ABSTRACT
PURPOSE: Sorafenib has recently been recognized as an important standard option for the management of patients with differentiated thyroid cancer. Although data concerning cardiac safety are available in pan-tumor studies, no data are available on its use in everyday clinical practice in patients with thyroid cancer. METHODS: In the off-label program of our institution, we enrolled 14 patients with different histological types of thyroid cancer suitable for treatment with sorafenib. Our aims were to evaluate cardiac safety factors-LVEF (left ventricular ejection fraction), heart rate and blood pressure-the cardiac markers NT-proBNP and troponin I, radiological response evaluated by CT and (18)FDG-PET (according to RECIST 1.1 criteria) and biomarker reduction (Eastern Cooperative Oncology Group Performance Status: ECOG PS) 0-2. RESULTS: Patients with ECOG PS 2 accounted for 36%. After starting sorafenib, many patients displayed reduced or stabilized metabolic activity in target lesions (clinical benefit = 44%), radiologic reduction or stabilization (74%) and decreased cancer markers (90%). Lung metastases displayed the largest reductions in size. Median overall survival (OS) was 7 months and median progression-free survival (PFS) was 3 months. No sign of cardiotoxicity was observed in almost all patients. LVEF was altered in two patients and proved symptomatic in one. CONCLUSIONS: Sorafenib seems to be effective in reducing disease progression in the early stages of treatment (3-6 months). Responses varied considerably according to the criteria investigated. Cardiac toxicities did not raise concerns and were in line with data reported in other malignancies. However, cardiac monitoring is recommended.
Subject(s)
Antineoplastic Agents/therapeutic use , Biomarkers, Tumor/blood , Niacinamide/analogs & derivatives , Phenylurea Compounds/therapeutic use , Stroke Volume/physiology , Thyroid Neoplasms/blood , Thyroid Neoplasms/drug therapy , Aged , Aged, 80 and over , Antineoplastic Agents/pharmacology , Electrocardiography/drug effects , Female , Follow-Up Studies , Humans , Male , Middle Aged , Niacinamide/pharmacology , Niacinamide/therapeutic use , Phenylurea Compounds/pharmacology , Retrospective Studies , Sorafenib , Thyroid Neoplasms/diagnosis , Treatment OutcomeSubject(s)
Dietary Supplements/statistics & numerical data , Minerals , Vitamins , Adult , Female , Humans , Male , Middle Aged , SpainABSTRACT
This study evaluated pelvic floor rehabilitation as a possible treatment for premature ejaculation. In this treatment it is assumed that the pelvic muscles are involved in the control of the ejaculatory reflex. The treatment avails itself of a method already used for fecal and urinary incontinence. Eighteen patients with premature ejaculation were recruited. Fifteen (83%) of them had suffered from this disturbance for at least five years. Most of them had experienced other therapies without success. After 15-20 sessions of pelvic floor rehabilitation, 11 (61%) patients were cured and are able to control the ejaculatory reflex; seven (39%) patients had no improvement. All patients were followed for a minimum of 6 months to a maximum of 14 months. This therapy is easy to perform, has no side effects, and can be included among the therapuetic options for patients with premature ejaculation.