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V Valentino

Publications and source records attributed to V Valentino.

At least 19 recordsLinked to original sources
PubMed2000

Radiosurgery in the management of pediatric brain tumors.

A total of 114 patients with benign and malignant intracranial tumors were treated by Valentino at the Flaminia Radiosurgical Center using a Philips 6-MeV linear accelerator between 1987 and 1995. The tumor locations break down as follows: 36 in the cerebral hemispheres, 14 in the region of the hypothalamus/optic chiasm, 21 in the III ventricle/pineal region, 3 in the basal ganglia, 27 in the posterior fossa, 13 in the brain stem. Seventy-nine patients had multivariate/combined treatment consisting of surgery or biopsy followed by chemotherapy, radiotherapy and/or radiosurgery. Thirty-five were not operated on or biopsied but were treated primarily by radiosurgery, which was associated with chemotherapy and conventional radiotherapy. The short- and long-term results were evaluated separately for each pathology in an attempt to derive guidelines for future treatment. For tumors of the pineal region, we are of the opinion that radiosurgery is the treatment of choice in children and that more than one-third of patients can be cured by this means. The remaining patients require surgery and/or chemotherapy in addition. For medulloblastomas radiosurgery may be useful to control local recurrence if coupled with chemotherapy. In the case of ependymomas, partly because of the extreme malignancy of the lesions in our series, radiosurgery did not succeed in controlling local recurrence. We fear that limiting treatment to radiosurgery, rather than prescribing conventional radiotherapy when indicated, could permit CNS seeding. For craniopharyngiomas radiosurgery proved useful for controlling solid remnants. In glial tumors radiosurgery helped either to "sterilize" the tumor bed after removal or to treat remnants of the lesions in critical areas; for diffuse brain stem gliomas it should be considered the treatment of choice.

Adolescent↗
PubMed1995

The results of radiosurgical management of 139 single cerebral metastases.

Between March 1984 and June 1993, linac radiosurgery was performed in 139 patients for single brain metastases, using the non-invasive (Greitz-Bergström) head fixation system. This atraumatic system was utilized for subsequent stereotactic CT/NMR staging to obtain strictly comparable neuro-imaging. Thus, tumour response was evaluated precisely and radiosurgery repeated (straight after the diagnostic sitting), as needed. No hospitalization or anaesthesia was necessary. The 25 mm target was the maximum size to avoid the risk of radiation induced reactions. In metastases exceeding this limit single doses were directed at more than one target at the same session. Focusing upon single or multiple targets was facilitated by 3-D stereotactic NMR. The results after one single sitting were compared with those obtained after staged sittings in the same patients. Radiosurgery achieved disappearance or shrinkage of the metastasis with resolution of the oedema and mid-line shift in 86% of the 139 patients treated. In 47% of them, however, the success was the result of repeat radiosurgery and staged sittings. The non-invasive procedure is the keystone to optimize the radiosurgical results.

Adult↗
PubMed1995

Tumour response and morphological changes of acoustic neurinomas after radiosurgery.

Twenty-seven of the 1560 patients treated by radiosurgery during the period 1984-1993 had acoustic neurinomas. Four cases were excluded from this study because they had a follow-up of less than 2 years. There were 24 neurinomas treated in 23 patients as one patient had a bilateral tumour. Seven patients underwent radiosurgery for a recurrent tumour (already operated on once or twice), while it was the first treatment for 16 patients. The tumour volume ranged from 1.99 cm3 to 18.30 cm3, and the patient follow-up was from 2 to 8 years. To determine the target on CT/NMR for linear accelerator stereotactic irradiation, the Greitz-Bergström non-invasive head fixation device was used. It was again adopted for subsequent serial imaging, and for repeat radiosurgery when necessary. The total peripheral tumour dose ranged from 12 to 45 Gy. In 9 patients there was a reduction in tumour volume varying from 39 to 100%, while 14 of the neurinomas appeared stable after an average follow-up of 3 years. In one patient there was an increase in size of the tumour. Variable morphological changes were present in 66% of the neurinomas treated. Radiosurgery is indicated as an alternative to microsurgery for inoperable patients and for those who refuse surgery, for recurrent tumours, and as a post-operative complementary treatment for partially removed tumours. A gradual approach to radiosurgery, depending on tumour response, allows a greater efficacy with minimal risk. In the present series no complications were observed. Hearing was preserved at almost the same level as that prior to radiosurgery in all patients.

Adult↗
PubMed1994

Magnetic resonance guided radiosurgery in children: tridimensional extrapolation from isodose neuroimaging superimposition.

In stereotactic radiosurgery, thin external beams of ionizing radiation concentrated in a single dose onto a sharply defined target are employed to treat lesions within the brain, avoiding doses which may produce unwanted damage to the surrounding healthy tissue. The dynamic irradiation technique used with the linear accelerator employs variable arcs of irradiation rotating around the isocenter of the target. The technique of stereotactic magnetic resonance (MR) guided radiosurgery is supported by a dedicated computerized system for treatment planning simulation. The system, based on a personal computer, allows the acquisition, reconstruction, and visualization of the target volume from MR images, and permits calculation and visualization of a three-dimensional dose distribution directly superimposed upon MR images of the lesion. The desired goal of destroying neoplastic tissue without damaging cerebral parenchyma is of particular importance in children. Consequently, adapting the three-dimensional isodose profiles to the morphology of the lesion to be treated is crucial. From this, the importance of the computer simulation is evident, as it permits one to go deeply into the study of isodose distribution, changing beam collimation, and the number and amplitude of arcs of irradiation.

Brain Neoplasms↗
PubMed1994

Cardiovascular adaptation to cyclosporine-induced hypertension.

Arterial hypertension is a complication of cyclosporine therapy in heart transplant recipients. We studied cardiovascular adaptation to cyclosporine-induced hypertension by determining haemodynamic and echocardiographic indexes in 25 cardiac transplant recipients matched by mean arterial pressure, age, sex, height and weight to 25 patients with established essential hypertension. Twenty-five normotensive subjects matched by age, sex and body habitus were used as controls. Systemic vascular resistance was 15% higher (P = 0.07) and cardiac and stroke volume indices were 20% and 25% lower (P < 0.01), respectively, in the hypertensive cardiac transplant recipients compared with patients with essential hypertension. Patients with essential hypertension and hypertensive cardiac transplant recipients had greater posterior wall thickness and left ventricular mass index than normotensive subjects (P < 0.01); however, hypertensive cardiac transplant recipients had a greater left ventricular mass (245 +/- 7 vs. 223 +/- 8 g, P < 0.05) than patients with markedly established essential hypertension. Left ventricular ejection fraction was significantly lower in hypertensive cardiac transplant recipients when compared with either normotensives or patients with established essential hypertension. These results indicate that established essential and cardiac transplant hypertension are associated with markedly increased systemic vascular resistance. However, after heart transplantation, hypertension is associated with higher systemic vascular resistance, lower cardiac output, stroke volume and stroke work compared with patients with established essential hypertension at the same level of mean arterial pressure. The cardiac adaptation to cyclosporine-induced hypertension has more severe concentric left ventricular hypertrophy and impaired left ventricular systolic performance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed1993

The results of radiosurgical management of 72 middle fossa meningiomas.

Of 812 patients with intracranial tumours treated by radiosurgery during the period 1984-1990, 129 had meningiomas. Of these latter, 72 had middle fossa meningiomas. Patients with meningiomas treated by us since March 1990 are not included in this report since we established the investigative principle of a minimum of 30 months follow-up. Seventeen of the 72 patients were treated after incomplete surgical resection, and 21 for tumour regrowth. In 34 patients, radiosurgery was the primary treatment. The tumour volume was calculated by the ellipsoid method. It ranged from 0.588-76.346 ml. Radiosurgery was performed using the non-invasive stereotactic fixation head device (Greitz-Bergström) adapted to the Fixster frame, and dynamic irradiation performed with the linear accelerator, using especially designed collimators. The total tumour dose for each patient ranged from 15-45 Gy. The minimum follow-up was 2 1/2 years and the maximum 8 years. In 50 patients there was tumour shrinkage ranging from 24-91% of the initial tumour volume. Shrinkage was associated with central tumour necrosis in 11 of these 50 patients. In 18 patients the tumour volume remained stable. In 2 patients there was tumour progression and in 2 there was regrowth after initial reduction of tumour volume. There were no significant treatment complications. Radiosurgery is preferable to re-operation in recurrent meningiomas and indicated after incomplete surgical removal. In high risk patients, as well as in "unresectable" meningiomas, it is an obvious alternative to microsurgery.

Adult↗
PubMed1993

Linear accelerator and Greitz-Bergstrom's head fixation system in radiosurgery of single cerebral metastases. A report of 86 cases.

Between 1984 and 1991 86 patients with single cerebral metastases underwent linear accelerator radiosurgery using the atraumatic and reproducible Greitz-Bergström head-fixation device. Routine one-month follow-up documented disappearance of the tumour in 16 patients, with resolution of the oedema and ventricular shift. Shrinkage of the metastasis occurred in 51 patients. In 9 patients the tumour remained stable, in 7 there was progression of tumour size. Among the patients showing shrinkage of the tumour or unchanged tumour volume, repeated radiosurgery resulted in disappearance of the metastasis in 5 and further shrinkage in 28. In 14 patients routine stereotactic CT follow-up study led to the detection of a new metastasis, again treated with excellent results. Local recurrence occurred in 2 patients and radiation necrosis in the target area in 5 patients. Radiosurgery thus proves to be an appropriate alternative to surgery. The versatility of our non-invasive and painless method permits CT staging (which we consider essential) without hospitalization of the patient.

Adult↗
PubMed1992

A new marker for early detection and indicator of progression of cancer of the bladder. Preliminary results with Ag-NOR index in 38 cases of superficial bladder cancer.

The multiform biology of superficial bladder tumors, both morphologically and evolutively, and the lack of reliable predictors of progression have led the authors to study the Ag-NOR proteins as a new marker of these tumors. It is well known that particularly the low-grade superficial tumors frequently relapse on the same histologic and proliferative module. Their potential of progression is probably present at the time of the first manifestation of the disease or it can show itself along the relapsing evolution with classic modifications translating the cellular dedifferentiation. The NOR index, set up by the authors, has several advantages: firstly, it corresponds to a functional value of normal and neoplastic cells; secondly, it can be used also with paraffin blocks. Another advantage is the semiautomatic lecture, reproducible also in the urinary cytology, mainly of low-grade tumors, reducing the number of false-negatives. The conclusion of the study of 38 cases of superficial bladder cancer has induced the authors to believe that an increased NOR index is a reliable 'marker' of their progression. Therefore, the authors suggest the use of the NOR activity for the surveillance of the urothelial disease and for a more logical therapeutic strategy.

Adult↗
PubMed1992

Nucleolar organizer regions: preliminary results of the clinical use of a new marker for prostatic carcinoma (40 cases).

It is a widely diffused opinion that moving backwards in time the moment of the diagnosis of cancer of prostate, so that the tumor is detected earlier than normal, means that the treatment would be more effective than the one adopted in the usual times of diagnosis. For this reason the earlier diagnosis of prostate cancer has become more and more a compulsory target of the modern urologist, at a time of booming of the third age, of increased lifetime expectancy, of significant elevation of prostate cancer rate and of the persistent uncertainty of the efficacy of available treatments. Theoretically the mortality rate of prostate cancer can be reduced by the prevention programs and by the improvements of treatment methods, but the 'earlier' diagnosis is certainly an easier and less expensive strategy to achieve the same objective. The authors have evaluated the argyrophilic-nucleolar organizer region (Ag-NOR) proteins on 40 cases of adenocarcinoma of prostate collected through a multicentric program in France and in Italy. The Ag-NOR have been stained with silver technique set up by Ploton and Derenzini while the quantitative index has been evaluated by a semiautomatic system partially commercially available, partially modified by the authors. The conclusions: (a) the Ag-NOR index is a simple and reproducible method; (b) the Ag-NOR staging system corresponds to Gleason's grading; (c) the Ag-NOR elevation is a reliable marker of increased cell proliferation and is detectable much earlier than the morphologic changes of Gleason's classification.

Adenocarcinoma↗
PubMed1991

New directions in percutaneous intervention for peripheral vascular disease.

Balloon angioplasty is a safe and effective alternative to surgical reconstruction or bypass in selected patients with symptomatic iliofemoral and popliteal atherosclerosis. The current literature suggests an expanding role for balloon angioplasty in patients with symptomatic tibioperoneal disease as well as upper extremity claudication and subclavian steal syndrome. Newer percutaneous devices such as atherectomy, intravascular stents, and laser angioplasty may further broaden the indications for percutaneous intervention by improving their safety and long-term benefit. The latest advances in percutaneous intervention for peripheral vascular disease are reviewed.

Angioplasty, Balloon, Coronary↗
PubMed1988

Radiosurgery in cerebral tumours and AVM.

In collaboration with the Institute of Neurosurgery, La Sapienza Rome University, we have treated 214 patients with stereotactic irradiation. The series began in March 1984 and includes 198 cerebral tumours of different histology and 16 AVM. 73% of the patients had been operated on before irradiation. From this first experience the following considerations can be drawn: (a) radiosurgery is not an alternative to neurosurgery except for particular cases; neurosurgery is therefore essential because the smaller the target area the higher the efficiency of stereotactic irradiation; (b) compared to conventional radiotherapy, damage to the brain is minimized as shown by NMR. The follow-up time is too short to allow any definite conclusion. However, positive effects have been observed in malignant gliomas and single metastases. In craniopharyngiomas and pituitary adenomas, tumour growth was arrested or decreased with the disappearance of the tumour in 3 adenomas and 1 craniopharyngioma. With regard to the response of meningiomas to irradiation we have shown that radiosurgery is able to cause a decrease in tumour size as well as reduced contrast enhancement, probably due to vascular changes and fibrosis. In AVM the efficiency of radiosurgery has been further confirmed.

Brain Neoplasms↗
PubMed1986

Stereotactic radiation therapy in arteriovenous malformations and brain tumors using the Fixster system.

In brain tumours, stereotactic radiation therapy, performed in a single high dose (SHD) or fractionated (FSR), gives better results than conventional methods. In arteriovenous malformations (AVM), radiosurgery is a well-defined alternative to neurosurgery and embolization, if the malformation is not wider than 3 cm. In large AVMs, a successful combined technique of radiosurgery and FSR has been developed. In a series of 110 patients the experience proved that the atraumatic Greitz-Bergström stereotactic system is appropriate.

Brain Neoplasms↗
PubMed1984

Digitalized venous angiography in the investigation of the neck vessels.

An X-ray imaging system, using digital subtraction techniques, has been developed. The authors relate the results of a comparative study in 20 patients, affected by cervical occlusive vascular disease, whose arterial cervical system has been investigated both by conventional angiography and intravenous digital subtraction angiography. Indications, advantages and limitations of this new computerized apparatus are discussed.

Brain Ischemia↗
PubMed1982

[Albright's syndrome. Report of a case, complicated by pleural effusion and diabetes].

A case of Albright's disease in a 54-yr-old man is presented. A brief account of the nosological placement of the disease is followed by a review of the relevant literature, with particular reference to the clinical, anatomo-pathological, and aetiopathogenetic aspects. The salient points of the reported case were: 1) extensive cutaneous hyperpigmentation; 2) polyostotic fibrous dysplasia involving the skull, humeri, femurs, and pelvis; 3) voluminous bilateral costal cysts, with greater extension on the right; 4) right pleural effusion; 5) diabetes; 6) mental under-development; 7) 1/4 balanced translocation.

Bone Cysts↗
PubMed1981

[Use of a synchronized protocol of cytostatic drugs in the treatment of advanced lung cancer].

A synchronised programme consisting of VCR, CTX and MTX has been employed in 57 patients suffering fom lung carcinoma. Average survival was 10.6 months and overall tolerance was good. The best indications are intermittent long-term treatment and retreatment of patients with cancer recalcitrant to the same drugs. With the simplification of cell kinetics study techniques, more meaningful results can be expected in the application of this treatment programme.

Aged↗
PubMedDate not supplied

Postoperative radiosurgery of pituitary adenomas.

From 1984-1990, 52 patients with pituitary adenomas had postoperative radiosurgery for incomplete surgical removal or regrowth of the tumor. The atraumatic Greitz-Bergström fixation head device was adopted for the stereotactic procedure and irradiation was performed with a linear accelerator. Because of the variability of the tumor response, a 10-20 Gy single dose was directed at 1-2 targets and radiosurgery repeated if the result was unsatisfactory. The median radiation dose was 30 Gy. No adverse effects occurred. Regression of pretreatment symptoms caused by tumor mass was observed in 67% of patients. GH and PRL activity decreased in 20 patients, was stable in 11 and increased in 2 prolactinomas. CT studies showed disappearance of the tumor in 4 patients and shrinkage in 36. Postoperative radiosurgery is a valuable method of treatment whenever pituitary surgery has been incomplete.

Adenoma↗