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    Estudo do tempo entre o diagnóstico e início do tratamento do câncer de mama em idosas de um hospital de referência em São Paulo-Brasil
    (Universidade Federal de São Paulo (UNIFESP), 2014-10-29) Souza, Camila Brandao de [UNIFESP]; Schirmer, Janine Schirmer [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The time interval between diagnosis and initiation of treatment of breast cancer is an important variable in the outcome of cases, and the shorter, the better the prognosis. From 2012, the Federal Law n° 12,732 secured to cancer patients that this interval does not exceed 60 days. Objective: To analyze the time between diagnosis and start of treatment in older women diagnosed with breast cancer between the years 2001 to 2006, in a reference service in São Paulo, and find out the socio demographic and clinical profile. Methodology: A descriptive study of secondary data from the Hospital Cancer Registry, in a reference hospital in São Paulo, Brazil. 1299 cases were analyzed and socio demographic, clinical and temporal variables were collected . It was used the Statistical Package for Social Sciences (SPSS) version 20.0. The univariate analysis was made for the association between time and the study variables used the chi-square test of association. Two groups of women were formed using the time variable, the time between diagnosis and initiation of treatment "within 60 days" and "greater than 60 days." It was considered for a level of significance, p <0.05. It was obtained approval from the Federal University of São Paulo Research Ethics Committee and funding from the National Council for Scientific and Technological Development. Results: Over 50% were between 60-69 years old, 90% came to the hospital without diagnosis and earlier treatment. In 98% of the cases the primary location of the breast tumor was inaccurate in 78% and the histological type was invasive ductal carcinoma. The stage II in 44%. The average time between diagnosis and start of treatment was two months or 60 days, with 80% of women seen within that range. Elderly women undiagnosed and without treatment took less time to start treatment (p = 0.001). Women with tumor staging in early stage, in situ and I, had an advantage in agility of treatment (p = 0.001). The time was significant for the outcome of relapse (p = 0.004) and metastasis (p = 0.038). Conclusion: It is emphasized that the study period precedes the "Law of 60 days," and yet the time intervals demonstrate quality and solvability of service. This study serves as a basis for planning strategies and policies to clinical care to elderly woman by the interdisciplinary team interventions
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    Waiting time to radiotherapy as a prognostic factor for glioblastoma patients in a scenario of medical disparities
    (Academia Brasileira de Neurologia - ABNEURO, 2015-02-01) Loureiro, Luiz Victor Maia; Pontes, Lucíola de Barros; Callegaro-Filho, Donato; Koch, Ludmila de Oliveira; Weltman, Eduardo; Victor, Elivane da Silva; Santos, Adrialdo José; Borges, Lia Raquel Rodrigues; Segreto, Roberto Araujo [UNIFESP]; Malheiros, Suzana Maria Fleury [UNIFESP]; Hospital Israelita Albert Einstein; Universidade Federal de São Paulo (UNIFESP); Hospital do Coração Departamento de Oncologia; Universidade de São Paulo (USP)
    Objective To evaluate the effect of waiting time (WT) to radiotherapy (RT) on overall survival (OS) of glioblastoma (GBM) patients as a reliable prognostic variable in Brazil, a scenario of medical disparities. Method Retrospective study of 115 GBM patients from two different health-care institutions (one public and one private) in Brazil who underwent post-operative RT. Results Median WT to RT was 6 weeks (range, 1.3-17.6). The median OS for WT ≤ 6 weeks was 13.5 months (95%CI , 9.1-17.9) and for WT > 6 weeks was 14.2 months (95%CI, 11.2-17.2) (HR 1.165, 95%CI 0.770-1.762; p = 0.470). In the multivariate analysis, the variables associated with survival were KPS (p < 0.001), extent of resection (p = 0.009) and the adjuvant treatment (p = 0.001). The KPS interacted with WT to RT (HR 0.128, 95%CI 0.034-0.476; p = 0.002), showing that the benefit of KPS on OS depends on the WT to RT. Conclusion No prognostic impact of WT to RT could be detected on the OS. Although there are no data to ensure that delays to RT are tolerable, we may reassure patients that the time-length to initiate treatment does not seem to influence the control of the disease, particularly in face of other prognostic factors.