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1.
BMC Cancer ; 22(1): 948, 2022 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36057562

RESUMO

BACKGROUND: One-year S-1 or six-month capecitabine/oxaliplatin (CAPOX) has been the standard adjuvant chemotherapy for gastric cancer (GC). We investigated outcomes according to the cycles of adjuvant chemotherapy, using data from the Korean Health Insurance and Assessment Service. METHODS: A total of 20,552 patients, including 13,614 patients who received S-1 and 6,938 patients who received CAPOX extracted from 558,442 patients were retrospectively analyzed. The five-year overall survival rate was evaluated according to the duration of adjuvant chemotherapy. RESULTS: The five-year overall survival rate gradually increased according to the increase in adjuvant chemotherapy cycles in both the S-1 (≤ 5 cycles: 48.4%, hazard ratio [HR] 4.06, 95% confidence interval [CI] 3.74-4.40, P < 0.0001; 5 < cycles ≤ 6: 55.4%, HR 3.08, 95% CI 2.65-3.57, P < 0.0001; 6 < cycles ≤ 7: 64.1%, HR 2.11, 95% CI 1.84-2.41, P < 0.0001; 7 < cycles < 8: 71.1%, HR 1.60, 95% CI 1.39-1.84, P < 0.0001; ≥ 8 cycles: 77.9%) and the CAPOX groups (≤ 4 cycles: 43.5%, HR 3.20, 95% CI 2.84-3.61, P < 0.0001; 5 cycles: 45.3%, HR 2.63, 95% CI 2.11-3.27, P < 0.0001; 6 cycles: 47.1%, HR 2.09, 95% CI 1.76-2.49, P < 0.0001; 7 cycles: 55.3%, HR 1.63, 95% CI 1.35-1.96, P < 0.0001; ≥ 8 cycles: 67.2%). CONCLUSIONS: Reducing the treatment cycles of adjuvant chemotherapy in GC with S-1 or CAPOX showed inferior survival outcomes. Completing the standard duration of adjuvant chemotherapy with S-1 or CAPOX would be strongly recommended.


Assuntos
Neoplasias Gástricas , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Capecitabina/uso terapêutico , Quimioterapia Adjuvante , Estudos de Coortes , Intervalo Livre de Doença , Fluoruracila , Humanos , Estadiamento de Neoplasias , Compostos Organoplatínicos , Oxaliplatina , Estudos Retrospectivos , Neoplasias Gástricas/tratamento farmacológico , Resultado do Tratamento
4.
J Egypt Natl Canc Inst ; 34(1): 38, 2022 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-36089614

RESUMO

BACKGROUND: Preclinical studies prove that short-term fasting secures healthy cells against chemotherapy side effects and makes malignant cells more vulnerable to them. This study aimed to examine the effects of intermittent fasting (IF) during adjuvant chemotherapy AC (doxorubicin, cyclophosphamide) protocol in breast cancer (BC) patients. METHODS: Forty-eight newly diagnosed human epidermal growth factor receptor 2-negative (HER2 negative) BC patients were divided equally into two groups (24 each). The first group was recruited to fast intermittently for three consecutive days around chemotherapy for 18 h a day from 12 am to 6 pm and eats through 6 h a day from 6 pm to 12 am with permission of drinking water during fasting hours (IF group). This IF was repeated every 3 weeks for four cycles. The second group is a non-fasting (NF) group that was allowed to eat regularly. Toxicity in the two groups was compared. Hematologic, metabolic, and inflammatory parameters were measured and compared. RESULTS: Toxicity related to the gastrointestinal tract (GIT) was reduced in the IF group. Hematologic parameters showed no significant variations between the two studied groups after cycle 4. There was a significant increase in median glucose and median insulin levels (P < 0.001 and P = 0.001, respectively) in the NF group between baseline and after cycle 4. In addition, there was a significant decrease in the median insulin level (P = 0.002) in the IF group between the two time points. CONCLUSION: IF throughout chemotherapy was well tolerated and decreased the toxicity of chemotherapy. Additionally, IF-improved metabolic profiles of patients may have a positive impact on the clinical efficacy of chemotherapy.


Assuntos
Neoplasias da Mama , Insulinas , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/patologia , Quimioterapia Adjuvante/efeitos adversos , Jejum , Feminino , Humanos , Insulinas/uso terapêutico
5.
Ann Ital Chir ; 92: 263-270, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36052460

RESUMO

AIM: We aimed to evaluate (immunohistochemically) the YAP expression in breast cancer patients undergoing neoadjuvant chemotherapy and to clarify the relationship between the molecular characteristics, treatment response and survival data and the YAP expression, and hence, to clarify the prognostic significance. MATERIAL AND METHODS: One hundred and four patients who were diagnosed with Breast Cancer between 2015-2020 and underwent Neo Adjuvant Chemotherapy were included in the study. Estrogen Receptor(ER), Progesterone Receptor(PR), Human Epidermal Growth Receptor-2(HER2) and Ki-67. Expression are routinely stained immunohistochemically. In this study, existing immunohistochemical markers were reviewed and also, the relationship of YAP with these biological markers was evaluated by using immunohistochemistry and its effect on prognosis has been investigated. RESULTS: The average age of the patients was 52.37. While YAP was positive in 78 patients (75%), it was negative in 26 patients (25%). In the evaluation after neoadjuvant therapy, pathological complete response (MillerPayne Grade5 response) in 28 patients (26.9%), relapse in 6 patients (5.8%), and exitus in 6 patients (5.8%) were detected. In the pathological evaluation, invasive Ductal Carcinoma was the most common one observed in 88 patients (84.6%). As a result of the statistical evaluation, no significant result was obtained between the parameters and YAP negative/positive. CONCLUSION: As a result of staining with additional YAP in patients who were diagnosed with breast cancer and routinely stained with ER, PR, Cerb B2 and Ki-67 in pathology samples, we could not reach a result that would contribute positively to survival. Longer studies to be conducted prospectively will be meaningful. KEY WORDS: Breast Cancer, Chemotherapy, Neoadjuvant, Yes Associated Protein.


Assuntos
Neoplasias da Mama , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais , Neoplasias da Mama/patologia , Quimioterapia Adjuvante , Feminino , Humanos , Antígeno Ki-67 , Terapia Neoadjuvante , Recidiva Local de Neoplasia/tratamento farmacológico , Receptor ErbB-2/metabolismo , Receptor ErbB-2/uso terapêutico , Receptores de Estrogênio/metabolismo , Receptores de Estrogênio/uso terapêutico , Receptores de Progesterona/metabolismo , Receptores de Progesterona/uso terapêutico , Estudos Retrospectivos , Proteínas de Sinalização YAP
6.
Zhonghua Yi Xue Za Zhi ; 102(34): 2651-2654, 2022 Sep 13.
Artigo em Chinês | MEDLINE | ID: mdl-36096693

RESUMO

The incidence and mortality of pancreatic cancer are increasing year by year worldwide, but the effect of prevention and treatment is not ideal. The standardized implementation of multi-disciplinary treatment (MDT) can make the diagnosis of pancreatic cancer more clear and more accurate clinical staging, surgical resection rate can be improved and the ratio of adjuvant chemotherapy and other comprehensive treatment can be improved, the treatment mode of pancreatic cancer can be optimized, combined with individual differences of patients, and to develop a comprehensive and personalized treatment plan. The standardized development of MDT is simple, fast and economical, and has the optimal health economic value.


Assuntos
Neoplasias Pancreáticas , Quimioterapia Adjuvante , Terapia Combinada , Humanos , Neoplasias Pancreáticas/terapia
7.
Cancer Cell ; 40(9): 911-913, 2022 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-36055230

RESUMO

In stage II colorectal cancer, adjuvant chemotherapy is controversial, and overtreatment is substantial due to suboptimal risk stratification. In a recent New England Journal of Medicine article reporting from a prospective randomized phase II trial, Tie and colleagues demonstrate how ctDNA-guided risk-stratification reduces the use of adjuvant chemotherapy without compromising recurrence risk.


Assuntos
DNA Tumoral Circulante , Neoplasias Colorretais , Quimioterapia Adjuvante , DNA Tumoral Circulante/genética , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Humanos , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Estudos Prospectivos
8.
BMJ Open ; 12(9): e058107, 2022 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104135

RESUMO

INTRODUCTION: Glioblastoma (GBM) is the most common malignant primary central nervous system cancer in adults. The objective of the Multi-Arm GlioblastoMa Australasia (MAGMA) trial is to test hypotheses in real world setting to improve survival of people with GBM. Initial experimental arms are evaluating the effectiveness of interventions in newly diagnosed GBM (ndGBM). This study will compare maximal surgical resection followed by chemoradiotherapy plus adjuvant chemotherapy for 6 months with the addition of (1) 'neoadjuvant' chemotherapy beginning as soon as possible after surgery and/or (2) adjuvant chemotherapy continued until progression within the same study platform. METHODS AND ANALYSIS: MAGMA will establish a platform for open-label, multiarm, multicentre randomised controlled testing of treatments for GBM. The study began recruiting in September 2020 and recruitment to the initial two interventions in MAGMA is expected to continue until September 2023.Adults aged ≥18 years with ndGBM will be given the option of undergoing randomisation to each study intervention separately, thereby giving rise to a partial factorial design, with two separate randomisation time points, one for neoadjuvant therapy and one for extended therapy. Patients will have the option of being randomised at each time point or continuing on with standard treatment.The primary outcome for the study is overall survival from the date of initial surgery until death from any cause. Secondary outcomes include progression-free survival, time to first non-temozolomide treatment, overall survival from each treatment randomisation, clinically significant toxicity as measured by grade 3 or 4 adverse events and health-related quality-of-life measures. Tertiary outcomes are predictive/prognostic biomarkers and health utilities and incremental cost-effectiveness ratio.The primary analysis of overall survival will be performed separately for each study intervention according to the intention to treat principle on all patients randomised to each study intervention. ETHICS AND DISSEMINATION: The study (Protocol version 2.0 dated 23 November 2020) was approved by a lead Human Research Ethics Committee (Sydney Local Health District: 2019/ETH13297). The study will be conducted in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice. TRIAL REGISTRATION NUMBER: ACTRN12620000048987.


Assuntos
Glioblastoma , Adolescente , Adulto , Australásia , Quimiorradioterapia , Quimioterapia Adjuvante , Glioblastoma/terapia , Humanos , Intervalo Livre de Progressão , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
Breast J ; 2022: 8582894, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36111211

RESUMO

Objective: Given the challenges rural cancer patients face in accessing cancer care as well as the slower diffusion and adoption of new medical technologies among rural providers, the aim of our study was to examine trends in gene expression profiling (GEP) testing and evaluate the association between hospital rurality and receipt of GEP testing. Methods: Data from the Iowa Cancer Registry (ICR) were used to identify women with newly diagnosed, histologically confirmed breast cancer from 2010 through 2018 who met eligibility criteria for GEP testing. Patients were allocated to the hospitals where their most definitive surgical treatment was received, and Rural-Urban Commuting Area codes were used to categorize hospitals into urban (N = 43), large rural (N = 16), and small rural (N = 48). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression to evaluate the association between hospital rurality and GEP test use, adjusting for demographic and clinical characteristics. The association between test result and treatment received was assessed among patients who received Oncotype DX (ODX) testing. Results: Of 6,726 patients eligible for GEP test use, 46% (N = 3,069) underwent testing with 95% receiving ODX. While overall GEP testing rates increased over time from 42% between 2010 and 2012 to 51% between 2016 and 2018 (P trend < 0.0001), use continued to be the lowest among patients treated at hospitals in small rural areas. The odds of GEP testing remained significantly lower among patients treated at hospitals located in small rural areas (aOR 0.55; 95% CI 0.43-0.71), after adjusting for demographic and clinical characteristics. ODX recurrence scores were highly correlated with chemotherapy use across all strata of hospital rurality. Conclusions: GEP testing continues to be underutilized, especially among those treated at small rural hospitals. Targeted interventions aimed at increasing rates of GEP testing to ensure the appropriate use of adjuvant chemotherapy may improve health outcomes and lower treatment-related costs.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/terapia , Quimioterapia Adjuvante , Feminino , Perfilação da Expressão Gênica , Hospitais , Humanos , Iowa
11.
Med Sci Monit ; 28: e937757, 2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-36117308

RESUMO

BACKGROUND We aimed to evaluate the ability of circulating cell-free methylated SETP9 DNA (mSEPT9) to identify recurrence and to determine its clinical utility in adjuvant chemotherapy (ACT) regimen decisions. MATERIAL AND METHODS This study enrolled 426 patients with stage II-III CRC who received radical resection between January 8, 2018, and November 30, 2020. The median follow-up duration was 15.8 months (range, 8.1-43.4 months). The primary endpoint was recurrence-free survival (RFS). A propensity score matching model was used to minimize potential confounding covariates and to confirm our findings. RESULTS In stage II-III CRC patients, postoperative (within 1 month after surgery) mSEPT9 positivity was significantly correlated with worse RFS (HR=6.21, P<0.001), and it remained the strongest independent predictor in multivariate Cox regression analysis (HR=5.83, P<0.001), which was significantly superior to CEA, CA19-9, and CA242. During disease surveillance, mSEPT9 positivity preceded radiographic recurrence by a median of 5.0 months. The postoperative mSEPT9-positive patients benefited more from CAPEOX compared to FOLFOX (HR=3.97, P=0.017), while for mSEPT9-negative patients, CAPEOX and FOLFOX resulted in similar RFS (HR=1.70, P=0.322). Furthermore, 3 months of CAPEOX was more effective than 3 and 6 months of FOLFOX (HR=4.40, P=0.065; HR=1.56, P=0.073, respectively). CONCLUSIONS Our results revealed that mSEPT9 detection after radical resection could identify minimal residual disease (MRD) and could predict a high risk of recurrence in patients with stage II-III CRC. Furthermore, we show pioneering work that mSEPT9 detection could be used to guide the selection of an adjuvant chemotherapy regimen to improve RFS.


Assuntos
Ácidos Nucleicos Livres , Neoplasias Colorretais , Biomarcadores Tumorais/genética , Antígeno CA-19-9 , Ácidos Nucleicos Livres/genética , Quimioterapia Adjuvante , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , DNA , Humanos , Septinas/genética , Septinas/metabolismo
12.
Int J Surg ; 105: 106889, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36084807

RESUMO

BACKGROUND: Gastric cancer (GC) is a major health problem worldwide, with high prevalence and mortality. The present GC staging system provides inadequate prognostic information and does not reflect the chemotherapy benefit of GC. METHODS: Two hundred fifty-five patients who underwent surgical resection were enrolled in our study (training cohort = 212, internal validation cohort = 43). Nine clinicopathologic features were obtained to construct an support vector machine (SVM) model. The cohorts from 4 domestic centres and The Cancer Genome Atlas (TCGA) were used for external validation. RESULTS: In the training cohort, the AUCs were 0.773 (95% CI 0.708-0.838) for 5-year overall survival (OS) and 0.751 (95% CI 0.683-0.820) for 5-year disease-free survival (DFS); in the domestic validation cohort, the AUCs were 0.852 (95% CI 0.810-0.894) and 0.837 (95% CI 0.792-0.882), respectively. The model performed better than the TNM staging system according to the receiver operator characteristic(ROC) curve. GC patients were significantly divided into low, moderate and high risk based on the SVM. High-risk TNM stage Ⅱ and Ⅲ patients were more likely to benefit from adjuvant chemotherapy than low-risk patients. CONCLUSIONS: The SVM-based model may be used to predict OS and DFS in GC patients and the benefit of adjuvant chemotherapy in TNM stage Ⅱ and Ⅲ GC patients.


Assuntos
Neoplasias Gástricas , Inteligência Artificial , Quimioterapia Adjuvante , Gastrectomia , Humanos , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
13.
Front Immunol ; 13: 901636, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36045677

RESUMO

Background: The benefits of talazoparib compared with conventional chemotherapy in HER2-negative advanced breast cancer (ABC) remain unclear. Methods: Patients older than 18 years, with a deleterious germline BRCA1/2 (gBRCA1/2) mutated, metastatic, or locally advanced and HER2-positive breast cancer were enrolled. Patient data including age, menostatus, tumor grade, pathologic tumor size, lymph node status, and whether they had received adjuvant radiation or chemotherapy was collected. The primary outcomes of the study were disease-free survival (DFS), which was defined as the time from randomization to death or recurrence due to any reason, and overall survival (OS), which was defined as the time from randomization to death due to any reason. P<0.05 was considered to be statistically significant. Results: A total of 136 patients were finally enrolled in the present retrospective study, including 62 patients in the talazoparib group (group A) and 74 in the conventional chemotherapy group (group B). After a median follow-up of 70.9 months [95% confidence interval (CI): 68.3-78.5], both DFS and OS did not differ significantly between the two groups (P=0.658 and P=0.690, respectively). The exploratory subgroup analyses further validated the robustness of the primary results across the subgroups. Conclusions: Talazoparib was not better than conventional chemotherapy in terms of DFS and OS for the treatment of gBRCA1/2 mutated HER2-positive breast cancer patients.


Assuntos
Neoplasias da Mama , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Quimioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Humanos , Estudos Retrospectivos
14.
Front Immunol ; 13: 950782, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36081499

RESUMO

Colorectal cancer (CRC) is one of the most fatal cancers of the digestive system. Although cancer stem cells and metabolic reprogramming have an important effect on tumor progression and drug resistance, their combined effect on CRC prognosis remains unclear. Therefore, we generated a 21-gene mRNA stemness index-related metabolic risk score model, which was examined in The Cancer Genome Atlas and Gene Expression Omnibus databases (1323 patients) and validated using the Zhongshan Hospital cohort (200 patients). The high-risk group showed more immune infiltrations; higher levels of immunosuppressive checkpoints, such as CD274, tumor mutation burden, and resistance to chemotherapeutics; potentially better response to immune therapy; worse prognosis; and advanced stage of tumor node metastasis than the low-risk group. The combination of risk score and clinical characteristics was effective in predicting overall survival. Zhongshan cohort validated that high-risk score group correlated with malignant progression, worse prognosis, inferior adjuvant chemotherapy responsiveness of CRC, and shaped an immunoevasive contexture. This tool may provide a more accurate risk stratification in CRC and screening of patients with CRC responsive to immunotherapy.


Assuntos
Neoplasias Colorretais , Aprendizado de Máquina , Quimioterapia Adjuvante , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Humanos , Prognóstico , Fatores de Risco
15.
Medicine (Baltimore) ; 101(36): e30127, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36086737

RESUMO

The purpose of the present study was to clarify clinical outcomes of elderly patients with soft tissue sarcoma who underwent surgery neither with neoadjuvant nor adjuvant chemotherapy. The median follow-up period was 46.3 (range 6.7-99.0) months. All patients underwent surgical resections. R0 margins were achieved in 24 cases (92.3%) and R1 margins in 2 cases (7.7%). The 1-, 2-, and 5-year sarcoma-specific survival (SSS) rates were 92.3%, 88.5%, and 83.8%, respectively. Multivariate analysis showed no significant risk factors for SSS. No significant relationship of histological grades and local recurrences (P = .56) or distant metastases (P = .54) was shown. In the current study, we observed a comparable survival ratio, despite no neoadjuvant or adjuvant chemotherapies performed. Tumor resections with adequate margins might, at least in part, have contributed to the decent survival ratio regardless of histological grade. Twenty-six consecutive patients aged ≥ 70 years, who underwent surgical resections of soft tissue sarcoma between January 2013 and December 2019, were included. SSS were analyzed by the Kaplan-Meier method, and the relationships between SSS and clinical parameters were evaluated by Cox proportional hazards analysis.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Idoso , Quimioterapia Adjuvante , Humanos , Margens de Excisão , Fatores de Risco , Sarcoma/patologia , Neoplasias de Tecidos Moles/patologia
16.
Diagn. tratamento ; 27(3): 76-9, jul-set. 2022. ilus, ilus, ilus, tab
Artigo em Português | LILACS | ID: biblio-1380672

RESUMO

Contexto: Os sarcomas de partes moles de extremidades compreendem um grupo de neoplasias raras com características histopatológicas variadas. A incidência anual exata dos sarcomas de parte moles é desconhecida. Embora os tecidos mesenquimais (incluindo o tecido ósseo) contribuam com dois terços do peso corporal humano, os sarcomas representam 1% das neoplasias sólidas nos adultos e 15% na infância. Descrição do caso: Paciente do sexo masculino, 65 anos, apresentando nódulo na coxa direita, realizou ressonância magnética (RM) que detectou lesão sarcomatosa, confirmada pelo estudo anatomopatológico. Foi realizada a extração tumoral com sucesso, sem necessidade de amputação de membro inferior direito. O paciente realizou 30 sessões de radioterapia e atualmente realiza acompanhamento ambulatorial após quatro anos de cirurgia, sem evidências de lesão residual ou recidiva local. Discussão: Os sarcomas de alto grau são mais invasivos localmente e com maior propensão a metástases. Um dos maiores problemas dos sarcomas é a demora no diagnóstico. Embora tenham prognóstico pior que o sarcoma de baixo grau, o sarcoma de alto grau diagnosticado sem metástases poderá ser curado com maior facilidade. As formas mais acuradas de diagnóstico são RM e ultrassonografia. Devido ao seu alto contraste e capacidade de geração de imagens de tecidos moles superficiais e profundos, a RM está sendo cada vez mais realizada para vigilância de recorrência local e diagnóstico no sarcoma de partes moles nas extremidades. Conclusão: Os sarcomas de partes moles nos membros inferiores, muitas vezes, não são incluídos como diagnóstico diferencial inicial. Logo, quando a lesão atinge um tamanho considerável, leva a um diagnóstico tardio e perigoso.


Assuntos
Humanos , Masculino , Idoso , Sarcoma , Imageamento por Ressonância Magnética , Quimioterapia Adjuvante , Radioterapia Adjuvante , Neoplasias
20.
J Med Case Rep ; 16(1): 330, 2022 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-36002876

RESUMO

BACKGROUND: Medulloblastoma is a malignant brain tumor that is common in children but very uncommon in adults, especially those older than 40 years, accounting for less than 1% of all primary brain tumors in adults. Although surgery and radiotherapy play an important role treatment of adult medulloblastoma, the use of chemotherapy is controversial. This is the first instance of adult medulloblastoma at the Ocean Road Cancer Institute in Tanzania. CASE DESCRIPTION: We report the case of a 51-year-old female of African ethnicity who was diagnosed with high-risk hemispheric posterior cranial fossa medulloblastoma of classic type with World Health Organization central nervous system grade 4 and Chang stage M0. Immunohistochemistry, reticulin stain, and molecular subtyping could not be done because they were not available. She was treated by subtotal posterior cranial fossa tumor resection followed by adjuvant concurrent chemo-craniospinal radiation and adjuvant chemotherapy. CONCLUSION: Even in adults over 50 years old, medulloblastoma should be included in the differential diagnosis of posterior fossa tumor. Adult medulloblastoma is a very rare and very heterogeneous tumor, but it has a good prognosis. Immunohistochemistry and molecular subclustering are difficult to implement in low-income countries such as Tanzania owing to cost. Treatment of adult medulloblastoma is highly heterogeneous among (and even within) facilities. There is no evidence that the extent of resection enhances survival. While craniospinal radiation therapy improves survival, there is controversy about the role of chemotherapy in managing adult MB.


Assuntos
Neoplasias Encefálicas , Neoplasias Cerebelares , Meduloblastoma , Adulto , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/terapia , Neoplasias Cerebelares/tratamento farmacológico , Neoplasias Cerebelares/terapia , Quimioterapia Adjuvante , Criança , Terapia Combinada , Feminino , Humanos , Meduloblastoma/tratamento farmacológico , Meduloblastoma/terapia , Pessoa de Meia-Idade
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