KARINA GONDIM MOUTINHO DA CONCEICAO

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

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Agora exibindo 1 - 10 de 24
  • article 6 Citação(ões) na Scopus
    Calcified carotid artery atheromas on panoramic radiographs of head and neck cancer patients before and after radiotherapy
    (2017) MARKMAN, Renata-Lucena; CONCEICAO-VASCONCELOS, Karina-Gondim-Moutinho; BRANDAO, Thais-Bianca; PRADO-RIBEIRO, Ana-Carolina; SANTOS-SILVA, Alan-Roger; LOPES, Marcio-Ajudarte
    Background: The aims of this study were to verify if head and neck radiotherapy (RT) is able to induce calcified carotid artery atheroma (CCAA) in a large head and neck cancer (HNC) population and also to compare the socio-demographic and clinical findings of patients with and without CCAA detected on panoramic radiographs. Material and Methods: Panoramic radiographs taken before and after head and neck radiotherapy (RT) of 180 HNC patients were selected and analyzed in order to identify the presence of CCAA. In addition, CCAA presence or absence on panoramic radiographs were compared and correlated with clinicopathological findings. Results: A high overall prevalence of CCAA was found on panoramic radiographs (63 out of 180 = 35%) of HNC patients. No significant difference of CCAA before and after RT was observed. There were also no differences between groups (with and without CCAA) regarding age, gender, tobacco and alcohol use, arterial hypertension, diabetes mellitus, acute myocardial infarction, hypercholesterolemia, tumor location, clinical stage of disease and RT dose. However, there was a greater prevalence of strokes in patients with CCAA (p<0.05). Conclusions: Although CCAA were frequently found in panoramic radiographs of patients with HNC, RT seems not to alter the prevalence of these calcifications.
  • article 5 Citação(ões) na Scopus
    The wolf in sheep's clothing: Microtomographic aspects of clinically incipient radiation-related caries
    (2016) MORAIS-FARIA, Karina; NEVES-SILVA, Rodrigo; LOPES, Marcio-Ajudarte; RIBEIRO, Ana-Carolina-Prado; CASTRO JR., Gilberto de; CONCEICAO-VASCONCELOS, Karina-Gondim-Moutinho da; BRANDAO, Thais-Bianca; SANTOS-SILVA, Alan-Roger
    Background: Radiation-related caries (RRC) can cause rapid progression, with a high potential for dental destruction affecting mainly cervical and incisal areas. Unlike the injuries that occur in the conventional caries, incipient RRC present in unusual surfaces have difficult diagnosis and classification stages of cavitation. Material and Methods: Evaluate the radiographic patterns of demineralization of RRC by using micro-CT. Ten teeth with incipient RRC and 10 teeth with incipient conventional caries (control group) matched by anatomic teeth group and caries affected surfaces were evaluated by X-ray microtomography (micro-CT) Skyscan 1174V2 (50Kv, 1.3 megapixel, Kontich, Belgium). Teeth were placed in a standard position for micro-CT (coronal, transaxial and sagittal sections) during images acquisition. Lesions were classified according to the depth of invasion and relationship with enamel, dentin and pulp. Results: RRC samples presented deeper lesions with higher involvement of enamel and dentin. Control group presented focal and superficial lesions with lower involvement of enamel and dentin. Conclusions: Incipient RRC present aggressive microtomographic patterns of demineralization when compared to conventional caries, as indicated by deep lesions, regardless of its clinically incipient aspects.
  • 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.
  • bookPart
    Cuidados e intervenções em pacientes com metástase óssea
    (2014) SILVA, Adriana Marques da; SOUSA, Angela Maria; VASCONCELOS, Karina Gondim Moutinho da Conceição; ALMEIDA, Luciana Alexandra Antônia de; CORREIA, Luiz Filipe Marques; ANDRADE, Lydia Caldeira Tavares de Oliveira; DIZ, Maria Del Pilar Estevez; SOARES, Melissa Wilhelm; CECATTO, Rebeca Boltes; ANDRADE, Rodrigo Guimarãesde; TEIXEIRA, William Gemio Jacobsen
  • article 26 Citação(ões) na Scopus
    Dosimetric distribution to the teeth of patients with head and neck cancer who underwent radiotherapy
    (2015) MORAIS-FARIA, Karina; MENEGUSSI, Gisela; VASCONCELOS, Karina Gondim Moutinho Conceicao; MARTA, Gustavo Nader; FERNANDES, Patricia Maria; DIAS, Reinaldo Brito; RIBEIRO, Ana Carolina Prado; LOPES, Marcio Ajudarte; CERNEA, Claudio Roberto; BRANDAO, Thais Bianca; SANTOS-SILVA, Alan Roger
  • conferenceObject
    Quality of life and sexual function of men who have sex with other men treated for anal cancer
    (2020) MAURO, G. P.; VASCONCELOS, K. G. M. D. C.; CARVALHO, H. D. A.
  • article 23 Citação(ões) na Scopus
    IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients
    (2016) FREGNANI, Eduardo Rodrigues; PARAHYBA, Claudia Joffily; MORAIS-FARIA, Karina; FONSECA, Felipe Paiva; RAMOS, Pedro Augusto Mendes; MORAES, Fabio Yone de; VASCONCELOS, Karina Gondim Moutinho da Conceicao; MENEGUSSI, Gisela; SANTOS-SILVA, Alan Roger; BRANDAO, Thais B.
    Background: Radiotherapy (RT) is frequently used in the treatment of head and neck cancer, but different side-effects are frequently reported, including a higher frequency of radiation-related caries, what may be consequence of direct radiation to dental tissue. The intensity-modulated radiotherapy (IMRT) was developed to improve tumor control and decrease patient's morbidity by delivering radiation beams only to tumor shapes and sparing normal tissue. However, teeth are usually not included in IMRT plannings and the real efficacy of IMRT in the dental context has not been addressed. Therefore, the aim of this study is to assess whether IMRT delivers lower radiation doses to dental structures than conformal 3D radiotherapy (3DRT). Material and methods: Radiation dose delivery to dental structures of 80 patients treated for head and neck cancers (oral cavity, tongue, nasopharynx and oropharynx) with IMRT (40 patients) and 3DRT (40 patients) were assessed by individually contouring tooth crowns on patients' treatment plans. Clinicopathological data were retrieved from patients' medical files. Results: The average dose of radiation to teeth delivered by IMRT was significantly lower than with 3DRT (p = 0. 007); however, only patients affected by nasopharynx and oral cavity cancers demonstrated significantly lower doses with IMRT (p = 0.012 and p = 0.011, respectively). Molars received more radiation with both 3DRT and IMRT, but the latter delivered significantly lower radiation in this group of teeth (p < 0.001), whereas no significant difference was found for the other dental groups. Maxillary teeth received lower doses than mandibular teeth, but only IMRT delivered significantly lower doses (p = 0.011 and p = 0.003). Ipsilateral teeth received higher doses than contralateral teeth with both techniques and IMRT delivered significantly lower radiation than 3DRT for contralateral dental structures (p < 0.001). Conclusion: IMRT delivered lower radiation doses to teeth than 3DRT, but only for some groups of patients and teeth, suggesting that this decrease was more likely due to the protection of other high risk organs, and was not enough to remove teeth from the zone of high risk for radiogenic disturbance (>30Gy).
  • article 3 Citação(ões) na Scopus
    Quality of Life and Sexual Function of Men Who Have Sex With Men Treated for Anal Cancer: A Prospective Trial of a Neglected Population
    (2021) MAURO, Geovanne Pedro; VASCONCELOS, Karina Gondim Moutinho da Conceicao; CARVALHO, Heloisa de Andrade
    Background: Anal cancer is a rare disease, more prevalent in women. Men who have sex with men (MSM) are a high-risk neglected population. Aim: The primary objective was to assess quality of life (QoL) and sexual function (SxF) among MSM treated with radical chemoradiation for anal cancer. Secondary objectives were to assess survivals and to describe the sexual habits of the target population. Methods: Prospective single institution trial of MSM who were treated for anal cancer with curative intent between 2015 and 2019. QoL and SxF were the primary end-points and were assessed by validated questionnaires and sexual inventory. Overall survival, locoregional relapse-free, distant metastases free, and colostomy-free survivals were evaluated. Outcomes: Quality of life and sexual function. Results: Nineteen patients were accrued between November 2015 and August 2019. Median age was 59.3 years. Stage III disease was 53.4% and mean tumor size was 5.4 cm. Fifteen (79.0%) patients were living with HIV (PLHIV). Median follow-up was 21.8 months. Mean overall survival, locoregional relapse-free survival, distant metastases-free survival, and colostomy-free survival were, respectively, 20.8, 17.2, 19.8 and 17.4 months. No median value was reached. QoL followed a trend among questionnaires with significantly worsened values by the end of treatment and a raise to maximum value by three months after treatment, followed by a stabilization reached at 12 months after treatment. IIEF questionnaire showed moderate erectile dysfunction among the population. Intercourse frequency followed QoL measures. Clinical Implications: In a MSM population with anal canal cancer, QoL and SxF followed the same pattern up to one year after treatment. Most patients had their SxF compromised during follow-up as shown by IIEF levels and sexual inventory. Strengths and Limitations: It is a single institution prospective trial with a limited sample size. Nevertheless, there are no studies addressing this minority population, quality of life or otherwise, making it unique and a special contribution for the literature. Conclusion: Anal cancer and its treatment represent a burden to MSM regarding QoL and SxF. (C) 2021, International Society of Sexual Medicine.
  • article 0 Citação(ões) na Scopus
    Protocol determination for OSL in vivo measurements of absorbed dose in the oral mucosa in oral cancer patients: A pilot study
    (2023) VILLANI, D.; FARIA, K. M.; KAUARK-FONTES, E.; RIBEIRO, C. T. M.; MASCARENHAS, Y. M.; RIBEIRO, A. C. P.; VECHIATO-FILHO, A. J.; MENEGUSSI, G.; VASCONCELOS, K. G. M. C.; SANTOS-SILVA, A. R.; BRANDA, T. B.
    Radiation-induced oral mucositis (RIOM) is one of the major oral complications caused by radiotherapy (RT), and can lead a negative impact on patients' quality of life. Considering that there is no specific radiation therapy dose constraint for oral mucosa, the need to study the correlation between absorbed dose and effect in this area is crucial. This pilot study aims to report in vivo OSL dosimetry protocol to investigate the dose distribution in the oral mucosa in patients with oral cancer using Intraoral customised Stent (IOS). For measurements, aluminium oxide nanoDot dosimeters and a microStar ii OSL reader from Landauer Inc. were used. The OSL dosimetry system was calibrated with a 6 MV photon beam using an Elekta Synergy linear accelerator and solid water phantoms following the recommendations of the AAPM TG 191 protocol. The dose distribution in the oral mucosa using seven OSL dosimeters fixed on the intraoral stent was evaluated and compared with the dose distribution available from the RT planning for the patient. Our experimental results showed the expected linearity response of the nanoDot dosimeters from 20 to 200 cGy. The repeatability of readings was better than 1.0% in all commissioning measurements. The uncertainty budget of the commissioning analysis resulted in an overall type An uncertainty of similar to 3.4% at the 1-sigma level for dose calculation, compatible with the TG 191 protocol. The dose distribution in the oral mucosa was assessed and dose deviations up to 35% can be found in high dose gradient regions of the treatment planning. This type of deviation may impact on the development and progression of RIOM, as analysed in this protocol. It is feasible to establish this procedure in vivo dosimetry for a patient undergoing RT using a multidisciplinary approach. Additionally, intraoral customised stents can decrease radiation doses in the oral mucosa, and the understanding of the dose distribution in the oral mucosa may help to minimise damages from radiation.
  • article 7 Citação(ões) na Scopus
    Impact of radiation on tooth loss in patients with head and neck cancer: a retrospective dosimetric-based study
    (2021) GOMES-SILVA, Wagner; MORAIS-FARIA, Karina; RIVERA, Cesar; NAJAS, Gabriel Faria; MARTA, Gustavo Nader; VASCONCELOS, Karina Gondim Moutinho da Conceicao; CARVALHO, Heloisa de Andrade; CASTRO JR., Gilberto de; BRANDAO, Thais Bianca; EPSTEIN, Joel B.; SANTOS-SILVA, Alan Roger
    Objective. To characterize the dental adverse events after head and neck radiation therapy (HNRT) and to investigate the impact of regional radiation dose upon tooth loss outcomes. Study Design. A retrospective dosimetric-based analysis was conducted to assess dental events affecting post-HNRT extracted teeth and the impact of 3 different radiation doses ( 30 Gy, 30-60 Gy, and .001). The odds ratio for post-HNRT tooth extraction risk was approximately 3-fold higher for teeth exposed to 60 Gy (confidence interval, 1.56-5.35; P < .001), followed by an increased risk of delayed healing and osteoradionecrosis (ORN) in sites receiving doses above 50 Gy. Conclusions. Radiation caries was the major cause of dental extractions after HNRT, and the dosimetric analysis suggested that a high dose of radiation may negatively impact the dentition of survivors of head and neck cancer, increasing the risk of tooth loss and ORN. (Oral Surg Oral Med Oral Pathol Oral Radiol 2021;132:409-417)