DANIELA DE FREITAS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
9 resultados
Resultados de Busca
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conferenceObject Neoadjuvant chemotherapy with six cycles of carboplatin and paclitaxel in advanced ovarian cancer patients not candidates for optimal primary surgery: Safety and effectivenes(2013) MIRANDA, Vanessa Costa; FEDE, Angelo Bezerra de Sousa; ANJOS, Carlos Henrique Dos; SILVA, Juliana Ribeiro da; SANCHEZ, Fernando Barbosa; BESSA, Lyvia Rodrigues da Silva; CARVALHO, Jesus Paula; ABDO FILHO, Elias; FREITAS, Daniela; BARROS, Laryssa Almeida Borges de; SILVA, Samantha Cabral Severino da; ESTEVEZ-DIZ, Maria Del Pilar- Phase II study of capecitabine in substitution of 5-FU in the chemoradiotherapy regimen for patients with squamous cell carcinoma of the anal canal.(2012) RIBEIRO, Suilane Coelho; VENCHIARUTTI, Camila; RIECHELMANN, Rachel; GIL, Erlon; NAHAS, Caio; COUDRY, Renata; FREITAS, Daniela; SARAGIOTTO, Daniel F.; ARRUDA, Fernando; AZAMBUJA, Rodrigo; HOFF, Paulo
- 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 PilarPURPOSE 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
- 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 EstevezPurpose 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
- 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
conferenceObject Carboplatin-based chemoradiotherapy in advanced cervical cancer: An alternative to cisplatin-based regimen?(2014) SEBASTIAO, Ana Morals; ROCHA, Lucila Soares Da Silva; GIMENEZ, Rodrigo Darouche; CAIRES, Inacelli Queiroz De Souza; SILVA, Samantha Cabral Severino Da; BARROS, Laryssa Almeida Borges de; FUKUSHIMA, Julia Tizue; MIRANDA, Vanessa Costa; ABDO FILHO, Elias; FREITAS, Daniela; ESTEVEZ-DIZ, Maria Del Pilar- Neoadjuvant chemotherapy with cisplatin and gemcitabine followed by chemoradiation with cisplatin in locally advanced cervical cancer: A phase II, prospective, randomized, trial(2018) SILVA, Samantha; BONADIO, Renata R. C. Colombo; GABRIELLI, Flavia; ARANHA, Andrea Souza; GENTA, Maria Luiza; MIRANDA, Vanessa Costa; FREITAS, Daniela; FILHO, Elias Abdo; FERREIRA, Patricia Alves De Oliveira; KALIL, Karime; SCARANTI, Mariana; ESTEVEZ-DIZ, Maria Del Pilar
- CLINICOPATHOLOGICAL FEATURES ASSOCIATED WITH IMMUNOHISTOCHEMISTRY LOSS OF MISMATCH REPAIR PROTEIN MLH1 IN ENDOMETRIOID ENDOMETRIAL CARCINOMA(2019) FREITAS, D. de; AGUIAR, F. N.; ANTON, C.; BACCHI, C. E.; CARVALHO, J. P.; CARVALHO, F. M.
- Neoadjuvant chemotherapy with six cycles of carboplatin and paclitaxel in advanced ovarian cancer patients unsuitable for primary surgery: Safety and effectiveness(2014) MIRANDA, Vanessa da Costa; FEDE, Angelo Bezerra de Souza; ANJOS, Carlos Henrique dos; SILVA, Juliana Ribeiro da; SANCHEZ, Fernando Barbosa; BESSA, Lyvia Rodrigues da Silva; CARVALHO, Jesus de Paula; ABDO FILHO, Elias; FREITAS, Daniela de; DIZ, Maria del Pilar EstevezObjective. Three cycles of neoadjuvant chemotherapy (NACT) followed by interval debulking (ID) surgery is an alternative for patients with advanced ovarian cancer unresectable disease. This study aimed to determine the efficacy and safety of six cycles of NACT followed by cytoreduction. Methods. Retrospective analysis of all patients with advanced epithelial ovarian cancer, tubal carcinoma, or primary peritoneal carcinoma treated with platinum based NACT between January 2008 and February 2012. Results. Eighty-two patients underwent NACT; 78% and 18.2% had extensive stage IIIC or IV disease at diagnosis, respectively. Their median age was 60 years (41-82). On histology, serous adenocarcinoma was found in 90.2%. Patients did not receive chemotherapy after debulking surgery. 35.4% suffered grade 3/4 toxicity; the most commonly observed toxicities were hematologic and nausea. After NACT, 23.1% experienced clinical complete response, 57.4% partial response, and 12.1% disease progression. Complete resection of all macroscopic and microscopic disease (R0) was performed in 63.7%. Surgical complications were uncommon; however, four (6.2%) patients needed a second procedure due to operative complications and 18 (27.3%) needed blood transfusion after debulking. Over a median follow-up period of 19.2 months, median overall survival and chemotherapy-free interval were 37.5 months (confidence interval not reached) and 16 months, respectively. Conclusion. Six cycles of neoadjuvant carboplatin and paclitaxel was safe and effective and did not increase perioperative or postoperative complications in patients with stage IIIC/IV disease who were unsuitable for optimal PDS. The overall survival of this cohort was higher than that of those treated with ID surgery.