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10 results on '"Ercole Mazzeo"'

1. Unexpected tumor response to palliative pelvic radiotherapy in mismatch repair-deficient advanced prostate cancer: a case report

Author

Giovanni Aluisio, Ercole Mazzeo, Frank Lohr, Federica Fiocchi, Stefania Bettelli, Cinzia Baldessari, Maurizio Paterlini, and Alessio Bruni

Subjects
Microsatellite instability, Radiosensitivity, Prostate cancer, Medicine
Abstract

Abstract Background Mismatch-repair-deficiency resulting in microsatellite instability (MSI) may confer increased radiosensitivity in locally advanced/metastatic tumors and thus radiotherapy (RT) potentially might have a changing role in treating this subset of patients, alone or in combination with checkpoint inhibitors. Case presentation We report a 76 year-old Italian male patient presenting with locally advanced undifferentiated prostate cancer (LAPC), infiltrating bladder and rectum. Molecular analysis revealed high-MSI with an altered expression of MSH2 and MSH6 at immunohistochemistry. Two months after 6 chemotherapy cycles with Docetaxel associated to an LHRH analogue, a computed tomography scan showed stable disease. After palliative RT (30 Gy/10 fractions) directed to the tumor mass with a 3D-conformal setup, a follow-up computed tomography scan at 8 weeks revealed an impressive response that remained stable at computed tomography after 9 months, with sustained biochemical response. To our knowledge, this is the first case of such a sustained response to low dose RT alone in high-MSI LAPC. Conclusions Routine evaluation of MSI in patients with locally problematic advanced tumors might change treatment strategy and treatment aim in this setting, from a purely palliative approach to a quasi-curative paradigm.

Published
2020
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2. Treatment paths for localised prostate cancer in Italy: The results of a multidisciplinary, observational, prospective study (Pros-IT CNR).

Author

Michela Buglione, Marianna Noale, Alessio Bruni, Alessandro Antonelli, Filippo Bertoni, Renzo Corvo', Umberto Ricardi, Paolo Borghetti, Marta Maddalo, Claudio Simeone, Ercole Mazzeo, Angelo Porreca, Sergio Serni, Pierfrancesco Bassi, Mauro Gacci, Vincenzo Mirone, Rodolfo Montironi, Andrea Tubaro, Alfredo Berruti, Giario Natale Conti, Stefania Maggi, Stefano Maria Magrini, Luca Triggiani, and Pros-IT CNR study group

Subjects
Medicine, Science
Abstract

BACKGROUND:There are several treatments available to newly diagnosed prostate cancer (PCA) patients. Although surgery and radiotherapy (RT) with or without androgen deprivation therapy (ADT) are widely adopted treatment options for localized PCA together with active surveillance (AS), there is no consensus nor randomised trials on treatment selection, prospective quality of life (QOL), along with toxicity outcomes and according to treatment modality in the Italian population. The current study aimed to describe clinical-therapeutic features and QOL at PCA diagnosis, according to different treatment patterns in a large prospective, Italian population, enrolled in the Pros-IT CNR study. METHODS:The Pros-IT CNR is an on-going national, multicenter, observational, prospective study on patients affected by PCA who have been referred by 97 Italian Urology, Radiation Oncology and Medical Oncology facilities participating in the project. The possible relationships between the treatment patterns reported in the 6 month follow-up case report form and patients' features at diagnosis were evaluated using exploratory multiple correspondence analysis (MCA) and other data analysis method. RESULTS:At diagnosis, surgery and AS patients were significantly younger, had fewer comorbidities, lower PSA levels and Gleason Score (GS) values; they were also diagnosed at an earlier stage of disease with respect to the RT or ADT patients who showed significantly worse QoL scores at the time of diagnosis. CONCLUSIONS:An analysis of the data collected at baseline and 6 months later uncovered substantial differences in ages, comorbidities, clinical and QOL features in the various treatment groups. These findings do not fully reflect the current PCA treatment guidelines and suggest the need for a multidisciplinary consensus guideline to ameliorate both the counselling and treatments of PCA patients.

Published
2019
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3. How Has Prostate Cancer Radiotherapy Changed in Italy between 2004 and 2011? An Analysis of the National Patterns-Of-Practice (POP) Database by the Uro-Oncology Study Group of the Italian Society of Radiotherapy and Clinical Oncology (AIRO)

Author

Stefania Gottardo, Diana Greco, Simona Borghesi, Beatrice Detti, Gianluca Ingrosso, Paolo Antognoni, Umberto Ricardi, Alessandro Magli, Stefano Maria Magrini, Ercole Mazzeo, Luigi Spiazzi, Andrea Emanuele Guerini, Luca Frassinelli, Sara Nanni, Sara Bartoncini, Frank Lohr, Alessio Bruni, Rolando Maria D'Angelillo, Giulio Francolini, Stefano Arcangeli, Alessia Guarneri, Luca Triggiani, Mazzeo, E, Triggiani, L, Frassinelli, L, Guarneri, A, Bartoncini, S, Antognoni, P, Gottardo, S, Greco, D, Borghesi, S, Nanni, S, Bruni, A, Ingrosso, G, D'Angelillo, R, Detti, B, Francolini, G, Magli, A, Guerini, A, Arcangeli, S, Spiazzi, L, Ricardi, U, Lohr, F, and Magrini, S

Subjects
0301 basic medicine, Oncology, Cancer Research, medicine.medical_specialty, genetic structures, medicine.medical_treatment, behavioral disciplines and activities, Article, Settore MED/06, Pattern Of Practice, Late toxicity, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Settore MED/36, Internal medicine, medicine, External beam radiotherapy, RC254-282, radiotherapy, Image-guided radiation therapy, Clinical Oncology, Radiotherapy, urogenital system, business.industry, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, prostate cancer, Acute toxicity, body regions, Radiation therapy, 030104 developmental biology, 030220 oncology & carcinogenesis, Toxicity, business, psychological phenomena and processes
Abstract

Background and purpose: Two previous “Patterns Of Practice” surveys (POP I and POP II), including more than 4000 patients affected by prostate cancer treated with radical external beam radiotherapy (EBRT) between 1980 and 2003, established a “benchmark” Italian data source for prostate cancer radiotherapy. This report (POP III) updates the previous studies. Methods: Data on clinical management and outcome of 2525 prostate cancer patients treated by EBRT from 2004 to 2011 were collected and compared with POP II and, when feasible, also with POP I. This report provides data on clinical presentation, diagnostic workup, radiation therapy management, and toxicity as collected within the framework of POP III. Results: More than 50% of POP III patients were classified as low or intermediate risk using D’Amico risk categories as in POP II, 46% were classified as ISUP grade group 1. CT scan, bone scan, and endorectal ultrasound were less frequently prescribed. Dose-escalated radiotherapy (RT), intensity modulated radiotherapy (IMRT), image guided radiotherapy (IGRT), and hypofractionated RT were more frequently offered during the study period. Treatment was commonly well tolerated. Acute toxicity improved compared to the previous series, late toxicity was influenced by prescribed dose and treatment technique. Five-year overall survival, biochemical relapse free survival (BRFS), and disease specific survival were similar to those of the previous series (POP II). BRFS was better in intermediate- and high-risk patients treated with ≥ 76 Gy. Conclusions: This report highlights the improvements in radiotherapy planning and dose delivery among Italian Centers in the 2004–2011 period. Dose-escalated treatments resulted in better biochemical control with a reduction in acute toxicity and higher but acceptable late toxicity, as not yet comprehensively associated with IMRT/IGRT. CTV-PTV margins &gt, 8 mm were associated with increased toxicity, again suggesting that IGRT—allowing for tighter margins—would reduce toxicity for dose escalated RT. These conclusions confirm the data obtained from randomized controlled studies.

Published
2021

4. Unexpected tumor response to palliative pelvic radiotherapy in mismatch repair-deficient advanced prostate cancer: a case report

Author

Stefania Bettelli, Maurizio Paterlini, Alessio Bruni, Frank Lohr, G. Aluisio, Cinzia Baldessari, Federica Fiocchi, and Ercole Mazzeo

Subjects
Male, 0301 basic medicine, Oncology, medicine.medical_specialty, medicine.medical_treatment, lcsh:Medicine, Rectum, Case Report, DNA Mismatch Repair, Microsatellite instability, Prostate cancer, Radiosensitivity, 03 medical and health sciences, 0302 clinical medicine, Neoplastic Syndromes, Hereditary, Surgical oncology, Internal medicine, medicine, Humans, Aged, Chemotherapy, business.industry, lcsh:R, Prostatic Neoplasms, General Medicine, medicine.disease, Radiation therapy, 030104 developmental biology, medicine.anatomical_structure, Docetaxel, MSH2, 030220 oncology & carcinogenesis, Colorectal Neoplasms, business, medicine.drug
Abstract

Background Mismatch-repair-deficiency resulting in microsatellite instability (MSI) may confer increased radiosensitivity in locally advanced/metastatic tumors and thus radiotherapy (RT) potentially might have a changing role in treating this subset of patients, alone or in combination with checkpoint inhibitors. Case presentation We report a 76 year-old Italian male patient presenting with locally advanced undifferentiated prostate cancer (LAPC), infiltrating bladder and rectum. Molecular analysis revealed high-MSI with an altered expression of MSH2 and MSH6 at immunohistochemistry. Two months after 6 chemotherapy cycles with Docetaxel associated to an LHRH analogue, a computed tomography scan showed stable disease. After palliative RT (30 Gy/10 fractions) directed to the tumor mass with a 3D-conformal setup, a follow-up computed tomography scan at 8 weeks revealed an impressive response that remained stable at computed tomography after 9 months, with sustained biochemical response. To our knowledge, this is the first case of such a sustained response to low dose RT alone in high-MSI LAPC. Conclusions Routine evaluation of MSI in patients with locally problematic advanced tumors might change treatment strategy and treatment aim in this setting, from a purely palliative approach to a quasi-curative paradigm.

Published
2020

5. Radiotherapy-induced malfunctions of cardiac implantable electronic devices in cancer patients

Author

Giuseppe Boriani, Frank Lohr, Gianfranco Cicoria, Filippo Placentino, Jacopo Francesco Imberti, Ercole Mazzeo, Marco Vitolo, Giuseppina De Marco, Vincenzo Turco, Edoardo Casali, and Vincenzo Livio Malavasi

Subjects
Male, medicine.medical_specialty, Cancer, Cardiac implantable electrical device, Cardio-oncology, Oncology, Radiotherapy, medicine.medical_treatment, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Aged, Aged, 80 and over, Defibrillators, Implantable, Female, Humans, Neoplasms, Retrospective Studies, Equipment Failure, Internal Medicine, 80 and over, Medicine, In patient, 030212 general & internal medicine, Cardio oncology, Cumulative dose, business.industry, Clinical events, Medical record, medicine.disease, Cancer treatment, Radiation therapy, Emergency Medicine, Radiology, Implantable, business, Defibrillators
Abstract

The number of patients with cardiac implantable electronic devices (CIEDs) requiring radiation therapy (RT) for cancer treatment is increasing. The purpose of this study is to estimate the prevalence, possible predictors, and clinical impact of RT-related CIEDs malfunctions. We retrospectively reviewed the medical records of all pacemaker (PM)/implantable cardioverter-defibrillator (ICD) patients who underwent RT in the last 14 years. One hundred and twenty-seven patients who underwent 150 separate RT courses were analysed (99 with a PM and 27 with an ICD). Of note, 21/127 (16.6%) patients were PM-dependent. Neutron-producing RT was used in 37/139 (26.6%) courses, whereas non-neutron-producing RT was used in 102/139 (73.4%) courses. The cumulative dose (Dmax) delivered to the CIED exceeded 5 Gy only in 2/132 (1.5%) cases. Device malfunctions were observed in 3/150 (2%) RT courses, but none was life-threatening or led to a major clinical event and all were resolved by CIED reprogramming. In all cases, the Dmax delivered to the CIED was

Published
2020

6. Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: The Pros-IT CNR study

Author

Angelo, Porreca, Marianna, Noale, Walter, Artibani, Pier Francesco Bassi, Filippo, Bertoni, Sergio, Bracarda, Giario Natale Conti, Renzo, Corvò, Mauro, Gacci, Pierpaolo, Graziotti, Magrini, STEFANO MARIA, Vincenzo, Mirone, Rodolfo, Montironi, Giovanni, Muto, Stefano, Pecoraro, Umberto, Ricardi, Elvio, Russi, Andrea, Tubaro, Vittorina, Zagonel, Gaetano, Crepaldi, Stefania, Maggi, Pierfrancesco, Bassi, Stefano Maria Magrini, Anna Rita Alitto, Enrica, Ambrosi, Alessandro, Antonelli, Cynthia, Aristei, Michele, Barbieri, Franco, Bardari, Lilia, Bardoscia, Salvina, Barra, Sara, Bartoncini, Umberto, Basso, Carlotta, Becherini, Rita, Bellavita, Franco, Bergamaschi, Stefania, Berlingheri, Berruti, Alfredo, Marco, Borghesi, Roberto, Bortolus, Valentina, Borzillo, Davide, Bosetti, Giuseppe, Bove, Pierluigi, Bove, Maurizio, Brausi, Alessio, Bruni, Giorgio, Bruno, Eugenio, Brunocilla, Alberto, Buffoli, BUGLIONE DI MONALE E BASTIA, Michela, Consuelo, Buttigliero, Giovanni, Cacciamani, Michela, Caldiroli, Giuseppe, Cardo, Giorgio, Carmignani, Giuseppe, Carrieri, Emanuele, Castelli, Elisabetta, Castrezzati, Gianpiero, Catalano, Susanna, Cattarino, Francesco, Catucci, Francolini Dario Cavallini, Ofelia, Ceccarini, Antonio, Celia, Francesco, Chiancone, Tommaso, Chini, Claudia, Cianci, Antonio, Cisternino, Devis, Collura, Franco, Corbella, Matteo, Corinti, Paolo, Corsi, Fiorenza, Cortese, Luigi, Corti, Cosimo de Nunzio, Olga, Cristiano, Rolando, M D'Angelillo, Luigi Da Pozzo, Daniele, D'Agostino, Carolina, D'Elia, Matteo, Dandrea, Michele De Angelis, Paolo De Angelis, Ottavio De Cobelli, Bernardino De Concilio, Antonello De Lisa, Stefano De Luca, Agostina De Stefani, Chiara Lucrezia Deantoni, Esposti Claudio Degli, Anna, Destito, Beatrice, Detti, Nadia Di Muzio, Andrea Di Stasio, Calogero Di Stefano, Danilo Di Trapani, Giuseppe, Difino, Sara, Falivene, Giuseppe, Farullo, Paolo, Fedelini, Ilaria, Ferrari, Francesco, Ferrau, Matteo, Ferro, Andrei, Fodor, Francesco, Fontanta, Francesco, Francesca, Giulio, Francolini, Paolo, Frata, Giovanni, Frezza, Pietro, Gabriele, Maria, Galeandro, Elisabetta, Garibaldi, Pietro Giovanni Gennari, Alessandro, Gentilucci, Alessandro, Giacobbe, Laura, Giussani, Giuseppe, Giusti, Paolo, Gontero, Alessia, Guarneri, Cesare, Guida, Alberto, Gurioli, Dorijan, Huqi, Ciro, Imbimbo, Gianluca, Ingrosso, Cinzia, Iotti, Corrado, Italia, Pierdaniele La Mattina, Enza, Lamanna, Luciana, Lastrucci, Grazia, Lazzari, Fabiola, Liberale, Giovanni, Liguori, Roberto, Lisi, Frank, Lohr, Riccardo, Lombardo, Jon A, J Lovisolo, Giuseppe Mario Ludovico, Nicola, Macchione, Francesca, Maggio, Michele, Malizia, Gianluca, Manasse, Giovanni, Mandoliti, Giovanna, Mantini, Luigi, Marafioti, Luisa, Marciello, Alberto Mario Marconi, Antonietta, Martilotta, Salvino, Marzano, Stefano, Masciullo, Gloria, Maso, Adele, Massenzo, Ercole, Mazzeo, Luigi, Mearini, Serena, Medoro, Rosa, Molè, Giorgio, Monesi, Emanuele, Montanari, Franco, Montefiore, Giampaolo, Montesi, Giuseppe, Morgia, Gregorio, Moro, Giorgio, Muscas, Daniela, Musio, Paolo, Muto, Giovanni, Muzzonigro, Giorgio, Napodano, Carlo Luigi Augusto Negro, Mattia, Nidini, Maria, Ntreta, Marco, Orsatti, Carmela, Palazzolo, Isabella, Palumbo, Alessandro, Parisi, Paolo, Parma, Nicola, Pavan, Martina, Pericolini, Francesco, Pinto, Antonio, Pistone, Valerio, Pizzuti, Angelo, Platania, Caterina, Polli, Giorgio, Pomara, Elisabetta, Ponti, Antonio Benito Porcaro, Francesco, Porpiglia, Dario, Pugliese, Armin, Pycha, Giuseppe, Raguso, Andrea, Rampini, Donato Franco Randone, Valentina, Roboldi, Marco, Roscigno, Maria Paola Ruggieri, Giuseppe, Ruoppo, Roberto, Sanseverino, Anna, Santacaterina, Michele, Santarsieri, Riccardo, Santoni, Sarah, Scagliarini, Giorgio Vittorio Scagliotti, Mauro, Scanzi, Marcello, Scarcia, Riccardo, Schiavina, Alessandro, Sciarra, Carmine, Sciorio, Tindaro, Scolaro, Salvatore, Scuzzarella, Oscar, Selvaggio, Armando, Serao, Sergio, Serni, Marco Andrea Signor, Mauro, Silvani, Giovanni, Silvano, Franco, Silvestris, Simeone, Claudio, Valeria, Simone, Girolamo, Spagnoletti, Matteo Giulio Spinelli, Luigi, Squillace, Vincenzo, Tombolini, Mariastella, Toninelli, Triggiani, Luca, Alberto, Trinchieri, Luca Eolo Trodella, Lucio, Trodella, Carlo, Trombetta, Lidia, Tronnolone, Marcello, Tucci, Daniele, Urzì, Riccardo, Valdagni, Maurizio, Valeriani, Maurizio, Vanoli, Elisabetta, Vitali, Alessandro, Volpe, Stefano, Zaramella, Guglielmo, Zeccolini, Giampaolo, Zini, Porreca, Angelo, Noale, Marianna, Artibani, Walter, Bassi, Pier Francesco, Bertoni, Filippo, Bracarda, Sergio, Conti, Giario Natale, Corvò, Renzo, Gacci, Mauro, Graziotti, Pierpaolo, Magrini, Stefano Maria, Mirone, Vincenzo, Montironi, Rodolfo, Muto, Giovanni, Pecoraro, Stefano, Ricardi, Umberto, Russi, Elvio, Tubaro, Andrea, Zagonel, Vittorina, Crepaldi, Gaetano, Maggi, Stefania, Gaetano, Crepaldi, Umberto, Basso, Luigi, Corti, D'Agostino, Daniele, Matteo, Dandrea, Davide, Bosetti, Gianpiero, Catalano, Ottavio, De Cobelli, Lucrezia, Deantoni Chiara, Nadia, Di Muzio, Ferro, Matteo, Andrei, Fodor, Pierdaniele, La Mattina, Emanuele, Montanari, Barbieri, Michele, Valentina, Borzillo, Chiancone, Francesco, Sara, Falivene, Paolo, Fedelini, Imbimbo, Ciro, Paolo, Muto, Sarah, Scagliarini, Giovanni, Muzzonigro, Enrica, Ambrosi, Alessandro, Antonelli, Lilia, Bardoscia, Stefania, Berlingheri, Alfredo, Berruti, Alberto, Buffoli, Michela, Buglione, Mauro, Scanzi, Elisabetta, Castrezzati, Paolo, Frata, Giulio, Francolini, Beatrice, Detti, Tommaso, Chini, Carlotta, Becherini, Olga, Cristiano, Cesare, Guida, Sara, Bartoncini, Consuelo, Buttigliero, Emanuele, Castelli, Devis, Collura, Stefano, De Luca, Pietro, Gabriele, Elisabetta, Garibaldi, Alessandro, Giacobbe, Paolo, Gontero, Alessia, Guarneri, Alberto, Gurioli, Francesco, Porpiglia, Franco, Randone Donato, Vittorio, Scagliotti Giorgio, Cynthia, Aristei, Rita, Bellavita, Isabella, Palumbo, Franco, Bardari, Augusto, Negro Carlo Luigi, Franco, Bergamaschi, Maria, Galeandro, Cinzia, Iotti, Giuseppe, Raguso, Paola, Ruggieri Maria, Giuseppe, Ruoppo, Marco, Borghesi, Eugenio, Brunocilla, Claudio, Degli Esposti, Giovanni, Frezza, Michele, Malizia, Maria, Ntreta, Alessandro, Parisi, Riccardo, Schiavina, Roberto, Bortolu, Giuseppe, Bove, Antonio, Cisternino, Carrieri, Giuseppe, Giuseppe, Difino, Oscar, Selvaggio, Maurizio, Brausi, Alessio, Bruni, Frank, Lohr, Ercole, Mazzeo, Enza, Lamanna, Calogero, Di Stefano, Giorgio, Bruno, Michela, Caldiroli, Ilaria, Ferrari, Laura, Giussani, Lovisolo Jon, A. J., Mario, Marconi Alberto, Giuseppe, Cardo, Mario, Ludovico Giuseppe, Marcello, Scarcia, Giorgio, Carmignani, Salvina, Barra, Dario, Cavallini Francolini, Franco, Corbella, Ofelia, Ceccarini, Luigi, Da Pozzo, Agostina, De Stefani, Corrado, Italia, Stefano, Masciullo, Valentina, Roboldi, Marco, Roscigno, Antonio, Celia, Bernardino, De Concilio, Claudia, Cianci, Francesco, Francesca, Giorgio, Pomara, Michele, Santarsieri, Fiorenza, Cortese, Andrea, Di Stasio, Franco, Montefiore, Armando, Serao, D'Elia, Carolina, Armin, Pycha, Dorijan, Huqi, Paolo, De Angeli, Nicola, Macchione, Francesco, Fontanta, Giorgio, Monesi, Antonello, De Lisa, Giuseppe, Giusti, Giorgio, Musca, Anna, Destito, Rosa, Molè, Danilo, Di Trapani, Francesco, Ferrau, Carmela, Palazzolo, Angelo, Platania, Anna, Santacaterina, Grazia, Lazzari, Fabiola, Liberale, Gregorio, Moro, Giovanni, Liguori, Nicola, Pavan, Francesca, Maggio, Marco, Orsatti, Giovanni, Mandoliti, Giampaolo, Montesi, Luigi, Marafioti, Antonietta, Martilotta, Adele, Massenzo, Luisa, Marciello, Salvino, Marzano, Caterina, Polli, Gloria, Maso, Serena, Medoro, Giuseppe, Morgia, Napodano, Giorgio, Pistone, Antonio, Roberto, Sanseverino, Mattia, Nidini, Paolo, Parma, Valerio, Pizzuti, Sciorio, Carmine, Scuzzarella, Salvatore, Tindaro, Scolaro, Porreca A, Noale M, Artibani W, Bassi PF, Bertoni F, Bracarda S, Conti GN, Corvò R, Gacci M, Graziotti P, Magrini SM, Mirone V, Montironi R, Muto G, Pecoraro S, Ricardi U, Russi E, Tubaro A, Zagonel V, Crepaldi G, Maggi S, Crepaldi G, Maggi S, Noale M, Porreca A, Artibani W, Bassi P, Bracarda S, Conti GN, Corvò R, Graziotti P, Russi E, Mirone V, Montironi R, Bertoni F, Gacci M, Magrini SM, Muto G, Pecoraro S, Ricardi U, Tubaro A, Zagonel V, Alitto AR, Ambrosi E, Antonelli A, Aristei C, Barbieri M, Bardari F, Bardoscia L, Barra S, Bartoncini S, Basso U, Becherini C, Bellavita R, Bergamaschi F, Berlingheri S, Berruti A, Borghesi M, Bortolus R, Borzillo V, Bosetti D, Bove G, Bove P, Brausi M, Bruni A, Bruno G, Brunocilla E, Buffoli A, Buglione M, Buttigliero C, Cacciamani G, Caldiroli M, Cardo G, Carmignani G, Carrieri G, Castelli E, Castrezzati E, Catalano G, Cattarino S, Catucci F, Cavallini FD, Ceccarini O, Celia A, Chiancone F, Chini T, Cianci C, Cisternino A, Collura D, Corbella F, Corinti M, Corsi P, Cortese F, Corti L, de Nunzio C, Cristiano O, D'Angelillo RM, Da Pozzo L, D'agostino D, D'Elia C, Dandrea M, De Angelis M, De Angelis P, De Cobelli O, De Concilio B, De Lisa A, De Luca S, De Stefani A, Deantoni CL, Degli EC, Destito A, Detti B, Di Muzio N, Di Stasio A, Di Stefano C, Di Trapani D, Difino G, Falivene S, Farullo G, Fedelini P, Ferrari I, Ferrau F, Ferro M, Fodor A, Fontanta F, Francesca F, Francolini G, Frata P, Frezza G, Gabriele P, Galeandro M, Garibaldi E, Gennari PG, Gentilucci A, Giacobbe A, Giussani L, Giusti G, Gontero P, Guarneri A, Guida C, Gurioli A, Huqi D, Imbimbo C, Ingrosso G, Iotti C, Italia C, La Mattina P, Lamanna E, Lastrucci L, Lazzari G, Liberale F, Liguori G, Lisi R, Lohr F, Lombardo R, Lovisolo JAJ, Ludovico GM, Macchione N, Maggio F, Malizia M, Manasse G, Mandoliti G, Mantini G, Marafioti L, Marciello L, Marconi AM, Martilotta A, Marzano S, Masciullo S, Maso G, Massenzo A, Mazzeo E, Mearini L, Medoro S, Molè R, Monesi G, Montanari E, Montefiore F, Montesi G, Morgia G, Moro G, Muscas G, Musio D, Muto P, Muzzonigro G, Napodano G, Negro CLA, Nidini M, Ntreta M, Orsatti M, Palazzolo C, Palumbo I, Parisi A, Parma P, Pavan N, Pericolini M, Pinto F, Pistone A, Pizzuti V, Platania A, Polli C, Pomara G, Ponti E, Porcaro AB, Porpiglia F, Pugliese D, Pycha A, Raguso G, Rampini A, Randone DF, Roboldi V, Roscigno M, Ruggieri MP, Ruoppo G, Sanseverino R, Santacaterina A, Santarsieri M, Santoni R, Scagliarini S, Scagliotti GV, Scanzi M, Scarcia M, Schiavina R, Sciarra A, Sciorio C, Scolaro T, Scuzzarella S, Selvaggio O, Serao A, Serni S, Signor MA, Silvani M, Silvano G, Silvestris F, Simeone C, Simone V, Spagnoletti G, Spinelli MG, Squillace L, Tombolini V, Toninelli M, Triggiani L, Trinchieri A, Trodella LE, Trodella L, Trombetta C, Tronnolone L, Tucci M, Urzì D, Valdagni R, Valeriani M, Vanoli M, Vitali E, Volpe A, Zaramella S, Zeccolini G, Zini G, Porreca, A., Noale, M., Artibani, W., Bassi, P. F., Bertoni, F., Bracarda, S., Conti, G. N., Corvo, R., Gacci, M., Graziotti, P., Magrini, S. M., Mirone, V., Montironi, R., Muto, G., Pecoraro, S., Ricardi, U., Russi, E., Tubaro, A., Zagonel, V., Crepaldi, G., Maggi, S., Alitto, A. R., Ambrosi, E., Antonelli, A., Aristei, C., Barbieri, M., Bardari, F., Bardoscia, L., Barra, S., Bartoncini, S., Basso, U., Becherini, C., Bellavita, R., Bergamaschi, F., Berlingheri, S., Berruti, A., Borghesi, M., Bortolus, R., Borzillo, V., Bosetti, D., Bove, G., Bove, P., Maurizio, B., Alessio, B., Giorgio, B., Eugenio, B., Alberto, B., Michela, B., Consuelo, B., Giovanni, C., Michela, C., Giuseppe, C., Giorgio, C., Emanuele, C., Elisabetta, C., Gianpiero, C., Susanna, C., Catucci, F., Dario, C. F., Ofelia, C., Antonio, C., Francesco, C., Tommaso, C., Claudia, C., Devis, C., Franco, C., Matteo, C., Paolo, C., Fiorenza, C., Luigi, C., Cosimo, N., Cristiano, O., D'Angelillo, R. M., Da Pozzo, L., D'Agostino, D., D'Elia, C., Dandrea, M., De Angelis, M., De Angelis, P., De Cobelli, O., De Concilio, B., De Lisa, A., De Luca, S., De Stefani, A., Deantoni, C. L., Degli, E. C., Destito, A., Detti, B., Di Muzio, N., Di Stasio, A., Di Stefano, C., Di Trapani, D., Difino, G., Falivene, S., Farullo, G., Fedelini, P., Ferrari, I., Ferrau, F., Ferro, M., Fodor, A., Fontanta, F., Francesca, F., Francolini, G., Frata, P., Frezza, G., Gabriele, P., Galeandro, M., Garibaldi, E., Gennari, P. G., Gentilucci, A., Giacobbe, A., Giussani, L., Giusti, G., Gontero, P., Guarneri, A., Guida, C., Gurioli, A., Huqi, D., Imbimbo, C., Ingrosso, G., Iotti, C., Italia, C., La Mattina, P., Lamanna, E., Lastrucci, L., Lazzari, G., Liberale, F., Liguori, G., Lisi, R., Lohr, F., Lombardo, R., Lovisolo, J. A. J., Ludovico, G. M., Macchione, N., Maggio, F., Malizia, M., Manasse, G., Mandoliti, G., Mantini, G., Marafioti, L., Marciello, L., Marconi, A. M., Martilotta, A., Marzano, S., Masciullo, S., Maso, G., Massenzo, A., Mazzeo, E., Mearini, L., Medoro, S., Mole, R., Monesi, G., Montanari, E., Montefiore, F., Montesi, G., Morgia, G., Moro, G., Muscas, G., Musio, D., Muto, P., Muzzonigro, G., Napodano, G., Negro, C. L. A., Nidini, M., Ntreta, M., Orsatti, M., Palazzolo, C., Palumbo, I., Parisi, A., Parma, P., Pavan, N., Pericolini, M., Pinto, F., Pistone, A., Pizzuti, V., Platania, A., Polli, C., Pomara, G., Ponti, E., Porcaro, A. B., Porpiglia, F., Pugliese, D., Pycha, A., Raguso, G., Rampini, A., Randone, D. F., Roboldi, V., Roscigno, M., Ruggieri, M. P., Ruoppo, G., Sanseverino, R., Santacaterina, A., Santarsieri, M., Santoni, R., Scagliarini, S., Scagliotti, G. V., Scanzi, M., Scarcia, M., Schiavina, R., Sciarra, A., Sciorio, C., Scolaro, T., Scuzzarella, S., Selvaggio, O., Serao, A., Serni, S., Signor, M. A., Silvani, M., Silvano, G., Silvestris, F., Simeone, C., Simone, V., Spagnoletti, G., Spinelli, M. G., Squillace, L., Tombolini, V., Toninelli, M., Triggiani, L., Trinchieri, A., Trodella, L. E., Trodella, L., Trombetta, C., Tronnolone, L., Tucci, M., Urzi, D., Valdagni, R., Valeriani, M., Vanoli, M., Vitali, E., Volpe, A., Zaramella, S., Zeccolini, G., Zini, G., Porreca, A, Noale, M, Artibani, W, Bassi, P, Bertoni, F, Bracarda, S, Conti, G, Corvò, R, Gacci, M, Graziotti, P, Magrini, S, Mirone, V, Montironi, R, Muto, G, Pecoraro, S, Ricardi, U, Russi, E, Tubaro, A, Zagonel, V, Crepaldi, G, Maggi, S, and Da Pozzo, L

Subjects
Male, 030232 urology & nephrology, Severity of Illness Index, Prostate cancer, 0302 clinical medicine, Quality of life, Activities of Daily Living, Diagnosis, Medicine, Age Factor, Prospective Studies, Prospective cohort study, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, Age Factors, Pros-IT CNR study, General Medicine, Health Survey, Middle Aged, Neoadjuvant Therapy, 3. Good health, Italy, 030220 oncology & carcinogenesis, lcsh:R858-859.7, Regression Analysis, Public Health, Human, Diagnosi, prostate cancer, survival, quality of life, medicine.medical_specialty, lcsh:Computer applications to medicine. Medical informatics, Regression Analysi, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, Severity of illness, Humans, Aged, Cancer staging, business.industry, Research, Environmental and Occupational Health, Public Health, Environmental and Occupational Health, Prostatic Neoplasms, Cancer, medicine.disease, Health Surveys, Comorbidity, Quality of Life, Prospective Studie, Settore MED/24, Prostatic Neoplasm, business, Sexual function
Abstract

Background The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. Methods One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). Results At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. Conclusions Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care.

Published
2018

7. Metastasis-directed stereotactic radiotherapy for oligoprogressive castration-resistant prostate cancer: a multicenter study

Author

Fabio Trippa, Ercole Mazzeo, Beatrice Detti, Ciro Franzese, Piet Ost, Rosario Mazzola, Gianluca Ingrosso, Michela Buglione, Fabio Matrone, Fabiola Paiar, Alessandro Magli, Filippo Alongi, Giuseppe Fanetti, Stefano Maria Magrini, Marta Scorsetti, Alessio Bruni, Ernesto Maranzano, Roberto Bortolus, Barbara Alicja Jereczek-Fossa, Paolo Borghetti, Luca Triggiani, Andrea Lancia, Marco Lorenzo Bonù, Giulio Francolini, and Francesco Pasqualetti

Subjects
Male, medicine.medical_specialty, Urology, medicine.medical_treatment, Metastasis-directed therapy, 030232 urology & nephrology, Radiosurgery, CRPC, Prostate cancer, Radiotherapy, SBRT, Metastasis, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, medicine, Humans, Enzalutamide, Neoplasm Metastasis, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Abiraterone acetate, Middle Aged, medicine.disease, Primary tumor, Radiation therapy, Prostatic Neoplasms, Castration-Resistant, Docetaxel, chemistry, 030220 oncology & carcinogenesis, business, Progressive disease, medicine.drug
Abstract

Herein, we report the clinical outcomes of a multicenter study evaluating the role of SBRT in a cohort of patients affected by oligoprogressive castration-resistant prostate cancer (CRPC). This is a retrospective multicenter observational study including eleven centers. Inclusion criteria of the current study were: (a) Karnofsky performance status > 80, (b) histologically proven diagnosis of PC, (c) 1–5 oligoprogressive metastases, defined as progressive disease at bone or nodes levels (detected by means of choline PET/CT or CT plus bone scan) during ADT, (d) serum testosterone level under 50 ng/ml during ADT, (e) controlled primary tumor, (f) patients treated with SBRT with a dose of at least 5 Gy per fraction to a biologically effective dose (BED) of at least 80 Gy using an alpha-to-beta ratio of 3 Gy, (g) at least 6 months of follow-up post-SBRT. Eighty-six patients for a total of 117 lesions were treated with SBRT. The median follow-up was 30.7 months (range 4–91 months). The median new metastasis-free survival after SBRT was 12.3 months (95% CI 5.5–19.1 months). One- and two-year distant progression-free survival was 52.3% and 33.7%, respectively. Twenty-six out of 86 patients underwent a second course of SBRT due to further oligoprogressive disease: This resulted in a median systemic treatment-free survival of 21.8 months (95% CI 17.8–25.8 months). One-year systemic treatment-free survival was 72.1%. SBRT appears to be a promising approach in oligoprogressive castration-resistant prostate cancer. Further investigations are warranted.

Published
2019

8. Consensus statements on ablative radiotherapy for oligometastatic prostate cancer: A position paper of Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Author

Ercole Mazzeo, Alessandro Magli, Luca Triggiani, Gianluca Ingrosso, Giovanni L Pappagallo, Giulio Francolini, Stefano Pergolizzi, Barbara Alicja Jereczek-Fossa, Stefano Arcangeli, Stefano Maria Magrini, Rolando Maria D'Angelillo, Filippo Alongi, Vincenzo Ravo, D'Angelillo, R, Francolini, G, Ingrosso, G, Ravo, V, Triggiani, L, Magli, A, Mazzeo, E, Arcangeli, S, Alongi, F, Jereczek-Fossa, B, Pergolizzi, S, Pappagallo, G, and Magrini, S

Subjects
0301 basic medicine, Male, medicine.medical_specialty, Consensus, medicine.medical_treatment, Ablative radiotherapy, Oligometastatic, Prostate cancer, SABR, SBRT, Stereotactic radiotherapy, Hematology, Oncology, Disease, Ablative radiotherapy, Oligometastatic, Prostate cancer, SABR, SBRT, Stereotactic radiotherapy, SABR volatility model, Radiosurgery, Systemic therapy, Settore MED/06, 03 medical and health sciences, 0302 clinical medicine, Settore MED/36, Ablative case, medicine, Humans, Neoplasm Metastasis, Radiotherapy, business.industry, Prognosis, Prostatic Neoplasms, Cancer, Hematology, medicine.disease, Radiation therapy, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Position paper, Radiology, business
Abstract

Oligometastatic prostate cancer comprises a wide spectrum of conditions, ranging from de novo oligometastatic cancer at diagnosis to oligometastatic castration-resistant disease, which are distinct entities in terms of biology and prognosis. In order to clarify and standardize the clinical role of ablative radiotherapy in oligometastatic prostate cancer, the Italian Association of Radiotherapy and Clinical Oncology (AIRO) formed an expert panel to review the current literature and develop a formal consensus. Oligometastatic prostate cancer was defined as the presence of up to three metastatic lesions involving bones or nodes outside pelvis. Thereafter, four clinical scenarios were explored: metastatic castration-sensitive disease at diagnosis and after primary treatment, and metastatic castration-resistant disease at diagnosis and during treatment, where the role of ablative radiotherapy was defined either in conjunction with systemic therapy or as the only treatment in selected cases. This paper summarizes the current literature about these issues and the proposed recommendations.

Published
2019

9. Expert system classifier for adaptive radiation therapy in prostate cancer

Author

G.M. Mistretta, P. Giacobazzi, Frank Lohr, G. Gottardi, Ercole Mazzeo, N. Maffei, A. Ciarmatori, Gabriele Guidi, C. Vecchi, and T. Costi

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Biomedical Engineering, Biophysics, General Physics and Astronomy, Expert Systems, Adenocarcinoma, computer.software_genre, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Prostate cancer, Imaging, Three-Dimensional, 0302 clinical medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Adaptive radiation therapy, Clinical decision making, Deformable image registration, K-means clustering, Similarity index, Support vector machine, Radiology, Nuclear Medicine and Imaging, Image warping, Cluster analysis, Aged, Image-guided radiation therapy, Aged, 80 and over, business.industry, Radiotherapy Planning, Computer-Assisted, k-means clustering, Prostatic Neoplasms, Dose-Response Relationship, Radiation, Middle Aged, medicine.disease, Expert system, Radiation therapy, 030220 oncology & carcinogenesis, Radiology, Tomography, X-Ray Computed, business, computer, Biomedical engineering
Abstract

A classifier-based expert system was developed to compare delivered and planned radiation therapy in prostate cancer patients. Its aim is to automatically identify patients that can benefit from an adaptive treatment strategy. The study predominantly addresses dosimetric uncertainties and critical issues caused by motion of hollow organs. 1200 MVCT images of 38 prostate adenocarcinoma cases were analyzed. An automatic daily re-contouring of structures (i.e. rectum, bladder and femoral heads), rigid/deformable registration and dose warping was carried out to simulate dose and volume variations during therapy. Support vector machine, K-means clustering algorithms and similarity index analysis were used to create an unsupervised predictive tool to detect incorrect setup and/or morphological changes as a consequence of inadequate patient preparation due to stochastic physiological changes, supporting clinical decision-making. After training on a dataset that was considered sufficiently dosimetrically stable, the system identified two equally sized macro clusters with distinctly different volumetric and dosimetric baseline properties and defined thresholds for these two clusters. Application to the test cohort resulted in 25% of the patients located outside the two macro clusters thresholds and which were therefore suspected to be dosimetrically unstable. In these patients, over the treatment course, mean volumetric changes of 30 and 40% for rectum and bladder were detected which possibly represents values justifying adjustment of patient preparation, frequent re-planning or a plan-of-the-day strategy. Based on our research, by combining daily IGRT images with rigid/deformable registration and dose warping, it is possible to apply a machine learning approach to the clinical setting obtaining useful information for a decision regarding an individualized adaptive strategy. Especially for treatments influenced by the movement of hollow organs, this could reduce inadequate treatments and possibly reduce toxicity, thereby increasing overall RT efficacy.

Published
2017

10. Reirradiation in head and neck recurrent or second primary tumor: efficacy, safety, and prognostic factors

Author

Laura Rubino, Luigi Spiazzi, Fabiola Paiar, Alessio Bruni, Stefano Maria Magrini, Luca Triggiani, Filippo Bertoni, Daniela Greto, Pierluigi Bonomo, Michela Buglione, Marta Maddalo, Lorenzo Livi, and Ercole Mazzeo

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, MEDLINE, Kaplan-Meier Estimate, Disease-Free Survival, Medical Records, Re-Irradiation, Patient safety, Risk Factors, medicine, Humans, In patient, Karnofsky Performance Status, Head and neck, Aged, Retrospective Studies, Aged, 80 and over, Salvage Therapy, business.industry, Medical record, Head and neck cancer, Retrospective cohort study, Neoplasms, Second Primary, Radiotherapy Dosage, General Medicine, Second primary cancer, Middle Aged, medicine.disease, Prognosis, Treatment Outcome, Oncology, Head and Neck Neoplasms, Female, Radiology, Patient Safety, Neoplasm Recurrence, Local, business
Abstract

Aims and background We investigated efficacy, safety, and prognostic factors of reirradiation in patients with recurrent or second primary head and neck cancer. Methods Records of 75 consecutive patients treated with reirradiation between August 2005 and December 2013 were reviewed. Results Median overall survival (OS) and cancer-specific survival (CSS) were 29.5 and 33.6 months. Median local control (LC) and progression-free survival (PFS) were 21.7 and 16.2 months. Univariate analysis showed that patients younger than 70 years, with a Karnofsky Performance Status (KPS) >90 or with 2 or less comorbidities at time of reirradiation, have a better OS; KPS >90 and biological equivalent dose (BED) >72 Gy positively influenced the PFS. At multivariate analysis, KPS at reirradiation was an independent predictive factor for OS, while BED was an independent predictive factor for CSS and OS. At univariate analysis, patients with planning target volume (PTV) >221 mL had worse LC and PFS rates, with results confirmed at multivariate analysis. The rate of fatal treatment-related adverse events was 6.7% (3 carotid blowout, 1 soft tissue necrosis, and 1 thromboembolic event). Conclusions This study confirms the role and outcomes of reirradiation. A careful selection of patients could minimize acute and late side effects and influence survival: elderly patients, with significant medical comorbidities or poor KPS, are worse candidate for reirradiation. Total dose delivered with reirradiation and PTV appear to be other potential prognostic factors. Further studies of dose escalation are needed to establish the total dose that could achieve better LC rates with a safer toxicity profile.

Published
2015

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