RESUMO
BACKGROUND: Oral mucositis is a frequent and serious complication in patients receiving chemo-radiotherapy for head and neck squamous cell carcinoma. This study evaluated the effects of administering Lactobacillus brevis CD2 lozenges on the incidence and severity of mucositis and tolerance to chemo-radiotherapy. METHODS: Two hundred patients suitable for chemo-radiotherapy were enrolled in a randomised, double-blind study to receive daily treatment with lozenges containing either L. brevis CD2 or placebo. Anticancer therapy was RT 70 Grays/35 fractions over 7 weeks with weekly Inj. Cisplatin 40 mg/m(2). The study treatment was given during, and for 1 week after completion of anticancer therapy. Primary end-points were the incidence of grade III and IV oral mucositis and the percentage of patients able to complete anticancer treatment. FINDINGS: The efficacy analysis included the 188 patients who received ≥ 1 week of study treatment. Grade III and IV mucositis developed in 52% of patients in the L. brevis CD2 arm and 77% in the placebo arm (P<0.001). Anticancer treatment completion rates were 92% in the L. brevis CD2 arm and 70% in the placebo arm (P=0.001). A larger proportion of patients remained free of mucositis when treated with L. brevis CD2 (28%) compared to the placebo (7%). INTERPRETATION: L. brevis CD2 lozenges reduced the incidence of grade III and IV anticancer therapy-induced oral mucositis and were associated with a lower overall rate of mucositis and a higher rate of anticancer treatment completion.
Assuntos
Carcinoma de Células Escamosas/terapia , Quimiorradioterapia/efeitos adversos , Neoplasias de Cabeça e Pescoço/terapia , Levilactobacillus brevis , Estomatite/prevenção & controle , Administração Oral , Adulto , Idoso , Método Duplo-Cego , Feminino , Humanos , Incidência , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/efeitos dos fármacos , Mucosa Bucal/efeitos da radiação , Estomatite/epidemiologia , Estomatite/etiologia , Análise de SobrevidaAssuntos
Inibidores da Angiogênese/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Neovascularização de Coroide/complicações , Hemorragia Retiniana/terapia , Anticorpos Monoclonais Humanizados , Bevacizumab , Terapia Combinada , Humanos , Injeções Intraoculares , Masculino , Pessoa de Meia-Idade , Pressão , Hemorragia Retiniana/complicações , Fator A de Crescimento do Endotélio Vascular/imunologiaAssuntos
Retinopatia Diabética/terapia , Glucocorticoides/uso terapêutico , Fotocoagulação a Laser/métodos , Edema Macular/terapia , Triancinolona Acetonida/uso terapêutico , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/tratamento farmacológico , Retinopatia Diabética/cirurgia , Glucocorticoides/administração & dosagem , Humanos , Injeções , Fotocoagulação a Laser/efeitos adversos , Edema Macular/tratamento farmacológico , Edema Macular/cirurgia , Conservantes Farmacêuticos , Retratamento , Tomografia de Coerência Óptica , Resultado do Tratamento , Triancinolona Acetonida/efeitos adversos , Acuidade Visual/fisiologia , Corpo VítreoRESUMO
We report a case of cystoid macular edema in a patient who underwent bone marrow transplant for aplastic anemia. After having ruled out all the other causes of cystoid macular edema, we concluded that it was secondary to the bone marrow transplant. The patient had mild visual impairment and did not recover the lost vision. In this case report, we describe in detail the clinical presentation, follow-up, and course of medication that this patient had. It is an illustrated case report of cystoid macular edema after bone marrow transplant with mild visual impairment and no recovery.
Assuntos
Transplante de Medula Óssea/efeitos adversos , Edema Macular/etiologia , Transtornos da Visão/etiologia , Adolescente , Anemia Aplástica/cirurgia , Angiofluoresceinografia , Humanos , Edema Macular/diagnóstico , Masculino , Tomografia de Coerência Óptica , Transtornos da Visão/diagnóstico , Acuidade VisualRESUMO
Optic nerve cysticercosis is rare but causes significant visual morbidity. A high index of suspicion is warranted for patients in endemic areas who present with sudden vision loss. Visual morbidity can be prevented by early imaging studies and therapeutic interventions.