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8 results on '"Puma N"'

1. Reduced-dose craniospinal irradiation is feasible for standard-risk adult medulloblastoma patients

Author

Massimino, M, Sunyach, M, Barretta, F, Gandola, L, Garegnani, A, Pecori, E, Spreafico, F, Bonneville-Levard, A, Meyronet, D, Mottolese, C, Boschetti, L, Biassoni, V, Schiavello, E, Giussani, C, Carrabba, G, Diletto, B, Pallotti, F, Stefini, R, Ferrari, A, Terenziani, M, Casanova, M, Luksch, R, Meazza, C, Podda, M, Chiaravalli, S, Puma, N, Bergamaschi, L, Morosi, C, Calareso, G, Giangaspero, F, Antonelli, M, Buttarelli, F, Frappaz, D, Massimino M., Sunyach M. P., Barretta F., Gandola L., Garegnani A., Pecori E., Spreafico F., Bonneville-Levard A., Meyronet D., Mottolese C., Boschetti L., Biassoni V., Schiavello E., Giussani C., Carrabba G., Diletto B., Pallotti F., Stefini R., Ferrari A., Terenziani M., Casanova M., Luksch R., Meazza C., Podda M., Chiaravalli S., Puma N., Bergamaschi L., Morosi C., Calareso G., Giangaspero F., Antonelli M., Buttarelli F. R., Frappaz D., Massimino, M, Sunyach, M, Barretta, F, Gandola, L, Garegnani, A, Pecori, E, Spreafico, F, Bonneville-Levard, A, Meyronet, D, Mottolese, C, Boschetti, L, Biassoni, V, Schiavello, E, Giussani, C, Carrabba, G, Diletto, B, Pallotti, F, Stefini, R, Ferrari, A, Terenziani, M, Casanova, M, Luksch, R, Meazza, C, Podda, M, Chiaravalli, S, Puma, N, Bergamaschi, L, Morosi, C, Calareso, G, Giangaspero, F, Antonelli, M, Buttarelli, F, Frappaz, D, Massimino M., Sunyach M. P., Barretta F., Gandola L., Garegnani A., Pecori E., Spreafico F., Bonneville-Levard A., Meyronet D., Mottolese C., Boschetti L., Biassoni V., Schiavello E., Giussani C., Carrabba G., Diletto B., Pallotti F., Stefini R., Ferrari A., Terenziani M., Casanova M., Luksch R., Meazza C., Podda M., Chiaravalli S., Puma N., Bergamaschi L., Morosi C., Calareso G., Giangaspero F., Antonelli M., Buttarelli F. R., and Frappaz D.

Abstract

Introduction: Medulloblastoma is the most common malignant brain tumor in children, but accounts for only 1% of brain cancers in adults. For standard-risk pediatric medulloblastoma, current therapy includes craniospinal irradiation (CSI) at reduced doses (23.4 Gy) associated with chemotherapy. Whereas most same-stage adult patients are still given CSI at 36 Gy, with or without chemotherapy, we report here on our use of reduced-dose CSI associated with chemotherapy for older patients. Methods: We gathered non-metastatic patients over 18 years old (median age 28 years, range 18–48) with minimal or no residual disease after surgery, no negative histological subtypes, treated between 1996–2018 at the Centre Léon Bérard (Lyon) and the INT (Milano). A series of 54 children with similar tumors treated in Milano was used for comparison. Results: Forty-four adults were considered (median follow-up 101 months): 36 had 23.4 Gy of CSI, and 8 had 30.6 Gy, plus a boost to the posterior fossa/tumor bed; 43 had chemotherapy as all 54 children, who had a median 83-month follow-up. The PFS and OS were 82.2 ± 6.1% and 89 ± 5.2% at 5 years, and 78.5 ± 6.9% and 75.2 ± 7.8% at ten, not significantly different from those of the children. CSI doses higher than 23.4 Gy did not influence PFS. Female adult patients tended to have a better outcome than males. Conclusion: The results obtained in our combined series are comparable with, or even better than those obtained after high CSI doses, underscoring the need to reconsider this treatment in adults.

Published
2020

2. The Sooner the Better? How Symptom Interval Correlates With Outcome in Children and Adolescents With Solid Tumors: Regression Tree Analysis of the Findings of a Prospective Study

Author

Ferrari, A, Lo Vullo, S, Giardiello, D, Veneroni, L, Magni, C, Clerici, C, Chiaravalli, S, Casanova, M, Luksch, R, Terenziani, M, Spreafico, F, Meazza, C, Catania, S, Schiavello, E, Biassoni, V, Podda, M, Bergamaschi, L, Puma, N, Massimino, M, Mariani, L, Ferrari A., Lo Vullo S., Giardiello D., Veneroni L., Magni C., Clerici C. A., Chiaravalli S., Casanova M., Luksch R., Terenziani M., Spreafico F., Meazza C., Catania S., Schiavello E., Biassoni V., Podda M., Bergamaschi L., Puma N., Massimino M., Mariani L., Ferrari, A, Lo Vullo, S, Giardiello, D, Veneroni, L, Magni, C, Clerici, C, Chiaravalli, S, Casanova, M, Luksch, R, Terenziani, M, Spreafico, F, Meazza, C, Catania, S, Schiavello, E, Biassoni, V, Podda, M, Bergamaschi, L, Puma, N, Massimino, M, Mariani, L, Ferrari A., Lo Vullo S., Giardiello D., Veneroni L., Magni C., Clerici C. A., Chiaravalli S., Casanova M., Luksch R., Terenziani M., Spreafico F., Meazza C., Catania S., Schiavello E., Biassoni V., Podda M., Bergamaschi L., Puma N., Massimino M., and Mariani L.

Abstract

BackgroundThe potential impact of diagnostic delays on patients' outcomes is a debated issue in pediatric oncology and discordant results have been published so far. We attempted to tackle this issue by analyzing a prospective series of 351 consecutive children and adolescents with solid malignancies using innovative statistical tools.MethodsTo address the nonlinear complexity of the association between symptom interval and overall survival (OS), a regression tree algorithm was constructed with sequential binary splitting rules and used to identify homogeneous patient groups vis-a-vis functional relationship between diagnostic delay and OS.ResultsThree different groups were identified: group A, with localized disease and good prognosis (5-year OS 85.4%); group B, with locally or regionally advanced, or metastatic disease and intermediate prognosis (5-year OS 72.9%), including neuroblastoma, Wilms tumor, nonrhabdomyosarcoma soft tissue sarcoma, and germ cell tumor; and group C, with locally or regionally advanced, or metastatic disease and poor prognosis (5-year OS 45%), including brain tumors, rhabdomyosarcoma, and bone sarcoma. The functional relationship between symptom interval and mortality risk differed between the three subgroups, there being no association in group A (hazard ratio [HR]: 0.96), a positive linear association in group B (HR: 1.48), and a negative linear association in group C (HR: 0.61).ConclusionsOur analysis suggests that at least a subset of patients can benefit from an earlier diagnosis in terms of survival. For others, intrinsic aggressiveness may mask the potential effect of diagnostic delays. Based on these findings, early diagnosis should remain a goal for pediatric cancer patients.

Published
2016

3. Necrosis of mesenteric lymph nodes in Henoch-Schönlein purpura

Author

Ferrara, P., Rigante, Donato, Leone, A., Orchi, C., Puma, N., Rossodivita, A., Sacco, E., Liberatore, P., Laino, M. E., Stabile, A., Rigante D. (ORCID:0000-0001-7032-7779), Ferrara, P., Rigante, Donato, Leone, A., Orchi, C., Puma, N., Rossodivita, A., Sacco, E., Liberatore, P., Laino, M. E., Stabile, A., and Rigante D. (ORCID:0000-0001-7032-7779)

Abstract

The paper describes the report of necrosis in mesenteric lymph nodes related to a child affected by IgA vasculitis.

Published
2012

4. Anthracycline-related cardiotoxicity: Risk factors and therapeutic options in childhood cancers

Author

Puma, N., Ruggiero, Antonio, Ridola, Vita, Maurizi, Palma, Lazzareschi, Ilaria, Attina, G., Mastrangelo, Stefano, De Rosa, Gabriella, Riccardi, Riccardo, Ruggiero A. (ORCID:0000-0002-6052-3511), Ridola V., Maurizi P. (ORCID:0000-0002-5930-0193), Lazzareschi I. (ORCID:0000-0001-7221-2983), Mastrangelo S. (ORCID:0000-0002-3305-6014), De Rosa G. (ORCID:0000-0002-8780-5105), Riccardi R. (ORCID:0000-0001-7515-6622), Puma, N., Ruggiero, Antonio, Ridola, Vita, Maurizi, Palma, Lazzareschi, Ilaria, Attina, G., Mastrangelo, Stefano, De Rosa, Gabriella, Riccardi, Riccardo, Ruggiero A. (ORCID:0000-0002-6052-3511), Ridola V., Maurizi P. (ORCID:0000-0002-5930-0193), Lazzareschi I. (ORCID:0000-0001-7221-2983), Mastrangelo S. (ORCID:0000-0002-3305-6014), De Rosa G. (ORCID:0000-0002-8780-5105), and Riccardi R. (ORCID:0000-0001-7515-6622)

Abstract

Anthracyclines play an important role in chemotherapeutic regimens for a wide spectrum of childhood tumors, but they can cause cytotoxic damage to cardiac cells, especially in combination with radiotherapy. Furthermore, cardiotoxicity increases with the cumulative dose and may lead to congestive heart failure and cardiomyopathy. Other factors, including age, pre-existing cardiac disease, length of follow-up, gender, route of administration, concomitant exposure to some chemotherapeutic drugs, trisomy 21 and black race, play a role in increasing the risk of cardiac dysfunction. The prevention of anthracycline-induced cardiotoxicity is mandatory as children are expected to survive for decades after being cured of their cancer. The purpose of this work is to point out the major risk factors of cardiotoxicity in children and to summarize some strategies to limit or prevent this complication and to treat the development of acute heart failure.

Published
2008

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