Serena Chiacchio

Publications (4)7.58 Total impact

• Article: Radiofármacos para el tratamiento paliativo del dolor en pacientes con metástasis óseas y su posible integración con la quimioterapia. / Radiopharmaceuticals for pain palliation therapy in patients with skeletal metastases, and their possible integration with chemotherapy

  Serena Chiacchio, Elisa. Borso, Abedallatif A AlSharif, Giuseppe Boni, Giuliano Mariani
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  ABSTRACT: Resumen.Los informes de autopsia relatan la ocurrencia de metástasis óseas hasta en el 70% de los pacientes con cáncer de mama o de próstata. La localización preferencial de metástasis óseas en el esqueleto axial es probablemente debida al flujo sanguíneo en la médula ósea (especialmente abundante en el esqueleto axial) y al hecho de que la sangre venosa de la pelvis o mama a través del plexo venoso vertebral (circulación de Batson) representan factores de riesgo predisponentes para la siembra del tumorAbstract.Autopsy-based studies report the occurrence of skeletal metastases in up to 70% of the patients with breast or prostate cancer. Common localization of bone metastases in the axial skeleton is probably due to sluggish blood flow in the red marrow (which is particularly abundant in the axial skeleton) and to the fact that venous blood from the pelvis or breast flows through the vertebral-venous plexus (Batson circulation); both these occurrences represent predisposing conditions for tumor seeding
  Alasbimn Journal. 01/2010;
• Article: Clinical benefit of bone-targeted radiometabolic therapy with 153Sm-EDTMP combined with chemotherapy in patients with metastatic hormone-refractory prostate cancer.

  Sergio Ricci, Giuseppe Boni, Ilaria Pastina, Dario Genovesi, Claudia Cianci, Serena Chiacchio, Cinzia Orlandini, Mariano Grosso, Abedallatif Alsharif, Aldo Chioni, Samantha Di Donato, Francesco Francesca, Cesare Selli, Domenico Rubello, Giuliano Mariani
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  ABSTRACT: Bone metastases are responsible for most of the morbidity associated with hormone-refractory prostate cancer (HRPC). 153Sm-ethylenediaminetetramethylene phosphonate (153Sm-EDTMP) has been approved for palliation of painful skeletal metastases. We retrospectively investigated the possible synergistic effect on survival of 153Sm-EDTMP (given to HRPC patients for bone pain palliation) and chemotherapy. Forty-five HRPC patients were evaluated, with a median age of 71 years. The number of metastatic bone sites was <or=10 in 25 patients and >10 in 20 patients. Median serum PSA was 224 ng/ml. Bone pain was mild in 6 patients, moderate in 16, severe in 22 and intolerable in 1. Fifteen patients were only treated with 153Sm-EDTMP (group A), while 30 patients also received chemotherapy (estramustine phosphate or mitoxantrone plus prednisone) at variable times: between 3 and 5 months after 153Sm-EDTMP (14 patients, group B) or within 1 month after 153Sm-EDTMP (16 patients, group C). Haematological toxicities observed after either regimen were in general mild, consistent with common observations after either 153Sm-EDTMP or chemotherapy, and without any additive adverse effects in the patients receiving both 153Sm-EDTMP and chemotherapy. Bone pain palliation to some degree was induced by 153Sm-EDTMP in 32/45 patients (71.1%), the proportion of patients with a favourable clinical response being significantly higher in group C than in group A (87.5% vs 53.3%, p = 0.0388). Also in terms of biochemical response (serum PSA levels), patients of group C performed significantly better than patients of group A (p = 0.0235). Overall median survival from the time of administration of 153Sm-EDTMP was 15 months in the total cohort of 45 patients, and was significantly longer in group C than in either group B (30 months vs 11 months, p = 0.023) or group A (30 months vs 10 months, p = 0.008). The results of this study confirm that 153Sm-EDTMP is effective in terms of pain relief and PSA response, with minimal toxicity. When it was administered in combination with chemotherapy, prolonged survival indicated actual clinical benefit, while there were no additive toxicities. These results provide the rationale for future prospective evaluation of combined therapeutic strategies.
  European journal of nuclear medicine and molecular imaging 08/2007; 34(7):1023-30. · 4.99 Impact Factor
• Article: Comparison of different thyroid committed doses in radioiodine therapy for Graves' hyperthyroidism.

  Mariano Grosso, Antonio Traino, Giuseppe Boni, Elena Banti, Mauro Della Porta, Gianpiero Manca, Duccio Volterrani, Serena Chiacchio, Abedallatif AlSharif, Elisa Borsò, Rosanna Raschillà, Fabio Di Martino, Giuliano Mariani
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  ABSTRACT: Despite vast worldwide experience in the use of 131I for treating Graves' disease (GD), no consensus of opinion exists concerning the optimal method of dose calculation. In one of the most popular equations, the administered (131)I dose is directly proportional to the estimated thyroid gland volume and inversely proportional to the measured 24-hour radioiodine uptake. In this study, we compared the efficiency of different tissue-absorbed doses to induce euthyroidism or hypothyroidism within 1 year after radioiodine therapy in GD patients. The study was carried out in 134 GD patients (age, 53 +/- 14 year; range, 16-82 year; thyroid volume, 28 +/- 18 mL; range, 6-95 mL; average 24-hour thyroid uptake, 72%) treated with (131)I therapy. The average radioiodine activity administered to patients was 518 +/- 226 MBq (range, 111-1110). The corresponding average thyroid absorbed dose, calculated by a modified Medical Internal Radiation Dose (MIRD) equation was 376 +/- 258 Gy (range, 99-1683). One year after treatment, 58 patients (43%) were hypothyroid, 57 patients (43%) were euthyroid, and 19 patients (14%) remained hyperthyroid. The patients were divided into 3 groups: 150 Gy (n = 32), 300 Gy (n = 58) and >300 Gy (n = 44). No significant difference in the rate of recurrent hyperthyroidism was found among the 3 groups (150 Gy: 15%; 300 Gy: 14%; and > or =300 Gy: 14%; chi-square test, p = 0.72). Whereas, the rate of hypothyroidism in the 3 groups was significantly correlated with the dose (150 Gy: 30%; 300 Gy: 46%; >300 Gy: 71%; chi-square test, p = 0.0003). The results obtained in this study show no correlation between dose and outcome of radioiodine therapy (in terms of persistent hyperthyroidism) for thyroid absorbed doses > or =150 Gy, while confirming the relation between the thyroid absorbed dose and the incidence of hypothyroidism in GD patients.
  Cancer Biotherapy and Radiopharmaceuticals 04/2005; 20(2):218-23. · 1.79 Impact Factor
• Article: Contribution of radioiodine uptake measurement and thyroid scintigraphy to the differential diagnosis of thyrotoxicosis.

  Abedallatif A Al-Sharif, Mousa A Abujbara, Serena Chiacchio, Kamel M Ajlouni, Giuliano Mariani
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  ABSTRACT: Both clinical and subclinical thyrotoxicosis can result from a wide range of disorders. Establishing the correct etiology underlying thyrotoxicosis is essential to direct treatment towards its specific pathophysiologic process. Based on clinical experience and guideline recommendations, radioiodine iodine uptake (RAIU) measurement and scintigraphy are often requested as the first-line investigation in thyrotoxic patients; however, their specific individual contribution to the differential diagnosis of thyrotoxicosis has not been previously investigated. In our study we aimed at evaluating the diagnostic role of RAIU measurement and scintigraphy in the management of thyrotoxicosis. A total of 108 patients with clinical and 42 patients with subclinical thyrotoxicosis were included in this retrospective study. All patients had RAIU measured at 24 hours after (131)I-iodide administration, followed by thyroid scintigraphy. Based on the combination of RAIU and scintigraphy, patients were classified as having diffuse toxic goiter (DTG) in 44% (the most common diagnosis), toxic adenoma in 15.9%, thyroiditis in 14%, and toxic multinodular goiter in 2.7%, while the pattern was inconclusive in 22.7% of all patients. When considering only patients with clinical thyrotoxicosis, the scan was inconclusive in 12.9% of patients whereas it was inconclusive in 47.6% of patients with subclinical thyrotoxicosis. There was a highly significant association between thyrotoxic status and scan result, with a statistically significant better performance of RAIU and scintigraphy in patients with clinical thyrotoxicosis when compared to patients with subclinical thyrotoxicosis considered as a whole (P<0.001). Instead, no statistically significant difference was observed between patients with subclinical thyrotoxicosis and TSH <0.1 mU/L and patients with TSH between 0.1 mU/L and 0.4 mU/L (P=0.191). In conclusion, we confirm the key role of RAIU and scintigraphy in the management of thyrotoxicosis and document its better performance in patients with clinical thyrotoxic status.
  Hellenic journal of nuclear medicine 13(2):132-7. · 0.81 Impact Factor