Nasopharyngeal carcinoma (NPC) is distinct from other cancers of the head and neck in biology, epidemiology, histology, natural history, and response to treatment. Radiotherapy (RT) is the cornerstone of locoregional treatment of non-disseminated disease and the association of chemotherapy improves the rates of survival. In the case of metastatic disease stages, treatment requires platinum/gemcitabine-based chemotherapy and patients may achieve a long survival time.
Nasopharyngeal Carcinoma/therapy , Nasopharyngeal Neoplasms/pathology , Diagnosis , Therapeutics , Practice Guidelines as Topic
Nasopharyngeal carcinoma (NPC) is distinct from other cancers of the head and neck in biology, epidemiology, histology, natural history, and response to treatment. Radiotherapy (RT) is the cornerstone of locoregional treatment of non-disseminated disease and the association of chemotherapy improves the rates of survival. In the case of metastatic disease stages, treatment requires platinum/gemcitabine-based chemotherapy and patients may achieve a long survival time.
Nasopharyngeal Neoplasms , Humans , Nasopharyngeal Carcinoma/therapy , Nasopharyngeal Neoplasms/pathology
Research into cancer-associated thrombosis (CAT) entails managing dynamic data that pose an analytical challenge. Thus, methods that assume proportional hazards to investigate prognosis entail a risk of misinterpreting or overlooking key traits or time-varying effects. We examined the AGAMENON registry, which collects data from 2,129 patients with advanced gastric cancer. An accelerated failure time (AFT) multistate model and flexible competing risks regression were used to scrutinize the time-varying effect of CAT, as well as to estimate how covariates dynamically predict cumulative incidence. The AFT model revealed that thrombosis shortened progression-free survival and overall survival with adjusted time ratios of 0.72 and 0.56, respectively. Nevertheless, its prognostic effect was nonproportional and disappeared over time if the subject managed to survive long enough. CAT that occurred later had a more pronounced prognostic effect. In the flexible competing risks model, multiple covariates were seen to have significant time-varying effects on the cumulative incidence of CAT (Khorana score, secondary thromboprophylaxis, high tumor burden, and cisplatin-containing regimen), whereas other predictors exerted a constant effect (signet ring cells and primary thromboprophylaxis). The model that assumes proportional hazards was incapable of capturing the effect of these covariates and predicted the cumulative incidence in a biased way. This study evinces that flexible and multistate models are a useful and innovative method to describe the dynamic effect of variables associated with CAT and should be more widely used.
Decision Support Techniques , Stomach Neoplasms/epidemiology , Venous Thromboembolism/epidemiology , Adult , Aged , Aged, 80 and over , Cause of Death , Disease Progression , Female , Fibrinolytic Agents/therapeutic use , Humans , Incidence , Male , Middle Aged , Predictive Value of Tests , Progression-Free Survival , Registries , Retrospective Studies , Risk Assessment , Risk Factors , Spain/epidemiology , Stomach Neoplasms/blood , Stomach Neoplasms/drug therapy , Stomach Neoplasms/mortality , Time Factors , Venous Thromboembolism/blood , Venous Thromboembolism/drug therapy , Venous Thromboembolism/mortality , Young Adult
Colorectal Neoplasms/genetics , Colorectal Neoplasms/therapy , Molecular Targeted Therapy , Antineoplastic Agents, Immunological/therapeutic use , Cell Transformation, Neoplastic/genetics , Colorectal Neoplasms/classification , CpG Islands , DNA Methylation , DNA Repair , Genes, Neoplasm , Genes, Tumor Suppressor , Genetic Predisposition to Disease , Genotype , Humans , Medical Oncology/trends , Microsatellite Instability , Molecular Biology/trends , Mutation , Neoplastic Syndromes, Hereditary/genetics , Neoplastic Syndromes, Hereditary/therapy , Prognosis
The use of central venous catheters for various applications (administration of chemotherapy, blood products and others) in patients with cancer is increasingly frequent. The association between thrombosis and catheter use has been fully established but aspects such as its causes, diagnosis, prophylaxis and treatment have not. We describe a case of thrombosis in a patient with cancer treated with chemotherapy who carried a central venous catheter. We also perform a review of the risk factors, the role of the prophylaxis and the treatment.
Adenocarcinoma/therapy , Catheterization, Central Venous/adverse effects , Colonic Neoplasms/therapy , Jugular Veins , Venous Thrombosis/etiology , Adenocarcinoma/complications , Colonic Neoplasms/complications , Humans , Male , Middle Aged , Venous Thrombosis/diagnosis
La utilización de catéteres venosos centrales en pacientes con cáncer para diferentes usos (administración de quimioterapia, productos sanguíneos y otros) es cada vez más frecuente. La asociación de trombosis con catéter está completamente establecida, pero no así aspectos como causas, diagnóstico, profilaxis y tratamiento. Se describe un caso de trombosis en un paciente con cáncer en tratamiento con quimioterapia portador de catéter venoso central y realizamos una revisión de los factores de riesgo, el papel de la profilaxis y el tratamiento (AU)
The use of central venous catheters for various applications (administration of chemotherapy, blood products and others) in patients with cancer is increasingly frequent. The association between thrombosis and catheter use has been fully established but aspects such as its causes, diagnosis, prophylaxis and treatment have not. We describe a case of thrombosis in a patient with cancer treated with chemotherapy who carried a central venous catheter. We also perform a review of the risk factors, the role of the prophylaxis and the treatment (AU)
Humans , Male , Middle Aged , Venous Thrombosis/etiology , Catheterization, Central Venous/adverse effects , Heparin, Low-Molecular-Weight/administration & dosage , Central Venous Catheters/adverse effects , Venous Thromboembolism/epidemiology , Colorectal Neoplasms/complications , Premedication/methods , Risk Factors
