PubMed Health⌕ Search

Biomedical subjects

F Volterrani

Publications and source records attributed to F Volterrani.

At least 19 recordsLinked to original sources
PubMed1999

Long-term results of sequential chemotherapy-radiotherapy-chemotherapy in locally advanced squamous cell carcinoma of the uterine cervix.

PURPOSE OF INVESTIGATION: In order to evaluate the impact of sequential chemotherapy-radiotherapy-chemotherapy on local control and survival, a follow-up study was carried out 12 years after the treatment of 22 patients with FIGO stage IIB-III squamous cell cervical cancer. METHODS: Patients were submitted to three cycles of induction chemotherapy (cisplatin and bleomycin) followed by whole pelvis irradiation and central boost with endocavitary brachytherapy. Ten patients underwent three further cycles of chemotherapy after radiotherapy. All patients were maintained by regular follow-up. Only one patient was lost 48 months after treatment. RESULTS: At the end of treatment complete response was obtained in 14 patients (63.5%). Four of these recurred locally, and one at also distance. Eight patients failed to obtain a complete response. Twelve patients died from disease and one patient died from other causes. Nine of 22 (41%) patients are alive without evidence of disease with a median follow-up of 134 months. Acute toxicity was mild, while two severe late complications were observed. CONCLUSIONS: The achievement of complete remission at the end of treatment is important in terms of life expectancy. Further chemotherapy appears useful for patients who do not reach complete local remission after radiotherapy.

Adult↗
PubMed1997

[Videothoracoscopy in the spreading evaluation of bronchogenic cancers].

Mediastinoscopy is often necessary in management of lung cancer. Progress recently achieved in the field of thoracoscopy has led us to introduce videothoracoscopy as a complement to mediastinoscopy in preoperative management of such tumors. From June 1994 to June 1995, 113 patients presenting with stage I-IIIA lung cancer underwent a videothoracoscopy before surgery. No side-effects were observed. Results obtained in this study lead us to conclude that videothoracoscopy is useful before surgery of lung cancer.

Carcinoma, Bronchogenic↗
PubMed1995

[Computerized tomography with lipiodol in the assessment of hepatocellular carcinoma].

In this paper we report the results obtained with Lipiodol CT in 39 patients with hepatocellular carcinoma (HCC). All patients had focal or multifocal nodular HCC with FNB confirmation and were all submitted to CT 15-20 days after the injection of Lipiodol in common or proper hepatic arteries during an angiographic maneuver. Lipiodol CT showed all the lesions US had demonstrated and depicted more lesions in 12 patients (30.7%)--67 lesions in all. The lesions demonstrated by Lipiodol CT were always smaller than 2 cm: 9/12 had been missed by US, 6/12 by CT and 7/12 by arteriography. In 34/67 lesions (50.7%) enhancement was homogeneous, in 29/67 (43.2%) inhomogeneous and in 4/67 cases (5.9%) Lipiodol was not retained. Lipiodol uptake depended on lesion size: if the lesion was 1-2 cm, uptake was homogeneous, while bigger lesions exhibited inhomogeneous uptake. Lesions bigger than 4 cm exhibited no Lipiodol uptake and were necrotic. A surgical resection was performed in 21/39 patients (53.8%). To conclude, Lipiodol CT is a valuable technique in the preoperative screening of HCC, particularly in the detection of additional lesions: in our series they were demonstrated in 30.7% of patients.

Adult↗
PubMed1992

[Dosimetric problems and their solution in the preparation of a 6-dual-field total-skin technique].

The six-field total skin electron irradiation (TSEI) technique needs an accurate preliminary dosimetric study. The American Association Physics in Medicine (AAPM) defined a dosimetric protocol that recommends the careful dosimetry of the horizontal, the dual and the six-dual fields by using both a cubic and a cylindrical phantoms. In our Institute, in a TSEI development program, we carried out the preliminary dosimetry according to AAPM criteria. We also investigated some dosimetric problems--e.g., the so-called "cable effect", which takes place when the detector cable in a TSEI field is not well shielded, polarity effects and photon contamination. As to the "cable effect", it is especially marked with the Markus NE2534 chamber; moreover, this effect, if not considered, can lead to overestimation of X-rays contamination.

Calibration↗
PubMed1991

[Analysis of the results of 264 cases of small breast carcinoma treated with conservative surgery and radiotherapy].

From January 1981 to December 1987, 264 patients affected with small breast cancers were treated with quadrantectomy plus axillary dissection and radiation therapy on the breast remnant (QUART). Mean age of the patients was 53 years; 124 of them were less than or equal to 50 years old (46.9%); 85 had axillary nodal metastases (32.2%), and 58 presented a primary tumor with pathologic size (greater than 2 cm) (22.9%). Overall actuarial survival at 3 and 7 years, according to the Kaplan and Meyer method, was 95.5% and 85.3%, respectively; NED survival was 85.9% and 77.4%. Twenty patients died (19 of cancer). Local relapses were 6 (2.3% on the whole and 13.3% on the whole of recurrences observed at follow-up). Local relapses were central in the quadrantectomy scar in 4/6 patients. Histology and site of the primary lesion were not correlated with a major risk of local failure. Isolated recurrences in the breast did not worsen survival. Nodal failures were 5 (1.9% on the whole of cases; 11.1% on the whole of failures). Our study confirms the role of QUART as an effective and reliable method in the treatment of small breast carcinomas.

Adult↗
PubMed1991

[Postoperative radiotherapy in the treatment of adenocarcinoma of the endometrium in pathological stage I].

We report on 49 patients with pathologic stage I endometrial adenocarcinoma who underwent postoperative whole-pelvis irradiation (RT) (45-50 Gy in 5-6 weeks) from November 1981 to December 1988. RT was performed when one or more of the following unfavorable prognostic factors were discovered: myometrial infiltration greater than 1/3 (42 cases, or 85.7%), poorly-differentiated tumor (10, or 20.4%), tubaric angles involvement (4; or 8.2%), pelvic nodal metastases (1, or 2.0%). Five-year actuarial disease-free survival was 91.4%. After an average follow-up of 58 months, we observed recurrent disease in 4 patients (8.2%) (3 cases with distant metastases, 6.1%; 1 case with vaginal relapse, 2.0%). All recurrences were observed within 18 months from treatment and occurred only in patients with both myometrial infiltration greater than 1/3 and poorly or moderately differentiated tumor. The patient with vaginal relapse had a complete response after endocavitary curietherapy, but died later on from lung metastases. None of the treated patients experienced severe complications related to the treatment. Our results are comparable with those of the most recent literature, and confirm the good tolerance and efficacy of postoperative RT to prevent loco-regional relapses in early stage endometrial cancer with unfavorable prognostic factors.

Adenocarcinoma↗
PubMed1990

Quadrantectomy versus lumpectomy for small size breast cancer.

Between 1985 and 1987 quadrantectomy plus external radiotherapy and lumpectomy plus external and interstitial radiotherapy were compared in a randomized trial of patients with small carcinomas of the breast. Quadrantectomy involves excision of 2-3 cm of normal tissue around the tumour plus the removal of a sufficiently large portion of overlying skin and underlying fascia whilst lumpectomy removes only the tumour mass with a narrow margin of normal tissue. Patients in both groups also received total axillary dissection. 705 cases were evaluable, 360 quadrantectomies and 345 lumpectomies. No differences in distant metastases and survival were observed in the two groups. However, lumpectomy patients had a much higher frequency of local recurrences (7.0 vs. 2.2%). Since a local recurrence needs a second operation and creates severe psychological distress to the patient, conservative surgical procedures should include generous excision of normal tissue around the primary carcinoma plus intensive postoperative radiotherapy.

Breast Neoplasms↗
PubMed1990

[Description and results of a simplified procedure for intraoperative electron radiotherapy].

In San Raffaele Institute a simplified procedure for intraoperative radiotherapy (IORT) was developed. An applicator system of "guide-containers" was used to facilitate the use of IORT (with electron beam) with different treatment fields. Application of this technique was studied; no IORT related complications was observed in phase I and clinical good results are reported.

Combined Modality Therapy↗
PubMed1987

Topical benzydamine in the treatment of vaginal radiomucositis.

Radiotherapy for invasive cervical cancer involves a high risk of local complications. Classically, the critical structures are the rectum, the bladder and the bony ring of the pelvis. However, endocavitary curietherapy is an important component in the radiological treatment since it delivers the highest dose to the vaginal mucosa. The anti-inflammatory efficacy of benzydamine in gynaecology, already well documented, was investigated in our controlled clinical study (benzydamine vs. placebo) involving 32 consecutive unselected patients treated by endocavitary curietherapy with 137caesium sources, alone, after radical surgery, or in association with megavoltage external irradiation. In the group with topical benzydamine, we have observed a statistically significant improvement of subjective symptomatology and colposcopic view. On the contrary in the placebo group a worsening of all the clinical parameters considered became evident.

Administration, Intravaginal↗
PubMed1984

Short-term variation in labeling index as a predictor of radiotherapy response in human oral cavity carcinoma.

In vitro determination of [3H]thymidine labeling index (LI) was carried out on squamous cell carcinomas of the oral cavity from 52 patients before and during radiotherapy. Pretreatment LI values ranged from 0.01% to 50%. After administration of the first 10 Gy in five consecutive daily fractions, a decrease in LI was observed in 39 cases and an enhancement in 13 cases, with an overall median 70% decrease in the initial value. The type of variation induced by radiotherapy was not related to pretreatment LI except for tumors with a very low proliferative activity (LI less than or equal to 1.9%), which all showed a marked increase in LI. Pretreatment LI was not indicative of short- or long-term response to radiotherapy, whereas the variation induced on LI after 10 Gy was related to the clinical outcome. A variation in LI of more or less than 70% was not significantly associated (p = 0.077) with clinical objective response (respectively, 85 and 53%). However, all 8 patients who reached a complete regression, notwithstanding an enhancement or a slight decrease in LI, had a local recurrence within 19 months. Conversely, the probability of disease-free survival was 82% for the 11 patients whose tumors had a significant decrease in LI (greater than or equal to 70%) after the first 10 Gy.

Aged↗
PubMed1984

[Radiotherapy of cervix cancer in an advanced stage].

Fifty nine stage II-distal (i.e. with involvement of medium third of parametrium and/or vagina), 220 stage III and 5 stage IV cervical carcinomas were treated with radiotherapy alone (combination of intracavitary radium therapy and megavoltage external irradiation on the pelvis) in the years 1971-79. The 5-year relapse free survival by actuarial method was 52.0% for stage II-distal and 40.6% for stage III, while all stage IV patients relapsed within the third year from the start of the treatment. Failures were pelvic recurrence in 98/227 patients with follow-up greater than or equal to 1 year (43.2%), distant metastases in 15 (6.7%), pelvic plus distant relapse in 10 (4.4%) and 2nd tumor in 2 (0.9%). In stage III patients the renal exclusion and positivity at lymphography were the major adverse prognostic factors and 5-year relapse free survival was respectively 28.5% and 19.6%. Improvement of the results can probably derive from a combined therapeutic approach with chemotherapy and radiotherapy in a sequential scheme.

Adult↗
PubMed1983

VBM chemotherapy before curietherapy in the treatment of T2 oral carcinomas.

According to previous personal experience with conventional 226-Ra sources, in T2 oral carcinomas treated with curietherapy alone the incidence of local failures was 23%. Moreover, 50% of the local relapses were marginal with respect to the treated volume. From May 1980 to November 1981, 29 T2 oral carcinomas suitable for correct curietherapy received 3 weekly courses of VBM chemotherapy: i.e., vincristine, 1 mg i.v.; bleomycin, 15 mg i.m. after 6 and 24 h; and methotrexate, 30 mg p.o. after 48 h. A full dose curietherapy was performed 2 weeks after the completion of VBM. Twenty-seven patients have had a minimum follow-up of 12 months. The overall treatment was well tolerated and immediate results were encouraging. However, the local failure rate does not seem to have decreased by the combined treatment in comparison with curietherapy alone in historical series.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Radiotherapy versus surgery in the treatment of cervix stage Ib cancer.

In the years 1971-77 we have treated 250 Stage Ib patients with cancers of the cervix. One hundred twenty-three (49.2%) underwent a radical surgery, 37 had a classical Wertheim-Meigs operation, and 86 had a lymphadenectomy that was extended to the lumbar-aortic region. When feasible, all patients received postoperative radium therapy on the vaginal vault. The remaining 127 patients received a complete course of radiotherapy. This was not a randomized clinical trial. In fact surgery was preferred for patients who were younger (mean age: 49.6 years) and more physically fit, while radiotherapy was the treatment chosen for those who were older (mean age: 57.7) and generally less fit or obese. The 5 year NED survival was 89.3% in the surgical group and 90.9% in the radiotherapy group (P less than .05). Four fatal complications were observed in the surgical group (3.2%). Rate and causes of failures or complications are analyzed in detail.

Adenocarcinoma↗
PubMed1982

Arguments in favor of precautional treatment of cervical nodes in clinically N0 oral cancer.

Our retrospective and unrandomized clinical study covers 317 squamous cell carcinomas of the oral cavity initially N0 and treated with curietherapy from January 1959 to December 1970. Upon conclusion of the treatment of T, a radical dissection of the neck was performed only on 110 patients (34.7%) and the other 207 were not submitted to surgery. The incidence of N0 N+ cases was 27.3% (30/110). The clinical evolution showed that in the group not submitted to radical dissection 53 of 179 cases (29.6%) with adequate follow-up had lymph nodal relapses; 15/69 of these were initially T1 (21.7%) and 38/110 initially T2,3 (34.5%). The data concerning clinical evolution and analysis of the survival curves for the 2 groups supply arguments in favor of the systematic treatment of the lymphatic areas of the neck in initially N0 oral carcinomas.

Humans↗