Local treatment in oligometastasis from breast cancer: an overview

Oligometastasic breast cancer (OMBC) consists of breast cancer patient with a limited number of systemic metastases (≤ 5), all of them candidates for local ablative treatment with the intention of achieving long-term control of the metastasis and, eventually, an increase in survival The first consensus for the management of patients with oligometastatic breast cancer (OMBC) was published in 2007, establishing that a more aggressive multidisciplinary strategy is recommended in order to increase the survival while maintaining a good quality of life. The current scientific evidence is based on observational studies, mainly retrospective, systematic reviews and meta-analyses, and only a randomized nonexclusive study of oligometastatic (OM) published. All trials with Stereotactic Body Radiation Therapy (SBRT) in OM cancer have shown excellent tolerance and good local control, although first trials on Lung SBRT did not prove so excellent tolerance and had some deaths due to bronchus irradiation and secondary hemoptysis. There are multiple ongoing studies researching the benefit of SBRT in oligometastatic breast cancer. Despite the lack of impact on survival seen in the NRG BR-002 Trial, SBRT probably allows the delay of the systemic treatment until progression, and so, improves the quality of life of patients. We have to wait for the results of the ongoing and future studies for clarification of the role of local treatment in OMBC (AU)

[Paraneoplastic hemolytic anemia associated with prostate cancer. A case report].

Paraneoplastic syndromes are a group of tumor-related symptoms not directly attributable to tumors or metastasis. Symptoms are caused by secretion of substances by the tumor or the production of antibodies from immune cross-reactivity between tumor and normal tissues. Among hematological paraneoplastic syndromes, cancer-associated hemolytic anemias associated are rare, particularly in solid tumors. We present the case of a patient with localized bladder (high-grade infiltrating papillary carcinoma pT1) and prostate (Gleason 7) cancer who developed warm antibody autoimmune hemolytic anemia during radiation therapy for prostate cancer. It was resolved with prednisone (1 mg/Kg/day, tapering schedule). To the best of our knowledge, this is the first time an autoimmune hemolytic anemia is described in the literature as a paraneoplastic syndrome in such early stages of tumor disease.

Anemia hemolítica paraneoplasica asociada a cáncer de próstata. A propósito de un caso / Paraneoplastic hemolytic anemia associated with prostate cancer. A case report

Los síndromes paraneoplásicos son un conjunto de síntomas asociados a los tumores, no atribuibles al efecto directo del tumor o de sus metástasis. Estos síntomas pueden ser secundarios a sustancias secretadas por el tumor, o a la producción de anticuerpos contra tejido tumoral que presenta reacción cruzada con tejidos normales. Dentro de los síndromes paraneoplásicos hematológicos, las anemias hemolíticas son poco frecuentes, especialmente en tumores sólidos. Presentamos el caso de un paciente con tumores localizados de vejiga (carcinoma papilar infiltrante de alto grado pT1) y próstata (Gleason 7) que durante el tratamiento radioterápico de este último desarrolló una anemia hemolítica autoinmune por anticuerpos calientes, que se resolvió con tratamiento con prednisona (1 mg/Kg/día en pauta descendente). Este sería la primera descripción en la literatura de anemia hemolítica autoinmune como síndrome paraneoplásico en un estadio tan precoz de la enfermedad tumoral.(AU)

Paraneoplastic syndromes are a group of tumor-related symptoms not directly attributable to tumors or metastasis. Symptoms are caused by secretion of substances by the tumor or the production of antibodies from immune cross-reactivity between tumor and normal tissues. Among hematological paraneoplastic syndromes, cancer-associated hemolytic anemias associated are rare, particularly in solid tumors. We present the case of a patient with localized bladder (high-grade infiltrating papillary carcinoma pT1) and prostate (Gleason 7) cancer who developed warm antibody autoimmune hemolytic anemia during radiation therapy for prostate cancer. It was resolved with prednisone (1 mg/Kg/day, tapering schedule). To the best of our knowledge, this is the first time an autoimmune hemolytic anemia is described in the literature as a paraneoplastic syndrome in such early stages of tumor disease.(AU)