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Id: biblio-1136210
Autor: Ferreira, Caroline Petersen da Costa; Ribeiro, Mauricio Alves; Szutan, Luiz Arnaldo.
Título: Overall survival predictors in hepatocellular carcinoma patients treated with sorafenib
Fonte: Rev. Assoc. Med. Bras. (1992);66(3):275-283, Mar. 2020. tab, graf.
Idioma: en.
Resumo: SUMMARY Malignant liver tumors are the fourth leading cause of cancer death worldwide. Hepatocellular carcinoma (HCC) accounts for 75-85% of these. Most patients are diagnosed at incurable stages. Palliative care is the appropriate treatment course in these circumstances (chemoembolization and sorafenib). There are few national studies on sorafenib. The objective is to evaluate survival predictors of HCC patients treated with sorafenib and evaluate the compliance of its indication in relation to BCLC recommendations. METHODS A total of 88 patients with an indication of sorafenib from 2010 to 2017 at the ISCMSP were retrospectively analyzed. Univariate and multivariate analyzes were performed in the search for predictors of survival. RESULTS The mean age was 61.2 years, 70.5% were men, most were classified as Child-Pugh A (69.3%), and BCLC C (94.3%). Cirrhosis was present in 84.6% and portal hypertension in 55.7%. Hepatitis C virus was the most common etiology (40.9%). Sixty-nine (78.4%) patients received the medication, with the average duration of treatment being 9.7 months. The mean overall survival was 16.8 months. Significant differences were observed in the multivariate analysis: ECOG PS (p = 0.024): Child-Pugh (p = 0.013), time of medication use (p <0.001), clinical worsening (p = 0.031) and portal thrombosis (p = 0.010). CONCLUSION Absence of portal thrombosis, Child-Pugh A, longer time of medication use, ECOG PS 0, and absence of suspension due to clinical worsening were predictors of better overall survival in the study. The drug's indication complies with BCLC guidelines in 94% of patients.

RESUMO Tumores malignos do fígado são a quarta maior causa de morte por câncer, sendo que o carcinoma hepatocelular (CHC) corresponde a 85-90% desses casos. A maioria dos doentes apresenta-se, ao diagnóstico, sem possibilidade de tratamento curativo, restando apenas as opções paliativas (quimioembolização e sorafenibe). Há poucos estudos nacionais acerca do sorafenibe. OBJETIVO Avaliar fatores preditivos de sobrevida em pacientes com CHC que tiveram indicação de tratamento com sorafenibe na Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP) e avaliação da conformidade da indicação da medicação em relação às recomendações do BCLC. MÉTODOS Foram analisados retrospectivamente os dados de 88 pacientes que tiveram indicação de tratamento com sorafenibe no período de 2010 a 2017 na ISCMSP. Análises univariada e multivariada foram realizadas na busca de preditores de sobrevida global nos pacientes que receberam a medicação. RESULTADOS Idade média de 61,2 anos, sendo 70,5% homens. A maioria (69,3%) foi classificada como Child Pugh A e BCLC C (94,3%). A cirrose esteve presente em 84,6% e a hipertensão portal em 55,7% desses. O vírus da hepatite C foi a etiologia mais comum (40,9%) do CHC. Sessenta e nove (78,4%) pacientes receberam a medicação, sendo o tempo médio de duração do tratamento 9,7 meses e a sobrevida global média, 16,8 meses. Diferenças significativas foram observadas na análise multivariada: Ecog PS (p=0,024), CP (p=0,013), tempo de uso de medicação (p<0,001), suspensão por piora clínica (p=0,031) e trombose portal (p=0,010). CONCLUSÃO Ausência de trombose portal, Child Pugh A, Ecog PS 0, tempo maior de uso de medicação e ausência de suspensão por piora clínica foram fatores preditores de melhor sobrevida global e a indicação da medicação esteve em conformidade com as orientações do BCLC em 94% dos pacientes.
Descritores: Carcinoma Hepatocelular/tratamento farmacológico
Sorafenibe/uso terapêutico
Neoplasias Hepáticas/tratamento farmacológico
Antineoplásicos/uso terapêutico
-Cuidados Paliativos
Métodos Epidemiológicos
Resultado do Tratamento
Carcinoma Hepatocelular/mortalidade
Carcinoma Hepatocelular/patologia
Neoplasias Hepáticas/mortalidade
Neoplasias Hepáticas/patologia
Pessoa de Meia-Idade
Estadiamento de Neoplasias
Limites: Humanos
Masculino
Feminino
Responsável: BR1.1 - BIREME


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Id: biblio-950869
Autor: Visagie, Michelle Helen; Jaiswal, Seema Rummurat; Joubert, Anna Margaretha.
Título: In vitro assessment of a computer-designed potential anticancer agent in cervical cancer cells
Fonte: Biol. Res;49:1-13, 2016. ilus, graf, tab.
Idioma: en.
Resumo: BACKGROUND: Computer-based technology is becoming increasingly essential in biological research where drug discovery programs start with the identification of suitable drug targets. 2-Methoxyestradiol (2ME2) is a 17ß-estradiol metabolite that induces apoptosis in various cancer cell lines including cervical cancer, breast cancer and multiple myeloma. Owing to 2ME2's poor in vivo bioavailability, our laboratory in silico-designed and subsequently synthesized a novel 2ME2 analogue, 2-ethyl-3-O-sulphamoyl-estra-1,3,5(10),15-tetraen-17-ol (ESE-15-ol), using receptor- and ligand molecular modeling. In this study, the biological effects of ESE-15-ol (180 nM) and its parent molecule, 2ME2 (1 µM), were assessed on morphology and apoptosis induction in cervical cancer cells. RESULTS: Transmission electron microscopy, scanning electron microscopy and polarization-optical transmitted light differential interference contrast (PlasDIC) images demonstrated morphological hallmarks of apoptosis including apoptotic bodies, shrunken cells, vacuoles, reduced cell density and cell debris. Flow cytometry analysis showed apoptosis induction by means of annexin V-FITC staining. Cell cycle analysis showed that ESE-15-ol exposure resulted in a statistically significant increase in the G2M phase (72%) compared to 2ME2 (19%). Apoptosis induction was more pronounced when cells were exposed to ESE-15-ol compared to 2ME2. Spectrophotometric analysis of caspase 8 activity demonstrated that 2ME2 and ESE-15-ol both induced caspase 8 activation by 2- and 1.7-fold respectively indicating the induction of the apoptosis. However, ESE-15-ol exerted all of the above-mentioned effects at a much lower pharmacological concentration (180 nM) compared to 2ME2 (1 µM physiological concentration). CONCLUSION: Computer-based technology is essential in drug discovery and together with in vitro studies for the evaluation of these in silico-designed compounds, drug development can be improved to be cost effective and time consuming. This study evaluated the anticancer potential of ESE-15-ol, an in silico-designed compound in vitro. Research demonstrated that ESE-15-ol exerts antiproliferative activity accompanied with apoptosis induction at a nanomolar concentration compared to the micromolar range required by 2ME2. This study is the first study to demonstrate the influence of ESE-15-ol on morphology, cell cycle progression and apoptosis induction in HeLa cells. In silico-design by means of receptor- and ligand molecular modeling is thus effective in improving compound bioavailability while preserving apoptotic activity in vitro.
Descritores: Sulfonamidas/farmacologia
Inibidores da Anidrase Carbônica/farmacologia
Neoplasias do Colo do Útero/tratamento farmacológico
Desenho Assistido por Computador
Estradiol/análogos & derivados
Antineoplásicos/farmacologia
-Fatores de Tempo
Células HeLa
Microscopia Eletrônica de Varredura
Ciclo Celular/efeitos dos fármacos
Ciclo Celular/fisiologia
Células Cultivadas
Neoplasias do Colo do Útero/patologia
Reprodutibilidade dos Testes
Apoptose/efeitos dos fármacos
Meios de Cultura
Microscopia Eletrônica de Transmissão
Estradiol/farmacologia
Caspase 8/metabolismo
Citometria de Fluxo/métodos
2-Metoxiestradiol
Microscopia de Polarização
Limites: Humanos
Feminino
Tipo de Publ: Estudo de Avaliação
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1178047
Autor: Casari, Larissa; Silva, Vera Lúcia Ferreira da; Fernandes, Otávio Augusto Moura; Goularte, Laura Moreira; Fanka, Deize Elizandra Vieira; Oliveira, Shirley Sousa de; d'Almeida, Karina Sanches Machado; Marques, Anne y Castro.
Título: Estado Nutricional e Sintomas Gastrointestinais em Pacientes Oncológicos Submetidos à Quimioterapia / Nutritional Status and Gastrointestinal Symptoms in Oncology Patients Receiving Chemotherapy / Estado Nutricional y Síntomas Gastrointestinales en Pacientes con Cáncer Sometidos a Quimioterapia
Fonte: Rev. bras. cancerol;67(2), 2021.
Idioma: pt.
Resumo: Introdução: O estado nutricional do paciente oncológico apresenta grande variação ao longo da doença, além de efeitos adversos relacionados ao trato gastrointestinal serem comuns durante o tratamento quimioterápico. Objetivo: Avaliar o estado nutricional e a presença de sintomas gastrointestinais em pacientes oncológicos submetidos à quimioterapia. Método: Estudo transversal com pacientes em tratamento no setor de Quimioterapia do Hospital Escola da Universidade Federal de Pelotas (UFPel), RS, no período de abril a julho de 2019. Dados sociodemográficos e questões relacionadas à doença foram obtidos por meio de um questionário. Para avaliação do estado nutricional e dos sintomas gastrointestinais, utilizou-se a avaliação subjetiva global produzida pelo paciente. A análise dos dados foi realizada por meio de análise descritiva, e a associação entre variáveis categóricas, verificada pelo teste qui-quadrado de Pearson (p<0,05). Resultados:Foram avaliados 101 pacientes, com média de idade de 58,6 anos e maior prevalência de indivíduos do sexo feminino (58,4%), de cor branca (77,2%), casados (53,0%), pertencentes à classe C (50,4%). Encontrou-se maior prevalência dos cânceres do trato gastrointestinal (34,6%) e mama (27,8%). A maioria dos pacientes foi classificada como bem nutrido (66,3%), enquanto saciedade precoce (56,0%), xerostomia (54,0%), inapetência (42,0%) e náusea (37,0%) foram os sintomas mais citados. Não foi encontrada associação estatística entre o estado nutricional e qualquer um dos sintomas gastrointestinais. Conclusão: O estado nutricional da maioria dos pacientes foi classificado como bem nutrido, mas necessitando de atenção para a ocorrência dos sintomas gastrointestinais.

Introduction: The nutritional status of oncologic patients varies greatly throughout the disease, further to gastrointestinal tract related adverse effects that are common during chemotherapy treatment. Objective: Evaluate the nutritional status and the presence of gastrointestinal symptoms in oncologic patients undergoing chemotherapy. Method: Cross-sectional study with patients in treatment in the Chemotherapy Unit of the Hospital School of Pelotas Federal University (UFPel), RS, from April to July 2019. Sociodemographic data and questions related to the disease were obtained through a questionnaire. To assess the nutritional status and gastrointestinal symptoms the Patient-Generated Subjective Global Assessment was utilized. Data analysis was performed through descriptive analysis, and the association between categorical variables was verified by Pearson's chi-square test (p<0.05). Results: A total of one hundred one patients was evaluated, mean age of 58.6 years, with higher prevalence of females (58.4%), Caucasian (77.2%), married (53.0%), belonging to class C (50.4%). Higher prevalence of gastrointestinal tract (34.6%) and breast (27.8%) cancer was found. Most patients were classified as well-nourished (66.3%), while early satiety (56.0%), xerostomia (54.0%), loss of apetite (42.0%), and nausea (37.0%) were the symptoms most cited. No statistical association was encountered between nutritional status and any of the gastrointestinal symptoms. Conclusion: The nutritional status of most patients was classified as well nourished, but attention is needed for the occurrence of gastrointestinal symptoms.

Introducción: El estado nutricional del paciente oncológico presenta variacones durante la enfermedad, además de los efectos adversos relacionados con el tracto gastrointestinal comunes durante la quimioterapia. Objetivo: Evaluar el estado nutricional y la presencia de síntomas gastrointestinales en pacientes con cáncer sometidos a quimioterapia. Método: Estudio transversal con pacientes tratados en el sector de quimioterapia del Hospital Escuela de la Universidad Federal de Pelotas (UFPel), RS, de abril a julio de 2019. Se obtuvieron datos sociodemográficos y relacionados con la enfermedad a través de un cuestionario. Para evaluar el estado nutricional y los síntomas gastrointestinales se utilizó la Evaluación Subjetiva Global Producida por el Paciente. Las análisis de los datos se realizó mediante análisis descriptiva, y la asociación entre variables categóricas se verificó mediante la prueba de chi-cuadrado de Pearson (p<0,05). Resultados: Se evaluaron 101 pacientes, con edad media de 58,6 años, mayor prevalencia de mujeres (58,4%), blancos (77,2%), casados (53,0%), pertenecientes a la clase C (50,4%). Se encontró una mayor prevalencia de cánceres del tracto gastrointestinal (34,6%) y de mama (27,8%). La mayoría de los pacientes se clasificó como bien nutrido (66,3%), mientras que saciedad temprana (56,0%), boca seca (54,0%), falta de apetito (42,0%) y náuseas (37,0%) fueron los síntomas más frecuentemente. No se encontró asociación estadística entre el estado nutricional y los síntomas gastrointestinales. Conclusión: El estado nutricional de la mayoría de los pacientes se clasificó como bien nutrido, pero necesita la atención a presencia de síntomas gastrointestinales.
Descritores: Estado Nutricional
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
Neoplasias/tratamento farmacológico
Antineoplásicos/efeitos adversos
-Avaliação Nutricional
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Estudo Observacional
Responsável: BR440.1 - Biblioteca Geraldo Matos de Sá . Hospital do Câncer I


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Id: biblio-1094211
Autor: Ríos, Juvenal A; Rojo, Pamela; Schuster, Andrés; Gormaz, Juan G; Carrasco, Rodrigo; Neira, Carolina; Becerra, Sergio; Labbé, Tomas P.
Título: Impacto cardiovascular secundario a la terapia para el control del cáncer / The cardiovascular impact of cancer control therapy
Fonte: Rev. méd. Chile;148(1):93-102, Jan. 2020. graf.
Idioma: es.
Resumo: Cardiovascular diseases and cancer account for 27 and 25% of mortality in Chile, respectively. In the last decades, survival of people with cancer has improved due to preventive programs, early detection strategies, advances in technology and development of new antineoplastic therapies. Consequently, a progressive number of cancer-surviving patients have been generated, who may develop cardiovascular diseases, secondary to the same cancer therapy. Cardio-Oncology has emerged as the necessary link between both specialties to promote the prevention and early detection of cardiac complications, in patients undergoing oncological therapies. The aim is to curb cardiovascular complications. Also, to acquire knowledge about the mechanisms and effects of drugs that lead to heart damage aiming to develop efficient cardioprotective therapies. In this article we review and propose a didactic organization and classification of the main cardiovascular effects of cancer control therapy. We recognize that there is still a knowledge gap in basic sciences about the mechanisms that underlie these alterations.
Descritores: Doenças Cardiovasculares
Neoplasias
-Chile
Cardiotoxicidade
Antineoplásicos
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1139411
Autor: Mardones, Lorena.
Título: Vitamina C y Cáncer ¿amigos o enemigos? / Vitamin C and Cancer, friends or foes?
Fonte: Rev. méd. Chile;148(7):1047-1048, jul. 2020. graf.
Idioma: es.
Descritores: Ácido Ascórbico/administração & dosagem
Vitaminas/administração & dosagem
Suplementos Nutricionais
Neoplasias/tratamento farmacológico
-Ácido Ascórbico/efeitos adversos
Ácido Ascórbico/uso terapêutico
Vitaminas/efeitos adversos
Vitaminas/uso terapêutico
Neoplasias/diagnóstico
Antineoplásicos/uso terapêutico
Limites: Humanos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-838095
Autor: Waseem, David; Tushar, Patel.
Título: Intrahepatic, Perihilar and Distal Cholangiocarcinoma: Management and Outcomes
Fonte: Ann. hepatol;16(1):133-139, Jan.-Feb. 2017. graf.
Idioma: en.
Resumo: Abstract: Introduction and aims. Cholangiocarcinomas are a heterogeneous group of tumors that can be classified into three clinically distinct types of cancers, intrahepatic, perihilar and distal cholangiocarcinoma. The inconsistent use of nomenclature for these cancers has obscured a true knowledge of the epidemiology, natural history and response to therapy of these cancers. Our aims were to define demographic characteristics, management and outcomes of these three distinct cancer types. Materials and methods. A retrospective study of patients enrolled in an institutional cancer registry from 1992 to 2010. Median survival was compared between different treatment modalities over three time periods for the three types of cholangiocarcinoma at different stages of the disease using Kaplan Meyer analysis. Results. 242 patients were identified. All cases were reviewed and classified into intrahepatic (90 patients), distal (48 patients) or perihilar (104 patients) cholangiocarcinomas. These cancers differed in median age of onset, gender distribution, median survival and stage. 13.8% of patients presented with stage I, 5.8% with stage II, 9.6% with stage III, 28% with stage IV, with 41.8% having unknown stage. The overall median survival was 15.8 months, and was 23, 25, 14, and 4.5 months for stages I, II, III, and IV respectively. Surgery improved survival in both early and advanced stages. Multimodality therapies further improved outcomes, particularly for perihilar cholangiocarcinoma. Conclusion. Perihilar, distal and intrahepatic cholangiocarcinoma vary in their presentation, natural history and therapeutic approach to management. A consistently applied classification is essential for meaningful interpretation of studies of these cancers.
Descritores: Neoplasias dos Ductos Biliares/terapia
Procedimentos Cirúrgicos do Sistema Biliar
Colangiocarcinoma/terapia
Antineoplásicos/uso terapêutico
-Fatores de Tempo
Neoplasias dos Ductos Biliares/classificação
Neoplasias dos Ductos Biliares/mortalidade
Neoplasias dos Ductos Biliares/patologia
Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos
Procedimentos Cirúrgicos do Sistema Biliar/mortalidade
Sistema de Registros
Florida
Estudos Retrospectivos
Resultado do Tratamento
Quimioterapia Adjuvante
Tumor de Klatskin/classificação
Tumor de Klatskin/mortalidade
Tumor de Klatskin/patologia
Tumor de Klatskin/terapia
Colangiocarcinoma/classificação
Colangiocarcinoma/mortalidade
Colangiocarcinoma/patologia
Radioterapia Adjuvante
Estimativa de Kaplan-Meier
Estadiamento de Neoplasias
Antineoplásicos/efeitos adversos
Limites: Humanos
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-950875
Autor: Cheng, Ming-Jun; Cao, Yun-Gui.
Título: TMPYP4 exerted antitumor effects in human cervical cancer cells through activation of p38 mitogen-activated protein kinase
Fonte: Biol. Res;50:24, 2017. graf.
Idioma: en.
Projeto: National Natural Science Foundation of China; . Chongqing Science and Technology.
Resumo: BACKGROUND: The aim of the present study was to investigate the potential effects of the 5,10,15,20-tetrakis (1-methylpyridinium-4-yl) porphyrin (TMPyP4) on the proliferation and apoptosis of human cervical cancer cells and the underlying mechanisms by which TMPyP4 exerted its actions. RESULTS: After human cervical cancer cells were treated with different doses of TMPyP4, cell viability was determined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) method, the apoptosis was observed by flow cytometry (FCM), and the expression of p38 mitogen-activated protein kinase (MAPK), phosphated p38 MAPK (p-p38 MAPK), capase-3, MAPKAPK2 (MK-2) and poly ADP-ribose polymerase (PARP) was measured by Western blot analysis. The analysis revealed that TMPyP4 potently suppressed cell viability and induced the apoptosis of human cervical cancer cells in a dose-dependent manner. In addition, the up-regulation of p-p38 MAPK expression levels was detected in TMPyP4-treated human cervical cancer cells. However, followed by the block of p38 MAPK signaling pathway using the inhibitor SB203580, the effects of TMPyP4 on proliferation and apoptosis of human cervical cancer cells were significantly changed. CONCLUSIONS: It was indicated that TMPyP4-inhibited proliferation and -induced apoptosis in human cervical cancer cells was accompanied by activating the p38 MAPK signaling pathway. Taken together, our study demonstrates that TMPyP4 may represent a potential therapeutic method for the treatment of cervical carcinoma.
Descritores: Porfirinas/farmacologia
Neoplasias do Colo do Útero/tratamento farmacológico
Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
Antineoplásicos/farmacologia
-Sais de Tetrazólio
Células HeLa/efeitos dos fármacos
Sobrevivência Celular/efeitos dos fármacos
Células Cultivadas
Western Blotting
Reprodutibilidade dos Testes
Apoptose/efeitos dos fármacos
Proteínas Quinases p38 Ativadas por Mitógeno/antagonistas & inibidores
Proliferação de Células/efeitos dos fármacos
Ativação Enzimática/efeitos dos fármacos
Caspase 3/análise
Formazans
Limites: Humanos
Feminino
Tipo de Publ: Estudo de Avaliação
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-887223
Autor: Guarino, Maria; Picardi, Marco; Vitiello, Anna; Pugliese, Novella; Rea, Matilde; Cossiga, Valentina; Pane, Fabrizio; Caporaso, Nicola; Morisco, Filomena.
Título: Viral Outcome in Patients with Occult HBV Infection or HCV-Ab Positivity Treated for Lymphoma
Fonte: Ann. hepatol;16(2):198-206, Mar.-Apr. 2017. tab.
Idioma: en.
Resumo: ABSTRACT HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples "Federico II". A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HBsAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lamivudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivation is strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored.
Descritores: Ativação Viral
Linfoma não Hodgkin/tratamento farmacológico
Doença de Hodgkin/tratamento farmacológico
Vírus da Hepatite B/patogenicidade
Hospedeiro Imunocomprometido
Hepatite C/virologia
Hepacivirus/patogenicidade
Anticorpos Anti-Hepatite C/sangue
Rituximab/efeitos adversos
Hepatite B/virologia
Antineoplásicos/efeitos adversos
-Antivirais/administração & dosagem
Linfoma não Hodgkin/imunologia
Doença de Hodgkin/imunologia
Biomarcadores/sangue
Vírus da Hepatite B/imunologia
Estudos Retrospectivos
Hepatite C/diagnóstico
Hepatite C/imunologia
Hepatite C/prevenção & controle
Hepacivirus/imunologia
Centros de Atenção Terciária
Hepatite B/diagnóstico
Hepatite B/imunologia
Hepatite B/prevenção & controle
Itália
Limites: Humanos
Adulto
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


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Id: biblio-887229
Autor: Varghese, Joy; Kedarisetty, Chandan Kumar; Venkataraman, Jayanthi; Srinivasan, Vijaya; Deepashree, Thiruchunapalli; Uthappa, Mangerira Chinnappa; Ilankumaran, Kaliamurthy; Govil, Sanjay; Reddy, Mettu Srinivas; Rela, Mohamed.
Título: Combination of TACE and Sorafenib Improves Outcomes in BCLC Stages B/C of Hepatocellular Carcinoma: A Single Centre Experience
Fonte: Ann. hepatol;16(2):247-254, Mar.-Apr. 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT Background & Aim. Transarterial chemoembolization (TACE) or sorafenib is recommended for hepatocellular carcinoma BCLC stages B and C respectively. We studied the role of combination of TACE and sorafenib in BCLC stages B/C. Material and methods. We undertook an observational study on a cohort of cirrhotics with HCC from August 2010 through October 2014. Patients in BCLC stages B/C who had received TACE and/or sorafenib were included. mRECIST criteria were used to assess tumor response. The primary end point was overall survival. Results. Out of 124 patients, 47.6% were in BCLC-B and 52.4% in BCLCC. Baseline characteristics were comparable. The predominant etiology was cryptogenic (37.2% and 38.5%, p = NS). 49.1% in BCLC-B and 56.9% in BCLC-C had received TACE+sorafenib. In BCLC-B, the overall survival improved from 9 months (95% CI 6.3-11.7) using TACE only to 16 months (95% CI 12.9-19.1) using TACE+sorafenib (p < 0.05). In BCLC-C, addition of TACE to sorafenib improved the overall survival from 4 months (95%CI 3-5) to 9 months (95%CI 6.8-11.2) (p < 0.0001). As per mRECIST criteria, patients on TACE+sorafenib had reduced progressive disease (37.8% vs. 83.3%), improved partial response (43.2% vs. 3.3%) and one had complete response compared to those on sorafenib alone (p < 0.0001) in BCLC-C but not in BCLC-B group. Hand foot syndrome was noted in 27.7% patients on sorafenib and post TACE syndrome in 80.2% patients, but both were reversible. No major adverse events were noted. Conclusion. TACE+sorafenib was more effective than TACE or sorafenib alone in HCC BCLC stages B or C with a significant survival benefit and improved tumour regression especially in BCLC-C patients.
Descritores: Compostos de Fenilureia/uso terapêutico
Niacinamida/análogos & derivados
Carcinoma Hepatocelular/terapia
Inibidores de Proteínas Quinases/uso terapêutico
Neoplasias Hepáticas/terapia
Antineoplásicos/uso terapêutico
-Compostos de Fenilureia/efeitos adversos
Fatores de Tempo
Resultado do Tratamento
Quimioembolização Terapêutica/efeitos adversos
Quimioembolização Terapêutica/mortalidade
Niacinamida/efeitos adversos
Niacinamida/uso terapêutico
Carcinoma Hepatocelular/etiologia
Carcinoma Hepatocelular/mortalidade
Carcinoma Hepatocelular/patologia
Inibidores de Proteínas Quinases/efeitos adversos
Carga Tumoral
Estimativa de Kaplan-Meier
Neoplasias Hepáticas/etiologia
Neoplasias Hepáticas/mortalidade
Estadiamento de Neoplasias
Antineoplásicos/efeitos adversos
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-887230
Autor: Carvalho, Sandra R. Almeida; Ferraz, Maria L. Gomes; Matos, Carla A. Loureiro; Silva, Antônio E. Benedito; Carvalho Filho, Roberto J; Perez, Rogério Renato; Gonzalez, Adriano Miziara; Salzedas-Netto, Alcides A; Szejnfeld, Denis; D'Ippolito, Giuseppe; Lanzoni, Valéria Pereira; Silva, Ivonete S. Souza.
Título: Practical Considerations of Real Life of Hepatocellular Carcinoma in a Tertiary Center of Brazil
Fonte: Ann. hepatol;16(2):255-262, Mar.-Apr. 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT Background. Hepatocellular carcinoma (HCC) is the most common malignancy that develops in cirrhotic livers. Its clinical and epidemiological characteristics and mortality rates vary according to geographical region. The objective of this study was to evaluate the clinical profile, epidemiological characteristics, laboratory parameters, treatment and survival of patients with HCC. Material and methods. Patients with HCC seen between 2000 and 2012 were studied. The Kaplan-Meier method was used for survival analysis according to variables in question. Results. The study included 247 patients with a mean age of 60 ± 10 years. There was a predominance of males (74%). The main etiologies of HCC were HCV infection (55%), excessive alcohol consumption (12%), and HBV infection (8%). Liver cirrhosis was present in 92% of cases. The mean tumor number and diameter were 2 and 5 cm, respectively. Patients meeting the Milan criteria corresponded to 43% of the sample. Liver transplantation was performed in 22.4% of patients of the Milan subset and in 10% of the whole sample. The overall mean survival was 60 months, with a 1-, 3- and 5-year survival probability of 74%, 40% and 29%, respectively. Lower survival was observed among patients with alcoholic etiology. Survival was higher among patients submitted to liver transplantation (P < 0.001), TACE (P < 0.001), or any kind of treatment (P < 0.001). However, no difference was found for surgical resection (P = 0.1) or sorafenib (P = 0.1). Conclusion. Patients with HCC were mainly older men diagnosed at an advanced stage. Treatment was associated with better overall survival, but few patients survived to be treated.
Descritores: Transplante de Fígado
Quimioembolização Terapêutica
Carcinoma Hepatocelular/terapia
Técnicas de Ablação
Hepatectomia
Neoplasias Hepáticas/terapia
Antineoplásicos/uso terapêutico
-Compostos de Fenilureia/uso terapêutico
Fatores de Tempo
Brasil/epidemiologia
Fatores de Risco
Resultado do Tratamento
Quimioembolização Terapêutica/efeitos adversos
Quimioembolização Terapêutica/mortalidade
Niacinamida/análogos & derivados
Carcinoma Hepatocelular/etiologia
Carcinoma Hepatocelular/mortalidade
Carcinoma Hepatocelular/patologia
Carga Tumoral
Estimativa de Kaplan-Meier
Centros de Atenção Terciária
Hepatectomia/efeitos adversos
Hepatectomia/mortalidade
Neoplasias Hepáticas/etiologia
Estadiamento de Neoplasias
Antineoplásicos/efeitos adversos
Limites: Humanos
Responsável: BR1.1 - BIREME



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