Long-term follow-up of patients with high-risk facial basal cell carcinoma treated with interferon.

BACKGROUND: Surgery is the treatment of choice for patients with basal cell carcinoma (BCC). When surgery is not a choice, only radiotherapy is recommended for patients with high-risk facial BCC. Interferon could be an acceptable therapeutic option for these patients. OBJECTIVE: To evaluate the long-term clinical response to interferon therapy in patients with high-risk facial BCC. METHODS: Patients with high-risk facial BCC were treated with perilesional injections of alpha-2b+ gamma interferons. Those with incomplete clinical response were reevaluated, their residual tumors excised, and declared cured. Patients treated with interferon and those treated with interferon plus surgery were followed for five years. Time to recurrence and the emergence of a new facial BCC were estimated by Kaplan-Meier survival analysis. Adverse events were documented. RESULTS: This study included 195 participants; 143 (73.3%) showed a complete response (95% CI 67.2‒80.1). Patients developed recurrence after a mean of 55 months (95% CI 53.8‒57.4). The estimated rate of recurrence was 12.3% (95% CI 7.4‒17.1). Patients developed a new BCC after a mean of 52.7 months (95% CI 50.4‒54.9). The estimated rate for development of a new BCC was 20.0% (95% CI 14.4‒25.9). Fifteen (7.7%) patients abandoned the study during follow-up. Adverse events were frequent but moderate or mild; fever and local pain were the most frequent. STUDY LIMITATIONS: Observational cohort design without a control group for comparison. CONCLUSIONS: Perilesional injections of alpha-2b+ gamma interferons in patients with facial high-risk BCC offer a satisfactory cure rate after five years of follow-up with an acceptable safety profile.

Long-term follow-up of patients with high-risk facial basal cell carcinoma treated with interferon

Abstract Background Surgery is the treatment of choice for patients with basal cell carcinoma (BCC). When surgery is not a choice, only radiotherapy is recommended for patients with high-risk facial BCC. Interferon could be an acceptable therapeutic option for these patients. Objective To evaluate the long-term clinical response to interferon therapy in patients with high-risk facial BCC. Methods Patients with high-risk facial BCC were treated with perilesional injections of alpha-2b+ gamma interferons. Those with incomplete clinical response were reevaluated, their residual tumors excised, and declared cured. Patients treated with interferon and those treated with interferon plus surgery were followed for five years. Time to recurrence and the emergence of a new facial BCC were estimated by Kaplan-Meier survival analysis. Adverse events were documented. Results This study included 195 participants; 143 (73.3%) showed a complete response (95% CI 67.2‒80.1). Patients developed recurrence after a mean of 55 months (95% CI 53.8‒57.4). The estimated rate of recurrence was 12.3% (95% CI 7.4‒17.1). Patients developed a new BCC after a mean of 52.7 months (95% CI 50.4‒54.9). The estimated rate for development of a new BCC was 20.0% (95% CI 14.4‒25.9). Fifteen (7.7%) patients abandoned the study during follow-up. Adverse events were frequent but moderate or mild; fever and local pain were the most frequent. Study limitations Observational cohort design without a control group for comparison. Conclusions Perilesional injections of alpha-2b+ gamma interferons in patients with facial high-risk BCC offer a satisfactory cure rate after five years of follow-up with an acceptable safety profile.

Estrutura fitossociológica de um fragmento natural de floresta inundável em área de Campo Sujo, Lagoa da Confusão, Tocantins / Phytosociological structure of a natural fragment of floodplain forest in area of Campo Sujo, municipal district of Lagoa da Confusão, Tocantins, Brazil

Fragmentos de florestas inundáveis localizam-se naturalmente na Planície do Araguaia entre os estados de Tocantins e Mato Grosso nas áreas de Cerrado. Ocorrem sob a forma de depressões naturais, que no estado do Tocantins estão situados nas áreas de planícies de inundação, que favorecem seu alagamento, conseqüentemente, o maior tempo de retenção da água em épocas de elevada precipitação. Este estudo teve como objetivo caracterizar a estrutura de um fragmento de floresta inundável de aproximadamente um hectare, inserido em área de Campo Sujo, no município de Lagoa da Confusão, TO. Foram amostrados todos os indivíduos arbustivo-arbóreos com circunferência 1,30m do solo (CAP) > 15 cm. Ao todo, foram encontrados 665 indivíduos, 34 famílias e 49 espécies. As espécies com maior valor de cobertura, em ordem decrescente, foram Sclerolobium paniculatum var. rubiginosum (Mart. ex Tul.) Benth., Calophyllum brasiliense Cambess. e Licania apetala (E. Mey.) Fritsch. As famílias mais ricas foram Fabaceae (8), Arecaceae, Chrysobalanaceae e Vochysiaceae (3). O índice de diversidade de Shannon (H') foi de 2,97nats/ind. A distribuição de classes de diâmetro apresentou curva na forma de "J" invertido estando a maioria dos indivíduos nas sete primeiras classes.

Fragments of floodplain forests occur naturally in the Araguaia plain between the states of Tocantins and Mato Grosso on the ares of Cerrado. These fragments happen in form of natural depressions, which are located in areas of floodplains in the State of Tocantins, which favors its flooding and, consequently, the largest period of water retention during periods of high precipitation. The objective of this study was to characterize the structure of a fragment of floodplain forest of approximately one hectare, inserted in area of Campo Sujo, in Lagoa da Confusão, TO. Were sampled all the tree/shrub individuals with circumference at 1,30m of the soil (CAB) > 15 cm. On the whole, 665 individuals, 34 families and 49 species were found. The species with larger cover value, in descending order, were Sclerolobium paniculatum var. rubiginosum (Mart. former Tul.) Benth., Calophyllum brasiliense Cambess. and Licania apetala (E. Mey.) Fritsch.. The richest families were Fabaceae (8), Arecaceae, Chrysobalanaceae and Vochysiaceae (3). The Shannon diversity index (H') was 2,97 nats/ind. The distribution of diameter classes showed an inverted "J" curve.