RESUMO
A produção do (123)I no IEN/CNEN-RJ a partir da reação (124)TeO2(p,2n)(123)I é limitada tanto pelo seu baixa rendimento como pela sua pureza radionuclídica inviabilizando sua expedição para for a do Rio de Janeiro. Com o intuito de se vencer estas limitações é que se decidiu pela implantação da produção de (123)I ultra-puro a partir da reação (124)Xe(p,2n)(123)Cs©(123)Xe©(123)©I, método utilizado pelo FZK com quem se iniciou um intercâmbio para transferência da tecnologia dentro da nossa realidade. Com este método será possível produzir 1,0 Ci/batelada de (123)I ultra-puro.
Assuntos
Telúrio/efeitos da radiação , Oxigênio/efeitos da radiação , Radioisótopos de Césio/efeitos da radiação , Radioisótopos de Xenônio/efeitos da radiação , Radioisótopos do Iodo , Prótons , Brasil , Ciclotrons/instrumentação , Medicina NuclearRESUMO
PURPOSE AND METHODS: Thirty-nine consecutive children (age, 2 to 11 years) with nonlymphoblastic (NL) lymphomas were treated uniformly with chemotherapy based on the LNH-II-85 protocol. The protocol consisted of a remission-induction phase that lasted 30 days and started with cyclophosphamide (CTX) 1.2 g/m2 on day 1, followed by vincristine (VCR) 1.5 mg/m2 on days 3, 10, 17, and 24, daunomycin (DAUNO) 60 mg/m2 on days 12 and 13, and prednisone 40 mg/m2/d for 30 days. If a complete remission was achieved, an intensification regimen was given that consisted of eight courses of teniposide (VM-26) 165 mg/m2 plus cytarabine (ARA-C) 300 mg/m2 every 4 days according to bone marrow tolerance. A continuation phase was subsequently started, with alternating courses of thioguanine (6-TG) 300 mg/m2/d for 4 days plus CTX 1.2 g/m2 on day 5; hydroxyurea 2.5 g/m2/d for 4 days plus DAUNO 45 mg/m2 on day 5; VCR 1.5 mg/m2 plus methotrexate (MTX) 120 mg/m2 (24 hours apart); mercaptopurine (6-MP) 500 mg/m2/d for 4 days plus MTX 40 mg/m2; and VM-26 plus ARA-C for 3 courses (4 days apart), by the end of 48 weeks. CNS prophylaxis consisted of intrathecal administration of MTX, ARA-C, and dexamethasone according to age, administered three times during remission induction and every 6 weeks afterwards. RESULTS: By the end of the analysis in July 1991, 38 of 39 patients had attained a complete remission and 36 were event-free survivors. Two failures that occurred after completion of therapy were second malignancies (acute lymphocytic leukemia and acute nonlymphocytic leukemia). CONCLUSION: These results are significantly better than those obtained with less intensive former regimens performed in our institution before the availability of VM-26. The favorable impact of an intense consolidation phase with VM-26 is remarkably exemplified by three additional patients not included in this study whose families withdrew them from therapy after the intensification phase, all three of whom have been in remission.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma não Hodgkin/tratamento farmacológico , Linfoma de Burkitt/tratamento farmacológico , Linfoma de Burkitt/mortalidade , Criança , Pré-Escolar , Ciclofosfamida/administração & dosagem , Citarabina/administração & dosagem , Daunorrubicina/administração & dosagem , Dexametasona/administração & dosagem , Feminino , Humanos , Linfoma Difuso de Grandes Células B/mortalidade , Linfoma não Hodgkin/mortalidade , Masculino , Mercaptopurina/administração & dosagem , Metotrexato/administração & dosagem , Prednisona/administração & dosagem , Recidiva , Indução de Remissão , Taxa de Sobrevida , Teniposídeo/administração & dosagem , Tioguanina/administração & dosagem , Vincristina/administração & dosagemRESUMO
In 1985 a new treatment regimen for advanced non-Hodgkin's lymphoma was started in the "Instituto da Criança-HC-FMUSP". The final results are remarkably better than those achieved with former programs. Two cases of children who developed a second neoplasm after the therapy was completed are described and discussed.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Leucemia Mielomonocítica Aguda/induzido quimicamente , Segunda Neoplasia Primária/induzido quimicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras/induzido quimicamente , Neoplasias Abdominais/induzido quimicamente , Neoplasias Abdominais/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Linfoma de Burkitt/tratamento farmacológico , Criança , Pré-Escolar , Feminino , HumanosRESUMO
From January 1980 to December 1984, 22 children with non-Hodgkin's lymphoma were admitted to the "Instituto da Criança-HCFMUPS" and according to the LNH-I-80 Protocol including a remission induction phase (Cyclofosfamide day 1, Vincristine days 3, 10, 17, 24, Daunomycin days 12 and 13, Prednisone for 30 days), followed by a continuation phase (Cyclofosfamide x 7 days + Adriamycin day 8 ARA-C x 4 days + Vincristine day 5, Mercaptopurine x 4 days + Methotrexate day 5) alternating three pairs of drugs during 72 weeks. Mercaptopurine and Methotrexate given during additional 48 weeks completes therapy. Twenty-one out of 22 patients attained complete remission. One patient died after widespread infection. Six relapses occurred, five of them in Burkitt's lymphoma patients. Although highly effective in the non-Burkitt's patients, the LNH-I-80 Protocol failed in keeping Burkitt's patients in event free survival.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma não Hodgkin/tratamento farmacológico , Adolescente , Criança , Pré-Escolar , Ciclofosfamida/administração & dosagem , Daunorrubicina/administração & dosagem , Feminino , Humanos , Linfoma não Hodgkin/patologia , Masculino , Estadiamento de Neoplasias , Prednisona/administração & dosagem , Indução de Remissão , Resultado do Tratamento , Vincristina/administração & dosagemRESUMO
A case of multicentric synchronous osteosarcoma occurring in a 9 year old girl is reported. Some particular features of this rare disease namely its rapid progression despite intensive drug therapy is stressed. Current hypothesis for the occurrence of this unusual form of neoplasm are here discussed.
Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Osteossarcoma/diagnóstico por imagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/patologia , Criança , Cisplatino/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Humanos , Osteossarcoma/tratamento farmacológico , Osteossarcoma/patologia , CintilografiaRESUMO
In the recent few years the treatment of the stages I and II of non-Hodgkin lymphomas with the simultaneous use of several drugs showed improvement of results. In the period between 1977 and 1992 three consecutive chemotherapy programs have been developed in the "Instituto da Criança-HC-FMUSP". Between 1977 and 1980 five patients belonging to stage II were treated according to the LSA 2 L-Protocol; complete remission was attained in all of them and three patients have been kept in remission so far. In 1980-1984 period a new regimen (Protocol-I-80) was instituted using the same remission induction strategy as before adding a consolidation with Cyclo and Adria combination and a continuation phase with 6-MP+MTX; five out of six patients have survived free of events till now. In the 1984-1992 period a new protocol was designed (VM-26+ARA-C) replacing Cyclo+Adria. Five patients were included and all of them are disease free survivors.