Navegando por Palavras-chave "cystic craniopharyngioma"

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    Apoptosis in alpha interferon (IFN-alpha) intratumoral chemotherapy for cystic craniopharyngiomas
    (Springer, 2007-09-01) Ierardi, D. F.; Fernandes, M. J. S.; Silva, I. R.; Thomazini-Gouveia, J.; Silva, Nasjla Saba; Dastoli, Patricia; Toledo, Silvia Regina Caminada de [UNIFESP]; Cavalheiro, Sergio; Universidade Federal de São Paulo (UNIFESP)
    Objectives the aim of this study was to verify whether intracystic injections of alpha-Interferon (IFN-alpha) in cystic craniopharyngiomas were able to reduce the tumor by activating the Fas apoptotic pathway.Materials and methods Twenty-one patients with cystic craniopharyngiomas treated at the Pediatric Oncology Institute (IOP/GRAACC) of Federal University of São Paulo were submitted to intracystic chemotherapy with IFN-alpha. the tumor sizes of all patients were monitored and the apoptotic factor soluble FasL (sFasL) concentration was determined by ELISA (enzyme-linked immunosorbent assay) in tumor fluid samples from eight patients.Results There was a complete reduction in 11 patients, a partial response in seven, and a minor response in three patients. the concentration of sFasL was increased in all the eight patients examined concomitantly with the tumor size reduction.Conclusions Our data demonstrated that the IFN-a was able to induce Fas-mediated apoptosis together with a reduction in the tumor size; such an observation may suggest the importance to investigate still unexplored mechanisms to be exploited in craniopharyngioma therapy.
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    Cystic craniopharyngioma: intratumoral chemotherapy with alpha interferon
    (Academia Brasileira de Neurologia - ABNEURO, 2011-02-01) Dastoli, Patrícia Alessandra [UNIFESP]; Nicácio, Jardel Mendonça [UNIFESP]; Silva, Nasjla Saba [UNIFESP]; Capellano, Andrea Maria [UNIFESP]; Toledo, Silvia Regina Caminada de [UNIFESP]; Ierardi, Daniela [UNIFESP]; Cavalheiro, Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To assess whether the cystic craniopharyngiomas can be controlled with the use of intratumoral applications of interferon alpha. METHOD: Nineteen patients with the diagnosis of cystic craniopharyngioma were treated with intratumoral chemotherapy with interferon alpha from January 2002 to April 2006. All patients underwent placement of an intracystic catheter connected to an Ommaya reservoir. Through this reservoir were made applications during chemotherapy cycles. Each cycle corresponded to application of 3,000,000 units of interferon alpha three times per week on alternate days totalizing 36,000,000 units. Response to treatment was evaluated by calculating the tumor volume on MRI control after one, three and six months after the end of each cycle. Patients who developed worsening of symptoms or who had insignificant reduction in tumor volume during follow-up underwent repeat cycle chemotherapy. RESULTS: Four patients received four cycles of chemotherapy, three patients received three cycles, six patients received two cycles and six patients received one. The lower percentage of reduction in tumor volume was 60% and the bigger reduction was 98.37%. Eleven patients had a reduction greater than 90%. Five patients had a tumor reduction between 75 and 90% and in three patients the tumors were reduced by less than 75%. No deaths occurred during treatment and side effects of interferon alpha were well tolerated. No treatment was discontinued. Follow-up after the last application ranged from one year and five months to three years and nine months. CONCLUSION: The intratumoral chemotherapy with interferon alpha decreases the volume of cystic craniopharyngiomas and so far can be considered a new therapeutic alternative.
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    Does the choice of surgical approach to insert an intratumoral catheter influence the results of intratumoral cystic treatment?
    (Elsevier B.V., 2008-07-01) Zanon, Nelci; Cavalheiro, Sergio; Silva, Marcia C. da; Universidade Federal de São Paulo (UNIFESP)
    Background: in the literature, only a few articles are related to the surgical approach for insertion of an intratumoral catheter. No one has evaluated the complications related to the different surgical techniques for the treatment of pediatric cystic craniopharyngiomas.Methods: A cooperative, multicenter (France and Brazil) study was carried out and included 50 patients (aged between 9 months and 21 years) diagnosed as having cystic craniopharyngioma treated between 1990 and 2000. Forty-nine children were available for the final analysis. the patients were divided into 3 groups: group I, 24 children who underwent a craniotomy and catheter placement under direct vision using a surgical microscope; group II, 14 children who were submitted to a stereotactic approach for the placement of the intratumoral catheter; and group III, 11 children whose catheters were placed by a freehand approach through a burr hole.Results: Eight children (16.3%) presented complications related to the placement of the catheter, namely, misplacement or leakage. the rate of the complications did not appear to be related to one specific modality of the catheter insertion.Conclusion: Intracystic antiblastic drug injection is one available option in the treatment of cystic craniopharyngiomas. Because of the toxic effect of these drugs on the brain, determination of the exact placement to avoid leakage is mandatory for correct treatment. However, the results of the present study appear to indicate an excessively high incidence of complications whichever technique is used. (C) 2008 Published by Elsevier Inc.
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    Use of interferon alpha in intratumoral chemotherapy for cystic craniopharyngioma
    (Springer, 2005-08-01) Cavalheiro, Sergio; Dastoli, Patricia A.; Silva, Nasjla Saba; Toledo, Silvia Regina Caminada de [UNIFESP]; Lederman, Henrique; Silva, M. C. da; Universidade Federal de São Paulo (UNIFESP)
    Objectives: This study analyzed the intratumoral activity of interferon alpha (IFN-alpha) in the treatment of cystic craniopharyngiomas. Patients and methods: From January 2000 to January 2004, nine patients presenting with cystic craniopharyngiomas were treated with intratumoral injection of IFN-alpha at the Pediatric Oncology Institute of the Federal University of São Paulo-Escola Paulista de Medicina. Age ranged from 1 year and 10 months to 18 years (mean 10 years). All intratumoral catheters were inserted by a subfrontal approach. Doses varied from 36 to 108 MU. Results: There was complete disappearance of the lesion in seven cases. in two cases, partial reduction of tumor size was observed at follow-up. Follow-up varied from 1 year to 3 years and 6 months (mean 1 year 8 months). Conclusions: IFN-alpha proved to be an effective drug in the control of cystic craniopharyngiomas. Additional studies should be carried out to determine the optimal dose of IFN-alpha in the treatment of cystic craniopharyngioma. in addition, other drugs possessing high efficacy and low neurotoxicity should be analyzed.