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Accuracy of Ultrasound Examination of Loco-Regional Lymph Nodes in Breast Cancer Follow-Up and Its Role in the Axillary Surgical Management

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Advances in Breast Cancer Research 2014年第1期3卷 5-11页

作者： Jacopo Nori Icro Meattini Dalmar Abdulcadir Elisabetta Giannotti Diego De Benedetto Luis Sanchez lorenzo Orzalesi Simonetta Bianchi Leonardo Capaccioli lorenzo livi Breast Unit Department of Surgery and Translational Medicine AOU Careggi Florence Italy Department of Radiology AOU Careggi Florence Italy Diagnostic Senology Unit AOU Careggi Florence Italy Pathological Anatomy Unit Department of Surgery and Translational Medicine AOU Careggi Florence Italy Radiotherapy Unit Clinical Physiopathology Department AOU Careggi Florence Italy

Objective: Major international guidelines have not standardized the sequence of diagnostic examinations during the follow-up of a patient with a diagnosed breast cancer. The aim of this study is to investigate the accuracy of sonography in the diagnosis of loco-regional lymphatic recurrences in comparison to the core needle biopsy results. Materials and Methods: Among 6455 patients who were followed up with clinical examination, mammography and ultrasound between January 2004 and November 2011, 125 (1.93%) patients had to be investigated with a core needle biopsy of a sonographically suspicious loco-regional lymph node. Results: Among the whole series, a total of 142 ultrasound-guided core needle biopsies were performed. Follow-up for the primary tumor lasted for a median time of 6.1 years (range 1 - 27 years). Ultrasound of suspicious loco-regional lymph nodes showed a sensitivity of 89.5%, a specificity of 87.1% and a positive predictive value of 89.5%. Conclusions: In our experience, ultrasound of suspicious loco-regional lymph nodes showed good accuracy and it should be a part of the standard examinations performed during follow-up for breast cancer.

关键词： Ultrasound Loco-Regional Lymph Nodes Breast Cancer Follow-Up Sentinel Node Dissection Axillary Surgery

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Therapeutic usability of two different fiducial gold markers for robotic stereotactic radiosurgery of liver malignancies:A pilot study

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World Journal of Hepatology 2016年第17期8卷 731-738页

作者： Maria Marsico Tommaso Gabbani lorenzo livi Maria Rosa Biagini Andrea Galli Integrate Activity Department 1 Gastroen-terology AOU Modena University Hospital Oncology Department Clinical Gastroenterology AOU CareggiFlorence University Hospital Oncology Department Radiotherapy SOD AOU Careggi Florence University Hospital

AIM: To assess how the application of different types of markers affects the tracking accuracy of Cyber Knife'***: Fifteen patients were recruited and subjected to the ultrasound-guided placement of markers. Two different type of needles 25 gauge(G) and 17 G containing two different fiducial marker, gold notched flexible anchor wire 0.28 mm × 10 mm(25 G needle) and gold cylindrical grain 1 mm × 4 mm(17 G), were used. Seven days after the procedure, a Cyber Knife planning computed tomography(CT) for the simulation of radiation treatment was performed on all patients.A binary CT score was assigned to the fiducial markers visualization. Also, the CT number was calculated for each fiducial and the values compared with a specific ***: For each patient from 1 to 5, intra-hepatic markers were placed(one in 2 patients, three in 8 patients, four in 3 patients, and five in 2 patients). A total of 48 needles were used(thirty-two 17 G and sixteen 25 G) and 48 gold markers were placed(32 Grain shaped markers and 16 Gold Anchor). The result showed that the CT visualization of the grain markers was better than the anchor markers(P = 5 × 10^(-9)). Furthermore, the grain markers were shown to present minor late complications(P = 3 × 10^(-6)), and the best CT threshold number(P = 0.0005). CONCLUSION: The study revealed that the Gold Anchor fiducial marker is correlated with a greater number of late minor complications and low visualization by the CT.

关键词： Robotic radiosurgery Fiducial markers Liver malignancies Cyber Knife Radiation therapy Stereotactic

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免疫疗法联合立体定向放疗治疗非小细胞肺癌脑转移:一项AIRO多中心回顾性研究

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中国肺癌杂志 2022年第4期25卷 I0007-I0022页

作者： Silvia SCOCCIANTI Emanuela OLMETTO Valentina PINZI Mattia Falchetto OSTI Rossella Di FRANCO Saverio CAINI Paola ANSELMO Paolo MATTEUCCI Davide FRANCESCHINI Cristina MANTOVANI Giancarlo BELTRAMO Francesco PASQUALETTI Alessio BRUNI Paolo TINI Emilia GIUDICE Patrizia CIAMMELLA Anna MERLOTTI Sara PEDRETTI Marianna TRIGNANI Marco KRENGLI NiccolòGIAJ-LEVRA Isacco DESIDERI Guido PECCHIOLI Paolo MUTO Ernesto MARANZANO Laura FARISELLI Pierina NAVARRIA Umberto RICARDI Vieri SCOTTI lorenzo livi 王绿化(翻译/校对) Radiation Oncology Unit Ospedale Santa Maria AnnunziataDepartment of OncologyBagno a RipoliFlorenceItaly Radiation Oncology Unit Azienda Ospedaliero Universitaria CareggiDepartment of Experimental and Clinical Biomedical Sciences"Mario Serio"FlorenceItaly U.O Radioterapia Fondazione IRCCS Istituto Neurologico Carlo BestaDepartment of NeurosurgeryMilanItaly U.O.C Radioterapia A.O.U Sant'Andrea Facolta Medicina e Psicologia Universita SapienzaDepartment of MedicineSurgery and Translational MedicineRomeItaly Istituto Nazionale Tumori IRCCS Fondazione G.PascaleDepartment of RadiotherapyNaplesItaly Institute for Cancer Research Prevention and Clinical Network(ISPRO)Cancer Risk Factors and Life-Style Epidemiology UnitFlorenceItaly Radiotherapy Oncology Center S.Maria HospitalDepartment of OncologyTerniItaly Humanitas Research Hospital Radiotherapy and Radiosurgery DepartmentRozzanoItaly Radiotherapy Unit Department of OncologyTurinItaly Cyberknife Centro Diagnostico Italiano Department of RadiologyMilanItaly Radiation Oncology Azienda Ospedaliero Universitaria PisanaDepartment of Translational MedicinePisaItaly Radiotherapy Unit University Hospital of ModenaDepartment of Oncology and HematologyModenaItaly Radiotherapy Unit University of SienaDepartment of Radiotherapy and OncologySienaItaly UOC di Radioterapia Policlinico Universitario Tor VergataDepartment of Onco-HaematologyRomeItaly Radioterapia Oncologica"G.Prodi "AO-IRCCS Arcispedale S.Maria NuovaDepartment of Oncology and Advanced TechnologyReggio EmiliaItaly Radiation Oncology A.S.O.S.Croce e Carle Department of Radiation OncologyCuneoItaly U.O.Radioterapia Oncologica Department of Radiation OncologyASST Spedali Civili di Brescia e Universita degli studi di BresciaBresciaItaly U.O.C.Radioterapia Oncologica Ospedale Clinicizzato SS Annunziata-Universita Chieti G.D'AnnunzioDepartment of Radiation OncologyChietiItaly Radiation Oncology University Hospital Maggiore della CaritdDepartment of Translational Medicine

背景与目的通过意大利放射治疗和临床肿瘤学学会(Italian Association of Radiotherapy and Clinical Oncology, AIRO)的一项多中心回顾性研究,明确免疫疗法(immunotherapy, IT)和立体定向放疗(stereotactic radiotherapy,SRT)包括放射外科治疗(radiosurgery, RS)或大分割立体定向放疗(hypofractionated stereotactic radiotherapy, HFSRT)治疗非小细胞肺癌(non-small cell lung cancer, NSCLC)脑转移的疗效和毒性。方法对来自19个意大利中心接受SRT+IT的NSCLC伴脑转移患者进行分析,并与单独接受SRT的对照组患者进行比较。结果共纳入SRT+IT组100例和单独SRT组50例。接受SRT+IT的患者有更长的颅内局部无进展生存期(intracranial local progression-free survival, i LPFS)(经倾向性评分调整后,P=0.007)。在诊断为脑转移时接受IT合并有颅外进展的患者中(n=24),接受SRT后再进行IT与较好的总生存期(overall survival, OS)相关(P=0.037)。多因素分析显示组织学类型为非腺癌、卡氏体能状态(Karnofsky performance status,KPS)评分=70分以及接受HFSRT与显著减少的生存期相关(P值分别为0.019、0.017和0.007)。与SRT和IT治疗间隔>7天(n=10)相比,治疗间隔≤7天(n=90)与更长的OS相关(经倾向性评分调整后,P=0.008)。联合治疗耐受性良好。在放射性坏死方面,接受SRT+IT的患者与单独SRT的患者无显著差异。SRT和IT的治疗间隔对毒性发生率无影响。结论 SRT+IT是一种安全的联合治疗方法,与单独SRT相比,具有更长的i LPFS。

关键词：立体定向放疗回顾性研究脑转移倾向性评分临床肿瘤学免疫疗法放射治疗

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