Publications by authors named "Morganti Alessio"

Background: The impact of the dietary macronutrient composition and its subcomponents (saccharides, fatty acids, and protein sources) on radiation-induced acute skin toxicity (AST) in breast cancer (BC) patients is unknown. Hence, we examined the association between dietary macronutrients and their subcomponents and the risk of ≥grade 2 (G2) AST post-radiotherapy among women with BC.

Methods: An observational study was conducted among 161 BC patients treated with radiotherapy and enrolled in the ATHENA project in Italy.

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Purpose: This systematic review aimed to assess the feasibility, safety, and efficacy of using modern external beam radiotherapy (EBRT) techniques, such as intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic body radiotherapy (SBRT) as alternative approaches to brachytherapy (BRT) in adjuvant treatment of endometrial cancer (EC).

Material And Methods: A systematic review was conducted following PRISMA guidelines. The research question was framed using the PICO method, focusing on patients with EC [P] and comparing modern EBRT techniques (IMRT, VMAT, SBRT) [I] vs.

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Introduction: Biliary tract cancers (BTC) are rare and aggressive neoplasms. The current management of locally advanced or unresectable BTC is primarily based on chemotherapy (CHT) alone, linked to a median overall survival (OS) of approximately 12 months. However, international guidelines still consider concurrent chemoradiation (CRT) as an alternative treatment option.

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Aims: This study aimed to evaluate the symptomatic efficacy and tolerability of three different radiotherapy (RT) regimens for patients with vertebral metastases in a low-middle-income country setting, focusing specifically on the effectiveness of single-fraction radiotherapy.

Methods: Conducted at the National Institute of Cancer Research and Hospital, Bangladesh, from July 1, 2020, to June 30, 2021, this prospective, non-randomized study enrolled 90 patients aged 18 to 75 years with histologically confirmed primary malignancies and vertebral metastases. Patients were allocated to one of three treatment arms: 8 Gy in a single fraction (Arm A), 20 Gy in 5 fractions (Arm B), or 30 Gy in 10 fractions (Arm C).

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Background: Aim was to compare the efficacy of interventional radiotherapy (IRT) boost vs. external beam radiotherapy (EBRT) boost after chemoradiation (CCRT) in patients with anal cancer (AC).

Methods: The P.

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Electrochemotherapy (ECT) is an emerging therapeutic approach gaining growing interest for its potential immunomodulatory effects in cancer treatment. This narrative review systematically examines the current state of knowledge regarding the interplay between ECT and the immune system. Through an analysis of preclinical and clinical studies, the review highlights ECT capacity to induce immunogenic cell death, activate dendritic cells, release tumor antigens, trigger inflammatory responses, and occasionally manifest systemic effects-the abscopal phenomenon.

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Background: The decision to administer palliative radiotherapy (RT) to patients with bone metastases (BMs), as well as the selection of treatment protocols (dose, fractionation), requires an accurate assessment of survival expectancy. In this study, we aimed to develop three predictive models (PMs) to estimate short-, intermediate-, and long-term overall survival (OS) for patients in this clinical setting.

Materials And Methods: This study constitutes a sub-analysis of the PRAIS trial, a longitudinal observational study collecting data from patients referred to participating centers to receive palliative RT for cancer-induced bone pain.

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Article Synopsis
  • The MITO-RT3/RAD trial was a Phase II study that evaluated the safety and effectiveness of stereotactic body radiotherapy (SBRT) for patients with oligometastatic ovarian cancer, focusing on those with lymph node disease.
  • Results showed a significant improvement in complete response (CR) rates, with 77.9% of lesions achieving CR, and an overall clinical benefit rate of 99.6% from 135 enrolled patients with 249 lesions across various institutions.
  • The trial indicated that SBRT has minimal toxicity, with 17% experiencing mild acute side effects, and it confirmed a strong correlation between CR and better progression-free survival (PFS)
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Article Synopsis
  • Salvage radiation therapy (sRT) is crucial for patients who experience biochemical recurrence after prostate surgery, and a new nomogram has been developed to predict their chances of remaining free from this recurrence.
  • * This study aims to evaluate the effectiveness of PSMA-PET-based assessments in guiding sRT for cases of prostate-specific antigen (PSA) persistence or recurrence, and it seeks to improve predictive models using random survival forests compared to traditional Cox models.
  • * Data from 1029 patients across five countries were analyzed to validate these predictive models, utilizing machine learning techniques to better understand outcomes related to biochemical failure after treatment.
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Cachectic patients frequently require transdermal fentanyl (TDF) for pain management, but data on its efficacy and safety are scarce and inconsistent. This scoping review aims to analyze the evidence concerning TDF administration in patients with cachexia irrespective of the underlying pathology. The primary objective is to assess the analgesic efficacy and tolerability of TDF in cachectic patients.

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Oligometastatic breast cancer patients can today could benefit from a multimodal approach, combining systemic therapy with metastasis-directed treatment using stereotactic body radiotherapy (SBRT). However, the possibility to synchronously treat multiple lesions is still challenging, needing the ability to generate complex dose distributions with steep dose gradients outside the lesions and major sparing of surrounding organs at risk and accurately track and reproduce the patient's position before and during radiation therapy. We report the case of an oligometastatic patient from left breast cancer, which occurred after a full course of whole breast radiotherapy, treated using the potential of modern technology including single-isocenter setup, plan automation, breath-hold technique and surface guided tracking and reproducibility of patient's position before and during radiation therapy.

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This study aimed to investigate the efficacy and duration of multiple non-ablative intravaginal CO2 laser (V-lase) cycles in breast cancer patients, gynecological and other pelvic cancers previously subjected to multiple oncological treatments. This prospective study enrolled women under the age of 65 years who reported vaginal symptoms. Data on the Vaginal Health Index (VHI), vaginal length (VL), vaginal pain measured using a Visual Analog Scale (VAS), and the Female Sexual Function Index (FSFI) were collected at baseline and before each laser application, and at subsequent follow-up visits.

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The standard of care for non-metastatic muscle invasive bladder cancer is either radical cystectomy or bladder preservation therapy, which consists of maximal transurethral bladder resection of the tumor followed by concurrent chemoradiation with a cisplatin-based regimen. However, for older cancer patients who are too frail for surgical resection or have decreased renal function, radiotherapy alone may offer palliation. Recently, immunotherapy with immune checkpoint inhibitors (ICI) has emerged as a promising treatment when combined with radiotherapy due to the synergy of those two modalities.

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Background/aim: Heterotopic ossification (HO) is a common complication following total hip arthroplasty. Various prophylactic treatments have been proposed, including radiotherapy (RT). This review summarizes the evidence from meta-analyses on the efficacy of RT in preventing hip HO.

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Purpose: The estimation of prognosis and life expectancy is critical in the care of patients with advanced cancer. To aid clinical decision making, we build a prognostic strategy combining a machine learning (ML) model with explainable artificial intelligence to predict 1-year survival after palliative radiotherapy (RT) for bone metastasis.

Materials And Methods: Data collected in the multicentric PRAIS trial were extracted for 574 eligible adults diagnosed with metastatic cancer.

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The standard of care for non-metastatic renal cancer is surgical resection followed by adjuvant therapy for those at high risk for recurrences. However, for older patients, surgery may not be an option due to the high risk of complications which may result in death. In the past renal cancer was considered to be radio-resistant, and required a higher dose of radiation leading to excessive complications secondary to damage of the normal organs surrounding the cancer.

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Objectives: Stereotactic body radiotherapy (SBRT) and/or single fraction stereotactic body radiosurgery (SRS) are effective treatment options for the treatment of oligometastatic disease of lymph nodes. Despite the encouraging local control rate, progression-free survival remains unfair due to relapses that might occur in the same district or at other sites. The recurrence pattern analysis after nodal local ablative RT (laRT) in oligometastatic patients is presented in this study.

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Introduction: The OligoMetastatic Esophagogastric Cancer (OMEC) project aims to provide clinical practice guidelines for the definition, diagnosis, and treatment of esophagogastric oligometastatic disease (OMD).

Methods: Guidelines were developed according to AGREE II and GRADE principles. Guidelines were based on a systematic review (OMEC-1), clinical case discussions (OMEC-2), and a Delphi consensus study (OMEC-3) by 49 European expert centers for esophagogastric cancer.

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Background: The accurate discrimination of uterine leiomyosarcomas and leiomyomas in a pre-operative setting remains a current challenge. To date, the diagnosis is made by a pathologist on the excised tumor. The aim of this study was to develop a machine learning algorithm using radiomic data extracted from contrast-enhanced computed tomography (CECT) images that could accurately distinguish leiomyosarcomas from leiomyomas.

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Background: The primary objective of this study was to assess the adequacy of analgesic care in radiotherapy (RT) patients, with a secondary objective to identify predictive variables associated with pain management adequacy using a modern statistical approach, integrating the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm and the Classification and Regression Tree (CART) analysis.

Methods: This observational, multicenter cohort study involved 1387 patients reporting pain or taking analgesic drugs from 13 RT departments in Italy. The Pain Management Index (PMI) served as the measure for pain control adequacy, with a PMI score < 0 indicating suboptimal management.

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Article Synopsis
  • The study uses Discriminant Analysis of Principal Components (DAPC) to evaluate genetic clusters, specifically focusing on treatment responses to Stereotactic Body Radiation Therapy (SBRT) for lung lesions through radiomics analysis of pre-treatment CT scans.
  • A total of 80 lung metastases from 56 patients were analyzed, with treatment responses categorized as complete, incomplete, or null, and 107 radiomics features were extracted to compare their correlations.
  • Results showed that DAPC effectively grouped the lesions into three distinct clusters based on the response to treatment, with specific radiomics features, such as sphericity and correlation, playing key roles in differentiating the responses.
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Brachytherapy (BRT) plays a pivotal role in the treatment of tumors, offering precise radiation therapy directly to the affected area. However, this technique demands extensive training and skills development, posing challenges for widespread adoption and ensuring patient safety. This narrative review explored the utilization of augmented reality (AR) in BRT, seeking to summarize existing evidence, discuss key findings, limitations, and quality of research as well as outline future research directions.

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