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Buonomo OC, Vanni G, Mainolfi M, Materazzo M, Pellicciaro M, Papi S, Combi F, Tazzioli G. Telehealth in oncofertility and breast cancer patients during COVID-19: preliminary results of insenoallasalute.it project. Eur Rev Med Pharmacol Sci 2023; 27:5327-5337. [PMID: 37318507 DOI: 10.26355/eurrev_202306_32652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Breast cancer (BC) is the leading diagnosis in premenopausal patients. Lockdown measures during COVID-19 pandemic reduced facilities for premenopausal patients, impairing oncological and reproductive health. To reduce its effect, a telehealth program called insenoallasalute.it was designed in Italy. PATIENTS AND METHODS A national-based multicentric observational study was undertaken by insenoallasalute.it study group (Italian Ministry of Health, Modena Hospital and Tor Vergata University Hospital) to raise awareness among women on a) BC and its negative role on reproductive health; b) increase adherence to screening programs and self-examination; c) present oncofertility strategies. A web-based platform with two sections was designed: an informative section and a telehealth application activated with a mobile one-time password. After a self-evaluation test to select premenopausal women with maternal desire and family or personal history for BC or ovarian cancer, and premenopausal women with maternity desires with prior medically assisted procreation, a dedicated agenda for telehealth evaluation was displayed and planned. In case the patients fulfilled the criteria for further evaluation, they were invited to perform an outpatient evaluation in one of the pilot centers. RESULTS From July 2021 to December 2021, 2,830 single accounts were activated, and 2,450 (86.57%) completed the tests. 53 patients were selected to undergo telehealth consultation and 40 (80.0%) scheduled the telehealth visit. 6 patients underwent surgery in the study centers. CONCLUSIONS In our experience insenoallasalute.it embodied an innovative solution to spread BC awareness, BC screening program, and oncofertility opportunities in the oncological population.
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Affiliation(s)
- O C Buonomo
- Department of Surgical Science, Breast Unit, Policlinico Tor Vergata University, Rome, Italy.
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Vanni G, Materazzo M, Pellicciaro M, Mainolfi M, Combi F, Papi S, Tazzioli G, Buonomo O. P071 Telehealth in oncofertility and Breast Cancer Patients during COVID-19: Preliminary Results of Insenoallasalute.it project. Breast 2023. [DOI: 10.1016/s0960-9776(23)00189-3] [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: 03/17/2023] Open
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Morganti S, Bertani E, Bocci V, Colandrea M, Collamati F, Cremonesi M, De Simoni M, Ferrari E, Fischetti M, Funicelli L, Grana CM, Mancini-Terracciano C, Mirabelli R, Papi S, Pisa E, Solfaroli-Camillocci E, Traini G, Faccini R. Tumor-non-tumor discrimination by a β - detector for Radio Guided Surgery on ex-vivo neuroendocrine tumors samples. Phys Med 2020; 72:96-102. [PMID: 32247965 DOI: 10.1016/j.ejmp.2020.03.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 01/06/2023] Open
Abstract
This paper provides a first insight of the potential of the β- Radio Guided Surgery (β--RGS) in a complex surgical environment like the abdomen, where multiple sources of background concur to the signal at the tumor site. This case is well reproduced by ex-vivo samples of 90Y-marked Gastro-Entero-Pancreatic Neuroendocrine Tumors (GEP NET) in the bowel. These specimens indeed include at least three wide independent sources of background associated to three anatomical districts (mesentery, intestine, mucose). The study is based on the analysis of 37 lesions found on 5 samples belonging to 5 different patients. We show that the use of electrons, a short range particle, instead of γ particles, allows to limit counts read on a lesion to the sum of the tumor signal plus the background generated by the sole hosting district.The background on adjacent districts in the same specimen/patient is found to differ up to a factor 4, showing how the specificity and sensitivity of the β--RGS technique can be fully exploited only upon a correct measurement of the contributing background. This locality has been used to set a site-specific cut-off algorithm to discriminate tumor and healthy tissue with a specificity of 100% and a sensitivity, on this test data sample, close to 100%. Factors influencing the sensitivity are also discussed. One of the specimens set allowed us evaluate the volume of the lesions, thus concluding that the probe was able to detect lesions as small as 0.04 mL in that particular case.
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Affiliation(s)
- S Morganti
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy
| | - E Bertani
- Division of Digestive Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - V Bocci
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy
| | - M Colandrea
- Division of Nuclear Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - F Collamati
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy.
| | - M Cremonesi
- Radiation Research Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M De Simoni
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy; Dipartimento di Fisica, Sapienza Università di Roma, Rome, Italy
| | - E Ferrari
- Division of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Fischetti
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy; Dipartimento Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Rome, Italy
| | - L Funicelli
- Division of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - C M Grana
- Division of Nuclear Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - C Mancini-Terracciano
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy; Dipartimento di Fisica, Sapienza Università di Roma, Rome, Italy
| | - R Mirabelli
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy; Dipartimento di Fisica, Sapienza Università di Roma, Rome, Italy; Dipartimento Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Rome, Italy; Museo Storico della Fisica e Centro Studi e Ricerche E. Fermi, Rome, Italy
| | - S Papi
- Division of Nuclear Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - E Pisa
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - E Solfaroli-Camillocci
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy; Scuola di Specializzazione in Fisica Medica, Sapienza Università di Roma, Rome, Italy
| | - G Traini
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy; Dipartimento di Fisica, Sapienza Università di Roma, Rome, Italy; Dipartimento Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Rome, Italy; Museo Storico della Fisica e Centro Studi e Ricerche E. Fermi, Rome, Italy
| | - R Faccini
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy; Dipartimento di Fisica, Sapienza Università di Roma, Rome, Italy
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Russomando A, Schiariti M, Bocci V, Colandrea M, Collamati F, Cremonesi M, Ferrari M, Ferroli P, Ghielmetti F, Ghisini R, Grana C, Mancini Terracciano C, Marafini M, Mirabelli R, Morganti S, Papi S, Patanè M, Pedroli G, Pollo B, Solfaroli Camillocci E, Traini G, Faccini R. The β- radio-guided surgery: Method to estimate the minimum injectable activity from ex-vivo test. Phys Med 2019; 58:114-120. [DOI: 10.1016/j.ejmp.2019.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 01/21/2019] [Accepted: 02/09/2019] [Indexed: 11/16/2022] Open
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Omarini C, Guaitoli G, Noventa S, Andreotti A, Gambini A, Palma E, Papi S, Tazzioli G, Balduzzi S, Dominici M, Cascinu S, Piacentini F. Impact of time to surgery after neoadjuvant chemotherapy in operable breast cancer patients. Eur J Surg Oncol 2016; 43:613-618. [PMID: 27793416 DOI: 10.1016/j.ejso.2016.09.020] [Citation(s) in RCA: 35] [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: 06/23/2016] [Revised: 09/08/2016] [Accepted: 09/26/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The optimal time interval between the end of neoadjuvant systemic therapy (NST) and breast surgery is still unclear. It is not known if a delay in surgery might influence the benefit of primary chemotherapy. The aim of this study is to evaluate the relationship between time to surgery (TTS) and survival outcomes. PATIENTS AND METHODS According to TTS, women with diagnosis of BC treated with NST were divided into two cohorts: group A = 21 days or fewer and group B = longer than 21 days. OS and RFS were estimated and compared according to TTS and known prognostic factors. RESULTS A total of 319 patients were included in the study: 61 in group A and 258 in group B. Median TTS was 34 days. No association between clinical stage, nuclear grade, type of chemotherapy, type of surgery and TTS was detected. OS and RFS were significantly worse for group B compared with group A, with a hazard ratio of 3.1 (95% CI, 1.1-8.6 p = 0.03) and 3.1 (95% CI, 1.3-7.1 p = 0.008) respectively. Multivariate analysis confirmed that TTS was an independent prognostic factor in term of OS (p = 0.03) and RFS (p = 0.01). Even in the subgroup of patients with pCR, TTS continued to be an independent prognostic factor for both OS and RFS (p = 0.05 and p = 0.03). CONCLUSIONS TTS after NST seems to influence survival outcomes. BC patients underwent surgery within 21 days experienced maximal benefit from previous treatment: this advantage is consistent and maintained over time.
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Affiliation(s)
- C Omarini
- Division of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy.
| | - G Guaitoli
- Division of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
| | - S Noventa
- Division of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
| | - A Andreotti
- Breast Oncology Unit, Department of General Surgery and Surgical Specialities, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
| | - A Gambini
- Breast Oncology Unit, Department of General Surgery and Surgical Specialities, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
| | - E Palma
- Breast Oncology Unit, Department of General Surgery and Surgical Specialities, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
| | - S Papi
- Breast Oncology Unit, Department of General Surgery and Surgical Specialities, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
| | - G Tazzioli
- Breast Oncology Unit, Department of General Surgery and Surgical Specialities, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
| | - S Balduzzi
- Department of Medicine and Public Health, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
| | - M Dominici
- Division of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
| | - S Cascinu
- Division of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
| | - F Piacentini
- Division of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Via del Pozzo 71, 41122 Modena, Italy
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Sirna V, Garaboldi L, Papi S, Martano L, Omodeo Salè E, Paganelli G, Chinol M. Testing of microbial contamination during the preparation of the radiocompound [⁹⁰Y]DOTATOC for clinical trials: a process validation study by Media Fill approach. Q J Nucl Med Mol Imaging 2010; 54:553-559. [PMID: 20927022] [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: 05/30/2023]
Abstract
AIM Radioisotopes used in nuclear radiopharmacy possess short half-lives, not allowing enough time to wait for completion of sterility tests. Moreover, carrying out sterility tests on highly radioactive solutions inside the hospital microbiology laboratory arises concerns about radioprotection. Therefore, the release of radiopharmaceuticals for injection is allowed in microbial analysis. For this reason, the effectiveness of the aseptic procedures has to be continuously assessed in order to guarantee the safety of the drug. The aim of this study was to validate the sterile preparation of [⁹⁰Y]DOTATOC by means of media fill test. METHODS In order to validate the process, a simulation test was used: the media fill test. To apply this method, operators simulated each step of the process using culture medium (Triptic Soy Broth, TSB) instead of actual radiopharmaceutical product. Media fill test procedure has been subdivided into 5 phases, from the simulation of reagent preparation through the dispensing operations up to ward delivery. After every step, the processed medium was incubated at 35 °C for 14 days. If the compounding procedures are adequately performed, no growth of microorganisms will be detected. RESULTS Microbiological analyses, carried out on all vials obtained at the end of each step, showed no microbial growth. For this reason, sterility tests were considered satisfactory. CONCLUSION Application of media-fill test allowed both to validate operative modality used for [⁹⁰Y]-DOTATOC handling and to attest the ability of operators who worked on it. Additionally, a correct quality control of the radiopharmaceutical i.v. preparations allows clinic infections control and prevention.
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Affiliation(s)
- V Sirna
- Hospital Pharmacy, European Institute of Oncology, Milan, Italy.
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Canella L, Bonardi ML, Groppi F, Persico E, Zona C, Menapace E, Alfassi ZB, Chinol M, Papi S, Tosi G. Accurate determination of half-life and radionuclidic purity of reactor produced 177gLu (177mLu) for metabolic radiotherapy. J Radioanal Nucl Chem 2008. [DOI: 10.1007/s10967-008-0637-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cremonesi M, Ferrari M, Grana CM, Vanazzi A, Stabin M, Bartolomei M, Papi S, Prisco G, Martinelli G, Paganelli G, Ferrucci PF. High-Dose Radioimmunotherapy with 90Y-Ibritumomab Tiuxetan: Comparative Dosimetric Study for Tailored Treatment. J Nucl Med 2007; 48:1871-9. [DOI: 10.2967/jnumed.107.044016] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Vanazzi A, Ferrucci P, Grana C, Cremonesi M, Chinol M, Papi S, Calabrese L, Radice D, Paganelli G, Martinelli G. High dose 90Yttrium ibritumomab tiuxetan with PBSC support in refractory-resistant NHL patients: Preliminary results of a phase I/II study. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7587 Background: Therapeutic options are limited in the treatment of relapsing NHL pts not suitable to HDCT. 90Yttrium ibritumomab tiuxetan (Zevalin) is active in DLBCL at 0.4 mCi/kg, but duration of response is usually short. We present feasibility and toxicity results of a phase I/II study of HD-Zevalin with PBSC support in resistant-refractory NHL pts. From 04/04 to 11/05, 14 pts were enrolled. Median age was 68ys. 13/14 pts had advanced stage disease (III/IV) at diagnosis. 8 DLBCL, 4 MCL, 1 FL G3, 1 transformed MZL. Median number of prior therapies were 3, including rituximab, RT and HD-CT. Methods: 3 dose levels were fixed: 0.8, 1.2, 1.5 mCi/kg. 4 pts received 0.8, 4 pts 1.2 and 6 pts 1.5 mCi/kg. 1wk prior to Zevalin all pts underwent dosimetry: if no abnormal uptake was observed they received the planned dose. On d13 pts received PBSC previously harvested. On d28 from reinfusion (+41 from Zevalin) engraftment was considered to be delayed if ANC <1.0×109/L or PLT<20.0×109/L. Results: Dosimetry showed acceptable radiation-absorbed doses to uninvolved organs, reaching max 20Gy. Only 1pt received 30Gy to the liver without developing toxicity. The median radiation-activity delivered was 90 mCi (range 57–150): 8 pts received a dose within 80 and 100 and 6 pts >100 mCi. Mean dose to red marrow: 0.8±0.2 mGy/MBq. All pts but 1 engrafted promptly. PLT/ANC count nadirs were observed 21/17 days after Zevalin (median values: 11×109/L and 0.01×109/L). No statistically significant difference in terms of hematological toxicity exists in PLT-recovering for pts receiving 1.5 mCi/kg and it is probably influenced by PLT count at baseline and by the several treatment previously received. Non-haematologic toxicity: 1 febrile neutropenia and 1HZV at 2nd level; 1 febrile neutropenia, 1 G3 liver toxicity, 1 bacterial pneumonia, 1HZV, 1HCV reactivation (pt died 4 months after treatment) at the 3rd level. 13/14pts are evaluable for response: 6CR, 2PR, 5PD. Conclusions: Zevalin at myeloablative activity with PBSC is feasible. It could be safely delivered in elderly and heavily pretreated pts, including those who previously received HDCT. Efficacy and mild toxicities suggest further investigation. We are continuing enrollment, including pts who previously received no more than 2 lines of CT. No significant financial relationships to disclose.
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Affiliation(s)
- A. Vanazzi
- European Institute of Oncology, Milan, Italy
| | - P. Ferrucci
- European Institute of Oncology, Milan, Italy
| | - C. Grana
- European Institute of Oncology, Milan, Italy
| | | | - M. Chinol
- European Institute of Oncology, Milan, Italy
| | - S. Papi
- European Institute of Oncology, Milan, Italy
| | | | - D. Radice
- European Institute of Oncology, Milan, Italy
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Chini B, Chinol M, Cassoni P, Papi S, Reversi A, Areces L, Marrocco T, Paganelli G, Manning M, Bussolati G. Improved radiotracing of oxytocin receptor-expressing tumours using the new [111In]-DOTA-Lys8-deamino-vasotocin analogue. Br J Cancer 2003; 89:930-6. [PMID: 12942128 PMCID: PMC2394487 DOI: 10.1038/sj.bjc.6601189] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Oxytocin receptors (OTR) have been described in a number of tumours of different origin, and represent a new target for specific radiolabelled oxytocin (OT) analogues in cancer diagnosis and therapy. By linking the DOTA chelating agent to position 8 of the deamino derivative of Lys(8)-vasotocin (dLVT), we obtained a new compound (DOTA-dLVT) with the following characteristics: (1) it forms a monomeric and stable compound that binds to OTR with an affinity comparable to that of the endogenous OT ligand; (2) it is characterised by a very good selectivity profile for the human OTR, with a low affinity binding to the closely related V1a, V1b and V2 vasopressin receptor subtypes; (3) it induces rapid and persistent receptor internalisation and (4) when radiolabelled, [(111)In]-DOTA-dLVT is efficiently and selectively taken up by OTR-positive tumours grown in mice. These features makes radiolabelled DOTA-dLVT a very good candidate for the radiotargeting of OTR-expressing tumours.
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Affiliation(s)
- B Chini
- CNR Institute of Neuroscience, Cellular and Molecular Pharmacology Section, Via Vanvitelli 32, 20129 Milano, Italy
| | - M Chinol
- European Institute of Oncology, Division of Nuclear Medicine, Via Ripamonti 435, 20141 Milano, Italy
| | - P Cassoni
- Department of Biomedical Sciences and Human Oncology, University of Turin, Via Santena 7, 10126 Torino, Italy
| | - S Papi
- European Institute of Oncology, Division of Nuclear Medicine, Via Ripamonti 435, 20141 Milano, Italy
| | - A Reversi
- CNR Institute of Neuroscience, Cellular and Molecular Pharmacology Section, Via Vanvitelli 32, 20129 Milano, Italy
| | - L Areces
- European Institute of Oncology, Division of Nuclear Medicine, Via Ripamonti 435, 20141 Milano, Italy
| | - T Marrocco
- Department of Biomedical Sciences and Human Oncology, University of Turin, Via Santena 7, 10126 Torino, Italy
| | - G Paganelli
- European Institute of Oncology, Division of Nuclear Medicine, Via Ripamonti 435, 20141 Milano, Italy
| | - M Manning
- Department of Biochemistry and Molecular Biology, Medical College of Ohio, Toledo, PO Box 10008, OH, USA
| | - G Bussolati
- Department of Biomedical Sciences and Human Oncology, University of Turin, Via Santena 7, 10126 Torino, Italy
- Department of Biomedical Sciences and Human Oncology, University of Turin, Via Santena 7, 10126 Torino, Italy. E-mail:
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Paganelli G, Bodei L, Handkiewicz Junak D, Rocca P, Papi S, Lopera Sierra M, Gatti M, Chinol M, Bartolomei M, Fiorenza M, Grana C. 90Y-DOTA-D-Phe1-Try3-octreotide in therapy of neuroendocrine malignancies. Biopolymers 2003; 66:393-8. [PMID: 12658726 DOI: 10.1002/bip.10349] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Somatostatin receptors type 2 (sst(2)) are expressed in high concentration on numerous neudoendocrine tumors. The successful use of radiolabeled somatostatin analogs in imaging promoted further studies in utilizing them in radiopeptide therapy. The somatostatin analog [(90)Y-DOTA-D-Phe(1)-Try3]octreotide (DOTATOC) (DOTA: 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid) possesses favorable characteristic for its therapeutic use; shows high affinity for sst(2), moderately high affinity for sst(5), and intermediate affinity for sst(3); high hydrophilicity; stable and facile labeling with (111) In and (90) Y. In this article we report our experience with (90)Y-DOTATOC in neuroendocrine tumors. Eighty-seven patients with neuroendocrine tumors were treated with a cumulated activity ranging from 7.4 to 20.2 GBq. Most patients responded with stabilization of disease (48%); however, objective responses were observed in 28% of patients (5% complete response). No major acute reactions were observed up to the activity of 5.55 GBq per cycle. The dose limiting was bone marrow toxicity and the maximal tolerated dose was defined as 5.18 GBq.
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Affiliation(s)
- G Paganelli
- Division of Nuclear Medicine-European Institute of Oncology, Milano, Italy.
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Pitton MA, Petolillo M, Papi S, Grismondi GL, Masin GP, Forcellini F. [Hemolytic uremic syndrome in twin pregnancy at 32 weeks gestation with HELLP syndrome. Case report]. Minerva Ginecol 2001; 53:279-81. [PMID: 11431643] [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: 02/20/2023]
Abstract
Renal failure occurring in pregnancy or post partum is an unusual but well-described complication. Acute renal failure seems to be associated more often with HELLP syndrome rather than with pre-eclampsia or chronic hypertension. Probable overlapping of HELLP and hemolytic uremic syndrome in pregnancy or postpartum should be taken into consideration when treating pregnant women who show signs of proteinuria, hypertension, hematuria, increase of reticulocytes, decrease of haptoglobin with thrombocytopenia and microangiopathic hemolytic anemia. Our case refers to a 32 year old woman at 32 weeks gestation in twin pregnancy who presented with HELLP syndrome and renal failure. Immediately postpartum oliguria was noted and the laboratory analyses suggested the coexistence of HELLP and hemolytic uremic syndrome. In patients with gestosis and/or HELLP syndrome presenting oliguria combined with a decrease of hemoglobin level not due to intraoperative hematic leaks it is always necessary to ask for haptoglobin dosage. In treating hemolytic uremic syndrome it is very important to use a high dosage of plasma and sometimes plasmapheresis. HELLP syndrome contributes to various complications which are sometimes responsible for kidney or maternal mortality. In treating these patients early diagnosis combined with a specific treatment can considerably reduce kidney and maternal mortality.
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Affiliation(s)
- M A Pitton
- Istituto di Anestesiologia e Rianimazione, Complesso convenzionato Ospedale-Università Azienda, Ospedaliera, Padova, Italy
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