Paolo Muto - Academia.edu (original) (raw)
Papers by Paolo Muto
La radiologia medica
The authors present the results obtained in 14 children affected with orbital rhabdomyosarcoma, w... more The authors present the results obtained in 14 children affected with orbital rhabdomyosarcoma, who were studied between 1979 and 1991 at the I Dept. of Radiology and Radiotherapy of the II Policlinico, Naples, Italy. The patients (age range: 14 months to 15 years) had received radiotherapy and chemotherapy: the dose was 6000 cGy to the orbital region (one case was given 4500 cGy and then interrupted radiotherapy for personal reasons). Twelve children underwent a standard protocol, that is biopsy followed by immediate irradiation and chemotherapy; surgery was performed in 2 cases. 90% survival at 2 years was obtained in our series. All 14 patients are alive and free of detectable disease, after a minimum of 7 to a maximum of 126 months from diagnosis. In 3 children a locoregional relapse was observed 12, 15, and 16 months after clinical diagnosis. They have received a new cycle of radiation therapy and are now free of detectable disease. In all children, ocular structures have been spared, and the complications observed so far have been few. Therefore, the authors suggest that the combination of immediate radiotherapy and chemotherapy might represent an optimal tool for the treatment of orbital rhabdomyosarcomas.
Oncotarget, Jan 30, 2015
We have previously shown that an intensified preoperative regimen including oxaliplatin plus ralt... more We have previously shown that an intensified preoperative regimen including oxaliplatin plus raltitrexed and 5-fluorouracil/folinic acid (OXATOM/FUFA) during preoperative pelvic radiotherapy produced promising results in locally advanced rectal cancer (LARC). Preclinical evidence suggests that the scheduling of bevacizumab may be crucial to optimize its combination with chemo-radiotherapy. This non-randomized, non-comparative, phase II study was conducted in MRI-defined high-risk LARC. Patients received three biweekly cycles of OXATOM/FUFA during RT. Bevacizumab was given 2 weeks before the start of chemo-radiotherapy, and on the same day of chemotherapy for 3 cycles (concomitant-schedule A) or 4 days prior to the first and second cycle of chemotherapy (sequential-schedule B). Primary end point was pathological complete tumor regression (TRG1) rate. The accrual for the concomitant-schedule was early terminated because the number of TRG1 (2 out of 16 patients) was statistically incon...
Journal of Nuclear Medicine
A preliminary study in humans, using a 3021D molecular weight synthetic peptide (26 amino acids) ... more A preliminary study in humans, using a 3021D molecular weight synthetic peptide (26 amino acids) which includes the RGD sequence that binds to the IIb/IIIa receptor expressed by activated platelets as well as by neoplasm cells, is reported. P-280 labelled with Tc-99M, via a chelator fused to the peptide, allows external gamma imaging. We have studied 21 patients (8 M/ 13 F, 21 to 80 years) with various diseases to define the pharmacokinetic and diagnostic accuracy of this probe. Imaging was performed as follows: dynamic, 0-15 min; planar 0.5, 2 and 4hrs; SPET 3 hrs. p.i. Doses ranged between 17.5-28 mCi of Tc-99m P-280 (0.2-0.4 mg).
OncoTargets and Therapy, 2015
5 lester and sue smith Breast center, Baylor college of Medicine, houston, TX, Usa; 6 Division of... more 5 lester and sue smith Breast center, Baylor college of Medicine, houston, TX, Usa; 6 Division of Oncology, centro di riferimento Oncologico di Basilicata, irccs rionero in Vulture, Potenza, 7 Department of radiotherapy, istituto nazionale per la cura dei Tumori-Fondazione g. Pascale. irccs di napoli, naples, italy Background: The clinical benefits of postoperative radiation therapy (PORT) for patients with thymoma are still controversial. In the absence of defined guidelines, prognostic factors such as stage, status of surgical margins, and histology are often considered to guide the choice of adjuvant treatment (radiotherapy and/or chemotherapy). In this study, we describe our singleinstitution experience of three-dimensional conformal PORT administered as adjuvant treatment to patients with thymoma. Methods: Twenty-two consecutive thymoma patients (eleven male and eleven female) with a median age of 52 years and treated at our institution by PORT were analyzed. The patients were considered at high risk of recurrence, having at least one of the following features: stage IIB or III, involved resection margins, or thymic carcinoma histology. Three-dimensional conformal PORT with a median total dose on clinical target volume of 50 (range 44-60) Gy was delivered to the tumor bed by 6-20 MV X-ray of the linear accelerator. Follow-up after radiotherapy was done by computed tomography scan every 6 months for 2 years and yearly thereafter. Results: Two of the 22 patients developed local recurrence and four developed distant metastases. Median overall survival was 100 months, and the 3-year and 5-year survival rates were 83% and 74%, respectively. Median disease-free survival was 90 months, and the 5-year recurrence rate was 32%. On univariate analysis, pathologic stage III and presence of positive surgical margins had a significant impact on patient prognosis. Radiation toxicity was mild in most patients and no severe toxicity was registered. Conclusion: Adjuvant radiotherapy achieved good local control and showed an acceptable toxicity profile in patients with high-risk thymoma.
World journal of clinical cases, Jan 16, 2014
Nasopharyngeal carcinoma is rare in western countries, accounting for less than 1% of all maligna... more Nasopharyngeal carcinoma is rare in western countries, accounting for less than 1% of all malignancies. Despite prognosis is satisfactory for newly diagnosed, non-metastatic disease, management of recurrent disease is challenging, with a survival expectancy of approximately 6 mo with the use of chemotherapy as the sole salvage treatment. We report a case of recurrent nasopharyngeal carcinoma treated with a combination of chemotherapy, radiotherapy and surgery in the context of a multidisciplinary approach. A durable complete response was achieved.
Anticancer research, 2013
Cervical metastases from unknown primary tumors are rare and no clear therapeutic options are ava... more Cervical metastases from unknown primary tumors are rare and no clear therapeutic options are available. This retrospective analysis aimed to evaluate toxicity and activity of a sequential chemoradiation regimen consisting of induction chemotherapy followed by extended-field radiotherapy in patients with cervical metastases from unknown primary tumors. Patients with cytological or histological diagnosis of latero-cervical lymph-node metastasis from carcinoma with unknown origin treated with sequential chemotherapy (3 cycles of docetaxel and cisplatin, each administered as intravenous infusion at the dose of 75 mg/m(2) on day 1, every 21 days) and radiotherapy (cumulative dose of 70 Gy) were included in this study. The radiological response was assessed by central review according to the revised RECIST criteria. Fifteen patients received three cycles of induction chemotherapy with the combination of docetaxel and cisplatin. Patients were subsequently treated with extended-field radio...
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2000
Annals of medicine, 1999
Human thymomas are rare tumours which usually develop in the chest. The diagnosis via guided biop... more Human thymomas are rare tumours which usually develop in the chest. The diagnosis via guided biopsy, the evaluation of the extent of the tumour and its boundaries with adjacent organs, the choice of the appropriate therapeutic option, and the assessment of response to treatment are usually made with computed tomography (CT) alone or in combination with magnetic resonance imaging (MRI). More recently, radiopharmaceuticals and nuclear medicine procedures have been used increasingly in the imaging and functional characterization of benign and malignant thymic disorders. Two groups of radiopharmaceuticals have been used. The first includes several oncotropic tracers, such as 201Tl-chloride, 99mTc-sestamibi and 18F-fluorodeoxyglucose, which are significantly concentrated in thymic tumours. Their uptake correlates with tumour grades and cellularity. The second class includes two radioligands: [(111)In-DTPA-D-Phe1]-octreotide (DTPA, diethylenetriamine penta-acetic acid) and [(111)In-DTPA-A...
Reports of Practical Oncology & Radiotherapy, 2010
and sharing with colleagues.
Radiotherapy and Oncology, 1994
International Journal of Radiation Oncology*Biology*Physics, 1996
Cancer Chemotherapy and Pharmacology, 1997
Vinorelbine and paclitaxel interfere with mitotic spindle function through different mechanisms o... more Vinorelbine and paclitaxel interfere with mitotic spindle function through different mechanisms of action. Both of the drugs show antitumor activity in small-cell lung cancer when used as single agents; furthermore, in vitro and in vivo studies have shown a synergistic activity between the two drugs. Patients with small-cell lung cancer no longer amenable to conventional treatment were entered into a phase I study in which vinorelbine was given at a fixed dose of 30 mg/m2 by 15-min intravenous infusion, whereas paclitaxel was given by 3-h infusion starting 1 h after vinorelbine at an initial dose of 90 mg/m2, which was subsequently escalated by 30-mg/m2 steps. Cycles were repeated every 21 days. Grade 3 neutropenia was observed only in three patients treated at the fifty dose level. Thrombocytopenia never reached grade 3. Neurotoxicity was considered dose-limiting, since grade 3 peripheral neuropathy occurred in three of five patients treated at the fifth dose level (paclitaxel 210 mg/m2). Other side effects were generally mild. The overall response rate in 22 evaluable patients was 32% (95% CI 13-51%); in particular, 1 complete response (4.5%) and 6 partial responses (27.3%) were observed. The maximally tolerated doses recommended for phase II studies are 180 mg/m2 for paclitaxel and 30 mg/m2 for vinorelbine. The observed myelosuppression was less severe than anticipated on the basis of the effects of each drug alone. The promising activity of this drug combination warrants a phase II study in untreated patients with extensive-stage small-cell lung cancer.
BMC cancer, 2014
Locally advanced rectal cancer (LARC) is a heterogeneous group of tumors where a risk-adapted the... more Locally advanced rectal cancer (LARC) is a heterogeneous group of tumors where a risk-adapted therapeutic strategy is needed. Short-course radiotherapy (SCRT) is a more convenient option for LARC patients than preoperative long-course RT plus capecitabine. Histone-deacetylase inhibitors (HDACi) have shown activity in combination with RT and chemotherapy in the treatment of solid tumors. Valproic acid (VPA) is an anti-epileptic drug with HDACi and anticancer activity. In preclinical studies, our group showed that the addition of HDACi, including VPA, to capecitabine produces synergistic antitumour effects by up-regulating thymidine phosphorylase (TP), the key enzyme converting capecitabine to 5-FU, and by downregulating thymidylate synthase (TS), the 5-FU target. Two parallel phase-1 studies will assess the safety of preoperative SCRT (5 fractions each of 5 Gy, on days 1 to 5) combined with (a) capecitabine alone (increasing dose levels: 500-825 mg/m2/bid), on days 1-21, or (b) capec...
La radiologia medica
The authors present the results obtained in 14 children affected with orbital rhabdomyosarcoma, w... more The authors present the results obtained in 14 children affected with orbital rhabdomyosarcoma, who were studied between 1979 and 1991 at the I Dept. of Radiology and Radiotherapy of the II Policlinico, Naples, Italy. The patients (age range: 14 months to 15 years) had received radiotherapy and chemotherapy: the dose was 6000 cGy to the orbital region (one case was given 4500 cGy and then interrupted radiotherapy for personal reasons). Twelve children underwent a standard protocol, that is biopsy followed by immediate irradiation and chemotherapy; surgery was performed in 2 cases. 90% survival at 2 years was obtained in our series. All 14 patients are alive and free of detectable disease, after a minimum of 7 to a maximum of 126 months from diagnosis. In 3 children a locoregional relapse was observed 12, 15, and 16 months after clinical diagnosis. They have received a new cycle of radiation therapy and are now free of detectable disease. In all children, ocular structures have been spared, and the complications observed so far have been few. Therefore, the authors suggest that the combination of immediate radiotherapy and chemotherapy might represent an optimal tool for the treatment of orbital rhabdomyosarcomas.
Oncotarget, Jan 30, 2015
We have previously shown that an intensified preoperative regimen including oxaliplatin plus ralt... more We have previously shown that an intensified preoperative regimen including oxaliplatin plus raltitrexed and 5-fluorouracil/folinic acid (OXATOM/FUFA) during preoperative pelvic radiotherapy produced promising results in locally advanced rectal cancer (LARC). Preclinical evidence suggests that the scheduling of bevacizumab may be crucial to optimize its combination with chemo-radiotherapy. This non-randomized, non-comparative, phase II study was conducted in MRI-defined high-risk LARC. Patients received three biweekly cycles of OXATOM/FUFA during RT. Bevacizumab was given 2 weeks before the start of chemo-radiotherapy, and on the same day of chemotherapy for 3 cycles (concomitant-schedule A) or 4 days prior to the first and second cycle of chemotherapy (sequential-schedule B). Primary end point was pathological complete tumor regression (TRG1) rate. The accrual for the concomitant-schedule was early terminated because the number of TRG1 (2 out of 16 patients) was statistically incon...
Journal of Nuclear Medicine
A preliminary study in humans, using a 3021D molecular weight synthetic peptide (26 amino acids) ... more A preliminary study in humans, using a 3021D molecular weight synthetic peptide (26 amino acids) which includes the RGD sequence that binds to the IIb/IIIa receptor expressed by activated platelets as well as by neoplasm cells, is reported. P-280 labelled with Tc-99M, via a chelator fused to the peptide, allows external gamma imaging. We have studied 21 patients (8 M/ 13 F, 21 to 80 years) with various diseases to define the pharmacokinetic and diagnostic accuracy of this probe. Imaging was performed as follows: dynamic, 0-15 min; planar 0.5, 2 and 4hrs; SPET 3 hrs. p.i. Doses ranged between 17.5-28 mCi of Tc-99m P-280 (0.2-0.4 mg).
OncoTargets and Therapy, 2015
5 lester and sue smith Breast center, Baylor college of Medicine, houston, TX, Usa; 6 Division of... more 5 lester and sue smith Breast center, Baylor college of Medicine, houston, TX, Usa; 6 Division of Oncology, centro di riferimento Oncologico di Basilicata, irccs rionero in Vulture, Potenza, 7 Department of radiotherapy, istituto nazionale per la cura dei Tumori-Fondazione g. Pascale. irccs di napoli, naples, italy Background: The clinical benefits of postoperative radiation therapy (PORT) for patients with thymoma are still controversial. In the absence of defined guidelines, prognostic factors such as stage, status of surgical margins, and histology are often considered to guide the choice of adjuvant treatment (radiotherapy and/or chemotherapy). In this study, we describe our singleinstitution experience of three-dimensional conformal PORT administered as adjuvant treatment to patients with thymoma. Methods: Twenty-two consecutive thymoma patients (eleven male and eleven female) with a median age of 52 years and treated at our institution by PORT were analyzed. The patients were considered at high risk of recurrence, having at least one of the following features: stage IIB or III, involved resection margins, or thymic carcinoma histology. Three-dimensional conformal PORT with a median total dose on clinical target volume of 50 (range 44-60) Gy was delivered to the tumor bed by 6-20 MV X-ray of the linear accelerator. Follow-up after radiotherapy was done by computed tomography scan every 6 months for 2 years and yearly thereafter. Results: Two of the 22 patients developed local recurrence and four developed distant metastases. Median overall survival was 100 months, and the 3-year and 5-year survival rates were 83% and 74%, respectively. Median disease-free survival was 90 months, and the 5-year recurrence rate was 32%. On univariate analysis, pathologic stage III and presence of positive surgical margins had a significant impact on patient prognosis. Radiation toxicity was mild in most patients and no severe toxicity was registered. Conclusion: Adjuvant radiotherapy achieved good local control and showed an acceptable toxicity profile in patients with high-risk thymoma.
World journal of clinical cases, Jan 16, 2014
Nasopharyngeal carcinoma is rare in western countries, accounting for less than 1% of all maligna... more Nasopharyngeal carcinoma is rare in western countries, accounting for less than 1% of all malignancies. Despite prognosis is satisfactory for newly diagnosed, non-metastatic disease, management of recurrent disease is challenging, with a survival expectancy of approximately 6 mo with the use of chemotherapy as the sole salvage treatment. We report a case of recurrent nasopharyngeal carcinoma treated with a combination of chemotherapy, radiotherapy and surgery in the context of a multidisciplinary approach. A durable complete response was achieved.
Anticancer research, 2013
Cervical metastases from unknown primary tumors are rare and no clear therapeutic options are ava... more Cervical metastases from unknown primary tumors are rare and no clear therapeutic options are available. This retrospective analysis aimed to evaluate toxicity and activity of a sequential chemoradiation regimen consisting of induction chemotherapy followed by extended-field radiotherapy in patients with cervical metastases from unknown primary tumors. Patients with cytological or histological diagnosis of latero-cervical lymph-node metastasis from carcinoma with unknown origin treated with sequential chemotherapy (3 cycles of docetaxel and cisplatin, each administered as intravenous infusion at the dose of 75 mg/m(2) on day 1, every 21 days) and radiotherapy (cumulative dose of 70 Gy) were included in this study. The radiological response was assessed by central review according to the revised RECIST criteria. Fifteen patients received three cycles of induction chemotherapy with the combination of docetaxel and cisplatin. Patients were subsequently treated with extended-field radio...
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2000
Annals of medicine, 1999
Human thymomas are rare tumours which usually develop in the chest. The diagnosis via guided biop... more Human thymomas are rare tumours which usually develop in the chest. The diagnosis via guided biopsy, the evaluation of the extent of the tumour and its boundaries with adjacent organs, the choice of the appropriate therapeutic option, and the assessment of response to treatment are usually made with computed tomography (CT) alone or in combination with magnetic resonance imaging (MRI). More recently, radiopharmaceuticals and nuclear medicine procedures have been used increasingly in the imaging and functional characterization of benign and malignant thymic disorders. Two groups of radiopharmaceuticals have been used. The first includes several oncotropic tracers, such as 201Tl-chloride, 99mTc-sestamibi and 18F-fluorodeoxyglucose, which are significantly concentrated in thymic tumours. Their uptake correlates with tumour grades and cellularity. The second class includes two radioligands: [(111)In-DTPA-D-Phe1]-octreotide (DTPA, diethylenetriamine penta-acetic acid) and [(111)In-DTPA-A...
Reports of Practical Oncology & Radiotherapy, 2010
and sharing with colleagues.
Radiotherapy and Oncology, 1994
International Journal of Radiation Oncology*Biology*Physics, 1996
Cancer Chemotherapy and Pharmacology, 1997
Vinorelbine and paclitaxel interfere with mitotic spindle function through different mechanisms o... more Vinorelbine and paclitaxel interfere with mitotic spindle function through different mechanisms of action. Both of the drugs show antitumor activity in small-cell lung cancer when used as single agents; furthermore, in vitro and in vivo studies have shown a synergistic activity between the two drugs. Patients with small-cell lung cancer no longer amenable to conventional treatment were entered into a phase I study in which vinorelbine was given at a fixed dose of 30 mg/m2 by 15-min intravenous infusion, whereas paclitaxel was given by 3-h infusion starting 1 h after vinorelbine at an initial dose of 90 mg/m2, which was subsequently escalated by 30-mg/m2 steps. Cycles were repeated every 21 days. Grade 3 neutropenia was observed only in three patients treated at the fifty dose level. Thrombocytopenia never reached grade 3. Neurotoxicity was considered dose-limiting, since grade 3 peripheral neuropathy occurred in three of five patients treated at the fifth dose level (paclitaxel 210 mg/m2). Other side effects were generally mild. The overall response rate in 22 evaluable patients was 32% (95% CI 13-51%); in particular, 1 complete response (4.5%) and 6 partial responses (27.3%) were observed. The maximally tolerated doses recommended for phase II studies are 180 mg/m2 for paclitaxel and 30 mg/m2 for vinorelbine. The observed myelosuppression was less severe than anticipated on the basis of the effects of each drug alone. The promising activity of this drug combination warrants a phase II study in untreated patients with extensive-stage small-cell lung cancer.
BMC cancer, 2014
Locally advanced rectal cancer (LARC) is a heterogeneous group of tumors where a risk-adapted the... more Locally advanced rectal cancer (LARC) is a heterogeneous group of tumors where a risk-adapted therapeutic strategy is needed. Short-course radiotherapy (SCRT) is a more convenient option for LARC patients than preoperative long-course RT plus capecitabine. Histone-deacetylase inhibitors (HDACi) have shown activity in combination with RT and chemotherapy in the treatment of solid tumors. Valproic acid (VPA) is an anti-epileptic drug with HDACi and anticancer activity. In preclinical studies, our group showed that the addition of HDACi, including VPA, to capecitabine produces synergistic antitumour effects by up-regulating thymidine phosphorylase (TP), the key enzyme converting capecitabine to 5-FU, and by downregulating thymidylate synthase (TS), the 5-FU target. Two parallel phase-1 studies will assess the safety of preoperative SCRT (5 fractions each of 5 Gy, on days 1 to 5) combined with (a) capecitabine alone (increasing dose levels: 500-825 mg/m2/bid), on days 1-21, or (b) capec...