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1.
Rev. lab. clín ; 12(3): e1-e8, jul.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-187160

RESUMO

En las últimas décadas ha habido grandes avances en los tratamientos personalizados en pacientes oncológicos gracias a un importante desarrollo científico. El análisis genómico ha mostrado que tumores que parecían tener un origen común, en realidad constituyen un grupo de diversas entidades moleculares. Por otro lado, ha sido muy importante el desarrollo de fármacos dirigidos que actúan de forma específica en las rutas bioquímicas involucradas en el proceso oncológico. El conocimiento de la biología celular y molecular del cáncer ha hecho posible identificar los mecanismos responsables de la transformación maligna y está permitiendo utilizar nuevos marcadores de especial utilidad para definir el pronóstico y determinar el tratamiento de las enfermedades oncológicas


Due to significant scientific developments in the last decades, treatment for oncology patients has started to use more specific and personalised approaches. The genomic analysis has demonstrated that tumours that seemed similar constitute a diverse group of molecular entities. One of the most important breakthroughs is the development of targeted drugs aimed at specific biochemical pathways. Recent advances in knowledge of the cellular and molecular biology of cancer have helped in the identification of the mechanisms of cell malignant transformation, therefore allowing the use of new predictive factors and molecular treatments in cancer


Assuntos
Humanos , Medicina de Precisão/tendências , Oncologia/tendências , Marcadores Genéticos , Biomarcadores Tumorais/análise , Farmacogenética/tendências , Modelagem Computacional Específica para o Paciente/tendências , Critérios de Avaliação de Resposta em Tumores Sólidos
2.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(6): 448-459, jul.-ago. 2019. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-185272

RESUMO

A pesar del avance que ha supuesto en la supervivencia de los pacientes oncológicos, la aparición de nuevos agentes quimioterápicos y nuevas combinaciones, estos han traído consigo numerosos efectos adversos que pueden llegar a comprometer el tratamiento y, por consiguiente, el pronóstico de la enfermedad. Entre otros efectos secundarios los citostáticos pueden causar toxicidad dermatológica. El efecto adverso más conocido de la quimioterapia es la alopecia que, aunque no es grave, altera la apariencia externa de los pacientes con cáncer. Otros efectos adversos que pueden observarse son las reacciones de hipersensibilidad y fotosensibilidad, el síndrome mano-pie, la necrólisis epidérmica, las reacciones de reactivación, las reacciones esclerodermiformes, el fenómeno de Raynaud, la siringometaplasia escamosa ecrina, la hidradenitis neutrofílica ecrina, las alteraciones ungueales, las alteraciones en la pigmentación y las lesiones por extravasación. La aparición de estos efectos adversos produce en muchas ocasiones una reducción de dosis y/o retraso del tratamiento, lo que puede afectar a la supervivencia y a la calidad de vida del paciente. Por ello, es importante prevenir su aparición e instaurar un tratamiento temprano, para lo que se hace imprescindible la colaboración entre oncólogos médicos y dermatólogos. En este artículo se revisa la toxicidad dermatológica asociada con la quimioterapia, así como su diagnóstico y abordaje terapéutico


Although the arrival of new chemotherapy drugs and combinations has brought progress in terms of cancer patient survival, they entail many adverse effects that can compromise treatment, and hence prognosis, of the disease. Cytostatic agents can cause dermatological toxicity, among other side effects. The most familiar adverse effect of chemotherapy is alopecia. Although not serious, this changes the outward appearance of cancer patients. Other adverse effects include hypersensitivity and photosensitivity reactions, hand-foot syndrome, epidermal necrolysis, recall reactions, scleroderma-like reactions, Raynaud's phenomenon, eccrine squamous syringometaplasia, neutrophilic eccrine hidradenitis, nail abnormalities, pigmentation changes and extravasation injuries. Onset of these adverse effects often causes dose reduction and/or delayed treatment, which can affect patient survival and quality of life. It is therefore important to prevent their occurrence and treat them promptly, which requires cooperation between medical oncologists and dermatologists. This article reviews chemotherapy-associated dermatological toxicity, along with its diagnosis and therapeutic management


Assuntos
Humanos , Conferências de Consenso como Assunto , Sociedades Médicas/normas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Prognóstico , Dermatopatias/induzido quimicamente , Antineoplásicos/efeitos adversos , Oncologia/normas , Espanha , Alopecia/induzido quimicamente , Hipersensibilidade a Drogas/complicações , Transtornos de Fotossensibilidade/induzido quimicamente , Hiperpigmentação/induzido quimicamente
6.
Arch. Soc. Esp. Oftalmol ; 94(2): 81-84, feb. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-180369

RESUMO

Describimos el caso de un melanoma amelanótico del iris en un niño hispano de 7 años con perforación del globo subclínica. El melanoma uveal raramente ocurre en niños. La mayoría de los pacientes jóvenes afectados se presentan en la etapa de la pubertad, son caucásicos y con ojos claros. Debido a su rareza, estos tumores pueden no ser reconocidos o ser diagnosticados erróneamente. Destacamos el diagnóstico diferencial y las opciones terapéuticas


We report an unusual case of an amelanotic melanoma in a 7 year old hispanic child with subclinical globe perforation. Uveal melanoma rarely occurs in children. Young affected patients are mostly light-colored eye Caucasian adolescents. Since they are not common, these tumors are usually not recognized and misdiagnosed. Differential diagnoses and therapeutic options are outlined


Assuntos
Criança , Oftalmopatias/classificação , Oftalmopatias/diagnóstico , Oftalmopatias/patologia , Criança , Melanoma/classificação , Melanoma/patologia , Puberdade , Diagnóstico Diferencial , Pacientes/classificação , Ultrassonografia/classificação , Tomografia/classificação , Oncologia/classificação
7.
Rev. esp. salud pública ; 93: 0-0, 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-189480

RESUMO

OBJETIVO: La implementación de la Toma de Decisiones Compartidas (TDC) en oncología es escasa. El objetivo del estudio fue determinar el conocimiento de la TDC que tienen los médicos que tratan a pacientes con cáncer, la utilidad que le conceden, el rol que desempeñan, la evaluación que hacen, y las barreras y facilitadores que encuentran para su uso. MÉTODOS: Se realizó una encuesta a oncólogos médicos, oncólogos radioterápicos y cirujanos generales que ejercían en Andalucía (España). Se recogieron variables sociodemográficas, clínico-asistenciales y de aspectos de la TDC. La TDC se evaluó mediante el cuestionario SDM-Q-Doc. Se emplearon contrastes no paramétricos para determinar las posibles diferencias entre especialidades médicas. RESULTADOS: El cuestionario se envió a 351 médicos y la tasa de respuesta fue del 37,04%. Respondieron 63 mujeres y 67 hombres, con un promedio de 45,6 años de edad y 18,04 años de experiencia. El 33,08% eran oncólogos médicos, el 34,61% oncólogos radioterápicos y el 29,23% cirujanos generales. El 82,3% no tenía formación en TDC y el 33,8% reconocía saber bastante y utilizarla en su práctica habitual. El 80% consideró que era muy útil. El 60% respondió que la decisión sobre el tratamiento la tomaban mayormente ellos. Al evaluar la TDC con la escala SDM-Q-Doc, todas las especialidades obtuvieron más de 80 puntos sobre 100. Las principales barreras para aplicar la TDC fueron la dificultad del paciente para entender lo que necesitaba saber, la falta de instrumentos de apoyo, así como la falta de tiempo. CONCLUSIONES: Un 82% de los médicos no tiene formación en TDC y un 66% no la utiliza en su práctica habitual, tomando la decisión sobre el tratamiento mayoritariamente ellos. Es importante adoptar estrategias para aumentar la formación en TDC e implementarla en la práctica clínica diaria


OBJECTIVE: Implementation of Shared Decision Making (SDM) in oncology is limited. The objective of the study was to determine the extent of physicians' awareness of Shared Decision Making (SDM) in their treatment of cancer patients, the usefulness that they assign to SDM, the role they play, their assessment of SDM, and perceptions of the main barriers and facilitators to its use. METHODS: A questionnaire was completed by medical oncologists, radiation oncologists and general surgeons working in Andalusia (Spain). Sociodemographic, clinical-care and aspects of SDM variables were collected. SDM was evaluated using the SDM-Q-Doc questionnaire. Non-parametric contrasts were used to determine the possible differences between medical specialties. RESULTS: The questionnaire was sent to 351 physicians. The response rate was 37.04%, 63 women and 67 men, with an average age of 45.6 years and 18.04 years' experience. Of these, 33.08% were medical oncologists, 34.61% radiation oncologists and 29.23% general surgeons. A total of 82.3% stated they had received no training in SDM, whereas 33.8% said they knew a lot about SDM and applied it in practice; 80% considered it to be very useful. In addition, 60% of respondents said they were mainly the ones who made the decisions on treatment. An evaluation of SDM on the SDM-Q-Doc scale showed that all the specialities scored more than 80/100. The main barriers to applying SDM were the difficulty patients experienced in understanding what they needed to know, the lack of decision aids and time. CONCLUSIONS: Some 82% of physicians have no training in SDM and 66% don't use it in practice, with decisions on treatment taken mainly by the physicians themselves. Strategies to increase training in SDM and to implement it into clinical practice are important


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tomada de Decisões , Oncologia , Padrões de Prática Médica , Radioterapia (Especialidade) , Técnicas de Apoio para a Decisão , Neoplasias/terapia , Participação do Paciente , Relações Médico-Paciente , Médicos , Classe Social , Cirurgiões , Inquéritos e Questionários
8.
Farm. hosp ; 42(6): 261-268, nov.-dic. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-183872

RESUMO

Objective: To define recommendations that permit safe management of antineoplastic medication, minimise medication errors and improve the safety of cancer patients undergoing treatment. Method: By reviewing the literature and consulting the websites of various health organisations and agencies, an expert committee from the Spanish Society of Hospital Pharmacy and the Spanish Society of Medical Oncology defined a set of safe practices covering all stages of providing cancer therapy to patients. The Spanish Society of Oncology Nursing revised and endorsed the final lis Results: In total, 68 recommendations arranged in 5 sections were defined. They include issues concerning the training of health professionals, the technological resources needed, treatment planning, informing the patient and his family, the processes of prescribing, preparing, dispensing and administering cancer therapy (orally, parenterally or intrathecally), assessing patient adherence and treatment toxicity Conclusions: It is essential for healthcare establishments to implement specific measures designed to prevent medication errors, in order to ensure the safety of cancer patients treated with antineoplastic medication


Objetivo: Definir unas recomendaciones que permitan el manejo seguro de la medicación antineoplásica, minimizar los errores de medicación y mejorar la seguridad de los pacientes oncológicos tratados. Método: A partir de una revisión de la bibliografía, así como de la consulta de páginas web de varias agencias y organismos sanitarios, un comité de expertos de la Sociedad Española de Farmacia Hospitalaria y la Sociedad Española de Oncología Médica han definido una serie de prácticas seguras para todas las etapas de la provisión del tratamiento antineoplásico al paciente. La Sociedad Española de Enfermería Oncológica revisó y respaldó la lista final. Resultados: Se han definido 68 recomendaciones estructuradas en 5 secciones. Se incluyen aspectos relacionados con la formación de los profesionales sanitarios; los recursos tecnológicos necesarios; la planificación del tratamiento; la información al paciente y a sus familiares; los procesos de prescripción, preparación, dispensación y administración del tratamiento antineoplásico (por vía oral, parenteral o intratecal), así como la evaluación de la adherencia del paciente y la toxicidad del tratamiento. Conclusiones: El establecimiento de medidas concretas destinadas a prevenir los errores de medicación en los centros sanitarios es esencial para garantizar la seguridad de los pacientes oncológicos tratados con medicación antineoplásica


Assuntos
Humanos , Antineoplásicos/efeitos adversos , Oncologia/normas , Conduta do Tratamento Medicamentoso , Segurança do Paciente , Antineoplásicos/uso terapêutico , Consenso , Neoplasias/tratamento farmacológico , Espanha
9.
Ars pharm ; 59(4): 221-226, oct.-dic. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-177736

RESUMO

Objective: to evaluate the main clinical symptoms associated with the toxic effects of antineoplastic therapy in women with breast cancer at a cancer treatment center in the city of Caruaru/PE. Methods: This is an analytical and transversal study with a quantitative approach, carried out between September and December 2017, whose data source was the medical records of the patients included in the study. Results: the majority of the sample consisted of women aged between 41 and 50 years (28.6%). This study made it possible to identify the most frequent histological type of breast cancer, with invasive ductal carcinoma observed in 88.6% and the most used protocol was Doxorubicin, Cyclophosphamide and Paclitaxel. Alopecia (91.4%) was the main adverse event observed in patients. Conclusion: it was possible to verify that the observation of these effects, allows a better control during the therapy, enabling improvement of the time and quality of life


Objetivo: evaluar los principales síntomas clínicos asociados con los efectos tóxicos de la terapia antineoplásica en mujeres con cáncer de mama en un centro de tratamiento del cáncer en la ciudad de Caruaru/PE. Métodos: este es un estudio analítico y transversal con un enfoque cuantitativo, realizado entre septiembre y diciembre de 2017, cuya fuente de datos fueron las historias clínicas de los pacientes incluidos en el estudio. Resultados: la mayor parte de la muestra estuvo formada por mujeres de 41 a 50 años (28,6%). Este estudio permitió identificar el tipo histológico más frecuente de cáncer de mama, con un carcinoma ductal invasivo observado en el 88,6% y el protocolo más utilizado fue la doxorubicina, la ciclofosfamida y el paclitaxel. La alopecia (91,4%) fue el principal evento adverso observado en los pacientes. Conclusión: fue posible verificar que la observación de estos efectos permite un mejor control durante la terapia, lo que permite mejorar el tiempo y la calidad de la vida


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/toxicidade , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal de Mama/tratamento farmacológico , Alopecia/induzido quimicamente , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Estudos Transversais , 25783 , Antineoplásicos/efeitos adversos , Oncologia/métodos
10.
Actas dermo-sifiliogr. (Ed. impr.) ; 109(10): 878-887, dic. 2018. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-175854

RESUMO

El sarcoma de Kaposi es un sarcoma vascular con cuatro variantes clínicas: el clásico, que asienta preferentemente en las extremidades de pacientes ancianos, de curso crónico y poco agresivo; el endémico de África central; el de pacientes inmunodeprimidos, y el asociado a SIDA. En todas las variedades se ha demostrado que el virus herpes tipo 8 es el agente etiológico. El angiosarcoma cutáneo es una de las neoplasias cutáneas de peor pronóstico, con gran tendencia a la recidiva local y una supervivencia a 5años del 10-50%. Existen 3 grandes variedades de angiosarcomas cutáneos: los idiopáticos de cara y cuero cabelludo, los desarrollados sobre áreas de linfedema crónico y los que aparecen sobre áreas de piel irradiada. El único tratamiento potencialmente curativo es la cirugía asociada o no a radioterapia, pero su mala delimitación y su carácter multicéntrico obligan en muchos casos a emplear tratamientos paliativos con quimio y/o radioterapia


Kaposi sarcoma is a vascular sarcoma with 4 clinical variants: classic Kaposi sarcoma, which mainly affect the extremities of elderly patients and follows a chronic, generally indolent course; African Kaposi sarcoma; immunosuppression-associated Kaposi sarcoma; and AIDS-associated Kaposi sarcoma. Type 8 human herpesvirus is the etiologic agent in all 4 variants. Cutaneous angiosarcoma is a cutaneous neoplasm with a very poor prognosis. It carries a high probability of local relapse and has a 10% to 15% survival rate at 5 years. There are 3 main variants of cutaneous angiosarcoma: idiopathic angiosarcoma of the face and scalp; Stewart-Treves syndrome; and postradiation angiosarcoma. The only potentially curative treatment is surgery with or without radiotherapy. However, its indistinct borders and multicentric nature mean that treatment is often palliative with chemotherapy, radiotherapy, or both


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Hemangiossarcoma/diagnóstico , Hemangiossarcoma/terapia , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/terapia , Guias de Prática Clínica como Assunto , Oncologia/normas , Imunossupressão , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Dermatologia/normas , Estadiamento de Neoplasias
11.
Clin. transl. oncol. (Print) ; 20(12): 1493-1501, dic. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-173756

RESUMO

Cancer cases are growing in an exponential way, likewise the prices of new cancer drugs. Continuing in this way, in the near future, it will be impossible to provide optimum care for all cancer patients. Therefore, it is important to establish mechanisms that enable the National Health Systems to provide the best options of treatment, either through the elaboration of decision-binding frameworks or through other initiatives that guarantee the best quality care for all oncology patients to overcome, in the best possible way, this difficult illness. Here, we review current proposals that have been established by different cancer organizations worldwide, their similarities, their differences and whether they are helpful in a real clinical setting. Facing present reality and despite these organizations’ huge efforts, these proposals are not being implemented at all and it does not seem feasible that they will in the short run. In the same way, we support and argue why oncologists should have a crucial and a preponderant role to establish the best way of guaranteeing an equal access to the latest oncology care


No disponible


Assuntos
Humanos , Oncologia/tendências , Tecnologia de Alto Custo , Neoplasias/economia , Equidade no Acesso aos Serviços de Saúde , Acesso aos Serviços de Saúde/tendências , Custos de Cuidados de Saúde/tendências , Papel Profissional
12.
Clin. transl. oncol. (Print) ; 20(12): 1612-1616, dic. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-173768

RESUMO

Introduction: Madrid’s CNIO (Spanish National Oncological Research Center) ranks among the three first institutions in the world, specifically dedicated to cancer research. CNIO research mainly focuses on three aspects: use of stem cells to fix problematic cancer damage, searches for genes that cause cancer disease, and use of drug design to manage oncological disorders. Objectives: The main goal of this study is to determine the effectiveness of the ‘translation’ of basic discoveries generated at this cancer research center, into new interventions aimed at preventing and treating various types of cancer, with bibliometric criteria. Methods: A corpus of published articles and citations received by CNIO between 1998 and 2016 has been retrieved from the Web of Science (WoS) database. Bibliometric indicators considered here are: citation practices, use of journals on the basis of their impact factors, scientific literature citing CNIO publications, and international connectedness of CNIO researchers. Results: A total of 3510 articles were published by CNIO between 1998 and 2016, 23% of which in journals with impact factors between 10 and 15 and above 15. Along the same period, the institution received 135,769 citations published in more than 5800 journals, where the most important citing journals were the Plos One with 3.6% of all the citing articles, Oncotarget with 1.8%, and Scientific Reports with 1.2%. The highest number of citations was 18,005 in 2007; in terms of average citation rate, the first ranked CNIO research program was in the area of experimental therapeutics (77.79%), followed by molecular oncology (68.1%). This position was provided by the active growth in citation to the articles whose themes are related to the problems of the consequences of the design of preclinical drug candidates and the study of oncological disorders. Conclusions: From this study on a number of bibliometric characteristics of the Spanish National Oncological Research Center (CNIO), we conclude that the publication activity (since 2006 its scientific production has increased in about 83%), the number of high-quality journals used per year, the high influence, and impact of the journals and organizations citing the institution, consolidate its image as a top-notch oncological research center


No disponible


Assuntos
Humanos , Pesquisa Médica Translacional/estatística & dados numéricos , Oncologia/tendências , Pesquisa Biomédica/estatística & dados numéricos , Sociedades Científicas/estatística & dados numéricos , Relatório de Pesquisa , Indicadores de Produção Científica , Publicações/estatística & dados numéricos , Indicadores Bibliométricos
14.
Actas urol. esp ; 42(8): 488-498, oct. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-174756

RESUMO

Objetivo: Conocer las últimas evidencias sobre Urología oncológica de tumores de próstata, riñón y vejiga, analizando su impacto en la práctica clínica diaria, además de los esquemas futuros a medio y largo plazo. Métodos: Se revisan los resúmenes sobre cáncer de próstata, renal y vejiga presentados en los congresos del año 2017 (EAU, AUA, ASCO, ESMO y ASTRO) y las publicaciones de mayor impacto en este periodo que recibieron mayor valoración por parte del comité del OncoForum. Resultados: En pacientes con cáncer renal de alto riesgo de recurrencia tras nefrectomía, se observó beneficio de sunitinib adyuvante versus placebo en el subgrupo de mayor riesgo. En pacientes con cáncer uroterial avanzado inelegibles a cisplatino, pembrolizumab en primera línea dio lugar a respuestas duraderas clínicamente significativas. En pacientes con cáncer de próstata (CaP) localizado, el tratamiento por progresión de la enfermedad fue menos frecuente con prostatectomía radical (PR) que con observación (diferencia absoluta de 26,2%) y se asoció a mayor frecuencia de eventos adversos (EA). En pacientes con CaP M0, la adición de abiraterona más prednisona (ABI + P) a deprivación androgénica (TDA) supuso menos muertes y menos eventos por fallo de tratamiento (p < 0,001). En pacientes con cáncer de próstata resistente a castración metastásico (CPRCm) tratados previamente con abiraterona, la mediana de supervivencia libre de progresión radiográfica (SLPr) con enzalutamida fue de 8,1 meses y la de supervivencia global (SG) no se alcanzó. Conclusiones: En pacientes con cáncer renal de alto riesgo de recurrencia tras nefrectomía, sunitinib adyuvante otorgó beneficio en todos los subgrupos, incluidos aquellos de mayor riesgo. En pacientes con CaP localizado, la PR no se asoció significativamente con mortalidad por todas las causas o mortalidad cáncer específica en comparación con observación. En pacientes con CaP M0, TDA combinado con ABI + P se asoció significativamente con mayores tasas de SG y SLP que TDA solo. En pacientes con CPRCm tratados previamente con abiraterona en tratamiento con enzalutamida permaneció activo


Objective: To put forth new findings of urologic oncology with impact on clinical practice presented during 2017 in the main annual meetings. Methods: This document reviews abstracts on prostate, kidney and bladder cancer presented at the congresses of 2016 (EAU, AUA, ASCO, ESMO and ASTRO) and publications with the highest impact in this period valued with the highest scores by the OncoForum committee. Results: Among patients at high risk of recurrent renal cell carcinoma after nephrectomy, adjuvant sunitinib compared to placebo showed a benefit in patients at higher risk of recurrence. In cisplatin-ineligible advanced urothelial cancer, pembrolizumab elicits clinically meaningful, durable responses. Among patients with localized prostate cancer, treatment for disease progression was less frequent (absolute difference, 26.2 percentage pontis) and adverse events was more frequent with surgery than with observation. Among patients with locally advanced or merastatic prostate cancer, androgen-deprivation therapy plus abiraterone and prednisolone resulted in fewer deaths and fewer treatment-failure events (P < .001). Among patients with metastatic castration-resistant prostate cancer previously treated with abiraterone acetate, enzalutamide median radiographic progression free survival was 8,1 months and enzalutamide median overall survival was not reached. Conclusions: Among patients at high risk of recurrent renal cell carcinoma after nephrectomy, adjuvant sunitinib showed a benefit across subgroups including patients at higher risk of recurrence. Among patients with localized prostate cancer, surgery was not associated with significantly lower all-cause or porstate-cancer mortality than observation. Among patients with locally advanced or merastatic prostate cancer, androgen-deprivation therapy plus abiraterone and prednisolone was associated with significantly higher rates of overall and failure-free survival than androgen-deprivation therapy alone. In patients with metastatic castration-resistant prostate cancer previously treated with abiraterone enzalutamide remained active


Assuntos
Humanos , Neoplasias Urológicas/epidemiologia , Medicina Baseada em Evidências , Neoplasias da Próstata/epidemiologia , Neoplasias Renais/epidemiologia , Neoplasias da Bexiga Urinária/epidemiologia , Recidiva Local de Neoplasia/epidemiologia , Resultado do Tratamento , Avaliação de Eficácia-Efetividade de Intervenções , Oncologia
16.
Clin. transl. oncol. (Print) ; 20(8): 954-965, ago. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-173679

RESUMO

Observational studies using registry data make it possible to compile quality information and can surpass clinical trials in some contexts. However, data heterogeneity, analytical complexity, and the diversity of aspects to be taken into account when interpreting results makes it easy for mistakes to be made and calls for mastery of statistical methodology. Some questionable research practices that include poor analytical data management are responsible for the low reproducibility of some results; yet, there is a paucity of information in the literature regarding specific statistical pitfalls of cancer studies. In addition to proposing how to avoid or solve them, this article seeks to expose ten common problematic situations in the analysis of cancer registries: convenience, dichotomization, stratification, regression to the mean, impact of sample size, competing risks, immortal time and survivor bias, management of missing values, and data dredging


No disponible


Assuntos
Humanos , Pesquisa Biomédica/métodos , Oncologia/estatística & dados numéricos , Estudos Observacionais como Assunto/métodos , Relatório de Pesquisa/normas , Interpretação Estatística de Dados , Viés
17.
Clin. transl. oncol. (Print) ; 20(8): 1087-1092, ago. 2018. mapas, graf
Artigo em Inglês | IBECS | ID: ibc-173693

RESUMO

Introduction: Geriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016. Objectives: The main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists. Methods: A descriptive survey was sent to several hospitals by means of the SEOM website. A personal e-mail was also sent to SEOM members. Results: Between March 2016 and April 2017, 154 answers were collected. Only 74 centers (48%) had a geriatrics department and a mere 21 (14%) medical oncology departments had a person dedicated to GO. The vast majority (n = 135; 88%) had the perception that the number of elderly patients with cancer seen in clinical practice had increased. Eighteen (12%) oncologists had specific protocols and geriatric scales were used at 55 (31%) centers. Almost all (92%) claimed to apply special management practices using specific tools. There was agreement that GO afforded certain potential advantages. Finally, 99% of the oncologists surveyed believed it and that training in GO had to be improved. Conclusions: From the nationwide survey promoted by the Spanish Geriatric Oncology Working Group on behalf of SEOM, we conclude that there is currently no defined care structure for elderly cancer patients. There is an increasing perception of the need for training in GO. This survey reflects a reality in which specific needs are perceived


No disponible


Assuntos
Humanos , Oncologia/tendências , Geriatria/tendências , Avaliação Geriátrica/métodos , Espanha , Equipe de Assistência ao Paciente/tendências , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos
19.
Clin. transl. oncol. (Print) ; 20(5): 613-618, mayo 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-173538

RESUMO

Purpose. Breakthrough cancer pain (BTcP) has been shown to be a prevalent and poor prognostic factor for oncologic patients, which remain under diagnosed and undertreated. In 2012, the Spanish Society of Medical Oncology (SEOM) published a clinical practice guideline (CPG) for the treatment of cancer pain which specifically addressed the management of BTcP. Methods. Fundación ECO designed a qualitative study using an Internet-based survey to investigate the attitudes toward, compliance with, and use of SEOM Guideline. Results. A total of 83 oncologists with a mean experience of 13 years responded. Overall, 82% were aware of different guidelines to manage BTcP. Notably, attitudes toward guidelines were highly positive and there was nearly unanimous agreement that CPG provided the best scientific evidence available (99%), on the minimum information to be gathered for the medical history (100%), on the need for a specific treatment for BTcP (100%), and fentanyl as the first-choice drug (99%). Interestingly, there were discrepancies between what oncologists agreed with and what they do in clinical practice. In fact, 87.6% declare full compliance with SEOM guideline, although adherence to registration of BTcP data in medical records ranged from 30.1 to 91.6% (mean 64.5%); therapeutic management compliance was higher ranging from 75.9 to 91.6%. Main barriers identified were time pressure together with vague statements and limited dissemination of the guidelines. Conclusion. Despite oncologist’s clinical practice is increasingly guided by GPC, it suffers from limited compliance, at least in part due to suboptimal statements. Improved dissemination and education are needed to enhance guideline implementation


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Assuntos
Humanos , Dor do Câncer/tratamento farmacológico , Fidelidade a Diretrizes/estatística & dados numéricos , Dor Irruptiva/tratamento farmacológico , Oncologia/estatística & dados numéricos , Manejo da Dor/métodos , Dor do Câncer/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Oncologistas , Inquéritos e Questionários , Espanha/epidemiologia
20.
Clin. transl. oncol. (Print) ; 20(5): 630-638, mayo 2018. ilus
Artigo em Inglês | IBECS | ID: ibc-173540

RESUMO

Purpose. Management of metastatic disease in oncology includes monitoring of therapy response principally by imaging techniques like CT scan. In addition to some limitations, the irruption of liquid biopsy and its application in personalized medicine has encouraged the development of more efficient technologies for prognosis and follow-up of patients in advanced disease. Methods. PrediCTC constitutes a panel of genes for the assessment of circulating tumor cells (CTC) in metastatic colorectal cancer patients, with demonstrated improved efficiency compared to CT scan for the evaluation of early therapy response in a multicenter prospective study. In this work, we designed and developed a technology transfer strategy to define the market opportunity for an eventual implementation of PrediCTC in the clinical practice. Results. This included the definition of the regulatory framework, the analysis of the regulatory roadmap needed for CE mark, a benchmarking study, the design of a product development strategy, a revision of intellectual property, a cost-effectiveness study and an expert panel consultation. Conclusion. The definition and analysis of an appropriate technology transfer strategy and the correct balance among regulatory, financial and technical determinants are critical for the transformation of a promising technology into a viable technology, and for the decision of implementing liquid biopsy in the monitoring of therapy response in advanced disease


No disponible


Assuntos
Humanos , Biópsia , Oncologia/métodos , Células Neoplásicas Circulantes/patologia , Medicina de Precisão/métodos , Transferência de Tecnologia , Benchmarking , Avaliação de Custo-Efetividade
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