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[PMID]:29330228
[Au] Autor:McCormack A; Dekkers OM; Petersenn S; Popovic V; Trouillas J; Raverot G; Burman P; ESE survey collaborators
[Ad] Endereço:St Vincent's Hospital and Garvan Institute of Medical ResearchSydney, Australia.
[Ti] Título:Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016.
[So] Source:Eur J Endocrinol;178(3):265-276, 2018 03.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To collect outcome data in a large cohort of patients with aggressive pituitary tumours (APT)/carcinomas (PC) and specifically report effects of temozolomide (TMZ) treatment. DESIGN: Electronic survey to ESE members Dec 2015-Nov 2016. RESULTS: Reports on 166 patients (40 PC, 125 APT, 1 unclassified) were obtained. Median age at diagnosis was 43 (range 4-79) years. 69% of the tumours were clinically functioning, and the most frequent immunohistochemical subtype were corticotroph tumours (45%). Ki-67 index did not distinguish APT from PC, median 7% and 10% respectively. TMZ was first-line chemotherapy in 157 patients. At the end of the treatment (median 9 cycles), radiological evaluation showed complete response (CR) in 6%, partial response (PR) in 31%, stable disease (SD) in 33% and progressive disease in 30%. Response was more frequent in patients receiving concomitant radiotherapy and TMZ. CR was seen only in patients with low MGMT expression. Clinically functioning tumours were more likely to respond than non-functioning tumours, independent of MGMT status. Of patients with CR, PR and SD, 25, 40 and 48% respectively progressed after a median of 12-month follow-up. Other oncological drugs given as primary treatment and to TMZ failures resulted in PR in 20%. CONCLUSION: This survey confirms that TMZ is established as first-line chemotherapeutic treatment of APT/PC. Clinically functioning tumours, low MGMT and concurrent radiotherapy were associated with a better response. The limited long-term effect of TMZ and the poor efficacy of other drugs highlight the need to identify additional effective therapies.
[Mh] Termos MeSH primário: Adenoma/terapia
Antineoplásicos Alquilantes/uso terapêutico
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Carcinoma/terapia
Irradiação Craniana
Dacarbazina/análogos & derivados
Procedimentos Neurocirúrgicos
Neoplasias Hipofisárias/terapia
[Mh] Termos MeSH secundário: Adenoma/metabolismo
Adenoma/patologia
Adolescente
Adulto
Idoso
Bevacizumab/administração & dosagem
Capecitabina/administração & dosagem
Carcinoma/metabolismo
Carcinoma/patologia
Carmustina/administração & dosagem
Criança
Pré-Escolar
Metilases de Modificação do DNA/metabolismo
Enzimas Reparadoras do DNA/metabolismo
Dacarbazina/administração & dosagem
Dacarbazina/uso terapêutico
Endocrinologia
Europa (Continente)
Feminino
Seres Humanos
Antígeno Ki-67/metabolismo
Masculino
Meia-Idade
Invasividade Neoplásica
Neoplasias Hipofisárias/metabolismo
Neoplasias Hipofisárias/patologia
Sociedades Médicas
Inquéritos e Questionários
Talidomida/administração & dosagem
Proteínas Supressoras de Tumor/metabolismo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Alkylating); 0 (Ki-67 Antigen); 0 (Tumor Suppressor Proteins); 2S9ZZM9Q9V (Bevacizumab); 4Z8R6ORS6L (Thalidomide); 6804DJ8Z9U (Capecitabine); 7GR28W0FJI (Dacarbazine); EC 2.1.1.- (DNA Modification Methylases); EC 2.1.1.63 (MGMT protein, human); EC 6.5.1.- (DNA Repair Enzymes); U68WG3173Y (Carmustine); YF1K15M17Y (temozolomide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180114
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-0933


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[PMID]:29209924
[Au] Autor:Oosten LEM; Chamuleau MED; Thielen FW; de Wreede LC; Siemes C; Doorduijn JK; Smeekes OS; Kersten MJ; Hardi L; Baars JW; Demandt AMP; Stevens WBC; Nijland M; van Imhoff GW; Brouwer R; Uyl-de Groot CA; Kluin PM; de Jong D; Veelken H
[Ad] Endereço:Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. l.e.m.oosten@lumc.nl.
[Ti] Título:Treatment of sporadic Burkitt lymphoma in adults, a retrospective comparison of four treatment regimens.
[So] Source:Ann Hematol;97(2):255-266, 2018 Feb.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Burkitt lymphoma is an aggressive B cell malignancy accounting for 1-2% of all adult lymphomas. Treatment with dose-intensive, multi-agent chemotherapy is effective but associated with considerable toxicity. In this observational study, we compared real-world efficacy, toxicity, and costs of four frequently employed treatment strategies for Burkitt lymphoma: the Lymphome Malins B (LMB), the Berlin-Frankfurt-Münster (BFM), the HOVON, and the CODOX-M/IVAC regimens. We collected data from 147 adult patients treated in eight referral centers. Following central pathology assessment, 105 of these cases were accepted as Burkitt lymphoma, resulting in the following treatment groups: LMB 36 patients, BFM 19 patients, HOVON 29 patients, and CODOX-M/IVAC 21 patients (median age 39 years, range 14-74; mean duration of follow-up 47 months). There was no significant difference between age, sex ratio, disease stage, or percentage HIV-positive patients between the treatment groups. Five-year progression-free survival (69%, p = 0.966) and 5-year overall survival (69%, p = 0.981) were comparable for all treatment groups. Treatment-related toxicity was also comparable with only hepatotoxicity seen more frequently in the CODOX/M-IVAC group (p = 0.004). Costs were determined by the number of rituximab gifts and the number of inpatients days. Overall, CODOX-M/IVAC had the most beneficial profile with regards to costs, treatment duration, and percentage of patients completing planned treatment. We conclude that the four treatment protocols for Burkitt lymphoma yield nearly identical results with regards to efficacy and safety but differ in treatment duration and costs. These differences may help guide future choice of treatment.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Linfoma de Burkitt/tratamento farmacológico
Análise Custo-Benefício
Infecções por HIV/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Linfoma de Burkitt/complicações
Linfoma de Burkitt/economia
Linfoma de Burkitt/mortalidade
Carmustina/economia
Carmustina/uso terapêutico
Ciclofosfamida/economia
Ciclofosfamida/uso terapêutico
Citarabina/economia
Citarabina/uso terapêutico
Etoposídeo/economia
Etoposídeo/uso terapêutico
Feminino
Infecções por HIV/complicações
Infecções por HIV/economia
Infecções por HIV/mortalidade
Seres Humanos
Ifosfamida/economia
Ifosfamida/uso terapêutico
Masculino
Melfalan/economia
Melfalan/uso terapêutico
Metotrexato/economia
Metotrexato/uso terapêutico
Meia-Idade
Estadiamento de Neoplasias
Estudos Retrospectivos
Rituximab/economia
Rituximab/uso terapêutico
Análise de Sobrevida
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
04079A1RDZ (Cytarabine); 4F4X42SYQ6 (Rituximab); 6PLQ3CP4P3 (Etoposide); 8N3DW7272P (Cyclophosphamide); Q41OR9510P (Melphalan); U68WG3173Y (Carmustine); UM20QQM95Y (Ifosfamide); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-3167-7


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[PMID]:28696028
[Au] Autor:Ozuah NW; Dahmoush HM; Grant FD; Lehmann LE; LaCasce AS; Billett AL; Margossian SP
[Ad] Endereço:Department of Pediatric Hematology/Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:Pretransplant functional imaging and outcome in pediatric patients with relapsed/refractory Hodgkin lymphoma undergoing autologous transplantation.
[So] Source:Pediatr Blood Cancer;65(1), 2018 Jan.
[Is] ISSN:1545-5017
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pretransplant functional imaging (FI), particularly a negative positron emission tomography (PET), is a strong predictor of outcome in adults with relapsed or refractory Hodgkin lymphoma (HL), but data in pediatrics are limited. METHODS: The medical records of 49 consecutive pediatric patients, who received autologous transplant at a single institution, were retrospectively analyzed. All patients had either gallium or PET scan before transplant and were conditioned with carmustine, etoposide, cytarabine, and melphalan (BEAM). Deauville scores were retrospectively assigned for patients with PET (score ≥ 4 positive). RESULTS: Of the 49 patients (median age, 16.2 years), 41 (84%) were pretransplant FI negative and eight (16%) were pretransplant FI positive, after first- to fourth-line salvage therapy, and a median of two salvage cycles. Eighteen patients (37%) received posttransplant radiation. At a median follow up of 46 months, 45 patients (92%) were alive and disease free, and there were three nonrelapse deaths and only one relapse death (Deauville score of 5). The 4-year progression-free survival (PFS) for the entire cohort was 92% (95% confidence interval [CI]: 78-97), and PFS based on pretransplant disease status was 95% (95% CI: 82-99%) in the negative FI group versus 75% (95% CI: 31-93) if positive FI (P = 0.057). CONCLUSION: Our analysis revealed outstanding outcomes for children and adolescents with relapsed/refractory HL. There were too few relapses to identify the predictive value of pretransplant metabolic status, but pediatric patients with relapsed/refractory HL and a negative pretransplant FI had excellent survival.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Doença de Hodgkin
Tomografia por Emissão de Pósitrons
Cuidados Pré-Operatórios
Transplante de Células-Tronco
[Mh] Termos MeSH secundário: Adolescente
Adulto
Autoenxertos
Carmustina/administração & dosagem
Criança
Citarabina/administração & dosagem
Intervalo Livre de Doença
Feminino
Seguimentos
Doença de Hodgkin/diagnóstico por imagem
Doença de Hodgkin/mortalidade
Doença de Hodgkin/terapia
Seres Humanos
Masculino
Melfalan/administração & dosagem
Podofilotoxina/administração & dosagem
Estudos Retrospectivos
Taxa de Sobrevida
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
04079A1RDZ (Cytarabine); L36H50F353 (Podophyllotoxin); Q41OR9510P (Melphalan); U68WG3173Y (Carmustine)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171201
[Lr] Data última revisão:
171201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1002/pbc.26707


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[PMID]:28879595
[Au] Autor:Partanen A; Valtola J; Ropponen A; Vasala K; Penttilä K; Ågren L; Pyörälä M; Nousiainen T; Selander T; Mäntymaa P; Pelkonen J; Varmavuo V; Jantunen E
[Ad] Endereço:Department of Medicine, Kuopio University Hospital, P.O.B. 100, 70029 KYS, Kuopio, Finland. anu.partanen@kuh.fi.
[Ti] Título:Preemptive plerixafor injection added to pegfilgrastim after chemotherapy in non-Hodgkin lymphoma patients mobilizing poorly.
[So] Source:Ann Hematol;96(11):1897-1906, 2017 Nov.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Filgrastim is usually combined with chemotherapy to mobilize hematopoietic progenitor cells in non-Hodgkin lymphoma (NHL) patients. Limited information is available on the efficacy of a preemptive plerixafor (PLER) injection in poor mobilizers after chemotherapy and pegfilgrastim. In this prospective study, 72 patients with NHL received chemotherapy plus pegfilgrastim, and 25 hard-to-mobilize patients received also PLER. The usefulness and efficacy of our previously developed algorithm for PLER use in pegfilgrastim-containing mobilization regimen were evaluated as well as the graft cellular composition, hematological recovery, and outcome after autologous stem cell transplantation (auto-SCT) according to the PLER use. A median 3.4-fold increase in blood CD34 cell counts was achieved after the first PLER dose. The minimum collection target was achieved in the first mobilization attempt in 66/72 patients (92%) and 68 patients (94%) proceeded to auto-SCT. An algorithm for PLER use was fulfilled in 76% of the poor mobilizers. Absolute numbers of T-lymphocytes and NK cells were significantly higher in the PLER group, whereas the number of CD34 cells collected was significantly lower. Early neutrophil engraftment was slower in the PLER group, otherwise hematological recovery was comparable within 12 months from auto-SCT. No difference was observed in survival according to the PLER use. Chemotherapy plus pegfilgrastim combined with preemptive PLER injection is an effective and convenient approach to minimize collection failures in NHL patients intended for auto-SCT. A significant effect of PLER on the graft cellular composition was observed, but no difference in outcome after auto-SCT was detected.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Fator Estimulador de Colônias de Granulócitos/administração & dosagem
Mobilização de Células-Tronco Hematopoéticas/tendências
Compostos Heterocíclicos/administração & dosagem
Linfoma não Hodgkin/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Carmustina/administração & dosagem
Citarabina/administração & dosagem
Quimioterapia Combinada
Feminino
Filgrastim
Mobilização de Células-Tronco Hematopoéticas/métodos
Seres Humanos
Injeções Subcutâneas
Linfoma não Hodgkin/sangue
Linfoma não Hodgkin/diagnóstico
Masculino
Melfalan/administração & dosagem
Meia-Idade
Podofilotoxina/administração & dosagem
Polietilenoglicóis
Estudos Prospectivos
Proteínas Recombinantes/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Heterocyclic Compounds); 0 (Recombinant Proteins); 04079A1RDZ (Cytarabine); 143011-72-7 (Granulocyte Colony-Stimulating Factor); 155148-31-5 (JM 3100); 30IQX730WE (Polyethylene Glycols); 3A58010674 (pegfilgrastim); L36H50F353 (Podophyllotoxin); PVI5M0M1GW (Filgrastim); Q41OR9510P (Melphalan); U68WG3173Y (Carmustine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170908
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-3123-6


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[PMID]:28668386
[Au] Autor:Chiappella A; Martelli M; Angelucci E; Brusamolino E; Evangelista A; Carella AM; Stelitano C; Rossi G; Balzarotti M; Merli F; Gaidano G; Pavone V; Rigacci L; Zaja F; D'Arco A; Cascavilla N; Russo E; Castellino A; Gotti M; Congiu AG; Cabras MG; Tucci A; Agostinelli C; Ciccone G; Pileri SA; Vitolo U
[Ad] Endereço:Department of Haematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy. Electronic address: achiappella@cittadellasalute.to.it.
[Ti] Título:Rituximab-dose-dense chemotherapy with or without high-dose chemotherapy plus autologous stem-cell transplantation in high-risk diffuse large B-cell lymphoma (DLCL04): final results of a multicentre, open-label, randomised, controlled, phase 3 study.
[So] Source:Lancet Oncol;18(8):1076-1088, 2017 Aug.
[Is] ISSN:1474-5488
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The prognosis of young patients with diffuse large B-cell lymphoma at high risk (age-adjusted International Prognostic Index [aa-IPI] score 2 or 3) treated with R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone) is poor. The aim of this study was to investigate the possible benefit of intensification with high-dose chemotherapy and autologous stem-cell transplantation as part of first-line treatment in these patients. METHODS: We did a multicentre, open-label, randomised, controlled, phase 3 trial with a 2 × 2 factorial design to compare, at two different R-CHOP dose levels, a full course of rituximab-dose-dense chemotherapy (no transplantation group) versus an abbreviated course of rituximab-dose-dense chemotherapy followed by consolidation with R-MAD (rituximab plus high-dose cytarabine plus mitoxantrone plus dexamethasone) and high-dose BEAM chemotherapy (carmustine, etoposide, cytarabine, and melphalan) plus autologous stem-cell transplantation (transplantation group) in young patients (18-65 years) with untreated high-risk diffuse large B-cell lymphoma (aa-IPI score 2-3). At enrolment, patients were stratified according to aa-IPI score and randomly assigned (1:1:1:1) to receive R-CHOP (intravenous rituximab 375 mg/m , cyclophosphamide 750 mg/m , doxorubicin 50 mg/m , and vincristine 1·4 mg/m on day 1, plus oral prednisone 100 mg on days 1-5) delivered in a 14-day cycle (R-CHOP-14) for eight cycles; high-dose R-CHOP-14 (R-MegaCHOP-14; R-CHOP-14 except for cyclophosphamide 1200 mg/m and doxorubicin 70 mg/m ) for six cycles; R-CHOP-14 for four cycles followed by R-MAD (intravenous rituximab 375 mg/m on day 1 or 4 plus intravenous cytarabine 2000 mg/m and dexamethasone 4 mg/m every 12 h on days 1-3 plus intravenous mitoxantrone 8 mg/m on days 1-3) plus BEAM (intravenous carmustine 300 mg/m on day -7, intravenous cytarabine 200 mg/m twice a day on days -6 to -3, intravenous etoposide 100 mg/m twice a day on days -6 to -3, plus intravenous melphalan 140 mg/m on day -2) and autologous stem-cell transplantation (day 0); or R-MegaCHOP-14 for four cycles followed by R-MAD plus BEAM and autologous stem-cell transplantation. The primary endpoint was failure-free survival at 2 years in the intention-to-treat population. This study is registered with EudraCT (2005-002181-14; 2007-000275-42) and with ClinicalTrials.gov, number NCT00499018. FINDINGS: Between Jan 10, 2006, and Sept 8, 2010, 399 patients were randomly assigned to receive transplantation (n=199) or no transplantation (n=200); 203 patients were assigned to receive R-CHOP-14 and 196 were assigned to receive R-MegaCHOP-14. With a median follow-up of 72 months (IQR 57-88), 2-year failure-free survival was 71% (95% CI 64-77) in the transplantation group versus 62% (95% CI 55-68) in the no transplantation group (hazard ratio [HR] 0·65 [95% CI 0·47-0·91]; stratified log-rank test p=0·012). No difference in 5-year overall survival was observed between these groups (78% [95% CI 71-83] versus 77% [71-83]; HR 0·98 [0·65-1·48]; stratified log-rank test p=0·91). Grade 3 or worse haematological adverse events were reported in 183 (92%) of 199 patients in the transplantation group versus 135 (68%) of 200 patients in the no transplantation group. Grade 3 or worse non-haematological adverse events were reported in 90 (45%) versus 31 (16%); the most common grade 3 or worse non-haematological adverse event was gastrointestinal (49 [25%] vs 19 [10%]). Treatment-related deaths occurred in 13 (3%) patients; eight in the transplantation group and five in the no transplantation group. INTERPRETATION: Abbreviated rituximab-dose-dense chemotherapy plus R-MAD plus BEAM and autologous stem-cell transplantation reduced the risk of treatment failure compared with full course rituximab-dose-dense chemotherapy in young patients with diffuse large B-cell lymphoma at high risk. However, these results might not be clinically meaningful, since this improvement did not reflect an improvement in overall survival. These results do not support further consideration of the use of intensification of R-CHOP as an upfront strategy in patients with diffuse large B-cell lymphoma with poor prognosis. FUNDING: Fondazione Italiana Linfomi.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Linfoma Difuso de Grandes Células B/terapia
Rituximab/administração & dosagem
Transplante de Células-Tronco
[Mh] Termos MeSH secundário: Adulto
Anticorpos Monoclonais Murinos/administração & dosagem
Anticorpos Monoclonais Murinos/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Carmustina/administração & dosagem
Quimioterapia de Consolidação
Ciclofosfamida/administração & dosagem
Ciclofosfamida/efeitos adversos
Citarabina/administração & dosagem
Dexametasona/administração & dosagem
Intervalo Livre de Doença
Doxorrubicina/administração & dosagem
Doxorrubicina/efeitos adversos
Etoposídeo/administração & dosagem
Feminino
Seguimentos
Doenças Hematológicas/induzido quimicamente
Seres Humanos
Quimioterapia de Indução
Análise de Intenção de Tratamento
Masculino
Melfalan/administração & dosagem
Meia-Idade
Mitoxantrona/administração & dosagem
Prednisona/administração & dosagem
Prednisona/efeitos adversos
Fatores de Risco
Transplante de Células-Tronco/efeitos adversos
Taxa de Sobrevida
Transplante Autólogo
Vincristina/administração & dosagem
Vincristina/efeitos adversos
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Murine-Derived); 0 (R-CHOP protocol); 04079A1RDZ (Cytarabine); 4F4X42SYQ6 (Rituximab); 5J49Q6B70F (Vincristine); 6PLQ3CP4P3 (Etoposide); 7S5I7G3JQL (Dexamethasone); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); BZ114NVM5P (Mitoxantrone); Q41OR9510P (Melphalan); U68WG3173Y (Carmustine); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170703
[St] Status:MEDLINE


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[PMID]:28522381
[Au] Autor:Illic R; Somma T; Savic D; Frio F; Milicevic M; Solari D; Nikitovic M; Lavrnic S; Raicevic S; Milosevic S; Cavallo LM; Cappabianca P; Grujicic D
[Ad] Endereço:Clinic of Neurosurgery, Clinical Center of Serbia, Medical Faculty University of Belgrade, Belgrade, Serbia.
[Ti] Título:A Survival Analysis with Identification of Prognostic Factors in a Series of 110 Patients with Newly Diagnosed Glioblastoma Before and After Introduction of the Stupp Regimen: A Single-Center Observational Study.
[So] Source:World Neurosurg;104:581-588, 2017 Aug.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Current treatment protocol for glioblastoma multiforme (GBM) is based on maximal safe resection followed by the Stupp protocol. In Serbia, temozolomide was introduced as adjuvant therapy in 2011. The aims of this study were to confirm the safety and efficacy on overall and progression-free survival of the Stupp protocol and evaluate the influence of prognostic factors in one of the largest series of patients with GBM treated over a 2-year period. METHODS: Between January 2010 and December 2012, 110 patients with newly diagnosed GBM underwent surgical removal at the Neurooncology Department of the Clinic Center of Serbia. Patients were divided into 2 groups according to postoperative treatment. Group A (n = 24 patients), treated before January 2011, received adjuvant standard radiation therapy and carmustine (bis-chloroethyl-nitrosourea), and group B (n = 86 patients), treated after January 2011, received postoperative treatment according to the Stupp protocol. RESULTS: The Stupp protocol had a significant favorable impact on overall survival at 1-year follow-up (79.1% in group B vs. 62.5% in group A; P = 0.016); no differences were noted in regard to progression-free survival. Multivariate analysis identified younger age and gross total resection of tumor as positive prognostic factors. CONCLUSIONS: Adoption of the Stupp protocol had a favorable impact on overall, but not on progression-free, survival rate. Wider surgical resection involving the peritumoral brain zone, as confirmed by univariate and multivariate analysis, represents the most favorable prognostic factor.
[Mh] Termos MeSH primário: Neoplasias Encefálicas/mortalidade
Neoplasias Encefálicas/terapia
Carmustina/uso terapêutico
Quimioterapia Adjuvante
Craniotomia
Dacarbazina/análogos & derivados
Glioblastoma/mortalidade
Glioblastoma/terapia
Complicações Pós-Operatórias/mortalidade
Radioterapia Adjuvante
[Mh] Termos MeSH secundário: Adulto
Idoso
Terapia Combinada
Dacarbazina/uso terapêutico
Intervalo Livre de Doença
Feminino
Seguimentos
Seres Humanos
Masculino
Margens de Excisão
Meia-Idade
Análise Multivariada
Prognóstico
Estudos Retrospectivos
Sérvia
Análise de Sobrevida
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
7GR28W0FJI (Dacarbazine); U68WG3173Y (Carmustine); YF1K15M17Y (temozolomide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170520
[St] Status:MEDLINE


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[PMID]:28512049
[Au] Autor:Beez T; Burgula S; Kamp M; Rapp M; Steiger HJ; Sabel M
[Ad] Endereço:Department of Neurosurgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. Electronic address: thomas.beez@med.uni-duesseldorf.de.
[Ti] Título:Space-Occupying Tumor Bed Cysts as a Complication of Modern Treatment for High-Grade Glioma.
[So] Source:World Neurosurg;104:509-515, 2017 Aug.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The management of high-grade glioma (HGG) has been affected by recent landmark trials and is now more proactive. More aggressive treatment leads to hospitalization due to side effects, however. Space-occupying tumor bed cysts have been described, but not systematically assessed. We sought to analyze this complication in a contemporary HGG cohort. METHODS: We performed a retrospective review of patients with HGG treated between 2007 and 2013, identified patients with space-occupying tumor bed cysts, and reviewed their hospital notes for relevant variables. Statistical analyses were performed, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. RESULTS: Tumor bed cysts were found in 12 of 282 patients (4%). The main symptoms were increased intracranial pressure (n = 11), new focal deficits (n = 6), and pseudomeningocele (n = 3), presenting at a median of 19 days since the last resection. Cysts were treated with cystoperitoneal (n = 7) and ventriculoperitoneal (n = 5) shunts, resulting in clinical benefit in 75% of those treated. Intraoperative opening of ventricles is a risk factor, with an OR of 39.339. We propose a classification system comprising 3 cyst types: isolated cyst, cyst with local cerebrospinal fluid (CSF) disturbance, and cyst with global CSF disturbance. CONCLUSIONS: In modern neuro-oncology, the rate of tumor bed cysts complicating HGG management appears stable compared with historical data. Shunt implantation is feasible and effective. We propose a classification system as a common data element for comparison across future studies.
[Mh] Termos MeSH primário: Cistos do Sistema Nervoso Central/patologia
Cistos do Sistema Nervoso Central/cirurgia
Glioma/patologia
Glioma/cirurgia
Neoplasias Supratentoriais/patologia
Neoplasias Supratentoriais/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Edema Encefálico/classificação
Edema Encefálico/diagnóstico
Edema Encefálico/patologia
Edema Encefálico/cirurgia
Carmustina/administração & dosagem
Cistos do Sistema Nervoso Central/classificação
Cistos do Sistema Nervoso Central/diagnóstico
Ventrículos Cerebrais/patologia
Ventrículos Cerebrais/cirurgia
Quimiorradioterapia Adjuvante
Terapia Combinada
Irradiação Craniana
Craniotomia
Feminino
Glioblastoma/classificação
Glioblastoma/diagnóstico
Glioblastoma/patologia
Glioblastoma/cirurgia
Glioma/classificação
Glioma/diagnóstico
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Gradação de Tumores/classificação
Estudos Retrospectivos
Neoplasias Supratentoriais/classificação
Neoplasias Supratentoriais/diagnóstico
Tomografia Computadorizada por Raios X
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
U68WG3173Y (Carmustine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170518
[St] Status:MEDLINE


  8 / 3818 MEDLINE  
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[PMID]:28485023
[Au] Autor:Srour SA; Li S; Popat UR; Qazilbash MH; Lozano-Cerrada S; Maadani F; Alousi A; Kebriaei P; Anderlini P; Nieto Y; Jones R; Shpall E; Champlin RE; Hosing C
[Ad] Endereço:Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer, Houston, TX, USA.
[Ti] Título:A randomized phase II study of standard-dose versus high-dose rituximab with BEAM in autologous stem cell transplantation for relapsed aggressive B-cell non-hodgkin lymphomas: long term results.
[So] Source:Br J Haematol;178(4):561-570, 2017 Aug.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:High-dose rituximab (HD-R) combined with carmustine, cytarabine, etoposide and melphalan (BEAM) and autologous stem cell transplant (ASCT) was effective and tolerable in a single-arm prospective study of relapsed aggressive B-cell non-Hodgkin lymphoma (R-NHL). We performed a randomized phase 2 study comparing HD-R versus standard-dose rituximab (SD-R) in R-NHL. Ninety-three patients were randomized to HD-R (1000 mg/m ) (n = 42) or SD-R (375 mg/m ) (n = 51) administered on post-transplant days +1 and +8, using a Bayesian adaptive algorithm. The 2 treatment arms were balanced in regards to patient demographic and clinical characteristics. At a median follow-up of 7·92 years, the 5-year disease-free survival (DFS) and overall survival (OS) were 40% and 48%, respectively. We found no statistically significant differences between HD-R and SD-R in 5-year DFS (36% vs. 43%; P = 0·205) and OS (43% vs. 52%; P = 0·392). In multivariate analyses, only disease status before ASCT [residual disease versus complete remission (CR)] (hazard ratio [HR] 1·79, 95% confidence interval [CI]: 1·08-2·95) and number of prior treatments received (>2 vs. ≤2 lines of treatment) (HR 1·89, 95% CI: 1·13-3·18) were associated with worse DFS and OS. Patients who had SCT while in CR or who received ≤2 lines of treatment prior to SCT had better 5-year OS (57% vs. 35%; P = 0·02 and 54% vs. 30%, P = 0·001, respectively) in both arms. No differences in engraftments or adverse events were noted in the 2 arms. When combined with BEAM and ASCT in relapsed aggressive B-cell NHL, HD-R provided no DFS or OS advantage over SD-R. In patients who have been exposed to rituximab in the frontline or salvage setting, the addition of rituximab in the peri-transplant setting remains controversial.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Linfoma de Células B/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Carmustina/administração & dosagem
Carmustina/efeitos adversos
Criança
Citarabina/administração & dosagem
Citarabina/efeitos adversos
Relação Dose-Resposta a Droga
Etoposídeo/administração & dosagem
Etoposídeo/efeitos adversos
Feminino
Seguimentos
Sobrevivência de Enxerto
Transplante de Células-Tronco Hematopoéticas
Seres Humanos
Linfoma Difuso de Grandes Células B/tratamento farmacológico
Masculino
Melfalan/administração & dosagem
Melfalan/efeitos adversos
Meia-Idade
Segunda Neoplasia Primária
Recidiva
Rituximab/administração & dosagem
Rituximab/efeitos adversos
Análise de Sobrevida
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
04079A1RDZ (Cytarabine); 4F4X42SYQ6 (Rituximab); 6PLQ3CP4P3 (Etoposide); Q41OR9510P (Melphalan); U68WG3173Y (Carmustine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170510
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.14731


  9 / 3818 MEDLINE  
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[PMID]:28395288
[Au] Autor:Klein J; Juratli TA; Radev Y; Daubner D; Soucek S; Schackert G; Krex D
[Ad] Endereço:Department of Neurosurgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
[Ti] Título:Safety and Effectiveness of Bis-Chloroethylnitrosourea Wafer Chemotherapy in Elderly Patients with Recurrent Glioblastoma.
[So] Source:Oncology;93(1):43-50, 2017.
[Is] ISSN:1423-0232
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the safety and effectiveness of bis-chloroethylnitrosourea (BCNU) wafers in elderly patients with recurrent glioblastoma (GBM). METHODS: Patients with recurrent GBM operated on between 2007 and 2014 were divided into 3 groups: >65 years with BCNU wafer implantation, >65 years without BCNU wafer implantation, and ≤65 years with BCNU wafer implantation. We compared survival and complications. RESULTS: A total of 79 patients were identified: 24 in the older BCNU group (median age 68.2 years, 33.3% with a methylated MGMT promoter), 16 in the older non-BCNU group (median age 68.6 years, 31.3% with a methylated MGMT promoter), and 39 in the younger BCNU group (median age 56.8 years). Survival after progression was 9.2 months in the elderly BCNU group and 7.6 months in the elderly non-BCNU group (p = 0.34); overall survival was 17.2 and 15.9 months, respectively (p = 0.35). We found a tendency toward a higher rate of seizures and pneumonia in the older BCNU group. CONCLUSION: BCNU wafer implantation after resection of recurrent GBM is a reasonably safe treatment in patients aged >65 years. Seizures and systemic infections may occur more frequently, but the trade-off is still favorable as survival may be influenced positively. Higher age should not be regarded as a contraindication for BCNU wafers.
[Mh] Termos MeSH primário: Antineoplásicos Alquilantes/efeitos adversos
Antineoplásicos Alquilantes/uso terapêutico
Neoplasias Encefálicas/tratamento farmacológico
Carmustina/efeitos adversos
Carmustina/uso terapêutico
Glioblastoma/tratamento farmacológico
Recidiva Local de Neoplasia/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Protocolos de Quimioterapia Combinada Antineoplásica
Neoplasias Encefálicas/mortalidade
Neoplasias Encefálicas/patologia
Intervalo Livre de Doença
Feminino
Glioblastoma/mortalidade
Glioblastoma/patologia
Seres Humanos
Masculino
Meia-Idade
Recidiva Local de Neoplasia/mortalidade
Recidiva Local de Neoplasia/patologia
Estudos Retrospectivos
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Alkylating); U68WG3173Y (Carmustine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.1159/000464464


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[PMID]:28319810
[Au] Autor:Azzalin A; Nato G; Parmigiani E; Garello F; Buffo A; Magrassi L
[Ad] Endereço:Neurochirurgia, Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia - Fondazione IRCCS Policlinico S. Matteo, v.le Golgi 19, 27100 Pavia, Italy; Istituto di Genetica Molecolare IGM-CNR, via Abbiategrasso 207, 27100 Pavia, Italy.
[Ti] Título:Inhibitors of GLUT/SLC2A Enhance the Action of BCNU and Temozolomide against High-Grade Gliomas.
[So] Source:Neoplasia;19(4):364-373, 2017 Apr.
[Is] ISSN:1476-5586
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Glucose transport across glioblastoma membranes plays a crucial role in maintaining the enhanced glycolysis typical of high-grade gliomas and glioblastoma. We tested the ability of two inhibitors of the glucose transporters GLUT/SLC2A superfamily, indinavir (IDV) and ritonavir (RTV), and of one inhibitor of the Na/glucose antiporter type 2 (SGLT2/SLC5A2) superfamily, phlorizin (PHZ), in decreasing glucose consumption and cell proliferation of human and murine glioblastoma cells. We found in vitro that RTV, active on at least three different GLUT/SLC2A transporters, was more effective than IDV, a specific inhibitor of GLUT4/SLC2A4, both in decreasing glucose consumption and lactate production and in inhibiting growth of U87MG and Hu197 human glioblastoma cell lines and primary cultures of human glioblastoma. PHZ was inactive on the same cells. Similar results were obtained when cells were grown in adherence or as 3D multicellular tumor spheroids. RTV treatment but not IDV treatment induced AMP-activated protein kinase (AMPKα) phosphorylation that paralleled the decrease in glycolytic activity and cell growth. IDV, but not RTV, induced an increase in GLUT1/SLC2A1 whose activity could compensate for the inhibition of GLUT4/SLC2A4 by IDV. RTV and IDV pass poorly the blood brain barrier and are unlikely to reach sufficient liquoral concentrations in vivo to inhibit glioblastoma growth as single agents. Isobologram analysis of the association of RTV or IDV and 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) or 4-methyl-5-oxo-2,3,4,6,8-pentazabicyclo[4.3.0]nona-2,7,9-triene-9-carboxamide (TMZ) indicated synergy only with RTV on inhibition of glioblastoma cells. Finally, we tested in vivo the combination of RTV and BCNU on established GL261 tumors. This drug combination increased the overall survival and allowed a five-fold reduction in the dose of BCNU.
[Mh] Termos MeSH primário: Antineoplásicos Alquilantes/farmacologia
Carmustina/farmacologia
Dacarbazina/análogos & derivados
Proteínas Facilitadoras de Transporte de Glucose/antagonistas & inibidores
[Mh] Termos MeSH secundário: Animais
Transporte Biológico/efeitos dos fármacos
Linhagem Celular Tumoral
Proliferação Celular/efeitos dos fármacos
Dacarbazina/farmacologia
Modelos Animais de Doenças
Sinergismo Farmacológico
Feminino
Glioma/diagnóstico
Glioma/tratamento farmacológico
Glioma/metabolismo
Glioma/mortalidade
Glucose/metabolismo
Proteínas Facilitadoras de Transporte de Glucose/metabolismo
Seres Humanos
Camundongos
Ensaios Antitumorais Modelo de Xenoenxerto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Alkylating); 0 (Glucose Transport Proteins, Facilitative); 7GR28W0FJI (Dacarbazine); IY9XDZ35W2 (Glucose); U68WG3173Y (Carmustine); YF1K15M17Y (temozolomide)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170321
[St] Status:MEDLINE



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