LUIZ GUILHERME CERNAGLIA AURELIANO DE LIMA
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3
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
20 resultados
Resultados de Busca
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- High dose image-guided, intensity modulated radiation therapy (IG-IMRT) for chordomas of the sacrum, mobile spine and skull base: preliminary outcomes(2022) CHEN, Andre Tsin Chih; HONG, Carlos Bo Chur; NARAZAKI, Douglas Kenji; RUBIN, Virginio; SERANTE, Alexandre Ruggieri; RIBEIRO JUNIOR, Ulysses; LIMA, Luiz Guilherme Cernaglia Aureliano de; COIMBRA, Brian Guilherme Monteiro Marta; CRISTANTE, Alexandre Fogaca; TEIXEIRA, William Gemio JacobsenPurpose To report preliminary outcomes of high dose image-guided intensity modulated radiotherapy (IG-IMRT) in the treatment of chordomas of the sacrum, mobile spine and skull base. Methods Retrospective analysis of chordoma patients treated with surgery and/or radiotherapy (RT) in a single tertiary cancer center. Initial treatment was categorized as (A) Adjuvant or definitive high-dose RT (78 Gy/39fx or 24 Gy/1fx) vs (B) surgery-only or low dose RT. The primary endpoint was the cumulative incidence of local failure. Results A total of 31 patients were treated from 2010 through 2020. Median age was 55 years, tumor location was 64% sacrum, 13% lumbar, 16% cervical and 6% clivus. Median tumor volume was 148 cc (8.3 cm in largest diameter), 42% of patients received curative-intent surgery and 65% received primary RT (adjuvant or definitive). 5-year cumulative incidence of local failure was 48% in group A vs 83% in group B (p = 0.041). Tumor size > 330 cc was associated with local failure (SHR 2.2, 95% CI 1.12 to 7.45; p = 0.028). Eight patients developed distant metastases, with a median metastases-free survival of 56.1 months. 5-year survival for patients that received high dose RT was 72% vs 76% in patients that received no or low dose RT (p = 0.63). Conclusion Our study suggests high-dose photon IG-IMRT improves local control in the initial management of chordomas. Health systems should promote reference centers with clinical expertise and technical capabilities to improve outcomes for this complex disease.
conferenceObject Characterization of EGFR Activating Mutations in Brazilian Patients with Pulmonary Adenocarcinoma(2015) YEN, Cheng T.; BITTON, Rafael C.; LIMA, Luiz G. C. A. De; AMADIO, Alex V.; TAKAHASHI, Tiago K.; MARINI, Andrea M.; TAKAGAKI, Tereza Y.; TERRA, Ricardo M.; MELLO, Evandro S.; CASTRO JR., Gilberto De- Tumor Reduction with Pazopanib in a Patient with Recurrent Lumbar Chordoma(2018) RIBEIRO, Mauricio Fernando Silva Almeida; SOUSA, Micelange Carvalho de; HANNA, Samir Abdallah; MALDAUN, Marcos Vinicius Calfat; KURIMORI, Ceci Obara; LIMA, Luiz Guilherme Cernaglia Aureliano de; MATTEDI, Romulo Loss; MUNHOZ, Rodrigo RamellaIntroduction. Chordomas are rare malignancies of bone origin that occur in the axial skeleton, typically the skull base and lumbar/sacral regions. Although often classified as low-grade neoplasms, its locally infiltrative behavior may result in significant morbidity and mortality. Optimal surgical resection may be curative, but up to 50% of the cases relapse within 5 years, and currently there are no systemic treatments approved in this setting. A large proportion of these tumors express stem-cell factor receptor (c-KIT) and platelet-derived growth factor receptors (PDGFRs), providing a rationale for the use of tyrosine-kinase inhibitors (TKIs). Case report. A 27-year-old male presented with recurrent chordoma of the lumbar spine 4 years after initial diagnosis. Salvage therapies in the interval included repeat resections and radiation therapy. He ultimately developed multifocal recurrence not amenable to complete excision or reirradiation. A comprehensive genomic profiling assay was performed and revealed nondrugable alterations. Decision was made to proceed with systemic treatment with pazopanib 800 mg/day, resulting in tumor reduction (-23.1% reduction in size) and prolonged disease control. Conclusion. For this patient with a multiple recurrent chordoma and limited treatment options, pazopanib resulted in sustained clinical benefit following initial tumor reduction.
- Complete response to alectinib following crizotinib in an ALK-positive tumor with CNS involvement(2021) XAVIER, Camila B.; CANEDO, Felipe S. N. A.; LIMA, Fabiola A. S.; MELO, Raissa R.; LIMA, Luiz Guilherme C. A.; MARIN, Jose Flavio G.; SOUZA, Ciro E.; FEHER, OlavoInflammatory myofibroblastic tumor (IMT) is a rare entity that affects mostly children and young adults. The lungs are the most frequent primary site. When feasible, surgical resection is the standard of care and it is associated with long-term survival benefit. Metastatic disease is rare, and central nervous system involvement is very infrequent. There is paucity of data regarding systemic treatment of recurrent or metastatic disease but most IMTs present with ALK rearrangements, becoming potential targets to ALK inhibition. Diagnosis of ALK rearrangements by FISH or RT-PCR is standard and discordant results from immunohistochemistry are rare. Crizotinib is considered the standard therapy in ALK-positive cases. Data supporting the use of other ALK inhibitors are scant and derived only from case reports. We report a case of a patient harboring an ALK-positive by IHC, FISH-negative IMT, that initially responded well to crizotinib but progressed in the CNS, presenting a complete CNS response with second-generation ALK inhibitor alectinib.
conferenceObject Primary Lung Fibrous Histiocytoma Presenting as Diffuse Pulmonary Cystic Disease(2020) MAIA, A. P.; MARTIN, S. R. San; BRIDI, G. P.; BEDER, T. N.; COLARES, P. F.; HOLZ, I. M.; SERRA, J. P.; NASCIMENTO, E. C. T.; LIMA, L. G. C. A.; AMARAL, A. F.; OLIVEIRA, M. R.; BALDI, B. G.; KAIRALLA, R. A.conferenceObject Metastatic vena cava leiomyoma of Mullerian origin: an unusual presentation of a histologically benign smooth muscle tumour(2018) ANDRADE, D. Carvalho; NAVAS, D. A. Ortiz; LIMA, L. G. C. A. de- Rectal leiomyosarcoma as the initial phenotypic manifestation of Li–Fraumeni-like syndrome: a case report and review of the literature(2022) SEVERINO, N. P.; WAISBERG, J.; FRAGOSO, M. C. B. V.; LIMA, L. G. C. A. de; BALSAMO, F.; HENRIQUES, A. C.; BIANCO, B.; GEHRKE, F. de SousaBackground: Leiomyosarcoma is a rare malignant tumor of smooth muscle origin and represents 10–20% of all soft tissue sarcomas. Primary colon and rectal sarcomas constitute < 0.1% of all large bowel malignancies. In Li–Fraumeni syndrome, sarcomas are the second most frequent cancer (25%). Li–Fraumeni syndrome is a genetic disease with a familial predisposition to multiple malignant neoplasms. This syndrome has an autosomal dominant pattern of inheritance and high penetrance characterized by germline TP53 mutations. Patients with a history of cancer who do not meet all the “classic” criteria for Li–Fraumeni syndrome are considered to have Li–Fraumeni-like syndrome. To the best of our knowledge, this article is the first report of a patient with rectal leiomyosarcoma as the initial phenotypic manifestation of Li–Fraumeni-like syndrome. The authors also present a literature review. Case presentation: A 67-year-old Brazilian woman underwent anterior rectosigmoidectomy and panhysterectomy secondary to rectal leiomyosarcoma. She subsequently developed carcinomatosis and died 2 years after the operation. Her family medical history consisted of a daughter who died at 32 years of age from breast cancer, a granddaughter diagnosed with adrenocortical carcinoma at 6 years of age and two siblings who died from prostate cancer. A genetic study was carried out to identify a pathogenic variant of Li–Fraumeni syndrome. In the DNA extracted from the peripheral blood leukocyte, restriction fragment length polymorphism was analyzed to search for mutations in the TP53 gene. The DNA sequencing identified the germline pathogenic variant p. R337H heterozygous in exon 10 of TP53. The patient was classified as having Li–Fraumeni-like syndrome. Conclusion: In patients with rectal leiomyosarcoma, it is advisable to investigate the family history of cancer and perform genetic studies to screen for Li–Fraumeni syndrome. © 2022, The Author(s).
conferenceObject Nodal Upstaging Comparison of Open, Video-Assisted Thoracoscopic, and Robotic Lung Resections Form Non-Small Cell Lung Cancer(2021) TERRA, R.; VEGA, A. Dela; LAURICELLA, L.; ROCHA JR., E.; LIMA, L.; CREMONESE, M.; PEGO-FERNANDES, P.conferenceObject Sarcoid-Like Pulmonary Reaction Due To Chronic Lymphocitic Leukaemia(2017) KAWASSAKI, A. M.; BALDI, B. G.; AMARAL, A. F.; PEREIRA, D. A. S.; LIMA, L. G. C. A.; FREITAS, C. S. G.; CARVALHO, C. R. R.; KAIRALLA, R. A.conferenceObject Learning Curve in Robotic-Assisted Thoracoscopic Pulmonary Resection: Experience of a Brazilian Surgeon(2021) TERRA, R.; SOARES, M.; LIMA, L.; LAURICELLA, L.; ARAUJO, P. H. De; CAMPOS, J. R. De; PEGO-FERNANDES, P.