Navegando por Palavras-chave "Medical oncology"
Agora exibindo 1 - 3 de 3
Resultados por página
Opções de Ordenação
- ItemSomente MetadadadosCT and MRI in monitoring response: state-of-the-art and future developments(Edizioni Minerva Medica, 2011-12-01) D'Ippolito, Giuseppe [UNIFESP]; Torres, Lucas Rios [UNIFESP]; Saito Filho, Celso Fernando [UNIFESP]; Ferreira, R. M. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The present review is aimed at updating the reader with the current role of computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of tumor response, contextualizing the imaging methods advantages and limitations. CT has been the most frequent and widely adopted diagnostic tool. The main advantages of such method include wide availability, high reproducibility, capability to contemporarily evaluate soft tissues, bone and lung parenchyma, besides being easy to perform. Its main limitation is related to the use of ionizing radiation. MRI has emerged as a feasible alternative to CT, particularly in patients with contraindications to the use of iodinated contrast agents, with advantages related to its high soft tissues contrast. The disadvantages are based on its operational complexity and the many technical variables involved which may influence and compromise the reproducibility and broad implementation of the method. New criteria for evaluation of tumor response have recently been proposed, contemplating lately developed drugs and therapeutic strategies that demand the utilization of functional parameters. In this context, the technological developments incorporated in the CT and MRI imaging techniques, such as perfusion analysis, diffusion studies (DW-RM) and MR spectroscopy (MRS), among others, have provided relevant information regarding the tumor response to targeted therapies, anticipating dimensional alterations and guiding physicians in the course of the treatment. Despite such developments, further efforts are needed to establish reproducible protocols, functional response criteria and time intervals for response evaluation in order to allow a definitive incorporation of these new technologies in the assessment of tumor response.
- ItemAcesso aberto (Open Access)Protocolo de um banco de tecidos neoplásicos(Sociedade Brasileira de Ortopedia e Traumatologia, 2008-03-01) Alimena, Luiz José Moura [UNIFESP]; Garcia Filho, Reynaldo Jesus [UNIFESP]; Toledo, Silvia Regina Caminada de [UNIFESP]; Alves, Maria Teresa de Seixas [UNIFESP]; Petrilli, Antonio Sergio [UNIFESP]; De Luca Junior, Giuseppe; Jacobus, Lucas Senger [UNIFESP]; Romani, Ricardo Filipe; Spader, Daniel Lunardi; Universidade Federal de São Paulo (UNIFESP); Santa Casa de Porto Alegre Setor de Ortopedia Oncológica; Instituto de Oncologia Pediátrica; Fundação Faculdade de Ciências Médicas de Porto Alegre; Universidade Federal do Rio Grande do SulA Tumor Bank with systematic organization of data allows for the carrying out of cancer research with sound and scientific conclusions. The need thus arises for a specific protocol whose main advantage would be that of adding qualified donor information to tumor samples used in research. The purpose of this study was to develop a simple, reliable, and replicable procedures protocol to acquire and store samples of musculoskeletal tumors. The basis for the planning of this protocol comprises the information gathered in the literature relating to tumor tissue banks from 1969 to 2005. The paper describes the capture, storage, and donor background. The tumor bank with an efficient protocol allows to store both healthy and neoplastic tissue, and to record information relating to patients with neoplastic lesions. Furthermore, it enables supplying tissue samples in ideal research conditions.
- ItemAcesso aberto (Open Access)Reabilitação fonoaudiológica da disfagia em pacientes pediátricos com tumor encefálico(Universidade Federal de São Paulo (UNIFESP), 2010-02-24) Radzinsky, Tatiana Couto [UNIFESP]; Gonçalves, Maria Inês Rebelo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To verify the efficacy of the dysphagia therapy performed by speech pathologists in pediatric patients with brain tumors using the Functional Oral Intake Scale (FOIS; Crary et al, 2005). Materials and Methods: The sample consisted children and adolescents with central nervous system tumors (23 male and 8 female), ages ranging from 11 months to 22 years old. Was performed a retrospective charts review of patients with central nervous system tumors and diagnosed oropharyngeal dysphagia, that were submitted to swallowing rehabilitation during internment period at the Pediatric Oncology Institute (IOP/GRAACC/UNIFESP) in the period from September 2003 to July 2009. To obtain the data, an evolution chart protocol was created, comprising patient’s identification, gender, initial diagnosis, underlying disease, injury site, speech-language diagnosis, specific tumor treatment, speech-language evaluation date, speech-language discharge date, number of speech-language therapy sessions, complications during the therapy period, respiratory conditions, and intubation period. Was used the Functional Oral Intake Scale (FOIS), a functional feeding evaluation scale, enabling to classify the patient according to the feeding intake (Crary, 2005). In addition, for speech-language diagnosis definition, and modified version of the Dysphagia Outcome and Severity Scale (O’Neil, 1999) was utilized. The scores were registered during the pre therapy period (speech-language functional evaluation) and post therapy. Improvement was considered when there was a change in the score to level 5 or higher, and decline when the score changed level 5 or lower. Results: All 31 patients showed improvement in the FOIS scale level after speech-language therapy. Level 5 or higher was achieved by 17 (54.8%) and was observed that 14 patients (45.2%) maintained the same FOIS level, not evolving as adequately. Results show that 19 patients (61.7%) presented severe dysphagia during the pre therapy period, out of those 11 (57.9%) managed to evolve to mild dysphagia, functional deglutition or normal deglutition. The dysphagia severity degree lowered in the post therapy on 21 patients (67.7%) while 10 (32.3%) maintained the same score. Conclusion: The patients that showed major improvement on the FOIS level had few clinical complications, tumors with better prognosis, and mean age of 12 years, whereas the patients that evolved in a less significant manner all presented clinical complications (decreased level of alertness and/or worsening of the clinical picture), tumors with bad prognosis (glioblastoma multiform stage IV, anaplasic ependymoma stage II, high-grade meduloblastoma, and brainstem glioma), in addition to mean age of 7.8 years.