HELOISA DE ANDRADE CARVALHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Implementation of image-guided brachytherapy (IGBT) for patients with uterine cervix cancer: a tumor volume kinetics approach(2016) CARVALHO, Heloisa de Andrade; MENDEZ, Lucas Castro; STUART, Silvia Radwanski; GUIMARAES, Roger Guilherme Rodrigues; RAMOS, Clarissa Cerchi Angotti; PAULA, Lucas Assad de; SALES, Camila Pessoa de; CHEN, Andre Tsin Chih; BLASBALG, Roberto; BARONI, Ronald HuebPurpose: To evaluate tumor shrinking kinetics in order to implement image-guided brachytherapy (IGBT) for the treatment of patients with cervix cancer. Material and methods: This study has prospectively evaluated tumor shrinking kinetics of thirteen patients with uterine cervix cancer treated with combined chemoradiation. Four high dose rate brachytherapy fractions were delivered during the course of pelvic external beam radiation therapy (EBRT). Magnetic resonance imaging (MRI) exams were acquired at diagnosis (D), first (B1), and third (B3) brachytherapy fractions. Target volumes (GTV and HR-CTV) were calculated by both the ellipsoid formula (VE) and MRI contouring (VC), which were defined by a consensus between at least two radiation oncologists and a pelvic expert radiologist. Results: Most enrolled patients had squamous cell carcinoma and FIGO stage IIB disease, and initiated brachytherapy after the third week of pelvic external beam radiation. Gross tumor volume volume reduction from diagnostic MRI to B1 represented 61.9% and 75.2% of the initial volume, when measured by VE and VC, respectively. Only a modest volume reduction (15-20%) was observed from B1 to B3. Conclusions: The most expressive tumor shrinking occurred in the first three weeks of oncological treatment and was in accordance with gynecological examination. These findings may help in IGBT implementation.
bookPart Radioterapia no Tratamento do Doente com Dor(2019) GUIMARãES, Roger Guilherme Rodrigues; SOUZA, Evandro Cesar de; CARVALHO, Heloisa de Andrade- 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 dePurpose 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
conferenceObject Prophylactic cranial irradiation for extensive stage small cell lung cancer(2015) MATUTINO, A. Reis Brandao; MAK, M. Perez; TAKAHASHI, T. Kenji; BITTON, R. Caparica; NAKAZATO, D.; GUIMARAES, R. G. Rodrigues; GABRIELLI, F. C. Grosso; VASCONCELOS, K. Gondim Moutinho da Conceicao; CARVALHO, H. Andrade; CASTRO-JUNIOR, G.- Urinary infection or radiation cystitis? A prospective evaluation of urinary symptoms in patients submitted to pelvic radiotherapy(2019) XAVIER, Vitor Fonseca; GABRIELLI, Flavia Carolina Grosso; IBRAHIM, Karim Yaqub; GOMES, Mariana Vilela Soares; GUIMARAES, Roger Guilherme Rodrigues; ABDALA, Edson; CARVALHO, Heloisa de AndradeOBJECTIVES: The purpose of this study was to evaluate the incidence of urinary tract infection (UTI) in patients with cystitis symptoms who underwent pelvic radiation therapy and identify correlated predictive factors. METHODS: A prospective cohort study was conducted of patients who met the following: primary pelvic cancer treated with curative intent, older than 18 years old, and good performance status. The exclusion criteria were patients being treated for a UTI, using a urinary catheter, in dialysis or with cystostomy or nephrostomy, and using antibiotics during treatment. Urinalysis and urine culture were collected before the beginning of radiation therapy. Weekly evaluations of urinary symptoms were subsequently performed. In cases of new or worsening symptoms, a questionnaire was applied, and new urine exams were collected. The UTI diagnosis was defined by uroculture as bacterial growth greater than 104 CFU/mL. RESULTS: From September 2014 to November 2015, 112 patients were sequentially recruited, and 72 (64%) fulfilled the inclusion criteria. During follow-up, 24 (33%) patients had new urinary symptoms or worse preexisting symptoms. A UTI was confirmed in the second urinary culture in only one (1.4%) patient. CONCLUSIONS: The incidence of UTI was much lower than expected, suggesting that asymptomatic bacteriuria develops symptoms due to radiotherapy. Due to the low rate of UTI, no predictive factor was identified.