LUIZ GUILHERME CERNAGLIA AURELIANO DE LIMA
Índice h a partir de 2011
3
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
3 resultados
Resultados de Busca
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- Tumor Reduction with Pazopanib in a Patient with Recurrent Lumbar Chordoma(2018) RIBEIRO, Mauricio Fernando Silva Almeida; SOUSA, Micelange Carvalho de; HANNA, Samir Abdallah; MALDAUN, Marcos Vinicius Calfat; KURIMORI, Ceci Obara; LIMA, Luiz Guilherme Cernaglia Aureliano de; MATTEDI, Romulo Loss; MUNHOZ, Rodrigo RamellaIntroduction. Chordomas are rare malignancies of bone origin that occur in the axial skeleton, typically the skull base and lumbar/sacral regions. Although often classified as low-grade neoplasms, its locally infiltrative behavior may result in significant morbidity and mortality. Optimal surgical resection may be curative, but up to 50% of the cases relapse within 5 years, and currently there are no systemic treatments approved in this setting. A large proportion of these tumors express stem-cell factor receptor (c-KIT) and platelet-derived growth factor receptors (PDGFRs), providing a rationale for the use of tyrosine-kinase inhibitors (TKIs). Case report. A 27-year-old male presented with recurrent chordoma of the lumbar spine 4 years after initial diagnosis. Salvage therapies in the interval included repeat resections and radiation therapy. He ultimately developed multifocal recurrence not amenable to complete excision or reirradiation. A comprehensive genomic profiling assay was performed and revealed nondrugable alterations. Decision was made to proceed with systemic treatment with pazopanib 800 mg/day, resulting in tumor reduction (-23.1% reduction in size) and prolonged disease control. Conclusion. For this patient with a multiple recurrent chordoma and limited treatment options, pazopanib resulted in sustained clinical benefit following initial tumor reduction.
- Neoadjuvant stereotactic ablative radiotherapy (SABR) for soft tissue sarcomas of the extremities(2021) LEITE, Elton Trigo Teixeira; MUNHOZ, Rodrigo Ramella; CAMARGO, Veridiana Pires de; LIMA, Luiz Guilherme Cernaglia Aureliano de; REBOLLEDO, Daniel Cesar Seguel; MAISTRO, Carlos Eduardo Bravin; BUSNARDO, Fabio de Freitas; FERREIRA, Fabio de Oliveira; SALVAJOLI, Joao Victor; CARVALHO, Heloisa de AndradeBackground: Soft tissue sarcomas (STS) comprise a diverse group of mesenchymal malignancies that require multidisciplinary care. Although surgery remains the primary form of treatment for those with localized disease, radiation therapy (RT) is often incorporated either in the neo-or adjuvant setting. Given the development of modern RT techniques and alternative dosing schedules, stereotactic ablative radiotherapy (SABR) has emerged as a promising technique. However, the current role of SABR in the treatment of STS of the extremities remains uncertain. Methods and Materials: This was a single-center, prospective, single-arm phase II trial. Patients with localized STS who were candidates for limb-preservation surgery were included. Experimental treatment consisted of SABR with 40 Gy in 5 fractions, administered on alternate days, followed by surgery after a minimum interval of 4 weeks. The primary outcome was the rate of wound complication. Secondary outcomes included 2-year local control (LC), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS) rates (and other toxicities). Results: Twenty-five patients were enrolled between October 2015 and November 2019 and completed the treatment protocol. The median rate of histopathologic regression was 65% (range 0-100) and 20.8% of tumors presented pathologic complete response (pCR). Wound complications were observed in 7/25 patients (28%). Three patients underwent disarticulation by vascular occlusion after plastic reconstruction and one patient was amputated by grade 3 limb dysfunction. After a median follow up of 20.7 months, the 2-year estimated risk of local recurrence, distant metastasis and cause-specific death were 0%, 44.7% and 10.6% respectively. Conclusions: Neoadjuvant SABR appears to improve the pCR for patients with eSTS, with acceptable rate of wound complications. Nevertheless, this benefit should be weighed against the risk of late of vascular toxicity with SABR regimen since, even in a short median follow-up, a higher rate of amputation than expected was observed. A larger sample size with longer follow-up is necessary to conclude the overall safety of this strategy.
conferenceObject Impact of histopathological revision and molecular pathology in the diagnosis of sarcomas in a reference center in Brazil.(2022) LOPES, Carlos Diego Holanda; QUEIROZ, Marcello Moro; SAMPAIO, Luana Alencar Fernandes; PERINA, Andre; AKAISHI, Eduardo Hiroshi; TEIXEIRA, Frederico Ribeiro; FERREIRA, Fabio Oliveira; HANNA, Samir Abdallah; SILVA, Joao Luis da; LIMA, Luiz Guilherme C. A. De; OLIVEIRA, Claudia Regina G. C. M. De; MUNHOZ, Rodrigo Ramella