CAROLINA RIBEIRO VICTOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Induction Chemotherapy for Locally Advanced Esophageal Cancer(2020) HARADA, Guilherme; BONADIO, Renata Rodrigues da Cunha Colombo; ARAUJO, Frederico Cantarino Cordeiro de; VICTOR, Carolina Ribeiro; SALLUM, Rubens Antonio Aissar; RIBEIRO JUNIOR, Ulysses; CECCONELLO, Ivan; TAKEDA, Flavio Roberto; CASTRIA, Tiago Biachi deBackground Concurrent chemoradiotherapy followed by surgery is the standard treatment for locally advanced esophageal cancer (EC), and the role of induction chemotherapy (IC) remains unclear. We aimed to study if the addition of IC to standard treatment increases the rate of pathologic complete response (pCR). Methods We assembled a retrospective analysis of patients (pts) diagnosed with locally advanced EC and treated with preoperative chemoradiotherapy followed by esophagectomy (CRT+S), preceded or not by IC, between 2009 and 2017. Patients' characteristics, tumor variables, and treatment outcomes were evaluated. The Kaplan-Meier method was used to estimate overall survival and the Cox proportional hazard model to evaluate prognostic factors. Results One hundred and three patients were studied, with a median age of 62 years (range 37-84). Seventy-five patients (73%) were male, 67 (65%) had squamous cell carcinoma, and 31 (30%) had adenocarcinoma. Forty-three patients (41.7%) received IC followed by CRT+S (IC+CRT+S). The most frequent IC consisted of paclitaxel and platinum chemotherapy (90%), and the median number of cycles was 2. All patients received CRT+S. Concurrent chemotherapy was a combination of paclitaxel and platinum in 94 patients (91%). There was no statistically significant difference in pCR between the IC group and the standard CRT+S group. The pCR was 41.9% and 46.7% in the IC+CRT+S and CRT+S groups (p = 0.628), respectively. In the multivariate analysis, pCR was an independent prognostic factor for time to treatment failure (TTF) (HR 0.35, p = 0.021), but not for overall survival (OS) (p = 0.863). The factor that significantly affected OS in the multivariate analysis was positive lymph node (HR 5.9, 95%, p = 0.026). Conclusions Our data suggest that the addition of IC to standard CRT + S does not increase the pCR rate in locally advanced EC. No difference in OS was observed between pts. that received or not IC. Regardless of the treatment received, pts. achieving a pCR presented improved TTF.
- INTRAPERITONEAL CHEMOTHERAPY FOR GASTRIC CANCER WITH PERITONEAL CARCINOMATOSIS: STUDY PROTOCOL OF A PHASE II TRIAL(2023) RAMOS, Marcus Fernando Kodama Pertille; PEREIRA, Marina Alessandra; CHARRUF, Amir Zeide; VICTOR, Carolina Ribeiro; GREGORIO, Joao Vitor Antunes Marques; ALBAN, Luciana Bastos Valente; MONIZ, Camila Motta Venchiarutti; ZILBERSTEIN, Bruno; MELLO, Evandro Sobroza De; HOFF, Paulo Marcelo Gehm; JUNIOR, Ulysses Ribeiro; DIAS, Andre RonconBackground: Peritoneal carcinomatosis in gastric cancer is considered a fatal disease, without expectation of definitive cure. As systemic chemotherapy is not sufficient to contain the disease, a multimodal approach associating intraperitoneal chemotherapy with surgery may represent an alternative for these cases.Aims: The aim of this study was to investigate the role of intraperitoneal chemotherapy in stage IV gastric cancer patients with peritoneal metastasis.Methods: This study is a single institutional single-arm prospective clinical trial phase II (NCT05541146). Patients with the following inclusion criteria undergo implantation of a peritoneal catheter for intraperitoneal chemotherapy: Stage IV gastric adenocarcinoma; age 18-75 years; Peritoneal carcinomatosis with peritoneal cancer index<12; Eastern Cooperative Oncology Group 0/1; good clinical status; and lab exams within normal limits. The study protocol consists of four cycles of intraperitoneal chemotherapy with paclitaxel associated with systemic chemotherapy. After treatment, patients with peritoneal response assessed by staging laparoscopy undergo conversion gastrectomy.Results: The primary outcome is the rate of complete peritoneal response. Progression-free and overall survivals are other outcomes evaluated. The study started in July 2022, and patients will be screened for inclusion until 30 are enrolled.Conclusions: Therapies for advanced gastric cancer patients have been evaluated in clinical trials but without success in patients with peritoneal metastasis. The treatment proposed in this trial can be promising, with easy catheter implantation and ambulatory intraperitoneal chemotherapy regime. Verifying the efficacy and safety of paclitaxel with systemic chemotherapy is an important progress that this study intends to investigate.
- PREOPERATIVE CHEMOTHERAPY VERSUS UPFRONT SURGERY FOR ADVANCED GASTRIC CANCER: A PROPENSITY SCORE MATCHING ANALYSIS(2023) HONG, Stefany; PEREIRA, Marina Alessandra; VICTOR, Carolina Ribeiro; GREGORIO, Joao Vitor Antunes; ZILBERSTEIN, Bruno; RIBEIRO JUNIOR, Ulysses; D'ALBUQUERQUE, Luiz Augusto Carneiro; RAMOS, Marcus Fernando Kodama PertilleBACKGROUND: Surgical resection remains the main curative therapeutic modality for RESUMO -Racional: O tratamento de escolha para pacientes com hipertensao portal advanced gastric cancer. Recently, the association of preoperative chemotherapy has allowed the improvement of results without increasing surgical complications. AIMS: To evaluate the surgical esquistossomotica com sangramento de varizes e a desconexao azgo-portal mais and oncological outcomes of preoperative chemotherapy in a real-world setting. METHODS: A esplenectomia (DAPE) associada a trai doscopica. Porem, estudos ostrm aumento retrospective review of gastric cancer patients who underwent gastrectomy was performed. do calibre das varizes em alguns pacientes durante segimento em lngo prazo. Objetivo: Patients were divided into two groups for analysis: upfro nt surgery and preoperative chemotherapy. Avaliar o impacto da DAPE e tratamento endoscopico pos-operatorio no comportameno The propensity score matching analysis, including 9 variables, was applied to adjust for potential das varizes esofagicas e recidiva hemorragica, de pacientes esquistossomoticos. Metodos: confounding factors. RESULTS: Of the 536 patients included, 112 (20.9%) were referred for preoperative chemotherapy. Before the propensity score matching analysis, the groups were Foram estudados 36 pacientes com seguimento superior a cinco anos, distribuidos em different in terms of age, hemoglobin level, node metastasis at clinical stage-status, and extent dois grupos: queda da pressao portal abaixo de 30% e acima de 30% comparados com o of gastrectomy. After the analysis, 112 patients were stratified for each group. Both were similar calibre ds varize esofagicas no pos-operaorio precoce tardio ale do indice de reciiva for all variables assigned in the score. Patients in the preope rative chemotherapy group had less hemorragica. Resultados advanced postoperative p staging (p=0.010), postoperative n staging (p<0.001), and pTNM stage esofagicas que, durante o seguimento aumentaram de calibre e foram controladas com (p<0.001). Postoperative complications, 30-and 90-days mortality were similar between both groups. Before the propensity score matching analysis, there was no difference in survival between the groups. After the analysis, patients in the preoperative chemotherapy group had better overall o comportamento do calibre das varizes no pos-operatorio precoce nem tardio nm os survival compared to upfront surgery group (p=0.012). Multivariate analyses demonstrated that indices de recidiva hemorragica. Conclusao American Society of Anesthesiologists III/IV category and the presence of lymph node metastasis were factors significantly associated with worse overall survival. CONCLUSIONS: Preoperative operatorios precoces ou tardios. A comparacao entre a queda de pressao do portal e as chemotherapy was associated with increased survival in gastric cancer. There was no difference in the postoperative complication rate and mortality compared to upfront surgery.