TIAGO BIACHI DE CASTRIA
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- Safety and Effectiveness of Chemotherapy for Metastatic Esophageal Cancer in a Community Hospital in Brazil(2019) VICTOR, Carolina Ribeiro; FUJIKI, Femanda Kaori; TAKEDA, Flavio Roberto; HOFF, Paulo Marcelo Gehm; CASTRIA, Tiago Biachi dePURPOSE Despite epidemiologic and molecular differences between esophageal and stomach cancers, most published studies have included patients with either disease in a metastatic scenario. We evaluated the safety and effectiveness of chemotherapy in patients with metastatic esophageal cancer in the community setting. PATIENTS AND METHODS We performed a retrospective cohort study of patients with synchronous metastatic esophageal cancer treated at a public hospital between 2008 and 2016. Patients were grouped according to a prescribed chemotherapy protocol: platinum and taxane (group A); platinum and irinotecan (group B); platinum and fluoropyrimidine (group C); and without platinum (group D). RESULTS Of the 1,789 patients with esophageal cancer treated, we included 397 with metastatic disease at presentation. Squamous cell carcinoma was the most frequent histology (78.8%). Median overall survival (OS) was 7 months (95% CI, 6.15 to 7.85 months). Chemotherapy was administered to 285 patients, who reached a median OS of 9.0 months (95% CI, 8.0 to 9.9 months); for 112 patients who did not receive treatment, median OS was 3 months (95% CI, 2.3 to 3.7 months; P < .001). The most used combination was platinum plus irinotecan (A; 55.5%). Disease control with in groups A, B, C, and D was 39.2%, 30.1%, 53% and 14.3%, respectively. Patients in group C reached a median OS of 17 months (95% CI, 13.1 to 20.8 months; P = .034). No differences were observed in median OS obtained with other protocols (9 months). The toxicity profile was different according to chemotherapy, with more severe events (hematologic, diarrhea, and number of days hospitalized) occurring in group B. CONCLUSION Platinum plus paclitaxel or platinum plus irinotecan provided similar OS in community patients, although patients receiving irinotecan experienced more severe events. In the adenocarcinoma population, a fluoropyrimidine plus platinum-based regimen, although less frequently used, had a more favorable toxicity profile, with superior median OS and disease control. J Global Oncol. (C) 2019 by American Society of Clinical Oncology
conferenceObject Predicting adverse outcomes after cisplatin administration in head & neck and thoracic cancer(2013) BITTON, R. C.; CASTRIA, T. B.; AMARAL, A. A.; LOLLO, J. G.; SILVA, V. T. Costa e; BUDMANN, E.; HOFF, P. M.; CASTRO JR., G.conferenceObject Prognostic impact of primary tumor sidedness in stage III colorectal cancer(2023) PROTASIO, Bruno Mendonca; CASTRIA, Tiago Biachi de; SARAGIOTTO, Daniel Fernandes; NATALINO, Renato Jose Mendonca; MANGONE, Flavia Regina Rotea; SABBAGA, Jorge; HOFF, Paulo M.; CHAMMAS, RogerconferenceObject Maintenance chemotherapy (MC) in advanced non-small cell Jung cancer (NSCLC): A meta-analysis.(2014) CASTRIA, Tiago Biachi De; CASTRO, Gilberto; HOFF, Paulo MarceloconferenceObject THE IMPACT OF POSTOPERATIVE COMPLICATIONS ON A RETURN TO INTENDED ONCOLOGIC TREATMENT (RIOT) IN RESECTED GASTRIC CANCER PATIENTS(2019) RAMOS, Marcus F.; CASTRIA, Tiago B. de; PEREIRA, Marina A.; DIAS, Andre R.; ANTONACIO, Fernanda F.; HOFF, Paulo M.; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; RIBEIRO, Ulysses- Epidemiology and Outcomes of Patients With Brain Metastases From Colorectal Cancer-Who Are These Patients?(2021) BONADIO, Renata Colombo; FREITAS, Guilherme Fialho; BATISTA, Daniel Negrini; MOREIRA, Otavio Augusto Noschang; DIAS, Carla A. R.; CASTRIA, Tiago Biachi; SABBAGA, Jorge; HOFF, Paulo M.Brain metastases have been seen more frequently in the late course of colorectal cancer. In this large cohort, we showed that, despite the advances in systemic therapy, prognosis remains poor for patients who develop brain metastases. Aggressive local therapy should be considered for selected patients. Background: Brain metastases (BMs) from colorectal cancer (CRC) are unusual; however, an increase in incidence has been reported. The evidence available on the subject is scarce, and a better understanding is warranted. We aimed to characterize the epidemiology and the outcomes of patients with BMs from CRC. Patients and Methods: A cohort of patients with BMs from CRC was retrospectively evaluated. Patients were treated in a single center between May 2008 and April 2019. BMs were confirmed by brain computed tomography or magnetic resonance imaging. Results: A total of 247 consecutive patients were evaluated. Most patients had a left-sided primary tumor (193, 78%) and at least two extra-cranial metastatic sites (194, 78%). Ninety-six patients (39%) were RAS wild-type; 68 patients (27%) were RAS mutated; and 83 patients (34%) were not characterized. Median time from the initial diagnosis to BMs was 27.6 months (interquartile range, 13.1-46.9). Regarding local therapy, 43 patients (17.4%) were treated with BM surgery alone, 76 patients (30.8%) with radiotherapy (RT) alone, and 58 patients (23.5%) with both surgery and RT. Median overall survival (OS) was 2.9 months (95% confidence interval [CI], 2.2-3.5). Six-month and 1-year OS rates were 29% (95% CI, 23-25) and 13.5% (95% CI, 9.2-18.6), respectively. In a multivariable analysis, BM surgery alone (hazard ratio [HR], 0.56; P =.018), RT alone (HR, 0.51; P =.001), and surgery plus RT (HR, 0.27; P <.001) were associated with superior OS, whereas Eastern Cooperative Oncology Group Performance Status 3 or 4 (HR, 2.01; P =.009) and male gender (HR, 1.46; P =.012) were negative prognostic factors. RAS status was not associated with OS. Conclusion: BMs occur late during the course of colorectal cancer and are more common in patients with a left-sided primary tumor and a high volume of metastatic disease. BMs from colorectal cancer are still associated with an extremely poor prognosis; however, selected patients may benefit from treatment with surgical resection and radiotherapy.
- Gastric cancer molecular classification and adjuvant therapy: Is there a different benefit according to the subtype?(2020) RAMOS, Marcus F. K. P.; PEREIRA, Marina A.; AMORIM, Larissa C.; MELLO, Evandro S. de; FARAJ, Sheila F.; JR, Ulysses Ribeiro; HOFF, Paulo M. G.; CECCONELLO, Ivan; CASTRIA, Tiago B. deBackground Gastric cancer (GC) has been defined in distinct molecular subtypes with different therapeutic implications. However, its clinical significance and prognosis regarding standard chemotherapy (CMT) remains unclear. This study aimed to analyze the impact of perioperative or adjuvant treatment among subtypes of GC. Methods We retrospectively evaluated all stage II/III patients with GC who underwent a curative gastrectomy. Based on immunohistochemistry and in situ hybridization techniques, GC was classified into five subtypes: Epstein-Barr virus (EBV) positive, microsatellite instability (MSI), e-cadherin aberrant, p53-aberrant, and p53-normal. Results Among the 178 CG included, 111 patients received CMT and 67 were treated with surgery alone. Survival analysis showed that p53-aberrant GC treated with CMT had better disease-free survival (DFS) compared with surgery alone (P = .001).There was no significant difference in DFS between patients who received CMT and those with surgery alone for EBV, MSI, E-cadherin, and p53-normal GC. An improvement in overall survival was observed only for E-cadherin (P = .001) and p53-aberrant (P < .001) patients who received CMT. Conclusions CMT showed different impact on the survival of CG according to the molecular subtype. No survival benefit was observed for EBV and MSI groups who received CMT. GC with p53-aberrant had a significant benefit in survival with standard therapy.
conferenceObject Comparison of CKD-EPI, MDRD and Cockcroft-Gault to estimate baseline renal function in patients with head & neck and thoracic cancers(2013) CASTRIA, T. B.; BITTON, R. C.; AMARAL, A. A.; LOLLO, J. G.; SILVA, V. T. Costa e; BURDMANN, E.; HOFF, P. M.; CASTRO JR., G.- Return to Intended Oncologic Treatment (RIOT) in Resected Gastric Cancer Patients(2020) RAMOS, Marcus Fernando Kodama Pertille; CASTRIA, Tiago Biachi de; PEREIRA, Marina Alessandra; DIAS, Andre Roncon; ANTONACIO, Fernanda Fronzoni; ZILBERSTEIN, Bruno; HOFF, Paulo Marcelo Gehm; RIBEIRO JR., Ulysses; CECCONELLO, IvanBackground Postoperative chemotherapy (CMT) or chemoradiotherapy (CRT) is commonly recommended for gastric cancer (GC) patients in order to improve survival. However, some factors that prevent patients from return to intended oncologic treatment (RIOT) may increase the risk of recurrence and decrease the survival benefits achieved with curative resection. The aim of this study was to determine the frequency and factors associated with inability to RIOT and their impact on survival. Methods This retrospective study included stage II/III GC patients treated with potentially curative gastrectomy. Patients who could return to intended oncologic treatment (RIOT group) and those who could not (inability to RIOT group) were analyzed. Results Of the 313 eligible GC patients, 89 (28.4%) and 85 (27.2%) patients receive CRT and CMT, respectively, representing a RIOT rate of 55.6%. The main reason was attributed to general poor performance status (30.2%), followed by surgical postoperative complications (POC) (20.1%). Older age, higher ASA, D1 lymphadenectomy, and major POC were related to inability to RIOT. Older age, neutrophil-lymphocyte ratio (NLR), and major POC were independent risk factors for inability to RIOT. Five-year DFS and OS were worse for the inability to RIOT group than for the RIOT group (p = 0.008 and p = 0.004, respectively). In multivariate analyses, absence of neoadjuvant therapy, total gastrectomy, pT3/T4, pN+, and inability to RIOT were associated with worse DFS. Type of gastrectomy, lymphadenectomy, pN status, Rx resection, and RIOT group were associated with OS. Conclusion Older age, high NLR, and major POC were risk factors for inability to RIOT. RIOT was an independent predictor of survival.
- Impact of adjuvant treatment according to gastric cancer molecular subtypes.(2019) CASTRIA, Tiago Biachi De; AMORIM, Larissa Costa; RAMOS, Marcus Fernando Kodama Pertille; PEREIRA, Marina Alessandra; MELLO, Evandro Sobroza de; FARAJ, Sheila; SABBAGA, Jorge; HOFF, Paulo Marcelo