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Previous issue date: 2013 / Introdução: O tratamento de criancas com craniofaringioma (CF) ainda e insatisfatorio ou ate mesmo frustrante, ja que a abordagem cirurgica do tumor por vezes provoca ou exacerba a sindrome clinica. Assim, se fez necessaria a elaboracao desse estudo, no qual foram analisados os resultados dos diferentes tipos de tratamento multimodal de CF em criancas realizados por profissionais de um centro de referencia. Objetivo: Verificar a indicacao e a efiCiência dos tratamentos utilizados em criancas com CF de acordo com sua apresentacao clinica e radiologica, atraves da validacao de uma escala. Materiais e metodos: Foi desenvolvida a Escala Clinico-Radiologica de Avaliacao de Criancas Portadoras de Craniofaringioma, atraves da qual os pacientes foram classificados de acordo com a gravidade de sua doenca com uma pontuacao variando de 0 a 8 e distribuidos em tres grandes grupos de acordo com sua indicacao inicial de tratamento. Os pacientes com pontuacao de 0 a 3 foram considerados como portadores de doenca leve e tiveram a indicacao de Resseccao Total (RT) (grupo I), enquanto aqueles com 4 a 6 foram considerados portadores de doenca moderada e foram indicados a aplicacao intratumoral de interferon alfa (IFN-α) nas lesoes cisticas seguida de Resseccao Parcial (RP) e Radioterapia (RxT) (grupo II), sendo que os com 7 a 8 foram considerados portadores de doenca grave e indicados a cirurgias para o controle de hidrocefalia e, apos, int-α e RP+RxT (grupo III). Resultados: Os pacientes do grupo I nao melhoraram de forma significativa com a terapia instituida. Ja os pacientes dos grupos II e III receberam o tratamento adequado, sendo que a melhora foi mais evidente no ultimo grupo. Conclusoes: a escala proposta por nos permitiu o tratamento individualizado dos pacientes, embora ainda seja necessario um estudo prospectivo para sua validacao. Alem disso, notamos que os pacientes mais graves estao recebendo terapia combinada eficiente, obtendo maior qualidade de vida e tempo de sobrevida / Introduction: The treatment of children with craniopharyngioma (CP) is still unsatisfactory or even frustrating since the tumor surgical approach sometimes causes or exacerbates clinical syndrome. Thus, it was necessary the elaboration of this study, which analyzed the results of different types of multimodal treatment of CP in children performed by professionals from a referral center. Objective: To verify the indication and effectiveness of treatments used in children with CP according to their clinical and radiological presentation through the validation of a scale. Materials and methods: We developed the Clinical-Radiologic Assessment Scale of Children with Craniopharyngioma, through which the patients were classified according to the severity of their disease with a score ranging from 0 to 8 and were divided into three groups according with its initial indication for treatment. Patients with score 0-3 were considered to have mild disease and were indicated to total removal (TR) (group I), while those with 4-6 were considered with moderate disease and were given the application of intratumoral interferon-alpha (IFN-α) into cystic lesions and then partial resection (PR) and radiotherapy (RxT) (group II). Those with 7-8 were classified as having severe disease and were indicated to surgeries for hydrocephalus control and after, IFN-α and PR + RxT (group III). Results: Patients from group I have not improved significantly with the indicated therapy. In contrast, the patients from groups II and III received appropriated treatment and improved, the improvement being more evident in the latter group. Conclusions: the scale proposed by us allowed individualized treatment of patients, although a prospective study is needed to validate it. Furthermore, we note that the sickest patients are receiving combined therapy efficiently, achieving greater quality of life and survival time / BV UNIFESP: Teses e dissertações
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unifesp.br:11600/23195 |
| Date | January 2013 |
| Creators | Battaglia, Luana de Assis [UNIFESP] |
| Contributors | Universidade Federal de São Paulo (UNIFESP), Cavalheiro, Sergio [UNIFESP] |
| Publisher | Universidade Federal de São Paulo (UNIFESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | 50 p. |
| Source | reponame:Repositório Institucional da UNIFESP, instname:Universidade Federal de São Paulo, instacron:UNIFESP |
| Rights | info:eu-repo/semantics/openAccess |
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