Publications by authors named "Francesca De Felice"

Purpose: In locally advanced cervical cancer (LACC), chemoradiotherapy (CRT) represents the standard of care. The aim of this narrative review is to investigate the prognostic role of metabolic response of F-FDG PET-CT after CRT in LACC patients.

Methods: We reviewed the literature according to the PRISMA guidelines to identify studies up to December 2023.

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Introduction: Radiotherapy is an effective anticancer agent. Radiosensitivity varies between individuals. While disparities in radiosensitivity between sex have been well documented, most radiotherapy guidelines and clinical trials do not take into account this important sex/gender factor.

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: Chimeric antigen receptor T-cell (CAR-T) therapy is a novel form of adoptive cellular immunotherapy that involves modifying autologous T cells to recognize and target tumor-associated antigens (TAAs) on malignant cells, independent of major histocompatibility complex (MHC) restriction. Although CAR-T therapy has shown remarkable success in treating hematologic malignancies, its efficacy in solid tumors remains limited, largely due to the lack of tumor-specific antigens and the complexity of the tumor microenvironment. This review aims to explore the rationale for continuing the development of adoptive cellular therapies in head and neck cancer (HNC), offering insights into the diagnostic and therapeutic challenges associated with this heterogeneous group of malignancies.

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Importance: This was a clinical study of total neoadjuvant therapy (TNT) for rectal cancer.

Objective: To assess the use and outcomes of TNT in routine practice.

Design, Setting, And Participants: This international, multicenter study was conducted at 61 centers across 21 countries and included consecutive patients treated off trial with TNT for stage II/III rectal adenocarcinoma from September 2012 to December 2023.

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This study examines the shortage of radiation oncologists in Italy and Europe, analysing systemic challenges in postgraduate training and proposing solutions to enhance the appeal of radiation oncology. A review of literature from Italy and Europe evaluated trends in training programmes, workforce dynamics. Analysis included residency vacancies, economic constraints, training disparities, and visibility of the field during medical education.

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Management of patients with head and neck cancer (HNC) is a complex process that involves extensive knowledge on (at least) the discipline of surgery, radiation oncology, medical oncology and molecular biology. It includes prevention, cancer treatment, follow up schedule and potential risk from treatment (radiation exposure). A major point is that perhaps now more than ever process management needs to be at the center of the HNC care.

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Purpose: Chemoradiation (CRT) is used to treat anal carcinomas which, for most patients with loco-regional disease, results in a cure but is associated with acute and chronic complications impairing quality of life (QoL). Patients with metastatic disease or recurrence are likely to experience additional QoL concerns. This paper identifies the QoL issues of these patients and determines whether the EORTC QLQ-ANL27 (QLQ-ANL27), a measure of QoL of patients treated with CRT for anal cancer used alongside the core EORTC QLQ-C30 (QLQ-C30), is suitable or needs adapting.

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Objective: The management of recurrent and/or metastatic (RM) head and neck squamous cell carcinoma (HNSCC) poses significant clinical challenges. This study aimed to develop expert consensus statements to improve the multidisciplinary management of RM HNSCC.

Methods: A multidisciplinary team of 39 Italian experts, including medical oncologists, surgeons, radiation oncologists, radiologists, and pathologists, employed the Delphi method to achieve consensus on critical aspects of RM HNSCC management.

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Introduction: Preoperative radiochemotherapy (RCHT) is the standard of care for locally advanced rectal cancer (LARC). While there are several data regarding chemotherapy intensification, actually, no reliable data directly comparing different radiotherapy (RT) dose levels are available. The present study aimed to compare intensified RT versus standard dose in patients with LARC.

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Background: Human papilloma virus (HPV)-related cancers are well-known clinical entities in different body sites. Cervix, anus, and oropharynx are the most common tumors related to the virus infection. The aim of this work was to highlight similarities and differences among HPV-related cancers of different subsites.

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Purpose: To investigate the effects of radical radiotherapy (RT) relevant interruptions (RRI), single (sRRI) or multiple (mRRI), on Biochemical Failure-Free Survival (BFFS), Metastases-Free Survival (MFS) and Overall Survival (OS) in prostate cancer (PCa) patients.

Methods: We conducted a retrospective analysis involving 383 patients diagnosed with prostate cancer (PCa) who received radical RT between March 2013 and April 2021, with doses ranging from 60 to 80 Gy (median dose 76.0 Gy), either alone or in combination with androgen deprivation therapy.

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Background: The enhanced application of imaging techniques is resulting in the diagnosis of more patients with asymptomatic metastatic esophagogastric cancer (mEGC). We conducted a Delphi study to gather insights from European experts on the optimal timing for initiating palliative systemic therapy for these patients.

Methods: An online survey featured 14 scenarios where physicians chose their preferred timing for initiating systemic therapy: immediate(<3 weeks) or deferred.

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Imaging of parotid tumors is crucial for surgery planning, but it cannot distinguish malignant from benign lesions with absolute reliability. The aim of the study was to establish a diagnostic MRI algorithm to differentiate parotid tumors. A retrospective study was conducted including all patients with parotid tumors, who underwent 3T-MRI and surgery.

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Introduction: Nutritional care is a cornerstone of cancer treatment, with the potential to significantly improve patient outcomes by addressing malnutrition and enhancing recovery. Despite growing awareness, the integration of evidence-based nutritional strategies into oncology remains inconsistent. Following a 2020 survey that highlighted critical gaps, the NutriOnc Research Group launched targeted initiatives to raise awareness and improve practices.

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Purpose: To investigate the awareness and the spread of ChatGPT and its possible role in both scientific research and clinical practice among the young radiation oncologists (RO).

Material And Methods: An anonymous, online survey via Google Forms (including 24 questions) was distributed among young (< 40 years old) ROs in Italy through the yAIRO network, from March 15, 2024, to 31, 2024. These ROs were officially registered with yAIRO in 2023.

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Purpose: To compare Italian use with current international guidelines and to evaluate oncological outcomes and toxicity patterns of adjuvant radiation therapy (RT) for endometrial cancer (EC) in Italian women.

Materials And Methods: To conduct a retrospective multicentre Italian study a large database was set up. Inclusion criteria were: accrual between 2010 and 2020, treatment with surgery, post-operative external beam RT (EBRT) and/or interventional radiotherapy (IRT) associated or not with adjuvant chemotherapy.

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Objectives: Comprehensive care is fundamental to cancer survivors enduring long-term side-effects of cancer treatment including nutrition impact symptoms and critical weight loss (CWL). The aim of our study was to address weight loss (WL), nutritional aspects, and quality of life (QoL) in head and neck cancer (HNC) survivors.

Study Design: This was a cross-sectional study of HNC patients treated at the Sapienza University-Hospital, 2018-2022.

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Background: To investigate changes of objective instrumental measures and correlate with patient reported outcomes (PROs) of radiation-induced dysphagia (RID) after swallowing organs at risk (SWOARs)-sparing IMRT.

Methods: Patients (pts) underwent Fiberoptic Endoscopic Evaluation of Swallowing (FEES), Videofluoroscopy (VFS) and M.D.

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Treatment monitoring in metastatic castrate-resistant prostate cancer has become a hot topic in the androgen receptor pathway inhibitors (ARPIs) era. Patients without increase in their PSA level at the time of imaging progression are not a rare phenomenon. What is the best monitoring strategy in asymptomatic cases represents a salient question.

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Article Synopsis
  • The review examines how online medical resources and AI tools are changing radiation oncology practices by enhancing clinical decision-making.* -
  • A search of several databases identified 70 relevant studies that demonstrate the integration of web-based tools in various aspects of radiation therapy, including calculations and educational needs.* -
  • The findings indicate that these digital tools can improve personalized cancer treatment strategies, particularly across different cancer types, with a focus on breast and head & neck cancers.*
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Article Synopsis
  • The MITO-RT3/RAD trial was a Phase II study that evaluated the safety and effectiveness of stereotactic body radiotherapy (SBRT) for patients with oligometastatic ovarian cancer, focusing on those with lymph node disease.
  • Results showed a significant improvement in complete response (CR) rates, with 77.9% of lesions achieving CR, and an overall clinical benefit rate of 99.6% from 135 enrolled patients with 249 lesions across various institutions.
  • The trial indicated that SBRT has minimal toxicity, with 17% experiencing mild acute side effects, and it confirmed a strong correlation between CR and better progression-free survival (PFS)
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Multi-modal therapies for gynecological cancers management may determine a wide range of side effects which depend on therapy-related factors and patient characteristics and comorbidities. Curative or adjuvant pelvic radiotherapy is linked with acute and late toxicity due to irradiation of organs at risk, as small and large bowel, rectum, bladder, pelvic bone, vagina and bone marrow. Successful toxicity management varies with its severity, Radiation Centre practice and experience and skills of radiation oncologists.

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