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  1. Article ; Online: On the necessity of specialized knowledge-based models for SBRT prostate treatments plans.

    Scaggion, Alessandro / Cavinato, Samuele / Dusi, Francesca / El Khouzai, Badr / Guida, Federica / Paronetto, Chiara / Rossato, Marco Andrea / Sapignoli, Sonia / Scott, Anthony St Aubin / Sepulcri, Matteo / Paiusco, Marta

    Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)

    2024  Volume 121, Page(s) 103364

    Abstract: Purpose: Test whether a well-grounded KBP model trained on moderately hypo-fractionated prostate treatments can be used to satisfactorily drive the optimization of SBRT prostate treatments.: Materials and methods: A KBP model (SBRT-model) was ... ...

    Abstract Purpose: Test whether a well-grounded KBP model trained on moderately hypo-fractionated prostate treatments can be used to satisfactorily drive the optimization of SBRT prostate treatments.
    Materials and methods: A KBP model (SBRT-model) was developed, trained and validated using the first forty-seven clinically treated VMAT SBRT prostate plans (42.7 Gy/7fx or 36.25 Gy/5fx). The performance and robustness of this model were compared against a high-quality KBP-model (ST-model) that was already clinically adopted for hypo-fractionated (70 Gy/28fx and 60 Gy/20fx) prostate treatments. The two models were compared in terms of their predictions robustness, and the quality of their outcomes were evaluated against a set of reference clinical SBRT plans. Plan quality was assessed using DVH metrics, blinded clinical ranking, and a dedicated Plan Quality Metric algorithm.
    Results: The plan libraries of the two models were found to share a high degree of anatomical similarity. The overall quality (APQM%) of the plans obtained both with the ST- and SBRT-models was compatible with that of the original clinical plans, namely (93.7 ± 4.1)% and (91.6 ± 3.9)% vs (92.8.9 ± 3.6)%. Plans obtained with the ST-model showed significantly higher target coverage (PTV V95%): (97.9 ± 0.8)% vs (97.1 ± 0.9)% (p < 0.05). Conversely, plans optimized following the SBRT-model showed a small but not-clinically relevant increase in OAR sparing. ST-model generally provided more reliable predictions than SBRT-model. Two radiation oncologists judged as equivalent the plans based on the KBP prediction, which was also judged better that reference clinical plans.
    Conclusion: A KBP model trained on moderately fractionated prostate treatment plans provided optimal SBRT prostate plans, with similar or larger plan quality than an embryonic SBRT-model based on a limited number of cases.
    MeSH term(s) Humans ; Radiotherapy Planning, Computer-Assisted/methods ; Radiosurgery/methods ; Male ; Prostatic Neoplasms/radiotherapy ; Knowledge Bases ; Radiotherapy, Intensity-Modulated/methods ; Radiotherapy Dosage
    Language English
    Publishing date 2024-05-02
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 1122650-x
    ISSN 1724-191X ; 1120-1797
    ISSN (online) 1724-191X
    ISSN 1120-1797
    DOI 10.1016/j.ejmp.2024.103364
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  2. Article ; Online: Metastasis From Clear Cell Renal Cell Carcinoma Mimicking Well-Differentiated Pancreatic Neuroendocrine Tumor at 18F-FDG and 68Ga-DOTATOC PET/CT.

    Guglielmo, Priscilla / Pesella, Fiammetta / Sartorello, Alida / El Khouzai, Badr / Berti, Sara / Muccioli, Simona / Gregianin, Michele

    Clinical nuclear medicine

    2022  Volume 47, Issue 7, Page(s) e498–e499

    Abstract: Abstract: Dual-tracer PET/CT with both 18F-FDG and 68Ga-DOTA-conjugated peptides is currently used in clinical routine for characterizing pNET (pancreatic masses suspicious for neuroendocrine tumor). We describe here the case of a 81-year-old man with a ...

    Abstract Abstract: Dual-tracer PET/CT with both 18F-FDG and 68Ga-DOTA-conjugated peptides is currently used in clinical routine for characterizing pNET (pancreatic masses suspicious for neuroendocrine tumor). We describe here the case of a 81-year-old man with a pancreatic lesion showing high 68Ga-DOTATOC uptake and mild 18F-FDG avidity, thus suggesting a well-differentiated pNET, which resulted at endoscopic ultrasound-guided fine-needle aspiration to be a clear cell renal cell carcinoma metastasis. In fact, the patient had right nephrectomy for clear cell renal cell carcinoma 27 years earlier. This case puts light on the role of PET/CT with 68Ga-DOTATOC in imaging RCC, a field which deserves to be further explored.
    MeSH term(s) Aged, 80 and over ; Carcinoma, Renal Cell/diagnostic imaging ; Fluorodeoxyglucose F18 ; Humans ; Kidney Neoplasms/diagnostic imaging ; Male ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors/diagnostic imaging ; Neuroendocrine Tumors/pathology ; Octreotide/analogs & derivatives ; Organometallic Compounds ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/pathology ; Positron Emission Tomography Computed Tomography/methods ; Radiopharmaceuticals
    Chemical Substances Ga(III)-DOTATOC ; Organometallic Compounds ; Radiopharmaceuticals ; Fluorodeoxyglucose F18 (0Z5B2CJX4D) ; Octreotide (RWM8CCW8GP)
    Language English
    Publishing date 2022-04-05
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 197628-x
    ISSN 1536-0229 ; 0363-9762
    ISSN (online) 1536-0229
    ISSN 0363-9762
    DOI 10.1097/RLU.0000000000004151
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Updating a clinical Knowledge-Based Planning prediction model for prostate radiotherapy.

    Scaggion, Alessandro / Fusella, Marco / Cavinato, Samuele / Dusi, Francesca / El Khouzai, Badr / Germani, Alessandra / Pivato, Nicola / Rossato, Marco Andrea / Roggio, Antonella / Scott, Anthony / Sepulcri, Matteo / Zandonà, Roberto / Paiusco, Marta

    Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)

    2023  Volume 107, Page(s) 102542

    Abstract: Background and purpose: Clinical knowledge-based planning (KBP) models dedicated to prostate radiotherapy treatment may require periodical updates to remain relevant and to adapt to possible changes in the clinic. This study proposes a paired comparison ...

    Abstract Background and purpose: Clinical knowledge-based planning (KBP) models dedicated to prostate radiotherapy treatment may require periodical updates to remain relevant and to adapt to possible changes in the clinic. This study proposes a paired comparison of two different update approaches through a longitudinal analysis.
    Materials and methods: A clinically validated KBP model for moderately hypofractionated prostate therapy was periodically updated using two approaches: one was targeted at achieving the biggest library size (M
    Results: Both update procedures allowed for an increase in the OARs sparing between +3.9 % and +19.2 % compared to plans generated by a human planner. Target coverage and homogeneity slightly reduced [-0.2 %;-14.7 %] while plan complexity showed only minor changes. Increasing the sample size resulted in more reliable predictions and improved goodness-of-fit, while increasing the mean sample quality improved the outcomes but slightly reduced the models reliability.
    Conclusions: Repeated updates of clinical KBP models can enhance their robustness, reliability and the overall quality of automatically generated plans. The periodical expansion of the model sample accompanied by the removal of the unacceptable low quality plans should maximize the benefits of the updates while limiting the associated workload.
    MeSH term(s) Male ; Humans ; Radiotherapy Dosage ; Prostate ; Reproducibility of Results ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Intensity-Modulated/methods ; Organs at Risk
    Language English
    Publishing date 2023-02-11
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 1122650-x
    ISSN 1724-191X ; 1120-1797
    ISSN (online) 1724-191X
    ISSN 1120-1797
    DOI 10.1016/j.ejmp.2023.102542
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  4. Article: Obesity may not be related to pathologic response in locally advanced rectal cancer following neoadjuvant chemoradiotherapy.

    Bao, Quoc Riccardo / Crimì, Filippo / Valotto, Giovanni / Chiminazzo, Valentina / Bergamo, Francesca / Prete, Alessandra Anna / Galuppo, Sara / El Khouzai, Badr / Quaia, Emilio / Pucciarelli, Salvatore / Urso, Emanuele Damiano Luca

    Frontiers in oncology

    2022  Volume 12, Page(s) 994444

    Abstract: Background: The aim of this study is to evaluate the correlation between body mass index (BMI) and body fat composition (measured with radiological fat parameters (RFP)) and pathological response after neoadjuvant chemoradiotherapy for locally advanced ... ...

    Abstract Background: The aim of this study is to evaluate the correlation between body mass index (BMI) and body fat composition (measured with radiological fat parameters (RFP)) and pathological response after neoadjuvant chemoradiotherapy for locally advanced rectal cancer patients. The secondary aim of the study was to assess the role of BMI and RFP on major surgical complications, overall survival (OS), and disease-free survival (DFS).
    Methods: All patients who underwent surgical resection following nCRT between 2005 and 2017 for mid-low rectal cancer were retrospectively collected. Visceral fat area (VFA), superficial fat area (SFA), visceral/superficial fat area ratio (V/S), perinephric fat thickness (PNF), and waist circumference (WC) were estimated by baseline CT scan. Predictors of pathologic response and postoperative complications were investigated using logistic regression analysis. The correlations between BMI and radiologic fat parameters and survival were investigated using the Kaplan-Meier method and log-rank test.
    Results: Out of 144 patients included, a complete (TRG1) and major (TRG1+2) pathologic response was reported in 32 (22%) and 60 (45.5%) cases, respectively. A statistically significant correlation between BMI and all the RFP was found. At a median follow-up of 60 (35-103) months, no differences in terms of OS and DFS were found considering BMI and radiologic fat parameters. At univariable analysis, neither BMI nor radiologic fat parameters were predictors of complete or major pathologic response; nevertheless, VFA, V/S>1, and BMI were predictors of postoperative major complications.
    Conclusions: We found no associations between BMI and body fat composition and pathological response to nCRT, although VFA, V/S, and BMI were predictors of major complications. BMI and RFP are not related to worse long-term OS and DFS.
    Language English
    Publishing date 2022-09-29
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2022.994444
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  5. Article: Effectiveness of Cone Beam Computed Tomography Imaging During Radiation Therapy for the Detection of Initial Coronavirus Lung Disease 2019.

    Sepulcri, Matteo / Paronetto, Chiara / El Khouzai, Badr / Novo, Alessandro / Aldegheri, Vittoria / Scaggion, Alessandro / Fusella, Marco

    Advances in radiation oncology

    2020  Volume 5, Issue 4, Page(s) 697–699

    Abstract: In this unique historic period afflicted by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, radiation therapy treatments cannot be delayed or suspended. We report the case of a 73-year-old woman with recently diagnosed ... ...

    Abstract In this unique historic period afflicted by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, radiation therapy treatments cannot be delayed or suspended. We report the case of a 73-year-old woman with recently diagnosed extensive-stage small cell lung cancer with metastatic liver and bone lesions. A SARS-CoV-2 test was performed upon hospital admission and was negative. After 5 days she underwent radiation therapy on T6 and T11 with single fractions of 8 Gy each. Before treatment a cone beam computed tomography (CBCT) scan was performed to check the setup of the patient. Some suspected lung areas of ground glass opacities (GGOs) were clearly visible in the CBCT without any counterpart in the previous computed tomography (CT) simulation scan 3 days before. A new high-quality chest CT scan confirmed the previously suspected GGOs. The exam revealed multiple bilateral areas of subpleural GGOs, which are the primary findings on CT scan in the early phases of coronavirus disease 2019 (COVID-19) lung infection, in addition to pleural effusions, a finding that may occur as a complication of COVID-19. The patient then urgently repeated the SARS-CoV-2 test, which was positive and confirmed the infection. In conclusion, daily CBCT can be effective for early detection of COVID-19 lung disease in asymptomatic or mildly symptomatic patients.
    Keywords covid19
    Language English
    Publishing date 2020-05-08
    Publishing country United States
    Document type Journal Article
    ISSN 2452-1094
    ISSN 2452-1094
    DOI 10.1016/j.adro.2020.04.019
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  6. Article: Individual Radiosensitivity in Oncological Patients: Linking Adverse Normal Tissue Reactions and Genetic Features.

    Palumbo, Elisa / Piotto, Celeste / Calura, Enrica / Fasanaro, Elena / Groff, Elena / Busato, Fabio / El Khouzai, Badr / Rigo, Michele / Baggio, Laura / Romualdi, Chiara / Zafiropoulos, Demetre / Russo, Antonella / Mognato, Maddalena / Corti, Luigi

    Frontiers in oncology

    2019  Volume 9, Page(s) 987

    Abstract: Introduction: ...

    Abstract Introduction:
    Language English
    Publishing date 2019-10-01
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2019.00987
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  7. Article ; Online: External validation of a composite bio-humoral index in anal cancer patients undergoing concurrent chemoradiation.

    Franco, Pierfrancesco / Porreca, Annamaria / Mantello, Giovanna / Valvo, Francesca / Gasparini, Lucrezia / Slim, Najla / Manfrida, Stefania / De Felice, Francesca / Gerardi, Marianna A / Vagge, Stefano / Krengli, Marco / Palazzari, Elisa / Osti, Mattia Falchetto / Gonnelli, Alessandra / Catalano, Gianpiero / Pittoni, Patrizia / Ivaldi, Giovani B / Lupattelli, Marco / Rosetto, Maria Elena /
    Niespolo, Rita Marina / Guido, Alessandra / Durante, Oreste / Macchia, Gabriella / Munoz, Fernando / El Khouzai, Badr / Lucido, Maria Rosaria / Arcadipane, Francesca / Casadei Gardini, Andrea / Maria D'Angelillo, Rolando / Gambacorta, Maria Antonietta / Genovesi, Domenico / Di Nicola, Marta / Caravatta, Luciana

    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

    2022  Volume 177, Page(s) 9–15

    Abstract: Background and purpose: A prognostic scoring system based on laboratory inflammation parameters, [Hemo-Eosinophils-Inflammation (HEI) index], including baseline hemoglobin level, the systemic inflammatory index and eosinophil count was recently proposed ...

    Abstract Background and purpose: A prognostic scoring system based on laboratory inflammation parameters, [Hemo-Eosinophils-Inflammation (HEI) index], including baseline hemoglobin level, the systemic inflammatory index and eosinophil count was recently proposed in patients with squamous cell carcinoma of the anus (ASCC). HEI was shown to discriminate disease-free (DFS) and overall (OS) survival in ASCC patients treated with concurrent chemoradiation (CRT). We tested the accuracy of the model on a multicentric cohort for external validation.
    Materials and methods: Patients treated with CRT were enrolled. The Kaplan-Meier curves for DFS and OS based on HEI risk group were calculated and the log-rank test was used. Cox proportional hazards models were used to assess the prognostic factors for DFS and OS. The exponential of the regression coefficients provided an estimate of the hazard ratio (HR). For model discrimination, we determined Harrell's C-index, Gönen & Heller K Index and the explained variation on the log relative hazard scale.
    Results: A total of 877 patients was available. Proportional hazards were adjusted for age, gender, tumor-stage, and chemotherapy. Two-year DFS was 77 %(95 %CI:72.0-82.4) and 88.3 %(95 %CI:84.8-92.0 %) in the HEI high- and low- risk groups. Two-year OS was 87.8 %(95 %CI:83.7-92.0) and 94.2 %(95 %CI:91.5-97). Multivariate Cox proportional hazards model showed a HR = 2.02(95 %CI:1.25-3.26; p = 0.004) for the HEI high-risk group with respect to OS and a HR = 1.53(95 %CI:1.04-2.24; p = 0.029) for DFS. Harrel C-indexes were 0.68 and 0.66 in the validation dataset, for OS and DFS. Gonen-Heller K indexes were 0.67 and 0.71, respectively.
    Conclusion: The HEI index proved to be a prognosticator in ASCC patients treated with CRT. Model discrimination in the external validation cohort was acceptable.
    MeSH term(s) Humans ; Disease-Free Survival ; Prognosis ; Chemoradiotherapy/adverse effects ; Chemoradiotherapy/methods ; Anus Neoplasms/therapy ; Anus Neoplasms/pathology ; Proportional Hazards Models ; Inflammation ; Retrospective Studies
    Language English
    Publishing date 2022-10-20
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 605646-5
    ISSN 1879-0887 ; 0167-8140
    ISSN (online) 1879-0887
    ISSN 0167-8140
    DOI 10.1016/j.radonc.2022.10.015
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  8. Article: 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.

    Caravatta, Luciana / Mantello, Giovanna / Valvo, Francesca / Franco, Pierfrancesco / Gasparini, Lucrezia / Rosa, Consuelo / Slim, Najla / Manfrida, Stefania / De Felice, Francesca / Gerardi, Marianna A / Vagge, Stefano / Krengli, Marco / Palazzari, Elisa / Osti, Maria Falchetto / Gonnelli, Alessandra / Catalano, Gianpiero / Pittoni, Patrizia / Ivaldi, Giovani Battista / Galardi, Alessandra /
    Lupattelli, Marco / Rosetto, Maria Elena / Niespolo, Rita Marina / Guido, Alessandra / Durante, Oreste / Macchia, Gabriella / Munoz, Fernando / El Khouzai, Badr / Lucido, Maria Rosaria / Porreca, Annamaria / Di Nicola, Marta / Gambacorta, Maria Antonietta / Donato, Vittorio / Genovesi, Domenico

    Cancers

    2021  Volume 13, Issue 8

    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 ... ...

    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 (
    Language English
    Publishing date 2021-04-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers13081902
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