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Métodos Terapêuticos e Terapias MTCI
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1.
Clin Lymphoma Myeloma Leuk ; 14(3): 203-10, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24417911

RESUMO

BACKGROUND: Lymphoma rarely presents in the ocular adnexa but is usually extranodal marginal zone (ENMZ) lymphoma when it does. Involved-field radiotherapy (IFRT) is the standard of care for unilateral disease, but the optimal management of more extensive disease is unclear. PATIENTS AND METHODS: We retrospectively evaluated the clinical characteristics and outcomes of 95 patients with ocular adnexal lymphoma (OAL) or uveal lymphoma treated or diagnosed at our institution. All patients identified were included in the risk factor analysis for progression-free survival (PFS). The initial treatment-related outcomes were assessed for ENMZ OAL only (n = 62). RESULTS: With a median follow-up of 32 months, significant risk factors for PFS after initial treatment were age (hazard ratio, 1.33; 95% confidence interval, 1.02-1.74), female gender (hazard ratio, 2.04; 95% confidence interval, 1.04-4.00), and a history of lymphoma (hazard ratio, 2.31; 95% confidence interval, 1.12-4.78). In ENMZ, IFRT was associated with improved PFS (median, 5.4 years; P < .001). Progression occurred in 7 of 39 (23%), with 6 of the 7 (86%) at systemic sites. Single-agent rituximab was typically used for bilateral ocular or systemic presentations of ENMZ OAL. Progression occurred in 7 of 11 (64%), with no progression at systemic sites. All progression events in those initially treated with rituximab occurred in the ocular adnexa. CONCLUSION: The results of the present study have confirmed IFRT as the standard for unilateral ENMZ OAL. Single-agent rituximab was an effective agent for bilateral ocular or systemic ENMZ OAL, particularly for systemic control, but ocular progression should be closely monitored. Combined modality therapy should be studied further in bilateral and systemic ENMZ OAL.


Assuntos
Neoplasias Oculares/diagnóstico , Neoplasias Oculares/terapia , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/terapia , Neoplasias Uveais/diagnóstico , Neoplasias Uveais/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Murinos/uso terapêutico , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Combinada , Neoplasias Oculares/mortalidade , Feminino , Humanos , Linfoma de Zona Marginal Tipo Células B/mortalidade , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Rituximab , Resultado do Tratamento , Carga Tumoral , Neoplasias Uveais/mortalidade , Adulto Jovem
2.
Clin Nucl Med ; 36(8): e72-80, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21716005

RESUMO

This guideline is intended to guide appropriately trained and licensed physicians performing therapy with unsealed radiopharmaceutical sources. Adherence to this guideline should help to maximize the efficacious use of these procedures, maintain safe conditions, and ensure compliance with applicable regulations. The topics dealt with in this guideline include indications for the use of iodine-131, both for the treatment of hyperthyroidism and thyroid carcinoma. In addition, indications for other less common procedures include those for the use of phosphorous-32 in its liquid and colloidal forms, strontium-89, samarium-153, and the use of Y-90 antibodies.


Assuntos
Radioterapia (Especialidade)/normas , Compostos Radiofarmacêuticos/uso terapêutico , Radioterapia/normas , Sociedades Médicas , Técnicas de Ablação , Ascite/radioterapia , Neoplasias Ósseas/complicações , Neoplasias Ósseas/secundário , Quimioterapia Adjuvante , Documentação , Feminino , Seguimentos , Humanos , Hipertireoidismo/radioterapia , Controle de Infecções , Linfoma não Hodgkin/radioterapia , Neoplasias Ovarianas/radioterapia , Dor/etiologia , Dor/radioterapia , Educação de Pacientes como Assunto , Derrame Pleural/radioterapia , Policitemia Vera/complicações , Policitemia Vera/radioterapia , Período Pós-Operatório , Controle de Qualidade , Radioimunoterapia , Compostos Radiofarmacêuticos/administração & dosagem , Compostos Radiofarmacêuticos/efeitos adversos , Radioterapia/efeitos adversos , Segurança , Trombocitose/complicações , Neoplasias da Glândula Tireoide/radioterapia
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