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1.
Angiol. (Barcelona) ; 71(4): 154-159, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-190298

RESUMO

Se resumen a continuación las principales reacciones y eventos de interés que se han venido produciendo en la comunidad vascular internacional desde el pasado mes de diciembre de 2018, cuando se publicó el metaanálisis de Konstantinos Katsanos, hasta junio de 2019. Este estudio, que ha sido severamente criticado, identifica la falta de fiabilidad de los resultados comunicados por la industria. A la luz de los datos hasta ahora expuestos, la SEACV hace una serie de recomendaciones basadas en la información disponible hasta ahora sobre los balones y stent farmacoactivos con paclitaxel que están en la misma línea que los organismos internacionales


This paper summarizes the main reactions and events of interest that have been occurring in the international vascular community since last December 2018, when the meta-analysis by Konstantinos Katsanos was published. This study, which has been severely criticized, identifies the unreliability of the results reported by the industry. In light of the data presented so far, the SEACV makes a series of recommendations about the paclitaxel-eluting balloons and stents based on the information available until now which are in line with international organizations


Assuntos
Humanos , Doenças Vasculares Periféricas/terapia , Doenças Vasculares Periféricas/mortalidade , Paclitaxel/administração & dosagem , Stents Farmacológicos
4.
Rev. esp. patol ; 51(3): 188-192, jul.-sept. 2018. ilus
Artigo em Inglês | IBECS | ID: ibc-179075

RESUMO

Taxanes are antineoplastic drugs that can cause dermatotoxicity which can mimic an intraepidermal carcinoma. A 65-year-old woman presented with a cutaneous eruption suggestive of a paraneoplastic syndrome. Imaging studies showed multiple peritoneal nodules and associated ascites. A sample taken from the greater omentum revealed an adenocarcinoma. Clinical data and family history pointed to a gynecological origin of the tumor and the patient was treated with carboplatin and paclitaxel. A new cutaneous biopsy showed that the epidermis was acanthotic with atypical keratinocytes, abundant mitoses, and apoptotic figures, arising concerns of malignancy. According to the Plummer and Shea criteria, the lesion was ultimately interpreted as reactive cutaneous hyperplasia and expression of the taxane effect. We report, for the first time, paclitaxel-induced histologic changes on a previous cutaneous eruption. Pathologists should be aware of the profound cytopathic effects of taxane therapy in order to interpret skin biopsies of patients undergoing this treatment


Los taxanos son fármacos antineoplásicos que pueden causar dermatotoxicidad simulando un carcinoma intraepidérmico. Una mujer de 65 años se presentó con una erupción cutánea sugestiva de síndrome paraneoplásico. Los estudios de imagen mostraron múltiples nódulos peritoneales y ascitis asociada. Una muestra tomada del epiplón mayor reveló un adenocarcinoma. Teniendo en cuenta los datos clínicos y la historia familiar se asumió un origen ginecológico del tumor, y la paciente fue tratada con carboplatino y paclitaxel. Una nueva biopsia cutánea mostró que la epidermis era acantótica con queratinocitos atípicos, abundantes mitosis y figuras apoptóticas. Estos hallazgos levantaron la sospecha de malignidad. De acuerdo con los criterios de Plummer y Shea la lesión fue finalmente interpretada como hiperplasia reactiva epidérmica y expresión del efecto taxano. Presentamos por primera vez los cambios inducidos por paclitaxel sobre una erupción cutánea previa. Los patólogos deberían estar al tanto de los profundos efectos citopáticos de la terapia con taxanos con el fin de interpretar adecuadamente las biopsias cutáneas de los pacientes bajo este tratamiento


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Paclitaxel/efeitos adversos , Exantema/patologia , Neoplasias Cutâneas/induzido quimicamente , Carcinoma in Situ/patologia , Diagnóstico Diferencial , Síndromes Paraneoplásicas/patologia , Taxoides/efeitos adversos , Mitose , Reticulose Pagetoide/patologia
5.
Rev. esp. cardiol. (Ed. impr.) ; 71(8): 620-627, ago. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-178615

RESUMO

Introducción y objetivos: No se ha estudiado bien la incidencia y los predictores de la reestenosis recurrente tras angioplastia con balón farmacoactivo (BFA) en reestenois de stents farmacoactivos (SFA). Nuestro objetivo es analizar la incidencia y los predictores de la reestenosis recurrente en los estudios aleatorizados en que se utilizaron BFA para el tratamiento de la reestenosis del SFA. Métodos: Los datos clínicos y anatómicos de los pacientes incluidos en 6 estudios aleatorizados sobre BFA para el tratamiento de reestenosis de SFA se analizaron en conjunto. Se asignó a todos los pacientes incluidos en este análisis a tratamiento con el BFA de paclitaxel SeQuent Please (B Braun; Melsungen, Alemania). El análisis se centró en los pacientes que tenían seguimiento angiográfico a los 6-9 meses. Se evaluó tanto la incidencia de reestenosis (definida como estenosis ≥ 50% del diámetro luminal en el análisis por segmento durante el seguimiento angiográfico tardío) como sus predictores clínicos y angiográficos. Resultados: Los datos de 546 pacientes se incluyeron en una única base de datos. De 484 pacientes (88,6%), con un total de 518 lesiones tratadas, se disponía de seguimiento angiográfico tardío, y se detectó recurrencia de reestenosis en 101 pacientes (20,8%). En el análisis multivariable, la longitud de la lesión (por cada incremento de 5 mm, OR = 1,58; IC95%, 1,10-2,26; p = 0,012) y el tamaño del vaso (por cada reducción de 0,5 mm, OR = 1,42; IC95%, 1,12-1,79; p = 0,003) se asociaron de manera independiente con la recurrencia de reestenosis. Conclusiones: Este estudio, el mayor disponible de pacientes tratados con BFA por reestenosis de SFA con seguimiento angiográfico tardío, demuestra que la recurrencia de reestenosis se produce en 1 de cada 5 de estos pacientes. Los predictores de la reestenosis recurrente son la longitud de la lesión y el tamaño del vaso


Introduction and objectives: The incidence and predictors of recurrent restenosis after drug-coated balloon (DCB) angioplasty for drug-eluting stent (DES) restenosis remain poorly studied. We sought to evaluate the incidence and predictors of recurrent restenosis among participants in randomized controlled trials receiving DCB angioplasty for DES restenosis. Methods: The clinical and lesion data of individuals enrolled in 6 randomized controlled trials of DCB angioplasty for DES restenosis were pooled. All patients included in this report were assigned to receive paclitaxel-coated balloon angioplasty with the SeQuent Please DCB (B Braun, Melsungen, Germany). The current analysis focused on participants with available follow-up angiography at 6 to 9 months. The incidence of recurrent restenosis, defined as diameter restenosis ≥ 50% in the in-segment area at follow-up angiography, and its clinical and angiographic predictors were evaluated. Results: A total of 546 patients were combined in a single dataset. Angiographic follow-up at 6 to 9 months was available for 484 patients (88.6%) with 518 treated lesions. Recurrent restenosis was detected in 101 (20.8%) patients. On multivariable analysis, lesion length (OR, 1.58; 95%CI, 1.10-2.26; P = .012 for 5 mm increase) and vessel size (OR, 1.42; 95%, 1.12-1.79; P = .003 for 0.5 mm reduction) were independently associated with recurrent restenosis. Conclusions: In the largest cohort to date of individuals with angiographic surveillance after DCB angioplasty for DES restenosis, we demonstrated that recurrent restenosis occurs in approximately 1 out of 5 patients. Predictors of recurrent restenosis are increased lesion length and small vessel size


Assuntos
Humanos , Reestenose Coronária/fisiopatologia , Angioplastia Coronária com Balão , Stents Farmacológicos , Doença das Coronárias/complicações , Recidiva , Ponte de Artéria Coronária , Intervenção Coronária Percutânea , Paclitaxel/uso terapêutico , Infarto do Miocárdio/epidemiologia , Diabetes Mellitus/epidemiologia
6.
Metas enferm ; 21(3): 67-73, abr. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-172676

RESUMO

OBJETIVO: determinar la incidencia y evolución de la neuropatía periférica inducida por taxanos (NPIT) en pacientes con cáncer de mama y valorar la influencia de la NPIT en la calidad de vida global (CV). MÉTODO: estudio descriptivo longitudinal prospectivo realizado en el Servicio de Oncología del Hospital Clínic de Barcelona (julio 2015-abril 2016). Se incluyeron mujeres diagnosticadas de cáncer de mama en su primera línea de tratamiento con quimioterapia (paclitaxel o docetaxel) en quienes se evaluó la neurotoxicidad y la calidad de vida mediante tres cuestionarios autoinformados validados al inicio, a las 6 y 12 semanas y un mes tras finalizar el tratamiento. RESULTADOS: participaron 33 pacientes de las cuales el 84,4% había desarrollado algún grado de NP al final del seguimiento. La neurotoxicidad empeoró de manera estadísticamente significativa con la acumulación de dosis hasta el final del tratamiento y se mantuvo estable un mes tras la última administración (p< 0,001). La neuropatía sensitiva aumentó de manera estadísticamente significativa a lo largo del seguimiento (p< 0,001). La afectación de la sensibilidad motora también, salvo en la última medición (p< 0,005). Se observó una correlación positiva entre la neurotoxicidad y deterioro de la CV (r= 0,609 (p< 0,0001)) CONCLUSIONES: la NPIT es un efecto secundario con una alta incidencia en la población de mujeres con cáncer de mama estudiada y provoca un efecto negativo en la CV percibida de las pacientes. Las enfermeras oncológicas son profesionales clave en la prevención y el manejo de este efecto secundario


OBJECTIVE: to determine the incidence and evolution of taxane-induced peripheral neuropathy (TIPN) in breast cancer patients, and to assess the influence of TIPN on overall quality of life (QoL). METHOD: a prospective longitudinal descriptive study conducted at the Oncology Unit of the Hospital Clínic de Barcelona (July, 2015- April, 2016). The study included women with diagnosis of breast cancer, on their first line of treatment with chemotherapy (paclitaxel or docetaxel); neurotoxicity and quality of life were evaluated through three self-reported questionnaires validated at baseline, at 6 and 12 weeks, and one month after completing treatment. RESULTS: the study included 33 patients; 84.4% of them had developed some degree of PN at the end of follow-up. There was a statistically significant worsening in neurotoxicity with dose accumulation until the end of the treatment, and it remained stable one month after the last administration (p< 0.001). There was a statistically significant increase in sensitive neuropathy throughout follow-up (p< 0.001); also in terms of involvement in motor sensitivity, except in the final measurement (p< 0-005). A positive correlation was observed between neurotoxicity and QoL deterioration (r= 0.609 (p < 0.0001)). CONCLUSIONS: TIPN is a side effect with high incidence among the population studied of women with breast cancer, and it causes a negative impact on patient-perceived QoL. Oncology nurses are the key professionals for the prevention and management of this side effect


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/tratamento farmacológico , Antineoplásicos/efeitos adversos , Taxoides/toxicidade , Estudos Prospectivos , Neoplasias da Mama/complicações , Neurotoxinas/efeitos adversos , Qualidade de Vida , Paclitaxel/toxicidade , Resultado do Tratamento , Autorrelato
7.
Clin. transl. oncol. (Print) ; 20(3): 411-419, mar. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-171326

RESUMO

Purpose. This study was conducted to investigate the efficacy and toxicity of combination treatment with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy with paclitaxel plus different platinum agents in locally advanced esophageal squamous cell carcinoma (ESCC). Methods. This retrospective study enrolled 242 patients treated with paclitaxel (135 mg/m2) plus platinum regimens. According to the different platinum agents used, patients were classified into: cisplatin 80 mg/m2 (CP), nidaplatinum 80 mg/m2 (NP), lobaplatin 35 mg/m2 (LP), and oxaliplatin 135 mg m2 (OP) groups, and survival and toxicity rates between the four groups were compared. The median overall survival (OS) was 31.1 months. Results. No significant differences were observed among the CP, NP, LP, and OP groups with regard to 3-year survival rates (46.2, 56.4, 45.7, and 29.0%, respectively). A stratified analysis indicated that 3-year survival rates were significantly lower in the OP group. Renal toxicities and gastrointestinal reactions were more frequent in the CP group than in the other three groups. Three-year survival rates were similar among patients receiving 2, 3, or ≥4 cycles of chemotherapy (40.1, 49.5, and 50.8%, respectively). Multivariate analysis indicated that tumor volume and maximum diameter of metastatic lymph nodes might be independent prognostic factors. Conclusion. Paclitaxel plus nidaplatinum or lobaplatin is recommended in locally advanced ESCC due to their satisfying therapeutic effects and less toxicity. Tumor volume and maximum diameter of metastatic lymph nodes are independent prognostic factors in ESCC patients receiving IMRT and concurrent chemotherapy (AU)


No disponible


Assuntos
Humanos , Carcinoma de Células Escamosas/terapia , Neoplasias Esofágicas/terapia , Quimiorradioterapia/métodos , Estudos Retrospectivos , Paclitaxel/uso terapêutico , Cisplatino/uso terapêutico
8.
Farm. hosp ; 42(1): 10-15, ene.-feb. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-169907

RESUMO

Objetivo: Determinar la prevalencia de potenciales interacciones clínicamente relevantes en pacientes oncológicos adultos ingresados, mediante una base de datos de uso habitual, así como describir las interacciones más frecuentes. Método: Estudio observacional, transversal, descriptivo, que incluye pacientes ingresados a cargo del Servicio de Oncología de un hospital de referencia. Se recopilaron todas las prescripciones dos veces por semana durante un periodo de un mes. Se analizaron mediante la base de datos Lexicomp ® , registrando todas las interacciones clasificadas con un nivel de riesgo C, D o X. Resultados: Se detectaron un total de 1.850 interacciones farmacológicas en 218 tratamientos. La prevalencia de tratamientos con al menos una interacción clínicamente relevante fue de un 95%, siendo del 94,5% para las de nivel C y del 26,1% para los niveles D y X. Los analgésicos opioides, antipsicóticos (butirofenonas), benzodiacepinas, pirazolonas, glucocorticoides y heparinas fueron los fármacos más comúnmente involucrados en las interacciones detectadas, mientras que las interacciones con antineoplásicos fueron mínimas, destacando las relacionadas con paclitaxel y entre metamizol y diversos antineoplásicos. Conclusiones: La prevalencia de tratamientos con interacciones farmacológicas clínicamente relevantes fue muy elevada, destacando el elevado porcentaje de riesgo X. Por la frecuencia de aparición y potencial gravedad destacan el uso concomitante de fármacos depresores del sistema nervioso central con riesgo de depresión respiratoria, el riesgo de aparición de síntomas anticolinérgicos cuando se combinan morfina o haloperidol con butilescopolamina, bromuro de ipratropio o dexclorfe-niramina, así como las múltiples interacciones que implican al metamizol (AU)


Objective: To determine the prevalence of potential clinically relevant drug-drug interactions in adult oncological inpatients, as well as to describe the most frequent interactions. A standard database was used. Method: An observational, transversal, and descriptive study including patients admitted to the Oncology Service of a reference hospital. All prescriptions were collected twice a week during a month. They were analysed using Lexicomp ®database, recording all interactions classified with a level of risk: C, D or X. Results: A total of 1 850 drug-drug interactions were detected in 218 treatments. The prevalence of treatments with at least one clinically relevant interaction was 95%, being 94.5% for those at level C and 26.1% for levels D and X. The drugs most commonly involved in the interactions detected were opioid analgesics, antipsychotics (butyrophenones), benzodiazepines, pyrazolones, glucocorticoids and heparins, whereas interactions with antineoplastics were minimal, highlighting those related to paclitaxel and between metamizole and various antineoplastics. Conclusions: The prevalence of clinically relevant drug-drug interactions rate was very high, highlighting the high risk percentage of them related to level of risk X. Due to the frequency of onset and potential severity, highlighted the concomitant use of central nervous system depressants drugs with risk of respiratory depression, the risk of onset of anticholinergic symptoms when combining morphine or haloperidol with butyl scopolamine, ipratropium bromide or dexchlorpheniramine and the multiple interactions involving metamizole (AU)


Assuntos
Humanos , Interações Medicamentosas , Neoplasias/tratamento farmacológico , Prescrições de Medicamentos , Dipirona/uso terapêutico , Antineoplásicos/uso terapêutico , Paclitaxel/uso terapêutico , Fatores de Risco , Estudos Transversais/métodos , Transtornos Relacionados ao Uso de Opioides/diagnóstico , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Antipsicóticos/efeitos adversos , Benzodiazepinas/efeitos adversos , Pirazolonas/efeitos adversos , Dipirona/efeitos adversos
10.
Clin. transl. oncol. (Print) ; 19(6): 769-776, jun. 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-162835

RESUMO

Background. Standard treatment for recurrent/metastatic head and neck squamous cell carcinoma (RM-SCCHN) is based in on platinum and cetuximab combination therapy. Unfortunately, not all patients are candidates to receive platinum-based treatment, because of different conditions as comorbidity and poor performance status. Weekly paclitaxel and cetuximab (WPC) is an active therapeutic alternative, based on a phase II study, with less toxicity. Our main objective is to confirm its activity in unselected patients, mostly unfit for aggressive therapies, analysing also some clinically relevant prognostic factors (PFs). Methods. Retrospective data was collected for RM-SCCHN patients, treated at our institution between January 2008 and July 2014 with weekly paclitaxel (80 mg/m2) and cetuximab (400/250 mg/m2). Results. 148 patients were treated. The objective response rate (OR) was as follows: 13 patients (8.78%) complete response (CR); 57 patients (38.51%) partial response (PR) and 30 patients (20.3%) stable disease (SD). Median overall survival (OS) was 10 months (95% CI 8.31-11.69) and median progression free survival (PFS) was 7 months (95% CI 5.88-8.12). Response to treatment showed independent prognosis relevance as PF in multivariate analysis for PFS and OS. Furthermore, decline in serum magnesium during the treatment was also an independent PF for OS. Conclusions. WPC activity was confirmed as a useful therapy on real-life unselected RM-SCCHN patients, with similar benefit to that obtained in the phase II study, and comparable to platinum and cetuximab based treatment, confirming its value in unfit patients. In addition to treatment response, a change in serum magnesium values during treatment was proved as independent PF on OS (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/tratamento farmacológico , Cetuximab/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Cisplatino/administração & dosagem , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/radioterapia , Cetuximab/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/uso terapêutico , Paclitaxel/administração & dosagem , Paclitaxel/uso terapêutico , Análise de Sobrevida , Recidiva Local de Neoplasia/tratamento farmacológico , Prognóstico , Estudos Retrospectivos
11.
Clin. transl. oncol. (Print) ; 19(3): 326-331, mar. 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-160188

RESUMO

Purpose. Paclitaxel is an effective treatment for some of the non-small-cell lung cancer (NSCLC) patients. However, prediction of the outcome of paclitaxel treatment at the early stage of the chemotherapy is difficult. M30 and M65 are circulating fragments of cytokeratin 18 released during apoptosis or necrosis, respectively, and have been used as markers to evaluate chemotherapy in some cancers. Here, we aimed to examine M30 and M65 values for predicting the therapeutic outcome of paclitaxel treatment of NSCLC. Methods. The serum levels of M30 and M65 before and after paclitaxel treatment in advance-stage NSCLC patients were analyzed, and compared to those in healthy controls. The importance of the M30 and M65 levels to the outcome of chemotherapy was analyzed. Result. We found that the serum M30 and M65 levels were higher in patients with NSCLC (n = 44) than in control healthy subjects (n = 56) (p < 0.001). Two days after paclitaxel treatment, the serum levels of both M30 and M65 significantly increased in NSCLC patients (p < 0.001). Neither marker alone significantly correlated with overall patient survival, but the ratio of M30 vs M65 appeared to be an important prognostic factor for the overall survival of the patients (p < 0.01). Conclusion. Our results suggest that the serum M30/M65 ratio may be a prognostic factor for the outcome of paclitaxel treatment in NSCLC (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Paclitaxel/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Prognóstico , Queratinas/administração & dosagem , Queratinas/análise , Queratinas/classificação , Testes Sorológicos/métodos , Queratinócitos/citologia , Biomarcadores Tumorais/análise , Biomarcadores/análise , Biomarcadores/sangue
12.
Rev. esp. cardiol. (Ed. impr.) ; 69(11): 1026-1032, nov. 2016. graf, tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-157508

RESUMO

Introducción y objetivos: Hay pocos datos sobre la evaluación morfológica y funcional seriada del tratamiento con balón recubierto de paclitaxel mediante coronariografía, tomografía de coherencia óptica y reserva fraccional de flujo. Métodos: En este estudio observacional, prospectivo y realizado en un solo centro, se trató a pacientes con lesiones de novo mediante balón recubierto de paclitaxel. Se realizaron mediciones en serie mediante coronariografía, tomografía de coherencia óptica y reserva fraccional de flujo antes y después de una angioplastia clásica con balón simple, así como a los 9 meses de seguimiento. Resultados: En este estudio participaron 20 pacientes (21 lesiones). El diámetro vascular de referencia era 2,68 ± 0,34 mm y la pérdida luminal tardía, 0,01 ± 0,21 mm. Las medianas de los cambios en el área luminal mínima entre la situación previa a la angioplastia clásica con balón simple y la situación posterior, y entre esta y el seguimiento aumentaron el 75,2% (intervalo intercuartílico, [37,2-164,7%] y el 50,0% [1,1-64,5%]) respectivamente. Se observaron disecciones de la íntima en todas las imágenes de tomografía de coherencia óptica tomadas tras la intervención; el 66,6% de ellas estaban selladas en las imágenes obtenidas en el seguimiento (mediana, 278 días). La reserva fraccional de flujo distal a la lesión de interés fue de 0,71 ± 0,14 antes de la dilatación, 0,87 ± 0,04 tras la dilatación y 0,83 ± 0,08 en el seguimiento. Conclusiones: El balón recubierto de paclitaxel restablece el flujo coronario modificando las placas ateromatosas, lo que causa un aumento del área luminal mínima. A los 9 meses de seguimiento, el flujo coronario era continuo y persistía la permeabilidad luminal, resultado de suprimir la progresión de la estenosis luminal producida por los efectos localizados del fármaco en las lesiones coronarias de novo (AU)


Introduction and objectives: There is limited data on the serial morphological and functional assessment of paclitaxel-coated balloon treatment using coronary angiography, optical coherence tomography, and fractional flow reserve. Methods: In this prospective, single-center observational study, patients with de novo lesions were treated with the paclitaxel-coated balloon. Serial angiographic, optical coherence tomography and fractional flow reserve measurements were performed before and after plain old balloon angioplasty, as well as at 9-month follow-up. Results: Twenty patients (21 lesions) were enrolled in this study. The reference vessel diameter was 2.68 ± 0.34 mm and late luminal loss was 0.01 ± 0.21 mm. The median changes in the minimal lumen area between pre- and postplain old balloon angioplasty, and postplain old balloon angioplasty and follow-up were an increase of 75.2% [interquartile range of 37.2 to 164.7] and 50.0% [interquartile range of 1.1% to 64.5%], respectively. Intimal dissections were seen in all postprocedural optical coherence tomography images, and 66.6% of them were sealed on follow-up optical coherence tomography (median 278 days). The fractional flow reserve distal to the target lesion was 0.71 ± 0.14 predilatation, 0.87 ± 0.04 postdilatation, and 0.83 ± 0.08 at follow-up. Conclusions: The paclitaxel-coated balloon restores coronary blood flow by means of plaque modification, causing an increment in minimal lumen area. At 9-month follow-up, coronary flow was sustained and the luminal patency was the result of suppressed luminal narrowing progression from local drug effects on the de novo coronary lesions (AU)


Assuntos
Humanos , Stents Farmacológicos , Paclitaxel/farmacocinética , Doença das Coronárias/tratamento farmacológico , Reserva Fracionada de Fluxo Miocárdico , Tomografia de Coerência Óptica , Resultado do Tratamento , Revascularização Miocárdica/métodos , Estudos Prospectivos
13.
Clin. transl. oncol. (Print) ; 18(8): 813-824, ago. 2016. tab, graf
Artigo em Inglês | IBECS | ID: ibc-154057

RESUMO

Various kinetic parameters, based on a minimum of two time points, have been built with CA125 determinations. The aim of this study is to review studies about the clinical application of CA125-related tumor cell kinetics variables in patients with advanced ovarian cancer (AOC) receiving chemotherapy. A literature search for studies about CA125-related variables in patients with AOC was undertaken on three databases, by predefined search criteria, and a selection of studies was performed. Sixty-two studies were selected. CA125-related variables were summarized in three groups: response-related, timeto- event, and other CA125-related tumor cell kinetics variables. Even though CA125 changes and half-life after chemotherapy were the most studied, other variables and two models have been well defined, and often showed an interesting power to predict survival. These kinetics variables are related to the CA125 regression curve, pre- and post-chemotherapy kinetics, or are variables inferred from a population model of CA125 kinetics (AU)


No disponible


Assuntos
Humanos , Feminino , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/tratamento farmacológico , Biomarcadores Tumorais/análise , Antígeno Ca-125/administração & dosagem , Antígeno Ca-125/análise , Cisplatino/uso terapêutico , Carboplatina/uso terapêutico , Paclitaxel/uso terapêutico , Topotecan/uso terapêutico , Antígeno Ca-125/biossíntese , Antígeno Ca-125/classificação
15.
Nutr. hosp ; 33(3): 698-702, mayo-jun. 2016.
Artigo em Inglês | IBECS | ID: ibc-154491

RESUMO

The endangered causes of Taxus chinensis var. mairei in the Taihang Mountains are analyzed in three sides in connection with the situation that is resources increasing attenuation. The first is biological factors such as pollination barriers, deeply dormancy seed, cannot vegetative propagation under natural conditions, poor adaptability of seedling to environment and slow growth. The second is environmental factors such as very limited distribution environment and position in community. The third is interference of persons and other animals. According to these factors, we provide three measures to protect Taxus chinensis var. mairei in three sides that protect existing resources, breed subsequent resources and find new pathway of producing taxol (AU)


Las razones por las que la especie Taxus chinensis var. mairei está en peligro de extinción en las montañas de Taihang giran en torno a tres ejes distintos en relación a la disminución de ejemplares. En primer lugar contamos con factores biológicos, como las barreras de polinización, el alto grado de inactividad de sus semillas, la imposibilidad de propagación vegetal por medios naturales, la escasa adaptación de los vástagos al medio y su lento crecimiento. El segundo factor es de carácter ambiental: medio de distribución y posición en la comunidad muy limitados. Por último, la tercera causa es la interferencia de personas y animales. De acuerdo con estos factores, proponemos tres medidas para proteger la especie Taxus chinensis var. mairei con el fin de conservar los ejemplares existentes, cultivar nuevos ejemplares y encontrar nuevas vías para producir taxol (AU)


Assuntos
Taxus/crescimento & desenvolvimento , Espécies em Perigo de Extinção , Paclitaxel/farmacologia , Antineoplásicos Fitogênicos/provisão & distribução , Proteção de Cultivos/métodos
16.
Clin. transl. oncol. (Print) ; 18(6): 592-598, jun. 2016. tab, graf
Artigo em Inglês | IBECS | ID: ibc-152754

RESUMO

Introduction: The esophageal squamous cell carcinoma (ESCC) is the predominant pathological type and accounts for more than 80 % of esophageal cancer in China. The successful use of anti-epidermal growth factor receptor (EGFR) treatment in head and neck squamous cell carcinoma provides the rationale for introducing anti-EGFR targeting treatment in ESCC. One of our prospective phase II clinical trials analyzed the efficacy of nimotuzumab, an anti-EGFR agent, combined with chemotherapy (paclitaxel and cisplatin) to treat unresectable ESCC. Materials and methods: We analyzed the correlation of the clinical response with EGFR expression by immunohistochemical staining (IHC). Results: Totally 55 tumor samples were analyzed. 18/55 (32.7 %) cases were with high EGFR expression while the other 37/55 (67.3 %) cases were with low to moderate EGFR expression. The expression of EGFR was not related to gender, age, tumor location, tumor differentiation and clinical stage of disease. The objective response rate (ORR) in high EGFR expression group was 55.6 % (10/18) while that in low to moderate EGFR expression group was 54.1 % (20/37) (P = 0.57). Both the progression-free survival (PFS) and overall survival (OS) in high EGFR expression group were much shorter than those in low to moderate EGFR expression group (PFS: 5.8 ± 0.5 vs. 11.0 ± 2.8 months, P = 0.007; OS: 9.7 ± 0.5 vs. 21.5 ± 1.5 months, P = 0.03). Conclusions: The results showed that over-expression of EGFR was related to poor survival of ESCC. The overexpression of EGFR by IHC might not be an ideal predictive biomarker of nimotuzumab treatment. Other EGFR pathway-associated molecules should be analyzed in further studies (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/tratamento farmacológico , Receptores ErbB/análise , Receptores ErbB/imunologia , Imuno-Histoquímica/métodos , Imuno-Histoquímica/normas , Anticorpos Monoclonais/uso terapêutico , Cisplatino/uso terapêutico , Paclitaxel/uso terapêutico , Imuno-Histoquímica/tendências , Imuno-Histoquímica , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Resultado do Tratamento , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia
18.
Nutr. hosp ; 32(6): 2932-2937, dic. 2015. tab, graf
Artigo em Inglês | IBECS | ID: ibc-146165

RESUMO

The objective of this study was to isolate endophytic fungi producing paclitaxel from yew for the purpose of paclitaxel manufacture. Surface sterilized bark of Taxus wallichiana var. mairei was used as source material and potato dextrose agar culture medium was used in isolation of endophytic fungi. Fungal cultures were extracted with a mixture of chloroform / methanol (1:1, v/v) and the paclitaxel in the extracts was determined and authenticated with LC-MS. An endophytic fungus that produced paclitaxel was identified by ITS rDNA and 26S D1/D2 rDNA sequencing. The results showed that a total of 435 endophytic fungal strains were isolated from T. wallichiana var. mairei and purified. Only one of these strains produced paclitaxel and it belongs to Fusarium. The paclitaxel productivity in whole PDB culture and that in spent culture medium from this strain is 0.0153 mg/L and 0.0119 mg/L respectively. The paclitaxel content in dry mycelium is 0.27 mg/kg. This isolated endophytic fungus produced paclitaxel at a considerable level and shows potentiality as a producing strain for paclitaxel manufacture after strain improvement (AU)


El objetivo de este estudio fue aislar hongos endofíticos productores de paclitaxel a partir de tejo con el propósito de fabricar paclitaxel. Se utilizó la superficie de la corteza esterilizada de Taxus wallichiana var. mairei como material de origen y dextrosa de patata en medio de cultivo de agar para el aislamiento de hongos endófitos. Los cultivos de hongos se extrajeron con una mezcla de cloroformo /metanol (1:1, v/v) y el paclitaxel en los extractos se determinó y autentificó con LC-MS. Un hongo endófito que produjo paclitaxel fue identificado por su ADNr 26S y secuenciación D1/D2 ADNr. Los resultados mostraron que un total de 435 cepas de hongos endófitos se aislaron y purificarón a partir de T. wallichiana var. mairei. Solo una de estas cepas produce paclitaxel y pertenece a Fusarium. La productividad del cultivo de paclitaxel procedente de esta cepa es 0,0153 mg/L y 0,0119 mg/L, respectivamente. El contenido de paclitaxel en micelio seco es 0,27 mg/kg. Este aislado de hongos endófitos produjo paclitaxel a un nivel considerable y muestra potencial como cepa para la fabricación de paclitaxel después de llevar a cabo una mejora de las cepas (AU)


Assuntos
Endófitos/isolamento & purificação , Fungos/isolamento & purificação , Paclitaxel/farmacologia , Taxus
19.
Clin. transl. oncol. (Print) ; 17(11): 862-869, nov. 2015. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-143456

RESUMO

Purpose. Trastuzumab has proven to improve the prognosis of HER2-positive breast cancer, but the information available about its administration for small tumors is still limited. Therefore, we assessed the use of adjuvant regimens with trastuzumab for the treatment of small HER2-positive breast cancer in routine clinical practice. Methods. This observational study was conducted in patients with HER2-positive breast adenocarcinoma ≤1.5 cm who received trastuzumab-based adjuvant treatment in clinical practice. Clinical/histopathological data were retrieved from patients’ medical charts. Results. A total of 101 evaluable patients were enrolled (median age [range], 56.7 [49.0–64.8] years; ECOG 0, 98.0 %; ductal carcinoma, 88.1 %; lymph nodes N0, 79.2 %). Only five (5.0 %) patients received neoadjuvant treatment, while all patients underwent tumor surgery. Adjuvant trastuzumab was administered at a mean (±SD) dose of 5.9 ± 1.5 mg/kg/cycle, and mostly in a three-weekly schedule (89 [89.0 %] patients). The most frequent adjuvant therapy used with trastuzumab was chemotherapy (87 [86.1 %] patients), followed by radiotherapy (63 [62.4 %] patients) and hormone therapy (52 [51.5 %] patients). Chemotherapy regimens mainly included doxorubicin, cyclophosphamide and paclitaxel/docetaxel (n = 30), docetaxel and cyclophosphamide (n = 15), docetaxel and carboplatin (n = 13). Hormone therapy mainly included letrozole (n = 17) and tamoxifen (n = 17). Nine (8.9 %) patients reported trastuzumab-related adverse events; only one allergic reaction reached grade 3 toxicity. Conclusion. This study shows that trastuzumab-based adjuvant treatment of small HER2-positive breast cancer is mostly based on chemotherapy—mainly paclitaxel/docetaxel. Adjuvant administration of trastuzumab for small HER2-positive breast cancer seems to be similar to that used for larger tumors (AU)


No disponible


Assuntos
Feminino , Humanos , Neoplasias da Mama/tratamento farmacológico , Quimioterapia Adjuvante/instrumentação , Quimioterapia Adjuvante/métodos , Quimioterapia Adjuvante , Ciclofosfamida/uso terapêutico , Paclitaxel/uso terapêutico , Carboplatina/uso terapêutico , Receptor ErbB-2/análise , Receptor ErbB-2 , Anticorpos Monoclonais/uso terapêutico , Tamoxifeno/uso terapêutico , Imuno-Histoquímica/métodos , Imuno-Histoquímica
20.
Prog. obstet. ginecol. (Ed. impr.) ; 58(9): 417-421, nov. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-143481

RESUMO

El cáncer de cérvix constituye una enfermedad muy frecuente y presenta una elevada mortalidad a nivel mundial a pesar de la instauración de diversas modalidades terapéuticas. Presentamos el caso de una paciente de 47 años con un cáncer de cérvix con metástasis a distancia en el momento del diagnóstico (estadio IVB de la FIGO), que recibió tratamiento multimodal con quimioterapia basada en carboplatino y cirugía. Presentó una respuesta completa al tratamiento y mantiene una supervivencia libre de enfermedad hasta el momento actual de 53 meses (AU)


Cervical cancer is a very common disease with a high mortality rate worldwide, despite multiple types of treatment. We report the case of a 47-year-old woman with metastatic cervical cancer at the time of diagnosis (FIGO stage IVB) who was treated with carboplatin-based chemotherapy and surgery. The patient had a complete response to the treatment and currently has a disease-free survival of 53 months (AU)


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/cirurgia , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Terapia Combinada , Carboplatina/uso terapêutico , Biomarcadores Tumorais/análise , Paclitaxel/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia/métodos , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/cirurgia , Prognóstico
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