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1. Changes in Patterns of Practice for Prostate Cancer Radiotherapy in Italy 1995–2003. A Survey of the Prostate Cancer Study Group of the Italian Radiation Oncology Society

Author

Ludovica Pegurri, Michela Buglione, Giovanni Girelli, Alessia Guarnieri, Icro Meattini, Umberto Ricardi, Monica Mangoni, Pietro Gabriele, Rita Bellavita, Marco Krengli, Alberto Bonetta, Emanuela Cagna, Feisal Bunkheila, Simona Borghesi, Marco Signor, Adriano Di Marco, Filippo Bertoni, Marco Stefanacci, Roberto Gatta, Berardino De Bari, and Stefano Maria Magrini

Subjects
Male, Cancer Research, Kaplan-Meier Estimate, Risk Assessment, Disease-Free Survival, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Biomarkers, Tumor, Humans, Practice Patterns, Physicians', Survey, Societies, Medical, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, Prostate cancer, Radiotherapy, Prostatic Neoplasms, Dose-Response Relationship, Radiation, Radiotherapy Dosage, General Medicine, Middle Aged, Prostate-Specific Antigen, Treatment Outcome, Italy, Oncology, Health Care Surveys, 030220 oncology & carcinogenesis, Neoplasm Grading, Radiotherapy, Conformal
Abstract

In 2002, a survey including 1759 patients treated from 1980 to 1998 established a "benchmark" Italian data source for prostate cancer radiotherapy. This report updates the previous one.Data on clinical management and outcomes of 3001 patients treated in 15 centers from 1999 through 2003 were analyzed and compared with those of the previous survey.Significant differences in clinical management (-10% had abdominal magnetic resonance imaging; +26% received ≥70 Gy, +48% conformal radiotherapy, -20% pelvic radiotherapy) and in G3-4 toxicity rates (-3.8%) were recorded. Actuarial 5-year overall, disease-specific, clinical relapse-free, and biochemical relapse-free survival rates were 88%, 96%, 96% and 88%, respectively. At multivariate analysis, D'Amico risk categories significantly impacted on all the outcomes; higher radiotherapy doses were significantly related with better overall survival rates, and a similar trend was evident for disease-specific and biochemical relapse-free survival; cumulative probability of 5-year late G1-4 toxicity was 24.8% and was significantly related to higher radiotherapy doses (P0.001).The changing patterns of practice described seem related to an improvement in efficacy and safety of radiotherapy for prostate cancer. However, the impact of the new radiotherapy techniques should be prospectively evaluated.

Published
2014

2. Changes in patterns of practice for prostate cancer radiotherapy in Italy 1995-2003. A survey of the Prostate Cancer Study Group of the Italian Radiation Oncology Society

Author

Ludovica, Pegurri, BUGLIONE DI MONALE E BASTIA, Michela, Giovanni, Girelli, Alessia, Guarnieri, Icro, Meattini, Umberto, Ricardi, Monica, Mangoni, Pietro, Gabriele, Rita, Bellavita, Marco, Krengli, Alberto, Bonetta, Emanuela, Cagna, Feisal, Bunkheila, Simona, Borghesi, Marco, Signor, Adriano Di Marco, Filippo, Bertoni, Marco, Stefanacci, Roberto, Gatta, Berardino De Bari, Magrini, Stefano Maria, and Gatta, Roberto

Published
2014

3. Continuous infusion of carboplatin during conventional radiotherapy treatment in advanced squamous carcinoma of the cervix uteri IIB-IIIB (UICC). A phase I/II and pharmacokinetic study

Author

Ernestina Bianchi, Pietro Apostoli, E. Micheletti, Beniamino La Face, Rosanna Verardi, Emanuela Cagna, Enrico Sartori, and Giuseppina Ruggeri

Subjects
Adult, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Brachytherapy, Urology, Uterine Cervical Neoplasms, Antineoplastic Agents, Carboplatin, Radiotherapy, High-Energy, chemistry.chemical_compound, medicine, Humans, Prospective Studies, Infusions, Intravenous, Cervix, Aged, Neoplasm Staging, Chemotherapy, business.industry, Middle Aged, Combined Modality Therapy, Survival Analysis, Surgery, Squamous carcinoma, Radiation therapy, medicine.anatomical_structure, Oncology, Epidermoid carcinoma, chemistry, Concomitant, Carcinoma, Squamous Cell, Feasibility Studies, Female, business
Abstract

OBJECTIVE A prospective, single-arm phase-I/II trial performed to assess the efficacy and toxicity of the concomitant use continuous infusion of low-dose carboplatin and pelvic conventional radiotherapy in patients with locally advanced squamous cell carcinoma of the cervix. MATERIALS AND METHODS Between January and July 1994, a total of 12 patients consecutively diagnosed to have squamous cell carcinoma of the cervix uteri stages IIB-IIIB UICC-TNM (five patients, IIB; and seven patients, IIIB) entered the study. All patients were evaluated by a gynecologist and a radiation oncologist and were submitted to standard pretreatment staging procedures. Radiation was delivered with 10-MeV photon beams with the shrinking-field technique. The patients received 2 Gy radiotherapy daily, 5 fractions per week, up to a planned total of 60 Gy in 6 weeks to the primary tumor and 46 Gy in 4 weeks to the whole pelvis. Irradiation was performed using four fixed orthogonal fields. One intracavitary insertion, 8 Gy to point A (dose rate, 1.1 Gy/h), was performed immediately after external pelvic irradiation. Carboplatin (12 mg/m2/day) was also administered in a continuous infusion, starting 1 day before the first fraction of radiotherapy. The platinum in plasma and urine, as well as the platinum concentration in the cytosols of lymphocytes and tumor, was measured weekly. RESULTS A complete response was seen in nine (75%) of the 12 patients. Of the nine patients who achieved a complete remission, only one had subsequent failure in the pelvis. The total pelvic failure rate was 33.3% (four of 12 patients). With a median follow-up time of 20 months, the actuarial survival rate at 24 months was 64.8%. All patients completed the treatment without major protocol violations. Grade-2 leukopenia (in nine patients) and grade-1 nausea and vomiting (in five) were the most common acute toxicities. There was one grade-3 hematologic toxicity. Grade-3 late complications were observed in 16.6% of cases (two of 12 patients). On days 28 and 42 of the treatment, the mean total platinum plasma concentrations were 491 micrograms/L (SD = 129) and 672 micrograms/L (SD = 160), and the ultrafilterable fraction was 8-10%. At the same time points, the concentration in lymphocytes was constant at 21 picograms (pg) platinum/lymphocyte. The levels of platinum concentration measured on days 14 and 28 in the cytosols of tumor cells were 0.3 microgram/g (SD = 0.1) and 0.93 microgram/g (SD = 0.2). CONCLUSION The combination of continuous infusion of carboplatin and radiotherapy at the aforementioned doses in patients with locally advanced cervical carcinoma resulted in a relatively low frequency of significant acute and late complications. Platinum in normal tissue (picograms per lymphocyte) was stable from week 1 of treatment, whereas the platinum steady state in plasma and in tumor cells was not reached in 6 weeks and was below that required in vitro to produce radiopotentiation. Further studies to determine the optimal dose of carboplatin and irradiation are needed prior to the initiation of phase-III studies.

Published
1997

4. MULTIDISCIPLINARY MANAGEMENT OF PROSTATE CANCER PATIENTS: THE PerSTEP DATA

Author

Magnani, Tiziana, Labianca, Roberto, Baier, Susanne, Baldazzi, Valentina, Barni, Sandro, Barone, Carlo, Bassi, Pierfrancesco, Basso, Umberto, Beatrici, Valerio, Bellardita, Lara, Bertolotto, Franco, Bombardieri, Emilio, Roberto Bortolus, Bracarda, Sergio, Bunkheila, Feisal, Cagna, Emanuela, Cazzaniga, Luigi Franco, Ceresoli, Giovanni Luigi, Corti, Luigi, D Agostino, Giuseppe A., Da Pozzo, Luigi, Angelis, Michele, Di Grazia, Alfio, Facchini, Gaetano, Ferrau, Francesco, Fragala, Eugenia, Fratino, Lucia, Frezza, Giovanni, Gabrielloni, Giuliana, Garbeglio, Antonio, Garibaldi, Elisabetta, Giordano, Monica, Graiff, Claudio, Guttilla, Andrea, Hurle, Rodolfo, Kaelli, Maurizio, Lapini, Alberto, Lastrucci, Luciana, Livi, Lorenzo, Lukas, Peter, Mantini, Giovanna, Marafioti, Luigi, Martorana, Giuseppe, Mattioli, Rodolfo, Micheli, Emanuele, Morgia, Giuseppe, Muto, Giovanni, Muto, Paolo, Orsatti, Marco, Ortega, Cinzia, Palazzo, Salvatore, Perdona, Sisto, Pinto, Francesco, Prati, Veronica, Procopio, Giuseppe, Pycha, Armin, Repetto, Lazzaro, Sarti, Enrico, Scarzello, Giovanni, Schiavina, Riccardo, Schinzari, Giovanni, Stagni, Silvia, Valentini, Vincenzo, Valdagni, Riccardo, Vavassori, Ivano, Vavassori, Vittorio, Ventura, Francesco, Villa, Sergio, Vitali, Elisabetta, Zagonel, Vittorina, Zani, Tania, Zattoni, Filiberto, Zucali, Paolo Andrea, Gabriele, Pietro, Conti, Giario, SIU, Magnani, T., Labianca, R., Baier, S., Baldazzi, V., Barni, S., Barone, C., Bassi, P., Basso, U., Beatrici, V., Bellardita, L., Bertolotto, F., Bombardieri, E., Bortolus, R., Bracarda, S., Bunkheila, F., Cagna, E., Cazzaniga, L., Ceresoli, G., Corti, L., D'Agostino, G., Da Pozzo, L., De Angelis, M., Di Grazia, A., Facchini, G., Ferraù, F., Fragalà, E., Fratino, L., Frezza, G., Gabrielloni, G., Garbeglio, A., Garibaldi, E., Giordano, M., Graiff, C., Guttilla, A., Hurle, R., Kaelli, M., Lapini, A., Lastrucci, L., Livi, L., Lukas, P., Mantini, G., Marafioti, L., Martorana, G., Mattioli, R., Micheli, E., Morgia, G., Muto, G., Muto, P., Orsatti, M., Ortega, C., Palazzo, S., Perdonà, S., Pinto, F., Prati, V., Procopio, G., Pycha, A., Repetto, L., Sarti, E., Scarzello, G., Schiavina, R., Schinzari, G., Stagni, S., Valentini, V., Valdagni, R., Vavassori, I., Vavassori, V., Ventura, F., Villa, S., Vitali, E., Zagonel, V., Zani, T., Zattoni, F., Zucali, P., Gabriele, P., Conti, G., Tiziana Magnani, Roberto Labianca, Susanne Baier, Valentina Baldazzi, Sandro Barni, Carlo Barone, Pierfrancesco Bassi, Umberto Basso, Valerio Beatrici, Lara Bellardita, Franco Bertolotto, Emilio Bombardieri, Roberto Bortolu, Sergio Bracarda, Feisal Bunkheila, Emanuela Cagna, Luigi Franco Cazzaniga, Giovanni Luigi Ceresoli, Luigi Corti, Giuseppe A D’agostino, Luigi Da Pozzo, Michele De Angeli, Alfio Di Grazia, Gaetano Facchini, Francesco Ferraù, Eugenia Fragalà, Lucia Fratino, Giovanni Frezza, Giuliana Gabrielloni, Antonio Garbeglio, Elisabetta Garibaldi, Monica Giordano, Claudio Graiff, Andrea Guttilla, Rodolfo Hurle, Maurizio K lli, Alberto Lapini, Luciana Lastrucci, Lorenzo Livi, Peter Luka, Giovanna Mantini, Luigi Marafioti, Giuseppe Martorana, Rodolfo Mattioli, Emanuele Micheli, Giuseppe Morgia, Giovanni Muto, Paolo Muto, Marco Orsatti, Cinzia Ortega, Salvatore Palazzo, Sisto Perdonà, Francesco Pinto, Veronica Prati, Giuseppe Procopio, Armin Pycha, Lazzaro Repetto, Enrico Sarti, Giovanni Scarzello, Riccardo Schiavina, Giovanni Schinzari, Silvia Stagni, Vincenzo Valentini, Riccardo Valdagni, Ivano Vavassori, Vittorio Vavassori, Francesco Ventura, Sergio Villa, Elisabetta Vitali, Vittorina Zagonel, Tania Zani, Filiberto Zattoni, Paolo Andrea Zucali, Pietro Gabriele, and Giario Conti

Subjects
MULTIDISCIPLINARY MANAGEMENT OF PROSTATE CANCER PATIENTS: THE PERSTEP DATA

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