RESUMO
Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer and the second leading cause of cancer death in the United States. Management of disseminated metastatic CRC involves various active drugs, either in combination or as single agents. The choice of therapy is based on consideration of the goals of therapy, the type and timing of prior therapy, the mutational profile of the tumor, and the differing toxicity profiles of the constituent drugs. This manuscript summarizes the data supporting the systemic therapy options recommended for metastatic CRC in the NCCN Guidelines for Colon Cancer.
Assuntos
Neoplasias do Colo , Humanos , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/terapia , Neoplasias do Colo/patologia , Neoplasias do Colo/tratamento farmacológico , Oncologia/normas , Oncologia/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Estados UnidosRESUMO
Concentrations of perfluoroalkyl acids (PFAAs), polybrominated diphenyl ethers (PBDEs), and "novel" brominated flame retardants (NBFRs) were determined in lagoons processing wastewater from two high-Arctic and two sub-Arctic of Canada communities to assess the importance of local anthropogenic sources. ∑PFAAs in influent and effluent of the Arctic lagoons were within the lower end of the range of concentrations previously observed in Canadian temperate wastewater treatment plants (WWTPs). In comparison, influent and effluent concentrations of ∑PBDEs and NBFRs were significantly greater (p < 0.05) in high-Arctic lagoons compared to sub-Arctic and temperate plants. The surprisingly elevated concentrations of PBDEs and NBFRs in high-Arctic lagoons were probably related to high organic matter found in Arctic wastewater due to lower consumption of potable water leading to less dilution compared to temperate regions. Although PFAAs also sorb to solids, the wastewater samples were filtered prior to analysis of PFAAs (but not PBDEs and NBFRs), which likely reduced the impacts of solids on the results for PFAAs. Based on an extrapolation of per capita mass effluent loadings of the four Arctic lagoons, mass loadings to the Arctic of Canada via WWTP effluent were estimated as 1405 g/year and 549 g/year for ∑PFAAs and ∑PBDEs, respectively.
