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Contenu archivé le 2024-04-15

RADIATION CARCINOGENESIS

Objectif

THE FOLLOW UP OF ABOUT 2,500 PATIENTS PER YEAR IS PERFORMED AT THE OUTPATIENTS CLINIC OF THE RADIOTHERAPY UNIT OF THE DEPARTMENT OF CLINICAL PHYSIOPATHOLOGY AT THE UNIVERSITY OF FLORENCE. ABOUT 1,500 NEW PATIENTS PER YEAR WERE TREATED. SOME OUT OF THOSE 2,500 HAVE BEEN TREATED MANY YEARS AGO (UP TO 25 YEARS) AND THEREFORE ARE LONG SURVIVORS.
THE AIM OF THE PROJECT IS TO COLLECT BETTER INFORMATION ABOUT THE RADIATION CARCINOGENESIS:
Cancer patients treated by radiotherapy have been followed up for the appearance of a second independent tumour and compared with those treated by chemotherapy.

The result of this study appear interesting and increase the previously available information. Since the observation period is still short, especially with regard to the appearance of solid tumours, the study has continued with characterisation of available control groups from the tumour registries. Analysis of the data related to the single neoplastic pathologies must still be completed in the various Centres collected in the research. In the near future, besides updating the follow up and completion of the study of the other clinical records, an epidemiological analysis will be performed in order to evaluate the incidence of second tumours in patients treated with RT as compared to those treated with CT. Furthermore, based on the analysis of the tumour registries, the significance of the increase in the incidence of the second tumours in patients treated with RT will be determined.
IN THIS PERSPECTIVE CLINICAL RECORDS REGARDING PATIENTS TREATED WITH RADIOTHERAPY IN THE PAST TIME WILL BE REVIEWED IN ORDER TO POINT OUT THE INCIDENCE OF A SECOND PRIMARY TUMOR IN, OR OUTSIDE, THE IRRADIATED AREA. THIS EVALUATION WILL BE CHIEFLY CARRIED OUT ON PATIENTS TREATED FOR CANCER OF THE BREAST, OF THE UTERINE CERVIX, OF THE HEAD AND NECK AND FOR MALIGNANT LYMPHOMAS.
BESIDES CLINICAL AND RADIOLOGICAL EXAMINATIONS, ROUTINE BLOOD AND URINE TESTS, THE CONCENTRATION OF SOME MOLECULES CONSIDERED AS IMPORTANT TUMOR MARKERS WILL BE DETERMINED IN ORDER TO POINT OUT THE CORRELATION WITH THE STATUS OF THE PATIENTS, PRESENCE OR ABSENCE OF RELAPSES, AND EVENTUALLY, THE APPEARANCE OF A SECOND PRIMARY TUMOR: AGE AND SEX, THE TOTAL GIVEN DOSE, THE IRRADIATED VOLUME, THE DIFFERENT RADIATION SOURCES (CO-60, ELECTRON BEAMS, LINEAR ACCELERATOR), DIFFERENT TECHNIQUES ADOPTED, OTHER THAN THE DOSE FRACTIONATION. IN FACT SEVERAL FRACTIONATION SCHEDULES HAVE BEEN USED IN THE PAST YEARS: CONVENTIONAL FRACTIONATION (2 GY PER DAY, 10 GY PER WEEK) OF MULTIPLE DAILY FRACTIONATION (1 GY X 3 PER DAY OR 2 GY X 3 PER DAY).
THE STUDIES CARRIED ON FOR MANY YEARS IN THE LABORATORY ON PATIENTS BEFORE RADIOTHERAPY TREATMENT, SHOWED ALTERED CONCENTRATIONS, IN PLASMA OR URINE, OF CU (INCREASE), ZN (DECREASE) CORRELATED WITH THE STATE OF NEOPLASIA AND MODIFIABLE BY THE THERAPY.
IN THE SAME PATIENTS URINARY EXCRETION OF SOME PLYAMINES (PUTRESCINE AND SPERMIDINE) ARE INCREASED AND GENERALLY SERUM CONCENTRATIONS OF ALPHA 1 ANTITRYPSIN, ALPHA 1 ACID GLYCOPROTEIN AND CERULOPLASMINE ARE HIGHER THAN IN NORMAL SUBJECTS. THE CONCENTRATION OF THESE MOLECULES CHANGES DURING THE TREATMENT. OTHER TUMOR MARKERS SUCH AS PSEUDOURIDINE, METHYLGUANIDINE, NEOPTERIN, FP, CEA, TPA AND GLYCOSYLATED ISOFERRITINES WILL BE DETERMINED USING RIA TESTS.

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Coordinateur

UNIVERSITA DEGLI STUDI DI FIRENZE
Contribution de l’UE
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Adresse
PIAZZA SAN MARCO 4
50121 FIRENZE
Italie

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