Papers by Cecilia Arrichiello
Life
In recent years, stereotactic body radiation therapy (SBRT) has gained popularity among clinical ... more In recent years, stereotactic body radiation therapy (SBRT) has gained popularity among clinical methods for the treatment of medium and low risk prostate cancer (PCa), mainly as an alternative to surgery. The hypo-fractionated regimen allows the administration of high doses of radiation in a small number of fractions; such a fractionation is possible by exploiting the different intrinsic prostate radiosensitivity compared with the surrounding healthy tissues. In addition, SBRT treatment guaranteed a better quality of life compared with surgery, avoiding risks, aftermaths, and possible complications. At present, most stereotactic prostate treatments are performed with the CyberKnife (CK) system, which is an accelerator exclusively dedicated for stereotaxis and it is not widely spread in every radiotherapy centre like a classic linear accelerator (LINAC). To be fair, a stereotactic treatment is achievable also by using a LINAC through Volumetric Modulated Arc Therapy (VMAT), but some...
PET based dosimetry in patients undergoing 90Y-SIR-spheres treatment for liver metastases: Correlation with response
Geometric contour variation in clinical target volume of axillary lymph nodes in breast cancer radiotherapy: an AIRO multi-institutional study
The British journal of radiology, 2021
OBJECTIVES To determine interobserver variability in axillary nodal contouring in breast cancer (... more OBJECTIVES To determine interobserver variability in axillary nodal contouring in breast cancer (BC) radiotherapy (RT) by comparing the clinical target volume of participating single centres (SC-CTV) with a gold-standard CTV (GS-CTV). METHODS The GS-CTV of 3 patients (P1, P2, P3) with increasing complexity was created in DICOM format from the median contour of axillary CTVs drawn by BC experts, validated using the simultaneous truth and performance level estimation and peer-reviewed. GS-CTVs were compared with the correspondent SC-CTVs drawn by radiation oncologists, using validated metrics and a total score (TS) integrating all of them. RESULTS Eighteen RT centres participated in the study. Comparative analyses revealed that, on average, the SC-CTVs were smaller than GS-CTV for P1 and P2 (by -29.25% and -27.83%, respectively) and larger for P3 (by +12.53%). The mean Jaccard index was greater for P1 and P2 compared to P3, but the overlap extent value was around 0.50 or less. Regardi...
1Nuclear Medicine Unit, Istituto Nazionale Tumori “Fondazione G. Pascale” – IRCCS, Naples, Italy;... more 1Nuclear Medicine Unit, Istituto Nazionale Tumori “Fondazione G. Pascale” – IRCCS, Naples, Italy; 2Clinical Trials Unit, Istituto Nazionale Tumori “Fondazione G. Pascale” – IRCCS, Naples, Italy; 3Abdominal Oncology Department, Istituto Nazionale Tumori “Fondazione G. Pascale” – IRCCS, Naples, Italy; 4Radiology 2 Unit, Istituto Nazionale Tumori “Fondazione G. Pascale” – IRCCS, Naples, Italy; 5Pathology Department, Istituto Nazionale Tumori “Fondazione G. Pascale” – IRCCS, Naples, Italy; 6Epato-Biliary Surgery Unit, Istituto Nazionale Tumori “Fondazione G. Pascale” – IRCCS, Naples, Italy; and 7Medical Statistics, Second University of Napoli, Napoli, Italy
X-rays affect cytoskeleton assembly and nanoparticle uptake: Preliminary results
Valeria Panzetta(), Mariagabriella Pugliese(), Gioia di Gennaro(), Costabile Federico(), Cecilia ... more Valeria Panzetta(), Mariagabriella Pugliese(), Gioia di Gennaro(), Costabile Federico(), Cecilia Arrichiello(), Paolo Muto(), Paolo A. Netti()()()() and Sabato Fusco() () Interdisciplinary Research Centre on Biomaterials (CRIB), Università degli Studi di Napoli “Federico II” Piazzale Tecchio 80, 80125 Naples, Italy () Dipartimento di Fisica, Università degli Studi di Napoli “Federico II” and INFN, Sezione di Napoli Monte S. Angelo, Via Cintia, 80126 Naples, Italy () Radiotherapy Unit, Istituto Nazionale Tumori-IRCCS-Fondazione “G. Pascale” Via Semmola, 53, 80131 Naples, Italy () Center for Advanced Biomaterials for Healthcare@CRIB, Istituto Italiano di Tecnologia (IIT) Largo Barsanti e Matteucci 53, 80125 Naples, Italy
Investigation of Biophysical Migration Parameters for Normal Tissue and Metastatic Cancer Cells After Radiotherapy Treatment
Frontiers in Physics
A large body of literature has demonstrated that the mechanical properties of microenvironment ha... more A large body of literature has demonstrated that the mechanical properties of microenvironment have a key role in regulating cancer cell adhesion, motility, and invasion. In this work, we have introduced two additional parameters, named cell trajectory extension and area traveled by cell, to describe the tendency of normal tissue and metastatic cancer cells to move in a directional way when they interact with physio-pathological substrates, characterized by stiffnesses of 1–13 kPa, before and after treatment with 2 doses of X-rays (2 and 10 Gy). We interpreted these data by evaluating also the impact of substrate stiffness on 2 morphological parameters which indicate not only the state of cell adhesion, but also cell polarization, prerequisite to directional movement, and the formation of protrusions over cell perimeters. We believe that a so wide analysis can give an efficient and easily readable overview of effects of radiation therapy on cell-ECM crosstalk when used as therapeutic agent.
Cancers
The structural and mechanical properties of the microenvironmental context have a profound impact... more The structural and mechanical properties of the microenvironmental context have a profound impact on cancer cell motility, tumor invasion, and metastasis formation. In fact, cells react to their mechanical environment modulating their adhesion, cytoskeleton organization, changes of shape, and, consequently, the dynamics of their motility. In order to elucidate the role of extracellular matrix stiffness as a driving force in cancer cell motility/invasion and the effects of ionizing radiations on these processes, we evaluated adhesion and migration as biophysical properties of two different mammary cell lines, over a range of pathophysiological stiffness (1–13 kPa) in a control condition and after the exposure to two different X-ray doses (2 and 10 Gy, photon beams). We concluded that the microenvironment mimicking the normal mechanics of healthy tissue has a radioprotective role on both cell lines, preventing cell motility and invasion. Supraphysiological extracellular matrix stiffne...
Early PET/CT scan compared with RECIST to predict long-term outcome of patients with liver metastases from colorectal cancer treated with preoperative chemotherapy plus bevacizumab
Journal of Clinical Oncology
11008 Background: Early changes in tumor metabolism measured with positron-emission-tomography/co... more 11008 Background: Early changes in tumor metabolism measured with positron-emission-tomography/computerized tomography (PET/CT) could predict the long-term efficacy of treatment better than dimensional RECIST response. Methods: We performed PET/CT before and after 1 cycle of treatment in patients with resectable liver metastases from colorectal cancer, within a phase II trial of preoperative FOLFIRI plus bevacizumab. For each lesion, the maximum SUV (SUVmax) and the total lesion glycolisis (TLG) were determined. For both, based on previous studies, a ≤-50% change from baseline was used as threshold for significant response. Metabolic response was categorized no/yes by using three different methods that enter into the calculation (i) the largest observed value (highest SUVmax/TLG), or (ii) the sum of all the observed values (Total SUVmax/TLG), or (iii) each observed values (SUVmax/TLG-by-lesion). Standard RECIST response was assessed after 3 months of treatment. The association betwe...
Journal of Nuclear Medicine, Oct 1, 2013
EP-1148: In vivo dosimetry with mosfet detectors for whole breast tomodirect treatments
Radiotherapy and Oncology, 2013
PO-0821: Tomodirect for breast cancer patients with supraclavicular nodes involvement
Radiotherapy and Oncology, 2013
EP-1039: Hypofractionated breast radiation and simultaneous integrated boost with TomoDirect: a prospective phase II trial
Radiotherapy and Oncology, 2013
Hypofractionated Adjuvant Breast Radiation and Simultaneous Integrated Boost Delivered With Static Angle Tomotherapy: A Prospective Phase 2 Trial
International Journal of Radiation Oncology*Biology*Physics, 2013
PD-0600: A geometrical analysis focused on the beam-on time reduction in helical tomotherapy-based SBRT for lung tumors
Radiotherapy and Oncology, 2013
FOLFIRI plus bevacizumab (B) as neoadjuvant treatment for potentially resectable colorectal cancer patients (pts) with liver metastasis: A phase II trial
Asco Meeting Abstracts, May 20, 2012
e14130 Background: Irinotecan-based chemotherapy plus B was shown to be effective and safe in bot... more e14130 Background: Irinotecan-based chemotherapy plus B was shown to be effective and safe in both first- and second-line treatment for metastatic colorectal cancer (mCRC) pts.We designed this trial to assess whether the combination of FOLFIRI + B given to untreated, potentially resectable mCRC pts was feasible and active. Methods: Phase II, single arm trial with 1-year progression-free rate (PFR) as primary end-point. A sample size of 39 pts was calculated to detect a 70% ± 12% 1-year PFR. The treatment was FOLFIRI q2w (irinotecan 180 mg/m2, leucovorin 200 mg/m2, 5FU 2400 mg/m2 iv in 46 hrs) plus B 5mg/kg q2w. Last cycle before surgery was without B. Potentially resectable, untreated mCRC pts, with liver as unique site of metastases, were eligible. Normal organ function and no contraindications to B were required. Pts were reevaluated for surgery after 6 cycles. PET-Scan were performed at baseline and at the second cycle. Results: Overall 39 pts were enrolled. Median age was 58 (range 30-75), male/female were 24/15. Twenty seven pts (69.2%; 95%CI 52.4% – 83.0%) were progression-free at 1-year. Thirty seven pts (94.9%) underwent surgery. One complete and 22 partial responses were observed (response rate 59.0%; 95% CI 42.1% – 74.4%); 5 pts had disease progression (4 resectable and 1 unresectable). Early PET-scan was assessed according PERCIST criteria [Wahl RL, J Nucl Med 2009] in 29 pts and showed metabolic response (SUV-max decrease > 30%) in 17 (58.6%; 95% CI: 38.9%- 76.5%).Severe toxicity includes grade 3 neutropenia (3 pts, 7.7%) and grade 3 diarrhea (1 pt, 2.6%). Other toxicities include grade 1-2 diarrhea (15.4%), grade 2 nausea (7.8%), grade 2 leucopenia (5.1%), grade 2 asthenia (5.1%), grade 1 anemia (2.6%), grade 2 thrombosis (2.6%). Overall, 16 pts out of 37 experienced surgical complications (43.2%; 95%CI 27.1% - 60.5%): biliary leak (11 pts, 29.7%), biliary fistula (1 pt, 2.7%), other complications (4 pts, 10.8%). All complications were reversible. No peri-operative bleeding was observed. Conclusions: The trial yielded its primary aim and shows that FOLFIRI plus B is feasible and active as neo-adjuvant treatment in patients with resectable liver metastases of CRC.
Journal of Nuclear Medicine, 2013
Authors’ reply to: Radiobiology as a basic and clinical medical science: what the Physicists have forgotten
Tumori Journal, 2015
Cancer Investigation, 2014
Purpose: To evaluate the feasibility and response to palliative radiotherapy delivered with stati... more Purpose: To evaluate the feasibility and response to palliative radiotherapy delivered with static ports of tomotherapy-TomoDirect (TD) in patients affected with painful bone metastases from solid tumors. Methods: A prospective cohort of 130 patients (185 osseous lesions) was treated between 2010 and 2013 with TD. Three fractionation schedules were employed according to clinical decision-making (3 Gy × 10; 4 Gy × 5; 8 Gy × 1). Pain response was investigated at 2 weeks and 2 months (for evaluable patients). The Numeric Rating Scale (NRS-11) was used to assess pain. Response rates to radiotherapy were calculated following the criteria of the International Bone Metastases Consensus Group (IBMCG), accounting for the use of concomitant analgesics (response: complete or partial; non-response: stable pain, pain progression or "other"). Analgesic consumption was recalculated into the daily oral morphine-equivalent dose (OMED). Results: Most of the patients had 1-2 bone metastases (91); those with multiple lesions mostly had a metachronous presentation (60%). Synchronous lesions were mainly approached with multiple plans (63%). Most treatments employed 3-4 fields (77%). Treatment times ranged from 255 to 939 s depending on fractionation, fields, and target lesions number. At 2 weeks, the median self-reported worst pain decreased significantly as median oral morphine-equivalent dose regardless of fractionation used. The response rate according to the IBMCG-based response categories ranged from 45 to 55%. Pain relief duration seems (response at 2 months) slightly inferior with the single fraction approach, with a higher re-treatment rate. At 2 weeks, the median self-reported worst pain and OMED significantly decreased regardless of fractionation (response rate: 49-55%). Pain relief decreased at 2 months, especially for single fraction (higher re-treatment rate).
Journal of Cancer Research and Clinical Oncology, 2013
Purpose To report the 2-year outcomes of whole breast intensity-modulated radiotherapy (IMRT) aft... more Purpose To report the 2-year outcomes of whole breast intensity-modulated radiotherapy (IMRT) after conserving surgery for early breast cancer (EBC) delivered with static angle tomotherapy (TomoDirect) (TD). Methods A prospective cohort of 120 EBC patients underwent whole breast IMRT with TD between 2010 and 2012. Radiation was delivered to a conventionally fractionated whole breast total dose of 50 Gy with TD, followed by a sequential conventionally fractionated tumor bed boost dose of 10-16 Gy with helical tomotherapy (HT). Clinical endpoints include acute and late toxicity, cosmesis, quality of life and local control. Results Median follow-up was 24 months (range 12-36 months); maximum detected acute skin toxicity was G0 22 %; G1 63 %; G2 12 % and G3 3 %. Predictors of acute dermatitis were as follows: volume of the whole breast minus boost volume receiving 105, 110 and 115 % of prescription dose, whole breast and boost volume, breast thickness and soft tissue thickness. Late skin toxicity was mild with no [G2 events. Cosmesis was good/excellent in 91.7 % of patients and fair/poor in 8.3 %. Quality of life was preserved over time, but for fatigue, transiently increased. Conclusion Adjuvant whole breast IMRT delivered sequentially with both TD and HT provides consistent clinical results. An observed unintended excessive dose outside the tumor bed might increase acute toxicity and eventually affect long-term clinical endpoints. The incorporation of the boost dose within the whole breast phase employing a simultaneous integrated boost (SIB) approach might mitigate this issue.
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Papers by Cecilia Arrichiello