RESUMO
Gastrointestinal stromal tumor (GIST) is the most common malignant neoplasm of mesenchymal origin, and a paradigmatic model for a successful rational development of targeted therapies in cancer. The introduction of tyrosine kinase inhibitors with activity against KIT/PDGFRA in both localized and advanced stages has remarkably improved the survival in a disease formerly deemed resistant to all systemic therapies. These guidelines are elaborated by the conjoint effort of the Spanish Society of Medical Oncology (SEOM) and the Spanish Sarcoma Research Group (GEIS) and provide a multidisciplinary and updated consensus for the diagnosis and treatment of GIST patients. We strongly encourage that the managing of these patients should be performed within multidisciplinary teams in reference centers.
Assuntos
Tumores do Estroma Gastrointestinal , Sarcoma , Humanos , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/terapia , Oncologia , Consenso , Receptores Proteína Tirosina QuinasesRESUMO
OBJECTIVE: To adapt and assess reliability of the Chilean version of Nutritional Environment Measurement for Stores (NEMS-S-CHILE) to measure the food environment of stores in urban areas. DESIGN: NEMS-S-CHILE was the NEMS-S tool adapted to the Chilean food patterns; foods were grouped according to level of processing in (a) unprocessed or minimally processed foods, (b) processed culinary ingredients, (c) processed foods, and (d) ultra-processed foods, and scored according to NEMS-S-CHILE tool. Reliability inter evaluators was measured. SETTING: City of Concepción, Bio-Bio region, Chile. PARTICIPANTS: Seventeen of a total of 25 supermarkets, and 9 out of 10 street markets according to the municipal registry and the street market trade unions, representing 74.3% of both types of food premises in Concepción. RESULTS: Reliability inter evaluators was measured by the following aspects: product availability, price, quality, and variety, through the intraclass correlation coefficient (ICC), percent agreement, and Cohen's kappa analysis. Reliability was high for availability, where the kappa index and ICC were acceptable, ranging from moderate to high (0.42 to 1.00 for the kappa coefficient and 0.65 to 1.00 for ICC), as well as for prices (ICC: 0.65-1.00 ), variety (kappa: 0.76-1.00) and quality (percent agreement: 68.2- 100%). CONCLUSIONS: The adapted instrument, NEMS-S-CHILE, has a high reliability inter evaluators and can be useful to measure the availability of foods by the level of processing according to the prevalent food system in developing countries.