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1. 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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2. PO-1406 Re-irradiation in locally recurrent rectal cancer: a national survey of the AIRO GI study group

Author

MANTELLO, G., primary, Galofaro, E., additional, Di Carlo, C., additional, Montrone, S., additional, Caravatta, L., additional, De Paoli, A., additional, Gambacorta, M.A., additional, Genovesi, D., additional, Lupattelli, M., additional, Macchia, G., additional, Niespolo, R.M., additional, Valvo, F., additional, Arpa, D., additional, Scricciolo, M., additional, Chiloiro, V., additional, Montesi, G., additional, Pontoriero, A., additional, Donato, V., additional, and Franco, P., additional

Published
2023
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3. [18F]Fluorocholine PET/CT-guided stereotactic body radiotherapy in patients with recurrent oligometastatic prostate cancer

Author

Pasqualetti, F, Panichi, M, Sollini, M, Sainato, A, Galli, L, Morganti, R, Chiacchio, S, Marciano, A, Zanca, R, Mannelli, L, Coraggio, G, Sbrana, A, Cocuzza, P, Montrone, S, Baldaccini, D, Gonnelli, A, Molinari, A, Cantarella, M, Mazzotti, V, Ricci, S, Paiar, F, Erba, P, Pasqualetti F., Panichi M., Sollini M., Sainato A., Galli L., Morganti R., Chiacchio S., Marciano A., Zanca R., Mannelli L., Coraggio G., Sbrana A., Cocuzza P., Montrone S., Baldaccini D., Gonnelli A., Molinari A., Cantarella M., Mazzotti V., Ricci S., Paiar F., Erba P. A., Pasqualetti, F, Panichi, M, Sollini, M, Sainato, A, Galli, L, Morganti, R, Chiacchio, S, Marciano, A, Zanca, R, Mannelli, L, Coraggio, G, Sbrana, A, Cocuzza, P, Montrone, S, Baldaccini, D, Gonnelli, A, Molinari, A, Cantarella, M, Mazzotti, V, Ricci, S, Paiar, F, Erba, P, Pasqualetti F., Panichi M., Sollini M., Sainato A., Galli L., Morganti R., Chiacchio S., Marciano A., Zanca R., Mannelli L., Coraggio G., Sbrana A., Cocuzza P., Montrone S., Baldaccini D., Gonnelli A., Molinari A., Cantarella M., Mazzotti V., Ricci S., Paiar F., and Erba P. A.

Abstract

Background: In the last years, functional imaging has given a significant contribution to the clinical decision-making of biochemically relapsed prostate cancer (PCa). Hereby, we present a prospective study aiming to validate the role of [18F]Fluoro-Methyl Choline ([18F]FMCH) PET/CT in the selection of PCa patients suitable for stereotactic body radiotherapy (SBRT). Methods: Patients with biochemical recurrence limited up to three lesions revealed by [18F]FMCH PET/CT were enrolled in the present study and treated with SBRT on all active lesions. Systemic therapy-free survival since the [18F]FMCH PET/CT was considered as the primary endpoint. Results: Forty-six patients were evaluated, and a total of 67 lesions were treated. After a median follow-up of 28.9 months, systemic therapy was started in 30 patients (65.2%) and median systemic therapy-free survival was 39.1 months (95% CI 6.5–68.6); 6, 12, and 24-month ratios were 93.5%, 73.9%, and 63.1%, respectively. At univariate Cox regression analysis, Delta PSA demonstrated an impact on systemic therapy-free survival (p < 0.001). Conclusions: Based on our findings, [18F]FMCH PET/CT can identify oligometastatic prostate cancer patients suitable for SBRT, resulting in a systemic therapy-free survival of 39.1 months.

Published
2020

5. Treatment volume, dose prescription and delivery techniques for dose-intensification in Rectal Cancer: A national survey

Author

Caravatta, L., Lupattelli, M., Mantello, G., Gambacorta, Maria Antonietta, Chiloiro, Giuditta, Di Tommaso, M., Rosa, C., Gasparini, L., Morganti, Alessio Giuseppe, Picardi, V., Niespolo, R. M., Osti, M. F., Montrone, S., Simoni, N., Boso, C., Facchin, F., Deidda, M. A., Piva, C., Guida, C., Ziccarelli, L., Munoz, F., Ivaldi, G. B., Marchetti, V., Franzone, P., Spatola, C., Franco, P., Donato, V., Genovesi, D., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Chiloiro G., Morganti A. G., Caravatta, L., Lupattelli, M., Mantello, G., Gambacorta, Maria Antonietta, Chiloiro, Giuditta, Di Tommaso, M., Rosa, C., Gasparini, L., Morganti, Alessio Giuseppe, Picardi, V., Niespolo, R. M., Osti, M. F., Montrone, S., Simoni, N., Boso, C., Facchin, F., Deidda, M. A., Piva, C., Guida, C., Ziccarelli, L., Munoz, F., Ivaldi, G. B., Marchetti, V., Franzone, P., Spatola, C., Franco, P., Donato, V., Genovesi, D., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Chiloiro G., and Morganti A. G.

Abstract

Background/Aim: The aim of the study was to investigate boost volume definition, doses, and delivery techniques for rectal cancer dose intensification. Patients and Methods: An online survey was made on 25 items (characteristics, simulation, imaging, volumes, doses, planning and treatment). Results: Thirty-eight radiation oncologists joined the study. Twenty-one delivered long-course radiotherapy with dose intensification. Boost volume was delineated on diagnostic magnetic resonance imaging (MRI) in 18 centres (85.7%), and computed tomography (CT) and/or positron emission tomography-CT in 9 (42.8%); 16 centres (76.2%) performed co-registration with CT-simulation. Boost dose was delivered on gross tumor volume in 10 centres (47.6%) and on clinical target volume in 11 (52.4%). The most common total dose was 54-55 Gy (71.4%), with moderate hypofractionation (85.7%). Intensity-modulated radiotherapy (IMRT) was used in all centres, with simultaneous integrated boost in 17 (80.8%) and image-guidance in 18 (85.7%). Conclusion: A high quality of treatment using dose escalation can be inferred by widespread multidisciplinary discussion, MRI-based treatment volume delineation, and radiation delivery relying on IMRT with accurate image-guided radiation therapy protocols.

Published
2021

7. Image-guided stereotactic body radiotherapy in metastatic prostate cancer

Author

Pasqualetti, F, Panichi, M, Sainato, A, Baldaccini, D, Cocuzza, P, Gonnelli, A, Montrone, S, Molinari, A, Barbiero, S, Bruschi, A, Notini, E, Ursino, S, Mazzotti, V, Morganti, R, Coraggio, G, Cantarella, M, Erba, P, Paiar, F, Pasqualetti F., Panichi M., Sainato A., Baldaccini D., Cocuzza P., Gonnelli A., Montrone S., Molinari A., Barbiero S., Bruschi A., Notini E., Ursino S., Mazzotti V., Morganti R., Coraggio G., Cantarella M., Erba P. A., Paiar F., Pasqualetti, F, Panichi, M, Sainato, A, Baldaccini, D, Cocuzza, P, Gonnelli, A, Montrone, S, Molinari, A, Barbiero, S, Bruschi, A, Notini, E, Ursino, S, Mazzotti, V, Morganti, R, Coraggio, G, Cantarella, M, Erba, P, Paiar, F, Pasqualetti F., Panichi M., Sainato A., Baldaccini D., Cocuzza P., Gonnelli A., Montrone S., Molinari A., Barbiero S., Bruschi A., Notini E., Ursino S., Mazzotti V., Morganti R., Coraggio G., Cantarella M., Erba P. A., and Paiar F.

Abstract

Background/Aim: In the last years, the use of Image Guided Stereotactic Radiotherapy (IG-SBRT) in patients with metastatic prostate cancer has increased. In this study, we aimed to assess the role of IG-SBRT in terms of local control and safety in patients with metastatic prostate cancer. Materials and Methods: Primary and secondary endpoints of this prospective observational study were local control and safety related to IG-SBRT. All lesions were treated with 24 Gy as a single fraction or 27 Gy in 3 fractions. After SBRT, Systemic therapies were administered only after the occurrence of more than three synchronous active lesions in oligometastatic patients (patients with less than 4 active synchronous lesions) or new lesions occurrence in patients with more than 3 synchronous lesions. Results: From April 2011 to June 2017, 78 metastatic lesions (32 bone and 46 node) from 51 patients with prostate cancer were treated. After a median follow-up of 18.5 months (range=3-103 months), only 2 lesions (4%) relapsed inside the radiation field. All local recurrences were located on the bone. Estimated 12 and 24 months local control ratios were 98.7 and 97.4%, respectively. Except for one case, toxicity greater than G2 was not recorded. Conclusion: IG-SBRT is safe and can be considered as a valid therapy in patients with metastatic prostate cancer requiring a long-lasting metastases control.

Published
2018

9. EP-1568 Long-term results of [18F] Fluorocholine PET/CT guided SBRT in patients with prostate cancer

Author

Pasqualetti, F., primary, Panichi, M., additional, Cocuzza, P., additional, Gonnelli, A., additional, Baldaccini, D., additional, Molinari, A., additional, Cantarella, M., additional, Mattioni, R., additional, Montrone, S., additional, Cristaudo, A., additional, Marciano, A., additional, Zanca, R., additional, Sollini, M., additional, Sainato, A., additional, Erba, P.A., additional, and Paiar, F., additional

Published
2019
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10. Stereotactic body radiotherapy of bone metastases in oligometastatic disease: Prognostic factors of oncologic outcomes

Author

Ursino, S, Montrone, S, Cantarella, M, Menghini, V, Matteucci, F, Mazzotti, V, Fiorica, F, Fedele, D, Erba, P, Morganti, R, Fabrini, M, Caramella, D, Ursino S., Montrone S., Cantarella M., Menghini V., Matteucci F., Mazzotti V., Fiorica F., Fedele D., Erba P., Morganti R., Fabrini M. G., Caramella D., Ursino, S, Montrone, S, Cantarella, M, Menghini, V, Matteucci, F, Mazzotti, V, Fiorica, F, Fedele, D, Erba, P, Morganti, R, Fabrini, M, Caramella, D, Ursino S., Montrone S., Cantarella M., Menghini V., Matteucci F., Mazzotti V., Fiorica F., Fedele D., Erba P., Morganti R., Fabrini M. G., and Caramella D.

Abstract

Background: To evaluate the safety of stereotactic body radiotherapy (SBRT) of bone metastases in oligometastatic disease and to investigate prognostic factors of local control (LC), progression/disease-free survival (PDFS), and overall survival (OS). Methods: Eligibility criteria were number of metastates ≤5, controlled primary tumor without evidence of progression under systemic therapy, exclusion of surgery, and no previous radiotherapy of the lesion of interest. Oligometastatic status was classified into only bone (BOD) and outside bone disease (OBOD), whereas SBRT was delivered to bone lesions using 2 different schedules: 24 Gy/1 fraction or 27 Gy/3 fractions. A positron emission tomography study of the lesion of interest was performed at baseline and at 3 months after SBRT to evaluate metabolic response according to European Organization for Research and Treatment of Cancer (EORTC) criteria. A Cox regression model was used for univariate and multivariate analysis. Results: Between January 2010 and December 2013, 40 patients were enrolled. Only 1 patient experienced severe late toxicity (radiation-related fracture). Local control was longer among responders' than nonresponders' lesions (94.2% and 91.2% versus 63% and 35% at 1 and 2 years, respectively) (p = 0.004; hazard ratio = 9.958). The multivariate analysis of PDFS showed a significant correlation with planning target volume (PTV) size (p = 0.003) and oligometastatic status (p = 0.002). The multivariate analysis of OS confirmed a statistically significant value of the oligometastatic status (p = 0.002) and a significant trend for PTV size (p = 0.065). Conclusions: Stereotactic body radiotherapy is safe with a low incidence of severe toxicity. Positron emission tomography response was a strong prognostic factor of LC whereas BOD status and small PTV size could identify a subset of oligometastatic patients at better prognosis.

Published
2016

14. EP-1129: Perfusion CT in the evaluation of Nodal response after RCT in H&N cancers: a prospective study

Author

Delishaj, D., primary, Ursino, S., additional, Cristaudo, A., additional, Pasqualetti, F., additional, Morganti, R., additional, Matteucci, F., additional, Lombardo, E., additional, Cantarella, M., additional, Orlandi, F., additional, Montrone, S., additional, Baldaccini, D., additional, Gonnelli, A., additional, Molinari, A., additional, Mattioli, R., additional, Calistri, E., additional, Ferrazza, P., additional, Faggioni, L., additional, Caramella, D., additional, and Paiar, F., additional

Published
2018
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16. EP-1587: Stereotactic Image-Guided Intensity-Modulated Radiotherapy for metastatic prostate cancer patients

Author

Pasqualetti, F., primary, Panichi, M., additional, Sainato, A., additional, Barbiero, S., additional, Baldaccini, D., additional, Notini, E., additional, Morganti, R., additional, Mazzotti, V., additional, Montrone, S., additional, Matteucci, F., additional, Bruschi, A., additional, Gonnelli, A., additional, Molinari, A., additional, Cristaudo, A., additional, Marciano, A., additional, Cartei, F., additional, and Paiar, F., additional

Published
2018
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18. PO-1088: Pattern of late dysphagia after IMRT of head and neck cancers: a prospective study

Author

Delishaj, D., primary, Ursino, S., additional, Cristaudo, A., additional, Molinari, A., additional, Orlandi, F., additional, Coccuzza, P., additional, Seccia, V., additional, Giusti, P., additional, Pasqualetti, F., additional, Santopadre, S., additional, Morganti, R., additional, Montrone, S., additional, Baldaccini, D., additional, Gonnelli, A., additional, Nacci, A., additional, Fattori, B., additional, and Paiar, F., additional

Published
2018
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20. EP-1282: Clinical and pathological prognostic factors in locally advanced rectal cancer (larc)

Author

Montrone, S., primary, Sainato, A., additional, Morganti, R., additional, Vivaldi, C., additional, Laliscia, C., additional, Manfredi, B., additional, Coraggio, G., additional, Cantarella, M., additional, Musettini, G., additional, Delishaj, D., additional, Lombardo, E., additional, Cristaudo, A., additional, Orlandi, F., additional, Masi, G., additional, Buccianti, P., additional, Falcone, A., additional, Pasqualetti, F., additional, and Paiar, F., additional

Published
2017
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21. PO-0630: The role of mc4r gene polymorphisms in gbm patients treated with concomitant radio-chemotherapy

Author

Cantarella, M., primary, Pasqualetti, F., additional, Gonnelli, A., additional, Orlandi, P., additional, Giuliani, D., additional, Delishaj, D., additional, Montrone, S., additional, Coraggio, G., additional, Lombardo, E., additional, Simeon, V., additional, Di Desiderio, T., additional, Fioravanti, A., additional, Fabrini, M., additional, Danesi, R., additional, Guarini, S., additional, Paiar, F., additional, and Bocci, G., additional

Published
2017
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22. EP-1275: Patients with locally advanced rectal cancer (larc): predictive factors of pathological response

Author

Montrone, S., primary, Sainato, A., additional, Morganti, R., additional, Vivaldi, C., additional, Manfredi, B., additional, Laliscia, C., additional, Cantarella, M., additional, Coraggio, G., additional, Musettini, G., additional, Gonnelli, A., additional, Masi, G., additional, Buccianti, P., additional, Pasqualetti, F., additional, and Paiar, F., additional

Published
2017
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23. Time to surgery and pathologic complete response after neoadjuvant chemoradiation in rectal cancer: A population study on 2094 patients

Author

Macchia, G., Gambacorta, Maria Antonietta, Masciocchi, Carlotta, Chiloiro, Giuditta, Mantello, G., Di Giambenedetto, Simona, Lupattelli, M., Palazzari, E., Belgioia, L., Bacigalupo, Andrea, Sainato, A., Montrone, S., Turri, L., Caroli, A., De Paoli, A., Matrone, F., Capirci, C., Montesi, G., Niespolo, R. M., Osti, M. F., Caravatta, L., Galardi, A., Genovesi, D., Rosetto, M. E., Boso, C., Sciacero, P., Giaccherini, L., Parisi, S., Fontana, A., Filippone, F. R., Picardi, V., Morganti, A. G., Valentini, Vincenzo, Gambacorta M. A. (ORCID:0000-0001-5455-8737), Masciocchi C., Chiloiro G., di Benedetto M. (ORCID:0000-0001-6990-5076), Bacigalupo A. (ORCID:0000-0002-9119-567X), Valentini V. (ORCID:0000-0003-4637-6487), Macchia, G., Gambacorta, Maria Antonietta, Masciocchi, Carlotta, Chiloiro, Giuditta, Mantello, G., Di Giambenedetto, Simona, Lupattelli, M., Palazzari, E., Belgioia, L., Bacigalupo, Andrea, Sainato, A., Montrone, S., Turri, L., Caroli, A., De Paoli, A., Matrone, F., Capirci, C., Montesi, G., Niespolo, R. M., Osti, M. F., Caravatta, L., Galardi, A., Genovesi, D., Rosetto, M. E., Boso, C., Sciacero, P., Giaccherini, L., Parisi, S., Fontana, A., Filippone, F. R., Picardi, V., Morganti, A. G., Valentini, Vincenzo, Gambacorta M. A. (ORCID:0000-0001-5455-8737), Masciocchi C., Chiloiro G., di Benedetto M. (ORCID:0000-0001-6990-5076), Bacigalupo A. (ORCID:0000-0002-9119-567X), and Valentini V. (ORCID:0000-0003-4637-6487)

Abstract

Background To retrospectively evaluate the difference in terms of pathologic complete response (pCR) according to time elapsed between chemoradiation (CRT) and total mesorectal excision (TME) on a large unselected real-life dataset of locally advanced rectal cancer (LARC) patients. Methods A multicentre retrospective cohort study of LARC patients from 21 Italian Radiotherapy Institutions was performed. Patients were stratified into 3 different time intervals from CRT. The 1st group included 300 patients who underwent TME within 6 weeks, the 2nd 1598 patients (TME within 7–12 weeks) and the 3rd 196 patients (TME within 13 or more weeks after CRT), respectively. Results Data on 2094 LARC patients treated between 1997 and 2016 were considered suitable for analysis. Overall, 578 patients had stage II while 1516 had stage III histological proven invasive rectal adenocarcinoma. A CRT schedule of one agent (N = 1585) or 2-drugs (N = 509) was administered. Overall, pCR was 22.3% (N = 468 patients). The proportion of patients achieving pCR with respect to time interval was, as follows: 12.6% (1st group), 23% (2nd group) and 31.1% (3rd group) (p < 0.001), respectively. The pCR relative risk comparison of 2nd to 1st group was 1.8, while 3rd to 2nd group was 1.3. Moreover, between the 3rd and 1st group, a pCR relative risk of 2.4 (p < 0.01) was noted. At univariate analysis, clinical stage III (p < 0.001), radiotherapy dose >5040 cGy (p = 0.002) and longer interval (p < 0.001) were significantly correlated to pCR. The positive impact of interval (p < 0.001) was confirmed at multivariate analysis as the only correlated factor. Conclusion We confirmed on a population-level that lengthening the interval (>13 weeks) from CRT to surgery improves the pathological response (pCR and pathologic partial response; pPR) in comparison to historic data. Furthermore, radiotherapy dose >5040 cGy and two drugs chemotherapy correlated with pPR rate.

Published
2017

24. TRUST: Phase II trial of induction chemotherapy (CT) with FOLFOXIRI + bevacizumab (BV) followed by chemo-radiotherapy (CRT) + BV and surgery in locally advanced rectal carcinoma (LARC)

Author

Vivaldi, C., primary, Buccianti, P., additional, Musettini, G., additional, Bergamo, F., additional, Rizzato, M.D., additional, Sainato, A., additional, Martignetti, A., additional, Lucchesi, S., additional, Franceschi, M., additional, Boso, C., additional, Pasqualetti, F., additional, Ginocchi, L., additional, Di Clemente, F., additional, Gonnelli, A., additional, Urbani, L., additional, Montrone, S., additional, Maretto, I., additional, Sidoti, F., additional, Falcone, A., additional, and Masi, G., additional

Published
2016
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25. TRUST: phase II trial of induction chemotherapy (CT) with FOLFOXIRI plus bevacizumab (BV) followed by chemo-radiotherapy (CRT) plus BV and surgery in locally advanced rectal carcinoma (LARC)

Author

Vivaldi, C., primary, Buccianti, P., additional, Musettini, G., additional, Bergamo, F., additional, Rizzato, M.D., additional, Sainato, A., additional, Martignetti, A., additional, Lucchesi, S., additional, Franceschi, M., additional, Boso, C., additional, Pasqualetti, F., additional, Ginocchi, L., additional, Di Clemente, F., additional, Gonnelli, A., additional, Urbani, L., additional, Fornaro, L., additional, Montrone, S., additional, Maretto, I., additional, Balestro, R., additional, Falcone, A., additional, and Masi, G., additional

Published
2016
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26. PO-0756: Choline PET/CT and Stereotactic Body Radiotherapy in oligometastatic prostate cancer patients

Author

Pasqualetti, F., primary, Panichi, M., additional, Sainato, A., additional, Matteucci, F., additional, Derosa, L., additional, Cocuzza, P., additional, Coraggio, G., additional, Ferrazza, P., additional, Montrone, S., additional, Cantarella, M., additional, Delishaj, D., additional, Cristaudo, A., additional, Fabrini, M., additional, Greco, C., additional, and Erba, P., additional

Published
2016
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32. 2255 Safety and effectiveness of the combination of single chemotherapeutic agent (gemcitabine) with radiotherapy in radically resected pancreatic adenocarcinoma

Author

Sainato, A., primary, Montrone, S., additional, Coppola, M., additional, Cernusco, N.L., additional, Ferrazza, P., additional, Cantarella, M., additional, Cocuzza, P., additional, Mazzotti, V., additional, Morganti, R., additional, Pasqualetti, F., additional, Vasile, E., additional, Falcone, A., additional, and Boggi, U., additional

Published
2015
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38. 517P - TRUST: Phase II trial of induction chemotherapy (CT) with FOLFOXIRI + bevacizumab (BV) followed by chemo-radiotherapy (CRT) + BV and surgery in locally advanced rectal carcinoma (LARC)

Author

Vivaldi, C., Buccianti, P., Musettini, G., Bergamo, F., Rizzato, M.D., Sainato, A., Martignetti, A., Lucchesi, S., Franceschi, M., Boso, C., Pasqualetti, F., Ginocchi, L., Di Clemente, F., Gonnelli, A., Urbani, L., Montrone, S., Maretto, I., Sidoti, F., Falcone, A., and Masi, G.

Published
2016
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39. D12 - TRUST: phase II trial of induction chemotherapy (CT) with FOLFOXIRI plus bevacizumab (BV) followed by chemo-radiotherapy (CRT) plus BV and surgery in locally advanced rectal carcinoma (LARC)

Author

Vivaldi, C., Buccianti, P., Musettini, G., Bergamo, F., Rizzato, M.D., Sainato, A., Martignetti, A., Lucchesi, S., Franceschi, M., Boso, C., Pasqualetti, F., Ginocchi, L., Di Clemente, F., Gonnelli, A., Urbani, L., Fornaro, L., Montrone, S., Maretto, I., Balestro, R., Falcone, A., and Masi, G.

Published
2016
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41. [18F]Fluorocholine PET/CT-guided stereotactic body radiotherapy in patients with recurrent oligometastatic prostate cancer

Author

Lorenzo Di Cesare Mannelli, Gabriele Coraggio, S. Montrone, Serena Chiacchio, Roberta Zanca, Sergio Ricci, A. Gonnelli, Martina Sollini, Davide Baldaccini, Francesco Pasqualetti, M. Cantarella, P. Cocuzza, Valentina Mazzotti, Andrea Sbrana, Riccardo Morganti, Paola Anna Erba, A. Molinari, Aldo Sainato, Luca Galli, Marco Panichi, Fabiola Paiar, Andrea Marciano, Pasqualetti, F, Panichi, M, Sollini, M, Sainato, A, Galli, L, Morganti, R, Chiacchio, S, Marciano, A, Zanca, R, Mannelli, L, Coraggio, G, Sbrana, A, Cocuzza, P, Montrone, S, Baldaccini, D, Gonnelli, A, Molinari, A, Cantarella, M, Mazzotti, V, Ricci, S, Paiar, F, and Erba, P

Subjects
Biochemical recurrence, medicine.medical_specialty, Stereotactic body radiotherapy, medicine.medical_treatment, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, medicine, Clinical endpoint, Radiology, Nuclear Medicine and imaging, Prospective cohort study, Survival analysis, PET-CT, F]FMCH PET/CT, Chemistry, General Medicine, medicine.disease, Radiation therapy, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Radiology, [, 18
Abstract

Background In the last years, functional imaging has given a significant contribution to the clinical decision-making of biochemically relapsed prostate cancer (PCa). Hereby, we present a prospective study aiming to validate the role of [18F]Fluoro-Methyl Choline ([18F]FMCH) PET/CT in the selection of PCa patients suitable for stereotactic body radiotherapy (SBRT). Methods Patients with biochemical recurrence limited up to three lesions revealed by [18F]FMCH PET/CT were enrolled in the present study and treated with SBRT on all active lesions. Systemic therapy-free survival since the [18F]FMCH PET/CT was considered as the primary endpoint. Results Forty-six patients were evaluated, and a total of 67 lesions were treated. After a median follow-up of 28.9 months, systemic therapy was started in 30 patients (65.2%) and median systemic therapy-free survival was 39.1 months (95% CI 6.5–68.6); 6, 12, and 24-month ratios were 93.5%, 73.9%, and 63.1%, respectively. At univariate Cox regression analysis, Delta PSA demonstrated an impact on systemic therapy-free survival (p Conclusions Based on our findings, [18F]FMCH PET/CT can identify oligometastatic prostate cancer patients suitable for SBRT, resulting in a systemic therapy-free survival of 39.1 months.

Published
2019
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42. Treatment volume, dose prescription and delivery techniques for dose-intensification in Rectal Cancer: A national survey

Author

Monica Di Tommaso, Paola Franzone, Mattia Falchetto Osti, Vania Marchetti, Alessio G. Morganti, Giuditta Chiloiro, N. Simoni, R.M. Niespolo, Consuelo Rosa, Luciana Caravatta, Maria Antonietta Gambacorta, Cristina Piva, Maria Assunta Deidda, Vincenzo Picardi, L. Gasparini, Vittorio Donato, Domenico Genovesi, Fernando Munoz, Cesare Guida, S. Montrone, Corrado Spatola, Giovanna Mantello, Francesca Facchin, Pierfrancesco Franco, L. Ziccarelli, Marco Lupattelli, Caterina Boso, Giovanni Ivaldi, Caravatta L., Lupattelli M., Mantello G., Gambacorta M.A., Chiloiro G., Di Tommaso M., Rosa C., Gasparini L., Morganti A.G., Picardi V., Niespolo R.M., Osti M.F., Montrone S., Simoni N., Boso C., Facchin F., Deidda M.A., Piva C., Guida C., Ziccarelli L., Munoz F., Ivaldi G.B., Marchetti V., Franzone P., Spatola C., Franco P., Donato V., and Genovesi D.

Subjects
Male, Cancer Research, Colorectal cancer, Intensity modulated radiotherapy, medicine.medical_treatment, Radiotherapy Planning, Practice Patterns, Computer-Assisted, Surveys and Questionnaires, Positron Emission Tomography Computed Tomography, Intensity-Modulated, Simultaneous integrated boost, Surveys and Questionnaire, Rectal cancer, Practice Patterns, Physicians', Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, medicine.diagnostic_test, Radiotherapy Dosage, General Medicine, Magnetic Resonance Imaging, Gross tumor volume, Tumor Burden, Oncology, Image-Guided, Italy, Lymphatic Metastasis, Female, Survival Analysi, Human, medicine, Humans, Dose intensification, Neoplasm Staging, Physicians', Radiotherapy, Rectal Neoplasm, business.industry, Rectal Neoplasms, Radiotherapy Planning, Computer-Assisted, Magnetic resonance imaging, Lymphatic Metastasi, medicine.disease, Survival Analysis, Dose prescription, Radiation therapy, Positron-Emission Tomography, Radiotherapy, Intensity-Modulated, Nuclear medicine, business, Volume (compression), Radiotherapy, Image-Guided
Abstract

Background/aim The aim of the study was to investigate boost volume definition, doses, and delivery techniques for rectal cancer dose intensification. Patients and methods An online survey was made on 25 items (characteristics, simulation, imaging, volumes, doses, planning and treatment). Results Thirty-eight radiation oncologists joined the study. Twenty-one delivered long-course radiotherapy with dose intensification. Boost volume was delineated on diagnostic magnetic resonance imaging (MRI) in 18 centres (85.7%), and computed tomography (CT) and/or positron emission tomography-CT in 9 (42.8%); 16 centres (76.2%) performed co-registration with CT-simulation. Boost dose was delivered on gross tumor volume in 10 centres (47.6%) and on clinical target volume in 11 (52.4%). The most common total dose was 54-55 Gy (71.4%), with moderate hypofractionation (85.7%). Intensity-modulated radiotherapy (IMRT) was used in all centres, with simultaneous integrated boost in 17 (80.8%) and image-guidance in 18 (85.7%). Conclusion A high quality of treatment using dose escalation can be inferred by widespread multidisciplinary discussion, MRI-based treatment volume delineation, and radiation delivery relying on IMRT with accurate image-guided radiation therapy protocols.

Published
2021

43. Image-guided Stereotactic Body Radiotherapy in Metastatic Prostate Cancer

Author

Riccardo Morganti, Fabiola Paiar, Stefano Ursino, Marco Panichi, P. Cocuzza, S. Montrone, Paola Anna Erba, Andrea Bruschi, Elisa Notini, S. Barbiero, A. Molinari, Davide Baldaccini, Valentina Mazzotti, Aldo Sainato, A. Gonnelli, M. Cantarella, Gabriele Coraggio, Francesco Pasqualetti, Pasqualetti, F, Panichi, M, Sainato, A, Baldaccini, D, Cocuzza, P, Gonnelli, A, Montrone, S, Molinari, A, Barbiero, S, Bruschi, A, Notini, E, Ursino, S, Mazzotti, V, Morganti, R, Coraggio, G, Cantarella, M, Erba, P, and Paiar, F

Subjects
Male, Cancer Research, medicine.medical_specialty, Metastatic lesions, Kaplan-Meier Estimate, Radiosurgery, image guided radiotherapy, 030218 nuclear medicine & medical imaging, Stereotactic radiotherapy, 03 medical and health sciences, Prostate cancer, Metastatic prostate cancer, 0302 clinical medicine, Oligometastatic patient, medicine, Humans, In patient, Prospective Studies, Aged, Proportional Hazards Models, business.industry, Radiation field, Prostatic Neoplasms, General Medicine, Middle Aged, medicine.disease, Single fraction, oligometastatic patients, stereotactic body radiotherapy, Oncology, 030220 oncology & carcinogenesis, Observational study, Radiology, Neoplasm Recurrence, Local, business, Stereotactic body radiotherapy, Radiotherapy, Image-Guided
Abstract

Background/aim In the last years, the use of Image Guided Stereotactic Radiotherapy (IG-SBRT) in patients with metastatic prostate cancer has increased. In this study, we aimed to assess the role of IG-SBRT in terms of local control and safety in patients with metastatic prostate cancer. Materials and methods Primary and secondary endpoints of this prospective observational study were local control and safety related to IG-SBRT. All lesions were treated with 24 Gy as a single fraction or 27 Gy in 3 fractions. After SBRT, Systemic therapies were administered only after the occurrence of more than three synchronous active lesions in oligometastatic patients (patients with less than 4 active synchronous lesions) or new lesions occurrence in patients with more than 3 synchronous lesions. Results From April 2011 to June 2017, 78 metastatic lesions (32 bone and 46 node) from 51 patients with prostate cancer were treated. After a median follow-up of 18.5 months (range=3-103 months), only 2 lesions (4%) relapsed inside the radiation field. All local recurrences were located on the bone. Estimated 12 and 24 months local control ratios were 98.7 and 97.4%, respectively. Except for one case, toxicity greater than G2 was not recorded. Conclusion IG-SBRT is safe and can be considered as a valid therapy in patients with metastatic prostate cancer requiring a long-lasting metastases control.

Published
2018

44. Stereotactic body radiotherapy of bone metastases in oligometastatic disease: prognostic factors of oncologic outcomes

Author

S. Montrone, Francesco Fiorica, Fabrizio Matteucci, David Fedele, Valentina Mazzotti, Riccardo Morganti, Stefano Ursino, Maria Grazia Fabrini, Paola Anna Erba, Valentina Menghini, Davide Caramella, M. Cantarella, Ursino, S, Montrone, S, Cantarella, M, Menghini, V, Matteucci, F, Mazzotti, V, Fiorica, F, Fedele, D, Erba, P, Morganti, R, Fabrini, M, and Caramella, D

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Positron emission tomography, Stereotactic body radiotherapy, medicine.medical_treatment, Standardized uptake value, Bone Neoplasms, Radiosurgery, Risk Assessment, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, medicine, Humans, Oligometastatic disease, Survival analysis, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Dose fractionation, Retrospective cohort study, General Medicine, Middle Aged, Prognosis, Survival Analysis, Surgery, Bone metastase, Treatment Outcome, Oncology, Italy, 030220 oncology & carcinogenesis, Predictive value of tests, Positron-Emission Tomography, Standard uptake value, Female, Radiology, Dose Fractionation, Radiation, business, 030217 neurology & neurosurgery
Abstract

Background To evaluate the safety of stereotactic body radiotherapy (SBRT) of bone metastases in oligometastatic disease and to investigate prognostic factors of local control (LC), progression/disease-free survival (PDFS), and overall survival (OS). Methods Eligibility criteria were number of metastates ≤5, controlled primary tumor without evidence of progression under systemic therapy, exclusion of surgery, and no previous radiotherapy of the lesion of interest. Oligometastatic status was classified into only bone (BOD) and outside bone disease (OBOD), whereas SBRT was delivered to bone lesions using 2 different schedules: 24 Gy/1 fraction or 27 Gy/3 fractions. A positron emission tomography study of the lesion of interest was performed at baseline and at 3 months after SBRT to evaluate metabolic response according to European Organization for Research and Treatment of Cancer (EORTC) criteria. A Cox regression model was used for univariate and multivariate analysis. Results Between January 2010 and December 2013, 40 patients were enrolled. Only 1 patient experienced severe late toxicity (radiation-related fracture). Local control was longer among responders’ than nonresponders’ lesions (94.2% and 91.2% versus 63% and 35% at 1 and 2 years, respectively) (p = 0.004; hazard ratio = 9.958). The multivariate analysis of PDFS showed a significant correlation with planning target volume (PTV) size (p = 0.003) and oligometastatic status (p = 0.002). The multivariate analysis of OS confirmed a statistically significant value of the oligometastatic status (p = 0.002) and a significant trend for PTV size (p = 0.065). Conclusions Stereotactic body radiotherapy is safe with a low incidence of severe toxicity. Positron emission tomography response was a strong prognostic factor of LC whereas BOD status and small PTV size could identify a subset of oligometastatic patients at better prognosis.

Published
2016

46. RadiOnCOVID: Multicentric Analysis of the Impact of COVID-19 on Patients Undergoing Radiation Therapy in Italy.

Author

Guerini AE, Marvaso G, Tonoli S, Corrao G, Teriaca MA, Sepulcri M, Scricciolo M, Gava A, Montrone S, Giaj-Levra N, Chiorda BN, Mantello G, Fiorica F, Borghesi S, Belgioia L, Caroli A, Fiorentino A, Radioncovid Study Group, Jereczek-Fossa BA, Magrini SM, and Buglione M

Abstract

Methods and Materials: Patients with ongoing or planned anticancer treatment at 19 Italian Radiation Oncology centers were included in the study retrospectively from 3 February 2020 to 31 December 2020 and prospectively from 1 January 2021 to 31 May 2021. Anonymized data were processed through a specific website and database. Antineoplastic treatment characteristics and timing and outcomes of COVID-19 and its impact on radiotherapy or systemic therapy were described., Results: The retrieved cohort included 41,039 patients that received treatment or were planned for therapy in the study period. Overall, 123 patients had a confirmed COVID-19 diagnosis during antineoplastic treatment (group A) and 99 patients before treatment start (group B). The incidence of COVID-19 across the whole cohort in the index period was 0.54% (groups A + B) and 0.30% considering only group A. A total of 60 patients developed severe COVID-19, and a total of 45 patients died as a consequence of the infection (incidence of 0.15% and 0.11%, respectively). Nonetheless, mortality among COVID-19 patients was high, with an attributable death rate after confirmed infection of 20.27%. Among the 123 patients in group A, 37.4% required temporary treatment suspension, 32.5% definitive suspension and 37 patients continued treatment while positive. As for the 99 patients in group B, 53.5% experienced temporary delay, 20.2% experienced definitive treatment suspension and 26.3% had no delay., Conclusions: Most of the patients with a COVID-19 diagnosis in our cohort recovered and completed their treatment; nonetheless, the attributable death rate after confirmed infection was 20.27%, and mortality was high among cancer patients with severe COVID-19 presentation. The global incidence of death due to COVID-19 or severe COVID-19 was low and decreased over time. Radiation oncology activity could be safely continued during the COVID-19 pandemic with the adoption of adequate preventive measures.

Published
2024
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47. Pattern of care for re-irradiation in locally recurrent rectal cancer: a national survey on behalf of the AIRO gastrointestinal tumors study group.

Author

Mantello G, Galofaro E, Caravatta L, Di Carlo C, Montrone S, Arpa D, Chiloiro G, De Paoli A, Donato V, Gambacorta MA, Genovesi D, Lupattelli M, Macchia G, Montesi G, Niespolo RM, Palazzari E, Pontoriero A, Scricciolo M, Valvo F, and Franco P

Subjects
Humans, Prospective Studies, Neoplasm Recurrence, Local pathology, Rectum, Re-Irradiation methods, Rectal Neoplasms radiotherapy, Rectal Neoplasms surgery, Rectal Neoplasms pathology
Abstract

Purpose: Radical resection (R0) represents the best curative treatment for local recurrence (LR) rectal cancer. Re-irradiation (re-RT) can increase the rate of R0 resection. Currently, there is a lack of guidelines on Re-RT for LR rectal cancer. The Italian Association of Radiation and clinical oncology for gastrointestinal tumors (AIRO-GI) study group released a national survey to investigate the current clinical practice of external beam radiation therapy in these patients., Material and Methods: In February 2021, the survey was designed and distributed to members of the GI working group. The questionnaire consisted of 40 questions regarding center characteristics, clinical indications, doses, and treatment techniques of re-RT for LR rectal cancer., Results: A total of 37 questionnaires were collected. Re-RT was reported as an option for neoadjuvant treatment in resectable and unresectable disease by 55% and 75% of respondents, respectively. Long-course treatment with 30-40 Gy (1.8-2 Gy/die, 1.2 Gy bid) and hypofractionated regimen of 30-35 Gy in 5 fractions were used in most centers. A total dose of 90-100 Gy as EqD2 dose (α/β = 5 Gy) was delivered by 46% of the respondents considering the previous treatment. Modern conformal techniques and daily image-guided radiation therapy protocols were used in 94% of centers., Conclusion: Our survey showed that re-RT treatment is performed with advanced technology that allow a good management of LR rectal cancer. Significant variations were observed in terms of dose and fractionation, highlighting the need for a consensus on a common treatment strategy that could be validated in prospective studies., (© 2023. The Author(s).)

Published
2023
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48. Correlation of Pre- and Post-radio-chemotherapy MRI Texture Features With Tumor Response in Rectal Cancer.

Author

Paiar F, Gabelloni M, Pasqualetti F, Cocuzza P, Montrone S, Arena C, Faggioni L, Falaschi Z, Del Secco L, Alberich-Bayarri A, Bonmati LM, and Neri E

Subjects
Male, Female, Humans, Retrospective Studies, Chemoradiotherapy methods, Magnetic Resonance Imaging methods, Rectum pathology, Neoadjuvant Therapy methods, Treatment Outcome, Rectal Neoplasms diagnostic imaging, Rectal Neoplasms therapy, Rectal Neoplasms pathology, Neoplasms, Second Primary pathology
Abstract

Background/aim: The present study aimed to investigate radiomics features derived from magnetic resonance imaging (MRI) in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy (CRT)., Patients and Methods: We retrospectively evaluated data of 53 patients (32 males, 21 females) with T3/T4 or N+ rectal cancer who underwent MRI before and after CRT. Twenty-seven texture radiomics features were extracted from regions of interest, delimiting the tumor on T2-weighted images., Results: All 27 radiomics features extracted before CRT showed a statistically significant association with the tumor regression grade (TRG) (p<0.05), whereas, after CRT, only the Cluster Prominence value was the only variable to predict TRG (p=0.037, r=0.291)., Conclusion: All 27 features extracted before CRT were able to predict response to CRT and Cluster Prominence continued to be statistically significant even after CRT. The impact of radiomics features derived from MRI could be further investigated in patients with locally advanced rectal cancer., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Published
2023
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49. Impact of temporalis muscle thickness in elderly patients with newly diagnosed glioblastoma treated with radio or radio-chemotherapy.

Author

Pasqualetti F, Gabelloni M, Gonnelli A, Faggioni L, Cantarella M, Montrone S, Gadducci G, Giannini N, Montemurro N, Mattioni R, Perrini P, Morganti R, Cosottini M, Neri E, and Paiar F

Subjects
Aged, Chemoradiotherapy, Humans, Prognosis, Retrospective Studies, Temporal Muscle, Brain Neoplasms drug therapy, Brain Neoplasms therapy, Glioblastoma diagnostic imaging, Glioblastoma drug therapy
Abstract

Background: There is an unmet need for new biomarkers able to predict both the outcomes of up-front therapy and the compliance of elderly patients diagnosed with glioblastoma. For this purpose, temporal muscle thickness is a promising tool to be investigated., Methods: Data from 52 glioblastoma patients older than 65 years, treated with post-operative radio or radio-chemotherapy and referred to Pisa University Hospital, were retrieved. The thickness of temporal muscle (TMT) was divided into quartiles and correlated with overall survival (Our primary endpoint). Survival curves were calculated using Kaplan-Meier method, and log-rank test was used to evaluate the differences between curves., Results: Patients in the lower quartile of TMT, with TMT thinner than 7 mm, have survived longer; both univariate and multivariate analyses showed a statistically significant correlation between TMT and overall survival (P = 0.012 and P = 0.003, respectively)., Conclusion: Future prospective and more extensive studies focused on elderly glioblastoma patients are needed to confirm the role of TMT as prognostic value on OS and to help explaining this association., (© 2022. Italian Society of Medical Radiology.)

Published
2022
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50. Role of magnetic resonance imaging following postoperative radiotherapy in clinical decision-making of patients with high-grade glioma.

Author

Pasqualetti F, Malfatti G, Cantarella M, Gonnelli A, Montrone S, Montemurro N, Gadducci G, Giannini N, Pesaresi I, Perrini P, Morganti R, Cosottini M, and Paiar F

Subjects
Clinical Decision-Making, Disease Progression, Humans, Magnetic Resonance Imaging, Neoplasm Recurrence, Local radiotherapy, Retrospective Studies, Brain Neoplasms diagnostic imaging, Brain Neoplasms radiotherapy, Glioma diagnostic imaging, Glioma drug therapy, Glioma radiotherapy
Abstract

Objectives: The present study aims to investigate the role of the first magnetic resonances (MRI) following radio-chemotherapy (RT-CT) in patients diagnosed with high-grade glioma., Methods: We retrospectively recorded radiological evaluations following RT-CT, symptoms related to disease progression (avoiding any sign due to radiotherapy or chemotherapy) and the change of therapeutic strategy., Results: In March 2021, at data analysis, the data of 149 patients diagnosed with high-grade glioma and treated between May 2013 and July 2020 were retrieved for the present analysis. Two out of 122 (1.6%), 5 out of 106 (4.7%) and 8 out of 92 (8.6%) asymptomatic patients received the diagnosis of disease recurrence at the time of the first, second and third MRI, respectively. Otherwise, 16 out of 27 (59.2%), 16 out of 24 (66.6%) and 13 out of 16 (82.2%) symptomatic patients changed their therapy after the first, second and third MRI, respectively. Among patients that experienced radiological signs of distant progression, 10 out of 14 were symptomatic and changed their therapy., Conclusions: MRIs performed by 6 months after the end of RT-CT lead to change treatment strategy mostly in symptomatic patients., (© 2022. Italian Society of Medical Radiology.)

Published
2022
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