ANDRE TSIN CHIH CHEN

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Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina

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  • article 4 Citação(ões) na Scopus
    High dose image-guided, intensity modulated radiation therapy (IG-IMRT) for chordomas of the sacrum, mobile spine and skull base: preliminary outcomes
    (2022) CHEN, Andre Tsin Chih; HONG, Carlos Bo Chur; NARAZAKI, Douglas Kenji; RUBIN, Virginio; SERANTE, Alexandre Ruggieri; RIBEIRO JUNIOR, Ulysses; LIMA, Luiz Guilherme Cernaglia Aureliano de; COIMBRA, Brian Guilherme Monteiro Marta; CRISTANTE, Alexandre Fogaca; TEIXEIRA, William Gemio Jacobsen
    Purpose To report preliminary outcomes of high dose image-guided intensity modulated radiotherapy (IG-IMRT) in the treatment of chordomas of the sacrum, mobile spine and skull base. Methods Retrospective analysis of chordoma patients treated with surgery and/or radiotherapy (RT) in a single tertiary cancer center. Initial treatment was categorized as (A) Adjuvant or definitive high-dose RT (78 Gy/39fx or 24 Gy/1fx) vs (B) surgery-only or low dose RT. The primary endpoint was the cumulative incidence of local failure. Results A total of 31 patients were treated from 2010 through 2020. Median age was 55 years, tumor location was 64% sacrum, 13% lumbar, 16% cervical and 6% clivus. Median tumor volume was 148 cc (8.3 cm in largest diameter), 42% of patients received curative-intent surgery and 65% received primary RT (adjuvant or definitive). 5-year cumulative incidence of local failure was 48% in group A vs 83% in group B (p = 0.041). Tumor size > 330 cc was associated with local failure (SHR 2.2, 95% CI 1.12 to 7.45; p = 0.028). Eight patients developed distant metastases, with a median metastases-free survival of 56.1 months. 5-year survival for patients that received high dose RT was 72% vs 76% in patients that received no or low dose RT (p = 0.63). Conclusion Our study suggests high-dose photon IG-IMRT improves local control in the initial management of chordomas. Health systems should promote reference centers with clinical expertise and technical capabilities to improve outcomes for this complex disease.
  • conferenceObject
    An Observational Study of the Prognosis of Inpatients Evaluated for Palliative Radiation Therapy
    (2018) SR., A. T. C. Chen; MAURO, G. P.; GABRIELLI, F.; CHAVES, C.; CASTRO, I.; VASCONCELOS, K.; SARAIVA, T.; REIS, M.; CARVALHO, H. D. A.
  • 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.
  • conferenceObject
    Prospective study of biomarkers in squamous cell carcinoma of the anal canal (SCCAC) and their influence on treatment outcomes: Five-year long-term results.
    (2020) MONIZ, Camila Motta Venchiarutti; RIECHELMANN, Rachel Pimenta; BRAGHIROLI, Maria Ignez; RIBEIRO, Suilane Coelho; RIVELLI, Thomas Giollo; BARIANI, Giovanni M.; CHEN, Andre Tsin Chih; NAHAS, Caio; BONADIO, Renata Colombo; ORTEGA, Cinthia; FRANCO, Rejane; MEIRELES, Sibele; PEREIRA, Allan Andresson Lima; SABBAGA, Jorge; COUDRY, Renata A.; HOFF, Paulo Marcelo
  • bookPart
    Radioterapia paliativa
    (2015) CHEN, André Tsin Chih; BARALDI, Helena Espindola
  • article 0 Citação(ões) na Scopus
    A Prospective Cohort Study of Biomarkers in Squamous Cell Carcinoma of the Anal Canal (SCCAC) and their Influence on Treatment Outcomes
    (2021) MONIZ, C. M. V.; RIECHELMANN, R. P.; OLIVEIRA, S. C. R.; BARIANI, G. M.; RIVELLI, T. G.; ORTEGA, C.; PEREIRA, A. A. L.; MEIRELES, S. I.; FRANCO, R.; CHEN, A.; BONADIO, R. C.; NAHAS, C.; SABBAGA, J.; COUDRY, R. A.; BRAGHIROLI, M. I.; HOFF, P. M.
    Background: Although Chemoradiation (CRT) is the curative treatment for SCCAC, many patients present primary resistance. Since it is a rare tumor, response predictors remain unknown. Methods: We performed a prospective cohort study to evaluate biomarkers associated with CRT response, progression-free survival (PFS), and overall survival (OS). The primary endpoint was response at 6 months (m). Tumor DNA and HPV were analyzed by next-generation sequencing, while KI-67 and PD-L1 by immunohistochemistry in tumor tissue. Results: Seventy-eight patients were recruited between October/2011 and December/2015, and 75 were response evaluable. The median age was 57 years, 65% (n=49) were stage III and 12% (n=9) were HIV positive (HIV+). At 6m, 62.7% (n=47) presented CR. On multivariate analyses, stage II patients were 4.7 more likely to achieve response than stage III (OR, 4.70; 95%CI, 1.36-16.30; p=0.015). HIV+ was associated with a worse response (OR, 5.72; 95%CI, 2.5-13.0; p<0.001). 5-year PFS and OS rates were 63.3% and 76.4%, respectively, with a median follow up of 66m. On multivariate analyses, older age (HR 1.06, p=0.022, 95%IC 1.01-1.11) and absence of CR at 6m (HR 3.36, p=0.007, 95%IC 1.39-8.09) were associated with inferior OS. The 5-year OS rate was 62.5% in HIV+ group compared to 78% among HIVpts, although this difference was not statistically significant (p=0.4). PIK3CA, MET and TP53 mutations, HPV, Ki-67 expression, and PD-L1 expression, were not associated with PFS and OS. Conclusions: Clinical stage III and HIV+ were associated with worse response to CRT at 6m. The absence of CR was the main factor associated with poor 5-year OS. © The author(s).
  • bookPart
    Radioterapia paliativa
    (2023) CHEN, André Tsin Chih; BARALDI, Helena Espindola
  • article 6 Citação(ões) na Scopus
    Implementation of image-guided brachytherapy (IGBT) for patients with uterine cervix cancer: a tumor volume kinetics approach
    (2016) CARVALHO, Heloisa de Andrade; MENDEZ, Lucas Castro; STUART, Silvia Radwanski; GUIMARAES, Roger Guilherme Rodrigues; RAMOS, Clarissa Cerchi Angotti; PAULA, Lucas Assad de; SALES, Camila Pessoa de; CHEN, Andre Tsin Chih; BLASBALG, Roberto; BARONI, Ronald Hueb
    Purpose: To evaluate tumor shrinking kinetics in order to implement image-guided brachytherapy (IGBT) for the treatment of patients with cervix cancer. Material and methods: This study has prospectively evaluated tumor shrinking kinetics of thirteen patients with uterine cervix cancer treated with combined chemoradiation. Four high dose rate brachytherapy fractions were delivered during the course of pelvic external beam radiation therapy (EBRT). Magnetic resonance imaging (MRI) exams were acquired at diagnosis (D), first (B1), and third (B3) brachytherapy fractions. Target volumes (GTV and HR-CTV) were calculated by both the ellipsoid formula (VE) and MRI contouring (VC), which were defined by a consensus between at least two radiation oncologists and a pelvic expert radiologist. Results: Most enrolled patients had squamous cell carcinoma and FIGO stage IIB disease, and initiated brachytherapy after the third week of pelvic external beam radiation. Gross tumor volume volume reduction from diagnostic MRI to B1 represented 61.9% and 75.2% of the initial volume, when measured by VE and VC, respectively. Only a modest volume reduction (15-20%) was observed from B1 to B3. Conclusions: The most expressive tumor shrinking occurred in the first three weeks of oncological treatment and was in accordance with gynecological examination. These findings may help in IGBT implementation.
  • conferenceObject
    OBSERVATION VERSUS SURGICAL RESECTION IN PATIENTS WITH RECTAL CANCER WHO ACHIEVED COMPLETE CLINICAL RESPONSE AFTER NEOADJUVANT CHEMORADIOTHERAPY: PRELIMINARY RESULTS OF A RANDOMIZED TRIAL (NCT02052921).
    (2015) NAHAS, S.; NAHAS, C.; RIBEIRO JUNIOR, U.; MARQUES, C. Sparapan; COTTI, G. C.; IMPERIALE, A.; ORTEGA, C.; AZAMBUJA, R.; CHEN, A.; HOFF, P.; CECCONELLO, I.
  • conferenceObject
    Liver Irradiation Increases Relapse-Free Survival in Adjuvant Gastric Cancer Treatment
    (2013) VASCONCELOS, K.; CHEN, A. T. C.; HONG, C. B. C.; NAKAZATO, D.; STELKO, G.; HOFF, P. M. G.; TAKEDA, F. R.; ZILBERSTEIN, B.; RIBEIRO JUNIOR, U.; NADALIN, W.