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Purpose: To assess clinical outcomes and toxicities in patients with stage III unresectable non-small cell lung cancer (NSCLC) treated with a moderately escalated hypofractionated radiotherapy delivered with Helical Intensity-Modulated Technique in combination with sequential or concurrent chemotherapy., Materials and Methods: Sixty-one consecutive patients considered non-progressive after two cycles of induction chemotherapy were treated with a moderately escalated hypofractionated radiation course of 30 daily fractions of 2.25-2.28 Gy each administered in 6 weeks up to a total dose of 67.5-68.4 Gy (range, 64.5-71.3 Gy). Thirty-two received sequential RT after two more cycles (total = 4 cycles) of chemotherapy, while 29 were treated with concurrent chemo-radiation. The target was considered the gross tumor volume and the clinically proven nodal regions, without elective nodal irradiation., Results: With a median follow up of 27 months (range 6-40), 1-year and 2-year OS rate for all patients was 77 and 53%, respectively, with a median survival duration of 18.6 months in the sequential group and 24.1 months in the concomitant group. No Grade ≥4 acute and late toxicity was reported. Acute Grade 3 treatment-related pneumonitis was detected in 10% of patients. Two patients, both receiving the concurrent schedule, developed a Grade 3 acute esophagitis. The overall incidence of late Grade 3 lung toxicity was 5%. No patients experienced a Grade 3 late esophageal toxicity., Conclusion: A moderately hypofractionated radiation course delivered with a Helical Intensity-Modulated Technique is a feasible treatment option for patients with unresectable locally advanced NSCLC receiving chemotherapy (sequentially or concurrently). Hypofractionated radiotherapy with a dedicated technique allows safely dose escalation, minimizing the effect of tumor repopulation that may occur with prolonged treatment time. more...

Background: The aim of this study was to evaluate the potential association between single nucleotide polymorphisms related response to radiotherapy injury, such as genes related to DNA repair or enzymes involved in anti-oxidative activities. The paper aims to identify marker genes able to predict an increased risk of late toxicity studying our group of patients who underwent a Single Shot 3D-CRT PBI (SSPBI) after BCS (breast conserving surgery)., Methods: A total of 57 breast cancer patients who underwent SSPBI were genotyped for SNPs (single nucleotide polymorphisms) in XRCC1, XRCC3, GST and RAD51 by Pyrosequencing technology. Univariate analysis (ORs and 95% CI) was performed to correlate SNPs with the risk of developing ≥ G2 fibrosis or fat necrosis., Results: A higher significant risk of developing ≥ G2 fibrosis or fat necrosis in patients with: polymorphic variant GSTP1 (Ile105Val) (OR = 2.9; 95%CI, 0.88-10.14, p = 0.047)., Conclusions: The presence of some SNPs involved in DNA repair or response to oxidative stress seem to be able to predict late toxicity., Trial Registration: ClinicalTrials.gov: NCT01316328. more...

Purpose: To analyze the outcome of reirradiation of recurrent/metastatic or new primary tumors with three-dimensional conformal (3D-CRT) or stereotactic (SRT) techniques., Patients and Methods: 108 patients reirradiated between 01/2002 and 01/2005 at the European Institute of Oncology, Milan, Italy, were analyzed. Primary diagnosis included breast, lung, head/neck, urologic tumors, and other primaries. Curative and palliative intent were applied to 27 (25%) and 81 patients (75%), respectively. 3D-CRT and SRT were employed in 57 (53%) and 48 patients (44%), respectively, up to a mean dose of 23 Gy., Results: Median follow-up was 7 months (range, 1-50 months). Response, stabilization, and progression were observed in 33%, 36%, and 17% of patients, respectively (15 patients were not evaluable). No severe toxicity was reported. Median overall survival amounted to 32.6 months and was longer in patients treated with curative intent., Conclusion: A small portion of patients can be cured with a second course of radiotherapy, and in many cases, palliation can be obtained. Low toxicity of reirradiation with use of modern techniques should allow for the delivery of higher doses and, in consequence, lead to an improvement in reirradiation outcome. more...

Labio-maxillo-palatine clefts are pathological conditions accompanied by severe handicaps, congenital malformations of particular interest for medical assistance because of several reasons, including the following: they are the most frequent congenital malformations of the bucco-maxillo-facil region: in certain cases there are other teratologic conditions in other parts of the organism that are associated to these clefts; there are no disturbances from the intellectual viewpoint; there are efficient possibilities for therapy as a result of a multidisciplinary approach, and the progress achieved in each of the fields involved may contribute to continuous improvement of the therapeutical prognosis; because of the therapeutical problems that these pathological conditions may raise, and because of the long duration of the treatment, the pathology involved in labio-maxillo-palatine clefts has a special social character which renders necessary the support of extra-medical factors (special schooling, special conditions for work, etc.). All these aspects explain the world-wide interest for this type of pathology, as it is also reflected in the large number of scientific manifestations dedicated exclusively, or in association to this problem, aimed at achieving a permanent therapeutic progress in this field. In the period between 1986 and 1987 the authors have selected 60 patients out of those hospitalized for this defect in the Clinic. The patients were aged between 2 and 43 years. Orthodontal therapy is the type of therapy which takes the longest time in these patients. This is achieved by the successive application of orthodontal devices, which necessitate a long-term therapeutic strategy. In the course of this therapy a permanent cooperation is necessary between the specialist in orthodontics and the maxillofacial surgeon. A common approach is beneficial for both specialties. The number of specialists in orthodontics involved in the orthodontal therapy of labio-maxillo-palatine clefts is alarmingly low, and thus there is no possibility to evolve a special program for their further special education. Another difficulty is the fact that patients from all over the country demand the services of the same specialist, and a series of aspects evolve from this situation, as follows: the patients (usually accompanied by one of the parents) have to perform long trips, which are also expensive; when incidents occur, in relation with the use of a orthodontal device these patients cannot require immediately the assistance of specialized services, and, as a result, the number of recidives is alarmingly high.(ABSTRACT TRUNCATED AT 400 WORDS) more...

Dento-maxillary anomalies are the results of a deviation of growth processes, or of the development of the dento-maxillary apparatus. From the viewpoint of their frequencies the dento-maxillary anomalies hold the third place in the list of stomatological affections. The great variety of clinical manifestations of dento-maxillary anomalies has determined definition of therapeutical attitudes, in the frame of which therapy with orthodontal devices has an important place. This type of therapy exerts its effects also by implicating the parodontium, and this by at least two different mechanisms:-the induction of changes in the structures of the dento-maxillary apparatus by a direct parodontal mechanisms; as an element in the overall regulation of the growth of the dento-maxillary apparatus. The treatment with orthodontial devices should be conceived in such a way that it will protect the parodontium from the deleterious effects of these devices. The data presented further were obtained from 2 groups of patients and concern the improvement of the efficiency of treatments with orthodontal devices, and the protection of the parodontium during treatment. The first group was investigated in 1988, and criteria for the selection of participants in the second group were established. In the first group a total of 109 subjects were included, aged between 5 and 20 years, in whom stomatologic procedures were started in January 1988. These subjects were followed until the month of November of the same year. The most frequently encountered anomaly was maxillary compression (endalvellia) in 70 subjects. With regard to the condition of the marginal parodontium clinical exploration showed that 57 subjects had not underwent changes.(ABSTRACT TRUNCATED AT 250 WORDS) more...

The present paper forms part of a longitudinal study on prostheses restaurations with Romanian non-noble alloys for establishing the clinical, technological and biological implications of their utilization in mass assistance. The large contact surface with biological structures and the buccal medium of total conjoint restaurations permitted chacking of previous data regarding the biological behaviour of these alloys. In the group of 58 patients with total bridges followed up for 2 to 5 years there were no adverse reactions in which the alloy used could be incriminated. The iatrogenic aspects observed consequent to the application of prostheses were common to the use of any other metal alloy. The surface colour changes in a reduced number of cases depended upon the technologic preparation of the alloys and particularly upon the patient's limited ability to keep the plate under bacterial control. The study demonstrated that casting of a total Gaudent S bridge under present conditions does not give correct adaptation of the cervical limits which means more accurate compliance with the technology and homologation of the specific of this alloy. more...