MARIA DEL PILAR ESTEVEZ DIZ

(Fonte: Lattes)
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Lattes
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Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina

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  • conferenceObject
    Expression of ERCC1 protein (excision repair cross complementing group 1) in patients with invasive carcinoma of the uterine cervix (CC) undergoing definitive chemoradiation (CR)
    (2012) CAIRES, Inacelli Queiroz de Souza; CAIRES-LIMA, Rafael; COLOMBO, Renata; RAMOS, Clarissa C. A.; MACHADO, Karime Kalil; SIQUEIRA, Sheila Aparecida Coelho; CARVALHO, Heloisa de Andrade; FUKUSHIMA, Julia Tizue; ADRA, Thais Rodrigues; HOFF, Paulo M.; ESTEVEZ-DIZ, Maria Del Pilar
    Background: CC is the leading cause of cancer death among women in developing countries. ERCC1 protein participates in DNA repair through the nucleotide excision repair pathway, involved in resistance to platinum-based chemotherapy. Its value as a predictive marker of tumor response to treatment, progression or death is still unknown. We evaluated ERCC1 protein expression and clinical variables as a predictive marker of progression-free survival (PFS) and overall survival (OS) in patients (pts) with CC submitted to CR. Methods: Retrospective data analysis of pts with histological diagnosis of CC, treated with CR between 2004-2009. Platinum-based chemotherapy was administered weekly (x6) concurrent to external beam radiotherapy (EBRT) to the pelvis (39.6 – 45.0 Gy), parametrial boost (14.0 – 20.0 Gy) when indicated and high-dose rate brachytherapy (HDR) (28.0 – 30.0 Gy). ERCC1 expression was assessed by immunohistochemistry (IHC). Results: We analyzed 75 pts, median age was 55 years (range 24-76), the performance status (PS) was 0 or 1 at baseline in 50 pts (66%) and 63 had squamous histology (84%). Thirty-two were stage IIB (43%) and 19 were IIIB (25%). Sixty-five patients received cisplatin 40mg/m2/w (87%) and 9, carboplatin AUC2/w (12%), median of 6 cycles (range 2-9). Median RT and HDR doses were 59.4 Gy (range 40.4 to 60.3) and 28.0 Gy (range 14.0 – 37.5), respectively. Thirty-two pts were available by ERCC1 IHC and all expressed the marker. Median PFS and OS were 35.5 (95% CI – 13.8 - 57.6) and 81 (95% CI- 21.2 - 140.8) months, respectively. In multivariate analysis, receiving < 6 chemotherapy cycles and baseline Hb <10.0 were correlated with disease progression and death, HR 0.302; p 0.011 (95% CI- 0.012-0.762) and HR 0.6; p 0.00 (95% CI- 0.474 – 0.760), respectively. PS at baseline did not correlate with PFS or OS, HR 0.985; p 0.614 (95% CI 0.930 – 1.044). Conclusions: In this population, since all pts expressed the protein, ERCC1 expression couldn't discriminate patients who most benefit from CR. Interestingly, a minimum of 6 chemotherapy cycles and a baseline Hb ≥ 10.0 seem to have a prognostic value.
  • article 22 Citação(ões) na Scopus
    First report of a clinical isolate of Candida haemulonii in Brazil
    (2012) ALMEIDA JR., Joao Nobrega de; MOTTA, Adriana Lopes; ROSSI, Flavia; ABDALA, Edson; PIERROTTI, Ligia Camera; KONO, Adriana Satie Goncalves; DIZ, Maria Del Pilar Estevez; BENARD, Gil; NEGRO, Gilda Maria Barbaro Del
  • conferenceObject
    PROGNOSTIC FACTORS AND TREATMENT OF CERVICAL CANCER (CC) IN ELDERLY
    (2012) CAIRES, I. Q. S.; LIMA, R. C. A. D.; BARROSO-SOUSA, R.; ANDRADE, E. M. P. D.; SILVA, J. R. D.; SANCHEZ, F. B.; HOFF, P. M.; DIZ, M.
    Background Cancer diagnostics in the elderly is increasing over the years. Although elderly represent less than 10% of CC patients (pts), they usually present more advanced disease and do't receive aggressive treatment. Methods Retrospective analysis of pts ≥ 70 years old with CC consecutively admitted at single institution from Aug/2002 up to Feb/2012. Primary endpoint was overall survival (OS). Secondary endpoint was assessment of prognostic factors for OS and treatment received. Survival was estimated using the Kaplan-Meier methods, the curves were compared by the log-rank test and frequencies with chi-square test. Results 70 pts were analyzed (7.5% of all CC pts). Median age was 76 years old (range, 70-91y). Squamous carcinoma was the most common histological type (61 pts, 87.1%), 57 (81.4%) were performance status (PS) 0 or 1 and 37 (52.5%) were eutrophic (Body Mass Index 18.5- 25 Kg/m2). In terms of initial staging, 14 pts (20%) were stage I, 30 pts (42.8%) II, 10 pts (14.2%) III, 14 pts (20%) IVa and 2 pts (2.8%) IVb. Regarding the treatment, 32 pts (45.7%) underwent chemoradiotherapy (CRT), 19 pts (27.1%) isolated radiotherapy (RT), 12 pts (17.1%) surgery and 7 pts (10%) best supportive care (BSC). Among CRT pts, 19 (59.3%) completed the full treatment (platinum-based chemotherapy administered for 6 weeks concomitantly with external radiotherapy in the pelvis, total dose of 45 Gy, and 4 inserts from 7 to 7.5 Gy of brachytherapy); 16 (50%) received cisplatin and 16 (50%) carboplatin. In a median follow up of 15.3 mo (range, 0.1- 79.8 mo), mean OS was 79.8 mo for all pts in this analysis. Hemoglobin level ≥ 10 mg/dL pretreatment correlated with better mOS (HR 0.10; IC95% 0.02 to 0.42; p = 0.002), while creatinine ≥ 1 mg/dL before the treatment (HR 8.1; IC95% 1.87 to 34.88; p = 0.005) was considered risk factor to mortality. Pts who received QRT, RT had better mOS (HR 0,18; IC 95% 0,06 to 0.54; p= 0.002). Age, PS, BMI and comorbidities (pneumopathy, cardiopathy, dementia) did't correlate with mOS. Conclusions CRT is feasible in the elderly. Pts submitted to QRT, RT had better survival than those who did not undergo treatment and age alone can not be used to decide the conduct. Pts at baseline with Hb < 10 mg/dL and kidney disfunction had a poor prognosis.