Valor prognóstico da cintilografia de mamas com Sestamibi-99mTc na predição da resposta do tumor localmente avançado da mama a quimioterapia neoadjuvante
Carregando...
Data
2013-02-18
Autores
Barra, Renato Ramos [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Este estudo teve como objetivo avaliar a eficácia da cintilografia de mamas com sestamibi-99mTc na predição da resposta tumoral à quimioterapia neoadjuvante, em pacientes com tumor localmente avançado da mama (estadio T3 e T4, maiores que 5 cm, com invasão de parede ou pele). Foram selecionadas 33 pacientes do sexo feminino com câncer de mama que realizaram cintilografia de mamas antes, durante e após quimioterapia neoadjuvante (QT), seguida de cirurgia (mastectomia ou quadrantectomia). A cintilografia de mamas foi realizada nas incidências anterior e laterais, 10 minutos (precoce) e 60 minutos (tardia) após a injeção de 740 a 925 MBq de sestamibi-99mTc. A aquisição foi realizada em três momentos: estudo basal (antes da QT), após quatro ciclos de QT e após término do esquema quimioterápico, antes da cirurgia. Foi calculada a relação Tumor/Radiação de fundo, através de regiões de interesse com contagens/pixel, nas imagens precoces e tardias de cada estudo. Houve correlação estatisticamente significativa entre a imagem de aquisição tardia (60 minutos após a injeção) e a resposta tumoral à quimioterapia. Apesar de não ter sido estatisticamente significativo, observou-se que um valor de cutoff que separa os respondedores dos não respondedores seria de 28%, ou seja, taxa de washout < 28% preveria os respondedores e washout > 28% seria o grupo dos não respondedores. Os resultados encontrados são compatíveis com outras publicações disponíveis, sendo encorajadores, porém mais estudos e novas investigações são necessários
This study aimed to evaluate the efficacy of breast scintigraphy with 99mTc-sestamibi predicting tumor response to neoadjuvant chemotherapy in patients with locally advanced breast tumors (stage T3 and T4, larger than 5 cm, with chest wall or skin invasion). 33 female patients with breast cancer who underwent scintigraphy breast before, during and after neoadjuvant chemotherapy (NAC) followed by surgery (mastectomy or lumpectomy) were chosen. Breast scintigraphy was performed in front and side view, 10 minutes (early) and 60 min (delayed) after injection of 740-925 MBq of 99mTc-sestamibi. The acquisition was performed at three time points: baseline study (before NAC), after four cycles of NAC and after completion of chemotherapy regimen before surgery. The tumor / background radiation ration was calculated through regions of interest in counts / pixel in early and late images of each study. There was a statistical significant positive correlation in the Student t test between the mean values of the ratio tumor / background radiation of 10 and 60 minutes in the first and second studies. However, there was no statistical significance, cutoff value to distinguish responders would be 28%, that is, washout ratio < 28% would indicate NAC responders while washout ration > 28% nonresponders. Our results are encouraging and similar to some available publications; more research needed and further are investigations
This study aimed to evaluate the efficacy of breast scintigraphy with 99mTc-sestamibi predicting tumor response to neoadjuvant chemotherapy in patients with locally advanced breast tumors (stage T3 and T4, larger than 5 cm, with chest wall or skin invasion). 33 female patients with breast cancer who underwent scintigraphy breast before, during and after neoadjuvant chemotherapy (NAC) followed by surgery (mastectomy or lumpectomy) were chosen. Breast scintigraphy was performed in front and side view, 10 minutes (early) and 60 min (delayed) after injection of 740-925 MBq of 99mTc-sestamibi. The acquisition was performed at three time points: baseline study (before NAC), after four cycles of NAC and after completion of chemotherapy regimen before surgery. The tumor / background radiation ration was calculated through regions of interest in counts / pixel in early and late images of each study. There was a statistical significant positive correlation in the Student t test between the mean values of the ratio tumor / background radiation of 10 and 60 minutes in the first and second studies. However, there was no statistical significance, cutoff value to distinguish responders would be 28%, that is, washout ratio < 28% would indicate NAC responders while washout ration > 28% nonresponders. Our results are encouraging and similar to some available publications; more research needed and further are investigations
Descrição
Palavras-chave
Mamas - Cancer, Exploração por radioisotopos, Quimioterapia, Tumores - Crescimento, Breast Cancer
Como citar
BARRA, Renato Ramos. Valor prognóstico da cintilografia de mamas com Sestamibi-99mTc na predição da resposta do tumor localmente avançado da mama a quimioterapia neoadjuvante. 2013. 76 f. Dissertação (mestrado) - Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2013.