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33 results on '"Genovesi D."'

1. 18-FDG PET for large-vessel vasculitis diagnosis and follow-up

Author: Angelotti, F, Capecchi, R, Giorgetti, A, Erba, P, Genovesi, D, Emdin, M, Barison, A, Manca, L, Rocchi, V, Migliorini, P, Tavoni, A, Angelotti F., Capecchi R., Giorgetti A., Erba P. A., Genovesi D., Emdin M., Barison A., Manca L., Rocchi V., Migliorini P., Tavoni A., Angelotti, F, Capecchi, R, Giorgetti, A, Erba, P, Genovesi, D, Emdin, M, Barison, A, Manca, L, Rocchi, V, Migliorini, P, Tavoni, A, Angelotti F., Capecchi R., Giorgetti A., Erba P. A., Genovesi D., Emdin M., Barison A., Manca L., Rocchi V., Migliorini P., and Tavoni A.
Abstract: Objective. Large-vessel vasculitis (LVV) are chronic inflammatory diseases that affect arteries. While a mere clinical-serological approach does not seem sensitive either in the initial evaluation nor in long-term monitoring, 18-FDG positron emission tomography (18-FDG PET) is currently considered a useful assessment tool in LVV. We aimed at exploring the utility of 18-FDG, compared with traditional assessments, in the short- and long-term follow-up of patients with LVV. In addition, we compared patterns of vascular involvement in patients with Takayasu’s arteritis (TAK) and giant cell arteritis (GCA). Method. We retrospectively analysed 47 patients affected by LVV, evaluating clinics, blood chemistry and 18-FDG PET results, at two time points, short-term (average 8 months after diagnosis) and long-term (average 29 months). Results. 18-FDG PET uptake, expressed as mean value of SUV max, decreased significantly during follow-up in all the patients. A low concordance between 18-FDG PET and acute phase reactants levels was observed, but also a good sensitivity in detecting the response to treatment. Conclusion. The results confirm the role of 18-FDG PET as a powerful tool in the evaluation of LVV, both at the time of diagnosis and during monitoring. Furthermore, the data confirm that GCA and TAK are part of the same disease spectrum.
Published: 2021

2. Ways to improve breast cancer patients' management and clinical outcome: The 2020 Assisi Think Tank Meeting

Author: Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, Aristei C; Bölükbaşı Y; Kaidar-Person O; Pfeffer R; Arenas M; Boersma LJ; Ciabattoni A; Coles CE; Franco P; Krengli M; Leonardi MC; Marazzi F; Masiello V; Meattini I; Montero A; Offersen B; Trigo ML; Bourgier C; Genovesi D; Kouloulias V; Morganti AG; Meduri B; Pasinetti N; Pedretti S; Perrucci E; Rivera S; Tombolini V; Vidali C; Valentini V; Poortmans P, Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, and Aristei C; Bölükbaşı Y; Kaidar-Person O; Pfeffer R; Arenas M; Boersma LJ; Ciabattoni A; Coles CE; Franco P; Krengli M; Leonardi MC; Marazzi F; Masiello V; Meattini I; Montero A; Offersen B; Trigo ML; Bourgier C; Genovesi D; Kouloulias V; Morganti AG; Meduri B; Pasinetti N; Pedretti S; Perrucci E; Rivera S; Tombolini V; Vidali C; Valentini V; Poortmans P
Abstract: We report on the third Assisi Think Tank Meeting (ATTM) on breast cancer, a brainstorming project which involved European radiation and clinical oncologists who were dedicated to breast cancer research and treatment. Held on February 2020, the ATTM aimed at identifying key clinical questions in current clinical practice and "grey" areas requiring research to improve management and outcomes. Before the meeting, three key topics were selected: 1) managing patients with frailty due to either age and/or multi-morbidity; 2) stereotactic radiation therapy and systemic therapy in the management of oligometastatic disease; 3) contralateral breast tumour prevention in BCRA-mutated patients. Clinical practice in these areas was investigated by means of an online questionnaire. In the lapse period between the survey and the meeting, the working groups reviewed data, on-going studies and the clinical challenges which were then discussed in-depth and subjected to intense brainstorming during the meeting; research protocols were also proposed. Methodology, outcome of discussions, conclusions and study proposals are summarized in the present paper. In conclusion, this report presents an in-depth analysis of the state of the art, grey areas and controversies in breast cancer radiation therapy and discusses how to confront them in the absence of evidence-based data to guide clinical decision-making.Copyright © 2022 Elsevier B.V. All rights reserved.
Published: 2022

3. Definition of local recurrence site in resected pancreatic adenocarcinoma: A multicenter study (dolores-1)

Author: Arcelli, A., Bertini, F., Strolin, S., Macchia, Gabriella, Deodato, Francesco, Cilla, Savino, Parisi, S., Sainato, A., Fiore, M., Gabriele, P., Genovesi, D., Cellini, Francesco, Guido, A., Cammelli, S., Buwenge, M., Loi, E., Bisello, S., Renzulli, M., Golfieri, R., Morganti, Alessio Giuseppe, Strigari, L., Macchia G., Deodato F. (ORCID:0000-0003-1276-5070), Cilla S., Cellini F. (ORCID:0000-0002-2145-2300), Morganti A. G., Arcelli, A., Bertini, F., Strolin, S., Macchia, Gabriella, Deodato, Francesco, Cilla, Savino, Parisi, S., Sainato, A., Fiore, M., Gabriele, P., Genovesi, D., Cellini, Francesco, Guido, A., Cammelli, S., Buwenge, M., Loi, E., Bisello, S., Renzulli, M., Golfieri, R., Morganti, Alessio Giuseppe, Strigari, L., Macchia G., Deodato F. (ORCID:0000-0003-1276-5070), Cilla S., Cellini F. (ORCID:0000-0002-2145-2300), and Morganti A. G.
Abstract: The study aimed to generate a local failure (LF) risk map in resected pancreatic cancer (PC) and validate the results of previous studies, proposing new guidelines for PC postoperative radiotherapy clinical target volume (CTV) delineation. Follow-up computer tomography (CT) of resected PC was retrospectively reviewed by two radiologists identifying LFs and plotting them on a representative patient CT scan. The percentages of LF points randomly extracted based on CTV following the RTOG guidelines and based on the LF database were 70% and 30%, respectively. According to the Kernel density estimation, an LF 3D distribution map was generated and compared with the results of previous studies using a Dice index. Among the 64 resected patients, 59.4% underwent adjuvant treatment. LFs closer to the root of the celiac axis (CA) or the superior mesen-teric artery (SMA) were reported in 32.8% and 67.2% cases, respectively. The mean (± standard de-viation) distances of LF points to CA and SMA were 21.5 ± 17.9 mm and 21.6 ± 12.1 mm, respectively. The Dice values comparing our iso-level risk maps corresponding to 80% and 90% of the LF proba-bilistic density and the CTVs-80 and CTVs-90 of previous publications were 0.45–0.53 and 0.58–0.60, respectively. According to the Kernel density approach, a validated LF map was proposed, modeling a new adjuvant CTV based on a PC pattern of failure.
Published: 2021

4. COVID-19 safe and fully operational radiotherapy: An AIRO survey depicting the Italian landscape at the dawn of phase 2

Author: Jereczek-Fossa, B. A., Pepa, M., Zaffaroni, M., Marvaso, G., Bruni, A., Buglione di Monale e Bastia, M., Catalano, G., Filippi, A. R., Franco, P., Gambacorta, M. A., Genovesi, D., Iati, G., Magli, A., Marafioti, L., Meattini, I., Merlotti, A., Mignogna, M., Musio, D., Pacelli, R., Pergolizzi, S., Tombolini, V., Trovo, M., Leonardi, M. C., Ricardi, U., Magrini, S. M., Corvo, R., Donato, V., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Jereczek-Fossa, B. A., Pepa, M., Zaffaroni, M., Marvaso, G., Bruni, A., Buglione di Monale e Bastia, M., Catalano, G., Filippi, A. R., Franco, P., Gambacorta, M. A., Genovesi, D., Iati, G., Magli, A., Marafioti, L., Meattini, I., Merlotti, A., Mignogna, M., Musio, D., Pacelli, R., Pergolizzi, S., Tombolini, V., Trovo, M., Leonardi, M. C., Ricardi, U., Magrini, S. M., Corvo, R., Donato, V., and Gambacorta M. A. (ORCID:0000-0001-5455-8737)
Abstract: N/A
Published: 2021

5. Radiotherapy with intensity-modulated (Imrt) techniques in the treatment of anal carcinoma (rainstorm): A multicenter study on behalf of airo (Italian association of radiotherapy and clinical oncology) gastrointestinal study group

Author: Caravatta, L., Mantello, G., Valvo, F., Franco, P., Gasparini, L., Rosa, C., Slim, N., Manfrida, S., De Felice, F., Gerardi, M. A., Vagge, S., Krengli, M., Palazzari, E., Osti, M. F., Gonnelli, A., Catalano, G., Pittoni, P., Ivaldi, G. B., Galardi, A., Lupattelli, M., Rosetto, M. E., Niespolo, R. M., Guido, A., Durante, O., Macchia, G., Munoz, F., El Khouzai, B., Lucido, M. R., Porreca, A., Di Nicola, M., Gambacorta, M. A., Donato, V., Genovesi, D., Manfrida S., Macchia G., Porreca A., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Caravatta, L., Mantello, G., Valvo, F., Franco, P., Gasparini, L., Rosa, C., Slim, N., Manfrida, S., De Felice, F., Gerardi, M. A., Vagge, S., Krengli, M., Palazzari, E., Osti, M. F., Gonnelli, A., Catalano, G., Pittoni, P., Ivaldi, G. B., Galardi, A., Lupattelli, M., Rosetto, M. E., Niespolo, R. M., Guido, A., Durante, O., Macchia, G., Munoz, F., El Khouzai, B., Lucido, M. R., Porreca, A., Di Nicola, M., Gambacorta, M. A., Donato, V., Genovesi, D., Manfrida S., Macchia G., Porreca A., and Gambacorta M. A. (ORCID:0000-0001-5455-8737)
Abstract: A multi-institutional retrospective study was conducted to evaluate the pattern of care and clinical outcomes of anal cancer patients treated with intensity-modulated radiotherapy (IMRT) techniques. In a cohort of 987 patients, the clinical complete response (CR) rate (beyond 6 months) was 90.6%. The 3-year local control (LC) rate was 85.8% (95% CI: 84.4–87.2), and the 3-year colostomy-free survival (CFS) rate was 77.9% (95% CI: 76.1–79.8). Three-year progression-free survival (PFS) and overall survival (OS) rates were 80.2% and 88.1% (95% CI: 78.8–89.4) (95% CI: 78.5–81.9), respectively. Histological grade 3 and nodal involvement were associated with lower CR (p = 0.030 and p = 0.004, respectively). A statistically significant association was found between advanced stage and nodal involvement, and LC, CFS, PFS, OS and event-free survival (EFS). Overall treatment time (OTT) ≥45 days showed a trend for a lower PFS (p = 0.050) and was significantly associated with lower EFS (p = 0.030) and histological grade 3 with a lower LC (p = 0.025). No statistically significant association was found between total dose, dose/fraction and/or boost modality and clinical outcomes. This analysis reports excellent clinical results and a mild toxicity profile, confirming IMRT techniques as standard of care for the curative treatment of anal cancer patients. Lymph node involvement and histological grade have been confirmed as the most important negative prognostic factors.
Published: 2021

6. Treatment volume, dose prescription and delivery techniques for dose-intensification in Rectal Cancer: A national survey

Author: Caravatta, L., Lupattelli, M., Mantello, G., Gambacorta, Maria Antonietta, Chiloiro, Giuditta, Di Tommaso, M., Rosa, C., Gasparini, L., Morganti, Alessio Giuseppe, Picardi, V., Niespolo, R. M., Osti, M. F., Montrone, S., Simoni, N., Boso, C., Facchin, F., Deidda, M. A., Piva, C., Guida, C., Ziccarelli, L., Munoz, F., Ivaldi, G. B., Marchetti, V., Franzone, P., Spatola, C., Franco, P., Donato, V., Genovesi, D., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Chiloiro G., Morganti A. G., Caravatta, L., Lupattelli, M., Mantello, G., Gambacorta, Maria Antonietta, Chiloiro, Giuditta, Di Tommaso, M., Rosa, C., Gasparini, L., Morganti, Alessio Giuseppe, Picardi, V., Niespolo, R. M., Osti, M. F., Montrone, S., Simoni, N., Boso, C., Facchin, F., Deidda, M. A., Piva, C., Guida, C., Ziccarelli, L., Munoz, F., Ivaldi, G. B., Marchetti, V., Franzone, P., Spatola, C., Franco, P., Donato, V., Genovesi, D., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Chiloiro G., and Morganti A. G.
Abstract: Background/Aim: The aim of the study was to investigate boost volume definition, doses, and delivery techniques for rectal cancer dose intensification. Patients and Methods: An online survey was made on 25 items (characteristics, simulation, imaging, volumes, doses, planning and treatment). Results: Thirty-eight radiation oncologists joined the study. Twenty-one delivered long-course radiotherapy with dose intensification. Boost volume was delineated on diagnostic magnetic resonance imaging (MRI) in 18 centres (85.7%), and computed tomography (CT) and/or positron emission tomography-CT in 9 (42.8%); 16 centres (76.2%) performed co-registration with CT-simulation. Boost dose was delivered on gross tumor volume in 10 centres (47.6%) and on clinical target volume in 11 (52.4%). The most common total dose was 54-55 Gy (71.4%), with moderate hypofractionation (85.7%). Intensity-modulated radiotherapy (IMRT) was used in all centres, with simultaneous integrated boost in 17 (80.8%) and image-guidance in 18 (85.7%). Conclusion: A high quality of treatment using dose escalation can be inferred by widespread multidisciplinary discussion, MRI-based treatment volume delineation, and radiation delivery relying on IMRT with accurate image-guided radiation therapy protocols.
Published: 2021

7. Basics and frontiers on pancreatic cancer for radiation oncology: Target delineation, SBRT, SIB technique, MRgRT, particle therapy, immunotherapy and clinical guidelines

Author: Cellini, Francesco, Arcelli, A., Simoni, N., Caravatta, L., Buwenge, M., Calabrese, A., Brunetti, O., Genovesi, D., Mazzarotto, R., Deodato, Francesco, Mattiucci, Gian Carlo, Silvestris, N., Valentini, Vincenzo, Morganti, Alessio Giuseppe, Cellini F. (ORCID:0000-0002-2145-2300), Deodato F. (ORCID:0000-0003-1276-5070), Mattiucci G. C. (ORCID:0000-0001-6500-0413), Valentini V. (ORCID:0000-0003-4637-6487), Morganti A. G., Cellini, Francesco, Arcelli, A., Simoni, N., Caravatta, L., Buwenge, M., Calabrese, A., Brunetti, O., Genovesi, D., Mazzarotto, R., Deodato, Francesco, Mattiucci, Gian Carlo, Silvestris, N., Valentini, Vincenzo, Morganti, Alessio Giuseppe, Cellini F. (ORCID:0000-0002-2145-2300), Deodato F. (ORCID:0000-0003-1276-5070), Mattiucci G. C. (ORCID:0000-0001-6500-0413), Valentini V. (ORCID:0000-0003-4637-6487), and Morganti A. G.
Abstract: Pancreatic cancer represents a modern oncological urgency. Its management is aimed to both distal and local disease control. Resectability is the cornerstone of treatment aim. It influences the clinical presentation’s definitions as up-front resectable, borderline resectable and locally advanced (unresectable). The main treatment categories are neoadjuvant (preoperative), definitive and adjuvant (postoperative). This review will focus on i) the current indications by the available national and international guidelines; ii) the current standard indications for target volume delineation in radiotherapy (RT); iii) the emerging modern technologies (including particle therapy and Magnetic Resonance [MR]-guided-RT); iv) stereotactic body radiotherapy (SBRT), as the most promising technical delivery application of RT in this framework; v) a particularly promising dose delivery technique called simultaneous integrated boost (SIB); and vi) a multimodal integration opportunity: the combination of RT with immunotherapy.
Published: 2020

8. INTERACTS (INTErventional Radiotherapy ACtive Teaching School) consensus conference on sarcoma interventional radiotherapy (brachytherapy) endorsed by AIRO (Italian Association of Radiotherapy and Clinical Oncology)

Author: Tagliaferri, Luca, Vavassori, Andrea, Lancellotta, V., de Sanctis, V., Vidali, Cristiana, Casa, C., Aristei, Cynthia, Genovesi, D., Jereczek-Fossa, B. A., Morganti, Alessio Giuseppe, Kovacs, Gyorgy, Guinot, J. L., Rembielak, A., Greto, D., Gambacorta, Maria Antonietta, Valentini, Vincenzo, Donato, V., Corvo, R., Magrini, S. M., Livi, L., Autorino, Rosa, Caldarella, Carmelo, Cerrotta, Annamaria, de Paoli, A., Dinapoli, Nicola, Ferioli, M., Fusco, Vincenzo, Iezzi, Roberto, Leone, A., Maccauro, Giulio, Quirino, Michela, Ricardi, U., Rufini, Vittoria, Sanguineti, G., Tagliaferri L. (ORCID:0000-0003-2308-0982), Vavassori A., Vidali C., Aristei C., Morganti A. G., Kovacs G., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Valentini V. (ORCID:0000-0003-4637-6487), Autorino R., Caldarella C. (ORCID:0000-0002-1047-3333), Cerrotta A., Dinapoli N., Fusco V., Iezzi R. (ORCID:0000-0002-2791-481X), Maccauro G. (ORCID:0000-0002-7359-268X), Quirino M., Rufini V. (ORCID:0000-0002-2052-8078), Tagliaferri, Luca, Vavassori, Andrea, Lancellotta, V., de Sanctis, V., Vidali, Cristiana, Casa, C., Aristei, Cynthia, Genovesi, D., Jereczek-Fossa, B. A., Morganti, Alessio Giuseppe, Kovacs, Gyorgy, Guinot, J. L., Rembielak, A., Greto, D., Gambacorta, Maria Antonietta, Valentini, Vincenzo, Donato, V., Corvo, R., Magrini, S. M., Livi, L., Autorino, Rosa, Caldarella, Carmelo, Cerrotta, Annamaria, de Paoli, A., Dinapoli, Nicola, Ferioli, M., Fusco, Vincenzo, Iezzi, Roberto, Leone, A., Maccauro, Giulio, Quirino, Michela, Ricardi, U., Rufini, Vittoria, Sanguineti, G., Tagliaferri L. (ORCID:0000-0003-2308-0982), Vavassori A., Vidali C., Aristei C., Morganti A. G., Kovacs G., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Valentini V. (ORCID:0000-0003-4637-6487), Autorino R., Caldarella C. (ORCID:0000-0002-1047-3333), Cerrotta A., Dinapoli N., Fusco V., Iezzi R. (ORCID:0000-0002-2791-481X), Maccauro G. (ORCID:0000-0002-7359-268X), Quirino M., and Rufini V. (ORCID:0000-0002-2052-8078)
Abstract: Purpose: To report the results of INTERACTS (INTErventional Radiotherapy ACtive Teaching School) consensus conference on sarcoma interventional radiotherapy (brachytherapy). Material and methods: An international board of multidisciplinary experts was invited to a consensus conference on the state-of-the-art of sarcoma interventional oncology during the 9th Rome INTER-MEETING (INTERventional Radiotherapy Multidisciplinary Meeting), proposing 3 statements for each one speech. At the end of each lecture, the entire group of experts was invited to vote with an electronic device. The preliminary results were presented and discussed at the end of the meeting, during a dedicated session. After the meeting, a survey was distributed within the consensus conference board to share and definitively vote the statements. Results: All the invited authors of the consensus conference board completed the final survey. All the 38 statements received more than 70% of agreement, 31 statements (82%) obtained an agreement of level higher or equal to 90%, 6 statements (15.8%) received an agreement level between 80% and 90%, and 1 statement (2.6%) had less than 80% of agreement. Conclusions: The consensus conference demonstrated that interventional radiotherapy must be considered by a multidisciplinary management of patients affected by sarcoma.
Published: 2020

9. COVID-19 outbreak and cancer radiotherapy disruption in Italy: Survey endorsed by the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Author: Jereczek-Fossa, B. A., Pepa, M., Marvaso, G., Bruni, A., Buglione di Monale e Bastia, M., Catalano, G., Filippi, A. R., Franco, P., Gambacorta, Maria Antonietta, Genovesi, D., Iati, G., Magli, A., Marafioti, L., Meattini, I., Merlotti, A., Mignogna, M., Musio, D., Pacelli, R., Pergolizzi, S., Tombolini, V., Trovo, M., Ricardi, U., Magrini, S. M., Corvo, R., Donato, V., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Jereczek-Fossa, B. A., Pepa, M., Marvaso, G., Bruni, A., Buglione di Monale e Bastia, M., Catalano, G., Filippi, A. R., Franco, P., Gambacorta, Maria Antonietta, Genovesi, D., Iati, G., Magli, A., Marafioti, L., Meattini, I., Merlotti, A., Mignogna, M., Musio, D., Pacelli, R., Pergolizzi, S., Tombolini, V., Trovo, M., Ricardi, U., Magrini, S. M., Corvo, R., Donato, V., and Gambacorta M. A. (ORCID:0000-0001-5455-8737)
Abstract: Italy experienced one of the world's deadliest COVID-19 outbreaks and healthcare systems had to instantly reorganise activity. The Italian Radiation Oncology Departments adapted numerous solutions to minimize the disruptions. Information technologies, treatment prioritization and implementation of hypofractionation and protection procedures allowed balancing between cancer patient care and patient/healthcare workers safety.
Published: 2020

10. The role of interventional radiotherapy (brachytherapy) in stage i esophageal cancer: An AIRO (Italian Association of Radiotherapy and Clinical Oncology) systematic review

Author: Lancellotta, V., Cellini, F., Fionda, B., Sanctis, V. D., Vidali, C., Fusco, V., Frassine, F., Tomasini, D., Vavassori, A., Gambacorta, M. A., Franco, P., Genovesi, D., Corva, R., Tagliaferri, L., Cellini F. (ORCID:0000-0002-2145-2300), Vidali C., Fusco V., Vavassori A., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Tagliaferri L. (ORCID:0000-0003-2308-0982), Lancellotta, V., Cellini, F., Fionda, B., Sanctis, V. D., Vidali, C., Fusco, V., Frassine, F., Tomasini, D., Vavassori, A., Gambacorta, M. A., Franco, P., Genovesi, D., Corva, R., Tagliaferri, L., Cellini F. (ORCID:0000-0002-2145-2300), Vidali C., Fusco V., Vavassori A., Gambacorta M. A. (ORCID:0000-0001-5455-8737), and Tagliaferri L. (ORCID:0000-0003-2308-0982)
Abstract: OBJECTIVE: This review aimed at examining efficacy of interventional radiotherapy (brachytherapy-IRT) alone or combined with external beam radiotherapy (EBRT) in stage I esophageal cancer as exclusive treatment. MATERIALS AND METHODS: A systematic research using PubMed, Scopus, and Cochrane library was performed. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. We analyzed only clinical study as full-text publication, reporting on patients with stage I esophageal cancer treated with IRT alone or in combination with other treatments (e.g., EBRT). Conference paper, survey, letter, editorial, book chapter, and review were excluded. Patients who underwent previous surgery were excluded. Time restriction (1990-2018) was applied for years of the publication. RESULTS: Twelve studies have been selected. The number of evaluated patients was 514; the median age was 69 years. In the IRT group, the median: Local control (LC) was 77% (range 63%-100%), disease-free survival (DFS) was 68.4% (range 49%-86.3%), the overall survival (OS) was 60% (range 31%-84%), the cancer specific survival (CSS) was 80% (range 55-100%), and grade 3-4 toxicity range was 0%-26%. CONCLUSIONS: IRT alone or combined to EBRT is an effective and safe treatment option for patients with stage I esophageal cancer. Definitive radiation therapy could be an alternative to surgery in patients with superficial cancer.
Published: 2020

11. Palliative short-course radiotherapy in advanced pelvic cancer: A phase II study (SHARON project)

Author: Farina, E., Macchia, Gabriella, Siepe, G., Zamagni, A., Buwenge, M., Scirocco, E., Cellini, Francesco, Deressa, B. T., Tigeneh, W., Uddin, K. A. F. M., Sumon, M. A., Caravatta, L., Genovesi, D., Mauro, F. A., Cammelli, S., Cilla, Savino, Morganti, Alessio Giuseppe, Deodato, Francesco, Macchia G., Cellini F. (ORCID:0000-0002-2145-2300), Cilla S., Morganti A. G., Deodato F. (ORCID:0000-0003-1276-5070), Farina, E., Macchia, Gabriella, Siepe, G., Zamagni, A., Buwenge, M., Scirocco, E., Cellini, Francesco, Deressa, B. T., Tigeneh, W., Uddin, K. A. F. M., Sumon, M. A., Caravatta, L., Genovesi, D., Mauro, F. A., Cammelli, S., Cilla, Savino, Morganti, Alessio Giuseppe, Deodato, Francesco, Macchia G., Cellini F. (ORCID:0000-0002-2145-2300), Cilla S., Morganti A. G., and Deodato F. (ORCID:0000-0003-1276-5070)
Abstract: Aim: To define safety and efficacy of a palliative, short-course accelerated radiation therapy for symptomatic locally advanced primary pelvic cancer. Materials and Methods: A phase II trial was planned based on the minimax Simon’s two-stage design. A total of 18 Gy in 4.5 Gy/fraction administered twice a day was delivered (SHARON). Pain and quality of life were recorded according to the Visual Analogue self-assessment and the cancer linear analog scales (CLAS), respectively. Results: Twenty-five patients were enrolled in the study. The most frequent baseline symptoms were pain (48%), bleeding (40%), bleeding/pain (8%), and intestinal sub-occlusion (4%). The overall palliative response rate was 96.0%, with a median palliative duration of 6 months. An improvement of quality-of-life indices (well-being, fatigue, and ability to perform daily activities) was noted in 64.0%, 36.0%, and 48.0% of patients, respectively. Conclusion: The SHARON regimen was well tolerated and effective in the palliative treatment of patients with locally advanced pelvic cancer. Based on these results, a multicentric prospective phase III trial is ongoing to compare this regimen with traditional 2-week radiotherapy treatment.
Published: 2019

12. Combination of novel systemic agents and radiotherapy for solid tumors – part I: An AIRO (Italian association of radiotherapy and clinical oncology) overview focused on treatment efficacy

Author: Arcangeli, S, Jereczek-Fossa, B, Alongi, F, Aristei, C, Becherini, C, Belgioia, L, Buglione, M, Caravatta, L, D'Angelillo, R, Filippi, A, Fiore, M, Genovesi, D, Greco, C, Livi, L, Magrini, S, Marvaso, G, Mazzola, R, Meattini, I, Merlotti, A, Palumbo, I, Pergolizzi, S, Ramella, S, Ricardi, U, Russi, E, Trovò, M, Sindoni, A, Valentini, V, Corvò, R, Magrini, SM, Arcangeli, S, Jereczek-Fossa, B, Alongi, F, Aristei, C, Becherini, C, Belgioia, L, Buglione, M, Caravatta, L, D'Angelillo, R, Filippi, A, Fiore, M, Genovesi, D, Greco, C, Livi, L, Magrini, S, Marvaso, G, Mazzola, R, Meattini, I, Merlotti, A, Palumbo, I, Pergolizzi, S, Ramella, S, Ricardi, U, Russi, E, Trovò, M, Sindoni, A, Valentini, V, Corvò, R, and Magrini, SM
Abstract: Over the past century, technologic advances have promoted the evolution of radiation therapy into a precise treatment modality allowing for the maximal administration of dose to tumors while sparing normal tissues. In parallel with this technological maturation, the rapid expansion in understanding the basic biology and heterogeneity of cancer has led to the development of several compounds that target specific pathways. Many of them are in advanced steps of clinical development for combination treatments with radiotherapy, and can be incorporated into radiation oncology practice for a personalized approach to maximize the therapeutic gain. This review describes the rationale for combining novel agents with radiation, and provides an overview of the current landscape focused on treatment efficacy.
Published: 2019

13. Combination of novel systemic agents and radiotherapy for solid tumors – Part II: An AIRO (Italian association of radiotherapy and clinical oncology) overview focused on treatment toxicity

Author: Arcangeli, S, Jereczek-Fossa, B, Alongi, F, Aristei, C, Becherini, C, Belgioia, L, Buglione, M, Caravatta, L, D'Angelillo, R, Filippi, A, Fiore, M, Genovesi, D, Greco, C, Livi, L, Magrini, S, Marvaso, G, Mazzola, R, Meattini, I, Merlotti, A, Palumbo, I, Pergolizzi, S, Ramella, S, Ricardi, U, Russi, E, Trovò, M, Sindoni, A, Valentini, V, Corvò, R, Magrini, SM, Arcangeli, S, Jereczek-Fossa, B, Alongi, F, Aristei, C, Becherini, C, Belgioia, L, Buglione, M, Caravatta, L, D'Angelillo, R, Filippi, A, Fiore, M, Genovesi, D, Greco, C, Livi, L, Magrini, S, Marvaso, G, Mazzola, R, Meattini, I, Merlotti, A, Palumbo, I, Pergolizzi, S, Ramella, S, Ricardi, U, Russi, E, Trovò, M, Sindoni, A, Valentini, V, Corvò, R, and Magrini, SM
Abstract: Clinical development and use of novel systemic agents in combination with radiotherapy (RT) is at nowadays most advanced in the field of treatment of solid tumors. Although for many of these substances preclinical studies provide sufficient evidences on their principal capability to enhance radiation effects, the majority of them have not been investigated in even phase I clinical trials for safety in the context of RT. In clinical practice, unexpected acute and late side effects may emerge especially in combination with RT. As a matter of fact, despite combined modality treatment holds potential for enhancing the therapeutic ratio, some concerns are raised from the lack of high-quality clinical data to guide the care of patients who are treated with novel compounds in conjunction with RT. The aim of this review is to provide, from a radio-oncological point of view, an overview of the most advanced combined treatment concepts for solid tumors focusing on treatment toxicity.
Published: 2019

14. Guidelines on prostate carcinoma - AIRO, 2016

Author: Santoni, R, Arcangeli, S, Ingrosso, G, Antognoni, P, Mazzeo, E, D'Angelillo, R, Buglione, M, Borghesi, S, Petitti, T, Orecchia, R, Russi, E, Alitto, A, Alongi, F, Augurio, A, Bellavita, R, Bertoni, F, Bonetta, A, Bruni, A, Cagna, E, Cazzaniga, L, Corvo, R, D'Agostino, G, D'Amico, R, Detti, B, De Renzi, F, Fabrini, M, Fersino, S, Frascino, V, Gambarini, S, Genovesi, D, Grazioli, L, Guarneri, A, Jereczek-Fossa, B, Lancia, A, Livi, L, Magrini, S, Mantini, G, Mignogna, M, Mirri, M, Palumbo, I, Pergolizzi, S, Silvestro, G, Rubino, L, Tagliagambe, A, Tonoli, S, Valdagni, R, Vavassori, V, Vinciguerra, A, Santoni R., Arcangeli S., Ingrosso G., Antognoni P., Mazzeo E., D'angelillo R. M., Buglione M., Borghesi S., Petitti T., Orecchia R., Russi E., Alitto A., Alongi F., Augurio A., Bellavita R., Bertoni F., Bonetta A., Bruni A., Cagna E., Cazzaniga L. F., Corvo R., D'agostino G., D'amico R., Detti B., De Renzi F., Fabrini M. G., Fersino S., Frascino V., Gambarini S., Genovesi D., Grazioli L., Guarneri A., Jereczek-Fossa B. A., Lancia A., Livi L., Magrini S. M., Mantini G., Mignogna M., Mirri M. A., Palumbo I., Pergolizzi S., Silvestro G., Rubino L., Tagliagambe A., Tonoli S., Valdagni R., Vavassori V., Vinciguerra A., Santoni, R, Arcangeli, S, Ingrosso, G, Antognoni, P, Mazzeo, E, D'Angelillo, R, Buglione, M, Borghesi, S, Petitti, T, Orecchia, R, Russi, E, Alitto, A, Alongi, F, Augurio, A, Bellavita, R, Bertoni, F, Bonetta, A, Bruni, A, Cagna, E, Cazzaniga, L, Corvo, R, D'Agostino, G, D'Amico, R, Detti, B, De Renzi, F, Fabrini, M, Fersino, S, Frascino, V, Gambarini, S, Genovesi, D, Grazioli, L, Guarneri, A, Jereczek-Fossa, B, Lancia, A, Livi, L, Magrini, S, Mantini, G, Mignogna, M, Mirri, M, Palumbo, I, Pergolizzi, S, Silvestro, G, Rubino, L, Tagliagambe, A, Tonoli, S, Valdagni, R, Vavassori, V, Vinciguerra, A, Santoni R., Arcangeli S., Ingrosso G., Antognoni P., Mazzeo E., D'angelillo R. M., Buglione M., Borghesi S., Petitti T., Orecchia R., Russi E., Alitto A., Alongi F., Augurio A., Bellavita R., Bertoni F., Bonetta A., Bruni A., Cagna E., Cazzaniga L. F., Corvo R., D'agostino G., D'amico R., Detti B., De Renzi F., Fabrini M. G., Fersino S., Frascino V., Gambarini S., Genovesi D., Grazioli L., Guarneri A., Jereczek-Fossa B. A., Lancia A., Livi L., Magrini S. M., Mantini G., Mignogna M., Mirri M. A., Palumbo I., Pergolizzi S., Silvestro G., Rubino L., Tagliagambe A., Tonoli S., Valdagni R., Vavassori V., and Vinciguerra A.
Published: 2016

15. Policies for reirradiation of recurrent high-grade gliomas: a survey among Italian radiation oncologists

Author: Furlan, C, Arcangeli, S, Avanzo, M, Mirri, M, Munoz, F, Giudici, S, Perrone, A, Amelio, D, Tornio, L, Draghini, L, Deli, A, Pavanato, G, Giuliano, F, Pontoriero, A, Ciammella, P, Navarria, P, Lannalfi, A, Buglione, M, Guida, C, Cammelli, S, Lorio, V, Cardinali, M, Genovesi, D, Barsacchi, L, Balducci, M, Bagnoli, R, Berti, F, Montesi, G, Pasqualetti, F, Bonome, P, Santoni, R, Doino, D, Schirru, P, Pinzi, V, Borzillo, V, Ferrarese, F, Ferro, M, De Cicco, L, Krengli, M, Scoccianti, S, Donato, V, Mirri, MA, DELI, ANIKO' MARIA, Giuliano, FM, PINZI, VALENTINA, Furlan, C, Arcangeli, S, Avanzo, M, Mirri, M, Munoz, F, Giudici, S, Perrone, A, Amelio, D, Tornio, L, Draghini, L, Deli, A, Pavanato, G, Giuliano, F, Pontoriero, A, Ciammella, P, Navarria, P, Lannalfi, A, Buglione, M, Guida, C, Cammelli, S, Lorio, V, Cardinali, M, Genovesi, D, Barsacchi, L, Balducci, M, Bagnoli, R, Berti, F, Montesi, G, Pasqualetti, F, Bonome, P, Santoni, R, Doino, D, Schirru, P, Pinzi, V, Borzillo, V, Ferrarese, F, Ferro, M, De Cicco, L, Krengli, M, Scoccianti, S, Donato, V, Mirri, MA, DELI, ANIKO' MARIA, Giuliano, FM, and PINZI, VALENTINA
Abstract: Purpose To assess the contribution of Italian radiation oncologists in the current management of recurrent high-grade gliomas (HGG), focusing on a reirradiation (reRT) approach. Methods In 2015, the Reirradiation and the Central Nervous System Study Groups on behalf of the Italian Association of Radiation Oncology (AIRO) proposed a survey. All Italian radiation oncologists were individually invited to complete an online questionnaire regarding their clinical management of recurrent HGG, focusing on a reRT approach. Results A total of 37 of 210 questionnaires were returned (18% of all centers): 16 (43%) from nonacademic hospitals, 14 (38%) from academic hospitals, 5 (13%) from private institutions, and 2 (6%) from hadron therapy centers. The majority of responding centers (59%) treated ≤5 cases per year. Performance status at the time of recurrence, along with a target diameter <5 cm and an interval from primary radiation ≥6 months, were the prevalent predictive factors considered for reRT. Sixty percent of reirradiated patients had already received a salvage therapy, either chemotherapy (40%) or reoperation (20%). The most common approach for reRT was fractionated stereotactic radiotherapy to a mean (photon) dose of 41.6 Gy. Conclusions Although there were wide variations in the clinical practice of reRT across the 37 centers, the core activities were reasonably consistent. These findings provide a basis for encouraging a national collaborative study to develop, implement, and monitor the use of reRT in this challenging clinical setting
Published: 2018

16. A Feasibility Study for in vivo Dosimetry Procedure in Routine Clinical Practice

Author: Falco, Md, Giancaterino, S, De Nicola, A, Adorante, N, De Lorenzo, Rg, Di Tommaso, M, Vinciguerra, A, Trignani, M, Perrotti, F, Allajbej, A, Fidanzio, Andrea, Greco, F, Grusio, M, Genovesi, D, Piermattei, Angelo, Fidanzio, A (ORCID:0000-0002-6356-6381), Piermattei, A (ORCID:0000-0002-6835-1179), Falco, Md, Giancaterino, S, De Nicola, A, Adorante, N, De Lorenzo, Rg, Di Tommaso, M, Vinciguerra, A, Trignani, M, Perrotti, F, Allajbej, A, Fidanzio, Andrea, Greco, F, Grusio, M, Genovesi, D, Piermattei, Angelo, Fidanzio, A (ORCID:0000-0002-6356-6381), and Piermattei, A (ORCID:0000-0002-6835-1179)
Abstract: Purpose: The aim of the in vivo dosimetry, during the fractionated radiation therapy, is the verification of the correct dose delivery to patient. Nowadays, in vivo dosimetry procedures for photon beams are based on the use of the electronic portal imaging device and dedicated software to elaborate electronic portal imaging device images. Methods: In total, 8474 in vivo dosimetry tests were carried out for 386 patients treated with 3-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and volumetric modulated arc therapy techniques, using the SOFTDISO. SOFTDISO is a dedicated software that uses electronic portal imaging device images in order to (1) calculate the R index, that is, the ratio between daily reconstructed dose and the planned one at isocenter and (2) perform a gamma-like analysis between the signals, S, of a reference electronic portal imaging device image and that obtained in a daily fraction. It supplies 2 indexes, the percentage gamma% of points with gamma < 1 and the mean gamma value, gamma(mean). In gamma-like analysis, the pass criteria for the signals agreement Delta S% and distance to agreement Delta d have been selected based on the clinical experience and technology used. The adopted tolerance levels for the 3 indexes were fixed in 0.95 <= R <= 1.05, gamma% >= 90%, and gamma(mean) <= 0.5. Results: The results of R ratio, gamma-like, and a visual inspection of these data reported on a monitor screen permitted to individuate 2 classes of errors (1) class 1 that included errors due to inadequate standard quality controls and (2) class 2, due to patient morphological changes. Depending on the technique and anatomical site, a maximum of 18% of tests had at least 1 index out of tolerance; once removed the causes of class-1 errors, almost all patients (except patients with 4 lung and 2 breast cancer treated with 3-dimensional conformal radiotherapy) presented mean indexes values (<(R)over bar>, (gamma) over bar%
Published: 2018

17. Phase I-II study of short-course accelerated radiotherapy (SHARON) for palliation in head and neck cancer

Author: Farina, E., Capuccini, J., Macchia, G., Caravatta, L., Nguyen, N. P., Cammelli, S., Farioli, A., Rambaldi, G. Z., Cilla, S., Wondemagegnhu, T., Uddin, A. F. M. K., Sumon, M. A., Genovesi, D., Buwenge, M., Cellini, Francesco, Valentini, Vincenzo, Deodato, Francesco, Morganti, A. G., Cellini F. (ORCID:0000-0002-2145-2300), Valentini V. (ORCID:0000-0003-4637-6487), Deodato F. (ORCID:0000-0003-1276-5070), Farina, E., Capuccini, J., Macchia, G., Caravatta, L., Nguyen, N. P., Cammelli, S., Farioli, A., Rambaldi, G. Z., Cilla, S., Wondemagegnhu, T., Uddin, A. F. M. K., Sumon, M. A., Genovesi, D., Buwenge, M., Cellini, Francesco, Valentini, Vincenzo, Deodato, Francesco, Morganti, A. G., Cellini F. (ORCID:0000-0002-2145-2300), Valentini V. (ORCID:0000-0003-4637-6487), and Deodato F. (ORCID:0000-0003-1276-5070)
Abstract: Aim: To determine the maximum tolerated dose (MTD) of a short-course accelerated radiotherapy and its feasibility for symptomatic palliation of advanced head and neck cancer or head and neck metastases from any primary site. Patients and Methods: A phase I trial in four dose-escalation steps was planned: total dose ranged between 14 and 20 Gy in a total of four fractions administered twice a day. The dose-limiting toxicity (DLT) was determined as grade 3 or more toxicity occurring during treatment. The MTD obtained was used to plan a phase II trial. Results: A total of 48 patients were treated. In the phase I trial, the 20 Gy dose level was determined to be the MTD. In the phase II trial, the palliative response rate was 82.7%, with a median duration of palliation of 3 months. Conclusion: Short-course accelerated radiotherapy was well tolerated and effective for palliation. These findings may help design future prospective randomized studies.
Published: 2018

18. Short-course regimen of palliative radiotherapy in complicated bone metastases: a phase i–ii study (SHARON Project)

Author: Capuccini, J., Macchia, G., Farina, E., Buwenge, M., Genovesi, D., Caravatta, L., Nguyen, N. P., Cammelli, S., Cilla, S., Wondemagegnhu, T., Uddin, A. F. M. K., Aziz Sumon, M., Cellini, Francesco, Valentini, Vincenzo, Deodato, Francesco, Morganti, A. G., Cellini F. (ORCID:0000-0002-2145-2300), Valentini V. (ORCID:0000-0003-4637-6487), Deodato F. (ORCID:0000-0003-1276-5070), Capuccini, J., Macchia, G., Farina, E., Buwenge, M., Genovesi, D., Caravatta, L., Nguyen, N. P., Cammelli, S., Cilla, S., Wondemagegnhu, T., Uddin, A. F. M. K., Aziz Sumon, M., Cellini, Francesco, Valentini, Vincenzo, Deodato, Francesco, Morganti, A. G., Cellini F. (ORCID:0000-0002-2145-2300), Valentini V. (ORCID:0000-0003-4637-6487), and Deodato F. (ORCID:0000-0003-1276-5070)
Abstract: Metastases with soft tissues invasion, impending fractures or spinal cord compression (complicated bone metastases) represent a common clinical problem in advanced cancers and frequently lead to deterioration of patients’ quality of life (QoL). A phase I–II study was planned to define the maximum tolerated dose (MTD) of a short-course radiotherapy (RT) and its efficacy in palliation of complicated bone metastases. A phase I trial was designed with three dose-escalation steps: 16, 18, and 20 Gy. Total dose at each level was delivered in 2 days, twice daily. Eligibility criteria were painful complicated bone metastases and ECOG performance status ≤ 3. The presence of acute toxicity ≥ Grade 3 (RTOG scale) was considered the dose limiting toxicity. The MTD was used to plan a phase II trial with pain response as the primary outcome. Pain was recorded using a Visual Analogic Scale (VAS), and QoL using CLAS scales. Forty-five patients were enrolled in this trial. In phase I no Grade ≥ 2 acute toxicities were recorded. Thus 20 Gy was established as MTD. In phase II, with a median follow-up of 4 months, rates of complete symptom remission, partial response, no symptomatic change, and symptoms progression were 32.0%, 52.0%, 8.0%, and 8.0%, respectively. This RT protocol tested in our study is effective and tolerable with comparable results to traditional RT treatments delivered in 5–10 daily fractions.
Published: 2018

19. Time to surgery and pathologic complete response after neoadjuvant chemoradiation in rectal cancer: A population study on 2094 patients

Author: Macchia, G., Gambacorta, Maria Antonietta, Masciocchi, Carlotta, Chiloiro, Giuditta, Mantello, G., Di Giambenedetto, Simona, Lupattelli, M., Palazzari, E., Belgioia, L., Bacigalupo, Andrea, Sainato, A., Montrone, S., Turri, L., Caroli, A., De Paoli, A., Matrone, F., Capirci, C., Montesi, G., Niespolo, R. M., Osti, M. F., Caravatta, L., Galardi, A., Genovesi, D., Rosetto, M. E., Boso, C., Sciacero, P., Giaccherini, L., Parisi, S., Fontana, A., Filippone, F. R., Picardi, V., Morganti, A. G., Valentini, Vincenzo, Gambacorta M. A. (ORCID:0000-0001-5455-8737), Masciocchi C., Chiloiro G., di Benedetto M. (ORCID:0000-0001-6990-5076), Bacigalupo A. (ORCID:0000-0002-9119-567X), Valentini V. (ORCID:0000-0003-4637-6487), Macchia, G., Gambacorta, Maria Antonietta, Masciocchi, Carlotta, Chiloiro, Giuditta, Mantello, G., Di Giambenedetto, Simona, Lupattelli, M., Palazzari, E., Belgioia, L., Bacigalupo, Andrea, Sainato, A., Montrone, S., Turri, L., Caroli, A., De Paoli, A., Matrone, F., Capirci, C., Montesi, G., Niespolo, R. M., Osti, M. F., Caravatta, L., Galardi, A., Genovesi, D., Rosetto, M. E., Boso, C., Sciacero, P., Giaccherini, L., Parisi, S., Fontana, A., Filippone, F. R., Picardi, V., Morganti, A. G., Valentini, Vincenzo, Gambacorta M. A. (ORCID:0000-0001-5455-8737), Masciocchi C., Chiloiro G., di Benedetto M. (ORCID:0000-0001-6990-5076), Bacigalupo A. (ORCID:0000-0002-9119-567X), and Valentini V. (ORCID:0000-0003-4637-6487)
Abstract: Background To retrospectively evaluate the difference in terms of pathologic complete response (pCR) according to time elapsed between chemoradiation (CRT) and total mesorectal excision (TME) on a large unselected real-life dataset of locally advanced rectal cancer (LARC) patients. Methods A multicentre retrospective cohort study of LARC patients from 21 Italian Radiotherapy Institutions was performed. Patients were stratified into 3 different time intervals from CRT. The 1st group included 300 patients who underwent TME within 6 weeks, the 2nd 1598 patients (TME within 7–12 weeks) and the 3rd 196 patients (TME within 13 or more weeks after CRT), respectively. Results Data on 2094 LARC patients treated between 1997 and 2016 were considered suitable for analysis. Overall, 578 patients had stage II while 1516 had stage III histological proven invasive rectal adenocarcinoma. A CRT schedule of one agent (N = 1585) or 2-drugs (N = 509) was administered. Overall, pCR was 22.3% (N = 468 patients). The proportion of patients achieving pCR with respect to time interval was, as follows: 12.6% (1st group), 23% (2nd group) and 31.1% (3rd group) (p < 0.001), respectively. The pCR relative risk comparison of 2nd to 1st group was 1.8, while 3rd to 2nd group was 1.3. Moreover, between the 3rd and 1st group, a pCR relative risk of 2.4 (p < 0.01) was noted. At univariate analysis, clinical stage III (p < 0.001), radiotherapy dose >5040 cGy (p = 0.002) and longer interval (p < 0.001) were significantly correlated to pCR. The positive impact of interval (p < 0.001) was confirmed at multivariate analysis as the only correlated factor. Conclusion We confirmed on a population-level that lengthening the interval (>13 weeks) from CRT to surgery improves the pathological response (pCR and pathologic partial response; pPR) in comparison to historic data. Furthermore, radiotherapy dose >5040 cGy and two drugs chemotherapy correlated with pPR rate.
Published: 2017

20. Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries

Author: Lindner, O, Pascual, TNB, Mercuri, M, Acampa, W, Burchert, W, Flotats, A, Kaufmann, PA, Kitsiou, A, Knuuti, J, Underwood, SR, Vitola, JV, Mahmarian, JJ, Karthikeyan, G, Better, N, Rehani, MM, Kashyap, R, Dondi, M, Paez, D, Einstein, AJ, Bouyoucef, SE, Lele, V, Magboo, VPC, Mut, F, Meeks, JB, Alexanderson, E, Allam, A, Al-Mallah, MH, Bom, H, Jerome, S, Luxenburg, O, Mahmarian, J, Shaw, LJ, Vitola, J, Amouri, W, Essabbah, H, Gassama, SS, Makhdomi, KB, El Mustapha, GIE, El Ouchdi, N, Qais, N, Soni, N, Vangu, W, Abazid, RM, Adams, B, Agarwal, V, Alfeeli, MA, Alnafisi, N, Bernabe, L, Bural, GG, Chaiwatanarat, T, Chandraguptha, JM, Cheon, GJ, Cho, I, Dogan, AS, Eftekhari, M, Frenkel, A, Garty, I, George, S, Geramifar, P, Golan, H, Habib, S, Hussain, R, Im, H, Jeon, H-J, Kalawat, T, Kang, WJ, Keng, F, Klaipetch, A, Kumar, PG, Lee, J, Lee, WW, Lim, I, Macaisa, CMM, Malhotra, G, Mittal, BR, Mohammad, MH, Mohan, P, Mulyanto, ID, Nariman, D, Nayak, UN, Niaz, K, Nikolov, G, Obaldo, JM, Ozturk, E, Park, JM, Park, S, Patel, CD, Phuong, HK, Quinon, AP, Rajini, TR, Saengsuda, Y, Santiago, J, Sayman, HB, Shinto, AS, Sivasubramaniyan, V, Son, MH, Sudhakar, P, Syed, GMS, Tamaki, N, Thamnirat, K, Thientunyakit, T, Thongmak, S, Velasco, DN, Verma, A, Vutrapongwatana, U, Wang, Y, Won, KS, Yao, Z, Yingsa-nga, T, Yudistiro, R, Yue, KT, Zafrir, N, Adrian, SC, Agostini, D, Aguade, S, Armitage, G, Backlund, M, Backman, M, Baker, M, Balducci, MT, Bavelaar, C, Berovic, M, Bertagna, F, Beuchel, R, Biggi, A, Bisi, G, Bonini, R, Bradley, A, Brudin, L, Bruno, I, Busnardo, E, Casoni, R, Choudhri, A, Cittanti, C, Clauss, R, Costa, DC, Costa, M, Dixon, K, Dziuk, M, Egelic, N, Eriksson, I, Fagioli, G, de Faria, DB, Florimonte, L, Francini, A, French, M, Gallagher, E, Garai, I, Geatti, O, Genovesi, D, Gianolli, L, Gimelli, A, del Giudice, E, Halliwell, S, Hansson, MJ, Harrison, C, Homans, F, Horton, F, Jedrzejuk, D, Jogi, J, Johansen, A, Johansson, H, Kalnina, M, Kaminek, M, Kiss, A, Kobylecka, M, Kostkiewicz, M, Kropp, J, Kullenberg, R, Lahoutte, T, Lang, O, Larsson, YH, Lazar, M, Leccisotti, L, Leners, N, Lipp, RW, Maenhout, A, Maffioli, L, Marcassa, C, Martins, B, Marzullo, P, Medolago, G, Mendiguchia, CG, Mirzaei, S, Mori, M, Nardi, B, Nazarenko, S, Nikoletic, K, Oleksa, R, Parviainen, T, Patrina, J, Peace, R, Pirich, C, Piwowarska-Bilska, H, Popa, S, Prakash, V, Pubul, V, Puklavec, L, Rac, S, Ratniece, M, Rogan, SA, Romeo, A, Rossi, M, Ruiz, D, Sabharwal, N, Salobir, BG, Santos, AI, Saranovic, S, Sarkozi, A, Schneider, RP, Sciagra, R, Scotti, S, Servini, Z, Setti, LR, Starck, S-A, Vajauskas, D, Vesely, J, Vieni, A, Vignati, A, Vito, IM, Weiss, K, Wild, D, Zdraveska-Kochovska, M, Aguro, RN, Alvarado, N, Barral, CM, Beretta, M, Berrocal, I, Cuellar, JFB, Chang, TMC, Rodriguez, LOC, Canessa, J, Mora, GC, Claudia, AC, Clavelo, GF, Junior, AFC, Faccio, FF, Fernandez, KM, Garibo, JRG, Gonzalez, U, Gonzalez, PE, Guzzo, MA, Jofre, J, Kapitan, M, Kempfer, G, Lopez, JL, Massardo, TV, Colaco, IM, Mesquita, CT, Montecinos, M, Neubauer, S, Pabon, LM, Puente, A, Vazquez, LMR, Macias, JAS, Pino, AGS, Huber, FZT, Tovar, AP, Vargas, L, Wiefels, C, Aljizeeri, A, Alvarez, RJ, Barger, D, Beardwood, W, Behrens, J, Brann, L, Brown, D, Carr, H, Churchwell, K, Comingore, GA, Corbett, J, Costello, M, Cruz, F, Depinet, T, Dorbala, S, Earles, M, Esteves, FP, Etherton, E, Fanning, RJ, Fornace, J, Franks, L, Gewirtz, H, Gulanchyn, K, Hannah, C-L, Hays, J, Hendrickson, J, Hester, J, Holmes, K, Johnson, A, Jopek, C, Lewin, H, Lyons, J, Manley, C, Meden, J, Moore, S, Moore, WH, Murthy, V, Nace, R, Neely, D, Nelson, L, Niedermaier, O, Rice, D, Rigs, R, Schiffer, K, Schockling, E, Schultz, T, Schumacker, T, Sheesley, B, Sheikh, A, Siegel, B, Slim, AM, Smith, J, Szulc, M, Tanskersley, N, Tilkemeier, P, Valdez, GD, Vrooman, R, Wawrowicz, D, Winchester, DE, Alcheikh, A, Allen, B, Atkins, E, Bevan, J, Bonomini, C, Christiansen, J, Clack, L, Craig, E, Dixson, H, Duncan, I, Fredericks, S, Gales, S, Hampson, R, Hanley, T, Hartcher, K, Hassall, J, Kelley, B, Kelly, S, Kidd, T, de Kort, T, Larcos, G, Macdonald, W, McGrath, C, Murdoch, E, O'Malley, S, O'Rourke, M, Pack, M, Pearce, R, Praehofer, R, Ramsay, S, Scarlett, L, Smidt, K, Souvannavong, F, Taubman, K, Taylor, G, Tse, K, Unger, S, Weale, J, Lindner, O, Pascual, TNB, Mercuri, M, Acampa, W, Burchert, W, Flotats, A, Kaufmann, PA, Kitsiou, A, Knuuti, J, Underwood, SR, Vitola, JV, Mahmarian, JJ, Karthikeyan, G, Better, N, Rehani, MM, Kashyap, R, Dondi, M, Paez, D, Einstein, AJ, Bouyoucef, SE, Lele, V, Magboo, VPC, Mut, F, Meeks, JB, Alexanderson, E, Allam, A, Al-Mallah, MH, Bom, H, Jerome, S, Luxenburg, O, Mahmarian, J, Shaw, LJ, Vitola, J, Amouri, W, Essabbah, H, Gassama, SS, Makhdomi, KB, El Mustapha, GIE, El Ouchdi, N, Qais, N, Soni, N, Vangu, W, Abazid, RM, Adams, B, Agarwal, V, Alfeeli, MA, Alnafisi, N, Bernabe, L, Bural, GG, Chaiwatanarat, T, Chandraguptha, JM, Cheon, GJ, Cho, I, Dogan, AS, Eftekhari, M, Frenkel, A, Garty, I, George, S, Geramifar, P, Golan, H, Habib, S, Hussain, R, Im, H, Jeon, H-J, Kalawat, T, Kang, WJ, Keng, F, Klaipetch, A, Kumar, PG, Lee, J, Lee, WW, Lim, I, Macaisa, CMM, Malhotra, G, Mittal, BR, Mohammad, MH, Mohan, P, Mulyanto, ID, Nariman, D, Nayak, UN, Niaz, K, Nikolov, G, Obaldo, JM, Ozturk, E, Park, JM, Park, S, Patel, CD, Phuong, HK, Quinon, AP, Rajini, TR, Saengsuda, Y, Santiago, J, Sayman, HB, Shinto, AS, Sivasubramaniyan, V, Son, MH, Sudhakar, P, Syed, GMS, Tamaki, N, Thamnirat, K, Thientunyakit, T, Thongmak, S, Velasco, DN, Verma, A, Vutrapongwatana, U, Wang, Y, Won, KS, Yao, Z, Yingsa-nga, T, Yudistiro, R, Yue, KT, Zafrir, N, Adrian, SC, Agostini, D, Aguade, S, Armitage, G, Backlund, M, Backman, M, Baker, M, Balducci, MT, Bavelaar, C, Berovic, M, Bertagna, F, Beuchel, R, Biggi, A, Bisi, G, Bonini, R, Bradley, A, Brudin, L, Bruno, I, Busnardo, E, Casoni, R, Choudhri, A, Cittanti, C, Clauss, R, Costa, DC, Costa, M, Dixon, K, Dziuk, M, Egelic, N, Eriksson, I, Fagioli, G, de Faria, DB, Florimonte, L, Francini, A, French, M, Gallagher, E, Garai, I, Geatti, O, Genovesi, D, Gianolli, L, Gimelli, A, del Giudice, E, Halliwell, S, Hansson, MJ, Harrison, C, Homans, F, Horton, F, Jedrzejuk, D, Jogi, J, Johansen, A, Johansson, H, Kalnina, M, Kaminek, M, Kiss, A, Kobylecka, M, Kostkiewicz, M, Kropp, J, Kullenberg, R, Lahoutte, T, Lang, O, Larsson, YH, Lazar, M, Leccisotti, L, Leners, N, Lipp, RW, Maenhout, A, Maffioli, L, Marcassa, C, Martins, B, Marzullo, P, Medolago, G, Mendiguchia, CG, Mirzaei, S, Mori, M, Nardi, B, Nazarenko, S, Nikoletic, K, Oleksa, R, Parviainen, T, Patrina, J, Peace, R, Pirich, C, Piwowarska-Bilska, H, Popa, S, Prakash, V, Pubul, V, Puklavec, L, Rac, S, Ratniece, M, Rogan, SA, Romeo, A, Rossi, M, Ruiz, D, Sabharwal, N, Salobir, BG, Santos, AI, Saranovic, S, Sarkozi, A, Schneider, RP, Sciagra, R, Scotti, S, Servini, Z, Setti, LR, Starck, S-A, Vajauskas, D, Vesely, J, Vieni, A, Vignati, A, Vito, IM, Weiss, K, Wild, D, Zdraveska-Kochovska, M, Aguro, RN, Alvarado, N, Barral, CM, Beretta, M, Berrocal, I, Cuellar, JFB, Chang, TMC, Rodriguez, LOC, Canessa, J, Mora, GC, Claudia, AC, Clavelo, GF, Junior, AFC, Faccio, FF, Fernandez, KM, Garibo, JRG, Gonzalez, U, Gonzalez, PE, Guzzo, MA, Jofre, J, Kapitan, M, Kempfer, G, Lopez, JL, Massardo, TV, Colaco, IM, Mesquita, CT, Montecinos, M, Neubauer, S, Pabon, LM, Puente, A, Vazquez, LMR, Macias, JAS, Pino, AGS, Huber, FZT, Tovar, AP, Vargas, L, Wiefels, C, Aljizeeri, A, Alvarez, RJ, Barger, D, Beardwood, W, Behrens, J, Brann, L, Brown, D, Carr, H, Churchwell, K, Comingore, GA, Corbett, J, Costello, M, Cruz, F, Depinet, T, Dorbala, S, Earles, M, Esteves, FP, Etherton, E, Fanning, RJ, Fornace, J, Franks, L, Gewirtz, H, Gulanchyn, K, Hannah, C-L, Hays, J, Hendrickson, J, Hester, J, Holmes, K, Johnson, A, Jopek, C, Lewin, H, Lyons, J, Manley, C, Meden, J, Moore, S, Moore, WH, Murthy, V, Nace, R, Neely, D, Nelson, L, Niedermaier, O, Rice, D, Rigs, R, Schiffer, K, Schockling, E, Schultz, T, Schumacker, T, Sheesley, B, Sheikh, A, Siegel, B, Slim, AM, Smith, J, Szulc, M, Tanskersley, N, Tilkemeier, P, Valdez, GD, Vrooman, R, Wawrowicz, D, Winchester, DE, Alcheikh, A, Allen, B, Atkins, E, Bevan, J, Bonomini, C, Christiansen, J, Clack, L, Craig, E, Dixson, H, Duncan, I, Fredericks, S, Gales, S, Hampson, R, Hanley, T, Hartcher, K, Hassall, J, Kelley, B, Kelly, S, Kidd, T, de Kort, T, Larcos, G, Macdonald, W, McGrath, C, Murdoch, E, O'Malley, S, O'Rourke, M, Pack, M, Pearce, R, Praehofer, R, Ramsay, S, Scarlett, L, Smidt, K, Souvannavong, F, Taubman, K, Taylor, G, Tse, K, Unger, S, and Weale, J
Abstract: PURPOSE: Nuclear cardiology is widely used to diagnose coronary artery disease and to guide patient management, but data on current practices, radiation dose-related best practices, and radiation doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear cardiology practice. We present the European subanalysis. METHODS: In March 2013, the IAEA invited laboratories across the world to document all SPECT and PET studies performed in one week. The data included age, gender, weight, radiopharmaceuticals, injected activities, camera type, positioning, hardware and software. Radiation effective dose was calculated for each patient. A quality score was defined for each laboratory as the number followed of eight predefined best practices with a bearing on radiation exposure (range of quality score 0 - 8). The participating European countries were assigned to regions (North, East, South, and West). Comparisons were performed between the four European regions and between Europe and the rest-of-the-world (RoW). RESULTS: Data on 2,381 European patients undergoing nuclear cardiology procedures in 102 laboratories in 27 countries were collected. A cardiac SPECT study was performed in 97.9 % of the patients, and a PET study in 2.1 %. The average effective dose of SPECT was 8.0 ± 3.4 mSv (RoW 11.4 ± 4.3 mSv; P < 0.001) and of PET was 2.6 ± 1.5 mSv (RoW 3.8 ± 2.5 mSv; P < 0.001). The mean effective doses of SPECT and PET differed between European regions (P < 0.001 and P = 0.002, respectively). The mean quality score was 6.2 ± 1.2, which was higher than the RoW score (5.0 ± 1.1; P < 0.001). Adherence to best practices did not differ significantly among the European regions (range 6 to 6.4; P = 0.73). Of the best practices, stress-only imaging and weight-adjusted dosing were the least commonly used. CONCLUSION: In Europe, the mean effective dose from nuclear cardiology is lower and the average quality score is higher than in the RoW. There is regional
Published: 2016

21. Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS)

Author: Einstein, AJ, Pascual, TNB, Mercuri, M, Karthikeyan, G, Vitola, JV, Mahmarian, JJ, Better, N, Bouyoucef, SE, Bom, HH-S, Lele, V, Magboo, VPC, Alexanderson, E, Allam, AH, Al-Mallah, MH, Flotats, A, Jerome, S, Kaufmann, PA, Luxenburg, O, Shaw, LJ, Underwood, SR, Rehani, MM, Kashyap, R, Paez, D, Dondi, M, Allam, A, Bom, H, Mahmarian, J, Vitola, J, Amouri, W, Essabbah, H, Gassama, SS, Makhdomi, KB, El Mustapha, GIE, El Ouchdi, N, Qais, N, Soni, N, Vangu, W, Abazid, RM, Adams, B, Agarwal, V, Alfeeli, MA, Alnafisi, N, Bernabe, L, Bural, GG, Chaiwatanarat, T, Chandraguptha, JM, Cheon, GJ, Cho, I, Dogan, AS, Eftekhari, M, Frenkel, A, Garty, I, George, S, Geramifar, P, Golan, H, Habib, S, Hussain, R, Im, H, Jeon, H-J, Kalawat, T, Kang, WJ, Keng, F, Klaipetch, A, Kumar, PG, Lee, J, Lee, WW, Lim, I, Macaisa, CMM, Malhotra, G, Mittal, BR, Mohammad, MH, Mohan, P, Mulyanto, ID, Nariman, D, Nayak, UN, Niaz, K, Nikolov, G, Obaldo, JM, Ozturk, E, Park, JM, Park, S, Patel, CD, Phuong, HK, Quinon, AP, Rajini, TR, Saengsuda, Y, Santiago, J, Sayman, HB, Shinto, AS, Sivasubramaniyan, V, Son, MH, Sudhakar, P, Syed, GMS, Tamaki, N, Thamnirat, K, Thientunyakit, T, Thongmak, S, Velasco, DN, Verma, A, Vutrapongwatana, U, Wang, Y, Won, KS, Yao, Z, Yingsa-nga, T, Yudistiro, R, Yue, KT, Zafrir, N, Adrian, SC, Agostini, D, Aguade, S, Armitage, G, Backlund, M, Backman, M, Baker, M, Balducci, MT, Bavelaar, C, Berovic, M, Bertagna, F, Beuchel, R, Biggi, A, Bisi, G, Bonini, R, Bradley, A, Brudin, L, Bruno, I, Busnardo, E, Casoni, R, Choudhri, A, Cittanti, C, Clauss, R, Costa, DC, Costa, M, Dixon, K, Dziuk, M, Egelic, N, Eriksson, I, Fagioli, G, de Faria, DB, Florimonte, L, Francini, A, French, M, Gallagher, E, Garai, I, Geatti, O, Genovesi, D, Gianolli, L, Gimelli, A, del Giudice, E, Halliwell, S, Hansson, MJ, Harrison, C, Homans, F, Horton, F, Jedrzejuk, D, Jogi, J, Johansen, A, Johansson, H, Kalnina, M, Kaminek, M, Kiss, A, Kobylecka, M, Kostkiewicz, M, Kropp, J, Kullenberg, R, Lahoutte, T, Lang, O, Larsson, YH, Lazar, M, Leccisotti, L, Leners, N, Lindner, O, Lipp, RW, Maenhout, A, Maffioli, L, Marcassa, C, Martins, B, Marzullo, P, Medolago, G, Meeks, JB, Mendiguchia, CG, Mirzaei, S, Mori, M, Nardi, B, Nazarenko, S, Nikoletic, K, Oleksa, R, Parviainen, T, Patrina, J, Peace, R, Pirich, C, Piwowarska-Bilska, H, Popa, S, Prakash, V, Pubul, V, Puklavec, L, Rac, S, Ratniece, M, Rogan, SA, Romeo, A, Rossi, M, Ruiz, D, Sabharwal, N, Salobir, BG, Santos, AI, Saranovic, S, Sarkozi, A, Schneider, RP, Sciagra, R, Scotti, S, Servini, Z, Setti, LR, Starck, S-A, Vajauskas, D, Vesely, J, Vieni, A, Vignati, A, Vito, IM, Weiss, K, Wild, D, Zdraveska-Kochovska, M, Aguro, RN, Alvarado, N, Barral, CM, Beretta, M, Berrocal, I, Cuellar, JFB, Chang, T-MC, Rodriguez, LOC, Canessa, J, Mora, GC, Claudia, AC, Clavelo, GF, Cruz, AF, Faccio, FF, Fernandez, KM, Garibo, JRG, Gonzalez, U, Gonzalez E., P, Guzzo, MA, Jofre, J, Kapitan, M, Kempfer, G, Lopez, JL, Massardo V., T, Colaco, IM, Mesquita, CT, Montecinos, M, Neubauer, S, Pabon, LM, Puente, A, Vazquez, LMR, Macias, JAS, Pino, AGS, Huber, FZT, Tovar, AP, Vargas, L, Wiefels, C, Aljizeeri, A, Alvarez, RJ, Barger, D, Beardwood, W, Behrens, J, Brann, L, Brown, D, Carr, H, Churchwell, K, Comingore, GA, Corbett, J, Costello, M, Cruz, F, Depinet, T, Dorbala, S, Earles, M, Esteves, FP, Etherton, E, Fanning, RJ, Fornace, J, Franks, L, Gewirtz, H, Gulanchyn, K, Hannah, C-L, Hays, J, Hendrickson, J, Hester, J, Holmes, K, Johnson, A, Jopek, C, Lewin, H, Lyons, J, Manley, C, Meden, J, Moore, S, Moore, WH, Murthy, V, Nace, R, Neely, D, Nelson, L, Niedermaier, O, Rice, D, Rigs, R, Schiffer, K, Schockling, E, Schultz, T, Schumacker, T, Sheesley, B, Sheikh, A, Siegel, B, Slim, AM, Smith, J, Szulc, M, Tanskersley, N, Tilkemeier, P, Valdez, GD, Vrooman, R, Wawrowicz, D, Winchester, DE, Alcheikh, A, Allen, B, Atkins, E, Bevan, J, Bonomini, C, Christiansen, J, Clack, L, Craig, E, Dixson, H, Duncan, I, Fredericks, S, Gales, S, Hampson, R, Hanley, T, Hartcher, K, Hassall, J, Kelley, B, Kelly, S, Kidd, T, de Kort, T, Larcos, G, Macdonald, W, McGrath, C, Murdoch, E, O'Malley, S, O'Rourke, M, Pack, M, Pearce, R, Praehofer, R, Ramsay, S, Scarlett, L, Smidt, K, Souvannavong, F, Taubman, K, Taylor, G, Tse, K, Unger, S, Weale, J, Einstein, AJ, Pascual, TNB, Mercuri, M, Karthikeyan, G, Vitola, JV, Mahmarian, JJ, Better, N, Bouyoucef, SE, Bom, HH-S, Lele, V, Magboo, VPC, Alexanderson, E, Allam, AH, Al-Mallah, MH, Flotats, A, Jerome, S, Kaufmann, PA, Luxenburg, O, Shaw, LJ, Underwood, SR, Rehani, MM, Kashyap, R, Paez, D, Dondi, M, Allam, A, Bom, H, Mahmarian, J, Vitola, J, Amouri, W, Essabbah, H, Gassama, SS, Makhdomi, KB, El Mustapha, GIE, El Ouchdi, N, Qais, N, Soni, N, Vangu, W, Abazid, RM, Adams, B, Agarwal, V, Alfeeli, MA, Alnafisi, N, Bernabe, L, Bural, GG, Chaiwatanarat, T, Chandraguptha, JM, Cheon, GJ, Cho, I, Dogan, AS, Eftekhari, M, Frenkel, A, Garty, I, George, S, Geramifar, P, Golan, H, Habib, S, Hussain, R, Im, H, Jeon, H-J, Kalawat, T, Kang, WJ, Keng, F, Klaipetch, A, Kumar, PG, Lee, J, Lee, WW, Lim, I, Macaisa, CMM, Malhotra, G, Mittal, BR, Mohammad, MH, Mohan, P, Mulyanto, ID, Nariman, D, Nayak, UN, Niaz, K, Nikolov, G, Obaldo, JM, Ozturk, E, Park, JM, Park, S, Patel, CD, Phuong, HK, Quinon, AP, Rajini, TR, Saengsuda, Y, Santiago, J, Sayman, HB, Shinto, AS, Sivasubramaniyan, V, Son, MH, Sudhakar, P, Syed, GMS, Tamaki, N, Thamnirat, K, Thientunyakit, T, Thongmak, S, Velasco, DN, Verma, A, Vutrapongwatana, U, Wang, Y, Won, KS, Yao, Z, Yingsa-nga, T, Yudistiro, R, Yue, KT, Zafrir, N, Adrian, SC, Agostini, D, Aguade, S, Armitage, G, Backlund, M, Backman, M, Baker, M, Balducci, MT, Bavelaar, C, Berovic, M, Bertagna, F, Beuchel, R, Biggi, A, Bisi, G, Bonini, R, Bradley, A, Brudin, L, Bruno, I, Busnardo, E, Casoni, R, Choudhri, A, Cittanti, C, Clauss, R, Costa, DC, Costa, M, Dixon, K, Dziuk, M, Egelic, N, Eriksson, I, Fagioli, G, de Faria, DB, Florimonte, L, Francini, A, French, M, Gallagher, E, Garai, I, Geatti, O, Genovesi, D, Gianolli, L, Gimelli, A, del Giudice, E, Halliwell, S, Hansson, MJ, Harrison, C, Homans, F, Horton, F, Jedrzejuk, D, Jogi, J, Johansen, A, Johansson, H, Kalnina, M, Kaminek, M, Kiss, A, Kobylecka, M, Kostkiewicz, M, Kropp, J, Kullenberg, R, Lahoutte, T, Lang, O, Larsson, YH, Lazar, M, Leccisotti, L, Leners, N, Lindner, O, Lipp, RW, Maenhout, A, Maffioli, L, Marcassa, C, Martins, B, Marzullo, P, Medolago, G, Meeks, JB, Mendiguchia, CG, Mirzaei, S, Mori, M, Nardi, B, Nazarenko, S, Nikoletic, K, Oleksa, R, Parviainen, T, Patrina, J, Peace, R, Pirich, C, Piwowarska-Bilska, H, Popa, S, Prakash, V, Pubul, V, Puklavec, L, Rac, S, Ratniece, M, Rogan, SA, Romeo, A, Rossi, M, Ruiz, D, Sabharwal, N, Salobir, BG, Santos, AI, Saranovic, S, Sarkozi, A, Schneider, RP, Sciagra, R, Scotti, S, Servini, Z, Setti, LR, Starck, S-A, Vajauskas, D, Vesely, J, Vieni, A, Vignati, A, Vito, IM, Weiss, K, Wild, D, Zdraveska-Kochovska, M, Aguro, RN, Alvarado, N, Barral, CM, Beretta, M, Berrocal, I, Cuellar, JFB, Chang, T-MC, Rodriguez, LOC, Canessa, J, Mora, GC, Claudia, AC, Clavelo, GF, Cruz, AF, Faccio, FF, Fernandez, KM, Garibo, JRG, Gonzalez, U, Gonzalez E., P, Guzzo, MA, Jofre, J, Kapitan, M, Kempfer, G, Lopez, JL, Massardo V., T, Colaco, IM, Mesquita, CT, Montecinos, M, Neubauer, S, Pabon, LM, Puente, A, Vazquez, LMR, Macias, JAS, Pino, AGS, Huber, FZT, Tovar, AP, Vargas, L, Wiefels, C, Aljizeeri, A, Alvarez, RJ, Barger, D, Beardwood, W, Behrens, J, Brann, L, Brown, D, Carr, H, Churchwell, K, Comingore, GA, Corbett, J, Costello, M, Cruz, F, Depinet, T, Dorbala, S, Earles, M, Esteves, FP, Etherton, E, Fanning, RJ, Fornace, J, Franks, L, Gewirtz, H, Gulanchyn, K, Hannah, C-L, Hays, J, Hendrickson, J, Hester, J, Holmes, K, Johnson, A, Jopek, C, Lewin, H, Lyons, J, Manley, C, Meden, J, Moore, S, Moore, WH, Murthy, V, Nace, R, Neely, D, Nelson, L, Niedermaier, O, Rice, D, Rigs, R, Schiffer, K, Schockling, E, Schultz, T, Schumacker, T, Sheesley, B, Sheikh, A, Siegel, B, Slim, AM, Smith, J, Szulc, M, Tanskersley, N, Tilkemeier, P, Valdez, GD, Vrooman, R, Wawrowicz, D, Winchester, DE, Alcheikh, A, Allen, B, Atkins, E, Bevan, J, Bonomini, C, Christiansen, J, Clack, L, Craig, E, Dixson, H, Duncan, I, Fredericks, S, Gales, S, Hampson, R, Hanley, T, Hartcher, K, Hassall, J, Kelley, B, Kelly, S, Kidd, T, de Kort, T, Larcos, G, Macdonald, W, McGrath, C, Murdoch, E, O'Malley, S, O'Rourke, M, Pack, M, Pearce, R, Praehofer, R, Ramsay, S, Scarlett, L, Smidt, K, Souvannavong, F, Taubman, K, Taylor, G, Tse, K, Unger, S, and Weale, J
Abstract: AIMS: To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing 'best practices' worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose. METHODS AND RESULTS: We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March-April 2013. Eight 'best practices' relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED ≤ 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more 'best practices' had lower EDs. CONCLUSION: Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally.
Published: 2015

22. Adjuvant chemoradiotherapy in gastric cancer: a pooled analysis of the AIRO gastrointestinal group experience

Author: Mattiucci, Gian Carlo, Valentini, Chiara, D'Agostino, Giuseppe Roberto, Augurio, A, Capirci, C, De Paoli, A, Genovesi, D, Huscher, A, Iannone, T, Pani, G, Rosetto, Me, Sciacero, P, Manfrida, Stefania, Corazzi, F, Fusco, V, Luppattelli, M, Mangiacotti, Maria Grazia, Melano, A, Murino, Paola, Niespolo, R, Osti, Mf, Picardi, Vincenzo, Morganti, Alessio Giuseppe, Valentini, Vincenzo, Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Mattiucci, Gian Carlo, Valentini, Chiara, D'Agostino, Giuseppe Roberto, Augurio, A, Capirci, C, De Paoli, A, Genovesi, D, Huscher, A, Iannone, T, Pani, G, Rosetto, Me, Sciacero, P, Manfrida, Stefania, Corazzi, F, Fusco, V, Luppattelli, M, Mangiacotti, Maria Grazia, Melano, A, Murino, Paola, Niespolo, R, Osti, Mf, Picardi, Vincenzo, Morganti, Alessio Giuseppe, Valentini, Vincenzo, Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)
Abstract: Given the poor compliance with adjuvant chemoradiotherapy (CRT) in gastric cancer reported in previous studies, a survey was conducted among 18 Italian institutions within the AIRO Gastrointestinal Group to investigate current treatment modalities, toxicities, and compliance with adjuvant CRT.
Published: 2015

23. Adjuvant Chemoradiation in Pancreatic Cancer: A Pooled Analysis in Elderly (≥75 years) Patients

Author: Mattiucci, Gian Carlo, Falconi, M, Van Stiphout, Rgpm, Alfieri, Sergio, Calvo, Fa, Herman, Jm, Maidment, Bw, Miller, Rc, Regine, Wf, Reni, M, Sharma, N, Partelli, S, Genovesi, D, Balducci, Mario, Deodato, Francesco, Valentini, Vincenzo, Morganti, Alessio Giuseppe, Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Alfieri, Sergio (ORCID:0000-0002-0404-724X), Balducci, Mario (ORCID:0000-0003-0398-9726), Deodato, Francesco (ORCID:0000-0003-1276-5070), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Mattiucci, Gian Carlo, Falconi, M, Van Stiphout, Rgpm, Alfieri, Sergio, Calvo, Fa, Herman, Jm, Maidment, Bw, Miller, Rc, Regine, Wf, Reni, M, Sharma, N, Partelli, S, Genovesi, D, Balducci, Mario, Deodato, Francesco, Valentini, Vincenzo, Morganti, Alessio Giuseppe, Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Alfieri, Sergio (ORCID:0000-0002-0404-724X), Balducci, Mario (ORCID:0000-0003-0398-9726), Deodato, Francesco (ORCID:0000-0003-1276-5070), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)
Abstract: To determine the impact of postoperative chemoradiation (POCR) on overall survival (OS) after resection of pancreatic adenocarcinoma (PAC) in elderly (≥75 years) patients.
Published: 2015

24. Patterns of radiotherapy practice for pancreatic cancer: Results of the Gastrointestinal Radiation Oncology Study Group multi-institutional survey

Author: Macchia, Gabriella, Sainato, A, Talamini, R, Boz, G, Bacigalupo, A, Caravatta, Luciana, Fiore, M, Friso, Ml, Fusco, Vincenzo, Lupattelli, M, Mantello, G, Mattiucci, Gian Carlo, Slim, N, Sciacero, P, Turri, L, Valentini, Vincenzo, Morganti, Alessio Giuseppe, Genovesi, D., Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Macchia, Gabriella, Sainato, A, Talamini, R, Boz, G, Bacigalupo, A, Caravatta, Luciana, Fiore, M, Friso, Ml, Fusco, Vincenzo, Lupattelli, M, Mantello, G, Mattiucci, Gian Carlo, Slim, N, Sciacero, P, Turri, L, Valentini, Vincenzo, Morganti, Alessio Giuseppe, Genovesi, D., Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)
Abstract: No information is currently available regarding pancreatic cancer (PC) pattern of care in Italy. In the present study, a nationwide survey using a questionnaire was performed to enquire the local standards for PC diagnosis and radiotherapy treatment. Fifty-seven percent of 140 Italian centres completed questionnaire. The main causes of no radiotherapy indication were poor general condition (45%) and lack of guidelines (25%). Physicians (38%) employed neoadjuvant therapy in locally advanced PC patients, while in other centres (62%) adjuvant chemoradiation was administered. Adjuvant gemcitabine-based chemotherapy was selected as the treatment of choice by 59% of centres. Patients were treated mostly with doses of 50-54.9 Gy on the tumour (or bed) plus lymph nodes. A 3D-CRT technique was used in 81.2% of centres, while IMRT and IGRT were available in 61.2 and 48.7% of cases, respectively. Extensive variation exists with regard to patterns of care for PC in Italy. Nevertheless, cooperative studies emerging from this survey appeared beneficial.
Published: 2015

25. Interobserver variability of clinical target volume delineation in soft-tissue sarcomas

Author: Genovesi, D, Ausili Cèfaro, G, Trignani, M, Vinciguerra, A, Augurio, A, Di Tommaso, M, Perrotti, F, De Paoli, A, Olmi, P, Valentini, Vincenzo, Di Nicola, M., Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Genovesi, D, Ausili Cèfaro, G, Trignani, M, Vinciguerra, A, Augurio, A, Di Tommaso, M, Perrotti, F, De Paoli, A, Olmi, P, Valentini, Vincenzo, Di Nicola, M., and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)
Abstract: The present observational study reports the results of a multi-institutional dummy-run designed to estimate the consistency of interobserver variability in clinical target volume delineation in two different cases of soft-tissue sarcomas in which postoperative and preoperative radiotherapy were prescribed, respectively. The purpose of this work was to quantify interobserver variability in routine clinical practice.
Published: 2014

26. Role of microRNA in response to ionizing radiations: evidences and potential impact on clinical practice for radiotherapy

Author: Cellini, Francesco, Morganti, Alessio Giuseppe, Genovesi, D, Silvestris, N, Valentini, Vincenzo, Cellini, Francesco (ORCID:0000-0002-2145-2300), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Cellini, Francesco, Morganti, Alessio Giuseppe, Genovesi, D, Silvestris, N, Valentini, Vincenzo, Cellini, Francesco (ORCID:0000-0002-2145-2300), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)
Abstract: MicroRNAs (miRNA) are small, non-coding, RNAs with gene expression regulator roles. As an important class of regulators of many cellular pathways, miRNAs are involved in many signaling pathways and DNA damage repair processes, affecting cellular radiosensitivity. Their role has led to interest in oncological implications to improve treatment results. MiRNAs represent a great opportunity to enhance the efficacy of radiotherapy treatments-they can be used to profile the radioresistance of tumors before radiotherapy, monitor their response throughout the treatment, thus helping to select intensification strategies, and also to define the final response to therapy along with risks of recurrence or metastatization. Even though many interesting studies support such potential, nowadays most studies on patient data are limited to experiments profiling tumor aggressiveness and response to radiotherapy. Moreover many studies report different although not conflicting results on the miRNAs evaluated for each tumor type. Without doubt, the clinical potential of such molecules for radiotherapy is striking and of high interest.
Published: 2014

27. Inter-observer variability of clinical target volume delineation in radiotherapy treatment of pancreatic cancer: a multi-institutional contouring experience

Author: Mattiucci, Gian Carlo, Caravatta, Luciana, Macchia, Gabriella, Sainato, A, Cernusco, Nl, Mantello, G, Di Tommaso, M, Trignani, M, De Paoli, A, Boz, G, Friso, Ml, Fusco, Vincenzo, Di Nicola, Marco, Morganti, Alessio Giuseppe, Genovesi, D., Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Di Nicola, Marco (ORCID:0000-0001-7457-0426), Mattiucci, Gian Carlo, Caravatta, Luciana, Macchia, Gabriella, Sainato, A, Cernusco, Nl, Mantello, G, Di Tommaso, M, Trignani, M, De Paoli, A, Boz, G, Friso, Ml, Fusco, Vincenzo, Di Nicola, Marco, Morganti, Alessio Giuseppe, Genovesi, D., Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), and Di Nicola, Marco (ORCID:0000-0001-7457-0426)
Abstract: BACKGROUND: An observational multi-institutional study has been conducted aimed to evaluate the inter-observer variability in clinical target volume (CTV) delineation among different radiation oncologists in radiotherapy treatment of pancreatic cancer. METHODS: A multi-institutional contouring dummy-run of two different cases of pancreatic cancer treated by postoperative and preoperative radiotherapy (RT) was performed. Clinical history, diagnostics, and planning CT imaging were available on AIRO website (http://www.radioterapiaitalia.it). Participants were requested to delineate CTVs according to their skills and knowledge. Aiming to quantify interobserver variability of CTVs delineations, the total volume, craniocaudal, laterolateral, and anteroposterior diameters were calculated. Descriptive statistic was calculated. The 95% Confidence Interval (95% CI) for coefficient of variation (CV) was estimated. The Dice Similarity Index (DSI) was used to evaluate the spatial overlap accuracy of the different CTVs compared with the CTVs of a national reference Centre considered as a benchmark. The mean DSI (mDSI) was calculated and reported. RESULTS: A total of 18 radiation oncologists from different Institutes submitted the targets. Less variability was observed for the Elective CTV rather than the Boost CTV, in both cases. The estimated CV were 28.8% (95% CI: 21.2-45.0%) and 20.0% (95% CI: 14.9-30.6%) for the Elective CTV, in adjuvant (Case 1) and neoadjuvant (Case 2) case, respectively. The mDSI value was 0.68 for the Elective CTVs in both cases (range 0.19-0.79 in postoperative vs range 0.35-0.79 in preoperative case). The mDSI was increased to 0.71 (Case 1) and 0.72 (Case 2) if the observers with a worse agreement have been excluded. On the other hand, a CV of 42.4% (95% CI: 30.1-72.4%) and 63.8% (95% CI: 43.9-119.2%) with a mDSI value of 0.44 and 0.52, were calculated for the Boost CTV in Case 1 and Case 2, respectively. CONCLUSIONS: The CV and mDSI obtained
Published: 2014

28. Postoperative 5-FU based radiochemotherapy in rectal cancer: retrospective long term results and prognostic factors of a pooled analysis on 1,338 patients

Author: Genovesi, D, Myerson, Rj, Cèfaro, Ga, Vinciguerra, A, Augurio, A, Trignani, M, Di Tommaso, M, Nuzzo, M, Lupattelli, M, Aristei, C, Bellavita, R, Scandolaro, L, Cosentino, D, Pani, Giovambattista, Ziccarelli, L, Gambacorta, Maria Antonietta, Barba, Maria Cristina, Maranzano, E, Trippa, F, Sciacero, P, Niespolo, R, Leonardi, C, Iannone, T, Rosetto, Me, Fusco, Vincenzo, Sanpaolo, P, Melano, A, Valvo, F, Capirci, C, De Paoli, A, Di Nicola, Marco, Mantello, G, Valentini, Vincenzo, Pani, Giovambattista (ORCID:0000-0001-7133-8728), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Di Nicola, Marco (ORCID:0000-0001-7457-0426), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Genovesi, D, Myerson, Rj, Cèfaro, Ga, Vinciguerra, A, Augurio, A, Trignani, M, Di Tommaso, M, Nuzzo, M, Lupattelli, M, Aristei, C, Bellavita, R, Scandolaro, L, Cosentino, D, Pani, Giovambattista, Ziccarelli, L, Gambacorta, Maria Antonietta, Barba, Maria Cristina, Maranzano, E, Trippa, F, Sciacero, P, Niespolo, R, Leonardi, C, Iannone, T, Rosetto, Me, Fusco, Vincenzo, Sanpaolo, P, Melano, A, Valvo, F, Capirci, C, De Paoli, A, Di Nicola, Marco, Mantello, G, Valentini, Vincenzo, Pani, Giovambattista (ORCID:0000-0001-7133-8728), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Di Nicola, Marco (ORCID:0000-0001-7457-0426), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)
Abstract: To evaluate survival outcomes of patients in pStage II-III rectal cancer treated with adjuvant 5-fluorouracil-based radiochemotherapy and to retrospectively analyze the impact of prognostic variables on local control, metastasis-free survival and cause-specific survival.
Published: 2013

29. Interobserver variability of clinical target volume delineation in supra-diaphragmatic Hodgkin's disease: a multi-institutional experience

Author: Genovesi, D, Cèfaro, Ga, Vinciguerra, A, Augurio, A, Di Tommaso, M, Marchese, R, Ricardi, U, Filippi, Ar, Girinsky, T, Di Biagio, K, Belfiglio, M, Barbieri, E, Valentini, Vincenzo, Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Genovesi, D, Cèfaro, Ga, Vinciguerra, A, Augurio, A, Di Tommaso, M, Marchese, R, Ricardi, U, Filippi, Ar, Girinsky, T, Di Biagio, K, Belfiglio, M, Barbieri, E, Valentini, Vincenzo, and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)
Abstract: BACKGROUND: To determine interobserver variability in clinical target volume (CTV) of supra-diaphragmatic Hodgkin's lymphoma. MATERIALS AND METHODS: At the 2008 AIRO (Italian Society of Radiation Oncology) Meeting, the Radiation Oncology Department of Chieti proposed a multi-institutional contouring dummy-run of two cases of early stage supra-diaphragmatic Hodgkin's lymphoma after chemotherapy. Clinical history, diagnostics, and planning CT imaging were available on Chieti's radiotherapy website (www.radioterapia.unich.it). Participating centers were requested to delineate the CTV and submit it to the coordinating center. To quantify interobserver variability of CTV delineations, the total volume, craniocaudal, laterolateral, and anteroposterior diameters were calculated. RESULTS: A total of 18 institutions for case A and 15 institutions for case B submitted the targets. Case A presented significant variability in total volume (range: 74.1-1,157.1 cc), craniocaudal (range: 6.5-22.5 cm; median: 16.25 cm), anteroposterior (range: 5.04-14.82 cm; median: 10.28 cm), and laterolateral diameters (range: 8.23-22.88 cm; median: 15.5 cm). Mean CTV was 464.8 cc (standard deviation: 280.5 cc). Case B presented significant variability in total volume (range: 341.8-1,662 cc), cranio-caudal (range: 8.0-28.5 cm; median: 23 cm), anteroposterior (range: 7.9-1.8 cm; median: 11.1 cm), and laterolateral diameters (range: 12.9-24.0 cm; median: 18.8 cm). Mean CTV was 926.0 cc (standard deviation: 445.7 cc). CONCLUSION: This significant variability confirms the need to apply specific guidelines to improve contouring uniformity in Hodgkin's lymphoma.
Published: 2011

30. Rectal cancer multidisciplinary treatment: evidences, consensus and perspectives.

Author: Valvo, F., Mantello, G., Coco, Claudio, Corvo', R., Gambacorta, Maria Antonietta, Genovesi, D., Lupattelli, M., Valentini, Vincenzo, Coco, Claudio (ORCID:0000-0002-4713-7093), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Valvo, F., Mantello, G., Coco, Claudio, Corvo', R., Gambacorta, Maria Antonietta, Genovesi, D., Lupattelli, M., Valentini, Vincenzo, Coco, Claudio (ORCID:0000-0002-4713-7093), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)
Published: 2010

31. Multidisciplinary Rectal Cancer Management: 2nd European Rectal Cancer Consensus Conference (EURECA-CC2)

Author: Valentini, Vincenzo, Aristei, C, Glimelius, B, Minsky, Bd, Beets Tan, R, Borras, Jm, Haustermans, K, Maingon, P, Overgaard, J, Pahlman, L, Quirke, P, Schmoll, H, Sebag Montefiore, D, Taylor, I, Van Cutsem, E, Van De Velde, C, Cellini, Numa, Aranda, E, Latini, P, Blomqvist, L, Bosset, Jf, Brown, G, Bujko, K, Ectors, N, Gerard, Jp, Glynne Jones, R, Heald, R, Hohenberger, W, Holm, T, Laurberg, S, Leer, Jw, Marijnen, C, Nagtegaal, I, Rodel, C, Rutten, H, Scheithauer, W, Willet, Cg, Coco, Claudio, Gambacorta, Maria Antonietta, Genovesi, D, Lupattelli, M, Mantello, G, Valvo, E., Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Coco, Claudio (ORCID:0000-0002-4713-7093), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Valentini, Vincenzo, Aristei, C, Glimelius, B, Minsky, Bd, Beets Tan, R, Borras, Jm, Haustermans, K, Maingon, P, Overgaard, J, Pahlman, L, Quirke, P, Schmoll, H, Sebag Montefiore, D, Taylor, I, Van Cutsem, E, Van De Velde, C, Cellini, Numa, Aranda, E, Latini, P, Blomqvist, L, Bosset, Jf, Brown, G, Bujko, K, Ectors, N, Gerard, Jp, Glynne Jones, R, Heald, R, Hohenberger, W, Holm, T, Laurberg, S, Leer, Jw, Marijnen, C, Nagtegaal, I, Rodel, C, Rutten, H, Scheithauer, W, Willet, Cg, Coco, Claudio, Gambacorta, Maria Antonietta, Genovesi, D, Lupattelli, M, Mantello, G, Valvo, E., Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Coco, Claudio (ORCID:0000-0002-4713-7093), and Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737)
Abstract: During the first decade of the 21st century a number of important European randomized studies were published. In order to help shape clinical practice based on best scientific evidence from the literature, the International Conference on 'Multidisciplinary Rectal Cancer Treatment: Looking for an European Consensus' (EURECA-CC2) was organized in Italy under the endorsement of European Society of Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO), and European Society of Therapeutic Radiation Oncology (ESTRO).
Published: 2009

32. Preoperative T and N staging of colorectal cancer: accuracy of contrast-enhanced multi-detector row CT colonography--initial experience

Author: Filippone, Antonella, Ambrosini, Roberta, Fuschi, Maurizio, Marinelli, Tiziana, Genovesi, D, Bonomo, Lorenzo, Bonomo, Lorenzo (ORCID:0000-0001-5101-9367), Filippone, Antonella, Ambrosini, Roberta, Fuschi, Maurizio, Marinelli, Tiziana, Genovesi, D, Bonomo, Lorenzo, and Bonomo, Lorenzo (ORCID:0000-0001-5101-9367)
Abstract: PURPOSE: To evaluate the accuracy of contrast material-enhanced multi-detector row computed tomographic (CT) colonography for preoperative staging of colorectal cancer. MATERIALS AND METHODS: Forty-one patients with colorectal carcinoma underwent preoperative contrast-enhanced multi-detector row CT colonography. Images were obtained in the arterial (start delay of 35 seconds) and portal venous (start delay of 70 seconds) phases. The arterial phase was focused on the suspected region of neoplasm, whereas the venous phase included the whole abdomen and pelvis. Two radiologists independently evaluated the depth of tumor invasion into the colorectal wall (T) and regional lymph node involvement (N) on transverse CT images alone and in combination with multiplanar reformations (MPRs). Disagreements were resolved by means of consensus. CT findings were compared with pathologic results, which served as the reference standard. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were assessed. Differences in accuracy for T and N staging were assessed by using the McNemar test. RESULTS: In T staging, overall accuracy was 73% when transverse images were evaluated alone and 83% when they were evaluated in combination with MPRs. This difference was not significant. N staging was associated with an overall accuracy of 59% with transverse images alone and 80% with combined transverse and MPR images (P <.01). CONCLUSION: Contrast-enhanced multi-detector row CT colonography is an accurate technique for preoperative local staging of colorectal tumors. Copyright RSNA, 2004
Published: 2004

33. Split course concomitant radiochemotherapy followed by brachytherapy boost in the exclusive treatment of the anal canal cancer

Author: Valentini, Vincenzo, Mantello, G., Luzi, Stefano, Genovesi, D., Smaniotto, Daniela, Mantini, Giovanna, Coco, Claudio, Ratto, Carlo, Sofo, Luigi, Cellini, N., Valentini V. (ORCID:0000-0003-4637-6487), Luzi S. (ORCID:0000-0003-4076-6089), Smaniotto D. (ORCID:0000-0002-1246-8001), Mantini G. (ORCID:0000-0001-5303-4499), Coco C. (ORCID:0000-0002-4713-7093), Ratto C. (ORCID:0000-0002-0556-0037), Sofo L. (ORCID:0000-0002-0592-5999), Valentini, Vincenzo, Mantello, G., Luzi, Stefano, Genovesi, D., Smaniotto, Daniela, Mantini, Giovanna, Coco, Claudio, Ratto, Carlo, Sofo, Luigi, Cellini, N., Valentini V. (ORCID:0000-0003-4637-6487), Luzi S. (ORCID:0000-0003-4076-6089), Smaniotto D. (ORCID:0000-0002-1246-8001), Mantini G. (ORCID:0000-0001-5303-4499), Coco C. (ORCID:0000-0002-4713-7093), Ratto C. (ORCID:0000-0002-0556-0037), and Sofo L. (ORCID:0000-0002-0592-5999)
Abstract: From 1988 to 1996, twenty-six patients with epidermoid anal cancer were examined at the Radiotherapy Department of Università Cattolica del S.Cuore, Rome. At diagnosis, 13 patients were stage II, 11 patients were stage III, 2 patients had a small recurrence after local excision. All the patients were treated with concomitant radiochemotherapy followed by a brachytherapy boost Treatment was carried out in two cycles 4-5 weeks apart. Chemotherapy consisted of 5FU (1,000 mg/sqm, continuous infusion over the first 4 days) and Mitomycin C (10 mg/sqm on day 1, bolus administration). Radiotherapy was administered with two AP opposed coaxial beams of the same size. The target was T and inguinal, external, internal and common iliac lymph nodes. The total dose for each cycle was 23.4 Gy, administered with conventional fractionation and a daily dose of 180 cGy. Four-six weeks after the end of cycle 2, the patients received a boost of interstitial brachytherapy. During concomitant radiochemotherapy, grade 3-4 (RTOG-EORTC scale) acute hematologic and cutaneous toxicities were observed in 15% and 4% of patients, respectively; treatment was discontinued in 4 patients. Complete response was observed in 21 patients (81%) and partial response in 5 (19%). The latter underwent surgery, namely local excision in 1 patient and abdominoperineal resection in 4 patients. The median observation period of our study population was 45 months. Five-year actuarial local control of the 26 patients was 88%. Five year actuarial survival was 75% and sphincter conservation 77%. Our results confirm the data reported by Cummings of Princess Margaret Hospital, who observed low toxicity when the two cycles of concomitant radiochemotherapy are split. Randomized phase-III studies should clarify the potential role of the new radiochemotherapy combinations which should be compared with reference treatments providing repeatable results and low toxicity. Our treatment may make a reference for more innovative co
Published: 1997

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33 results on '"Genovesi D."'

1. 18-FDG PET for large-vessel vasculitis diagnosis and follow-up

2. Ways to improve breast cancer patients' management and clinical outcome: The 2020 Assisi Think Tank Meeting

3. Definition of local recurrence site in resected pancreatic adenocarcinoma: A multicenter study (dolores-1)

4. COVID-19 safe and fully operational radiotherapy: An AIRO survey depicting the Italian landscape at the dawn of phase 2

5. Radiotherapy with intensity-modulated (Imrt) techniques in the treatment of anal carcinoma (rainstorm): A multicenter study on behalf of airo (Italian association of radiotherapy and clinical oncology) gastrointestinal study group

6. Treatment volume, dose prescription and delivery techniques for dose-intensification in Rectal Cancer: A national survey

7. Basics and frontiers on pancreatic cancer for radiation oncology: Target delineation, SBRT, SIB technique, MRgRT, particle therapy, immunotherapy and clinical guidelines

8. INTERACTS (INTErventional Radiotherapy ACtive Teaching School) consensus conference on sarcoma interventional radiotherapy (brachytherapy) endorsed by AIRO (Italian Association of Radiotherapy and Clinical Oncology)

9. COVID-19 outbreak and cancer radiotherapy disruption in Italy: Survey endorsed by the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

10. The role of interventional radiotherapy (brachytherapy) in stage i esophageal cancer: An AIRO (Italian Association of Radiotherapy and Clinical Oncology) systematic review

11. Palliative short-course radiotherapy in advanced pelvic cancer: A phase II study (SHARON project)

12. Combination of novel systemic agents and radiotherapy for solid tumors – part I: An AIRO (Italian association of radiotherapy and clinical oncology) overview focused on treatment efficacy

13. Combination of novel systemic agents and radiotherapy for solid tumors – Part II: An AIRO (Italian association of radiotherapy and clinical oncology) overview focused on treatment toxicity

14. Guidelines on prostate carcinoma - AIRO, 2016

15. Policies for reirradiation of recurrent high-grade gliomas: a survey among Italian radiation oncologists

16. A Feasibility Study for in vivo Dosimetry Procedure in Routine Clinical Practice

17. Phase I-II study of short-course accelerated radiotherapy (SHARON) for palliation in head and neck cancer

18. Short-course regimen of palliative radiotherapy in complicated bone metastases: a phase i–ii study (SHARON Project)

19. Time to surgery and pathologic complete response after neoadjuvant chemoradiation in rectal cancer: A population study on 2094 patients

20. Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries

21. Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS)

22. Adjuvant chemoradiotherapy in gastric cancer: a pooled analysis of the AIRO gastrointestinal group experience

23. Adjuvant Chemoradiation in Pancreatic Cancer: A Pooled Analysis in Elderly (≥75 years) Patients

24. Patterns of radiotherapy practice for pancreatic cancer: Results of the Gastrointestinal Radiation Oncology Study Group multi-institutional survey

25. Interobserver variability of clinical target volume delineation in soft-tissue sarcomas

26. Role of microRNA in response to ionizing radiations: evidences and potential impact on clinical practice for radiotherapy

27. Inter-observer variability of clinical target volume delineation in radiotherapy treatment of pancreatic cancer: a multi-institutional contouring experience

28. Postoperative 5-FU based radiochemotherapy in rectal cancer: retrospective long term results and prognostic factors of a pooled analysis on 1,338 patients

29. Interobserver variability of clinical target volume delineation in supra-diaphragmatic Hodgkin's disease: a multi-institutional experience

30. Rectal cancer multidisciplinary treatment: evidences, consensus and perspectives.

31. Multidisciplinary Rectal Cancer Management: 2nd European Rectal Cancer Consensus Conference (EURECA-CC2)

32. Preoperative T and N staging of colorectal cancer: accuracy of contrast-enhanced multi-detector row CT colonography--initial experience

33. Split course concomitant radiochemotherapy followed by brachytherapy boost in the exclusive treatment of the anal canal cancer

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