bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proton Beam Radiotherapy: Report of the First Patient Treated at the Centro NAzionale di Adroterapia Oncologica (CNAO)
Authors: Orecchia Roberto , Srivastava Anurita , Fiore Maria Rosaria , Vitolo Viviana , Fossati Piero , Vischioni Barbara , Iannalfi Alberto , Tuan Jeffrey , Ciocca Mario , Molinelli Silvia , Mirandola Alfredo , Vilches Gloria , Mairani Andrea , Tagaste Barbara , Baroni Guido , Rossi Sandro , Krengli Marco 
Published: February 2018

Proton beam radiotherapy, an innovative treatment modality, allows delivery of high radiation doses to the target while sparing surrounding healthy structures. The Centro Nazionale di Adroterapia Oncologica (CNAO), equipped with a synchrotron and capable of using both protons and ions, initiated its clinical activity in September 2011. The first treatment of a skull base tumor with protons is reported here. The case of a 26-year-old man with an intracranial low-grade chondrosarcoma of the right petroclival junction is discussed with emphasis on technical and clinical details. Two previous surgical interventions had achieved partial removal of the tumor and the patient was treated with protons for residual disease. The prescribed dose was 70 GyE in 35 fractions of 2 GyE. Treatment was completed with minimal acute toxicity consisting of grade 1 alopecia and nausea. Nine months after treatment the disease is locally controlled. Use of high-energy protons at CNAO is a safe and effective means of treating a tumor located near critical normal structures.
Estimates of cancer burden in Piedmont and Aosta Valley
Authors: Rosso Stefano , Sacchetto Lidia , Giacomin Adriano , Foschi Roberto , De Angelis Roberta , Rossi Silvia , Zanetti Roberto 
Published: February 2018

Aims and background Cancer registration in Piedmont currently covers the city of Turin and the province of Biella, together representing 24% of the regional population. The objective of this paper is to provide estimates of the incidence and mortality rates and prevalence proportions for cancer of the lung, breast, cervix, prostate, colon-rectum and stomach and melanoma of the skin for 2012 and the time trends up to 2015 for the Piedmont and Aosta Valley regions. Methods The estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Published data from the Italian cancer registries were modeled in order to estimate the regional cancer survival. The MIAMOD estimates were also compared with those obtained by applying a method based on the mortality-incidence and prevalence-incidence ratios. Results The most frequently diagnosed cancers in absolute terms were prostate, colorectal, breast and lung cancer with about 5,000, 4,700, 3,300, and 2,900 new cases, respectively, in 2012. Incidence rates were rising for melanoma in both sexes and lung cancer in women, while they diminished for cervical and stomach cancer. For prostate cancer and male lung cancer the rates initially increased but were estimated to decrease in the most recent period. Colorectal cancer also increased up to the 1990s but was estimated to reach a plateau in the final years of estimation. Prevalence increased for all the considered cancers with the exception of cervical cancer. Mortality was declining for all considered cancers with the exception of lung cancer in women. Conclusions Monitoring indicators of the cancer burden is crucial for setting priorities among possible health system activities in a limited-resource setting. Piedmont has long invested in organized, population-based screening programs: these will have to be extended and accompanied by greater efforts in primary prevention.
Estimates of cancer burden in Veneto
Authors: Tognazzo Sandro , De Angelis Roberta , Ciampichini Roberta , Gatta Gemma 
Published: February 2018

Aims and background In Veneto a regional cancer registry has been operating since 1987 which provides incidence and survival data for the region. It currently covers 48% of the regional population. The aim of this paper is to provide estimates of the incidence, mortality and prevalence of the major cancers for the whole Veneto region in the period 1970—2015. Methods The estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Survival was modeled on the basis of published data from the Italian cancer registries. Results In 2012 the most frequent cancer sites were colon-rectum, prostate and breast with 4,677, 3,760 and 3,729 new diagnosed cases, respectively. The incidence rates were estimated to increase constantly for female lung cancer, prostate cancer, colorectal cancer and melanoma, while they were decreasing for cervical cancer and stomach cancer. For male lung cancer and female breast cancer the rates increased, reaching a peak, and then decreased. In the last years of the period of analysis, mortality declined for all cancers: the highest number of deaths (2,390 in both sexes) was estimated for lung cancer in 2012. Prevalence was increasing for all the considered cancer sites with the exception of lung cancer in men, for which the prevalence was estimated to increase until 2007 and then stabilize. By contrast, the cervical cancer decreased during the whole period. In 2012 breast cancer had the highest prevalence, with about 52,000 cases. Conclusion This paper provides a description of the burden of the major cancers in Veneto until 2015. The estimates highlight the continuing reduction of cancer mortality. This decline can be related to the improvement of clinical treatments and to multidisciplinary treatment approaches. In order for this positive trend to continue, implementation and reinforcement of the screening programs is needed, especially for breast and colorectal cancer.
Estimates of cancer burden in Tuscany
Authors: Ventura Leonardo , Miccinesi Guido , Buzzoni Carlotta , Crocetti Emanuele , Paci Eugenio , Foschi Roberto , Rossi Silvia 
Published: February 2018

Aims and background The Tuscan cancer registry has been operating since 1985, providing cancer incidence and survival data in Tuscany; it covers about 33% of the regional population. The purpose of this paper is to provide incidence, prevalence and mortality estimates for the major cancers in the whole Tuscany region for the period 1970—2015. Methods The estimated figures were obtained by applying the MIAMOD method. Starting from mortality and survival data, incidence and prevalence were derived using a statistical back-calculation approach. Survival was modeled on the basis of published data from the Italian cancer registries. Results According to the estimates, the most frequent cancer sites were colon-rectum in both genders, prostate in men and breast in women, with 4,188, 3,082 and 3,092 new diagnoses, respectively, in 2012. The incidence rates were steadily increasing for lung cancer in women and melanoma in both sexes, while they were decreasing for uterine cervix cancer in women, lung cancer in men and stomach cancer in both sexes. For colorectal cancer a small reduction in incidence was estimated for both sexes in recent years. The incidence rates for prostate cancer, after a steep increase and subsequent stabilization, were estimated to increase slightly in the last years. The breast cancer incidence was estimated to stabilize in the last 10 years. The mortality trends were decreasing for all considered cancers except female lung cancer. Prevalence increased for most of the studied cancers except stomach cancer in both sexes, lung cancer in men and cervix cancer in women. The highest prevalence was estimated for breast cancer, with over 42,000 cases in 2012. Conclusion This paper provides an updated description of the cancer burden in Tuscany until 2015. These trends will have a significant impact on the regional health services and it is therefore important to enhance both primary prevention, for reducing the cancer incidence, and oncological surveillance, for evaluating the care and assistance of cancer patients.
Estimates of cancer burden in Umbria
Authors: Stracci Fabrizio , Petrucci Maria Saba , Ciampichini Roberta , Tavilla Andrea , Foschi Roberto 
Published: February 2018

Aims and background Model-based estimates and projections of epidemiological indicators related to cancer are important tools to support public health policies and planning. The aim of the present study is to produce projections of cancer incidence, mortality and prevalence for the Umbria region (900,000 inhabitants) in central Italy. Methods The estimations were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Published data from the Italian cancer registries were modeled in order to estimate regional cancer survival. Estimated incidence rates were validated with observed incidence rates obtained from the Umbria regional cancer registry. Results The most frequent cancer sites estimated were colon-rectum, prostate and breast in women, with 970, 615 and 729 new diagnoses, respectively, in 2012. The incidence rates were increasing for female lung cancer, male colorectal cancer, and melanoma. By contrast, the rates have been declining for cervix and stomach cancer. For lung cancer and prostate cancer in men and colorectal cancer in women the rates increased, reaching a peak in different periods, and then decreased. The incidence rates of breast cancer rose, reaching a plateau in the mid 2010s. Favorable mortality trends were predicted for all cancers except skin melanoma and lung cancer in women. The prevalence of cancer was increasing with the only exception of cervical cancer in women and lung cancer in men in the most recent estimation period. Conclusion The scenario found for cancer incidence and prevalence was largely influenced by screening activities, so that increasing or stable incidence rates may reflect active preventive efforts. Aging, screening, and more complex and costly treatments pose a problem of sustainability and selection of interventions to the regional oncology system. Evaluation of effectiveness of intervention and cost-benefit analyses will be important to ensure cancer control in the future.
Estimates of cancer burden in Marche
Authors: Tavilla Andrea , Vitarelli Susanna , Rossi Silvia , Foschi Roberto 
Published: February 2018

Aims and background The aim of this paper is to provide estimates of the incidence, mortality and prevalence of seven major cancers in the Marche region for the period 1970—2015. Methods The MIAMOD method, a statistical back-calculation approach, was applied to derive incidence and prevalence figures from mortality and relative survival data. Published data from the Italian cancer registries were used as the basis for survival modeling. Results Colorectal, breast and prostate cancer were the most frequent cancers in 2012, with 1,563, 1,215 and 1,191 estimated incident cases, and leading to 539, 224 and 228 deaths, respectively. Age-standardized rates were estimated to decrease for stomach and cervical cancer and to increase for skin melanoma and female lung cancer. In men, the lung cancer incidence rates reached their maximum level during the late 1980s and decreased thereafter. The colorectal cancer trend showed an initially increasing pattern, followed by a decrease in the last decade, both for men and women. The estimated incidence rates of prostate cancer presented a very steep rise in the period 1985—2002 and then remained stable at the high levels reached in 2003. The largest increases in prevalence were for breast, colorectal and prostate cancer, for which 17,098, 11,844 and 9,269 cases were estimated, respectively, in 2012. Conclusion This paper provides a description of the burden of the major cancers in the Marche region until 2015. The estimates were fairly consistent with previously published data by the Macerata province cancer registry. The MIAMOD method provides a picture of the impressive increase in the prevalence of breast cancer and prostate cancer over the period studied, thereby allowing to foresee an increasing demand for cancer care services as one of the major challenges for the regional health care system.
Estimates of cancer burden in Italy
Authors: Rossi Silvia , Crocetti Emanuele , Capocaccia Riccardo , Gatta Gemma ,   AIRTUM Working Group, Buzzoni C. , Giacomin A. , Zanetti R. , Bisanti L. , Tessandori R. , Crosignani P. , Vercelli M. , Mazzoleni G. , Piffer S. , Zambon P. , Serraino D. , Ferretti S. , Michiara M. , Federico M. , de Leon M. Ponz , Mangone L. , Falcini F. , Crocetti E. , La Rosa F. , Vitarelli S. , Pannozzo F. , Fusco M. , Donato A. , Traina A. , Tumino R. , Madeddu A. , Contrino M.L. , Budroni M. 
Published: February 2018

Aims and background This paper presents updated estimates of the incidence, prevalence and mortality of stomach, colorectal, lung, breast, uterine cervix and prostate cancer and skin melanoma in the Italian population. In particular, point estimates for 2012 and time trends from 1970 to 2015 will be provided. Methods The presented figures were obtained by summing up the regional epidemiological indicator estimates presented in the other papers of this monographic issue, which were derived by applying the MIAMOD statistical back-calculation method to cancer registries survival data and official mortality rates. Results Our findings indicate that breast, colon-rectum and prostate will be the cancer sites with the highest incidence rates in the forthcoming years. The incidence rates still tend to increase for breast, male colorectal cancer and female lung cancer as well as for skin melanoma. By contrast, the incidence of stomach cancer, cervical cancer and male lung cancer, by far the most common tumor sites up to the early 1990s, will continue to decrease. The mortality estimates showed a decreasing trend for all considered cancers with the only exception of lung cancer in women. Conclusion These results point to the need to reinforce prevention activities by developing more effective preventive measures for population groups at risk. There is also a need to support timely and continuous cancer surveillance in the Italian population through cancer registries in order to monitor the spread of the cancer risk and to evaluate the impact of prevention policies and therapeutic advances.
Hypofractionated intensity-modulated radiotherapy using simultaneous integrated boost technique with concurrent and adjuvant temozolomide for glioblastoma
Authors: Yoon Sang Min , Kim Jeong Hoon , Kim Sang Joon , Khang Shin Kwang , Shin Seong Soo , Cho Young Hyun , Jwa Eunjin , Park Jin-hong , Ahn Seung Do 
Published: February 2018

Aims and background We assessed the therapeutic efficacy of combined hypofractionated intensity-modulated radiotherapy with temozolomide in patients with primary glioblastoma. Methods and study design Thirty-nine patients with histologically confirmed glioblastoma were accrued. Using the simultaneous integrated boost technique, a dose of 50 Gy in 5-Gy fractions was applied to the gross tumor volume, together with 40 Gy in 4-Gy fractions and 30 Gy in 3-Gy fractions to the 1- and 2-cm margins from the gross tumor volume, respectively. Patients were also treated with concurrent temozolomide during intensity-modulated radiotherapy, followed by six cycles of adjuvant temozolomide. Results Median follow-up was 16.8 months (range, 4.3–54.3). Tumor progression was observed in 28 patients (71.8%), and the median time to progression was 6.8 months. Median survival was 16.8 months, and it was affected significantly by the extent of surgery. During adjuvant temozolomide treatment, 3 patients (9.7%) developed grade 3–4 hematologic or hepatic toxicity. Radiation necrosis developed in 7 patients (17.9%) and massive necrosis, requiring emergency surgery, in 1 patient (2.6%). Conclusions The regimen of hypofractionated intensity-modulated radiotherapy with temozolomide showed a relatively good outcome in patients with glioblastoma. Further studies are required to define the optimal fraction size for glioblastoma using this highly sophisticated radiation technique.
Expression of cell metabolism-related genes in different molecular subtypes of triple-negative breast cancer
Authors: Jeon Hyae Min , Kim Do Hee , Jung Woo-Hee , Koo Ja Seung 
Published: February 2018

Aims and background We evaluated the difference in and significance of cancer cell metabolism by molecular subtyping of triple-negative breast carcinoma. Methods Tissue microarrays from 122 surgical specimens of triple-negative breast carcinoma patients and immunohistochemical staining for CK5/6, epidermal growth factor receptor, claudin 3, claudin 4, claudin 7, E-cadherin, androgen receptor, and gamma-glutamyltransferase 1 were used to classify triple-negative breast carcinoma as follows: basal-like type, molecular apocrine type, claudin low type, mixed type and null type. In addition, immunohistochemical staining for metabolism-related proteins such as c-myc, insulin-like growth factor (g)-1, hypoxia-inducible factor 1–1α, glucose transporter 1, carbonic anhydrase IX antibody, macrophage migration inhibitory factor, and pyruvate dehydrogenase kinase 1 was used to compare the differences according to molecular subtype and clinicopathological factors. Results The basal-like type showed the highest proportion of high glucose transporter 1 expression (P = 0.049) and carbonic anhydrase IX antibody expression (P = 0.008). Hypoxia-inducible factor 1–1α expression was associated with lymph node metastasis (P = 0.001) and central fibrotic zone (P = 0.012), and high glucose transporter 1 expression was related to high histologic grade (P = 0.007), cytokeratin 5/6 positivity (P = 0.002), and central fibrotic zone (P = 0.017). Finally, carbonic anhydrase IX antibody was associated with cytokeratin 5/6 positivity (P = 0.001) and central fibrotic zone (P = 0.048). Conclusions Our study revealed the different characteristics of cancer cell metabolism according to the molecular subtypes of triple-negative breast carcinoma. Among them, basal-like type was the most glycolytic and acid-resistant phenotype.
A School-Based Peer-Led Smoking Prevention Intervention with Extracurricular Activities: The LILT-LdP Cluster Randomized Controlled Trial Design and Study Population
Authors: Bosi Sandra , Gorini Giuseppe , Tamelli Marco , Monti Claudia , Storani Simone , Carreras Giulia , Martini Andrea , Allara Elias , Angelini Paola , Faggiano Fabrizio 
Published: February 2018

Aims and background Few school programs are effective in preventing adolescents' tobacco smoking initiation. The “Lega contro i Tumori - Luoghi di Prevenzione” is a cluster randomized controlled trial designed to evaluate a school-based peer-led smoking prevention intervention with extracurricular activities for students aged 14–15 years. This paper presents the study design and the baseline characteristics of the study population. Methods and study design Twenty secondary schools located in the Reggio Emilia province took part in the study. Five schools were excluded because they already participated in smoking prevention interventions. The schools were randomized to control or intervention arms. The study population consisted of students attending the first grade. Components of the intervention included 1) the out-of-school “Smoking Prevention Tour” (SPT) at the “Luoghi di Prevenzione” Center, a 4-hour (4 sessions) extracurricular activity; 2) the “Smoke-free Schools” intervention, combining a life–skills-based peer-led intervention at school, an in-depth lesson on one of the SPT sessions, and enforcement surveillance of the school antismoking policy. Tobacco use was studied through a questionnaire administered before and 6 months after the intervention. Results Eleven high schools and 9 vocational secondary schools took part in the study for a total of 2,476 out of 3,050 eligible students (81.2%). The proportions of respondents in high schools and vocational secondary schools were 90.9% and 64.5%, respectively (P <0.001). Intervention and control arms showed a different distribution of gender and school type, whereas no difference was observed in any tobacco-use characteristic. Conclusions This study is one of the few Italian trials to evaluate the effectiveness of a school-based program for preventing smoking initiation.
Antismoking Centers in Milan's Communal Pharmacies: Analysis of the 2010–2011 Campaign
Authors: Munarini Elena , Marabelli Chiara , Marmotti Aldo , Gardiner Anna , Invernizzi Giovanni , Mazza Roberto , De Marco Cinzia , Pozzi Paolo , Boffi Roberto 
Published: February 2018

Aims and background According to recent assessments from the Italian Istituto Superiore della Sanità, information and assistance to smokers are still far from satisfactory. We evaluated the impact of a new smoking cessation service located in pharmacies. Smokers' individual characteristics were also considered. Material and Methods A 1-year pilot study was carried out from October 2010 to September 2011. Five pharmacies in Milan were selected. A psychologist with experience in smoking cessation was present in each pharmacy one afternoon per week, and pharmacists were trained by a team from the Antismoking Center of the Fondazione IRCCS Istituto Nazionale dei Tumori. Each pharmacy was equipped with informative material, carbon monoxide analyzers, and motivational and nicotine dependence questionnaires, in addition to a clinical briefcase. Counseling sessions were also arranged upon request. Results In the first 12 months of activity, 216 persons asked for a consultation. The sample, aged 15–79 years, reported the following median values: 30 pack/years, 14 ppm CO, and a Fagerström Test of Nicotine Dependence score of 5. More than one-third of the sample (40.3%) had one pathology and 25% had more than one. In some cases (15.7%), people just wanted information about what the service offered. For those who tried to quit, smoking cessation rates were 33.3% at 3 months, 28% at 6 months, and 24.6% at 1 year. Three kinds of pharmacologic therapies were suggested to smokers: nicotine replacement therapy (75.5%), varenicline (17.5%), and bupropion (7%). Conclusions The results show that an accessible and free smoking cessation service is considered useful by smokers as demonstrated by the large number of requests compared with other smoking centers in Italy. Increased involvement of pharmacists in supporting smoking cessation makes this a promising initiative for the near future.
Male Breast Cancer: Clinical Features and Multimodal Treatment in a Retrospective Survey Analysis at Italian Centers
Authors: La Verde Nicla , Collovà Elena , Lonardi Sara , Generali Daniele , Moretti Anna , Atzori Francesco , Cazzaniga Marina , Saggia Chiara , Tondulli Luca , Marcon Ilaria , Gentile Anna Lisa , Rossello Rosalba , Martelli Olga , Aglione Stefania , Farina Gabriella , Cinquini Michela , Garassino Marina 
Published: February 2018

Aims and background We report a collection of data about early breast cancer in male patients from 13 Italian institutions. Methods and study design We obtained data from patient charts and performed statistical analysis. The primary end points were overall survival and disease-free survival. Results A total of 205 men with invasive breast cancer was identified, with a median age of 66 years. Pathological characteristics were heterogeneous for T stage, N stage and HER2 status. Histological subtype was predominantly ductal infiltrating carcinoma. Most of them were hormone receptor positive. Mastectomy was the most common strategy. Postsurgical treatment was not standardized. Patients with large tumors were more likely to be treated with chemotherapy. Disease recurrence was associated with an ER+ and PR+ status. Conclusions We identified a correlation between relapse and hormone receptor expression, as is the case in female breast cancer.