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5. Enhancing Soft Tissue Differentiation with Different Dual-Energy CT Systems: A Phantom Study

Author

Gallo, Pasqualina, primary, D’Alessio, Andrea, additional, Pascuzzo, Riccardo, additional, Gallo, Salvatore, additional, Fumagalli, Maria, additional, Ortenzia, Ornella, additional, Tenconi, Chiara, additional, Cavatorta, Claudia, additional, Pignoli, Emanuele, additional, Ghetti, Caterina, additional, Bruzzone, Maria, additional, and De Martin, Elena, additional

Published
2024
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6. Improving plan quality and consistency by standardization of dose constraints in prostate cancer patients treated with CyberKnife.

Author

Descovich, Martina, Carrara, Mauro, Morlino, Sara, Pinnaduwage, Dilini S, Saltiel, Daniel, Pouliot, Jean, Nash, Marc B, Pignoli, Emanuele, Valdagni, Riccardo, Roach, Mack, and Gottschalk, Alexander R

Subjects
Rectum, Prostate, Humans, Prostatic Neoplasms, Tomography, X-Ray Computed, Radiosurgery, Radiotherapy, Conformal, Radiotherapy Planning, Computer-Assisted, Phantoms, Imaging, Male, Radiotherapy, Intensity-Modulated, Urinary Bladder, prostate, stereotactic body radiation therapy, plan optimization, dose constraints, Tomography, X-Ray Computed, Radiotherapy, Conformal, Radiotherapy Planning, Computer-Assisted, Phantoms, Imaging, Intensity-Modulated, Nuclear Medicine & Medical Imaging, Other Physical Sciences, Clinical Sciences, Medical Physiology
Abstract

Treatment plans for prostate cancer patients undergoing stereotactic body radiation therapy (SBRT) are often challenging due to the proximity of organs at risk. Today, there are no objective criteria to determine whether an optimal treatment plan has been achieved, and physicians rely on their personal experience to evaluate the plan's quality. In this study, we propose a method for determining rectal and bladder dose constraints achievable for a given patient's anatomy. We expect that this method will improve the overall plan quality and consistency, and facilitate comparison of clinical outcomes across different institutions. The 3D proximity of the organs at risk to the target is quantified by means of the expansion-intersection volume (EIV), which is defined as the intersection volume between the target and the organ at risk expanded by 5 mm. We determine a relationship between EIV and relevant dosimetric parameters, such as the volume of bladder and rectum receiving 75% of the prescription dose (V75%). This relationship can be used to establish institution-specific criteria to guide the treatment planning and evaluation process. A database of 25 prostate patients treated with CyberKnife SBRT is used to validate this approach. There is a linear correlation between EIV and V75% of bladder and rectum, confirming that the dose delivered to rectum and bladder increases with increasing extension and proximity of these organs to the target. This information can be used during the planning stage to facilitate the plan optimization process, and to standardize plan quality and consistency. We have developed a method for determining customized dose constraints for prostate patients treated with robotic SBRT. Although the results are technology specific and based on the experience of a single institution, we expect that the application of this method by other institutions will result in improved standardization of clinical practice.

Published
2013

8. Management of the vertebrae as an organ at risk in paediatric radiotherapy clinical trials: Initial QUARTET experience

Author

Turcas, Andrada, primary, Kelly, Sarah M, additional, Bernier-Chastagner, Valérie, additional, Bolle, Stephanie, additional, Cameron, Alison, additional, Corning, Coreen, additional, Clementel, Enrico, additional, Dieckmann, Karin, additional, Davila Fajardo, Raquel, additional, Gaze, Mark N., additional, Laprie, Anne, additional, Magelssen, Henriette, additional, Meroni, Silvia, additional, Pignoli, Emanuele, additional, Safwat, Akmal, additional, Scarzello, Giovanni, additional, Talbot, James, additional, Timmermann, Beate, additional, Boterberg, Tom, additional, and Mandeville, Henry C., additional

Published
2023
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10. A monocentric, open-label randomized standard-of-care controlled study of XONRID®, a medical device for the prevention and treatment of radiation-induced dermatitis in breast and head and neck cancer patients

Author

Ingargiola, Rossana, De Santis, Maria Carmen, Iacovelli, Nicola Alessandro, Facchinetti, Nadia, Cavallo, Anna, Ivaldi, Eliana, Dispinzieri, Michela, Franceschini, Marzia, Giandini, Carlotta, Romanello, Domenico Attilio, Di Biaso, Simona, Sabetti, Michela, Locati, Laura, Alfieri, Salvatore, Bossi, Paolo, Guglielmo, Mauro, Macchi, Fabio, Lozza, Laura, Valdagni, Riccardo, Fallai, Carlo, Pignoli, Emanuele, and Orlandi, Ester

Published
2020
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11. Stability of Multi-Parametric Prostate MRI Radiomic Features to Variations in Segmentation

Author

Thulasi Seetha, Sithin, primary, Garanzini, Enrico, additional, Tenconi, Chiara, additional, Marenghi, Cristina, additional, Avuzzi, Barbara, additional, Catanzaro, Mario, additional, Stagni, Silvia, additional, Villa, Sergio, additional, Chiorda, Barbara Noris, additional, Badenchini, Fabio, additional, Bertocchi, Elena, additional, Sanduleanu, Sebastian, additional, Pignoli, Emanuele, additional, Procopio, Giuseppe, additional, Valdagni, Riccardo, additional, Rancati, Tiziana, additional, Nicolai, Nicola, additional, and Messina, Antonella, additional

Published
2023
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13. Multi-variable models of large International Prostate Symptom Score worsening at the end of therapy in prostate cancer radiotherapy

Author

Palorini, Federica, Rancati, Tiziana, Cozzarini, Cesare, Improta, Ilaria, Carillo, Viviana, Avuzzi, Barbara, Casanova Borca, Valeria, Botti, Andrea, Degli Esposti, Claudio, Franco, Pierfrancesco, Garibaldi, Elisabetta, Girelli, Giuseppe, Iotti, Cinzia, Maggio, Angelo, Palombarini, Marcella, Pierelli, Alessio, Pignoli, Emanuele, Vavassori, Vittorio, Valdagni, Riccardo, and Fiorino, Claudio

Published
2016
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14. Management of the vertebrae as an organ at risk in paediatric radiotherapy clinical trials: Initial QUARTET experience

Author

MS Radiotherapie, Cancer, Turcas, Andrada, Kelly, Sarah M., Bernier-Chastagner, Valérie, Bolle, Stephanie, Cameron, Alison, Corning, Coreen, Clementel, Enrico, Dieckmann, Karin, Davila Fajardo, Raquel, Gaze, Mark N., Laprie, Anne, Magelssen, Henriette, Meroni, Silvia, Pignoli, Emanuele, Safwat, Akmal, Scarzello, Giovanni, Talbot, James, Timmermann, Beate, Boterberg, Tom, Mandeville, Henry C., MS Radiotherapie, Cancer, Turcas, Andrada, Kelly, Sarah M., Bernier-Chastagner, Valérie, Bolle, Stephanie, Cameron, Alison, Corning, Coreen, Clementel, Enrico, Dieckmann, Karin, Davila Fajardo, Raquel, Gaze, Mark N., Laprie, Anne, Magelssen, Henriette, Meroni, Silvia, Pignoli, Emanuele, Safwat, Akmal, Scarzello, Giovanni, Talbot, James, Timmermann, Beate, Boterberg, Tom, and Mandeville, Henry C.

Published
2023

15. Proton Therapy, Magnetic Nanoparticles and Hyperthermia as Combined Treatment for Pancreatic BxPC3 Tumor Cells

Author

Brero, Francesca, primary, Calzolari, Paola, additional, Albino, Martin, additional, Antoccia, Antonio, additional, Arosio, Paolo, additional, Berardinelli, Francesco, additional, Bettega, Daniela, additional, Ciocca, Mario, additional, Facoetti, Angelica, additional, Gallo, Salvatore, additional, Groppi, Flavia, additional, Innocenti, Claudia, additional, Laurenzana, Anna, additional, Lenardi, Cristina, additional, Locarno, Silvia, additional, Manenti, Simone, additional, Marchesini, Renato, additional, Mariani, Manuel, additional, Orsini, Francesco, additional, Pignoli, Emanuele, additional, Sangregorio, Claudio, additional, Scavone, Francesca, additional, Veronese, Ivan, additional, and Lascialfari, Alessandro, additional

Published
2023
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16. Effects of the pre-irradiation storage procedure on the dose response of a Fricke xylenol orange gel dosimeter

Author

Liosi Giulia Maria, Giacobbo Francesca, Pignoli Emanuele, Carrara Mauro, Gambarini Grazia, and Mariani Mario

Subjects
radiation dosimetry · fricke-gelatin-xylenol orange dosimeter · optical absorbance measurement, Science
Abstract

The Fricke xylenol orange (FX) gel system is a chemical dosimeter characterized by good sensitivity, linear dose response, tissue equivalence, no toxicity, easy preparation, reproducibility and low cost. Thanks to the presence of the gelatinous matrix, the system is particularly suitable to perform reliable 3D mapping of the absorbed dose spatial distribution via magnetic resonance imaging (MRI) or optical techniques. The aim of this work is to study in a systematic way the influence of the pre-irradiation storage procedure upon sensitivity, dose response stability and lifetime of use of a FX gel system made with gelatin from porcine skin subjected to homogeneous irradiation. For this purpose, different pre-irradiation storage procedures, in terms of temperature and duration of each storage step, were investigated. In order to evaluate the dose response stability, the optical analyses of the samples were performed up to 6 hours after irradiation. Moreover, the samples were irradiated at time intervals of 24 hours for up to 7 days after preparation in order to evaluate the system lifetime of use. Regardless of their thermal and temporal life, the samples show linear dose responses in the investigated dose range (3-24 Gy) and an increase of sensitivity with the time elapsed between preparation and irradiation. Among the three pre-irradiation storage procedures considered here, a procedure that provides the best dose response stability and lifetime of use was identified and recommended for further use. The analyzed dosimetric system possesses good properties that make it promising for medical application, particularly concerning the evaluation of pre-treatment plan quality assurance within the conformational external beam radiotherapy

Published
2015
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19. A microRNA Prognostic Signature in Patients with Diffuse Intrinsic Pontine Gliomas through Non-Invasive Liquid Biopsy

Author

Iannó, Maria F., primary, Biassoni, Veronica, additional, Schiavello, Elisabetta, additional, Carenzo, Andrea, additional, Boschetti, Luna, additional, Gandola, Lorenza, additional, Diletto, Barbara, additional, Marchesi, Edoardo, additional, Vegetti, Claudia, additional, Molla, Alessandra, additional, Kramm, Christof M., additional, van Vuurden, Dannis G., additional, Gasparini, Patrizia, additional, Gianno, Francesca, additional, Giangaspero, Felice, additional, Modena, Piergiorgio, additional, Bison, Brigitte, additional, Anichini, Andrea, additional, Vennarini, Sabina, additional, Pignoli, Emanuele, additional, Massimino, Maura, additional, and De Cecco, Loris, additional

Published
2022
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20. MEDB-75. Treatment-induced pulmonary toxicity in patients with medulloblastoma: a retrospective analysis on 2 Italian institutions’ cohorts

Author

Biassoni, Veronica, primary, Busia, Alessandra, additional, Barretta, Francesco, additional, Gandola, Lorenza, additional, Vennarini, Sabina, additional, Meroni, Silvia, additional, Mastronuzzi, Angela, additional, Del Baldo, Giada, additional, Chiesa, Silvia, additional, Pignoli, Emanuele, additional, Terenziani, Monica, additional, Pecori, Emilia, additional, Schiavello, Elisabetta, additional, and Massimino, Maura, additional

Published
2022
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23. Proton Radiation Therapy for Nasopharyngeal Cancer Patients: Dosimetric and NTCP Evaluation Supporting Clinical Decision

Author

Vai, Alessandro, primary, Molinelli, Silvia, additional, Rossi, Eleonora, additional, Iacovelli, Nicola Alessandro, additional, Magro, Giuseppe, additional, Cavallo, Anna, additional, Pignoli, Emanuele, additional, Rancati, Tiziana, additional, Mirandola, Alfredo, additional, Russo, Stefania, additional, Ingargiola, Rossana, additional, Vischioni, Barbara, additional, Bonora, Maria, additional, Ronchi, Sara, additional, Ciocca, Mario, additional, and Orlandi, Ester, additional

Published
2022
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24. Dosimetric Impact of Inter-Fraction Anatomical Changes in Carbon Ion Boost Treatment for High-Risk Prostate Cancer (AIRC IG 14300)

Author

Russo, Stefania, primary, Ricotti, Rosalinda, additional, Molinelli, Silvia, additional, Patti, Filippo, additional, Barcellini, Amelia, additional, Mastella, Edoardo, additional, Pella, Andrea, additional, Paganelli, Chiara, additional, Marvaso, Giulia, additional, Pepa, Matteo, additional, Comi, Stefania, additional, Zaffaroni, Mattia, additional, Avuzzi, Barbara, additional, Giandini, Tommaso, additional, Pignoli, Emanuele, additional, Valdagni, Riccardo, additional, Baroni, Guido, additional, Cattani, Federica, additional, Ciocca, Mario, additional, Jereczek-Fossa, Barbara Alicja, additional, Orlandi, Ester, additional, Orecchia, Roberto, additional, and Vischioni, Barbara, additional

Published
2021
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25. Modelling Radiation-Induced Salivary Dysfunction during IMRT and Chemotherapy for Nasopharyngeal Cancer Patients

Author

Cavallo, Anna, primary, Iacovelli, Nicola Alessandro, additional, Facchinetti, Nadia, additional, Rancati, Tiziana, additional, Alfieri, Salvatore, additional, Giandini, Tommaso, additional, Cicchetti, Alessandro, additional, Fallai, Carlo, additional, Ingargiola, Rossana, additional, Licitra, Lisa, additional, Locati, Laura, additional, Cavalieri, Stefano, additional, Pignoli, Emanuele, additional, Romanello, Domenico Attilio, additional, Valdagni, Riccardo, additional, and Orlandi, Ester, additional

Published
2021
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26. Hypofractionated whole-breast radiotherapy in large breast size patients: is it really a resolved issue?

Author

Colciago, R, Cavallo, A, Magri, M, Vitullo, A, La Rocca, E, Giandini, C, Bonfantini, F, Di Cosimo, S, Baili, P, Sant, M, Pignoli, E, Valdagni, R, Lozza, L, De Santis, M, Colciago, Riccardo Ray, Cavallo, Anna, Magri, Maria Chiara, Vitullo, Angelo, La Rocca, Eliana, Giandini, Carlotta, Bonfantini, Francesca, Di Cosimo, Serena, Baili, Paolo, Sant, Milena, Pignoli, Emanuele, Valdagni, Riccardo, Lozza, Laura, De Santis, Maria Carmen, Colciago, R, Cavallo, A, Magri, M, Vitullo, A, La Rocca, E, Giandini, C, Bonfantini, F, Di Cosimo, S, Baili, P, Sant, M, Pignoli, E, Valdagni, R, Lozza, L, De Santis, M, Colciago, Riccardo Ray, Cavallo, Anna, Magri, Maria Chiara, Vitullo, Angelo, La Rocca, Eliana, Giandini, Carlotta, Bonfantini, Francesca, Di Cosimo, Serena, Baili, Paolo, Sant, Milena, Pignoli, Emanuele, Valdagni, Riccardo, Lozza, Laura, and De Santis, Maria Carmen

Abstract

The purpose of this study was to evaluate the impact of breast size on acute and late side effects in breast cancer (BC) patients treated with hypofractionated radiotherapy (Hypo-RT). In this study we analyzed patients over 50 years with a diagnosis of early BC, candidate for Hypo-RT after conservative surgery. Acute and late skin toxicities were evaluated in accordance with the RTOG scale. Multivariable logistic analysis was performed using dosimetric/anatomical factors resulted associated with toxicity outcome in univariable analysis. Among patients treated between 2009 and 2015, 425 had at least 5 years of follow-up. At RT end, acute skin toxicity ≥ G2 and edema ≥ G2 occurred in 88 (20.7%) and 4 (0.9%) patients, respectively. The multivariable analysis showed association of skin toxicity with boost administration (p < 0.01), treated skin area (TSA) receiving more than 20 Gy (p = 0.027) and breast volume receiving 105% of the prescription dose (V105%) (p = 0.016), but not breast size. At 5 years after RT, fibrosis ≥ G1 occurred in 89 (20.9%) patients and edema ≥ G1 in 36 (8.5%) patients. Fibrosis resulted associated with breast volume ≥ 1000 cm3 (p = 0.04) and hypertension (p = 0.04). As for edema, multivariable logistic analysis showed a correlation with hypertension and logarithm of age, but not with boost administration. Breast volume had an unclear impact (p = 0.055). A recurrent association was found between acute and late toxicities and breast V105%, which is correlated with breast size. This may suggest that a more homogenous RT technique may be preferred for patients with larger breast size.

Published
2021

27. Retrospective study of late radiation-induced damages after focal radiotherapy for childhood brain tumors

Author

Cavatorta, Claudia, primary, Meroni, Silvia, additional, Montin, Eros, additional, Oprandi, Maria C., additional, Pecori, Emilia, additional, Lecchi, Mara, additional, Diletto, Barbara, additional, Alessandro, Ombretta, additional, Peruzzo, Denis, additional, Biassoni, Veronica, additional, Schiavello, Elisabetta, additional, Bologna, Marco, additional, Massimino, Maura, additional, Poggi, Geraldina, additional, Mainardi, Luca, additional, Arrigoni, Filippo, additional, Spreafico, Filippo, additional, Verderio, Paolo, additional, Pignoli, Emanuele, additional, and Gandola, Lorenza, additional

Published
2021
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28. Baseline MRI-Radiomics Can Predict Overall Survival in Non-Endemic EBV-Related Nasopharyngeal Carcinoma Patients

Author

Bologna, Marco, primary, Corino, Valentina, additional, Calareso, Giuseppina, additional, Tenconi, Chiara, additional, Alfieri, Salvatore, additional, Iacovelli, Nicola Alessandro, additional, Cavallo, Anna, additional, Cavalieri, Stefano, additional, Locati, Laura, additional, Bossi, Paolo, additional, Romanello, Domenico Attilio, additional, Ingargiola, Rossana, additional, Rancati, Tiziana, additional, Pignoli, Emanuele, additional, Sdao, Silvana, additional, Pecorilla, Mattia, additional, Facchinetti, Nadia, additional, Trama, Annalisa, additional, Licitra, Lisa, additional, Mainardi, Luca, additional, and Orlandi, Ester, additional

Published
2020
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29. Hadron Therapy, Magnetic Nanoparticles and Hyperthermia: A Promising Combined Tool for Pancreatic Cancer Treatment

Author

Brero, Francesca, primary, Albino, Martin, additional, Antoccia, Antonio, additional, Arosio, Paolo, additional, Avolio, Matteo, additional, Berardinelli, Francesco, additional, Bettega, Daniela, additional, Calzolari, Paola, additional, Ciocca, Mario, additional, Corti, Maurizio, additional, Facoetti, Angelica, additional, Gallo, Salvatore, additional, Groppi, Flavia, additional, Guerrini, Andrea, additional, Innocenti, Claudia, additional, Lenardi, Cristina, additional, Locarno, Silvia, additional, Manenti, Simone, additional, Marchesini, Renato, additional, Mariani, Manuel, additional, Orsini, Francesco, additional, Pignoli, Emanuele, additional, Sangregorio, Claudio, additional, Veronese, Ivan, additional, and Lascialfari, Alessandro, additional

Published
2020
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30. Role of IMRT/VMAT-Based Dose and Volume Parameters in Predicting 5-Year Local Control and Survival in Nasopharyngeal Cancer Patients

Author

Iacovelli, Nicola Alessandro, primary, Cicchetti, Alessandro, additional, Cavallo, Anna, additional, Alfieri, Salvatore, additional, Locati, Laura, additional, Ivaldi, Eliana, additional, Ingargiola, Rossana, additional, Romanello, Domenico A., additional, Bossi, Paolo, additional, Cavalieri, Stefano, additional, Tenconi, Chiara, additional, Meroni, Silvia, additional, Calareso, Giuseppina, additional, Guzzo, Marco, additional, Piazza, Cesare, additional, Licitra, Lisa, additional, Pignoli, Emanuele, additional, Carlo, Fallai, additional, and Orlandi, Ester, additional

Published
2020
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31. Additional file 3 of A monocentric, open-label randomized standard-of-care controlled study of XONRID®, a medical device for the prevention and treatment of radiation-induced dermatitis in breast and head and neck cancer patients

Author

Ingargiola, Rossana, Santis, Maria Carmen De, Iacovelli, Nicola Alessandro, Facchinetti, Nadia, Cavallo, Anna, Ivaldi, Eliana, Dispinzieri, Michela, Franceschini, Marzia, Giandini, Carlotta, Romanello, Domenico Attilio, Biaso, Simona Di, Sabetti, Michela, Locati, Laura, Alfieri, Salvatore, Bossi, Paolo, Guglielmo, Mauro, Macchi, Fabio, Lozza, Laura, Valdagni, Riccardo, Fallai, Carlo, Pignoli, Emanuele, and Orlandi, Ester

Abstract

Additional file 3. AEs in BC patients.

Published
2020
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32. Additional file 2 of A monocentric, open-label randomized standard-of-care controlled study of XONRID®, a medical device for the prevention and treatment of radiation-induced dermatitis in breast and head and neck cancer patients

Author

Ingargiola, Rossana, Santis, Maria Carmen De, Iacovelli, Nicola Alessandro, Facchinetti, Nadia, Cavallo, Anna, Ivaldi, Eliana, Dispinzieri, Michela, Franceschini, Marzia, Giandini, Carlotta, Romanello, Domenico Attilio, Biaso, Simona Di, Sabetti, Michela, Locati, Laura, Alfieri, Salvatore, Bossi, Paolo, Guglielmo, Mauro, Macchi, Fabio, Lozza, Laura, Valdagni, Riccardo, Fallai, Carlo, Pignoli, Emanuele, and Orlandi, Ester

Abstract

Additional file 2. Skindex-16 in HNC patients.

Published
2020
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33. Additional file 1 of A monocentric, open-label randomized standard-of-care controlled study of XONRID®, a medical device for the prevention and treatment of radiation-induced dermatitis in breast and head and neck cancer patients

Author

Ingargiola, Rossana, Santis, Maria Carmen De, Iacovelli, Nicola Alessandro, Facchinetti, Nadia, Cavallo, Anna, Ivaldi, Eliana, Dispinzieri, Michela, Franceschini, Marzia, Giandini, Carlotta, Romanello, Domenico Attilio, Biaso, Simona Di, Sabetti, Michela, Locati, Laura, Alfieri, Salvatore, Bossi, Paolo, Guglielmo, Mauro, Macchi, Fabio, Lozza, Laura, Valdagni, Riccardo, Fallai, Carlo, Pignoli, Emanuele, and Orlandi, Ester

Abstract

Additional file 1. Skindex-16 in BC patients.

Published
2020
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34. Additional file 4 of A monocentric, open-label randomized standard-of-care controlled study of XONRID®, a medical device for the prevention and treatment of radiation-induced dermatitis in breast and head and neck cancer patients

Author

Ingargiola, Rossana, Santis, Maria Carmen De, Iacovelli, Nicola Alessandro, Facchinetti, Nadia, Cavallo, Anna, Ivaldi, Eliana, Dispinzieri, Michela, Franceschini, Marzia, Giandini, Carlotta, Romanello, Domenico Attilio, Biaso, Simona Di, Sabetti, Michela, Locati, Laura, Alfieri, Salvatore, Bossi, Paolo, Guglielmo, Mauro, Macchi, Fabio, Lozza, Laura, Valdagni, Riccardo, Fallai, Carlo, Pignoli, Emanuele, and Orlandi, Ester

Abstract

Additional file 4. AEs in HNC patients.

Published
2020
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35. Preliminary epi-diode characterization for HDR brachytherapy quality assurance

Author

Romanyukha, Anna, Carrara, Mauro, Cutajar, Dean L, Petasecca, Marco, Fuduli, Iolanda, Al-Salmani, Tebarak, Lerch, Michael L. F, Perevertaylo, Vladimir, Mazzeo, Davide, Cerrotta, Annamaria, Fallai, Carlo, Pignoli, Emanuele, Rosenfeld, Anatoly B, Romanyukha, Anna, Carrara, Mauro, Cutajar, Dean L, Petasecca, Marco, Fuduli, Iolanda, Al-Salmani, Tebarak, Lerch, Michael L. F, Perevertaylo, Vladimir, Mazzeo, Davide, Cerrotta, Annamaria, Fallai, Carlo, Pignoli, Emanuele, and Rosenfeld, Anatoly B

Abstract

High Dose Rate vaginal brachytherapy for endometrial cancer has evolved from simple single-channel (i.e. cylindrical applicator) deliveries to treatments involving several channels (i.e. multichannel applicator) for the radiotherapy source to dwell, increasing the complexity of the dose distribution, and allowing more space for potential errors. For this reason real-time treatment verification has gained a greater importance than ever before, and more methods need to be developed in order to provide assurance that the dose delivery has been carried out as intended by the hospital staff. P-type silicon epi diodes have been designed at the Centre for Medical Radiation Physics (CMRP) in Australia to suit the specific needs of HDR BT, and characterized in the clinical BT facility of the Fondazione IRCCS (INT) in Italy. They have shown great potential for BT treatment verification in real time due to their radiation hardness, dose rate independence, flexibility in physical design, and ability to monitor the treatment at a 1-kHz readout frequency. Their dynamic range has been determined as ± 17 to ± 20 mm and dwell time calculation accuracy of > 0.1 s has been shown. If placed on the same longitudinal plane of a treatment accessory, these detectors would enable coverage of about 40 mm for source position and dwell time tracking. Respective detector positioning at (0, +3, -3 mm) would extend this range to 45-50 mm, depending on the catheter location, proving to be sufficient for the majority of treatment cases. Further studies are encouraged to develop diodes with a wider dynamic range.

Published
2019

36. An innovative gynecological HDR brachytherapy applicator system for treatment delivery and real-time verification

Author

Romanyukha, Anna, Carrara, Mauro, Mazzeo, Davide, Tenconi, Chiara, Al-Salmani, Tebarak, Poder, Joel, Cutajar, Dean L, Fuduli, Iolanda, Petasecca, Marco, Bucci, Joseph A, Cerrotta, Annamaria, Pappalardi, Brigida, Piccolo, Federica, Pignoli, Emanuele, Rosenfeld, Anatoly B, Romanyukha, Anna, Carrara, Mauro, Mazzeo, Davide, Tenconi, Chiara, Al-Salmani, Tebarak, Poder, Joel, Cutajar, Dean L, Fuduli, Iolanda, Petasecca, Marco, Bucci, Joseph A, Cerrotta, Annamaria, Pappalardi, Brigida, Piccolo, Federica, Pignoli, Emanuele, and Rosenfeld, Anatoly B

Abstract

The multichannel vaginal cylinder (MVC) applicator employed for gynecological high dose rate (HDR) brachytherapy increases dose delivery complexity, and thus makes the treatment more prone to errors. A quality assurance (QA) procedure tracking the source throughout dose delivery can detect dwell position and time errors in the multiple channels of the applicator. A new MVC system with integrated real time in vivo treatment delivery QA has been developed based on diodes embedded on the outer surface of the MVC. It has been pre-calibrated and verified using a non-clinical treatment plan with consecutive test positions and dwell times within each catheter, followed by the delivery of ten clinical plans of adjuvant vaginal cuff brachytherapy following hysterectomy for endometrial cancer. The non-clinical verification showed overall mean dwell position and time discrepancies between the nominal and measured treatment of −0.2 ± 0.5 mm and −0.1 ± 0.1 s (k = 1), respectively. The clinical plans showed mean positional discrepancies of 0.2 ± 0.4 and 0.0 ± 0.8 mm, for the central and peripheral catheters, respectively, and mean dwell time discrepancies of −0.1 ± 0.2 and −0.0 ± 0.1 s for central and peripheral catheters, respectively. The innovative prototype of the MVC system has shown the ability to track the source with sub-mm and sub-second accuracy, and demonstrated potential for its incorporation into the clinical routine.

Published
2019

37. High-dose-rate brachytherapy for high-grade vaginal intraepithelial neoplasia: a dosimetric analysis

Author

Barcellini, Amelia, primary, Lecchi, Mara, additional, Tenconi, Chiara, additional, Macciotta, Alessandra, additional, Pignoli, Emanuele, additional, Pappalardi, Brigida, additional, Mazzarella, Ester, additional, Carrara, Mauro, additional, Giandini, Tommaso, additional, Fallai, Carlo, additional, Verderio, Paolo, additional, and Cerrotta, Annamaria, additional

Published
2019
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38. Applications of MOSkin dosimeters for quality assurance in gynecological HDR brachytherapy: An in-phantom feasibility study

Author

Romanyukha, Anna, Carrara, Mauro, Tenconi, Chiara, Mazzeo, Davide, Rossi, Giulio, Borroni, Marta, Pignoli, Emanuele, Cerrotta, Annamaria, Cutajar, Dean L, Petasecca, Marco, Lerch, Michael L. F, Bucci, Joseph A, Rosenfeld, Anatoly B, Romanyukha, Anna, Carrara, Mauro, Tenconi, Chiara, Mazzeo, Davide, Rossi, Giulio, Borroni, Marta, Pignoli, Emanuele, Cerrotta, Annamaria, Cutajar, Dean L, Petasecca, Marco, Lerch, Michael L. F, Bucci, Joseph A, and Rosenfeld, Anatoly B

Abstract

In vivo dosimetry (IVD) is an excellent mode of treatment verification and detection of possible overexposures. A feasibility study was conducted to evaluate a proposed IVD procedure for gynecological HDR brachytherapy procedure quality assurance. MO. Skin dosimeters were selected due to their small size and capability of measuring steep dose gradients, such as those relevant in HDR brachytherapy procedures. Two in-phantom experiments measuring dose with MO. Skins at the position simulating the rectal wall were conducted employing a cylindrical single channel applicator and a multichannel applicator. Three MO. Skins were incorporated onto a rectal catheter, which was then attached to the applicator, separated by a small wooden plaque, simulating the vaginal to rectal wall distance and fixing catheter position. This setup was inserted into a water phantom and three treatment plans prescribing 300 cGy to 3 different targets were assigned with various dose distributions. Each treatment was administered three times, and doses measured by the MO. Skins were recorded. Doses measured by the MO. Skins were within 5% of the dose determined by the treatment planning system (TPS), ranging between 208 and 332 cGy, depending on dosimeter position on the rectal catheter. The overall average dose difference between measured and TPS values was 2.09% ± 1.15% (ranging between 0.83 and 4.27%, with measured values always higher than TPS dose), subdivided in 1.40 ± 0.37% and 2.79 ± 1.27% for single and multichannel applicator experiments, respectively. An overall dose agreement between the TPS and measured values, detector reproducibility, and practicality of the rectal catheter demonstrated the suitability of the proposed method for in vivo real time QA purposes in gynecological HDR brachytherapy.

Published
2017

39. MB-49INTENSIVE TREATMENT OF HIGH-RISK MEDULLOBLASTOMA (HR-MB): HOW TO LEARN FROM TOXICITIES IN AN EUROPEAN SETTING OF RADIOTHERAPISTS AND PHYSICISTS OF THE SIOP BRAIN TUMOR WORKING GROUP

Author

Gandola, Lorenza, primary, Horan, Gail, additional, Meroni, Silvia, additional, Giralt, Jordi, additional, Mayles, Helen, additional, Thorp, Nicky, additional, Bailey, Simon, additional, Pizer, Barry, additional, Ramos, Monica, additional, Padovani, Laetitia, additional, Andre, Nicolas, additional, Malet, Claude, additional, Doz, François, additional, Janssens, Geert O., additional, Oldenburger, Foppe, additional, Hayden, James, additional, Kortmann, Rolf D., additional, Rutkowski, Stefan, additional, Massimino, Maura, additional, Giandini, Tommaso, additional, and Pignoli, Emanuele, additional

Published
2016
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40. EPN-15HYPOFRACTIONATED RADIOTHERAPY (RT) BOOST FOR CHILDREN WITH EPENDYMOMA AND A MEASURABLE RESIDUE AFTER SURGERY: FINAL RESULTS OF THE 2ND AIEOP PROTOCOL (ASSOCIAZIONE ITALIANA EMATOLOGIA ONCOLOGIA PEDIATRICA)

Author

Gandola, Lorenza, primary, Pecori, Emilia, additional, Scarzello, Giovanni, additional, Barra, Salvina, additional, Mascarin, Maurizio, additional, Scoccianti, Silvia, additional, Diletto, Barbara, additional, Mussano, Anna, additional, Garré, Maria Luisa, additional, Sardi, Iacopo, additional, Meroni, Silvia, additional, Biassoni, Veronica, additional, Schiavello, Elisabetta, additional, Spreafico, Filippo, additional, Pignoli, Emanuele, additional, Giangaspero, Felice, additional, and Massimino, Maura, additional

Published
2016
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41. HG-06RE-IRRADIATION (RE-RT) FOR CHILDREN WITH RELAPSING DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG): BETTER SURVIVAL AND BETTER TIME

Author

Massimino, Maura, primary, Pecori, Emilia, additional, Schiavello, Elisabetta, additional, Biassoni, Veronica, additional, Pignoli, Emanuele, additional, Diletto, Barbara, additional, Spreafico, Filippo, additional, Casanova, Michela, additional, Luksch, Roberto, additional, Ferrari, Andrea, additional, Terenziani, Monica, additional, Podda, Marta, additional, Meazza, Cristina, additional, Catania, Serena, additional, Chiaravalli, Stefano, additional, Puma, Nadia, additional, Bergamaschi, Stefano, additional, De Cecco, Loris, additional, Anichini, Andrea, additional, Antonelli, Manila, additional, Modena, Piergiorgio, additional, Buttarelli, Francesca, additional, Giangaspero, Felice, additional, and Gandola, Lorenza, additional

Published
2016
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42. MB-03LONG TERM FOLLOW-UP OF PATIENTS WITH METASTATIC (M+) AND OTHER HIGH-RISK MEDULLOBLASTOMA WITH TAILORED-DOSES HYPERFRACTIONATED ACCELERATED RADIOTHERAPY (HART) CRANIOSPINAL IRRADIATION (CSI) PLUS/MINUS HIGH-DOSE THIOTEPA

Author

Massimino, Maura, primary, Gandola, Lorenza, additional, Spreafico, Filippo, additional, Biassoni, Veronica, additional, Buttarelli, Francesca, additional, Schiavello, Elisabetta, additional, Pecori, Emilia, additional, Pignoli, Emanuele, additional, Giandini, Tommaso, additional, Luksch, Roberto, additional, Casanova, Michela, additional, Ferrari, Andrea, additional, Terenziani, Monica, additional, Poggi, Geraldina, additional, Podda, Marta, additional, Meazza, Cristina, additional, Catania, Serena, additional, Chiaravalli, Stefano, additional, Puma, Nadia, additional, Antonelli, Manila, additional, and Giangaspero, Felice, additional

Published
2016
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43. RO-14CRANIOSPINAL IRRADIATION (CSI) FOR MEDULLOBLASTOMA: FROM 3D CONFORMAL RADIOTHERAPY (3DCRT) TO VOLUMETRIC MODULATED ARC THERAPY (VMAT). ARE WE READY FOR THE CHANGE?

Author

Gandola, Lorenza, primary, Meroni, Silvia, additional, Giandini, Tommaso, additional, Pecori, Emilia, additional, Diletto, Barbara, additional, Cavatorta, Claudia, additional, Biassoni, Veronica, additional, Schiavello, Elisabetta, additional, Spreafico, Filippo, additional, Massimino, Maura, additional, and Pignoli, Emanuele, additional

Published
2016
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44. Sequential chemotherapy, high-dose thiotepa, circulating progenitor cell rescue, and radiotherapy for childhood high-grade glioma

Author

Massimino, Maura, Gandola, Lorenza, Luksch, Roberto, Spreafico, Filippo, Riva, Daria, Solero, Carlo, Giangaspero, Felice, Locatelli, Franco, Podda, Marta, Bozzi, Fabio, Pignoli, Emanuele, Collini, Paola, Cefalo, Graziella, Zecca, Marco, Casanova, Michela, Ferrari, Andrea, Terenziani, Monica, Meazza, Cristina, Polastri, Daniela, Scaramuzza, Davide, Ravagnani, Fernando, Fossati-Bellani, Franca, Locatelli, Franco (ORCID:0000-0002-7976-3654), Massimino, Maura, Gandola, Lorenza, Luksch, Roberto, Spreafico, Filippo, Riva, Daria, Solero, Carlo, Giangaspero, Felice, Locatelli, Franco, Podda, Marta, Bozzi, Fabio, Pignoli, Emanuele, Collini, Paola, Cefalo, Graziella, Zecca, Marco, Casanova, Michela, Ferrari, Andrea, Terenziani, Monica, Meazza, Cristina, Polastri, Daniela, Scaramuzza, Davide, Ravagnani, Fernando, Fossati-Bellani, Franca, and Locatelli, Franco (ORCID:0000-0002-7976-3654)

Abstract

Childhood malignant gliomas are rare, but their clinical behavior almost as aggressive as in adults, with resistance to therapy, rapid progression, and not uncommonly, dissemination. Our study protocol incorporated sequential chemotherapy and high-dose thiotepa in the preradiant phase, followed by focal radiotherapy and maintenance with vincristine and lomustine for a total duration of one year. The induction treatment consisted of two courses of cisplatin (30 mg/m(2)) plus etoposide (150 mg/m(2)) x 3 days and of vincristine (1.4 mg/m(2)) plus cyclophosphamide (1.5 g/m(2)) plus high-dose methotrexate (3 g/m(2)), followed by high-dose thiotepa (300 mg/m(2) x 3 doses), with harvesting of peripheral blood progenitor cells after the first cisplatin/etoposide course. From August 1996 to March 2003, 21 children, 14 females and 7 males, with a median age of 10 years were enrolled, 18 presenting with residual disease after surgery. Histologies were glioblastoma multiforme in 10, anaplastic astrocytoma in nine, and analplastic oligodendroglioma in two; sites of origin were supratentorial areas in 17, spine in two, and posterior fossa in two. Of the 21 patients, 12 have died (10 after relapse, with a median time to progression for the whole series of 14 months; one with intratumoral bleeding at 40 months after diagnosis; and one affected by Turcot syndrome for duodenal cancer relapse). Four of 12 relapsed children had tumor dissemination. At a median follow-up of 57 months, overall survival and progression-free survival at four years were 43% and 46%, respectively. Sequential and high-dose chemotherapy can be afforded in front-line therapy of childhood malignant glioma without excessive morbidity and rather encouraging results.

Published
2005

45. Thyroid-Stimulating Hormone Suppression for Protection Against Hypothyroidism Due to Craniospinal Irradiation for Childhood Medulloblastoma/Primitive Neuroectodermal Tumor

Author

Massimino, Maura, primary, Gandola, Lorenza, additional, Collini, Paola, additional, Seregni, Ettore, additional, Marchianò, Alfonso, additional, Serra, Annalisa, additional, Pignoli, Emanuele, additional, Spreafico, Filippo, additional, Pallotti, Federica, additional, Terenziani, Monica, additional, Biassoni, Veronica, additional, Bombardieri, Emilio, additional, and Fossati-Bellani, Franca, additional

Published
2007
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46. Supratentorial primitive neuroectodermal tumors (S-PNET) in children: A prospective experience with adjuvant intensive chemotherapy and hyperfractionated accelerated radiotherapy

Author

Massimino, Maura, primary, Gandola, Lorenza, additional, Spreafico, Filippo, additional, Luksch, Roberto, additional, Collini, Paola, additional, Giangaspero, Felice, additional, Simonetti, Fabio, additional, Casanova, Michela, additional, Cefalo, Graziella, additional, Pignoli, Emanuele, additional, Ferrari, Andrea, additional, Terenziani, Monica, additional, Podda, Marta, additional, Meazza, Cristina, additional, Polastri, Daniela, additional, Poggi, Geraldina, additional, Ravagnani, Fernando, additional, and Fossati-Bellani, Franca, additional

Published
2006
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47. Sequential chemotherapy, high-dose thiotepa, circulating progenitor cell rescue, and radiotherapy for childhood high-grade glioma

Author

Massimino, Maura, primary, Gandola, Lorenza, additional, Luksch, Roberto, additional, Spreafico, Filippo, additional, Riva, Daria, additional, Solero, Carlo, additional, Giangaspero, Felice, additional, Locatelli, Franco, additional, Podda, Marta, additional, Bozzi, Fabio, additional, Pignoli, Emanuele, additional, Collini, Paola, additional, Cefalo, Graziella, additional, Zecca, Marco, additional, Casanova, Michela, additional, Ferrari, Andrea, additional, Terenziani, Monica, additional, Meazza, Cristina, additional, Polastri, Daniela, additional, Scaramuzza, Davide, additional, Ravagnani, Fernando, additional, and Fossati-Bellani, Franca, additional

Published
2005
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49. Reirradiation of children with primary central nervous system malignancies relapsed after combined modality treatment

Author

Marchiano Alfonso, Cefalo Graziella, Fossati-Bellani Franca, Massimino Maura, Pignoli Emanuele, Lombardi Fabrizio, Gramaglia Alberto, Gandola Lorenza, Navarria Pierina, Somigliana Anna, Luksch Roberto, and Tesoro-Tess John David

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Radiation, medicine.anatomical_structure, business.industry, Internal medicine, Central nervous system, Medicine, Radiology, Nuclear Medicine and imaging, Combined modality treatment, business
Published
1998
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50. Hadron therapy, magnetic nanoparticles and hyperthermia: A promising combined tool for pancreatic cancer treatment

Author

Francesca Brero, Flavia Groppi, Renato Marchesini, Matteo Avolio, Maurizio Corti, Manuel Mariani, Mario Ciocca, Daniela Bettega, Silvia Locarno, Cristina Lenardi, P. Calzolari, Alessandro Lascialfari, Martin Albino, Francesco Orsini, Angelica Facoetti, Antonio Antoccia, Salvatore Gallo, Claudio Sangregorio, Emanuele Pignoli, Claudia Innocenti, Paolo Arosio, Andrea Guerrini, Francesco Berardinelli, Ivan Veronese, Simone Manenti, Brero, Francesca, Albino, Martin, Antoccia, Antonio, Arosio, Paolo, Avolio, Matteo, Berardinelli, Francesco, Bettega, Daniela, Calzolari, Paola, Ciocca, Mario, Corti, Maurizio, Facoetti, Angelica, Gallo, Salvatore, Groppi, Flavia, Guerrini, Andrea, Innocenti, Claudia, Lenardi, Cristina, Locarno, Silvia, Manenti, Simone, Marchesini, Renato, Mariani, Manuel, Orsini, Francesco, Pignoli, Emanuele, Sangregorio, Claudio, Veronese, Ivan, and Lascialfari, Alessandro

Subjects
Hyperthermia, Materials science, General Chemical Engineering, magnetic nanoparticle, hadron therapy [Keywords], 02 engineering and technology, Radiation, Article, lcsh:Chemistry, 03 medical and health sciences, Hadron therapy, 0302 clinical medicine, Pancreatic cancer, medicine, General Materials Science, Irradiation, Nanomaterials, pancreatic cancer, Specific absorption rate, 021001 nanoscience & nanotechnology, medicine.disease, Biocompatible material, hyperthermia, Magnetic fluid hyperthermia, magnetic fluid hyperthermia, lcsh:QD1-999, 030220 oncology & carcinogenesis, Magnetic nanoparticles, nanomaterial, 0210 nano-technology, Biomedical engineering
Abstract

A combination of carbon ions/photons irradiation and hyperthermia as a novel therapeutic approach for the in-vitro treatment of pancreatic cancer BxPC3 cells is presented. The radiation doses used are 0&ndash, 2 Gy for carbon ions and 0&ndash, 7 Gy for 6 MV photons. Hyperthermia is realized via a standard heating bath, assisted by magnetic fluid hyperthermia (MFH) that utilizes magnetic nanoparticles (MNPs) exposed to an alternating magnetic field of amplitude 19.5 mTesla and frequency 109.8 kHz. Starting from 37 &deg, C, the temperature is gradually increased and the sample is kept at 42 &deg, C for 30 min. For MFH, MNPs with a mean diameter of 19 nm and specific absorption rate of 110 &plusmn, 30 W/gFe3o4 coated with a biocompatible ligand to ensure stability in physiological media are used. Irradiation diminishes the clonogenic survival at an extent that depends on the radiation type, and its decrease is amplified both by the MNPs cellular uptake and the hyperthermia protocol. Significant increases in DNA double-strand breaks at 6 h are observed in samples exposed to MNP uptake, treated with 0.75 Gy carbon-ion irradiation and hyperthermia. The proposed experimental protocol, based on the combination of hadron irradiation and hyperthermia, represents a first step towards an innovative clinical option for pancreatic cancer.

Published
2020
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