RESUMO
BACKGROUND AND OBJECTIVES: The 1990s have established the contribution of multimodality therapy in the management of IIIb noninflammatory breast cancer (IIIb NIBC), by reducing the odds of recurrence and death. METHODS: A total of 300 women with IIIb NIBC received a multimodality therapy. The treatment consisted of neoadjuvant chemotherapy [FAC (5-fluorouracil, Adriamycin, cyclophosphamide) regimen], radical (Halsted) mastectomy or modified (Patey mastectomy), postoperative radiotherapy, and adjuvant chemohormone therapy [FAC regimen + cyclophosphamide, 5-fluorouracil and methotrexate (CMF) regimen or Tamoxifen]. RESULTS: Complete or partial clinical response (CR or PR) after neoadjuvant chemotherapy was obtained in 83% patients. Ninety-nine patients (33%) survived 5 years without evidence of disease (NED). The uni- and multivariate analyses factors that had significant influence on the treatment results were: clinical response to neoadjuvant chemotherapy, pathological tumor size, and microscopical status of the axillary lymph nodes. CONCLUSIONS: We conclude that neoadjuvant FAC regimen chemotherapy is very effective in producing objective tumor regression and offers the benefit of radical mastectomy to patients with previously unresectable IIIb NIBC.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/terapia , Mastectomia Radical , Adulto , Idoso , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Quimioterapia Adjuvante , Terapia Combinada , Ciclofosfamida/administração & dosagem , Intervalo Livre de Doença , Doxorrubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Humanos , Excisão de Linfonodo , Mastectomia Radical Modificada , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Análise de Sobrevida , Tamoxifeno/administração & dosagemAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Medroxiprogesterona/análogos & derivados , Adulto , Ensaios Clínicos como Assunto , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Humanos , Metástase Linfática , Medroxiprogesterona/administração & dosagem , Acetato de Medroxiprogesterona , Pessoa de Meia-IdadeAssuntos
Neoplasias Encefálicas/secundário , Metotrexato/administração & dosagem , Neoplasias da Medula Espinal/secundário , Adolescente , Adulto , Neoplasias Encefálicas/tratamento farmacológico , Feminino , Seguimentos , Humanos , Injeções Espinhais , Neoplasias Pulmonares , Masculino , Melanoma , Pessoa de Meia-Idade , Neoplasias Cutâneas , Neoplasias da Medula Espinal/tratamento farmacológicoAssuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Poluentes Atmosféricos/efeitos adversos , Cádmio/efeitos adversos , Eritropoese/efeitos dos fármacos , Anemia Hipocrômica/induzido quimicamente , Eritrócitos/metabolismo , Feminino , Humanos , Ferro/metabolismo , Masculino , Doenças Profissionais/induzido quimicamenteRESUMO
The authors present 10 acute suicidal poisonings with hypoglycaemic agents with particular reference to the course of disturbances of brain bioelectric activity. In most patients diffuse changes prevailed during the coma in the form of irregular, usually high-voltage slow activity. Normalization of EEG tracings was very slow, often it took several months, although the duration of hypoglycaemia was usually short (1--5 days). In patients with prolonged toxic coma profound structural lesions of the central nervous system developed with appearance of decortication (apallic syndrome). The authors think that the particular severity of central nervous system lesions in these intoxication and the persistence of changes point to the necessity of seeking more efficient measures of treating neuroglycopenia.
