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1.
Front Genet ; 12: 670390, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34646296

RESUMO

The genomes of crossbred (admixed) individuals are a mosaic of ancestral haplotypes formed by recombination in each generation. The proportion of these ancestral haplotypes in certain genomic regions can be responsible for either susceptibility or tolerance against pathogens, and for performances in production traits. Using a medium-density genomic marker panel from the Illumina Bovine SNP50 BeadChip, we estimated individual admixture proportions for Baoulé x Zebu crossbred cattle in Burkina Faso, which were tested for trypanosome infection by direct ELISA from blood samples. Furthermore, we calculated local ancestry deviation from average for each SNP across 29 autosomes to identify potential regions under selection in the trypanotolerant Baoulé cattle and their crossbreds. We identified significant deviation from the local average ancestry (above 5 and 10% genome-wide thresholds) on chromosomes 8 and 19 in the positive animals, while the negative ones showed higher deviation on chromosomes 6, 19, 21, and 22. Some candidate genes on chromosome 6 (PDGFRA) and chromosome 19 (CDC6) have been found associated to trypanotolerance in West African taurines. Screening for F ST outliers in trypanosome positive/negative animals we detected seven variants putatively under selection. Finally, we identified a minimum set of highly ancestry informative markers for routine admixture testing. The results of this study contribute to a better understanding of the genetic basis of trypanotolerance in Baoulé cattle and their crossbreeds. Furthermore, we provide a small informative marker set to monitor admixture in this valuable indigenous breed. As such, our results are important for conserving the genetic uniqueness and trypanotolerance of Baoulé cattle, as well as for the improvement of Baoulé and Zebu crossbreds in specific community-based breeding programs.

2.
PLoS One ; 16(8): e0255089, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34351956

RESUMO

In this study, single-SNP GWAS analyses were conducted to find regions affecting tolerance against trypanosomosis and morphometrics traits in purebred and crossbred Baoulé cattle of Burkina Faso. The trypanosomosis status (positive and negative) and a wide set of morphological traits were recorded for purebred Baoulé and crossbred Zebu x Baoulé cattle, and genotyped with the Illumina Bovine SNP50 BeadChip. After quality control, 36,203 SNPs and 619 animals including 343 purebred Baoulé and 279 crossbreds were used for the GWAS analyses. Several important genes were found that can influence morphological parameters. Although there were no genes identified with a reported strong connection to size traits, many of them were previously identified in various growth-related studies. A re-occurring theme for the genes residing in the regions identified by the most significant SNPs was pleiotropic effect on growth of the body and the cardiovascular system. Regarding trypanosomosis tolerance, two potentially important regions were identified in purebred Baoulé on chromosomes 16 and 24, containing the CFH, CRBN, TRNT1 and, IL5RA genes, and one additional genomic region in Baoulé, x Zebu crossbreds on chromosome 5, containing MGAT4C and NTS. Almost all of these regions and genes were previously related to the trait of interest, while the CRBN gene was to our knowledge presented in the context of trypanosomiasis tolerance for the first time.


Assuntos
Cruzamento , Bovinos/anatomia & histologia , Bovinos/parasitologia , Estudo de Associação Genômica Ampla , Trypanosoma/fisiologia , Animais , Burkina Faso , Bovinos/genética , Cromossomos de Mamíferos/genética , Polimorfismo de Nucleotídeo Único/genética , Prevalência
3.
Bull Soc Pathol Exot ; 113(1): 17-23, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32881447

RESUMO

This study aims to evaluate the therapeutic efficacy and tolerance of two ACTs widely used for the treatment of uncomplicated malaria due to Plasmodium falciparum in Niger. The study was conducted from September to November 2017, at the Integrated Health Centers of Dogondoutchi and Birni N'Gaouré, in patients aged from 6 months to 15 years, with uncomplicated malaria due to Plasmodium falciparum. They were treated with either Artemether-Lumefantrine (AL) or Artesunate-Amodiaquine (ASAQ). The primary endpoint was the appropriate clinical and parasitological response (RCPA) to D28, after PCR correction. The secondary criteria were the clearing time of fever, parasites, and gametocytes and then the occurrence of adverse events. A total of 459 patients were examined, of whom 312 patients met the inclusion criteria for therapeutic efficacy evaluation. We have followed 299 patients up to J28 including 146 in the AL arm and 153 in the ASAQ arm. After PCR correction at J28, RCPA were 95.8% and 96% (P = 0.7185) for arms AL and ASAQ, respectively, compared to 93.1% and 94.1% respectively before PCR correction (P = 0.7892). The number of patients on AL and ASAQ treatment who developed an adverse reaction were 6 (7.6%) and 23 (28%) respectively. AL and ASAQ associations are effective and well tolerated. No serious adverse event was noted. However, their monitoring must continue to detect possible resistance.


Cette étude vise à évaluer l'efficacité thérapeutique et la tolérance de deux combinaisons thérapeutiques à base d'artémisinine (CTA), largement utilisées pour le traitement du paludisme non compliqué à Plasmodium falciparum au Niger. L'étude a été conduite de septembre à novembre 2017, au niveau des centres de santé intégrée (CSI) de Dogondoutchi et de Birni N'Gaouré, chez des patients âgés de 6 mois à 15 ans, atteints de paludisme non compliqué. Ils ont été traités par l'artéméther-luméfantrine (AL) ou l'artésunate­amodiaquine (ASAQ). Le critère de jugement principal était la réponse clinique et parasitologique adéquate (RCPA) à j28, après correction PCR. Les critères secondaires étaient le temps de clairance de la fièvre, des parasites et des gamétocytes puis la survenue des événements indésirables. Au total, 459 patients ont été examinés : 312 patients répondaient aux critères d'inclusion, 299 patients ont été suivis jusqu'à j28 dont 146 dans le bras AL, 153 dans le bras ASAQ. Les RCPA après correction PCR à j28 étaient de 95,8 et 96 % (p = 0,7185) respectivement pour AL et ASAQ alors qu'elles étaient respectivement de 93,1 et 94,1 % avant correction PCR (p = 0,7892). Le nombre de patients sous traitement AL et ASAQ ayant développé une réaction indésirable sont respectivement de 6, soit 7,6 %, et 23, soit 28 %. Les associations AL et ASAQ sont efficaces et bien tolérées, la première étant mieux tolérée. Aucun événement indésirable grave n'a été noté. Cependant, la surveillance des effets indésirables et de l'efficacité doit se poursuivre.Cette étude vise à évaluer l'efficacité thérapeutique et la tolérance de deux combinaisons thérapeutiques à base d'artémisinine (CTA), largement utilisées pour le traitement du paludisme non compliqué à Plasmodium falciparum au Niger. L'étude a été conduite de septembre à novembre 2017, au niveau des centres de santé intégrée (CSI) de Dogondoutchi et de Birni N'Gaouré, chez des patients âgés de 6 mois à 15 ans, atteints de paludisme non compliqué. Ils ont été traités par l'artéméther-luméfantrine (AL) ou l'artésunate­amodiaquine (ASAQ). Le critère de jugement principal était la réponse clinique et parasitologique adéquate (RCPA) à j28, après correction PCR. Les critères secondaires étaient le temps de clairance de la fièvre, des parasites et des gamétocytes puis la survenue des événements indésirables. Au total, 459 patients ont été examinés : 312 patients répondaient aux critères d'inclusion, 299 patients ont été suivis jusqu'à j28 dont 146 dans le bras AL, 153 dans le bras ASAQ. Les RCPA après correction PCR à j28 étaient de 95,8 et 96 % (p = 0,7185) respectivement pour AL et ASAQ alors qu'elles étaient respectivement de 93,1 et 94,1 % avant correction PCR (p = 0,7892). Le nombre de patients sous traitement AL et ASAQ ayant développé une réaction indésirable sont respectivement de 6, soit 7,6 %, et 23, soit 28 %. Les associations AL et ASAQ sont efficaces et bien tolérées, la première étant mieux tolérée. Aucun événement indésirable grave n'a été noté. Cependant, la surveillance des effets indésirables et de l'efficacité doit se poursuivre.


Assuntos
Amodiaquina/uso terapêutico , Antimaláricos/uso terapêutico , Combinação Arteméter e Lumefantrina/uso terapêutico , Artemisininas/uso terapêutico , Malária Falciparum/tratamento farmacológico , Adolescente , Amodiaquina/efeitos adversos , Antimaláricos/efeitos adversos , Combinação Arteméter e Lumefantrina/efeitos adversos , Artemisininas/efeitos adversos , Criança , Pré-Escolar , Combinação de Medicamentos , Feminino , Humanos , Lactente , Masculino , Níger , Resultado do Tratamento
4.
Parasite ; 24: 44, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29173278

RESUMO

Gastrointestinal nematodes are a major threat to small ruminant rearing in the Sahel area, where farmers traditionally use bioactive plants to control these worms, including Acacia nilotica and Acacia raddiana. The main aim of this study was to screen the potential anthelmintic properties of aqueous and acetone extracts of leaves of these two plants based on three in vitro assays: (1) the egg hatch inhibition assay (EHA); (2) the larvae exsheathment inhibition assay (LEIA) using Haemonchus contortus as a model; and (3) an adult mortality test (AMT) applied on Caenorhabditis elegans. For the EHA, only A. raddiana was effective with IC50 = 1.58 mg/mL for aqueous extract, and IC50 = 0.58 mg/mL for acetonic extract. For the LEIA, all extracts inhibited the exsheathment of larvae compared to the controls, and the aqueous extract of A. nilotica was more larvicidal with IC50 = 0.195 mg/mL. In general, all responses to the substances were dose-dependent and were significantly different from the control group (p < 0.05). For the AMT, the extracts of the two Acacia species were effective but A. raddiana showed greater efficacy with 100% mortality at 2.5 mg/mL and LC50 = 0.84 mg/mL (acetonic extract). The addition of polyvinyl polypyrrolidone (PVPP) to the extracts suggested that tannins were responsible for blocking egg eclosion and inducing adult mortality but were not responsible for exsheathment inhibition. These results suggest that the leaves of these Acacia species possess ovicidal and larvicidal activities in vitro against H. contortus, and adulticidal effects against C. elegans.


Assuntos
Acacia/química , Anti-Helmínticos/farmacologia , Doenças das Cabras/tratamento farmacológico , Helmintíase Animal/tratamento farmacológico , Fitoterapia/veterinária , Extratos Vegetais/farmacologia , Animais , Anti-Helmínticos/isolamento & purificação , Caenorhabditis elegans/efeitos dos fármacos , Fezes/parasitologia , Doenças das Cabras/parasitologia , Cabras , Hemoncose/tratamento farmacológico , Hemoncose/veterinária , Haemonchus/efeitos dos fármacos , Concentração Inibidora 50 , Larva/efeitos dos fármacos , Dose Letal Mediana , Óvulo/efeitos dos fármacos , Extratos Vegetais/isolamento & purificação , Polifenóis/análise , Povidona/análogos & derivados , Povidona/farmacologia , Proantocianidinas/análise , Proantocianidinas/farmacologia , Taninos/análise , Taninos/farmacologia
5.
BMC Genet ; 13: 35, 2012 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-22564289

RESUMO

BACKGROUND: Introgression of Sahel livestock genes southwards in West Africa may be favoured by human activity and the increase of the duration of the dry seasons since the 1970's. The aim of this study is to assess the gene flow patterns in Burkina Faso goat and to ascertain the most likely factors influencing geographic patterns of genetic variation in the Burkina Faso goat population. RESULTS: A total of 520 goat were sampled in 23 different locations of Burkina Faso and genotyped for a set of 19 microsatellites. Data deposited in the Dryad repository: http://dx.doi.org/10.5061/dryad.41h46j37. Although overall differentiation is poor (FST = 0.067 ± 0.003), the goat population of Burkina Faso is far from being homogeneous. Barrier analysis pointed out the existence of: a) genetic discontinuities in the Central and Southeast Burkina Faso; and b) genetic differences within the goat sampled in the Sahel or the Sudan areas of Burkina Faso. Principal component analysis and admixture proportion scores were computed for each population sampled and used to construct interpolation maps. Furthermore, Population Graph analysis revealed that the Sahel and the Sudan environmental areas of Burkina Faso were connected through a significant number of extended edges, which would be consistent with the hypothesis of long-distance dispersal. Genetic variation of Burkina Faso goat followed a geographic-related pattern. This pattern of variation is likely to be related to the presence of vectors of African animal trypanosomosis. Partial Mantel test identified the present Northern limit of trypanosome vectors as the most significant landscape boundary influencing the genetic variability of Burkina Faso goat (p = 0.008). The contribution of Sahel goat genes to the goat populations in the Northern and Eastern parts of the Sudan-Sahel area of Burkina Faso was substantial. The presence of perennial streams explains the existence of trypanosome vectors. The South half of the Nakambé river (Southern Ouagadougou) and the Mouhoun river loop determined, respectively, the Eastern and Northern limits for the expansion of Sahelian goat genes. Furthermore, results from partial Mantel test suggest that the introgression of Sahelian goat genes into Djallonké goat using human-influenced genetic corridors has a limited influence when compared to the biological boundary defined by the northern limits for the distribution of the tsetse fly. However, the genetic differences found between the goat sampled in Bobo Dioulasso and the other populations located in the Sudan area of Burkina Faso may be explained by the broad goat trade favoured by the main road of the country. CONCLUSIONS: The current analysis clearly suggests that genetic variation in Burkina Faso goat: a) follows a North to South clinal; and b) is affected by the distribution of the tsetse fly that imposes a limit to the Sahelian goat expansion due to their trypanosusceptibility. Here we show how extensive surveys on livestock populations can be useful to indirectly assess the consequences of climate change and human action in developing countries.


Assuntos
Fluxo Gênico , Variação Genética , Cabras/genética , Gado/genética , Animais , Burkina Faso , Países em Desenvolvimento , Vetores de Doenças , Genótipo , Geografia , Cabras/parasitologia , Repetições de Microssatélites , Sudão , Moscas Tsé-Tsé
6.
Trop Anim Health Prod ; 44(7): 1469-72, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22290502

RESUMO

A total of 162 individuals, belonging to three Burkinabé and one Niger sheep populations, were analysed for prion protein (PrP) gene polymorphism at codons 136, 154 and 171. The ARQ allele was the most frequent in both the Burkinabé (86.7%) and the Niger (67.5%) sheep populations. The highly sensitive allele VRQ was not found in the sampled individuals. The highly resistant ARR allele was in very low frequency in the Burkina-Sahel (4.4%) and Mossi (3.2%) populations and was not present in the Djallonké and Touareg populations. Only 4 out of 15 possible PrP genotypes were identified in the sampled individuals. No favourable ARR/ARR genotypes were found in either of the breeds. Sequencing a subgroup of the samples allowed the identification of other five polymorphisms on the PrP gene sequence at codons 116, 138, 151, 237 and 240. The very low frequency of the ARR allele in the West African sheep should dissuade the implementation of a preventive selection programme aimed to increase resistance to scrapie, to avoid an extreme erosion of the genetic stock.


Assuntos
Frequência do Gene , Predisposição Genética para Doença , Polimorfismo Genético , Príons/genética , Scrapie/genética , Ovinos/genética , Animais , Burkina Faso , Níger , Reação em Cadeia da Polimerase/veterinária , Príons/sangue , Príons/química , Análise de Sequência de DNA , Análise de Sequência de Proteína
7.
J Surg Oncol ; 105(8): 761-6, 2012 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-22124932

RESUMO

BACKGROUND AND OBJECTIVES: Definitive chemoradiotherapy (CRT) is considered curative intent treatment for locally advanced esophageal squamous cell carcinoma. Data concerning the usefulness of definitive CRT in patients with esophageal adenocarcinoma (ADC) are lacking. The aim of the study was to compare the results of definitive CRT versus surgery in patients with an ADC. METHODS: All consecutive patients with a non-metastatic ADC treated between 1994 and 2008 were retrospectively assessed. Patients were divided into two groups: surgery group (±pre-operative treatment) versus definitive CRT group. RESULTS: In surgery and definitive CRT groups, 67 and 79 patients were evaluated, respectively. A complete resection was achieved in 92.5% of patients in surgery group and a clinical complete response was observed in 49.4% of patients in definitive CRT group. Overall survival was 36.2 ± 2.0 months in surgery group versus 16.5 ± 0.8 months in definitive CRT group (P = 0.02). The predictive factors of survival were age (P < 0.01), stage (P = 0.04), WHO performance status (P < 0.01), initial weight loss (P < 0.01), and the treatment group (P < 0.01). CONCLUSIONS: The results of the study do not support definitive CRT as an alternative to surgery in esophageal ADC treatment. Definitive CRT should be reserved for patients with a major operative risk.


Assuntos
Adenocarcinoma/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Esofágicas/terapia , Recidiva Local de Neoplasia/terapia , Adenocarcinoma/mortalidade , Adenocarcinoma/secundário , Idoso , Cisplatino/administração & dosagem , Terapia Combinada , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Feminino , Fluoruracila/administração & dosagem , Seguimentos , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
8.
J Laryngol Otol ; 125(6): 608-13, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21450130

RESUMO

OBJECTIVE: To evaluate the clinical course and pathological characteristics of basaloid head and neck squamous cell carcinoma. METHOD: Retrospective study of 18 cases of basaloid head and neck squamous cell carcinoma. Epidemiological, clinical and histological data were analysed and the Kaplan-Meier test used to estimate survival rates. RESULTS: The majority of lesions were at an advanced stage. These lesions were primarily localised in the larynx, hypopharynx and oropharynx. Routine pre-therapeutic assessment of squamous cell carcinoma was performed. Pathological diagnosis was difficult, although immunostaining was extremely useful. Positive staining for KL1, MNF 116 and 34ßE12 and negative immunostaining for chromogranin and synaptophysin were also important factors in obtaining a definitive diagnosis. In the majority of cases, treatment involved surgery and radiotherapy. The five-year survival rate was 5 per cent. CONCLUSION: Basaloid squamous cell carcinoma is an uncommon head and neck lesion, with a challenging histological diagnosis. These lesions must be carefully monitored due to their aggressive course, and require multimodality treatment.


Assuntos
Carcinoma Basoescamoso/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basoescamoso/epidemiologia , Carcinoma Basoescamoso/patologia , Carcinoma Basoescamoso/terapia , Terapia Combinada , Diagnóstico Diferencial , Progressão da Doença , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Estudos Retrospectivos , Fatores de Risco , Coloração e Rotulagem , Taxa de Sobrevida
9.
Gastroenterol Clin Biol ; 33(6-7): 485-7, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19477611

RESUMO

Patients with gastric adenocarcinoma frequently develop hepatic metastases or peritoneal carcinosis but involvement of the skeletal muscle is extremely rare. We report the case of a 71-year-old man with a painful soft tissue mass in the right shoulder. Two years previously, the patient had been treated for a locally advanced gastric carcinoma (surgery plus chemoradiotherapy). Surgical exploration with biopsy showed skeletal muscle metastasis from the gastric adenocarcinoma in the deltoid muscle. Chemoradiotherapy resulted in complete regression of symptoms from the metastatic lesion. The patient is alive and free of recurrence in the deltoid muscle after a follow-up of 13 months. Based on this case study, the difficulty of diagnosing skeletal muscle metastases, the prognosis and treatment options are discussed.


Assuntos
Adenocarcinoma/patologia , Adenocarcinoma/secundário , Neoplasias Musculares/secundário , Neoplasias Gástricas/patologia , Idoso , Humanos , Masculino , Neoplasias Musculares/terapia , Ombro
10.
Gastroenterol Clin Biol ; 33(12): 1106-13, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19423254

RESUMO

OBJECTIVE: The optimal treatment strategy for rectal cancer (RC) with synchronous metastases remains an issue of debate. The aim of this study was to evaluate the impact of surgery and radiation on the control of pelvic symptoms in this setting. METHODS: Consecutive patients with RC and synchronous metastases were retrospectively assessed and divided into four treatment groups: surgical resection of rectal tumor (S); radiotherapy with/without chemotherapy followed by surgery (CRTS); chemoradiotherapy (CRT); and chemotherapy only (CT). Each group was evaluated in terms of duration of pelvic symptom-free periods (relative to overall survival). RESULTS: A total of 96 patients were evaluated: S: n=30; CRTS: n=21; CRT: n=27; and CT: n=18. After treatment, pelvic symptoms persisted in 14.7% patients (S=0%, CRTS=7.1%, CRT=31.8%, CT=25%; P=0.01). The relative pelvic symptom-free periods were 93.0% in the S group, 83.1% in the CRTS group, 53.0% in the CRT group and 53.2% in the CT group (P<0.01). On multivariate analysis, only surgical treatment correlated with a significant relative pelvic symptom-free period (P<0.01), with an adjusted hazards ratio of 2.80 [95% CI: 1.79-4.39]. CONCLUSION: Our results suggest that rectal resection was the most effective therapeutic procedure in selected patients with RC and synchronous metastases, offering the patients the longest pelvic symptom-free periods.


Assuntos
Neoplasias Retais/terapia , Idoso , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Pelve , Neoplasias Retais/complicações , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/patologia , Neoplasias Retais/radioterapia , Neoplasias Retais/cirurgia , Estudos Retrospectivos
11.
Dig Liver Dis ; 41(7): e1-3, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18294934

RESUMO

We report a case of anal cancer with iris metastasis and summarize the iris metastasis literature. A 69 years old woman with a history of anal cancer presented with a visual field loss. Slit lamp examination showed a pink ovular mass on the iris of the left eye which was typical of iris metastasis. Because of worse prognosis of metastatic cancer and any ocular complications, the patient was treated by radiotherapy which allowed a clinical improvement. A review of medical records was performed to assess the clinical presentation, diagnosis and treatment. Anal carcinoma can metastasize to the iris. Radiotherapy allows a good local control of tumour but the prognosis depends on systemic disease which is generally bad.


Assuntos
Neoplasias do Ânus/patologia , Neoplasias da Íris/secundário , Idoso , Feminino , Humanos , Neoplasias da Íris/tratamento farmacológico , Neoplasias da Íris/radioterapia
12.
Br J Cancer ; 99(10): 1586-92, 2008 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-19002180

RESUMO

Little is known about chemoradiotherapy (CRT) in elderly patients with a locally advanced oesophageal cancer (OC). The aim of our study was to evaluate the tolerance and the outcome of elderly patients older than 70 years treated with CRT for a non-metastatic OC. Chemoradiotherapy was based on radiotherapy combined with a cisplatin-based chemotherapy. Clinical complete response (CCR) to CRT was evaluated on upper digestive endoscopy and computed tomography scan 6-8 weeks after CRT completion. One hundred and nine consecutive patients were included. A CCR was observed in 63 patients (57.8%) and 2-year survival was 35.5%. Adverse events > or =grade 3 were observed in 26 (23.8%) patients. Chemotherapy dose reduction, chemotherapy delays more than 1 week, and treatment discontinuation were observed in 33 (30.3%), 45 (41.3%), and 17 patients (15.6%), respectively. Comorbidity index according to Charlson score was significantly associated with treatment tolerance. In multivariate analysis, a CCR to CRT (P<0.01), a dose of radiotherapy > or =80% (P=0.02), and a Charlson score < or =2 (P=0.046) were identified as independent prognostic factors of overall survival. These results suggest that CRT could be considered as an effective treatment without major toxicity in elderly patients with OC.


Assuntos
Adenocarcinoma/terapia , Antineoplásicos/administração & dosagem , Carcinoma de Células Escamosas/terapia , Cisplatino/administração & dosagem , Neoplasias Esofágicas/terapia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/radioterapia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/radioterapia , Feminino , Humanos , Masculino , Análise de Sobrevida , Resultado do Tratamento
13.
Rev Chir Orthop Reparatrice Appar Mot ; 92(7): 637-50, 2006 Nov.
Artigo em Francês | MEDLINE | ID: mdl-17124447

RESUMO

The diagnostic and therapeutic management of patients with soft-tissue tumors would be similar to the approach used for bone tumors if it were not for one crucial factor: the absolute necessity to recognize a sarcoma. The predominant features are the size of the tumor and its superficial or deep localization. If the tumor is small and superficial, biopsy can be associated with immediate resection without risk of dissemination to the deep tissues: this is the biopsy-resection approach. If the tumor is deep or superficial but large sized, search for locoregional spread with MRI is necessary before undertaking any surgical procedure. MRI can help guide the biopsy and plan resection if the tumor is a sarcoma. A first biopsy is necessary to establish the histological diagnosis and elaborate the therapeutic strategy. Samples should be sent immediately to the pathology lab which should examine sterile fresh tissue. Experience has demonstrated that proper rules for diagnosis and treatment are not necessarily applied initially in approximately one-fourth of all subjects with a malignant soft-tissue tumor. Besides the medical problems caused by this situation, the patient loses a chance for cure. When the tumor is a sarcoma, surgery is the basis of treatment. Complementary radiation therapy may be necessary, particularly for high-grade tumors or if the surgical margin was insufficient. Systemic or locoregional chemotherapy can also be used for high-grade or non-resectable tumors.


Assuntos
Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/terapia , Biópsia , Humanos , Imageamento por Ressonância Magnética , Sarcoma/diagnóstico , Sarcoma/terapia
14.
Br J Cancer ; 95(6): 705-9, 2006 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-16967056

RESUMO

A recent phase I study showed that weekly cisplatin, irinotecan and concurrent radiotherapy can be administered with moderate toxicity in patients with oesophageal cancer. Patients with no prior treatment and oesophageal cancer stage I to III, performance status <3, caloric intake >1,500 kcal day(-1) were included. Chemotherapy, with cisplatin 30 mg m(-2) and irinotecan 60 mg m(-2), was administered at days 1, 8, 22, 29, and concurrently with radiotherapy at days 43, 50, 64 and 71. Radiotherapy was delivered with 50 or 50.4 Gy in 25 fractions/5 weeks. Forty-three patients were included, 10 stage I, 19 stage II and 14 stage III. Mean age was 59.2 years (range 44-79). A total of 30 out of 43 (69.8%) patients underwent all planned treatment. During induction chemotherapy, 14 severe toxicities of grade 3 or 4 in 10 patients (23.3%) were reported with 57.1% due to haematoxicity. During chemoradiotherapy, 31 severe toxicities of grade 3 or 4 with 64.5% due to haematotoxicity were reported in 18 patients. One toxic death occurred (diarrhoea grade 4). The complete clinical response rate was 58.1% (95% CI: 43.4-72.8%). Overall survival rate at 1 and 2 years was 62.8%, (95% CI, 58.3-77.3%) and 27.9% (95% CI, 13.4-41.3%), respectively. In conclusion, cisplatin-irinotecan-radiotherapy is an active and well-tolerated regimen feasible in out-patients.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Camptotecina/análogos & derivados , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Cisplatino/administração & dosagem , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/radioterapia , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Camptotecina/administração & dosagem , Camptotecina/efeitos adversos , Cisplatino/efeitos adversos , Terapia Combinada/efeitos adversos , Transtornos de Deglutição/etiologia , Fracionamento da Dose de Radiação , Feminino , Humanos , Irinotecano , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Indução de Remissão , Taxa de Sobrevida , Resultado do Tratamento
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