0000000000179775

AUTHOR

Gabriella Macchia

0000-0002-0529-201x

showing 7 related works from this author

Progestin-releasing intrauterine device insertion plus palliative radiotherapy in frail, elderly uterine cancer patients unfit for radical treatment.

2016

The present study investigated the combination of levonorgestrel-releasing intrauterine device (LNG-IUD) insertion and palliative radiotherapy (RT) as a potential approach for treating frail, elderly endometrial cancer (EC) patients considered unfit for curative oncological treatments. The inclusion criteria were an age of ≥65 years, pathological confirmation of a uterine neoplasm, a Charlson comorbidity index (CCI) value of ≥4 and the presence of vaginal bleeding. Patients underwent intrauterine insertion of an LNG-IUD, and thereafter, received a total dose of 30 Gy at 3 Gy per fraction, over 10 days. The clinical target volume (CTV) was defined as the uterus and disease-involved tissues i…

Cancer Researchmedicine.medical_specialtymedicine.drug_classUterusIntrauterine deviceelderlyuterine cancer03 medical and health sciences0302 clinical medicineUterine cancermedicineVaginal bleedingUterine NeoplasmSettore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIAprogestin-releasing intrauterine device030219 obstetrics & reproductive medicinebusiness.industryEndometrial cancerCancerArticlesmedicine.diseaseSurgeryElderly; Palliative radiotherapy; Progestin-releasing intrauterine device; Uterine cancer; Oncology; Cancer Researchmedicine.anatomical_structureOncology030220 oncology & carcinogenesispalliative radiotherapymedicine.symptombusinessProgestinOncology letters
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Intensity-modulated extended-field chemoradiation plus simultaneous integrated boost in the pre-operative treatment of locally advanced cervical canc…

2015

Objective: To investigate the feasibility and determine the recommended pre-operative intensity-modulated radiotherapy (IMRT) dose of extended-field chemoradiation along with simultaneous integrated boost (SIB) dose escalation. Methods: A radiation dose of 40Gy over 4 weeks, 2Gy/fraction, was delivered to the tumour and the lymphatic drainage (planning target volume, PTV3), which encompassed a volume larger than standard (common iliac lymphatic area up to its apex, in front of the L3 vertebra), concurrently with chemotherapy (cisplatin and 5-fluorouracil). Radiation dose was escalated to the pelvis (PTV2) and to the macroscopic disease (PTV1) with the SIB-IMRT strategy. Three dose levels we…

Chemoradiotherapy; Dose Fractionation; Feasibility Studies; Female; Humans; Middle Aged; Neoplasm Staging; Preoperative Period; Prospective Studies; Radiotherapy Dosage; Radiotherapy Planning Computer-Assisted; Radiotherapy Intensity-Modulated; Treatment Outcome; Uterine Cervical Neoplasms; Radiology Nuclear Medicine and Imaging; Medicine (all)Uterine Cervical NeoplasmRadiology Nuclear Medicine and Imagingcervical cancermedicine.medical_treatmentUterine Cervical NeoplasmsMedicineHumansProspective StudiesProspective cohort studyDose FractionationSettore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIANeoplasm StagingCervical cancerCisplatinChemotherapyFull Paperbusiness.industryMedicine (all)Radiotherapy Planning Computer-AssistedDose fractionationRadiotherapy DosageGeneral MedicineChemoradiotherapyMiddle Agedmedicine.diseaseRadiation therapyFeasibility StudieProspective StudieLymphatic systemTreatment OutcomePreoperative PeriodFeasibility StudiesFemaleDose Fractionation RadiationRadiotherapy Intensity-ModulatedbusinessNuclear medicineChemoradiotherapymedicine.drugHumanThe British journal of radiology
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Clinical outcome of recurrent locally advanced cervical cancer (LACC) submitted to primary multimodality therapies

2015

Abstract Objectives Recurrence of disease represents a clinical challenge in cervical cancer patients, especially when all available treatment modalities have been used in the primary setting. The aim of this study was to analyze the patterns of recurrence and their association with clinical outcome in locally advanced cervical cancer (LACC) patients submitted to primary chemoradiation (CTRT) followed by radical surgery (RS). Methods This study was conducted on 364 LACC patients treated with CTRT plus RS since January 1996 to July 2012. For each relapse, information on date of clinical/pathological recurrence, and pattern of disease presentation were retrieved. Post-relapse survival (PRS) w…

OncologyAdultmedicine.medical_specialtyUterine Cervical Neoplasmrecurrent cervical cancerPrognosimedicine.medical_treatmentUterine Cervical NeoplasmsDiseaseObstetrics and gynaecologyRetrospective StudieInternal medicinemedicineHumansRadical surgeryChemoradiation; Post-relapse survival; Prognosis; Radical hysterectomy; Recurrent cervical cancer; Adult; Chemoradiotherapy; Adjuvant; Female; Humans; Neoadjuvant Therapy; Neoplasm Recurrence; Local; Retrospective Studies; Survival Analysis; Treatment Outcome; Uterine Cervical NeoplasmschemoradiationSurvival analysisNeoadjuvant therapyAdjuvantRetrospective StudiesSettore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIACervical cancerbusiness.industrypost-relapse survivalObstetrics and GynecologyRetrospective cohort studyChemoradiotherapy AdjuvantChemoradiotherapymedicine.diseaseSurvival AnalysisNeoadjuvant TherapySurgeryLog-rank testTreatment OutcomeNeoplasm RecurrenceSettore MED/40 - GINECOLOGIA E OSTETRICIAOncologyLocalradical hysterectomyFemaleSurvival AnalysiprognosisNeoplasm Recurrence LocalbusinessHuman
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Completion Surgery After Concomitant Chemoradiation in Locally Advanced Cervical Cancer: A Comprehensive Analysis of Pattern of Postoperative Complic…

2014

Background: We provided a comprehensive analysis of rate, pattern, and severity of early and late postoperative complications in a very large, single-institution series of locally advanced cervical cancer (LACC) patients administered CT/RT plus radical surgery (RS). Methods: A total of 362 consecutive LACC (FIGO stage IB2-IVA) patients were submitted to RS after CT/RT at the Gynecologic Oncology Unit of the Catholic University (Rome/Campobasso). At 4 weeks after CT/RT, patients were evaluated for objective response and triaged to radical hysterectomy and pelvic ± aortic lymphadenectomy. Surgical morbidity was classified according to the Chassagne's grading system. Results: Most cases underw…

Malecervical cancermedicine.medical_treatmentUterine Cervical NeoplasmsPostoperative ComplicationsAntineoplastic Combined Chemotherapy Protocols80 and overlocally advanced cervical cancerAdjuvantSettore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIAAged 80 and overCervical cancerMedicine (all)Middle AgedPrognosisCombined Modality TherapyAdult; Aged; Aged; 80 and over; Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Squamous Cell; Chemotherapy; Adjuvant; Cisplatin; Combined Modality Therapy; Female; Fluorouracil; Follow-Up Studies; Humans; Hysterectomy; Lymph Node Excision; Male; Middle Aged; Neoplasm Grading; Postoperative Complications; Prognosis; Radiotherapy; Adjuvant; Survival Rate; Uterine Cervical Neoplasms; Young AdultSurvival RateOncologyChemotherapy AdjuvantCarcinoma Squamous CellFemaleFluorouracilAdultmedicine.medical_specialtyGynecologic oncologyHysterectomyYoung AdultmedicineHumansChemotherapyRadical HysterectomyRadical surgeryconcomitant chemoradiationSurvival rateAgedHysterectomyRadiotherapybusiness.industryCarcinomamedicine.diseaseSurgerySettore MED/40 - GINECOLOGIA E OSTETRICIASquamous CellConcomitantLymph Node ExcisionRadiotherapy AdjuvantSurgeryLymphadenectomyCisplatinNeoplasm GradingbusinessFollow-Up StudiesAnnals of Surgical Oncology
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Adjuvant volumetric-modulated arc therapy with simultaneous integrated boost in endometrial cancer. Planning and toxicity comparison

2014

Objective. To report dosimetric and acute toxicity data in prospectively enrolled high-intermediate risk endometrial cancer (HIR-EC) patients postoperatively irradiated by simultaneous integrated boost volumetric modulated arc therapy (SIB-VMAT). Methods. Thirty prospectively enrolled HIR-EC patients were postoperatively treated by SIB-VMAT. Target coverage, dose homogeneity, and sparing of organs at risk (OARs) were compared with corresponding data retrieved from an historical control (30 consecutive selected matched patients) treated by concomitant boost three-dimensional conformal radiotherapy (3D CRT CB) from a previously published study (ADA-I trial). All patients received 45 Gy on pel…

Simultaneous integrated boostAdultOrgans at RiskRadiology Nuclear Medicine and Imagingmedicine.medical_treatmentRectumvolumetric-modulated arc therapyMedicineHumansAgedAged 80 and overbusiness.industryEndometrial cancerRadiotherapy Planning Computer-AssistedtoxicityRadiotherapy DosageGeneral MedicineHematologyMiddle Agedmedicine.diseaseVolumetric modulated arc therapyAcute toxicityEndometrial Neoplasmsmedicine.anatomical_structureOncologysimultaneous integrated boostToxicityendometrial cancerVaginal vaultFemaleRadiotherapy Intensity-ModulatedbusinessNuclear medicineAdjuvant
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Minimally Invasive Approaches in Locally Advanced Cervical Cancer Patients Undergoing Radical Surgery After Chemoradiotherapy: A Propensity Score Ana…

2020

Abstract Purpose Chemoradiation (CT/RT) followed by radical surgery (RS) may play a role in locally advanced cervical cancer (LACC) patients with suboptimal response to CT/RT or in low-income countries with limited access to radiotherapy. Our aim is to evaluate oncological and surgical outcomes of minimally invasive radical surgery (MI-RS) compared with open radical surgery (O-RS). Patients and Methods Data for stage IB2–IVA cervical cancer patients managed by CT/RT and RS were retrospectively analyzed. Results Beginning with 686 patients, propensity score matching resulted in 462 cases (231 per group), balanced for FIGO stage, lymph node status, histotype, tumor grade, and clinical respons…

medicine.medical_specialtymedicine.medical_treatmentConcomitant Chemoradiation Neoadjuvant Chemotherapy Phase III Hysterectomy Radiation Therapy WomenUterine Cervical NeoplasmsHysterectomyDisease-Free Survival03 medical and health sciences0302 clinical medicinePhase IIIlocally advanced cervical cancer (LACC)locally advanced cervical cancerHumansMedicineWomenChemoradiotherapy; Disease-Free Survival; Female; Humans; Hysterectomy; Neoadjuvant Therapy; Neoplasm Recurrence Local; Neoplasm Staging; Propensity Score; Retrospective Studies; Uterine Cervical Neoplasms030212 general & internal medicineStage (cooking)Radical surgeryPropensity ScoreNeoadjuvant therapyNeoplasm StagingRetrospective StudiesCervical cancerHysterectomyRadiationbusiness.industrylocally advanced cervical cancer surgeryNeoadjuvant ChemotherapyRetrospective cohort studyChemoradiotherapyGynecologic Oncologymedicine.diseaseNeoadjuvant TherapySurgeryRadiation therapySettore MED/40 - GINECOLOGIA E OSTETRICIANeoplasm RecurrenceLocalOncology030220 oncology & carcinogenesisConcomitant ChemoradiationFemaleSurgeryTherapyNeoplasm Recurrence LocalbusinessChemoradiotherapy
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Successful treatment of a young patient with locally advanced clear cell adenocarcinoma of the uterine cervix undergoing chemoradiation followed by r…

2014

Clear cell adenocarcinoma (CCAC) of the uterine cervix is a rare variant of cervical adenocarcinoma accounting for approximately 4-9% of this disease. Given the rarity of this pathological entity, the optimal treatment management is far from being defined. Earlier evidence suggested that the prognosis of patients bearing cervical CCAC is worse than with other histotypes, thus making the investigation of multimodal treatment strategies clinically worthwhile. Herein, we report the first case of locally advanced, large size cervical CCAC in a young woman who was triaged to concomitant chemoradiotherapy followed by radical surgery and experienced a pathologically assessed optimal response to th…

Adultmedicine.medical_specialtyAdvanced clear cell adenocarcinomaUterine Cervical NeoplasmRadical surgeryUterine Cervical NeoplasmsDisease-Free SurvivalObstetrics and gynaecologyadenocarcinoma uterine cervixUterine cervixmedicineHumansCombined Modality TherapyClear-cell adenocarcinomaRadical surgeryPathologicalSettore MED/08 - ANATOMIA PATOLOGICAbusiness.industryObstetrics and GynecologyMultimodal therapyChemoradiotherapy Adjuvantmedicine.diseaseMultimodal approachCombined Modality TherapyImmunohistochemistryMagnetic Resonance ImagingSurgeryChemoradiationReproductive MedicineAdenocarcinomaFemalebusinessChemoradiotherapyAdenocarcinoma Clear CellHuman
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