Tumori Journal最新文献

{"title":"High consistency between characteristics of primary intraductal breast cancer and subtype of subsequent ipsilateral invasive cancer","authors":"M. Gennaro, E. Meneghini, P. Baili, S. Bravaccini, A. Curcio, M. D. De Santis, L. Lozza, C. Listorti, S. Di Cosimo, M. Sant, S. Folli","doi":"10.1177/0300891619867845","DOIUrl":"https://doi.org/10.1177/0300891619867845","url":null,"abstract":"Background: Ductal carcinoma in situ (DCIS) is considered a morphologic precursor of invasive cancer and is often treated with adjuvant whole-breast irradiation and endocrine therapy, as if it were an invasive cancer. Our aim was to provide further support for treatment de-escalation or enrollment of such patients in active surveillance trials. Methods: We retrospectively analyzed data on patients with conservatively treated primary DCIS subsequently diagnosed with ipsilateral invasive breast cancer (IBC) at 2 comprehensive breast cancer centers. From their merged databases, we identified 50 cases with full details on tumor grade, hormone receptor expression, and HER2 amplification, for both the primary DCIS and the corresponding IBC, and we assessed the similarities and differences between the two. Results: Distributions of hormone receptors were similar in primary DCIS and IBC, while high-grade and HER2-positive status was less common in IBC than in primary DCIS. The positivity for estrogen receptors (ER) and well-differentiated or moderately differentiated morphology in the primary DCIS persisted in 90% of the matching IBC. Changes in progesterone receptor expression were slightly more common than those in ER expression. Overall consistency for the luminal-like receptors subtype was found in 90% of cases. Conclusion: The high consistency between the features of primary DCIS and those of subsequent IBC (in the rare but not negligible cases of local failure) should be borne in mind when considering the therapeutic options. Treatment de-escalation and accrual of patients for active surveillance trials could be appropriate for luminal-like precursors.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"85 1","pages":"64 - 69"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81240242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tools for the assessment of neuropsychomotor profile in the rehabilitation of children with central nervous system tumor: a systematic review","authors":"Chiara Pellegrini, A. Caraceni, L. Bedodi, Raffaella Sensi, Simona Breggiè, F. Gariboldi, C. Brunelli","doi":"10.1177/0300891619868011","DOIUrl":"https://doi.org/10.1177/0300891619868011","url":null,"abstract":"Objective: This study reviews the scientific literature to identify and describe which assessment tools (ATs) are used in pediatric oncology and neuro-oncology rehabilitation and which development neuropsychomotor (DNPM) ATs were built for children with central nervous system (CNS) tumors. Methods: A systematic review was performed searching PubMed, CINAHL, PEDro, Science Direct, and Catalog of National Institute of Tumors databases and specialized journals. The search covered 7 years (2010–2017) and used relevant keywords in different combinations. A further search was carried out on DNPM rehabilitation manuals and academic thesis. Results: The review retrieved 35 eligible articles containing 63 ATs. The most common ATs were the Behavioral Rating Inventory of Executive Function (BRIEF) and the Wechsler Intelligence Scale for Children (WISC). Most of the ATs covered a single area of child development among behavioral/psychological, cognitive, and motor areas. A total of 159 ATs were found in manuals and thesis, and only 17 of them were already identified in the journal search. None of the ATs identified in both searches had been specifically developed for children with CNS tumor. Conclusion: The results highlight the need to develop and validate a global multidimensional AT for children with CNS tumor, overcoming the fragmentation of the assessment procedures and promoting standardized rehabilitation protocols.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"32 1","pages":"12 - 24"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87970577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invisible hemolysis in serum samples interferes in NSE measurement","authors":"A. Mastroianni, R. Panella, D. Morelli","doi":"10.1177/0300891619867836","DOIUrl":"https://doi.org/10.1177/0300891619867836","url":null,"abstract":"Introduction: The accuracy of serum neuron-specific enolase (NSE) measurements is critical, particularly in neurologic diseases and cancer. NSE measurements are compromised by slight, even invisible, hemolysis, which can produce apparently higher NSE levels, leading to inappropriate clinical decisions. In this article, we describe this issue and propose a solution for avoiding incorrect results. Methods: Twenty blood samples from donors with NSE values that were within the reference interval were considered. Experimental hemolysis was induced in vitro to examine the relationship between the degree of hemolysis and the increase in serum NSE. The data were then subjected to statistical analysis. Results: There was excellent correlation (r2 0.953) between the degree of hemolysis and the rise in NSE concentration. Each hemolysis unit (equal to 1 mg/dL of free hemoglobin) corresponded to a mean value of 0.29 ± 0.09 ng/mL NSE that was released from red blood cells. Conclusion: The hemolysis index must be measured in every sample with no evident hemolysis before assaying it for NSE. Moreover, if the degree of hemolysis is between 5 and 30 units, the increase in NSE (from 1.5 to 9.0 ng/mL) must be calculated, and the laboratory results should be appended with comments that suggest the approximate rise in NSE.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"2 1","pages":"79 - 81"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79231823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PGC-1α activator–induced fatty acid oxidation in tumor-infiltrating CTLs enhances effects of PD-1 blockade therapy in lung cancer","authors":"Huan Wan, Bin Xu, N. Zhu, Baozhong Ren","doi":"10.1177/0300891619868287","DOIUrl":"https://doi.org/10.1177/0300891619868287","url":null,"abstract":"Purpose: The present study aims to investigate the efficacy and mechanisms of peroxisome proliferator-activated receptor γ coactivator 1-α agonist, as adjuvant to programmed death-1 (PD-1) blockade in hyporesponsive lung cancer cells–derived in vivo tumor model, using bezafibrate. Methods: Mouse Lewis lung carcinoma (LLC) xenograft models were established and treated with programmed death-ligand 1 (PD-L1) monoclonal antibodies with or without bezafibrate. Tumors or peripheral blood of mice were harvested to investigate the quality, quantity, and function as well as energetic metabolism of cytotoxic T lymphocytes (CTLs) by flow cytometry or quantitative real-time polymerase chain reaction. Results: The combination of bezafibrate plus anti-PD-L1 reached synergistic tumoricidal effect in LLC xenograft mouse models, even though bezafibrate alone had no effect on tumor growth. Bezafibrate significantly facilitated CD8+ T cells infiltrating into tumor tissues by enhancing the expression of CXCL9 and CXCL10 within tumors as well as the receptor CXCR3 in infiltrating CTLs. Activated CTLs within tumors were also significantly upregulated by bezafibrate. Further data demonstrated that bezafibrate treatment could maintain the survival and functional capacity of tumor-infiltrating CTLs. Moreover, cellular reactive oxygen species in infiltrating CTLs and fatty acid oxidation (FAO)–related genes (PGC-1α, Cpt1a, and LCAD) expression within tumors were significantly increased after treatment with bezafibrate. Conclusions: Bezafibrate synergized the tumoricidal effect of PD-1 blockade in hyporesponsive lung cancer by expansion of effector CTLs within tumor microenvironment. The potential mechanism may relate to the capacity of bezafibrate in regulating FAO of tumor-infiltrating CTLs.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"11 1","pages":"55 - 63"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79994963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term sustainability of a quality improvement program on cancer pain management: a complex intervention in an inpatient setting","authors":"S. Tanzi, S. D. Leo, E. Mazzini, M. Castagnetti, Caterina Turrà, C. Peruselli, M. Costantini","doi":"10.1177/0300891619869513","DOIUrl":"https://doi.org/10.1177/0300891619869513","url":null,"abstract":"Background: Several approaches towards pain control for admitted cancer patients have been suggested by the literature without achieving satisfactory results. In this quality improvement project, we proposed a multicomponent intervention. Measures: A set of indicators was established for each component of the project. The feasibility of both the intervention and its evaluation system was measured. According to the literature review and the analysis of the local context, 5 active components were identified, piloted, and assessed: training of ward professionals, education of patients and nonprofessional caregivers, regular pain assessment, specialist-level pain consultation procedures, and involvement of hospital management. Results: Multiprofessional training programs with daily discussions, daily pain assessment, and a readily available specialized palliative care service seem to be the active components of this complex intervention. The quality improvement project achieved 2 years sustainability. Conclusion: Consolidated educational and organizational methodologies support the feasibility of this complex intervention.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"21 1","pages":"25 - 32"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74448473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of biological parameters in head and neck cancer based on in vivo distribution of 18F-FDG-FLT-FMISO-PET/CT images","authors":"P. Cegła, J. Kazmierska, S. Gwóźdź, R. Czepczyński, J. Malicki, W. Cholewiński","doi":"10.1177/0300891619868012","DOIUrl":"https://doi.org/10.1177/0300891619868012","url":null,"abstract":"Objective: Several genetic analyses have identified tumor diversity not only among tumors from different patients (intertumor heterogeneity) but also within individual tumors (intratumor heterogeneity). The aim of this study was to analyze the intratumor heterogeneity and other biological parameters based on in vivo distribution in triple-tracer positron emission tomography with computed tomography (PET/CT) study in patients with newly diagnosed head and neck (H&N) cancer. Methods: Thirty-six patients with newly diagnosed H&N cancer were included in the study. Institutional Bioethical Committee approved the study protocol and informed consent was received from every participant. All patients underwent series of 3 PET/CT scans with [18F]Fluorodeoxyglucose (18F-FDG-PET), [18F]Fluorothymidine (18F-FLT-PET), and [18F]Fluoromisonidazole (18F-FMISO-PET) before treatment. Scans were performed on separate days, within a timeframe of 2 weeks. Several PET/CT parameters grading tumor biology including maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), its equivalent (total hypoxic lesion [TLH] and total proliferative lesion [TLP]), and heterogeneity (area under the curve–cumulative SUV histogram) for the primary tumor were compared. Results: All patients showed increased uptake of 18F-FDG in primary tumor, ranging from 2.29 to 14.89 SUVmax. Respectively, SUVmax values for 18F-FLT ranged from 0.93 to 16.11 and for 18F-FMISO 0.36–4.07. Based on 3-year follow-up, we divided patients in terms of survival forecasts (first with good prognosis and second with worse). Higher values of TLG/TLP/TLH and SUVmax were observed in the second group in all 3 tracers (for 18F-FDG: 167.40 vs 100.32, 11.15 vs 8.95; for 18F-FLT: 116.61 vs 60.67, 7.09 vs 5.47; for 18F-FMISO: 37.34 vs 22.30, 1.70 vs 1.61 respectively). Statistically significant differences were shown in SUVmax in 18F-FDG and 18F-FLT (P<0.034, P<0.034, respectively; in TLG, P=0.05; TLP, P=0.04; and TLH, P=0.05). Conclusion: Our preliminary results suggest worse prognosis in patients with higher heterogeneity values of primary tumor in proliferation and hypoxia images and combination of metabolic and volumetric parameters in TLG and its equivalent and heterogeneity of primary tumor seems to be a prognostic factor.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"50 1","pages":"33 - 38"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75736099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic role of primary tumor, nodal neck, and retropharyngeal GTVs for unresectable sinonasal cancers treated with IMRT and chemotherapy","authors":"L. Ferella, A. Cavallo, R. Miceli, N. Iacovelli, T. Giandini, E. Pignoli, G. Calareso, P. Bossi, C. Resteghini, G. Gravina, P. Nicolai, P. Castelnuovo, C. Piazza, L. Licitra, C. Fallai, E. Orlandi","doi":"10.1177/0300891619868006","DOIUrl":"https://doi.org/10.1177/0300891619868006","url":null,"abstract":"Background: We evaluated the prognostic role of gross tumor volumes (GTVs) of primary tumor and positive lymph nodes on overall survival (OS) and progression-free survival (PFS) in locally advanced unresectable sinonasal cancer (SNC) treated with definitive intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Methods: Primary tumor GTV (GTV-T), pathologic neck nodes GTV (GTV-N), and positive retropharyngeal nodes GTV (GTV-RPN) of 34 patients with epithelial nonglandular SNC receiving IMRT with or without chemotherapy were retrospectively measured. The GTV variables were analyzed in relation with OS and PFS. Survival curves were estimated using the Kaplan-Meier method and compared with the log-rank test. We also estimated the crude cumulative incidence of locoregional relapses only. The optimal volume cutoff value was determined using an outcome-oriented method among the observed values. Results: GTV-T was significantly associated with decreased OS (P=0.003) and PFS (P=0.003). Moreover, patients with disease total volumes (GTV) smaller than 149.44 cm³ had better OS and PFS than patients with higher volumes (P<0.0001 for both). Neck nodal metastasis impacted on OS and PFS (P=0.030 and P=0.033, respectively), but GTV-N did not (P=0.961; P=0.958). Retropharyngeal nodes metastasis was not associated with prognosis (OS: P=0.400; PFS: P=0.104). When GTV-RPN was added to GTV-N (GTV-TN), a relation with PFS (P=0.041) and a trend toward significance for OS (P=0.075) were found. Conclusions: Our results show that tumor volume is a powerful predictor of outcome in SNC. This could be useful to identify patients with worse prognosis deserving different treatment strategies.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"25 1","pages":"39 - 46"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76956762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined dynamic DCE-MRI and diffusion-weighted imaging to evaluate the effect of neoadjuvant chemotherapy in cervical cancer","authors":"Yu Feng, Hui Liu, Yingying Ding, Ya Zhang, C. Liao, Yan Jin, Conghui Ai","doi":"10.1177/0300891619886656","DOIUrl":"https://doi.org/10.1177/0300891619886656","url":null,"abstract":"Purpose: To prospectively investigate changes in quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and the apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) in patients with cervical cancer before and after neoadjuvant chemotherapy (NACT). Methods: Thirty-eight patients with cervical cancer underwent DCE-MRI and DWI 1 week before and 4 weeks after NACT. The patients were classified into 2 groups: significant reaction (sCR) group and the non-sCR group. DCE-MRI parameters and ADC values were measured and compared between the 2 groups. Results: Before NACT, the mean Ktrans value was higher, but the mean Ve was lower, in the sCR group compared with the non-sCR group; these differences were statistically significant (p<0.05). After NACT, the mean Ktrans value and the delta (i.e., changed) value of Ktrans were significantly lower in the sCR group compared with the non-sCR group (p<0.05). However, the mean ADC and the delta value of the mean ADC between the 2 groups were slightly higher in the sCR group compared with the non-sCR group (p<0.05). The area under the curve of pre-mean Ktrans, DKtrans, and pre-mean Ktrans combined with post-mean ADC values were 0.801, 0.955, and 0.878, respectively (p<0.05). The optimal cutoff values for distinguishing sCR from non-sCR were pretreatment Ktrans (0.7020 min−1) and DKtrans (0.0437 min−1). Conclusions: Quantitative parameters (pre-mean Ktrans, DKtrans, and pre-mean Ktrans) combined with post-mean ADC could predict treatment efficacy more precisely. However, quantitative DCE-MRI combined with DWI could not significantly improve prognostic efficacy.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"1 7","pages":"155 - 164"},"PeriodicalIF":0.0,"publicationDate":"2019-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91427031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic CT findings of malignant bowel obstruction in patients with advanced ovarian cancer","authors":"M. Miccò, M. Sbarra, B. Gui, N. Bianco, E. Rodolfino, R. Manfredi","doi":"10.1177/0300891619886657","DOIUrl":"https://doi.org/10.1177/0300891619886657","url":null,"abstract":"Objective: To evaluate computed tomography (CT) findings able to predict outcome in patients with ovarian cancer (OC) and concomitant bowel occlusion. Methods: This institutional review board–approved retrospective study included 31 patients with OC and clinical evidence of bowel occlusion who underwent CT at presentation between February 2013 and June 2015. Two radiologists recorded various qualitative CT features. Correlations between CT and survival data were made with Mann-Whitney test, Wilcoxon test, and χ2 test, as appropriate. Receiver operating characteristic curves were generated for statistically significant CT findings using logistic regression model. Results: Two of 31 patients (6.5%) were alive at the end of this study; 29 patients (93.5%) died of disease. Median overall survival was 90 days. CT features associated with short life expectancy were bowel mural thinning (p=0.03), mesenteric tumor deposits (p=0.009), mesenteric infiltration (p=0.02), and ascites (p=0.04). Area under the curve was 0.728 (p=0.03) for mesenteric tumor deposits in predicting malignant bowel obstruction. Conclusions: Accurate interpretation of CT features may guide decisions in care of women with OC and bowel obstruction.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"11 1","pages":"149 - 154"},"PeriodicalIF":0.0,"publicationDate":"2019-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78679251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A home run for rhabdomyosarcoma after 30 years: What now?","authors":"A. Ferrari, P. Gasparini, M. Casanova","doi":"10.1177/0300891619888021","DOIUrl":"https://doi.org/10.1177/0300891619888021","url":null,"abstract":"Rhabdomyosarcoma is a rare tumor, with an annual incidence of 4 in 1 million population. Around 400 cases are diagnosed among 0to 19-year-olds in Europe each year,1 50–60 of them in Italy.2,3 It is nonetheless the most common soft tissue sarcoma in children and adolescents. This highly malignant tumor has a strong propensity to metastasize, but also a good chance of responding to conventional chemotherapy. Recent pediatric oncology studies report overall survival rates exceeding 70% for patients with localized rhabdomyosarcoma given risk-adapted multidisciplinary treatments, including surgery, radiotherapy, and multiagent chemotherapy in particular.4 The outcome is unsatisfactory for some patient categories, however, such as adolescents and young adults with rhabdomyosarcoma, patients with an alveolar histology, and those with distant metastases or relapsing disease. In September 2019, the European pediatric Soft Tissue Sarcoma Study Group (EpSSG) published the results of a rhabdomyosarcoma study (EpSSG RMS 2005), particularly reporting on the efficacy of maintenance therapy.5 When the study findings were presented at the plenary sessions of the congresses held by the American Society of Clinical Oncology in June 2018 and by the European Society of Paediatric Oncology in May 2019, the media described them as a “home run” for the treatment of rhabdomyosarcoma. Here we retrace the story of this important study to glean useful hints and explore what to do next in clinical research on rhabdomyosarcoma. The phase III randomized EpSSG RMS 2005 trial was tailored to patients under 21 years old with localized rhabdomyosarcoma. The protocol paid special attention to the so-called high-risk patients, i.e., those with incompletely resected embryonal rhabdomyosarcoma arising at unfavorable sites and age ⩾10 years and/or tumor size >5 cm, any embryonal rhabdomyosarcoma with nodal involvement, or any alveolar rhabdomyosarcoma without nodal involvement. This high-risk group was believed to represent 55%–60% of all patients with localized rhabdomyosarcoma, whose 5-year event-free survival (EFS) and overall survival (OS) rates were estimated at around 50%– 55% and 60%, respectively. For these patients, the protocol included 2 randomizations (Figure 1). The first, applied at the time of diagnosis, was used to investigate whether patients with rhabdomyosarcoma might benefit from a higher doxorubicin dose intensity in the initial period of their treatment. The results were published in 2018: with 484 patients treated, the 3-year EFS rate was 63.3% for patients in the standard arm (ifosfamide, vincristine, and actinomycin-D; IVA), and 67.5% for those in the experimental arm (ifosfamide, vincristine and actinomycin-D plus doxorubicin; IVADo) (p = 0.33). The study showed that adding dose-intensified doxorubicin to the standard IVA chemotherapy did not significantly improve the outcome for patients with high-risk nonmetastatic rhabdomyosarcoma. Acute toxicity was signif","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"103 1","pages":"11 - 5"},"PeriodicalIF":0.0,"publicationDate":"2019-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75666151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}