Repositório Institucional - Unifesp :: Navegando por Palavras-chave "Radiotherapy"

Navegando por Palavras-chave "Radiotherapy"

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Acesso aberto (Open Access)
Alterações Orais Tardias em Pacientes Submetidos a Radioterapia e/ou Quimioterapia em Cabeça e Pescoço
(Universidade Federal de São Paulo (UNIFESP), 2011-02-22) Deboni, Aline Lima da Silva [UNIFESP]; Segreto, Helena Regina Comodo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Purpose: To assess the late oral complications (LOC) in non surgical head and neck cancer (HNC) patients, submitted to radiotherapy (RT) with or without chemotherapy (chemo). Materials and Methods: The average follow-up for HNC patients was 17.1 months. Five hundred fifteen charts from patients treated for HNC between 2005 and 2009 were reviewed and 41 non surgical HNC patients met the inclusion criteria. Salivary glands function was assessed using a simplified new grading system (NGSX) (Esibruch et al. 2003) and sialometry. Late effects were assessed using the Common Toxicity Criteria (CTC) - Radiotherapy and Oncology Group /European Organization for Research and Treatment of Cancer (RTOG/EORTC) - Late Radiation Morbidity Scale. Data were submitted to statistical analysis. Results: There was a predominance of mild LOC complications among the variables studied. A statistical correlation was found for both unstimulated/stimulated salivary flow rates and the average CTC – RTOG/EORTC grades for the mucous membrane. The low salivary flow rates (<0.03 mL/min e <0.09 mL/min) were identified as a potential risk factor (p <0.005) and an independent predictor for mucous membrane toxicity (for ≥2 grades). A significant correlation was also found between objective NGSX scores (p = 0.001) and CTC – RTOG/EORTC grades for salivary glands. Eighty five percent of the patients were classified as suffered from hyposalivation as well as 58,7% considered the dryness in the mouth the most debilitating complication. Conclusions: Considering the late effects assessed, the majority of patients presented mild graduation (0 and 1) according to CTC – RTOG/EORTC criteria; the demographic, tumor and treatment variables were not statistically significant for the development and severity of late oral complication; the salivary hipofunction increased from 4.3 to 8.3 times the RR for the occurrence of severe late mucosal reaction; xerostomia was considered the most debilitating complication after treatment. Data show the role of salivary hypofunction as an independet predictor for the severity of late mucous membrane complication.
Acesso aberto (Open Access)
Análise comparativa dos histogramas de dose e volume entre planejamentos tridimensionais conformados e convencionais não conformados na radioterapia do câncer de próstata
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2009-04-01) Feitosa, Sílvia Moreira [UNIFESP]; Giordani, Adelmo José [UNIFESP]; Dias, Rodrigo Souza [UNIFESP]; Segreto, Helena Regina Comodo [UNIFESP]; Segreto, Roberto Araujo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: The present study was aimed at comparing conformal and non-conformal radiotherapy plans designed for patients with prostate cancer, by analyzing radiation doses in target volumes and organs at risk. MATERIALS AND METHODS: Radiotherapy plans for 40 patients with prostate cancer were analyzed. Conformal, conformal isocentric and non-conformal plans utilizing the source-surface distance were simulated for each of the patients for comparison of radiation dose in target volumes and organs at risk. For comparison purposes, dose-volume histograms for target volumes and organs at risk were analyzed. RESULTS: Median doses were significantly lower in the conformal planning, with 25%, 40% and 60% volumes in the rectum and 30% and 60% in the bladder. The median doses were significantly lower in the conformal planning analyzing the right and left coxofemoral joints. Maximum, mean and median doses in the clinical target volume and in the planned target volume were significantly higher in the conformal planning. CONCLUSION: The present study has demonstrated that the conformal radiotherapy planning for prostate cancer allows the delivery of higher doses to the target volume and lower doses to adjacent healthy tissues.
Acesso aberto (Open Access)
Análise histopatológica e imuno-histoquímica (antígeno nuclear de proliferação celular) de pacientes com carcinoma cervical invasor antes e após radioterapia e cirurgia
(Associação Médica Brasileira, 2002-03-01) Rosal, Marta Alves [UNIFESP]; Goncalves, Wagner Jose [UNIFESP]; Alves, Maria Teresa de Seixas [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Lima, Geraldo Rodrigues de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: To search for residual disease and to analyse the Proliferating Cellular Nuclear Antigen (PCNA) status, in patients with cervical squamous cell carcinoma, treated with both radiotherapy and surgery. METHODS: Histological slides from 16 patients with uterine cervix cancer, treated between April 1986 and August 1998, with preoperative radiotherapy and surgery, were reviewed. PCNA imunohistochemical reactivity of these samples was evalued, using the IMAGELAB 2.3 computer image analysis system. RESULTS: Residual carcinoma were found in eight cases (50%) and no malignant features was found in eight cases (50%). The mean value of PCNA before radiotherapy in patients with residual cancer was 61.56% and in cases without residual cancer was 60%. Its expression before radiotherapy was between 27.91% and 89.93% (60% average), while after radiotherapy it varied between 55.80% and 86.73% (74% average). CONCLUSIONS: The association between preoperative radiotherapy followed by surgery is adequated to treat patients with cervical cancer, when radical treatment is not possible. Meanwhile, exclusive radiotherapy shows a significant failure rate, detected after surgery and PCNA analysis.
Acesso aberto (Open Access)
Avaliação da resposta bioquímica no câncer inicial de próstata: experiência uninstitucional comparando teleterapia exclusiva ou associada à braquiterapia de alta taxa de dose
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2004-08-01) Castro, Douglas Guedes De; Pellizzon, Antônio Cássio Assis; Chen, Michael Jenwei; Nishimoto, Inês Nobuko; Maia, Maria Aparecida Conte; Novaes, Paulo Eduardo Ribeiro Dos Santos; Fogaroli, Ricardo César; Ferrigno, Robson; Salvajoli, João Victor [UNIFESP]; Hospital do Câncer A.C. Camargo Departamento de Radioterapia; Universidade de São Paulo (USP); Hospital do Câncer A.C. Camargo Centro de Estudos; Universidade Metodista de Santos Faculdade de Medicina; Hospital do Câncer A.C. Camargo; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Marília
OBJECTIVE: To compare the biochemical response in patients with locally advanced prostate cancer treated with external beam radiation therapy alone or in combination with conformal brachytherapy boost. MATERIALS AND METHODS: From November 1997 to January 2000, 74 patients received 45 Gy of pelvic external irradiation and four were treated with high dose rate iridium-192 conformal boost implants of 4 Gy each (BT). These were compared with 29 other patients treated with 45 Gy of pelvic external irradiation followed by a 24 Gy of bilateral ARC boost (RT) from October 1996 to February 2000. Some patients received neoadjuvant androgen deprivation therapy. Three-year actuarial biochemical control rates (BC3) and pretreatment biochemical response predictors such as prostate-specific antigen pretreatment (PSAi), Gleason score (GS) and clinical stage (CS), were evaluated. RESULTS: Median follow-up was of 25 months for the RT group and 37 months for the BT group. BC3 was 51% versus 73% (p = 0.032) for RT and BT, respectively. Comparisons of biochemical control by treatment group stratified by PSAi showed that BC3 for RT versus BT was 85.7% versus 79.1% (p = 0.76) for PSAi < 10 ng/mL and 38% versus 68% (p = 0.023) for PSAi > 10 ng/mL, respectively. For patients with GS < 6, BC3 was 37% versus 80% (p = 0.001) for RT versus BT and, for patients with GS > 6, BC3 was 78% versus 55% (p = 0.58) for RT versus BT, respectively. For patients with CS < T2a, BC3 was 36% versus 74% (p = 0.018) for RT versus BT and, for patients with CS > T2a, BC3 was 73% versus 69% (p = 0.692) for RT versus BT, respectively. The relative risk of biochemical relapse was 2.3 (95% IC: 1.0-5.1) for patients in RT group compared to the BT group. When adjusted for PSAi and GS, the relative risk of biochemical relapse was 2.4 (95% IC: 1.0-5.7). CONCLUSION: The treatment modality was an independent prognostic factor for biochemical relapse, with a significant improvement in the biochemical control with BT. These early results suggest that this treatment was most beneficial in patients with PSAi > 10 ng/mL, CS < T2a and GS < 6.
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Avaliação da vitalidade pulpar em pacientes com rabdomiossarcoma ou carcinoma de rinofaringe, que receberam radioterapia para controle local da neoplasia
(Universidade Federal de São Paulo (UNIFESP), 2021) Lopes, Rafael Paiva [UNIFESP]; Caran, Eliana Maria Monteiro [UNIFESP]; Universidade Federal de São Paulo
With the advancement of technology and scientific development, the survival of children undergoing cancer treatment has increased significantly. However, treatment sequelae can manifest even y ears after the end of therapy. Objective: To evaluate the dental pulp vitality of patients with head and neck parameningeal rhabdomyosarcoma and rhinopharyngeal carcinoma who received radiotherapy for local control of the neoplasia. Methodology: Fifteen pa tients were admitted to the study group and thirty patients to the control group. A total of 494 anterior teeth were analyzed. To assess the pulp vitality, use the pulse oximeter apparatus adapted for dental use (which has a sensor "Y"), it being possible to position the buccal and lingual or tongue of the dental element. The pulp sensitivity test was performed by cooling the dental surface, using the refrigerant gas applied with cotton swab to the tooth surface. Results: Student's t test (alpha = 0.05) was used to analyze the mean% SpO2 of the teeth of the study (N = 158) and control (N = 336) groups. The average oxygen saturation obtained in the teeth of the study group was 86.06%, and 90.05% in the control group. Demonstrating a statistically significant difference between groups (p <0.0001). Pearson's correlation test with 0.05 alpha adjustment was used to assess the correlation between the results obtained with pulse oximetry and the degree of sensitivity. The results demonstrate a negative correlation (r = 0.8525; p <0.0001) between the mean% SpO2 and the degree of sensitivity reported by the patients. Conclusions: The levels of pulp oxygenation saturation in irradiated patients were lower when compared to the control group. There seems to be a relatio nship between pulp oxygenation and tooth sensitivity. The lower the oxygen rate, the greater the sensitivity.
Acesso aberto (Open Access)
Causas de interrupção não-programadas da radioterapia
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2008-04-01) Diegues, Sylvia Suelotto; Ciconelli, Rozana Mesquita [UNIFESP]; Segreto, Roberto Araujo [UNIFESP]; Hospital Alemão Oswaldo Cruz; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: To evaluate the occurrence and causes of unplanned interruption of radiotherapy. MATERIALS AND METHODS: Retrospective study developed in the Division of Radiotherapy of Hospital Alemão Oswaldo Cruz in São Paulo, SP, Brazil, with data collected from 560 dossiers of patients submitted to radiotherapy in the period between January 1, 2005 and December 31, 2005. Chi-squared and Student t tests were utilized in the data analysis, and p < 0.05 was considered as statistically significant. RESULTS: Interruption of treatment was identified in 350 cases, corresponding to 62.5% of the patients. The reasons for treatment interruption were the following: preventive device maintenance (55%), patient's own private reasons (13%), adverse reactions to the treatment or to combined radiotherapy/chemotherapy (6%), clinical worsening (3%), two or more combined reasons (23%). The interruption time interval ranged between 1 and 24 days (mean 1.4 day). One-day interruption was mostly due to preventive device maintenance (84.4%); two-five-day interruption was due to combined reasons (48.28%). CONCLUSION: The most frequent cause of interruption was preventive device maintenance, with maximum two-day time interval.
Acesso aberto (Open Access)
Células mesenquimais adultas derivadas de tecido adiposo na distração osteogênica da mandíbula em coelhos pós radiação ionizante
(Universidade Federal de São Paulo (UNIFESP), 2016-06-30) Soares, Marcelo Melo [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; http://lattes.cnpq.br/1619822351741819; http://lattes.cnpq.br/3945294977132085; Universidade Federal de São Paulo (UNIFESP)
The aim of this study is to evaluate the effect of adipose derived mesnchymal stem cell (ADSC) on the regeneration of distraction osteogenesis on irradiated mandible of adult rabbit.Ten adult rabbits were selected and the dorsal fat penicle was removed for harvesting and culture of adipose derived adult mesenchymal stem cells. The mandibles were irradiated on a single dose of 20Gy. After 30 days the animals underwent to mandibular lengthening by distractions osteogenesis. After 10mm of mandibular lengthening, the animals were divided on two groups. On the control group, 1 ml of saline solution was injected and on the study group, and ADSC (1 x 106 ) was injected in the study group. After consolidation phase ( 4 weeks) the mandibles were removed and evaluated by tomography. The spiceaments were cuted in slices (7-?m per slice) forhistological evaluation. The sections were stained with Mallory trichome and assessed under a light microscope. Histomorphometric were analysed using J image program and stataistc analyses obtained by Mann-Withney test (p>0,05).The tomography shows a significant improvement on Hounsfield scale (ZFVL on GC 114,5 and GE 148 p= 0.0,0045* / ZFVC, 37, on GC to 96 GE,p=0.0045*).The Histomorphometric analysis demonstrated increase on the mineralized tissue occupation by new bone formation (ZFVD 37,5% on GC to 75.9% on GE p=0.0002*, ZFVM 39,1% on GC to 79,1% on GE p=0,0001*, ZFVC, 31,3% on GC to 61,2% no GE p= 0.045*) The results achived, showed a significative increase on bone formation on fibrovascular zone (z=2.61 and p=0.0045).The injection of adipose derived mesenchymal stem cell is able to improve bone regeneration on irradiated distraction callus on rabbit mandible.
Acesso aberto (Open Access)
Craniofaringioma na infância e adolescência: repercussões endócrino-metabólicas
(Universidade Federal de São Paulo (UNIFESP), 2017-02-07) Hernandez, Patricia Debora Cavalcanti Tosta [UNIFESP]; Castro, Angela Maria Spinola e [UNIFESP]; Siviero-Miachon, Adriana Aparecida [UNIFESP]; http://lattes.cnpq.br/2051040617850849; http://lattes.cnpq.br/8489881363515207; http://lattes.cnpq.br/2615946074156109; Universidade Federal de São Paulo (UNIFESP)
Objective: To evaluate the clinical and anthropometric characteristics and adiposity indexes of patients with craniopharyngioma and to correlate these parameters with the type of treatment performed, growth hormone deficiency (GHD), recombinant human growth hormone (rhGH) replacement therapy and adiposity at diagnosis. To analyze the risk factors associated with the evolution of obesity from diagnosis to the present moment. Methods: Fifty seven patients treated for craniopharyngioma underwent transversal evaluation (MAE) and survival analysis. Clinical characteristics, hormone replacement, type of treatment, anthropometric variables (Z score of weight and stature, at diagnosis and in MAE), adiposity indexes (Z BMI category at diagnosis and in MAE - overweight or obesity, percentage body fat (%BF), visceral and subcutaneous adipose tissue - VAT and SAT), criteria for metabolic syndrome (MS) were analysed by multiple regression and logistic models. The sample was divided according to GHD and rhGH replacement therapy: GHD with growth without GH, GHD using rhGH in MAE, GHD with prior rhGH use, GHD in programation of use rhGH and non-GHD. Survival analysis assessed the worsening of the Z BMI category according to adiposity indexes at diagnosis, treatment and rhGH replacement. Results: The medium age at diagnosis was 9.6 years-old and in MAE 16.6, 61.4% men. Surgery and radiotherapy (RT) was the most frequent combination of treatment (24/57; 42.1%) were treated with and 54/57 (94.7%) received at least two hormone replacements. Twenty-six of the 57 patients (45.6%) presented GHD with growth without GH. In the survival analysis, median time to worsening Z BMI category was 3.2 years after first treatment, with patients receiving both RT and α-interferon taking longer to worsen. Z BMI worsened equaly over time, regardless of the category at diagnosis. There was no influence of Z stature on Z BMI. The Z BMI at diagnosis worsened the Z BMI in the MAE (p=0.005). %BF was higher in patients with higher Z BMI at diagnosis (p <0.001) and %BF and VAT were lower in patients using rhGH in MAE (p <0.05). Obese patients at diagnosis presented more alteration in waist circumference (WC) (p=0.019) and more occurrence of MS (p=0.031). Conclusions: Patients with craniopharyngioma worsened the category of Z BMI with a median of 3.2 years after the first treatment. Regarding treatment, Z BMI category worsened less with α-interferon and RT use. Regardless of Z BMI category at diagnosis, there was an increase in Z BMI due to real weight gain, without height loss. The higher Z BMI at diagnosis, the higher the Z BMI and the %BF at the MAE. Replacement of rhGH at MAE had a beneficial effect on adiposity, decreasing %BF and VAT.
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Desenvolvimento de API gráfico para processamento de imagens e script para segmentação automática da cabeça femoral em ambiente eclipse®
(Universidade Federal de São Paulo (UNIFESP), 2019-12-10) Silva, Bruno Assumpcao Gomes Da [UNIFESP]; Paixao, Fabiano Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Introduction: Cancer is the second leading cause of death globally behind cardiovascular disease, approximately 18.1 million new causes and 9.4 million deaths related in 2018. Treatment against cancer is chosen by a medical team according cancer type, affected organs, and disease stage, and it is usually composed by association between surgery, chemotherapy, and radiotherapy. Radiotherapy employs ionizing radiation, produced by linear accelerators or radioactive material seeds, aiming to kill patient’s carcinogenic cells or slows their growth by damaging their DNA. The radiation oncologist must delineate target volume and organs-at-risk to deliver a high dose on the diseased tissue while missing dose to surrounding healthy structures, maximizing the effects of the treatment and minimizing side effects. Accurate delineation of volumes is a crucial step in radiotherapy treatment, however, it is the most time-consuming task for clinicians. Several authors proposed automatic segmentation methods for those structures, although manual contouring still remain the gold-standard method among the experts. Objective: The goal of this work is to develop an auto-segmentation algorithm of the femoral head to be used by radiation oncologists within a scripting tool inside Eclipse® Treatment Planning System, software developed by Varian® for radiotherapy treatments. Methodology: A software composed by a set of routines, protocols and tools, developed in C# as a platform entirely visual for image segmentation without the need of compiling numerous algorithms individually was developed. The developed script was successful characterized using pelvic CT scan in eleven prostate patients from Sao Paulo Hospital database (n=5) and AC Camargo Cancer Center (n=6). The automatic delineation was compared with manual delineation through blind test assessed by a panel of senior oncologists (n=9) from both hospitals and quantitative measurement was obtained through similarity delineation analysis using Dice Similarity Coefficient (DSC) for three distinct femoral head parts (lesser trochanter, femoral neck, and femoral head). Results: Specialists considered that none correction was needed at 77.8% of manual delineation and 67.8% of automatic delineation. Similarity of 0.94 ± 0,07 was achieved between manual and automatic for lesser trochanter, 0.91 ± 0.07 for femoral neck and 0.86 ± 0.08 for femoral head. The results showed that the automatic delineation was reproductible in all patients and its performance was similar to manual delineation done by their own specialists. Conclusion: In conclusion, the developed script is capable of reduce the contouring time in femoral head (only 1.3 ± 0.1 seconds each patient) and shows great potential to be applied in automatic segmentation of pelvic organs-at-risk as well as other anatomical regions.
Acesso aberto (Open Access)
Efeito do intervalo para início da radioterapia em pacientes com glioblastoma
(Universidade Federal de São Paulo (UNIFESP), 2017-08-22) Loureiro, Luiz Victor Maia [UNIFESP]; Malheiros, Suzana Maria Fleury [UNIFESP]; http://lattes.cnpq.br/9037639757788410; http://lattes.cnpq.br/8995517859449263; Universidade Federal de São Paulo (UNIFESP)
Objective: to evaluate the effect of waiting time between the neurosurgical intervention and the starting of radiotherapy on overall survival of Glioblastoma patients as an independent prognostic variable. Methods: two different methods were applied: 1) cohort study; 2) systematic review and meta-analysis. Cohort of 115 Glioblastoma patients from two different health-care institutions (one public and one private) who underwent post-operative radiotherapy. A systematic review of studies published between 1975 and 2015 reporting on the waiting time to radiotherapy for Glioblastoma patients who underwent a neurosurgical procedure. The meta-analysis was performed by converting the waiting time to radiotherapy studies intervals into a regression coefficient (β) and standard error expressing the effect size on overall survival per week of delay. Results: for the entire cohort the median waiting time to radiotherapy was 6 weeks (range, 1.3 – 17.6). The median overall survival for waiting time < 6 weeks was 13.5 months (95% CI, 9.1 – 17.9) and for those > 6 weeks was 14.2 months (95% CI, 11.2 – 17.2) (HR 1.16, 95% CI 0.77 – 1.76; p = 0.47). The waiting time to radiotherapy had no significant effect on overall survival even when compared to well- known prognostic variables (HR 1.32, 95% CI, 0.73 – 2.39; p = 0.35). Data required to calculate the effect size on overall survival were available for 14 studies retrieved for systematic review, including 5,429 patients. The combined analysis showed a median waiting time to radiotherapy of 37 days (ranges, 1 – 232) and provided no evidence for an association between waiting time to radiotherapy, per week of delay, and overall survival (HR 0.98, 95% CI, 0.89 – 1.07; p = 0.61). Conclusions: the waiting time to radiotherapy was not an independent prognostic variable for overall survival of Glioblastoma patients and had no significant effect on overall survival even when compared to well-known prognostic variables. The meta-analysis provided no evidence of a true effect on overall survival by delaying radiotherapy.
Acesso aberto (Open Access)
Epidemiologia e os desfechos clínicos de pacientes com carcinoma de pequenas células do ovário, tipo hipercalcêmico (SCCOHT)
(Universidade Federal de São Paulo (UNIFESP), 2020-11-26) Callegaro Filho, Donato [UNIFESP]; Speck, Neila Maria De Gois [UNIFESP]; Universidade Federal de São Paulo
Objective: Small cell carcinoma of the ovary-hypercalcemic type (SCCOHT) is a rare disease with a poor prognosis. SCCOHT has recently been shown to be associated with SMARCA4 gene mutations as well as molecular and genetic similarities to malignant rhabdoid tumors (MRT). The objective of our study is to describe the clinical characteristics, treatment modalities and outcomes of patients with SCCOHT. Methods: We performed a retrospective analysis of 47 patients with SCCOHT evaluated at MD Anderson Cancer Center between 1990 and 2014. Medical records were reviewed for demographic information, pathologic findings, treatment regimens and outcomes. Results: Median age at diagnosis was 30 years (range 5-46). All patients underwent surgery with unilateral salpingo-oophorectomy performed in 26 patients (55%), and hysterectomy with bilateral salpingo-oophorectomy in 21 patients (45%). Sixteen patients (34.0%) had stage I disease, six (12.8%) stage II, 23 (48.9%) stage III, and two patients (4.3%) had stage IV disease. Information on adjuvant treatment was available for 43 patients: 83.3% received chemotherapy alone, 9.5% chemotherapy followed by radiotherapy, 2.4% chemoradiation, and 4.8% did not receive any adjuvant therapy. Median follow-up was 13.2 months with a median overall survival of 14.9 months. Multi-agent chemotherapy and radiotherapy were associated with a better prognosis. On multivariate analysis, factors associated with favorable prognosis included absence of large cell component (p = 0.0003, HR = 0.19, 95% CI 0.08 to 0.47) and early stage disease (p=0.0029, HR=0.28, 95% CI 0.12 to 0.64). Median overall survival (OS) for the 12 patients with a large cell component was 8.8 months compared with 19.4 months for the 35 patients without a large cell component. Median OS for patients with early stage disease was 35.3 months compared with 10.4 months for patients with advanced stage disease. A better prognosis was also associated with the use of radiotherapy (p = 0.0365, HR = 0.26, 95% CI 0.07 to 0.92). The multiagent chemotherapy regimen of vinblastine, cisplatin, cyclophosphamide, bleomycin, doxorubicin and etoposide (VPCBAE) was associated with a decreased rate of recurrence (p = 0.0394). Conclusion: These findings shows a predominant incidence in young adults, caucasian, with large. Frequent misinterpreted as other ovarian neoplasms. Surgery was part of the initial treatment of all patients followed by complementary platinum- based chemotherapy for most patients. High recurrence rates despite treatments. Favorable prognostic factors included absence of large cell component, early stage disease, use of radiotherapy and chemotherapy with VPCBAE regimen. Further study is needed to improve outcomes in these patients including the adoption of systemic therapies used in MRT as well as the development of novel agents targeting specific mutations.
Acesso aberto (Open Access)
Estudo comparativo de anastomoses colorretais com anel biofragmentável e com grampeador em cães submetidos à irradiação gama pré-operatória
(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2003-12-01) Santos, José Mauro dos; Matos, Delcio [UNIFESP]; Fernandes, Luís César [UNIFESP]; Silva Júnior, João Péricles da [UNIFESP]; Silva, Marisa Helena da; Duarte, Fabrício; UFSC; Universidade Federal de São Paulo (UNIFESP); UFSC Departamento de Anatomia Patológica; UFSC Hospital Universitário; Hospital Georges Pompidou
PURPOSE: To compare the early results of colorectal anastomosis with the biofragmentable ring and with stapler after preoperative gamma irradiation with a 500 cGy single dose. METHODS: Forty beagle dogs were distributed in 2 groups of 20 animals submitted or not to preoperative gamma irradiation and named test(II) and control (I) groups respectively. Two subgroups of 10 animals were created: group A in which the biofragmentable ring was used and group B in which the stapler was used. The animals were submitted to full division of the large bowel at the rectosgmoid junction and the intestinal tube has been reconstructed by one of the two techniques randomly assigned. In the seventh postoperative day the animals were killed and histological specimens were collected for macro and microscopic analysis. RESULTS: Two deaths occurred before reoperation: one in the biofragmentable anastomosis group and the other in the stapler anastomosis group, due to generalized peritonitis. Adhesions and wound infection have occurred equally in all groups. The standard histological analysis and computorized morphometric study showed no significant differences between the groups. CONCLUSION: The early results of the two anastomosis technique under risk conditions were alike.
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Impact of low-level laser therapy on hyposalivation, salivary pH, and quality of life in head and neck cancer patients post-radiotherapy
(Springer London Ltd, 2017) Palma, Luiz Felipe [UNIFESP]; Stabile Gonnelli, Fernanda Aurora [UNIFESP]; Marcucci, Marcelo; Dias, Rodrigo Souza; Giordani, Adelmo Jose [UNIFESP]; Segreto, Roberto Araujo [UNIFESP]; Comodo Segreto, Helena Regina [UNIFESP]
Late effects of radiotherapy for head and neck cancer treatment have been increasingly investigated due to its impact on patients' quality of life. The purpose of this study was to evaluate the effect of low-level laser therapy on hyposalivation, low salivary pH, and quality of life in head and neck cancer patients post-radiotherapy. Twenty-nine patients with radiation-induced xerostomia received laser sessions twice a week, during 3 months (24 sessions). For this, a continuous wave Indium-Gallium-Aluminium-Phosphorus diode laser device was used punctually on the major salivary glands (808 nm, 0.75 W/cm(2), 30 mW, illuminated area 0.04 cm(2), 7.5 J/cm(2), 10 s, 0.3 J). Six extraoral points were illuminated on each parotid gland and three on each submandibular gland, as well as two intraoral points on each sublingual gland. Stimulated and unstimulated salivary flow rate, pH (two scales with different gradations), and quality of life (University Of Washington Quality of Life Questionnaire for Patients with Head and Neck Cancer) were assessed at baseline and at the end of the treatment. There were significant increases in both mean salivary flow rates (unstimulated: p = 0.0012
Acesso aberto (Open Access)
Impacto da laserterapia de baixa potência na hipossalivação, pH salivar e qualidade de vida de pacientes após radioterapia para câncer de cabeça e pescoço
(Universidade Federal de São Paulo (UNIFESP), 2017-11-30) Palma, Luiz Felipe [UNIFESP]; Segreto, Helena Regina Comodo [UNIFESP]; Gonnelli, Fernanda Aurora Stabile [UNIFESP]; http://lattes.cnpq.br/7504101247615306; http://lattes.cnpq.br/7589436047313703; Universidade Federal de São Paulo (UNIFESP)
Purpose: To evaluate the effect of low-level laser therapy on hyposalivation, salivary pH, and quality of life in head and neck cancer patients post-radiotherapy. Methods: Twenty-nine patients with radiation-induced xerostomia received laser sessions twice a week, during three months (24 sessions). For this, a continuous wave Indium-Gallium-Aluminium-Phosphorus diode laser device was used punctually (808 nm, 0.75 W/cm², 30 mW, illuminated area 0.04 cm², 7.5 J/cm², 10 seconds, 0.3 J) on the major salivary glands. Six extraoral points were illuminated on each parotid gland and three on each submandibular gland, as well as two intraoral points on each sublingual gland. Stimulated and unstimulated salivary flow rates, pH (two scales with different gradations), and quality of life (University Of Washington Quality of Life Questionnaire for Patients with Head and Neck Cancer) were assessed at baseline and at the end of the treatment. Results: There were significant increases in both mean salivary flow rates (unstimulated: p=0.0012; stimulated: p<0.0001), mean pH values (p=0.0002 and p=0.0004), and mean score from the quality of life questionnaire (p<0.0001). Conclusion: Low-level laser therapy was able to mitigate hyposalivation and increase salivary pH of patients submitted to radiotherapy for head and neck cancer, thereby contributing to an evident improvement in quality of life.
Acesso aberto (Open Access)
The influence of antineoplastic treatment on the weight of survivors of childhood cancer
(Soc Brasil Pediatria, 2016) Teixeira, Julia Ferrari Carneiro [UNIFESP]; Lemos-Maia, Priscila dos Santos [UNIFESP]; Cypriano, Monica dos Santos [UNIFESP]; Pisani, Luciana Pellegrini [UNIFESP]
Purpose: Obesity is a late effect in survivors of childhood cancer and correlates with chronic complications. Survivors of leukemia, brain tumors, and hematopoietic stem cell transplantation are more likely to develop obesity resulting from treatment modalities such as radiotherapy and glucocorticoids. This paper analyzes and integrates the current data available to health professionals in order to clarify strategies that can be used to treat and prevent obesity in childhood cancer survivors. Sources: This is a literature review from on scientifically reliable electronic databases. We selected articles published in the last five years and earlier articles of great scientific importance. Data synthesis: The mechanisms involved in the pathophysiology of obesity in cancer survivors are not completely understood, but it is believed that damage to the hypothalamus and endocrine disorders such as insulin resistance, leptin resistance, and hormone deficiency may be involved. The body composition of this group includes a predominance of adipose tissue, especially in those undergoing hematopoietic stem cell transplant and total body irradiation. The use of body mass index in these patients may lead to an underestimation of individuals' risk for metabolic complications. Conclusion: Early identification of groups using accurate anthropometric assessments, interventional treatment, and/or preventative measures and counseling is essential to minimize the adverse effects of treatment. Physical activity and healthy eating to promote adequacy of weight in the whole population should be encouraged. (C) 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda.
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Minimizing the uncertainties regarding the effects of delaying radiotherapy for glioblastoma: a systematic review and meta-analysis
(Elsevier ireland ltd, 2016) Loureiro, Luiz Victor Maia; Victor, Elivane da Silva; Callegaro-Filho, Donato; Koch, Ludmila de Oliveira; Pontes, Luciola de Barros; Weltman, Eduardo; Rother, Edna Terezinha; Fleury Malheiros, Suzana Maria
Background and purpose: Previous studies have provided no clear conclusions regarding the effects of delaying radiotherapy (RT) in GBM patients. We present a systematic review and meta-analysis to address the effect of delayed RT on the overall survival (OS) of GBM patients. Methods: A systematic search retrieved 19 retrospective studies published between 1975 and 2014 reporting on the waiting time (WT) to RT for GBM patients. The meta-analysis was performed by converting WT to RT studies intervals into a regression coefficient (beta) and standard error expressing the effect size on OS per week of delay. Results: Data required to calculate the effect size on OS per week of delay were available for 12 studies (5212 patients). A non-adjusted model and a meta-regression model based on well-recognized prognostic factors were performed. No association between WT to RT, per week of delay, and OS was found (HR = 0.98
Acesso aberto (Open Access)
Modelos experimentais de hiperplasia intimal: efeitos da radiação ionizante
(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2002-05-01) Costa, Regina de Faria Bittencourt da [UNIFESP]; Fagundes, Djalma José [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Most complications that may occur in response to vascular injury of endovascular and open vascular procedures are due to intimal hyperplasia. To a certain extent, intimal hyperplasia is present in all types of vascular reconstruction, including autologous grafts, allografts, and prosthetic grafts found in solid organs transplanted, having a substantial role in chronic rejection and following angioplasty with or without stenting. One of the greatest developments in recent years towards prevention of intimal hyperplasia is the use of ionizing radiation. Ionizing radiation inhibits proliferation of many cell types including fibroblasts and smooth muscle cells in vitro, and also suppresses the synthesis of collagen by cultured fibroblasts. Animal models have been a cornerstone to develop strategies aimed at understanding the basic physiopathologic mechanisms of intimal hyperplasia and at evaluating novel treatment strategies for clinical conditions. So, the aim of this study was to analyze animals models of intimal hyperplasia, type of injury, artery segments most used, as to the effects of different kinds and sources of ionizing radiation.
Acesso aberto (Open Access)
Mucosite em pacientes portadores de câncer de cabeça e pescoço submetidos à radioquimioterapia
(Universidade de São Paulo, Escola de Enfermagem, 2011-12-01) Santos, Renata Cristina Schmidt [UNIFESP]; Dias, Rodrigo Souza [UNIFESP]; Giordani, Adelmo José [UNIFESP]; Segreto, Roberto Araujo [UNIFESP]; Segreto, Helena Regina Comodo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The objective of present study was to classify oral mucositis according to the Common Toxicity Criterion (CTC) international parameters in head and neck tumor patients simultaneously treated with radio and chemotherapy, and characterize a patient profile in our area, observing the individuals' habits, tumor characteristics, treatment protocol and acute reaction intensity. Fifty patients undergoing simultaneous 66 to 70 Gy megavoltage radiotherapy and cisplatin/carboplatin chemotherapy were evaluated in this study. Weekly evaluations of the degree of mucositis were perfoemed according to CTC, a four-degree ordinal scale; 36% of all patients and 100% of those with diabetes discontinued treatment due to mucositis, showing that this pathology contributes to the severity of mucositis.
Acesso aberto (Open Access)
A novel method to evaluate salivary flow rates of head and neck cancer patients after radiotherapy: a pilot study
(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2018) Palm, Luiz Felipe [UNIFESP]; Gonnelli, Fernanda Aurora Stabile [UNIFESP]; Marcucci, Marcelo; Giordani, Adelmo Jose [UNIFESP]; Dias, Rodrigo Souza [UNIFESP]; Segreto, Roberto Araujo [UNIFESP]; Segreto, Helena Regina Comodo [UNIFESP]
Introduction: The procedure used to evaluate salivary flow rate is called sialometry. It can be performed through several techniques, but none appears to be really efficient for post radiotherapy patients. Objective: To adequate sialometry tests for head and neck cancer patients submitted to radiotherapy. Methods: 22 xerostomic patients post-radiotherapy (total radiation dose ranging from 60 to 70 Gy) were included in this study. Ten patients were evaluated using sialometries originally proposed by the Radiation Therapy Oncology Group and twelve were assessed by our modified methods. Unstimulated and stimulated sialometries were performed and the results were classified according a grading scale and compared between both groups. Results: There was no statistically significant difference between the salivary evaluations of both groups (p = 0.4487 and p = 0.5615). Also, most of these rates were classified as very low and low. Conclusion: This novel method seems to be suitable for patients submitted to radiotherapy. (C) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.
Acesso aberto (Open Access)
Oxigenoterapia hiperbárica em lesões actínicas de colo de ratos: aspectos morfológicos e morfométricos
(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2004-12-01) Pereira, Maria Ligia Lyra; Scheidt, Tânia Cilja [UNIFESP]; Simões, Manuel de Jesus [UNIFESP]; Mosquette, Rejane [UNIFESP]; Gomes, Paulo de Oliveira [UNIFESP]; UNILUS Departamento de Cirurgia; Universidade Federal de São Paulo (UNIFESP)
Purpose: To evaluate the effects of hiperbaric oxygen on the radiation-induced actinic lesions in the rat distal colon. Methods: Thirty-two Wistar female rats were divided into four groups: I - sham; II - hiperbaric oxygen therapy (HOT); III - radiotherapy (RT), e IV - radiotherapy and hiperbaric oxygen (the same manner of II and III group). Fragments of distal colon were fixed into 10% formadehyde and proceeded for the histological routine and morphology. Results: The experimental results showed the intestinal gland lesions, vasodilation and infiltrated leucocytes in propria laminae and submucosae in rat colon of GIII that accentuated colon after hiperbaric oxygen Conclusion: Hiperbaric oxygen attenuated the morphological changes in the mucosae and submucosae of the rat distal colon with radiation-induced inflammatory process.

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