Biomedical subjects

M G Ruo Redda

Publications and source records attributed to M G Ruo Redda.

8 recordsLinked to original sources

PubMed2002

CT-MRI image fusion for delineation of volumes in three-dimensional conformal radiation therapy in the treatment of localized prostate cancer.

The objective of this study was to assess the utility of CT-MRI image fusion software and compare both prostate volume and localization with CT and MRI studies. We evaluated the differences in clinical volumes in patients undergoing three-dimensional conformal radiation therapy for localized prostate cancer. After several tests performed to ensure the quality of image fusion software, eight patients suffering from prostate adenocarcinoma were submitted to CT and MRI studies in the treatment position within an immobilization device before the start of radiotherapy. The clinical target volume (CTV) (prostate plus seminal vesicles) was delineated on CT and MRI studies and image fusion was obtained from the superimposition of anatomical fiducial markers. A comparison of dose-volume histograms relative to CTV, rectum, bladder and femoral heads was performed for both studies. Image fusion showed a mean overestimation of CTV of 34% with CT compared with MRI. Along the anterior-posterior and superior-inferior direction, CTV was a mean 5 mm larger with CT study compared with MRI. The dose-volume histograms resulting from CT and MRI comparison showed that it is possible to spare a mean 10% of rectal volume and approximately 5% of bladder and femoral heads, respectively. This study confirmed an overestimation of CTV with CT images compared with MRI. Because this finding only allows a minimal sparing of organs at risk, considering the organ motion during each radiotherapy session and the excellent outcomes of prostate cancer treatment with CT based target identification, we are still reluctant to reduce the CTV to that identified by MRI.

Adenocarcinoma↗

PubMed1999

Small cell carcinoma of the esophagus.

Small cell carcinoma of the esophagus (SCEC) is a rare tumor with its particular biologic features, distinct from squamous and glandular carcinoma of esophagus. Although initial symptoms can be similar (with metastatic dissemination and paraneoplastic syndromes at presentation more frequent in SCEC), differences in age and sex distribution, tumor location, radiological and endoscopic findings, clinical course and prognosis have been observed between SCEC and other esophageal malignancies. SCEC should be considered a systemic disease, and by analogy to bronchogenic small cell carcinoma, multimodality approach including chemotherapy is recommended. In patients with limited disease, irradiation or surgery should be offered after induction chemotherapy to manage local disease. However, optimal treatment schedule has not yet been defined. In the future, registration of all SCEC cases and careful analysis of prognostic factors in the larger multi-institutional series could contribute to further progress in treatment outcome.

Carcinoma, Small Cell↗

PubMed1994

The cost of hyperthermia: nine years experience at the Radiation Therapy Department of the Turin University.

BACKGROUND: In this paper the authors try to quantify the expenditure for the equipment, staff, treatment per patient and research, sustained at the Radiation Therapy Department of the University of Turin for the treatment of cancer with hyperthermia, METHODS: Two hyperthermic computerized devices are available: the SAPIC SVO3 multifrequencies system (915, 434 and 2-30 MHz) for external hyperthermia, and the SACEM system. working only with the frequency of 915 MHz, for interstitial and intracavitary heating. From September 1983 to December 1991, 408 patients have been treated with hyperthermia, for a total number of treated sites of 483; 2960 heating sessions were performed, with a average of six sessions per patient. RESULTS: The overall cost of our "hyperthermia project" was about 2,000,000,000 Italian liras; the equipment cost was estimated at 1,258,650,000 Liras (839,100 US$), and the cost per treatment and per heat session at about 3,985,200 (2676 US$) and 664,200 liras (443 US$), respectively. The cost of the research program can be estimated in 175,000,000 liras (116,666 US$). The National Health System provides for a partial reimbursement of 2,000,000 liras (1,333 US$) for each course of hyperthermia. Taking into account the mean expected life expectancy and increasing purchases for replacement of equipment, these costs increase 10% each year. As regards the cost-benefit problem, using the Rees formula it varies from 1112 US$ when hyperthermia is used as elective treatment to 3380 US$ when hyperthermia is used as palliative treatment. CONCLUSIONS: Hyperthermia is, in our experience, an expensive therapy.

Hospitals, University↗

PubMed1994

[The exclusive radiotherapy of tumors of the paranasal sinuses. A retrospective analysis of 73 cases].

Seventy-three cases of paranasal sinus tumors observed between 1980 and 1991 were retrospectively analyzed. Our series consisted of 50 men and 23 women aged 43 to 83 years. Histology demonstrated 33 squamous cell carcinomas, 20 adenocarcinomas, 10 undifferentiated carcinomas, 3 mucoepidermoid carcinomas, 3 adenoid-cystic carcinomas, 2 osteosarcomas, 1 fibrosarcoma and 1 melanoma. All patients were untreated. The lesions from maxillary sinus consisted of 3 T2, 13 T3 and 39 T4 tumors; 50 cases were N0 and 5 N+. "Central" neoplasms consisted of 6 stage I, 7 stage II and 5 stage III lesions. All patients underwent irradiation (with 60Co) with two angled fields or three fields -2 opposing lateral and 1 anterior. Critical structures were shielded when possible and wedges were used to optimize dose distribution. Locoregional lymph nodes were treated in N+ cases only. Dose distribution was studied on CT images. All patients received a total dose of 54-72 Gy (mean: 61.4, median: 62 Gy) with 1.8-2 Gy/day fractions for 5 days/week. After irradiation 27/73 (30.8%) complete responses were observed. Local control at 6 months was obtained in 17/73 cases (23.3%) and it was correlated with the total dose. Actuarial survival rates at 3 and 5 years were 27.9% and 21.8%, respectively. At the multivariate analysis, the only significant variable was the stage; no correlations were found with sex, histology and site. During follow-up, lymph node metastases were observed in 4/66 initially N0 cases. Distant metastases were found in 10/73 patients (13.7%) and secondary lesions in 8/73 (11%). Severe complications were observed in 7/73 cases (9.6%).

Adult↗

PubMed1994

[Radiotherapy results in the treatment of malignant tumors of the nasal fossa and vestibule].

The authors report their personal experience in the treatment of malignant tumors of the nasal cavity and vestibule with irradiation alone or combined with surgery. From January 1976 to December 1989 we treated 40 patients with 22 squamous cell carcinomas, 12 adenocarcinomas or other glandular types, and 6 other histologic types of lesions: 23 patients received irradiation alone and 17 patients were treated with surgery and postoperative irradiation. The protocol included surgery as the treatment of choice: irradiation alone was administered to inoperable tumors or to the patients refusing surgery; postoperative irradiation was given when macroscopic or microscopic residual disease was observed after surgery or to particular histologic types. In the whole series of patients, 3- and 5-year local control rates were 70% and 50%, respectively; better results were obtained in the patients receiving the combined treatment (64% at 5 years) than in the patients receiving irradiation alone (43% at 5 years). Disease stages (I and II versus III and IV) were the only statistically significant prognostic factor; worse results in irradiated patients might be due to the higher rate of advanced lesions in this group. Salvage therapy (irradiation in 8 cases, surgery in 2 and chemotherapy in 1) was successfully performed in 5 of 11 treated patients. The 3- and 5-year overall survival rates were 88% and 70%, respectively. Severe complication rate was lower than 10% (3 cases only).

Adenocarcinoma↗

PubMedDate not supplied

[Invasive thermometry and prognostic thermometry in radiological hyperthermia].

The term radiological hyperthermia is used to describe the exposure of biological tissues to temperatures just above physiological ones, namely between 42 and 45 degrees C. A machine for hyperthermia (SAPIC SV03 produced by Aeritalia, Caselle, Turin) is been experimentally used at the authors' institute. The present study aims to analyse the technical and qualitative aspects of temperature control using invasive and previsional thermometry. The term invasive thermometry is used to describe the insertion of small teflon catheters into the biological body through which thermometric probes are introduced to control deep temperature. Previsional thermometry is the phrase used to describe the computer simulation of hyperthermic treatment, starting from knowledge of the tissue to be heated and the type of applicator used. The simulated treatment and the real temperature measured are then compared in order to optimize the treatment used.

Equipment Design↗

PubMedDate not supplied

[Radiotherapy of non-neoplastic diseases: the situation in Piedmont].

The authors report the results of a census among the Piedmont region radiation therapy departments during the period 1980-1991 concerning non antineoplastic radiotherapy. Eight out of eleven centers respond to the questionnaire. During the period considered 36,480 patients were treated, with an annual mean of 4056; the number of treated patients varies from 1.2% to over 71.3% in the different centers when compared to the number of neoplastic patients. Arthrosis, osseous angioma, cheloides and verruca were the most treated diseases. Plesioroentgentherapy and roentgentherapy were normally employed; telecesium and telecobalt therapy were also used; only two centers used electron beams or brachytherapy. The doses of radiotherapy were not uniform; also patients' information and follow-up criteria were quite different in the various centers. The authors conclude with a guidelines for future radiotherapy in benign diseases.

Humans↗

PubMedDate not supplied

Brachytherapy and local control.

Locoregional control of primary tumor is fundamental to cure since only in one third of patients the onset of distant metastases is the major cause of therapeutic failure. Thus recently, all therapeutic approaches aimed at the enhancement of locoregional control have been considered with growing interest. More particularly, brachytherapy alone or in combined modality therapy as an important option in the local treatment of various malignant tumors, has been widely used; this being related to the now available information on dose-rate, remote after-loading procedures, the new, safe and handy radionuclides and computerized dosimetry systems which allow a more accurate and rapid dose calculation. These advances have led to a wider application of brachytherapy. Together with the classical indications for head and neck and cervical tumors, brachytherapy plays now a well-established role in the treatment of breast, brain, gastrointestinal, genitourinary, soft tissue lung and eye tumors.

Bile Duct Neoplasms↗