Cancer Epidemiology and Prevention Biomarkers, Dec 1, 2006
B218 Stem cells have the remarkable potential to develop into many different cell types in the bo... more B218 Stem cells have the remarkable potential to develop into many different cell types in the body, and can theoretically divide without limit to replenish other cells as long as the person or animal is still alive. An increasing body of research is showing that cancers might contain their own stem cells. In fact, cancer cells, like stem cells, can proliferate indefinitely through a deregulated cellular self-renewal capacity. This raises the possibility that some features of tumor cells may be due to cancer stem cells. Stem cell-like cancer cells were isolated from several solid tumors, and new evidence has shown that brain cancers contain cells that may be multipotent neural stem cell-like cells. Researchers have successfully grown adult olfactory stem cells harvested from the human nose, but so far there is no evidence supportting that head and neck cancers are derived from multispecialized, pluripotential cells. In this review, we discuss the possibility of some molecular leads and poteins involved in carcinogenic pathways that could be involved in stem cell physiopathology of head and neck cancer.
We have tested a combined treatment for squamous cell carcinoma based on laser activation of anti... more We have tested a combined treatment for squamous cell carcinoma based on laser activation of anti-cancer drugs in human solid tumors. Cisplatinum and the new anthrapyrazole CI- 941 are reported to interact with photothermal energy. Combined intratumor drug and interstitial laser therapy were tested in nude mice bearing human squamous cell carcinomas grown as subcutaneous tumors. Cisplatinum injection (1.2 mg/500
5329 Squamous cell carcinoma of the head and neck occurs frequently worldwide with more than 500,... more 5329 Squamous cell carcinoma of the head and neck occurs frequently worldwide with more than 500,000 new cases projected annually. Once recurrent after primary treatment, survival rates for head and neck cancers are very poor. Management of recurrent head and neck cancer is a seldom reported but a common clinical dilemma. Only a small subset of patients are candidates for potentially curative surgery. Chemotherapy alone provides only limited palliation with no long term survivors, and reirradiation in most cases is unfeasible because of local toxicity. Experience is accumulating using laser-induced thermal therapy (LITT) for treatment of recurrent, unresectable head and neck cancers leading to favorable results and apparent long-term efficacy in some cases. In this study, we review our results on 104 patients with recurrent head and neck cancer that were treated by LITT . Best results were seen in oral cavity tumors where average survival was 20.3 months (10.7-30mo; 95%CI) compared to neck (avg.=14.4 months, 7.5-20.7mo; 95%CI) and other tumor sites (avg.=18 months, 13.8-22.3mo; 95%CI). Tumor regrowth was not seen after treatment for an average of 47 days with significant palliation of symptoms observed in most of these patients. Therapy response was inversely related to initial tumor volume and was dependent on both histology and growth rate. Smaller slow growing tumors and more differentiated tumors were palliated successfully with a better local therapy response rate than poorly differentiated and rapidly dividing malignancies. The results of LITT in recurrent head and neck cancer and the prognostic factors predicting outcome in this patient population are also reviewed.
Background: The number of new cases of head and neck cancers in the United States was 40,490 in 2... more Background: The number of new cases of head and neck cancers in the United States was 40,490 in 2006, accounting for about 3% of adult malignancies. 11,170 patients died of their disease in 2006. The worldwide incidence exceeds half a million cases annually. In North America and Europe, the tumors usually arise from the oral cavity, oropharynx, or larynx, whereas nasopharyngeal cancer is more common in the Mediterranean countries and in the Far East. In the United States, African Americans are disproportionately affected by head and neck cancer, with younger ages of incidence, increased mortality, and more advanced disease at presentation. Objective: To review the outcomes of a phase II study using laser-induced thermal therapy (LITT) as a palliative treatment for 106 patients with recurrent head and neck tumors. Study Design: Retrospective study. Setting: Tertiary hospital in the United States. Subjects And Methods: The primary endpoints were tumor response and survival. Prognostic values were assessed by the Kaplan-Meier method. Results: The best results were seen in oral cavity tumors, in which mean survival was 29.1 months, as compared to neck tumors (mean 14.4 +/-6.9 months; range 7.5-20.7 months; with a 95% confidence interval). Further analysis showed that clinical factors such as gender, smoking, and alcohol use were not indicators of poor prognosis, whereas neck disease and tumor stage at first treatment were relevant factors. Conclusion: In this study, 40 out of 106 patients treated by LITT remained alive at the end of our follow-up, and a complete response was seen in 24 (22.6%) patients. The highest response rate was seen in oral cavity tumors, which suggests that tumor location at this site may be a predictor of favorable outcome with LITT Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A64.
Journal of Clinical Laser Medicine & Surgery, Apr 1, 1994
Imaging-guided palliative therapy of recurrent and/or inaccessible head and neck tumors may soon ... more Imaging-guided palliative therapy of recurrent and/or inaccessible head and neck tumors may soon become clinically practical since sensitive and noninvasive monitoring techniques of energy deposition in tissues are now available. Interstitial tumor therapy (ITT) is a technique whereby a source of energy (laser, radiofrequency, ultrasonic, cryoenergy, etc.) is directly applied into tumors at various depths. Recent studies have demonstrated the efficiency of ultrasound (UTZ) and magnetic resonance imaging (MRI) for real and/or "near" real time tumor and vessel identification as well as monitoring and quantifying energy-induced tissue damage. We now report our initial clinical experience with patients in which UTZ and/or MRI-guided ITT techniques were successfully applied for the treatment of recurrent, nonresectable, local, and/or metastatic head and neck carcinomas. Patients were treated on an outpatient basis either in the operating room or in an upgraded specially equipped SIGNA 1.5T MR suite. Most patients tolerated these procedures well and were successfully palliated for periods ranging from 3 months to 5 years posttreatment. The upgrades introduced in a standard MRI suite, the clinical experience, and future perspectives will be reviewed.
Journal of Clinical Laser Medicine & Surgery, Dec 1, 1995
The search for simpler techniques for skin resurfacing has led many groups to investigate the use... more The search for simpler techniques for skin resurfacing has led many groups to investigate the usefulness of lasers as precision tools for photodermabrasion. A new modality for superficial skin rejuvenation using a dye-assisted low-level energy C02 laser system is now ...
Recurrent squamous cell carcinoma after major surgery and microvascular reconstruction with a fre... more Recurrent squamous cell carcinoma after major surgery and microvascular reconstruction with a free-flap transfer is difficult to handle via conventional treatment methods. Based on our experience with laser-induced thermal therapy for recurrent head and neck tumors, we explored an aggressive treatment protocol using laser thermal ablation with concurrent cisplatin chemotherapy as a minimally invasive option for the treatment of a patient with recurrent squamous cell carcinoma of the neck who had previously undergone a reconstructive free-flap transfer. Because of the very favorable outcome we observed in this patient with this combined treatment modality, we report this case, and we review some aspects of the treatment proposed. The remarkable survival of this patient suggests that the combination of laser-induced thermal therapy and chemotherapy warrants further investigation as an alternate treatment for patients with recurrent head and neck cancer.
Either modified type III radical neck dissection (MRND) or lateral neck dissections (LNDs) are co... more Either modified type III radical neck dissection (MRND) or lateral neck dissections (LNDs) are considered valid treatments for patients with laryngeal carcinoma with clinically negative neck findings (N0). The object of this prospective study was to compare complications, neck recurrences, and survival results of elective MRND and LND on the management of laryngeal cancer patients. Patients and Methods This prospective randomized study began in 1990, and patient accrual was closed on December 1993. A total of 132 patients was included in the trial. All patients had previously untreated T2-T4 N0 M0 supraglottic or transglottic squamous cell carcinoma. No significant imbalance was found between groups with respect to demographic, clinical, pathologic, and other therapeutic variables. Seventy-one patients were given MRNDs (13 bilateral) and 61 were given LNDs (18 bilateral). The false-negative rate was 26%, and most positive nodes were sited at levels II and III. Complications and period of hospitalization were similar in both groups. There were 6 ipsilateral neck recurrences (4 in the MRND group, and 2 in the LND group). The 5-year actuarial survival calculated by Kaplan-Meier method was 72.3% in the MRND group and 62. 4% in the LND group (log-rank test p =.312). The rate of false-negative nodes in supraglottic and transglottic carcinomas was 26%, and most positive nodes were at levels II and III. The rates of 5-year overall survival, neck recurrences, and complications were similar in both groups. These results confirm the efficacy of lateral neck dissection in the elective treatment of the neck in patients with supraglottic and transglottic carcinomas.
5572 Background: Laser induced thermal therapy (LITT) has been developed in a step-wise fashion a... more 5572 Background: Laser induced thermal therapy (LITT) has been developed in a step-wise fashion at UCLA as a minimally invasive treatment for head and neck cancer. Initial Phase-I studies demonstrated the feasibility and safety of using the Nd:YAG laser (near infra-red nm) for thermal ablation of tumors as a palliative treatment in 62 patients. This was followed by the current Phase II study that confirmed such finding using higher laser power densities (P.D. = 1,600–2,200 J/cm2). Patients and Methods: This was a single group study in patients with recurrent carcinoma of the head and neck, who failed at least one treatment modality, and had a Karnofsky performance status ≥ 70%, and ECOG performance status ≤ 2. The primary end points of the study were objective tumor response, and survival. Prognostic values were assessed by uni- and multivariate analysis using the Kaplan-Meier method and Cox model, respectively. Results: In this Phase II study, we review our results on 104 patients ...
Journal of Clinical Laser Medicine & Surgery, 1997
A new experimental therapy for squamous carcinoma was tested by sensitizing human tumor cells wit... more A new experimental therapy for squamous carcinoma was tested by sensitizing human tumor cells with light-sensitive anticancer drugs followed by laser illumination at visible or infrared wavelengths. The anthrapyrazole DUP-941 and the isoquinoline derivative DUP-840 were compared with the dianthraquinone hypericin. P3 human squamous carcinoma cells were incubated for 2 h with the drugs at escalating doses ranging from 5 to 100 micrograms/ml, then exposed to visible green 532-nm or infrared 1064-nm light at 300 J output from a KTP/Nd:YAG laser. Tumor cell toxicity measured by in vitro MTT viability assays was minimal after DUP-840 uptake but was slightly enhanced by infrared laser emissions. By contrast, the strong tumoricidal effects seen after DUP-941 uptake were amplified over 10-fold by 532-nm light and up to 2-fold by 1064-nm light. Hypericin-sensitized tumor cells were killed after 532 nm irradiation even at the lowest drug dose but were not affected by 1064-nm illumination. The results suggest that laser chemotherapy with drugs sensitive to photothermal energy could become a useful new treatment modality for cancer.
Laser interstitial thermal therapy (LITT) has been used and accepted as a palliative method for c... more Laser interstitial thermal therapy (LITT) has been used and accepted as a palliative method for cancer in many different sites of the head and neck, breast, colon, gastrointestinal and superficial tumors. In the head and neck region it has been successfully used to palliate cancer in different sites as a minimally invasive therapy in recurrent and metastatic head and neck cancer. Previous studies have shown that adjuvant chemotherapy can potentiate laser thermal ablation of obstructing tumors leading to improved palliation in advanced cancer patients. Eight patients with recurrent head and neck tumors volunteered to enroll as part of an ongoing phase II LITT clinical trial and also elected to be treated with systemic chemotherapy (cisplatin 80 mg/m2) followed 24 hours later by palliative laser thermal ablation. Laser treatments were repeated in patients with residual disease or recurrence for a total of 27 LITT sessions. Four of the 8 patients treated with laser thermal chemotherapy remained alive after a median follow-up of 12 months. Of the 12 tumor sites treated, complete responses were located in the oral cavity (3), oropharynx (1), hypopharynx (1), maxillary sinus (1), and median survival for these patients was 9.5 months. This initial experience with cisplatinum-based laser chemotherapy indicates both safety and therapeutic potential for palliation of advanced head and neck cancer, but this must be confirmed by longer follow-up in a larger cohort of patients.
Cisplatin is one of the most widely used anticancer drugs in the treatment of various types of so... more Cisplatin is one of the most widely used anticancer drugs in the treatment of various types of solid human cancers, as well as germ cell tumors, sarcomas, and lymphomas. Strong evidence from research has demonstrated higher efficacy of a combination of cisplatin and derivatives, together with hyperthermia and light, in overcoming drug resistance and improving tumoricidal efficacy. It is well known that the antioncogenic potential of CDDP is markedly enhanced by hyperthermia compared to drug treatment alone. However, more recently, accelerators of high energy particles, such as synchrotrons, have been used to produce powerful and monochromatizable radiation to induce an Auger electron cascade in cis-platinum molecules. This is the concept that makes photoactivation of cis-platinum theoretically possible. Both heat and light increase cisplatin anticancer activity via multiple mechanisms, generating DNA lesions by interacting with purine bases in DNA followed by activation of several s...
11O Congresso Internacional Da Rede Unida, Apr 30, 2014
A infeccao pelo HIV e pela sifilis continua sendo de grande relevância para a saude publica no Br... more A infeccao pelo HIV e pela sifilis continua sendo de grande relevância para a saude publica no Brasil. Estudos realizados mostram que a prevalencia da infeccao pelo HIV na populacao em geral entre 15 a 49 anos permanece estavel com 0,6%. Com relacao aos grupos em situacao de maior vulnerabilidade as taxas podem se elevar de 4,9% a 10,5% entre os usuarios de drogas, HSH e profissionais do sexo. Um dos instrumentos para promover os principios do SUS focando na universalidade do acesso e envolver de modo equânime os seguimentos de gestao multissetoriais, equipes multiprofissionais, organizacao da sociedade civil (OSC) e usuarios. OBJETIVO: Descrever o resultado de uma acao executada em outubro de 2013 entre profissionais de saude, gestao e OSC na realizacao de testes rapidos para Sifilis e HIV em grupo de vulnerabilidade. METODOLOGIA: Estudo do tipo descritivo, efetuado em outubro de 2013 com a populacao em situacao de rua do centro da cidade de Fortaleza oriunda apos uma mobilizacao do GRAB (Grupo Asa Branca-ONG) para a realizacao do teste rapido na UAPS Paulo Marcelo Regional II, Fortaleza – Ceara. Tendo a participacao dos profissionais de saude do SAE Anastacio Magalhaes, CTA/SAE Carlos Ribeiro e Area Tecnica de DST/Aids-SMS. Foram realizados testes rapidos da populacao alvo, acompanhados de pre e pos-aconselhamento com o preenchimento do Termo de Consentimento Livre e Esclarecido. Os dados foram tabulados em programa Excel. Foram respeitados todos os preceitos eticos da Resolucao 196/96. RESULTADOS: Os usuarios foram acolhidos pelos profissionais de saude e integrantes do GRAB conduzindo-os para o pre- aconselhamento e testagem. Os resultados foram entregues no pos- aconselhamento individualmente. Os que obtiveram resultado reagente foram encaminhados para os servicos especializados. Foram realizados 56 testes dos quais 04 (7,14%) foram reagentes para HIV com 100% no genero masculino e 15 (26,78%) foram reagente para Sifilis com 73,33% nos homens. Do total, 42 (75%) eram homens e 14 (35%) eram mulheres. A faixa etaria predominante na testagem foi de 21 a 40 anos com 53,56%. CONCLUSAO: No comparativo das prevalencias nos grupos de vulnerabilidade os resultados confirmaram a concentracao desta epidemia. Como potencializador da equidade esse tipo de acao deve ser expandida e fomentada em rede para realizacao de acompanhamentos e tratamentos eficazes facilitando o acesso, reduzindo o numero de abandonos e proporcionando qualidade de vida.
Cancer Epidemiology and Prevention Biomarkers, Dec 1, 2006
B218 Stem cells have the remarkable potential to develop into many different cell types in the bo... more B218 Stem cells have the remarkable potential to develop into many different cell types in the body, and can theoretically divide without limit to replenish other cells as long as the person or animal is still alive. An increasing body of research is showing that cancers might contain their own stem cells. In fact, cancer cells, like stem cells, can proliferate indefinitely through a deregulated cellular self-renewal capacity. This raises the possibility that some features of tumor cells may be due to cancer stem cells. Stem cell-like cancer cells were isolated from several solid tumors, and new evidence has shown that brain cancers contain cells that may be multipotent neural stem cell-like cells. Researchers have successfully grown adult olfactory stem cells harvested from the human nose, but so far there is no evidence supportting that head and neck cancers are derived from multispecialized, pluripotential cells. In this review, we discuss the possibility of some molecular leads and poteins involved in carcinogenic pathways that could be involved in stem cell physiopathology of head and neck cancer.
We have tested a combined treatment for squamous cell carcinoma based on laser activation of anti... more We have tested a combined treatment for squamous cell carcinoma based on laser activation of anti-cancer drugs in human solid tumors. Cisplatinum and the new anthrapyrazole CI- 941 are reported to interact with photothermal energy. Combined intratumor drug and interstitial laser therapy were tested in nude mice bearing human squamous cell carcinomas grown as subcutaneous tumors. Cisplatinum injection (1.2 mg/500
5329 Squamous cell carcinoma of the head and neck occurs frequently worldwide with more than 500,... more 5329 Squamous cell carcinoma of the head and neck occurs frequently worldwide with more than 500,000 new cases projected annually. Once recurrent after primary treatment, survival rates for head and neck cancers are very poor. Management of recurrent head and neck cancer is a seldom reported but a common clinical dilemma. Only a small subset of patients are candidates for potentially curative surgery. Chemotherapy alone provides only limited palliation with no long term survivors, and reirradiation in most cases is unfeasible because of local toxicity. Experience is accumulating using laser-induced thermal therapy (LITT) for treatment of recurrent, unresectable head and neck cancers leading to favorable results and apparent long-term efficacy in some cases. In this study, we review our results on 104 patients with recurrent head and neck cancer that were treated by LITT . Best results were seen in oral cavity tumors where average survival was 20.3 months (10.7-30mo; 95%CI) compared to neck (avg.=14.4 months, 7.5-20.7mo; 95%CI) and other tumor sites (avg.=18 months, 13.8-22.3mo; 95%CI). Tumor regrowth was not seen after treatment for an average of 47 days with significant palliation of symptoms observed in most of these patients. Therapy response was inversely related to initial tumor volume and was dependent on both histology and growth rate. Smaller slow growing tumors and more differentiated tumors were palliated successfully with a better local therapy response rate than poorly differentiated and rapidly dividing malignancies. The results of LITT in recurrent head and neck cancer and the prognostic factors predicting outcome in this patient population are also reviewed.
Background: The number of new cases of head and neck cancers in the United States was 40,490 in 2... more Background: The number of new cases of head and neck cancers in the United States was 40,490 in 2006, accounting for about 3% of adult malignancies. 11,170 patients died of their disease in 2006. The worldwide incidence exceeds half a million cases annually. In North America and Europe, the tumors usually arise from the oral cavity, oropharynx, or larynx, whereas nasopharyngeal cancer is more common in the Mediterranean countries and in the Far East. In the United States, African Americans are disproportionately affected by head and neck cancer, with younger ages of incidence, increased mortality, and more advanced disease at presentation. Objective: To review the outcomes of a phase II study using laser-induced thermal therapy (LITT) as a palliative treatment for 106 patients with recurrent head and neck tumors. Study Design: Retrospective study. Setting: Tertiary hospital in the United States. Subjects And Methods: The primary endpoints were tumor response and survival. Prognostic values were assessed by the Kaplan-Meier method. Results: The best results were seen in oral cavity tumors, in which mean survival was 29.1 months, as compared to neck tumors (mean 14.4 +/-6.9 months; range 7.5-20.7 months; with a 95% confidence interval). Further analysis showed that clinical factors such as gender, smoking, and alcohol use were not indicators of poor prognosis, whereas neck disease and tumor stage at first treatment were relevant factors. Conclusion: In this study, 40 out of 106 patients treated by LITT remained alive at the end of our follow-up, and a complete response was seen in 24 (22.6%) patients. The highest response rate was seen in oral cavity tumors, which suggests that tumor location at this site may be a predictor of favorable outcome with LITT Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A64.
Journal of Clinical Laser Medicine & Surgery, Apr 1, 1994
Imaging-guided palliative therapy of recurrent and/or inaccessible head and neck tumors may soon ... more Imaging-guided palliative therapy of recurrent and/or inaccessible head and neck tumors may soon become clinically practical since sensitive and noninvasive monitoring techniques of energy deposition in tissues are now available. Interstitial tumor therapy (ITT) is a technique whereby a source of energy (laser, radiofrequency, ultrasonic, cryoenergy, etc.) is directly applied into tumors at various depths. Recent studies have demonstrated the efficiency of ultrasound (UTZ) and magnetic resonance imaging (MRI) for real and/or "near" real time tumor and vessel identification as well as monitoring and quantifying energy-induced tissue damage. We now report our initial clinical experience with patients in which UTZ and/or MRI-guided ITT techniques were successfully applied for the treatment of recurrent, nonresectable, local, and/or metastatic head and neck carcinomas. Patients were treated on an outpatient basis either in the operating room or in an upgraded specially equipped SIGNA 1.5T MR suite. Most patients tolerated these procedures well and were successfully palliated for periods ranging from 3 months to 5 years posttreatment. The upgrades introduced in a standard MRI suite, the clinical experience, and future perspectives will be reviewed.
Journal of Clinical Laser Medicine & Surgery, Dec 1, 1995
The search for simpler techniques for skin resurfacing has led many groups to investigate the use... more The search for simpler techniques for skin resurfacing has led many groups to investigate the usefulness of lasers as precision tools for photodermabrasion. A new modality for superficial skin rejuvenation using a dye-assisted low-level energy C02 laser system is now ...
Recurrent squamous cell carcinoma after major surgery and microvascular reconstruction with a fre... more Recurrent squamous cell carcinoma after major surgery and microvascular reconstruction with a free-flap transfer is difficult to handle via conventional treatment methods. Based on our experience with laser-induced thermal therapy for recurrent head and neck tumors, we explored an aggressive treatment protocol using laser thermal ablation with concurrent cisplatin chemotherapy as a minimally invasive option for the treatment of a patient with recurrent squamous cell carcinoma of the neck who had previously undergone a reconstructive free-flap transfer. Because of the very favorable outcome we observed in this patient with this combined treatment modality, we report this case, and we review some aspects of the treatment proposed. The remarkable survival of this patient suggests that the combination of laser-induced thermal therapy and chemotherapy warrants further investigation as an alternate treatment for patients with recurrent head and neck cancer.
Either modified type III radical neck dissection (MRND) or lateral neck dissections (LNDs) are co... more Either modified type III radical neck dissection (MRND) or lateral neck dissections (LNDs) are considered valid treatments for patients with laryngeal carcinoma with clinically negative neck findings (N0). The object of this prospective study was to compare complications, neck recurrences, and survival results of elective MRND and LND on the management of laryngeal cancer patients. Patients and Methods This prospective randomized study began in 1990, and patient accrual was closed on December 1993. A total of 132 patients was included in the trial. All patients had previously untreated T2-T4 N0 M0 supraglottic or transglottic squamous cell carcinoma. No significant imbalance was found between groups with respect to demographic, clinical, pathologic, and other therapeutic variables. Seventy-one patients were given MRNDs (13 bilateral) and 61 were given LNDs (18 bilateral). The false-negative rate was 26%, and most positive nodes were sited at levels II and III. Complications and period of hospitalization were similar in both groups. There were 6 ipsilateral neck recurrences (4 in the MRND group, and 2 in the LND group). The 5-year actuarial survival calculated by Kaplan-Meier method was 72.3% in the MRND group and 62. 4% in the LND group (log-rank test p =.312). The rate of false-negative nodes in supraglottic and transglottic carcinomas was 26%, and most positive nodes were at levels II and III. The rates of 5-year overall survival, neck recurrences, and complications were similar in both groups. These results confirm the efficacy of lateral neck dissection in the elective treatment of the neck in patients with supraglottic and transglottic carcinomas.
5572 Background: Laser induced thermal therapy (LITT) has been developed in a step-wise fashion a... more 5572 Background: Laser induced thermal therapy (LITT) has been developed in a step-wise fashion at UCLA as a minimally invasive treatment for head and neck cancer. Initial Phase-I studies demonstrated the feasibility and safety of using the Nd:YAG laser (near infra-red nm) for thermal ablation of tumors as a palliative treatment in 62 patients. This was followed by the current Phase II study that confirmed such finding using higher laser power densities (P.D. = 1,600–2,200 J/cm2). Patients and Methods: This was a single group study in patients with recurrent carcinoma of the head and neck, who failed at least one treatment modality, and had a Karnofsky performance status ≥ 70%, and ECOG performance status ≤ 2. The primary end points of the study were objective tumor response, and survival. Prognostic values were assessed by uni- and multivariate analysis using the Kaplan-Meier method and Cox model, respectively. Results: In this Phase II study, we review our results on 104 patients ...
Journal of Clinical Laser Medicine & Surgery, 1997
A new experimental therapy for squamous carcinoma was tested by sensitizing human tumor cells wit... more A new experimental therapy for squamous carcinoma was tested by sensitizing human tumor cells with light-sensitive anticancer drugs followed by laser illumination at visible or infrared wavelengths. The anthrapyrazole DUP-941 and the isoquinoline derivative DUP-840 were compared with the dianthraquinone hypericin. P3 human squamous carcinoma cells were incubated for 2 h with the drugs at escalating doses ranging from 5 to 100 micrograms/ml, then exposed to visible green 532-nm or infrared 1064-nm light at 300 J output from a KTP/Nd:YAG laser. Tumor cell toxicity measured by in vitro MTT viability assays was minimal after DUP-840 uptake but was slightly enhanced by infrared laser emissions. By contrast, the strong tumoricidal effects seen after DUP-941 uptake were amplified over 10-fold by 532-nm light and up to 2-fold by 1064-nm light. Hypericin-sensitized tumor cells were killed after 532 nm irradiation even at the lowest drug dose but were not affected by 1064-nm illumination. The results suggest that laser chemotherapy with drugs sensitive to photothermal energy could become a useful new treatment modality for cancer.
Laser interstitial thermal therapy (LITT) has been used and accepted as a palliative method for c... more Laser interstitial thermal therapy (LITT) has been used and accepted as a palliative method for cancer in many different sites of the head and neck, breast, colon, gastrointestinal and superficial tumors. In the head and neck region it has been successfully used to palliate cancer in different sites as a minimally invasive therapy in recurrent and metastatic head and neck cancer. Previous studies have shown that adjuvant chemotherapy can potentiate laser thermal ablation of obstructing tumors leading to improved palliation in advanced cancer patients. Eight patients with recurrent head and neck tumors volunteered to enroll as part of an ongoing phase II LITT clinical trial and also elected to be treated with systemic chemotherapy (cisplatin 80 mg/m2) followed 24 hours later by palliative laser thermal ablation. Laser treatments were repeated in patients with residual disease or recurrence for a total of 27 LITT sessions. Four of the 8 patients treated with laser thermal chemotherapy remained alive after a median follow-up of 12 months. Of the 12 tumor sites treated, complete responses were located in the oral cavity (3), oropharynx (1), hypopharynx (1), maxillary sinus (1), and median survival for these patients was 9.5 months. This initial experience with cisplatinum-based laser chemotherapy indicates both safety and therapeutic potential for palliation of advanced head and neck cancer, but this must be confirmed by longer follow-up in a larger cohort of patients.
Cisplatin is one of the most widely used anticancer drugs in the treatment of various types of so... more Cisplatin is one of the most widely used anticancer drugs in the treatment of various types of solid human cancers, as well as germ cell tumors, sarcomas, and lymphomas. Strong evidence from research has demonstrated higher efficacy of a combination of cisplatin and derivatives, together with hyperthermia and light, in overcoming drug resistance and improving tumoricidal efficacy. It is well known that the antioncogenic potential of CDDP is markedly enhanced by hyperthermia compared to drug treatment alone. However, more recently, accelerators of high energy particles, such as synchrotrons, have been used to produce powerful and monochromatizable radiation to induce an Auger electron cascade in cis-platinum molecules. This is the concept that makes photoactivation of cis-platinum theoretically possible. Both heat and light increase cisplatin anticancer activity via multiple mechanisms, generating DNA lesions by interacting with purine bases in DNA followed by activation of several s...
11O Congresso Internacional Da Rede Unida, Apr 30, 2014
A infeccao pelo HIV e pela sifilis continua sendo de grande relevância para a saude publica no Br... more A infeccao pelo HIV e pela sifilis continua sendo de grande relevância para a saude publica no Brasil. Estudos realizados mostram que a prevalencia da infeccao pelo HIV na populacao em geral entre 15 a 49 anos permanece estavel com 0,6%. Com relacao aos grupos em situacao de maior vulnerabilidade as taxas podem se elevar de 4,9% a 10,5% entre os usuarios de drogas, HSH e profissionais do sexo. Um dos instrumentos para promover os principios do SUS focando na universalidade do acesso e envolver de modo equânime os seguimentos de gestao multissetoriais, equipes multiprofissionais, organizacao da sociedade civil (OSC) e usuarios. OBJETIVO: Descrever o resultado de uma acao executada em outubro de 2013 entre profissionais de saude, gestao e OSC na realizacao de testes rapidos para Sifilis e HIV em grupo de vulnerabilidade. METODOLOGIA: Estudo do tipo descritivo, efetuado em outubro de 2013 com a populacao em situacao de rua do centro da cidade de Fortaleza oriunda apos uma mobilizacao do GRAB (Grupo Asa Branca-ONG) para a realizacao do teste rapido na UAPS Paulo Marcelo Regional II, Fortaleza – Ceara. Tendo a participacao dos profissionais de saude do SAE Anastacio Magalhaes, CTA/SAE Carlos Ribeiro e Area Tecnica de DST/Aids-SMS. Foram realizados testes rapidos da populacao alvo, acompanhados de pre e pos-aconselhamento com o preenchimento do Termo de Consentimento Livre e Esclarecido. Os dados foram tabulados em programa Excel. Foram respeitados todos os preceitos eticos da Resolucao 196/96. RESULTADOS: Os usuarios foram acolhidos pelos profissionais de saude e integrantes do GRAB conduzindo-os para o pre- aconselhamento e testagem. Os resultados foram entregues no pos- aconselhamento individualmente. Os que obtiveram resultado reagente foram encaminhados para os servicos especializados. Foram realizados 56 testes dos quais 04 (7,14%) foram reagentes para HIV com 100% no genero masculino e 15 (26,78%) foram reagente para Sifilis com 73,33% nos homens. Do total, 42 (75%) eram homens e 14 (35%) eram mulheres. A faixa etaria predominante na testagem foi de 21 a 40 anos com 53,56%. CONCLUSAO: No comparativo das prevalencias nos grupos de vulnerabilidade os resultados confirmaram a concentracao desta epidemia. Como potencializador da equidade esse tipo de acao deve ser expandida e fomentada em rede para realizacao de acompanhamentos e tratamentos eficazes facilitando o acesso, reduzindo o numero de abandonos e proporcionando qualidade de vida.
Uploads
Papers by Marcos Paiva