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1. MRI-derived radiomics to guide post-operative management of glioblastoma: Implication for personalized radiation treatment volume delineation

Author

Chiesa, Silvia, Russo, Rosellina, Beghella Bartoli, Francesco, Palumbo, I, Sabatino, Giovanni, Cannatà, M C, Gigli, Riccardo, Longo, Silvia, Tran, H E, Boldrini, Luca, Dinapoli, Nicola, Votta, C, Cusumano, Davide, Pignotti, Fabrizio, Lupattelli, M, Camilli, F, Della Pepa, Giuseppe Maria, D'Alessandris, G Q, Olivi, Alessandro, Balducci, Mario, Colosimo, Cesare, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Aristei, Cynthia, Gaudino, Simona, Chiesa, S (ORCID:0000-0003-0168-3459), Russo, R, Beghella Bartoli, F, Sabatino, G (ORCID:0000-0002-4227-0434), Gigli, R, Longo, S, Boldrini, L, Dinapoli, N, Cusumano, D, Pignotti, F, Della Pepa, G M (ORCID:0000-0001-8698-3359), Olivi, A (ORCID:0000-0002-4489-7564), Balducci, M (ORCID:0000-0003-0398-9726), Colosimo, C (ORCID:0000-0003-3800-3648), Gambacorta, M A (ORCID:0000-0001-5455-8737), Valentini, V (ORCID:0000-0003-4637-6487), Aristei, C, Gaudino, S (ORCID:0000-0003-1681-4343), Chiesa, Silvia, Russo, Rosellina, Beghella Bartoli, Francesco, Palumbo, I, Sabatino, Giovanni, Cannatà, M C, Gigli, Riccardo, Longo, Silvia, Tran, H E, Boldrini, Luca, Dinapoli, Nicola, Votta, C, Cusumano, Davide, Pignotti, Fabrizio, Lupattelli, M, Camilli, F, Della Pepa, Giuseppe Maria, D'Alessandris, G Q, Olivi, Alessandro, Balducci, Mario, Colosimo, Cesare, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Aristei, Cynthia, Gaudino, Simona, Chiesa, S (ORCID:0000-0003-0168-3459), Russo, R, Beghella Bartoli, F, Sabatino, G (ORCID:0000-0002-4227-0434), Gigli, R, Longo, S, Boldrini, L, Dinapoli, N, Cusumano, D, Pignotti, F, Della Pepa, G M (ORCID:0000-0001-8698-3359), Olivi, A (ORCID:0000-0002-4489-7564), Balducci, M (ORCID:0000-0003-0398-9726), Colosimo, C (ORCID:0000-0003-3800-3648), Gambacorta, M A (ORCID:0000-0001-5455-8737), Valentini, V (ORCID:0000-0003-4637-6487), Aristei, C, and Gaudino, S (ORCID:0000-0003-1681-4343)

Abstract

BackgroundThe glioblastoma's bad prognosis is primarily due to intra-tumor heterogeneity, demonstrated from several studies that collected molecular biology, cytogenetic data and more recently radiomic features for a better prognostic stratification. The GLIFA project (GLIoblastoma Feature Analysis) is a multicentric project planned to investigate the role of radiomic analysis in GB management, to verify if radiomic features in the tissue around the resection cavity may guide the radiation target volume delineation. Materials and methodsWe retrospectively analyze from three centers radiomic features extracted from 90 patients with total or near total resection, who completed the standard adjuvant treatment and for whom we had post-operative images available for features extraction. The Manual segmentation was performed on post gadolinium T1w MRI sequence by 2 radiation oncologists and reviewed by a neuroradiologist, both with at least 10 years of experience. The Regions of interest (ROI) considered for the analysis were: the surgical cavity +/- post-surgical residual mass (CTV_cavity); the CTV a margin of 1.5 cm added to CTV_cavity and the volume resulting from subtracting the CTV_cavity from the CTV was defined as CTV_Ring. Radiomic analysis and modeling were conducted in RStudio. Z-score normalization was applied to each radiomic feature. A radiomic model was generated using features extracted from the Ring to perform a binary classification and predict the PFS at 6 months. A 3-fold cross-validation repeated five times was implemented for internal validation of the model. ResultsTwo-hundred and seventy ROIs were contoured. The proposed radiomic model was given by the best fitting logistic regression model, and included the following 3 features: F_cm_merged.contrast, F_cm_merged.info.corr.2, F_rlm_merged.rlnu. A good agreement between model predicted probabilities and observed outcome probabilities was obtained (p-value of 0.49 by Hosmer and Lemeshow statistical te

Published
2023

2. <math><mi>t</mi><mover><mi>t</mi><mo>¯</mo></mover><mi>b</mi><mover><mi>b</mi><mo>¯</mo></mover></math> at the LHC: On the size of off-shell effects and prompt <math><mi>b</mi></math>-jet identification

Author

Bevilacqua, G., Bi, H. Y., Hartanto, H. B., Kraus, M., Lupattelli, M., and Worek, M.

Abstract

We investigate full off-shell effects in tt¯bb¯ production in the dilepton channel at the LHC with the center-of-mass energy s=13 TeV. Specifically, we compute next-to-leading-order (NLO) QCD corrections to the pp→e+νeμ−ν¯μbb¯bb¯+X process and provide a prescription for b-jet identification to distinguish prompt b jets from b jets originating from the decay of the top quarks. As an important irreducible background to pp→tt¯H(H→bb¯), tt¯ production in association with two prompt b jets is a primary source of uncertainty in the measurement of tt¯H(H→bb¯). In quantifying full off-shell effects, we perform comparisons between the state-of-the-art full off-shell computation and the calculation in the narrow width approximation. The former includes all double-, single- and nonresonant Feynman diagrams, interferences as well as finite-width effects of the top quarks and W gauge bosons. The latter restricts the unstable top quarks and W gauge bosons to on-shell states and includes for the first time NLO QCD corrections to both production and decays. We observe that full off-shell effects are subdominant compared to the scale uncertainties for the integrated fiducial cross section and for the majority of differential observables in the phase-space regions that we investigated. However, for a number of observables related to beyond the Standard Model searches, full off-shell effects are significant. Furthermore, with our b-jet labeling prescription, the prompt b jets and the b jets from top-quark decays can be successfully disentangled.

Published
2023

4. MRI-derived radiomics to guide post-operative management of glioblastoma: Implication for personalized radiation treatment volume delineation

Author

Chiesa, S., primary, Russo, R., additional, Beghella Bartoli, F., additional, Palumbo, I., additional, Sabatino, G., additional, Cannatà, M. C., additional, Gigli, R., additional, Longo, S., additional, Tran, H. E., additional, Boldrini, L., additional, Dinapoli, N., additional, Votta, C., additional, Cusumano, D., additional, Pignotti, F., additional, Lupattelli, M., additional, Camilli, F., additional, Della Pepa, G. M., additional, D’Alessandris, G. Q., additional, Olivi, A., additional, Balducci, M., additional, Colosimo, C., additional, Gambacorta, M. A., additional, Valentini, V., additional, Aristei, C., additional, and Gaudino, S., additional

Published
2023
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5. Stereotactic radiotherapy for brain oligometastases

Author

Lupattelli, M., Tini, P., Nardone, V., Aristei, C., Borghesi, S., Maranzano, E., Anselmo, P., Ingrosso, G., Deantonio, L., di Monale e Bastia, M. B., Lupattelli, M., Tini, P., Nardone, V., Aristei, C., Borghesi, S., Maranzano, E., Anselmo, P., Ingrosso, G., Deantonio, L., and di Monale e Bastia, M. B.

Subjects
Oligometastasis, Brain metastase, Oncology, Toxicity, Local control, Oligometastasi, Stereotactic radiotherapy, Hypofractionation, Brain metastases, Radiology, Nuclear Medicine and imaging, Radionecrosi, Radiosurgery, Radionecrosis
Abstract

Brain metastases, the most common metastases in adults, will develop in up to 40% of cancer patients, accounting for more than one-half of all intracranial tumors. They are most associated with breast and lung cancer, melanoma and, less frequently, colorectal and kidney carcinoma. Magnetic resonance imaging (MRI) is the gold standard for diagnosis. For the treatment plan, computed tomography (CT ) images are co-registered and fused with a gadolinium-enhanced T1-weighted MRI where tumor volume and organs at risk are contoured. Alternatively, plain and contrast-enhanced CT scans are co-registered. Single-fraction stereotactic radiotherapy (SRT ) is used to treat patients with good performance status and up to 4 lesions with a diameter of 30 mm or less that are distant from crucial brain function areas. Fractionated SRT (2-5 fractions) is used for larger lesions, in eloquent areas or in proximity to crucial or surgically inaccessible areas and to reduce treatment-related neurotoxicity. The single-fraction SRT dose, which depends on tumor diameter, impacts local control. Fractionated SRT may encompass different schedules. No randomized trial data compared the safety and efficacy of single and multiple fractions. Both single-fraction and fractionated SRT provide satisfactory local control rates, tolerance, a low risk of transient acute adverse events and of radiation necrosis the incidence of which correlated with the irradiated brain volume.

Published
2022

6. P02.11.B An hypothesis generating study of MRI-Derived Radiomics on tumor and microenvironment tissue heterogeneity to guide post-operative management of glioblastoma: toward personalized radiation treatment volume delineation

Author

Cannatà, M, primary, Russo, R, additional, Beghella Bartoli, F, additional, Palumbo, I, additional, Tran, H, additional, Votta, C, additional, Lupattelli, M, additional, Boldrini, L, additional, Dinapoli, N, additional, Camilli, F, additional, Balducci, M, additional, Gambacorta, M, additional, Valentini, V, additional, Aristei, C, additional, Sabatino, G, additional, Pignotti, F, additional, Gaudino, S, additional, and Chiesa, S, additional

Published
2022
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7. Radiotherapy with intensity-modulated (Imrt) techniques in the treatment of anal carcinoma (rainstorm): A multicenter study on behalf of airo (Italian association of radiotherapy and clinical oncology) gastrointestinal study group

Author

Caravatta, L., Mantello, G., Valvo, F., Franco, P., Gasparini, L., Rosa, C., Slim, N., Manfrida, S., De Felice, F., Gerardi, M. A., Vagge, S., Krengli, M., Palazzari, E., Osti, M. F., Gonnelli, A., Catalano, G., Pittoni, P., Ivaldi, G. B., Galardi, A., Lupattelli, M., Rosetto, M. E., Niespolo, R. M., Guido, A., Durante, O., Macchia, G., Munoz, F., El Khouzai, B., Lucido, M. R., Porreca, A., Di Nicola, M., Gambacorta, M. A., Donato, V., Genovesi, D., Manfrida S., Macchia G., Porreca A., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Caravatta, L., Mantello, G., Valvo, F., Franco, P., Gasparini, L., Rosa, C., Slim, N., Manfrida, S., De Felice, F., Gerardi, M. A., Vagge, S., Krengli, M., Palazzari, E., Osti, M. F., Gonnelli, A., Catalano, G., Pittoni, P., Ivaldi, G. B., Galardi, A., Lupattelli, M., Rosetto, M. E., Niespolo, R. M., Guido, A., Durante, O., Macchia, G., Munoz, F., El Khouzai, B., Lucido, M. R., Porreca, A., Di Nicola, M., Gambacorta, M. A., Donato, V., Genovesi, D., Manfrida S., Macchia G., Porreca A., and Gambacorta M. A. (ORCID:0000-0001-5455-8737)

Abstract

A multi-institutional retrospective study was conducted to evaluate the pattern of care and clinical outcomes of anal cancer patients treated with intensity-modulated radiotherapy (IMRT) techniques. In a cohort of 987 patients, the clinical complete response (CR) rate (beyond 6 months) was 90.6%. The 3-year local control (LC) rate was 85.8% (95% CI: 84.4–87.2), and the 3-year colostomy-free survival (CFS) rate was 77.9% (95% CI: 76.1–79.8). Three-year progression-free survival (PFS) and overall survival (OS) rates were 80.2% and 88.1% (95% CI: 78.8–89.4) (95% CI: 78.5–81.9), respectively. Histological grade 3 and nodal involvement were associated with lower CR (p = 0.030 and p = 0.004, respectively). A statistically significant association was found between advanced stage and nodal involvement, and LC, CFS, PFS, OS and event-free survival (EFS). Overall treatment time (OTT) ≥45 days showed a trend for a lower PFS (p = 0.050) and was significantly associated with lower EFS (p = 0.030) and histological grade 3 with a lower LC (p = 0.025). No statistically significant association was found between total dose, dose/fraction and/or boost modality and clinical outcomes. This analysis reports excellent clinical results and a mild toxicity profile, confirming IMRT techniques as standard of care for the curative treatment of anal cancer patients. Lymph node involvement and histological grade have been confirmed as the most important negative prognostic factors.

Published
2021

8. Treatment volume, dose prescription and delivery techniques for dose-intensification in Rectal Cancer: A national survey

Author

Caravatta, L., Lupattelli, M., Mantello, G., Gambacorta, Maria Antonietta, Chiloiro, Giuditta, Di Tommaso, M., Rosa, C., Gasparini, L., Morganti, Alessio Giuseppe, Picardi, V., Niespolo, R. M., Osti, M. F., Montrone, S., Simoni, N., Boso, C., Facchin, F., Deidda, M. A., Piva, C., Guida, C., Ziccarelli, L., Munoz, F., Ivaldi, G. B., Marchetti, V., Franzone, P., Spatola, C., Franco, P., Donato, V., Genovesi, D., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Chiloiro G., Morganti A. G., Caravatta, L., Lupattelli, M., Mantello, G., Gambacorta, Maria Antonietta, Chiloiro, Giuditta, Di Tommaso, M., Rosa, C., Gasparini, L., Morganti, Alessio Giuseppe, Picardi, V., Niespolo, R. M., Osti, M. F., Montrone, S., Simoni, N., Boso, C., Facchin, F., Deidda, M. A., Piva, C., Guida, C., Ziccarelli, L., Munoz, F., Ivaldi, G. B., Marchetti, V., Franzone, P., Spatola, C., Franco, P., Donato, V., Genovesi, D., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Chiloiro G., and Morganti A. G.

Abstract

Background/Aim: The aim of the study was to investigate boost volume definition, doses, and delivery techniques for rectal cancer dose intensification. Patients and Methods: An online survey was made on 25 items (characteristics, simulation, imaging, volumes, doses, planning and treatment). Results: Thirty-eight radiation oncologists joined the study. Twenty-one delivered long-course radiotherapy with dose intensification. Boost volume was delineated on diagnostic magnetic resonance imaging (MRI) in 18 centres (85.7%), and computed tomography (CT) and/or positron emission tomography-CT in 9 (42.8%); 16 centres (76.2%) performed co-registration with CT-simulation. Boost dose was delivered on gross tumor volume in 10 centres (47.6%) and on clinical target volume in 11 (52.4%). The most common total dose was 54-55 Gy (71.4%), with moderate hypofractionation (85.7%). Intensity-modulated radiotherapy (IMRT) was used in all centres, with simultaneous integrated boost in 17 (80.8%) and image-guidance in 18 (85.7%). Conclusion: A high quality of treatment using dose escalation can be inferred by widespread multidisciplinary discussion, MRI-based treatment volume delineation, and radiation delivery relying on IMRT with accurate image-guided radiation therapy protocols.

Published
2021

10. EP-1463 Radiation dose intensification in rectal cancer: a survey by the AIRO gastrointestinal study group

Author

Caravatta, L., primary, Gambacorta, M.A., additional, Mantello, G., additional, Lupattelli, M., additional, Di Tommaso, M., additional, Consuelo, R., additional, Macchia, G., additional, De Paoli, A., additional, Niespolo, R.M., additional, Dionisi, F., additional, Rosetto, M.E., additional, Valvo, F., additional, Osti, M.F., additional, Morganti, A.G., additional, Valentini, V., additional, and Genovesi, D., additional

Published
2019
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11. PO-0809 Gross Tumor Volume delineation in pancreatic cancer using MRI: final results of a multicenter study.

Author

Caravatta, L., primary, Cellini, F., additional, Simoni, N., additional, Rosa, C., additional, Niespolo, R.M., additional, Lupattelli, M., additional, Picardi, V., additional, Macchia, G., additional, Sainato, A., additional, Mantello, G., additional, Dionisi, F., additional, Rosetto, M.E., additional, Fusco, V., additional, Navarria, F., additional, De Paoli, A., additional, Guido, A., additional, Vecchi, C., additional, Basilico, R., additional, Cianci, R., additional, Pizzi, A. Delli, additional, Di Nicola, M., additional, Mattiucci, G.C., additional, Valentini, V., additional, Morganti, A.G., additional, and Genovesi, D., additional

Published
2019
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14. PO-0775: MRI for GTV delineation in pancreatic cancer: preliminary results of a multi-institutional study

Author

Caravatta, L., primary, Cellini, F., additional, Simoni, N., additional, Rosa, C., additional, Niespolo, R., additional, Lupattelli, M., additional, Picardi, V., additional, Macchia, G., additional, Sainato, A., additional, Mantello, G., additional, Dionisi, F., additional, Rosetto, M.E., additional, Guida, C., additional, Basilico, R., additional, De Paoli, A., additional, Boz, G., additional, Fusco, V., additional, Mattiucci, G.C., additional, Morganti, A.G., additional, and Genovesi, D., additional

Published
2018
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15. P04.90 Observational prospective multi-centric study of delta radiomics Features Analysis for the prediction of patients outcomes in GLIoblastoma multifome: GLI.F.A. Project

Author

Lupattelli, M, Chiesa, Silvia, Beghella Bartoli, F, Palumbo, I, Gatta, Roberto, Tarducci, R, Dinapoli, Nicola, Balducci, Mario, Aristei, Cynthia, Valentini, Vincenzo, Chiesa, S (ORCID:0000-0003-0168-3459), Gatta, R, Dinapoli, N, Balducci, M (ORCID:0000-0003-0398-9726), Aristei, C, Valentini, V (ORCID:0000-0003-4637-6487), Lupattelli, M, Chiesa, Silvia, Beghella Bartoli, F, Palumbo, I, Gatta, Roberto, Tarducci, R, Dinapoli, Nicola, Balducci, Mario, Aristei, Cynthia, Valentini, Vincenzo, Chiesa, S (ORCID:0000-0003-0168-3459), Gatta, R, Dinapoli, N, Balducci, M (ORCID:0000-0003-0398-9726), Aristei, C, and Valentini, V (ORCID:0000-0003-4637-6487)

Abstract

Background Despite decades of research, glioblastoma (GBM) remains the most malignant primary brain tumor. Different investigations have focused on the GBM’s heterogeneous features to develop an individualized patient management. A multi-institutional study, the GLI.F.A. (Glioblastoma: advanced Imaging Features Analysis) Project, was performed for a comprehensive analysis of GBM heterogeneity in order to create a multidimensional map for predictive models (PM) and decision support systems (DSS) in GBM. Material and Methods Adult patient with newly diagnosed GBM, that undergo to surgery and chemo-radiotherapy according to EORTC 26981-22981-NCIC trial, were analyzed in this first phase of the study. Gross Tumor Volume (GTV) was contoured in the T1 post contrast and T2-FLAIR weighted images. A brain ontology and a platform for sharing and combining multiple datasets (SPIDER BOA System for Patient Individual Data Entry and Recording Beyond Ontology Awareness) were created in order to standardize data collection. Preoperative MRI features were extracted by the MODDICOM software. Wilcoxon Mann Whitney test, Log-rank test for Kaplan-Meier curves were utilized to evaluate the significance of the radiomic features on the T2-Flair and T1 images. The main outcomes we considered were overall survival, progression free survival and response to radio-chemotherapy (RTCT). The median value of the features was used to categorize the continue variables. Results Twenty-seven patients, treated from July 2014 to February 2018, were enrolled in this study. Median age was 61 years (range 45–75) and 20 patients are still alive. The MODDICOM software analyzed 94 image features. Significant features divided by MRI sequence and outcomes are reported in Tab1. The first order features, describing the statistical characteristics of images, resulted significant for OS on the T2-weighted MRI and for response to RTCT on the T1 weighted MRI; the second order features, describing the spatial correlat

Published
2018

16. PV-0326: Time to surgery and pCR after neoadjuvant CRT in rectal cancer: a population study on 2113 patients

Author

Macchia, G., primary, Gambacorta, M., additional, Chiloiro, G., additional, Mantello, G., additional, De Paoli, A., additional, Montesi, G., additional, Sainato, A., additional, Lupattelli, M., additional, Caravatta, L., additional, Perrotti, F., additional, Rosetto, M., additional, Filippone, F., additional, Niespolo, R., additional, Osti, M., additional, Belgioia, L., additional, Boso, C., additional, Fontana, A., additional, Parisi, S., additional, Galardi, A., additional, Turri, L., additional, Sciacero, P., additional, Giaccherini, L., additional, Masciocchi, C., additional, Morganti, A., additional, and Valentini, V., additional

Published
2017
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21. Time to surgery and pathologic complete response after neoadjuvant chemoradiation in rectal cancer: A population study on 2094 patients

Author

Macchia, G., Gambacorta, Maria Antonietta, Masciocchi, Carlotta, Chiloiro, Giuditta, Mantello, G., Di Giambenedetto, Simona, Lupattelli, M., Palazzari, E., Belgioia, L., Bacigalupo, Andrea, Sainato, A., Montrone, S., Turri, L., Caroli, A., De Paoli, A., Matrone, F., Capirci, C., Montesi, G., Niespolo, R. M., Osti, M. F., Caravatta, L., Galardi, A., Genovesi, D., Rosetto, M. E., Boso, C., Sciacero, P., Giaccherini, L., Parisi, S., Fontana, A., Filippone, F. R., Picardi, V., Morganti, A. G., Valentini, Vincenzo, Gambacorta M. A. (ORCID:0000-0001-5455-8737), Masciocchi C., Chiloiro G., di Benedetto M. (ORCID:0000-0001-6990-5076), Bacigalupo A. (ORCID:0000-0002-9119-567X), Valentini V. (ORCID:0000-0003-4637-6487), Macchia, G., Gambacorta, Maria Antonietta, Masciocchi, Carlotta, Chiloiro, Giuditta, Mantello, G., Di Giambenedetto, Simona, Lupattelli, M., Palazzari, E., Belgioia, L., Bacigalupo, Andrea, Sainato, A., Montrone, S., Turri, L., Caroli, A., De Paoli, A., Matrone, F., Capirci, C., Montesi, G., Niespolo, R. M., Osti, M. F., Caravatta, L., Galardi, A., Genovesi, D., Rosetto, M. E., Boso, C., Sciacero, P., Giaccherini, L., Parisi, S., Fontana, A., Filippone, F. R., Picardi, V., Morganti, A. G., Valentini, Vincenzo, Gambacorta M. A. (ORCID:0000-0001-5455-8737), Masciocchi C., Chiloiro G., di Benedetto M. (ORCID:0000-0001-6990-5076), Bacigalupo A. (ORCID:0000-0002-9119-567X), and Valentini V. (ORCID:0000-0003-4637-6487)

Abstract

Background To retrospectively evaluate the difference in terms of pathologic complete response (pCR) according to time elapsed between chemoradiation (CRT) and total mesorectal excision (TME) on a large unselected real-life dataset of locally advanced rectal cancer (LARC) patients. Methods A multicentre retrospective cohort study of LARC patients from 21 Italian Radiotherapy Institutions was performed. Patients were stratified into 3 different time intervals from CRT. The 1st group included 300 patients who underwent TME within 6 weeks, the 2nd 1598 patients (TME within 7–12 weeks) and the 3rd 196 patients (TME within 13 or more weeks after CRT), respectively. Results Data on 2094 LARC patients treated between 1997 and 2016 were considered suitable for analysis. Overall, 578 patients had stage II while 1516 had stage III histological proven invasive rectal adenocarcinoma. A CRT schedule of one agent (N = 1585) or 2-drugs (N = 509) was administered. Overall, pCR was 22.3% (N = 468 patients). The proportion of patients achieving pCR with respect to time interval was, as follows: 12.6% (1st group), 23% (2nd group) and 31.1% (3rd group) (p < 0.001), respectively. The pCR relative risk comparison of 2nd to 1st group was 1.8, while 3rd to 2nd group was 1.3. Moreover, between the 3rd and 1st group, a pCR relative risk of 2.4 (p < 0.01) was noted. At univariate analysis, clinical stage III (p < 0.001), radiotherapy dose >5040 cGy (p = 0.002) and longer interval (p < 0.001) were significantly correlated to pCR. The positive impact of interval (p < 0.001) was confirmed at multivariate analysis as the only correlated factor. Conclusion We confirmed on a population-level that lengthening the interval (>13 weeks) from CRT to surgery improves the pathological response (pCR and pathologic partial response; pPR) in comparison to historic data. Furthermore, radiotherapy dose >5040 cGy and two drugs chemotherapy correlated with pPR rate.

Published
2017

22. OC-0243: Randomised trial on preoperative platin-based Radiochemotherapy in rectal cancer: 10-years analysis

Author

Gambacorta, M., primary, Cellini, F., additional, Colangione, M., additional, Lupattelli, M., additional, Lancellotta, V., additional, Genovesi, D., additional, Cosimelli, M., additional, Picardi, V., additional, Osti, M., additional, Portaluri, M., additional, Tramacere, F., additional, Maranzano, E., additional, Mantello, G., additional, and Valentini, V., additional

Published
2016
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24. Patterns of radiotherapy practice for pancreatic cancer: Results of the Gastrointestinal Radiation Oncology Study Group multi-institutional survey

Author

Macchia, Gabriella, Sainato, A, Talamini, R, Boz, G, Bacigalupo, A, Caravatta, Luciana, Fiore, M, Friso, Ml, Fusco, Vincenzo, Lupattelli, M, Mantello, G, Mattiucci, Gian Carlo, Slim, N, Sciacero, P, Turri, L, Valentini, Vincenzo, Morganti, Alessio Giuseppe, Genovesi, D., Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Macchia, Gabriella, Sainato, A, Talamini, R, Boz, G, Bacigalupo, A, Caravatta, Luciana, Fiore, M, Friso, Ml, Fusco, Vincenzo, Lupattelli, M, Mantello, G, Mattiucci, Gian Carlo, Slim, N, Sciacero, P, Turri, L, Valentini, Vincenzo, Morganti, Alessio Giuseppe, Genovesi, D., Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)

Abstract

No information is currently available regarding pancreatic cancer (PC) pattern of care in Italy. In the present study, a nationwide survey using a questionnaire was performed to enquire the local standards for PC diagnosis and radiotherapy treatment. Fifty-seven percent of 140 Italian centres completed questionnaire. The main causes of no radiotherapy indication were poor general condition (45%) and lack of guidelines (25%). Physicians (38%) employed neoadjuvant therapy in locally advanced PC patients, while in other centres (62%) adjuvant chemoradiation was administered. Adjuvant gemcitabine-based chemotherapy was selected as the treatment of choice by 59% of centres. Patients were treated mostly with doses of 50-54.9 Gy on the tumour (or bed) plus lymph nodes. A 3D-CRT technique was used in 81.2% of centres, while IMRT and IGRT were available in 61.2 and 48.7% of cases, respectively. Extensive variation exists with regard to patterns of care for PC in Italy. Nevertheless, cooperative studies emerging from this survey appeared beneficial.

Published
2015

30. No benefit of adjuvant Fluorouracil Leucovorin chemotherapy after neoadjuvant chemoradiotherapy in locally advanced cancer of the rectum (LARC): Long term results of a randomized trial (I-CNR-RT)

Author

Sainato, A, Cernusco Luna Nunzia, V, Valentini, Vincenzo, De Paoli, A, Maurizi, Er, Lupattelli, M, Aristei, C, Vidali, C, Conti, M, Galardi, A, Ponticelli, P, Friso, Ml, Iannone, T, Osti, Fm, Manfredi, B, Coppola, M, Orlandini, C, Cionini, L., Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Sainato, A, Cernusco Luna Nunzia, V, Valentini, Vincenzo, De Paoli, A, Maurizi, Er, Lupattelli, M, Aristei, C, Vidali, C, Conti, M, Galardi, A, Ponticelli, P, Friso, Ml, Iannone, T, Osti, Fm, Manfredi, B, Coppola, M, Orlandini, C, Cionini, L., and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)

Abstract

To evaluate the effect of adjuvant chemotherapy (ACT) in locally advanced rectal cancer (LARC) after neoadjuvant chemoradiation (NACT-RT). The study was funded by the Italian National Research Council (CNR).

Published
2014

31. 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

32. Conformal postoperative radiotherapy in patients with positive resection margins and/or pT3-4 prostate adenocarcinoma

Author

Bellavita, R, Massetti, Massimo, Abraha, I, Lupattelli, M, Mearini, L, Falcinelli, L, Farneti, A, Palumbo, I, Porena, M, Aristei, C., Massetti, Massimo (ORCID:0000-0002-7100-8478), Bellavita, R, Massetti, Massimo, Abraha, I, Lupattelli, M, Mearini, L, Falcinelli, L, Farneti, A, Palumbo, I, Porena, M, Aristei, C., and Massetti, Massimo (ORCID:0000-0002-7100-8478)

Abstract

To evaluate outcome and toxicity of high-dose conformal radiotherapy (RT) after radical prostatectomy.

Published
2012

33. Rectal cancer multidisciplinary treatment: evidences, consensus and perspectives.

Author

Valvo, F., Mantello, G., Coco, Claudio, Corvo', R., Gambacorta, Maria Antonietta, Genovesi, D., Lupattelli, M., Valentini, Vincenzo, Coco, Claudio (ORCID:0000-0002-4713-7093), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Valvo, F., Mantello, G., Coco, Claudio, Corvo', R., Gambacorta, Maria Antonietta, Genovesi, D., Lupattelli, M., Valentini, Vincenzo, Coco, Claudio (ORCID:0000-0002-4713-7093), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)

Published
2010

34. Multidisciplinary Rectal Cancer Management: 2nd European Rectal Cancer Consensus Conference (EURECA-CC2)

Author

Valentini, Vincenzo, Aristei, C, Glimelius, B, Minsky, Bd, Beets Tan, R, Borras, Jm, Haustermans, K, Maingon, P, Overgaard, J, Pahlman, L, Quirke, P, Schmoll, H, Sebag Montefiore, D, Taylor, I, Van Cutsem, E, Van De Velde, C, Cellini, Numa, Aranda, E, Latini, P, Blomqvist, L, Bosset, Jf, Brown, G, Bujko, K, Ectors, N, Gerard, Jp, Glynne Jones, R, Heald, R, Hohenberger, W, Holm, T, Laurberg, S, Leer, Jw, Marijnen, C, Nagtegaal, I, Rodel, C, Rutten, H, Scheithauer, W, Willet, Cg, Coco, Claudio, Gambacorta, Maria Antonietta, Genovesi, D, Lupattelli, M, Mantello, G, Valvo, E., Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Coco, Claudio (ORCID:0000-0002-4713-7093), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Valentini, Vincenzo, Aristei, C, Glimelius, B, Minsky, Bd, Beets Tan, R, Borras, Jm, Haustermans, K, Maingon, P, Overgaard, J, Pahlman, L, Quirke, P, Schmoll, H, Sebag Montefiore, D, Taylor, I, Van Cutsem, E, Van De Velde, C, Cellini, Numa, Aranda, E, Latini, P, Blomqvist, L, Bosset, Jf, Brown, G, Bujko, K, Ectors, N, Gerard, Jp, Glynne Jones, R, Heald, R, Hohenberger, W, Holm, T, Laurberg, S, Leer, Jw, Marijnen, C, Nagtegaal, I, Rodel, C, Rutten, H, Scheithauer, W, Willet, Cg, Coco, Claudio, Gambacorta, Maria Antonietta, Genovesi, D, Lupattelli, M, Mantello, G, Valvo, E., Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Coco, Claudio (ORCID:0000-0002-4713-7093), and Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737)

Abstract

During the first decade of the 21st century a number of important European randomized studies were published. In order to help shape clinical practice based on best scientific evidence from the literature, the International Conference on 'Multidisciplinary Rectal Cancer Treatment: Looking for an European Consensus' (EURECA-CC2) was organized in Italy under the endorsement of European Society of Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO), and European Society of Therapeutic Radiation Oncology (ESTRO).

Published
2009

35. Radiation-induced emesis: A prospective observational multicenter Italian trial

Author

Maranzano, E, Latini, P, Roila, F, De Angelis, V, Tonato, M, Ballatori, E, Del Favero, A, Ciccarese, G, Palladino, Ma, Galardi, A, Cintolesi, V, Sulprizio, S, Biti, G, Dessi, M, Maxia, G, Lupattelli, M, Piro, F, Bellavita, R, Bianchi, P, Timurian, D, Dal Fior, S, Iannone, T, Bonanno, I, Magno, L, Fillini, C, Marchetti, G, Giudici, S, Corvo, R, Mignogna, M, Sargenti, A, DE RENZIS, Costantino, Sansotta, G, Di Russo, A, Ricci, Sb, Sciume, F, Liotta, P, Del Duca, M, Emiliani, E, Morganti, Ag, Cellini, N, Mandoliti, G, Polico, C, Trippa, F, Checcaglini, F, Sola, B, Trotti, Ab, Ponticelli, P, Lombardi, R, Sarti, E, Moro, G, Iacopino, B, Galuppi, A, Palmucci, T, La Monica MM, Leggio, M, Lonardi, F, Marzi, M, Di Marco, A, Pergolizzi, Stefano, Pizzi, G, Cerrotta, A, Orecchia, R, Barsacchi, L, Silvestro, G, Scoppa, G, Franchini, P, Vanzo, C, Cristallini, S, D'Abbiero, N, Salvi, G, Tombolini, V, Parisi, S, Alfieri, M, Sebaste, L, Malinverni, G., Tomio, L, Buffoli, A, and Pradella, R.

Published
1999

36. Infusional 5-fluorouracil and ZD1839 (Gefitinib-Iressa) in combination with preoperative radiotherapy in patients with locally advanced rectal cancer: a phase I and II Trial (1839IL/0092)

Author

Valentini, Vincenzo, De Paoli, A, Gambacorta, Maria Antonietta, Mantini, Giovanna, Ratto, Carlo, Vecchio, Fabio Maria, Barbaro, Brunella, Innocente, R, Rossi, Concettina, Boz, G, Barba, Maria Cristina, Frattegiani, Alessandro, Lupattelli, M, Doglietto, Giovanni, Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Mantini, Giovanna (ORCID:0000-0001-5303-4499), Ratto, Carlo (ORCID:0000-0002-0556-0037), Vecchio, Fabio Maria (ORCID:0000-0002-9197-2264), Barbaro, Brunella (ORCID:0000-0002-9638-543X), Doglietto, Giovanni (ORCID:0000-0002-7394-768X), Valentini, Vincenzo, De Paoli, A, Gambacorta, Maria Antonietta, Mantini, Giovanna, Ratto, Carlo, Vecchio, Fabio Maria, Barbaro, Brunella, Innocente, R, Rossi, Concettina, Boz, G, Barba, Maria Cristina, Frattegiani, Alessandro, Lupattelli, M, Doglietto, Giovanni, Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Mantini, Giovanna (ORCID:0000-0001-5303-4499), Ratto, Carlo (ORCID:0000-0002-0556-0037), Vecchio, Fabio Maria (ORCID:0000-0002-9197-2264), Barbaro, Brunella (ORCID:0000-0002-9638-543X), and Doglietto, Giovanni (ORCID:0000-0002-7394-768X)

Abstract

To report the final data of a Phase I and II study (1839IL/0092) on the combination of an anti-epidermal growth factor receptor drug (gefitinib), infusional 5-fluorouracil, and preoperative radiotherapy in locally advanced, resectable rectal cancer.

Published
2008

37. RANDOMIZED, MULTICENTER, PHASE IIB STUDY OF PREOPERATIVE CHEMORADIOTHERAPY IN T3 MID-DISTAL RECTAL CANCER: RALTITREXED + OXALIPLATIN + RADIOTHERAPY VERSUS CISPLATIN + 5-FLUOROURACIL + RADIOTHERAPY.

Author

Valentini, Vincenzo, Coco, Claudio, Minsky, Bd, Gambacorta, Maria Antonietta, Cosimelli, M, Bellavita, Rita, Morganti, Alessio Giuseppe, La Torre, Giuseppe, Trodella, Lucio, Genovesi, Domenico, Portaluri, M, Maurizi Enrici, R, Barbera, F, Maranzano, Ernesto, Lupattelli, M., Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Coco, Claudio (ORCID:0000-0002-4713-7093), Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737), Valentini, Vincenzo, Coco, Claudio, Minsky, Bd, Gambacorta, Maria Antonietta, Cosimelli, M, Bellavita, Rita, Morganti, Alessio Giuseppe, La Torre, Giuseppe, Trodella, Lucio, Genovesi, Domenico, Portaluri, M, Maurizi Enrici, R, Barbera, F, Maranzano, Ernesto, Lupattelli, M., Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Coco, Claudio (ORCID:0000-0002-4713-7093), and Gambacorta, Maria Antonietta (ORCID:0000-0001-5455-8737)

Published
2008

41. 2093

Author

Gambacorta, M.A., primary, Valentini, V., additional, Coco, C., additional, Ambesi-Impiombato, F., additional, D’Angelillo, R., additional, Deodato, F., additional, Genovesi, D., additional, Lupattelli, M., additional, Portaluri, M., additional, and Cellini, N., additional

Published
2006
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42. 1068

Author

Valentini, V., primary, De Paoli, A., additional, Gambacorta, M.A., additional, Mattiucci, G.C., additional, Ratto, C., additional, Boz, G., additional, Innocente, R., additional, Rossi, C., additional, Lupattelli, M., additional, and Doglietto, G.B., additional

Published
2006
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45. Multicentric randomized two ARMS study of preoperative chemoradiation, followed or not, by post-operative chemotherapy in locally advanced rectal cancer interim results of the preoperative time: Compliance, toxicity and downstaging

Author

Cionini, L., primary, Cartei, F., additional, Sainato, A., additional, Manfredi, B., additional, Laliscia, C., additional, Valentini, V., additional, Lupattelli, M., additional, Pizzi, GB, additional, Osti, M., additional, Friso, M.L., additional, Ponticelli, P., additional, Santoni, R., additional, Dal Fior, S., additional, and Vidali, C., additional

Published
1998
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50. Treatment volume, dose prescription and delivery techniques for dose-intensification in Rectal Cancer: A national survey

Author

Monica Di Tommaso, Paola Franzone, Mattia Falchetto Osti, Vania Marchetti, Alessio G. Morganti, Giuditta Chiloiro, N. Simoni, R.M. Niespolo, Consuelo Rosa, Luciana Caravatta, Maria Antonietta Gambacorta, Cristina Piva, Maria Assunta Deidda, Vincenzo Picardi, L. Gasparini, Vittorio Donato, Domenico Genovesi, Fernando Munoz, Cesare Guida, S. Montrone, Corrado Spatola, Giovanna Mantello, Francesca Facchin, Pierfrancesco Franco, L. Ziccarelli, Marco Lupattelli, Caterina Boso, Giovanni Ivaldi, Caravatta L., Lupattelli M., Mantello G., Gambacorta M.A., Chiloiro G., Di Tommaso M., Rosa C., Gasparini L., Morganti A.G., Picardi V., Niespolo R.M., Osti M.F., Montrone S., Simoni N., Boso C., Facchin F., Deidda M.A., Piva C., Guida C., Ziccarelli L., Munoz F., Ivaldi G.B., Marchetti V., Franzone P., Spatola C., Franco P., Donato V., and Genovesi D.

Subjects
Male, Cancer Research, Colorectal cancer, Intensity modulated radiotherapy, medicine.medical_treatment, Radiotherapy Planning, Practice Patterns, Computer-Assisted, Surveys and Questionnaires, Positron Emission Tomography Computed Tomography, Intensity-Modulated, Simultaneous integrated boost, Surveys and Questionnaire, Rectal cancer, Practice Patterns, Physicians', Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, medicine.diagnostic_test, Radiotherapy Dosage, General Medicine, Magnetic Resonance Imaging, Gross tumor volume, Tumor Burden, Oncology, Image-Guided, Italy, Lymphatic Metastasis, Female, Survival Analysi, Human, medicine, Humans, Dose intensification, Neoplasm Staging, Physicians', Radiotherapy, Rectal Neoplasm, business.industry, Rectal Neoplasms, Radiotherapy Planning, Computer-Assisted, Magnetic resonance imaging, Lymphatic Metastasi, medicine.disease, Survival Analysis, Dose prescription, Radiation therapy, Positron-Emission Tomography, Radiotherapy, Intensity-Modulated, Nuclear medicine, business, Volume (compression), Radiotherapy, Image-Guided
Abstract

Background/aim The aim of the study was to investigate boost volume definition, doses, and delivery techniques for rectal cancer dose intensification. Patients and methods An online survey was made on 25 items (characteristics, simulation, imaging, volumes, doses, planning and treatment). Results Thirty-eight radiation oncologists joined the study. Twenty-one delivered long-course radiotherapy with dose intensification. Boost volume was delineated on diagnostic magnetic resonance imaging (MRI) in 18 centres (85.7%), and computed tomography (CT) and/or positron emission tomography-CT in 9 (42.8%); 16 centres (76.2%) performed co-registration with CT-simulation. Boost dose was delivered on gross tumor volume in 10 centres (47.6%) and on clinical target volume in 11 (52.4%). The most common total dose was 54-55 Gy (71.4%), with moderate hypofractionation (85.7%). Intensity-modulated radiotherapy (IMRT) was used in all centres, with simultaneous integrated boost in 17 (80.8%) and image-guidance in 18 (85.7%). Conclusion A high quality of treatment using dose escalation can be inferred by widespread multidisciplinary discussion, MRI-based treatment volume delineation, and radiation delivery relying on IMRT with accurate image-guided radiation therapy protocols.

Published
2021

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