4 results on '"Pavarini, Maddalena"'
Search Results
2. Pelvic bone marrow dose-volume predictors of late lymphopenia following pelvic lymph node radiation therapy for prostate cancer.
- Author
-
Pavarini, Maddalena, Alborghetti, Lisa, Aimonetto, Stefania, Maggio, Angelo, Landoni, Valeria, Ferrari, Paolo, Bianculli, Antonella, Petrucci, Edoardo, Cicchetti, Alessandro, Farina, Bruno, Ubeira-Gabellini, Maria Giulia, Salmoiraghi, Paolo, Moretti, Eugenia, Avuzzi, Barbara, Giandini, Tommaso, Munoz, Fernando, Magli, Alessandro, Sanguineti, Giuseppe, Magdalena Waskiewicz, Justyna, and Rago, Luciana
- Subjects
- *
CANCER radiotherapy , *PELVIC bones , *BONE marrow , *LYMPHOPENIA , *LYMPH nodes - Abstract
• IHU is a prospective multi-institute study dealing with toxicity after PNI. • Dosimetry and clinical predictors of 2-year G2+ lymphopenia were investigated. • DVHs of Body and of pelvic bone marrow were associated with the end-point. • Multi-variable modelling showed baseline ALC as the most relevant predictor. • Smoke, lumbosacral DVH and acute G3 lymphopenia independently modulate the risk. Given the substantial lack of knowledge, we aimed to assess clinical/dosimetry predictors of late hematological toxicity on patients undergoing pelvic-nodes irradiation (PNI) for prostate cancer (PCa) within a prospective multi-institute study. Clinical/dosimetry/blood test data were prospectively collected including lymphocytes count (ALC) at baseline, mid/end-PNI, 3/6 months and every 6 months up to 5-year after PNI. DVHs of the Body, ileum (BMILEUM), lumbosacral spine (BMLS), lower pelvis (BMPELVIS), and whole pelvis (BMTOT) were extracted. Current analysis focused on 2-year CTCAEv4.03 Grade ≥ 2 (G2+) lymphopenia (ALC < 800/μL). DVH parameters that better discriminate patients with/without toxicity were first identified. After data pre-processing to limit overfitting, a multi-variable logistic regression model combining DVH and clinical information was identified and internally validated by bootstrap. Complete data of 499 patients were available: 46 patients (9.2 %) experienced late G2+ lymphopenia. DVH parameters of BMLS/BMPELVIS/BMTOT and Body were associated to increased G2+ lymphopenia. The variables retained in the resulting model were ALC at baseline [HR = 0.997, 95 %CI 0.996–0.998, p < 0.0001], smoke (yes/no) [HR = 2.9, 95 %CI 1.25–6.76, p = 0.013] and BMLS-V ≥ 24 Gy (cc) [HR = 1.006, 95 %CI 1.002–1.011, p = 0.003]. When acute G3+ lymphopenia (yes/no) was considered, it was retained in the model [HR = 4.517, 95 %CI 1.954–10.441, p = 0.0004]. Performances of the models were relatively high (AUC = 0.87/0.88) and confirmed by validation. Two-year lymphopenia after PNI for PCa is largely modulated by baseline ALC, with an independent role of acute G3+ lymphopenia. BMLS-V24 was the best dosimetry predictor: constraints for BMTOT (V10Gy < 1520 cc, V20Gy < 1250 cc, V30Gy < 850 cc), and BMLS (V24y < 307 cc) were suggested to potentially reduce the risk. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
3. Worsening of 2-year patient-reported intestinal functionality after radiotherapy for prostate cancer including pelvic node irradiation.
- Author
-
Sanguineti, Giuseppe, Pavarini, Maddalena, Munoz, Fernando, Magli, Alessandro, Cante, Domenico, Garibaldi, Elisabetta, Gebbia, Andrea, Noris Chiorda, Barbara, Girelli, Giuseppe, Villa, Elisa, Faiella, Adriana, Magdalena Waskiewicz, Justyna, Avuzzi, Barbara, Pastorino, Alice, Moretti, Eugenia, Rago, Luciana, Statuto, Teodora, Gatti, Marco, Rancati, Tiziana, and Valdagni, Riccardo
- Subjects
- *
PROSTATE cancer , *INFLAMMATORY bowel diseases , *CANCER radiotherapy , *INTESTINES , *IRRADIATION - Abstract
• The overall worsening at two years of intestinal function in men treated with radiotherapy including pelvic node irradiation (PNI) for prostate cancer is generally mild. • Nevertheless, such worsening may be greater in a non-negligible fraction of patients, especially for specific symptoms such as frequency, gas passage, rectal bleeding and accidental soiling. • Men experiencing severe acute bowel symptoms from PNI are at higher risk of symptom persistence two years after irradiation. • This risk is only minimally dependent on baseline bowel symptoms, and not related to radiotherapy intent. To quantify patient-reported 2-year intestinal toxicity (IT) from pelvic nodal irradiation (PNI) for prostate cancer. The association between baseline/acute symptoms and 2-year worsening was investigated. Patient-reported IT was prospectively assessed through the Inflammatory Bowel Disease Questionnaire (IBDQ), filled in at baseline, radiotherapy mid-point and end, at 3 and 6 months and every 6 months until 5 years. Two-year deterioration of IBDQ scores relative to the Bowel Domain was investigated for 400 patients with no severe baseline symptoms and with questionnaires available at baseline, 2 years, RT mid-point and/or end and at least three follow-ups between 3 and 18 months. The significance of the 2-year differences from baseline was tested. The association between baseline values and Δ Acute (the worst decline between baseline and RT mid-point/end) was investigated. In the IBDQ lower scores indicate worse symptoms. A significant (p < 0.0001) 2-year mean worsening, mostly in the range of −0.2/-0.4 points on a 1–7 scale, emerged excepting one question (IBDQ29, "nausea/feeling sick"). This decline was independent of treatment intent while baseline values were associated with 2-year absolute scores. The Δ Acute largely modulated 2-year worsening: patients with Δ Acute greater than the first quartile (Q1) and Δ Acute less or equal than Q1 showed no/minimal and highly significant (p < 0.0001) deterioration, respectively. Rectal incontinence, urgency, frequency and abdominal pain showed the largest mean changes (-0.5/-1): risk of severe worsening (deemed to be of clinical significance if ≤ 2) was 3–5 fold higher in the Δ Acute ≤ Q1 vs Δ Acute > Q1 group (p < 0.0001). A modest but significant deterioration of two-year patient-reported intestinal symptoms from PNI compared to baseline was found. Patients experiencing more severe acute symptoms are at higher risk of symptom persistence at 2 years, with a much larger prevalence of clinically significant symptoms. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. 1385: Beyond erectile dysfunction: time patterns of sexual health after radiotherapy for prostate cancer.
- Author
-
Spampinato, Sofia, Pelizzola, Marta, Rancati, Tiziana, Waskiewicz, Justyna Magdalena, Avuzzi, Barbara, Garibaldi, Elisabetta, Faiella, Adriana, Villa, Elisa, Magli, Alessandro, Cante, Domenico, Girelli, Giuseppe, Gatti, Marco, Chiorda, Barbara Noris, Rago, Luciana, Ferrari, Paolo, Piva, Cristina, Pavarini, Maddalena, Celia, Elena, Vavassori, Vittorio, and Munoz, Fernando
- Published
- 2024
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.