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G Frezza

Publications and source records attributed to G Frezza.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Extramedullary plasmocytoma (EMP) of the head and neck: a series of 22 cases].

Plasmacytoma is a rare neoplastic disorder arising from B-cell series lymphocytes. It can develop in three clinical variants: a) Multiple Myeloma (M.M.); b) Solitary Plasmacytoma of the bone; c) Extramedullary Plasmacytoma (EMP). EMP generally occurs in the submucosal tissue of the upper airways (80% of cases). This paper reports 22 cases of EMP of the head and neck observed in the last 20 years and reviews pertinent Literature. Four of our cases were located in the nasopharynx, four in the oropharynx and five in naso-sinusal sites. More rarely, the lesion occurred in the larynx (2 cases) or in the oral cavity (3 cases). In 4 patients multiple localizations in the upper airways were observed. Full evaluation was carried out in order to exclude disseminated disease. With the exception of 2 cases which were surgically treated, radiotherapy (RT) represented the treatment of choice in all patients, with doses ranging from 36 to 58 Gy. In 9 cases RT was administered after complete surgical resection. Follow-up time ranged from 13 to 167 months (mean 69.6). A partial response after treatment was observed in 4 cases. In only two of these cases neoplastic residue was observed (further RT allowed complete remission of the disease). In the other two cases, residual masses consisted in amyloid deposits. Three patients developed disseminated disease (MM) after a disease-free period ranging from 3 to 6 years. Five-year actuarial disease was 92%. Although surgery is generally considered a diagnostic tool, in our opinion local disease should always be removed surgically when surgery produces low morbidity. Surgical debulking of the lesion can increase the probability or local radiotherapeutic control.

Adolescent↗
PubMed1994

Erythropoietin increases the radioresistance of a clonal hematopoietic progenitor cell line expressing a transgene for the erythropoietin receptor.

Erythropoietin (Epo) is a serum glycoprotein growth factor required for the survival, proliferation and differentiation of committed erythroid progenitor cells. In the present study, we sought to determine whether the action of Epo via its receptor is also implicated in the repair of radiation-induced cell damage. Overexpression of the Epo receptor (Epo-R) was achieved as a result of transfection of the 32D cl 3 clonal hematopoietic cell line. These clonal lines allowed us to investigate the effects of Epo on the radiation sensitivity in vitro of a clonal murine hematopoietic progenitor cell line. Low level expression of Epo-R on many hematopoietic cell types was thus circumvented. Ligand binding of Epo resulted in increased radioresistance of 32D cl 3 subclonal lines expressing the Epo-R transgene. The D0 of 32D Epo-R cells at 1.49 Gy/min was 1.33 Gy and n was 1.39. The D0 of parental clonal cell line 32D cl 3 cells at 1.49 Gy/min was 1.36 Gy and n was 1.39. In contrast, at the low dose rate of 0.0595 Gy/min, the D0 of 32D Epo-R cells was 2.0 Gy and n was 1.24, while parental clonal line 32D cl 3 showed a D0 of 1.35 Gy and n was 1.39. The increased radioresistance was statistically significant at low dose rate (p < 0.05). Combined exposure to Epo and interleukin 3 (IL-3) increased proliferation of 32D Epo-R cells but did not induce a detectable further increase in radioresistance. Temporal dissociation between growth factor-activated tyrosine phosphorylation of intracellular substrates, and the radioprotective effect was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗
PubMed1994

Radiotherapy in early stage Hodgkin's disease.

Ninety-nine patients with "standard risk" Stage IA-IIA Hodgkin's disease observed between January 1983 and December 1990, received radiotherapy only. The complete response rate was 98% (97/99). Twenty-one patients (21%) relapsed, 17 of whom (81%) obtained a second complete remission. The projected 9-year overall survival and disease-free survival were 95% and 78%, respectively. In this study our goals were to reduce the irradiation volumes, to decrease the number of splenectomies performed at diagnosis, and to utilize radiotherapy alone in these patients. We were able to reduce the irradiation volumes in over 50% and 80% of the patients with disease in the upper torso and subdiaphragm, respectively. Furthermore, this therapeutic approach permitted us to reduce the acute and long-term toxic effects related to splenectomy and combined modality treatment.

Adolescent↗
PubMed1994

[In vivo dosimetry and radiographic confirmation in radiotherapy of Hodgkin's lymphoma].

In September 1991 a protocol for quality control of large shaped irradiation fields was started in our department. In vivo dosimetry with semiconductor detectors was used to measure the absorbed dose and patient positioning was checked with portal films weekly. First, we set a computed dosimetric system yielding dosimetric values in real time and allowing their easy storage. Then, we calibrated the diodes and determined the correction factors for each of them outside standard conditions. Entrance dose, exit dose and midline dose were measured in 62 patients undergoing supradiaphragmatic radiation therapy for Hodgkin's lymphoma. The exist dose was measured weekly to assess treatment repeatability. High agreement was observed between measured and calculated doses; repeatability was also high, since only 6% of exit dose measurements exceeded 5% of the first determination. In 33 patients portal films were obtained in the first treatment session, and thereafter weekly, to assess mispositioning relative to simulation (reproducibility) and from one session to another (repeatability). A small systematic error was detected in both longitudinal (x = -3 mm; SD = 3.7 mm) and transverse (x = -2 mm; SD = 3.4 mm) directions. Statistically significant errors (> 6 mm) were observed in 14% of patients. Reproducibility was excellent. The protocol reported on in this paper not only helps avoid systematic dosimetric and/or positioning errors in the patients, but also helps identify the main causes of uncertainty and thus remove them.

Hodgkin Disease↗
PubMed1992

Surgery and radiation therapy in the treatment of soft tissue sarcomas of extremities.

Between January 1979 and December 1987, 99 patients (pts.) with a diagnosis of localized soft tissue sarcoma of the extremities received preoperative radiation therapy (Preop. RT, 50 pts.) or postoperative irradiation (Postop. RT, 49 pts.). In the preop. RT group, doses ranged from 42 Gy/17 fractions to 51 Gy/17 fractions; pts. treated with RT after surgery, received a dose comprised between 46 Gy/23 fractions to 66 Gy/33 fractions. The surgical procedure consisted of making a wide resection of the mass with preservation of the affected limb, in each patient. The main cause of failure was dissemination of the disease (33.3%). The incidence of local failures was low (7.1%). Recurrences were related to the size of the disease (5 cm: 0/12; 5-10 cm: 2/45 2.3%; 10 cm: 5/42, 11.9%), as were also distant metastases. The incidence of distant failures was higher in the group treated with preop. RT (44.0% vs. 22.4%), probably because a higher percentage of patients in this group had large volume diseases. Late sequelae were evaluable in 59 pts. with a follow up longer than 24 months. The incidence of complications was low (10.1%, 6/59); it was higher in the preoperative than in the postoperative group (15.4% vs. 6.1%); this observation is probably related to the different modalities of fractionation.

Adolescent↗
PubMed1992

Massive mediastinal involvement in stage I-II Hodgkin's disease: response to combined modality treatment.

Thirty-seven patients with stage I-II Hodgkin's disease and massive mediastinal involvement, observed between June 1981 and November 1989, underwent combined modality treatment. This treatment included: 3 cycles of mechlorethamine, vincristine, procarbazine, and prednisone followed by mantle-field irradiation, and subsequently by 3 additional cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine. Thirty-five (95%) patients achieved complete responses and only 2 (5%) had partial responses. All the complete responders are living and relapse-free at a median follow-up of 62 months; no major toxic reactions were recorded. These data suggest, as did those of other studies, that combined modality therapy is superior to either radiotherapy or chemotherapy alone for patients in stage I-II with bulky disease, especially in the mediastinum. In fact, in these particular patients, if adequately treated with a combination of chemotherapy and radiotherapy, the role of massive mediastinal involvement as a poor prognostic factor appears to be less significant.

Adolescent↗
PubMed1991

[Radiosurgical combination for the treatment of soft tissue sarcoma of the extremities].

From January 1979 to December 1987, 99 patients with a diagnosis of localized soft-tissue sarcoma of the extremities received preoperative radiation therapy (50 patients) or postoperative irradiation (49 cases). In the preoperative RT group, doses ranged from 42 Gy/14 fractions to 51 Gy/17 fractions; the patients treated with postoperative radiation therapy received 46 Gy/23 fractions. The surgical procedure was in each patient complete resection of the mass with preservation of the affected limb. The main cause of failure were distant metastases (33.3%). The incidence of local recurrences was low (7.1%). Recurrences were related to tumor size [less than 5 cm: 0/12; 5-10 cm: 2/45 (2.3%; greater than 10 cm: 5/42 (11.9%)]. The incidence of distant metastases was higher in the group treated with preoperative radiation therapy (44% versus 22.4%), probably because a higher percentage of patients in this group had large tumors. Late complications were analyzed in 59 patients with a follow-up longer than 24 months. Severe complications rate was low (6/59 cases, 10.1%), and higher in the preoperative than in the postoperative RT group (15.4% versus 6.1%), which is probably related to the different fractionations administered.

Adolescent↗
PubMed1990

Combined therapy of localized Ewing's sarcoma of bone: analysis of results in 100 patients.

From 1979 to 1986, 182 patients with biopsy proven diagnosis of Ewing's sarcoma of bone were observed. One hundred of the 182 patients (72 males, 28 females, median age 15.8 years) with localized disease and no previous treatment were treated with chemotherapy (VCR, ADM, CTX, D-ACT) for 15-18 months. Local treatment was radiotherapy (42 patients), surgery (31 patients), or a combination of both (27 pts). Radiation doses ranged from 45 to 64 Gy given with conventional fractionation. Median follow-up was 51.2 months (24-106). Overall and disease-free survival were, respectively, 58.7 and 42.6%. Resected patients tended to have a better local control (Surgery 93.6%, Surgery + Radiation therapy 92.6%, Radiation therapy 69.1%). Disease-free survival was significantly related to the volume of the primary tumor (bulky: 33.2%, not-bulky: 57.7%), to site (extremities 54.6%, central sites 16.6%, other sites 40.9%), and to local treatment (Radiation therapy 30.3%, Surgery + Radiation therapy 47.9%, Surgery 59.1%). These results are, however, biased because resected patients tended to have smaller tumors in favorable sites.

Adolescent↗
PubMed1989

[Analysis of prognostic factors in 106 cases of carcinoma of the rhinopharynx treated with cobalt teletherapy].

A series of 106 patients affected with nasopharyngeal carcinomas and treated by definitive external irradiation from January 1975 to December 1986 was retrospectively reviewed. The median follow-up, from the end of the treatment, was 43 months (range 24-90). The nasopharynx received not less than 60 Gy to the midplane: the clinically negative neck (N0) was treated with a total dose of 50 Gy and the patients who had N1-3 disease received not less than 60 Gy. Thirty-eight patients had a recurrence in the irradiated areas (31 in the nasopharynx, and 7 in the neck); 17 patients developed distant metastases. Disease-free survival at 60 months was 42%. The most significant prognostic factor (p less than 0.05) was the presence of advanced neck involvement (N2-3), since most of the lymphatic and distant recurrences were observed in this group of patients. The overall results did not reveal but slight differences in the survival according to histology, even though patients with undifferentiated carcinomas had a local recurrence rate significantly lower than those with squamous cell carcinomas. Our findings suggest that patients with N2-3 neck diseases or with locally advanced involvement (T3-4) be treated by adjuvant chemotherapy in order to decrease the risk of local and distant relapses.

Adolescent↗
PubMed1988

Radio-induced sarcomas in survivors of Ewing's sarcoma.

Of 255 cases of Ewing's sarcoma recorded at the Bone Tumor Center of the Rizzoli Orthopaedic Institute, 78 patients (irradiated and with a follow-up of longer than 3 years) were considered "at risk" for the development of a second radio-induced sarcoma (RIS). Three of the 78 patients developed an RIS in the irradiated field. Theoretical and statistical analyses were carried out considering different modalities of local treatment. Statistically, the only significant factor was related to the irradiation dose. Surgical resection seems to prevent RIS.

Adolescent↗
PubMed1987

[Radiotherapy of carcinoma of the glottis in the initial stage].

The control of early glottic cancer is equally satisfactory with either surgical resection or radiation therapy; this last method gives the patient good functional results. During the period from 1/1978 to 12/1985, 73 patients with early glottic carcinoma (T1 N0 M0) were treated in the Institute of Radiotherapy L. Galvani, University of Bologna; 45 were stage T1a (tumour limited to one vocal cord) and 28 were stage T1b (tumour of both vocal cords or involving anterior commissure); radiation treatment utilised a 60Co machine and 5 x 5 cm fields; the median dose was 67.2 Gy (range 50-76) with conventional fractionation. Ten patients had local recurrence; the median time of recurrence was 13.4 months; 9/10 were treated by surgery and 2/10 died, so the overall control by radiotherapy with surgery in reserve was 100% in T1a tumours and 90.6% in T1b ones. The 5-years disease free survival rate was 93.1% in T1a tumours and 69% in T1b; lesions involving anterior commissure had the worst prognosis, independent of the dose and time-dose factor (3/10 recurrences in the group treated with TDF less than 110 and 4/18 recurrences in the group with TDF more than 110).

Adult↗
PubMed1986

Patterns of failure in nasopharyngeal cancer treated with megavoltage irradiation.

From 1976 to 1982, 78 patients with nasopharyngeal cancer (NPC) were treated with definitive megavoltage irradiation in accordance with a uniform protocol. The results of treatment were analyzed and prognostic factors reviewed. The incidence of primary failures was directly related to the extent of nasopharyngeal disease, since the relapse rate was 11% in T1T2 patients compared with 37.5% in T3T4 patients. Similarly, failure in the neck correlated with the N stage, being negligible for N0 and N1, while 35.7% for N3. The presence of bulky cervical nodes was associated with a higher risk for metastases: hematogenous dissemination occurred in 50% of N3B patients. The histology pattern seemed to significantly affect the ultimate outcome of patients with NPC, since disease-free survival was 65.5% in patients with a diagnosis of undifferentiated carcinoma (UC) and 23.8% in patients with squamous cell carcinoma (SC). The major cause of poor survival in this latter patient group was not only a higher recurrence rate of both primary and nodal disease but a greater incidence of distant metastases as well.

Carcinoma↗
PubMed1984

Serum LDH concentration in non-Hodgkin's lymphomas. Relationship to histologic type, tumor mass, and presentation features.

Serum lactate dehydrogenase (LDH) activity is increased in many tumor-bearing patients and can be used as a prognostic marker. We studied serum LDH concentration in 94 consecutive patients with non-Hodgkin's lymphoma who were histologically classified according to the Kiel Classification and were grouped according to the Non-Hodgkin's Lymphoma Pathologic Classification Project Working Formulation. 74 patients were studied at diagnosis, and 20 of them (27%) had an LDH level higher than 250 U/l. High LDH levels were more frequent in cases of true histiocytic, high-grade, and intermediate-grade malignancy lymphoma (4 of 7, 7 of 14, and 7 of 20, respectively) than in cases of low-grade lymphoma (2 of 33). A close relationship of LDH to several prognosis-related disease features was found, including general symptoms, bulky disease, big mediastinal tumor, huge hepatosplenomegaly, bone marrow involvement, and a leukemic syndrome. LDH was higher than normal in a high proportion of cases who were studied in relapse (13 of 20, 65%). These data suggest that in non-Hodgkin's lymphomas the LDH serum concentration is not independent of other disease features, so that the prognostic value of LDH is probably lower than expected from previous studies. Serum LDH activity decreased to normal in all cases of complete remission, but also in cases of partial remission, suggesting that measuring enzyme activity is of a limited usefulness for detecting and monitoring minimal residual disease. For that purpose, LDH isoenzyme studies would be more appropriate.

Adolescent↗
PubMed1983

Prognostic significance of large mediastinal involvement in Hodgkin's disease.

Relapse rates of 75 patients with previously untreated Hodgkin's disease with stages I and II nodular sclerosis were analyzed according to the mediastinal involvement. The overall relapse rate was 22.6%. The probability of relapse was much greater for patients with large mediastinal involvement (66.6%) compared with 17% for patients with small mass, and 11.7% of patients without mediastinal involvement (P less than 0.001). There was no significant difference in recurrence rates between patients without mediastinal mass and patients with a small mass, and in these patients adjuvant chemotherapy MOPP after radiotherapy showed an evident benefit in reducing the relapse rate. On the other hand, no beneficial effect of adjuvant chemotherapy was observed in patients with large mediastinal involvement. Finally, in the 17 relapsing patients, 'salvage' chemotherapy was less effective in patients with large mediastinal mass than in those with small or no mediastinal involvement.

Adolescent↗