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[PMID]:28463156
[Au] Autor:Demizu Y; Jin D; Sulaiman NS; Nagano F; Terashima K; Tokumaru S; Akagi T; Fujii O; Daimon T; Sasaki R; Fuwa N; Okimoto T
[Ad] Endereço:Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan. Electronic address: y_demizu@nifty.com.
[Ti] Título:Particle Therapy Using Protons or Carbon Ions for Unresectable or Incompletely Resected Bone and Soft Tissue Sarcomas of the Pelvis.
[So] Source:Int J Radiat Oncol Biol Phys;98(2):367-374, 2017 06 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To retrospectively analyze the treatment outcomes of particle therapy using protons or carbon ions for unresectable or incompletely resected bone and soft tissue sarcomas (BSTSs) of the pelvis. METHODS AND MATERIALS: From May 2005 to December 2014, 91 patients with nonmetastatic histologically proven unresectable or incompletely resected pelvic BSTSs underwent particle therapy with curative intent. The particle therapy used protons (52 patients) or carbon ions (39 patients). All patients received a dose of 70.4 Gy (relative biologic effectiveness) in 32 fractions (55 patients) or 16 fractions (36 patients). RESULTS: The median patient age was 67 years (range 18-87). The median planning target volume (PTV) was 455 cm (range 108-1984). The histologic type was chordoma in 53 patients, chondrosarcoma in 14, osteosarcoma in 10, malignant fibrous histiocytoma/undifferentiated pleomorphic sarcoma in 5, and other in 9 patients. Of the 91 patients, 82 had a primary tumor and 9 a recurrent tumor. The median follow-up period was 32 months (range 3-112). The 3-year rate of overall survival (OS), progression-free survival (PFS), and local control was 83%, 72%, and 92%, respectively. A Cox proportional hazards model revealed that chordoma histologic features and a PTV of ≤500 cm were significantly associated with better OS, and a primary tumor and PTV of ≤500 cm were significantly associated with better PFS. Ion type and number of fractions were not significantly associated with OS, PFS, or local control. Late grade ≥3 toxicities were observed in 23 patients. Compared with the 32-fraction protocol, the 16-fraction protocol was associated with significantly more frequent late grade ≥3 toxicities (18 of 36 vs 5 of 55; P<.001). CONCLUSIONS: Particle therapy using protons or carbon ions was effective for unresectable or incompletely resected pelvic BSTS, and the 32-fraction protocol was effective and relatively less toxic. Nevertheless, a longer follow-up period is needed to confirm these results.
[Mh] Termos MeSH primário: Neoplasias Ósseas/radioterapia
Radioterapia com Íons Pesados/métodos
Ossos Pélvicos
Terapia com Prótons/métodos
Sarcoma/radioterapia
[Mh] Termos MeSH secundário: Idoso
Neoplasias Ósseas/diagnóstico por imagem
Neoplasias Ósseas/mortalidade
Neoplasias Ósseas/cirurgia
Condrossarcoma/mortalidade
Condrossarcoma/radioterapia
Condrossarcoma/cirurgia
Cordoma/diagnóstico por imagem
Cordoma/mortalidade
Cordoma/radioterapia
Cordoma/cirurgia
Feminino
Radioterapia com Íons Pesados/estatística & dados numéricos
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Osteossarcoma/mortalidade
Osteossarcoma/radioterapia
Osteossarcoma/cirurgia
Ossos Pélvicos/diagnóstico por imagem
Modelos de Riscos Proporcionais
Terapia com Prótons/estatística & dados numéricos
Planejamento da Radioterapia Assistida por Computador/métodos
Eficiência Biológica Relativa
Estudos Retrospectivos
Sarcoma/diagnóstico por imagem
Sarcoma/mortalidade
Sarcoma/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:29254594
[Au] Autor:Austin AM; Douglass MJJ; Nguyen GT; Penfold SN
[Ad] Endereço:Department of Physics, University of Adelaide, Adelaide, SA 5005, Australia. Electronic address: annabelle.austin@adelaide.edu.au.
[Ti] Título:A radiobiological Markov simulation tool for aiding decision making in proton therapy referral.
[So] Source:Phys Med;44:72-82, 2017 Dec.
[Is] ISSN:1724-191X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Proton therapy can be a highly effective strategy for the treatment of tumours. However, compared with X-ray therapy it is more expensive and has limited availability. In addition, it is not always clear whether it will benefit an individual patient more than a course of traditional X-ray therapy. Basing a treatment decision on outcomes of clinical trials can be difficult due to a shortage of data. Predictive modelling studies are becoming an attractive alternative to supplement clinical decisions. The aim of the current work is to present a Markov framework that compares clinical outcomes for proton and X-ray therapy. METHODS: A Markov model has been developed which estimates the radiobiological effect of a given treatment plan. This radiobiological effect is estimated using the tumour control probability (TCP), normal tissue complication probability (NTCP) and second primary cancer induction probability (SPCIP). These metrics are used as transition probabilities in the Markov chain. The clinical outcome is quantified by the quality adjusted life expectancy. To demonstrate functionality, the model was applied to a 6-year-old patient presenting with skull base chordoma. RESULTS: The model was successfully developed to compare clinical outcomes for proton and X-ray treatment plans. For the example patient considered, it was predicted that proton therapy would offer a significant advantage compared with volumetric modulated arc therapy in terms of survival and mitigating injuries. CONCLUSIONS: The functionality of the model was demonstrated using the example patient. The proposed Markov method may be a useful tool for deciding on a treatment strategy for individual patients.
[Mh] Termos MeSH primário: Tomada de Decisões
Cadeias de Markov
Terapia com Prótons
Radiobiologia
Encaminhamento e Consulta
[Mh] Termos MeSH secundário: Criança
Cordoma/radioterapia
Seres Humanos
Masculino
Segunda Neoplasia Primária/etiologia
Terapia com Prótons/efeitos adversos
Anos de Vida Ajustados por Qualidade de Vida
Neoplasias Cranianas/radioterapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE


  3 / 2803 MEDLINE  
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[PMID]:29310398
[Au] Autor:Li X; Wang Y; Wang F; Li B; Sun S; Yang H
[Ad] Endereço:Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province.
[Ti] Título:An unusual case of oropharyngeal chordoma: A case report and literature review.
[So] Source:Medicine (Baltimore);96(48):e8963, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Chordomas are rare malignant neoplasms derived from incomplete regression of notochordal tissue along the cranio-coccygeal axis. Chordomas that develop in an atypical position are called ectopic chordomas, such as oropharyngeal chordomas (OCs). OCs are exceedingly rare; only 11 cases have been reported to date. Preoperative diagnosis is challenging, and an accurate diagnosis thus is based on postoperative pathologic examination findings and immunohistochemistry. Although surgical therapy and radiotherapy is performed in some patients, the 5-year survival rate is low. Increasingly more studies of chordomas have been based on molecular biology to increase the survival rate, and targeted therapy could be a new therapy in the future. PATIENT CONCERNS: The patient presented with a left oropharyngeal mass that had begun slowly enlarging 1 year previously. He reported a foreign body sensation and dysphonia during this time period. DIAGNOSES: The patient was initially diagnosed with a neurogenic tumor. Routine postoperative pathology showed that the mass was consistent with a chordoma. INTERVENTION: Mass resection was performed. OUTCOME: One year after the initial surgery, magnetic resonance imaging revealed block signal images at the left retropharyngeal space and clivus. The patient developed recurrence of the OC. LESSONS: Surgical resection is the mainstay of treatment for OC, and postoperative adjuvant radiotherapy is also important. An understanding of the unusual case described in this report may be helpful in diagnosing OC, and development of targeted therapy may help clinicians to provide novel treatment for patients with OC.
[Mh] Termos MeSH primário: Cordoma/diagnóstico
Cordoma/cirurgia
Neoplasias Orofaríngeas/diagnóstico
Neoplasias Orofaríngeas/cirurgia
[Mh] Termos MeSH secundário: Adulto
Cordoma/patologia
Seres Humanos
Masculino
Neoplasias Orofaríngeas/patologia
Orofaringe/diagnóstico por imagem
Orofaringe/patologia
Orofaringe/cirurgia
Recidiva
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008963


  4 / 2803 MEDLINE  
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[PMID]:28872530
[Au] Autor:Shah AA; Paulino Pereira NR; Pedlow FX; Wain JC; Yoon SS; Hornicek FJ; Schwab JH
[Ad] Endereço:1Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts 2Division of Thoracic Surgery, St. Elizabeth's Medical Center, Brighton, Massachusetts 3Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
[Ti] Título:Modified En Bloc Spondylectomy for Tumors of the Thoracic and Lumbar Spine: Surgical Technique and Outcomes.
[So] Source:J Bone Joint Surg Am;99(17):1476-1484, 2017 Sep 06.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Total en bloc spondylectomy (TES) for the treatment of spinal tumors decreases local recurrence and improves survival compared with intralesional resection. TES approaches vary in both the number of stages to complete the procedure and instruments with which osteotomies are performed. METHODS: We describe a 2-stage technique that employs the use of threadwire saws. We performed a retrospective review of cases of primary tumors and solitary metastases involving the thoracic or lumbar spine treated with use of our modified technique at our institution between 2010 and 2016, identifying eligible patients by searching for specific phrases in operative reports found in our oncologic database. Clinical notes, operative notes, imaging reports, and pathology reports were reviewed for all patients. RESULTS: Thirty-three patients underwent our modified technique, in which we pass a threadwire saw between the vertebral body and the thecal sac. The most common tumor type was chordoma (64%), and tumors were most commonly located in the lumbar spine (61%). There were no intraoperative injuries to the spinal cord or great vessels. One patient experienced a dural tear secondary to the passage of a saw. Seventeen (52%) of the patients had perioperative complications, with 1 death. Seven (22%) of the patients had complications occurring within 90 days after discharge, and 8 (25%) had complications occurring >90 days after discharge. Instrumentation failure was observed in 8 cases (25%). Negative margins were obtained in 94% of the cases. Local recurrence was observed in 2 cases (6%). The majority of patients had normal motor function at the time of the most recent follow-up. CONCLUSIONS: Our modified en bloc spondylectomy represents an effective technique for the resection of spinal tumors in selected patients, allowing for visualization of vessels anterior to the spine and the avoidance of spinal cord injury. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Condrossarcoma/cirurgia
Cordoma/cirurgia
Vértebras Lombares/cirurgia
Osteotomia/métodos
Neoplasias da Coluna Vertebral/cirurgia
Vértebras Torácicas/cirurgia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.17.00141


  5 / 2803 MEDLINE  
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[PMID]:28780352
[Au] Autor:Wen H; Ma H; Li P; Zheng J; Yu Y; Lv G
[Ad] Endereço:Department of Spine Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China.
[Ti] Título:Expression of far upstream element-binding protein 1 correlates with c-Myc expression in sacral chordomas and is associated with tumor progression and poor prognosis.
[So] Source:Biochem Biophys Res Commun;491(4):1047-1054, 2017 Sep 30.
[Is] ISSN:1090-2104
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The far upstream element (FUSE)-binding protein 1 (FUBP1), a well-known transcriptional regulator of the proto-oncogene c-Myc, has been demonstrated by previous work to be aberrantly expressed in a variety of tumors and plays a critical role in tumor progression; however, its expression and function in relatively rare and aggressive chordomas remains unclear. In this retrospective study, we reviewed clinicopathologic characteristics of 40 patients diagnosed with sacral chordoma, and analyzed 40 tumor and 20 distant normal tissues obtained from patients during the primary surgical tumor excision. Using immunohistochemistry, we observed an up-regulation in the expression of FUBP1 and c-Myc in sacral chordomas compared with the normal tissues (P = 0.001 for both). Additionally, positive correlations of FUBP1 expression with c-Myc (γ = 0.651, P < 0.001) and the cell proliferation index Ki-67 expression (γ = 0.447, P = 0.004) were indicated using Spearman's rank correlation coefficient. Increased expression of FUBP1 was significantly associated with tumor invasion into the surrounding muscles (P = 0.002). Kaplan-Meier curves demonstrated the association between FUBP1 levels and the patients' local recurrence-free survival (LRFS) (P < 0.001) but not with the overall survival (OS) (P = 0.070). The independent prognostic significance of FUBP1 levels for the LRFS was indicated by multivariate analysis (HR = 4.272; 95% CI, 1.133-16.112; P = 0.032). Our findings demonstrate an association between FUBP1 levels and chordoma progression and prognosis, suggesting that FUBP1 can be used as a biomarker and a potential therapeutic target.
[Mh] Termos MeSH primário: Biomarcadores Tumorais/biossíntese
Cordoma/metabolismo
DNA Helicases/biossíntese
Proteínas de Ligação a DNA/biossíntese
Proteínas Proto-Oncogênicas c-myc/biossíntese
Sacro/metabolismo
[Mh] Termos MeSH secundário: Adulto
Idoso
Cordoma/diagnóstico
Feminino
Seres Humanos
Masculino
Meia-Idade
Sacro/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (DNA-Binding Proteins); 0 (FUBP1 protein, human); 0 (Proto-Oncogene Proteins c-myc); EC 3.6.4.- (DNA Helicases)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170807
[St] Status:MEDLINE


  6 / 2803 MEDLINE  
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[PMID]:28750274
[Au] Autor:Colia V; Stacchiotti S
[Ad] Endereço:Adult Mesenchymal Tumour and Rare Cancer Medical Oncology Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy. Electronic address: vittoria.colia@istitutotumori.mi.it.
[Ti] Título:Medical treatment of advanced chordomas.
[So] Source:Eur J Cancer;83:220-228, 2017 Sep.
[Is] ISSN:1879-0852
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Chordoma is a very rare bone sarcoma that can arise from any site along the spine and from the skull base. En bloc resection is the gold standard for treatment while radiation therapy has been shown to provide both curative and palliative benefit. Unfortunately, local recurrences are common, even after a complete surgical resection, and up to 40% of patients suffer from distant metastases, while salvage treatments are challenging. Patients carrying an advanced disease need a systemic treatment. Unluckily, conventional chordoma are insensitive to cytotoxic chemotherapy that is considered the standard treatment option in patients with metastatic sarcoma. In the last decade, innovative therapies have been introduced, positively impacting disease control and patients' quality of life. In addition, a better understanding of the molecular characteristics of chordoma allowed to detect new potential targets. This review is focused on the pharmacological management of patients affected by an advanced disease, starting with a summary of data available on conventional chemotherapy, then moving to a deeper analysis of available data on molecular agents and immunotherapy, and finally providing an update on ongoing clinical trials and future prospective.
[Mh] Termos MeSH primário: Antineoplásicos/uso terapêutico
Neoplasias Ósseas/tratamento farmacológico
Cordoma/tratamento farmacológico
[Mh] Termos MeSH secundário: Neoplasias Ósseas/patologia
Vacinas Anticâncer/uso terapêutico
Cordoma/patologia
Ensaios Clínicos como Assunto
Seres Humanos
Imunoterapia/métodos
Terapia de Alvo Molecular/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Cancer Vaccines)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE


  7 / 2803 MEDLINE  
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[PMID]:28698083
[Au] Autor:Vilela MD; Pedrosa HAS; Dias Filho MA
[Ad] Endereço:Department of Neurosurgery, Mater Dei Hospital, Belo Horizonte, Brazil; Department of Neurological Surgery, University of Washington, Seattle, Washington, USA. Electronic address: vilelamd@gmail.com.
[Ti] Título:A Hemorrhagic Clival Chordoma with a Long Progression-Free Survival.
[So] Source:World Neurosurg;105:1042.e1-1042.e4, 2017 Sep.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Chordomas and ecchordosis physaliphora may on rare occasions present with intracranial hemorrhage. Their distinction usually relies on the results of the Ki-67 proliferative index, with a result lower than 1% favoring ecchordosis physaliphora. Intracranial hemorrhagic chordomas have been linked to unfavorable prognosis, due to acute neurologic deterioration and death, or progression after treatment. To the best of our knowledge, this is the first report of a patient with an intracranial hemorrhagic chordoma who had a long progression-free survival. CASE DESCRIPTION: A 67-year-old woman presented with a large hemorrhagic clival tumor that was resected through an endonasal endoscopic approach. Physallipharous cells interspersed in a myxoid matrix, positivity for S-100, cytokeratin, and epithelial membrane antigen were found, along with an extremely low Ki-67 index. Imaging findings of bone erosion, a large size, and enhancement favored the diagnosis of chordoma. The patient received adjuvant stereotactic radiotherapy and has remained disease free after 4 years. CONCLUSIONS: Although hemorrhagic intracranial chordomas have been linked to unfavorable outcomes, our case demonstrates that they may have a low proliferative index, and a long progression-free survival may be seen.
[Mh] Termos MeSH primário: Cordoma/cirurgia
Hemorragias Intracranianas/cirurgia
Neoplasias da Base do Crânio/cirurgia
[Mh] Termos MeSH secundário: Idoso
Cordoma/complicações
Cordoma/diagnóstico por imagem
Fossa Craniana Posterior/diagnóstico por imagem
Fossa Craniana Posterior/cirurgia
Intervalo Livre de Doença
Feminino
Seres Humanos
Hemorragias Intracranianas/diagnóstico por imagem
Hemorragias Intracranianas/etiologia
Neoplasias da Base do Crânio/complicações
Neoplasias da Base do Crânio/diagnóstico por imagem
Fatores de Tempo
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE


  8 / 2803 MEDLINE  
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[PMID]:28672709
[Au] Autor:Wang K; Zhang J
[Ad] Endereço:Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases; Center of Brain Tumor, Beijing Institute for Brain Disorders; Beijing Key Laboratory of Brain Tumor, Beijing, China.
[Ti] Título:In Reply to the Letter to the Editor Regarding "Expression of Cathepsin K in Skull Base Chordoma".
[So] Source:World Neurosurg;103:930, 2017 07.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Catepsina K
Cordoma
[Mh] Termos MeSH secundário: Neoplasias de Cabeça e Pescoço
Seres Humanos
Base do Crânio
Neoplasias da Base do Crânio
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
EC 3.4.22.38 (Cathepsin K)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE


  9 / 2803 MEDLINE  
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[PMID]:28672710
[Au] Autor:Tian K; Wang L; Zhang J
[Ad] Endereço:Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
[Ti] Título:In Reply to the Letter to the Editor Regarding "Expression of Cathepsin K in Skull Base Chordoma".
[So] Source:World Neurosurg;103:931, 2017 07.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Catepsina K
Cordoma
[Mh] Termos MeSH secundário: Neoplasias de Cabeça e Pescoço
Seres Humanos
Base do Crânio
Neoplasias da Base do Crânio
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
EC 3.4.22.38 (Cathepsin K)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE


  10 / 2803 MEDLINE  
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[PMID]:28672708
[Au] Autor:Dai ZH; Hao DJ; Yang M
[Ad] Endereço:Department of Orthopedics, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
[Ti] Título:Letter to the Editor Regarding "Expression of Cathepsin K in Skull Base Chordoma".
[So] Source:World Neurosurg;103:927-929, 2017 07.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Catepsina K
Cordoma
[Mh] Termos MeSH secundário: Neoplasias de Cabeça e Pescoço
Seres Humanos
Base do Crânio
Neoplasias da Base do Crânio
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
EC 3.4.22.38 (Cathepsin K)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE



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