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Biomedical subjects

C Biagini

Publications and source records attributed to C Biagini.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Hodgkin's disease stage I and II with exclusive subdiaphragmatic presentation. The experience of the Departments of Radiation Oncology and Hematology, University "La Sapienza" of Rome.

During the period 1978 to 1994, 1054 patients with Hodgkins's disease were evaluated and treated at the Departments of Radiation Oncology and Hematology, University "La Sapienza", Rome. A total of 549 patients presented with clinical or pathological stage I and II; 37 of these had Hodgkin's disease below the diaphragm (BDHD), and 512 above the diaphragm (ADHD). A comparison of patients with BDHD versus those with ADHD showed that the first group had a higher male to female ratio. A comparison of cases with stage II BDHD versus those with stage II ADHD showed that patients with BDHD were older (48 years vs 28 years), had different histologic features and a higher incidence of systematic symptoms (67% vs 33%). Stage II BDHD patients had a worse prognosis; in fact, there were significant differences in the overall survival and relapse-free-survival rates for cases with stage II BDHD versus those with stage II ADHD (overall survival, 46% vs 80%, P<0.001; relapse-free survival, 44% vs 69%, P<0.005). Stage was found to be the most important prognostic factor for BDHD cases without systematic symptoms treated with radiation therapy alone. The type of infradiaphragmatic presentation (intra-abdominal vs peripheral disease) did not influence outcome, probably due to the more aggressive therapy received by the intra-abdominal group. Treatment recommendations for BDHD cases should be tailored to the stage and the presence or absence of intra-abdominal localization. For patients with stage IA extended fields, irradiation (inverted Y) is sufficient. However, combined modality therapy should be the treatment of choice for stage II cases, particularly in the presence of intra-abdominal disease. Patients with systematic symptoms also require combined modalities.

Adolescent↗
PubMedDate not supplied

Radiation therapy for local-regional recurrences of rectal carcinoma following primary surgery.

AIMS AND BACKGROUND: Several studies have emphasized the role of radiation therapy for patients with pelvic recurrences of rectal carcinoma following primary surgery. The occurrence of local-regional relapse usually means a poor prognosis and often a poor quality of life, so that different authors consider the prognosis of patients relapsing after surgery worse than those with primary inoperable tumors or those with residual disease after resection. METHODS: Between January 1988 and January 1995, 43 patients with local recurrence of rectal carcinoma were treated at our Institution. Twenty-three had previously been operated by abdominoperineal resection and 20 by anterior resection. Thirteen cases also received adjuvant chemotherapy. All patients underwent irradiation with a 6-15 MeV linear accelerator; 8 (19%) received a total dose of up to 45 Gy on the pelvis and 35 (81%) higher than 45 Gy. Eighteen cases (42%) underwent 3-6 courses of chemotherapy with 5-fluorouracil and folates during radiation. RESULTS: Treatment tolerance was satisfactory. All cases underwent restaging at 45 days from completion of treatment. Sixteen cases (37%) showed a radiologic response > 50%. Median overall survival after relapse was 18.8 months. There were no statistical significant differences in survival between patients treated exclusively with radiation and those treated with chemo-radiotherapy (17 vs 22 months). The results of patients who received doses higher than 45 Gy were statically better (P < 0.05) than those irradiated up to 45 Gy. A slight increase in survival was demonstrated in cases submitted to radical surgery after combined treatment (25 months). Twenty-seven cases (63%) obtained pain control after radiation therapy (median pain remission, 11 months). CONCLUSIONS: Our results seem to encourage radiation therapists, surgeons and oncologists to have a more curative attitude in the treatment of selected patients with local-regional recurrences of rectal cancers by using multi-modality therapy.

Actuarial Analysis↗
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Combined modality (ABVD plus radiotherapy) versus radiotherapy in the management of early stage (IIA) Hodgkin's disease with mediastinal involvement.

The aim of this study was to establish whether combined modality treatment (ABVD plus radiotherapy) can reduce the risk of relapse in Hodgkin's disease patients with mediastinal involvement, as compared to radiotherapy alone. The results obtained suggest that one course of ABVD before irradiation can reduce the incidence of relapse. These findings, however, should be considered preliminary and need to be confirmed in larger studies.

Adult↗
PubMedDate not supplied

[Nasal dimorphism and respiratory dysfunction. Preoperative selection of patients and follow-up using computerized rhinomanometry].

Indications and results of corrective nasal surgery are at times uncertain with the traditional clinical evaluation. To find more certain parameters a study was made with active anterior computerized rhinomanometry (C.R.) pre- and post-operatively in 50 patients randomly chosen from those proposed for rhinoseptoplasty during 1990. The level of total basal resistance (TR) and total residual resistance after pharmacological decongestion were used as objective indicators of respiratory stenosis. Clinically these patients showed some degree of nasal deformity, usually associated with septal deviation. Difficulty in breathing did not always correspond to the level of TR recorded. At times habit or psychological factors related to nasal aesthetics could play an important role. Using CR it was possible to divide the patients into three categories: a) the first (9 patients with normal total basal resistance) required treatment for exclusively aesthetic reasons; b) the second (18 patients with increased basal TR but normal residual TR) required treatment of the conchae and medical therapy; c) the third (23 patients with increased basal and residual TR) had the broadest functional and aesthetic indications. Six months after surgery normal residual TR was found in 96% of these cases. Only 12% of the patients were functionally unsatisfactory, with residual anatomical alteration (4%), phlogosis (4%) or sensations "sine materia" (4%). The present experience confirms the value of CR as an objective test for surgical selection and functional results.

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

[Incidence of Ménière's disease in the Siena Local Health Unit 30 area].

Incidence of Ménière's disease has been the subject of many epidemiologic papers in Literature. Nevertheless, it varies greatly in studies from different countries and it is unclear to what degree these differences can be attributed to epidemiologic differences and to what degree to problems of methodology (selection and assessment of the patient). The objective of this paper is to evaluate the incidence of Ménière's disease in the USL district 30 of the Siennese Area following definite and easily reproduced criteria. A total of 33 new cases of Ménière's disease was identified during a 10-year period from 1981 to 1990. Thus, in relation to the total number of residents in the USL 30 of the Siennese Area (120,000), the average annual incidence rate may be calculated at 27.5 x 10, a relatively modest figure in comparison with other studies. Given this, the Authors discuss the methodological problems relative to the epidemiological assessment.

Adult↗
PubMedDate not supplied

[Initial experiences in the study of the pelvis using nuclear magnetic resonance imaging with 6.36 MHz radiofrequency].

Twenty-four patients with pelvic disease were examined using a resistive magnet operating at a field strength of 0.15 T. and a R.F. frequency of 6.36 MHz. Spin-echo, multiecho (TR = 0.5-2 s; TE = 50-100 ms) and Inversion Recovery techniques (TR = 1.4 s; TI = 0.4 s) were employed. The proliferative processes of the pelvic organs were subdivided into: prostate (adenoma 5 cases, carcinoma 5); bladder (carcinoma 3, lymphoma 1); uterus (fibroma 1, cervical carcinoma 6, endometrial carcinoma 3). All patients were evaluated with conventional methods and had histological diagnosis. The little respiratory motion of pelvic organs allowed to obtain good coronal, sagittal and axial images. The main aspects of normal anatomy and pathology are analized and described. The tissue characterization of normal structures provides good anatomic details; multiplanar images depict the extent of the lesions properly. N.M.R. is an interesting method in evaluating the extension of pelvic masses and staging pelvic tumors.

Diagnosis, Differential↗
PubMedDate not supplied

[Percutaneous treatment of calculi in the horseshoe kidney].

Horseshoe kidney and renal anomalies are not a contraindication for endourological procedures. In horseshoe kidney, anatomical features and impaired drainage of urine, make stone treatment by ESWL technically difficult and fragments output unsuccessfully. By PNL, via a middle or upper calix posterior approach, is possible to remove the stone without serious complications. Technical modifications of traditional percutaneous approach are required to deal with these cases. A careful preoperative study of caliceal and pelvic anatomy by retrograde pyelography with films taken in lateral and oblique position is needed to plan the correct approach to the stone. However, a skilled use of endourological procedures and techniques are required. Authors present our experience on two cases successfully treated.

Adult↗
PubMedDate not supplied

[Nuclear magnetic resonance in oncologic radiotherapy].

The possibilities of utilizing Nuclear Magnetic Resonance in Radiation Oncology are examined, on the basis of information provided by spectroscopy (MRS), studies on the tissues characterization of tumors, and preliminary practical application of imaging (MRI) to radiation therapy. MRS affords information on the bioenergetics of the tumor cells, and on the biochemical changes induced by ionizing radiation; further, some results of clinical importance were obtained in "monitoring" tumor response to radiation therapy and chemotherapy. Tissue characterization of normal tissues and of tumor is analyzed; technical factors, morphological elements, and structural elements are considered. Morphological elements include anatomical recognition, clinical and radiological evaluation, appraisal of the peritumoral tissues, and analysis of inhomogeneities. Among structural elements are considered some methods suitable to achieve a full evaluation of tissue characterization of tumors, on the basis of an appropriate employment of sequence parameters. Practical application of MRI on radiotherapy of tumors comprises staging procedures, contribution to the selection of differentiated radiation volumes for radiotherapy planning, and new data on the evaluation of biological effects of ionizing radiation on normal tissues of patients.

Brain Neoplasms↗
PubMedDate not supplied

[Non-Hodgkin's lymphoma. Extranodal localizations in the head and neck. Clinical and therapeutic evaluations].

The staging, therapy and course of 91 patients with extranodal NHL of the head and neck treated between 1970 and 1985, were analyzed. The sites involved were: Waldeyer's ring 71 patients, tonsil 59, nasopharynx 12 and extralymphatic sites 20 patients (larynx 6, paranasal sinus 5, orbit 5, oral cavity 3, salivary gland 1). Sixty-three patients had unfavourable histology with 22 patients in stage I; 33 in II; 21 in III; 15 in IV. Chemotherapy plus radiotherapy was used in 43 patients and 34 obtained Complete Remission (CR). Chemotherapy alone was used in 30 patients and in 11 CR was achieved, radiotherapy alone in 18 patients and 11 obtained CR. The actuarial survival rate was 55% and recurrence-free survival, evaluated only in those patients who achieved complete remission, was 80%. Results, as survival and freedom from recurrence, are analyzed in relation to main prognostic factors and therapy, and patterns of recurrence are reported. The present study confirmed the view that radiotherapy combined with chemotherapy represents the best treatment for NHL of the head and neck.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Long-term results of treatment of childhood and adolescent Hodgkin's disease in 73 patients: the experience of the Departments of Radiology and Hematology of the University of Rome "La Sapienza".

PURPOSE: Various experiences show no substantial differences between children and adults in the treatment of Hodgkin's disease. In consideration of some peculiar characteristics of these cases which might influence the therapeutical choice, particularly regarding long-term survival and therapeutical complications, we report the results of a series of 73 children and adolescents with Hodgkin's disease treated at the University of Rome "La Sapienza". METHODS: Between 1976 and 1983, 73 untreated pediatric cases of stage I-IV Hodgkin's disease were treated with radiotherapy, alone or associated with chemotherapy, using high doses and extended fields. RESULTS: Fifty-six patients (77%) were in continuous complete remission in April 1995 and seventeen (23%) had died. CONCLUSIONS: The authors confirm the excellent results in the treatment of pediatric Hodgkin's disease, both in terms of overall and relapse free survival, in spite of a high incidence of complications caused by the aggressive treatment used in this series. Therefore the majority of authors suggest combined alternating low-dose radiation administered with small portals and short-term chemotherapy. These procedures provide optimal results together with a significant reduction of complications. Consequently, it is very important to evaluate all patient characteristics accurately in order to tailor optimal treatment and select cases with risk factors which might be undertreated and therefore undergo a higher risk of recurrence.

Adolescent↗