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Vanderveken O.M.,University of Antwerp | Szturz P.,University of Antwerp | Szturz P.,University Hospital Brno | Szturz P.,Masaryk University | And 10 more authors.
Oncologist | Year: 2015

Background. Platinum-based concurrent chemoradiation (CCRT) improves locoregional control and overall survival of locoregionally advanced (LA) squamous cell carcinoma of the head and neck (SCCHN) when compared to radiotherapy alone, but this approach is hampered by significant toxicity. Therefore, alternativeways to enhance the radiation effects are worth investigating. Gemcitabine(2′,2′-difluorodeoxycytidine), in addition to its activity against a variety of solid tumors, including SCCHN, is one of the most potent radiosensitizers, and it has an overall favorable safety profile. In thispaper, the clinical experience with gemcitabine-based chemoradiation in the treatment of patients with LA-SCCHN is reviewed. Methods. We conducted a review of the literature on the clinical experience with radiotherapy combined with either single-agent gemcitabine or gemcitabine/cisplatin-based polychemotherapy for the treatment of patients with LA-SCCHN. Wealso searched abstracts in databases of major international oncology meetings from the last 20 years. A meta-analysis was performed to calculate pooled proportions with 95% confidence intervals (CIs) for complete response rate and grade 3–4 acute mucositis rate. Results. Atotal of13paperswereeligible for theliteraturereview. For schedules using a gemcitabine dose intensity (DI) below 50mg/m2 perweek,the completeresponseratewas86%(95%CI, 74%–93%) with grade 3–4 acute mucositis rate of 38% (95% CI, 27%–50%) and acceptable late toxicity. In one of the studies employing such low DIs, survival data were provided showing a 3-year overall survival of 50%. Comparedwith DI ≥ 50mg/m2 per week, there was no difference in the complete response rate (71%; 95% CI, 55%–83%; p =.087) but a significantly higher (p<.001) grade 3–4 acute mucositis rate of 74% (95% CI, 62%–83%), often leading to treatment interruptions (survival data provided in 8 studies; 3-year overall survival, 27%–63%). Late toxicity comprising mainly dysphagia was generally underreported, whereas information about xerostomia and skin fibrosis was scarce. Conclusion. This review highlights the radiosensitizing potential of gemcitabine and suggests that even very low dosages (less than 50mg/m2 perweek) provide a sufficient therapeutic ratio and thereforeshouldbefurtherinvestigated. Refinementsinradiationschemes, including intensity-modulated radiation therapy, in combination with low-dose gemcitabine and targeted agents, such as cetuximab, are currently being investigated. © AlphaMed Press 2016. Source

Dutto M.,Santa Croce e Carle General Hospital | Bertero M.,Santa Croce e Carle General Hospital
Journal of Preventive Medicine and Hygiene | Year: 2013

The present article discusses three cases of human infestation by Corythuca ciliata (Lace bugs), a parasite of plane trees. The cases were all in the Piedmont region of northwest Italy and the symptoms involved a large number of hives on the subjects' bodies which were scarcely or not at all itchy and which spontaneously cleared up in all the cases in less than 24 hours. It can be concluded that the Lace bug can be an agent of insect-caused dermatosis and this should be considered in examining subjects who visit or live near wooded areas which are infested. Source

Denaro N.,Santa Croce e Carle General Hospital | Russi E.G.,Santa Croce e Carle General Hospital | Adamo V.,Messina University | Merlano M.C.,Santa Croce e Carle General Hospital
Oncology (Switzerland) | Year: 2014

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cause of cancer death worldwide. Its treatment is complex and evolving. In general, early-stage disease may be managed with single-modality treatment while an advanced stage (about 60% of clinical presentation) needs a multidisciplinary approach. In this setting concurrent chemoradiation has been associated with improvement in locoregional control and organ preservation, but at the cost of significant acute and chronic toxicity. Molecular target therapies specially directed to epidermal growth factor receptor (EGFR) might improve the outcomes and reduce toxicities. In recurrent-metastatic (R/M) HNSCC, cetuximab, a monoclonal antibody against EGFR, plus platinum-based chemotherapy (CT) allow an overall survival (OS) of about 10 months. However, the prognosis for R/M-HNSCC remains dismal and additional efforts are needed. At the 2013 American Society of Clinical Oncology (ASCO) Meeting, data on induction CT, anti-EGFR inhibitors, innovative molecular targets and predictor factors were reported. Further results on target therapies were presented at the European Cancer Congress (ECC) 2013, where a large study also showed that hyperfractionated radiotherapy (RT) improve OS rates compared with standard RT. The aim of this review is to discuss current standards and emerging therapies by considering recent new updates. © 2014 S. Karger AG, Basel. Source

Dutto M.,Medical Entomology Collaborator | Dutto L.,Santa Croce e Carle General Hospital | Scaglione N.,Santa Croce e Carle General Hospital | Bertero M.,Santa Croce e Carle General Hospital
Journal of Venomous Animals and Toxins Including Tropical Diseases | Year: 2010

In the period between June 2008 and August 2009, three cases of stings of Euscorpius scorpions indigenous to Italy were treated at two different emergency departments (ED) in hospitals of the Piedmont region, northwest Italy: Santa Croce e Carle General Hospital in Cuneo, and Santissima Annunziata Hospital in Savigliano. Scorpion stings in Italy are rare and not well documented in the literature; this situation may raise doubts among medical personnel as to how such lesions are best treated. Analysis of the incidents confirms that the venom of Euscorpius do not provokes systemic poisoning in humans and in these cases even dermatological reactions were not significant. © CEVAP 2010. Source

Vigna-Taglianti R.,Santa Croce e Carle General Hospital | Russi E.G.,Santa Croce e Carle General Hospital | Denaro N.,Messina University | Numico G.,U. Parini Hospital | Brizio R.,Santa Croce e Carle General Hospital
Cancer/Radiotherapie | Year: 2011

Pemphigus vulgaris is a rare autoimmune mucocutaneous bullous disease. Patients with a history of pemphigus vulgaris - who need radiotherapy - may show a long lasting bullous cutaneous manifestation, typical of pemphigus, within radiation fields. The literature describes fewer than 20 radio-induced cases. While systematic corticosteroid therapy has proven to be useful, topical treatment used in association with corticosteroid therapy is rarely described. To our knowledge the use of modern dressing products has never been described. We report our experience in a case in which modern dressing products were usefully associated to systemic therapy. 2011 Société française de radiothérapie oncologique (SFRO). Source

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