Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 36
Filtrar
Mais filtros










Filtros aplicados
Base de dados
Intervalo de ano de publicação
3.
Nutr. hosp ; 36(4): 769-776, jul.-ago. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184699

RESUMO

Background: antineoplastic treatment for locally advanced breast cancer (LABC) includes neodjuvant chemotherapy (NeoCT). However, side effects occur frequently, affecting the functional capacity and quality of life of patients as a result of the proinflammatory state of this therapy. In this work, omega-3 polyunsaturated fatty acids (PUFA Ω-3) were administered as they have been reported to modulate some molecular pathways such as nuclear factor-kappa B (NF-κB), which is associated with toxicity secondary to the administration of anthracyclines. Objective: to evaluate the effects of PUFA Ω-3 on the toxicity, side effects, body composition, cardiometabolic profile and quality of life in women with LABC after NeoCT. Methods: fifty-three women with LABC were included in a double-blinded, placebo-controlled clinical trial. Patients randomly received 2.4 g/day of PUFA Ω-3 (EPA 1.6 g and DHA 0.8 g) or placebo during NeoCT with adriamycin/cyclophosphamide followed by paclitaxel+/-trastuzumab. Adverse effects related to chemotherapy were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE, version 4.03) and the Subjective Global Scale of the Edmonton Symptom Assessment System (ESAS). Body composition and cardiometabolic blood profile were also evaluated. Results: no significant differences were found between groups in the hematological and anthropometric toxicity parameters. Within the Edmonton scale, xerostomia presented a significant improvement (p = 0.032) in patients supplemented with PUFA Ω-3. Conclusion: supplementation with PUFA Ω-3 showed no change in body composition, cardiometabolic profile or toxicity due to NeoCT. It only showed significant improvement in xerostomia


Introducción: uno de los tratamientos para el cáncer de mama localmente avanzado (CMLA), es la quimioterapia neoadyuvante (QTNeo). Sin embargo, los efectos secundarios afectan el estado funcional y la calidad de vida de los pacientes, especialmente por el estado inflamatorio que originan. En este trabajo se administraron los ácidos grasos poliinsaturados omega 3 (AGPI Ω-3), ya que modulan negativamente algunas vías moleculares como las que inducen la activación del factor nuclear-kappa B (NF-κB), involucrado con los mecanismos de toxicidad secundaria a la administración de antraciclinas. Objetivo: valorar el efecto de los AGPI n-3, sobre la toxicidad de la QTneo, la composición corporal, el perfil cardiometabólico y la calidad de vida en mujeres con CMLA durante la QTNeo. Métodos: se incluyeron cincuenta y tres mujeres con CMLA, en un estudio clínico doble ciego controlado con placebo. Las pacientes recibieron aleatoriamente 2,4 g/día de AGPI Ω-3 (EPA 1,6 g y DHA 0,8 g) o placebo durante la quimioterapia neoadyuvante con adriamicina/ciclofosfamida seguido de paclitaxel +/- trastuzumab. Se evaluaron los eventos adversos relacionados con la quimioterapia mediante los Criterios de terminología común para eventos adversos (CTCAE, versión 4.03) y la escala Global subjetiva del Sistema de Evaluación de los Síntomas de Edmonton (ESAS), la composición corporal y la toxicidad cardiometabólica. Resultados: no hubo diferencias significativas entre los grupos en los parámetros de toxicidad hematológica y antropométricos. La xerostomía de la escala de Edmonton, presento una mejora significativa (p = 0,032) en los pacientes suplementados con AGPI Ω-3. Conclusión: la suplementación con AGPI Ω-3 no mostró cambios en la composición corporal ni en la toxicidad del tratamiento neoadyuvante, solamente se encontró una mejoría significativa en la xerostomía


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Ácidos Graxos Ômega-3/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Terapia Neoadjuvante/efeitos adversos , Composição Corporal , Ácidos Graxos Ômega-3/toxicidade , Antraciclinas/efeitos adversos , Antraciclinas/toxicidade , Placebos , Xerostomia/complicações
6.
Rev. clín. med. fam ; 11(1): 28-30, feb. 2018.
Artigo em Espanhol | IBECS | ID: ibc-171573

RESUMO

Presentamos el caso de una mujer de 72 años con antecedente de linfoma de Hodgkin B difuso hace 5 años, tratado con antraciclinas, con remisión completa del cuadro, a la que se le realizó ecocardiogramas de control durante 2 años, sin observarse alteración cardiaca. Consulta por disnea y nicturia. Ante el cuadro que refería y el antecedente del uso de antraciclinas se deriva al Servicio de Cardiología, donde se le realizaron pruebas que objetivaron miocardiopatía dilatada con marcada disminución de la fracción de eyección. Llamamos la atención sobre los efectos secundarios tardíos de este quimioterápico que, debido a la mayor supervivencia del cáncer, vamos a observar con mayor frecuencia cada vez, por lo que los médicos de familia deben conocer y sospecharlos (AU)


We present the case of a 72-year-old woman with a history of diffuse Hodgkin’s lymphoma 5 years ago, treated with anthracyclines with complete remission of the disease, who underwent control echocardiograms during 2 years without any cardiac abnormalities. She consults for dyspnea and nocturia. In view of these symptoms and the history of anthracycline use, she was referred to the cardiology department where tests showed dilated cardiomyopathy with markedly decreased ejection fraction. Attention should be drawn to the late side effects of this chemotherapy which, due to increased survival of cancer patients, will appear more frequently and should therefore be known and suspected by general practitioners (AU)


Assuntos
Humanos , Feminino , Idoso , Antraciclinas/efeitos adversos , Cardiotoxicidade/diagnóstico , Cardiomiopatia Dilatada/induzido quimicamente , Doença de Hodgkin/tratamento farmacológico , Efeitos Adversos de Longa Duração/diagnóstico , Diagnóstico Diferencial , Antineoplásicos/toxicidade
7.
Clin. transl. oncol. (Print) ; 19(9): 1067-1078, sept. 2017. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-165207

RESUMO

This Galician consensus statement is a joint oncologists/cardiologists initiative indented to establish basic recommendations on how to prevent and to manage the cardiotoxicity in breast cancer with the aim of ensuring an optimal cardiovascular care of these patients. A clinical screening of the patients before treatment is recommended to stratify them into a determined risk group based on their intrinsic cardiovascular risk factors and those extrinsic arose from breast cancer therapy, thereby providing individualized preventive and monitoring measures. Suitable initial and ongoing assessments for patients with low and moderate/high risk and planned treatment with anthracyclines and trastuzumab are given; also, measures aimed at preventing and correcting any modifiable risk factor are pointed out (AU)


No disponible


Assuntos
Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/terapia , Cardiotoxicidade/complicações , Fatores de Risco , Diagnóstico Precoce , Conferências de Consenso como Assunto , Doenças Cardiovasculares/complicações , Antraciclinas/uso terapêutico , Cardiotoxicidade/diagnóstico , Insuficiência Cardíaca/complicações
9.
Clin. transl. oncol. (Print) ; 19(8): 989-996, ago. 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-164677

RESUMO

Purpose. Proinflammatory markers, including neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), are associated with many aspects of different malignancies. The aim of this study was to assess the associations of NLR and PLR with estrogen receptor (ER) and progesterone receptor (PR) expression in locally advanced breast cancer patients and their changes after neoadjuvant chemotherapy (NAC). Whether these parameters were predictive for the response to NAC in breast cancer patients was also evaluated. Methods. 132 Female primary locally advanced breast cancer patients treated with either ET (epirubicin-docetaxel), TEC (docetaxel-epirubicin-cyclophosphamide), or CEF (cyclophosphamide-epirubicin-fluorouracil) as NAC were retrospectively studied. NLR and PLR were calculated from peripheral blood cell count and their optimal cutoff levels were determined by receiver operating characteristic curves. Results. The proportion of ER-positive breast cancers before NAC was higher both in NLRlow (<2.05) group and PLRlow group (<159.01). Changes in ER or PR expression level or status were observed in some patients. The alterations of NLR and PLR after NAC correlated with chemotherapy regimens, and elevated PLR was found. The patients with low pretreatment NLR (<1.67) or PLR (<151.27) had better responses to NAC than those with high NLR (≥1.67, 67.3 vs. 47.1%, P < 0.05) or PLR (≥151.27, 64.0 vs. 45.1%, P < 0.05). Conclusions. The patients with low pretreatment NLR (<2.05) or PLR (<159.01) had higher ER expression. Changes in ER and PR expression status or level occured following NAC. Elevated PLR was found aft-NAC. Pretreatment NLR and PLR may be important predictive indicators for NAC response in breast cancer patients (AU)


No disponible


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/tratamento farmacológico , Terapia Neoadjuvante/métodos , Receptores Estrogênicos/análise , Receptores de Progesterona/análise , Valor Preditivo dos Testes , Estudos Retrospectivos , Estudos de Coortes , Antraciclinas/uso terapêutico , Ciclofosfamida/uso terapêutico , Resultado do Tratamento , Imuno-Histoquímica/métodos , Curva ROC
10.
Clin. transl. oncol. (Print) ; 19(1): 91-104, ene. 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-159123

RESUMO

Purpose. While much progress has been made in the treatment of breast cancer, cardiac complications resulting from therapy remain a significant concern. Both anthracyclines and novel targeted agents can inflict cardiac damage. The present study aimed to evaluate the difference between what it is currently done and what standards of care should be used to minimizing and managing cardiac toxicity in breast cancer survivors. Methods. A two-round multicenter Delphi study was carried out. The panel consisted of 100 oncologists who were asked to define the elected therapies for breast cancer patients, the clinical definition and patterns of cancer drug-derived cardiac toxicity, and those protocols focused on early detection and monitoring of cardiovascular outcomes. Results. Experts agreed a more recent definition of cardiotoxicity. Around 38 % of patients with early-stage disease, and 51.3 % cases with advanced metastatic breast cancer had preexisting risk factors for cardiotoxicity. Among risk factors, cumulative dose of anthracycline ≥450 mg/m2 and its combination with other anticancer drugs, and a preexisting cardiovascular disease were considered the best predictors of cardiotoxicity. Echocardiography and radionuclide ventriculography have been the proposed methods for monitoring changes in cardiac structure and function. Breast cancer is generally treated with anthracyclines (80 %), so that the panel strongly stated about the need to plan a strategy to managing cardiotoxicity. A decline of left ventricular ejection fraction (LVEF) >10 %, to an LVEF value <53 % was suggested as a criterion for changing the dose schedule of anthracyclines, or suspending the treatment of chemotherapy plus trastuzumab until the normalization of the left ventricular function. The use of liposomal anthracyclines was strongly suggested as a treatment option for breast cancer patients. Conclusions. The present report is the first to produce a set of statements on the prevention, evaluation and monitoring of chemotherapy-induced cardiac toxicity in breast cancer patients (AU)


No disponible


Assuntos
Humanos , Feminino , Neoplasias da Mama/induzido quimicamente , Neoplasias da Mama/tratamento farmacológico , Cardiotoxicidade/complicações , Cardiotoxicidade/tratamento farmacológico , Antraciclinas/efeitos adversos , Fatores de Risco , Projetos de Pesquisa/normas , Análise de Dados/métodos , Análise Estatística
11.
Rev. senol. patol. mamar. (Ed. impr.) ; 29(3): 120-124, jul.-sept. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-154951

RESUMO

Objetivo. Evaluar la respuesta patológica a la quimioterapia neoadyuvante tanto en la mama como en la axila según los fenotipos moleculares de cáncer de mama. Pacientes y método. Estudio retrospectivo entre enero de 2011 y diciembre de 2014 que incluye a las pacientes con cáncer de mama infiltrante intervenidas tras tratamiento con quimioterapia neoadyuvante. Hemos considerado 5 fenotipos moleculares según los criterios de St. Gallen 2013. La respuesta patológica en mama y en axila se ha evaluado según los criterios de Sataloff. Resultados. Se recogen los datos de un total de 181 pacientes tratadas con quimioterapia neoadyuvante, de las que a 96 se les realizó linfadenectomía axilar. El 34,3% tenían un fenotipo molecular Her-2, 28,7% basal, 25,4% luminal B y 11,6% luminal A. En los luminal A, el 28,5% han tenido una respuesta patológica completa en la mama frente al 21,4% en la axila; en los luminal B, 34,7 frente al 13,7%; en los luminal B Her-2, 65 frente a 41,1%; en los Her-2, 95,4 frente a 70,5%; en los basales, 59,6 frente a 36,8%. Globalmente, la respuesta patológica completa en la mama ha sido del 55,2% frente al 35,4% en axila. Conclusiones. Los fenotipos moleculares Her-2 y basal presentan mayores tasas de respuesta patológica completa tras quimioterapia neoadyuvante. No existe correlación entre la respuesta patológica observada en la mama y en la axila. La respuesta axilar es, en términos generales, menor que en la mama (AU)


Objective. To evaluate pathological response to neoadjuvant chemotherapy in the breast and axilla according to the different molecular phenotypes of breast cancer. Patients and method. A retrospective study was performed between January 2011 and December 2014, including those patients with infiltrating carcinoma who underwent surgery after neoadjuvant chemotherapy. Five molecular phenotypes were considered according to St. Gallen's 2013 criteria. Pathological axillary and breast response were evaluated following the Sataloff system. Results. We analysed data from 181 patients treated with neoadjuvant chemotherapy. Of these, an axillary lymphadenectomy was performed in 96 patients. In total, 34.3% of the patients belonged to the Her-2 group, 28.7% to the basal group, 25.4% to the luminal B group and 11.6% to the luminal A group. In luminal A tumours, pathological complete response was observed in the breast in 28.5% of the patients and in the axilla in 21.4%; in luminal B group, 34.7 versus 13.7%; in luminal B-Her-2, 65 versus 41.1%; in Her-2 positive tumours, pathological complete response was observed in the breast in 95.4% of the patients versus 70.5% in the axilla; in the basal group, pathological complete response was achieved in the breast in 59.6% versus only 36.8% in the axilla. Overall, pathological complete response was observed in the breast in 55.2% compared with 35.4% in the axilla. Conclusions. Her-2 and basal phenotypes of breast cancer show better rates of complete pathological complete response after neoadjuvant chemotherapy. No correlation was found between pathological response in the breast and the axilla. Axillary response was worse than that found in the breast (AU)


Assuntos
Humanos , Feminino , Quimioterapia Adjuvante/instrumentação , Quimioterapia Adjuvante/métodos , Quimioterapia Adjuvante , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Patologia Molecular/instrumentação , Patologia Molecular/métodos , Excisão de Linfonodo/métodos , Excisão de Linfonodo/tendências , Fenótipo , Estudos Retrospectivos , Axila/patologia , Axila/cirurgia , Antraciclinas/uso terapêutico , Taxoides/uso terapêutico , Neoplasias da Mama/classificação , Relação Dose-Resposta a Droga
12.
Clin. transl. oncol. (Print) ; 16(9): 814-822, sept. 2014.
Artigo em Inglês | IBECS | ID: ibc-126572

RESUMO

PURPOSE: T cells are dominant in the immune regulation of malignant pleural effusion (MPE). However, it is unclear about the role of IL-17+ T cells, particularly for IL-17+CD8+ Tc17 cells in antitumor immunity. This retrospective study is aimed at evaluating the prognostic significance of IL-17+ T cells in patients with MPE. METHODS: The frequency of IL-17+CD4+ Th17 and IL-17+CD8+ Tc17 cells in peripheral blood (PB), pleural fluids (PF), and tumor tissues in 24 patients undergoing thoracoscopy was determined by flow cytometry, immunohistochemistry, and ELISA. The association among the different measures was analyzed by Spearman's correlation tests. RESULTS: The percentages of PF Th17 and Tc17 cells were significantly higher than those in the PB of MPE patients and healthy controls (p < 0.01). Analysis of Th17 and Tc17 cells in the tumor tissues indicated that the percentages of Th17 and Tc17 cells in the invading tumor edge were significantly higher than those in the non-tumor tissues and intra-tumor regions (p < 0.05). More importantly, the percentages of IL-17+ T cells were associated with prolonged survival of patients with MPE. CONCLUSIONS: Both Th17 and Tc17 cells were involved in the tumor immunity against MPE. Increased frequency of Tc17 cells may serve as a biomarker for the prognosis of patients with MPE (AU)


No disponible


Assuntos
Humanos , Feminino , Neoplasias da Mama/diagnóstico , Fator Estimulador de Colônias de Granulócitos , Fator Estimulador de Colônias de Granulócitos/metabolismo , Antraciclinas/metabolismo , Antraciclinas/uso terapêutico , Taxoides/uso terapêutico , Estudos Retrospectivos , Quimioterapia Adjuvante/métodos , Receptores de Fator Estimulador das Colônias de Granulócitos e Macrófagos/metabolismo , Sinais e Sintomas/análise
13.
Clin. transl. oncol. (Print) ; 16(1): 11-17, ene. 2014. tab
Artigo em Inglês | IBECS | ID: ibc-127514

RESUMO

Extravasation of cytotoxic agents is a true medical emergency. Dexrazoxane is the only licensed drug for the treatment of anthracycline extravasations. Dexrazoxane proved to be effective and moderately well tolerated. However, alternative approaches for the management of anthracycline extravasations are available such as topical DMSO and cooling. There appears to be general agreement about dexrazoxane usefulness when extravasations involve large volumes of anthracycline and/or central venous access device. Nevertheless, the non-invasive combination of DMSO and cooling is the most commonly described therapy, particularly in small anthracycline extravasations. Further research is still needed to establish unequivocal situations where dexrazoxane must be initiated (AU)


No disponible


Assuntos
Humanos , Animais , Antraciclinas/envenenamento , Antineoplásicos/envenenamento , Razoxano/uso terapêutico , Infusões Intravenosas/efeitos adversos , Extravasamento de Materiais Terapêuticos e Diagnósticos/tratamento farmacológico
14.
Rev. senol. patol. mamar. (Ed. impr.) ; 26(1): 11-17, ene.-mar. 2013.
Artigo em Espanhol | IBECS | ID: ibc-109848

RESUMO

Objetivos. La quimioterapia neoadyuvante (QNA) es el tratamiento de elección en las pacientes con cáncer de mama localmente avanzado. El objetivo de este estudio es evaluar la utilidad de QNA en tumores pequeños pero con factores pronósticos desfavorables. Material y métodos. Se compara la respuesta a la QNA en pacientes con tamaño tumoral T3-T4 frente a T1c-T2. Desde enero de 2000 a enero de 2011, 110 pacientes han recibido QNA. Se han revisado los datos demográficos, el tamaño tumoral, los factores pronósticos, la respuesta radiológica y anatomopatológica a la QNA, según la clasificación de Miller y Payne (MP), y la supervivencia en ambos grupos. Resultados. Se revisaron 76 casos en el grupo T1c-T2 y 34 en el T3-T4. En el grupo T3-T4 se observó en mayor porcentaje tumores con factores pronósticos desfavorables (afectación ganglionar, receptores hormonales negativos y Her2Neu positivo). En el grupo T1c-T2, 23 casos (30,3%) recibieron antraciclinas y 53 (69,7%) antraciclinas y taxanos, mientras que en el grupo T3-T4, 10 (29,4%) y 24 (70,6%) casos recibieron dichas pautas, respectivamente. En el grupo T1c-T2 se observó en mayor porcentaje el subtipo tumoral receptores hormonales positivos frente a tumores Her2Neu positivos en los T3-T4. En relación con la respuesta a la QNA no se observaron diferencias estadísticamente significativas en la valoración radiológica o anatomopatológica, 38 pacientes (50%) T1c-T2 presentaron MP 4/5 frente a 16 (47,1%) en T3-T4. Conclusiones. En las pacientes con cáncer de mama precoz existe la misma respuesta anatomopatológica a la QNA que en el grupo T3-T4. En nuestro estudio, el único factor independiente asociado a la respuesta patológica tumoral es el subtipo tumoral, presentando los tumores Her2Neu positivos mejor respuesta(AU)


Aims. In locally advanced breast tumors, neoadjuvant chemotherapy (NC) is the standard treatment. The aim of this study was to analyze the utility of NC in small tumors with unfavorable prognostic factors. Material and methods. We compared the response to NC in patients with T3-T4 tumors versus those with T1c-T2 tumors. From January 2000 to January 2011, 110 patients received NC. Demographic data, tumor size, prognostic factors, radiological and histopathological response according to the Miller-Payne classification and survival were reviewed. Results. We reviewed 76 patients in the T1c-T2 group and 34 in the T3-T4 groups. Tumors with poorer prognostic factors (negative hormone receptors, positive Her2Neu and metastatic nodal involvement) were observed in the T3-T4 group. In the T1c-T2 group, 23 patients (30.3%) received anthracyclines and 53 (69.7%) received anthracyclines plus taxanes. In the T3-T4 group, 10 (29.4%) and 24 (70.6%) patients received these chemotherapy regimens respectively. A higher percentage of the hormone receptor-positive tumor subtype was observed in the T1c-T2 group compared with Her2Neu-positive tumors in the T3-T4 group. No statistically significant differences in radiologic or histopathologic assessment were found: Miller-Payne grades 4/5 were found in 38 patients (50%) in the T1c-T2 group versus 16 (47.1%) in the T3-T4 group. Conclusions. Pathologic response to NC is the same in early-stage tumors as in locally-advanced breast cancer. In this study, the only independent factor associated with pathological tumor response was the tumor subtype, with the greatest response being found in Her2Neu-positive tumors(AU)


Assuntos
Humanos , Feminino , Terapia Neoadjuvante/instrumentação , Terapia Neoadjuvante/métodos , Terapia Neoadjuvante , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/tratamento farmacológico , Diagnóstico Precoce , Antraciclinas/uso terapêutico , Taxoides/uso terapêutico , Terapia Neoadjuvante/tendências , Neoplasias da Mama/fisiopatologia , Neoplasias da Mama , Prognóstico
15.
Sanid. mil ; 68(2): 106-108, abr.-jun. 2012.
Artigo em Espanhol | IBECS | ID: ibc-101794

RESUMO

Se reseñan los medicamentos ya evaluados por la Agencia Española de Medicamentos y Productos Sanitarios hechos públicos en el 1er trimestre de 2012, y considerados de mayor interés para el profesional sanitario en el ámbito hospitalario. Se trata de opiniones técnicas positivas que son previas a la autorización y puesta en el mercado del medicamento (AU)


The drugs assessed by the Spanish Agency for Medicines and Health Products made public in the first trimester of 2012, and considered of interest in hospital healthcare professional, are reviewed. These are positive technical reports prior to the authorization and placing on the market of the product (AU)


Assuntos
Humanos , Drogas em Investigação/análise , Granisetron/uso terapêutico , Agonistas do Receptor de Serotonina/análise , Vacinas Meningocócicas/uso terapêutico , Somatostatina/uso terapêutico , Antraciclinas/uso terapêutico
16.
Clin. transl. oncol. (Print) ; 14(3): 163-168, mar. 2012. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-126171

RESUMO

Anthracyclines are frequently used in the adjuvant setting for breast cancer treatment since it is considered that anthracycline-based chemotherapy treatment benefits breast cancer patients. Nonetheless, these drugs are associated with severe side effects and predictive factors, for sensitivity to anthracyclines, are warranted in clinical practice. Topoisomerase 2 alpha (TOP2A) is considered to be the molecular target of these drugs. The potential predictive value of TOP2A amplification and overexpression has been extensively studied in breast cancer patients treated with anthracyclines. However, results are not conclusive. In this paper, we review some of the published studies addressing the predictive value of TOP2A as well as the cellular functions of this enzyme and its status in breast cancer tissue (AU)


Assuntos
Animais , Feminino , Antraciclinas/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/diagnóstico , Antígenos de Neoplasias/fisiologia , DNA Topoisomerases Tipo II/fisiologia , Modelos Biológicos , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Biomarcadores Tumorais/fisiologia , Antígenos de Neoplasias/genética , Antígenos de Neoplasias/metabolismo , Antineoplásicos/uso terapêutico , Biomarcadores Farmacológicos/análise , Biomarcadores Farmacológicos/metabolismo , Carcinoma/diagnóstico , Carcinoma/tratamento farmacológico , DNA Topoisomerases Tipo II/genética , DNA Topoisomerases Tipo II/metabolismo , Proteínas de Ligação a DNA/genética
17.
Rev. calid. asist ; 26(5): 299-305, sept.-oct. 2011.
Artigo em Espanhol | IBECS | ID: ibc-91119

RESUMO

Objetivo. La quimioterapia adyuvante afecta a diferentes aspectos de la calidad de vida de la mujer con cáncer de mama. Se ha estudiado su efecto en la calidad de vida y el impacto de las variables clínicas y biográficas. Material y método. Una cohorte de mujeres con cáncer de mama, tratadas con quimioterapia adyuvante, participantes en un ensayo clínico aleatorizado de intervención no farmacológica (ClinicalTrials.gov Identifier: NCT00964522), completó los cuestionarios de calidad de vida EORTC QOL-C30 y QOL-BR23 antes, a mitad y al terminar el tratamiento. Resultados. Cincuenta mujeres completaron los cuestionarios. La salud global empeoró con el tiempo (p=0,01). El funcionamiento físico (p=0,0001) y la imagen corporal (p=0,002) fueron las escalas más deterioradas. La astenia (p=0,004), las náuseas y vómitos (p=0,05) y anorexia (p=0,025) fueron los síntomas con mayor efecto temporal de la quimioterapia. Las mujeres desempleadas sufrieron peor funcionamiento físico (p=0,046) y de rol (p=0,005). Las mayores presentaron más diarrea (p=0,013). Las más educadas mostraron peor puntuación en la escala de dificultades financieras (p=0,034). Los casos con estadios más avanzados sufrieron mayor deterioro en su imagen corporal (p=0,001) y estuvieron más preocupados por su futuro (p=0,006). Las tratadas con antraciclinas y taxanos sintieron también peor perspectiva de futuro (p=0,02). Conclusiones. La quimioterapia adyuvante deteriora la calidad de vida de mujeres con cáncer de mama, sobre todo en su funcionamiento físico e imagen corporal. La astenia y toxicidad digestiva son los efectos secundarios predominantes. Las mujeres necesitan soporte si son mayores, desempleadas, mejor formadas, con estadio III y tratadas con antraciclinas y taxanos(AU)


Objective. Adjuvant chemotherapy affects the life of women with breast cancer in different ways. The aim of this work is to study the effect of adjuvant chemotherapy on the quality of their lives and the impact of their clinical and biographical characteristics. Patients and method. Women with breast cancer, candidates for adjuvant chemotherapy, participating in a randomised trial with non-pharmacological intervention (ClinicalTrials.gov Identifier: NCT00964522), completed the EORTC QOL-C30 and QOL-BR23 quality of life questionnaires before, in the middle, and at the end of the treatment. Results. Fifty women completed the questionnaires. Overall health got worse over time (p=0.01). Physical functioning (p=0.0001) and body image (p=0.002) were the scales that deteriorated most, and asthenia (p=0.004), nausea/vomiting (p=0.05), and anorexia (p=0.025), were the symptoms with the largest temporary impact of the chemotherapy. Unemployed women had worse physical functioning (p=0.046) and role functioning (p=0.005). Older women had more diarrhoea (p=0.013). The most qualified women had a worse score in financial difficulties scale (p=0.034). Women with advanced stage (III) underwent more deterioration in the body image (p=0.001) and were more concerned about the future (p=0.006). Women treated with anthracycline and taxane also had a worse perspective of the future (p=0.02). Conclusions. Adjuvant chemotherapy deteriorates the quality of life of patients with breast cancer, basically in physical functioning and body image areas. Asthenia and gastrointestinal toxicity are the side effects that affect patients most. Women need support if they are older, unemployed, more educated, and have stage III breast cancer treated with anthracycline and taxane based chemotherapy(AU)


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Qualidade de Vida , Quimioterapia Adjuvante/métodos , Quimioterapia Adjuvante/tendências , Quimioterapia Adjuvante/instrumentação , Quimioterapia Adjuvante , Neoplasias da Mama/epidemiologia , Estudos de Coortes , Antraciclinas/uso terapêutico , Taxoides/uso terapêutico , Análise de Variância , Inquéritos e Questionários
18.
Rev. esp. cardiol. (Ed. impr.) ; 64(5): 409-415, mayo 2011. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-123502

RESUMO

Las mejoras que se han producido en la detección y el tratamiento del cáncer han dado origen a una nueva cohorte de pacientes que alcanzan una supervivencia suficiente para que puedan aparecer complicaciones cardiacas derivadas del tratamiento del cáncer. La ecografía tridimensional ha sido validada como la modalidad ecográfica que aporta mayor exactitud al cálculo de la fracción de eyección, en comparación con la resonancia magnética, que es el patrón de referencia actual a este respecto, y ello hace que sea el método de elección para la evaluación inicial y el seguimiento de los pacientes tratados con quimioterapia.Si no se dispone de ecocardiografía tridimensional o si la calidad de las imágenes es insuficiente, el uso de contraste ecográfico puede ser útil para definir el límite endocárdico e identificar el vértice cardiaco verdadero, con lo que se mejora la capacidad del evaluador para calcular con exactitud los volúmenes y la fracción de eyección.El strain bidimensional parece prometedor como instrumento para identificar anomalías en la mecánica miocárdica en una fase muy temprana de la cardiotoxicidad y permite predecir una posterior disfunción sistólica manifiesta. Este parámetro puede ser útil en la detección de los pacientes tratados con quimioterapia que pueden obtener beneficio con el empleo de otra alternativa terapéutica, con lo que se reduciría la incidencia de la cardiotoxicidad y la morbimortalidad asociada a ella (AU)


The improvements in cancer detection and therapy have created a new cohort of patients who will experience sufficient survival to develop the cardiac complications of the cancer therapy. Three-dimensional echocardiography has been validated as the ultrasound modality with the best accuracy for the calculation of ejection fraction when compared to magnetic resonance imaging, the current gold standard, making it the tool of choice, when available, for the initial evaluation and follow up of the patient receiving chemotherapy.If three-dimensional echocardiography is not available, or if the quality of the images is inadequate, the use of ultrasound contrast can be useful for the definition of the endocardial border and identification of the true apex of the heart, enhancing the ability of the interpreter to accurately calculate volumes and ejection fraction.Two-dimensional strain appears promising as a tool to identify abnormalities in myocardial mechanics very early on during cardiotoxicity, allowing the prediction of later overt systolic dysfunction. This parameter may be useful in the detection of chemotherapy treated patients who could benefit from alternate therapies, thereby decreasing the incidence of cardiotoxicity and its associated morbidity and mortality (AU)


Assuntos
Humanos , Cardiotoxinas/efeitos adversos , Antineoplásicos/efeitos adversos , Doenças Cardiovasculares/induzido quimicamente , Antraciclinas/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Anticorpos Monoclonais Humanizados/efeitos adversos , Ventriculografia com Radionuclídeos/métodos , Ecocardiografia Tridimensional/métodos
19.
Clin. transl. oncol. (Print) ; 13(4): 281-286, abr. 2011. tab
Artigo em Inglês | IBECS | ID: ibc-124436

RESUMO

INTRODUCTION: To assess the efficacy and safety profile of biweekly vinorelbine and tegafur/uracil (UFT) as treatment in patients with metastatic breast cancer previously treated with anthracyclines and taxanes. PATIENTS AND METHODS: Patients with histologically confirmed breast cancer, measurable disease, no more than one prior chemotherapy regimen for metastatic disease, an Eastern Cooperative Oncology Group (ECOG) performance status ≤2, and adequate bone marrow, renal and liver function were eligible. Patients received vinorelbine (30 mg/m(2) on day 1) and UFT (250 mg/m(2) daily) every two weeks for 12 cycles unless progression or unacceptable toxicity was observed. RESULTS: Thirty-seven patients were included and received 311 cycles of chemotherapy. Efficacy and toxicity analyses were carried out on an intention-to-treat basis. The overall response rate was 35% (95% CI: 20-53). With a median follow-up of 18.6 months (95% CI: 1.0-74.3), the median time to progression was 7.0 months (96% CI: 5.2-8.9) and the median overall survival was 19.4 months (95% CI: 11.1-27.8). The most common severe toxicities were neutropenia (38% of patients) and asthenia (11% of patients). CONCLUSION: The combination of biweekly vinorelbine and UFT in patients with metastatic breast cancer pretreated with anthracyclines and taxanes is a well tolerated and effective regimen. AEMPS Trial Registration No.: 00-0534 (AU)


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Ensaios Clínicos Fase II como Assunto , Estudos Multicêntricos como Assunto , Intervalo Livre de Doença , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Tegafur/uso terapêutico , Uracila/uso terapêutico , Vimblastina/análogos & derivados , Antraciclinas/uso terapêutico , Estimativa de Kaplan-Meier , Taxoides/uso terapêutico , Tegafur/administração & dosagem , Tegafur/efeitos adversos , Uracila/administração & dosagem , Uracila/efeitos adversos , Vimblastina/administração & dosagem , Vimblastina/efeitos adversos , Vimblastina/uso terapêutico
20.
Clin. transl. oncol. (Print) ; 12(10): 692-700, oct. 2010. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-124359

RESUMO

OBJECTIVES: Our aim was to evaluate the cost-effectiveness of docetaxel versus weekly paclitaxel regimen in patients with metastatic breast cancer previously treated with anthracycline from the Spanish National Health Service (NHS) perspective. METHODS: A Markov model with a 21-day cycle duration was developed to estimate total treatment-related costs and clinical benefits over 5 years of docetaxel (100 mg/m²) and weekly paclitaxel (80 mg/m²). Patient data were obtained from the Randomized Phase III Study of Docetaxel Compared with Paclitaxel in Metastatic Breast Cancer (TAX- 311) and Anglo-Celtic IV trials. Utilities were obtained from literature, and unitary costs (€2009) from a Spanish health-cost database and the Catalogue of Medicines. Cost and benefits [life-years gained (LYG) and quality-adjusted life years (QALY)] were discounted at 3%. Sensitivity analyses were performed. RESULTS: Docetaxel yields higher health benefits (1.83 LYG; 1.08 QALY) than paclitaxel (1.46 LYG; 0.84 QALY). Global costs (treatment, concomitant medication, adverse events management, progression, best supportive care, and end of life phase) per patient were €20,052 and €9,982 with docetaxel and paclitaxel, respectively. Incremental cost-effectiveness ratio (ICER) of docetaxel versus paclitaxel was €190/LYG and €295/QALY. Based on a €30,000/QALY threshold, docetaxel has 99% probability of being cost-effective. ICER was mostly sensitive to hazard ratio (HR) (when varied from 1.46 to 1.09; €3,517/ QALY), discount over the ex-lab price of Taxol® (75%; €6,396/QALY) and granulocyte colony-stimulating factor (G-CSF) prophylactic treatment (when administered in 60% of cycles instead of 100%; cost saving). Variations in other inputs, such as time horizon (3-10 years), discount rate (0-5%), or adverse event cost (± 25%) were shown not to have relevant influence on the results. CONCLUSION: Compared to weekly paclitaxel, docetaxel therapy is cost effective for treating metastatic breast cancer patient (AU)


Assuntos
Humanos , Feminino , Antineoplásicos/economia , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/economia , Ensaios Clínicos Fase III como Assunto/métodos , Ensaios Clínicos Fase III como Assunto , Paclitaxel/economia , Paclitaxel/uso terapêutico , Taxoides/economia , Taxoides/uso terapêutico , Antraciclinas/uso terapêutico , Neoplasias da Mama/patologia , Análise Custo-Benefício/métodos , Progressão da Doença , Cadeias de Markov , Expectativa de Vida Ajustada à Qualidade de Vida , Espanha/epidemiologia , Terapia de Salvação/métodos , Terapia de Salvação
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA