ABSTRACT
INTRODUCTION: Our aim was to assess efficacy and safety and prognostic factors associated with TAS-102 in clinical practice. METHOD: Retrospective, multicenter, and observational study including patients with advanced refractory colorectal cancer who started TAS-102 between March 2016 and August 2018. The primary end point was overall survival (OS). Secondary end points included progression-free survival, toxicity and analyze prognostic factors present at the beginning of TAS-102. RESULT: 84 patients were evaluable. The median OS was 8.30 (95% CI 6.23-9.87) months and PFS was 2.62 (95% CI 2.36-3.05) months. In multivariate analysis, ECOG 0 and reduced dose combined with more cycles were associated with better prognosis. Patients with an ECOG > 0 had worse prognosis (HR 3.34, 95% CI 1.09-10.27, p = 0.035). 95.2% experienced some type of adverse effect and 45.2% had grade ≥ 3 toxicities. CONCLUSION: Results suggest reconsidering TAS-102 in patients with ECOG > 0, something that should be investigated in prospective randomized clinical trials.
Subject(s)
Colonic Neoplasms/drug therapy , Pyrrolidines/therapeutic use , Rectal Neoplasms/drug therapy , Trifluridine/therapeutic use , Uracil/analogs & derivatives , Adult , Aged , Aged, 80 and over , Colonic Neoplasms/mortality , Colonic Neoplasms/pathology , Drug Administration Schedule , Drug Combinations , Feasibility Studies , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Progression-Free Survival , Pyrrolidines/adverse effects , Rectal Neoplasms/mortality , Rectal Neoplasms/pathology , Retrospective Studies , Severity of Illness Index , Thymine , Treatment Outcome , Trifluridine/adverse effects , Uracil/adverse effects , Uracil/therapeutic useABSTRACT
Los globos de látex de caucho natural y los guantes de examinación del mismo material inflados como globos, que se entregan a los pacientes para aliviar el estrés de la atención sanitaria en las instituciones de salud tanto públicas como privadas, pueden provocar reacciones de hipersensibilidad de tipo I y son una de las causas más comunes de aspiración fatal. La suelta de globos contaminan el ambiente y agravan la extinción de la fauna y de la vida marina. Los pacientes sensibilizados o alérgicos al látex que participan en los festejos donde se utilizan globos de látex corren el riesgo de una reacción anafiláctica, potencialmente fatal. Aconsejarles no concurrir a dichos eventos, implica impedirles el disfrute de las actividades recreativas que es un derecho de la infancia manifestado en la Declaración de los Derechos del Niño. Muchos hospitales de países desarrollados ya cuentan con una política de prohibición de los globos de látex en sus instituciones, que podría replicarse en nuestro medio por las ventajas que conlleva y su muy bajo costo de implementación (AU)
Natural rubber latex balloons and examining gloves of the same material blown up as balloons to entertain patients to alleviate the stress of care at public and private health institutions, may cause reactions of type-1 hypersensitivity and are the most common cause of fatal asphyxia. Balloons that are released up into the air contaminate the environment and aggravate the extinction of fauna and marine life. Patients who are sensitized or allergic to latex and participate in celebrations in which latex balloons are used are at risk of a potentially fatal anaphylactic reaction. To advise them not to participate in these events means to stop them from enjoying recreational activities which is a right manifested in the Declaration of the Rights of the Child. In many hospitals in developed countries a policy of prohibition of latex gloves is already in place. This prohibition may be replicated in our environment considering its advantages and very low cost of implementation (AU)
Subject(s)
Humans , Infant , Child, Preschool , Asphyxia , Child Advocacy , Environmental Hazards , Foreign Bodies , Health Facilities/legislation & jurisprudence , Latex Hypersensitivity , Latex/toxicityABSTRACT
El Cambio Climático (CC) está afectando la salud humana y los sistemas naturales. En los últimos 50 años, las actividades del hombre, particularmente la quema de combustibles fósiles, han liberado importante cantidad de gases de efecto invernadero (GEI) los que atrapan el calor adicional en la atmósfera calentando el planeta. La temperatura y el nivel del mar aumentan, los glaciares se derriten y los patrones de las precipitaciones están cambiando. Los eventos climáticos extremos son más intensos y frecuentes. Es importante conocer el impacto del CC en la salud y en los ecosistemas porque es posible manejar sus efectos a través de medidas de adaptación y mitigación (AU)
Climate change (CC) is affecting human health and natural systems. Over the past 50 years, activities of mankind, mainly the burning of fossil fuels, has released important amounts of greenhouse gases (GHG) that trap additional heat in the atmosphere heating the planet. The sea temperature and level rise, glaciers melt, and patterns of precipitations have changed. Extreme climatic events have become more intense and frequent. It is important to recognize the impact of CC on health and ecosystems as it is possible late its effects through measures of adaptation and mitigation (AU)