31 results on '"Marletta F"'
Search Results
2. Thyroid carcinosarcoma, a rare and aggressive histotype: A case report
- Author
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Giuffrida, D., Attard, M., Marasà, L., Ferraù, F., Marletta, F., Restuccia, N., Gambino, L., Jannì, F., and Failla, G.
- Published
- 2000
3. Preoperative hyperfractionated accelerated radiotherapy (HART) plus concomitant infusional 5-fluorouracil in stage T3 and locally advanced primary rectal cancer: Study of a single institution.
- Author
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Cordio, Stefano, Marletta, F., Foresta, G., Franco, S., Greco, P., Giuffrida, D., Manusia, M., Taffuri, G., Giannone, G., and Failla, G.
- Published
- 2000
4. A fully automatic method for biological target volume segmentation of brain metastases
- Author
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Stefano, A, Vitabile, S, Russo, G, Ippolito, M, Marletta, F, D'Arrigo, C, D'Urso, D, Gambino, O, Pirrone, R, Ardizzone, E, Gilardi, M, Stefano A., Vitabile S., Russo G., Ippolito M., Marletta F., D'Arrigo C., D'Urso D., Gambino O., Pirrone R., Ardizzone E., Gilardi M. C., Stefano, A, Vitabile, S, Russo, G, Ippolito, M, Marletta, F, D'Arrigo, C, D'Urso, D, Gambino, O, Pirrone, R, Ardizzone, E, Gilardi, M, Stefano A., Vitabile S., Russo G., Ippolito M., Marletta F., D'Arrigo C., D'Urso D., Gambino O., Pirrone R., Ardizzone E., and Gilardi M. C.
- Abstract
Leksell Gamma Knife is a mini-invasive technique to obtain a complete destruction of cerebral lesions delivering a single high dose radiation beam. Positron Emission Tomography (PET) imaging is increasingly utilized for radiation treatment planning. Nevertheless, lesion volume delineation in PET datasets is challenging because of the low spatial resolution and high noise level of PET images. Nowadays, the biological target volume (BTV) is manually contoured on PET studies. This procedure is time expensive and operator-dependent. In this article, a fully automatic algorithm for the BTV delineation based on random walks (RW) on graphs is proposed. The results are compared with the outcomes of the original RW method, 40% thresholding method, region growing method, and fuzzy c-means clustering method. To validate the effectiveness of the proposed approach in a clinical environment, BTV segmentation on 18 patients with cerebral metastases is performed. Experimental results show that the segmentation algorithm is accurate and has real-time performance satisfying the physician requirements in a radiotherapy environment.
- Published
- 2016
5. Semi-automatic brain lesion segmentation in gamma knife treatments using an unsupervised fuzzy c-means clustering technique
- Author
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Esposito A.,Esposito A.,Morabito F.C.,Pasero E.,Bassis S., Rundo, L, Militello, C, Vitabile, S, Russo, G, Pisciotta, P, Marletta, F, Ippolito, M, D'Arrigo, C, Midiri, M, Gilardi, M, Rundo L., Militello C., Vitabile S., Russo G., Pisciotta P., Marletta F., Ippolito M., D'Arrigo C., Midiri M., Gilardi M. C., Esposito A.,Esposito A.,Morabito F.C.,Pasero E.,Bassis S., Rundo, L, Militello, C, Vitabile, S, Russo, G, Pisciotta, P, Marletta, F, Ippolito, M, D'Arrigo, C, Midiri, M, Gilardi, M, Rundo L., Militello C., Vitabile S., Russo G., Pisciotta P., Marletta F., Ippolito M., D'Arrigo C., Midiri M., and Gilardi M. C.
- Abstract
MR Imaging is being increasingly used in radiation treatment planning as well as for staging and assessing tumor response. Leksell Gamma Knife® is a device for stereotactic neuro-radiosurgery to deal with inaccessible or insufficiently treated lesions with traditional surgery or radiotherapy. The target to be treated with radiation beams is currently contoured through slice-by-slice manual segmentation on MR images. This procedure is time consuming and operator-dependent. Segmentation result repeatability may be ensured only by using automatic/semi-automatic methods with the clinicians supporting the planning phase. In this paper a semi-automatic segmentation method, based on an unsupervised Fuzzy C-Means clustering technique, is proposed. The presented approach allows for the target segmentation and its volume calculation. Segmentation tests on 5 MRI series were performed, using both area-based and distance-based metrics. The following average values have been obtained: DS = 95.10, JC = 90.82, TPF = 95.86, FNF = 2.18, MAD = 0.302, MAXD = 1.260, H = 1.636.
- Published
- 2016
6. Gamma Knife treatment planning: MR brain tumor segmentation and volume measurement based on unsupervised Fuzzy C-Means clustering
- Author
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Militello, C, Rundo, L, Vitabile, S, Russo, G, Pisciotta, P, Marletta, F, Ippolito, M, D'Arrigo, C, Midiri, M, Gilardi, M, Militello C., Rundo L., Vitabile S., Russo G., Pisciotta P., Marletta F., Ippolito M., D'Arrigo C., Midiri M., Gilardi M. C., Militello, C, Rundo, L, Vitabile, S, Russo, G, Pisciotta, P, Marletta, F, Ippolito, M, D'Arrigo, C, Midiri, M, Gilardi, M, Militello C., Rundo L., Vitabile S., Russo G., Pisciotta P., Marletta F., Ippolito M., D'Arrigo C., Midiri M., and Gilardi M. C.
- Abstract
Nowadays, radiation treatment is beginning to intensively use MRI thanks to its greater ability to discriminate healthy and diseased soft-tissues. Leksell Gamma Knife® is a radio-surgical device, used to treat different brain lesions, which are often inaccessible for conventional surgery, such as benign or malignant tumors. Currently, the target to be treated with radiation therapy is contoured with slice-by-slice manual segmentation on MR datasets. This approach makes the segmentation procedure time consuming and operator-dependent. The repeatability of the tumor boundary delineation may be ensured only by using automatic or semiautomatic methods, supporting clinicians in the treatment planning phase. This article proposes a semiautomatic segmentation method, based on the unsupervised Fuzzy C-Means clustering algorithm. Our approach helps segment the target and automatically calculates the lesion volume. To evaluate the performance of the proposed approach, segmentation tests on 15 MR datasets were performed, using both area-based and distance-based metrics, obtaining the following average values: Similarity Index=95.59%, Jaccard Index=91.86%, Sensitivity=97.39%, Specificity=94.30%, Mean Absolute Distance=0.246[pixels], Maximum Distance=1.050[pixels], and Hausdorff Distance=1.365[pixels].
- Published
- 2015
7. An automatic method for metabolic evaluation of gamma knife treatments
- Author
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Murino V.,Puppo E.,Murino V., Stefano, A, Vitabile, S, Russo, G, Ippolito, M, Marletta, F, D'Arrigo, C, D'Urso, D, Sabini, M, Gambino, O, Pirrone, R, Ardizzone, E, Gilardi, M, Stefano A., Vitabile S., Russo G., Ippolito M., Marletta F., D'Arrigo C., D'Urso D., Sabini M. G., Gambino O., Pirrone R., Ardizzone E., Gilardi M. C., Murino V.,Puppo E.,Murino V., Stefano, A, Vitabile, S, Russo, G, Ippolito, M, Marletta, F, D'Arrigo, C, D'Urso, D, Sabini, M, Gambino, O, Pirrone, R, Ardizzone, E, Gilardi, M, Stefano A., Vitabile S., Russo G., Ippolito M., Marletta F., D'Arrigo C., D'Urso D., Sabini M. G., Gambino O., Pirrone R., Ardizzone E., and Gilardi M. C.
- Abstract
Lesion volume delineation of Positron Emission Tomography images is challenging because of the low spatial resolution and high noise level. Aim of this work is the development of an operator independent segmentation method of metabolic images. For this purpose, an algorithm for the biological tumor volume delineation based on random walks on graphs has been used. Twenty-four cerebral tumors are segmented to evaluate the functional follow-up after Gamma Knife radiotherapy treatment. Experimental results show that the segmentation algorithm is accurate and has real-time performance. In addition, it can reflect metabolic changes useful to evaluate radiotherapy response in treated patients.
- Published
- 2015
8. A fully automatic approach for multimodal PET and MR image segmentation in gamma knife treatment planning
- Author
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Rundo, L, Stefano, A, Militello, C, Russo, G, Sabini, M, D'Arrigo, C, Marletta, F, Ippolito, M, Mauri, G, Vitabile, S, Gilardi, M, RUNDO, LEONARDO, MAURI, GIANCARLO, GILARDI, MARIA CARLA, Rundo, L, Stefano, A, Militello, C, Russo, G, Sabini, M, D'Arrigo, C, Marletta, F, Ippolito, M, Mauri, G, Vitabile, S, Gilardi, M, RUNDO, LEONARDO, MAURI, GIANCARLO, and GILARDI, MARIA CARLA
- Abstract
Background and objectives: Nowadays, clinical practice in Gamma Knife treatments is generally based on MRI anatomical information alone. However, the joint use of MRI and PET images can be useful for considering both anatomical and metabolic information about the lesion to be treated. In this paper we present a co-segmentation method to integrate the segmented Biological Target Volume (BTV), using [11C]-Methionine-PET (MET-PET) images, and the segmented Gross Target Volume (GTV), on the respective co-registered MR images. The resulting volume gives enhanced brain tumor information to be used in stereotactic neuro-radiosurgery treatment planning. GTV often does not match entirely with BTV, which provides metabolic information about brain lesions. For this reason, PET imaging is valuable and it could be used to provide complementary information useful for treatment planning. In this way, BTV can be used to modify GTV, enhancing Clinical Target Volume (CTV) delineation. Methods: A novel fully automatic multimodal PET/MRI segmentation method for Leksell Gamma Knife® treatments is proposed. This approach improves and combines two computer-assisted and operator-independent single modality methods, previously developed and validated, to segment BTV and GTV from PET and MR images, respectively. In addition, the GTV is utilized to combine the superior contrast of PET images with the higher spatial resolution of MRI, obtaining a new BTV, called BTVMRI. A total of 19 brain metastatic tumors, undergone stereotactic neuro-radiosurgery, were retrospectively analyzed. A framework for the evaluation of multimodal PET/MRI segmentation is also presented. Overlap-based and spatial distance-based metrics were considered to quantify similarity concerning PET and MRI segmentation approaches. Statistics was also included to measure correlation among the different segmentation processes. Since it is not possible to define a gold-standard CTV according to both MRI and PET images without tre
- Published
- 2017
9. Clinical support in radiation therapy scenarios: MR brain tumor segmentation using an unsupervised fuzzy C-Means clustering technique
- Author
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Rundo, L, Militello, C, Vitabile, S, Russo, G, Pisciotta, P, Sabini, M, Marletta, F, Ippolito, M, Arrigo, C, Midiri, M, Gilardi, M, RUNDO, LEONARDO, GILARDI, MARIA CARLA, Sabini, MG, Rundo, L, Militello, C, Vitabile, S, Russo, G, Pisciotta, P, Sabini, M, Marletta, F, Ippolito, M, Arrigo, C, Midiri, M, Gilardi, M, RUNDO, LEONARDO, GILARDI, MARIA CARLA, and Sabini, MG
- Published
- 2016
10. Using anatomic and metabolic imaging in stereotactic radio neuro-surgery treatments
- Author
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Pisciotta, P, Militello, C, Rundo, L, Stefano, A, Russo, G, Vitabile, S, Sabini, M, Arrigo, C, Marletta, F, Urso, D, Ippolito, M, Midiri, M, Gilardi, M, Sabini, MG, RUNDO, LEONARDO, GILARDI, MARIA CARLA, Pisciotta, P, Militello, C, Rundo, L, Stefano, A, Russo, G, Vitabile, S, Sabini, M, Arrigo, C, Marletta, F, Urso, D, Ippolito, M, Midiri, M, Gilardi, M, Sabini, MG, RUNDO, LEONARDO, and GILARDI, MARIA CARLA
- Published
- 2016
11. Safety and efficacy of new techniques of radiotherapy in oligometastatic recurrence ovarian cancer ( ROC) patients with BRCA 1/2 mutation. A monoistitutional experience
- Author
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Scandurra, G., primary, Marletta, F., additional, Nicolini, S., additional, Banna, G.L., additional, Di Stefano, A.B., additional, Cali', S., additional, Acquaviva, G., additional, Tamburo, M., additional, Corsaro, G., additional, Scibilia, G., additional, Ippolito, M., additional, and Scollo, P., additional
- Published
- 2016
- Full Text
- View/download PDF
12. Preoperative hyperfractionated radiotherapy (HFRT) and concomitant chemotherapy (CT) in locally advanced primary rectal cancer (LA-PRC) in elderly patients
- Author
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Cordio S, Vitali G, Ronzoni M, Marletta F, Foresta G, Franco S, Reni M, Parra HS, Giannone G, Villa E, Cordio, S, Vitali, G, Ronzoni, M, Marletta, F, Foresta, G, Franco, S, Reni, M, Parra, H, Giannone, G, and Villa, E
- Published
- 2005
13. Predictive and prognostic value of early pet evaluation on disease progression of advanced non-small cell lung cancer
- Author
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Banna, G.L., primary, Anile, G., additional, Russo, G., additional, Vigneri, P., additional, Castaing, M., additional, Nicolosi, M., additional, Strano, S., additional, Fraggetta, F., additional, Marletta, F., additional, Gieri, S., additional, Spina, S., additional, Scandurra, G., additional, Calì, S., additional, Lipari, H., additional, and Ippolito, M., additional
- Published
- 2015
- Full Text
- View/download PDF
14. Pre-operative hyperfractionated radiotherapy and 5-Fluorouracil continuous infusion in elderly patients with locally advanced primary rectal cancer (LA-PRC): feasibility, pathologic complete response, sphincter preservation and local control
- Author
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Cordio, S., Condorelli, S., Foresta, G., Franco, S., Caputo, G., Catania, Vito Emanuele, SOTO PARRA, H., Marletta, F., and Giannone, R. BORDONARO AND G.
- Published
- 2007
15. Chemioterapia con fluorouracile (FU) in infusione continua e vinorelbina (VNB) nel carcinoma differenziato della tiroide (CDT) in fase avanzata
- Author
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Giuffrida, D., Pellegriti, G., Caraci, P., Regalbuto, Concetto, Lavenia, G., Attard, M., Marletta, F., Pappalardo, A., and Bordonaro, R.
- Published
- 2002
16. G02 - Safety and efficacy of new techniques of radiotherapy in oligometastatic recurrence ovarian cancer ( ROC) patients with BRCA 1/2 mutation. A monoistitutional experience
- Author
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Scandurra, G., Marletta, F., Nicolini, S., Banna, G.L., Di Stefano, A.B., Cali', S., Acquaviva, G., Tamburo, M., Corsaro, G., Scibilia, G., Ippolito, M., and Scollo, P.
- Published
- 2016
- Full Text
- View/download PDF
17. Phase II double-blind randomized study of lonidamine and radiotherapy in epidermoid carcinoma of the lung
- Author
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Privitera, Giuseppe, Ciottoli, Gb, Patane, C, Palmucci, T, Tafuri, G, Marletta, F, Luca, B, Magnani, F, DE GREGORIO, M, and Greco, S.
- Published
- 1987
18. Cultured epithelium obtained from autologous skin: clinical applications
- Author
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Marchese, C, Spampinato, G, Micali, G, Marletta, F, and Messina, A
- Published
- 1989
19. Ottimizzazione del piano di cura nella radioterapia dei tumori retroperitoneali
- Author
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Tafuri, G, Privitera, Giuseppe, Fichera, M, Palmucci, T, Petrillo, G, Scandurra, G, Patanè, C, Marletta, F, Milone, Pietro, and Greco, S.
- Published
- 1986
20. Copper(II) Complexes of Aminoacids: Gastric acid Antisecretory Activity in Rats
- Author
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Alberghina, M, Brogna, A, Mangiameli, A, Marletta, F, Rizzarelli, Enrico, and Sammartano, S.
- Published
- 1982
21. A fully automatic approach for multimodal PET and MR image segmentation in gamma knife treatment planning
- Author
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Corrado D’Arrigo, Giancarlo Mauri, Maria Carla Gilardi, Francesco Marletta, Giorgio Ivan Russo, Massimo Ippolito, Maria Gabriella Sabini, Alessandro Stefano, Salvatore Vitabile, Carmelo Militello, Leonardo Rundo, Rundo, L, Stefano, A, Militello, C, Russo, G, Sabini, M, D'Arrigo, C, Marletta, F, Ippolito, M, Mauri, G, Vitabile, S, Gilardi, M, Rundo, L., Stefano, A., Militello, C., Russo, G., Sabini, M., D'Arrigo, C., Marletta, F., Ippolito, M., Mauri, G., Vitabile, S., and Gilardi, M.
- Subjects
Radiotherapy Planning ,Brain tumor ,Health Informatics ,02 engineering and technology ,Fuzzy C-means clustering ,Radiosurgery ,Brain tumors ,Multimodal Imaging ,ING-INF/05 - SISTEMI DI ELABORAZIONE DELLE INFORMAZIONI ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Computer-Assisted ,0302 clinical medicine ,Random walker algorithm ,0202 electrical engineering, electronic engineering, information engineering ,Humans ,Medicine ,Segmentation ,Computer vision ,Radiation treatment planning ,Cluster analysis ,Image resolution ,PET/MR imaging ,Modality (human–computer interaction) ,Brain Neoplasms ,business.industry ,Radiotherapy Planning, Computer-Assisted ,INF/01 - INFORMATICA ,Multimodal therapy ,medicine.disease ,Random Walker algorithm ,Magnetic Resonance Imaging ,Computer Science Applications ,Gamma knife treatment ,Positron-Emission Tomography ,020201 artificial intelligence & image processing ,Multimodal image segmentation ,Gamma knife treatments ,Artificial intelligence ,business ,Software - Abstract
The aim of this study is to combine Biological Target Volume (BTV) segmentation and Gross Target Volume (GTV) segmentation in stereotactic neurosurgery.Our goal is to enhance Clinical Target Volume (CTV) definition, including metabolic and morphologic information, for treatment planning and patient follow-up.We propose a fully automatic approach for multimodal PET and MR image segmentation. This method is based on the Random Walker (RW) and Fuzzy C-Means clustering (FCM) algorithms. A total of 19 brain metastatic tumors, undergone stereotactic neuro-radiosurgery, were retrospectively analyzed. A framework for the evaluation of multimodal PET/MRI segmentation is presented, considering volume-based, overlap-based and spatial distance-based metrics. Statistics was also included to measure correlation. Finally, a five-point Likert scale was used to provide a qualitative evaluation about the clinical value of the proposed multimodal approach. Background and objectives: Nowadays, clinical practice in Gamma Knife treatments is generally based on MRI anatomical information alone. However, the joint use of MRI and PET images can be useful for considering both anatomical and metabolic information about the lesion to be treated. In this paper we present a co-segmentation method to integrate the segmented Biological Target Volume (BTV), using [11C]-Methionine-PET (MET-PET) images, and the segmented Gross Target Volume (GTV), on the respective co-registered MR images. The resulting volume gives enhanced brain tumor information to be used in stereotactic neuro-radiosurgery treatment planning. GTV often does not match entirely with BTV, which provides metabolic information about brain lesions. For this reason, PET imaging is valuable and it could be used to provide complementary information useful for treatment planning. In this way, BTV can be used to modify GTV, enhancing Clinical Target Volume (CTV) delineation.Methods: A novel fully automatic multimodal PET/MRI segmentation method for Leksell Gamma Knife treatments is proposed. This approach improves and combines two computer-assisted and operator-independent single modality methods, previously developed and validated, to segment BTV and GTV from PET and MR images, respectively. In addition, the GTV is utilized to combine the superior contrast of PET images with the higher spatial resolution of MRI, obtaining a new BTV, called BTVMRI. A total of 19 brain metastatic tumors, undergone stereotactic neuro-radiosurgery, were retrospectively analyzed. A framework for the evaluation of multimodal PET/MRI segmentation is also presented. Overlap-based and spatial distance-based metrics were considered to quantify similarity concerning PET and MRI segmentation approaches. Statistics was also included to measure correlation among the different segmentation processes. Since it is not possible to define a gold-standard CTV according to both MRI and PET images without treatment response assessment, the feasibility and the clinical value of BTV integration in Gamma Knife treatment planning were considered. Therefore, a qualitative evaluation was carried out by three experienced clinicians.Results: The achieved experimental results showed that GTV and BTV segmentations are statistically correlated (Spearman's rank correlation coefficient: 0.898) but they have low similarity degree (average Dice Similarity Coefficient: 61.8714.64). Therefore, volume measurements as well as evaluation metrics values demonstrated that MRI and PET convey different but complementary imaging information. GTV and BTV could be combined to enhance treatment planning. In more than 50% of cases the CTV was strongly or moderately conditioned by metabolic imaging. Especially, BTVMRI enhanced the CTV more accurately than BTV in 25% of cases.Conclusions: The proposed fully automatic multimodal PET/MRI segmentation method is a valid operator-independent methodology helping the clinicians to define a CTV that includes both metabolic and morphologic information. BTVMRI and GTV should be considered for a comprehensive treatment planning. Display Omitted
- Published
- 2017
22. Semi-automatic Brain Lesion Segmentation in Gamma Knife Treatments Using an Unsupervised Fuzzy C-Means Clustering Technique
- Author
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Corrado D’Arrigo, Francesco Marletta, Salvatore Vitabile, Pietro Pisciotta, Massimo Midiri, Maria Carla Gilardi, Massimo Ippolito, Carmelo Militello, Leonardo Rundo, Giorgio Ivan Russo, Bassis, S., Esposito, A., Morabito, F.C., Rundo, L, Militello, C, Vitabile, S, Russo, G, Pisciotta, P, Marletta, F, Ippolito, M, D'Arrigo, C, Midiri, M, Gilardi, MC, Esposito A.,Esposito A.,Morabito F.C.,Pasero E.,Bassis S., and Gilardi, M
- Subjects
Computer science ,Gamma knife ,Brain lesions, Gamma knife treatments, MR imaging, Semi-automatic segmentation, Unsupervised FCM clustering ,Fuzzy logic ,Brain lesions ,Gamma knife treatments ,MR imaging ,Semi-automatic segmentation ,Unsupervised FCM clustering ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Computer vision ,Segmentation ,Radiation treatment planning ,Cluster analysis ,Settore ING-INF/05 - Sistemi Di Elaborazione Delle Informazioni ,business.industry ,Mr imaging ,Brain lesion ,Gamma knife treatment ,Semi automatic ,Artificial intelligence ,business ,030217 neurology & neurosurgery - Abstract
MR Imaging is being increasingly used in radiation treatment planning as well as for staging and assessing tumor response. Leksell Gamma Knife (R) is a device for stereotactic neuro-radiosurgery to deal with inaccessible or insufficiently treated lesions with traditional surgery or radiotherapy. The target to be treated with radiation beams is currently contoured through slice-by-slice manual segmentation on MR images. This procedure is time consuming and operator-dependent. Segmentation result repeatability may be ensured only by using automatic/semi-automatic methods with the clinicians supporting the planning phase. In this paper a semi-automatic segmentation method, based on an unsupervised Fuzzy C-Means clustering technique, is proposed. The presented approach allows for the target segmentation and its volume calculation. Segmentation tests on 5 MRI series were performed, using both area-based and distance-based metrics. The following average values have been obtained: DS = 95.10, JC = 90.82, TPF = 95.86, FNF = 2.18, MAD = 0.302, MAXD = 1.260, H = 1.636.
- Published
- 2016
23. A phase II study of induction chemotherapy followed by concurrent chemoradiotherapy in elderly patients with locally advanced non-small-cell lung cancer
- Author
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Roberto Bordonaro, Concetto Scuderi, Antonio Russo, Nuccio Palermo, Alessandro Pappalardo, Franco Marletta, Giuseppe Bellissima, Carmelo Giannitto Giorgio, Sergio Castorina, Carmela Di Salvo, Daniele Santini, Carlo Di Rosa, Giorgio, CG, Pappalardo, A, Russo, A, Santini, D, Di Rosa, C, Di Salvo, C, Castorina, S, Marletta, F, Bellissima, G, Palermo, N, Scuderi, C, and Bordonaro, R
- Subjects
Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Settore MED/06 - Oncologia Medica ,Locally advanced ,Phases of clinical research ,Disease-Free Survival ,Drug Administration Schedule ,Older patients ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Pharmacology (medical) ,Lung cancer ,Aged ,Neoplasm Staging ,Pharmacology ,business.industry ,Induction chemotherapy ,medicine.disease ,Combined Modality Therapy ,Neoadjuvant Therapy ,Optimal management ,Concurrent chemoradiotherapy ,non-small-cell lung cancer,chemoradiotherapy ,Female ,Non small cell ,business - Abstract
The optimal management of unresectable locally advanced non-small-cell lung cancer in older patients has not been defined to date. The present phase II study was planned to evaluate the activity and safety of platinum-based induction chemotherapy followed by concurrent chemoradiotherapy in elderly patients with locally advanced non-small-cell lung cancer. Patients received two cycles of paclitaxel (175 mg/m) and carboplatin (area under the curve: 5) day 1, every 3 weeks. Chemoradiotherapy (thoracic radiation therapy) was initiated on day 42 and consisted of 1.8 Gy daily, five times per week over 5 weeks (45.0 Gy target dose) followed by 10 2.0 Gy daily fractions. Concomitant chemotherapy was weekly paclitaxel 50 mg/mq followed by weekly carboplatin at an area under the curve of 2. The eligibility for patients: age 70 or older and histologically documented untreated non-small-cell lung cancer, locally advanced, unresectable, stage III A N2 bulky or III B. Thirty consecutive patients were enrolled onto the study. The median age was 73 (range 70-76). According to the intention-to-treat analysis, 1 month after the end of combined chemoradiotherapy, we observed complete and partial responses in one and 19 of the 30 patients, respectively, for an overall response rate of 66% (95% confidence interval, 45-76%). Median progression-free survival was 8.7 months (95% confidence interval, 3.4-37.8) and median survival was 15 months (95% confidence interval, 4.2-52.1). During the treatment, 12 patients (40.0%) experienced grade 3-4 neutropenia, two patients neutropenic fever, and three patients grade 3 anaemia and grade 3 thrombocytopenia, respectively. Grade 3 oesophagitis, during concomitant radiotherapy, was observed in six patients (20.0%). No treatment-related mortality was reported. The investigated sequential approach including induction chemotherapy followed by concurrent chemoradiotherapy appears safe and seems a reasonable chance for the treatment of locally advanced non-small-cell lung cancer in the elderly population.
- Published
- 2007
24. Paclitaxel, carboplatin and gemcitabine combination as induction chemotherapy for stage IIIA N2 bulky non-small cell lung cancer
- Author
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Roberto Bordonaro, Bruno Vincenzi, Alessandro Pappalardo, Dario Giuffrida, Salvino Saita, Giorgio Carmelo Giannitto, Franco Marletta, Antonio Russo, Sergio Castorina, Enrico Potenza, Giuseppe La Venia, GIANNITTO GC, GIUFFRIDA D, PAPPALARDO A, RUSSO A, VINCENZI B, SAITA S, POTENZA, MARLETTA F, LA VENIA G, CASTORINA S, and BORDONARO R
- Subjects
Adult ,Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Paclitaxel ,medicine.drug_class ,medicine.medical_treatment ,Deoxycytidine ,Antimetabolite ,Disease-Free Survival ,Drug Administration Schedule ,Carboplatin ,chemistry.chemical_compound ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Lung cancer ,Aged ,Neoplasm Staging ,Chemotherapy ,business.industry ,Remission Induction ,Induction chemotherapy ,Lung cancer Paclitaxel Carboplatin, stage III Chemotherapy ,General Medicine ,Middle Aged ,medicine.disease ,Survival Analysis ,Gemcitabine ,respiratory tract diseases ,Surgery ,Radiation therapy ,Treatment Outcome ,chemistry ,Chemotherapy, Adjuvant ,Female ,Radiotherapy, Adjuvant ,business ,medicine.drug - Abstract
Background: Induction chemotherapy followed by surgical resection or definitive radiotherapy for patients affected by stage IIIA N2 bulky non-small cell lung cancer (NSCLC) has been investigated in several trials. Patients and Methods: In this present study, 52 patients with stage IIIA N2 bulky NSCLC with cytologically or histologically confirmed mediastinal lymph node involvement received paclitaxel 175 mg/mq on day 1, carboplatin AUC 5 on day 1 and gemcitabine 1,000 mg/mq on day 1 and 8 every 3 weeks for three cycles as induction chemotherapy. Results: Objective response (4 complete remission and 36 partial remission) was achieved in 40/52 patients. No early or toxic deaths were observed. Twenty-two patients were surgically explored. Fifteen were excluded for resection for biopsy-proven residual tumour in mediastinal nodes. Complete surgical resection was performed in 15 patients with confirmed pathological downstaging. Pathological complete response was achieved in 4 patients. No surgery-related mortality or significant morbidity was reported. Adjuvant radiotherapy was delivered in 15 patients, and 30 patients received definitive radiotherapy. Conclusion: In the present study, the combination of paclitaxel, carboplatin and gemcitabine has been a safe and active regimen in poor-prognosis stage IIIA N2 bulky NSCLC.
- Published
- 2005
25. Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective Experience.
- Author
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Cuccia F, Tamburo M, Piras A, Mortellaro G, Iudica A, Daidone A, Federico M, Zagardo V, Ferini G, Marletta F, Spatola C, Fazio I, Filosto S, Pergolizzi S, and Ferrera G
- Subjects
- Male, Humans, Aged, Retrospective Studies, Prospective Studies, Choline, Radiosurgery adverse effects, Prostatic Neoplasms radiotherapy
- Abstract
Background: The favorable role of SBRT for lymph-nodal oligometastases from prostate cancer has been reported by several retrospective and prospective experiences, suggesting a more indolent natural history of disease when compared to patients with bone oligometastases. This retrospective multicenter study evaluates the outcomes of a cohort of patients treated with stereotactic body radiotherapy for lymph-nodal oligometastases. Methods: Inclusion criteria were up to five lymph-nodal oligometastases detected either with Choline-PET or PSMA-PET in patients naïve for ADT or already ongoing with systemic therapy and at least 6 Gy per fraction for SBRT. Only patients with exclusive lymph-nodal disease were included. The primary endpoint of the study was LC; a toxicity assessment was retrospectively performed following CTCAE v4.0. Results: A total of 100 lymph-nodal oligometastases in 69 patients have been treated with SBRT between April 2015 and November 2022. The median age was 73 years (range, 60-85). Oligometastatic disease was mainly detected with Choline-PET in 47 cases, while the remaining were diagnosed using PSMA-PET, with most of the patients treated to a single lymph-nodal metastasis (48/69 cases), two in 14 cases, and three in the remaining cases. The median PSA prior to SBRT was 1.35 ng/mL (range, 0.3-23.7 ng/mL). Patients received SBRT with a median total dose of 35 Gy (range, 30-40 Gy) in a median number of 5 (range, 3-6) fractions. With a median follow-up of 16 months (range, 7-59 months), our LC rates were 95.8% and 86.3% at 1 and 2 years. DPFS rates were 90.4% and 53.4%, respectively, at 1 and 2 years, with nine patients developing a sequential oligometastatic disease treated with a second course of SBRT. Polymetastatic disease-free survival (PMFS) at 1 and 2 years was 98% and 96%. Six patients needed ADT after SBRT for a median time of ADT-free survival of 15 months (range, 6-22 months). The median OS was 16 months (range, 7-59) with 1- and 2-year rates of both 98%. In multivariate analysis, higher LC rates and the use of PSMA-PET were related to improved DPFS rates, and OS was significantly related to a lower incidence of distant progression. No G3 or higher adverse events were reported. Conclusions: In our experience, lymph-nodal SBRT for oligometastatic prostate cancer is a safe and effective option for ADT delay with no severe toxicity.
- Published
- 2023
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26. Hypofractionated Radiotherapy in Localized, Low-Intermediate-Risk Prostate Cancer: Current and Future Prospectives.
- Author
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Lo Greco MC, Marletta G, Marano G, Fazio A, Buffettino E, Iudica A, Liardo RLE, Milazzotto R, Foti PV, Palmucci S, Basile A, Marletta F, Cuccia F, Ferrera G, Parisi S, Pontoriero A, Pergolizzi S, and Spatola C
- Subjects
- Male, Humans, Radiation Dose Hypofractionation, Longitudinal Studies, Prostatic Neoplasms radiotherapy, Prostatic Neoplasms pathology, Brachytherapy
- Abstract
At the time of diagnosis, the vast majority of prostate carcinoma patients have a clinically localized form of the disease, with most of them presenting with low- or intermediate-risk prostate cancer. In this setting, various curative-intent alternatives are available, including surgery, external beam radiotherapy and brachytherapy. Randomized clinical trials have demonstrated that moderate hypofractionated radiotherapy can be considered as a valid alternative strategy for localized prostate cancer. High-dose-rate brachytherapy can be administered according to different schedules. Proton beam radiotherapy represents a promising strategy, but further studies are needed to make it more affordable and accessible. At the moment, new technologies such as MRI-guided radiotherapy remain in early stages, but their potential abilities are very promising.
- Published
- 2023
- Full Text
- View/download PDF
27. Erectile dysfunction following hydrogel injection and hypofractionated radiotherapy for prostate cancer: Our experience in 56 cases.
- Author
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Pepe P, Tamburo M, Panella P, Pepe L, Marletta G, Pennisi M, and Marletta F
- Subjects
- Aged, Humans, Hydrogels adverse effects, Male, Prostate, Prostate-Specific Antigen, Erectile Dysfunction etiology, Prostatic Neoplasms complications, Prostatic Neoplasms radiotherapy
- Abstract
Introduction: The incidence of erectile dysfunction (ED) in men with organ-confined prostate cancer (PCa) submitted to hypofractionated radiotherapy (HRT) has been prospectively evaluated., Materials and Methods: From April 2018 to September 2020, 56 patients (median age 70 years) with cT1c PCa were treated by HRT directed to the prostate and seminal vesicle. Median PSA was 8.3 ng/ml; 20 patients (35.7%) vs. 28 (50%) vs. 8 (22.3%) had a PCa Grade Group 1 vs. 2 vs. 3, respectively. All patients underwent hydrogel injection of Space OAR and intraprostatic fiducials before HRT. The prescription dose was 60 Gy in 20 fractions 5 days/week over 4 weeks. During the follow up, PSA, genitourinary (GU) and gastrointestinal (GI) toxicities were evaluated. The sexual function was evaluated by International Index of Erectile Function - 5 (IIEF-5) before, 6 and 18 months from HRT; 32/56 (57.1%) men referred a normal sexual activity before HRT (median IIEF-5 score: 22)., Results: Median PSA level at median follow up of 18 months was 0.92 ng/ml and none used adjuvant therapy. One man (1.8%) referred a tardive grade 1 GU complication. At a median follow up of 6 and 18 months, 20/32 (62.5%) kept pretreatment sexual potency (median IIEF-5 score: 21). The 12/32 men who worsened the sexual function following HRT had a median age higher than patients without ED (78 vs. 67 years)., Conclusions: The use of hydrogel injection and intraprostatic fiducials followed by HRT allowed to kept pretreatment sexual potency in 62.5% of the cases.
- Published
- 2022
- Full Text
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28. Clinical Outcomes of Hydrogel Spacer Injection Space OAR in Men Submitted to Hypofractionated Radiotherapy for Prostate Cancer.
- Author
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Pepe P, Tamburo M, Pennisi M, Marletta D, and Marletta F
- Subjects
- Humans, Male, Prostate-Specific Antigen, Radiation Dose Hypofractionation, Radiotherapy Dosage, Hydrogels, Prostatic Neoplasms radiotherapy
- Abstract
Background/aim: To evaluate the clinical outcomes of men with prostate cancer (PCa) submitted to hydrogel spacer injection before hypofractionated radiotherapy (HRT)., Patients and Methods: From April 2018 to April 2020, 32 patients with clinically localized PCa underwent hydrogel injection Space OAR before HRT to the prostate and seminal vesicle; the prescription dose was 60 Gy in 20 fractions, 5 days/week over 4 weeks. PSA levels, genitourinary (GU) and gastrointestinal (GI) toxicities, and sexual function were prospectively evaluated., Results: PSA levels at the median follow up of 15 months was 0.52 ng/ml; 28.1% vs. 78.1% patients had GI vs. GU Grade 0 acute toxicity and 93.7% vs. 0% had GI vs. GU Grade 0 late toxicity. Furthermore, 88.1% of patients kept pretreatment sexual potency., Conclusion: The use of the hydrogel Spacer OAR before HRT is useful for reducing acute and late GU and GI toxicities., (Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
- Published
- 2021
- Full Text
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29. Adenoid cystic carcinoma of trachea: long-term disease control after endoscopic surgery and radiotherapy.
- Author
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Spatola C, Tocco A, Marletta D, Milazzotto R, Marletta F, Pergolizzi S, Migliore M, Basile A, Privitera G, and Acquaviva G
- Subjects
- Aged, Biopsy, Bronchoscopy adverse effects, Carcinoma, Adenoid Cystic diagnosis, Carcinoma, Adenoid Cystic pathology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prosthesis Implantation adverse effects, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Radiotherapy, Adjuvant methods, Radiotherapy, Intensity-Modulated adverse effects, Time Factors, Trachea diagnostic imaging, Trachea pathology, Trachea surgery, Tracheal Neoplasms diagnosis, Tracheal Neoplasms pathology, Treatment Outcome, Bronchoscopy methods, Carcinoma, Adenoid Cystic therapy, Prosthesis Implantation methods, Radiotherapy, Intensity-Modulated methods, Tracheal Neoplasms therapy
- Abstract
Aim: Adenoid cystic carcinoma is a rare tumor of head and neck region and its development in the thoracic region is even less frequent. This implies the absence of guidelines for therapeutic management and a consequent case-by-case approach. The role of radiotherapy is not yet clearly defined, but intensity-modulated radiotherapy allows for improved organ-at-risk sparing. Materials & methods: We have collected the cases of four patients treated at our institutions by the means of intensity-modulated radiotherapy, after endoscopic resection. Results & conclusion: Patients treated achieved long-term disease control of about 5 years, with a minimal acute toxicity. Longer follow-up is needed to drain conclusion on the impact of this treatment on overall survival.
- Published
- 2020
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30. Lactobacillus rhamnosus GG: An Overview to Explore the Rationale of Its Use in Cancer.
- Author
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Banna GL, Torino F, Marletta F, Santagati M, Salemi R, Cannarozzo E, Falzone L, Ferraù F, and Libra M
- Abstract
Cancer is the second leading cause of death in the western world. In the era of precision medicine, a significant number of cancer patients can be cured with several anti-cancer therapeutic regimens. However, therapy failure may be caused by treatment side effects, such as diarrhea, especially occurring in patients with gastrointestinal or pelvic malignancies. In particular, diarrhea is one of the most frequent gastrointestinal toxicity during cancer treatment and it can result from nearly bot chemo- and radio-therapeutic strategies currently used. Diarrhea has a serious impact on patients' quality of life and treatment dosing and schedule modification due to its severity can negatively influence treatment outcomes. In this context, probiotics may play an interesting role in several human diseases with an inflammatory bowel involvement and, among these, Lactobacillus rhamnosus GG (LGG) is one of the most characterized and utilized. In particular, LGG is able to reverse intestinal dysbiosis and moderate diarrhea. Moreover, preclinical studies have documented its effects in reducing chronic inflammation associated with cancer development. This review summarizes the preclinical results of LGG on cancer cells proliferation and tumor invasion as well as the potential role of LGG use in cancer patients for the prevention and management of diarrhea associated with cancer treatment. Overall, these encouraging data support further investigation on the use of LGG in stratified patients undergoing specific therapeutic protocols, including chemotherapy and pelvic radiotherapy, in order to reduce the development of severe diarrhea and thus improve the adherence to the therapy and patients' quality of life.
- Published
- 2017
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31. Histology-based Combination Induction Chemotherapy for Elderly Patients with Clinical Stage III Non-small Cell Lung Cancer.
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Banna GL, Parra HJS, Castaing M, Dieci MV, Anile G, Nicolosi M, Strano S, Marletta F, Guarneri V, Conte P, and Lal R
- Subjects
- Aged, Aged, 80 and over, Carboplatin therapeutic use, Combined Modality Therapy, Deoxycytidine analogs & derivatives, Deoxycytidine therapeutic use, Female, Humans, Male, Neoplasm Staging, Pemetrexed therapeutic use, Treatment Outcome, Gemcitabine, Adenocarcinoma drug therapy, Adenocarcinoma pathology, Adenocarcinoma radiotherapy, Adenocarcinoma surgery, Antineoplastic Agents therapeutic use, Carcinoma, Non-Small-Cell Lung drug therapy, Carcinoma, Non-Small-Cell Lung pathology, Carcinoma, Non-Small-Cell Lung radiotherapy, Carcinoma, Non-Small-Cell Lung surgery, Carcinoma, Squamous Cell drug therapy, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell radiotherapy, Carcinoma, Squamous Cell surgery, Induction Chemotherapy, Lung Neoplasms drug therapy, Lung Neoplasms pathology, Lung Neoplasms radiotherapy, Lung Neoplasms surgery
- Abstract
Aim: To explore the feasibility and activity of a histology-based induction combination chemotherapy for elderly patients with clinical stage III non-small cell lung cancer (NSCLC)., Patients and Methods: Patients aged ≥70 years with stage IIIA and IIIB lung squamous cell carcinoma (SCC) or adenocarcinoma were treated with three cycles of carboplatin and gemcitabine or pemetrexed, respectively, followed by definitive radiotherapy or surgery. The primary endpoint was the overall response rate (ORR) following induction., Results: Twenty-seven patients, with a median age of 74 years (range=70-80 years) were treated for adenocarcinoma in 14 (52%) and SCC in 13 (48%), clinical stage IIIA in eight (30%) and IIIB in 19 (70%). Grade 3 or 4 toxicity was reported for five patients (18.5%). The ORR was 46% in 12 (partial responses) out of 26 assessable patients., Conclusion: Histology-based induction combination chemotherapy is active and feasible in elderly patients with stage III NSCLC., (Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
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