RESUMO
The incidence of squamous cell carcinoma of the anal canal (SCAC) is increasing in both sexes but the standard treatment remains that of 20 years ago. However, interesting data have recently emerged on the use of anti-epidermal growth factor receptor (EGFR) agents and immunotherapy in advanced disease. Thus, new avenues of research are opening up that will hopefully lead to more effective therapeutic strategies. We provide an overview of the latest studies published on this tumor and discuss the possible future therapeutic options for combination therapy, anti-EGFR treatment and radiotherapy.
Assuntos
Anticorpos Monoclonais/administração & dosagem , Antineoplásicos/administração & dosagem , Neoplasias do Ânus/terapia , Carcinoma de Células Escamosas/terapia , Receptores ErbB/antagonistas & inibidores , Imunoterapia/métodos , Neoplasias do Ânus/patologia , Carcinoma de Células Escamosas/patologia , Cetuximab/administração & dosagem , Terapia Combinada , Humanos , Terapias em Estudo/métodosRESUMO
OBJECTIVE AND IMPORTANCE: Arnold Chiari Type I malformation usually presents as headache, arm numbness, dysesthesia, upper weakness, or gait difficulty. We report a case of Chiari malformation presenting as a left trigeminal neuralgia. CLINICAL PRESENTATION: A patient with a history of 29 years of trigeminal neuralgia was admitted. He was treated with three thermocoagulations. Microvascular decompression was planified. Magnetic resonance imaging was performed, and it demonstrated an Arnold Chiari malformation. After surgery, the patient was asymptomatic. INTERVENTION: Posterior fossa decompression by enlarging the foramen magnum and aspiration of the cerebellar tonsils was performed. CONCLUSION: The trigeminal neuralgia could be attributable to a compression of the trigeminal nucleus. The compression of the nucleus could explain both the pain and the regression after surgery. This is the second reported case of pure trigeminal neuralgia in Arnold Chiari malformation.
Assuntos
Malformação de Arnold-Chiari/diagnóstico , Neuralgia do Trigêmeo/diagnóstico , Idoso , Malformação de Arnold-Chiari/cirurgia , Descompressão Cirúrgica , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , MasculinoRESUMO
Colorectal cancer with peritoneal carcinomatosis is usually considered incurable. Intraperitoneal carcinomatosis accounts for 25-35% of recurrences of colorectal cancer. Studies demonstrate that peritoneal carcinomatosis is not necessarily a terminal condition with no options for treatment or cure. Encouraging results were obtained in many studies by cytoreductive surgery followed by hyperthermic intraoperative intraperitoneal chemotherapy (HIIC). Oxaliplatin is a new agent whose clinical use with intraperitoneal administration has been pioneered by Elias et al. Eight patients with peritoneal carcinomatosis (PC) of colo-rectal origin underwent complete cytoreductive surgery from March 2004 to January 2005. Six of them were submitted to HIIC with semi-closed technique; in one patient mitomycin C (2 mg/m2/l) was used for intraperitoneal perfusion at 41.5-42 degrees for 60 minutes; in five patients IPCH was carried out for 30 minutes at 41.5-42 degrees with intraperitoneal oxaliplatin (460 mg/m2). Patients received intravenous leucovorin (10 mg/m2) and 5-fluorouracil (400 mg/m2) just before HIIC to maximize the effect of oxaliplatin. Preliminary results are reported.
Assuntos
Antineoplásicos/administração & dosagem , Neoplasias Colorretais/patologia , Compostos Organoplatínicos/administração & dosagem , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/secundário , Idoso , Quimioterapia do Câncer por Perfusão Regional , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oxaliplatina , PeritônioRESUMO
Even if surgical resection continues to be the mainstay of treatment in rectal cancer, preoperative chemoradiation may downstage locally advanced rectal cancer, in some cases with no residual tumors. Compared with surgery alone, preoperative radiotherapy and chemotherapy improves outcomes in patients with locally advanced rectal cancer. In the present review we summarize the results of preoperative chemoradiation therapy in a group of 15 patients who underwent surgical resection with total mesorectal excision (TME) for advanced mid and low rectal cancer from February 2002 to February 2004.