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Biomedical subjects

F Milani

Publications and source records attributed to F Milani.

At least 37 records · Page 2Linked to original sources
PubMed1993

Endoscopic treatment of postradiation strictures.

BACKGROUND: Esophageal stricture is a rare complication of radiotherapy: reports on its incidence and management are therefore anecdotal. METHODS: From January 1978 to September 1992, 44 patients presenting with an esophageal stricture related to a previous radiation treatment were endoscopically dilated at the Endoscopy Division of the Istituto Nazionale Tumori of Milan. RESULTS: Esophageal recanalization was obtained in 95% of the patients treated, and in 79% of these normal eating habits were restored. No strict correlation was observed between radiation dose and severity of the stricture, or time elapsed between first treatment and endoscopic dilation. CONCLUSIONS: In our experience, endoscopic dilation was a safe effective procedure and represented an effective palliative tool in dysphagic patients with esophageal strictures due to previous local radiotherapy.

Adult↗
PubMed1993

Non-resectable Stage IIIa-b lung carcinoma: a phase II study on continuous infusion of cisplatin and concurrent radiotherapy (plus adjuvant surgery).

Thirty-eight patients with non-resectable non-small-cell Stage IIIa-b lung cancer were treated in a Phase II study with radiotherapy (50 Gy in a 25-fraction split-course) plus con-current continuous infusion of cisplatin given at a daily dose of 6 mg/m2, with the aim of investigating its radiopotentiation properties. Treatments were given on an outpatient basis by means of a central venous catheter and a portable pump. Adjuvant surgery was undertaken when feasible. Toxicity was mild to moderate. The probability of a partial or complete locoregional response at 4 weeks after treatment completion was 83% (confidence limits at 95%: 13). Eighteen patients were resected. Overall 1-, 2- and 3-year progression-free survival probabilities were 42, 24 and 21%. These figures were 63, 37 and 24% in observed survival curves. Patients with squamous-cell tumors had observed survival rates of 82, 50 and 28% at 1, 2 and 3 years, compared to 42, 19 and 19% in patients with non-squamous histology. The high response and survival rates obtained at a low price according to toxicity require further investigation.

Adult↗
PubMed1993

[Neoplasms of the maxillary sinus. The clinico-radiological considerations of dental interest].

Early diagnosis of the maxillary antrum carcinoma is of considerable difficulty. There are, however, signs and a refined symptomatology that the stomatologist can recognize when the tumour is still in its intrinsic form. Although the maxillary antrum tumors are rare, they present an extremely difficult diagnosis. The patient comes to us when the tumor has already invaded all the contiguous structures pertaining to the oral cavity. For early diagnosis we can avail ourselves, besides a conventional radiographic test, also of more specific analysis, as the computed tomography and radio therapy. These last image methodologies are also employed to establish a radiation treatment plan. Actually the best therapeutic treatment seems to be the multidisciplinary one, combining therapy with surgery.

Adult↗
PubMed1992

[Radiotherapy in the control of bone metastases in patients with adenocarcinoma of the prostate].

Advanced prostatic carcinoma shows a high incidence of bone metastases. This is the main cause of clinical problems such as invalidating bone fractions, collapses and consequently of sharp pain syndromes. In these cases the therapy needs to achieve quick relief of symptoms. Radiotherapy, with its large variety of technical options, allows a wide modulation to fit a lot of clinical situations among the most frequent for these patients. A large series of treatment modalities and related indications will be presented and discussed in this work.

Adenocarcinoma↗
PubMed1991

Prolonged venous infusion of cisplatin and concurrent radiation therapy for lung carcinoma. A feasibility study.

Fifty patients with non resectable and/or inoperable bronchogenic carcinoma were entered into a feasibility study of cisplatin (CDDP) given in continuous infusion with concurrent radiation therapy. The radiation therapy regimen consisted of 2 Gy given 5 days a week in the first 3 and last 2 weeks of a 7-week split course (50 Gy of total dose). The CDDP (daily dose of 4 to 6 mg/m2) was administered to cover the days of radiation treatment by means of a central venous catheter and a portable pump. Less than 1% of predicted duration of infusion was lost due to complications related to venous access and pump. Toxicity was moderate. The overall probability of a locoregional major response (complete + partial) within 1 month after treatment completion was 86%. Twenty-three patients underwent resection. The 1-year actuarial probability of survival was 64%. The high response and survival rates warrant further studies on concurrent CDDP continuous infusion and radiation therapy in inoperable lung carcinoma.

Adult↗
PubMed1984

Surgical or radiosurgical failures on cervical lymph nodes in treatment of head and neck cancer.

From a series of 850 patients with head and neck carcinoma and subjected to lymph node dissection, 80 cases of recurrences in the neck have been collected. Postoperative radiotherapy was performed only in cases with metastatic extranodal spread. Of these recurrences, 56 occurred in the area of lymph node dissection, 7 were marginal and 17 were contralateral. The recurrences occurred prevalently in node-positive (N+) patients (70 of 80). The incidence of recurrences in the dissection area was 41.6% (25 of 60) in cases with metastatic extranodal spread, despite postoperative radiotherapy. The incidence of recurrences in cases with clinically evident metastases at the time of dissection but without extranodal spread and not subjected to postoperative radiotherapy was relatively high (24.1%, or 28 of 116). Since recurrences occurred, despite postoperative radiotherapy, in a relatively high percentage of cases with carcinoma of the oral floor and of the tongue (59.1% and 50%, respectively), it seems justifiable to perform preoperative radiation treatment in cases with clinically evident metastatic lymph nodes. As regards marginal recurrences, which all occurred in patients with carcinoma of the oral floor, it is considered sufficient to extend the surgical treatment to the subhyoid region. The high incidence of contralateral recurrences, which occurred mainly in patients with carcinoma of the larynx (13 of 17), shows the usefulness of radiation treatment of the contralateral region of the neck in these tumors, when dissection is limited to only one side of the neck.

Brachytherapy↗
PubMed1984

[Radiodiagnosis of radiation-treated lung cancer].

Consultation of an exhaustive iconographic casuistry concerning more of one thousand of primitive lung cancer, irradiated by high energies in the National Cancer Institute of Milan, has given in the opportunity of observing some changes induced by radiotherapy both on neoplastic focus and on health tissue near it. In the first instance we observed marked regressions both progressive and complete. In the second instance we saw structural characteristic reactions that can be classified in the, so called, "radiation pneumonia". In the first stage, these are characterized by hyperemia and exudate, liable to complete regression. In the following stages, we observed fibrous evolution which, in a second time, went in to a fixed stage of sclerosis. This produces, in most cases, a "print" of the irradiation fields. Here we present some representative iconographic examples.

Humans↗
PubMed1982

Follow-up of pathological stage I and IIA supradiaphragmatic Hodgkin's disease primarily treated with radiotherapy.

One hundred and fifty-five consecutive previously untreated adult patients with supradiaphragmatic pathologic stage IA (71) and IIA (84) Hodgkin's disease treated only with radiotherapy (RT) at the Istituto Nazionale Tumori of Milano from 1970 to 1978 were reviewed. Staging procedures included lymphangiography and laparotomy in all cases. Most patients were irradiated with a conventional cobalt machine. Mantle fields were adopted for 36.8% of cases, mainly at stage I, whereas 63.2% received mantle plus paraaortal irradiation. Doses were above 40 Gy for involved sites and 35-40 Gy for prophylactically irradiated nodes. Minimum and median follow-up were 30 months and 6 years, respectively. All patients achieved complete remission at the end of RT. As of June 1981, 89 of 155 patients (57.5%) were alive and free from progression, 60.6% at stage I, and 54.8% at stage II. Relapses occurred in 54 of 155 cases (35%) after a median free interval of 21 months. Marginal recurrences accounted for 5.8%, true recurrences for 9%, nodal extensions for 8.4%, and extranodal extensions for 11.6%. Males older than 40 years and mediastinal involvement were correlated with higher relapse rates. Salvage treatment consisted of RT alone in 8 patients and chemotherapy plus or minus RT in 44, whereas 2 patients died before a new treatment could start. As of June 1981, 38 of 54 relapsed patients (70.4%) were alive and disease free, whereas 2 were alive with evidence of disease. Actuarial overall survival at 6 years was 90.3% for all cases, 97.1% for stage I, and 84.8% for stage II. Treatment toxicity was analyzed, and problems concerning surgical staging procedures, optimal RT and role of chemotherapy as primary or salvage treatment were discussed.

Actuarial Analysis↗
PubMed1982

Secondary lung cancer resection with curative intent: causes of success and failure and prognostic factors.

Observed and disease-free survivals were evaluated in a consecutive series of 46 resections of pulmonary metastases, with major chance of being a unique phenomenon. Survival curves were computed both since the treatment of primary tumors and since resection of lung metastases. From the treatment of primary tumors, median disease-free interval was 33 months, and rose to 66 months after resection of lung metastases. From the treatment of secondary lung cancers the observed survivals at 1, 3 and 5 years were respectively 60%, 41% and 26%. Survival was clearly affected by development and resectability of post-thoracotomic recurrence (100% without recurrence, 50% with resectable recurrence and 4% with unresectable recurrence). Recurrence rate was related to the first disease-free interval and to the anatomical extent (particularly for nodal status) of secondary lung cancer. This fact suggests that the failure of secondary lung cancer resection may arise either from the primary cancer (poor selection) or from the secondary cancer (delay in treatment).

Adolescent↗