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J Natl Cancer Inst ; 92(12): 977-86, 2000 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-10861309


BACKGROUND: Preclinical evidence suggests that retinoids and antioxidants may prevent or delay the occurrence of cancer in the upper or lower airways, but such effects have not been reliably established in clinical studies. To assess the chemopreventive effects of vitamin A (retinyl palmitate) and N-acetylcysteine, we conducted a large randomized intervention study in patients with head and neck cancer or with lung cancer, most of whom had a history of smoking. METHODS: From June 1988 through July 1994, a total of 2592 patients (60% with head and neck cancer and 40% with lung cancer) were randomly assigned to receive 1) retinyl palmitate (300000 IU daily for 1 year followed by 150000 IU for a 2(nd) year), 2) N-acetylcysteine (600 mg daily for 2 years), 3) both compounds, or 4) no intervention. All statistical tests were two-sided. RESULTS: Of the patients, 93.5% had smoked tobacco at sometime in their lives (and 25% continued to smoke after cancer diagnosis). After a median follow-up of 49 months, 916 patients were reported with an event (recurrence, second primary tumor, or death). No statistically significant difference was observed in overall survival or event-free survival between patients who received retinyl palmitate and patients who did not. Similarly, no difference was seen in overall survival or event-free survival between patients who received N-acetylcysteine and patients who did not. There was a lower incidence of second primary tumors in the no intervention arm, but the difference was not statistically significant. CONCLUSION: A 2-year supplementation of retinyl palmitate and/or N-acetylcysteine resulted in no benefit-in terms of survival, event-free survival, or second primary tumors-for patients with head and neck cancer or with lung cancer, most of whom were previous or current smokers.

Acetilcisteína/uso terapéutico , Anticarcinógenos/uso terapéutico , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Vitamina A/análogos & derivados , Acetilcisteína/administración & dosificación , Acetilcisteína/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Anticarcinógenos/administración & dosificación , Anticarcinógenos/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Supervivencia sin Enfermedad , Diterpenos , Esquema de Medicación , Europa (Continente) , Femenino , Neoplasias de Cabeza y Cuello/etiología , Humanos , Neoplasias Pulmonares/etiología , Masculino , Persona de Mediana Edad , Neoplasias Primarias Secundarias/prevención & control , Cooperación del Paciente , Ésteres de Retinilo , Factores de Riesgo , Fumar/efectos adversos , Análisis de Supervivencia , Insuficiencia del Tratamiento , Vitamina A/administración & dosificación , Vitamina A/efectos adversos , Vitamina A/uso terapéutico
Semin Oncol ; 21(3 Suppl 6): 66-71, 1994 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-8052876


The history of chemotherapy for non-small cell lung carcinoma is one of very slow progress. Consequently, the categories of patients who will ultimately benefit from this modality are still debated. Recent European Organization for Research and Treatment of Cancer studies show that there is less concern about the importance of platinum as an ingredient of combination regimens or as an adjunct to radiotherapy. The presence of cisplatin is related to better response and survival in patients with locoregional and distant metastatic disease.

Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Cisplatino/administración & dosificación , Neoplasias Pulmonares/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Carcinoma de Pulmón de Células no Pequeñas/secundario , Quimioterapia Adyuvante , Ensayos Clínicos como Asunto , Humanos , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/radioterapia , Estadificación de Neoplasias , Compuestos de Platino/administración & dosificación
Chest ; 103(6): 1908-9, 1993 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-8404130


We describe a patient who suffered from a bacterial pneumonia and had a left-sided infiltrate on his chest radiograph. He was found to be cytopenic and acute myeloid leukemia was diagnosed. A complete remission was achieved after chemotherapy, and the patient was scheduled to have autologous bone marrow transplantation. Bronchoscopy was performed because of persistent hemoptysis and a squamous cell carcinoma in the right upper lobe bronchus was found. This small tumor was successfully treated with photodynamic therapy preventing any delay in the treatment of his leukemia, which would have occurred if surgery had been the treatment of choice. The patient is still in complete remission after a follow-up period of 12 months.

Trasplante de Médula Ósea , Carcinoma de Células Escamosas/tratamiento farmacológico , Leucemia Mieloide Aguda/terapia , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Primarias Múltiples/terapia , Fotoquimioterapia , Humanos , Masculino , Persona de Mediana Edad