FLAVIA CAROLINA GROSSO GABRIELLI

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Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • bookPart
    Opções não cirúrgicas no tratamento de câncer de pulmão
    (2013) ABREU, Carlos Eduardo Cintra Vita; CARVALHO, Heloisa de Andrade; GABRIELLI, Flavia
  • conferenceObject
    An Observational Study of the Prognosis of Inpatients Evaluated for Palliative Radiation Therapy
    (2018) SR., A. T. C. Chen; MAURO, G. P.; GABRIELLI, F.; CHAVES, C.; CASTRO, I.; VASCONCELOS, K.; SARAIVA, T.; REIS, M.; CARVALHO, H. D. A.
  • article 6 Citação(ões) na Scopus
    PROGRAD - An observational study of the prognosis of inpatients evaluated for palliative radiotherapy
    (2018) CHEN, Andre Tsin Chih; MAURO, Geovanne Pedro; GABRIELLI, Flavia; CHAVES, Cristiane de Lacerda Goncalves; CASTRO, Igor; VASCONCELOS, Karina Moutinho; REIS, Milena; SARAIVA, Thalita; CARVALHO, Heloisa Andrade de
    Background and purpose: Low-and-middle-income countries have resource constraints and waiting lists for radiotherapy (RT). In this context, we sought to determine the survival of inpatients evaluated for palliative RT in a large referral cancer center in Brazil. Material and methods: From November 2014 through December 2015, we enrolled 333 inpatients with palliative RT evaluation requests in this prospective observational study. We applied Palliative Prognostic Index (PPI) and Survival Prediction Score using Number of Risk Factors (NRF). Primary end-point was overall survival. Secondary endpoints were survival by PPI and NRF. (ClinicalTrials.gov number, NCT02312791). Results: Median survival (MS) for the entire cohort was 73 days. PPI <= 2 had MS of 120 days; PPI 2.5-4 had MS of 55 days (HR 1.84; 95% CI, 1.07-3.16); PPI >4 had MS of 39 days (HR 3.45; 95% CI, 2.07-5.74) (p<.0001). NRF 0-1 had MS of 129 days; NRF 2 had MS of 73 days (HR 1.74; 95% CI 0.89-3.38); NRF 3 had MS of 40 days (HR 2.95; 95% CI, 1.50-5.78) (p<.0001). Conclusion: Inpatients with palliative RT requests seem to have an overall poor survival. PPI and NRF can define subgroups with different prognosis. This could help hospitals and healthcare systems to standardize criteria for prioritization and contribute for fairness.
  • conferenceObject
    Neoadjuvant chemotherapy and radical surgery versus chemorradiation for stage IB2, IIA2 e IIB cervical cancer: A randomized controlled trial
    (2018) REIS FILHO, P. T. F.; ANDRADE, J. M.; BATISTA, M. P.; SOUSA, C. B.; OLIVEIRA, T. H. G. F.; ARRUDA, G. V.; OLIVEIRA, T. M. G.; GABRIELLI, F.; GENTA, M. L. N. D.; POVEDA, A. M.; DIZ, M. D. P. Estevez; REIS, F. J. Candido Dos
  • article 68 Citação(ões) na Scopus
    Neoadjuvant Chemotherapy With Cisplatin and Gemcitabine Followed by Chemoradiation Versus Chemoradiation for Locally Advanced Cervical Cancer: A Randomized Phase II Trial
    (2019) COSTA, Samantha Cabral S. da; BONADIO, Renata Colombo; GABRIELLI, Flavia Carolina G.; ARANHA, Andrea S.; GENTA, Maria Luiza N. Dias; MIRANDA, Vanessa C.; FREITAS, Daniela de; ABDO FILHO, Elias; FERREIRA, Patricia A. O.; MACHADO, Karime K.; SCARANTI, Mariana; CARVALHO, Heloisa de A.; ESTEVEZ-DIZ, Maria Del Pilar
    PURPOSE Although chemoradiation therapy (CRT) with cisplatin remains the standard treatment of patients with locally advanced cervical cancer (LACC), 40% of patients present with disease recurrence. Additional treatment strategies are required to improve outcomes. We conducted a trial to evaluate the efficacy and safety of neoadjuvant chemotherapy (NAC) with cisplatin and gemcitabine followed by CRT. METHODS In this phase II trial, patients with LACC (International Federation of Gynecology and Obstetrics stage IIB to IVA or with positive lymph nodes) were randomly assigned to three cycles of NAC with cisplatin and gemcitabine followed by standard CRT with weekly cisplatin plus pelvic radiotherapy or to standard CRT alone. The primary end point was 3-year progression-free survival (PFS). Secondary end points were response rate, 3-year locoregional control, 3-year overall survival (OS), safety, and quality of life. RESULTS From 107 patients enrolled in the trial, 55 were randomly assigned to the NAC arm and 52 to the CRT-alone arm. The majority of patients had squamous cell carcinoma (87.8%). After a median follow-up of 31.7 months, NAC was associated with an inferior PFS, with 3-year PFS rates of 40.9% v 60.4% in the CRT arm (hazard ratio, 1.84; 95% CI, 1.04 to 3.26; P = .033). NAC also was associated with a lower OS (3-year OS rate, 60.7% v 86.8%; hazard ratio, 2.79; 95% CI, 1.29 to 6.01; P = .006). After treatment completion, complete response rates were 56.3% in the NAC arm and 80.3% in the CRT arm (P = .008). Toxicities were similar in both arms, with the exception of hypomagnesemia and neuropathy being more common with NAC. CONCLUSION This study shows that the addition of NAC consisting of cisplatin and gemcitabine to standard CRT is not superior and is possibly inferior to CRT alone for the treatment of LACC. (C) 2019 by American Society of Clinical Oncology
  • conferenceObject
    Radiation Pneumonitis in Patients with Interstitial Lung Disease and Lung Cancer: Report of 6 Cases
    (2020) FREITAS, L. V. de; SERRA, J. P.; NAJAS, G. F.; PRADO, G. F.; KAWASSAKI, A. M.; TAKAGAKI, T. Y.; GABRIELLI, F.; JUNIOR, G. C.; OLIVEIRA, M. R.; KAIRALLA, R. A.; BALDI, B. G.
  • conferenceObject
    Efficacy and safety of adjuvant chemotherapy in lung cancer: Real-world evidence
    (2019) ROITBERG, F. S. R.; NEFFA, M. F. B. V.; BONADIO, R. R. C. C.; HARADA, G.; MENDOZA, E. Z.; MAK, M. P.; TAKAHASHI, T. K.; MARTINS, R. E.; MESQUITA, C.; SANTINI, F. C.; ARAUJO, P. H. X. N. de; LAURICELLA, L. L.; PRADO, G. F.; TAKAGAKI, T. Y.; MELLO, E. S. de; GABRIELLI, F.; CARVALHO, H. D. A. de Andrade; TERRA, R. M.; CASTRO JR., G. de
  • article 10 Citação(ões) na Scopus
    Adjuvant Carboplatin and Paclitaxel Chemotherapy Followed by Radiotherapy in High-Risk Endometrial Cancer: A Retrospective Analysis
    (2018) BONADIO, Renata Rodrigues da Cunha Colombo; AZEVEDO, Renata Gondim Meira Velame; HARADA, Guilherme; COSTA, Samantha Cabral Severino da; MIRANDA, Vanessa Costa; FREITAS, Daniela de; ABDO FILHO, Elias; FERREIRA, Patricia Alves de Oliveira; GABRIELLI, Flavia; DIZ, Maria del Pilar Estevez
    Purpose The best adjuvant treatment in high-risk endometrial cancer remains unclear. Although adjuvant chemotherapy seems to improve overall survival (OS) in locally advanced disease, the role of adding radiotherapy is not certain. We evaluated the outcomes of patients with high-risk endometrial cancer treated with adjuvant chemotherapy followed by radiotherapy. Patients and Methods We performed a retrospective analysis of patients with high-risk endometrial cancer (endometrioid histology stages III to IVA or carcinosarcoma, clear cell, or serous histology stages I to IVA) treated with adjuvant carboplatin and paclitaxel, followed by radiotherapy, from 2010 to 2017 at a Brazilian cancer center. The Kaplan-Meier method was used for survival analysis, and prognostic factors were analyzed using the Cox proportional hazards model. Results One hundred forty-six consecutive patients were evaluated. The OS rates were 86.2% at 3 years and 75.4% at 5 years. OS was significantly affected by pelvic lymphadenectomy (P = .001) and positive peritoneal cytology (P < .001). Three- and 5-year disease-free survival (DFS) rates were 78.3% and 69.5%, respectively. The initial site of recurrence was limited to the pelvis in 4.1% of patients, within the abdomen in 1.3%, and extra-abdominal in 11.6%. Patients with grade 1 or 2 endometrioid carcinoma had better prognosis than patients with endometrioid carcinoma grade 3 or nonendometrioid histology (3-year DFS, 93.67% v 68.5%, respectively; P = .0017). Conclusion Adjuvant carboplatin and paclitaxel, followed by radiotherapy, is effective in high-risk endometrial cancer and associated with low rates of pelvic recurrence, which might be explained by the addition of radiotherapy. The high-risk group is heterogeneous, and the benefit of adjuvant treatment in patients with grade 1 or 2 endometrioid carcinoma is less clear. (C) 2018 by American Society of Clinical Oncology
  • conferenceObject
    Adjuvant carboplatin and paclitaxel chemotherapy followed by radiotherapy in high-risk endometrial cancer: A retrospective analysis.
    (2017) BONADIO, Renata Rodrigues da Cunha Colombo; AZEVEDO, Renata Gondim Meira Velame; HARADA, Guilherme; COSTA, Samantha Cabral Severino da; MIRANDA, Vanessa Costa; FREITAS, Daniela de; FILHO, Elias Abdo; FERREIRA, Patricia Alves de Oliveira; GABRIELLI, Flavia; ESTEVEZ-DIZ, Maria Del Pilar
  • article 5 Citação(ões) na Scopus
    Prophylactic Cranial Irradiation for Extensive-Stage Small-Cell Lung Cancer: A Retrospective Analysis
    (2017) MATUTINO, Adriana; MAK, Milena P.; TAKAHASHI, Tiago K.; BITTON, Rafael C.; NAKAZATO, Denyei; FRAILE, Natalia M. P.; GUIMARAES, Roger G. R.; GABRIELLI, Flavia C. G.; VASCONCELOS, Karina G. M. C.; CARVALHO, Heloisa de A.; CASTRO JR., Gilberto de
    Purpose Extensive-stage small-cell lung cancer (esSCLC) is an incurable disease and represents a therapeutic challenge because of its poor prognosis. Studies in prophylactic cranial irradiation (PCI) in esSCLC have shown a decreased incidence of symptomatic brain metastases in patients who respond to systemic chemotherapy. However, its effect on overall survival is debatable. We evaluated the benefit of PCI in patients with esSCLC in terms of overall survival, progression-free survival, incidence of brain metastases, recurrence rate, and exposure to postrecurrence therapies. Materials and Methods We retrospectively reviewed electronic charts from patients diagnosed with esSCLC from 2008 to 2014 at our institution. All patients had negative baseline brain imaging before chemotherapy and PCI and received at least 4 cycles of platinum-based chemotherapy in the first-line setting without progressive disease on follow-up. PCI was performed at the discretion of the treating physician. Analyses were based on descriptive statistics. Survival curves were calculated by Kaplan-Meier method. Results Among 46 eligible patients, 16 (35%) received PCI and 30 (65%) did not. Compared with no PCI, PCI led to improved progression-free survival (median, 10.32 v 7.66 months; hazard ratio, 0.4521; 95% CI, 0.2481 to 0.8237; P < .001) and overall survival (median, 20.94 v 11.05 months; hazard ratio, 0.2655; 95% CI, 0.1420 to 0.4964; P < .001) as well as lower incidence of brain metastases (19% v 53%; P = .0273) and higher exposure to second-line chemotherapy (87% v 57%; P = .0479). Conclusion Careful patient selection for PCI can improve not only brain metastases control and higher second-line chemotherapy exposure but also patient survival. (c) 2017 by American Society of Clinical Oncology