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L Cionini

Publications and source records attributed to L Cionini.

At least 37 records · Page 2Linked to original sources
PubMed1988

Radiation therapy and chemotherapy in the management of testicular seminoma: a review.

Since the early '50s, radiation therapy has been regarded as the mainstay of treatment for testicular seminoma. In the last decade, however, several reports claimed optimal control (about 80% of lasting complete remissions) of advanced disease with cisplatin-containing chemotherapy regimens, consequently questioning the opportunity of irradiation in bulky retroperitoneal presentation. The respective role of radiotherapy and chemotherapy in the management of advanced locoregional seminoma has been reviewed, in view of the fact that our data, previously unpublished, show a 10-year disease-free survival probability of 70% for 27 bulky stage II patients submitted to irradiation. On the grounds of currently available data, a prospective randomized trial of chemotherapy versus radiotherapy in stage II testicular seminoma seems justified, in order to identify the optimal treatment policy for this disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Dysgerminoma of the ovary: a report on 29 patients.

Twenty nine patients with pure dysgerminoma of the ovary were referred to the Institute of Radiology of the University of Florence between 1960 and 1983. Twenty six patients received radiation therapy after surgery; three cases, classified as Stage IA, were not submitted to postoperative radiation therapy. Five patients relapsed 2 to 16 months after initial surgery, and three of them died because of their tumours. Sites of relapse were found to be outside the treated volume in four out of these five patients. The overall survival rate for this series is 90%. The survival rate seems to depend not only on the stage of the disease, but also on initial accurate staging and appropriate therapy. Criteria for selecting patients from whom post-operative radiotherapy may be withheld are discussed.

Adolescent↗
PubMed1987

Modifications of relaxation times induced by radiation therapy in cervical carcinoma: preliminary results.

Pelvic Magnetic Resonance Imaging (MRI) was performed in eight healthy women and in eight patients with carcinoma of the cervix, using a 0.5 T superconductive magnet, to evaluate relaxation times of the normal uterine cervix and carcinomas. Spin-lattice (T1) and spin-spin (T2) relaxation times for skeletal muscle, adipose tissue and bone marrow of the epiphysis of the femur were also measured in all cases. In the group of patients with carcinoma of the cervix MRI was performed before, during and after radiation therapy. The mean T1 and T2 values for the normal uterine cervix and cervical carcinoma were evaluated. Mean spin-lattice time for carcinomas were confirmed to be higher than the mean calculated value for the normal cervix, while no significant variation was observed with respect to spin-spin time. A high individual T1 and T2 variability was noted not only in the group of patients affected by cervical carcinoma, but among the healthy subjects too. After radiation therapy a mean T1 time reduction of approximately 20% was found in cervical carcinomas compared with pretreatment measurements, whereas no difference was evident for T2 time. These preliminary results confirm that reduction in spin-lattice time is demonstrated in tumours submitted to radiation therapy. More detailed biological information, such as percentages of vital and necrotic cells, tissue water content and cellular kinetics are probably necessary for a clearer understanding of this phenomenon even in an apparently homogeneous group of patients.

Adult↗
PubMed1986

Cost-effectiveness of chest X-ray follow-up of patients treated for seminoma of the testis.

The authors report on a consecutive series of 253 cases of seminoma of the testis followed with periodic chest X-ray examinations from a minimum of three to a maximum of 27 years. The detection rate of asymptomatic intrathoracic metastases (ITM) was considered together with the costs of the follow-up procedure. Chest X-ray follow-up is not advisable beyond one year from primary treatment, since most (14 of 18) ITM occur in the first year, the detection rate of ITM beyond this date is too low (0.11% patients/year), and the related costs are too high (over $130,000 per ITM detected). Chest X-ray follow-up is questionable even in the first year after primary treatment for Stage I cases because of the low detection rate (1.38% patients/year) and the high costs (over $14,000 per ITM detected), whereas it appears to be opportune in Stages IIA and IIB.

Cost-Benefit Analysis↗
PubMed1986

Symptomatic recurrences of carcinoma of the rectum and sigmoid. The influence of radiotherapy on the quality of life.

One hundred forty-three patients irradiated for locoregional recurrences after curative surgery for cancer of the rectum and sigmoid were studied retrospectively. An analysis was made of the symptomatic response and survival in the total series and in three subgroups treated with different dose levels (40 Gy or lower, between 40 and 50 Gy, 50 Gy or higher). The symptom-free period was calculated as percent of the overall survival. Symptomatic control was obtained in 80.4 percent of the cases, and the crude patient survival rate was 17.5 percent at two years. No significant difference was found in the three subgroups treated with different dose levels. The cumulative time/patient asymptomatic periods in the total series and in the three subgroups were 31.5, 30.2, 31.8, and 31.9 percent respectively, of the survival period.

Adult↗
PubMed1985

Waldeyer's ring (WR) involvement in Hodgkin's disease.

Of 750 patients with stage I, II or III Hodgkin's disease, admitted to the University and Hospital Radiotherapy Divisions, Florence, between 1960 and 1981, 28 (3.7%) had involvement of Waldeyer's ring (WR). In 25 patients there was associated involvement of upper cervical nodes. Other factors associated with WR involvement were age over 55 years, lymphocyte predominant histological sub-type, uninvolved mediastinum, and size of involved upper cervical nodes greater than that of involved lower cervical nodes. These factors help to define indications for prophylactic irradiation of WR.

Adolescent↗
PubMed1984

Plasma amylase activity as a biochemical indicator of radiation injury to salivary glands.

Irradiation of the salivary glands produces a rapid increase of salivary amylase in serum, released by the highly radiation sensitive serous cells of the glands. Serial assays of salivary amylase in serum were performed in patients treated by radiation to the upper neck region. The changes observed were compared with the amount of salivary gland mass irradiated and with the dose fractionation modality used. The irradiated volume included either the entire salivary gland mass or less than 50 per cent of the gland. Two fractionation modalities were used: a conventional fractionation of 2 Gy per day, 5 times a week, or a multiple daily fractionation of 2 Gy, 3 times a day in two series of 4 days with a 4-day interval. Both parameters (salivary gland mass irradiated and fractionation modality used) significantly influenced the shape of the amylase curve in the serum. Serum amylase may therefore be considered a reliable biologic indicator of early injury to the salivary glands.

Adolescent↗
PubMed1984

Respiratory function tests after mantle irradiation in patients with Hodgkin's disease.

Pulmonary function tests were performed in 43 patients with Hodgkin's disease before mantle irradiation and at 3, 6, 9, 12 and 15 or more months thereafter. Treatment was given with a telecobalt unit to a total dose of 36 to 42 Gy, the higher dose being reserved for cases with considerable mediastinal involvement. The functional parameters explored included static and dynamic lung volumes, gas exchanges, ventilatory efficiency, and airway resistance. Measured parameters were expressed as a percentage of the pre-treatment value (PTV) in the individual patient. In the whole group, only small variations in the functional indices were observed at 3 to 6 months after mantle irradiation. In patients with normal PTVs a greater variation in static and dynamic volumes was observed at 3 to 6 months after mantle irradiation, with complete recovery thereafter. The gas exchange parameters also showed a similar variation at 3 to 6 months but no recovery was demonstrated in the subsequent examinations. No changes in ventilatory efficiency and airway resistance were observed. In patients with abnormal PTVs, usually presenting large mediastinal adenopathy, all parameters improved after mantle irradiation, and the favourable effect of tumour regression was probably more important than the radiation damage on the pulmonary parenchyma.

Adolescent↗
PubMed1982

Stage I and II Hodgkin's disease presenting in infradiaphragmatic nodes.

Twenty patients with Hodgkin's disease limited to infradiaphragmatic (ID) nodes have been treated at the University and Hospital Radiotherapy Departments in Florence between 1960 and 1978. Clinicopathologic features and treatment modalities of these patients were reviewed and results compared with those of 2 similar series previously published by other authors. With respect to the patients with disease above the diaphragm, the ID presentation occurred more often in males in all the 3 reviewed series; a relative prevalence of the lymphocytic predominance histotype and of an older age was observed in 2 only of the 3 series; laparatomy seems unnecessary in lymphographic-negative patients. The analysis of therapeutic results suggests that inverted Y irradiation is a sufficient treatment when inguinal or lower iliac nodes only are affected; paraortic region and spleen involvement warrant a more radical program including the supradiaphragmatic irradiation or systemic chemotherapy.

Adolescent↗
PubMed1982

Mediastinal involvement in Hodgkin's disease: prognostic factors and distribution of intrathoracic adenopathies.

The files and the roentgenographic documentation of 624 patients affected by Hodgkin's disease have been reviewed. The presence and location of involved nodes in the different lymph node chains of the mediastinum have been determined and correlated with the distribution of the main anatomoclinic prognostic parameters of the disease. Feminine sex, histology of nodular sclerosis, presence of constitutional symptoms and age younger than 36 were found to be significantly more frequent in patients with mediastinal adenopathies than in patients with a normal mediastinum. Patients with mediastinal adenopathy at presentation were also more likely develop pulmonary involvement as first evidence of new manifestation of disease after the primary treatment. A different probability to be affected by disease was evident among the different lymph node groups in the mediastinum. The involvement of hilar nodes appeared to accompany a more advanced stage of disease and to favour the adjacent lung extension.

Adolescent↗
PubMed1982

Postoperative radiation therapy after vaginal surgery for endometrial cancer.

From 1958 to 1978, 88 consecutive patients affected by endometrial cancer were referred to the Radiology Institute of the University of Florence, for radiation therapy after vaginal hysterectomy and bilateral salpingo-oophorectomy. Five and ten-year actuarial survival rates are 71% and 62%. In the evaluable patients, results are analysed according to: extension of the tumor, as assessed by pathological evaluation (60 pats.), histologic grade of differentiation (44 pats.), and neoplastic infiltration of myometrium (32 pats.). When the tumor is limited to the uterine body, a 5-year actuarial survival is achieved in 89% of the cases; when the cervix or the adnexa and other pelvic structures are involved, this percentage decreases to 62.5% and 37.5%. The prognosis is also affected by the histological grade of differentiation and the depth of myometrial infiltration.

Actuarial Analysis↗
PubMed1982

Postoperative radiation therapy after vaginal surgery for endometrial cancer.

From 1958 to 1978, 88 consecutive patients affected by endometrial cancer were referred to the Radiology Institute of the University of Florence, for radiation therapy after vaginal hysterectomy and bilateral salpingo-oophorectomy. Five and ten-year actuarial survival rates are 71% and 62%. In the evaluable patients, results are analysed according to: extension of the tumor, as assessed by pathological evaluation (60 pats.), histologic grade of differentiation (44 pats.), and neoplastic infiltration of myometrium (32 pats.). When the tumor is limited to the uterine body, a 5-year actuarial survival is achieved in 89% of the cases; when the cervix or the adnexa and other pelvic structures are involved, this percentage decreases to 62.5% and 37.5%. The prognosis is also affected by the histological grade of differentiation and the depth of myometrial infiltration.

Adult↗
PubMed1981

Hodgkin's disease associated with sarcoidosis: case report.

Coexistence of true systemic sarcoidosis and Hodgkin's disease has been reported as a very exceptional occurrence. In this paper a case observed at the Institute of Radiology of Florence is described of which the most interesting features were 1) sarcoidosis appeared 5 years earlier than Hodgkin's disease; 2) at staging lymphography the paraortic nodes appeared extensively enlarged and showed multiple filling defects; 3) at laparotomy the nodes removed were histologically affected by sarcoidosis only; 4) multiple foci of sarcoidosis were found also in the spleen and liver; 5) this feature led us to refrain from irradiating the abdomen; 6) one year later a further enlargement of paraortic nodes was observed; 7) a second laparotomy revealed Hodgkin's infiltration in the removed nodes; 8) irradiation of the inverted "y" field was followed by complete regression of the nodes and the patient is alive and well 2.5 years after the relapse.

Adult↗
PubMed1981

Computed tomography and lymphography of the retroperitoneal space in testicular tumors. A comparison.

The value of CT and lymphography of the retroperitoneum was compared in 31 patients with testicular tumors. In no patient with normal or equivocal lymphography was more information gained by CT. In abnormal cases, the presence of metastatic deposits was well detected at both examinations, but CT proved more useful in defining the exact extent of the tumor and facilitated the proper arrangement of the irradiation fields. A strategy in the sequence of investigation in testicular tumors is suggested, aiming to save CT time when CT information is not likely to be of significance for treatment planning.

Adult↗
PubMed1980

Salvage with radiotherapy of postsurgical relapses of endometrial cancer.

From January 1960 to June 1974, 71 patients with a postsurgical relapse of endometrial adenocarcinoma have been referred to the Radiology Institute of the University of Florence. Eleven patients showed hematogenous metastases; the remaining 60 cases showed locoregional relapses and were treated with radiotherapy. Forty-eight patients, whose relapse was localized to the pelvis, vagina, inguinal nodes or perineal scar, were treated with a radical aim (4,500-6,000 rad in 5-6 weeks); the treatment was palliative in 12 cases with abdominal extrapelvic relapse. The therapeutic response was not evaluated in 8 patients lost to follow-up shortly after the treatment. In the cases treated with a radical scope, a complete regression was attained in 22 of 43 (51%); a survival rate of 16 of 43 (37%) was attained at 5 years. In 9 cases treated with a palliative aim, only subjective remission was attained, and no patient was alive one year after the therapy. The most favorable therapeutic response was attained in the vaginal relapses (50% survivors at 5 years) and the cases with a late recurrence (more than 3 years) after the initial surgery. No definite correlation was found between the prognosis of the relapse and the histological grading of the primary tumor.

Adenocarcinoma↗
PubMed1980

Radiotherapy for postoperative failures of carcinoma of the cervix uteri.

A series of 115 patients with a local postsurgical recurrence of carcinoma of the cervix uteri, treated with radiotherapy, were analyzed. Recurrences were subdivided into three categories based upon the site and extent of the disease, namely central, peripheral limited and peripheral massive recurrences. The objective and symptomatic response to the treatment and long term survival were examined separately for each category of lesion. Several correlations were attempted between the extension of the recurrence and the survival of treated patients and some clinical features, such as the length on the interval from primary operation, type of operation, age of the patient and the objective response to treatment. Only the objective response to treatment seems to be related to survival which was evidently better in complete responders. Local radiation achieved good results in the treatment of reported recurrence, depending mainly on the extent of the disease; those in the central recurrences group had the best results, with a high five year cure rate; in peripheral limited recurrence group, the curve rate was significantly lower, while, in peripheral massive recurrence group, palliation was the result.

Female↗