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J BUON ; 17(2): 363-8, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22740219


PURPOSE: Oral mucositis (OM) is one of the most frequent and bothersome complications of high-dose chemotherapy with subsequent auto- and allogeneic haematopoietic stem cell transplantation (HSCT). We have assessed the effectiveness of supersaturated calcium phosphate rinse (Caphosol ®) and palifermin (Kepivance®) in the prophylaxis of OM caused by HSCT. METHODS: Caphosol® and Kepivance® were prospectively evaluated in OM prophylaxis in 64 patients after HSCT and compared against themselves and an historical control group. RESULTS: Grade 3 and 4 OM was not observed in patients treated with Caphosol® and palifermin. None of those patients needed total parenteral nutrition (TPN), too. In the Caphosol® group 40.9% of the patients did not develop OM, and 70% of patients treated with palifermin were free of any kind of OM symptoms. In the control group OM was observed in all cases. CONCLUSION: Caphosol® seems to decrease the incidence, severity and duration of OM, the demand for opioids and for TPN. It needs to be tested in randomized trials, because its easy administration and cost-effectiveness may render it a valuable addition to the standard care in the treatment of OM.

Fosfatos de Calcio/uso terapéutico , Factor 7 de Crecimiento de Fibroblastos/uso terapéutico , Neoplasias Hematológicas/complicaciones , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Estomatitis/prevención & control , Adulto , Estudios de Casos y Controles , Estudios de Seguimiento , Neoplasias Hematológicas/terapia , Humanos , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos , Estomatitis/etiología , Tasa de Supervivencia , Adulto Joven
Transplant Proc ; 43(8): 3111-3, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21996239


OBJECTIVE: Oral mucositis (OM) is an unresolved problem among patients treated with a high-dose therapy supported by hematopoietic stem cell transplantation (HSCT). We tested the ability of supersaturated calcium phosphate mouth rinse (Caphosol) to ameliorate oral mucosal injury induced by a conditioning regimen. PATIENTS AND METHODS: Thirty-two patients with hematologic malignancies were treated with Caphosol to prevent OM during HSCT procedures. The conditioning regimens for 16 patients were BGNU 300 mg/m2, day 6; ARA-C 200 mg/m2 daily, days 5, 4, 3, 2; VP-16 200 mg/m2 daily, days 5, 4, 3, 2; L-PAM 140 mg/m2, day 1 (BEAM) and for 16 patients, MEL 200 (non-Hodgkin's lymphoma). A control group was composed of 24 consecutive patients, who had been treated with HSCT before Caphosol was available. The source of the graft was autologous peripheral blood. RESULTS: Among patients treated with Caphosol no one had to receive total parenteral nutrition. Among the BEAM group no one experienced III to IV degree OM compared with 40% of the control group. The median OM duration was 2.25 days versus controls of 8.6, (P<.001); only one patient received opioids versus 100% of controls. In the MEL 200 group, 93.7% of patients developed 0 to II degree OM vs 94% of the control group (P=.74) with median duration of 1, 73 days versus 2.42 for the controls (P=.73). In both control and Caphosol cohorts one patient received opioids. CONCLUSION: Caphosol may reduce the incidence, severity, and duration of oral mucositis and decrease the number of days with painkillers among patients treated with a BEAM but not a Mel 200 regimen.

Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Fosfatos de Calcio/administración & dosificación , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Melfalán/efectos adversos , Estomatitis/prevención & control , Adulto , Carmustina/efectos adversos , Citarabina/efectos adversos , Etopósido/efectos adversos , Femenino , Enfermedad de Hodgkin/terapia , Humanos , Linfoma no Hodgkin/terapia , Masculino , Persona de Mediana Edad , Antisépticos Bucales/uso terapéutico , Mieloma Múltiple/terapia , Acondicionamiento Pretrasplante/efectos adversos , Resultado del Tratamiento , Adulto Joven
Ann Oncol ; 21(5): 1027-31, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-19850637


BACKGROUND: This retrospective study evaluated the incidence of brain metastases in a subgroup of patients with metastatic renal cell carcinoma (RCC) who were randomly assigned to receive sorafenib, an oral multikinase inhibitor (400 mg b.i.d.), versus placebo in the phase III Treatment Approaches in Renal Cancer Global Evaluation Trial (TARGET). PATIENTS AND METHODS: Patients enrolled in TARGET at two centres (Institut Gustave Roussy, Villejuif, France, n = 85; Central Clinical Hospital of Military Medical Academy, Warsaw, Poland, n = 54) made up the current subgroup, who were retrospectively evaluated for the incidence of brain metastases during follow-up. The association between treatment (sorafenib versus placebo) and occurrence of brain metastases was evaluated by univariate analysis. RESULTS: The overall incidence of brain metastases in patients receiving sorafenib was 3% (2 of 70 patients) compared with 12% (8 of 69 patients) in patients receiving placebo (P < 0.05). The incidence of brain metastases was also significantly lower in the sorafenib group after 1 (P = 0.0447) and 2 years (P = 0.005) of treatment compared with the placebo group. CONCLUSIONS: In this subpopulation, sorafenib may reduce the occurrence of brain metastases. Antiangiogenic therapy, such as sorafenib, could be an effective preventive therapy for brain metastases in advanced RCC.

Antineoplásicos/uso terapéutico , Bencenosulfonatos/uso terapéutico , Neoplasias Encefálicas/prevención & control , Carcinoma de Células Renales/tratamiento farmacológico , Neoplasias Renales/tratamiento farmacológico , Piridinas/uso terapéutico , Administración Oral , Anciano , Neoplasias Encefálicas/secundario , Carcinoma de Células Renales/secundario , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Neoplasias Renales/patología , Neoplasias Hepáticas/prevención & control , Neoplasias Hepáticas/secundario , Neoplasias Pulmonares/prevención & control , Neoplasias Pulmonares/secundario , Masculino , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/patología , Niacinamida/análogos & derivados , Compuestos de Fenilurea , Estudios Retrospectivos , Sorafenib , Tasa de Supervivencia