RESUMEN
The authors developed a strategy that includes a novel approach of induction full-dose chemotherapy followed by traditional chemoradiation as a neoadjuvant therapy for pancreatic cancer. Here they report the results of a phase I/II trial of gemcitabine, cisplatin, and 5-FU for patients with advanced gastrointestinal malignancies.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Desoxicitidina/análogos & derivados , Neoplasias Gastrointestinales/patología , Neoplasias Gastrointestinales/terapia , Terapia Neoadyuvante , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/terapia , Adulto , Anciano , Quimioterapia Adyuvante , Cisplatino/uso terapéutico , Terapia Combinada , Desoxicitidina/uso terapéutico , Femenino , Fluorouracilo/uso terapéutico , Neoplasias Gastrointestinales/mortalidad , Humanos , Masculino , Dosis Máxima Tolerada , Persona de Mediana Edad , Estadificación de Neoplasias , Pancreatectomía/métodos , Neoplasias Pancreáticas/mortalidad , Selección de Paciente , Pronóstico , Dosificación Radioterapéutica , Radioterapia Adyuvante , Inducción de Remisión , Análisis de Supervivencia , Resultado del Tratamiento , GemcitabinaRESUMEN
Significant progress has been made in the prevention and management of many symptoms associated with cancer and its therapy. Anemia in cancer may be secondary to blood loss, displacement of normal bone marrow cells by malignant cells, myelotoxic therapy, or the tumor itself. Practitioners may not always adequately assess anemia unless it represents a source of significant symptoms or patient distress. Risk factors include platinum-based treatment regimens, specific tumor types, and low baseline hemoglobin levels. Anemia may have an impact on patient performance status, quality of life, clinical symptoms, and possibly therapeutic efficacy and survival. Treatment interventions, directed toward the underlying etiology of the anemia, involve iron supplementation, blood transfusion, and administration of recombinant human erythropoietin. Future advances may include new tools to assess physical or functional symptoms and predict therapeutic response more accurately, and more cost-effective, convenient agents to prevent or treat anemia in cancer. Novel approaches that may add to the armamentarium of strategies designed to address anemia in patients with cancer currently are being developed.
Asunto(s)
Anemia/etiología , Anemia/terapia , Neoplasias/complicaciones , Anemia/diagnóstico , Anemia/epidemiología , Transfusión Sanguínea , Eritropoyetina/uso terapéutico , Hematínicos/uso terapéutico , Humanos , Rol de la Enfermera , Evaluación en Enfermería/métodos , Enfermería Oncológica/métodos , Prevalencia , Calidad de Vida , Factores de Riesgo , Resultado del TratamientoRESUMEN
Significant progress has been made in the prevention and management of many symptoms associated with cancer and its therapy. However, cancer-related anemia, which may affect more than half of all patients with cancer, often is assessed and treated inadequately. Severe anemia not only causes significant symptomology but also may impair functional status and quality of life. In addition, anemia has been found to affect treatment outcomes, including disease-free and overall survival. Therapeutic strategies, based on the underlying etiology of anemia, include iron supplementation, blood transfusion, and administration of recombinant human erythropoietin. Future approaches may involve novel agents under investigation that are designed to address current concerns related to efficacy, convenience, and possible cost-effectiveness of treatment of cancer-related anemia.