34 results on '"Gambacorta, M"'
Search Results
2. Neoadjuvant radiochemotherapy and perioperative chemotherapy do not represent a standard at the same priority level for esophageal adenocarcinomas (with regard to 'Oesophageal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up')
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Cellini, Francesco, Manfrida, Stefania, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Cellini, F (ORCID:0000-0002-2145-2300), Manfrida, S, Gambacorta, M A (ORCID:0000-0001-5455-8737), Valentini, V (ORCID:0000-0003-4637-6487), Cellini, Francesco, Manfrida, Stefania, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Cellini, F (ORCID:0000-0002-2145-2300), Manfrida, S, Gambacorta, M A (ORCID:0000-0001-5455-8737), and Valentini, V (ORCID:0000-0003-4637-6487)
- Abstract
inglese
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- 2023
3. Dabrafenib-Trametinib and Radiotherapy for Oligoprogressive BRAF Mutant Advanced Melanoma
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Rossi, Ernesto, Schinzari, Giovanni, Cellini, Francesco, Balducci, Mario, Pasqualoni, Mariangela, Maiorano, Brigida Anna, Fionda, Bruno, Longo, Silvia, Deodato, Francesco, Di Stefani, Alessandro, Peris, Ketty, Gambacorta, Maria Antonietta, Tortora, Giampaolo, Rossi E., Schinzari G. (ORCID:0000-0001-6105-7252), Cellini F. (ORCID:0000-0002-2145-2300), Balducci M. (ORCID:0000-0003-0398-9726), Pasqualoni M., Maiorano B. A., Fionda B., Longo S., Deodato F. (ORCID:0000-0003-1276-5070), Di Stefani A., Peris K. (ORCID:0000-0002-5237-0463), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Tortora G. (ORCID:0000-0002-1378-4962), Rossi, Ernesto, Schinzari, Giovanni, Cellini, Francesco, Balducci, Mario, Pasqualoni, Mariangela, Maiorano, Brigida Anna, Fionda, Bruno, Longo, Silvia, Deodato, Francesco, Di Stefani, Alessandro, Peris, Ketty, Gambacorta, Maria Antonietta, Tortora, Giampaolo, Rossi E., Schinzari G. (ORCID:0000-0001-6105-7252), Cellini F. (ORCID:0000-0002-2145-2300), Balducci M. (ORCID:0000-0003-0398-9726), Pasqualoni M., Maiorano B. A., Fionda B., Longo S., Deodato F. (ORCID:0000-0003-1276-5070), Di Stefani A., Peris K. (ORCID:0000-0002-5237-0463), Gambacorta M. A. (ORCID:0000-0001-5455-8737), and Tortora G. (ORCID:0000-0002-1378-4962)
- Abstract
The clinical management of metastatic melanoma has been changed by BRAF (BRAFi) and MEK inhibitors (MEKi), which represent a standard treatment for BRAF-mutant melanoma. In oligoprogressive melanoma patients with BRAF mutations, target therapy can be combined with loco-regional radiotherapy (RT). However, the association of BRAF/MEK inhibitors and RT needs to be carefully monitored for potential increased toxicity. Despite the availability of some reports regarding the tolerability of RT + target therapy, data on simultaneous RT and BRAFi/MEKi are limited and mostly focused on the BRAFi vemurafenib. Here, we report a series of metastatic melanoma patients who received fractioned RT regimens for oligoprogressive disease in combination with the BRAFi dabrafenib and the MEKi trametinib, which have continued beyond progression. None of the cases developed relevant adverse events while receiving RT or interrupted dabrafenib and trametinib administration. These cases suggest that a long period of dabrafenib/trametinib interruption during radiotherapy for oligoprogressive disease can be avoided. Prospective trials are warranted to assess the efficacy and safety of the contemporary administration of BRAF/MEK inhibitors and radiotherapy for oligoprogressive disease.
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- 2023
4. MRI-derived radiomics to guide post-operative management of glioblastoma: Implication for personalized radiation treatment volume delineation
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Chiesa, Silvia, Russo, Rosellina, Beghella Bartoli, Francesco, Palumbo, I, Sabatino, Giovanni, Cannatà, M C, Gigli, Riccardo, Longo, Silvia, Tran, H E, Boldrini, Luca, Dinapoli, Nicola, Votta, C, Cusumano, Davide, Pignotti, Fabrizio, Lupattelli, M, Camilli, F, Della Pepa, Giuseppe Maria, D'Alessandris, G Q, Olivi, Alessandro, Balducci, Mario, Colosimo, Cesare, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Aristei, Cynthia, Gaudino, Simona, Chiesa, S (ORCID:0000-0003-0168-3459), Russo, R, Beghella Bartoli, F, Sabatino, G (ORCID:0000-0002-4227-0434), Gigli, R, Longo, S, Boldrini, L, Dinapoli, N, Cusumano, D, Pignotti, F, Della Pepa, G M (ORCID:0000-0001-8698-3359), Olivi, A (ORCID:0000-0002-4489-7564), Balducci, M (ORCID:0000-0003-0398-9726), Colosimo, C (ORCID:0000-0003-3800-3648), Gambacorta, M A (ORCID:0000-0001-5455-8737), Valentini, V (ORCID:0000-0003-4637-6487), Aristei, C, Gaudino, S (ORCID:0000-0003-1681-4343), Chiesa, Silvia, Russo, Rosellina, Beghella Bartoli, Francesco, Palumbo, I, Sabatino, Giovanni, Cannatà, M C, Gigli, Riccardo, Longo, Silvia, Tran, H E, Boldrini, Luca, Dinapoli, Nicola, Votta, C, Cusumano, Davide, Pignotti, Fabrizio, Lupattelli, M, Camilli, F, Della Pepa, Giuseppe Maria, D'Alessandris, G Q, Olivi, Alessandro, Balducci, Mario, Colosimo, Cesare, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Aristei, Cynthia, Gaudino, Simona, Chiesa, S (ORCID:0000-0003-0168-3459), Russo, R, Beghella Bartoli, F, Sabatino, G (ORCID:0000-0002-4227-0434), Gigli, R, Longo, S, Boldrini, L, Dinapoli, N, Cusumano, D, Pignotti, F, Della Pepa, G M (ORCID:0000-0001-8698-3359), Olivi, A (ORCID:0000-0002-4489-7564), Balducci, M (ORCID:0000-0003-0398-9726), Colosimo, C (ORCID:0000-0003-3800-3648), Gambacorta, M A (ORCID:0000-0001-5455-8737), Valentini, V (ORCID:0000-0003-4637-6487), Aristei, C, and Gaudino, S (ORCID:0000-0003-1681-4343)
- Abstract
BackgroundThe glioblastoma's bad prognosis is primarily due to intra-tumor heterogeneity, demonstrated from several studies that collected molecular biology, cytogenetic data and more recently radiomic features for a better prognostic stratification. The GLIFA project (GLIoblastoma Feature Analysis) is a multicentric project planned to investigate the role of radiomic analysis in GB management, to verify if radiomic features in the tissue around the resection cavity may guide the radiation target volume delineation. Materials and methodsWe retrospectively analyze from three centers radiomic features extracted from 90 patients with total or near total resection, who completed the standard adjuvant treatment and for whom we had post-operative images available for features extraction. The Manual segmentation was performed on post gadolinium T1w MRI sequence by 2 radiation oncologists and reviewed by a neuroradiologist, both with at least 10 years of experience. The Regions of interest (ROI) considered for the analysis were: the surgical cavity +/- post-surgical residual mass (CTV_cavity); the CTV a margin of 1.5 cm added to CTV_cavity and the volume resulting from subtracting the CTV_cavity from the CTV was defined as CTV_Ring. Radiomic analysis and modeling were conducted in RStudio. Z-score normalization was applied to each radiomic feature. A radiomic model was generated using features extracted from the Ring to perform a binary classification and predict the PFS at 6 months. A 3-fold cross-validation repeated five times was implemented for internal validation of the model. ResultsTwo-hundred and seventy ROIs were contoured. The proposed radiomic model was given by the best fitting logistic regression model, and included the following 3 features: F_cm_merged.contrast, F_cm_merged.info.corr.2, F_rlm_merged.rlnu. A good agreement between model predicted probabilities and observed outcome probabilities was obtained (p-value of 0.49 by Hosmer and Lemeshow statistical te
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- 2023
5. Radiomics-based prediction of two-year clinical outcome in locally advanced cervical cancer patients undergoing neoadjuvant chemoradiotherapy
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Autorino, R., Gui, B., Panza, G., Boldrini, L., Cusumano, D., Russo, L., Nardangeli, A., Persiani, S., Campitelli, M., Ferrandina, G., Macchia, G., Valentini, V., Gambacorta, M. A., Manfredi, R., Autorino R., Gui B., Panza G., Boldrini L., Cusumano D., Russo L., Persiani S., Ferrandina G. (ORCID:0000-0003-4672-4197), Macchia G., Valentini V. (ORCID:0000-0003-4637-6487), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Manfredi R. (ORCID:0000-0002-4972-9500), Autorino, R., Gui, B., Panza, G., Boldrini, L., Cusumano, D., Russo, L., Nardangeli, A., Persiani, S., Campitelli, M., Ferrandina, G., Macchia, G., Valentini, V., Gambacorta, M. A., Manfredi, R., Autorino R., Gui B., Panza G., Boldrini L., Cusumano D., Russo L., Persiani S., Ferrandina G. (ORCID:0000-0003-4672-4197), Macchia G., Valentini V. (ORCID:0000-0003-4637-6487), Gambacorta M. A. (ORCID:0000-0001-5455-8737), and Manfredi R. (ORCID:0000-0002-4972-9500)
- Abstract
Purpose: The aim of this study is to determine if radiomics features extracted from staging magnetic resonance (MR) images could predict 2-year long-term clinical outcome in patients with locally advanced cervical cancer (LACC) after neoadjuvant chemoradiotherapy (NACRT). Materials and methods: We retrospectively enrolled patients with LACC diagnosis who underwent NACRT followed by radical surgery in two different institutions. Radiomics features were extracted from pre-treatment 1.5 T T2w MR images. The predictive performance of each feature was quantified in terms of Wilcoxon–Mann–Whitney test. Among the significant features, Pearson correlation coefficient (PCC) was calculated to quantify the correlation among the different predictors. A logistic regression model was calculated considering the two most significant features at the univariate analysis showing the lowest PCC value. The predictive performance of the model created was quantified out using the area under the receiver operating characteristic curve (AUC). Results: A total of 175 patients were retrospectively enrolled (142 for the training cohort and 33 for the validation one). 1896 radiomic feature were extracted, 91 of which showed significance (p < 0.05) at the univariate analysis. The radiomic model showing the highest predictive value combined the features calculated starting from the gray level co-occurrence-based features. This model achieved an AUC of 0.73 in the training set and 0.91 in the validation set. Conclusions: The proposed radiomic model showed promising performances in predicting 2-year overall survival before NACRT. Nevertheless, the observed results should be tested in larger studies with consistent external validation cohorts, to confirm their potential clinical use.
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- 2022
6. A multicenter LArge retrospectIve daTabase on the personalization of stereotactic ABlative radiotherapy use in lung metastases from colon-rectal cancer: The LaIT-SABR study
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Nicosia, L, Franceschini, D, Perrone-Congedi, F, Casamassima, F, Gerardi, M, Rigo, M, Mazzola, R, Perna, M, Scotti, V, Fodor, A, Iurato, A, Pasqualetti, F, Gadducci, G, Chiesa, S, Niespolo, R, Bruni, A, Alicino, G, Frassinelli, L, Borghetti, P, Di Marzo, A, Ravasio, A, De Bari, B, Sepulcri, M, Aiello, D, Mortellaro, G, Sangalli, C, Franceschini, M, Montesi, G, Aquilanti, F, Lunardi, G, Valdagni, R, Fazio, I, Scarzello, G, Corti, L, Vavassori, V, Maranzano, E, Magrini, S, Arcangeli, S, Gambacorta, M, Valentini, V, Paiar, F, Ramella, S, Di Muzio, N, Livi, L, Jereczek-Fossa, B, Osti, M, Scorsetti, M, Alongi, F, Nicosia L., Franceschini D., Perrone-Congedi F., Casamassima F., Gerardi M. A., Rigo M., Mazzola R., Perna M., Scotti V., Fodor A., Iurato A., Pasqualetti F., Gadducci G., Chiesa S., Niespolo R. M., Bruni A., Alicino G., Frassinelli L., Borghetti P., Di Marzo A., Ravasio A., De Bari B., Sepulcri M., Aiello D., Mortellaro G., Sangalli C., Franceschini M., Montesi G., Aquilanti F. M., Lunardi G., Valdagni R., Fazio I., Scarzello G., Corti L., Vavassori V., Maranzano E., Magrini S. M., Arcangeli S., Gambacorta M. A., Valentini V., Paiar F., Ramella S., Di Muzio N. G., Livi L., Jereczek-Fossa B. A., Osti M. F., Scorsetti M., Alongi F., Nicosia, L, Franceschini, D, Perrone-Congedi, F, Casamassima, F, Gerardi, M, Rigo, M, Mazzola, R, Perna, M, Scotti, V, Fodor, A, Iurato, A, Pasqualetti, F, Gadducci, G, Chiesa, S, Niespolo, R, Bruni, A, Alicino, G, Frassinelli, L, Borghetti, P, Di Marzo, A, Ravasio, A, De Bari, B, Sepulcri, M, Aiello, D, Mortellaro, G, Sangalli, C, Franceschini, M, Montesi, G, Aquilanti, F, Lunardi, G, Valdagni, R, Fazio, I, Scarzello, G, Corti, L, Vavassori, V, Maranzano, E, Magrini, S, Arcangeli, S, Gambacorta, M, Valentini, V, Paiar, F, Ramella, S, Di Muzio, N, Livi, L, Jereczek-Fossa, B, Osti, M, Scorsetti, M, Alongi, F, Nicosia L., Franceschini D., Perrone-Congedi F., Casamassima F., Gerardi M. A., Rigo M., Mazzola R., Perna M., Scotti V., Fodor A., Iurato A., Pasqualetti F., Gadducci G., Chiesa S., Niespolo R. M., Bruni A., Alicino G., Frassinelli L., Borghetti P., Di Marzo A., Ravasio A., De Bari B., Sepulcri M., Aiello D., Mortellaro G., Sangalli C., Franceschini M., Montesi G., Aquilanti F. M., Lunardi G., Valdagni R., Fazio I., Scarzello G., Corti L., Vavassori V., Maranzano E., Magrini S. M., Arcangeli S., Gambacorta M. A., Valentini V., Paiar F., Ramella S., Di Muzio N. G., Livi L., Jereczek-Fossa B. A., Osti M. F., Scorsetti M., and Alongi F.
- Abstract
Introduction: Stereotactic ablative radiotherapy (SABR) has been shown to increase survival in oligometastatic disease, but local control of colorectal metastases remains poor. We aimed to identify potential predictive factors of SBRT response through a multicenter large retrospective database and to investigate the progression to the polymetastatic disease (PMD). Material and methods: The study involved 23 centers, and was approved by the Ethical Committee (Prot. Negrar 2019-ZT). 1033 lung metastases were reported. Clinical and biological parameters were evaluated as predictive for freedom from local progression-free survival (FLP). Secondary end-point was the time to the polymetastatic conversion (tPMC). Results: Two-year FLP was 75.4%. Two-year FLP for lesions treated with a BED < 00 Gy, 100–124 Gy, and ≥125 Gy was 76.1%, 70.6%, and 94% (p = 0.000). Two-year FLP for lesion measuring ≤10 mm, 10–20 mm, and >20 mm was 79.7%, 77.1%, and 66.6% (p = 0.027). At the multivariate analysis a BED ≥125 Gy significantly reduced the risk of local progression (HR 0.24, 95%CI 0.11–0.51; p = 0.000). Median tPMC was 26.8 months. Lesions treated with BED ≥125 Gy reported a significantly longer tPMC as compared to lower BED. The median tPMC for patients treated to 1, 2–3 or 4–5 simultaneous oligometastases was 28.5, 25.4, and 9.8 months (p = 0.035). Conclusion: The present is the largest series of lung colorectal metastases treated with SABR. The results support the use of SBRT in lung oligometastatic colorectal cancer patients as it might delay the transition to PMD or offer relatively long disease-free period in selected cases. Predictive factors were identified for treatment personalization.
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- 2022
7. MRI-derived radiomics to guide post-operative management of glioblastoma: Implication for personalized radiation treatment volume delineation
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Chiesa, S., primary, Russo, R., additional, Beghella Bartoli, F., additional, Palumbo, I., additional, Sabatino, G., additional, Cannatà, M. C., additional, Gigli, R., additional, Longo, S., additional, Tran, H. E., additional, Boldrini, L., additional, Dinapoli, N., additional, Votta, C., additional, Cusumano, D., additional, Pignotti, F., additional, Lupattelli, M., additional, Camilli, F., additional, Della Pepa, G. M., additional, D’Alessandris, G. Q., additional, Olivi, A., additional, Balducci, M., additional, Colosimo, C., additional, Gambacorta, M. A., additional, Valentini, V., additional, Aristei, C., additional, and Gaudino, S., additional
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- 2023
- Full Text
- View/download PDF
8. P02.11.B An hypothesis generating study of MRI-Derived Radiomics on tumor and microenvironment tissue heterogeneity to guide post-operative management of glioblastoma: toward personalized radiation treatment volume delineation
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Cannatà, M, primary, Russo, R, additional, Beghella Bartoli, F, additional, Palumbo, I, additional, Tran, H, additional, Votta, C, additional, Lupattelli, M, additional, Boldrini, L, additional, Dinapoli, N, additional, Camilli, F, additional, Balducci, M, additional, Gambacorta, M, additional, Valentini, V, additional, Aristei, C, additional, Sabatino, G, additional, Pignotti, F, additional, Gaudino, S, additional, and Chiesa, S, additional
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- 2022
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9. Developing and validating ultrasound‐based radiomics models for predicting high‐risk endometrial cancer
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Moro, F., primary, Albanese, M., additional, Boldrini, L., additional, Chiappa, V., additional, Lenkowicz, J., additional, Bertolina, F., additional, Mascilini, F., additional, Moroni, R., additional, Gambacorta, M. A., additional, Raspagliesi, F., additional, Scambia, G., additional, Testa, A. C., additional, and Fanfani, F., additional
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- 2022
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10. Art and digital technologies to support resilience during the oncological journey: The Art4ART project
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Tagliaferri, Luca, Dinapoli, Loredana, Casa, Cristina, Colloca, Giuseppe Ferdinando, Marazzi, Fabio, Cornacchione, Patrizia, Mazzarella, Maria Cristina, Masiello, Valeria, Chiesa, Silvia, Beghella Bartoli, Francesco, Marconi, Elisa, D'Oria, Marika, Cesario, Alfredo, Chieffo, Daniela Pia Rosaria, Valentini, Vincenzo, Gambacorta, Maria Antonietta, Tagliaferri L. (ORCID:0000-0003-2308-0982), Dinapoli L., Casa C., Colloca G. F., Marazzi F., Cornacchione P., Mazzarella C., Masiello V., Chiesa S. (ORCID:0000-0003-0168-3459), Beghella Bartoli F., Marconi E. (ORCID:0000-0001-6722-8390), D'Oria M., Cesario A. (ORCID:0000-0003-4687-0709), Chieffo D. P. R., Valentini V. (ORCID:0000-0003-4637-6487), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Tagliaferri, Luca, Dinapoli, Loredana, Casa, Cristina, Colloca, Giuseppe Ferdinando, Marazzi, Fabio, Cornacchione, Patrizia, Mazzarella, Maria Cristina, Masiello, Valeria, Chiesa, Silvia, Beghella Bartoli, Francesco, Marconi, Elisa, D'Oria, Marika, Cesario, Alfredo, Chieffo, Daniela Pia Rosaria, Valentini, Vincenzo, Gambacorta, Maria Antonietta, Tagliaferri L. (ORCID:0000-0003-2308-0982), Dinapoli L., Casa C., Colloca G. F., Marazzi F., Cornacchione P., Mazzarella C., Masiello V., Chiesa S. (ORCID:0000-0003-0168-3459), Beghella Bartoli F., Marconi E. (ORCID:0000-0001-6722-8390), D'Oria M., Cesario A. (ORCID:0000-0003-4687-0709), Chieffo D. P. R., Valentini V. (ORCID:0000-0003-4637-6487), and Gambacorta M. A. (ORCID:0000-0001-5455-8737)
- Abstract
Introduction: New digital technologies can become a tool for welcoming the patient through the artistic dimension. Cancer patients, in particular, need support that accompanies and supports them throughout their treatment. Materials and methods: The Art4ART project consist in the structural proposal to cancer patients of a web-based digital platform containing several forms of art as video-entertainments; a multimedia immersive room; an art-based welcoming of the patients with several original paintings; an environment with a peacefulness vertical garden; a reconceptualization of the chemotherapy-infusion seats. Data regarding patients’ preference and choices will be stored and analysed also using artificial intelligence (AI) algorithm to measure and predict impact indicators regarding clinical outcomes (survival and toxicity), psychological indicators. Moreover, the same digital platform will contribute to a better organization of the activities. Discussion: Through the systematic acquisition of patient preferences and through integration with other clinical parameters, it will be possible to measure the clinical, psychological, organisational, and social impact of the newly implemented Art4ART project. The use of digital technology leads us to apply the reversal of viewpoint from therapeutic acts to patient-centred care.
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- 2022
11. Management of oligometastatic ovarian cancer recurrence during PARP inhibitor maintenance
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Palluzzi, E., Marchetti, Claudia, Cappuccio, S., Avesani, Giacomo, Macchia, Gabriella, Gambacorta, Maria Antonietta, Cocciolillo, F., Scambia, Giovanni, Fagotti, Anna, Marchetti C. (ORCID:0000-0001-7098-8956), Avesani G., Macchia G., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Scambia G. (ORCID:0000-0003-2758-1063), Fagotti A. (ORCID:0000-0001-5579-335X), Palluzzi, E., Marchetti, Claudia, Cappuccio, S., Avesani, Giacomo, Macchia, Gabriella, Gambacorta, Maria Antonietta, Cocciolillo, F., Scambia, Giovanni, Fagotti, Anna, Marchetti C. (ORCID:0000-0001-7098-8956), Avesani G., Macchia G., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Scambia G. (ORCID:0000-0003-2758-1063), and Fagotti A. (ORCID:0000-0001-5579-335X)
- Abstract
Objective: The benefit of surgery and maintenance treatment with PARP inhibitors (PARPi) has been clearly demonstrated in ovarian cancer. Also, the efficacy and safety of stereotactic body radiotherapy has been shown in patients with metastatic, persistent, and recurrent disease. The aim of this study is to evaluate the management of oligometastatic progression during PARPi maintenance treatment. Methods: This is an observational, retrospective, single-arm study conducted from June 2017 to December 2020 in patients with recurrent ovarian cancer with oligometastatic progression under PARPi maintenance treatment and receiving surgery or stereotactic body radiotherapy for such recurrence. PARPi treatment was continued until further progression of the disease. The primary objective of the study was the median prolongation of the treatment-free interval-p (without platinum) after local treatment. Results: A total of 186 patients with ovarian cancer were treated with PARPi at recurrence. Of these, 30 (16%) developed oligometastatic progression. The median age was 49.5 years (range 35-73). Olaparib, niraparib and rucaparib were administered to 33%, 60%, and 7% of patients, respectively. The median prolongation of the treatment-free interval-p of patients treated with surgery or stereotactic body radiotherapy was 6 and 10 months, respectively (p=0.53). The median treatment-free interval-p of patients treated with surgery or stereotactic body radiotherapy at the time of oligometastatic progression was 32 and 29 months, respectively (p=0.44). At the time of this publication, 50% of patients are still on treatment with PARPi following progression. Conclusions: Patients with recurrent ovarian cancer who have oligometastic progression during PARPi maintenance may continue to benefit from PARPi if combined with local treatment.
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- 2022
12. Project for interventional Oncology LArge-database in liveR Hepatocellular carcinoma - Preliminary CT-based radiomic analysis (POLAR Liver 1.1)
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Iezzi, Roberto, Casà, C, Posa, Alessandro, Cornacchione, Patrizia, Carchesio, F, Boldrini, Luca, Tanzilli, A, Cerrito, Lucia, Fionda, B, Longo, V, Miele, Luca, Lancellotta, V, Cellini, Francesco, Tran, H E, Ponziani, Francesca Romana, Giuliante, Felice, Rapaccini, Gian Ludovico, Grieco, Antonio, Pompili, Maurizio, Gasbarrini, Antonio, Valentini, Vincenzo, Gambacorta, Maria Antonietta, Tagliaferri, Luca, Manfredi, Riccardo, Iezzi, R (ORCID:0000-0002-2791-481X), Posa, A, Cornacchione, P, Boldrini, L, Cerrito, L, Miele, L (ORCID:0000-0003-3464-0068), Cellini, F (ORCID:0000-0002-2145-2300), Ponziani, F R (ORCID:0000-0002-5924-6238), Giuliante, F (ORCID:0000-0001-9517-8220), Rapaccini, G L (ORCID:0000-0002-6467-857X), Grieco, A (ORCID:0000-0002-0544-8993), Pompili, M (ORCID:0000-0001-6699-7980), Gasbarrini, A (ORCID:0000-0002-7278-4823), Valentini, V (ORCID:0000-0003-4637-6487), Gambacorta, M A (ORCID:0000-0001-5455-8737), Tagliaferri, L (ORCID:0000-0003-2308-0982), Manfredi, R (ORCID:0000-0002-4972-9500), Iezzi, Roberto, Casà, C, Posa, Alessandro, Cornacchione, Patrizia, Carchesio, F, Boldrini, Luca, Tanzilli, A, Cerrito, Lucia, Fionda, B, Longo, V, Miele, Luca, Lancellotta, V, Cellini, Francesco, Tran, H E, Ponziani, Francesca Romana, Giuliante, Felice, Rapaccini, Gian Ludovico, Grieco, Antonio, Pompili, Maurizio, Gasbarrini, Antonio, Valentini, Vincenzo, Gambacorta, Maria Antonietta, Tagliaferri, Luca, Manfredi, Riccardo, Iezzi, R (ORCID:0000-0002-2791-481X), Posa, A, Cornacchione, P, Boldrini, L, Cerrito, L, Miele, L (ORCID:0000-0003-3464-0068), Cellini, F (ORCID:0000-0002-2145-2300), Ponziani, F R (ORCID:0000-0002-5924-6238), Giuliante, F (ORCID:0000-0001-9517-8220), Rapaccini, G L (ORCID:0000-0002-6467-857X), Grieco, A (ORCID:0000-0002-0544-8993), Pompili, M (ORCID:0000-0001-6699-7980), Gasbarrini, A (ORCID:0000-0002-7278-4823), Valentini, V (ORCID:0000-0003-4637-6487), Gambacorta, M A (ORCID:0000-0001-5455-8737), Tagliaferri, L (ORCID:0000-0003-2308-0982), and Manfredi, R (ORCID:0000-0002-4972-9500)
- Abstract
N/A
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- 2022
13. Modern Management of Esophageal Cancer: Radio-Oncology in Neoadjuvancy, Adjuvancy and Palliation
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Cellini, Francesco, Manfrida, Stefania, Casa, C., Romano, Angela, Arcelli, A., Zamagni, A., De Luca, V., Colloca, Giuseppe Ferdinando, D'Aviero, A., Fuccio, L., Lancellotta, V., Tagliaferri, Luca, Boldrini, Luca, Mattiucci, Gian Carlo, Gambacorta, Maria Antonietta, Morganti, Alessio Giuseppe, Valentini, Vincenzo, Cellini F. (ORCID:0000-0002-2145-2300), Manfrida S., Romano A., Colloca G. F., Tagliaferri L. (ORCID:0000-0003-2308-0982), Boldrini L., Mattiucci G. C. (ORCID:0000-0001-6500-0413), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Morganti A. G., Valentini V. (ORCID:0000-0003-4637-6487), Cellini, Francesco, Manfrida, Stefania, Casa, C., Romano, Angela, Arcelli, A., Zamagni, A., De Luca, V., Colloca, Giuseppe Ferdinando, D'Aviero, A., Fuccio, L., Lancellotta, V., Tagliaferri, Luca, Boldrini, Luca, Mattiucci, Gian Carlo, Gambacorta, Maria Antonietta, Morganti, Alessio Giuseppe, Valentini, Vincenzo, Cellini F. (ORCID:0000-0002-2145-2300), Manfrida S., Romano A., Colloca G. F., Tagliaferri L. (ORCID:0000-0003-2308-0982), Boldrini L., Mattiucci G. C. (ORCID:0000-0001-6500-0413), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Morganti A. G., and Valentini V. (ORCID:0000-0003-4637-6487)
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The modern management of esophageal cancer is crucially based on a multidisciplinary and multimodal approach. Radiotherapy is involved in neoadjuvant and adjuvant settings; moreover, it includes radical and palliative treatment intention (with a focus on the use of a stent and its potential integration with radiotherapy). In this review, the above-mentioned settings and approaches will be described. Referring to available international guidelines, the background evidence bases will be reviewed, and the ongoing, more relevant trials will be outlined. Target definitions and radiotherapy doses to administer will be mentioned. Peculiar applications such as brachytherapy (interventional radiation oncology), and data regarding innovative approaches including MRI-guided-RT and radiomic analysis will be reported. A focus on the avoidance of surgery for major clinical responses (particularly for SCC) is detailed.
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- 2022
14. The impact of radiomics in diagnosis and staging of pancreatic cancer
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Casa, Cristina, Piras, A., D'Aviero, A., Preziosi, Francesco, Mariani, Silvia, Cusumano, Davide, Romano, Angela, Boskoski, Ivo, Lenkowicz, Jacopo, Dinapoli, Nicola, Cellini, Francesco, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Mattiucci, Gian Carlo, Boldrini, Luca, Casa C., Preziosi F., Mariani S., Cusumano D., Romano A., Boskoski I. (ORCID:0000-0001-8194-2670), Lenkowicz J., Dinapoli N., Cellini F. (ORCID:0000-0002-2145-2300), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Valentini V. (ORCID:0000-0003-4637-6487), Mattiucci G. C. (ORCID:0000-0001-6500-0413), Boldrini L., Casa, Cristina, Piras, A., D'Aviero, A., Preziosi, Francesco, Mariani, Silvia, Cusumano, Davide, Romano, Angela, Boskoski, Ivo, Lenkowicz, Jacopo, Dinapoli, Nicola, Cellini, Francesco, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Mattiucci, Gian Carlo, Boldrini, Luca, Casa C., Preziosi F., Mariani S., Cusumano D., Romano A., Boskoski I. (ORCID:0000-0001-8194-2670), Lenkowicz J., Dinapoli N., Cellini F. (ORCID:0000-0002-2145-2300), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Valentini V. (ORCID:0000-0003-4637-6487), Mattiucci G. C. (ORCID:0000-0001-6500-0413), and Boldrini L.
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Introduction: Pancreatic cancer (PC) is one of the most aggressive tumours, and better risk stratification among patients is required to provide tailored treatment. The meaning of radiomics and texture analysis as predictive techniques are not already systematically assessed. The aim of this study is to assess the role of radiomics in PC. Methods: A PubMed/MEDLINE and Embase systematic review was conducted to assess the role of radiomics in PC. The search strategy was ‘radiomics [All Fields] AND (“pancreas” [MeSH Terms] OR “pancreas” [All Fields] OR “pancreatic” [All Fields])’ and only original articles referred to PC in humans in the English language were considered. Results: A total of 123 studies and 183 studies were obtained using the mentioned search strategy on PubMed and Embase, respectively. After the complete selection process, a total of 56 papers were considered eligible for the analysis of the results. Radiomics methods were applied in PC for assessment technical feasibility and reproducibility aspects analysis, risk stratification, biologic or genomic status prediction and treatment response prediction. Discussion: Radiomics seems to be a promising approach to evaluate PC from diagnosis to treatment response prediction. Further and larger studies are required to confirm the role and allowed to include radiomics parameter in a comprehensive decision support system.
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- 2022
15. The Role of Simultaneous Integrated Boost in Locally Advanced Rectal Cancer Patients with Positive Lateral Pelvic Lymph Nodes
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Meldolesi, Elisa, Chiloiro, Giuditta, Giannini, Roberta, Menghi, Roberta, Persiani, Roberto, Corvari, B., Coco, Claudio, Manfrida, Stefania, Ratto, Carlo, De Luca, V., Sofo, Luigi, Reina, Sara, Crucitti, Antonio, Masiello, V., Dinapoli, Nicola, Valentini, Vincenzo, Gambacorta, Maria Antonietta, Meldolesi E., Chiloiro G., Giannini R., Menghi R., Persiani R. (ORCID:0000-0002-1537-5097), Coco C. (ORCID:0000-0002-4713-7093), Manfrida S., Ratto C. (ORCID:0000-0002-0556-0037), Sofo L. (ORCID:0000-0002-0592-5999), Reina S., Crucitti A. (ORCID:0000-0003-3496-4185), Dinapoli N., Valentini V. (ORCID:0000-0003-4637-6487), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Meldolesi, Elisa, Chiloiro, Giuditta, Giannini, Roberta, Menghi, Roberta, Persiani, Roberto, Corvari, B., Coco, Claudio, Manfrida, Stefania, Ratto, Carlo, De Luca, V., Sofo, Luigi, Reina, Sara, Crucitti, Antonio, Masiello, V., Dinapoli, Nicola, Valentini, Vincenzo, Gambacorta, Maria Antonietta, Meldolesi E., Chiloiro G., Giannini R., Menghi R., Persiani R. (ORCID:0000-0002-1537-5097), Coco C. (ORCID:0000-0002-4713-7093), Manfrida S., Ratto C. (ORCID:0000-0002-0556-0037), Sofo L. (ORCID:0000-0002-0592-5999), Reina S., Crucitti A. (ORCID:0000-0003-3496-4185), Dinapoli N., Valentini V. (ORCID:0000-0003-4637-6487), and Gambacorta M. A. (ORCID:0000-0001-5455-8737)
- Abstract
Aims: Between 11 to 14% of patients with locally advanced rectal cancer (LARC) have positive lateral pelvic lymph nodes (LPLN) at diagnosis, related to a worse prognosis with a 5-year survival rate between 30 to 40%. The best treatment choice for this group of patients is still a challenge. The optimal radiotherapy (RT) dose for LPLN patients has been investigated. Methods: We retrospectively collected data from LARC patients with LPLN at the primary staging MRI, treated in our center from March 2003 to December 2020. Patients underwent a neoadjuvant concomitant chemo-radiotherapy (CRT) treatment on the primary tumor (T), mesorectum, and pelvic nodes, associated with a fluoride-based chemotherapy. The total reached dose was 45 Gy at 1.8 Gy/fr on the elective sites and 55 Gy at 2.2 Gy/fr on the disease and mesorectum. Patients were divided in two groups based on whether they received a simultaneous integrated RT boost on the LPLN or not. Overall Survival (OS), Disease Free Survival (DFS), Metastasis Free Survival (MFS), and Local Control (LC) were evaluated in the whole group and then compared between the two groups. Results: A total of 176 patients were evaluated: 82 were included in the RT boost group and 94 in the non-RT boost group. The median follow-up period was 57.8 months. All the clinical endpoint (OS, DFS, MFS, LC), resulted were affected by the simultaneous integrated boost on LPLN with a survival rate of 84.7%, 79.5%, 84.1%, and 92%, respectively, in the entire population. From the comparison of the two groups, there was a statistical significance towards the RT boost group with a p < 0.006, 0.030, 0.042, 0.026, respectively. Conclusions: Concomitant radiotherapy boost on positive LPLN has shown to be beneficial on the survival outcomes (OS, DFS, MFR, and LC) in patients with LARC and LPLN. This analysis demonstrates that a higher dose of radiotherapy on positive pelvic lymph nodes led not only to a higher local control but also to a better survival ra
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- 2022
16. THUNDER 2: THeragnostic Utilities for Neoplastic DisEases of the Rectum by MRI guided radiotherapy
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Chiloiro, Giuditta, Cusumano, Davide, Boldrini, Luca, Romano, Angela, Placidi, Lorenzo, Nardini, Matteo, Meldolesi, Elisa, Barbaro, Brunella, Coco, Claudio, Crucitti, Antonio, Persiani, Roberto, Petruzziello, Lucio, Ricci, Riccardo, Salvatore, Lisa, Sofo, Luigi, Alfieri, Sergio, Manfredi, Riccardo, Valentini, Vincenzo, Gambacorta, Maria Antonietta, Chiloiro G., Cusumano D., Boldrini L., Romano A., Placidi L., Nardini M., Meldolesi E., Barbaro B. (ORCID:0000-0002-9638-543X), Coco C. (ORCID:0000-0002-4713-7093), Crucitti A. (ORCID:0000-0003-3496-4185), Persiani R. (ORCID:0000-0002-1537-5097), Petruzziello L., Ricci R. (ORCID:0000-0002-9089-5084), Salvatore L., Sofo L. (ORCID:0000-0002-0592-5999), Alfieri S. (ORCID:0000-0002-0404-724X), Manfredi R. (ORCID:0000-0002-4972-9500), Valentini V. (ORCID:0000-0003-4637-6487), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Chiloiro, Giuditta, Cusumano, Davide, Boldrini, Luca, Romano, Angela, Placidi, Lorenzo, Nardini, Matteo, Meldolesi, Elisa, Barbaro, Brunella, Coco, Claudio, Crucitti, Antonio, Persiani, Roberto, Petruzziello, Lucio, Ricci, Riccardo, Salvatore, Lisa, Sofo, Luigi, Alfieri, Sergio, Manfredi, Riccardo, Valentini, Vincenzo, Gambacorta, Maria Antonietta, Chiloiro G., Cusumano D., Boldrini L., Romano A., Placidi L., Nardini M., Meldolesi E., Barbaro B. (ORCID:0000-0002-9638-543X), Coco C. (ORCID:0000-0002-4713-7093), Crucitti A. (ORCID:0000-0003-3496-4185), Persiani R. (ORCID:0000-0002-1537-5097), Petruzziello L., Ricci R. (ORCID:0000-0002-9089-5084), Salvatore L., Sofo L. (ORCID:0000-0002-0592-5999), Alfieri S. (ORCID:0000-0002-0404-724X), Manfredi R. (ORCID:0000-0002-4972-9500), Valentini V. (ORCID:0000-0003-4637-6487), and Gambacorta M. A. (ORCID:0000-0001-5455-8737)
- Abstract
Background: Neoadjuvant chemoradiation therapy (nCRT) is the standard treatment modality in locally advanced rectal cancer (LARC). Since response to radiotherapy (RT) is dose dependent in rectal cancer, dose escalation may lead to higher complete response rates. The possibility to predict patients who will achieve complete response (CR) is fundamental. Recently, an early tumour regression index (ERI) was introduced to predict pathological CR (pCR) after nCRT in LARC patients. The primary endpoints will be the increase of CR rate and the evaluation of feasibility of delta radiomics-based predictive MRI guided Radiotherapy (MRgRT) model. Methods: Patients affected by LARC cT2-3, N0-2 or cT4 for anal sphincter involvement N0-2a, M0 without high risk features will be enrolled in the trial. Neoadjuvant CRT will be administered using MRgRT. The initial RT treatment will consist in delivering 55 Gy in 25 fractions on Gross Tumor Volume (GTV) plus the corresponding mesorectum and 45 Gy in 25 fractions on the drainage nodes. Chemotherapy with 5-fluoracil (5-FU) or oral capecitabine will be administered continuously. A 0.35 Tesla MRI will be acquired at simulation and every day during MRgRT. At fraction 10, ERI will be calculated: if ERI will be inferior than 13.1, the patient will continue the original treatment; if ERI will be higher than 13.1 the treatment plan will be reoptimized, intensifying the dose to the residual tumor at the 11th fraction to reach 60.1 Gy. At the end of nCRT instrumental examinations are to be performed in order to restage patients. In case of stable disease or progression, the patient will undergo surgery. In case of major or complete clinical response, conservative approaches may be chosen. Patients will be followed up to evaluate toxicity and quality of life. The number of cases to be enrolled will be 63: all the patients will be treated at Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome. Discussion: This clinical tri
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- 2022
17. Multidisciplinary Tumor Board Smart Virtual Assistant in Locally Advanced Cervical Cancer: A Proof of Concept
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Macchia, Gabriella, Ferrandina, Maria Gabriella, Patarnello, S., Autorino, Rosa, Masciocchi, Carlotta, Pisapia, V., Calvani, C., Iacomini, C., Cesario, Alfredo, Boldrini, Luca, Gui, Benedetta, Rufini, Vittoria, Gambacorta, Maria Antonietta, Scambia, Giovanni, Valentini, Vincenzo, Macchia G., Ferrandina G. (ORCID:0000-0003-4672-4197), Autorino R., Masciocchi C., Cesario A. (ORCID:0000-0003-4687-0709), Boldrini L., Gui B., Rufini V. (ORCID:0000-0002-2052-8078), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Scambia G. (ORCID:0000-0003-2758-1063), Valentini V. (ORCID:0000-0003-4637-6487), Macchia, Gabriella, Ferrandina, Maria Gabriella, Patarnello, S., Autorino, Rosa, Masciocchi, Carlotta, Pisapia, V., Calvani, C., Iacomini, C., Cesario, Alfredo, Boldrini, Luca, Gui, Benedetta, Rufini, Vittoria, Gambacorta, Maria Antonietta, Scambia, Giovanni, Valentini, Vincenzo, Macchia G., Ferrandina G. (ORCID:0000-0003-4672-4197), Autorino R., Masciocchi C., Cesario A. (ORCID:0000-0003-4687-0709), Boldrini L., Gui B., Rufini V. (ORCID:0000-0002-2052-8078), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Scambia G. (ORCID:0000-0003-2758-1063), and Valentini V. (ORCID:0000-0003-4637-6487)
- Abstract
Aim: The first prototype of the “Multidisciplinary Tumor Board Smart Virtual Assistant” is presented, aimed to (i) Automated classification of clinical stage starting from different free-text diagnostic reports; (ii) Resolution of inconsistencies by identifying controversial cases drawing the clinician’s attention to particular cases worthy for multi-disciplinary discussion; (iii) Support environment for education and knowledge transfer to junior staff; (iv) Integrated data-driven decision making and standardized language and interpretation. Patients and Method: Data from patients affected by Locally Advanced Cervical Cancer (LACC), FIGO stage IB2-IVa, treated between 2015 and 2018 were extracted. Magnetic Resonance (MR), Gynecologic examination under general anesthesia (EAU), and Positron Emission Tomography–Computed Tomography (PET-CT) performed at the time of diagnosis were the items from the Electronic Health Records (eHRs) considered for analysis. An automated extraction of eHR that capture the patient’s data before the diagnosis and then, through Natural Language Processing (NLP), analysis and categorization of all data to transform source information into structured data has been performed. Results: In the first round, the system has been used to retrieve all the eHR for the 96 patients with LACC. The system has been able to classify all patients belonging to the training set and - through the NLP procedures - the clinical features were analyzed and classified for each patient. A second important result was the setup of a predictive model to evaluate the patient’s staging (accuracy of 94%). Lastly, we created a user-oriented operational tool targeting the MTB who are confronted with the challenge of large volumes of patients to be diagnosed in the most accurate way. Conclusion: This is the first proof of concept concerning the possibility of creating a smart virtual assistant for the MTB. A significant benefit could come from the integration of these automate
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- 2022
18. Contact skin radiotherapy (brachytherapy) for the treatment of non-melanoma skin cancers during COVID-19 pandemic
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Lancellotta, V., D'Aviero, A., Fionda, B., Di Stefani, Alessandro, Casa, Cristina, Del Regno, L., Gentileschi, Stefano, Colloca, Giuseppe Ferdinando, Rossi, E., Schinzari, Giovanni, Gambacorta, Maria Antonietta, Tagliaferri, Luca, Peris, Ketty, Di Stefani A., Casa C., Gentileschi S. (ORCID:0000-0001-9682-4706), Colloca G. F., Schinzari G. (ORCID:0000-0001-6105-7252), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Tagliaferri L. (ORCID:0000-0003-2308-0982), Peris K. (ORCID:0000-0002-5237-0463), Lancellotta, V., D'Aviero, A., Fionda, B., Di Stefani, Alessandro, Casa, Cristina, Del Regno, L., Gentileschi, Stefano, Colloca, Giuseppe Ferdinando, Rossi, E., Schinzari, Giovanni, Gambacorta, Maria Antonietta, Tagliaferri, Luca, Peris, Ketty, Di Stefani A., Casa C., Gentileschi S. (ORCID:0000-0001-9682-4706), Colloca G. F., Schinzari G. (ORCID:0000-0001-6105-7252), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Tagliaferri L. (ORCID:0000-0003-2308-0982), and Peris K. (ORCID:0000-0002-5237-0463)
- Abstract
In the context of the SARS-CoV-2 pandemic, it is important to ensure the quality of cancer treatment as well as patients and health professionals' safety. Individual-based treatment options should be considered in patients with advanced epithelial skin cancer, who are typically elderly and frail. Aim of this study was to assess feasibility and safety of Contact Skin Radiation Therapy (CSRT) to treat basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) during SARS-CoV-2 pandemic. Patients with advanced and difficult-to-treat BCC or SCC were discussed at skin multidisciplinary tumor board (S-MDTB) from February the 21st to May the 4th (phase 1 Italian Pandemic) and retrospectively analyzed. Patient's triage following internal recommendations was daily performed. CSRT was delivered in 8 fractions of 5 Gy each, twice a day. Beyond the clinical outcomes, treatment success indicators, such as the completion of CSRT without SARS-CoV-2 occurrence, were identified to evaluate the feasibility of CSRT during pandemic. A post-treatment psychological assessment regarding patient's safety perception was performed. Six male patients (median age 80 years; range 62–92) with histologically confirmed BCC or SCC were treated with CSRT. Complete clinical remission was achieved in 5/6 patients (83.4%). No high-grade acute toxicities occurred during treatment. No patients or healthcare personnel developed SARS-CoV-2 infection. All the treatment success indicators were achieved. CSRT represents a safe, and feasible treatment option even during the pandemic emergency period. Hypofractionation could be an option to reduce total number of fractions and, consequently, infective risk exposition.
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- 2022
19. Developing and validating ultrasound-based radiomics models for predicting high-risk endometrial cancer
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Moro, Francesca, Albanese, M, Boldrini, Luca, Chiappa, V, Lenkowicz, Jacopo, Bertolina, F, Mascilini, F, Moroni, R, Gambacorta, Maria Antonietta, Raspagliesi, F, Scambia, Giovanni, Testa, Antonia Carla, Fanfani, Francesco, Moro, F, Boldrini, L, Lenkowicz, J, Gambacorta, M A (ORCID:0000-0001-5455-8737), Scambia, G (ORCID:0000-0003-2758-1063), Testa, A C (ORCID:0000-0003-2217-8726), Fanfani, F (ORCID:0000-0003-1991-7284), Moro, Francesca, Albanese, M, Boldrini, Luca, Chiappa, V, Lenkowicz, Jacopo, Bertolina, F, Mascilini, F, Moroni, R, Gambacorta, Maria Antonietta, Raspagliesi, F, Scambia, Giovanni, Testa, Antonia Carla, Fanfani, Francesco, Moro, F, Boldrini, L, Lenkowicz, J, Gambacorta, M A (ORCID:0000-0001-5455-8737), Scambia, G (ORCID:0000-0003-2758-1063), Testa, A C (ORCID:0000-0003-2217-8726), and Fanfani, F (ORCID:0000-0003-1991-7284)
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n/a
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- 2022
20. Does restaging MRI radiomics analysis improve pathological complete response prediction in rectal cancer patients? A prognostic model development
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Chiloiro, Giuditta, Cusumano, Davide, de Franco, P., Lenkowicz, Jacopo, Boldrini, Luca, Carano, Davide, Barbaro, Brunella, Corvari, B., Dinapoli, Nicola, Giraffa, M., Meldolesi, Elisa, Manfredi, Riccardo, Valentini, Vincenzo, Gambacorta, Maria Antonietta, Chiloiro G., Cusumano D., Lenkowicz J., Boldrini L., Carano D., Barbaro B. (ORCID:0000-0002-9638-543X), Dinapoli N., Meldolesi E., Manfredi R. (ORCID:0000-0002-4972-9500), Valentini V. (ORCID:0000-0003-4637-6487), Gambacorta M. A. (ORCID:0000-0001-5455-8737), Chiloiro, Giuditta, Cusumano, Davide, de Franco, P., Lenkowicz, Jacopo, Boldrini, Luca, Carano, Davide, Barbaro, Brunella, Corvari, B., Dinapoli, Nicola, Giraffa, M., Meldolesi, Elisa, Manfredi, Riccardo, Valentini, Vincenzo, Gambacorta, Maria Antonietta, Chiloiro G., Cusumano D., Lenkowicz J., Boldrini L., Carano D., Barbaro B. (ORCID:0000-0002-9638-543X), Dinapoli N., Meldolesi E., Manfredi R. (ORCID:0000-0002-4972-9500), Valentini V. (ORCID:0000-0003-4637-6487), and Gambacorta M. A. (ORCID:0000-0001-5455-8737)
- Abstract
Purpose: Our study investigated the contribution that the application of radiomics analysis on post-treatment magnetic resonance imaging can add to the assessments performed by an experienced disease-specific multidisciplinary tumor board (MTB) for the prediction of pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC). Materials and methods: This analysis included consecutively retrospective LARC patients who obtained a complete or near-complete response after nCRT and/or a pCR after surgery between January 2010 and September 2019. A three-step radiomics features selection was performed and three models were generated: a radiomics model (rRM), a multidisciplinary tumor board model (yMTB) and a combined model (CM). The predictive performance of models was quantified using the receiver operating characteristic (ROC) curve, evaluating the area under curve (AUC). Results: The analysis involved 144 LARC patients; a total of 232 radiomics features were extracted from the MR images acquired post-nCRT. The yMTB, rRM and CM predicted pCR with an AUC of 0.82, 0.73 and 0.84, respectively. ROC comparison was not significant (p = 0.6) between yMTB and CM. Conclusion: Radiomics analysis showed good performance in identifying complete responders, which increased when combined with standard clinical evaluation; this increase was not statistically significant but did improve the prediction of clinical response.
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- 2022
21. A robust artificial intelligence approach for histopathological evaluation of prostate biopsies
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Mulliqi, N., primary, Kartasalo, K., additional, Ji, X., additional, Szolnoky, K., additional, Olsson, H., additional, Blilie, A., additional, Braun, M., additional, Gambacorta, M., additional, Hotakainen, K., additional, Janssen, E.A.M., additional, Kjosavik, S.R., additional, Łowicki, R., additional, Pedersen, B.G., additional, Sørensen, K.D., additional, Ulhøi, B.P., additional, Ruusuvuori, P., additional, Egevad, L., additional, and Eklund, M., additional
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- 2022
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22. OC10.01: *Developing and validating ultrasound‐based radiomics models for predicting high‐risk category in endometrial cancer patients
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Moro, F., primary, Albanese, M., additional, Boldrini, L., additional, Chiappa, V., additional, Lenkowicz, J., additional, Bertolina, F., additional, Mascilini, F., additional, Moroni, R., additional, Gambacorta, M., additional, Raspagliesi, F., additional, Scambia, G., additional, Testa, A.C., additional, and Fanfani, F., additional
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- 2021
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23. A multicenter LArge retrospectIve daTabase on the personalization of stereotactic ABlative radiotherapy use in lung metastases from colon-rectal cancer: The LaIT-SABR study
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L. Nicosia, D. Franceschini, F. Perrone-Congedi, F. Casamassima, M.A. Gerardi, M. Rigo, R. Mazzola, M. Perna, V. Scotti, A. Fodor, A. Iurato, F. Pasqualetti, G. Gadducci, S. Chiesa, R.M. Niespolo, A. Bruni, G. Alicino, L. Frassinelli, P. Borghetti, A. Di Marzo, A. Ravasio, B. De Bari, M. Sepulcri, D. Aiello, G. Mortellaro, C. Sangalli, M. Franceschini, G. Montesi, F.M. Aquilanti, G. Lunardi, R. Valdagni, I. Fazio, Giovanni Scarzello, L. Corti, V. Vavassori, E. Maranzano, S.M. Magrini, S. Arcangeli, Maria Antonietta Gambacorta, V. Valentini, F. Paiar, S. Ramella, N.G. Di Muzio, L. Livi, B.A. Jereczek-Fossa, M.F. Osti, M. Scorsetti, F. Alongi, Nicosia, L, Franceschini, D, Perrone-Congedi, F, Casamassima, F, Gerardi, M, Rigo, M, Mazzola, R, Perna, M, Scotti, V, Fodor, A, Iurato, A, Pasqualetti, F, Gadducci, G, Chiesa, S, Niespolo, R, Bruni, A, Alicino, G, Frassinelli, L, Borghetti, P, Di Marzo, A, Ravasio, A, De Bari, B, Sepulcri, M, Aiello, D, Mortellaro, G, Sangalli, C, Franceschini, M, Montesi, G, Aquilanti, F, Lunardi, G, Valdagni, R, Fazio, I, Scarzello, G, Corti, L, Vavassori, V, Maranzano, E, Magrini, S, Arcangeli, S, Gambacorta, M, Valentini, V, Paiar, F, Ramella, S, Di Muzio, N, Livi, L, Jereczek-Fossa, B, Osti, M, Scorsetti, M, and Alongi, F
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medicine.medical_specialty ,Multivariate analysis ,Colorectal cancer ,medicine.medical_treatment ,SABR volatility model ,Oligometastatic disease ,Predictive factors ,SABR ,SBRT ,Stereotactic ablative radiotherapy ,Retrospective database ,Ablative case ,medicine ,Radiology, Nuclear Medicine and imaging ,Lung ,business.industry ,Hematology ,medicine.disease ,Radiation therapy ,medicine.anatomical_structure ,Oncology ,Radiology ,Predictive factor ,business - Abstract
Introduction: Stereotactic ablative radiotherapy (SABR) has been shown to increase survival in oligometastatic disease, but local control of colorectal metastases remains poor. We aimed to identify potential predictive factors of SBRT response through a multicenter large retrospective database and to investigate the progression to the polymetastatic disease (PMD). Material and methods: The study involved 23 centers, and was approved by the Ethical Committee (Prot. Negrar 2019-ZT). 1033 lung metastases were reported. Clinical and biological parameters were evaluated as predictive for freedom from local progression-free survival (FLP). Secondary end-point was the time to the polymetastatic conversion (tPMC). Results: Two-year FLP was 75.4%. Two-year FLP for lesions treated with a BED < 00 Gy, 100–124 Gy, and ≥125 Gy was 76.1%, 70.6%, and 94% (p = 0.000). Two-year FLP for lesion measuring ≤10 mm, 10–20 mm, and >20 mm was 79.7%, 77.1%, and 66.6% (p = 0.027). At the multivariate analysis a BED ≥125 Gy significantly reduced the risk of local progression (HR 0.24, 95%CI 0.11–0.51; p = 0.000). Median tPMC was 26.8 months. Lesions treated with BED ≥125 Gy reported a significantly longer tPMC as compared to lower BED. The median tPMC for patients treated to 1, 2–3 or 4–5 simultaneous oligometastases was 28.5, 25.4, and 9.8 months (p = 0.035). Conclusion: The present is the largest series of lung colorectal metastases treated with SABR. The results support the use of SBRT in lung oligometastatic colorectal cancer patients as it might delay the transition to PMD or offer relatively long disease-free period in selected cases. Predictive factors were identified for treatment personalization.
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- 2022
24. A0613 - A robust artificial intelligence approach for histopathological evaluation of prostate biopsies.
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Mulliqi, N., Kartasalo, K., Ji, X., Szolnoky, K., Olsson, H., Blilie, A., Braun, M., Gambacorta, M., Hotakainen, K., Janssen, E.A.M., Kjosavik, S.R., Łowicki, R., Pedersen, B.G., Sørensen, K.D., Ulhøi, B.P., Ruusuvuori, P., Egevad, L., and Eklund, M.
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- *
PROSTATE biopsy , *ARTIFICIAL intelligence , *HISTOPATHOLOGY , *PROSTATE cancer - Published
- 2022
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25. Enhanced tissue slide imaging in the complex domain via cross-explainable GAN for Fourier ptychographic microscopy.
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Bardozzo F, Fiore P, Valentino M, Bianco V, Memmolo P, Miccio L, Brancato V, Smaldone G, Gambacorta M, Salvatore M, Ferraro P, and Tagliaferri R
- Subjects
- Humans, Fourier Analysis, Kidney diagnostic imaging, Image Processing, Computer-Assisted methods, Microscopy methods
- Abstract
Achieving microscopy with large space-bandwidth products plays a key role in diagnostic imaging and is widely significant in the overall field of clinical practice. Among quantitative microscopy techniques, Fourier Ptychography (FP) provides a wide field of view and high-resolution images, suitable to the histopathological field, but onerous in computational terms. Artificial intelligence can be a solution in this sense. In particular, this research delves into the application of Generative Adversarial Networks (GAN) for the dual-channel complex FP image enhancement of human kidney samples. The study underscores the GANs' efficacy in promoting biological architectures in FP domain, thereby still guaranteeing high resolution and visibility of detailed microscopic structures. We demonstrate successful GAN-based enhanced reconstruction through two strategies: cross-explainability and expert survey. The cross-explainability is evaluated through the comparison of explanation maps for both real and imaginary components underlining its robustness. This comparison further shows that their interplay is pivotal for accurate reconstruction without hallucinations. Secondly, the enhanced reconstruction accuracy and effectiveness in a clinical workflow are confirmed through a two-step survey conducted with nephrologists., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Authors M.V., V.B., L.M., P.M., P.Fe., P.Fi., F.B., and R.T. declare no financial or any other competing interest associated with the present manuscript. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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26. A Non-Invasive Technique to Unveil Renal Implications in Anderson-Fabry Disease.
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Gravina M, Troise D, Infante B, Tartaglia L, Minopoli B, Allegra C, Casavecchia G, Gambacorta M, Montanile C, Mercuri S, Macarini L, and Stallone G
- Abstract
Background: Anderson-Fabry disease (AFD) is a rare genetic disorder characterized by a deficiency of α-galactosidase A activity and the accumulation of glycosphingolipids in tissues, which leads to multiorgan damage. Cardiovascular magnetic resonance (CMR) and the T1 mapping technique are essential tools for the assessment of AFD cardiac involvement. Moreover, the T1 mapping technique has proved to be a successful non-invasive method for the early detection of patients most at risk for kidney disease. We evaluated the application of MRI in patients with AFD to assess renal involvement., Methods: We conducted a retrospective analysis of 19 patients (Group A) with histologically proven AFD who underwent routine CMR examinations for the evaluation of cardiac involvement, selecting specific sequences that also showed the left kidney, compared to a control population (Group B, 19 patients) without kidney disease. A Spearman's rank-order correlation was run to assess the relationship between the T1 mapping values of the heart and kidney in Group A and between the kidneys of Groups A and B., Results: There was a positive correlation between the heart and kidney T1 values in Group A (rho = 0.32). More interestingly, we observed a negative correlation between the kidney values of both groups (Group A mean 1284 ± 137 ms, Group B mean 1073 ± 57 ms, rho = -0.38), which is probably related to the presence of microvascular damage and infiltrates in the kidneys of AFD patients., Conclusions: To our knowledge, these results are the first to highlight the key value of T1 mapping in assessing pathological changes and aiding in the non-invasive diagnosis of renal involvement in AFD.
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- 2024
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27. Machine-learning prediction of treatment response to stereotactic body radiation therapy in oligometastatic gynecological cancer: A multi-institutional study.
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Cilla S, Campitelli M, Antonietta Gambacorta M, Michela Rinaldi R, Deodato F, Pezzulla D, Romano C, Fodor A, Laliscia C, Trippa F, De Sanctis V, Ippolito E, Ferioli M, Titone F, Russo D, Balcet V, Vicenzi L, Di Cataldo V, Raguso A, Giuseppe Morganti A, Ferrandina G, and Macchia G
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- Humans, Machine Learning, Algorithms, Area Under Curve, Pathologic Complete Response, Radiosurgery, Neoplasms
- Abstract
Background and Purpose: We aimed to develop and validate different machine-learning (ML) prediction models for the complete response of oligometastatic gynecological cancer after SBRT., Material and Methods: One hundred fifty-seven patients with 272 lesions from 14 different institutions and treated with SBRT with radical intent were included. Thirteen datasets including 222 lesions were combined for model training and internal validation purposes, with an 80:20 ratio. The external testing dataset was selected as the fourteenth Institution with 50 lesions. Lesions that achieved complete response (CR) were defined as responders. Prognostic clinical and dosimetric variables were selected using the LASSO algorithm. Six supervised ML models, including logistic regression (LR), classification and regression tree analysis (CART) and support vector machine (SVM) using four different kernels, were trained and tested to predict the complete response of uterine lesions after SBRT. The performance of models was assessed by receiver operating characteristic curves (ROC), area under the curve (AUC) and calibration curves. An explainable approach based on SHapley Additive exPlanations (SHAP) method was deployed to generate individual explanations of the model's decisions., Results: 63.6% of lesions had a complete response and were used as ground truth for the supervised models. LASSO strongly associated complete response with three variables, namely the lesion volume (PTV), the type of lesions (lymph-nodal versus parenchymal), and the biological effective dose (BED
10 ), that were used as input for ML modeling. In the training set, the AUCs for complete response were 0.751 (95% CI: 0.716-0.786), 0.766 (95% CI: 0.729-0.802) and 0.800 (95% CI: 0.742-0.857) for the LR, CART and SVM with a radial basis function kernel, respectively. These models achieve AUC values of 0.727 (95% CI: 0.669-0.795), 0.734 (95% CI: 0.649-0.815) and 0.771 (95% CI: 0.717-0.824) in the external testing set, demonstrating excellent generalizability., Conclusion: ML models enable a reliable prediction of the treatment response of oligometastatic lesions receiving SBRT. This approach may assist radiation oncologists to tailor more individualized treatment plans for oligometastatic patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)- Published
- 2024
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28. Stereotactic Body Reirradiation in Gynaecological Cancer: Outcomes and Toxicities from a Single Institution Experience.
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Macchia G, Pezzulla D, Cilla S, Buwenge M, Romano C, Ferro M, Boccardi M, Ferioli M, Bonome P, Lancellotta V, Tagliaferri L, Ferrandina G, Gambacorta MA, Morganti AG, and Deodato F
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- Humans, Middle Aged, Aged, Aged, 80 and over, Quality of Life, Retrospective Studies, Neoplasm Recurrence, Local surgery, Re-Irradiation adverse effects, Re-Irradiation methods, Radiosurgery adverse effects, Radiosurgery methods, Neoplasms
- Abstract
Aims: To report toxicity profile, outcomes and quality of life (QoL) data in patients with recurrent gynaecological cancer who underwent stereotactic body radiotherapy (SBRT) retreatment., Materials and Methods: Data from patients' folders were retrospectively extracted, focusing on the primary neoplasm, previous systemic therapies and previous radiotherapy. Concerning SBRT, the total dose (five daily fractions) was delivered with a linear accelerator using intensity-modulated radiotherapy techniques. Acute and late toxicities were assessed by the CTCAE 4.03 scale. QoL was evaluated according to the Cancer Linear Analogue Scale [CLAS1 (fatigue), CLAS2 (energy level), CLAS3 (daily activities)]., Results: Between December 2005 and August 2021, 23 patients (median age 71 years, range 48-80) with 27 lesions were treated. Most patients had endometrial (34.8%), ovarian (26.1%) and cervical cancer (26.1%) as the primary tumour. The most common SBRT schedules in five fractions were 30 Gy (33.3%), 35 Gy (29.6%) and 40 Gy (29.6%). The median follow-up was 32 months (range 3-128). There were no patients reporting acute or late toxicities higher than grade 2, except for a bone fracture. One- and 2-year local control was 77.9% and 70.8%, respectively. One- and 2-year overall survival was 82.6% and 75.1%, respectively. The overall response rate was 96.0%. Regarding QoL, no statistically significant difference was identified between the baseline and follow-up values: the median CLAS1, CLAS2 and CLAS3 scores for each category were 6 (range 4-10) at baseline and 6 (range 3-10) 1 month after SBRT., Conclusions: This preliminary experience suggests that SBRT retreatment for recurrent gynaecological cancer is a highly feasible and safe treatment with limited side-effects and no short-term QoL impairment., (Copyright © 2023. Published by Elsevier Ltd.)
- Published
- 2023
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29. Neoadjuvant radiochemotherapy and perioperative chemotherapy do not represent a standard at the same priority level for esophageal adenocarcinomas (with regard to 'Oesophageal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up').
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Cellini F, Manfrida S, Gambacorta MA, and Valentini V
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- Humans, Neoadjuvant Therapy, Follow-Up Studies, Chemoradiotherapy, Esophageal Neoplasms therapy, Esophageal Neoplasms drug therapy, Adenocarcinoma therapy, Adenocarcinoma drug therapy
- Abstract
Competing Interests: Disclosure The authors have declared no conflicts of interest.
- Published
- 2023
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30. Beyond conventional microscopy: Observing kidney tissues by means of fourier ptychography.
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Valentino M, Bianco V, Miccio L, Memmolo P, Brancato V, Libretti P, Gambacorta M, Salvatore M, and Ferraro P
- Abstract
Kidney microscopy is a mainstay in studying the morphological structure, physiology and pathology of kidney tissues, as histology provides important results for a reliable diagnosis. A microscopy modality providing at same time high-resolution images and a wide field of view could be very useful for analyzing the whole architecture and the functioning of the renal tissue. Recently, Fourier Ptychography (FP) has been proofed to yield images of biology samples such as tissues and in vitro cells while providing high resolution and large field of view, thus making it a unique and attractive opportunity for histopathology. Moreover, FP offers tissue imaging with high contrast assuring visualization of small desirable features, although with a stain-free mode that avoids any chemical process in histopathology. Here we report an experimental measuring campaign for creating the first comprehensive and extensive collection of images of kidney tissues captured by this FP microscope. We show that FP microscopy unlocks a new opportunity for the physicians to observe and judge renal tissue slides through the novel FP quantitative phase-contrast microscopy. Phase-contrast images of kidney tissue are analyzed by comparing them with the corresponding renal images taken under a conventional bright-field microscope both for stained and unstained tissue samples of different thicknesses. In depth discussion on the advantages and limitations of this new stain-free microscopy modality is reported, showing its usefulness over the classical light microscopy and opening a potential route for using FP in clinical practice for histopathology of kidney., Competing Interests: Authors MV, VBi, LM, PM, and PF were employed by the company National Research Council (CNR) of Italy. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Valentino, Bianco, Miccio, Memmolo, Brancato, Libretti, Gambacorta, Salvatore and Ferraro.)
- Published
- 2023
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31. The role of bone mineral density and cartilage volume to predict knee cartilage degeneration.
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Ciliberti FK, Cesarelli G, Guerrini L, Gunnarsson AE, Forni R, Aubonnet R, Recenti M, Jacob D, Jónsson H Jr, Cangiano V, Islind AS, Gambacorta M, and Gargiulo P
- Abstract
Knee Osteoarthritis (OA) is a highly prevalent condition affecting knee joint that causes loss of physical function and pain. Clinical treatments are mainly focused on pain relief and limitation of disabilities; therefore, it is crucial to find new paradigms assessing cartilage conditions for detecting and monitoring the progression of OA. The goal of this paper is to highlight the predictive power of several features, such as cartilage density, volume and surface. These features were extracted from the 3D reconstruction of knee joint of forty-seven different patients, subdivided into two categories: degenerative and non-degenerative. The most influent parameters for the degeneration of the knee cartilage were determined using two machine learning classification algorithms (logistic regression and support vector machine); later, box plots, which depicted differences between the classes by gender, were presented to analyze several of the key features' trend. This work is part of a strategy that aims to find a new solution to assess cartilage condition based on new-investigated features.
- Published
- 2022
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32. Project for interventional Oncology LArge-database in liveR Hepatocellular carcinoma - Preliminary CT-based radiomic analysis (POLAR Liver 1.1).
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Iezzi R, Casà C, Posa A, Cornacchione P, Carchesio F, Boldrini L, Tanzilli A, Cerrito L, Fionda B, Longo V, Miele L, Lancellotta V, Cellini F, Tran HE, Ponziani FR, Giuliante F, Rapaccini GL, Grieco A, Pompili M, Gasbarrini A, Valentini V, Gambacorta MA, Tagliaferri L, and Manfredi R
- Subjects
- Humans, Retrospective Studies, Tomography, X-Ray Computed methods, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular therapy, Liver Neoplasms diagnostic imaging, Liver Neoplasms pathology, Liver Neoplasms therapy
- Abstract
Objective: The objective of this study is to find a contrast-enhanced CT-radiomic signature to predict clinical incomplete response in patients affected by hepatocellular carcinoma who underwent locoregional treatments., Patients and Methods: 190 patients affected by hepatocellular carcinoma treated using focal therapies (radiofrequency or microwave ablation) from September 2018 to October 2020 were retrospectively enrolled. Treatment response was evaluated on a per-target-nodule basis on the 6-months follow-up contrast-enhanced CT or MR imaging using the mRECIST criteria. Radiomics analysis was performed using an in-house developed open-source R library. Wilcoxon-Mann-Whitney test was applied for univariate analysis; features with a p-value lower than 0.05 were selected. Pearson correlation was applied to discard highly correlated features (cut-off=0.9). The remaining features were included in a logistic regression model and receiver operating characteristic curves; sensitivity, specificity, positive and negative predictive value were also computed. The model was validated performing 2000 bootstrap resampling., Results: 56 treated lesions from 42 patients were selected. Treatment responses were: complete response for 26 lesions (46.4%), 18 partial responses (32.1%), 10 stable diseases (17.9%), 2 progression diseases (3.6%). Area-Under-Curve value was 0.667 (95% CI: 0.527-0.806); accuracy, sensitivity, specificity, positive and negative predictive values were respectively 0.66, 0.85, 0.50, 0.59 and 0.79., Conclusions: This contrast-enhanced CT-based model can be helpful to early identify poor responder's hepatocellular carcinoma patients and personalize treatments.
- Published
- 2022
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33. BRIDGE -1 TRIAL: BReak Interval Delayed surgery for Gastrointestinal Extraperitoneal rectal cancer, a multicentric phase III randomized trial.
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Chiloiro G, Meldolesi E, Corvari B, Romano A, Barbaro B, Coco C, Crucitti A, Genovesi D, Lupattelli M, Mantello G, Menghi R, Falchetto Osti M, Persiani R, Petruzziello L, Ricci R, Sofo L, Valentini C, De Paoli A, Valentini V, and Antonietta Gambacorta M
- Abstract
Design: Neoadjuvant chemoradiotherapy (nCRT) followed by surgery is the standard of care for locally advanced rectal cancer (LARC).Several studies have shown a correlation between a longer interval between the end of nCRT and surgery (surgical interval - SI) and an increased pathological complete response (pCR) rate, with a maximum obtained between 10 and 13 weeks.The primary endpoint of this multicenter, 2-arm randomised trial is to investigate SI lengthening, evaluating the difference in terms of complete response (CR) and Tumor Regression Grade (TRG)1 rate in the two arms. Secondly, the impact of SI lengthening on survival outcomes and quality of life (QoL) will be investigated., Methods: Intermediate-risk LARC patients undergoing nCRT will be prospectively included in the study. nCRT will be administered with a total dose of 55 Gy in 25 fractions on Gross Tumor Volume (GTV) plus the corresponding mesorectum of 45 Gy in 25 fractions on the whole pelvis. Chemotherapy with oral capecitabine will be administered continuously.The patients achieving a clinical major or complete response assessed at clinical-instrumental re-evaluation at 7-8 weeks after treatment completion, will be randomized into two groups, to undergo surgery or local excision at 9-11 weeks (control arm) or at 13-16 weeks (experimental arm). Pathological response will be assessed on the surgical specimen using the AJCC TNM v.7 and the TRG according to Mandard. Patients will be followed up to evaluate toxicity and QoL.The promoter center of the trial will conduct the randomization process through an automated procedure to prevent any possible bias.For sample size calculation, using CR difference of 20% as endpoint, 74 patients per arm will be enrolled., Conclusions: The results of this study may prospectively provide a new time frame for the clinical re-evaluation for complete/major responders patients in order to increase the CR rate to nCRT. Trial registration: ClinicalTrials.gov Identifier: NCT03581344., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.)
- Published
- 2022
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34. The "PC-WIRED" study: Patient Centred Evolution of Websites of Italian Radiotherapy Departments.
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Fionda B, Piras A, D'Aviero A, Venuti V, Casà C, Preziosi F, Catucci F, Boldrini L, Daidone A, Tagliaferri L, Gambacorta MA, and Valentini V
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- Humans, Italy, Surveys and Questionnaires, Patient-Centered Care, Radiotherapy
- Published
- 2021
- Full Text
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