Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Julie Gehl
- Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tobian Muir
- Plastic Surgery Department, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Gregor Sersa
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Ales Groselj
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Joy Odili
- Department of Plastic Surgery, St. Georges University Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Luca Giovanni Campana
- Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.,Department of Surgery, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - Giulia Bertino
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Pietro Curatolo
- Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University of Roma "La Sapienza", Roma, Italy
| | - Shramana Banerjee
- Division of Surgery and interventional Science, University College London, London, United Kingdom
| | - Erika Kis
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Torino, Torino, Italy
| | | | | | - Eva-Maria Grischke
- Department of Gynecology, University Hospital of Tübingen, Tübingen, Germany
| | - Christian Kunte
- Department of Dermatosurgery and Dermatology, Artemed Clinic of Munich, Munich, Germany.,Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
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Sersa G, Mascherini M, Di Prata C, Odili J, de Terlizzi F, McKenzie GA, Clover AJP, Bertino G, Spina R, Groselj A, Cappellesso R, Gehl J, Bisase B, Curatolo P, Kis E, Lico V, Muir T, Orlando A, Quaglino P, Matteucci P, Valpione S, Campana LG. Outcomes of older adults aged 90 and over with cutaneous malignancies after electrochemotherapy with bleomycin: A matched cohort analysis from the InspECT registry. Eur J Surg Oncol 2021; 47:902-912. [DOI: 10.1016/j.ejso.2020.10.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/09/2020] [Accepted: 10/30/2020] [Indexed: 12/11/2022] Open
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Ursitti F, Roberto D, Papetti L, Moavero R, Ferilli MAN, Fusco L, Vigevano F, Curatolo P, Valeriani M. Diagnosis of pediatric anti-NMDAR encephalitis at the onset: A clinical challenge. Eur J Paediatr Neurol 2021; 30:9-16. [PMID: 33321446 DOI: 10.1016/j.ejpn.2020.12.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/26/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUNDS To investigate the clinical and instrumental features at the onset addressing to the diagnosis of anti-NMDAR encephalitis. METHODS Twenty children (age: 15 months-17 years; 7 males, 13 females) with initial suspected diagnosis of autoimmune encephalitis, observed between January 2008 and March 2018, were included. The final diagnosis was anti-NMDAR encephalitis in 7 children, other/probable autoimmune encephalitis in 7 children, and primary psychosis in the remaining 6 children. RESULTS At the clinical onset, anxiety disorder was the main symptom that helped in distinguishing the group of psychotic children from children with non-infectious encephalitis (P = 0.05 OR = 0.001), while epileptic seizures strongly predicted anti-NMDAR encephalitis (P = 0.04 OR = 28.6). At the onset, anti-NMDAR encephalitis could be distinguished from other/probable autoimmune encephalitis for the presence of sleep/wake rhythm alteration (P = 0.05 OR = 15). Among the symptoms occurring during the hospitalization, movement disorders (P = 0.031 OR = 12) were predictive of non-infectious encephalitis rather than primary psychosis. More specifically, the occurrence of language impairment (P = 0.03 OR = 33), epileptic seizures (P = 0.04 OR = 28.6) and catatonia (P = 0.03, OR = 33), were predictive of anti-NMDAR encephalitis. Also at this stage, anxiety disorder (P = 0.03 OR = 0.033) was predictive of primary psychosis. CONCLUSION Our findings suggest that at the clinical onset epileptic seizures and sleep/wake rhythm alteration represent the main features addressing to the diagnosis of anti-NMDAR encephalitis rather than primary psychosis and other/probable autoimmune encephalitis, while anxiety disorder could be a solid predictor of primary psychosis.
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Affiliation(s)
- F Ursitti
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy
| | - D Roberto
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - L Papetti
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy
| | - R Moavero
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy; Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - M A N Ferilli
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy
| | - L Fusco
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy
| | - F Vigevano
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy
| | - P Curatolo
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - M Valeriani
- Department of Neurological and Psychiatric Sciences, Bambino Gesù Children Hospital, Rome, Italy; Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.
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Curatolo P, Careri R, Simioni A, Campana LG. Cryotherapy, Imiquimod, and Electrochemotherapy Are Effective Options for Kaposi Sarcoma: A Call for Standardization to Allow for Comparisons and Informed Decisions. J Cutan Med Surg 2020; 24:218-219. [DOI: 10.1177/1203475419893302] [Citation(s) in RCA: 2] [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: 01/13/2023]
Affiliation(s)
- Pietro Curatolo
- Department of Dermatology and Plastic Surgery, University 'La Sapienza', Rome, Italy
| | - Rosanna Careri
- Department of Dermatology and Plastic Surgery, University 'La Sapienza', Rome, Italy
| | | | - Luca G. Campana
- Department of Surgical Oncological and Gastroenterological Sciences - DISCOG, University of Padua, Italy
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Miraglia E, Curatolo P, Iacovino C, Careri R, Calvieri S, Giustini S. Electrochemotherapy in Gorlin-Goltz syndrome. Ital J Dermatol Venerol 2020; 156:95-97. [PMID: 32057218 DOI: 10.23736/s2784-8671.20.06474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Emanuele Miraglia
- Department of Dermatology and Venereology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy -
| | - Pietro Curatolo
- Department of Dermatology and Venereology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Chiara Iacovino
- Department of Dermatology and Venereology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Rosanna Careri
- Department of Dermatology and Venereology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Stefano Calvieri
- Department of Dermatology and Venereology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Sandra Giustini
- Department of Dermatology and Venereology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
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Miraglia E, Curatolo P, Iacovino C, Careri R, Calvieri S, Giustini S. Electrochemotherapy in Gorlin-Goltz syndrome: two case reports. Ital J Dermatol Venerol 2020. [DOI: 10.23736/s0392-0488.20.06474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Campana LG, Kis E, Bottyán K, Orlando A, de Terlizzi F, Mitsala G, Careri R, Curatolo P, Snoj M, Sersa G, Valpione S, Quaglino P, Mowatt D, Brizio M, Schepler H. Electrochemotherapy for advanced cutaneous angiosarcoma: A European register-based cohort study from the International Network for Sharing Practices of electrochemotherapy (InspECT). Int J Surg 2019; 72:34-42. [PMID: 31618680 DOI: 10.1016/j.ijsu.2019.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 09/24/2019] [Accepted: 10/09/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cutaneous angiosarcoma (cAS) is a highly aggressive malignancy that challenges the radicality of surgical treatment. Electrochemotherapy (ECT), a skin-directed treatment based on cytotoxic chemotherapy combined with local electric pulses, may be an intraoperative adjunct and a new opportunity in the therapeutic strategy. This cohort study reports the experience with ECT as an option. METHODS Data on patients with locally-advanced/metastatic cAS who underwent ECT between October 2013 and October 2018 at eight European centres were prospectively submitted to the InspECT (International network for sharing practices of ECT) register. Patients received therapy according to the European Standard Operating Procedures of ECT (ESOPE). Treatment feasibility was assessed based on tumour coverage with electrodes and recorded tissue current; treatment toxicity and tumour response were graded according to CTCAE v5.0 and RECIST v1.1 criteria, respectively; patient-reported outcomes (PRO) were evaluated using a visual analogue score (VAS) for pain, acceptance of retreatment and the EQ-5D questionnaire. RESULTS We enrolled 20 patients with advanced cAS in the scalp/face (n = 7), breast/trunk (n = 10) or limbs (n = 3). Target tumours (n = 51) had a median size of 2.3 cm (range, 1-20). We administered 24 ECT courses using 1-4 cm treatment safety margin around tumours. In five patients, ECT was combined/sequenced with surgery. Median tissue current was 3 A (range, 1.5-10), tumour margins coverage rate was 75% (15/20 patients). The objective response rate (ORR) was 80% (complete, 40%). Grade-3 toxicity included skin ulceration (15%) and pain (10%), with no significant change of PRO scores. Bleeding control was achieved in 13/14 patients with ulcerated tumours. With a median overall survival of 12.5 months, the local progression-free survival (LPFS) was 10.9 months. CONCLUSION ECT produces sustained response rate with minimal side effects and should be considered an option for advanced cAS. Palliative benefits include patient tolerability, local haemostasis and durable local control. Definition of optimal timing, treatment safety margins and combination with surgery need further investigation.
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Affiliation(s)
- Luca G Campana
- Department of Surgical Oncological and Gastroenterological Sciences - DISCOG, University of Padova, Padova, Italy.
| | - Erika Kis
- Department of Dermatology and Allergology, University of Szeged, Hungary
| | - Krisztina Bottyán
- Department of Dermatology and Allergology, University of Szeged, Hungary
| | - Antonio Orlando
- Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | | | - Grammatiki Mitsala
- Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Rosanna Careri
- Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University 'La Sapienza', Rome, Italy
| | - Pietro Curatolo
- Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University 'La Sapienza', Rome, Italy
| | - Marko Snoj
- Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Gregor Sersa
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Sara Valpione
- The Christie NHS Foundation Trust, CRUK Manchester Institute, The University of Manchester, Manchester, UK
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - David Mowatt
- Plastic Surgery Unit, The Christie NHS Foundation Trust, Manchester, UK
| | - Matteo Brizio
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - Hadrian Schepler
- Department of Dermatology, University Medical Center, Mainz, Germany
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Odili J, Kunte C, Clover J, Bertino G, Campana L, Muir T, Liew S, Moir G, Orlando A, Kis E, Mowatt D, Saxinger W, Quaglino P, Sersa G, Curatolo P, Bechara F, Rutkowski P, De Cian F, Matteucci P, Gehl J. Electrochemotherapy as an adjunct to the surgical management of metastatic melanoma: experience of the inspECT group (2008 to 2018). Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.117] [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] Open
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Bertino G, Di Felice S, De Terlizzi F, Muir T, Curatolo P, Rotunno R, Groselj A, Kis E, Gehl J, Clover A, Campana L, Moir G, Odili J, Liew S, Quaglino P, Kunte C, Orlando A. Basal cell carcinoma and electrochemotherapy: the InspECT experience. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.115] [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] Open
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Pro S, Moavero R, Marciano S, Vigevano F, Curatolo P, Valeriani M. ERP recording shows subclinical differences in ADHD patients with and without Tuberous Sclerosis. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.081] [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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Matthiessen LW, Keshtgar M, Curatolo P, Kunte C, Grischke EM, Odili J, Muir T, Mowatt D, Clover JP, Liew SH, Dahlstroem K, Newby J, Letulé V, Stauss E, Humphreys A, Banerjee S, Klein A, Rotunno R, de Terlizzi F, Gehl J. Electrochemotherapy for Breast Cancer—Results From the INSPECT Database. Clin Breast Cancer 2018; 18:e909-e917. [DOI: 10.1016/j.clbc.2018.03.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 03/04/2018] [Accepted: 03/08/2018] [Indexed: 12/21/2022]
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Gehl J, Sersa G, Matthiessen LW, Muir T, Soden D, Occhini A, Quaglino P, Curatolo P, Campana LG, Kunte C, Clover AJP, Bertino G, Farricha V, Odili J, Dahlstrom K, Benazzo M, Mir LM. Updated standard operating procedures for electrochemotherapy of cutaneous tumours and skin metastases. Acta Oncol 2018; 57:874-882. [PMID: 29577784 DOI: 10.1080/0284186x.2018.1454602] [Citation(s) in RCA: 195] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 03/13/2018] [Indexed: 12/21/2022]
Abstract
Electrochemotherapy is now in routine clinical use to treat cutaneous metastases of any histology, and is listed in national and international guidelines for cutaneous metastases and primary skin cancer. Electrochemotherapy is used by dermatologists, surgeons, and oncologists, and for different degrees and manifestations of metastases to skin and primary skin tumours not amenable to surgery. This treatment utilises electric pulses to permeabilize cell membranes in tumours, thus allowing a dramatic increase of the cytotoxicity of anti-cancer agents. Response rates, often after only one treatment, are very high across all tumour types. The most frequent indications are cutaneous metastases from malignant melanoma and breast cancer. In 2006, standard operating procedures (SOPs) were written for this novel technology, greatly facilitating introduction and dissemination of the therapy. Since then considerable experience has been obtained treating a wider range of tumour histologies and increasing size of tumours which was not originally thought possible. A pan-European expert panel drawn from a range of disciplines from dermatology, general surgery, head and neck surgery, plastic surgery, and oncology met to form a consensus opinion to update the SOPs based on the experience obtained. This paper contains these updated recommendations for indications for electrochemotherapy, pre-treatment information and evaluation, treatment choices, as well as follow-up.
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Affiliation(s)
- Julie Gehl
- a Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care , Zealand University Hospital , Roskilde , Denmark
- b Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
- c Department of Oncology Herlev and Gentofte Hospital , University of Copenhagen , Herlev , Denmark
| | - Gregor Sersa
- d Department of Experimental Oncology , Institute of Oncology Ljubljana , Ljubljana , Slovenia
| | | | - Tobian Muir
- e South Tees NHS Foundation Trust , James Cook University Hospital , Middlesbrough , UK
| | - Declan Soden
- f Cork Cancer Research Centre , Western Gateway Building University College Cork , Cork , Ireland
| | - Antonio Occhini
- g Department of Otolaryngology Head and Neck Surgery , University of Pavia - IRCCS Policlinico San Matteo Foundation , Pavia , Italy
| | - Pietro Quaglino
- h Department of Medical Sciences , Dermatologic Clinic, University of Turin , Turin , Italy
| | - Pietro Curatolo
- i Department of Dermatology and Plastic Surgery , La Sapienza University , Roma , Italy
| | - Luca G Campana
- j Department of Surgery Oncology and Gastroenterology (DISCOG) , University of Padova , Padova , Italy
- k Surgical Oncology Unit , Veneto Institute of Oncology IRCCS , Padova , Italy
| | - Christian Kunte
- l Department of Dermatologic Surgery and Dermatology , Artemed Fachklinik München , Munich , Germany
- m Department of Dermatology and Allergology , Ludwig-Maximillian University , Munich , Germany
| | - A James P Clover
- f Cork Cancer Research Centre , Western Gateway Building University College Cork , Cork , Ireland
- n Department of Plastic Surgery , Cork University Hospital , Cork , Ireland
| | - Giulia Bertino
- f Cork Cancer Research Centre , Western Gateway Building University College Cork , Cork , Ireland
| | - Victor Farricha
- o Melanoma and Sarcoma Unit Department of Surgery , Portuguese Institute of Oncology, Rua Professor Lima Basto, Faculty of Medicine of Lisbon , Lisbon , Portugal
| | - Joy Odili
- p Department of Plastic Surgery , St. George's University Hospitals NHS Foundation Trust , London , UK
| | - Karin Dahlstrom
- q Department of Plastic Surgery , Herlev and Gentofte Hospital, University of Copenhagen , Copenhagen , Denmark
| | - Marco Benazzo
- g Department of Otolaryngology Head and Neck Surgery , University of Pavia - IRCCS Policlinico San Matteo Foundation , Pavia , Italy
| | - Lluis M Mir
- r Vectorology and Anticancer Therapies , UMR 8203, CNRS, Univ. Paris-Sud, Gustave Roussy, Université Paris-Saclay , Villejuif , France
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Rotunno R, Campana LG, Quaglino P, de Terlizzi F, Kunte C, Odili J, Gehl J, Ribero S, Liew SH, Marconato R, Brizio M, Curatolo P. Electrochemotherapy of unresectable cutaneous tumours with reduced dosages of intravenous bleomycin: analysis of 57 patients from the International Network for Sharing Practices of Electrochemotherapy registry. J Eur Acad Dermatol Venereol 2017; 32:1147-1154. [PMID: 29178483 DOI: 10.1111/jdv.14708] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 11/09/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Electrochemotherapy (ECT) is currently used to treat unresectable superficial tumours of different histotypes through the combination of cytotoxic chemotherapy and local application of electric pulses. In 2006, a collaborative project defined the ESOPE (European Standard Operating Procedures of Electrochemotherapy) guidelines to standardize the procedure. The International Network for Sharing Practices of Electrochemotherapy (InspECT) aims to refine the ESOPE and improve clinical practice. Limiting patient exposure to systemic chemotherapy would be advisable to ameliorate ECT safety profile. OBJECTIVE The aim of this study was to evaluate the efficacy and toxicity of ECT with reduced chemotherapy dosages. METHODS In a retrospective analysis of a prospectively maintained database (InspECT registry), we evaluated the outcome of patients who received ECT with reduced dosages of bleomycin (7500, 10 000 or 13 500 IU/m2 , instead of the standard dose of 15 000 IU/m2 ). Tumour response in melanoma patients was compared with melanoma patients of the InspECT registry who received the standard dose of bleomycin. RESULTS We identified 57 patients with 147 tumours (melanoma, 38.6%; squamous cell carcinoma, 22.8%; basal cell carcinoma, 17.5%; breast cancer 7%; Kaposi sarcoma 7%; other histotypes, 7.1%). Per-tumour complete response (CR) rate at 60 days was 70.1% (partial, 16.3%); per-patient CR was 57.9% (partial, 21.1%). Local pain was the most frequently reported side-effect (n = 22 patients [39%]), mostly mild; two patients experienced flu-like symptoms, one patient nausea. We observed the same CR rate (55%) in patients with melanoma treated by reduced or conventional bleomycin dosages (P = 1.00). CONCLUSIONS Electrochemotherapy performed with reduced bleomycin dosages could be as effective as with currently recommended dose. Patients with impaired renal function or candidate to multiple ECT cycles could benefit from a reduced dose protocol. Our findings need prospective confirmation before being adopted in clinical practice.
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Affiliation(s)
- R Rotunno
- Dermatologic Clinic, 'Sapienza' University of Rome, Rome, Italy
| | - L G Campana
- Department of Surgery Oncology and Gastroenterology (DISCOG), University of Padova, Padova, Italy.,Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - P Quaglino
- Dermatologic Clinic, Department Medical Sciences, University of Turin, Turin, Italy
| | - F de Terlizzi
- Scientific & Medical Department, IGEA S.p.A., Carpi, Modena, Italy
| | - C Kunte
- Department of Dermatologic Surgery and Dermatology, Artemed Fachklinik München, Munich, Germany.,Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Munich, Germany
| | - J Odili
- Plastic and Reconstructive Surgeon, St Georges' University Hospitals NHS Foundation Trust, London, UK
| | - J Gehl
- Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - S Ribero
- Dermatologic Clinic, Department Medical Sciences, University of Turin, Turin, Italy
| | - S H Liew
- Department of Plastic Surgery, Whiston Hospital, Liverpool, UK
| | - R Marconato
- Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - M Brizio
- Scientific & Medical Department, IGEA S.p.A., Carpi, Modena, Italy
| | - P Curatolo
- Dermatologic Clinic, 'Sapienza' University of Rome, Rome, Italy
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French J, Lawson J, Yapici Z, Ikeda H, Polster T, Nabbout R, Curatolo P, de Vries P, Dlugos D, Voi M, Fan J, Ridolfi A, Pelov D, Franz D. Outcomes in patients with tuberous sclerosis complex-associated treatment-refractory seizures, transitioning from placebo in core phase to everolimus during extension phase of the EXIST-3 trial. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.293] [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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Guida M, Cabula C, Campana L, Grilz G, Galuppo S, Bussone R, De Meo L, Bonadies A, Curatolo P, De Laurentiis M, Renne M, Valpione S, Fabrizio T, Solari N, Santoriello A, D'Aiuto M, Agresti R. Electrochemotherapy in the treatment of cutaneous metastases from breast cancer: a multicenter cohort analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kunte C, Letulé V, Gehl J, Dahlstroem K, Curatolo P, Rotunno R, Muir T, Occhini A, Bertino G, Powell B, Saxinger W, Lechner G, Liew SH, Pritchard-Jones R, Rutkowski P, Zdzienicki M, Mowatt D, Sykes A, Orlando A, Mitsala G, Rossi C, Campana L, Brizio M, de Terlizzi F, Quaglino P, Odili J. Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT. Br J Dermatol 2017; 176:1475-1485. [DOI: 10.1111/bjd.15340] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2016] [Indexed: 12/16/2022]
Affiliation(s)
- C. Kunte
- Department of Dermatology and Allergology; Ludwig-Maximilian University; Munich Germany
| | - V. Letulé
- Department of Dermatology and Allergology; Ludwig-Maximilian University; Munich Germany
| | - J. Gehl
- Center for Experimental Drug and Gene Electrotransfer; Department of Oncology; Copenhagen University Hospital Herlev; Herlev Denmark
| | - K. Dahlstroem
- Department of Plastic Surgery; Copenhagen University Hospital Herlev; Denmark
| | - P. Curatolo
- Department of Dermatology and Plastic Surgery; Dermatologic Clinic; University of Rome ‘La Sapienza’; Rome Italy
| | - R. Rotunno
- Department of Dermatology and Plastic Surgery; Dermatologic Clinic; University of Rome ‘La Sapienza’; Rome Italy
| | - T. Muir
- Department of Reconstructive Plastic Surgery; James Cook University Hospital; Middlesbrough U.K
| | - A. Occhini
- Department of Otolaryngology Head & Neck Surgery; University of Pavia; IRCCS Policlinico San Matteo Foundation; Pavia Italy
| | - G. Bertino
- Department of Otolaryngology Head & Neck Surgery; University of Pavia; IRCCS Policlinico San Matteo Foundation; Pavia Italy
| | - B. Powell
- Department of Plastic Surgery; St George's Hospital; London U.K
| | - W. Saxinger
- Department of Dermatology; Klinikum Wels-Grieskirchen; Wels Austria
| | - G. Lechner
- Department of Dermatology; Klinikum Wels-Grieskirchen; Wels Austria
| | - S.-H. Liew
- Department of Plastic Surgery; Whiston Hospital; Prescot Merseyside U.K
| | | | - P. Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Warsaw Poland
| | - M. Zdzienicki
- Department of Soft Tissue/Bone Sarcoma and Melanoma; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Warsaw Poland
| | | | - A.J. Sykes
- Department of Clinical Oncology; Christie Hospital; NHS Foundation Trust; Manchester U.K
| | - A. Orlando
- Department of Plastic and Reconstructive Surgery; Southmead Hospital; North Bristol NHS Trust; Bristol U.K
| | - G. Mitsala
- Department of Plastic and Reconstructive Surgery; Southmead Hospital; North Bristol NHS Trust; Bristol U.K
| | - C.R. Rossi
- Veneto Institute of Oncology IOV-IRCCS; Padova Italy
- Department of Surgery, Oncology and Gastroenterology; University of Padova; Padova Italy
| | - L. Campana
- Veneto Institute of Oncology IOV-IRCCS; Padova Italy
- Department of Surgery, Oncology and Gastroenterology; University of Padova; Padova Italy
| | - M. Brizio
- Department of Medical Sciences; Dermatologic Clinic; University of Torino; Torino Italy
| | - F. de Terlizzi
- Scientific and Medical Department; IGEA S.p.A.; Carpi Italy
| | - P. Quaglino
- Department of Medical Sciences; Dermatologic Clinic; University of Torino; Torino Italy
| | - J. Odili
- Department of Plastic Surgery; St George's Hospital; London U.K
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Campana L, Testori A, Curatolo P, Quaglino P, Mocellin S, Framarini M, Borgognoni L, Ascierto P, Mozzillo N, Guida M, Bucher S, Rotunno R, Marenco F, De Salvo G, De Paoli A, Rossi C, Bonadies A. Treatment efficacy with electrochemotherapy: A multi-institutional prospective observational study on 376 patients with superficial tumors. Eur J Surg Oncol 2016; 42:1914-1923. [DOI: 10.1016/j.ejso.2016.06.399] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 06/17/2016] [Accepted: 06/21/2016] [Indexed: 12/21/2022] Open
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Rotunno R, Marenco F, Ribero S, Calvieri S, Amerio P, Curatolo P, Quaglino P. Electrochemotherapy in non-melanoma head and neck skin cancers: a three-center experience and review of the literature. GIORN ITAL DERMAT V 2016; 151:610-618. [PMID: 26376042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The main purposes of this study were to evaluate the efficacy of electrochemotherapy in head and neck tumors, to assess local tumor control, its safety profile and its impact on the patients' quality of life. METHODS This is a multicenter prospective, non-randomized phase II trial. This trial was carried out at the Dermatology Clinic of the "Sapienza" University of Rome, at the Dermatology Clinic of the University of Chieti and at the Dermatology Clinic of the University of Turin. Fifty-five patients with head and neck cancer were recruited. Electrochemotherapy was carried out according to the ESOPE guidelines. Statistical analyses were performed using Stata/SE v.12.0 Statistical Software. RESULTS A significant clinical response was achieved in 50/55 patients with 91% of objective response rate (OR). Thirty-three out of 55 patients showed a complete response (CR) (60%); 17 treated patients had a partial response (PR) (31%). A significantly higher CR rate was obtained in patients not previously treated by surgery (15/19; 79%), with respect to those with a previous excision of the tumor (14/30; 47%) (P=0.025). An additional parameter influencing response is represented by anesthesia: patients treated by ECT with general anesthesia were characterized by significantly higher CR rate (68%) than those treated with local anesthesia (27%) (P=0.014). CONCLUSIONS Our experience confirmed high efficiency in local tumor control, excellent toxicity profile, tissue preservation with good cosmetic and functional results, even with repeated applications. ECT can represent a first-line treatment in the local management of head and neck cancers.
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Affiliation(s)
- Roberta Rotunno
- Dermatology and Plastic Surgery Clinic, "Sapienza" University, Rome, Italy -
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Matthiessen L, Keshtgar M, Kunte C, Grischke EM, Odili J, Muir T, Curatolo P, Mowatt D, Clover J, Liew S, Hansen H, Newby J, Letulé V, Stauss E, Humphreys A, Banerjee S, Klein A, de Terlizzi F, Gehl J. Electrochemotherapy for breast cancer - results from the INSPECT database. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guida M, Campana L, Curatolo P, Strippoli S, Bonadies A, Grilz G, Cabula C, Rotunno R, Bucher S, Solari N, Santoriello A, Valpione S, Rossi C. Local treatment with electrochemotherapy of superficial angiosarcomas: Efficacy and safety results from a multi-institutional retrospective study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw343.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guida M, Campana LG, Curatolo P, Strippoli S, Bonadies A, Grilz G, Cabula C, Rotunno R, Bucher S, Solari N, Santoriello A, Valpione S, Rossi CR. Local treatment with electrochemotherapy of superficial angiosarcomas: Efficacy and safety results from a multi-institutional retrospective study. J Surg Oncol 2016; 114:246-53. [DOI: 10.1002/jso.24287] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 02/08/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Michele Guida
- Medical Oncology Unit; Istituto dei Tumori; Bari Italy
| | - Luca G. Campana
- Veneto Institute of Oncology IOV-IRCCS; Padova Italy
- Department of Surgery, Oncology and Gastroenterology; University of Padova; Italy
| | - Pietro Curatolo
- Department of Dermatology and Plastic Surgery; La Sapienza University; Roma Italy
| | | | - Antonio Bonadies
- Plastic Surgery Unit; San Gallicano Dermatologic Institute IRCCS IFO; Roma Italy
| | - Gretha Grilz
- Breast Surgery Unit; Città della salute e della scienza di Torino; Italy
| | - Carlo Cabula
- Oncologic Surgery; Ospedale Oncologico A. Businco; Cagliari Italy
| | - Roberta Rotunno
- Department of Dermatology and Plastic Surgery; La Sapienza University; Roma Italy
| | - Stefania Bucher
- Plastic Surgery Unit; San Gallicano Dermatologic Institute IRCCS IFO; Roma Italy
| | - Nicola Solari
- Surgical Unit 1; San Martino IST-IRCCS; Genova Italy
| | - Antonio Santoriello
- Dipartimento di chirurgia generale e specialistica II Università di Napoli; Italy
| | - Sara Valpione
- Department of Surgery, Oncology and Gastroenterology; University of Padova; Italy
- Medical Oncology; The Christie NHS Trust; Manchester United Kingdom
| | - Carlo R. Rossi
- Veneto Institute of Oncology IOV-IRCCS; Padova Italy
- Department of Surgery, Oncology and Gastroenterology; University of Padova; Italy
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Guida M, Campana LG, Strippoli S, Curatolo P, Bonadies A, Grilz G, Cabula C, Rotunno R, Bucher S, Solari N, Santoriello A, Rossi CR. Local treatment with electrochemotherapy of superficial angiosarcomas: efficacy and safety results from a multi-institutional retrospective study. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.02.135] [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] Open
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DE Iuliis F, Mandolini PL, Cursano MC, Menghi A, Salerno G, Taglieri L, Curatolo P, Lanza R, Scarpa S. Nodal and cutaneous Kaposi's sarcoma. GIORN ITAL DERMAT V 2016; 151:215-216. [PMID: 27068602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Rotunno R, Paolino G, Cantisani C, Solito C, Calvieri S, Curatolo P. Predictive factors in non-melanoma skin cancers treated with electrochemotherapy. Ital J Dermatol Venerol 2016; 153:11-18. [PMID: 26989995 DOI: 10.23736/s0392-0488.16.05336-0] [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: 11/08/2022]
Abstract
BACKGROUND The management of non-melanoma skin cancers may benefit from alternative treatments and in this spectrum electrochemotherapy plays a pivotal role. The aim was to describe the predictive features of patients with cutaneous carcinomas treated with electrochemotherapy, with regard to clinical, pathological and instrumental predictors. METHODS We analyzed disease free survival (DFS), and overall survival (OS) for each patient. Assuming that the effects of the predictor variables are constant over time, the independent predictive factors were assessed by Cox-proportional hazards regression in both univariate and multivariate analyses. RESULTS We can assess that in the brief-term (DFS), the patients' age, tumor-site, tumor size, photo-type and the dose of the cytotoxic drug showed a statistical significant better behavior. However, in the multivariate, only the variables tumor's site (P=0.01) and tumor appearance (P=0.03) reached the statistical significance. In the long-term, female patients, patients with a median age ≤70 years, with III-IV photo types and patients, which received a dosage of bleomycin, ≤14 mg/m2 presented a significant better behavior. However in the multivariate analysis a significance was maintained for the variables tumor's appearance (HR: 11.6; 95% CI: 11.56 to 27.5; P=0.01), infiltration (HR:0.11; 95% CI: 0.012 to 0.9; P=0.04), electrode type (HR:0.19; 95% CI:0.04 to 0.8; P=0.03) and photo type (HR:5.7; 95% CI:1.3 to 24.3; P=0.01). CONCLUSIONS According to our results, in electrochemotherapy different individual variables can have an important influence, which shows how this treatment could improve. The refinement of the technique and the optimization of patients' selection has the aim to improve the therapeutic response.
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Affiliation(s)
- Roberta Rotunno
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy -
| | - Giovanni Paolino
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy
| | - Carmen Cantisani
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy
| | - Carmen Solito
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy
| | - Stefano Calvieri
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy
| | - Pietro Curatolo
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy
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Agresti R, Cabula C, Campana L, Grilz G, Bussone R, Galuppo S, Valpione S, De Meo L, Bonadies A, Curatolo P, De Laurentiis M, Renne M, Fabrizio T, Solari N, Guida M, Santoriello A, D'Aiuto M. BP103 ELECTROCHEMOTHERAPY IN THE TREATMENT OF CUTANEOUS METASTASES FROM BREAST CANCER: A MULTICENTER COHORT ANALYSIS. Breast 2015. [DOI: 10.1016/s0960-9776(15)30115-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Cabula C, Campana LG, Grilz G, Galuppo S, Bussone R, De Meo L, Bonadies A, Curatolo P, De Laurentiis M, Renne M, Valpione S, Fabrizio T, Solari N, Guida M, Santoriello A, D'Aiuto M, Agresti R. Electrochemotherapy in the Treatment of Cutaneous Metastases from Breast Cancer: A Multicenter Cohort Analysis. Ann Surg Oncol 2015; 22 Suppl 3:S442-50. [PMID: 26242370 PMCID: PMC4686551 DOI: 10.1245/s10434-015-4779-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [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: 05/13/2015] [Indexed: 12/25/2022]
Abstract
Background The management of breast cancer (BC) skin metastases represents a therapeutic challenge. Electrochemotherapy (ECT) combines the administration of bleomycin with temporary permeabilization induced by locally administered electric pulses. Preliminary experience with ECT in BC patients is encouraging. Methods A total of 125 patients with BC skin metastases who underwent ECT between 2010 and 2013 were enrolled onto a multicenter retrospective cohort study. The treatment was administered following the European Standard Operative Procedures of Electrochemotherapy. Tumor response was clinically assessed adapting the Response Evaluation Criteria in Solid Tumors, and toxicity was evaluated according to Common Terminology Criteria for Adverse Events 4.0. Cox regression analysis was used to identify predictive factors. Results Response was evaluable in 113 patients for 214 tumors (median 1 per patient, range 1–3). The overall response rate after 2 months was 90.2 %, while the complete response (CR) rate was 58.4 %. In multivariate analysis, small tumor size (P < 0.001), absence of visceral metastases (P = 0.001), estrogen receptor positivity (P = 0.016), and low Ki-67 index (P = 0.024) were significantly associated with CR. In the first 48 h, 10.4 % of patients reported severe skin pain. Dermatologic toxicity included grade 3 skin ulceration (8.0 %) and grade 2 skin hyperpigmentation (8.8 %). Tumor 1-year local progression-free survival was 86.2 % (95 % confidence interval 79.3–93.8) and 96.4 % (95 % confidence interval 91.6–100) in the subgroup of those with CR. Conclusions In this study, small tumor size, absence of visceral metastases, estrogen receptor positivity, and low Ki-67 index were predictors of CR after ECT. Patients who experienced CR had durable local control. ECT represents a valuable skin-directed therapy for selected patients with BC.
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Affiliation(s)
- C Cabula
- Oncologic Surgery, Ospedale Oncologico A. Businco, Cagliari, Italy
| | - L G Campana
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - G Grilz
- Breast Surgery Unit, Ospedale Le Molinette, Turin, Italy
| | - S Galuppo
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - R Bussone
- Breast Surgery Unit, Ospedale Le Molinette, Turin, Italy
| | - L De Meo
- Humanitas-Centro Catanese di Oncologia, Catania, Italy
| | - A Bonadies
- Plastic Surgery Unit, San Gallicano Dermatologic Institute, Rome, Italy
| | - P Curatolo
- Dermatology and Plastic Surgery Department, La Sapienza University, Rome, Italy
| | | | - M Renne
- Fondazione T. Campanella, Catanzaro, Italy
| | - S Valpione
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - T Fabrizio
- Plastic Surgery Unit, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy
| | - N Solari
- Surgical Unit 1, IRCCS San Martino-IST, Genoa, Italy
| | - M Guida
- Medical Oncology Unit, Istituto dei Tumori, Bari, Italy
| | - A Santoriello
- Department of Medicine and Surgery, "Federico II" University, Naples, Italy
| | - M D'Aiuto
- Breast Surgery Unit, Istituto Nazionale Tumori "Pascale", Naples, Italy
| | - R Agresti
- Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Campana LG, Quaglino P, Bonadies A, Curatolo P, Testori A, Framarini M, Cubicciotti E, Gerlini G, Ascierto PA, Guida M, Rotunno R, Marenco F, De Paoli A, De Salvo GL, Rossi CR. Skin-directed electrochemotherapy: A prospective multi-institutional study on 394 patients with superficial tumors. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e20001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Torino, Torino, Italy, Torino, Italy
| | - Antonio Bonadies
- Plastic Surgery Unit, San Gallicano Dermatology Institute, Rome, Italy
| | - Pietro Curatolo
- Department of Dermatology and Plastic Surgery, University of Rome "La Sapienza", Rome, Italy
| | | | - Massimo Framarini
- Department of Surgery and Advanced Cancer Therapies, Morgagni-Pierantoni Hospital, Forlì, Italy
| | | | - Gianni Gerlini
- Plastic Surgery Unit, Tuscan Tumor Institute (ITT), Santa Maria Annunziata Hospital, Florence, Italy
| | | | | | - Roberta Rotunno
- Department of Dermatology and Plastic Surgery, University of Rome "La Sapienza", Rome, Italy
| | - Federica Marenco
- Department of Biomedical Sciences and Human Oncology, University of Turin, Turin, Italy
| | - Angela De Paoli
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology, IOV-IRCCS, Padova, Italy
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Diociaiuti A, Rotunno R, El Hachem M, Latorre S, Cozza R, Curatolo P. Electrochemotherapy, a potential new treatment for the management of squamous cell carcinoma in patients with recessive dystrophic epidermolysis bullosa: report of three cases. J Eur Acad Dermatol Venereol 2015; 30:1195-6. [PMID: 25758658 DOI: 10.1111/jdv.13116] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A Diociaiuti
- U.O. Dermatologia, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - R Rotunno
- Clinica Dermatologica, Università di Roma "La Sapienza", Rome, Italy
| | - M El Hachem
- U.O. Dermatologia, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Latorre
- U.O. Dermatologia, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - R Cozza
- U.O. Dermatologia, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - P Curatolo
- Clinica Dermatologica, Università di Roma "La Sapienza", Rome, Italy
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Ricci F, Paradisi A, Fossati B, Mancini M, Curatolo P, Guerriero C, Capizzi R. Giant neglected squamous cell carcinoma of the skin. Dermatol Ther 2015; 28:230-4. [DOI: 10.1111/dth.12214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Francesco Ricci
- Department of Dermatology; Catholic University of Sacred Heart; Rome Italy
| | - Andrea Paradisi
- Department of Dermatology; Health Services Research Unit; Istituto Dermopatico dell'Immacolata - Istituto di ricovero e cura a carattere scientifico; Rome Italy
| | - Barbara Fossati
- Department of Dermatology; Catholic University of Sacred Heart; Rome Italy
| | - Monica Mancini
- Department of Dermatology; University of Rome “La Sapienza”; Rome Italy
| | - Pietro Curatolo
- Department of Dermatology; University of Rome “La Sapienza”; Rome Italy
| | - Cristina Guerriero
- Department of Dermatology; Catholic University of Sacred Heart; Rome Italy
| | - Rodolfo Capizzi
- Department of Dermatology; Catholic University of Sacred Heart; Rome Italy
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Quaglino P, Matthiessen LW, Curatolo P, Muir T, Bertino G, Kunte C, Odili J, Rotunno R, Humphreys AC, Letulé V, Marenco F, Cuthbert C, Albret R, Benazzo M, De Terlizzi F, Gehl J. Predicting patients at risk for pain associated with electrochemotherapy. Acta Oncol 2015; 54:298-306. [PMID: 25591818 DOI: 10.3109/0284186x.2014.992546] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Electrochemotherapy describes the use of electric pulses to enhance chemotherapy uptake, and has proven highly efficient in treating cutaneous metastases. Patients referred for electrochemotherapy present with diverse clinical pictures, from multiple small lesions to large, ulcerated lesions. Post-electrochemotherapy pain has been observed in some patients. The objectives of this study were to evaluate pain scores before and after electrochemotherapy, and to investigate if patients at risk of post-procedure pain could be identified. METHODS Seven cancer centres in the International Network for Sharing Practices on Electrochemotherapy (INSPECT) consecutively and prospectively reported to a common database. Electrochemotherapy consisted of intratumoural or intravenous injection of bleomycin, followed by delivery of electric pulses in local or general anesthesia. RESULTS Of 121 patients 39% had metastatic melanoma, 18% squamous cell carcinoma, 16% breast cancer, 13% basal-cell carcinoma, and 14% other malignancies. Median size of the largest nodules was 2.3 cm (range 0.3-40 cm). A majority of patients presented with low pain scores, and this continued through follow-up (74%). A subset of patients had moderate (13%) or severe pain (13%) after treatment. Post-procedure pain was statistically significantly associated with: 1) moderate or severe pain before treatment (p<0.0001); 2) size of the largest treated lesion (p<0.01); 3) previous irradiation (p<0.02); and 4) high treatment current value (p<0.0001). CONCLUSION The majority of patients had no or mild pain after electrochemotherapy. Patients at risk for post-procedure pain could be identified at the pre-treatment visit, and/or at the time of treatment, enabling a pain management strategy for this group.
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Affiliation(s)
- Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Torino , Torino , Italy
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El Malhany N, Gulisano M, Rizzo R, Curatolo P. Tourette syndrome and comorbid ADHD: causes and consequences. Eur J Pediatr 2015; 174:279-88. [PMID: 25224657 DOI: 10.1007/s00431-014-2417-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 08/27/2014] [Accepted: 09/01/2014] [Indexed: 12/17/2022]
Abstract
UNLABELLED Attention deficit hyperactivity disorder (ADHD) is the most common comorbid condition in patients with Tourette syndrome (TS). The co-occurrence of ADHD and TS is in most cases associated with a higher social and psychopathological impairment. Comorbidity between Tourette and ADHD appears to have a complex and partially known pathogenesis in which genetic, environmental, and neurobiological factors can be implicated. Genetic studies have revealed an involvement of dopaminergic, catecholaminergic, and GABAergic genes that modulated the activity of neurotransmitters. Furthermore, there are a lot of networks implicated in the development of ADHD and TS, involving cortical and striatal areas and basal ganglia. Although a large number of studies tried to find a common pathogenesis, the complex pathways responsible are not clear. The genes implicated in both disorders are currently unidentified, but it is probable that epigenetic factors associated with neural modifications can represent a substrate for the development of the diseases. CONCLUSION In this paper, recent advances in neurobiology of ADHD and TS are reviewed, providing a basis for understanding the complex common pathogenesis underlying the frequent co-occurrence of the two conditions and the therapeutic choices.
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Affiliation(s)
- N El Malhany
- Section of Child Neuropsychiatry, Department of Neurosciences, Tor Vergata University, Viale Oxford 81, 00133, Rome, Italy,
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Abstract
Tuberous sclerosis complex (TSC) is a genetic multisystem disorder characterized by widespread hamartomas in several organs, including the brain, heart, skin, eyes, kidney, lung, and liver. The affected genes are TSC1 and TSC2, encoding hamartin and tuberin respectively. The hamartin-tuberin complex inhibits the mammalian-target-of-Rapamycin (mTOR) pathway, which controls cell growth and proliferation. Variations in the distribution, number, size, and location of lesions cause the clinical syndrome to vary even between relatives. About 85% of children and adolescents with TSC have CNS complications, including epilepsy, cognitive impairment, challenging behavioral problems, and autism-like symptoms. Epilepsy generally begins during the first year of life, with focal seizures and spasms. The discovery of the mTOR pathway upregulation in TSC-associated lesions presents new possibilities for treatment strategy. Increasing understanding of the molecular abnormalities caused by TSC may enable improved management of the disease.
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Affiliation(s)
- P Curatolo
- Department of Neuroscience, Pediatric Neurology Unit, Tor Vergata University of Rome, Rome, Italy.
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Pasini A, Sinibaldi L, Paloscia C, Douzgou S, Pitzianti MB, Romeo E, Curatolo P, Pizzuti A. Neurocognitive effects of methylphenidate on ADHD children with different DAT genotypes: a longitudinal open label trial. Eur J Paediatr Neurol 2013; 17:407-14. [PMID: 23541676 DOI: 10.1016/j.ejpn.2013.02.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 11/10/2012] [Accepted: 02/19/2013] [Indexed: 11/30/2022]
Abstract
The variable number of tandem repeat polymorphism in the 3'-untranslated region of the dopamine transporter gene (DAT) may influence the variability of the therapeutic response to methylphenidate (MPH) in Attention Deficit/Hyperactivity Disorder (ADHD). For this reason we evaluated the neuropsychological functioning after a prolonged period of MPH treatment and after a specific time from MPH suspension. Relationship between DAT VNTR genotypes and neurocognitive response to MPH was analyzed in a sample of 108 drug-naive ADHD patients. The performance of children with ADHD on measures of working memory, inhibition and planning was assessed at 4, 8 and 24 weeks and at 8 weeks after MPH withdrawal. Patients with 9/9 genotype evidenced an improvement in response inhibition and working memory only at 4 weeks of treatment, in planning at 24 weeks of therapy and after 8 weeks of MPH suspension. Patients with 9/10 showed an improvement in response inhibition at 4, 8 and 24 weeks of treatment, in planning at 24 weeks and after 8 weeks of MPH suspension. Patients with 10/10 evidenced an improvement in response inhibition and working memory at 4, 8 and 24 weeks of treatment and in planning at 4, 8 and 24 weeks of treatment and after 8 weeks of suspension. These results indicate that the 9/9 ADHD genotype has a different response at 24 weeks treatment with MPH. 10/10 DAT allele seems to be associated with an increased expression level of the dopamine transporter and seems to mediate the MPH treatment response in ADHD patients.
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Affiliation(s)
- A Pasini
- Division of Child Neuropsychiatry, Department of Neuroscience, University of Rome Tor Vergata, Via Alberico 2 n.35, 00193 Rome, Italy.
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Curatolo P, Rotunno R, Miraglia E, Mancini M, Calvieri S, Giustini S. Complete remission of Merkel cell carcinoma treated with electrochemotherapy and etoposide. GIORN ITAL DERMAT V 2013; 148:310-311. [PMID: 23670070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Benvenuto A, Marciano S, Capuano I, Curatolo P. An update on autism spectrum disorders in children. Minerva Pediatr 2013; 65:19-36. [PMID: 23422571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Autism spectrum disorders (ASDs) constitute a class of severe neurodevelopmental conditions caused by atypical brain development beginning during early prenatal or postnatal life. Autistic features begin to be evident in children between 12 and 18 months of age and are considered to be life-long conditions, with core symptoms being permanent across the lifespan. Etiology is multifactorial, involving a strong genetic underpinning. Studies of genetic and environmental epigenetic factors are beginning to provide some clues to clarify the complexities of autism pathogenesis, associated with altered functional and structural connectivity patterns in several brain regions that occur early in life. Genetic syndromes, defined chromosomal abnormalities, and metabolic diseases account for less than 20% of autistic patients and etiologic causes of ASDs remain elusive in more than 80% of cases. Currently, no treatments have been proven to completely reverse the core symptoms but progress in early detection of autistic symptoms in young children has promoted earlier interventions, which should begin soon after the diagnosis is made and be individualized and intensive, for reaching more positive outcomes in terms of cognitive improvement and decrease of symptoms severity. The management of individuals with ASDs requires a multimodal approach of behavioral, medical and pharmacological treatments. Therefore, it is highly important for pediatricians to recognize early signs of ASDs and to know multiple genetic and non genetic disorders that underlie autistic phenotype.
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Affiliation(s)
- A Benvenuto
- Department of Neuroscience, Tor Vergata University, Rome, Italy.
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40
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Curatolo P, Miraglia E, Rotunno R, Calvieri S, Giustini S. Electrochemotherapy: a valid treatment for Gorlin-Goltz syndrome. Acta Dermatovenerol Croat 2013; 21:132-133. [PMID: 24001423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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41
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Curatolo P, Quaglino P, Marenco F, Mancini M, Nardò T, Mortera C, Rotunno R, Calvieri S, Bernengo MG. Electrochemotherapy in the treatment of Kaposi sarcoma cutaneous lesions: a two-center prospective phase II trial. Ann Surg Oncol 2011; 19:192-8. [PMID: 21822561 DOI: 10.1245/s10434-011-1860-7] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Indexed: 12/11/2022]
Abstract
BACKGROUND Electrochemotherapy (ECT) is an emerging treatment for cutaneous lesions of different tumor types. The combination of chemotherapy and electroporation enhances drug uptake into tumoral cells. However, its role in the treatment of Kaposi sarcoma (KS) has not yet been well defined, and to date, literature reports are scarce. We prospectively evaluated clinical activity and safety of ECT in KS patients. METHODS Twenty-three patients with histologically confirmed unresectable KS, not treatable by radiotherapy or intralesional vincristine therapy, were enrolled onto the study according to the European Standard Operating Procedures of Electrochemotherapy (ESOPE) guidelines and treated with a pulse generator. RESULTS A response to the first ECT session was obtained in all patients, with a complete response (CR) in 14 (60.9%) of 23 patients. A second ECT was performed in 5 (21.7%) and a third in 2, with a median interval between two sessions of 5.1 (range 2.5-25.5) months. Overall, a total of 15 patients (65%) experienced a CR. After a median follow-up of 1.5 years (range 2 months to 4.2 years), 16 patients maintained the response, 4 after repeated courses. Sustained local control of treated lesions was present in 20 of 23 patients. The overall survival rate was 74.4% at 2 years. CONCLUSIONS ECT represents an additional therapeutic tool for the management of KS cutaneous lesions, characterized by a definite clinical activity and long-lasting remissions. The absence of systemic side effects and the low impact on the immune system also make this treatment suitable for elderly people, even with repeated courses.
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Affiliation(s)
- Pietro Curatolo
- Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University of Rome La Sapienza, Rome, Italy
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Affiliation(s)
- R Rizzo
- Section of Child Neurology, Department of Pediatrics, Catania University, Italy.
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Abstract
An 11-year-old boy with attention deficit/hyperactivity disorder (ADHD) presented with visual hallucinations several years after starting methylphenidate (MPH). The hallucinations resolved upon discontinuation of the drug. Reports of toxic hallucinosis during treatment with MPH are rare. Although the pathogenetic mechanism is unclear, the occurrence of hallucinations may be explained by a chronic increase in synaptic dopamine. Clinicians should be aware of this possible rare adverse manifestation occurring at therapeutic doses.
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Affiliation(s)
- M C Porfirio
- Department of Neuroscience, Child Neurology Unit, Tor Vergata University, Rome, Italy
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Coppola G, Grosso S, Franzoni E, Veggiotti P, Zamponi N, Parisi P, Spalice A, Habetswallner F, Fels A, Verrotti A, D’Aniello A, Mangano S, Balestri A, Curatolo P, Pascotto A. Rufinamide in refractory childhood epileptic encephalopathies other than Lennox–Gastaut syndrome. Eur J Neurol 2011; 18:246-251. [DOI: 10.1111/j.1468-1331.2010.03113.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G. Coppola
- Clinic of Child Neuropsychiatry, Second University of Naples, Naples
| | - S. Grosso
- Department of Pediatrics, Pediatric Neurology Section, University of Siena, Siena
| | - E. Franzoni
- Child Neuropsychiatry Unit, Bologna University, Bologna
| | - P. Veggiotti
- Department of Child Neurology and Psychiatry, C. Mondino Institute, University of Pavia, Pavia
| | - N. Zamponi
- Pediatric Neurology Department, G. Salesi Hospital, Ancona
| | - P. Parisi
- Chair of Pediatrics, Second Faculty of Medicine, Sapienza University
| | - A. Spalice
- Department of Pediatrics, First Faculty of Medicine, Sapienza University, Sapienza
| | | | - A. Fels
- Clinical Neurophysiology Unit, Cardarelli Hospital, Naples
| | - A. Verrotti
- Department of Pediatrics, University of Chieti, Chieti
| | - A. D’Aniello
- Clinic of Child Neuropsychiatry, Second University of Naples, Naples
| | - S. Mangano
- Child Neuropsychiatry, Palermo University, Palermo
| | - A. Balestri
- Department of Pediatrics, Pediatric Neurology Section, University of Siena, Siena
| | - P. Curatolo
- Pediatric Neuroscience Unit, Tor Vergata University of Rome, Rome, Italy
| | - A. Pascotto
- Clinic of Child Neuropsychiatry, Second University of Naples, Naples
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Richetta AG, Curatolo P, D'Epiro S, Mancini M, Mattozzi C, Giancristoforo S, Rotunno R, Calvieri S. Efficacy of electrochemotherapy in ulcerated basal cell carcinoma. Clin Ter 2011; 162:443-445. [PMID: 22041802] [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: 05/31/2023]
Abstract
Basal cell carcinoma is the most common cutaneous malignant tumor, accounting for up to 80% of non melanoma skin cancers. Surgery, radiotherapy and chemotherapy have been for long time the main options for its treatment. Electrochemotherapy (ECT) is a novel local treatment successfully used in primary skin tumors. We report a case of a man affected by ulcerated basal cell carcinoma treated with ECT. In our case ECT was successful in the management of extensive basal cell carcinoma in clinical conditions whereas other approaches, would have been dangerous and inappropriate. To our knowledge, ECT must be considered as an alternative of traditional techniques when they are contraindicated in relation to the appearance of the lesions or the patient medical history.
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Affiliation(s)
- A G Richetta
- Department of Dermatology, Umberto I Hospital, University Sapienza, Rome, Italy.
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46
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Affiliation(s)
- R Rizzo
- Section of Child Neuropsychiatry, Department of Pediatrics, Catania University, Catania, Italy.
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Cantisani C, Richetta AG, Bitonti A, Curatolo P, Ferretti G, Mattozzi C, Luca M, Silvestri E, Calvieri S. Recurrent cutaneous abscesses in two Italian family members. Infect Dis Rep 2010; 2:e11. [PMID: 24470891 PMCID: PMC3892580 DOI: 10.4081/idr.2010.e11] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 07/15/2010] [Accepted: 07/15/2010] [Indexed: 11/22/2022] Open
Abstract
Environmental mycobacteria are the causative factors of an increasing number of infections worldwide. Cutaneous infections as a result of such mycobacteria are often misdiagnosed, and their treatment is difficult since they can show in vivo and in vitro multidrug resistance. Absence of pathognomonic clinical signs and variable histological findings often delay diagnosis. We report a case of localized recurrent soft tissue swelling by Mycobacterium marinum in 2 members of the same family. The cases are being reported for their uncommon clinical presentation and the associated etiological agent. Patients recovered completely following therapy with rifampicin 600 mg plus isoniazide 300 mg daily for 45 days.
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Affiliation(s)
| | | | - Andrea Bitonti
- Department of Oncoematology-Dermatology and Plastic Surgery
| | | | - Gianfranco Ferretti
- Department of Tropical Medicine, Azienda Policlinico Umberto I, University "Sapienza" of Rome, Italy
| | - Carlo Mattozzi
- Department of Oncoematology-Dermatology and Plastic Surgery
| | - Melis Luca
- Department of Oncoematology-Dermatology and Plastic Surgery
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Verrotti A, Parisi P, Loiacono G, Mohn A, Grosso S, Balestri P, Tozzi E, Iannetti P, Chiarelli F, Curatolo P. Levetiracetam monotherapy for childhood occipital epilepsy of gastaut. Acta Neurol Scand 2009; 120:342-6. [PMID: 19754870 DOI: 10.1111/j.1600-0404.2009.01264.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this open label pilot study was to evaluate the efficacy and tolerability of levetiracetam (LEV) as 'de novo' monotherapy in children and adolescents with late onset childhood occipital epilepsy-Gastaut type (COE-G). MATERIAL AND METHODS Twelve patients suffering from COE-G were enrolled in this prospective study. The age of seizures onset ranged from 6.1 to 16.2 years with a peak of frequency at mean (+/-SD) 10.54 +/- 2.77 years. Therapy with LEV was started at 10 mg/kg/day and, after titration, the final dose was generally achieved within 4 weeks and ranged from 20.7 to 45.2 mg/kg/day. RESULTS At the 6 month evaluation, 11 (91.6%) of the 12 patients studied were seizure free, and one (8.3%) showed four additional episodes. Electroencephalography (EEG) activity was normal in six (54.5%) patients, unchanged in two (18.1%) children, and in four (33.3%) patients sporadic occipital abnormalities persisted. At the 12-month evaluation all patients were completely seizure free. Four patients (33.3%) continued to show some EEG abnormalities, while eight (72.8%) patients had normal EEG. At the 18-month evaluation all patients were seizure free and 10 patients (83.3%) showed a complete normalization of EEG abnormalities. DISCUSSION Monotherapy with LEV was effective and well tolerated in patients with COE-G. Nevertheless, prospective, large, long-term double-blind studies are needed to confirm these findings.
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Affiliation(s)
- A Verrotti
- Department of Paediatrics, University of Chieti, Chieti, Italy.
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Lintas C, Sacco R, Garbett K, Mirnics K, Militerni R, Bravaccio C, Curatolo P, Manzi B, Schneider C, Melmed R, Elia M, Pascucci T, Puglisi-Allegra S, Reichelt KL, Persico AM. Involvement of the PRKCB1 gene in autistic disorder: significant genetic association and reduced neocortical gene expression. Mol Psychiatry 2009; 14:705-18. [PMID: 18317465 DOI: 10.1038/mp.2008.21] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Protein kinase C enzymes play an important role in signal transduction, regulation of gene expression and control of cell division and differentiation. The fsI and betaII isoenzymes result from the alternative splicing of the PKCbeta gene (PRKCB1), previously found to be associated with autism. We performed a family-based association study in 229 simplex and 5 multiplex families, and a postmortem study of PRKCB1 gene expression in temporocortical gray matter (BA41/42) of 11 autistic patients and controls. PRKCB1 gene haplotypes are significantly associated with autism (P<0.05) and have the autistic endophenotype of enhanced oligopeptiduria (P<0.05). Temporocortical PRKCB1 gene expression was reduced on average by 35 and 31% for the PRKCB1-1 and PRKCB1-2 isoforms (P<0.01 and <0.05, respectively) according to qPCR. Protein amounts measured for the PKCbetaII isoform were similarly decreased by 35% (P=0.05). Decreased gene expression characterized patients carrying the 'normal' PRKCB1 alleles, whereas patients homozygous for the autism-associated alleles displayed mRNA levels comparable to those of controls. Whole genome expression analysis unveiled a partial disruption in the coordinated expression of PKCbeta-driven genes, including several cytokines. These results confirm the association between autism and PRKCB1 gene variants, point toward PKCbeta roles in altered epithelial permeability, demonstrate a significant downregulation of brain PRKCB1 gene expression in autism and suggest that it could represent a compensatory adjustment aimed at limiting an ongoing dysreactive immune process. Altogether, these data underscore potential PKCbeta roles in autism pathogenesis and spur interest in the identification and functional characterization of PRKCB1 gene variants conferring autism vulnerability.
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Affiliation(s)
- C Lintas
- Laboratory of Molecular Psychiatry and Neurogenetics, University Campus Bio-Medico, Rome, Italy
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Lo-Castro A, Galasso C, Cerminara C, El-Malhany N, Benedetti S, Nardone AM, Curatolo P. Association of syndromic mental retardation and autism with 22q11.2 duplication. Neuropediatrics 2009; 40:137-40. [PMID: 20020400 DOI: 10.1055/s-0029-1237724] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We describe a 5.3-year-old girl with autism, mental retardation, hypotonia, marked speech delay, and mild dysmorphic features with a 22q11.2 duplication. Her mother carries the same duplication and presents cleft palate, and normal intelligence. The clinical and behavioural phenotype of this relatively new syndrome is very heterogeneous, with high variability also in the familiar cases. Up till now, about 50 cases of 22q11.2 duplication have been reported, but only three of them are associated with autistic disorders. We propose that in addition to 22q13.3 deletion syndrome, also 22q11.2 duplication should be suspected in a patient with unspecified dysmorphisms, mental retardation, autism, hypotonia, and severe speech delay.
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Affiliation(s)
- A Lo-Castro
- Department of Neuroscience, Paediatric Neurology Unit, Tor Vergata University of Rome, Rome, Italy.
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