Publications by authors named "Maria Alessia Zerella"

Article Synopsis
  • A study was conducted to assess current treatment practices for extensive-stage small-cell lung cancer (ES-SCLC) among Italian clinicians, especially regarding the use of radiation therapy.
  • The survey involved 225 cancer care professionals, with 90 responding, mainly radiation oncologists with significant experience; the results highlighted a preference for combining chemotherapy with immunotherapy and the common use of prophylactic cranial irradiation (PCI).
  • The findings revealed variability in treatment approaches for ES-SCLC, indicating a need for further clinical trials and improved multidisciplinary strategies for managing these patients.
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Article Synopsis
  • Breast conserving treatment usually includes surgery to remove tumors followed by radiotherapy, but accurately identifying the tumor bed can result in unnecessary radiation to healthy tissue. Preoperative stereotactic body radiotherapy (SBRT) aims to target the tumor more precisely.
  • A systematic review was conducted analyzing ten clinical trials involving 188 patients, focusing on early toxicity and cosmetic results of SBRT, with median follow-up of 15 months. Treatments varied in radiation doses and fractionation methods.
  • Findings showed low rates of acute and late toxicity and excellent cosmetic outcomes for most patients. Pathological complete response rates improved with longer intervals between SBRT and surgery and when combined with other therapies, suggesting SBRT’s potential to
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Purpose: To evaluate the outcome of partial breast reirradiation (re-PBI) with intensity modulated radiation therapy using a hypofractionated scheme for breast cancer (BC) local relapse (LR) operated on with repeat breast-conservative surgery.

Methods And Materials: Intensity modulated radiation therapy-based re-PBI was performed using either helical or step-and-shoot modality to deliver 37.05 Gy in 13 fractions in 2.

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Similar to invasive breast cancer, ductal carcinoma in situ is also going through a phase of changes not only from a technical but also a conceptual standpoint. From prescribing radiotherapy to everyone to personalized approaches, including radiotherapy omission, there is still a lack of a comprehensive framework to guide radiation oncologists in decision making. Many pieces of the puzzle are finding their place as high-quality data mature and are disseminated, but very often, the interpretation of risk factors and the perception of risk remain very highly subjective.

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Background: Currently, main treatment strategies for early-stage non-small cell lung cancer (ES-NSCLC) disease are surgery or stereotactic body radiation therapy (SBRT), with successful local control rates for both approaches. However, regional and distant failure remain critical in SBRT, and it is paramount to identify predictive factors of response to identify high-risk patients who may benefit from more aggressive approaches. The main endpoint of the MONDRIAN trial is to identify multi-omic biomarkers of SBRT response integrating information from the individual fields of radiomics, genomics and proteomics.

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This study quantified the incidental dose to the first axillary level (L1) in locoregional treatment plan for breast cancer. Eighteen radiotherapy centres contoured L1-L4 on three different patients (P1,2,3), created the L2-L4 planning target volume (single centre planning target volume, SC-PTV) and elaborated a locoregional treatment plan. The L2-L4 gold standard clinical target volume (CTV) along with the gold standard L1 contour (GS-L1) were created by an expert consensus.

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Article Synopsis
  • Researchers are looking into giving radiotherapy (RT) before surgery for breast cancer (BC), which could help more patients get better treatment.
  • * This new approach uses advanced technology to focus the treatment more accurately, reducing side effects and improving results.
  • * The study aims to gather important data that can help design better future treatments and make RT more personalized for patients with early-stage BC.
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Purpose: To evaluate oncological outcomes and late toxicities in a retrospective series of patients with locally-extended anal squamous cell carcinoma (ASCC), treated with curative Intensity Modulated Radiotherapy (IMRT) and chemotherapy.

Methods: ASCC patients who underwent chemo-radiotherapy with IMRT from 2010 to 2020 were included. Oncological outcomes were assessed in terms of overall survival (OS), disease-free survival (DFS), colostomy-free survival (CFS) and event-free survival (EFS).

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Aim: To evaluate outcome of intraoperative electron boost (IOERT) and hypofractionated whole breast irradiation (HWBI) for breast cancer (BC) in young women.

Methods And Materials: Women aged ≤ 48 with pT1-2 N0-1 BC received 12 Gy IOERT boost during conservative surgery followed by 3-dimensional conformal HWBI in 13 fractions (2.85 Gy/die).

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Background: Breast-conserving surgery (BCS) and whole breast radiation therapy (WBRT) are the standard of care for early-stage breast cancer (BC). Based on the observation that most local recurrences occurred near the tumor bed, accelerated partial breast irradiation (APBI), consisting of a higher dose per fraction to the tumor bed over a reduced treatment time, has been gaining ground as an attractive alternative in selected patients with low-risk BC. Although more widely delivered in postoperative setting, preoperative APBI has also been investigated in a limited, though increasing, and number of studies.

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Purpose: To assess outcomes between salvage radiation therapy (SRT) with curative intent and stereotactic radiotherapy for macroscopic prostate recurrence (SSRT) after radical prostatectomy (RP). In order to compare these two different options, we compared their outcomes with a propensity score-based matched analysis.

Methods: Data from 185 patients in seven Italian centres treated for macroscopic prostate bed recurrence after RP were retrospectively collected.

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Purpose: To critically review available literature on hypofractionated (≥ 3 Gy/fraction) proton therapy (PT) for breast cancer (BCa).

Methods: A systematic screening of the literature was performed in April 2021 in compliance with the preferred reporting items for systematic reviews and meta-analyses recommendations. All full-text publication written in English were considered eligible.

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Purpose: The purpose of the study was to evaluate the toxicity, local control, overall and disease-free survival of elderly breast cancer (BC) patients treated with adjuvant once-weekly ultra-hypofractionated radiotherapy (RT) either with intensity-modulated RT (IMRT) or 3D conformal RT (3DCRT).

Methods: From July 2011 to July 2018, BC patients receiving 5.7 Gy once a week for 5 weeks to the whole breast after breast-conserving surgery were considered for the study.

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Article Synopsis
  • The study looks at a new way to give radiation therapy to breast cancer patients who had cancer come back after already receiving radiation during surgery.
  • They used a method that protects the area that was already treated, so it doesn't get too much radiation again.
  • The results showed that this method worked well without causing serious side effects, and all the patients stayed healthy after the treatment.
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Background: Postmastectomy radiotherapy (PMRT) with TomoHelical™ (TH) or TomoDirect™ (TD) allows a uniform target coverage. In this study, we compare treatment plans using TD and TH in the setting of hypofractionated PMRT and immediate breast reconstruction.

Material And Methods: The TD-treatment plans of breast cancer patients treated between May 2016 and August 2019 were retrospectively selected.

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Aim: To assess the rate of positive non-sentinel lymph nodes (non-SLNs) after neoadjuvant systemic therapy (NAST) in breast cancer (BC) following positive sentinel lymph node biopsy (SLNB).

Materials And Methods: From institutional database, 265 consecutive patients receiving NAST for cT1-3, any N, M0 BC between 2001 and 2018 were identified. Patients presented clinically negative axilla before surgery and were candidate for SLNB.

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Introduction: During the COVID-19 pandemic, Lombardy (Northern Italy) Regional Health Council created hubs for cancer care, meant to be SARS-CoV-2-free pathways for cancer patients. The workflow of breast cancer (BC) radiotherapy (RT) in one of the hubs is presented here.

Methods: Candidates to adjuvant RT during the pandemic peak of March-April 2020 were compared to those treated in the same period of 2019, and patient volume, deferral rate, and type of RT were analyzed.

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Purpose: To assess outcome of breast cancer (BC) stages pT1-2 N0-1 after mastectomy alone and to identify prognostic factors calling for the need of postmastectomy radiotherapy.

Methods: Patients who were not eligible for breast conserving surgery (BCS) were operated on with mastectomy between 1998 and 2008. Locoregional (LRR), distant (DM) control and breast cancer specific survival (BCSS) were retrospectively evaluated.

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Objective: The space comprised between tumor and neck lymph nodes (T-N tract) is one of the main routes of tumor spread in oral cavity tumors. Aim of the study was to investigate the impact of T-N tract involvement on the postoperative radiotherapy (PORT) outcomes.

Materials And Methods: Patients (pts) treated between 2000 and 2016 with indication to PORT were retrospectively retrieved.

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Purpose: To retrospectively review our experience on 84 patients with squamous cell anal canal cancer (SCAC) within 12 months after combined treatment with intensity-modulated RT (IMRT), in terms of acute and early-late toxicity, overall treatment time and interruptions, colostomy-free survival (CFS), and tumor response.

Methods: Acute gastrointestinal (GI), genitourinary (GU), and cutaneous (CU) toxicities were assessed according to Common Toxicity Criteria for Adverse Events (CTCAE) version 4.03.

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Article Synopsis
  • The study aimed to evaluate the safety and effectiveness of stereotactic salvage radiotherapy (SSRT) for patients with macroscopic prostate bed recurrence who had not previously received radiation treatment.
  • A total of 90 patients were analyzed after receiving SSRT, and the results showed a complete biochemical response in 43.3% of patients, with varying rates of biochemical recurrence-free survival (BCRFS) based on different PSA thresholds.
  • The findings indicate that SSRT provides significant control over biochemical recurrence without causing severe side effects, and it may help delay the need for androgen-deprivation therapy (ADT).
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Article Synopsis
  • The study evaluated the effectiveness of SRT (stereotactic radiotherapy) in treating patients with oligometastatic colorectal cancer (CRC), assessing local control (LC), progression-free survival (PFS), overall survival (OS), and toxicity.
  • A total of 102 patients with a median follow-up of 11.4 months were analyzed, showing no severe adverse effects, with significant local control and survival rates observed.
  • Findings suggest better outcomes with higher biological equivalent doses (BED ≥ 75 Gy) and smaller planning target volumes, highlighting the need for further research on patient selection and optimal dosing to enhance treatment effectiveness while minimizing side effects.
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Purpose: Evaluation of target coverage and verification of safety margins, in motion management strategies implemented by Lung Optimized Treatment (LOT) module in CyberKnife system.

Methods: Three fiducial-less motion management strategies provided by LOT can be selected according to tumor visibility in the X ray images acquired during treatment. In 2-view modality the tumor is visible in both X ray images and full motion tracking is performed.

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