Asunto(s)
Hiperparatiroidismo Primario , Neoplasias Peritoneales , Humanos , Tomografía Computarizada por Tomografía de Emisión de Positrones , Hiperparatiroidismo Primario/diagnóstico por imagen , Hiperparatiroidismo Primario/etiología , Neoplasias Peritoneales/diagnóstico por imagen , Glándulas ParatiroidesRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Anciano , Neoplasias de la Próstata/radioterapia , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Neoplasias Óseas/diagnóstico por imagen , Radiocirugia/métodos , Neoplasias de la Próstata/patología , Diagnóstico Diferencial , Fluorodesoxiglucosa F18/administración & dosificación , Radiofármacos/administración & dosificación , Neoplasias Óseas/secundario , Metástasis de la Neoplasia/diagnóstico por imagenRESUMEN
Hodgkin lymphoma (HL) is a disease characterized by a high curability rate, and the treatment benefit-risk balance must be carefully addressed to achieve complete disease control with low risk of long-term toxicities. Most patients are treated with a combination of chemotherapy and radiotherapy, after disease staging and response to treatment evaluated by FDG PET/CT. We report the case of a 28-year-old patient concomitantly diagnosed of a Hodgkin lymphoma and active tuberculosis. Initial staging was difficult due to pulmonary and abdominal tuberculosis localization that induced FDG PET/CT hypermetabolism. Anti-tuberculosis treatment was first started, allowing secondary an early accurate Hodgkin lymphoma staging by FDG PET/CT. The patient was then treated by chemotherapy and radiotherapy. Helical TomoTherapy® was used with involved site (IS) irradiation volume was performed to decrease the high doses to organs-at-risk (OAR), especially lungs in this context of tuberculosis.
Asunto(s)
Enfermedades del Colon/tratamiento farmacológico , Enfermedad de Hodgkin/terapia , Tuberculosis Gastrointestinal/tratamiento farmacológico , Tuberculosis Pulmonar/tratamiento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Antituberculosos/uso terapéutico , Bleomicina/administración & dosificación , Enfermedades del Colon/complicaciones , Enfermedades del Colon/diagnóstico por imagen , Enfermedades del Colon/metabolismo , Dacarbazina/administración & dosificación , Doxorrubicina/administración & dosificación , Enfermedad de Hodgkin/complicaciones , Enfermedad de Hodgkin/diagnóstico por imagen , Enfermedad de Hodgkin/metabolismo , Humanos , Pulmón , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/metabolismo , Masculino , Órganos en Riesgo , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radioterapia de Intensidad Modulada , Medición de Riesgo , Tomografía Computarizada por Rayos X , Tuberculosis Gastrointestinal/complicaciones , Tuberculosis Gastrointestinal/diagnóstico por imagen , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/diagnóstico por imagen , Vinblastina/administración & dosificaciónAsunto(s)
Adenocarcinoma/secundario , Ácidos Carboxílicos , Ciclobutanos , Radioisótopos de Flúor , Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias de la Próstata/patología , Radiofármacos , Radiocirugia , Radioterapia Guiada por Imagen , Neoplasias de la Columna Vertebral/secundario , Vértebras Torácicas/diagnóstico por imagen , Adenocarcinoma/sangre , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/radioterapia , Anciano , Diagnóstico Diferencial , Humanos , Calicreínas/sangre , Imagen por Resonancia Magnética , Masculino , Antígeno Prostático Específico/sangre , Prostatectomía , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/radioterapia , Neoplasias de la Próstata/cirugía , Terapia Recuperativa , Neoplasias de la Columna Vertebral/sangre , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Neoplasias de la Columna Vertebral/radioterapiaRESUMEN
Hodgkin lymphoma is a highly curable malignancy involving lymph nodes and the lymphatic system. Even at late stage disease, about 70% of patients will be cured with standard first line therapy. For patients who experience relapse or refractory classical Hodgkin lymphoma, the standard treatment option is high-dose chemotherapy followed by autologous stem cell rescue or transplant. However about 50% of patients will have recurrence after high-dose chemotherapy followed by autologous stem cell rescue or transplantation and have worse prognosis with median overall survival of 32% at 5 years. The anti-PD1 checkpoints inhibitors pembrolizumab and nivolumab have remarkably improved outcomes of patients with relapse of refractory classical Hodgkin lymphoma after high-dose chemotherapy followed by autologous stem cell rescue or transplantation. On the other hand, radiotherapy is an entire component of salvage therapy and its efficacy is now well established in term of local disease control in sites of relapsed or refractory Hodkin lymphoma. Defining the optimal modality and timing of radiotherapy as these new agents arrive is a challenge. An interesting approach is the combination of radiotherapy with checkpoint inhibitor and the possibility of stopping the treatment when complete response is achieved. We add to the literature two new cases of combination of radiotherapy with immunotherapy in patients who relapsed after high-dose chemotherapy followed by autologous stem cell rescue or transplantation and consolidation with brentuximab vedotin, resulting in excellent outcomes.
Asunto(s)
Antineoplásicos Inmunológicos/uso terapéutico , Enfermedad de Hodgkin/tratamiento farmacológico , Enfermedad de Hodgkin/radioterapia , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/radioterapia , Nivolumab/uso terapéutico , Adulto , Terapia Combinada , Femenino , Humanos , Masculino , Adulto JovenAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Sustitución de Medicamentos , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Biopsia , Ciclofosfamida/administración & dosificación , Ciclofosfamida/efectos adversos , Dacarbazina/administración & dosificación , Dacarbazina/análogos & derivados , Hipersensibilidad a las Drogas , Resultado Fatal , Fluorodesoxiglucosa F18 , Humanos , Inmunofenotipificación , Linfoma de Células B Grandes Difuso/diagnóstico , Tomografía Computarizada por Tomografía de Emisión de Positrones , Recurrencia , Temozolomida , Resultado del Tratamiento , Adulto JovenRESUMEN
The oropharyngeal candidiasis is a common condition in cancer patients treated by irradiation, during and after their treatment. For example, almost 70% of patients treated with chemoradiation for head and neck cancer are colonized, and 40% of symptomatic patients have an oropharyngeal candidiasis. Furthermore, we noticed an increase in non-albicans Candida strains, which are present in almost 50% of samples. Cancer treatments, especially radiation therapy, and comorbidities are risk factors of oropharyngeal candidiasis. Oropharyngeal candidiasis has substantial effects on quality of life, and may limit treatment. Epidemiologic data, physiopathology, clinical diagnosis criteria, consequences and treatment of oropharyngeal candidiasis will be discussed in this article.