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1.
Clin Transl Oncol ; 22(2): 270-278, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31981078

ABSTRACT

Cervical cancer (CC) is the fourth most common cancer in women worldwide, strongly linked to high-risk human papilloma virus infection. In high-income countries, the screening programs have dramatically decreased the incidence of CC; however, the lack of accessibility to them in developing countries makes CC an important cause of mortality. Clinical stage is the most relevant prognostic factor in CC. The new FIGO staging system published in 2018 is more accurate than the previous one since it takes into account the lymph node status. In early stages, the primary treatment is surgery-with some concerns recently raised regarding minimally invasive surgery because it might decrease survival-or radiotherapy, whereas concomitant chemo-radiotherapy is the conventional approach in locally advanced stages. For recurrent or metastatic CC, the combination of chemotherapy plus bevacizumab is the preferred therapy. Immunotherapy approach based on checkpoint inhibitors is evolving as the election therapy following failure to platinum therapy.


Subject(s)
Clinical Trials as Topic/standards , Practice Guidelines as Topic/standards , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/therapy , Female , Humans , Medical Oncology , Societies, Medical
3.
Oncología (Barc.) ; 29(5): 185-193, mayo 2006. tab
Article in En | IBECS | ID: ibc-047796

ABSTRACT

No disponibleEste estudio fue diseñado para determinar la eficacia y seguridad de la combinación de paclitaxel ycarboplatino como quimioterapia de segunda línea de pacientes con cáncer de células no pequeñas depulmón. El tratamiento consistió en la infusión de 175 mg/m2 de paclitaxel durante 1 hora y carboplatinoAUC 5 durante 30 minutos, administrados cada 3 semanas con un máximo de 6 ciclos. Se incluyeronen el estudio tres grupos de pacientes: los diagnosticados de encontrarse en estadio IV; los quepresentaron progresión durante o después de la administración previa de quimioterapia de primera línea;y los que tenían PS ≤ con funciones hepática, renal y ósea normales. Se incluyeron veintidós pacientesentre enero de 2000 y diciembre de 2002. Sus características clínicas fueron: varones 81%/mujeres19%; histología de adenocarcinoma 12 pacientes (55%)/carcinoma escamoso 6 pacientes(27%)/carcinoma de células grandes 2 pacientes (9%)/otros tipos histológicos 2 pacientes (9%). Lostratamientos administrados previamente fueron: combinaciones con cisplatino en 11 pacientes (50%) ycombinaciones sin cisplatino (ifosfamida, gemcitabina, vinorelbina) en 11 pacientes (50%). En la quimioterapiade primera línea, el 50% de los pacientes recibió en promedio 1 a 4 ciclos. Como quimioterapiade segunda línea se administraron 1 a 3 ciclos en el 50% de los casos y 3 a 6 ciclos en el otro50%. Las dosis administradas fueron el 100% de las planeadas en 20 pacientes, en tanto que en 2 fuenecesario reducir las dosis por la aparición de neutropenia y neurotoxicidad de grado 3. El tratamientofue bien tolerado en general, observándose en cuatro pacientes toxicidad de grados 3 y 4: neutropeniaen 2 de ellos (9%) y neuropatía periférica en otros 2 (9%). En conjunto, respondió el 23% de los enfermos(CI 95%, 8-45): 5 pacientes (23%) con respuesta parcial, 9 casos (36%) con enfermedad estable y8 enfermos (31%) con progresión. El tiempo medio de la progresión con el tratamiento de segunda líneafue de 16 semanas, alcanzando una supervivencia global media de 79 semanas. Desde el comienzodel tratamiento de segunda línea la supervivencia media fue de 24,1 semanas (CI 95%, 13,7-34,5).En este estudio se observó que los pacientes con cáncer de células no pequeñas de pulmón que recibieronla combinación de paclitaxel y carboplatino como tratamiento de segunda línea presentaron unarestricción moderada de actividad sin gran toxicidad


This study was designed to determine the efficacy and safety of the paclitaxel and carboplatincombination in second-line chemotherapy treatment of patients with non-small-cell lung cancer.Treatment consisted of 175 mg/m2 paclitaxel infused in 1 hour and carboplatin AUC 5 infused in 30minutes, administered each 3 weeks for a maximum of 6 cycles. The following patient groups wereincluded in the study: those who were stage IV at diagnosis; with progression during or after theadministration of previous first-line chemotherapy; PS ≤ 2 and with normal hepatic, renal and bonemarrow function. Twenty-two patients were included between January 2000 and December 2002. Theirclinical characteristics were: male 81% / female 19%; adenocarcinoma histology in 12 patients (55%) /squamous carcinoma in 6 patients (27%) / large cell carcinoma in 2 patients (9%), and other types in 2patients (9%). The Performance Status (ECOG Scale) was 0 in 5 patients (22%), 1 in 5 patients (22%)and 2 in 12 patients (55%). Previously administered treatments were: combinations with cisplatin in 11patients (50%) and combinations without cisplatin (ifosfamide, gemcitabine, vinorelbine) in 11 patients(50%). The mean number of first-line chemotherapies received was 1 to 4 cycles in 50% patients. Themean number of second-line treatments was 1 to 3 cycles in 50% and 3 to 6 cycles in the others. Thedoses administered were 100% of that planned in 20 patients, with 2 patients requiring dose reductionsdue to neutropenia and grade 3 neurotoxicity. The treatment was well tolerated with presentation of thefollowing grade 3-4 toxicities: neutropenia in 2 patients (9%), peripheral neuropathy in 2 patients (9%).The overall response rate was 23% (CI 95%, 8-45): 5 patients (23%) with partial response, 9 (36%)with stable disease and 8 (31%) with progression. The median time to progression with second-linetreatment was 16 weeks, reaching a median overall survival of 79 weeks. From the initiation of secondlinetreatment median survival was 24.1 weeks (CI 95%, 13.7-34.5).In this study it was observed that the combination of paclitaxel with carboplatin as second-linechemotherapy in patients with non-small-cell lung cancer presented moderate/restrained activitywithout severe toxicity


Subject(s)
Male , Female , Aged , Middle Aged , Humans , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Carboplatin/therapeutic use , Paclitaxel/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Patient Selection
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