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Denaro N, Bareggi C, Galassi B, Beltramini G, Wekking D, Proh M, Ibba T, Solinas C, Garrone O. Nutrition in HNSCC: is it a matter for oncologists? The role of multidisciplinary team-a narrative literature review. Front Oncol 2024; 14:1430845. [PMID: 39022585 PMCID: PMC11251948 DOI: 10.3389/fonc.2024.1430845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/11/2024] [Indexed: 07/20/2024] Open
Abstract
Background Malnutrition, defined as weight loss and unsatisfactory nutrient intake, is very common in patients with head and neck squamous cell carcinoma (HNSCC) in either the early or palliative setting. Despite increased awareness, nutritional programs are not yet adequately implemented in these patients. There are several reasons for this delay: differences in composition, the expertise of the multidisciplinary teams involved in HNSCC patients' treatment, and economic and network resources conditioning faster or slower nutritional supply delivery. This situation affects the outcomes and the quality of life of HNSCC patients. Materials and methods We investigated available literature about nutritional support in HNSCC patients and its impact on outcomes, prognosis, and quality of life, and we focused on the role of the multidisciplinary team. We considered 8,491 articles, and after excluding duplicates and manuscripts not written in English, 1,055 were analyzed and 73 were deemed eligible for the present work. Results After the literature review, we can state that malnutrition, sarcopenia, and cachexia are associated with systemic inflammation and closely correlated with poor outcomes. An evaluation of the nutritional status of the multidisciplinary team before, during, and after therapy could improve patient outcomes, as the goal of the therapeutic approach is widely designed. Conclusions We suggest that the treatment workflow definition is fundamental and propose a tailored nutritional approach that could benefit HNSCC patients' outcomes and quality of life. These results could be achieved by a multidisciplinary team.
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Torretta S, Ibba T, Guastella C, Gaini L, Di Cicco M, Folino F, Marchisio P, Bosis S, Pinzani R, D'Amico M, Pignataro L. Management of upper retropharyngeal abscesses in children: Two case reports of a troublesome situation. Clin Case Rep 2021; 9:e04598. [PMID: 34631059 PMCID: PMC8489505 DOI: 10.1002/ccr3.4598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/13/2021] [Accepted: 06/24/2021] [Indexed: 11/24/2022] Open
Abstract
Management of upper retropharyngeal abscesses in children is challenging. In surgical cases, ultrasound-assisted intra-operative procedures may be helpful to reach peculiar locations, thus reducing surgical morbidity and complications rate.
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Borin M, Pignataro L, Ibba T, Di Cicco M, Folino F, Marchisio P, Capaccio P, Torretta S. Unrevealed foreign body in the deep neck space: A case report. Clin Case Rep 2021; 9:1478-1482. [PMID: 33768872 PMCID: PMC7981780 DOI: 10.1002/ccr3.3806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/10/2020] [Accepted: 12/28/2020] [Indexed: 12/04/2022] Open
Abstract
Clinical data provided by the patient are not always reliable or could be difficult to collect. In this case, a difficult history collection resulted in a diagnostic delay. Major complications were avoided performing an urgent surgical intervention.
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Torretta S, Guastella C, Ibba T, Gaffuri M, Pignataro L. Surgical Treatment of Paediatric Chronic Rhinosinusitis. J Clin Med 2019; 8:jcm8050684. [PMID: 31096610 PMCID: PMC6571701 DOI: 10.3390/jcm8050684] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/26/2019] [Accepted: 05/13/2019] [Indexed: 11/16/2022] Open
Abstract
Rhinosinusitis (RS) is a common disease in children, significantly affecting their quality of life. Chronic rhinosinusitis (CRS) is frequently linked to other respiratory diseases, including asthma. Children affected by CRS may be candidates for surgery in the case of failure of maximal medical therapy comprising three to six weeks of broad-spectrum systemic antibiotics with adjunctive therapies. Although endoscopic sinus surgery (ESS) is the surgical treatment of choice in adult patients with CRS, different surgical procedures are scheduled for refractory paediatric CRS and include adenoidectomy, paediatric ESS (PESS), and balloon catheter sinuplasty (BCS). The present paper discusses the indications and limitations of each treatment option in children with CRS. Given the amount of current evidence, it is reasonable to suggest that, in young and otherwise healthy children with refractory CRS, an adenoidectomy (eventually combined with BCS) should be offered as the first-line surgical treatment. Nevertheless, this approach may be considered ineffective in some patients who should be candidates for traditional ESS. In older children, those with asthma, or in the case of peculiar conditions, traditional ESS should be considered as the primary treatment.
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Torretta S, Drago L, Marchisio P, Ibba T, Pignataro L. Role of Biofilms in Children with Chronic Adenoiditis and Middle Ear Disease. J Clin Med 2019; 8:jcm8050671. [PMID: 31086039 PMCID: PMC6571864 DOI: 10.3390/jcm8050671] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/26/2019] [Accepted: 05/10/2019] [Indexed: 01/31/2023] Open
Abstract
Chronic adenoiditis occurs frequently in children, and it is complicated by the subsequent development of recurrent or chronic middle ear diseases, such as recurrent acute otitis media, persistent otitis media with effusion and chronic otitis media, which may predispose a child to long-term functional sequalae and auditory impairment. Children with chronic adenoidal disease who fail to respond to traditional antibiotic therapy are usually candidates for surgery under general anaesthesia. It has been suggested that the ineffectiveness of antibiotic therapy in children with chronic adenoiditis is partially related to nasopharyngeal bacterial biofilms, which play a role in the development of chronic nasopharyngeal inflammation due to chronic adenoiditis, which is possibly associated with chronic or recurrent middle ear disease. This paper reviews the current evidence concerning the involvement of bacterial biofilms in the development of chronic adenoiditis and related middle ear infections in children.
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Torretta S, Gaffuri M, Ibba T, Capaccio P, Marchisio P, Maruca A, Bosis S, Pignataro L. Surgical treatment of non-tuberculous mycobacterial lymphadenitis in children: Our experience and a narrative review. Int J Immunopathol Pharmacol 2019; 32:2058738418806413. [PMID: 30354841 PMCID: PMC6202736 DOI: 10.1177/2058738418806413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Non-tuberculous mycobacterial lymphadenitis (NTML) accounts for about 95% of the cases of head-and-neck mycobacterial lymphadenitis, and its prevalence has been increasing in the Western world. The diagnostic work-up can be challenging, and differential diagnoses such as tuberculous and suppurative lymphadenitis need to be considered. It may, therefore, not be diagnosed until the disease is in a late stage, by which time it becomes locally destructive and is characterized by a chronically discharging sinus. The treatment options include a medical approach, a wait-and-see policy, and surgery, with the last being considered the treatment of choice despite the high risk of iatrogenic nerve lesions. The aim of this article is to provide an overview of pediatric, head-and-neck NTML based on the literature and our own experience, with particular emphasis on the impact and limitations of surgery.
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Torretta S, Guastella C, Marchisio P, Marom T, Bosis S, Ibba T, Drago L, Pignataro L. Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview. J Clin Med 2019; 8:jcm8010101. [PMID: 30654566 PMCID: PMC6351922 DOI: 10.3390/jcm8010101] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/09/2019] [Accepted: 01/14/2019] [Indexed: 12/21/2022] Open
Abstract
Sinonasal-related orbital infections (SROIs) are typically pediatric diseases that occur in 3⁻4% of children with acute rhinosinusitis. They are characterised by various clinical manifestations, such as peri-orbital and orbital cellulitis or orbital and sub-periosteal abscesses that may develop anteriorly or posteriorly to the orbital septum. Posterior septal complications are particularly dangerous, as they may lead to visual loss and life-threatening events, such as an intracranial abscess and cavernous sinus thrombosis. Given the possible risk of permanent visual loss due to optic neuritis or orbital nerve ischemia, SROIs are considered ophthalmic emergencies that need to be promptly recognised and treated in an urgent-care setting. The key to obtaining better clinical outcomes in children with SROIs is a multi-disciplinary assessment by pediatricians, otolaryngologists, ophthalmologists, radiologists, and in selected cases, neurosurgeons, neurologists, and infectious disease specialists. The aim of this paper is to provide an overview of the pathogenesis, clinical manifestations, diagnosis, and treatment of pediatric SROIs, and to make some practical recommendations for attending clinicians.
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Torretta S, Pignataro L, Ibba T, Folino F, Fattizzo M, Marchisio P. Supervised Nasal Saline Irrigations in Otitis-Prone Children. Front Pediatr 2019; 7:218. [PMID: 31214553 PMCID: PMC6554444 DOI: 10.3389/fped.2019.00218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 05/15/2019] [Indexed: 12/01/2022] Open
Abstract
Objectives: To retrospectively investigate the impact of supervised daily nasal saline irrigations (NSI) with 0. 9% saline solution in children with a history of recurrent acute otitis media (RAOM). Methods: A retrospective pilot study was planned to evaluate the possible effect of supervised NSI in reducing the number of acute otitis media (AOM) episodes in otitis-prone children aged 1-5 years, compared to children not instructed to correct NSI performance. Results: Analysis was based on the data contained in 173 charts (57.3% males, mean age of 30.9 ± 7.3 months). 52.0% of children had not been instructed to perform NSI, while the remaining (48.0%) patients had received supervised NSI. At the 4-months follow-up visit a significant reduced number of AOM episodes (1.03 ± 0.14 vs. 2.08 ± 0.16; p < 0.001) as well as antibiotic treatments (1.48 ± 0.17 vs. 2.59 ± 0.18; p < 0.001) was documented in children receiving supervised NSI compared to those not instructed for NSI performance. Conclusions: These data suggest that NSI should be considered in the therapeutic management of children with RAOM, and should be routinely prescribed as a daily adjunctive treatment to reduce acute infectious exacerbations in otitis-prone patients. Accurate parents training is crucial in order to improve children compliance and treatment effectiveness.
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Pignataro L, Marchisio P, Ibba T, Torretta S. Topically administered hyaluronic acid in the upper airway: A narrative review. Int J Immunopathol Pharmacol 2018; 32:2058738418766739. [PMID: 29569499 PMCID: PMC5871036 DOI: 10.1177/2058738418766739] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Hyaluronic acid plays a role in controlling inflammatory airway processes and
mucociliary clearance, and it is also involved in tissue healing and
remodelling. Some studies have tested the effectiveness of topically
administered hyaluronic acid in patients with upper airway diseases with
positive preliminary results. This article describes the use of topically
administered hyaluronic acid in patients with otolaryngological disorders.
Pertinent studies published between January 2000 and October 2016 were selected
by means of a MEDLINE search using the following terms: ‘hyaluronic acid’ and
‘otolaryngology’, ‘otitis’, ‘pharyngitis’, ‘tonsillitis’, ‘rhinitis’,
‘rhinosinusitis’ and ‘nose’. Twelve of the 19 initially identified papers were
selected, corresponding to 902 patients as a whole. There is some evidence that
topically administered hyaluronic acid is effective or moderately effective in
different otolaryngological conditions, as it improves the global subjective and
clinical status of patients with inflammation of the nasopharyngeal and
oto-tubaric complex, those with rhinitis or rhinosinusitis and those who have
undergone nasal and sinonasal surgery. However, these findings should be viewed
cautiously as they are based on a limited number of studies, some of which were
probably under-powered because of their small patient samples.
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Guzzo M, Ferraro L, Ibba T, Quattrone P, Bianchi R, Rezzonico S, Scaramellini G. Schwannoma in the Parotid Gland. Experience at Our Institute and Review of the Literature. TUMORI JOURNAL 2018; 95:846-51. [DOI: 10.1177/030089160909500636] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Schwannoma of the parotid gland is an uncommon tumor. When the facial nerve is involved by the tumor at the time of the operation, the surgical approach requires careful evaluation. The purpose of this study is to provide indications which can support the decision, taking into account the different clinical presentations of parotid schwannoma. In a retrospective study, eight cases of parotid schwannoma were collected between 1975 and 2006. In three cases the tumor affected the facial nerve itself and in the remaining ones it originated from intraparotid nonfacial peripheral nerves. When the facial nerve is involved by the tumor a conservative approach should always be considered. The indication for a surgical procedure should be discussed with the patient. If a conservative strategy is chosen, yearly follow-up by means of MRI and clinical observation should be planned.
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Torretta S, Pasquale DD, Carioli D, Guastella C, Ibba T, Marchision P, Pignataro L. Aneurysmal bone cyst in the inferior nasal turbinate in a pediatric patient: A case report. Turk J Pediatr 2018; 60:747-750. [PMID: 31365215 DOI: 10.24953/turkjped.2018.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Torretta S, Di Pasquale D, Carioli D, Guastella C, Ibba T, Marchision P, Pignataro L. Aneurysmal bone cyst in the inferior nasal turbinate in a pediatric patient: A case report. Turk J Pediatr 2018; 60: 747-750. Aneurysmal bone cysts (ABCs) are non-neoplastic, highly vascularised bone lesions that rarely involve the craniofacial complex. We describe the first case of an ABC involving the inferior turbinate in a 17-month-old boy who attended our Pediatric Emergency Department because of recurrent epistaxis, and discuss the diagnostic and therapeutic work-up in children with nasal masses.
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Torretta S, Pignataro L, Carioli D, Ibba T, Folino F, Rosazza C, Fattizzo M, Marchisio P. Phenotype Profiling and Allergy in Otitis-Prone Children. Front Pediatr 2018; 6:383. [PMID: 30564563 PMCID: PMC6288470 DOI: 10.3389/fped.2018.00383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/19/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Otitis-prone children can present some distinctive clinical patterns and although a number of known risk factors for recurrent acute otitis media (RAOM) are known, no dedicated epidemiological models have been developed to explain clinical heterogeneity. Methods: A preliminary retrospective pilot study was planned to evaluate the possible effect of allergic disease in the development of different disease phenotypes in otitis-prone children aged 3-10 years, particularly the absence (simple RAOM), or presence of episodes of otitis media with effusion between acute infections (RAOM with OME). Results: Analysis was based on the data contained in 153 charts (55.6% males, mean age of 59.4 ± 16.4 months). 75.8% of children had a simple RAOM and 24.2% a RAOM with OME. Atopy or allergy were documented in respectively 47.7 and 41.3% of children considered as a whole. The prevalence of atopy or allergy was significantly higher in the children with a RAOM with OME (atopy: 73.0 vs. 39.5%, p < 0.001; allergy: 60.0 vs. 36.1%, p = 0.049), who also more frequently showed adenoidal hypertrophy (p = 0.016), chronic adenoiditis (p = 0.007), conductive hearing loss (p = 0.004), and impaired tympanometry (p < 0.001). Conclusions: These data suggest that children with a RAOM with OME are clinically different from children with simple RAOM, as they have a more complex clinical presentation that includes not only adenoidal disease and audiological impairment, but also an underlying allergy or atopy. The possibility that the factors mentioned above may be differently involved in the heterogeneous clinical manifestations occurring in otitis-prone children needs to be further investigated in ad hoc epidemiological studies.
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Mantovani M, Carioli D, Torretta S, Rinaldi V, Ibba T, Pignataro L. Barbed snore surgery for concentric collapse at the velum: The Alianza technique. J Craniomaxillofac Surg 2017; 45:1794-1800. [PMID: 28941735 DOI: 10.1016/j.jcms.2017.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 07/10/2017] [Accepted: 08/07/2017] [Indexed: 10/19/2022] Open
Abstract
Recently, new conservative and non-resective surgical techniques, including palatopharyngeal surgical lifting and suspension (the 'Roman blinds technique') and modular barbed snore surgery (MBSS), have been successfully introduced for the treatment of obstructive sleep apnea syndrome (OSAS). This pilot longitudinal study describes our preliminary experience with the 'Alianza technique' (the simultaneous use of Roman blinds and MBSS) in mild to moderate OSAS patients with concentric pharyngeal collapse at the velum, previously documented by means of drug-induced sleep endoscopy. Effectiveness of the surgical procedure was assessed by means of the Epworth sleepiness scale (ESS), overnight polysomnography, and a 0-10 snoring visual analogue scale (VAS); tolerability was assessed by means of a 0-10 pain VAS. The final analysis relating to 19 patients (18 males; 94.8%), with a mean age of 43.8 ± 8.8 years, showed a statistically significant reduction in mean post-operative apnea-hypopnea indexes (22.3 ± 5.1 vs 7.0 ± 9.4 events/hour; p-value = 0.002) and mean ESS scores (11.3 ± 5.4 vs 3.9 ± 4.0; p-value < 0.001). There was also a significant decrease in mean post-operative snoring VAS scores (9.5 ± 0.7 vs 2.1 ± 1.7; p-value < 0.001). Surgery was well tolerated in most patients (mean pain VAS scores on day seven: 2.4 ± 1.4), and there were no major complications. In experienced hands, the Alianza can be considered an effective and safe technique for the treatment of mild to moderate OSAS.
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Bergamini C, Locati L, Bossi P, Granata R, Alfieri S, Resteghini C, Imbimbo M, Fallai C, Orlandi E, Tana S, Iacovelli NA, Guzzo M, Ibba T, Colombo S, Bianchi R, Pizzi N, Fontanella W, Licitra L. Does a multidisciplinary team approach in a tertiary referral centre impact on the initial management of head and neck cancer? Oral Oncol 2016; 54:54-7. [PMID: 26774920 DOI: 10.1016/j.oraloncology.2016.01.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 12/29/2015] [Accepted: 01/04/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES A multi-disciplinary team (MDT) is essential in the management of cancer. Head and neck cancer (HNC) is a rare, complex and heterogeneous group of malignancies for which different treatment options are available. However, the potential impact of MDT on the management of HNC has been only poorly evaluated to date. This study evaluates the impact of MDT on the management of HNC in a tertiary centre. METHODS We retrospectively analysed records of HNC patients referred to a MDT evaluation at the Istituto Nazionale Tumori of Milan, Italy, from May 2007 to January 2012. All cases were reviewed by a MDT consisting of a head and neck surgeon, a radiation oncologist, and a medical oncologist. RESULTS Data from 781 HNC patients were analysed. Approximately 70% of patients were referred to our Institution for a second opinion consultation. Following MDT evaluation, new staging examinations were requested in 49% of patients, and treatment plan was modified in 10%. CONCLUSIONS A MDT approach in a tertiary referral hospital leads to staging refinement of disease or changes in treatment plan in about 60% of patients.
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Orlandi E, Takanen S, Giandini T, Iannacone E, Fontanella W, Locati L, Carrara M, Bossi P, Bergamini C, Granata R, Tombolini V, Ibba T, Licitra L, Pignoli E, Fallai C. Postoperative radiotherapy with volumetric modulated arc therapy of lacrimal gland carcinoma: two case reports and literature review. Future Oncol 2014; 10:2111-20. [PMID: 25471025 DOI: 10.2217/fon.14.148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIMS To evaluate technical issues and clinical outcomes after postoperative volumetric-modulated arc therapy (VMAT) in two cases of malignant lacrimal gland cancer. PATIENTS & METHODS Patients were treated by postoperative VMAT and post-treatment clinical outcomes were followed-up to 18 months. RESULTS Dosimetric results were acceptable and acute toxicity was manageable in both patients. No evidence of disease was found at latest follow-up. One patient underwent corneal transplant for central corneal ulceration, experiencing reduction of visual acuity. CONCLUSION Postoperative VMAT for treatment of lacrimal gland tumors offers improved outcome, with manageable side effects. In the context of photon beam radiotherapy, VMAT emerged as a valuable treatment option for these malignant tumors.
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Orlandi E, Tomatis S, Potepan P, Bossi P, Mongioj V, Carrara M, Palazzi M, Franceschini M, Bergamini C, Locati L, Iannacone E, Guzzo M, Ibba T, Crippa F, Licitra L, Pignoli E, Fallai C. Critical analysis of locoregional failures following intensity-modulated radiotherapy for nasopharyngeal carcinoma. Future Oncol 2013; 9:103-14. [PMID: 23252567 DOI: 10.2217/fon.12.166] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To analyze the patterns of locoregional failure following intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) at our institution, as part of an internal quality assurance program. We aimed to investigate the potential existence of a correlation between any part of the IMRT process and clinical outcome. METHODS & MATERIALS A total of 106 non-metastatic NPC patients consecutively treated with IMRT (with or without chemotherapy) were analyzed. Radiotherapy was administered using a sequential or simultaneous integrated boost approach at the total prescribed dose of 66-70 Gy (2.00-2.12 Gy per fraction). MRI studies of recurrences were recorded with the planning computed tomography studies to identify volume of failure. Recurrence-related characteristics were analyzed with respect to the original treatment. Failures were classified as 'in-field', 'marginal' or 'out-field' if at least 95, 20-95 or less than 20% of the volume of failure, respectively, was within 95% of the total prescription dose. RESULTS With a median follow-up of 43.4 months, 5-years local control, regional control, locoregional control and overall survival rates were 87.7, 88.0, 83.5 and 81.3% respectively. A total of 21 failures were registered in 15 patients. In particular, ten failures (47.6%) were classified as 'in-field' (seven local failures and three regional failures [RFs]), nine failures (42.9%) as 'marginal' (five local failures and four RFs) and only two failures (9.5%) as 'out-field' (both RFs). The most relevant causes of failures were suboptimal target definition and target coverage as well as a longer than planned overall treatment time. CONCLUSION IMRT determines excellent outcome in NPC patients. However, great attention in all IMRT steps is necessary to reduce potential causes of failure.
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Guzzo M, Ferraro L, Rezzonico S, Ibba T, Bianchi R, Fontanella W, Scaramellini G. Open organ preservation surgery of the larynx: Experience of Istituto Nazionale Tumori of Milan. Head Neck 2010; 33:673-8. [DOI: 10.1002/hed.21519] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2010] [Indexed: 11/06/2022] Open
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Bianchi R, Scaramellini G, Fontanella W, Ibba T, Tragni G, Ferraro L, Rezzonico S, Guzzo M. O.500 Oral cavity melanoma: series of the Istituto Nazionale dei Tumori. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71624-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Bianchi R, Scaramellini G, Fontanella W, Ibba T, Tragni G, Ferraro L, Rezzonico S, Guzzo M. O.501 Oral cavity melanoma: series of the Istituto Nazionale dei Tumori. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71625-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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