Monitoramento auditivo em adultos submetidos à quimioterapia com carboplatina / Auditory monitoring in adults undergoing chemotherapy with carboplatin / Monitoreo del oído en adultos sometidos a quimioterapia con carboplatino

Objetivo: Caracterizar a audição de pacientes adultos submetidos à quimioterapia com carboplatina por meio de exames audiológicos em dois momentos durante o tratamento quimioterápico. Métodos: Prospectivo e observacional. Participaram da pesquisa seis sujeitos adultos entre 53 e 59 anos e 11 meses, em tratamento quimioterápico com carboplatina submetidos a uma bateria de exames audiológicos. Os dados foram analisados por meio do teste ANOVA, teste z para proporções e Teste de Wilcoxon. O valor de significância adotado foi de 5% (p≤0,05). Resultados: Um aumento nos limiares auditivos foi observado, sobretudo nas frequências mais altas, porém não houve significância. Também foi observado aumento na relação sinal/ruído das emissões otoacústicas evocadas transientes e por produto de distorção, porém sem significância estatística. Conclusão: Não foram observadas mudanças estatisticamente significantes quanto aos limiares auditivos e as respostas das emissões otoacústicas, no entanto pode-se notar um aumento nos limiares audíveis, especialmente nas altas frequências, bem como aumento da amplitude de respostas nas emissões otoacústicas.

Purpose: To characterize the hearing of adult patients undergoing chemotherapy with carboplatin using two sequential audiological tests during chemotherapy treatment. Methods: Prospective and observational. The participants were six adult subjects between 53 and 59 years and 11 months, undergoing chemotherapy treatment with carboplatin subjected to a battery of audiological exams. Data were analyzed using the ANOVA test, z test for proportions and Wilcoxon signed-ranks test. The adopted significance was 5% (p ≤ 0.05). Results: An increase in hearing thresholds was observed, particularly in the higher frequencies, but there was no significance. It was also observed an increase in the signal / noise ratio of transient evoked otoacoustic emissions and for distortion product, but without statistical significance. Conclusion: No statistically significant changes regarding the hearing thresholds and responses of otoacoustic emissions were observed, however it could be noted an increase in hearing thresholds, especially at high frequencies, as well as the increased amplitude on the responses in otoacoustic emissions.

Objetivo: Caracterizar la audición de pacientes adultos sometidos a quimioterapia con carboplatino a través de pruebas audiológicas dos veces durante la quimioterapia. Métodos: Estudio prospectivo observacional. Los participantes fueron seis sujetos adultos de entre 53 y 59 años y 11 meses, sometidos a quimioterapia con carboplatino sometido a una batería de pruebas audiológicas. Los datos se analizaron mediante la prueba de ANOVA, prueba z para proporciones y prueba de los rangos con signo de Wilcoxon. La significancia fue del 5% (p ≤ 0,05). Resultados: fueron observados un aumento de los umbrales de audición, en particular en las frecuencias más altas, pero no identificaron significación. También se observó un aumento de la relación señal / ruido de emisiones otoacústicas evocadas transitorias y productos de distorsión, pero sin significación estadística. Conclusión: Los cambios estadísticamente significativos con respecto a los umbrales de audición y las respuestas de las emisiones otoacústicas, fueron observadas sin embargo es posible que observe un aumento de los umbrales audibles, especialmente a altas frecuencias, así como una mayor gama de respuestas de las emisiones otoacústicas.

Brazilian data of renal cell carcinoma in a public university hospital

ABSTRACT Purpose Among renal malignancies, renal cell carcinoma (RCC) accounts for 85% of cases. Stage is a relevant prognostic factor; 5-year survival ranges from 81% to 8% according to the stage of disease. The treatment is based on surgery and molecularly targeted therapy has emerged as a choice for metastatic disease. Materials and Methods Retrospective study by reviewing the medical records of patients with RCC treated in the last 10 years at UNIFESP. The primary end point of this trial was to evaluate the overall survival (OS) of the patients. The secondary end point was to evaluate the progression-free survival (PFS) after nephrectomy. Results 118 patients with RCC were included. The mean age was 58.3 years, 61.9% men; nephrectomy was performed in 90.7%, clear cell was the histology in 85.6%, 44 patients were classified as stage IV at diagnosis. Among these, 34 had already distant metastasis. 29 patients were treated with sunitinib. The median OS among all patients was 55.8 months. The median PFS after nephrectomy was 79.1 months. Sarcomatoid differentiation HR29.74 (95% CI, 4.31-205.26), clinical stage IV HR1.94 (95% CI, 1.37-2.75) and nephrectomy HR0.32 (95% CI, 0.15-0.67) were OS prognostic factors. Sunitinib had clinical activity. Conclusions Patients treated in our hospital achieved median OS compatible with literature. Nevertheless, this study has shown a high number of patients with advanced disease. For patients with advanced disease, treatment with sunitinib achieved median OS of 28.7 months, consistent with the literature.