RESUMO
BACKGROUND: A high cure rate may be attained for locally advanced, undifferentiated nasopharyngeal carcinoma (NPC) in children, provided that a combined modality of treatment is employed. Both local and systemic therapies are necessary. Results at a single pediatric institution were analyzed. METHODS: From November 1988 to December 1997, 16 consecutive patients were treated with NPC at the Hospital Garrahan in Buenos Aires, Argentina. The authors were able to evaluate 11 patients (9 boys and 2 girls); their median age was 12 (range, 8-14) years. Chemotherapy consisted of 3 courses, every 3 weeks, of 5-fluorouracil (500 mg/m(2)) plus bleomycin (15 mg/m(2)) daily for 4 days, with cisplatin (100 mg/m(2)) added the last day. External beam radiotherapy was delivered over a median of 52 (range, 45-63) days, to a median cumulative dose to the primary site of 55 (range, 50-61.2) grays (Gy). The median dose for the lower neck area was 45 (range, 45-55.8) Gy. All patients received radiotherapy to the primary site and to the initially involved lymphoid areas, with daily single doses of 1.8 Gy (5 of 7 days per week). RESULTS: The main symptoms at onset were cervical mass (100%), epistaxis (54%), cephalalgia (36%), and trismus (36%). All cases were Stage IV (American Joint Committee on Cancer and International Union Against Cancer TNM system). Complete response was achieved in 45% of patients after initial chemotherapy. With a median follow-up of 63 (range, 23-119) months, disease free survival (with standard error [SE]) and overall survival estimates were 61% (16%) and 91% (9%), respectively, at 75 months. Acute toxicity due to therapy was tolerable. Chronic sinusitis (73%), hypothyroidism (73%), and mild (64%) or moderate (9%) neck fibrosis were detected at follow-up. CONCLUSIONS: Although this series is small, the authors concluded that NPC patients have a good chance of survival in the setting described, in spite of locally advanced disease. Chemotherapy might be useful in preventing the development of systemic metastases.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/terapia , Neoplasias Nasofaríngeas/terapia , Radioterapia de Alta Energia , Adolescente , Bleomicina/administração & dosagem , Carcinoma/patologia , Carcinoma/virologia , Criança , Cisplatino/administração & dosagem , Terapia Combinada , Feminino , Fluoruracila/administração & dosagem , Herpesvirus Humano 4/isolamento & purificação , Humanos , Masculino , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/virologia , Indução de Remissão , Análise de SobrevidaRESUMO
Foram efetuados estudos histoquimicos em cortes histologicos de paracoccidioidomicose, obtidos de biopsias de lesoes bucais. As pecas foram cortadas com espessura de 6 micrometros. A analise dos resultados obtidos nos leva a seguinte conclusao: 1) O conteudo citoplasmatico nao demonstrou a presenca de glicogenio (homoglicans), mas sim de glicosaminoglicuronoglicans carboxilados e homopoliaminossacarideo. 2) A capsula demonstrou possuir glicosaminoglicuronoglicans sulfatados.3) A quantidade de glicosaminoglicuronoglicans carboxilados na capsula e maior que o sulfatado. 4) Presenca de maior quantidade de homopoliaminossacarideo que o composto descrito anteriormente foi demonstrado pela capsula de paracoccidioides brasiliensis