RESUMO
Cancer is an infrequent disease in childhood. However, it is responsible for 13.06% of child deaths between 1 and 14 years in Cuba. The aim of our work was to describe the incidence of childhood cancer in the period 1986 to 1990 using data reported to the National Cancer Registry (NCR) of Cuba. All cancer cases between 0 and 14 years of age reported to the NCR in the period 1986 to 1990, were included. The cases were classified histologically, by age and gender. Average age-specific and age-standardized rates were calculated; 1428 children were registered, an average of 286 each year, with a mean annual rate of 117.8 per million. The world-population standardized rate was 120.7 and the male-to-female ratio was 0.98. Leukaemias, lymphomas and malignant tumours of the central nervous system were the most common childhood neoplasm groups. The majority of leukaemias were acute lymphoblastic leukaemias (ALL), and the incidence peak extended until 6 years of age. The first peak of incidence of Hodgkin's disease is found in older age-groups. Burkitt's lymphoma showed a male-to-female ratio of 0.44. Most of the hepatic tumours were carcinomas, and only one fourth were hepatoblastomas. In bone tumours, similar rates were observed for osteosarcomas and Ewing's sarcoma.
Assuntos
Neoplasias/epidemiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Cuba/epidemiologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , MasculinoRESUMO
PURPOSE: To analyse the results of the therapy administered to children with ALL in Cuba. PATIENTS AND METHODS: Four-hundred and twenty-five children (aged below 15 years), diagnosed of ALL in 8 different Cuban hospitals between 1973 and 1991, were evaluated. Five different therapeutic regimes were used: three "classic" GLATHEM protocols in the first period (1973-1981) and two intensive BFM-like protocols in the second period (1982-1991). The Kaplan-Meier method was applied for survival analysis, and the differences were evaluated by the log-rank and Mantel-Cox methods. RESULTS: Two-hundred and sixty-five patients were included in the first period, 81 with low-risk disease, 133 with standard risk and 51 with poor-risk leukaemia. The second period comprised 160 cases, 50 of low-risk, 83 with standard risk and 27 with poor-risk leukaemia. The disease-free survival probability at 60 months was 35% for the first group and 55% for the second (p < 0.0001). The 60-month survival (SV) as a whole was 45% for the "classic" treatments and 60% for the BFM-like protocols (p < 0.01). The disease-free survival (DFS) probability for each prognostic group was as follows: 50% for low-risk, 43% for standard risk, and 25% for poor-risk (p < 0.001) and the probability of survival as a whole was, respectively, 65%, 49% and 28% (p < 0.001). as for this compilation, 172 patients were out of any treatment for periods ranging between 14 and 168 months. CONCLUSIONS: 1) The percentage of remissions was similar for both groups of treatments. 2) The results attained with BFM-like protocols were better than those of the "classic" therapy with regard to the SV and DFS differences. 3) Significant differences can be appreciated between good- and poor-prognosis groups for both types of treatment.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Adolescente , Criança , Pré-Escolar , Cuba , Feminino , Humanos , Lactente , Tábuas de Vida , Masculino , Indução de Remissão , Análise de Sobrevida , Resultado do TratamentoRESUMO
Las úlceras cutáneas producidas por las radiaciones ionizantes o por extravasación de citostáticos, son una complicación frecuente en el tratamiento de los pacientes con neoplasias malignas. Estas lesiones son frecuentemente difíciles de tratar e introducen morbilidad adicional y deterioro de la calidad de vida. En este trabajo presentamos las primeras evidencias clínicas del efecto cicatrizante del factor de crecimiento epidérmico en úlceras cutáneas. Se trataron ocho pacientes(dos con úlceras radiógenas, cinco con úlceras por extravasación de citostáticos y uno con úlcera varicosa) mediante aplicación tópica dos veces al día, de una crema de factor de crecimiento epidérmico (EGF, 10*g/g en crema de sulfadiazina de plata al 1 %). Los dos pacientes con úlcera radiógena de larga evolución cicatrizaron 100 % y 70 % respectivamente. Igualmente, tres pacientes con úlceras por extravasación de epiadriamicina y mostaza nitrogenada tuvieron una respuesta parcial. En otros dos pacientes se pudo detectar precozmente la ulceración por extravasación de vincristina y en estos se logró una re-epitelización completa. La paciente tratada de úlcera varicosa crónica también logró una cicatrización completa en tres meses de tratamiento. Estos resultados constituyen el primer reporte de tratamiento de las úlceras cutáneas en pacientes oncológicos, empleando el factor de crecimiento epidérmico. Esta nueva modalidad puede tener importancia práctica en el tratamiento de tales complicaciones
Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Administração Tópica , Fator de Crescimento Epidérmico/uso terapêutico , Úlcera Cutânea/tratamento farmacológicoRESUMO
La radioterapia es una de las modalidades terapéuticas más empleadas en las neoplasias malignas. Una de las complicaciones más frecuentes es la radiodermitis, que obliga frecuentemente a interrumpir el tratamiento. En este trabajo presentamos una evaluación del efecto del factor de crecimiento epidérmico (EGF) en la prevención de la radiodermitis. Se incluyeron 59 pacientes con diagnóstico histològico de carcinoma de piel, los cuales recibieron 2 Gy diarios de roentgenterapia superficial (80 kV) hasta completar 60 Gy. Los pacientes fueron asignados, al azar, a tres grupos: el primer grupo recibió aplicación tópica del EGF (10 *g/g en crema de sulfadiazina de plata al 1 %) en el área irradiada, dos veces al día durante todo el tiempo de tratamiento; el segundo recibió aplicaciones de la crema de sulfadiazina de plata sin EGF y el tercer grupo no recibió tratamiento local. El porcentaje de aparición de radiodermitis fue de 4 %, 41 % y 64 % en los tres grupos, respectivamente. La diferencia en la frecuencia de aparición de radiodermitis entre el grupo tratado con EGF y los restantes fue estadísticamente significativa (p<0,001). Otro grupo de pacientes -en este caso cinco niños que recibieron radioterapia sobre ojo y órbita-, fue tratado con colirio de kanamicina que contenía, además, EGF humano recombinante (10 *g/ml), aplicando 2 gotas cada 4-6 horas durante todo el período de tratamiento. Solamente uno de estos pacientes presentó conjuntivitis radiógena ligera, a una dosis acumulada de radiaciones de 50 Gy, lo cual se compara favorablemente con la experiencia histórica en que la mayoría de estos pacientes padecen conjuntivitis radiógena. Estos resultados constituyen la primera evidencia clínica de efecto radioprotector del EGF humano recombinante, en la piel y en el epitelio ocular, lo cual tiene importancia práctica en el tratamiento radiante de los tumores malignos
Assuntos
Lactente , Pré-Escolar , Criança , Humanos , Conjuntivite/tratamento farmacológico , Fator de Crescimento Epidérmico/uso terapêutico , Lesões por Radiação/tratamento farmacológico , Radiodermite/tratamento farmacológicoRESUMO
Soft-tissue sarcomas arising in parameningeal sites are characterized by the potential of a direct meningeal invasion. In order to improve survival rates, we started a treatment program which included whole cranial irradiation with a dose of 24-30 Gy and primary tumor irradiation with 55-65 Gy, and polychemotherapy with vincristine, actinomycin D and cyclophosphamide, and, in some cases, adriamycin. Results in a series of 9 children treated by this program were compared with a historical group of 12 children without cranial irradiation. In the group with extended irradiation to brain, survival was 40%, stabilized at the 13th month of treatment, and 38.1%, respectively, if orbitary tumors were excluded. In the historical group these values were only 20.83% and 15.67%, respectively. The differences were statistically significant.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Meníngeas/radioterapia , Sarcoma/radioterapia , Neoplasias de Tecidos Moles/radioterapia , Criança , Pré-Escolar , Terapia Combinada , Ciclofosfamida/administração & dosagem , Dactinomicina/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Seguimentos , Humanos , Masculino , Neoplasias Meníngeas/tratamento farmacológico , Sarcoma/tratamento farmacológico , Neoplasias de Tecidos Moles/tratamento farmacológico , Vincristina/administração & dosagemRESUMO
Results obtained in 50 children with abdominal non-Hodgkin's lymphoma after a treatment program that comprised entire abdominal irradiation and chemotherapy are presented. Actuarial survival of the series at 3, 5 and 10 years is 65.8%, with 75.2% for patients in Stage II and 58.6% in Stage III. Patients in 5-9-year age group, or in Stage II comported with a better prognosis, with significant differences. Majority of deaths occurred during the first 6 months with stabilization of survival after the second year of treatment.
Assuntos
Neoplasias Abdominais/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma/tratamento farmacológico , Neoplasias Abdominais/mortalidade , Neoplasias Abdominais/radioterapia , Análise Atuarial , Adolescente , Criança , Pré-Escolar , Terapia Combinada , Cuba , Esquema de Medicação , Feminino , Humanos , Lactente , Laparotomia , Linfoma/mortalidade , Linfoma/radioterapia , Masculino , Estadiamento de NeoplasiasRESUMO
Tumors of the nervous system are the third most common malignant disease in Cuban children, after leukemia and lymphoma. In 138 patients with the diagnosis of brain tumor results of treatment by surgery and radiation were studied. The survival rate at 1, 3 and 5 years was 50, 40 and 37.6%. The best results were achieved in astrocytomas, mid grain and brain stem tumors and oligodendrogliomas.
Assuntos
Neoplasias Encefálicas/radioterapia , Astrocitoma/radioterapia , Neoplasias Encefálicas/cirurgia , Tronco Encefálico , Neoplasias Cerebelares/radioterapia , Criança , Craniofaringioma/radioterapia , Cuba , Ependimoma/radioterapia , Glioblastoma/radioterapia , Humanos , Meduloblastoma/radioterapia , Mesencéfalo , Neoplasias Hipofisárias/radioterapia , PrognósticoRESUMO
The incidence of malignant tumors in children is not as high as that in adults, though in Cuba and other countries they are the most frequent causes of death in this age group. Data of the fourth triennial of the Registro Nacional del Cáncer (Cuban Cancer Registry) in the period 1973-1975 are presented. In the age group 0-14 years, 1038 new cases were diagnosed and registered; this figure represented 2.5% of the total of tumors in the period studied; the mean annual rate was 11.3% per 100 000 population. Male patients were more frequently affected. Morbidity decreased in 0-4 year group and increased in 10-14 year group. As in the first, second and third triennials, malignant diseases as leukemia, lymphoma and tumors of the nervous system prevailed among children: these accounted for a little more than 2/3 of the total of tumors followed by tumors of the kidney and eye.