Navegando por Palavras-chave "glioblastoma"
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- ItemSomente MetadadadosAnálise da reoperação na recidiva do glioblastoma em um serviço público no Brasil(Universidade Federal de São Paulo (UNIFESP), 2015-09-30) Zanovello, Willey Goncalves [UNIFESP]; Paiva Neto, Manoel Antonio de Paiva Neto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Glioblastoma (GBM) recurrence in patients treated with surgery, radiotherapy and chemotherapy is practically universal. Recently, several studies showed an increase in overall survival in patients undergoing reoperation for recurrent GBM. Objectives: The primary objective of the study was to analyze patients with recurrent GBM who underwent reoperation in a public Institution in Brazil and describe the epidemiological, clinical and survival characteristics of the patients. As a secondary objective, we tried to assess which patients would benefit from reoperations after recurrence. Materials/Methods: We retrospectively analyzed 39 patients who underwent reoperation for recurrent GBM (GIV WHO) in the Neurosurgery Department of the Hospital São Paulo, Federal University of São Paulo from January 2000 to December 2014. Data were collected from medical records and from the Neuro-oncology database. Results: The median age was 49 years (range of 20-69 years), with 21 males (54%). The initial symptom was headache in 59% of patients. The median functional performance index measured by the Karnofsky scale (KPS) at presentation was 80. Sixteen patients (41%) underwent re-operation before starting adjuvant treatment. In 29 patients (74%), there was a delay of radiotherapy (> 6 weeks). The median overall survival was 20 months (95% CI 14.9 ? 25.2) and survival after reoperation was 9.1 months (95% CI 2.8 ? 15.4). The only factor associated with overall survival in a multivariate analysis was adjuvant therapy after first surgery (HR 0.3 95% CI 0.2 ? 0.7; p: 0.005). Conclusion: Survival of patients with recurrent GBM undergoing reoperation in a public Institution in Brazil was similar to the literature. Reoperation should be considered as a treatment option in selected patients.
- ItemSomente MetadadadosExpression of HOXC9 and E2F2 are up-regulated in CD133+cells isolated from human astrocytomas and associate with transformation of human astrocytes(Elsevier B.V., 2007-07-01) Okamoto, Oswaldo K.; Oba-Shinjo, Sueli M.; Lopes, Luciana; Marie, Suely K. Nagahashi; Universidade Federal de São Paulo (UNIFESP); Inst Israelita Ensino & Pesquisa Albert EinsteinComparative analysis of cancer stem cells with their neoplastic and non-neoplastic counterparts should help better understand the underlying molecular events leading to transformation and tumor dissemination. Here, we report a molecular signature comprised by genes with exclusive aberrant expression in CD133+ cells, a reported subpopulation of tumorigenic stem-like cells, isolated from human glioblastomas. Microarrays covering 55,000 transcripts were used to compare gene expression profiles in purified subpopulations of CD133+ and CD133- GBM cells. Sixteen genes, many of which not previously associated with astrocytomas, were found aberrantly expressed in CD133+ cells, but not in CD133-, when compared with corresponding non-neoplastic controls. Up-regulation of two of such genes, E2F2 and HOXC9, was detected in a set of 54 astrocytomas of different grades and significantly associated with malignancy. Due to their distinctive expression in CD133+ cells, the use of E2F2 and HOXC9 as therapeutic targets for tumor eradication is suggested. (c) 2007 Elsevier B.V. All rights reserved.
- ItemSomente MetadadadosInitial care and outcome of glioblastoma multiforme patients in 2 diverse health care scenarios in Brazil: does public versus private health care matter?(Oxford Univ Press Inc, 2014-07-01) Maia Loureiro, Luiz Victor; Pontes, Luciola de Barros; Callegaro-Filho, Donato; Koch, Ludmila de Oliveira; Weltman, Eduardo; Victor, Elivane da Silva; Santos, Adrialdo Jose [UNIFESP]; Rodrigues Borges, Lia Raquel [UNIFESP]; Segreto, Roberto Araujo [UNIFESP]; Fleury Malheiros, Suzana Maria [UNIFESP]; Hosp Israelita Albert Einstein; Universidade Federal de São Paulo (UNIFESP)The aim of this study was to describe the epidemiological and survival features of patients with glioblastoma multiforme treated in 2 health care scenarios-public and private-in Brazil.We retrospectively analyzed clinical, treatment, and outcome characteristics of glioblastoma multiforme patients from 2003 to 2011 at 2 institutions.The median age of the 171 patients (117 public and 54 private) was 59.3 years (range, 18-84). the median survival for patients treated in private institutions was 17.4 months (95% confidence interval, 11.1-23.7) compared with 7.1 months (95% confidence interval, 3.8-10.4) for patients treated in public institutions (P < .001). the time from the first symptom to surgery was longer in the public setting (median of 64 days for the public hospital and 31 days for the private institution; P = .003). the patients at the private hospital received radiotherapy concurrent with chemotherapy in 59.3% of cases; at the public hospital, only 21.4% (P < .001). Despite these differences, the institution of treatment was not found to be an independent predictor of outcome (hazard ratio, 1.675; 95% confidence interval, 0.951-2.949; P = .074). the Karnofsky performance status and any additional treatment after surgery were predictors of survival. A hazard ratio of 0.010 (95% confidence interval, 0.003-0.033; P < .001) was observed for gross total tumor resection followed by radiotherapy concurrent with chemotherapy.Despite obvious disparities between the hospitals, the medical assistance scenario was not an independent predictor of survival. However, survival was directly influenced by additional treatment after surgery. Therefore, increasing access to resources in developing countries like Brazil is critical.
- ItemSomente MetadadadosMaternal embryonic leucine zipper kinase transcript abundance correlates with malignancy grade in human astrocytomas(Wiley-Blackwell, 2008-02-15) Marie, Suely K. N.; Okamoto, Oswaldo Keith [UNIFESP]; Uno, Miyuki; Hasegawa, Ana Paula G.; Oba-Shinjo, Sueli Mieko [UNIFESP]; Cohen, Tzeela; Camargo, Anamaria A.; Kosoy, Ana; Carlotti, Carlos G.; Toledo, Silvia Regina Caminada de [UNIFESP]; Moreira-Filho, Carlos A.; Zago, Marco A.; Simpson, Andrew J.; Caballero, Otavia L.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Mem Sloan Kettering Canc Ctr; Hosp Alemao Oswaldo Cruz; Albert Einstein Res & Educ InstWe have performed cDNA microarray analyses to identify gene expression differences between highly invasive glioblastoma multiforme (GBM) and typically benign pilocytic astrocytomas (PA). Despite the significant clinical and pathological differences between the 2 tumor types, only 63 genes were found to exhibit 2-fold or greater overexpression in GBM as compared to PA. Forty percent of these genes are related to the regulation of the cell cycle and mitosis. QT-PCR validation of 6 overexpressed genes: MELK, AUKB, ASPM, PRC1, IL13RA2 and KIAA0101 confirmed at least a 5-fold increase in the average expression levels in GBM. Maternal embryonic leucine zipper kinase (MELK) exhibited the most statistically significant difference. A more detailed investigation of MELK expression was undertaken to study its oncogenic relevance. in the examination of more than 100 tumors of the central nervous system, we found progressively higher expression of MELK with astrocytoma grade and a noteworthy uniformity of high level expression in GBM. Similar level of overexpression was also observed in medulloblastoma. We found neither gene promoter hypomethylation nor amplification to be a factor in MELK expression, but were able to demonstrate that MELK knockdown in malignant astrocytoma cell lines caused a reduction in proliferation and anchorage-independent growth in in vitro assays. Our results indicate that GBM and PA differ by the expression of surprisingly few genes. Among them, MELK correlated with malignancy grade in astrocytomas and represents a therapeutic target for the management of the most frequent brain tumors in adult and children. (C) 2007 Wiley-Liss, Inc.
- ItemAcesso aberto (Open Access)Performance of adjuvant treatment correlates with survival in reoperated glioblastomas(Assoc Arquivos Neuro- Psiquiatria, 2016) Zanovello, Willey Goncalves [UNIFESP]; Malheiros, Suzana Maria Fleury [UNIFESP]; Stávale, João Norberto [UNIFESP]; Lanzoni, Oreste Paulo [UNIFESP]; Canteras, Miguel Montes [UNIFESP]; Santos, Adrialdo José [UNIFESP]; Slaviero, Felipe [UNIFESP]; Fernandes, Bruno [UNIFESP]; Cavalheiro, Sergio [UNIFESP]; Paiva Neto, Manoel Antonio de [UNIFESP]Objective: To analyze cases of recurrent glioblastoma subjected to reoperation at a Brazilian public healthcare service. Methods: A total of 39 patients subjected to reoperation for recurrent glioblastoma at the Department of Neurosurgery, Sao Paulo Hospital, Federal University of Sao Paulo, from January 2000 to December 2013 were retrospectively analyzed. Results: The median overall survival was 20 months (95% confidence interval -CI = 14.9-25.2), and the median survival after reoperation was 9.1 months (95% CI: 2.8-15.4). The performance of adjuvant treatment after the first operation was the single factor associated with overall survival on multivariate analysis (relative risk - RR = 0.3
- ItemSomente MetadadadosThe Ultrastructural Study of Tumorigenic Cells Using Nanobiomarkers(Mary Ann Liebert Inc, 2010-06-01) Pavon, Lorena Favaro; Marti, Luciana Cavalheiro; Sibov, Tatiana Tais; Malheiros, Suzana M. F. [UNIFESP]; Oliveira, Daniela Mara; Guilhen, Daiane Donna; Camargo-Mathias, Maria Izabel; Amaro Junior, Edson; Gamarra, Lionel Fernel; SBIBHAE; IIEPAE; Universidade Federal de São Paulo (UNIFESP); Univ Fed Sao Joao Del Rei; UNESP; Universidade de São Paulo (USP)Despite recent advances, patients with malignant brain tumors still have a poor prognosis. Glioblastoma (WHO grade 4 astrocytoma), the most malignant brain tumor, represents 50% of all astrocytomas, with a median survival rate of <1 year. It is, therefore, extremely important to search for new diagnostic and therapeutic approaches for patients with glioblastoma. This study describes the application of superparamagnetic nano-particles of iron oxide, as well as monoclonal antibodies, of immunophenotypic significance, conjoined to quantum dots for the ultrastructural assessment of glioblastoma cells. for this proposal, an immunophenotypic study by flow cytometry was carried out, followed by transmission electron microscopy analysis. the process of tumor cell labeling using nanoparticles can successfully contribute to the identification of tumorigenic cells and consequently for better understanding of glioblastoma genesis and recurrence. in addition, this method may help further studies in tumor imaging, diagnosis, and prognostic markers detection.
- ItemAcesso aberto (Open Access)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.