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2. MO-0216 Hypofractionated IGRT for prostate cancer: first report on toxicity of a phase III randomized trial

Author

Mazzeo, E., primary, Bruni, A., additional, Iotti, C., additional, Frezza, G., additional, Meduri, B., additional, Guidi, G., additional, Vigo, F., additional, Vicini, R., additional, Vernaleone, M., additional, Ciabatti, S., additional, Cenacchi, E, additional, Stefanelli, A., additional, Miranda, G., additional, Diquattro, S., additional, Romeo, A., additional, D'Amico, R., additional, Bertoni, F., additional, and Lohr, F., additional

Published
2023
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3. PO-1372 Stereotactic Radiotherapy In Pancreatic Cancer: An Update Of A National Survey

Author

Lucarelli, M., primary, Di Carlo, C., additional, Mantello, G., additional, Osti, M.F., additional, Guido, A., additional, Montrone, S., additional, Bacigalupo, A., additional, Ciabattoni, A., additional, Meduri, B., additional, Macchia, G., additional, Cellini, F., additional, Giaccherini, L., additional, Lupatelli, M., additional, Bignardi, M., additional, Fiore, M., additional, Troiano, M., additional, Simoni, N., additional, Mazzarotto, R., additional, Loi, M., additional, Niespolo, R.M., additional, Borzillo, V., additional, Gerardi, M.A., additional, Comito, T., additional, and Caravatta, L., additional

Published
2023
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4. Axillary Management in Breast Cancer Patients Undergoing Upfront Surgery: Results from a Nationwide Survey on Behalf of the Clinical Oncology Breast Cancer Group (COBCG) and the Breast Cancer Study Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Author

De Rose, F, Colciago, R, Lucidi, S, La Rocca, E, Prisco, A, Bonzano, E, Meduri, B, De Santis, M, Dicuonzo, S, Pasinetti, N, Palumbo, I, Meattini, I, Franco, P, De Rose, Fiorenza, Colciago, Riccardo, Lucidi, Sara, La Rocca, Eliana, Prisco, Agnese, Bonzano, Elisabetta, Meduri, Bruno, De Santis, Maria, Dicuonzo, Samantha, Pasinetti, Nadia, Palumbo, Isabella, Meattini, Icro, Franco, Pierfrancesco, De Rose, F, Colciago, R, Lucidi, S, La Rocca, E, Prisco, A, Bonzano, E, Meduri, B, De Santis, M, Dicuonzo, S, Pasinetti, N, Palumbo, I, Meattini, I, Franco, P, De Rose, Fiorenza, Colciago, Riccardo, Lucidi, Sara, La Rocca, Eliana, Prisco, Agnese, Bonzano, Elisabetta, Meduri, Bruno, De Santis, Maria, Dicuonzo, Samantha, Pasinetti, Nadia, Palumbo, Isabella, Meattini, Icro, and Franco, Pierfrancesco

Abstract

Background: We assessed the current practice concerning the axillary management of breast cancer (BC) patients undergoing upfront surgery among radiation oncologists (ROs) practising in Italy. Methods: An online survey via SurveyMonkey (including 21 questions) was distributed amongst ROs in Italy through personal contacts and the Italian Association for Radiotherapy and Clinical Oncology (AIRO) network from August to September 2022. We particularly focused on the emerging omission of axillary lymph node dissection (ALND) in the presence of 1-2 sentinel node-positive patients and the consequent change in the role of regional nodal irradiation (RNI). Results: A total of 101/195 (51% response rate) Italian Radiotherapy Cancer Care Centres answered the survey. With respect to patients with 1-2 sentinel node-positive, the relative proportion of respondents that offer patients ALND a) always, b) only in selected cases, and c) never was 37.6%, 60.4%, and 2.0%, respectively, with no significant geographical (North vs. Centre-South Italy; p = 0.92) or institutional (Academic vs. non-Academic; p = 0.49) differences. Radiation therapy indications varied widely in patients who did not undergo ALND. Among these, about a third of the respondents (17/56, 30.4%) stated that RNI was constantly performed. On the other hand, half of the respondents offered RNI in selected cases, stating that an unfavourable biologic tumour profile and extracapsular nodal extension were considered drivers of their decision. Conclusions: Results of the present survey show the variability of axillary management offered in clinical practice for BC patients undergoing conserving surgery upfront in Italy. Analysis of these attitudes may trigger the modification of some clinical approaches through multidisciplinary collaboration and create the background for future clinical investigations.

Published
2023

7. Loco-regional adjuvant radiation therapy in breast cancer patients with positive axillary lymph-nodes at diagnosis (CN2) undergoing preoperative chemotherapy and with complete pathological lymph-nodes response. Development of GRADE (Grades of recommendation, assessment, Development and Evaluation) recommendation by the Italian Association of radiation therapy and Clinical Oncology (AIRO)

Author

Marino, L, Lancellotta, V, Franco, P, Meattini, I, Meduri, B, Bernini, M, Fabi, A, Corvo, R, Magrini, S, Pappagallo, G, Arcangeli, S, D'Angelillo, R, Marino L., Lancellotta V., Franco P., Meattini I., Meduri B., Bernini M., Fabi A., Corvo R., Magrini S. M., Pappagallo G. L., Arcangeli S., D'Angelillo R. M., Marino, L, Lancellotta, V, Franco, P, Meattini, I, Meduri, B, Bernini, M, Fabi, A, Corvo, R, Magrini, S, Pappagallo, G, Arcangeli, S, D'Angelillo, R, Marino L., Lancellotta V., Franco P., Meattini I., Meduri B., Bernini M., Fabi A., Corvo R., Magrini S. M., Pappagallo G. L., Arcangeli S., and D'Angelillo R. M.

Abstract

Objective: To perform a meta-analysis to determine the effect of loco-regional radiation therapy (RT) compared to no loco-regional RT for operated patients in clinical stage cN2 breast cancer at diagnosis and ypN0 after preoperative chemotherapy (PST). Material and Methods: Eligible studies were identified through a systematic search of the medical literature performed independently by two researchers using a validated search strategy. An electronic search of Medline via PubMed and Embase (Breast cancer AND preoperative chemotherapy AND radiation therapy) was conducted with no language or publication status restrictions. The effect of loco-regional RT on overall (OS), disease free (DFS), loco-regional recurrence-free (LRRFS) survival and local recurrence was evaluated. An electronic search of Medline via PubMed and Embase (Toxicity AND radiation therapy breast cancer AND preoperative therapy; toxicity AND breast surgery AND preoperative chemotherapy) was conducted for outcomes of harm: major acute and late skin toxicity, lymphedema and cardiac events. Results: Of 333 studies identified, 4 retrospective studies reporting on a total of 1107 patients were included in the meta-analysis. Six and 3 reported data of acute and late skin toxicity, while 2 studies provided information on cardiac events. Pooled results showed no difference in terms of hazard ratio for loco-regional RT versus no loco-regional RT [hazard ratio (HR) = 0.82, 95% confidence interval (CI) 0.63–1.68]. Loco-regional RT was associated with an OS benefit in the subgroup analysis: IIIB-C (loco-regional RT 79.3% vs no loco-regional RT 71.2%, p = 0.027) and T3-T4 (loco-regional RT 82.6% vs no loco-regional RT 76.6%, p = 0.025). No difference was shown in terms of 5-year DFS (loco-regional RT 91.2% vs no loco-regional RT 83%, p = 0.441) and LRRFS (loco-regional RT 98.1% vs no loco-regional RT 92.3%, p = 0.148). There was no significant difference between the groups in terms of acute and late skin toxicities

Published
2021

9. Rethinking breast cancer follow-up based on individual risk and recurrence management

Author

De Rose, F, Meduri, B, De Santis, M, Ferro, A, Marino, L, Colciago, R, Gregucci, F, Vanoni, V, Apolone, G, Di Cosimo, S, Delaloge, S, Cortes, J, Curigliano, G, De Rose, Fiorenza, Meduri, Bruno, De Santis, Maria Carmen, Ferro, Antonella, Marino, Lorenza, Colciago, Riccardo Ray, Gregucci, Fabiana, Vanoni, Valentina, Apolone, Giovanni, Di Cosimo, Serena, Delaloge, Suzette, Cortes, Javier, Curigliano, Giuseppe, De Rose, F, Meduri, B, De Santis, M, Ferro, A, Marino, L, Colciago, R, Gregucci, F, Vanoni, V, Apolone, G, Di Cosimo, S, Delaloge, S, Cortes, J, Curigliano, G, De Rose, Fiorenza, Meduri, Bruno, De Santis, Maria Carmen, Ferro, Antonella, Marino, Lorenza, Colciago, Riccardo Ray, Gregucci, Fabiana, Vanoni, Valentina, Apolone, Giovanni, Di Cosimo, Serena, Delaloge, Suzette, Cortes, Javier, and Curigliano, Giuseppe

Abstract

Current follow-up policies for early breast cancer aim to detect loco-regional recurrences and manage treatment-related adverse effects. Their "one size fits all" approach does not take into account differences in subtypes at initial diagnosis, individual prognosis and treatments received. They are derived from clinical trials conducted when early detection means - other than mammography - and treatment options were limited. Herein, we address the arguments for re-evaluating current breast cancer follow-up strategies starting from recent advances in breast cancer local and systemic treatments and discussing individual risk of recurrence prediction models, time-adapted imaging and biomarker assessment for disease diagnostic anticipation. This change in perspective would transform breast cancer follow-up into an integrated, multidisciplinary team medical practice. Hence we discuss the important role of patient-centered approaches, but also of general practitioners and other health professionals, in the final promotion of personalized surveillance programs and patient education.

Published
2022

10. Ways to improve breast cancer patients' management and clinical outcome: The 2020 Assisi Think Tank Meeting

Author

Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, Aristei C; Bölükbaşı Y; Kaidar-Person O; Pfeffer R; Arenas M; Boersma LJ; Ciabattoni A; Coles CE; Franco P; Krengli M; Leonardi MC; Marazzi F; Masiello V; Meattini I; Montero A; Offersen B; Trigo ML; Bourgier C; Genovesi D; Kouloulias V; Morganti AG; Meduri B; Pasinetti N; Pedretti S; Perrucci E; Rivera S; Tombolini V; Vidali C; Valentini V; Poortmans P, Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, and Aristei C; Bölükbaşı Y; Kaidar-Person O; Pfeffer R; Arenas M; Boersma LJ; Ciabattoni A; Coles CE; Franco P; Krengli M; Leonardi MC; Marazzi F; Masiello V; Meattini I; Montero A; Offersen B; Trigo ML; Bourgier C; Genovesi D; Kouloulias V; Morganti AG; Meduri B; Pasinetti N; Pedretti S; Perrucci E; Rivera S; Tombolini V; Vidali C; Valentini V; Poortmans P

Abstract

We report on the third Assisi Think Tank Meeting (ATTM) on breast cancer, a brainstorming project which involved European radiation and clinical oncologists who were dedicated to breast cancer research and treatment. Held on February 2020, the ATTM aimed at identifying key clinical questions in current clinical practice and "grey" areas requiring research to improve management and outcomes. Before the meeting, three key topics were selected: 1) managing patients with frailty due to either age and/or multi-morbidity; 2) stereotactic radiation therapy and systemic therapy in the management of oligometastatic disease; 3) contralateral breast tumour prevention in BCRA-mutated patients. Clinical practice in these areas was investigated by means of an online questionnaire. In the lapse period between the survey and the meeting, the working groups reviewed data, on-going studies and the clinical challenges which were then discussed in-depth and subjected to intense brainstorming during the meeting; research protocols were also proposed. Methodology, outcome of discussions, conclusions and study proposals are summarized in the present paper. In conclusion, this report presents an in-depth analysis of the state of the art, grey areas and controversies in breast cancer radiation therapy and discusses how to confront them in the absence of evidence-based data to guide clinical decision-making.Copyright © 2022 Elsevier B.V. All rights reserved.

Published
2022

12. Present clinical practice of breast cancer radiotherapy in Italy: a nationwide survey by the Italian Society of Radiotherapy and Clinical Oncology (AIRO) Breast Group

Author

Gregucci, F., Fozza, A., Falivene, S., Smaniotto, D., Morra, A., Daidone, A., Barbara, R., Ciabattoni, A., Andrulli, D., Arcidiacono, F., Baiocchi, C., Baldissera, A., Barbarino, R., Bartoncini, S., Bono, M., Buffoli, A., Campanella, B., Campoccia, S., Catalano, G., Cavallari, M., Cerreta, V., Deantonio, L., De Rose, F., Del Bufalo, S., Digennaro, D., Doino, D., Evangelista, G., Fedele, F., Fiorentino, A., Fodor, A., Fontana, A., Fusco, V., Gatti, M., Gerardi, M., Giannini, M., Girlando, A., Guenzi, M., Guida, C., Huscher, A., Iannone, T., Iorio, V., Ippolito, E., Ivaldi, G., La Porta, M., Lazzari, G., Lioce, M., Lora, O., Macchia, G., Mangiacotti, M. G., Marafioti, L., Marino, L., Marmiroli, L., Maucieri, A., Maurizi, F., Mazzuoli, L., Meattini, I., Meduri, B., Montesi, G., Munoz, F., Nuzzo, M., Orru, S., Parisi, S., Pasinetti, N., Pedretti, S., Perrucci, E., Piva, D., Prisco, A., Ravo, V., Santacaterina, A., Scolaro, T., Serafini, F., Spigone, B., Tolento, G., Vidali, C., Vitucci, P., and Zini, G.

Subjects
Hypofractionated Radiotherapy, medicine.medical_specialty, medicine.medical_treatment, Breast Neoplasms, Breast cancer radiotherapy, Nationwide survey, Hypofractionated radiotherapy, 030218 nuclear medicine & medical imaging, AIRO, Breast cancer, Partial-breast irradiation, Radiotherapy and neoadjuvant therapy, Re-irradiation, Survey, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, medicine, Humans, Radiology, Nuclear Medicine and imaging, Practice Patterns, Physicians', Medical prescription, Societies, Medical, Clinical Oncology, business.industry, General surgery, Radiation Oncologists, General Medicine, medicine.disease, Clinical Practice, Radiation therapy, Italy, 030220 oncology & carcinogenesis, Female, business
Abstract

To investigate the present attitude of the Italian Radiation Oncologists in the management of breast cancer (BC) concerning hypofractionated radiotherapy (hRT), partial-breast irradiation (PBI), re-irradiation (rRT) and radiotherapy after neoadjuvant chemotherapy (post-NAC RT). A nationwide, 21-point questionnaire was distributed online via SurveyMonkey. Seventy-four Italian Radiotherapy Centers answered to the survey. In most cases, the responding centers treated more than 100 BC patients/year between January 2016 and December 2017. Almost half of responding centers (49%) treated patients with hRT, out of these, 95% as routine practice for early-stage BC. Dose prescriptions ranged between 39 and 45 Gy indicating a high use of moderate hRT. The chest wall and regional lymph nodes were irradiated with hRT by 13% and 15% of the responding centers, respectively. PBI was used by 60% of responders, with different techniques. Only 0.6% of participants perform rRT after BC recurrence. Finally, only 11% of the interviewed centers responded to their attitude toward post-NAC RT, which, however, was indicated in 97% of patients after breast-conserving surgery. This survey shows a fairly good use of hRT and a moderate practice of PBI in Italy. Some practices like hRT to the chest wall and regional lymph nodes as well as rRT need further verification. Likewise, the management of post-NAC RT is very heterogeneous. Future national clinical collaborative studies are advocated in order to investigate these controversial topics about breast cancer radiotherapy.

Published
2020
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14. Breast reconstruction and radiation therapy: consensus statements of the Italian association of radiotherapy and clinical oncology (AIRO) breast cancer group

Author

Meattini, I., primary, Rocco, N., additional, Bernini, M., additional, Bonzano, E., additional, De Rose, F., additional, De Santis, M.C., additional, Franco, P., additional, Meduri, B., additional, Parisi, S., additional, Pasinetti, N., additional, Prisco, A., additional, Fontana, A., additional, Becherini, C., additional, and Livi, L., additional

Published
2021
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17. OC-0611: APBI with 3D-CRT vs. WBI: cosmetic and toxicity results of the prospective randomised IRMA trial

Author

Meduri, B., primary, Baldissera, A., additional, Stam, M., additional, Blandino, G., additional, Boersma, L., additional, Parisi, S., additional, Valli, M., additional, Koiter, E., additional, Frassinelli, L., additional, Ciabatti, S., additional, Giacobazzi, P., additional, Morganti, A.G., additional, D'amico, R., additional, Iotti, C., additional, Bertoni, F., additional, Poortmans, P.M.P., additional, and Frezza, G.P., additional

Published
2020
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18. PO-0842: PRO.M.E.THE.O.: the development of an italian multicentric OS predictive model in oropharynx cancer

Author

Miccichè, F., primary, Chiloiro, G., additional, Longo, S., additional, Bonomo, P., additional, Bacigalupo, A., additional, Merlotti, A., additional, D'angelo, E., additional, Franco, P., additional, Belgioia, L., additional, Desideri, I., additional, Denaro, N., additional, Meduri, B., additional, Arcadipane, F., additional, Lenkowicz, J., additional, Pesce, A., additional, Autorino, R., additional, Massaccesi, M., additional, and Valentini, V., additional

Published
2020
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19. 425P Statins increase pathological response in locally advanced rectal cancer (LARC) treated with chemo-radiation (CRT): A multicentric experience

Author

Santini, C., primary, Caputo, F., additional, Gardini, A. Casadei, additional, Cerma, K., additional, Bardasi, C., additional, Passardi, A., additional, Garajovà, I., additional, Rapposelli, I.G., additional, Lattanzi, E., additional, Spallanzani, A., additional, Bonetti, L. Reggiani, additional, Piccoli, M., additional, Meduri, B., additional, Gelmini, R., additional, Pecchi, A., additional, Benatti, S., additional, Dominici, M., additional, Luppi, G., additional, and Gelsomino, F., additional

Published
2020
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24. Radiotherapy‐induced subclinical skin changes revealed by dynamic optical coherence tomography: a case‐controlled pilot study.

Author

Chello, C., Ciardo, S., Chester, J., Guanti, M., Farnetani, F., Guida, S., Sticchi, A., Giacobazzi, P., Meduri, B., Lohr, F., Pellacani, G., and Manfredini, M.

Subjects
OPTICAL coherence tomography, SKIN ulcers, PILOT projects, COHERENCE (Optics), RADIATION injuries, RADIODERMATITIS
Abstract

Radiotherapy-induced subclinical skin changes revealed by dynamic optical coherence tomography: a case-controlled pilot study Radiotherapy (RT) is often used in the treatment of several cancers, including breast cancer.1-3 However, RT can invoke toxic cutaneous effects, depending directly on the amount of RT irradiation and duration and individual clinical patient characteristics. Images (VivoSight SP ® sp D-OCT Michelson Diagnostics Ltd, Maidstone, Kent, UK) were acquired at the superior anterior axillary line that was directly included in the target region of one of the RT fractions, 21-28 days from final RT session (treatment group). [Extracted from the article]

Published
2022
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27. OC-0587: Hypofractionated radiotherapy vs temozolomide in glioblastoma RPA V-VI: a randomized phase II trial

Author

Pedretti, S., primary, Masini, L., additional, Turco, E., additional, Triggiani, L., additional, Krengli, M., additional, Meduri, B., additional, Pirtoli, L., additional, Faedi, M., additional, Gatta, R., additional, Scoccianti, S., additional, Ricardi, U., additional, Santoni, R., additional, Magrini, S., additional, and Buglione, M., additional

Published
2018
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28. Ductal carcinoma in situ treated with breast conservative surgery and radiotherapy: A national multicentre experience

Author

Meattini, I., primary, Pasinetti, N., additional, Meduri, B., additional, De Rose, F., additional, De Santis, M.C., additional, Lancellotta, V., additional, Rossi, F., additional, Franco, P., additional, Alongi, F., additional, Saieva, C., additional, Delli Paoli, C., additional, Desideri, I., additional, D’angelo, E., additional, Triggiani, L., additional, Ricardi, U., additional, Bastiani, P., additional, Aristei, C., additional, Lozza, L., additional, Scorsetti, M., additional, and Livi, L., additional

Published
2018
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29. OC-0160: DCIS treated with breast conservative surgery and radiotherapy: a national multicentre experience

Author

Meattini, I., primary, Pasinetti, N., additional, Meduri, B., additional, De Rose, F., additional, De Santis, M.C., additional, Lancellotta, V., additional, Rossi, F., additional, Franco, P., additional, Alongi, F., additional, Saieva, C., additional, Olmetto, E., additional, Desideri, I., additional, D'Angelo, E., additional, Triggiani, L., additional, Ricardi, U., additional, Bastiani, P., additional, Aristei, C., additional, Lozza, L., additional, Scorsetti, M., additional, and Livi, L., additional

Published
2018
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33. Incidence and survival of secondary malignances (SM) in oropharingeal squamous cell carcinoma (OPSCC): A homogeneous single report institution

Author

Napolitano, M., primary, Bertolini, F., additional, D'Angelo, E., additional, Spallanzani, A., additional, Tassi, S., additional, Meduri, B., additional, Bettelli, S., additional, Depenni, R., additional, Ghidini, A., additional, Lohr, F., additional, Presutti, L., additional, and Cascinu, S., additional

Published
2017
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35. OC-0568: Accelerated PBI VS standard radiotherapy (IRMA trial): interim cosmetic and toxicity results

Author

Meduri, B., primary, Baldissera, A., additional, Galeandro, M., additional, Donini, E., additional, Tolento, G., additional, Giacobazzi, P., additional, Calmieri, T., additional, Vasilyeva, P., additional, Morganti, A.G., additional, Parisi, S., additional, Kaleci, S., additional, Lohr, F., additional, D'amico, R., additional, Poortmans, P.M., additional, Bertoni, F., additional, and Frezza, G.P., additional

Published
2017
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45. OC-0367: A Neural Network analysis to support Adaptive RT strategies: a multicenter retrospective study

Author

Guidi, G., primary, Maffei, N., additional, Meduri, B., additional, Maggi, S., additional, Cardinali, M., additional, Morabito, V.M., additional, Rosica, F., additional, Malara, S., additional, Savini, A., additional, Orlandi, G., additional, Ugo, C.D., additional, Bunkheila, F., additional, Bono, M., additional, Lappi, S., additional, Blasi, C., additional, Mistretta, G.M., additional, Ceroni, P., additional, Ciarmatori, A., additional, Bernabei, A., additional, Giacobazzi, P., additional, and Costi, T., additional

Published
2016
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