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Papers by Giuseppe Girelli

Research paper thumbnail of 4006 POSTER Gene profile predicts protection from radio-induced late rectal bleeding in prostate cancer

Research paper thumbnail of 177 oral FOCUSING ON A LONGITUDINAL DEFINITION OF LATE FECAL INCONTINENCE AFTER HIGH-DOSE RADIATION FOR PROSTATE CANCER: A STRONGER EVIDENCE OF CLINICAL AND DOSIMET-RIC PREDICTORS

Radiotherapy and Oncology, 2011

Research paper thumbnail of Image-guided Intensity-modulated Radiotherapy for Prostate Cancer Employing Hypofractionation and Simultaneous Integrated Boost: Results of a Consecutive Case Series with Focus on Erectile Function

Anticancer research, 2015

To report on clinical outcomes of prostate cancer patients treated with hypofrationated radiother... more To report on clinical outcomes of prostate cancer patients treated with hypofrationated radiotherapy employing a simultaneous integrated boost strategy. A consecutive series of 104 patients affected with prostate cancer was treated with intensity-modulated radiotherapy using a hypofractionated schedule and a simultaneous integrated boost consisting of 70 Gy (2.5 Gy daily) to the prostate gland, 63 Gy to the seminal vescicles (2.25 Gy daily) and 53.2 Gy to the pelvic nodes (1.9 Gy daily) when needed, delivered in 28 fractions. All patients underwent image-guided radiotherapy procedure consisting of daily cone-beam computed tomography. After a median observation time of 26 (range=15-48) months, the 3-year biochemical failure-free survival was 96.5% [95% confidence interval (CI)=89%-98%], 3-year cancer-specific survival was 98.5% (95% CI=91%-99%) and 3-year overall survival was 96.5% (95% CI=89%-98%). The gastrointestinal and genitourinary toxicity profiles were mild with fewer than 2%...

Research paper thumbnail of Penile metastasis from prostate cancer: a case report

Tumori

Metastatic involvement of the penis is rare. About 80% of secondary lesions originate from pelvic... more Metastatic involvement of the penis is rare. About 80% of secondary lesions originate from pelvic primary tumors, mainly bladder and prostate. We present a case of prostatic mucinous adenocarcinoma with penile metastasis symptomatic for pain, which was treated with external-beam radiation (35 Gy/14 fractions; 2.5 Gy daily) combined with androgen deprivation, resulting in complete pain relief and objective response after treatment.

Research paper thumbnail of TomoDirect: an efficient means to deliver radiation at static angles with tomotherapy

Tumori

The TomoTherapy Hi-Art II system is able to deliver dynamic intensity-modulated radiation therapy... more The TomoTherapy Hi-Art II system is able to deliver dynamic intensity-modulated radiation therapy within a helical geometry providing robust conformality and modulation, abrupt dose falloff, and reliable accuracy. A new upgrade named TomoDirect was introduced recently, allowing delivery of radiation at discrete angles with a fixed gantry. We present our preliminary clinical experience with TomoDirect. Three specific clinical contexts were chosen for the implementation of TomoDirect, namely palliation of bone metastasis pain (BP), whole brain radiation therapy for intracranial secondary lesions (WBRT), and adjuvant whole breast radiation therapy after conservative surgery for early stage breast cancer (AWBRT). After appropriate positioning, planning CT, contouring, and plan generation, all patients were treated with the TomoDirect upgrade of the TomoTherapy Hi-Art II system with different doses and fractionation according to clinical decision-making. Between May and December 2010, 41...

Research paper thumbnail of Inclusion of clinical risk factors into NTCP modelling of late rectal toxicity after high dose radiotherapy for prostate cancer

Research paper thumbnail of Tumor Bed Boost Integration during Whole Breast Radiotherapy: A Review of the Current Evidence

Research paper thumbnail of Fitting late rectal bleeding data using different NTCP models: Results from an Italian multi-centric study (AIROPROS0101)

Radiotherapy and Oncology, 2004

Research paper thumbnail of Palliative Radiotherapy for Painful Bone Metastases from Solid Tumors Delivered with Static Ports of Tomotherapy (TomoDirect): Feasibility and Clinical Results

Cancer Investigation, 2014

Research paper thumbnail of Five-year results of a prospective case series of accelerated hypofractionated whole breast radiation with concomitant boost to the surgical bed after conserving surgery for early breast cancer

Research paper thumbnail of Inclusion of clinical risk factors into NTCP modelling of late rectal toxicity after high dose radiotherapy for prostate cancer

Radiotherapy and Oncology, 2011

Research paper thumbnail of Long term rectal function after high-dose prostatecancer radiotherapy: Results from a prospective cohort study

Radiotherapy and Oncology, 2014

Research paper thumbnail of Relationships between bladder dose–volume/surface histograms and acute urinary toxicity after radiotherapy for prostate cancer

Radiotherapy and Oncology, 2014

Research paper thumbnail of Pretreatment Nomograms Predicting Severe Rectal Toxicity after Prostate Cancer 3D-CRT

International Journal of Radiation Oncology Biology Physics, 2008

Research paper thumbnail of Late rectal bleeding: fitting clinical data with different NTCP models

International Journal of Radiation Oncology*Biology*Physics, 2003

Research paper thumbnail of Late Rectal Bleeding Despite the Strict Observance of DVH Constraints: Does Gene Expression Profile Concur to Unveil Individual Radio-Sensitivity?

International Journal of Radiation Oncology*Biology*Physics, 2008

Research paper thumbnail of To Bleed or Not to Bleed. A Prediction Based on Individual Gene Profiling Combined With Dose–Volume Histogram Shapes in Prostate Cancer Patients Undergoing Three-Dimensional Conformal Radiation Therapy

International Journal of Radiation Oncology*Biology*Physics, 2009

The main purpose of this work was to try to elucidate why, despite excellent rectal dose-volume h... more The main purpose of this work was to try to elucidate why, despite excellent rectal dose-volume histograms (DVHs), some patients treated for prostate cancer exhibit late rectal bleeding (LRB) and others with poor DVHs do not. Thirty-five genes involved in DNA repair/radiation response were analyzed in patients accrued in the AIROPROS 0101 trial, which investigated the correlation between LRB and dosimetric parameters. Thirty patients undergoing conformal radiotherapy with prescription doses higher than 70 Gy (minimum follow-up, 48 months) were selected: 10 patients in the low-risk group (rectal DVH with the percent volume of rectum receiving more than 70 Gy [V70Gy] < 20% and the percent volume of rectum receiving more than 50 Gy [V50Gy] < 55%) with Grade 2 or Grade 3 (G2-G3) LRB, 10 patients in the high-risk group (V70Gy > 25% and V50Gy > 60%) with G2-G3 LRB, and 10 patients in the high-risk group with no toxicity. Quantitative reverse-transcriptase polymerase chain reaction was performed on RNA from lymphoblastoid cell lines obtained from Epstein-Barr virus-immortalized peripheral-blood mononucleated cells and on peripheral blood mononucleated cells. Interexpression levels were compared by using the Kruskal-Wallis test. Intergroup comparison showed many constitutive differences: nine genes were significantly down-regulated in the low-risk bleeder group vs. the high-risk bleeder and high-risk nonbleeder groups: AKR1B1 (p = 0.019), BAZ1B (p = 0.042), LSM7 (p = 0.0016), MRPL23 (p = 0.015), NUDT1 (p = 0.0031), PSMB4 (p = 0.079), PSMD1 (p = 0.062), SEC22L1 (p = 0.040), and UBB (p = 0.018). Four genes were significantly upregulated in the high-risk nonbleeder group than in the other groups: DDX17 (p = 0.048), DRAP1 (p = 0.0025), RAD23 (p = 0.015), and SRF (p = 0.024). For most of these genes, it was possible to establish a cut-off value that correctly classified most patients. The predictive value of sensitivity and resistance to LRB of the genes identified by the study is promising and should be tested in a larger data set.

Research paper thumbnail of Gene Profile Highlights Late Rectal Bleeding Protection in Prostate Cancer 3D Conformal Radiation

International Journal of Radiation Oncology*Biology*Physics, 2007

Research paper thumbnail of More Restrictive Rectal Dose-volume Constraints Should be Applied to 3D-CRT Prostate Cancer Patients Who Underwent Previous Abdominal Surgery

International Journal of Radiation Oncology*Biology*Physics, 2009

Research paper thumbnail of Role of Pelvic Lymphadenectomy (PL) and Adjuvant Androgent Deprivation (AAD) in Patients Treated with Radical Prostatectomy (RP) and Early Adjuvant RT (EART): Results of a Multi-Institutional, Retrospective, Italian Study on 681 Cases

International Journal of Radiation Oncology*Biology*Physics, 2005

Research paper thumbnail of 4006 POSTER Gene profile predicts protection from radio-induced late rectal bleeding in prostate cancer

Research paper thumbnail of 177 oral FOCUSING ON A LONGITUDINAL DEFINITION OF LATE FECAL INCONTINENCE AFTER HIGH-DOSE RADIATION FOR PROSTATE CANCER: A STRONGER EVIDENCE OF CLINICAL AND DOSIMET-RIC PREDICTORS

Radiotherapy and Oncology, 2011

Research paper thumbnail of Image-guided Intensity-modulated Radiotherapy for Prostate Cancer Employing Hypofractionation and Simultaneous Integrated Boost: Results of a Consecutive Case Series with Focus on Erectile Function

Anticancer research, 2015

To report on clinical outcomes of prostate cancer patients treated with hypofrationated radiother... more To report on clinical outcomes of prostate cancer patients treated with hypofrationated radiotherapy employing a simultaneous integrated boost strategy. A consecutive series of 104 patients affected with prostate cancer was treated with intensity-modulated radiotherapy using a hypofractionated schedule and a simultaneous integrated boost consisting of 70 Gy (2.5 Gy daily) to the prostate gland, 63 Gy to the seminal vescicles (2.25 Gy daily) and 53.2 Gy to the pelvic nodes (1.9 Gy daily) when needed, delivered in 28 fractions. All patients underwent image-guided radiotherapy procedure consisting of daily cone-beam computed tomography. After a median observation time of 26 (range=15-48) months, the 3-year biochemical failure-free survival was 96.5% [95% confidence interval (CI)=89%-98%], 3-year cancer-specific survival was 98.5% (95% CI=91%-99%) and 3-year overall survival was 96.5% (95% CI=89%-98%). The gastrointestinal and genitourinary toxicity profiles were mild with fewer than 2%...

Research paper thumbnail of Penile metastasis from prostate cancer: a case report

Tumori

Metastatic involvement of the penis is rare. About 80% of secondary lesions originate from pelvic... more Metastatic involvement of the penis is rare. About 80% of secondary lesions originate from pelvic primary tumors, mainly bladder and prostate. We present a case of prostatic mucinous adenocarcinoma with penile metastasis symptomatic for pain, which was treated with external-beam radiation (35 Gy/14 fractions; 2.5 Gy daily) combined with androgen deprivation, resulting in complete pain relief and objective response after treatment.

Research paper thumbnail of TomoDirect: an efficient means to deliver radiation at static angles with tomotherapy

Tumori

The TomoTherapy Hi-Art II system is able to deliver dynamic intensity-modulated radiation therapy... more The TomoTherapy Hi-Art II system is able to deliver dynamic intensity-modulated radiation therapy within a helical geometry providing robust conformality and modulation, abrupt dose falloff, and reliable accuracy. A new upgrade named TomoDirect was introduced recently, allowing delivery of radiation at discrete angles with a fixed gantry. We present our preliminary clinical experience with TomoDirect. Three specific clinical contexts were chosen for the implementation of TomoDirect, namely palliation of bone metastasis pain (BP), whole brain radiation therapy for intracranial secondary lesions (WBRT), and adjuvant whole breast radiation therapy after conservative surgery for early stage breast cancer (AWBRT). After appropriate positioning, planning CT, contouring, and plan generation, all patients were treated with the TomoDirect upgrade of the TomoTherapy Hi-Art II system with different doses and fractionation according to clinical decision-making. Between May and December 2010, 41...

Research paper thumbnail of Inclusion of clinical risk factors into NTCP modelling of late rectal toxicity after high dose radiotherapy for prostate cancer

Research paper thumbnail of Tumor Bed Boost Integration during Whole Breast Radiotherapy: A Review of the Current Evidence

Research paper thumbnail of Fitting late rectal bleeding data using different NTCP models: Results from an Italian multi-centric study (AIROPROS0101)

Radiotherapy and Oncology, 2004

Research paper thumbnail of Palliative Radiotherapy for Painful Bone Metastases from Solid Tumors Delivered with Static Ports of Tomotherapy (TomoDirect): Feasibility and Clinical Results

Cancer Investigation, 2014

Research paper thumbnail of Five-year results of a prospective case series of accelerated hypofractionated whole breast radiation with concomitant boost to the surgical bed after conserving surgery for early breast cancer

Research paper thumbnail of Inclusion of clinical risk factors into NTCP modelling of late rectal toxicity after high dose radiotherapy for prostate cancer

Radiotherapy and Oncology, 2011

Research paper thumbnail of Long term rectal function after high-dose prostatecancer radiotherapy: Results from a prospective cohort study

Radiotherapy and Oncology, 2014

Research paper thumbnail of Relationships between bladder dose–volume/surface histograms and acute urinary toxicity after radiotherapy for prostate cancer

Radiotherapy and Oncology, 2014

Research paper thumbnail of Pretreatment Nomograms Predicting Severe Rectal Toxicity after Prostate Cancer 3D-CRT

International Journal of Radiation Oncology Biology Physics, 2008

Research paper thumbnail of Late rectal bleeding: fitting clinical data with different NTCP models

International Journal of Radiation Oncology*Biology*Physics, 2003

Research paper thumbnail of Late Rectal Bleeding Despite the Strict Observance of DVH Constraints: Does Gene Expression Profile Concur to Unveil Individual Radio-Sensitivity?

International Journal of Radiation Oncology*Biology*Physics, 2008

Research paper thumbnail of To Bleed or Not to Bleed. A Prediction Based on Individual Gene Profiling Combined With Dose–Volume Histogram Shapes in Prostate Cancer Patients Undergoing Three-Dimensional Conformal Radiation Therapy

International Journal of Radiation Oncology*Biology*Physics, 2009

The main purpose of this work was to try to elucidate why, despite excellent rectal dose-volume h... more The main purpose of this work was to try to elucidate why, despite excellent rectal dose-volume histograms (DVHs), some patients treated for prostate cancer exhibit late rectal bleeding (LRB) and others with poor DVHs do not. Thirty-five genes involved in DNA repair/radiation response were analyzed in patients accrued in the AIROPROS 0101 trial, which investigated the correlation between LRB and dosimetric parameters. Thirty patients undergoing conformal radiotherapy with prescription doses higher than 70 Gy (minimum follow-up, 48 months) were selected: 10 patients in the low-risk group (rectal DVH with the percent volume of rectum receiving more than 70 Gy [V70Gy] < 20% and the percent volume of rectum receiving more than 50 Gy [V50Gy] < 55%) with Grade 2 or Grade 3 (G2-G3) LRB, 10 patients in the high-risk group (V70Gy > 25% and V50Gy > 60%) with G2-G3 LRB, and 10 patients in the high-risk group with no toxicity. Quantitative reverse-transcriptase polymerase chain reaction was performed on RNA from lymphoblastoid cell lines obtained from Epstein-Barr virus-immortalized peripheral-blood mononucleated cells and on peripheral blood mononucleated cells. Interexpression levels were compared by using the Kruskal-Wallis test. Intergroup comparison showed many constitutive differences: nine genes were significantly down-regulated in the low-risk bleeder group vs. the high-risk bleeder and high-risk nonbleeder groups: AKR1B1 (p = 0.019), BAZ1B (p = 0.042), LSM7 (p = 0.0016), MRPL23 (p = 0.015), NUDT1 (p = 0.0031), PSMB4 (p = 0.079), PSMD1 (p = 0.062), SEC22L1 (p = 0.040), and UBB (p = 0.018). Four genes were significantly upregulated in the high-risk nonbleeder group than in the other groups: DDX17 (p = 0.048), DRAP1 (p = 0.0025), RAD23 (p = 0.015), and SRF (p = 0.024). For most of these genes, it was possible to establish a cut-off value that correctly classified most patients. The predictive value of sensitivity and resistance to LRB of the genes identified by the study is promising and should be tested in a larger data set.

Research paper thumbnail of Gene Profile Highlights Late Rectal Bleeding Protection in Prostate Cancer 3D Conformal Radiation

International Journal of Radiation Oncology*Biology*Physics, 2007

Research paper thumbnail of More Restrictive Rectal Dose-volume Constraints Should be Applied to 3D-CRT Prostate Cancer Patients Who Underwent Previous Abdominal Surgery

International Journal of Radiation Oncology*Biology*Physics, 2009

Research paper thumbnail of Role of Pelvic Lymphadenectomy (PL) and Adjuvant Androgent Deprivation (AAD) in Patients Treated with Radical Prostatectomy (RP) and Early Adjuvant RT (EART): Results of a Multi-Institutional, Retrospective, Italian Study on 681 Cases

International Journal of Radiation Oncology*Biology*Physics, 2005