Epidemiological Profile of Malignant Brain Neoplasms in the Northern Region of Brazil: data from the Cancer Hospital Registry of the Instituto Nacional de Câncer

Objective Tumors of the central nervous system (CNS) are considered rare, with an incidence of 3.4 cases per 100,000 individuals worldwide. Although uncommon, CNS tumors have been gaining epidemiological importance due to their increased incidence and mortality. In Brazil, there is a lack of population research regarding CNS cancer, especially in the Northern region. Thus, the authors aim to trace an epidemiological profile of malignant brain neoplasms in the Northern region from 2001 to 2013. Methods Data were collected from the Cancer Hospital Registry of the Instituto Nacional de Câncer (RHC-INCA, in the Portuguese acronym) and stratified according to origin, gender, age, detailed primary location, and histological type. A total of 742 cases were analyzed. Most of the cases came from inland areas, with a male predominance. Results The most affected age groups were between 0 and 9 years old and between 30 and 49 years old, with an accentuated decrease in incidence starting at the age of 70 years old. The frontal lobe was themost affected area, followed by the temporal and parietal lobes. Astrocytic tumors accounted for 64.3% of cases, followed by embryonal tumors (18.2%), and ependymal tumors (7.4%). Among the astrocytic tumors, astrocytoma, not otherwise specified (NOS), and glioblastoma, NOS corresponded to 82.2% of the cases. Among embryonal tumors, medulloblastoma accounted for 71.9% of the cases. Conclusion More epidemiological studies in this area, especially in the Northern region, are required to identify risk factors and allow prevention and early diagnosis.

Tumor neuroepitelial disembrioplásico: presentación de caso y revisión de la literatura / Dysembryoplastic Neuroepithelial Tumor (DNT): Case Presentation and Literature Review

El tumor neuroepitelial disembrioplásico (DNT) fue descrito por primera vezpor Daumas-Duport, en 1988, e incorporado a la clasificación de tumores de laOrganización Mundial de la Salud, desde 1993, como parte del grupo de tumoresneurogliales. El artículo describe un caso típico, dada su presentación clínica, hallazgosimaginólógicos e histológicos, con adecuada evolución postoperatoria. Se haceuna revisión de la literatura del DNT, describiendo su epidemiología, presentaciónclínica, hallazgos imaginólógicos e histológicos, posibilidades de tratamiento actualy pronóstico...

Dysembryoplastic neuroepithelial tumors (DNT)were first described by Daumas-Duport in 1988and incorporated into the new World Health Organizationclassification of brain tumours as partof the group of glioneuronal tumours in 1993. Wedescribe a typical case due to its clinical presentation,image and hystologic findings, with goodpostoperative course. A review of the literatureof DNT is made, describing its epidemiology,clinical presentation, image and histological findings,current treatment options and prognosis...

Trinta anos de irradiação craniana profilática em pacientes com câncer de pulmão de pequenas células: uma meta-análise de ensaios clínicos randomizados / Thirty years of prophylactic cranial irradiation in patients with small cell lung cancer: a meta-analysis of randomized clinical trials

OBJETIVO: Determinar o papel da irradiação craniana profilática (ICP) em pacientes com câncer de pulmão de pequenas células (CPPC). MÉTODOS: Foi realizada uma pesquisa para selecionar estudos em várias bases de dados, com os seguintes critérios de inclusão: ensaios clínicos randomizados, publicados em periódicos ou em anais de congressos nos últimos 30 anos, avaliando o papel da ICP sobre a mortalidade em pacientes com CPPC que receberam ICP ou não. RESULTADOS: Foram considerados elegíveis 16 estudos clínicos randomizados, os quais envolveram 1.983 pacientes. Entre esses, 1.021 foram submetidos a ICP e 962 não foram submetidos a ICP. Houve uma redução absoluta na mortalidade de 4,4% nos pacientes submetidos a ICP quando comparados com o grupo controle (OR = 0,73; IC95%: 0,57-0,97; p = 0,01), principalmente naqueles com resposta completa à quimioterapia de indução (OR = 0,68; IC95%: 0,50-0,93; p = 0.02) e que foram submetidos a ICP ao término desse tratamento (OR = 0,68; IC95%: 0,49-0,94; p = 0.03). A diminuição da mortalidade não se correlacionou com o estádio da doença: doença limitada (OR = 0,73; IC95%: 0,55-0,97; p = 0,03) e doença extensa (OR = 0,48; IC95%: 0,26-0,87; p = 0,02). CONCLUSÕES: Nossos achados sugerem que a ICP reduz a mortalidade em pacientes com CPPC, principalmente naqueles com resposta a quimioterapia de indução e que sejam submetidos a ICP ao término desse tratamento, independentemente do estadiamento da doença.

OBJECTIVE: To determine the role of prophylactic cranial irradiation (PCI) in patients with small cell lung cancer (SCLC). METHODS: We searched various databases, selecting randomized clinical trials published in journals or conference proceedings within the last 30 years and investigating the role of PCI in the mortality of patients with SCLC, submitted to PCI or not. RESULTS: Sixteen randomized clinical trials, collectively involving 1,983 patients, were considered eligible for inclusion. Of those 1,983 patients, 1,021 were submitted to PCI and 962 were not. Overall mortality was 4.4% lower in the patients submitted to PCI than in those who were not (OR = 0.73; 95% CI: 0.57-0.97; p = 0.01), especially among the patients showing a complete response after induction chemotherapy (OR = 0.68; 95% CI: 0.50-0.93; p = 0.02) and in those submitted to PCI after that treatment (OR = 0.68; 95% CI: 0.49-0.94; p = 0.03). That decrease did not correlate with the stage of the disease: limited disease (OR = 0.73; 95% CI: 0.55-0.97; p = 0.03); and extensive disease (OR = 0.48; 95% CI: 0.26-0.87; p = 0.02). CONCLUSIONS: Our findings suggest that PCI decreases mortality in patients with SCLC, especially in those showing a complete response after induction chemotherapy and in those submitted to PCI after that treatment, regardless of the stage of the disease.

Tratamiento de la leucemia linfoide aguda del adulto: Experiencia de un hospital en la Ciudad de México / Results of treatment of acute lymphoblastic leukemia in two cohorts of Mexican patients

Background: GIMEMA ALL 0288 trial was designed to evaluate the impact of a 7-day prednisone (PDN) pretreatment on complete remission of acute lymphoblastic leukemia. We adopted this trial in 2007. Aim: To evaluate the results of treatment in two cohorts of patients with acute lymphoblastic leukemia, treated from 2007 to January 2009 and from February to December 2009. Material and Methods: We studied 99 patients treated in the first period (58 males) and 54 patients treated in the second period (33 males) The age of patients ranged from 16 to 60 years and 70 percent of patients were of high risk. BCR/ABL fusion transcript was present in 12 percent of patients. Results: Remission rates were 61 and 51 percent for patients of the first and second group of treatment, respectively. The main cause of death were infections during the induction period. There were 49 relapses, mainly detected in the blood marrow. Global and event free 34 months survival were 32 and 30 percent respectively. Multivariate analysis disclosed risk stratification and central nervous system infiltration as risk factors for mortality. Conclusions: The main obstacles for the treatment of acute lymphoblastic leukemia in these cohorts of patients were the high incidence of infections and the lack of use of growth stimulating factors.