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1. Italian Guidelines for the Management of Prolactinomas

Author

Cozzi, R., Auriemma, R. S., De Menis, E., Esposito, F., Ferrante, E., Iati, G., Mazzatenta, D., Poggi, M., Ruda, R., Tortora, F., Cruciani, F., Mitrova, Z., Saulle, R., Vecchi, S., Basile, M., Cappabianca, P., Paoletta, A., Papini, E., Persichetti, A., Samperi, I., Scoppola, A., Bozzao, A., Caputo, M., Doglietto, Francesco, Ferrau, F., Lania, A. G., Laureti, S., Lello, S., Locatelli, D., Maffei, P., Minniti, G., Peri, A., Ruini, C., Settanni, F., Silvani, A., Veronese, N., Grimaldi, F., Attanasio, R., Doglietto F. (ORCID:0000-0002-7438-0734), Cozzi, R., Auriemma, R. S., De Menis, E., Esposito, F., Ferrante, E., Iati, G., Mazzatenta, D., Poggi, M., Ruda, R., Tortora, F., Cruciani, F., Mitrova, Z., Saulle, R., Vecchi, S., Basile, M., Cappabianca, P., Paoletta, A., Papini, E., Persichetti, A., Samperi, I., Scoppola, A., Bozzao, A., Caputo, M., Doglietto, Francesco, Ferrau, F., Lania, A. G., Laureti, S., Lello, S., Locatelli, D., Maffei, P., Minniti, G., Peri, A., Ruini, C., Settanni, F., Silvani, A., Veronese, N., Grimaldi, F., Attanasio, R., and Doglietto F. (ORCID:0000-0002-7438-0734)

Abstract

Introduction: This guideline (GL) is aimed at providing a reference for the management of prolactin (PRL)-secreting pituitary adenoma in adults. However, pregnancy is not considered. Methods: This GL has been developed following the methods described in the Manual of the Italian National Guideline System. For each question, the panel appointed by Associazione Medici Endocrinologi (AME) has identified potentially relevant outcomes, which have then been rated for their impact on therapeutic choices. Only outcomes classified as “critical” and “important” have been considered in the systematic review of evidence and only those classified as “critical” have been considered in the formulation of recommendations. Results: The present GL provides recommendations regarding the role of pharmacological and neurosurgical treatment in the management of prolactinomas. We recommend cabergoline (Cab) vs. bromocriptine (Br) as the first-choice pharmacological treatment to be employed at the minimal effective dose capable of achieving the regression of the clinical picture. We suggest that medication and surgery are offered as suitable alternative first-line treatments to patients with non-invasive PRL-secreting adenoma, regardless of size. We suggest Br as an alternative drug in patients who are intolerant to Cab and are not candidates for surgery. We recommend pituitary tumor resection in patients 1) without any significant neuro-ophthalmologic improvement within two weeks from the start of Cab, 2) who are resistant or do not tolerate Cab or other dopamine-agonist drugs (DA), 3) who escape from previous efficacy of DA, and 4) who are unwilling to undergo a chronic DA treatment. We recommend that patients with progressive disease notwithstanding previous tumor resection and ongoing DA should be managed by a multidisciplinary team with specific expertise in pituitary diseases using a multimodal approach that includes repeated surgery, radiother-apy, DA, and possibly, the use of temoz

Published
2023

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

Author

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

Abstract

N/A

Published
2021

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

Author

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

Abstract

Italy experienced one of the world's deadliest COVID-19 outbreaks and healthcare systems had to instantly reorganise activity. The Italian Radiation Oncology Departments adapted numerous solutions to minimize the disruptions. Information technologies, treatment prioritization and implementation of hypofractionation and protection procedures allowed balancing between cancer patient care and patient/healthcare workers safety.

Published
2020

5. Stereotactic radiotherapy in the retreatment of recurrent cervical cancers

Author

Brogna, A., primary, Midili, F., additional, Siragusa, C., additional, Mongelli, V., additional, Di Pasquale, A., additional, Micali, A., additional, Angiocchi, M.C., additional, Bonaparte, I., additional, Feti, G., additional, Pontoriero, A., additional, Iati, G., additional, Pergolizzi, S., additional, and Ielo, I., additional

Published
2016
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17. Stereotactic Body Radiation Therapy With Simultaneous Integrated Boost in Patients With Spinal Metastases

Author

C. Siragusa, I. Ielo, Consuelo Tamburella, Gianluca Ferini, Silvana Parisi, Cesare Severo, Domenico Cambareri, Giuseppe Iatì, Stefano Pergolizzi, A. Brogna, Alberto Cacciola, Valerio Davì, Antonio Pontoriero, Nicola Settineri, Laura Molino, Alfredo Conti, Pontoriero A., Iati G., Cacciola A., Conti A., Brogna A., Siragusa C., Ferini G., Davi V., Tamburella C., Molino L., Cambareri D., Severo C., Parisi S., Settineri N., Ielo I., and Pergolizzi S.

Subjects
Simultaneous integrated boost, Adult, Male, robotic, Cancer Research, medicine.medical_specialty, oligometastatic, Stereotactic body radiation therapy, medicine.medical_treatment, CyberKnife, Fluid-attenuated inversion recovery, Radiation Dosage, lcsh:RC254-282, Radiosurgery, 03 medical and health sciences, 0302 clinical medicine, Cyberknife, Fractures, Compression, medicine, Humans, Pain Management, In patient, Adverse effect, CyberKnife, SBRT, Oligometastatic, Radiosurgery, Robotic, Simultaneous integrated boost, Aged, Retrospective Studies, Aged, 80 and over, Spinal Neoplasms, SBRT, business.industry, Vertebral compression fracture, radiosurgery, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Survival Rate, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, simultaneous integrated boost, Spinal Fractures, Female, Original Article, Radiology, Dose Fractionation, Radiation, business, 030217 neurology & neurosurgery
Abstract

Stereotactic body radiation therapy in patients with spine metastases maximizes local tumor control and preserves neurologic function. A novel approach could be the use of stereotactic body radiation therapy with simultaneous integrated boost delivering modality. The aim of the present study is to report our experience in the treatment of spine metastases using a frameless radiosurgery system delivering stereotactic body radiation therapy–simultaneous integrated boost technique. The primary endpoints were the pain control and the time to local progression; the secondary ones were the overall survival and toxicity. A total of 20 patients with spine metastases and 22 metastatic sites were treated in our center with stereotactic body radiation therapy–simultaneous integrated boost between December 2007 and July 2018. Stereotactic body radiation therapy–simultaneous integrated boost treatments were delivered doses of 8 to 10 Gy in 1 fraction to isodose line of 50%. The median follow-up was 35 months (range: 12-110). The median time to local progression for all patients was not reached and the actuarial 1-, 2-, and 3-years local free progression rate was 86.36%. In 17 of 20 patients, a complete pain remission was observed and 3 of 20 patients had a partial pain remission (complete pain remission + partial pain remission: 100%). The median overall survival was 38 months (range 12-83). None of the patients experienced neither radiation adverse events (grade 1-4) nor reported pain flair reaction. None of the patients included in our series experienced vertebral compression fracture. Spine radiosurgery with stereotactic body radiation therapy–simultaneous integrated boost is safe. The use of this modality in spine metastases patients provides an excellent local control.

Published
2020

18. Image-guided multisession radiosurgery of skull base meningiomas

Author

Silvana Parisi, Antonio Pontoriero, Salvatore Cardali, Filippo Friso, Alberto Cacciola, Diego Mazzatenta, Stefano Pergolizzi, Alfredo Conti, Giuseppe Iatì, A. Brogna, Matteo Zoli, Sara Lillo, Vittoria Rosetti, Conti A., Pontoriero A., Iati G., Cardali S.M., Brogna A., Friso F., Rosetti V., Zoli M., Parisi S., Cacciola A., Lillo S., Pergolizzi S., and Mazzatenta D.

Subjects
Cancer Research, medicine.medical_specialty, medicine.medical_treatment, CyberKnife, Hypofractionated stereotactic radiotherapy, Image-guided radiotherapy, Meningioma, Radiosurgery, Skull base, lcsh:RC254-282, Article, 03 medical and health sciences, 0302 clinical medicine, Trigeminal neuralgia, Cyberknife, otorhinolaryngologic diseases, medicine, business.industry, Cranial nerves, CAROTID OCCLUSION, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Radiation therapy, Skull, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Radiology, business, 030217 neurology & neurosurgery
Abstract

Background: The efficacy of single-session stereotactic radiosurgery (sSRS) for the treatment of intracranial meningioma is widely recognized. However, sSRS is not always feasible in cases of large tumors and those lying close to critically radiation-sensitive structures. When surgery is not recommended, multi-session stereotactic radiosurgery (mSRS) can be applied. Even so, the efficacy and best treatment schedule of mSRS are not yet established. The aim of this study is to validate the role of mSRS in the treatment of skull base meningiomas. Methods: A retrospective analysis of patients with skull base meningiomas treated with mSRS (two to five fractions) at the University of Messina, Italy, from 2008 to 2018, was conducted. Results: 156 patients met the inclusion criteria. The median follow-up period was 36.2 &plusmn, 29.3 months. Progression-free survival at 2-, 5-, and 10- years was 95%, 90%, and 80.8%, respectively. There were no new visual or motor deficits, nor cranial nerves impairments, excluding trigeminal neuralgia, which was reported by 5.7% of patients. One patient reported carotid occlusion and one developed brain edema. Conclusion: Multisession radiosurgery is an effective approach for skull base meningiomas. The long-term control is comparable to that obtained with conventionally-fractionated radiotherapy, while the toxicity rate is very limited.

Published
2020

19. Factors affecting outcome in frameless non-isocentric stereotactic radiosurgery for trigeminal neuralgia: a multicentric cohort study

Author

Alfredo Conti, Gueliz Acker, Antonio Pontoriero, Juliane Hardt, Anne Kluge, Alberto Cacciola, Giuseppe Iatì, Markus Kufeld, Volker Budach, Peter Vajkoczy, Giancarlo Beltramo, Stefano Pergolizzi, Achille Bergantin, Franziska Loebel, Silvana Parisi, Carolin Senger, Pantaleo Romanelli, Conti A., Acker G., Pontoriero A., Hardt J., Kluge A., Cacciola A., Iati G., Kufeld M., Budach V., Vajkoczy P., Beltramo G., Pergolizzi S., Bergantin A., Loebel F., Parisi S., Senger C., and Romanelli P.

Subjects
lcsh:Medical physics. Medical radiology. Nuclear medicine, Adult, Male, lcsh:R895-920, CyberKnife, Radiation Dosage, Radiosurgery, Neuropathic pain, lcsh:RC254-282, Young Adult, Robotic Surgical Procedures, Humans, ddc:610, Radiochirurgie, Stereotactic radiosurgery, Aged, Retrospective Studies, Aged, 80 and over, Research, Trigeminal neuralgia, Trigeminus, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Treatment Outcome, 610 Medizin, Gesundheit, Neuralgie, Female, Cyber-Knife, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, Radiotherapy, Image-Guided
Abstract

Background: Stereotactic radiosurgery (SRS) is an effective treatment for trigeminal neuralgia (TN). Nevertheless, a proportion of patients will experience recurrence and treatment-related sensory disturbances. In order to evaluate the predictors of efficacy and safety of image-guided non-isocentric radiosurgery, we analyzed the impact of trigeminal nerve volume and the nerve dose/volume relationship, together with relevant clinical characteristics. Methods: Two-hundred and ninety-six procedures were performed on 262 patients at three centers. In 17 patients the TN was secondary to multiple sclerosis (MS). Trigeminal pain and sensory disturbances were classified according to the Barrow Neurological Institute (BNI) scale. Pain-free-intervals were investigated using Kaplan Meier analyses. Univariate and multivariate Cox regression analyses were performed to identify predictors. Results: The median follow-up period was 38 months, median maximal dose 72.4 Gy, median target nerve volume 25 mm(3), and median prescription dose 60 Gy. Pain control rate (BNI I-III) at 6, 12, 24, 36, 48, and 60 months were 96.8, 90.9, 84.2, 81.4, 74.2, and 71.2%, respectively. Overall, 18% of patients developed sensory disturbances. Patients with volume ≥ 30 mm(3) were more likely to maintain pain relief (p = 0.031), and low integral dose (< 1.4 mJ) tended to be associated with more pain recurrence than intermediate (1.4-2.7 mJ) or high integral dose (> 2.7 mJ; low vs. intermediate: log-rank test, χ(2) = 5.02, p = 0.019; low vs. high: log-rank test, χ(2) = 6.026, p = 0.014). MS, integral dose, and mean dose were the factors associated with pain recurrence, while re-irradiation and MS were predictors for sensory disturbance in the multivariate analysis. Conclusions: The dose to nerve volume ratio is predictive of pain recurrence in TN, and re-irradiation has a major impact on the development of sensory disturbances after non-isocentric SRS. Interestingly, the integral dose may differ significantly in treatments using apparently similar dose and volume constraints.

Published
2020
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20. Frameless Stereotactic Radiosurgery for Treatment of Multiple Sclerosis-Related Trigeminal Neuralgia

Author

A. Brogna, Antonio Pontoriero, Francesco Tomasello, Felice Esposito, Sergio Vinci, Giuseppe Iatì, Francesco Saverio De Ponte, Enrico Nastro Siniscalchi, Salvatore Crimi, Stefano Pergolizzi, Antonino Germanò, Alfredo Conti, Conti Alfredo, Pontoriero A., Iati G., Esposito F., Siniscalchi E.N., Crimi S., Vinci S., Brogna A., De Ponte F., Germano A., Pergolizzi S., and Tomasello F.

Subjects
Male, Multiple Sclerosis, medicine.medical_treatment, CyberKnife, Radiosurgery, Follow-Up Studie, Rhizotomy, 03 medical and health sciences, 0302 clinical medicine, Trigeminal neuralgia, Cyberknife, Multiple Sclerosi, medicine, Humans, Trigeminal Nerve, Stereotactic radiosurgery, Facial numbne, medicine.diagnostic_test, business.industry, Multiple sclerosis, Magnetic resonance imaging, Pain scale, Middle Aged, Trigeminal Neuralgia, facial numbness, medicine.disease, Magnetic Resonance Imaging, 030220 oncology & carcinogenesis, Frameless radiosurgery, Cyberknife, facial numbness, frameless radiosurgery, multiple sclerosis, stereotactic radiosurgery, trigeminal neuralgia, Surgery, Female, Neurology (clinical), CyberKnife Radiosurgery, business, Nuclear medicine, Tomography, X-Ray Computed, 030217 neurology & neurosurgery, Human, Follow-Up Studies, Radiotherapy, Image-Guided
Abstract

Background Trigeminal neuralgia (TN) affects 7% of patients with multiple sclerosis (MS). In such patients, TN is difficult to manage either pharmacologically and surgically. Radiosurgical rhizotomy is an effective treatment option. The nonisocentric geometry of radiation beams of CyberKnife introduces new concepts in the treatment of TN. Its efficacy for MS-related TN has not yet been demonstrated. Methods Twenty-seven patients with refractory TN and MS were treated. A nonisocentric beams distribution was chosen; the maximal target dose was 72.5 Gy. The maximal dose to the brainstem was

Published
2017

21. Curative Radiotherapy in Elderly Patients With Muscle Invasive Bladder Cancer: The Prognostic Role of Sarcopenia.

Author

Ferini G, Cacciola A, Parisi S, Lillo S, Molino L, Tamburella C, Davi V, Napoli I, Platania A, Settineri N, Iati G, Pontoriero A, Pergolizzi S, and Santacaterina A

Subjects
Aged, Aged, 80 and over, Humans, Muscle, Skeletal pathology, Prognosis, Retrospective Studies, Survival Rate, Sarcopenia, Urinary Bladder Neoplasms complications, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms radiotherapy
Abstract

Background/aim: To evaluate the impact of sarcopenia in muscle invasive bladder cancer (MIBC) elderly patients submitted to curative radiotherapy., Patients and Methods: Patients received radiotherapy between 2013 and 2018, and the skeletal muscle index was calculated to classify them as sarcopenic or non-sarcopenic. Primary endpoints were overall survival (OS), cancer specific survival (CSS), 90-day mortality and toxicity., Results: A total of 28 patients with a median age of 85 years met our inclusion criteria and 8 of them were sarcopenic. With a median prescribed dose of 61 Gy and a median follow-up of 24.5 months, OS rates in the sarcopenic and non-sarcopenic groups were 100% and 84.4% at 3 months, 57.1% and 56.6% at 12 months, 38.1% and 50.3% at 24 months and 38.1% and 33.5% at 48 months, respectively; the CSS rates were 100% and 94.1% at 3 months and 68.6% and 88.2% at 12, 24 and 48 months, respectively. The actuarial 90-day mortality rate was 17.9% for the whole cohort, and 20% and 12.5% for the non-sarcopenic and sarcopenic groups, respectively. The radio-induced toxicity was similar in both groups., Conclusion: Sarcopenia cannot be considered a negative prognostic factor for MIBC elderly patients treated with external beam radiotherapy. Irradiation is therefore a feasible and effective choice for these patients, especially if unfit for surgery., (Copyright© 2021, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Published
2021
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22. DCE and DSC perfusion MRI diagnostic accuracy in the follow-up of primary and metastatic intra-axial brain tumors treated by radiosurgery with cyberknife.

Author

Morabito R, Alafaci C, Pergolizzi S, Pontoriero A, Iati' G, Bonanno L, Gaeta M, Salpietro FM, Mormina E, Longo M, and Granata F

Subjects
Adult, Aged, Aged, 80 and over, Brain Neoplasms surgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, ROC Curve, Retrospective Studies, Brain Neoplasms secondary, Contrast Media, Magnetic Resonance Angiography methods, Radiosurgery methods
Abstract

Background: The differential diagnosis between radiation necrosis, tumor recurrence and tumor progression is crucial for the evaluation of treatment response and treatment planning. The appearance of treatment-induced tissue necrosis on conventional Magnetic Resonance Imaging (MRI) is similar to brain tumor recurrence and it could be difficult to differentiate the two entities on follow-up MRI examinations. Dynamic Susceptibility Contrast-enhanced (DSC) and Dynamic Contrast-Enhanced (DCE) are MRI perfusion techniques that use an exogenous, intravascular, non-diffusible gadolinium-based contrast agent. The aim of this study was to compare the diagnostic accuracy of DSC and DCE perfusion MRI in the differential diagnosis between radiation necrosis and tumor recurrence, in the follow-up of primary and metastatic intra-axial brain tumors after Stereotactic RadioSurgery (SRS) performed with CyberKnife., Methods: A total of 72 enhancing lesions (57 brain metastases and 15 primary brain tumors) were analyzed with DCE and DSC, by means of MRI acquisition performed by 1,5 Tesla MR scanner. The statistical relationship between the diagnosis of tumor recurrence or radiation necrosis, decided according to clinicoradiologically criteria, rCBV and Ktrans was evaluated by the point-biserial correlation coefficient respectively., Results: The statistical analysis showed a correlation between the diagnosis of radiation necrosis or recurrent tumor with Ktrans (rpb = 0.54, p < 0.001) and with rCBV (rpb = 0.37, p = 0.002). The ROC analysis of rCBV values demonstrated a good classification ability in differentiating radiation necrosis from tumour recurrence as well as the Ktrans. The optimal cut-off value for rCBV was k = 1.23 with 0.88 of sensitivity and 0.75 of specificity while for Ktrans was k = 28.76 with 0.89 of sensitivity and 0.97 of specificity., Conclusions: MRI perfusion techniques, particularly DCE, help in the differential diagnosis by tumor recurrence and radiation necrosis during the follow-up after radiosurgery.

Published
2019
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23. Clinical Evaluation of Low-Molecular-Weight Hyaluronic Acid-Based Treatment on Onset of Acute Side Effects in Women Receiving Adjuvant Radiotherapy after Cervical Surgery: A Randomized Clinical Trial.

Author

Delia P, Sansotta G, Pontoriero A, Iati G, De Salvo S, Pisana M, Potami A, Lopes S, Messina G, and Pergolizzi S

Subjects
Adult, Aged, Female, Humans, Middle Aged, Neoplasm Staging, Radiation Injuries prevention & control, Radiotherapy, Adjuvant, Uterine Cervical Neoplasms therapy, Vaginal Diseases etiology, Hyaluronic Acid administration & dosage, Uterine Cervical Neoplasms radiotherapy, Vaginal Diseases prevention & control
Abstract

Background: Radiotherapy treatment for cervical cancer (CC) often induces side effects, including inflammation, dryness, dyspareunia. Considering its key role in the healing process, hyaluronic acid (HA) could be useful for the completion of radiotherapy., Objectives: The aim of this work was to evaluate the ability of HA to reduce the onset of side effects due to radiotherapy., Materials and Methods: In total, 180 women undergoing radiotherapy were randomized into two arms: controls and those treated with vaginal suppositories containing low-molecular-weight HA from day 1 of radiotherapy. The study lasted 5 weeks and was characterized by three visits: at baseline (T0), 15 days later (T1), and at the end of the radiotherapy cycle (T2). The onset of side effects, pain, safety, efficacy, acceptability of treatment, and compliance to the therapy were evaluated., Results: Patients in the control arm reported the onset and worsening of all symptoms with a moderate or severe grade at T2, whereas in the treatment arm almost 90% of patients reported the absence of symptoms or a mild grade. All patients in the treatment arm referred a lower intensity of pain on a visual analog scale compared with the control arm at T2 (6.85 ± 0.94 vs. 1.88 ± 1.02)., Conclusions: HA was able to help vaginal mucosa healing during radiotherapy in patients with CC., (© 2019 S. Karger AG, Basel.)

Published
2019
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