Marcel Palumbo | Universidade Federal de São Paulo (UNIFESP) (original) (raw)

Papers by Marcel Palumbo

A termoablacao de tumores pelo laser Nd:YAG vem crescendo como especialidade multidisciplinar den... more A termoablacao de tumores pelo laser Nd:YAG vem crescendo como especialidade multidisciplinar denominada LITT, principalmente devido a grande procura procedimentos menos invasivos para pacientes em cuidados paliativos em pacientes com tumores de cabeca e pescoco. Nesta terapia, altas doses de energia termica sao direcionadas para a area central do tumor, causando danos irreversiveis as celulas tumorais, mas doses menores sao direcionadas a areas perifericas, causando alteracoes reversiveis, mantendo a viabilidade do tumor, com risco de recidiva. A associacao de quimioterapicos, principalmente a cisplatina nestas areas perifericas vem sendo estudada com resultados satisfatorios, diminuindo possibilidade de recidiva local. Desde os primeiros estudos da cisplatina, sabe-se que o principal efeito colateral e a nefrotoxicidade, que pode ser minimizada com aplicacao intra-tumoral, e potencializada pelo LITT, ja que o calor aumenta absorcao intracelular, e a susceptibilidade da celula a ci...

International Journal of Molecular Sciences

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...

Brazilian Journal of Otorhinolaryngology, 2021

To investigate the prognostic factors to developing parotid and neck metastasis in locally advanc... more To investigate the prognostic factors to developing parotid and neck metastasis in locally advanced and relapsed Cutaneous Squamous Cell Carcinoma (CSCC) of the head and neck region. Single-center retrospective cohort study enrolling consecutive patients with advanced CSCC from 2009 to 2019. Seventy-four cases were identified. Study variables demographic data, clinical skin tumor stage, neck stage, parotid stage (P stage), surgical treatment features, and parotid, regional, and distant metastases. Survival measures: Overall Survival (OS) and Disease-Specific Survival (DSS). The study group included 72.9% men (median age, 67 years); 67.5% showed T2/T3 tumors, 90.5% comorbidities, 20.2% immunosuppressed, with median follow-up: 35.8 months. The most frequent skin primary were auricular and eyelid regions, 75% underwent primary resection with flap reconstruction. Parotid metastasis was present in 50%, 32.4% showing parotid extracapsular spread, multivariate analysis found OR = 37.6 of positive parotid metastasis evolving into positive neck metastasis, p = 0.001. Occult neck metastasis, neck metastasis, and neck extracapsular spread were observed in 13.5%, 51.3%, and 37.8%, respectively. Kaplan-Meier survival: Clinical T4 versus T1, p = 0.028, P1 stage: 30% and 5% survival at 5 and 10 years, P3 stage: 0%, p = 0.016; OS and DSS showed negative survival for the parotid metastasis group, p = 0.0283. Our outcomes support a surgically aggressive approach for locally advanced and relapsed CSCC, with partial parotidectomy for P0, total parotidectomy for P1-3, selective I-III neck dissection for all patients and adjuvant radiochemotherapy to appropriately treat these patients with advanced CSCC of the head and neck region. II b - Retrospective Cohort Study - Oxford Centre for Evidence-Based Medicine (OCEBM).

O hemangiopericitoma e um tumor raro em cabeca e pescoco, comlocalizacao mais frequente na cavida... more O hemangiopericitoma e um tumor raro em cabeca e pescoco, comlocalizacao mais frequente na cavidade nasossinusal. Em 1942,quando Stout e Murray aplicaram o termo ?hemangiopericitoma?para essa neoplasia, verificaram que nao havia caracteristicasmacroscopicas que permitissem seu reconhecimento ediagnostico. O tratamento de escolha em qualquer localizacao ea resseccao cirurgica ampla, com margens oncologicas. A via deacesso transmento-transglosso e uma boa opcao para tumoreslocalizados em parede posterior de orofaringe. O objetivo denosso estudo e relatar um caso de um hemangiopericitomalocalizado em valecula em um paciente jovem do sexo masculino,dada a raridade deste tipo de tumor nessa topografia, bem comodescrever o acesso cirurgico utilizado.(AU)

Revista Brasileira de Otorrinolaringologia, 2008

O tratamento das perfurações da membrana timpânica na população pediátrica com seqüelas de Otite ... more O tratamento das perfurações da membrana timpânica na população pediátrica com seqüelas de Otite Média Crônica representa um desafio ao Otorrinolaringologista. OBJETIVO: Avaliar os resultados clínicos e audiométricos da técnica "inlay" com colocação de plugue de cartilagem do trago. MATERIAL E MÉTODOS: Foram analisados 23 pacientes (idade 1-15 anos) submetidos à timpanoplastia com plugue. FORMA DE ESTUDO: Clínico retrospectivo. RESULTADOS: A taxa de sucesso de fechamento foi de 82,6%, com melhora dos parâmetros audiométricos em 87,5% dos pacientes. As complicações foram mínimas. CONCLUSÃO: Em face dos resultados obtidos, este método de timpanoplastia deve ser considerado uma boa opção para o tratamento das perfurações da membrana timpânica na infância.

Lasers in surgery and medicine, Oct 9, 2017

Thermal ablation of tumors by Nd:YAG laser has been growing as a multidisciplinary subspecialty d... more Thermal ablation of tumors by Nd:YAG laser has been growing as a multidisciplinary subspecialty defined as laser-induced thermal therapy (LITT), and has been increasingly accepted as a minimally invasive method for palliation of advanced or recurrent cancer. Previous studies have shown that adjuvant chemotherapy can potentiate laser thermal ablation of tumors leading to improved palliation in advanced cancer patients. Evaluate nephrotoxicity by early markers of renal function in treating head and neck cancer using intra-tumor injections of cisplatin combined with laser-induced thermal therapy (CDDP-LITT). Nine patients with recurrent head and neck tumors were treated by CDDP-LITT in order to determine nephrotoxicity related to this synergistic association. Among the tests requested to detect early were creatinine, magnesium, creatinine clearance, serum urea-BUN, type I urine, and proteinuria at 24 hours. Twelve recurrent tumors in nine patients were treated by CDDP-LITT. Pain was th...

Rev Bras Clin Ter, Mar 1, 2001

Current Cancer Treatment - Novel Beyond Conventional Approaches, 2011

Otolaryngology -- Head and Neck Surgery, 2012