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1. Almost one year of COVID-19 pandemic: how radiotherapy centers have counteracted its impact on cancer treatment in Lombardy, Italy. CODRAL/AIRO-L study

Author

Jereczek-Fossa, B, Palazzi, M, Tonoli, S, Zaffaroni, M, Marvaso, G, Ivaldi, G, Amadori, M, Antognoni, P, Arcangeli, S, Buffoli, A, Beltramo, G, Bignardi, M, Bracelli, S, De Stefani, A, Castiglioni, S, Catalano, G, Di Muzio, N, Cerrotta, A, Fariselli, L, Filippi, A, Gramaglia, A, Italia, C, Massaro, P, Magrini, S, Nava, S, Orlandi, E, Pasinetti, N, Sbicego, E, Scandolaro, L, Scorsetti, M, Barbonetti, C, Tortini, R, Valdagni, R, Vavassori, V, Pepa, M, Cazzaniga, L, Soatti, C, Jereczek-Fossa B. A., Palazzi M. F., Tonoli S., Zaffaroni M., Marvaso G., Ivaldi G. B., Amadori M., Antognoni P., Arcangeli S., Buffoli A., Beltramo G., Bignardi M., Bracelli S., De Stefani A., Castiglioni S., Catalano G., Di Muzio N., Cerrotta A., Fariselli L., Filippi A. R., Gramaglia A., Italia C., Massaro P., Magrini S. M., Nava S., Orlandi E., Pasinetti N., Sbicego E. L., Scandolaro L., Scorsetti M., Barbonetti C., Tortini R., Valdagni R., Vavassori V., Pepa M., Cazzaniga L. F., Soatti C. P., Jereczek-Fossa, B, Palazzi, M, Tonoli, S, Zaffaroni, M, Marvaso, G, Ivaldi, G, Amadori, M, Antognoni, P, Arcangeli, S, Buffoli, A, Beltramo, G, Bignardi, M, Bracelli, S, De Stefani, A, Castiglioni, S, Catalano, G, Di Muzio, N, Cerrotta, A, Fariselli, L, Filippi, A, Gramaglia, A, Italia, C, Massaro, P, Magrini, S, Nava, S, Orlandi, E, Pasinetti, N, Sbicego, E, Scandolaro, L, Scorsetti, M, Barbonetti, C, Tortini, R, Valdagni, R, Vavassori, V, Pepa, M, Cazzaniga, L, Soatti, C, Jereczek-Fossa B. A., Palazzi M. F., Tonoli S., Zaffaroni M., Marvaso G., Ivaldi G. B., Amadori M., Antognoni P., Arcangeli S., Buffoli A., Beltramo G., Bignardi M., Bracelli S., De Stefani A., Castiglioni S., Catalano G., Di Muzio N., Cerrotta A., Fariselli L., Filippi A. R., Gramaglia A., Italia C., Massaro P., Magrini S. M., Nava S., Orlandi E., Pasinetti N., Sbicego E. L., Scandolaro L., Scorsetti M., Barbonetti C., Tortini R., Valdagni R., Vavassori V., Pepa M., Cazzaniga L. F., and Soatti C. P.

Abstract

Lombardy has represented the Italian and European epicenter of the coronavirus disease 2019 (COVID-19) pandemic. Although most clinical efforts within hospitals were diverted towards the care of virally infected patients, therapies for patients with cancer, including radiotherapy (RT), have continued. During both the first and second pandemic waves, several national and regional organizations provided Italian and Lombardian RT departments with detailed guidelines aimed at ensuring safe treatments during the pandemic. The spread of infection among patients and personnel was limited by adopting strict measures, including triage procedures, interpersonal distance, and adequate implementation of personal protective equipment (PPE). Screening procedures addressed to both the healthcare workforce and patients, such as periodic nasopharyngeal swabs, have allowed the early identification of asymptomatic or pauci-symptomatic COVID-19 cases, thus reducing the spread of the infection. Prevention of infection was deemed of paramount importance to protect both patients and personnel and to ensure the availability of a minimum number of staff members to maintain clinical activity. The choice of treating COVID-19–positive patients has represented a matter of debate, and the risk of oncologic progression has been weighted against the risk of infection of personnel and other patients. Such risk was minimized by creating dedicated paths, reserving time slots, applying intensified cleaning procedures, and supplying personnel and staff with appropriate PPE. Remote working of research staff, medical physicists, and, in some cases, radiation oncologists has prevented overcrowding of shared spaces, reducing infection spread.

Published
2022

2. Back to (new) normality—A CODRAL/AIRO-L survey on cancer radiotherapy in Lombardy during Italian COVID-19 phase 2

Author

Jereczek-Fossa, B, Pepa, M, Marvaso, G, Isaksson, J, Soatti, C, Cazzaniga, L, Ivaldi, G, Amadori, M, Antognoni, P, Arcangeli, S, Buffoli, A, Beltramo, G, Bignardi, M, Bracelli, S, Bruschieri, L, Castiglioni, S, Catalano, G, Di Muzio, N, Fallai, C, Fariselli, L, Filippi, A, Gramaglia, A, Italia, C, Lombardi, F, Magrini, S, Nava, S, Orlandi, E, Pasinetti, N, Sbicego, E, Scandolaro, L, Scorsetti, M, Stiglich, F, Tortini, R, Valdagni, R, Vavassori, V, Tonoli, S, Palazzi, M, Jereczek-Fossa B. A., Pepa M., Marvaso G., Isaksson J. L., Soatti C. P., Cazzaniga L. F., Ivaldi G. B., Amadori M., Antognoni P., Arcangeli S., Buffoli A., Beltramo G., Bignardi M., Bracelli S., Bruschieri L., Castiglioni S., Catalano G., Di Muzio N., Fallai C., Fariselli L., Filippi A. R., Gramaglia A., Italia C., Lombardi F., Magrini S. M., Nava S., Orlandi E., Pasinetti N., Sbicego E. L., Scandolaro L., Scorsetti M., Stiglich F., Tortini R., Valdagni R., Vavassori V., Tonoli S., Palazzi M. F., Jereczek-Fossa, B, Pepa, M, Marvaso, G, Isaksson, J, Soatti, C, Cazzaniga, L, Ivaldi, G, Amadori, M, Antognoni, P, Arcangeli, S, Buffoli, A, Beltramo, G, Bignardi, M, Bracelli, S, Bruschieri, L, Castiglioni, S, Catalano, G, Di Muzio, N, Fallai, C, Fariselli, L, Filippi, A, Gramaglia, A, Italia, C, Lombardi, F, Magrini, S, Nava, S, Orlandi, E, Pasinetti, N, Sbicego, E, Scandolaro, L, Scorsetti, M, Stiglich, F, Tortini, R, Valdagni, R, Vavassori, V, Tonoli, S, Palazzi, M, Jereczek-Fossa B. A., Pepa M., Marvaso G., Isaksson J. L., Soatti C. P., Cazzaniga L. F., Ivaldi G. B., Amadori M., Antognoni P., Arcangeli S., Buffoli A., Beltramo G., Bignardi M., Bracelli S., Bruschieri L., Castiglioni S., Catalano G., Di Muzio N., Fallai C., Fariselli L., Filippi A. R., Gramaglia A., Italia C., Lombardi F., Magrini S. M., Nava S., Orlandi E., Pasinetti N., Sbicego E. L., Scandolaro L., Scorsetti M., Stiglich F., Tortini R., Valdagni R., Vavassori V., Tonoli S., and Palazzi M. F.

Abstract

Background: Italy experienced one of the world’s severest COVID-19 outbreak, with Lombardy being the most afflicted region. However, the imposed safety measures allowed to flatten the epidemic curve and hence to ease the restrictions and inaugurate, on the 4th of May 2020, the Italian phase (P) 2 of the pandemic. The present survey study, endorsed by CODRAL and AIRO-L, aimed to assess how radiotherapy (RT) departments in Lombardy have dealt with the recovery. Materials and methods: A questionnaire dealing with the management of pandemic was developed online and sent to all CODRAL Directors on the 10th of June 2020. Answers were collected in full anonymity one week after. Results: All the 33 contacted RT facilities (100%) responded to the survey. Despite the scale of the pandemic, during P1 14 (42.4%) centres managed to safely continue the activity (≤ 10% reduction). During P2, 10 (30.3%) centres fully recovered and 14 (42.4%) reported an increase. Nonetheless, 6 (18.2%) declared no changes and, interestingly, 3 (9.1%) reduced activities. Overall, 21 centres (63.6%) reported suspected or positive cases within healthcare workforce since the beginning of the pandemic. Staff units were quarantined in 19 (57.6%) and 6 (18.2%) centres throughout P1 and P2, respectively. In the two phases, about two thirds centres registered positive or suspected cases amongst patients. Conclusion: The study revealed a particular attention to anti-contagion measures and a return to normal or even higher clinical workload in most RT centres in Lombardy, necessary to carry out current and previously deferred treatments.

Published
2020

3. COVID-19 Outbreak and Cancer Radiotherapy Disruption in Lombardy, Northern Italy

Author

Jereczek-Fossa, B, Palazzi, M, Soatti, C, Cazzaniga, L, Ivaldi, G, Pepa, M, Amadori, M, Antognoni, P, Arcangeli, S, Buffoli, A, Beltramo, G, Berlinghieri, S, Bignardi, M, Bracelli, S, Bruschieri, L, Castiglioni, S, Catalano, G, Di Muzio, N, Fallai, C, Fariselli, L, Filippi, A, Gramaglia, A, Italia, C, Lombardi, F, Magrini, S, Nava, S, Orlandi, E, Pasinetti, N, Sbicego, E, Scandolaro, L, Scorsetti, M, Stiglich, F, Tonoli, S, Tortini, R, Valdagni, R, Vavassori, V, Marvaso, G, Jereczek-Fossa B. A., Palazzi M. F., Soatti C. P., Cazzaniga L. F., Ivaldi G. B., Pepa M., Amadori M., Antognoni P., Arcangeli S., Buffoli A., Beltramo G., Berlinghieri S., Bignardi M., Bracelli S., Bruschieri L., Castiglioni S., Catalano G., Di Muzio N., Fallai C., Fariselli L., Filippi A. R., Gramaglia A., Italia C., Lombardi F., Magrini S. M., Nava S., Orlandi E., Pasinetti N., Sbicego E. L., Scandolaro L., Scorsetti M., Stiglich F., Tonoli S., Tortini R., Valdagni R., Vavassori V., Marvaso G., Jereczek-Fossa, B, Palazzi, M, Soatti, C, Cazzaniga, L, Ivaldi, G, Pepa, M, Amadori, M, Antognoni, P, Arcangeli, S, Buffoli, A, Beltramo, G, Berlinghieri, S, Bignardi, M, Bracelli, S, Bruschieri, L, Castiglioni, S, Catalano, G, Di Muzio, N, Fallai, C, Fariselli, L, Filippi, A, Gramaglia, A, Italia, C, Lombardi, F, Magrini, S, Nava, S, Orlandi, E, Pasinetti, N, Sbicego, E, Scandolaro, L, Scorsetti, M, Stiglich, F, Tonoli, S, Tortini, R, Valdagni, R, Vavassori, V, Marvaso, G, Jereczek-Fossa B. A., Palazzi M. F., Soatti C. P., Cazzaniga L. F., Ivaldi G. B., Pepa M., Amadori M., Antognoni P., Arcangeli S., Buffoli A., Beltramo G., Berlinghieri S., Bignardi M., Bracelli S., Bruschieri L., Castiglioni S., Catalano G., Di Muzio N., Fallai C., Fariselli L., Filippi A. R., Gramaglia A., Italia C., Lombardi F., Magrini S. M., Nava S., Orlandi E., Pasinetti N., Sbicego E. L., Scandolaro L., Scorsetti M., Stiglich F., Tonoli S., Tortini R., Valdagni R., Vavassori V., and Marvaso G.

Published
2020

4. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma

Author

Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJB, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J, Janzer RC, Ludwin SK, Gorlia T, Allgeier A, Lacombe D, Cairncross JG, Eisenhauer E, Mirimanoff RO, Van Den Weyngaert D, Kaendler S, Krauseneck P, Vinolas N, Villa S, Wurm RE, Maillot MHB, Spagnolli F, Kantor G, Malhaire JP, Renard L, De Witte O, Scandolaro L, Vecht CJ, Maingon P, Lutterbach J, Kobierska A, Bolla M, Souchon R, Mitine C, Tzuk-Shina T, Kuten A, Haferkamp G, de Greve J, Priou F, Menten J, Rutten I, Clavere P, Malmstrom A, Jancar B, Newlands E, Pigott K, Twijnstra A, Chinot O, Reni M, Boiardi A, Fabbro M, Campone M, Bozzino J, Frenay M, Gijtenbeek J, Delattre JY, De Paula U, Hanzen C, Pavanato G, Schraub S, Pfeffer R, Soffietti R, Kortmann RD, Taphoorn M, Torrecilla JL, Grisold W, Huget P, Forsyth P, Fulton D, Kirby S, Wong R, Fenton D, Cairncross G, Whitlock P, Burdette-Radoux S, Gertler S, Saunders S, Laing K, Siddiqui J, Martin LA, Gulavita S, Perry J, Mason W, Thiessen B, Pai H, Alam ZY, Eisenstat D, Mingrone W, Hofer S, Pesce G, Dietrich PY, Thum P, Baumert B, Ryan G, Stupp, R, Mason, Wp, van den Bent, Mj, Weller, M, Fisher, B, Taphoorn, Mjb, Belanger, K, Brandes, Aa, Marosi, C, Bogdahn, U, Curschmann, J, Janzer, Rc, Ludwin, Sk, Gorlia, T, Allgeier, A, Lacombe, D, Cairncross, Jg, Eisenhauer, E, Mirimanoff, Ro, Van Den Weyngaert, D, Kaendler, S, Krauseneck, P, Vinolas, N, Villa, S, Wurm, Re, Maillot, Mhb, Spagnolli, F, Kantor, G, Malhaire, Jp, Renard, L, De Witte, O, Scandolaro, L, Vecht, Cj, Maingon, P, Lutterbach, J, Kobierska, A, Bolla, M, Souchon, R, Mitine, C, Tzuk-Shina, T, Kuten, A, Haferkamp, G, de Greve, J, Priou, F, Menten, J, Rutten, I, Clavere, P, Malmstrom, A, Jancar, B, Newlands, E, Pigott, K, Twijnstra, A, Chinot, O, Reni, M, Boiardi, A, Fabbro, M, Campone, M, Bozzino, J, Frenay, M, Gijtenbeek, J, Delattre, Jy, De Paula, U, Hanzen, C, Pavanato, G, Schraub, S, Pfeffer, R, Soffietti, R, Kortmann, Rd, Taphoorn, M, Torrecilla, Jl, Grisold, W, Huget, P, Forsyth, P, Fulton, D, Kirby, S, Wong, R, Fenton, D, Cairncross, G, Whitlock, P, Burdette-Radoux, S, Gertler, S, Saunders, S, Laing, K, Siddiqui, J, Martin, La, Gulavita, S, Perry, J, Mason, W, Thiessen, B, Pai, H, Alam, Zy, Eisenstat, D, Mingrone, W, Hofer, S, Pesce, G, Dietrich, Py, Thum, P, Baumert, B, Ryan, G, Neurology, and Plastic and Reconstructive Surgery and Hand Surgery

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Adrenal Cortex Hormones, Adrenal Cortex Hormones/therapeutic use Adult Aged Antineoplastic Agents, Alkylating/adverse effects/*therapeutic use Brain Neoplasms/*drug therapy/mortality/*radiotherapy Chemotherapy, Adjuvant Dacarbazine/adverse effects/*analogs & derivatives/*therapeutic use Disease Progression Female Glioblastoma/*drug therapy/mortality/*radiotherapy Humans Male Middle Aged Proportional Hazards Models Radiotherapy, Computer-Assisted/adverse effects Survival Analysis, medicine, Temozolomide, Humans, Survival rate, Pseudoprogression, Antineoplastic Agents, Alkylating, Aged, Proportional Hazards Models, business.industry, Brain Neoplasms, Hazard ratio, General Medicine, Middle Aged, Debulking, medicine.disease, Survival Analysis, Radiotherapy, Computer-Assisted, Surgery, Radiation therapy, Dacarbazine, Chemotherapy, Adjuvant, Concomitant, Disease Progression, Female, business, Glioblastoma, medicine.drug, Anaplastic astrocytoma
Abstract

BACKGROUND: Glioblastoma, the most common primary brain tumor in adults, is usually rapidly fatal. The current standard of care for newly diagnosed glioblastoma is surgical resection to the extent feasible, followed by adjuvant radiotherapy. In this trial we compared radiotherapy alone with radiotherapy plus temozolomide, given concomitantly with and after radiotherapy, in terms of efficacy and safety. METHODS: Patients with newly diagnosed, histologically confirmed glioblastoma were randomly assigned to receive radiotherapy alone (fractionated focal irradiation in daily fractions of 2 Gy given 5 days per week for 6 weeks, for a total of 60 Gy) or radiotherapy plus continuous daily temozolomide (75 mg per square meter of body-surface area per day, 7 days per week from the first to the last day of radiotherapy), followed by six cycles of adjuvant temozolomide (150 to 200 mg per square meter for 5 days during each 28-day cycle). The primary end point was overall survival. RESULTS: A total of 573 patients from 85 centers underwent randomization. The median age was 56 years, and 84 percent of patients had undergone debulking surgery. At a median follow-up of 28 months, the median survival was 14.6 months with radiotherapy plus temozolomide and 12.1 months with radiotherapy alone. The unadjusted hazard ratio for death in the radiotherapy-plus-temozolomide group was 0.63 (95 percent confidence interval, 0.52 to 0.75; P

Published
2005

5. Internal Mammary and Medial Supraclavicular Irradiation in Breast Cancer

Author

Poortmans, P.M.P., Collette, S., Kirkove, C., Limbergen, E. van, Budach, V., Struikmans, H., Collette, L., Fourquet, A., Maingon, P., Valli, M., Winter, K. De, Marnitz, S., Barillot, I., Scandolaro, L., Vonk, E., Rodenhuis, C., Marsiglia, H., Weidner, N., Tienhoven, G. van, Glanzmann, C., Kuten, A., Arriagada, R., Bartelink, H., Bogaert, W. Van den, Poortmans, P.M.P., Collette, S., Kirkove, C., Limbergen, E. van, Budach, V., Struikmans, H., Collette, L., Fourquet, A., Maingon, P., Valli, M., Winter, K. De, Marnitz, S., Barillot, I., Scandolaro, L., Vonk, E., Rodenhuis, C., Marsiglia, H., Weidner, N., Tienhoven, G. van, Glanzmann, C., Kuten, A., Arriagada, R., Bartelink, H., and Bogaert, W. Van den

Abstract

Contains fulltext : 153199.pdf (publisher's version ) (Open Access), BACKGROUND: The effect of internal mammary and medial supraclavicular lymph-node irradiation (regional nodal irradiation) added to whole-breast or thoracic-wall irradiation after surgery on survival among women with early-stage breast cancer is unknown. METHODS: We randomly assigned women who had a centrally or medially located primary tumor, irrespective of axillary involvement, or an externally located tumor with axillary involvement to undergo either whole-breast or thoracic-wall irradiation in addition to regional nodal irradiation (nodal-irradiation group) or whole-breast or thoracic-wall irradiation alone (control group). The primary end point was overall survival. Secondary end points were the rates of disease-free survival, survival free from distant disease, and death from breast cancer. RESULTS: Between 1996 and 2004, a total of 4004 patients underwent randomization. The majority of patients (76.1%) underwent breast-conserving surgery. After mastectomy, 73.4% of the patients in both groups underwent chest-wall irradiation. Nearly all patients with node-positive disease (99.0%) and 66.3% of patients with node-negative disease received adjuvant systemic treatment. At a median follow-up of 10.9 years, 811 patients had died. At 10 years, overall survival was 82.3% in the nodal-irradiation group and 80.7% in the control group (hazard ratio for death with nodal irradiation, 0.87; 95% confidence interval [CI], 0.76 to 1.00; P=0.06). The rate of disease-free survival was 72.1% in the nodal-irradiation group and 69.1% in the control group (hazard ratio for disease progression or death, 0.89; 95% CI, 0.80 to 1.00; P=0.04), the rate of distant disease-free survival was 78.0% versus 75.0% (hazard ratio, 0.86; 95% CI, 0.76 to 0.98; P=0.02), and breast-cancer mortality was 12.5% versus 14.4% (hazard ratio, 0.82; 95% CI, 0.70 to 0.97; P=0.02). Acute side effects of regional nodal irradiation were modest. CONCLUSIONS: In patients with early-stage breast cancer, irradiatio

Published
2015

6. Postoperative 5-FU based radiochemotherapy in rectal cancer: retrospective long term results and prognostic factors of a pooled analysis on 1,338 patients

Author

Genovesi, D, Myerson, Rj, Cèfaro, Ga, Vinciguerra, A, Augurio, A, Trignani, M, Di Tommaso, M, Nuzzo, M, Lupattelli, M, Aristei, C, Bellavita, R, Scandolaro, L, Cosentino, D, Pani, Giovambattista, Ziccarelli, L, Gambacorta, Maria Antonietta, Barba, Maria Cristina, Maranzano, E, Trippa, F, Sciacero, P, Niespolo, R, Leonardi, C, Iannone, T, Rosetto, Me, Fusco, Vincenzo, Sanpaolo, P, Melano, A, Valvo, F, Capirci, C, De Paoli, A, Di Nicola, Marco, Mantello, G, Valentini, Vincenzo, Pani, Giovambattista (ORCID:0000-0001-7133-8728), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Di Nicola, Marco (ORCID:0000-0001-7457-0426), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Genovesi, D, Myerson, Rj, Cèfaro, Ga, Vinciguerra, A, Augurio, A, Trignani, M, Di Tommaso, M, Nuzzo, M, Lupattelli, M, Aristei, C, Bellavita, R, Scandolaro, L, Cosentino, D, Pani, Giovambattista, Ziccarelli, L, Gambacorta, Maria Antonietta, Barba, Maria Cristina, Maranzano, E, Trippa, F, Sciacero, P, Niespolo, R, Leonardi, C, Iannone, T, Rosetto, Me, Fusco, Vincenzo, Sanpaolo, P, Melano, A, Valvo, F, Capirci, C, De Paoli, A, Di Nicola, Marco, Mantello, G, Valentini, Vincenzo, Pani, Giovambattista (ORCID:0000-0001-7133-8728), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Di Nicola, Marco (ORCID:0000-0001-7457-0426), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)

Abstract

To evaluate survival outcomes of patients in pStage II-III rectal cancer treated with adjuvant 5-fluorouracil-based radiochemotherapy and to retrospectively analyze the impact of prognostic variables on local control, metastasis-free survival and cause-specific survival.

Published
2013

7. The essential role of radiotherapy in the treatment of merkel cell carcinoma: a study from the rare cancer network

Author

Ghadjar, P., Kaanders, J.H.A.M., Poortmans, P.M.P., Zaucha, R., Krengli, M., Lagrange, J.L., Ozsoy, O., Nguyen, T.D., Miralbell, R., Baize, A., Boujelbene, N., Collen, T., Scandolaro, L., Untereiner, M., Goldberg, H., Pesce, G.A., Anacak, Y., Friedrich, E.E., Aebersold, D.M., Beer, K.T., Ghadjar, P., Kaanders, J.H.A.M., Poortmans, P.M.P., Zaucha, R., Krengli, M., Lagrange, J.L., Ozsoy, O., Nguyen, T.D., Miralbell, R., Baize, A., Boujelbene, N., Collen, T., Scandolaro, L., Untereiner, M., Goldberg, H., Pesce, G.A., Anacak, Y., Friedrich, E.E., Aebersold, D.M., and Beer, K.T.

Abstract

Item does not contain fulltext, PURPOSE: To evaluate the role of postoperative radiotherapy (RT) in Merkel cell carcinoma (MCC). METHODS AND MATERIALS: A retrospective multicenter study was performed in 180 patients with MCC treated between February 1988 and September 2009. Patients who had had surgery alone were compared with patients who received surgery and postoperative RT or radical RT. Local relapse-free survival (LRFS), regional relapse-free survival (RRFS), and distant metastasis-free survival (DMFS) rates were assessed together with disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) rates. RESULTS: Seventy-nine patients were male and 101 patients were female, and the median age was 73 years old (range, 38-93 years). The majority of patients had localized disease (n = 146), and the remaining patients had regional lymph node metastasis (n = 34). Forty-nine patients underwent surgery for the primary tumor without postoperative RT to the primary site; the other 131 patients received surgery for the primary tumor, followed by postoperative RT (n = 118) or a biopsy of the primary tumor followed by radical RT (n = 13). Median follow-up was 5 years (range, 0.2-16.5 years). Patients in the RT group had improved LRFS (93% vs. 64%; p < 0.001), RRFS (76% vs. 27%; p < 0.001), DMFS (70% vs. 42%; p = 0.01), DFS (59% vs. 4%; p < 0.001), and CSS (65% vs. 49%; p = 0.03) rates compared to patients who underwent surgery for the primary tumor alone; LRFS, RRFS, DMFS, and DFS rates remained significant with multivariable Cox regression analysis. However OS was not significantly improved by postoperative RT (56% vs. 46%; p = 0.2). CONCLUSIONS: After multivariable analysis, postoperative RT was associated with improved outcome and seems to be an important component in the multimodality treatment of MCC.

Published
2011

8. Almost one year of COVID-19 pandemic: how radiotherapy centers have counteracted its impact on cancer treatment in Lombardy, Italy. CODRAL/AIRO-L study

Author

Nadia Pasinetti, Riccardo Valdagni, Claudio Barbonetti, Barbara Alicja Jereczek-Fossa, M. Amadori, Vittorio Vavassori, Annamaria Cerrotta, C. Italia, Matteo Pepa, Paolo Antognoni, Ester Orlandi, Marta Scorsetti, S. Castiglioni, Mattia Zaffaroni, Alberto Buffoli, Laura Fariselli, Luciano Scandolaro, Giulia Marvaso, Giancarlo Beltramo, Gianpiero Catalano, Alberto Gramaglia, Giovanni Ivaldi, Andrea Riccardo Filippi, Patrizia Massaro, Stefano Bracelli, Agostina De Stefani, Mario Bignardi, Stefano Maria Magrini, Simonetta Nava, Elena Lara Sbicego, Stefano Arcangeli, S. Tonoli, Roberto Tortini, Nadia Di Muzio, L.F. Cazzaniga, Mauro Palazzi, Carlo Pietro Soatti, Jereczek-Fossa, B, Palazzi, M, Tonoli, S, Zaffaroni, M, Marvaso, G, Ivaldi, G, Amadori, M, Antognoni, P, Arcangeli, S, Buffoli, A, Beltramo, G, Bignardi, M, Bracelli, S, De Stefani, A, Castiglioni, S, Catalano, G, Di Muzio, N, Cerrotta, A, Fariselli, L, Filippi, A, Gramaglia, A, Italia, C, Massaro, P, Magrini, S, Nava, S, Orlandi, E, Pasinetti, N, Sbicego, E, Scandolaro, L, Scorsetti, M, Barbonetti, C, Tortini, R, Valdagni, R, Vavassori, V, Pepa, M, Cazzaniga, L, Soatti, C, Jereczek-Fossa, B. A., Palazzi, M. F., Tonoli, S., Zaffaroni, M., Marvaso, G., Ivaldi, G. B., Amadori, M., Antognoni, P., Arcangeli, S., Buffoli, A., Beltramo, G., Bignardi, M., Bracelli, S., De Stefani, A., Castiglioni, S., Catalano, G., Di Muzio, N., Cerrotta, A., Fariselli, L., Filippi, A. R., Gramaglia, A., Italia, C., Massaro, P., Magrini, S. M., Nava, S., Orlandi, E., Pasinetti, N., Sbicego, E. L., Scandolaro, L., Scorsetti, M., Barbonetti, C., Tortini, R., Valdagni, R., Vavassori, V., Pepa, M., Cazzaniga, L. F., and Soatti, C. P.

Subjects
AIRO-L, Cancer Research, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, CODRAL, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Neoplasms, Pandemic, Humans, Medicine, Pandemics, Personal Protective Equipment, Personal protective equipment, radiotherapy, Screening procedures, SARS-CoV-2, business.industry, Risk of infection, COVID-19, General Medicine, Overcrowding, medicine.disease, Triage, Radiation therapy, Italy, Oncology, 030220 oncology & carcinogenesis, Lombardy, Radiation Oncology, Medical emergency, business
Abstract

Lombardy has represented the Italian and European epicenter of the coronavirus disease 2019 (COVID-19) pandemic. Although most clinical efforts within hospitals were diverted towards the care of virally infected patients, therapies for patients with cancer, including radiotherapy (RT), have continued. During both the first and second pandemic waves, several national and regional organizations provided Italian and Lombardian RT departments with detailed guidelines aimed at ensuring safe treatments during the pandemic. The spread of infection among patients and personnel was limited by adopting strict measures, including triage procedures, interpersonal distance, and adequate implementation of personal protective equipment (PPE). Screening procedures addressed to both the healthcare workforce and patients, such as periodic nasopharyngeal swabs, have allowed the early identification of asymptomatic or pauci-symptomatic COVID-19 cases, thus reducing the spread of the infection. Prevention of infection was deemed of paramount importance to protect both patients and personnel and to ensure the availability of a minimum number of staff members to maintain clinical activity. The choice of treating COVID-19–positive patients has represented a matter of debate, and the risk of oncologic progression has been weighted against the risk of infection of personnel and other patients. Such risk was minimized by creating dedicated paths, reserving time slots, applying intensified cleaning procedures, and supplying personnel and staff with appropriate PPE. Remote working of research staff, medical physicists, and, in some cases, radiation oncologists has prevented overcrowding of shared spaces, reducing infection spread.

Published
2021

9. Back to (new) normality—A CODRAL/AIRO-L survey on cancer radiotherapy in Lombardy during Italian COVID-19 phase 2

Author

Stefano Bracelli, Giulia Marvaso, Matteo Pepa, Mauro Palazzi, Mario Bignardi, Marta Scorsetti, Barbara Alicja Jereczek-Fossa, Fabrizio Lombardi, Lorenza Bruschieri, S. Tonoli, Roberto Tortini, Nadia Di Muzio, Stefano Maria Magrini, L.F. Cazzaniga, C. Italia, Laura Fariselli, Luciano Scandolaro, Johannes Lars Isaksson, Nadia Pasinetti, Riccardo Valdagni, Francesco Stiglich, Carlo Pietro Soatti, Andrea Riccardo Filippi, Simonetta Nava, Elena Lara Sbicego, Stefano Arcangeli, Gianpiero Catalano, Carlo Fallai, Vittorio Vavassori, Alberto Buffoli, Paolo Antognoni, Ester Orlandi, M. Amadori, S. Castiglioni, Alberto Gramaglia, Giovanni Ivaldi, Giancarlo Beltramo, Jereczek-Fossa, B. A., Pepa, M., Marvaso, G., Isaksson, J. L., Soatti, C. P., Cazzaniga, L. F., Ivaldi, G. B., Amadori, M., Antognoni, P., Arcangeli, S., Buffoli, A., Beltramo, G., Bignardi, M., Bracelli, S., Bruschieri, L., Castiglioni, S., Catalano, G., Di Muzio, N., Fallai, C., Fariselli, L., Filippi, A. R., Gramaglia, A., Italia, C., Lombardi, F., Magrini, S. M., Nava, S., Orlandi, E., Pasinetti, N., Sbicego, E. L., Scandolaro, L., Scorsetti, M., Stiglich, F., Tortini, R., Valdagni, R., Vavassori, V., Tonoli, S., Palazzi, M. F., Jereczek-Fossa, B, Pepa, M, Marvaso, G, Isaksson, J, Soatti, C, Cazzaniga, L, Ivaldi, G, Amadori, M, Antognoni, P, Arcangeli, S, Buffoli, A, Beltramo, G, Bignardi, M, Bracelli, S, Bruschieri, L, Castiglioni, S, Catalano, G, Di Muzio, N, Fallai, C, Fariselli, L, Filippi, A, Gramaglia, A, Italia, C, Lombardi, F, Magrini, S, Nava, S, Orlandi, E, Pasinetti, N, Sbicego, E, Scandolaro, L, Scorsetti, M, Stiglich, F, Tortini, R, Valdagni, R, Vavassori, V, Tonoli, S, and Palazzi, M

Subjects
Cancer Research, medicine.medical_specialty, Health Personnel, Pneumonia, Viral, Betacoronavirus, 03 medical and health sciences, Patient safety, 0302 clinical medicine, Ambulatory care, Neoplasms, Oncology Service, Hospital, Surveys and Questionnaires, Pandemic, Humans, Medicine, Infection control, Northern Italy, Survey, Pandemics, Personal Protective Equipment, Personal protective equipment, Radiation oncologist, Original Paper, SARS-CoV-2, business.industry, COVID-19, Outbreak, Workload, Hematology, General Medicine, Italy, Oncology, Cancer radiotherapy, 030220 oncology & carcinogenesis, Family medicine, Lombardy, Coronavirus Infections, business
Abstract

Background Italy experienced one of the world’s severest COVID-19 outbreak, with Lombardy being the most afflicted region. However, the imposed safety measures allowed to flatten the epidemic curve and hence to ease the restrictions and inaugurate, on the 4th of May 2020, the Italian phase (P) 2 of the pandemic. The present survey study, endorsed by CODRAL and AIRO-L, aimed to assess how radiotherapy (RT) departments in Lombardy have dealt with the recovery. Materials and methods A questionnaire dealing with the management of pandemic was developed online and sent to all CODRAL Directors on the 10th of June 2020. Answers were collected in full anonymity one week after. Results All the 33 contacted RT facilities (100%) responded to the survey. Despite the scale of the pandemic, during P1 14 (42.4%) centres managed to safely continue the activity (≤ 10% reduction). During P2, 10 (30.3%) centres fully recovered and 14 (42.4%) reported an increase. Nonetheless, 6 (18.2%) declared no changes and, interestingly, 3 (9.1%) reduced activities. Overall, 21 centres (63.6%) reported suspected or positive cases within healthcare workforce since the beginning of the pandemic. Staff units were quarantined in 19 (57.6%) and 6 (18.2%) centres throughout P1 and P2, respectively. In the two phases, about two thirds centres registered positive or suspected cases amongst patients. Conclusion The study revealed a particular attention to anti-contagion measures and a return to normal or even higher clinical workload in most RT centres in Lombardy, necessary to carry out current and previously deferred treatments. Electronic supplementary material The online version of this article (10.1007/s12032-020-01434-1) contains supplementary material, which is available to authorized users.

Published
2020

10. COVID-19 Outbreak and Cancer Radiotherapy Disruption in Lombardy, Northern Italy

Author

Laura Fariselli, Barbara Alicja Jereczek-Fossa, C. Italia, Stefano Bracelli, M. Amadori, Gianpiero Catalano, L.F. Cazzaniga, Francesco Stiglich, Giancarlo Beltramo, S. Castiglioni, Fabrizio Lombardi, Giovanni Ivaldi, S. Tonoli, Roberto Tortini, Simonetta Nava, Stefano Arcangeli, Elena Lara Sbicego, Paolo Antognoni, Stefano Maria Magrini, Riccardo Valdagni, Giulia Marvaso, Luciano Scandolaro, Mario Bignardi, S. Berlinghieri, Lorenza Bruschieri, Ester Orlandi, A. Gramaglia, Nadia Pasinetti, Matteo Pepa, Marta Scorsetti, V. Vavassori, Alberto Buffoli, Andrea Riccardo Filippi, N. Di Muzio, Mauro Palazzi, Carlo Pietro Soatti, Carlo Fallai, Jereczek-Fossa, B, Palazzi, M, Soatti, C, Cazzaniga, L, Ivaldi, G, Pepa, M, Amadori, M, Antognoni, P, Arcangeli, S, Buffoli, A, Beltramo, G, Berlinghieri, S, Bignardi, M, Bracelli, S, Bruschieri, L, Castiglioni, S, Catalano, G, Di Muzio, N, Fallai, C, Fariselli, L, Filippi, A, Gramaglia, A, Italia, C, Lombardi, F, Magrini, S, Nava, S, Orlandi, E, Pasinetti, N, Sbicego, E, Scandolaro, L, Scorsetti, M, Stiglich, F, Tonoli, S, Tortini, R, Valdagni, R, Vavassori, V, Marvaso, G, Jereczek-Fossa, B. A., Palazzi, M. F., Soatti, C. P., Cazzaniga, L. F., Ivaldi, G. B., Pepa, M., Amadori, M., Antognoni, P., Arcangeli, S., Buffoli, A., Beltramo, G., Berlinghieri, S., Bignardi, M., Bracelli, S., Bruschieri, L., Castiglioni, S., Catalano, G., Di Muzio, N., Fallai, C., Fariselli, L., Filippi, A. R., Gramaglia, A., Italia, C., Lombardi, F., Magrini, S. M., Nava, S., Orlandi, E., Pasinetti, N., Sbicego, E. L., Scandolaro, L., Scorsetti, M., Stiglich, F., Tonoli, S., Tortini, R., Valdagni, R., Vavassori, V., and Marvaso, G.

Subjects
2019-20 coronavirus outbreak, Medical staff, Infectious Disease Transmission, Patient-to-Professional, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Betacoronavirus, Environmental health, Neoplasms, Medicine, Humans, Covid-19, Radiotherapy, Radiology, Nuclear Medicine and imaging, Pandemics, Infection Control, business.industry, SARS-CoV-2, Outbreak, COVID-19, Northern italy, Oncology, Italy, Radiology Nuclear Medicine and imaging, Treatment interruption, Cancer Radiotherapy, Practice Guidelines as Topic, business, Coronavirus Infections
Published
2020

11. Equipment, staffing, and provision of radiotherapy in Lombardy, Italy: Results of three surveys performed between 2012 and 2016

Author

M. Amadori, Mario Bignardi, Simonetta Nava, Marta Scorsetti, Ambrogia Baio, Carlo Fallai, Gianstefano Gardani, Alberto Buffoli, Vittorio Vavassori, Enrico Sarti, S. Castiglioni, L.F. Cazzaniga, Paolo Antognoni, Francesco Stiglich, Elena Lara Sbicego, Fabrizio Lombardi, Laura Fariselli, A. Gramaglia, Giancarlo Beltramo, Paolo Frata, Stefano Maria Magrini, C. Italia, S. Tonoli, Barbara Alicja Jereczek-Fossa, Roberto Orecchia, Roberto Tortini, Nadia Di Muzio, Gianpiero Catalano, Riccardo Valdagni, Giovanni Ivaldi, Francesca Valvo, Luciano Scandolaro, Stefano Bracelli, Mauro Palazzi, Carlo Pietro Soatti, Palazzi, M. F., Soatti, C., Jereczek-Fossa, B. A., Cazzaniga, L. F., Antognoni, P., Gardani, G., Amadori, M., Baio, A., Beltramo, G., Bignardi, M., Bracelli, S., Buffoli, A., Castiglioni, S., Catalano, G., Di Muzio, N., Fallai, C., Fariselli, L., Frata, P., Gramaglia, A., Italia, C., Ivaldi, G., Lombardi, F., Magrini, S. M., Nava, S., Sarti, E., Scandolaro, L., Scorsetti, M., Stiglich, F., Tortini, R., Valdagni, R., Valvo, F., Vavassori, V., Sbicego, E. L., Tonoli, S., and Orecchia, R.

Subjects
Cancer Research, European level, Staffing, Equipment, Conformal radiotherapy, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Neoplasms, Surveys and Questionnaires, Intensity-Modulated, Radiation oncology, Humans, Operations management, Survey, Cancer, Staff, Radiotherapy, Conformal, General Medicine, Intensity-modulated radiation therapy, Health Resources, Needs Assessment, Practice Guidelines as Topic, Radiation Oncology, Radiotherapy, Conformal, Radiotherapy, Intensity-Modulated, Geography, Oncology, 030220 oncology & carcinogenesis, Needs assessment
Abstract

Introduction: Several efforts are being implemented at the European level to measure provision of up-to-date radiation treatments across the continent. Methods: A snapshot survey involving all radiation oncology centers within Lombardy, Italy, was performed in 2012 and repeated in 2014 and 2016, in cooperation with regional governmental officers. Centers were asked to provide detailed information concerning all individual patients being treated on the index day, and to report data on available local resources. Results: We observed an increase in the number of centers and of megavoltage units (MVU) (from 76 to 87, i.e., 8.7 MVU per million inhabitants in 2016). Mean number of MVU per center was 2.5. Average age of MVU increased from 5.3 to 7.5 years and patients on the waiting list also increased. Conformal 3D radiotherapy (RT) treatments decreased from 56% to 42% and were progressively replaced by intensity-modulated RT treatments (from 39% to 49%). Waiting times were overall satisfactory. Radiation oncologists treated on average 152 and radiation therapists 100 RT courses per year. Average reimbursement per course was €4,879 (range €2,476–€8,014). Conclusions: The methodology of snapshot survey proved feasible and provided valuable information about radiation oncology provision and accessibility in Lombardy.

Published
2018

12. Radiotherapy for oligometastatic cancer: a survey among radiation oncologists of Lombardy (AIRO-Lombardy), Italy

Author

Riccardo Valdagni, F Piccoli, P. Romanelli, Michela Buglione, S. Morlino, Davide Franceschini, Arienti Vm, Marta Scorsetti, Bortolato B, Laudati A, F. Filippone, Di Muzio N, Andrei Fodor, Stefano Maria Magrini, Flavia Serafini, Barbara Alicja Jereczek-Fossa, Meaglia I, Roberto Orecchia, Luciano Scandolaro, S. Gottardo, Gianpiero Catalano, Paolo Antognoni, Giovanni Ivaldi, Stefano Bracelli, Mantero E, L.F. Cazzaniga, De Cicco L, Paolo Frata, Samantha Dicuonzo, Mauro Palazzi, S. Berlinghieri, Mariangela Caputo, Marianna Alessandra Gerardi, Jereczek-Fossa, B. A., Bortolato, B., Gerardi, M. A., Dicuonzo, S., Arienti, V. M., Berlinghieri, S., Bracelli, S., Buglione, M., Caputo, M., Catalano, G., Cazzaniga, L. F., De Cicco, L., Di Muzio, N., Filippone, F. R., Fodor, A., Franceschini, D., Frata, P., Gottardo, S., Ivaldi, G. B., Laudati, A., Magrini, S. M., Mantero, E., Meaglia, I., Morlino, S., Palazzi, M., Piccoli, F., Romanelli, P., Scorsetti, M., Serafini, F., Scandolaro, L., Valdagni, R., Orecchia, R., and Antognoni, P.

Subjects
Male, medicine.medical_specialty, Stereotactic body radiotherapy, medicine.medical_treatment, Radiation Dosage, 030218 nuclear medicine & medical imaging, Metastasis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Surveys and Questionnaires, Nuclear Medicine and Imaging, medicine, Humans, Radiology, Nuclear Medicine and imaging, Neoplasm Metastasis, Practice Patterns, Physicians', Survey, Lymph node, Radiation oncologist, medicine.diagnostic_test, Radiotherapy, business.industry, Radiation Oncologists, Cancer, Interventional radiology, General Medicine, medicine.disease, Primary tumor, Radiation therapy, medicine.anatomical_structure, Italy, 030220 oncology & carcinogenesis, Lombardy, Observational study, Female, Dose Fractionation, Radiation, Oligometastatic cancer, business, Radiology, Nuclear Medicine and Imaging, Radiology
Abstract

Aims: To evaluate the use of radiotherapy (RT) for oligometastatic cancer (OMC) among radiation oncologists in Lombardy, Italy. Methods and study design: A survey with 12 items regarding data of 2016 was sent to all 34 Lombardy RT centers. The survey included six general items and six specific items regarding patient/disease/treatment characteristics. Results: Thirteen centers answered the survey (38%). All centers responded to general items and 12 centers submitted patient/disease/treatment data. General items The majority of centers (8/13) consider OMC if metastases number is less than 5. The most commonly prescribed dose/fraction is 5–10Gy (8/13) using schedules of 3–5 fractions (11/13). Patient data items A total of 15.681 patients were treated in 2016 with external beam RT in 12 responding centers, and 1.087 patients were treated for OMC (7%). Primary tumor included lung, prostate, breast, colorectal and other malignancies in 33%, 21%, 12%, 9% and 25% of all OMC patients, respectively. Brain, lymph node, lung, bone, liver and others were the most common treated sites (24%, 24%, 22%, 17%, 8% and 5%, respectively). One and more than one metastasis were treated in 75 and 25% of patients, respectively. The vast majority of patients (95%) were treated with image-guided intensity-modulated RT or stereotactic RT. Conclusions: Seven percent of all RT patients in Lombardy are treated for OMC. Extreme hypofractionation and high-precision RT are commonly employed. The initiative of multicenter and multidisciplinary collaboration has been undertaken in order to prepare the platform for prospective and/or observational studies in OMC.

Published
2018

13. Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma: A Rare Cancer Network study.

Author

Pellanda AF, De Bari B, Deniaud-Alexandre E, Krengli M, Van Houtte P, Richetti A, Villà S, Goldberg H, Szutowicz-Zielińska E, Bolla M, Rutten H, Van Eijkeren M, Poortmans P, Henke G, Anacak Y, Chan S, Landmann C, Kirkove C, Scandolaro L, Bernier J, Mirimanoff RO, and Ozsahin M

Abstract

Objective: Primary uterine leiomyosarcomas (ULMS) are rare, and the optimal treatment is controversial. We aimed to assess the outcome and prognostic factors in a multicenter population of women treated for primary ULMS., Methods: We retrospectively collected data of 110 women treated in 19 institutions of the Rare Cancer Network (RCN). Inclusion criteria consisted of a pathology report confirming the diagnosis of ULMS, aged 18-80 years, complete International Federation of Gynecology and Obstetrics (FIGO) stage information, complete information on treatment, and a minimum follow-up of 6 months. Local control (LC) and locoregional control (LRC), overall survival (OS) and disease-free survival (DFS) rates were computed using the Kaplan-Meier method. Univariate analysis was implemented using the log rank test, and multivariate analysis using the Cox model., Results: All patients underwent surgery. Seventy-five patients (68%) received adjuvant radiotherapy (RT), including brachytherapy in 18 (16%). Seventeen patients (15%) received adjuvant chemotherapy. Median follow-up was 58 (range, 6-240) months. Five-year OS and DFS rates were 50% and 34%, and LC and LRC rates were 88% and 72%, respectively. On multivariate analysis, independent favorable prognostic factors were younger age, FIGO stage I, small tumor size, previous uterine disease, and no vascular invasion for OS and DFS. FIGO stage was the only favorable factor influencing LRC. Adjuvant local or systemic treatments did not improve the outcomes. Eight patients treated with RT presented a grade 3 acute toxicity, and only one patient with grade 3 late toxicity., Conclusions: In this large population of primary ULMS patients, we found good results in terms of LC and LRC. Nevertheless, OS remains poor, mainly due to the occurrence of distant metastases. An early diagnosis seemed to improve the prognosis of the patients. Adjuvant local or systemic treatments, or more aggressive surgical procedures such as the Wertheim procedure, did not seem to impact the outcome.

Published
2017
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14. History of the rare cancer network and past research.

Author

Mirimanoff RO, Ozsahin M, Thariat J, Ozyar E, Schick U, Pehlivan B, Krengli M, Pellanda AF, Vees H, Cai L, Scandolaro L, Belkacemi Y, Villà S, Igdem S, Lutsyk M, and Miller RC

Abstract

Approximately, twenty years ago, the Rare Cancer Network (RCN) was formed in Lausanne, Switzerland, to support the study of rare malignancies. The RCN has grown over the years and now includes 130 investigators from twenty-four nations on six continents. The network held its first international symposium in Nice, France, on March 21-22, 2014. The proceedings of that meeting are presented in two companion papers. This manuscript reviews the history of the growth of the RCN and contains the abstracts of fourteen oral presentations made at the meeting of prior RCN studies. From 1993 to 2014, 74 RCN studies have been initiated, of which 54 were completed, 10 are in progress or under analysis, and 9 were stopped due to poor accrual. Forty-four peer reviewed publications have been written on behalf of the RCN.

Published
2014
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15. Postoperative 5-FU based radiochemotherapy in rectal cancer: retrospective long term results and prognostic factors of a pooled analysis on 1,338 patients.

Author

Genovesi D, Myerson RJ, Cèfaro GA, Vinciguerra A, Augurio A, Trignani M, DI Tommaso M, Nuzzo M, Lupattelli M, Aristei C, Bellavita R, Scandolaro L, Cosentino D, Pani G, Ziccarelli L, Gambacorta MA, Barba MC, Maranzano E, Trippa F, Sciacero P, Niespolo R, Leonardi C, Iannone T, Rosetto ME, Fusco V, Sanpaolo P, Melano A, Valvo F, Capirci C, DE Paoli A, DI Nicola M, Mantello G, and Valentini V

Subjects
Chemoradiotherapy, Disease-Free Survival, Humans, Kaplan-Meier Estimate, Lymphatic Metastasis, Postoperative Period, Prognosis, Rectal Neoplasms mortality, Rectal Neoplasms pathology, Retrospective Studies, Treatment Outcome, Antimetabolites, Antineoplastic therapeutic use, Fluorouracil therapeutic use, Rectal Neoplasms therapy
Abstract

Aim: To evaluate survival outcomes of patients in pStage II-III rectal cancer treated with adjuvant 5-fluorouracil-based radiochemotherapy and to retrospectively analyze the impact of prognostic variables on local control, metastasis-free survival and cause-specific survival., Patients and Methods: A total of 1,338 patients, treated between 1985-2005 for locally advanced rectal cancer, who underwent surgery and postoperative 5-fluorouracil-based chemoradiation, were selected., Results: The actuarial 5- and 10-year outcomes were: local control 87.0%-84.1%, disease-free survival 61.6%-52.1%, metastasis-free survival 72.0%-67.2%, cause-specific survival 70.4%-57.5%, and overall survival 63.8%-53.4%. Better outcomes were observed in patients with IIA, IIIA stage. Multivariate analyses showed that variables significantly affecting metastasis-free survival were pT4 and pN2, while for cancer-specific survival those variables were age >65 years, pT4, pN1, pN2, distal tumors and number of lymph nodes removed ≤ 12., Conclusion: This study confirmed that among stage II-III rectal cancer patients there are subgroups of patients with different clinical outcomes.

Published
2013

16. Curative external beam radiotherapy in patients over 80 years of age with localized prostate cancer: a retrospective rare cancer network study.

Author

Nguyen TD, Azria D, Brochon D, Poortmans P, Miller RC, Scandolaro L, Majewski W, Krengli M, Abacioglu U, Moretti L, Villa S, Akyol F, and Jovenin N

Subjects
Antineoplastic Agents, Hormonal therapeutic use, Chemotherapy, Adjuvant, Disease-Free Survival, Europe, Humans, Kaplan-Meier Estimate, Male, Neoplasm Staging, Prostatic Neoplasms drug therapy, Prostatic Neoplasms mortality, Prostatic Neoplasms pathology, Radiation Injuries etiology, Radiation Tolerance, Radiotherapy adverse effects, Retrospective Studies, Time Factors, Treatment Outcome, Prostatic Neoplasms radiotherapy
Abstract

Purpose: To analyse tolerance and outcome of patients over 80 years of age who choose external beam radiation therapy to the prostate as a curative treatment., Methods and Material: We evaluated acute and late side effects, biological DFS (bDFS) and actuarial survival as well as causes of death in relation to the clinical status including co-morbidity, PSA value, Gleason score and modalities of external radiotherapy in patients with localised prostate cancer >80 years of age., Results: From January 1990 to December 2000, 65 eligible cases (median age: 81) were treated by 12 different participating institutions in the Rare Cancer Network. Tumour stage was T1N0M0, T2N0M0 and T3N0M0 for 10, 40, and 15 patients, respectively. Median follow-up was 65 months (range 22-177). Five-year overall survival rate was 77% with a 5-year bDFS rate of 73%. The incidence of grade 3 early toxicity was 12% and 9% for urinary and digestive tract, respectively., Conclusions: Radiation therapy given with curative intent is well tolerated in this selected group of patients aged over 80 years with localised prostate cancer. Results in terms of survival do not suggest a deleterious impact of this treatment. Therefore the authors recommend that radiation therapy with curative intent should not be withheld in selected elderly patients with localised prostate cancer.

Published
2010
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17. [Postoperative radiotherapy of rectal carcinoma].

Author

Cionini L, Scandolaro L, and Genovesi D

Subjects
Combined Modality Therapy, Humans, Postoperative Care, Rectal Neoplasms surgery, Rectal Neoplasms radiotherapy
Abstract

In the last 40 years, radiotherapy as gained a major role in the curative treatment of rectal carcinoma. Based on a reported incidence of local failure after surgery between 15% and 50%, in patients with T3-4 rectal cancer, postoperative radiation has been proposed in this group of patients. However, postoperative radiotherapy results associated with a relatively high incidence of acute and late toxicity and the reported improvement in local control attained statistical significance only in the MRC randomized trial. A recent publication suggests that postoperative radiation should probably be reserved to the subgroup of pT3 patients with unfavourable features. Postoperative radiation therapy is considered also for patients with G1-2 carcinoma treated with local excision, who do not show lymphatic or venous invasion, and for those with pT2 stage or pT1 carcinoma with involved resection margins.

Published
2001

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