TY  - JOUR
A1  - Altieri, Barbara
A1  - Di Dato, Carla
A1  - Modica, Roberta
A1  - Bottiglieri, Filomena
A1  - Di Sarno, Antonella
A1  - Pittaway, James F.H.
A1  - Martini, Chiara
A1  - Faggiano, Antongiulio
A1  - Colao, Annamaria
T1  - Bone metabolism and vitamin D implication in gastroenteropancreatic neuroendocrine tumors
JF  - Nutrients
N2  - Patients affected by gastroenteropancreatic–neuroendocrine tumors (GEP–NETs) have an increased risk of developing osteopenia and osteoporosis, as several factors impact on bone metabolism in these patients. In fact, besides the direct effect of bone metastasis, bone health can be affected by hormone hypersecretion (including serotonin, cortisol, and parathyroid hormone-related protein), specific microRNAs, nutritional status (which in turn could be affected by medical and surgical treatments), and vitamin D deficiency. In patients with multiple endocrine neoplasia type 1 (MEN1), a hereditary syndrome associated with NET occurrence, bone damage may carry other consequences. Osteoporosis may negatively impact on the quality of life of these patients and can increment the cost of medical care since these patients usually live with their disease for a long time. However, recommendations suggesting screening to assess bone health in GEP–NET patients are missing. The aim of this review is to critically analyze evidence on the mechanisms that could have a potential impact on bone health in patients affected by GEP–NET, focusing on vitamin D and its role in GEP–NET, as well as on factors associated with MEN1 that could have an impact on bone homeostasis.
KW  - bone
KW  - vitamin D
KW  - neuroendocrine tumor
KW  - osteoporosis
KW  - mineral bone density
KW  - cortisol
KW  - serotonin
KW  - miRNA
KW  - MEN1
KW  - therapy
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-203823
SN  - 2072-6643
VL  - 12
IS  - 4
ER  - 
TY  - JOUR
A1  - Kimpel, Otilia
A1  - Schindler, Paul
A1  - Schmidt-Pennington, Laura
A1  - Altieri, Barbara
A1  - Megerle, Felix
A1  - Haak, Harm
A1  - Pittaway, James
A1  - Dischinger, Ulrich
A1  - Quinkler, Marcus
A1  - Mai, Knut
A1  - Kroiss, Matthias
A1  - Polat, Bülent
A1  - Fassnacht, Martin
T1  - Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma
JF  - British Journal of Cancer
N2  - Background
International guidelines emphasise the role of radiotherapy (RT) for the management of advanced adrenocortical carcinoma (ACC). However, the evidence for this recommendation is very low.

Methods
We retrospectively analysed all patients who received RT for advanced ACC in five European centres since 2000. Primary endpoint: time to progression of the treated lesion (tTTP). Secondary endpoints: best objective response, progression-free survival (PFS), overall survival (OS), adverse events, and the establishment of predictive factors by Cox analyses.

Results
In total, 132 tumoural lesions of 80 patients were treated with conventional RT (cRT) of 50–60 Gy (n = 20) or 20–49 Gy (n = 69), stereotactic body RT of 35–50 Gy (SBRT) (n = 36), or brachytherapy of 12–25 Gy (BT) (n = 7). Best objective lesional response was complete (n = 6), partial (n = 52), stable disease (n = 60), progressive disease (n = 14). Median tTTP was 7.6 months (1.0–148.6). In comparison to cRT\(_{20-49Gy}\), tTTP was significantly longer for cRT\(_{50-60Gy}\) (multivariate adjusted HR 0.10; 95% CI 0.03–0.33; p < 0.001) and SBRT (HR 0.31; 95% CI 0.12–0.80; p = 0.016), but not for BT (HR 0.66; 95% CI 0.22–1.99; p = 0.46). Toxicity was generally mild and moderate with three grade 3 events. No convincing predictive factors could be established.

Conclusions
This largest published study on RT in advanced ACC provides clear evidence that RT is effective in ACC.
KW  - adrenal tumours
KW  - adrenocortical carcinoma (ACC)
KW  - radiotherapy (RT)
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324411
VL  - 128
IS  - 4
ER  -