RESUMO
Despite remarkable advances in the knowledge of molecular biology and treatment, ovarian cancer remains the leading cause of death from gynecologic cancer. In the last decade, there have been important advances both in systemic and surgical treatment. However, there is no doubt that the incorporation of PARP inhibitors as maintenance after the response to platinum-based chemotherapy, first in recurrent disease and recently also in first line, will change the natural history of the disease.The objective of this guide is to summarize the current evidence for the diagnosis, treatment, and follow-up of ovarian cancer, and to provide evidence-based recommendations for clinical practice.
Assuntos
Carcinoma Epitelial do Ovário/diagnóstico , Carcinoma Epitelial do Ovário/terapia , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/terapia , Antineoplásicos Imunológicos/uso terapêutico , Bevacizumab/uso terapêutico , Carcinoma Epitelial do Ovário/patologia , Quimioterapia Adjuvante/métodos , Ensaios Clínicos Fase III como Assunto , Procedimentos Cirúrgicos de Citorredução/métodos , Feminino , Humanos , Quimioterapia de Manutenção/métodos , Oncologia , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias/métodos , Neoplasias Ovarianas/patologia , Inibidores de Poli(ADP-Ribose) Polimerases/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Sociedades Médicas , EspanhaRESUMO
Breast cancer is the most common cancer in women in our country and it is usually diagnosed in the early and potentially curable stages. Nevertheless, around 20-30% of patients will relapse despite appropriate locoregional and systemic therapies. A better knowledge of this disease is improving our ability to select the most appropriate therapy for each patient with a recent diagnosis of an early stage breast cancer, minimizing unnecessary toxicities and improving long-term efficacy.
Assuntos
Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Guias de Prática Clínica como Assunto/normas , Ensaios Clínicos como Assunto , Terapia Combinada , Gerenciamento Clínico , Detecção Precoce de Câncer , Feminino , Humanos , Prognóstico , Sociedades MédicasRESUMO
Fungi of yield soils represent a significant portion of the microbial biomass and reflect sensitivity to changes in the ecosystem. Our hypothesis was that crops included in cropping regimes under the zero tillage system modify the structure of the soil fungi community. Conventional and molecular techniques provide complementary information for the analysis of diversity of fungal species and successful information to accept our hypothesis. The composition of the fungal community varied according to different crops included in the cropping regimes. However, we detected other factors as sources of variation among them, season and sampling depth. The mixed cropping regimes including perennial pastures and one crop per year promote fungal diversity and species with potential benefit to soil and crop. The winter season and 0-5 cm depth gave the largest evenness and fungal diversity. Trichoderma aureoviride and Rhizopus stolonifer could be used for monitoring changes in soil under zero tillage.
Assuntos
Produção Agrícola/métodos , Fungos/isolamento & purificação , Microbiologia do Solo , Biodiversidade , Biomassa , Produtos Agrícolas/crescimento & desenvolvimento , Produtos Agrícolas/microbiologia , Ecossistema , Fungos/classificação , Fungos/genética , Fungos/crescimento & desenvolvimento , Solo/químicaRESUMO
BACKGROUND: Efficacy and safety data for combining bevacizumab, gemcitabine, and paclitaxel for locally advanced/metastatic breast cancer are limited. PATIENTS AND METHODS: AVALUZ trial evaluates the combination of bevacizumab 10 mg/kg, gemcitabine 2,000 mg/m(2) plus paclitaxel 150 mg/m(2), on days 1 and 15 of each 28-day course in previously untreated HER-2 negative patients. RESULTS: Median progression-free survival (PES): 12.3 months. The overall response and clinical benefit rate (CR + PR + SD) were 72 % (95 % CI 60.9-82.0 %) and 89 % (95 % CI 80.3-95.3 %), respectively. Median overall survival: 27.4 mo. Baseline circulating tumor cell (CTCs) ≥2 versus CTCs <2 was associated with lower PFS, p = 0.046. Overall response was significantly greater in patients with intense angiotensin type 1 receptor (AGTR1) expression (99 vs. 60 % [p = 0.021]). The most frequent grade 3/4 adverse events were: neutropenia (10 %); febrile neutropenia (1 %); sensory neuropathy (13 %); and asthenia (6 %). Grade 3 adverse events of interest with bevacizumab included bleeding (1 %) and hypertension (4 %). One patient developed cardiac ischemia (1 %). CONCLUSIONS: Adding bevacizumab to chemotherapy appeared feasible and well tolerated, producing toxicity comparable to other effective combined first-line regimens. Baseline circulating endothelial cells and AGTR1 expression are predictive of PFS and response.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Células Neoplásicas Circulantes/patologia , Receptor Tipo 1 de Angiotensina/metabolismo , Receptor ErbB-2/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados/administração & dosagem , Bevacizumab , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Paclitaxel/administração & dosagem , Prognóstico , Taxa de Sobrevida , Pesquisa Translacional Biomédica , GencitabinaRESUMO
PURPOSE: Metronomic administration of the same chemotherapy agents (lower doses with closer intervals) may optimize their antiangiogenic properties. The aim of our study was to determine the efficacy and safety of a metronomic regimen based in non-pegylated liposomal doxorubicin (NPLD) in advanced breast cancer patients. METHODS: Clinical records of patients with pretreated advanced breast cancer and who were treated with the Metronomic-Cooper-type regimen consisting of weekly fixed doses of NPLD (30 mg IV) plus 5-Fluorouracil (5-FU) (500 mg IV) plus vincristine (0.25 mg IV) and daily oral cyclophosphamide (50 mg) plus prednisone (20 mg) were reviewed. RESULTS: In 84 pretreated patients, a tumor response was observed in 38 patients (45 %); stable disease was observed in 23 patients (27 %). Median progression-free survival (PFS) time to progression was 8.4 months and median overall survival (OS) was 21 months. The most common grade 2-3 hematologic adverse event was neutropenia, which was observed in 47 patients (56 %). Febrile neutropenia was observed in 10 patients (12 %). The most common non-hematologic adverse events were asthenia and mucositis which were observed in 60 patients (71 %) and 26 patients (31 %), respectively. Three patients (4 %) experienced an asymptomatic decline of the left ventricular ejection fraction. CONCLUSIONS: NPLD-based metronomic regimen was effective and safe in pretreated advanced breast cancer patients. It could be considered as an appealing option to treat patients previously exposed to anthracyclines.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Adulto , Idoso , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Doxorrubicina/análogos & derivados , Feminino , Fluoruracila/administração & dosagem , Seguimentos , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Metástase Neoplásica , Polietilenoglicóis/administração & dosagem , Prednisona/administração & dosagem , Prognóstico , Estudos Retrospectivos , Segurança , Taxa de Sobrevida , Vincristina/administração & dosagemRESUMO
OBJECTIVE: To present a rare case of well-differentiated mucus-producing adenocarcinoma of the renal pelvis. METHODS: Patient history, the results of the complementary tests after surgery, treatment and anatomopathological findings are presented. RESULTS/CONCLUSIONS: Well-differentiated mucus-producing adenocarcinoma of the renal pelvis is rare and is often associated with lithiasis, a long history of obstruction and inflammation. Nests of tumor cells surrounded by abundant mucus is a characteristic histological finding in this tumor type.
Assuntos
Adenocarcinoma Mucinoso/patologia , Neoplasias Renais/patologia , Adenocarcinoma Mucinoso/complicações , Adulto , Feminino , Humanos , Cálculos Renais/terapia , Neoplasias Renais/complicações , Gravidez , Complicações na Gravidez/terapiaRESUMO
OBJECTIVE: To report a case of renal parenchymal neurilemoma and review the literature. METHODS/RESULTS: A 44-year-old male patient presented with total hematuria. Patient evaluation by IVP, renal US and CT revealed a right renal mass. Radical nephrectomy was decided. The anatomopathòlogical analysis showed a renal parenchymal neurilemoma. CONCLUSIONS: Renal parenchymal neurilemoma is a rare benign tumor. The diagnosis is based on the clinical symptoms and the IVP, renal US and CT findings and confirmed by the anatomopathological findings. Surgical resection achieves cure and there is usually no recurrence.
Assuntos
Neoplasias Renais/patologia , Neurilemoma/patologia , Adulto , Carcinoma de Células Renais/diagnóstico , Diagnóstico Diferencial , Hematúria/etiologia , Humanos , Neoplasias Renais/complicações , Neoplasias Renais/diagnóstico , Neoplasias Renais/cirurgia , Masculino , Nefrectomia , Neurilemoma/complicações , Neurilemoma/diagnóstico , Neurilemoma/cirurgiaRESUMO
OBJECTIVES: A case of renal angiomyolipoma in a boy is described. The rarity of this condition prompted us to report on the present case. The problems encountered in making the differential diagnosis are discussed. METHODS/RESULTS: The clinical history of the patient with renal angiomyolipoma is presented. CONCLUSIONS: Renal angiomyolipoma is extremely rare in children.
Assuntos
Angiomiolipoma/patologia , Neoplasias Renais/patologia , Biópsia , Criança , Humanos , Rim/patologia , MasculinoRESUMO
We report on a 52-year-old patient who presented with a right-sided tumor mass of the spermatic cord. We describe the operative and biopsy procedures and present our conclusions.