INACELLI QUEIROZ DE SOUZA CAIRES

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Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina

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Assunto: Cervical cancer ×

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  • article 12 Citação(ões) na Scopus
    Carboplatin-based chemoradiotherapy in advanced cervical cancer: an alternative to cisplatin-based regimen?
    (2016) SEBASTIAO, Ana Morais; ROCHA, Lucila Soares da Silva; GIMENEZ, Rodrigo Darouche; BARROS, Laryssa Almeida Borges de; FUKUSHIMA, Julia Tizuko; SILVA, Samantha Cabral Severino da; MIRANDA, Vanessa da Costa; CAIRES, Inacelli Queiros de Souza; FREITAS, Daniela de; ABDO FILHO, Elias; DIZ, Maria Del Pilar Estevez
    Objective: To evaluate the results of treatment with cisplatin or carboplatin concomitant with radiotherapy (RT) in cases of locally advanced cervical cancer (CC). Methods: This study is a retrospective analysis of medical records of 184 patients with cervical cancer stage IIB-IVA who were treated at Instituto do Cancer do Estado de Sao Paulo from May 2008 to December 2012. All patients received complete pelvic region external-beam RT with weekly cisplatin (cis-RT, 40 mg/m(2); n = 159) or carboplatin (carbo-RT, AUC 2; n = 25), followed by high-dose-rate intracavitary brachytherapy (HDR-ICBT). Primary endpoint was progression free survival; secondary endpoints were overall survival and overall response rate, which includes complete and partial responses. Results: Five or more chemotherapy cycles were administered to 87.3% and 84% of the cis-RT- and carbo-RT- treated patients, respectively (p = 0.749). Estimated 3-years progression free survival was 59% in the cis-RT group vs 40% in the carbo-RT group (p = 0.249). Estimated 3-years overall survival was 70% in the cis-RT group vs 68% in the carbo-RT group (p = 0.298). Overall response rate (95.3% cis-RT vs 95.4% carbo-RT; p = 0.911) and grade >= 3 toxic effects (8.5% cis-RT vs 11.8% carbo-RT; p = 0.757) were similar. In multivariate analysis, only the overall response rate was a significant predictor of survival. Conclusions: Patients with advanced cervical cancer who are treated with carbo-RT have similar 3-years overall survival, progression free survival, overall response rate, and toxic effects when compared to cis-RT-treated patients. Carbo-RT may be an alternative treatment in patients that cannot receive cisplatin.
  • article 7 Citação(ões) na Scopus
    Definitive chemoradiotherapy for advanced cervical cancer: should it be different in the elderly?
    (2015) CAIRES, Inacelli Queiroz de Souza; SOUZA, Karla Teixeira; NEGRAO, Marcelo Vailati; OLIVEIRA, Julia Andrade de; BARROSO-SOUSA, Romualdo; LIMA, Rafael Caires Alvino de; HOFF, Paulo Marcelo Gehm; DIZ, Maria del Pilar Estevez
    Background: Cervical cancer (CC) is the second most common cancer in Brazilian women, and approximately 10% of cases occur in elderly patients (pts). In this age group, disease is usually diagnosed in more advanced stages and oncological therapies are usually less intensive, due to comorbidities and impaired performance status. Methods: Retrospective analysis of pts >= 65 years old with CC admitted at a Brazilian University Cancer Center from August 2008 to February 2012. We performed a descriptive analysis of baseline performance status (PS), disease stage (FIGO), histology, body mass index (BMI), treatment received and overall survival, using the Kaplan-Meier method. Results: 900 medical records were analyzed and 75 pts (8%) fulfilled the inclusion criteria. Median age was 73.4 years old (+/- 5.5 years). Squamous cell carcinoma (SCC) was the most common histology (71 pts, 94.7%). 67 (89.3%) had PS 0 or 1 and 52 pts (69.3%) were eutrophic (BMI 18.5-25 kg/m(2)). At presentation, disease staging consisted of 18 pts (24%) stage I, 35 pts (46.7%) stage II, 8 pts (10.7%) stage III, 12 pts (16%) stage IVa and 2 pts (2.7%) stage IVb. 24 pts (32%) underwent surgery (hysterectomy, adnexectomy, pelvic and paraaortic lymphadenectomy). Adjuvant treatment with radiotherapy (RT) was performed in 13 pts (total dose of external RT in pelvis ranged from 39.6 to 45 Gy, parametrial boost ranged from 14 to 20 Gy and 4 inserts from 7 to 7.5 Gy of brachytherapy); 8 of them received concomitant platinum-based chemotherapy (CT). 30 pts underwent definitive CRT, 17 definitive RT, 1 palliative CT and 3 best supportive care. In the CRT group, 18 pts received cisplatin (CDDP 40 mg/m(2)/w/6w) and 12 carboplatin (AUC 2/w/6w). During definitive CRT, treatment was discontinued in 39% of pts who received CDDP and 25% of pts who received carboplatin, all due to treatment toxicities. CDDP was associated with more nefrotoxicity (5 pts, 28%) than carboplatin (1 Pt, 8.3%). The CDDP group also presented more radiodermatitis and stroke. However, myelosuppression and diarrhea were similar in both groups. After a 26.1-month follow-up, median OS was not reached. Conclusions: Despite advanced age, more than 60% of pts underwent complete CRT treatment. Thus, age should not be the only factor to guide therapeutic decisions in CC. Carboplatin was better tolerated than CDDP in CRT group, but prospective trials are necessary to evaluate the best treatment option in this population.