Terapia citorredutora pré-operatória associada ou não à quimioterapia metronômica adjuvante com ciclofosfamida e piroxicam em cães com carcinoma de células escamosas cutâneo
Carregando...
Data
2019-02-14
Autores
Albernaz, Vinicius Gonzalez Peres [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
O carcinoma de células escamosas (CCE) é uma neoplasia epitelial originada dos queratinócitos da pele de cães. Sua etiologia está relacionada à exposição a raios solares ultravioletas, o que o coloca como uma das neoplasias mais frequentes em países tropicais de clima quente. O CCE cutâneo tem comportamento invasivo local, baixa capacidade de metástase e frequentemente encontra-se associado à ceratose actinica. Neste estudo, objetivou-se avaliar o efeito do tratamento pré-operatório com piroxicam (Px) na expressão de COX-2 e Ki67, indicadores de inflamação e proliferação celular, respectivamente, em cães acometidos por CCE cutâneo. Além disso, o intervalo livre de doença (ILD) por um período de pelo menos 180 dias após excisão cirúrgica associada a regime de baixa dose diária com Px (0.3mg/kg) e ciclofosfamida (CYC; 15mg/m2) foi determinado nesta população. Não houve diferença estatística significativa na expressão de COX-2 após o tratamento pré-cirúrgico com Px; no entanto, houve diminuição no índice proliferativo marcado com Ki67 (P<0.05). Não foi encontrada alteração significativa no ILD no grupo tratado com Px e CYC (160 dias), quando comparado com o grupo controle retrospectivo (145 dias), tratado somente com ressecção cirúrgica. Não houve diferença estatística no ILD quando analisados o grau histológico, índice mitótico, tempo de evolução, metástase de linfonodos e o comprometimento das margens cirúrgicas. Adicionalmente, cães com estadiamento T4, independente do tratamento, estavam 3.2x e 4.8x mais propensos a recidiva precoce quando comparados aos estádios T3 e T2, respectivamente. Os resultados deste estudo demonstram o efeito anti-proliferativo do Px, independente da inibição de COX-2. O tratamento com baixa dose de Px e CYC associado a cirurgia não foi acompanhado por um aumento do ILD, em comparação com animais submetidos apenas ao tratamento cirúrgico.
Squamous cell carcinoma (SCC) is an epithelial neoplasm that arises from skin keratinocytes of the dogs. Its etiology is related to ultraviolet sunlight, which puts it as one of the most frequent neoplasm in tropical hot weather countries. Cutaneous SCC have a locally invasive, low metastatic behavior, and is often associated with actinic keratosis. This study aimed to evaluate the effect of pre-operative treatment with piroxicam (Px) on COX-2 and Ki67 expression, indicators of inflammation and cell proliferation, respectively. Besides that, the evaluation of disease-free interval (DFI) of these animals for at least 180 days after surgical excision associated with a daily low-dose treatment with Px (0.3mg/kg) and cyclophosphamide (CYC; 15mg/m2). There was no statically significant difference between COX-2 expression before and after treatment with Px; However, there was a significant decrease on Ki67 proliferative index (P<0.05). No significance was found in DFI when comparing the group treated with Px and CYC (160 days) and the control retrospective group (145 days), treated only with surgical resection. There was no statically difference on DFI when accessing histological grade, mitotic index, evolution time, lymph node metastasis, and incomplete surgical margins (P>0.05). Additionally, dogs with T4 stage, independent of the treatment, were 3.2 and 4.8-fold more likely to develop an early recurrence when comparing with T3 and T2, respectively. The results of this study demonstrate the antiproliferative effect of the Px independent of the COX-2 inhibition. The treatment with low-dose Px and CYC in association with surgery was not followed by an improvement on DFI in comparison with surgically treated animals.
Squamous cell carcinoma (SCC) is an epithelial neoplasm that arises from skin keratinocytes of the dogs. Its etiology is related to ultraviolet sunlight, which puts it as one of the most frequent neoplasm in tropical hot weather countries. Cutaneous SCC have a locally invasive, low metastatic behavior, and is often associated with actinic keratosis. This study aimed to evaluate the effect of pre-operative treatment with piroxicam (Px) on COX-2 and Ki67 expression, indicators of inflammation and cell proliferation, respectively. Besides that, the evaluation of disease-free interval (DFI) of these animals for at least 180 days after surgical excision associated with a daily low-dose treatment with Px (0.3mg/kg) and cyclophosphamide (CYC; 15mg/m2). There was no statically significant difference between COX-2 expression before and after treatment with Px; However, there was a significant decrease on Ki67 proliferative index (P<0.05). No significance was found in DFI when comparing the group treated with Px and CYC (160 days) and the control retrospective group (145 days), treated only with surgical resection. There was no statically difference on DFI when accessing histological grade, mitotic index, evolution time, lymph node metastasis, and incomplete surgical margins (P>0.05). Additionally, dogs with T4 stage, independent of the treatment, were 3.2 and 4.8-fold more likely to develop an early recurrence when comparing with T3 and T2, respectively. The results of this study demonstrate the antiproliferative effect of the Px independent of the COX-2 inhibition. The treatment with low-dose Px and CYC in association with surgery was not followed by an improvement on DFI in comparison with surgically treated animals.
Descrição
Palavras-chave
AINEs, Prognóstico, Intervalo livre de doença, Carcinoma espinocelular, Prognostic, NSAIDs, Disease-free interval, Spinocellular carcinoma