Search

OBJECTIVE: This study aims at comparing the severity score assessed using high-resolution computed tomography (HRCT) in vaccinated and unvaccinated COVID-19 patients. PATIENTS AND METHODS: From the first of December 2021 to first of February 2022, we conducted a single-center retrospective analysis on COVID-19 patients who accessed ED services. The hospital in question is a level II facility with a catchment area of around 200,000 people. According to the Italian recommendations, patients were divided into four groups based on the CT score of Micheal Chung. The sum of acute inflammatory lung lesions involving each lobe was scored as 1 (0-25%), 2 (26-50%), 3 (51-75%) or 4 (76-100%) on a visual quantitative assessment of CT. The total severity score (TSS) was determined by summing the five lobe scores. RESULTS: The study included 134 patients divided into two groups: 67 vaccinated and 67 unvaccinated people. 53 people had incomplete (single dose/double dose) immunization, while 14 people completed the vaccination cycle. It was discovered that the mean CT severity score was lower in fully vaccinated patients compared to partially vaccinated or unvaccinated patients. The mean CT score was significantly lower in fully vaccinated patients aged 60 compared to older patients. The mean CT score was higher in unvaccinated patients compared to fully vaccinated patients. CONCLUSIONS: Individuals who received three doses of COVID-19 vaccination had lower CT severity scores than patients who received only one dose of vaccine or no vaccines at all.

Cancer immunotherapy has produced an unprecedented durable response rate, thus shifting from traditional doublet chemotherapy to immunotherapy-based treatments with and without chemotherapy as the first line strategies for advanced non-small cell lung cancer patients without a molecular driver. However, the majority of patients do not benefit from the treatment or may relapse after a period of response. As few treatment options are available after failure of cancer immunotherapy, including the combination of chemotherapy and anti-angiogenic drugs, a better understanding of the mechanisms limiting cancer immunotherapy may be of help in the definition of the best second line. Whereas only retrospective data support an immunotherapy rechallenge approach, new combination strategies including immunotherapy and cell-signaling inhibitors or double immunotherapy represent the newest and most promising strategy to overcome primary or acquired resistance to first line immunotherapy. Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

The original version of this Article contained errors in the spelling of the authors Roberto Grassi, Roberta Fusco, Maria Paola Belfiore, Alessandro Montanelli, Gianluigi Patelli, Fabrizio Urraro, Antonella Petrillo, Vincenza Granata, Palmino Sacco, Maria Antonietta Mazzei, Beatrice Feragalli, Alfonso Reginelli & Salvatore Cappabianca which were incorrectly given as Grassi Roberto, Fusco Roberta, Belfiore Maria Paola, Montanelli Alessandro, Patelli Gianluigi, Urraro Fabrizio, Petrillo Antonella, Granata Vincenza, Sacco Palmino, Mazzei Maria Antonietta, Feragalli Beatrice, Reginelli Alfonso & Cappabianca Salvatore. These errors have now been corrected in the PDF and HTML versions of the Article.

Background: This study aims to compare retrospectively generated gated internal target volumes (ITVs) and to evaluate whether gated ITVs can reduce planned target volumes (PTVs) compared with standard ITV expansions. Materials and Methods: In this study, we retrospectively generated respiratory-gated ITVs and PTVs for our cohort of patients who underwent four-dimensional computed tomography for thoracic radiotherapy in our department between August 2018 and February 2019. We calculated the standard ITVs and two gated ITVs to analyze the volumetric reduction. Further, we considered a PTV reduction of >10% to be significant, and we analyzed the role of the localization and the size of the gross tumor volumes. Results: We included 38 patients with a median age of 70 years (mean = 68, SD ± 13,4, range =43-89), of whom 18 (47%) were females and 20 (52%) were males. The two gated PTVs (PTV 30%-70% and PTV 80%-20%) were significantly smaller than the standard PTVs (p-value < 0,001 for both PTVs). Considering the volume of the gross target volume (GTV), we found a significant correlation between GTV30cc and ITV30%-70% (chi-square analysis, p:0,006) and between GTV5cc and ITV80%-20% (p:0,003). We also found a correlation between the localization of the target lesion (mediastinal/ central/peripheral lesion) for both the gated ITVs (p: 0,030 for ITV 30%-70% and p:0,018 for ITV 80%-20%). Conclusion: Gated ITV plans could be useful for the sparing of normal tissues. Our results show that this approach could be useful for small lesions and for certain localizations (island tumors).

Background: We report a case of a metastatic breast cancer woman undergoing therapy with fulvestrant and palbociclib that was successfully treated with thoracic stereotactic ablative radiation therapy (SABR) for a hilar lymph node metastasis. Case Description: The patient began the radiation treatment in the week off of the palbociclib and reported no acute toxicity. The CT scan showed acute pneumonia 60 days after RT although the patient reported no symptomatology. In addition, the subsequent PET/TC scan performed six months after RT exhibited a complete response of the irradiated lesion. Conclusion: The use of SABR in patients undergoing cyclin inhibitors appears to be potentially effective although the association must be further studied to investigate the toxicities.

Extranodal lymphomas represent an extranodal location of both non-Hodgkin and Hodgkin lym-phomas. This study aims to evaluate the role of CT and MRI in the assessment of relationships of extranodal lymphomas with surrounding tissues and in the characterization of the lesion. We selected and reviewed ten recent studies among the most recent ones present in literature exclusively about CT and MRI imaging of extranodal lymphomas. Contrast-enhanced computed tomography (CT) is usually the first-line imaging mo-dality in the evaluation of extranodal lymphomas, according to Lugano classification. However, MRI has a crucial role thanks to the superior soft-tissue contrast resolution, particularly in the anatomical region as head and neck. (www.actabiomedica.it).

This article reviews the main toxic effect, complications and relative imaging findings of the liver that may appear during the oncologic follow up among patients affected by gastrointestinal malignancy. Awareness of the causative chemotherapeutic agent and regimens, pathophysiology and relative characteristic imaging findings of hepatic injuries is critical in order to obtain an accurate diagnosis especially when these parenchymal lesions are focal. An accurate synergic radiological diagnosis with Computed Tomography (CT) and Magnetic Resonance (MR) techniques may induce a potential termination of ineffective/toxic chemotherapy during early phases of treatment, changing the therapeutic plan in order to avoid first unnecessary liver biopsy and then invasive treatment as hepatic resection if not required. (www.actabiomedica.it)

Introduction Henoch Schonlein Purpura (HSP) is the most common form of systemic vasculitis in children; its annual incidenceis 15/100,000

Purpose Increased complexity of interventional radiotherapy (brachytherapy - BT) treatment planning and quality control procedures has led to the need of a specific training. However, the details of the features of BT learning objectives and their distribution in the training paths of the Italian Radiation Oncology Schools are not known. This paper aims to provide the actual 'state-of-the-art' of BT education in Italy and to stimulate the debate on this issue. Material and methods All the Italian radiation oncology schools' directors (SD) were involved in a web survey, which included questions on the teaching of BT, considering also the 2011 ESTRO core curriculum criteria. The survey preliminary results were discussed at the 8th Rome INTER-MEETING (INTERventional Radiotherapy Multidisciplinary Meeting), June 24th, 2017. The present paper describes the final results of the survey and possible future teaching strategies resulting from the discussion. Results A total of 23 SDs answered the survey. The results evidenced a wide heterogeneity in the learning activities available to trainees in BT across the country. While theoretical knowledge is adequately and homogeneously transmitted to trainees, the types of practice to which they are exposed varies significantly among different schools. Conclusions This survey proves the need for an improvement of practical BT education in Italy and the advisability of a national BT education programme networking schools of different Universities. Beside the organization of national/international courses for BT practical teaching, Universities may also establish post-specialization courses ('second level' Masters) to allow professionals (already certified in radiation oncology) to acquire more advanced BT knowledge.