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Management of Painful Bone Metastases: The Interaction between Radiation Therapy and Zoledronate

Journal of Cancer Therapy 2011年第5期2卷 697-702页

作者： Rossella Di Franco Mariagrazia Calvanese Mariagrazia Cuomo Roberto Manzo Paola Murino Salvatore Cappabianca vincenzo ravo 不详

Background: Advanced cancers frequently metastasize to bone, and the presence of bone metastases is the most common cause of cancer-related pain. Pain management requires a multidisciplinary approach that involves the use of analgesics, bisphosphonates, radiotherapy, chemotherapy, surgery. The aim of our study was to evaluate the enhancement of radiotherapy on painful bone metastases in patients treated also with bisphosphonates. Materials and Methods: We analyzed the differences in benefit on pain and on quality of life comparing two groups of treatment. The first group comprised 104 patients treated with Radiotherapy (RT), the second one included 50 patients treated with radiotherapy associated to zoledronic acid (RT + Z). All patients completed before, during and after treatment, a questionnaire that rated the grade of pain, the pharmacological type of analgesic therapy and patient’s performance status. For each patient a total score was calculated, from a minimum value of 0% to a maximum of 20%, then expressed as a percentage. Patients were classified as responder if at the follow-up reported a reduction of over 20% of the initial score, no-change if there was a reduction of between 0% and 20%, progression if there was an increasing of the score. Results: In the group RT + Z we found fewer patients that started radiation therapy with severe pain (16% vs 32%), no patient had pain of grade 10, and a higher proportion of asymptomatic patients (12% vs 4%) was observed. In the RT alone group a higher percentage of patients started treatment assuming strong opioid more than once a day (26% vs 24%) and a reduction in number of these patients was about 14% compared with the reduction of 23.6% observed in the group RT + Z. Furthermore an increased total score was calculated only in the 6% of patient belonged to group RT alone. Finally, in the group RT + Z responder patients are 52%, compared to 36% of the RT group, non-responder were 36% versus 60% in the RT. The risk of

关键词： Bone Metastases Radiotherapy Zoledronate

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Predictability and Management of OARs Toxicity in Patients with Prostate Cancer Treated with High-Dose Radiotherapy

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Journal of Cancer Therapy 2013年第10期4卷 1452-1458页

作者： vincenzo ravo Domenico Borrelli Sara Falivene Rossella Di Franco Matteo Muto Angela Argenone Valentina Borzillo Fabrizio Cammarota Paolo Muto Radiotherapy Emicenter Naples Italy Radiotherapy of Second University of Naples Naples Italy Radiotherapy Unit Istituto Nazionale per lo Studio e la Cura dei Tumori “Fondazione Giovanni Pascale”—IRCCS Naples Italy

Aim: To evaluate the predictability of toxicity analyzing the dose-volume histograms (DVHs) and to verify the effectiveness of preventive measures limiting side toxicity considering the evolution of the radiation techniques for prostate cancer treatment. Materials and Methods: 208 patients with localized prostate cancer were treated with exclusive radiotherapy until 73.8 Gy (group A) or 79.2 Gy (group B) with the dose escalation technique. Preventive measures to minimize the side effects were recommended in group B. Results: The assessment of genitourinary toxicity was similar while gastrointestinal toxicity was better in group B. Valuating the treatment plans, we found that most of the patients developing toxicity had “borderline” DVHs. Conclusion: Our analysis led to the establishment of a protocol for the management of patients with “border-line” DVH.

关键词： Toxicity Radiotherapy Prostate Cancer Prevention

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Prevention and Treatment of Radiation Induced Skin Damage in Breast Cancer

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Journal of Cosmetics, Dermatological Sciences and Applications 2014年第1期4卷 16-23页

作者： Rossella Di Franco vincenzo ravo Sara Falivene Angela Argenone Valentina Borzillo Francesca Maria Giugliano Elena Sammarco Matteo Muto Salvatore Cappabianca Paolo Muto Radiation Oncology Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione “Giovanni Pascale” IRCCS Naples Italy Radiation Oncology Muto-Onlus Foundation of Naples Casavatore Naples Italy Radiation Oncology Second University of Naples Naples Italy U.O.S. of Dermatology P.O. Ascalesi Naples Italy

Introduction: Skin toxicity is a frequent side effect of radio and chemo-treatments in patients treated for breast cancer after conservative surgery. The aim of this paper is to report our experience in the management of skin toxicity evaluating radiotherapy planning and using preventive local aids. Materials and Methods: We have observed 300 patients undergoing radiotherapy. All received the prescription of a prophylactic moisturizing cream. Skin toxicity was valuated according to Acute Radiation Morbidity Scoring Criteria of the RTOG. Moreover, in a subgroup of 100 patients, we correlated the study of breast volume and features of treatment plans, with the addition of topic prophylactic treatment, using an oral therapy based on Resveratrol, Lycopene, Vitamin C and Anthocyanins (Ixor?). In another subgroup, 100 patients were subjected to corneometry assessing numerically skin hydration before, during and after radiotherapy. Results: In all patients, we related skin toxicity and the type of cream used. All patients completed the radiotherapy treatment, and G4 cutaneous toxicity was not observed in any of them. In patients treated with topic treatment and therapy based on Resveratrol, Lycopene, Vitamin C and Anthocyanins (Ixor?), the protective effect of (Ixor?) is more detected in patients with PTV (Planning Target Volume) <500 ml, when Dmax reaches values lower or equal to 107%, but not exceeding 110% of the prescribed dose, and in patients undergoing adjuvant chemotherapy with anthracyclines and taxanes. The values of corneometry allow us to evaluate the moisturizing effect for products used, and identify cases of skin toxicity in a first phase. Conclusions: Our study confirms the value of moisturizers in the prevention and resolution of radiotherapy-induced skin damage. An instrumental assessment of skin hydration with corneometry can help the radiation oncologist to use strategies that prevent the onset of toxicity of high degree.

关键词： Skin Toxicity Prevention and Treatment Radiotherapy

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