MARILIA POLO MINGUETI E SILVA
Índice h a partir de 2011
1
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
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- Effects of Palliative Chemotherapy in Unresectable or Metastatic Colorectal Cancer Patients With Poor Performance Status(2023) ROCHA, Lucila Soares da Silva; MONIZ, Camila Motta Venchiarutti; SILVA, Marilia Polo Mingueti e; FREITAS, Guilherme Fialho de; SILVA, Virgilio Souza e; HOFF, Paulo Marcelo Gehm; RIECHELMANN, Rachel P.Chemotherapy's benefit in frail (ECOG PS 3 and 4) patients with metastatic colorectal cancer (mCRC) is uncertain. We evaluated symptom improvement, quality of life, clinical improvement, toxicity, response rate, improvement of ECOG PS, and overall survival in these patients. Multiagent chemotherapy improved symptoms in 42.8% without grade 3 to 4 toxicity, but 46% of patients presented early clinical deterioration. Palliative multiagent chemotherapy in poor-performance mCRC patients resulted in mild impact in symptoms with no benefit in OS and a high risk of toxicity and treatment-related death.Introduction: Colorectal cancer is the second most common cancer in both genders and often presents as a metastatic, unresectable, or recurrent disease in early follow-up. It is uncertain the benefit of oxaliplatin-based palliative chemotherapy (CT) in the first line of treatment in patients with compromised performance status (PS), Eastern Cooperative Oncology Group (ECOG) 3 and 4. These patients are systematically excluded from clinical trials but may be treated in clinical practice. Methods: We conducted a prospective observational cohort whose primary outcome was improving at least 2 points in the worst symptom in the Edmonton Symptom Assessment System Scale (ESAS-r), without grade 3 to 4 toxicity, comparing baseline and fourth week of treatment. Secondary endpoints included quality of life using the European Quality of Life-5 dimensions questionnaire, toxicity, response rate, clinical improvement of ECOG PS, and overall survival (OS). Results: We included 28 patients, and 12 (42.8%) achieved the primary endpoint. Median overall survival was 86 days, 46% of patients did not respond to the fourth-week reevaluation due to clinical deterioration, and 17.8% presented toxicity grade & GE;3, with 5 patients dying from toxicity. In addition, ECOG PS 4 or cholestasis had poorer overall survival. Finally, 25% and 53.6% of patients received these treatments in the last 14 and 30 days of life, respectively. Conclusion: In the present study, palliative multiagent chemotherapy in poor performance status patients with non-molecularly selected colorectal cancer tended to impact tumor symptoms control; however, there is no benefit in OS and a considerable risk of toxicity and treatment-related death.
conferenceObject Treatment outcomes for adult patients with localized osteosarcoma treated with chemotherapy without methotrexate(2019) SILVA, M. P. M.; BONADIO, R. R. D. C. C.; MATOS, G. D. R.; CAMARGO, V. P.- HIV impact in localized anal carcinoma: A matched cohort study(2022) ALMEIDA, A. Acioli De; ROCHA, E.; BONADIO, R. Colombo; GALHERA, D.; BRAGHIROLI, M. I.; ALBAN, L. B.; VICTOR, C. R.; DORNELLAS, A. F. L.; SILVA, M. Polo Mingueti E; CARVALHO, C. S. Araujo De; BUENO, A.; NAHAS, C.; IBRAHIM, K.; CHEN, A.; HOFF, P. M.; MONIZ, C. Motta Venchiarutti