Asunto(s)
Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Leucemia Mieloide Aguda , Síndromes Mielodisplásicos , Humanos , Tiotepa/uso terapéutico , Busulfano/uso terapéutico , Vidarabina/uso terapéutico , Leucemia Mieloide Aguda/terapia , Síndromes Mielodisplásicos/terapia , Acondicionamiento PretrasplanteRESUMEN
A total of 21 elderly patients with breast carcinoma without evidence of systemic dissemination received tamoxifen (20 mg daily) as primary treatment. Of these 57% had a potentially operable tumor (stages I:2, IIa:6, IIb:2, IIIa:2) with a high operative risk that contraindicated the surgery and 43% had a locally advanced tumor unfit for primary radiotherapy, chemotherapy, or surgery. The mean age was 81.3 +/- 5.7 years (range 70-91). Diagnosis was made by fine-needle aspiration cytology in 16 patients and by incision biopsy in 5 of them. The median follow-up was 11.5 months (range 3-54). In 67% there was a clinical objective response (RC: 14%, RP: 53%), and 33% had disease stabilization. There was no evidence of systemic dissemination during the follow-up. Two patients who had achieved a partial response with a duration of 11 and 54 months, respectively, had a loco regional progress. One of them responded to a second hormonal treatment. Of the patients, 81% are still alive, and 14% died of other causes. One patient was lost during the follow-up. These preliminary results show a high loco regional response to tamoxifen. A higher number of patients and a longer time of follow-up are needed to establish the habitual use of tamoxifen as primary treatment of breast carcinoma in elderly patients.
Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Tamoxifeno/uso terapéutico , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/patología , Femenino , Humanos , Estudios Prospectivos , Resultado del TratamientoRESUMEN
155 pacientes con un seguimiento minimo de 3 anos fueron evaluados. La demora en la consulta no influyo en la incidencia de ganglios metastasicos. El 73.5% de las parecurrencia o metastasis a los 3 y 5 anos T3, T4). El 56% presento metastasis en los ganglios axilares. El tamano tumoral influyo en la incidencia de metastasis axilares excepto cuando se comparo T1 con T2 (PO. 06). Cuando se correlaciono tamano tumoral (T) con el estado de ganglios y recurrencia o metastasis a los 3 y5 anos no se observo diferencia significativa.Los pacientes con ganglios positivos tuvieron peor pronostico que las con ganglios negativos a los 3 y 5 anos (P 0.01). El estado menopausico no influyo en la sobrevida libre de enfermedad. El 87% de las pacientes con recurrencia a los 5 anos presentaron enfermedad diseminada. Los resultados terapeuticos a los 5 anos son similares a los publicados por otros autores en U.S.A.y Europa
