14500 Background: We have previously reported that 3 cycles of Oxaliplatin (OXA), Raltitrexed (TO... more 14500 Background: We have previously reported that 3 cycles of Oxaliplatin (OXA), Raltitrexed (TOM) and 5-Fluorouracile (FU) + levo-folinic acid (LFA) during pelvic RT had an acceptable toxicity and produced a complete (TRG1, 42%) or subtotal (TRG2, 29%) pathologic tumor regression in 71% of 31 pts with poor prognosis LARC (Avallone et al, Br J Cancer 2006). Here we report an expanded experience on such treatment. Methods: We enrolled 62 eligible pts (M, 33; F, 29), with median age of 58 (27–79) yrs, and adenocarcinoma of the extraperitoneal rectum, with at least one of the following characteristics: cT4 (N pts), cN+ (N), cT3N0 with tumor location = 5 cm from the anal verge and/or CRM +ve (assessed by MRI) (N). Pts received 3 biweekly courses of OXA 100 mg/sqm + TOM 2.5 mg/sqm on day 1, and LFA 250 mg/sqm + FU 900 mg/sqm (31 pts) or 800 mg/sqm (31 pts) on day 2, and concomitant pelvic RT (1.8 Gy/day, total dose 45 Gy). TME was planned 8 weeks after the end of treatment. Pathologic response was evaluated by tumor regression grading (TRG) according to Mandard’s modified classification. Pts with cT4, pN+ and pCRM +ve received also 4 months of weekly FU/FA. Results: All pts received full dose of RT, and 98% of the planned CT cycles. Neutropenia was the most common grade = 3 toxicity (40%), while grade 3 diarrhea was seen in 19% of pts with FU 900 mg/sqm, and in only 6% of pts with FU 800 mg/sqm. All but 2 pts had a TME with R0 resection, and no treatment-related or perioperative death occurred. Median number of sampled lymph nodes was 36 (range, 10–80). 28 (45%) pts obtained a TRG1, and 17 (27%) pts a TRG2. Activity of the treatment was similar in all risk groups, regardless of FU dosage. 1 pt suffered a local recurrence (after 9 months), and 3 pts had distant metastases (after 22, 33, and 47 months). After a median follow-up of 34 (range 6–54) months, all pts are alive, and the estimated 34-month RFS was 95%. All pts achieving a TRG1, and all but one with TRG2 (pCRM +ve), were recurrence-free. Conclusions: These data confirm the feasibility and activity of the whole treatment. A slight reduction of FU dosage appeared to improve the safety of this combination. Currently, we are now evaluating the addition of bevacizumab 5 mg/kg every 2 weeks before and during this concurrent treatment. No significant financial relationships to disclose.
Objectives: The objective of the study is to validate the strategy to find the smallest margins t... more Objectives: The objective of the study is to validate the strategy to find the smallest margins to be safely added the gross tumor volumes (GTVs) of the thorax without any breath control system during Stereotactic Body Radiation Therapy (SBRT). In our experience the measure of inter-fractional tumour motion was determined among the daily pretreatment CBCTs, the simulation CT "slow" and the diagnostic 4D PET/CT . Methods: Thirty-nine patients (p) with primary non-small cell lung cancer (NSCLC) and forty two with lung metastases were treated on this study from June 2012-June 2015. All patients were simulated and treated in a stereotactic immobilization system with BodyFIX® 14 BlueBAG HIP and Total Body with Diaphragm Control and Mechanical Pressure System with compression arch. All CT images (3-mm thickness) were registered and transferred in the treatment planning system (Xio). Plans were generated with variable ( > seven) non-coplanar beams of 6-MV X-rays. The GTV was c...
Aging clinical and experimental research, Jan 24, 2017
The Pros-IT CNR project aims to monitor a sample of Italian males ≥18 years of age who have been ... more The Pros-IT CNR project aims to monitor a sample of Italian males ≥18 years of age who have been diagnosed in the participating centers with incident prostate cancer, by analyzing their clinical features, treatment protocols and outcome results in relation to quality of life. Pros-IT CNR is an observational, prospective, multicenter study. The National Research Council (CNR), Neuroscience Institute, Aging Branch (Padua) is the promoting center. Ninety-seven Italian centers located throughout Italy were involved. The field study began in September 1, 2014. Subjects eligible were diagnosed with biopsy-verified prostate cancer, naïve. A sample size of 1500 patients was contemplated. A baseline assessment including anamnestic data, clinical history, risk factors, the initial diagnosis, cancer staging information and quality of life (Italian UCLA Prostate Cancer Index; SF-12 Scale) was completed. Six months after the initial diagnosis, a second assessment evaluating the patient's hea...
3584 Background: Preoperative chemo-radiation (CT-RT) in LARC has been shown to improve prognosis... more 3584 Background: Preoperative chemo-radiation (CT-RT) in LARC has been shown to improve prognosis of patients (pts) in whom a total (TRG1) or subtotal (TRG2) pathologic tumor regression is achieved...
Introduction The aim of the narrative review was to analyse the applications of nuclear medicine ... more Introduction The aim of the narrative review was to analyse the applications of nuclear medicine (NM) techniques such as PET/CT with different tracers in combination with radiotherapy for the clinical management of glioblastoma patients. Materials and methods Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used. Results This paper contains a narrative report and a critical discussion of NM approaches in combination with radiotherapy in glioma patients. Conclusions NM can provide the Radiation Oncologist several aids that can be useful in the clinical management of glioblastoma patients. At the same, these results need to be validated in prospective and multicenter trials.
logica che, in ultima istanza, ha consentito un notevole miglioramento delle tecniche di trattame... more logica che, in ultima istanza, ha consentito un notevole miglioramento delle tecniche di trattamento: cio ’ ha conseguentemente portato, nella gran parte delle situa-zioni cliniche, ad una maggiore efficacia nella cura delle neoplasie ed allo stesso tempo ad una minore inci-denza di tossicità acuta e tardiva per i pazienti, in defi-nitiva ad un miglioramento dell’indice terapeutico. Unitamente alla continua ottimizzazione ingegneristica degli acceleratori lineari, il passaggio alla radioterapia moderna è stato definito, verso la fine degli anni ’70, dall’introduzione della tomografia computerizzata (TC) come procedura principale nella simulazione di un trat-tamento. La possibilità di acquisire immagini del target tumorale tridimensionalmente, unitamente al parallelo sviluppo di softwares dedicati alla pianificazione del
14500 Background: We have previously reported that 3 cycles of Oxaliplatin (OXA), Raltitrexed (TO... more 14500 Background: We have previously reported that 3 cycles of Oxaliplatin (OXA), Raltitrexed (TOM) and 5-Fluorouracile (FU) + levo-folinic acid (LFA) during pelvic RT had an acceptable toxicity and produced a complete (TRG1, 42%) or subtotal (TRG2, 29%) pathologic tumor regression in 71% of 31 pts with poor prognosis LARC (Avallone et al, Br J Cancer 2006). Here we report an expanded experience on such treatment. Methods: We enrolled 62 eligible pts (M, 33; F, 29), with median age of 58 (27–79) yrs, and adenocarcinoma of the extraperitoneal rectum, with at least one of the following characteristics: cT4 (N pts), cN+ (N), cT3N0 with tumor location = 5 cm from the anal verge and/or CRM +ve (assessed by MRI) (N). Pts received 3 biweekly courses of OXA 100 mg/sqm + TOM 2.5 mg/sqm on day 1, and LFA 250 mg/sqm + FU 900 mg/sqm (31 pts) or 800 mg/sqm (31 pts) on day 2, and concomitant pelvic RT (1.8 Gy/day, total dose 45 Gy). TME was planned 8 weeks after the end of treatment. Pathologic response was evaluated by tumor regression grading (TRG) according to Mandard’s modified classification. Pts with cT4, pN+ and pCRM +ve received also 4 months of weekly FU/FA. Results: All pts received full dose of RT, and 98% of the planned CT cycles. Neutropenia was the most common grade = 3 toxicity (40%), while grade 3 diarrhea was seen in 19% of pts with FU 900 mg/sqm, and in only 6% of pts with FU 800 mg/sqm. All but 2 pts had a TME with R0 resection, and no treatment-related or perioperative death occurred. Median number of sampled lymph nodes was 36 (range, 10–80). 28 (45%) pts obtained a TRG1, and 17 (27%) pts a TRG2. Activity of the treatment was similar in all risk groups, regardless of FU dosage. 1 pt suffered a local recurrence (after 9 months), and 3 pts had distant metastases (after 22, 33, and 47 months). After a median follow-up of 34 (range 6–54) months, all pts are alive, and the estimated 34-month RFS was 95%. All pts achieving a TRG1, and all but one with TRG2 (pCRM +ve), were recurrence-free. Conclusions: These data confirm the feasibility and activity of the whole treatment. A slight reduction of FU dosage appeared to improve the safety of this combination. Currently, we are now evaluating the addition of bevacizumab 5 mg/kg every 2 weeks before and during this concurrent treatment. No significant financial relationships to disclose.
Objectives: The objective of the study is to validate the strategy to find the smallest margins t... more Objectives: The objective of the study is to validate the strategy to find the smallest margins to be safely added the gross tumor volumes (GTVs) of the thorax without any breath control system during Stereotactic Body Radiation Therapy (SBRT). In our experience the measure of inter-fractional tumour motion was determined among the daily pretreatment CBCTs, the simulation CT "slow" and the diagnostic 4D PET/CT . Methods: Thirty-nine patients (p) with primary non-small cell lung cancer (NSCLC) and forty two with lung metastases were treated on this study from June 2012-June 2015. All patients were simulated and treated in a stereotactic immobilization system with BodyFIX® 14 BlueBAG HIP and Total Body with Diaphragm Control and Mechanical Pressure System with compression arch. All CT images (3-mm thickness) were registered and transferred in the treatment planning system (Xio). Plans were generated with variable ( > seven) non-coplanar beams of 6-MV X-rays. The GTV was c...
Aging clinical and experimental research, Jan 24, 2017
The Pros-IT CNR project aims to monitor a sample of Italian males ≥18 years of age who have been ... more The Pros-IT CNR project aims to monitor a sample of Italian males ≥18 years of age who have been diagnosed in the participating centers with incident prostate cancer, by analyzing their clinical features, treatment protocols and outcome results in relation to quality of life. Pros-IT CNR is an observational, prospective, multicenter study. The National Research Council (CNR), Neuroscience Institute, Aging Branch (Padua) is the promoting center. Ninety-seven Italian centers located throughout Italy were involved. The field study began in September 1, 2014. Subjects eligible were diagnosed with biopsy-verified prostate cancer, naïve. A sample size of 1500 patients was contemplated. A baseline assessment including anamnestic data, clinical history, risk factors, the initial diagnosis, cancer staging information and quality of life (Italian UCLA Prostate Cancer Index; SF-12 Scale) was completed. Six months after the initial diagnosis, a second assessment evaluating the patient's hea...
3584 Background: Preoperative chemo-radiation (CT-RT) in LARC has been shown to improve prognosis... more 3584 Background: Preoperative chemo-radiation (CT-RT) in LARC has been shown to improve prognosis of patients (pts) in whom a total (TRG1) or subtotal (TRG2) pathologic tumor regression is achieved...
Introduction The aim of the narrative review was to analyse the applications of nuclear medicine ... more Introduction The aim of the narrative review was to analyse the applications of nuclear medicine (NM) techniques such as PET/CT with different tracers in combination with radiotherapy for the clinical management of glioblastoma patients. Materials and methods Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used. Results This paper contains a narrative report and a critical discussion of NM approaches in combination with radiotherapy in glioma patients. Conclusions NM can provide the Radiation Oncologist several aids that can be useful in the clinical management of glioblastoma patients. At the same, these results need to be validated in prospective and multicenter trials.
logica che, in ultima istanza, ha consentito un notevole miglioramento delle tecniche di trattame... more logica che, in ultima istanza, ha consentito un notevole miglioramento delle tecniche di trattamento: cio ’ ha conseguentemente portato, nella gran parte delle situa-zioni cliniche, ad una maggiore efficacia nella cura delle neoplasie ed allo stesso tempo ad una minore inci-denza di tossicità acuta e tardiva per i pazienti, in defi-nitiva ad un miglioramento dell’indice terapeutico. Unitamente alla continua ottimizzazione ingegneristica degli acceleratori lineari, il passaggio alla radioterapia moderna è stato definito, verso la fine degli anni ’70, dall’introduzione della tomografia computerizzata (TC) come procedura principale nella simulazione di un trat-tamento. La possibilità di acquisire immagini del target tumorale tridimensionalmente, unitamente al parallelo sviluppo di softwares dedicati alla pianificazione del
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