Cozzarini C.,San Raffaele Scientific Institute |
Rancati T.,Prostate Cancer Program |
Carillo V.,San Raffaele Scientific Institute |
Civardi F.,Prostate Cancer Program |
And 9 more authors.
Radiotherapy and Oncology
Purpose A prospective trial started in 2010, aiming at developing models for urinary toxicity and erectile dysfunction after radiotherapy for prostate cancer. This analysis is finalised at highlighting correlations between clinical/dosimetric factors and acute urinary specific symptoms, as measured by single questions of the International Prostate Symptom Score (IPSS). Materials/methods IPSS was prospectively collected before and at the end of radiotherapy; absolute weekly bladder dose-surface histograms (DSHw) were chosen as dosimetric descriptors. Relevant clinical factors were prospectively gathered. Backward feature selection was used to identify variables to be included in logistic models for moderate-severe (scores ≥ 4) urinary symptoms. Results Complete data of 262 patients (120 conventional fractionation, 142 hypofractionation) were available. Smoking was a strong predictor for feeling of incomplete emptying, frequency, intermittency, urgency and straining; neoadjuvant hormonal therapy and use of antihypertensive drugs were risk factors for intermittency and weak stream, respectively. The baseline score was a major predictor for all symptoms with the exception of intermittency. DSHw were correlated to increased risk of frequency, intermittency, urgency and nocturia. Most models showed moderate-high discrimination (AUC 0.60-0.79). Conclusions Smoking and other clinical and dosimetric factors predict for specific moderate-severe acute urinary symptoms; baseline condition heavily modulated the risk in most endpoints. © 2015 Elsevier Ireland Ltd. Source
Franco P.,TomoTherapy |
Ciammella P.,Radiation Therapy Unit |
Peruzzo Cornetto A.,Ospedale Regionale U. Parini |
De Bari B.,University of Brescia |
And 4 more authors.
In order to evaluate the perceived quality of training and education among young Italian radiation oncologists (age <40), AIRO Giovani (Italian Association of Radiation Oncology-Young Members Working Group) carried out a nationwide online survey in 2011, employing a 63-item-based questionnaire, addressed to physician's self-perception of personal training experience (during decade 2001-2011). Issues explored investigated demographics data, duration/organization/content/characteristics of residency programs, the quality of education in clinical oncology, radiation oncology, management and communication attitudes. A total of 382 questionnaires were sent out to physicians and 217 (56.8 %) were returned with 197 (51.6 %) appropriately filled in and considered for the analysis. The general perception of education and training is positive in most of the explored fields, however some specific contexts and skills still require optimization (combination therapy, peculiar clinical scenarios, particular radiotherapy technical issues, structural organization of residency programs). The present report is expected to be useful for residents, program directors and scientific societies (such as AIRO), to further continue the effort in the improvement of training in radiation oncology. © 2013 Springer Science+Business Media New York. Source
Lombardi L.,Oncology Unit |
Troiano M.,Radiation Therapy Unit |
Silvestris N.,Italian National Cancer Institute |
Nanni L.,Oncology Unit |
And 6 more authors.
Expert Opinion on Therapeutic Targets
Introduction: Of all the carcinomas, pancreatic carcinoma (PC) has the highest mortality rate, with a 1- and 5-year survival rate of 25% and less than 5% respectively. This is regardless of the stage at diagnosis. Areas covered: In this review relevant literature assessing the evidence regarding preoperative and adjuvant chemoradiotherapy (CRT) is discussed. Furthermore, new therapeutic approaches are summarized, while the future direction regarding the multimodality approach to PC is also discussed. Expert opinion: The role of combined-modality therapy for PC is continuously evolving. There have been several recent developments, as well as the completion of major, multi-institutional clinical trials. One of the challenges for the busy clinician is to appreciate the variation in staging, surgical expertise, and application of either definitive CRT or neo-adjuvant CRT for local and/or borderline disease. © Informa UK, Ltd. Source
Guedea F.,Catalan Institute of Nanoscience and Nanotechnology |
Ventura M.,Catalan Institute of Nanoscience and Nanotechnology |
Londres B.,Catalan Institute of Nanoscience and Nanotechnology |
Pinillos L.,University of Lima |
And 12 more authors.
Purpose: Relatively little is known about available resources and patterns of practice for brachytherapy (BT) in Latin America. To rectify this situation, we performed a patterns-of-care survey whose aim was to assess the human and material resources available for BT in Latin America and document current clinical practices. Methods and Materials: A total of 392 radiotherapy (RT) centers located in 17 Latin American countries were asked to complete an online survey that included detailed questions about BT practices, facilities, and staffing. The study was coordinated through central offices located in Spain and Peru. National coordinators were appointed to manage the survey in each individual country. Results: Overall, 77 of the 392 institutions (20%) completed the questionnaire. Of the 14 countries with at least one response, the participation rate was 35% (77 of 223 RT centers). The average number of patients (RT. +. BT) per center was 917. The mean number of BT patients per center increased by 46% (from 105 to 153 patients) from 2002 to 2007. Gynecologic localizations (endometrium, cervix, and vagina) accounted for 95% of treatments, and the uterine cervix was the most common tumor site (75% of all treatments). Conclusions: In Latin America, BT is most commonly used to treat gynecologic tumors, particularly of the cervix. Relatively few interventions were performed for breast and prostate. This was the first study of its kind in this region and should be repeated periodically. © 2011 American Brachytherapy Society. Source
Filippi A.R.,University of Turin |
Ciammella P.,Radiation Therapy Unit |
Piva C.,University of Turin |
Ragona R.,University of Turin |
And 6 more authors.
International Journal of Radiation Oncology Biology Physics
Purpose Image-guided intensity modulated radiation therapy (IG-IMRT) allows for margin reduction and highly conformal dose distribution, with consistent advantages in sparing of normal tissues. The purpose of this retrospective study was to compare involved-site IG-IMRT with involved-site 3D conformal RT (3D-CRT) in the treatment of early stage Hodgkin lymphoma (HL) involving the mediastinum, with efficacy and toxicity as primary clinical endpoints. Methods and Materials We analyzed 90 stage IIA HL patients treated with either involved-site 3D-CRT or IG-IMRT between 2005 and 2012 in 2 different institutions. Inclusion criteria were favorable or unfavorable disease (according to European Organization for Research and Treatment of Cancer criteria), complete response after 3 to 4 cycles of an adriamycin- bleomycin-vinblastine-dacarbazine (ABVD) regimen plus 30 Gy as total radiation dose. Exclusion criteria were chemotherapy other than ABVD, partial response after ABVD, total radiation dose other than 30 Gy. Clinical endpoints were relapse-free survival (RFS) and acute toxicity. Results Forty-nine patients were treated with 3D-CRT (54.4%) and 41 with IG-IMRT (45.6%). Median follow-up time was 54.2 months for 3D-CRT and 24.1 months for IG-IMRT. No differences in RFS were observed between the 2 groups, with 1 relapse each. Three-year RFS was 98.7% for 3D-CRT and 100% for IG-IMRT. Grade 2 toxicity events, mainly mucositis, were recorded in 32.7% of 3D-CRT patients (16 of 49) and in 9.8% of IG-IMRT patients (4 of 41). IG-IMRT was significantly associated with a lower incidence of grade 2 acute toxicity (P=.043). Conclusions RFS rates at 3 years were extremely high in both groups, albeit the median follow-up time is different. Acute tolerance profiles were better for IG-IMRT than for 3D-CRT. Our preliminary results support the clinical safety and efficacy of advanced RT planning and delivery techniques in patients affected with early stage HL, achieving complete response after ABVD-based chemotherapy. © 2014 Elsevier Inc. All rights reserved. Source