G L Buttini

Publications (3)5.49 Total impact

• Article: Multivariate analysis of a tissue CEA, TPA, and CA 19.9 quantitative study in colorectal cancer patients. A preliminary finding.

  M Cosimelli, F De Peppo, M Castelli, D Giannarelli, G Schinaia, P Castaldo, G L Buttini, F Sciarretta, G Bigotti, F Di Filippo
  [show abstract] [hide abstract]
  ABSTRACT: Tissue CEA, TPA, and CA 19.9 concentrations from samples of surgical specimens were measured in 47 evaluable colorectal cancer patients (median follow-up, 20 months, 13 recurrences) and correlated with individual patient follow-up status. The quantitative method appeared to be sensitive, easily reproducible, and standardizable. The tissue marker concentration was analyzed by means of the multivariate discriminant analysis, to evaluate the risk of relapse in each patient; the tumor CEA (CEA T) showed the best discriminant capacity (P = .005). The relative Fisher function provided a reliable prognostic patient index, independently of other recognized prognostic factors (Dukes' stage and cellular differentiation grade). The Cox model showed a statistical significance analyzing the tumor (T) and healthy mucosa (M) CEA values (P = .001 and P = .006, respectively). The combination of these two variables allowed for identification of three classes of patients according to CEA T and M threshold values of 216 and 85 ng/mg of protein, respectively, and different disease-free curves were obtained for each group. The two-year disease-free rate was 81 percent for patients with low values of both CEA T and M, and 21.4 percent for the group with both values above these thresholds (P = .0008). In the third class (CEA T or M higher than the reported cut-off levels), the two-year disease-free rate was 65.9 percent.
  Diseases of the Colon & Rectum 06/1989; 32(5):389-97. · 3.13 Impact Factor
• Article: Thermochemotherapy for soft tissue sarcoma.

  F Di Filippo, G L Buttini, A M Calabro, S Carlini, D Gianarelli, F Moscarelli, F Graziano, A Cavallari, F Cavaliere, R Cavaliere
  Cancer treatment and research 02/1989; 44:111-27.
• Article: The role of hyperthermic perfusion as a first step in the treatment of soft tissue sarcoma of the extremities.

  F Di Filippo, A M Calabrò, A Cavallari, S Carlini, G L Buttini, F Moscarelli, F Cavaliere, L Piarulli, R Cavaliere
  [show abstract] [hide abstract]
  ABSTRACT: Eighty-six patients with locally advanced, high-grade soft tissue sarcomas of the extremities were studied prospectively in order to determine the efficacy of hyperthermic perfusion (HP) or hyperthermic antiblastic perfusion (HAP) as the first step of a combined multimodality therapy. The immediate response was evaluated in terms of tumor regression, and results confirmed the in vivo sensitivity of human sarcomas to the selective antineoplastic action of heat alone or combined with drugs (melphalan, actinomycin D, and cis-platinum). HAP has been shown to be simpler and safer than HP, and it is now currently routinely employed. As far as the long-term cure is concerned, all the patients have been evaluated for functional results, locoregional control, and survival, according to the different treatment schedules. The first clinical trials employed HP or HAP followed by delayed surgery alone. In 11 of 17 evaluable patients treated with HP, and in 17 of 29 treated with HAP, conservative surgery could be performed. A high incidence of locoregional relapse (24%) occurred, with low overall survival rates: 50.1% and 31.7% at 5 and 10 years after HP plus surgery, and 47.9% after HAP plus surgery at both 5 and 10 years. The protocol was, therefore, modified to include continuous intraarterial infusion of Adriamycin (ADR) (17 patients) or radiotherapy (9 patients) before surgery. The results obtained thus far may be summarized as follows: (a) conservative surgery with functional limb-salvage was possible in all patients; (b) the percentage of locoregional failure decreased to approximately 12% after HAP + ADR infusion + excision, the 5- and 10-year overall survival rates both being 77.6 %, and the 5- and 10-year disease-free rates both being 57.8%; (c) no local recurrences occurred in the group treated with HAP + radiotherapy + excision with a 5-year overall survival rate of 71.5% and a 5-year disease-free rate of 50.4%. In conclusion, the combined multimodality approaches employed appear to have improved both functional results and long-term cure, even though these must be further confirmed on a larger series of patients.Ochenta y seis pacientes con sarcomas de los tejidos blandos de las extremidades, de alto grado histolgico, e invasin local avanzada fueron estudiados en forma prospectiva con el objeto de determinar la eficacia de la perfusin hipertrmica (PH) o la perfusin hipertrmica antiblstica (PHA) como primer paso dentro de una terapia combinada multimodal.La respuesta inmediata fue valorada en trminos de la regresin tumoral, y los resultados confirmaron la sensibilidad in vivo de los sarcomas humanos a la accin antineoplsica selectiva del calor slo o combinado con drogas (melfaln, actinomicina D, y cis-platino). La PHA ha demostrado ser ms sencilla y ms segura que la PH y actualmente es utilizada en forma rutinaria.En lo referente a curacin a largo plazo, todos los pacientes han sido evaluados en cuanto a resultados funcionales, control locorregional, y supervivencia, de acuerdo a los diferentes programas teraputicos.En los primeros ensayos clnicos se utiliz PH o PHA seguida de ciruga solamente. En 11 de 17 pacientes valorables tratados con PH y 17 con PHA, fue posible realizar ciruga conservadora. Se present una incidencia alta de relapso locorregional (24%), con tasas bajas de supervivencia global: 50.1% y 31.7% a 5 y 10 aos con PH y ciruga, y 47.9% con PHA y ciruga tanto a 5 como a 10 aos.El protocolo fue consecuentemente modificado para incluir una infusin intraarterial continua de Adriamicina (ADR) (17 pacientes) o radioterapia (9 pacientes) antes de la ciruga.Los resultados logrados hasta el momento pueden ser resumidos as: (a) la ciruga conservadora con salvamento del miembro fue posible en la totalidad de los pacientes; (b) el porcentaje de falla locorregional disminuy aproximadamente 12% despus de PHA + infusin de ADR + reseccin, con supervivencias globales a 5 y 10 aos de 77.6%, y tasas de estado libre de enfermedad a 5 y 10 aos de 57.8%; (c) no se presentaron recurrencias locales en el grupo tratado con PHA + radioterapia + reseccin, con una tasa de supervivencia global a 5 aos de 71.5% y una tasa de estado libre de enfermedad a 5 aos de 50.4%.En conclusin, los aproches con terapia combinada multimodal empleados parecen haber mejorado tanto los resultados funcionales como las tasas de curacin a largo plazo, aunque estos resultados an deben ser reconfirmados en una serie mayor de pacientes.Une tude prospective concernant 86 malades qui prsentaient un sarcome des parties molles des membres de stade volutif avanc a t entreprise pour dterminer l'efficacit de la perfusion hyperthermique ou de la perfusion hyperthermique antiblastique en tant que premire tape d'un traitement modalits multiples.La rponse immdiate a t apprcie en fonction de la rgression tumorale. Les rsultats ont confirm la sensibilit in vivo des sarcomes humains l'action antinoplasique slective de la chaleur employe isolemment ou combine avec des drogues (melphalan, actinomycine D, et cis-platinum). La perfusion hyperthermique antiblastique s'est montre plus simple et plus sre que la perfusion hyperthermique, et de ce fait est devenue une mthode thrapeutique normalement employe.Pour apprcier l'action thrapeutique long terme tous les malades ont t tudis en tenant compte des rsultats fonctionnels, du contrle loco-rgional, et de la survie obtenus selon les diffrentes thrapeutiques appliques.Les premiers essais ont eu recours l'hyperthermie thermique ou l'hyperthermie thermique antiblastique suivie d'une intervention chirurgicale. Chez 11 des 17 malades traits par l'hyperthermie thermique, et chez 17 des 29 malades soumis l'hyperthermie antiblastique le traitement chirurgical conservateur a pu tre ralis. Les rsultats furent les suivants: frquence importante des rcidives loco-rgionales (24%); taux global de survie bas: 50.1% et 31.7% 5 ans et 10 ans aprs perfusion hyperthermique suivie de chirurgie, ce taux tant de 47.9% aprs perfusion hyperthermique antiblastique suivie de chirurgie 5 ans et 10 ans.En fonction de ces rsultats le protocole thrapeutique fut modifi en y ajoutant une transfusion intra-artrielle continue d'Adriamycine (17 malades) ou de la radiothrapie (9 malades) avant l'intervention.Les rsultats obtenus ce jour peuvent se rsumer ainsi: (a) la chirurgie conservatrice permettant de sauver un membre fonctionnel est toujours possible; (b) la poucentage d'chec rgional dcroit environ jusqu' 12% aprs perfusion hyperthermique antiblastique associe la perfusion d'Adriamycine et l'excision, le taux global de survie 5 ans et 10 ans tant de 77.6%, le taux d'absence de la maladie 5 ans et 10 ans tant de 57.8%; (c) aucune rcidive locale n'est survenue dans le groupe trait par perfusion hyperthermique antiblastique associ la radiothrapie et l'exrse, le taux global de survie 5 ans tant de 71.5% et le taux d'absence de la maladie 5 ans tant de 50.4%.En conclusion le traitement qui a t employ associant plusieurs modalits thrapeutiques a entrain une amlioration des rsultats fonctionnels et de la cure long terme encore que ce fait demande a t confirm par une tude tendue un plus grand mombre de malades.
  World Journal of Surgery 07/1988; 12(3):332-9. · 2.36 Impact Factor