RESUMEN
Os tumores neuroendócrinos primários de mama (TNPMs) são incomuns e não há consenso quanto a tratamento e prognóstico. No presente trabalho, foram revisados os diagnósticos de 1.184 pacientes com câncer de mama atendidos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP/USP), identificando três casos que preenchiam os critérios de TNPM, segundo classificação estabelecida pela Organização Mundial da Saúde (OMS) em 2003. Foram avaliados os achados clinicopatológicos e imuno-histoquímicos e as terapias realizadas, buscando caracterizar os padrões histopatológicos e de comportamento distintos dos carcinomas convencionais de mama.
Primary neuroendocrine breast carcinomas (NECs) are uncommon. Moreover, there is no consensus as to its treatment and prognosis. In this study, the diagnoses of 1,184 cases of breast cancer treated at Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto/Universidade de São Paulo (HCFMRP/USP) were reviewed. Three among them fulfilled the criteria for primary NEC according to the classification established by the World Health Organization (WHO) in 2003. Clinicopathological, immunohistochemical features and treatments were assessed in order to characterize histopathological and distinct patterns of conventional breast carcinomas.
Asunto(s)
Humanos , Femenino , Adulto , Anciano , Neoplasias de la Mama , Carcinoma Neuroendocrino , InmunohistoquímicaRESUMEN
Metastatic breast cancers (MBC) previously treated with anthracyclines (A) and taxanes (T) have a complicated management. Gemcitabine (G)-cisplatin (C) combinations have been used as synergistic salvage therapy in MBC and are considered as another option for patients with important symptoms and aggressive visceral disease. We analyzed the safety and efficacy of GC in AT-pretreated MBC, as well as overall survival (OS) and time to progression (TTP). Forty-nine subjects received IV G 750 mg/m(2) and C 30 mg/m(2), both d1 and d8 every 3 weeks. Response evaluation was performed every second cycle and in the end of treatment. GC protocol was the first-line palliative chemotherapy in half of the cases, and median number of cycles/patient were 4(2-12). Lung (75.5%) was the most frequent site of metastasis. Most of the patients related clinical improvement with chemotherapy with minimal/mild tolerable collateral effects in 85.7% of cases. Following 34 months, mean OS/TTP was 13.12/6.6 months. Objective-responded patients (40.3%) were statistically associated with the improvement in symptoms after CT (P < 0.01), and OS was directly correlated with chemotherapy response (P < 0.01). HER-2 overexpression was a prognostic factor with reduced OS (P = 0.01). GC protocol was effective and tolerable in objective-responded patients.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/mortalidad , Terapia Recuperativa/métodos , Adulto , Anciano , Neoplasias de la Mama/patología , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Desoxicitidina/administración & dosificación , Desoxicitidina/efectos adversos , Desoxicitidina/análogos & derivados , Femenino , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Metástasis de la Neoplasia/tratamiento farmacológico , Estadificación de Neoplasias , Estudios Retrospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento , GemcitabinaRESUMEN
This is the first study to evaluate the prevalence of headache and migraine among Tupiniquim Brazilian natives. A high prevalence of headache was found and the most prevalent headache was migraine. Women were more commonly affected than men. A high impact of headache was found, especially among migraineurs. Half of the headache sufferers were under medical assistance for headache given by the government Family Health Program (PSF). Most of them declared to use common analgesics. None of them was taking prophylactic therapy for this medical problem.
Asunto(s)
Cefalea/epidemiología , Indígenas Sudamericanos/estadística & datos numéricos , Trastornos Migrañosos/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Femenino , Cefalea/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Trastornos Migrañosos/tratamiento farmacológico , Prevalencia , Encuestas y Cuestionarios , Adulto JovenRESUMEN
This is the first study to evaluate the prevalence of headache and migraine among Tupiniquim Brazilian natives. A high prevalence of headache was found and the most prevalent headache was migraine. Women were more commonly affected than men. A high impact of headache was found, especially among migraineurs. Half of the headache sufferers were under medical assistance for headache given by the government Family Health Program (PSF). Most of them declared to use common analgesics. None of them was taking prophylactic therapy for this medical problem.
Este é o primeiro estudo a avaliar prevalência de cefaléias entre índios tuiniquins do Brasil. A prevalência de cefaléia encontrada nesta população foi alta, sendo que a migrânea foi a mais frequente. Encontrou-se maior prevalência de cefaléias entre as mulheres do que entre os homens. O impacto da cefaléia foi considerável, sendo maior entre os portadores de migrânea do que nas cefaléias não migranosas. Cinquenta por cento dos indivíduos com cefaléia recebiam atendimento médico devido a este problema, através do Programa de Saúde da Família (PSF). O tratamento empregado consistia apenas em analgésicos comuns para alívio das crises. Nenhum indivíduo estava em uso de tratamento profilático.