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1.
Marco Maruzzo Umberto Basso Eugenio Borsatti Laura Evangelista Filippo Alongi Orazio Caffo Francesca Maines Sara Galuppo Rocco De Vivo Fable Zustovich Dario Palleschi Andrea Zivi Teodoro Sava Mariella Sorarù Roberto Iacovelli Maurizio Nicodemo Susanne Baier Lucia Fratino Vittorina Zagonel 《Clinical genitourinary cancer》2019,17(1):e187-e194
Background
Radium 223 was introduced for metastatic castration-resistant prostate cancer based on the results of a randomized controlled trial showing risk reduction for death and skeletal events. Our aim was to evaluate the outcome of patients receiving radium 223 in a real-world setting.Patients and Methods
We conducted a multicenter retrospective analysis in the Triveneto region of Italy.Results
One hundred fifty-eight patients received radium 223 in our region. After a median follow-up of 9.5 months, 75 patients died. The median overall survival (OS) was 14.2 months, and the median progression-free survival (PFS) was 6.2 months. Seventy-one (45%) patients achieved progression as best response. Thirty-seven (23%) patients stopped the treatment early because of progression. Eastern Cooperative Oncology Group performance status was prognostic for OS (18.4 vs. 12.3 vs. 7.5 months; 0 vs. 1, P = .0062; 0 vs. 2, P = .0002), whereas previous prostatectomy or docetaxel exposure were not. A neutrophil to lymphocytes ratio ≥ 3 significantly impacted OS (18.1 vs. 9.7 months; P < .001) and slightly impacted PFS (6.6 vs. 5.6 months; P = .05). Patients with a baseline alkaline phosphatase (ALP) value ≥ 220 U/L had worse OS and PFS (24.1 vs. 10.5 months; 7.2 vs. 5.5 months; P < .001). Patients with changes in ALP value achieved better OS (P = .029) and PFS (P = .002). There was no difference according to the line of therapy (0 vs. ≥ 1; P = .490). The main grade 3/4 toxicities were anemia, asthenia, and thrombocytopenia.Conclusion
This large real-world report confirms comparable OS and PFS data when compared with the pivotal study, as well as the predictive role of ALP and neutrophil to lymphocytes ratio. The definition of the optimal position of radium 223 in the treatment of metastatic castration-resistant prostate cancer has still to be defined. 相似文献2.
3.
The management of patients with glioblastoma remains challenging with an average survival of 32-56 weeks. We report on a clinical trial of patients with recurrent glioblastoma treated with adenovirus/herpex simplex-thymidine kinase/ganciclovir (ADV/HSV-tk/GC). Entry criteria for this study included: recurrent malignant glioma after surgical resection and conventional radiation therapy. At the time of recurrence, computerized volumetric resection of the tumor was performed and the ADV/HSV-tk complex was injected in the tumor bed. GC was administered 24 h after surgery (10 mg/kg/day) for 7 days. Patients were divided into 3 ADV/HSV-tk dose-escalating cohorts. Adenoviral vector shedding, and local or systemic toxicity did not occur in this study. Magnetic resonance imaging showed lack of increased brain edema in the treated patients. Histological examination of the 5 patients that had repeated surgery after gene therapy treatment showed lack of tissue toxicity. Additionally, PCR for HSV-tk was negative in the brain 3 months after injection. The patients' Karnofsky score was maintained > or = 70 in 8/10 patients (80%) and 5/9 patients (55%) 3 and 6 months respectively, after gene therapy. Ten of 11 patients survived > or = 52 weeks from diagnosis with an average survival of 112.3 weeks. One patient is still alive 248 weeks from diagnosis. These data show that the ADV/HSV-tk/GC complex at the dose used in this study is safe. Additional dose escalation is currently in progress. 相似文献
4.
Zustovich F Della Puppa A Scienza R Anselmi P Furlan C Cartei G 《Acta neurochirurgica》2008,150(7):699-703
Summary Oligodendroglioma cells are detectable in the cerebro-spinal fluid in up to 14% of patients [10] and cerebellar and/or spinal
cord involvement is a well known phenomenon [3]. Distant spread of oligodendroglioma is exceptional, probably due to the presence
of the blood-brain barrier, the absence of lymphatic vessels and the short survival of patients.
A review of the worldwide literature yielded 32 previously reported examples since 1951 to the present (Tab1e 1). This review
was performed using NCBI-PubMed and “oligodendroglioma, oligodendrogliomas, metastatic, metastasis, metastases, extraneural”,
in different combinations, as key words and reviewing the bibliography of the consequent selected articles.
New therapeutic approaches are prolonging the overall survival of patients with primitive brain tumours and in particular
of those with high grade oligodendroglioma which is a chemo-sensitive disease. A longer overall survival could increase the
risk of extracranial dissemination of gliomas that in the future might become a less rare clinical complication.
Correspondence: Fable Zustovich, Oncologia Medica 1, Istituto Oncologico Veneto, I.R.C.C.S, Padova, Italy; Ospedale Busonera,
Via Gattamelata 64, 35128 Padova, Italy. 相似文献
5.
Giuseppe Lombardi Fable Zustovich Martin Donach Maurizia Dalla Palma Ornella Nicoletto Davide Pastorelli 《Urologic oncology》2012,30(3):240-246
An improved understanding of the biological pathways deregulated in renal cell carcinoma has led to the development of various targeted agents, changing dramatically the therapeutic options for this disease. However, despite numerous opinions and guidelines, the optimal treatment still remains uncertain. In this review, we analyze the most recent published reports regarding the agents sunitinib, bevacizumab, sorafenib, temsirolimus, and everolimus. Moreover, we assess the novel targeted drugs pazopanib and axitinib. In addition, given the likely lack of cross-resistance between these targeting agents, we discuss sequential and combination targeted therapy in metastatic renal cell carcinoma, analyzing the most recent data. 相似文献
6.
Caffo O Sava T Comploj E Fariello A Zustovich F Segati R Sacco C Veccia A Galligioni E 《BJU international》2011,107(11):1825-1832
Study Type – Therapy (RCT) Level of Evidence 1b What’s known on the subject? and What does the study add? Data on quality of life during docetaxel treatment in castration resistant prostate cancer was mainly provided by SWOG and TAX327 trials. In the TAX327 trial biochemical response and pain predicted survival, whereas quality of life outcomes did not. In the present study, there were no statistically significant changes in the quality of life scales during treatment except in the case of patients receiving docetaxel and estramustine, who experienced a significant decrease in pain. Our data seem to suggest that patients with a better baseline quality of life (and consequently with fewer symptoms) are more likely to achieve a biochemical response.
OBJECTIVES
? To assess quality of life (QoL) outcomes and pain changes in patients affected by castration‐resistant prostate cancer enrolled in a phase II randomized trial of 3‐week docetaxel (DOC)‐based chemotherapy. ? To provide further data to clarify the conflicting published data concerning the impact of DOC on the patients’ QoL.PATIENTS AND METHODS
? QoL outcomes were assessed using the European Organisation for the Research and Treatment of Cancer QLQ‐C30 questionnaire. ? Pain changes were evaluated by means of the Brief Pain Inventory at baseline and after every two DOC courses. ? The patients completing at least two questionnaires (at baseline and before the third course) were considered evaluable.RESULTS
? In all, 59 patients were evaluable. ? Asymptomatic patients and responders had a better baseline QoL than symptomatic patients and non‐responders. ? There were no statistically significant changes in the QLQ‐C30 scales during treatment except in the case of patients receiving DOC and estramustine, who experienced a significant decrease in pain. ? There was a progressive improvement in the mean intensity and interference scores of the Brief Pain Inventory.CONCLUSIONS
? Our data confirm that QoL is generally maintained during chemotherapy. ? There is a substantial reduction in pain. ? Our results also suggest that baseline QoL may predict treatment response. 相似文献7.
Giulia Pasello Giovanni Vicario Fable Zustovich Francesco Oniga Stefania Gori Francesco Rosetti Andrea Bonetti Adolfo Favaretto Silvia Toso Roberta Redelotti Antonio Santo Daniele Bernardi Petros Giovanis Cristina Oliani Lorenzo Calvetti Carlo Gatti Giovanni Palazzolo Zora Baretta Alberto Bortolami Laura Bonanno Marco Basso Jessica Menis Donatella Da Corte Stefano Frega Valentina Guarneri PierFranco Conte 《The oncologist》2019,24(6):e318-e326
8.
Zustovich F Gottardo F De Zorzi L Cecchetto A Dal Bianco M Mauro E Cartei G 《International journal of clinical oncology / Japan Society of Clinical Oncology》2008,13(3):271-274
We report the case of a 59-year-old man with advanced renal cell carcinoma (RCC), without inferior vena cava (IVC) involvement, treated with radical nephrectomy, palliative radiotherapy for bone metastasis, and medical therapy for bone and lung metastases. The patient died of cardiac arrest after evidence of massive malignant pericardial effusion. At autopsy, massive myocardial and pericardial neoplastic invasion was found. Heart involvement via the IVC is a well-known phenomenon during RCC progression, while in the absence of IVC involvement, clinically evident cardiac involvement is exceptional, with few cases reported in the worldwide literature. Analysis of prior reports and of the present case provides evidence on how the cardiac metastasis may have two distinct origins and clinical features. The first is hematogenous, via the IVC, even in the absence of renal vein involvement; it is generally circumscribed and has a good prognosis after surgery. The second is through the intrathoracic lymphatic system, in the presence of disseminated disease, especially pulmonary metastasis, and this type has a very poor prognosis. 相似文献
9.
Caffo O Sava T Comploj E Fariello A Zustovich F Segati R Sacco C Valduga F Cetto G Galligioni E 《BJU international》2008,102(9):1080-1085
OBJECTIVE
To report the results of a randomized phase II trial of docetaxel with and without estramustine phosphate (EP) in patients with hormone‐refractory prostate cancer (HRPC).PATIENTS AND METHODS
Patients with progressive HRPC were randomized to receive docetaxel 70 mg/m2 on day 1 (arm A), or docetaxel 70 mg/m2 on day 2 plus oral EP three times daily, at a total daily dose of 840 mg, on days 1–5 (arm B). The primary objective of the trial was to evaluate the activity of the treatments in terms of the response in prostate‐specific antigen (PSA) level.RESULTS
Forty‐five of the 49 patients centrally randomized to arm A and 44 of the 46 in arm B were evaluable for activity. The PSA level decreased by ≥50% in 40% of the patients in arm A and in 75% of those in arm B. The median time to PSA progression was 20 weeks in arm A and 30 weeks in arm B. The patients in arm B had an improvement in pain over time.CONCLUSION
These data support the existence of a possible advantage in combining docetaxel and EP, which should be verified in a specific randomized phase III study. 相似文献10.
Safety and clinical outcomes of patients treated with abiraterone acetate after docetaxel: results of the Italian Named Patient Programme 下载免费PDF全文
Orazio Caffo Ugo De Giorgi Lucia Fratino Giovanni Lo Re Umberto Basso Alessandro D'Angelo Maddalena Donini Francesco Verderame Raffaele Ratta Giuseppe Procopio Enrico Campadelli Francesco Massari Donatello Gasparro Sveva Macrini Caterina Messina Monica Giordano Daniele Alesini Fable Zustovich Anna P. Fraccon Giovanni Vicario Vincenza Conteduca Francesca Maines Enzo Galligioni 《BJU international》2015,115(5):764-771