Search PubMed⌕ Search

Biomedical subjects

N Cellini

Publications and source records attributed to N Cellini.

114 records · Page 7Linked to original sources
PubMedDate not supplied

Organ preservation in the management of prostatic cancer.

Thirty-two patients with cT2 prostatic adenocarcinoma underwent a protocol of combined treatment based on: neoadjuvant hormonotherapy (LH-RH analogues + antiandrogens) and concomitant external radiotherapy (ERT), two months before ERT until the end of it; ERT to the entire pelvis (45 Gy) with a boost dose to the prostatic volume (+20 Gy). All patients completed the planned treatment. Acute toxicity was moderate (Gr 1-2 RTOG). At a median follow-up of 22 months (range: 6-68) one patient (3.1%) showed bone metastases while none had local disease progression. Overall 5 year survival and disease-free survival were 100% and 97% respectively. Late toxicity was mild (Gr 1 RTOG: intestinal: 3.1%; urological: 21.9%). The protocol was shown to be feasible with no relevant toxicity. Even if the follow-up was short, results achieved in this group of potentially resectable prostatic cancer patients seem to confirm the possibility of achieving results comparable to those of surgery with no relevant impairment of urinary and intestinal function, thus with an acceptable quality of life.

Actuarial Analysis↗
PubMedDate not supplied

Organ preservation in the management of pancreatic cancer.

Over a 5-year period, 6 patients with potentially resectable (cT2) pancreatic adenocarcinoma underwent exclusive radiotherapy. Surgery was ruled out because of the patients' age (> 75 years) in 5 cases and for contraindication for anesthesia in the remaining one. Four patients underwent intraluminal brachytherapy (50 Gy) with linear 192Ir sources; the remaining two underwent concomitant radiochemotherapy (39.6 and 50.4 Gy respectively) followed by a boost dose (50 and 20 Gy respectively) of intraluminal brachytherapy. All patients completed the treatment without relevant acute side-effects. One patient undergoing combined treatment showed gastric ulcer 8 months after treatment. Two patients showed local progression of the disease and two distant metastases. In one of the two patients with local progression, digestive by-pass was required. All patients died. Median survival was of 14 months. Actuarial survival at 1, 2 and 3 years was 66%, 33% and 16% respectively. No patient showed pain during follow-up. The fairly good quality of life observed in these patients undergoing conservative treatment and the rate of survival, comparable with that of surgical series, suggest that irradiation should be considered in those patients in whom radical surgery in contraindicated.

Actuarial Analysis↗
PubMedDate not supplied

Radiotherapy, local control and survival in carcinomas of the exocrine pancreas.

Local recurrence affects approximately 50% of patients undergoing surgery for pancreatic adenocarcinoma. To lower the incidence of locoregional recurrence, the combination with surgery of adjuvant radiotherapy has been proposed. The latter is based on external radiotherapy (ERT), intraoperative radiotherapy (IORT) or their combination. To evaluate the impact on local control and survival, results achieved in a a group of patients undergoing surgical resection and combined adjuvant radiotherapy, are analyzed. 17 patients with adenocarcinoma of the exocrine pancreas were treated with a therapeutic protocol based on pancreatectomy and intraoperative radiotherapy (IORT) to the tumor bed (10 Gy) followed by postoperative radiotherapy (50 Gy); 9 patients underwent also preoperative radiotherapy (5 Gy) to the pancreas and liver. With a median follow-up of 45 months, in 3 patients (17.6%) local recurrence was observed while 12 patients (70.6%) showed liver metastases or peritoneal spread. Median survival was 17.5 months and actuarial survival at 2 and 5 years was 41.2% and 11.2%, respectively. As compared to a moderate local control, the prognosis of patients undergoing surgical resection remained disappointing. Thus, the effort of improving results with new therapeutic modalities as preoperative radiochemotherapy and adjuvant chemotherapy, seems justified.

Adenocarcinoma↗
PubMedDate not supplied

Radiation, hormonotherapy, survival and local control in prostatic carcinoma.

The combination of concomitant external beam radiotherapy (ERT) and neoadjuvant hormonotherapy was shown to be able to significantly improve local control and disease-free survival in locally advanced prostatic carcinoma. (RTOG study 8610). Aim of this analysis was to assess the clinical results observed in a population of patients undergoing this combined treatment and, more particularly, to examine the prognostic impact of local control. 84 patients (T2: 47%, T3: 49.4%, T4: 3.6%) underwent concomitant ERT (dose to pelvic volume: 45 Gy; mean dose to prostatic volume: 65 Gy) and neoadjuvant hormonotherapy (flutamide: 250 mg three times/daily for 30 days; LH-RH analogue: 1 oral dose every 28 days starting 2 months prior to radiotherapy and for its whole duration). With a median follow-up of 36 months, 3.6% of patients were deceased; hematogenous metastases and local disease progression were recorded in 16.7% and 4.8% of patients, respectively. Local disease progression was shown to be significantly correlated with the incidence of metastases. In fact, the actuarial incidence of metastases at 5 years was 100% and 27% in patients with and without local recurrence (p = 0.0043) respectively. Overall, metastases-free local and biochemical recurrence-free survival was 89.2%, 66.5%, 85.0% and 41.9% respectively. At univariate analysis (logrank) the clinical stage (T) was shown to be significantly correlated with the incidence of metastases (p = .0004) and local progression (p < .0001). In conclusion, this study has confirmed the low rate of local progression with the combination of hormonotherapy and radiotherapy and the significant correlation of local control with the incidence of hematogenous metastases.

Adenocarcinoma↗
PubMedDate not supplied

Radiotherapy, local control and survival in cervical carcinoma.

The natural history of cervical carcinoma is characterized by a close correlation between local control and survival. Local eradication of the disease is justified for the obvious impact on the quality of life as well as on long-term survival. A series of analyses carried out in the last decades have elucidated the role of a number of prognostic factors in local control. Among treatment modalities applied to attain this aim, particular interest has been focused in recent years on concomitant radiation and chemotherapy. While some experiences have shown promising results, the precise role of this combination will be defined based on the outcomes of some randomized studies now in progress. Among the modalities of concomitant radiation and chemotherapy, some authors have proposed the following sequence: neoadjuvant chemotherapy and surgical resection. It is an aggressive approach potentially associated to major side-effects. This therapeutic modality will require an accurate assessment of clinical results both in terms of clinical response, local control and effects on organ function and quality of life.

Antineoplastic Agents↗