[Study on the adverse reactions related to paclitaxel and docetaxel infusion]. / Estudio de las reacciones adversas relacionadas con la infusión de paclitaxel y docetaxel.

OBJECTIVE: To determine the incidence of paclitaxel and docetaxel infusion-associated reactions, and the likely causes that may trigger them. METHOD: Cohort study of the paclitaxel and docetaxel infusions carried out at a tertiary hospital from July of 2010 to December of 2011 (18 months). For each infusion, the clinical data and the drug-related data were recorded. When a reaction occurred during the infusion the following data were specified: type, severity, if treatment withdrawal was needed. The clinical charts and treatment orders were reviewed. The follow-up of the infusions were done by contacting the day-care hospital nurses. A descriptive study was done for the most relevant variables included in the follow-up and we analyzed if any of them could have had an influence on the occurrence of the reactions. RESULTS: During the study period, 357 paclitaxel and docetaxel infusions were administered to 92 patients: mean age 61.4 years (SD 11.1), 50.0% were female. 9 infusion reactions affecting 8 patients occurred, all of them caused by docetaxel (c2 = 8.3, p = 0.004); 14.5% of the patients receiving it, and always during the first or second treatment cycle. The variables significantly associated to the occurrence of the reaction were: lung cancer (p< 0.005), docetaxel-cisplatin regime (p< 0.005), receiving the drug as first line (p=0.021), and non-advanced disease (p = 0.014). CONCLUSIONS: At our hospital, docetaxel is the taxane that has provoked the most frequent safety problems during the infusion.

Objetivo: Determinar la incidencia de reacciones a la infusión de paclitaxel y docetaxel, y las posibles causas que pueden desencadenarlas. Método: Estudio de cohortes de las infusiones de paclitaxel y docetaxel realizadas en un hospital de tercer nivel, desde julio de 2010 hasta diciembre de 2011 (18 meses). Para cada infusión se registraron los datos clínicos del paciente y los referentes al taxano administrado. Ante la aparición de una reacción durante la infusión se especificó: tipo, gravedad y si ésta obligó a la suspensión del tratamiento. Se consultaron las historias clínicas y las órdenes médicas. El seguimiento de las infusiones se realizó contactando con las enfermeras de hospital de día. Se efectuó un estudio descriptivo de las variables más relevantes incluidas en el seguimiento y se analizó si alguna de ellas podía influir en la aparición de reacciones. Resultados: Durante el periodo de estudio, se administraron 357 infusiones de paclitaxel y docetaxel a 92 pacientes: media de edad 61,4 años (DE 11,1), 50,0% mujeres. Se detectaron 9 reacciones infusionales que afectaron a 8 pacientes, todas ellas causadas por docetaxel (c2 = 8,3, p = 0,004); el 14,5% de los pacientes que lo llevaron, y siempre durante el primer o segundo ciclo de tratamiento. Las variables asociadas significativamente a la aparición de reacciones fueron: neoplasia de pulmón (p< 0,005), esquema docetaxel-cisplatino (p < 0,005), recibir el fármaco en primera línea (p=0,021) y enfermedad no avanzada (p=0,014). Conclusiones: En nuestro centro hospitalario, docetaxel es el taxano que ha provocado más problemas de seguridad durante su infusión.

[Pericardial tamponade and a mass in the pericardial cavity as the first clinical manifestation of a pulmonary neoplasms]. / Taponamiento pericárdico y masa en la cavidad pericárdica como primera manifestación clínica de una neoplasia pulmonar.

Cardiac tamponade and the finding of a simple pericardial mass as the first manifestations of a malignant neoplasia from another location are exceedingly rare events. Here we present a patient affected with a lung carcinoma whose first clinical manifestation was the development of a cardiac tamponade that established itself quickly within the context of a mass inside the pericardial cavity and adhered to the left atrium.

[Left supraclavicular adenopathy. Metastasis of carcinoma of the prostate]. / Adenopatía supraclavicular izquierda. Metástasis por carcinoma de próstata.

Herein we describe two cases of prostatic carcinoma whose presenting feature was a left supraclavicular lymphadenopathy. The patients had presented no urinary symptomatology and the rectal examination of the prostate had disclosed minimal changes. A review of the literature has shown that the survival and treatment should be approached with the same protocols used in patient that initially present with bony or visceral metastasis. The finding of a supraclavicular lymphadenopathy should always prompt us to suspect the possibility of prostatic cancer.