RESUMEN
PURPOSE: Colorectal cancer (CRC) is one of the major health problems of the Western world and the proportion of elderly patients with CRC is growing. Raltitrexed ('Tomudex'), a specific thymidylate synthase inhibitor, has shown efficacy and manageable toxicity in elderly CRC patients. In this retrospective study, the tolerability of raltitrexed in patients with CRC was examined in relation to age. PATIENTS AND METHODS: Toxicity parameters, graded according to World Health Organization criteria, were assessed in two patient groups: < 70 and > or = 70 years old. In total, 56% (50 out of 90) of patients treated with raltitrexed (3 mg/m2 as a 15-minute intravenous infusion every 3 weeks) were aged > 70 years (M:F 28:22; Eastern Cooperative Oncology Group performance status 0-1:2 38:12). RESULTS: Overall, 437 cycles of chemotherapy were administered and grade 3-4 toxicity was reported in < 10% of patients. There were no clinically significant differences between the two age groups, apart from grade 3-4 asthenia, which was reported by 6% and 0% of patients aged > or = 70 and < 70 years, respectively. This was in spite of a significantly lower calculated mean creatinine clearance in patients aged > or = 70 years compared with those patients < 70 years of age. CONCLUSION: The raltitrexed toxicity profile does not appear to be significantly influenced by age; however caution is recommended in the management of elderly patients, particularly in the presence of impaired renal function.
Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Antimetabolitos Antineoplásicos/efectos adversos , Neoplasias Colorrectales/tratamiento farmacológico , Quinazolinas/efectos adversos , Tiofenos/efectos adversos , Adenocarcinoma/metabolismo , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Antimetabolitos Antineoplásicos/farmacocinética , Antimetabolitos Antineoplásicos/uso terapéutico , Quimioterapia Adyuvante , Neoplasias Colorrectales/metabolismo , Creatinina/sangre , Creatinina/orina , Femenino , Humanos , Riñón/metabolismo , Masculino , Persona de Mediana Edad , Quinazolinas/farmacocinética , Quinazolinas/uso terapéutico , Estudios Retrospectivos , Factores Sexuales , Tiofenos/farmacocinética , Tiofenos/uso terapéuticoRESUMEN
We present a rare case of renal cell carcinoma (RCC) with a metastatic, mainly osteoblastic lesion of the skull and spread to the lymph nodes. Renal tumors are often associated with bone metastases; these are most often of the osteolytic type, while osteoblastic metastases are extremely rare. In the case presented here, the primary metastasis was a large osteoblastic lesion of the skull that spread to the lymph nodes. The patient has undergone treatment for 20 months with interleukin-2: 3 million IU/day (subcutaneous) for six consecutive days once every four weeks, ie a total weekly dose of 18 million IU.