Navegando por Palavras-chave "radioterapia"
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- ItemAcesso aberto (Open Access)Adiposity in childhood cancer survivors: insights into obesity physiopathology(Sociedade Brasileira de Endocrinologia e Metabologia, 2009-03-01) Siviero-Miachon, Adriana Aparecida [UNIFESP]; Spinola-Castro, Angela Maria [UNIFESP]; Guerra-Junior, Gil; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)As childhood cancer treatment has become more effective, survival rates have improved, and a number of complications have been described while many of these patients reach adulthood. Obesity is a well-recognized late effect, and its metabolic effects may lead to cardiovascular disease. Currently, studies concerning overweight have focused on acute lymphocytic leukemia and brain tumors, since they are at risk for hypothalamic-pituitary axis damage secondary to cancer therapies (cranial irradiation, chemotherapy, and brain surgery) or to primary tumor location. Obesity and cancer have metabolic syndrome features in common. Thus, it remains controversial if overweight is a cause or consequence of cancer, and to date additional mechanisms involving adipose tissue and hypothalamic derangements have been considered, comprising premature adiposity rebound, hyperinsulinemia, leptin regulation, and the role of peroxisome proliferator-activated receptor γ. Overall, further research is still necessary to better understand the relationship between adipogenesis and hypothalamic control deregulation following cancer therapy.
- ItemAcesso aberto (Open Access)Anaplastic meningioma: case report(Academia Brasileira de Neurologia - ABNEURO, 2001-12-01) Falavigna, Asdrubal [UNIFESP]; Santos, José Augusto Nasser dos [UNIFESP]; Chimelli, Leila; Ferraz, Fernando Antonio Patriani [UNIFESP]; Bonatelli, Antonio de Padua Furquim [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Pró-Cardíaco e Estereolife, Neurocirurgia Estereotáxica e Funcional; Federal University of Rio de JaneiroIntracranial meningiomas continue to challenge our best clinical efforts to eliminate them once discovered and deemed appropriate for treatment. Malignant meningiomas constitute 10% to 15% of all meningiomas and limited information exists regarding adjuvant treatment. The external whole brain irradiation is recommended. Traditional chemotherapy has proven ineffective; thus, new chemotherapeutic agents and new methods of delivery should be developed. Immunotherapy may be considered for patients with malignant meningiomas when all others previous treatment have failed. We report a case of anaplastic papillary meningioma. A 67-year-old man presented with partial complex seizures, headache and aggressiveness. A computerized tomography and magnetic resonance image demonstrated a large left temporo-occipital mass with difuse contrast enhancement and extensive surrounding edema. A left temporo-occipital flap was performed. The tumor and the infiltrated dura were radically removed. Postoperatively, the patient remained neurologically intact. The treatment was complemented by external whole brain radiation.
- ItemAcesso aberto (Open Access)Implantes extraorais em pacientes irradiados(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2013-04-01) Oliveira, Joaquim Augusto Piras de; Abrahão, Márcio [UNIFESP]; Dib, Luciano Lauria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade PaulistaThe aim of this study is to analyze the success of extraoral osseointegrated implants used to support designed to rehabilitate craniofacial deformities. METHOD: This study was based on the retrospective assessment of charts from 59 patients submitted to cancer surgery and who received 164 extraoral implants to contain facial prosthesis. RESULTS: Among 164 implants, 42 were fixed in previously irradiated regions. Eight of the implants did not have osseointegration; and from these, two were fixed in irradiated bone. The result show 116 (95.1%) successfully osseointegrated implants in non-irradiated sites. The success rate among 42 implants fixed in previously irradiated bones was 40 (95.3%) osseointegrated implants. CONCLUSION: The use of extraoral craniofacial implants represents a safe and effective approach to treat facial deformities as a support for the rehabilitation prosthesis. Radiotherapy treatment does not prevent osseointegration.
- ItemAcesso aberto (Open Access)Metástases do segmento torácico e lombar da coluna vertebral: estudo prospectivo comparativo entre o tratamento cirúrgico e radioterápico com a imobilização externa e radioterapia(Academia Brasileira de Neurologia - ABNEURO, 2007-09-01) Falavigna, Asdrubal [UNIFESP]; Righesso Neto, Orlando; Ioppi, Ana Elisa Empinotti; Grasselli, Juliana; Universidade Federal de São Paulo (UNIFESP); Santa Casa de São Paulo Faculdade Federal de Ciências Médicas; UCSBone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had better results with preserving the ambulation longer and significant reduction of pain.
- ItemAcesso aberto (Open Access)Radiotherapy for early glottic cancer and salvage surgery after recurrence(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2011-06-01) Pontes, Paulo [UNIFESP]; Brasil, Osiris de Oliveira Campones do [UNIFESP]; Amorim Filho, Francisco de Souza [UNIFESP]; Moraes, Bruno Teixeira de [UNIFESP]; Pontes, Antonio [UNIFESP]; Caporrino Neto, José [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Early glottic cancer can be effectively treated with radiation or surgery, but recurrence is a possibility when using any of the treatment modalities. AIM: To assess the outcome of radiotherapy as initial treatment in the control of squamous cell carcinoma of vocal cord (T1) and the effectiveness of salvage surgery (endoscopic or open) after treatment failure. MATERIALS AND METHODS: A retrospective study was based on the analysis of medical records from 43 patients with T1 squamous cell carcinoma of the glottis, radiotherapy as initial treatment and follow-up period of five years. RESULTS: The rate of recurrence after radiotherapy was 30.2% of the cases, mean diagnosis interval was 29.5 months. As an option for salvage treatment, patients underwent open partial laryngectomy or endoscopic surgery with control rates of 77.7% and 25% respectively. CONCLUSION: Our cases showed high rates of recurrence after radiotherapy and open partial laryngectomy was more effective for the salvage surgery.
- ItemRestritoRTOG criteria to evaluate acute skin reaction and its risk factors in patients with breast cancer submitted to radiotherapy(Univ São Paulo, Escola de Enfermagem de Ribeirao Preto, 2008-09-01) Pires, Ana Maria Teixeira [UNIFESP]; Segreto, Roberto Araujo [UNIFESP]; Segreto, Helena Regina Comodo [UNIFESP]; Hosp Alemao Oswaldo Cruz; Universidade Federal de São Paulo (UNIFESP)Purpose: Evaluate and classify skin reactions through the Radiation Therapy Oncology Group (RTOG) criteria and characterize factors that can intervene in these reactions. Method: Prospective study, with 86 women submitted to adjuvant breast radiotherapy with a total dose of 5040cGy, in a 6 MeV Linear Accelerator. Personal data were collected and breast size was measured (distance between field separation and breast height). the treated skin area was evaluated weekly. Results: Breast height and treatment technique were significant factors in the univariate analysis for the incidence of degree 3 skin reactions. However, only breast height was a significant factor in the multivariate analysis for the severity of skin reactions. the chances of occurring degree 3 reactions increase 2.61 times for each increase in height unit (cm). These findings allow nurses to plan more adequate and individualized procedures for each patient and contribute to the optimization of treatment.
- 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.