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M Rampino,
U Ricardi,
F Munoz,
A Reali,
C Barone,
A R Musu,
V Balcet,
P Franco,
R Grillo,
S Bustreo, G Pecorari,
A Cavalot,
P Garzino Demo,
L Ciuffreda,
R Ragona,
M Schena
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ABSTRACT: Several randomised trials have tested adjuvant regimens using concomitant high-dose cisplatin and radiotherapy to improve outcome in high-risk locally advanced squamous cell head and neck cancer (HNSCC), showing a substantial increase in locoregional control and disease-free survival, despite a higher and eventually detrimental toxicity profile. The aim of the present phase II single-stage prospective study was to investigate whether a weekly cisplatin-based chemoradiotherapy regimen might be able to improve patients' compliance compared with standard-dose cisplatin with similar outcome results.
Between January 2004 and November 2008, 54 patients with high-risk locally advanced HNSCC were enrolled on to this phase II trial. Patient characteristics were: median age 59.7 years, Eastern Cooperative Oncology Group performance status 1 in 72% of patients and stage IV disease in 82%, extracapsular nodal spread in 67% and positive/close surgical margins in 37%. Patients received cisplatin (30 mg/m(2)) once a week for 7-8 weeks concurrent with external beam radiotherapy delivered with a median dose of 66.6 Gy (1.8 Gy each day; five fractions/week) on the primary site and 50 Gy (2 Gy each day) for the lower neck.
Major acute toxicity of the combined treatment, defined as grade 3-4 mucositis, was observed in 35.2% of patients. No fatal complications occurred, with 81.5% of patients completing the planned regimen. Late reactions were mild (total 16% with a grade 3 dysphagia rate of 12%). The locoregional control rate was 82%; 5 year overall and disease-free survival were 63 and 62%, respectively.
Concomitant adjuvant chemoradiotherapy with weekly cisplatin seems to be a feasible and well-tolerated therapeutic approach in 'unfit' patients. Clinical results seem to be at least comparable with those previously reported. However, to draw any definitive conclusion, large confirmatory phase III randomised trials are demanded.
Clinical Oncology 10/2010; 23(2):134-40. · 2.07 Impact Factor
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ABSTRACT: Polymorphous low grade adenocarcinoma (PLGA) is a rare malignant neoplasm of the minor salivary glands occurring in the fifth and sixth decade with a 2:1 female predominance. The nasal cavity is involved in less than 1% of cases. The incidence of clinically recognisable pituitary adenoma is 15 cases/million/year. The prevalence of non-functioning pituitary adenoma (NFPA) is estimated to be 70-90 cases/million. Both types of adenoma represent 20-45% of pituitary tumours.
The report describes the first case of PLGA associated with NFPA, both incidentally diagnosed. Three months after the exeresis of the NFPA using a trans-sphenoidal approach, an endoscopic resection of the PLGA was performed. No recurrence was observed during a 13 months follow-up.
Complete surgical excision is the preferred management for PLGA. Radiotherapy has not been demonstrated to be effective in treating PLGA. The prognosis is good with a very low rate of metastasis and local recurrence.
B-ENT 01/2010; 6(1):59-62.
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ABSTRACT: Many individuals with body dysmorphic disorder (BDD) seek non-psychiatric treatment. BDD occurs in about 5% of patients who seek cosmetic surgery, and rhinoplasty is the most frequently sought treatment. A correlation exists between individuals' self-esteem and demand for cosmetic surgery.
To investigate whether those subjects with BDD traits requesting cosmetic rhinoplasty differ from those without BDD traits in self-esteem, personality and quality of life.
This study included 54 patients applying to the 1st ENT Division of Turin University. Assessment of the patients before cosmetic rhinoplasty includes: nasal obstruction symptom evaluation, health-related quality of life, Rosenberg self-esteem scale, body dysmorphic disorder questionnaire (BDDQ) and temperament and character inventory (TCI). Based on their responses to BDDQ questions 1, 3 and 4, patients were subdivided into subgroups and then compared.
No difference emerged in the objective data. Lower self-esteem, higher harm avoidance (HA) and lower self-directedness (SD) are found in subjects who are worried about how they look, in those with interference in their social life due to this worry and in those who spend more than 3h per day thinking about the way they look. Novelty seeking (NS) is significantly higher in subjects who think about their looks for up to 3h than in those who spend less than 1h.
Different subgroups of patients are identified. The first group includes pessimistic, shy, insecure subjects; people with fragile and immature personality and poor self-esteem; individuals concerned about the way they look and those who spend more time thinking about it. The second group includes more confident subjects with stronger personality and greater self-esteem. A third, less differentiated group, includes more impulsive (high NS) subjects who spend an intermediate amount of time thinking about the way they look. Patients should be carefully screened and assessed before cosmetic surgery interventions to avoid frustration to both, clinicians and patients.
Journal of Plastic Reconstructive & Aesthetic Surgery 01/2009; 63(3):493-8. · 1.49 Impact Factor
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ABSTRACT: Subjective disturbances, due to hearing loss, are auditory disability and handicap which can be evaluated with a questionnaire. The present study refers to a population of industrial workers affected by noise-induced hearing loss. Aim of the study is to identify the minimal level of hearing loss over which the patient felt changes in his quality of life, and the average auditory threshold at which the patient considered the application of a hearing aid useful or necessary. The sample comprised 180 males with noise-induced hearing loss. Each subject received a questionnaire designed for this study. Data show a correlation between disability, handicap and the degree of noise-induced hearing loss. The most relevant problems in noise-induced hearing loss are correlated with disability rather than handicap. 35 dB can be considered as the level above which these devices can be suggested to patients. Hearing aids can become a therapeutic instrument even in the presence of a low degree of hearing loss.
Acta otorhinolaryngologica Italica: organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale 09/2008; 28(4):200-5. · 0.86 Impact Factor
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ABSTRACT: It has been confirmed that middle latency auditory-evoked potentials are good indicators of the hypnotic level in patients undergoing general anesthesia. The focal point for the evocation of auditory-evoked potentials is the presence of a serviceable hearing function. The aim of the study was to evaluate the limit of hearing loss above which the test could not be applied.
To determine the limit of applicability of the technique, 100 subjects were studied. Twenty of them were normally hearing and 80 were affected by sensorineural hearing loss of various degrees. Each subject was submitted to pure tone audiometry, to determine hearing threshold, and then, in awake status, to auditory-evoked potentials recording using acoustic stimuli of 85 dB HL.
All the 20 normally hearing subjects showed a reliable auditory-evoked potentials. Among the 80 subjects affected by hearing loss, only five had no potentials. These five subjects presented a pure tone audiometry threshold greater than 85 dB HL.
The study demonstrated that middle latency auditory-evoked potentials recorded using an A-Line (software version 1.4) AEP monitor (Danmeter, Odense, Denmark) can be carried out even in presence of hearing loss if the pure tone threshold is less than 85 dB HL.
Acta Anaesthesiologica Scandinavica 08/2005; 49(6):774-7. · 2.19 Impact Factor
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ABSTRACT: The purpose of this study was to assess and discuss the effects of old age and systemic diseases on complications related to the use of a pectoralis major myocutaneous flap (PMMF) for reconstruction in head and neck surgery. Eighty-four consecutive patients, operated on between January 1992 and December 1998, were included in the study. Of these patients, 47 were in relatively good condition, while 37were old and frail or affected by systemic diseases. Patients were monitored for complications during a follow-up of 2 years. All patients included in the study had very advanced squamous cell carcinomas (T3-T4) and reconstruction with PMMF was performed after a commando procedure, a total laryngectomy with partial pharyngectomy, or a composite resection. Necrosis of skin island was the most frequently encountered complication, but no surgical intervention was needed. Overall, complications occurred more frequently in patients with underlying pathologies, the risk ratio adjusted for age and sex being 2.94, but 95% confidence intervals were 0.99-8.65 and all complications were minor. In summary, we recommend the use of PMMF for immediate repair in difficult patients who have large oropharyngo-laryngeal excisions and radical neck dissections and who suffer concomitantly with various medical problems known to increase complication rates. PMMF proved to be suitable to give these patients good chances of a quick recovery with satisfactory aesthetic and functional results.
Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 01/2002; 258(10):542-5. · 1.29 Impact Factor
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ABSTRACT: The possibility of applying immunological methods to head and neck tumors prevention is discussed. The biological significance of tests evaluating the natural killer activity is reviewed. The IgA serum level in patients at risk for head and neck malignancy is proposed as a screening test.
Acta otorhinolaryngologica Italica: organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale 02/1990; 10 Suppl 27:55-8. · 0.86 Impact Factor
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ABSTRACT: The purpose of the present work was to analyze the role of PgE2 and indomethacin in the regulation of immune response. 18 patients with laryngeal cancer were chosen for the study. Three cultures on peripheral venous blood were taken from each subject in order to evaluate the variation in the different lymphocyte groups after the addition of PgE2 and its inhibiting factor: indomethacin. In the cultures with PgE2, an increase in T suppressor lymphocytes was observed while the T helper group showed a significant reduction (cultures with indomethacin produced the opposite effect). This result bears witness to the inhibiting effect PgE2 has on the immune system in subjects with laryngeal cancer. On the basis of these results, while awaiting further data, it can be suggested that future therapy be based on the administration of indomethacin in patients suffering from this disease.
Acta otorhinolaryngologica Italica: organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale 10(1):73-8. · 0.86 Impact Factor
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ABSTRACT: Clinical and biological prognostic factors in 135 patients affected by sinonasal carcinoma treated in Piedmont. Long-term survival of patients with sinonasal carcinoma remains disappointing in spite of aggressive treatment. The aim of the study is the assessment of overall survival in a group of patients treated with a fixed protocol and the positivity of proliferation and neoangiogenesis markers (Ki-67 and VEGF). From our data it comes out that staging, histological type and treatment are the most important clinical and pathological prognostic factors, moreover surgery +/- radiotherapy is the first line treatment for these tumors. Proliferation index and neoangiogenesis plays a pivotal role in the natural history of such neoplasms.
Giornale italiano di medicina del lavoro ed ergonomia 33(3 Suppl):108-11.
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ABSTRACT: Educational objectives at the conclusion of this presentation, the participant should be able to identify the different criteria that lead to the surgical approach rather than to the medical treatment (radiation therapy -RT--and/or chemotherapy--CT). Introduction. When we have to deal with medium or big recurrence of an oral or oropharingeal cancer is very difficult to make the right choice between the surgical or medical therapy: what we have to ask to ourselves is whether is legitimate to reoperate considering the sequences due to surgery and the results expected. Methods. From January 1997 to December 2002 we have treated by surgery 135 patients (mean age, 54) with oral and/or oropharingeal squamous cell carcinoma (SCC). The percentage of local recurrence was 30% (41/135 patients) and nodal recurrence was 6% (8/135 pt). Twenty-two/53 patients underwent to a salvage surgery; the others 31 patients to a RT and/or CT therapy. Conclusion. The overall survival was 29% in surgical patients after 3 years and 14% after 5; in the other patients the survival was 11% after 3 and 3% after 5 years. The comparison between the results in case of recurrent cancer of this distrect shows that the best approach is the surgery, where is possible; the choice is conditioned by the following parameters: the extension of the tumor, primary and recurrent; the presence of lymph node or distant metastases; time of recurrence; grading and histological characteristics of the tumor and performance status of patients.
I supplementi di Tumori : official journal of Società italiana di cancerologia ... [et al.]. 4(3):S193-4.
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C Barone,
R Grillo,
D Dongiovanni,
N Birocco,
M Rampino,
M G Ruo Redda,
E Garibaldi,
F Munoz, G Pecorari,
A Cavalot,
P Garzinodemo,
L Buffoni,
L Ciuffreda,
U Ricardi,
G Cortesina,
C Giordano,
M Fasolis,
S Berrone,
O Bertetto,
M Schena
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ABSTRACT: A phase II study was carried out to investigate an induction regimen with cisplatin, paclitaxel followed by radiotherapy concurrent with weekly cisplatin for locally advanced squamous cell carcinoma of the head and neck.
Stage III-IV disease patients were eligible. Two cisplatin (100 mg/m2) and paclitaxel (175 mg/m2) courses were administered every 21 days followed by standard fractionated external beam radiotherapy (approximately 70 Gy), concomitant to weekly cisplatin (30 mg/m2).
Thirty-five patients were enrolled: over 70% had unresectable disease with bulky lesions. Grade 3-4 neutropenia developed in 14% and G3 mucositis in 23%. Locoregional control was achieved in 51%. Median time to progression and overall survival were 10,7 and 17 months respectively; 2- and 3-year survival rates were 30% and 25% respectively.
Our induction two-drug regimen followed by chemoradiotherapy with concurrent weekly cisplatin was well tolerated with low acute toxicity and good locoregional control and survival rate.
Anticancer research 28(2B):1285-91. · 1.73 Impact Factor
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M Boita,
M Garzaro,
Luca Raimondo,
G Riva,
J Mazibrada,
B Vizio,
G Bellone, G Pecorari,
C Bucca,
G Rolla,
C Giordano
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ABSTRACT: Chronic Rhinosinusitis with or without Nasal Polyps (CRSwNP and CRSsNP) may be characterized by different cytokine profiles. Generally, Th2 cytokines and eosinophilic infiltration have been reported to be more specific of CRSwNP compared to CRSsNP, where neutrophils seem to play a major role. The epithelial cell-derived thymic stromal lymphopoietin (TSLP) has been recently identified as a key factor in Th2-inflammatory response. The aim of this study is to investigate the expression of TSLP Receptor (TSLP R) in surgical specimens obtained from patients affected by CRSwNP (n=10) and CRSsNP (n=5) by immunohistochemical techniques (immunostaining score, IS). TSLP R expression was significantly higher in the inflammatory infiltrate and in the epithelial cells of CRSwNP, CRSsNP patients compared to the control group (IS 4.5±0.68, 4.4±1.44 and 0.43±0.3 respectively, p=0.0024 for inflammatory infiltrate and IS 5.8±0.92, 7.8±2.06 and 0.86±0.55 respectively, p=0.0018 for epithelial cells). No significant difference was observed in IS of inflammatory infiltrate and epithelial cells in CRSwNP compared to CRSsNP. Very low IS for TSLP R was found in connective tissue of all the samples, with no difference among the groups. TSLP receptor is highly expressed in CRS compared to controls and independently from the polyps suggesting an early common inflammatory pathway in the two CRS phenotypes.
International journal of immunopathology and pharmacology 24(3):761-8. · 2.99 Impact Factor
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ABSTRACT: Dietary habits can be influenced by several factors such as emotional status and food palatability represented by food smell, taste, texture, appearance and temperature. The aim of this study is to assess the palatability and digestibility of a coffee-flavored iced dessert ingested at the end of a standardized meal and its impact on emotional status in a sample of 30 healthy female volunteers. Thirty healthy female volunteers, after ENT and psychological assessment, were asked to fill in a Psycho-Emotional Questionnaire to assess their basal emotional pattern before the consumption of an iced coffee-flavored dessert after a standard meal. After the meal they filled in an Organoleptic-Sensory questionnaire, a Dynamic Digeribility questionnaire and again a Psycho-Emotional Questionnaire. In our study, most of the subjects found the tested coffee-flavoured iced dessert pleasant according to the Organoleptic-Sensorial Questionnaire (OSQ), in terms of taste, aspect, texture and smell; moreover, in 29 subjects the Dynamic Digestibility Questionnaire (DDQ) resulted in a good digestive experience. By means of the Psycho-Emotional Questionnaire (PEQ), an improvement of feelings and mood, associated with good data of digestibility and palatability was recorded. Although this observation is not statistically significant, the results seem to show a positive correlation between pleasure in eating such a product and emotional status. These data are preliminary and need further investigations on a larger population, in order to confirm this association, also in a mixed population, comparing male and female eating behaviour.
Journal of biological regulators and homeostatic agents 24(4):391-5. · 5.18 Impact Factor
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ABSTRACT: Food choices are influenced by many factors, perhaps the most important being availability. However, the desire to consume one item over another may be viewed as an outcome of sensory hedonic likes, situation and current internal state. In a previous preliminary report, an improvement of joy and mood, associated with good data of digestibility and palatability, was observed in a group of 30 healthy female subjects who consumed a coffee-flavoured iced dessert immediately after a standardized meal. The aim of this study is to confirm the results previously obtained in a smaller population and to investigate whether any differences between male and female subjects could be observed concerning the digestive process and emotional status. One hundred volunteers, after ENT and psychological assessment, were asked to fill out a Psycho-Emotional Questionnaire to assess their basal emotional pattern before the consumption of an iced coffee-flavoured dessert after a standard meal. After the meal they completed an Organoleptic-Sensory questionnaire, a Dynamic Digestibility questionnaire and again the Psycho-Emotional Questionnaire. In our study, most of the 100 subjects found the tested coffee-flavoured iced dessert pleasant according to the Organoleptic-Sensorial Questionnaire (OSQ), in terms of taste, aspect, texture and smell; moreover, the Dynamic Digestibility Questionnaire (DDQ) showed a good digestive experience in 71 subjects. According to the Psycho-Emotional Questionnaire (PEQ), an improvement of joy, activation and mood, associated with good data of digestibility and palatability was recorded. All these observations are statistically significant and the results seem to show a positive correlation between pleasure in eating such a product and emotional status. No statistically significant differences were recorded between male and female subjects.
Journal of biological regulators and homeostatic agents 25(1):101-7. · 5.18 Impact Factor
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ABSTRACT: The aim of our study is to assess, with objective measures, the impact on digestion of a coffee-flavoured iced dessert ingested at the end of a standardized meal; moreover, a subjective assessment, using a specific questionnaire, was carried out in order to compare objective and subjective data. Ten healthy male volunteers, after ENT and psychological assessment, underwent two scintigraphic evaluations (standardized meal without and with coffee-flavoured iced dessert) and, after the meal, filled in a specific questionnaire named dynamic digestibility questionnaire. In our sample the ingestion of the coffee-flavoured iced dessert seemed to improve the digestibility of a standardized meal: the difference between the curves of gastric emptying without and with iced dessert is statistically significant. These data are strongly confirmed by subjective assessment: the dynamic digestibility questionnaire (DDQ) showed a higher digestibility of a standardized meal with the coffee-flavoured iced dessert in comparison to a normal meal. The current study represents a preliminary report on this topic with a small sample of healthy volunteers: further studies on larger population are requested in order to confirm all the encouraging results herein discussed.
Journal of biological regulators and homeostatic agents 24(2):215-20. · 5.18 Impact Factor
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ABSTRACT: Several variables lead to changes in human and animal eating behaviour and food choices. A pivotal role is played by food palatability, represented by food, smell, taste, texture, appearance and temperature. The aim of our study is to assess the potential differences in palatability and digestibility of four different flavoured iced desserts, consumed at the end of a standardized meal, and their impact on the emotional status of 60 healthy volunteers. Sixty healthy volunteers, after ENT and psychological assessment, were asked to fill out a Psycho-Emotional Questionnaire (PEQ) to assess their basal emotional pattern before the consumption of an iced dessert at the end of a standard meal, after which they completed an Organoleptic-Sensory Questionnaire (OSQ), a Dynamic Digestibility Questionnaire (DDQ) and again the PEQ. Four different flavors (lemon, tangerine, pineapple and chocolate) were tested on 4 consecutive days on the same subjects. Most of the 60 subjects, by means of OSQ, found taste, aspect, texture and smell of the 4 flavours pleasant, lemon and tangerine were the freshest and lightest. The DDQ identified pineapple and chocolate dessert as those less digestible. By means of PEQ we recorded an improvement in joy, mood and activation, associated with good data of digestibility and palatability after the consumption of all flavors. Our data showed that all flavors improve joy, mood and activation, after their consumption, without statistically significant differences. However, among the tested flavours, lemon and tangerine appear to be the most pleasant and those which facilitate the digestive process.
Journal of biological regulators and homeostatic agents 26(2):237-43. · 5.18 Impact Factor
