Eugenio Borsatti

CRO Centro di Riferimento Oncologico di Aviano, Aviano, Friuli Venezia Giulia, Italy

Are you Eugenio Borsatti?

Claim your profile

Publications (32)118.98 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose The purpose of this study was to evaluate patient-centered outcomes of decompressive percutaneous endoscopic gastrostomy (dPEG) in patients with malignant bowel obstruction due to advanced gynecological and gastroenteric malignancies. Methods This is a prospective analysis of 158 consecutive patients with small-bowel obstruction from advanced gynecological and gastroenteric cancer who underwent PEG or percutaneous endoscopic jejunostomy (PEJ) positioning for decompressive purposes from 2002 to 2012. All of them had previous abdominal surgery and were unfit for any other surgical procedures. Symptom relief, procedural complications, and post dPEG palliation were assessed. Global Quality of Life (QoL) was evaluated in the last 2 years (25 consecutive patients) before and 7 days after dPEG placement using the Symptom Distress Scale (SDS). Results dPEG was successfully performed in 142 out of 158 patients (89.8 %). Failure of tube placement occurred in 16 patients (10.1 %). In 8/142 (5.6 %) patients, dPEG was guided by abdominal ultrasound. In 3/142 patients, dPEG was CT-guided. In 14 (9.8 %) patients, who had previously undergone total or subtotal gastrectomy, decompressive percutaneous endoscopic jejunostomy (dPEJ) was performed. In 1/14 patients, dPEJ was CT-guided. Out of 142 patients, 110 (77.4 %) experienced relief from nausea and vomiting 2 days after PEG. Out of 142 patients, 116 (81.6 %) were discharged. The median postoperative hospital stay was 9 days (range 3–60). Peristomal infection (14 %) and intermittent obstruction (8.4 %) were the most frequent complications associated with PEG. Median survival time was 57 days (range 4–472) after PEG placement. Twenty-five patients had QoL properly evaluated with SDS score before and 7 days after dPEG. Sixteen patients (64 %) out of 25 exhibited an improvement of QoL (p < 0.05), 7 (28 %) patients exhibited a non-significant worsening of QoL (p = 0.18), and in 2 (8 %) patients, it remained unmodified. Conclusions dPEG is feasible, effective, relieves nausea and vomiting in patients with unremitting small-bowel obstruction from advanced gynecological and gastroenteric cancer, and improves QoL.
    No preview · Article · Feb 2016 · Supportive Care Cancer
  • [Show abstract] [Hide abstract]
    ABSTRACT: The advent of antiretroviral therapy (ART) has markedly extended the survival rates of patients with human immunodeficiency virus (HIV), leading to suppression even though not eradication of HIV. In HIV infected patients, cancer has become a growing problem, representing the first cause of death. A large number of worldwide studies have shown that HIV infection raises the risk of many non-AIDS defining cancers (NADCs), including squamous cell carcinoma of the anus (SCCA), testis cancer, lung cancer, cancer of the colon and rectum (CRC), skin (basal cell skin carcinoma and melanoma), Hodgkin disease (HD) and hepatocellular carcinoma (HCC). Generally in HIV positive patients NADCs are more aggressive and in advanced stage disease than in the general population. In the ART era, however, the outcome of HIV positive patients is more similar as in the general population. Only about lung cancer the outcome seems different between HIV positive and HIV negative patients. The aim of this article is to provide an update on NADCs within the activity of the Italian Cooperative Group on AIDS and Tumors (GICAT) to identify clinical prognostic and predicting factors in patients with HIV infection included in the GICAT.
    No preview · Article · Oct 2015 · European review for medical and pharmacological sciences
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To determine when 18F-choline PET/CT can truly identify local recurrence of prostate cancer. Methods: 1031 patients from 3 European centers underwent (18)F-choline PET/CT (FCH PET/CT) for recurrent disease; 131 subjects (12.7%) showed a positive FCH uptake in the prostatic gland or prostatic fossa. Median age was 72 years (range 48-87 years), and the median PSA level at the time of FCH PET/CT scan was 4.41 ng/mL (0.22-18.13 ng/mL). 45 patients (34.4%) had a Gleason score (GS) >7, and the residual subjects had a GS ≤7. The assessment of true or false-positive FCH PET/CT findings was made by magnetic resonance imaging (n = 34) and/or biopsy in 75/131 cases. A χ (2) test and a Z Kolmogorov-Smirnov test were used to assess the correlation between clinical variables (age, PSA, GS, type of therapy) and FCH PET/CT findings. Results: FCH PET/CT resulted truly positive (TP) for recurrent disease in the prostatic gland/fossa in 59/75 patients (79%) and falsely positive (FP) in 16 subjects (21%). The median value of PSA at the time of FCH PET/CT scan was higher in TP as compared to FP, although not statistically significant (4.76 vs. 3.04 ng/mL p > 0.05). Similarly, median age, GS categories, and the type of therapy were similar between the two groups (p > 0.05). However, when matching GS categories and PSA values, we found that the number of patients with TP findings were higher in the case of a PSA >2 ng/mL, independently from the GS (ranging between 74% and 92%). Conversely, FP rate ranged between 50% and 65% in patients with a PSA ≤2 ng/mL, especially in the case of GS ≤7, whereas FP was around 25% in those with a GS >7 and PSA >2 ng/mL. Conclusions: FCH PET/CT has a limited role in evaluation of prostatic gland/fossa recurrence, due to the physiological biodistribution of the radiopharmaceutical agent. However, in 70-90% of patients with a PSA >2 ng/mL, independently from GS, a focal FCH uptake is compatible with a true local recurrence.
    Full-text · Article · Oct 2015 · Abdominal Imaging
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Rationale: Gleason score (GS) is a well-established predictive risk factor for recurrence prostate cancer (PCa) after primary treatment, but its value to predict a positive radiolabelled choline positron emission tomography (PET)/computed tomography (CT) has been reported to be less robust than that of trigger PSA. To explore the ability of the initial GS to predict the detection rate of recurrent PCa with (18)F-fluorocholine (FCH) PET/CT in a large cohort of patients. Data of 1,000 patients who had undergone FCH PET/CT because of biochemical relapse of PCa between 2004 and 2013 were retrieved from four centers' databases. Continuous data were compared by t-Student test or ANOVA test, and categorical variables by the chi-square test. Univariable and multivariable analysis were performed using logistic regression. GS at diagnosis was ≤6 in 257 patients, 7 in 347, and >7 in 396. A total of 645 PET/CT scans (64.5%) were positive for PCa recurrence. Eighty-one percent of the positive PET/CTs were in patients with PSA≥2 ng/mL, 43% and 31% being found among patients with 1 ng/mL>PSA<2 ng/mL, and PSA≤1 ng/mL, respectively; 78.8% of patients with a positive PET/CT had GS>7. FCH PET/CT scans were negative in 300 patients, 44% of whom had GS≤6, 35% had GS=7 and 17% had GS>7. PET/CTs were rated as doubtful in only 5.5% of patients (median PSA: 1.8 ng/mL). With GS>7, the detection rate of FCH PET/CT was 51%, 65% and 91% for PSA<1 ng/mL, 1 ng/mL>PSA<2 ng/mL, and PSA>2 ng/mL, respectively. At univariable and multivariable analysis, both GS=7 and GS>7 were independent predictors for a positive FCH PET/CT (odds ratios: 0.226 and 0.330, respectively; both with P < 0.001). High GS at diagnosis is a strong predictive factor for a positive FCH PET/CT scan for recurrent PCa, also at a low biochemical failure level (PSA ≤1 ng/mL). Copyright © 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
    Full-text · Article · Dec 2014 · Journal of Nuclear Medicine
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This case report evaluates the feasibility and efficacy of intraperitoneal (IP) trastuzumab administration in gastric cancer (GC) patients with peritoneal carcinomatoses. Peritoneal metastasis is a common sign of advanced tumor stage, tumor progression or disease recurrence in patients with GC. Recently, the role of HER2 overexpression in GC, occurring in about 20% of cases, is correlated with a worse prognosis. We report the case of 61-years old female, admitted to our Hospital after curative surgery for GC with over-expression of HER2. Seven months after the start of first line chemotherapy treatment a pleuro-peritoneal disease progression occurred, documented by cytological exam; according to HER2 status, we decided to treat the patient with IP trastuzumab administration. Between September and October 2012, the patient (ECOG performance status was 0), underwent to 6 cycles of IP trastuzumab. Trastuzumab was administered weekly at a dose of 150 mg for each cycle after paracentesis. The safety was good, no local complications (e.g. abdominal pain, peritonitis) occurred. The clinical revaluation evidenced a stable peritoneal disease. To our knowledge this is the first report on Trastuzumab use to treat IP metastases from GC, with acceptable toxicity and local disease control.
    Full-text · Article · Mar 2014 · European review for medical and pharmacological sciences
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Concurrent chemo-radiotherapy is demonstrately superior to sequential chemo-radiotherapy in the treatment of advanced Non-Small-Cell Lung Cancer not suitable for surgery. Docetaxel is considered to enhance the cytotoxic effect of radiotherapy on the tumour cells. Tomotherapy (HT) is a novel radiotherapeutic technique, which allows the delivery of Image Guided-IMRT (IG-IMRT), with a highly conformal radiation dose distribution.The goal of the study was to estimate tolerability of Docetaxel concurrent with IMRT and to find the maximum tolerated dose of weekly Docetaxel concurrent with IMRT delivered with HT Tomotherapy after induction chemotherapy with Cisplatin and Docetaxel in patients affected with stage III Non-Small Cell Lung Cancer. We designed a phase I, dose-finding study to determine the dose of weekly Docetaxel concurrent with Tomotherapy after induction chemotherapy, in patients affected by Non-Small Cell Lung Cancer with Stage III disease, not suitable for surgery. Concurrent weekly Docetaxel and Tomotherapy are feasible; we did not reach a maximum tolerated dose, because no life-threatening toxicity was observed, stopping the accrual at a level of weekly docetaxel 38 mg/m2, a greater dose than in previous assessments, from both phase-I studies with weekly docetaxel alone and with Docetaxel concomitant with standard radiotherapy. Concurrent weekly Docetaxel and Tomotherapy are feasible, and even with Docetaxel at 38 mg/m2/week we did not observe any limiting toxicity. For those patients who completed the combined chemo-radio treatment, median progression-free survival (PFS) was 20 months and median overall survival (OS) was 24 months.
    Full-text · Article · Oct 2013 · BMC Cancer
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: Elderly patients with metastatic colorectal cancer (mCRC) differ from the general population and are underrepresented in clinical trials. We, retrospectively, analyzed the safety and efficacy of XELOX regimen in the treatment of elderly patients affected by mCRC. Patients and methods: One-hundred-eleven consecutive patients, aged 70 years or older, were enrolled in the study. Results: All patients were evaluated for safety and efficacy (male/female, 63/48). Median age was 75 years (range 71-85 years). Median Eastern Cooperative Oncology Group Performance Status (ECOG PS) was 0 (range 0-2). Metastatic sites distribution is as follows: liver (44.1%), lung (13.5%), liver plus lung (12.6%) and other (29.7%). A total of 584 cycles were administered (median 6 cycles/patient, range 2-10). Median follow-up time was 14.5 months (range 1-41 months). In an intent-to-treat analysis, objective responses and stable disease were recorded in 41 (40.4%) and 29 (26.6%) patients, respectively. The median response duration was 5.9 months (range 0.5-28.8). The median progression free-survival (PFS) was 7.5 months (range 1-26 months). The median overall survival (OS) was 15 months (range 1-64 months). The grade 3 toxicities were: neutropenia (8.1%), diarrhea and neurotoxicity (5.4% respectively). Most adverse events were mild to moderate; the most common was acute sensory neuropathy (57.6%). Conclusion: XELOX is a highly effective first-line treatment for mCRC elderly patients. Response rates, PFS and OS are similar to those observed with fluorouracil/leucovorin/oxaliplatin combinations. XELOX is a convenient regimen, likely to be preferred by both patient and healthcare providers.
    Full-text · Article · Oct 2013 · Anti-cancer agents in medicinal chemistry
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report a case of a 62-year-old man with biochemical recurrence of prostate cancer disease, investigated by fluorine-18-Choline (F-FCH) PET/CT. F-FCH PET/CT demonstrated focal increased uptake of F-FCH inside the right testis, suggestive for distant recurrent disease. On testis removal, a Leydig cell tumor of 2.5 cm in diameter was unexpectedly found. F-FCH PET/CT may demonstrate tumors other than prostate cancer.
    No preview · Article · Jul 2013 · Clinical nuclear medicine
  • Source
    Dataset: bcr3047-s1

    Full-text · Dataset · Nov 2012
  • Source
    Dataset: bcr3047-s2

    Full-text · Dataset · Nov 2012
  • Source
    Dataset: bcr3047-s3

    Full-text · Dataset · Nov 2012
  • Source
    Dataset: bcr3047-s4

    Full-text · Dataset · Nov 2012
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to evaluate the efficiency of 18F-FDG PET/CT in suspected recurrence of epithelial ovarian cancer, after treatment, comparing outcomes of PET/CT with histological tumor subtype, CA-125 serum levels, and findings of conventional diagnostic imaging modalities (CI). Data from 121 women who underwent FDG PET/CT for suspected recurrence of epithelial ovarian cancer after treatment were reviewed retrospectively. Of all patients, 80% had recurrent disease and 20% were disease-free on the final clinical diagnosis. PET/CT showed true-positive findings in 82% of patients, whereas CI demonstrated true-positives in 70% of cases. At the time of PET/CT scanning, only 55 patients had serum CA-125 level greater than 35 U/mL, whereas 52 patients presented with CA-125 levels in a reference range. PET/CT sensitivity (82%) was significantly higher than that of CA-125 (59%), whereas difference in sensitivity between PET/CT and CI (69%) was limited. PET/CT specificity (87%) was significantly better than that of CI (47%), although no difference in specificity between PET/CT and CA-125 (80%) was found. However, no difference in CA-125 serum levels between patients with local tumor relapse and those with distant metastases was found. PET/CT showed the highest positive predictive value (96%) and negative predictive value (55%) when compared with other modalities. In high-grade tumors (n = 66), PET/CT accuracy was 80%, better than that of serum CA-125 (64%) and that of CI (62%). Equally in low-grade ovarian carcinomas (n = 55), PET/CT accuracy (87%) was significantly higher than that of the tumor marker (60%) and also higher than that of CI (70%). FDG PET/CT was proven to be more efficient than serum CA-125 assay and CI in detecting recurrences of ovarian cancer after treatment. The sensitivity of FDG PET/CT is not influenced by tumor histology. FDG PET/CT should be considered a useful diagnostic tool in the surveillance of patients that received treatment for epithelial ovarian carcinoma.
    No preview · Article · Aug 2012 · Clinical nuclear medicine
  • Source
    M Avanzo · A Rink · A Dassie · S Massarut · M Roncadin · E Borsatti · E Capra
    [Show abstract] [Hide abstract]
    ABSTRACT: EBT2 radiochromic films were studied and used for in vivo dosimetry in targeted intraoperative radiotherapy (TARGIT), a technique in which the Intrabeam system (Carl Zeiss, Oberkochen, Germany) is used to perform intraoperative partial breast irradiation with x-rays of 50 kV(p). The energy of the radiation emitted by the Intrabeam with the different spherical applicators, under 1 and 2 cm of solid water, and under the tungsten impregnated rubber used for shielding of the heart in TARGIT of the breast, was characterized with measurements of half-value layer (HVL). The stability of response of EBT2 was verified inside this range of energies. EBT2 films were calibrated using the red and green channels of the absorption spectrum in the 0-20 Gy dose range delivered by the Intrabeam x-rays. The dependence of film response on temperature during irradiation was measured. For in vivo dosimetry, pieces of radiochromic films wrapped in sterile envelopes were inserted after breast conserving surgery and before TARGIT into the excision cavity, on the skin and on the shielded pectoralis fascia for treatments of the left breast. HVLs of the Intrabeam in TARGIT of the breast correspond to effective energies of 20.7-36.3 keV. The response of EBT2 was constant inside this range of energies. We measured the dose to the target tissue and to organs at risk in 23 patients and obtained an average dose of 13.52 ± 1.21 Gy to the target tissue. Dose to the skin in close proximity to the applicator was 2.22 ± 0.97 Gy, 0.29 ± 0.17 Gy at 5-10 cm from the applicator, and 0.08 ± 0.07 Gy at more than 10 cm from the applicator. Dose to the pectoral muscle for left breast treatment was 0.57 ± 0.23 Gy. Our results show that EBT2 films are accurate at the beam energies, dose range, and irradiation temperature found in TARGIT and that in vivo dosimetry in TARGIT with EBT2 films wrapped in sterile envelopes is a feasible procedure. Measured dose to the organs at risk indicates that the technique is safe from side effects to the skin and the heart.
    Full-text · Article · May 2012 · Medical Physics
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The increased bone degradation in osteolytic metastases depends on stimulation of mature osteoclasts and on continuous differentiation of new pre-osteoclasts. Metalloproteinases (MMP)-13 is expressed in a broad range of primary malignant tumours and it is emerging as a novel biomarker. Recent data suggest a direct role of MMP-13 in dissolving bone matrix complementing the activity of MMP-9 and other enzymes. Tumour-microenvironment interactions alter gene expression in malignant breast tumour cells promoting osteolytic bone metastasis. Gene expression profiles revealed that MMP-13 was among the up-regulated genes in tumour-bone interface and its abrogation reduced bone erosion. The precise mechanism remained not fully understood. Our purpose was to further investigate the mechanistic role of MMP-13 in bone osteolytic lesions. MDA-MB-231 breast cancer cells that express MMP-13 were used as a model for in vitro and in vivo experiments. Conditioned media from MDA-MB-231 cells were added to peripheral blood mononuclear cultures to monitor pre-osteoclast differentiation and activation. Bone erosion was evaluated after injection of MMP-13-silenced MDA-MB-231 cells into nude mice femurs. MMP-13 was co-expressed by human breast tumour bone metastases with its activator MT1-MMP. MMP-13 was up-regulated in breast cancer cells after in vitro stimulation with IL-8 and was responsible for increased bone resorption and osteoclastogenesis, both of which were reduced by MMP inhibitors. We hypothesized that MMP-13 might be directly involved in the loop promoting pre-osteoclast differentiation and activity. We obtained further evidence for a direct role of MMP-13 in bone metastasis by a silencing approach: conditioned media from MDA-MB-231 after MMP-13 abrogation or co-cultivation of silenced cells with pre-osteoclast were unable to increase pre-osteoclast differentiation and resorption activity. MMP-13 activated pre-MMP-9 and promoted the cleavage of galectin-3, a suppressor of osteoclastogenesis, thus contributing to pre-osteoclast differentiation. Accordingly, MMP-13 abrogation in tumour cells injected into the femurs of nude mice reduced the differentiation of TRAP positive cells in bone marrow and within the tumour mass as well as bone erosion. These results indicate that within the inflammatory bone microenvironment MMP-13 production was up-regulated in breast tumour cells leading to increased pre-osteoclast differentiation and their subsequent activation.
    Full-text · Article · Oct 2011 · Breast cancer research: BCR
  • [Show abstract] [Hide abstract]
    ABSTRACT: The present study evaluated toxicity, local control, and survival in patients with relapsed high-grade glioma after surgery and external beam radiation therapy and treated with re-operation and GliaSite brachytherapy. Between 2006 and 2008, 15 patients with recurrent high-grade glioma underwent re-operation and GliaSite brachytherapy. Ten patients were males and 5 females. Median age was 40 years (range, 20-71). Karnofsky performance status was ≥70. All patients but one received GliaSite irradiation of the surgical cavity wall at the dose of 4500 cGy at a depth of 1 cm. No severe acute side effects were observed during GliaSite brachytherapy. Pathologically documented, symptomatic late radiation necrosis was observed in 3 patients (20%); 2 subsequently died of further complications. Two patients were alive at a median follow-up 13 months (range, 1-30). Median overall survival after GliaSite brachytherapy was 13 months. Patients with recurrent high-grade glioma can be treated with additional surgery and GliaSite brachytherapy, delivering 4500 cGy at 1 cm depth without significant acute side effects but with a significant rate (20%) of late radiation necrosis, resulting in 13% of treatment-related deaths. Compared with the literature, survival results in our study appear to be satisfactory, but they may be related to patient selection criteria. Re-intervention followed by GliaSite brachytherapy should not be offered as a standard treatment for recurrent high-grade glioma, because of the high rate of late complications, treatment-related deaths, and high treatment costs.
    No preview · Article · Sep 2011

  • No preview · Article · May 2010 · Journal of the American Academy of Dermatology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To compare the accuracy of magnetic resonance (MR) imaging and combined fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT), alone and in combination, in detection and restaging treated nasopharyngeal carcinoma (NPC). This retrospective study was performed after institutional review board approval and informed consent were obtained. Sixty-three consecutive patients treated for NPC underwent follow-up with both MR imaging and FDG PET/CT. Findings were evaluated according to the TNM classification. Final diagnosis was confirmed at biopsy or imaging follow-up for at least 6 months. Proportions and their 95% confidence intervals were computed; for comparison of data obtained separately from MR imaging and FDG PET/CT and those obtained from their combined use, the McNemar test was used. P < .05 was considered to indicate a statistically significant difference. There was a trend toward greater overall accuracy of MR over PET/CT in detecting residual and/or recurrent NPC at the primary site; 92.1% (58 of 63 patients) for MR versus 85.7% (54 of 63) for FDG PET/CT (P = .16). Overall accuracy for tumor restaging was 74.6% (47 of 63) for MR and 73.0% (46 of 63) for FDG PET/CT (either modality used alone), but the overall combined accuracy was 92.1% (58 of 63) (all P values < .01). MR imaging demonstrated a trend toward higher accuracy than did FDG PET/CT in detecting residual and/or recurrent NPC at the primary tumor site. The combined use of MR and FDG PET/CT was more accurate for tumor restaging than when either modality was used independently.
    Preview · Article · Aug 2008 · Radiology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Treatment of cerebral gliomas with the GliaSite® Radiation Therapy System has been performed in the United States since 2001. The procedure assumes the use of a spherical unsealed source containing 125I in liquid form. The amount of the activities utilized (GBq) is such that enacting appropriate radiation safety measures for the patient and personnel as prescribed by law and standards of good practice is a necessity. Dosimetry also requires special attention given the low energy of the radioisotope employed in therapy. In this study, the operative methods and results of radiation protection and dosimetric measurements performed on 10 patients in treatment with this system within our Institute between 2006 and 2007 are described.
    No preview · Article · Dec 2007
  • [Show abstract] [Hide abstract]
    ABSTRACT: Despite macroscopically radical surgery and combined adjuvant chemoradiation recurrence of malignant glioma remains a certainty. About 80% of patients experience a tumor recurrence within 2 cm of the resection margin. Only a select group of patients with recurrent malignant gliomas are candidates for reoperation, but in spite of further adjuvant therapy, long-term survival is rare. The GliaSite® RTS was developed in an attempt to allow an additional radiation dose to be delivered in a way that maximizes the patient's quality of life while delivering a radiation dose to the tissue at greatest risk of recurrence. This study reports our experience with GliaSite® on 12 patients with recurrent high grade gliomas. The median radiation dose delivered was 46.5 Gy (range 45-60 Gy) to an average depth of 1 cm from the surgical cavity wall. Mild side effects post lotrex infusion were easily managed with drug therapy. One case of late symptomatic radiation necrosis was pathologically documented and a second case radiologically suspected. At the time of this analysis (median follow up 8.4 months, range 1-14 months) two patients died after 12 months from GliaSite® treatment for disease progression. These preliminary data need to be confirmed by a larger patient population with more information on the progression-free survival and overall survival. Our preliminary results confirm that brachytherapy treatment with GliaSite® is safe, improves quality of life and reduces the radiation adverse effects versus external beam radiotherapy.
    No preview · Article · Dec 2007