Correction to: Persistent major alopecia following adjuvant docetaxel for breast cancer: incidence, characteristics, and prevention with scalp cooling.

In the original publication of the article, Table 1 was published with incorrect caption and values. The Table 1 with corrected caption and values is given in this Correction.

Persistent major alopecia following adjuvant docetaxel for breast cancer: incidence, characteristics, and prevention with scalp cooling.

BACKGROUND: Persistent alopecia (PA) after docetaxel has been recently described. The aim of our study is to establish the incidence and characteristics of PA following adjuvant docetaxel for breast cancer (BC) and to test the ability of scalp cooling in prevention. PATIENTS AND METHODS: BC patients receiving adjuvant chemotherapy followed or not by endocrine therapy (and a control group receiving only endocrine therapy) were interviewed in a single institution at 1.5 to 5 years following primary diagnosis searching for PA. A confirmatory prevalence study was later performed in other two institutions. Finally, a prevention study using prophylactic scalp cooling (PSC) with ELASTO-GEL hypothermia caps in patients receiving adjuvant docetaxel was performed. RESULTS: In the initial prevalence study (492 patients), minor forms of PA (grade 1) were recorded with all chemotherapy regimens and aromatase inhibitors. Patients receiving docetaxel regimens at cumulative dose (CD) ≥ 400 mmg/m2 presented a significantly higher prevalence of grades 1 PA (33-52%) and 2 PA (5-12%). Prevalence of grade 2 PA with docetaxel CD ≥ 400 mmg/m2 was confirmed in two other institutions. Overall, grade 2 PA was seen in 10.06% (95% CI 7.36-13.61) of 358 patients with docetaxel regimens reaching CD ≥ 400 mmg/m2, but not in patients with lower docetaxel CD, other chemotherapy regimens, or endocrine therapy alone. In prevention trial, no grade 2 PA occurred among 116 patients receiving adjuvant docetaxel (≥ 400 mmg/m2) and PSC followed-up after a 96 months median time. PSC was well tolerated. No scalp relapses were seen among 30 patients (22% of all inclusions) having disease relapse. CONCLUSION: Adjuvant treatment with docetaxel (CD ≥ 400 mmg/m2) is associated with a significant rate of grade 2 PA, leading to wearing a wig, in around 10% of patients. This toxicity was completely prevented with scalp cooling. Clinical Trial Reference: NCT00515762.

Use of bevacizumab as a first-line treatment for metastatic breast cancer.

OBJECTIVE: During clinical practice, it can be challenging, given the lack of response biomarkers, to identify the patients with metastatic breast cancer (mbca) who would benefit most from the addition of bevacizumab to first-line standard chemotherapy. The aim of the present review was to summarize the relevant scientific evidence and to discuss the experience of a group of experts in using bevacizumab to treat mbca. METHODS: A panel of 17 Spanish oncology experts met to discuss the literature and their experience in the use of bevacizumab as first-line treatment for mbca. During the meeting, discussions focused on three main issues: the profile of the patients who could benefit most from bevacizumab, the optimal bevacizumab treatment duration, and the safety profile of bevacizumab. RESULTS: The subset of mbca patients who would benefit the most from the addition of bevacizumab to first-line standard chemotherapy are those with clinically defined aggressive disease. Treatment with bevacizumab should be maintained until disease progression or the appearance of unacceptable toxicity. In the mbca setting, the toxicity profile of bevacizumab is well known and can be managed in clinical practice after adequate training. CONCLUSIONS: This expert group recommends administering bevacizumab as first-line treatment in patients with clinically aggressive disease.

[Chemotherapy in prostatic carcinoma]. / Quimioterapia en el carcinoma prostático.

Carcinoma of the prostate has been treated by monochemotherapy, polychemotherapy, intraarterial chemotherapy, combined chemo and hormone therapy and growth factor antagonists. Difficulties exist in evaluating the efficacy of chemotherapy due to the scant number of patients treated and the different criteria used to assess response. Monochemotherapy has achieved a response rate (complete and partial) of less than 20% in randomized studies and that obtained with polychemotherapy is only slightly higher. The studies that have been conducted comparing these two treatment modalities have not clearly demonstrated the superiority of the latter. The duration of response is short and is measured in weeks. There is no standard treatment. Adriamycin, fluorouracil and cyclophosphamide appear to be the most effective cytostatic agents. There is no evidence that chemotherapy improves survivorship, and in comparison to symptomatic treatment, the former has been superior. The combination of chemotherapy with hormone therapy as a first line of treatment can improve the response rate slightly and enhance survivorship, although further studies are warranted to determine this definitely. Recruitment with androgens increases the response, but may entail risks. The growth factor antagonists have extended the therapeutic possibilities in prostate carcinoma, but further studies are warranted to determine its true value.

[Subacute paraneoplastic cerebellar degeneration in microcytic carcinoma of the lung. Presentation of 2 cases]. / Degeneración subaguda cerebelosa paraneoplásica en el carcinoma microcítico de pulmón. Presentación de dos casos.

Subacute paraneoplastic cerebellous degeneration is a rare syndrome which is found in less than 1% of patients with cancer. Small cell cancer of the lung and of the ovary are the two neoplasms most frequently associated to this entity. Two patients with small cell lung cancer who initially had a cerebellous syndrome in which no sign of macroscopic cerebellous lesion could be demonstrated by either computerized tomography or nuclear magnetic resonance of the head are presented. One of the patients was evaluated at autopsy. Both patients were treated with polychemotherapy with which partial response was obtained. Neurologic symptomatology was not alleviated in the first patient with death due to bronchopneumonia at 5.5 months of initiation of the disease, while improvement of the cerebellous paraneoplastic syndrome was achieved in the second patient. The different evolution of subacute paraneoplastic cerebellous degeneration in two patients in whom antibodies were not demonstrated and in whom initial response of the tumor to chemotherapy was achieved may be explained by the second patient having undergone prolonged treatment of 6 cycles suggesting a strict relation ship between the tumor and subacute cerebellous degeneration which, to date, remains unknown.

[Chemotherapy with cisplatin, adriamycin, etoposide and ifosfamide in microcytic lung carcinoma]. / Quimioterapia con cisplatino, adriamicina, etopósido e ifosfamida en el carcinoma microcítico pulmonar.

BACKGROUND: The aim of this study was to analyze the results obtained in the treatment of small cell lung cancer (SCLC) with the PAVI chemotherapy protocol (cisplatin, adriamycin, etoposide and ifosfamide). METHODS: Over a period of 3 years, 41 patients with a mean age of 57 years were treated. Twenty-two patients were considered as having limited disease (LD) and 19 disseminated disease (DD). Survival was studied by the Kaplan and Meier method. RESULTS: The percentage of complete response (CR) achieved was 42%, LD 52% and 27% for DD, with partial responses (PR) being achieved in 50%, 43% in LD and 60% in DD. With a mean follow up of 32 months, the mean 2 length of response was 13 months in the patients with CR and 9 months in those with PR. The median of survival in LD was 22 months and 10 months for patients with DD. Prolonged survival of over 2 years, was only achieved in LD (16%). Five patients died in relation with the treatment. Hematologic toxicity was doses-limited with the greatest toxicity being found in patients with DD under the Karnofsky index (KI). CONCLUSIONS: The PAVI protocol is effective in the treatment of small cell lung cancer and a good median of survival may be achieved in patients with limited disease. Toxicity is elevated and is fundamentally found in patients with disseminated disease and under the Karnofsky index, with its use not being recommended in these cases.