Subject(s)
Humans , Corneal Neovascularization , Risk Factors , Corneal Transplantation , Laser Therapy , TherapeuticsABSTRACT
BACKGROUND: Intralesional methotrexate (MTX-il) has been used as neoadjuvant therapy for keratoacanthoma but has only been utilized in a few isolated cases of cutaneous squamous cell carcinoma as neoadjuvant therapy (cSCC). OBJECTIVES: The objective of this study was to evaluate the effectiveness in clinical practice of presurgical MTX-il infiltration to reduce the size of the cSCC. Safety and the impact on subsequent reconstructive surgical techniques was also assessment. METHODS: Single, retrospective, observational study of two historical cohorts differentiated in time. Subjects included were diagnosed with infiltrating cSCC. Patients included in group-A received neoadjuvant MTX-il and patients included in group-B underwent scheduled surgery without prior infiltration. Univariate and multivariate analyses were performed. RESULTS: Group-A patients (n = 43) showed an average reduction in the tumour area of 0.52 cm(2) , while in group-B (n = 43), the area increased by 0.49 cm(2) . A multivariate linear regression analysis demonstrated that MTX-il was the only independent variable that significantly reduced the tumour size [mean 42.6% (95% CI: 31.17-54.03)]. Tumours ≥2 cm in size required significantly a lower percentage of complex reconstructions (P = 0.026). Lower lip tumours showed a higher reduction in group treated with MTX-il (P = 0.045). The only complication observed was discomfort during methotrexate infiltration (60.47%). CONCLUSIONS: Neoadjuvant MTX-il reduced the presurgical size of cSCC lesions and could simplify their subsequent surgery.
Subject(s)
Carcinoma, Squamous Cell/drug therapy , Methotrexate/therapeutic use , Skin Neoplasms/drug therapy , Aged , Aged, 80 and over , Chemotherapy, Adjuvant , Cohort Studies , Female , Humans , Injections, Intralesional , Male , Methotrexate/administration & dosageSubject(s)
Angiofibroma/drug therapy , Facial Neoplasms/drug therapy , Immunosuppressive Agents/therapeutic use , Sirolimus/therapeutic use , Administration, Topical , Chemistry, Pharmaceutical , Child, Preschool , Female , Humans , Immunosuppressive Agents/administration & dosage , Male , Sirolimus/administration & dosage , Tuberous Sclerosis/complicationsABSTRACT
BACKGROUND: Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disorder characterized by the development of multisystem hamartomatous tumours. Facial angiofibroma appears in up to 80% of patients and has a considerable psychological impact. Various invasive procedures have been used, although they show limited effectiveness and potential adverse effects. OBJECTIVES: To evaluate the sustained clinical benefits and safety profile of topical sirolimus applied to treat facial angiofibromas. METHODS: This study was a non-blinded, uncontrolled case-series comprising 10 patients with TSC-associated facial angiofibroma that was treated with 0.4% sirolimus ointment 3 times a week for 9 months. Patients were clinically evaluated at baseline and at 6, 12, 24 and 36 weeks. Plasma levels of sirolimus were determined. RESULTS: A sustained improvement was observed in erythema and in the size and extension of the lesions as early as the first weeks of treatment. Sirolimus plasma levels remained below detection limits (0.3 ng/mL) in all cases. The formula was well-tolerated with no local or systemic adverse effects. CONCLUSIONS: Topical sirolimus seems to be an effective and safe medical alternative to surgery or laser-based treatments in patients with TSC-associated facial angiofibromas.
Subject(s)
Angiofibroma/etiology , Immunosuppressive Agents/therapeutic use , Sirolimus/therapeutic use , Tuberous Sclerosis/drug therapy , Administration, Topical , Adolescent , Adult , Child , Face , Female , Humans , Immunosuppressive Agents/adverse effects , Male , Middle Aged , Sirolimus/adverse effects , Tuberous Sclerosis/complications , Young AdultABSTRACT
Objetivo Evaluar la efectividad y seguridad del tratamiento con 5-azacitidina en síndrome mielodisplásico. Métodos Revisión de historias clínicas de pacientes que recibieron 5-azacitidina 75mg/m2 subcutánea durante 7 días, cada 28 días en 12 ciclos. Se valoró la respuesta objetiva, mejoría clínica y tiempo hasta la progresión de la enfermedad. Se recogieron las reacciones adversas descritas en la historia clínica. Resultados Seis pacientes fueron candidatos a tratamiento con 5-azacitidina. Tres casos fueron evaluables tras el período considerado. La mayoría permanecieron en respuesta parcial o mejor al finalizar el estudio, dejando de precisar transfusiones. En una paciente se retrasó la progresión a leucemia.Conclusiones5-Azacitidina podría considerarse un fármaco relativamente efectivo y seguro, pudiendo haber contribuido al control de citopenias periféricas, a mejorar la calidad de vida y a retrasar la progresión a leucemia. Serían necesarios estudios con mayor número de pacientes que corroborasen estos resultados (AU)
Objective To assess the effectiveness and safety of using 5-azacitidine to treat myelodysplastic syndromes. Methods Review of medical records of patients who received 5-azacitidine 75mg/m2 subcutaneously for during 7 days every 28 days in twelve cycles as compassionate use. We evaluated the objective response, clinical improvement and time to disease progression. We recorded adverse reactions described in the medical history. Results Six patients were candidates for treatment with 5-azacitidine. Three cases were evaluated over the study period. Most remained in partial response or better after the study, and no longer needed transfusions. In one patient, the treatment appeared to delay progression to leukaemia.Conclusions5-Azacitidine might be considered an effective and relatively safe drug, and may have contributed to controlling peripheral cytopenias, improving the quality of life and delaying progression to leukaemia. Additional studies with more patients are needed to support these results (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Antimetabolites/therapeutic use , Azacitidine/therapeutic use , Myelodysplastic Syndromes , Anemia, Refractory, with Excess of Blasts/drug therapy , Anemia, Refractory, with Excess of Blasts/therapy , Combined Modality Therapy , Disease Progression , Drug Eruptions , Drug Evaluation , Medical Records , Platelet Transfusion , Quality of Life , Recombinant Proteins , Retrospective StudiesABSTRACT
OBJECTIVE: To assess the effectiveness and safety of using 5-azacitidine to treat myelodysplastic syndromes. METHODS: Review of medical records of patients who received 5-azacitidine 75mg/m(2) subcutaneously for during 7 days every 28 days in twelve cycles as compassionate use. We evaluated the objective response, clinical improvement and time to disease progression. We recorded adverse reactions described in the medical history. RESULTS: Six patients were candidates for treatment with 5-azacitidine. Three cases were evaluated over the study period. Most remained in partial response or better after the study, and no longer needed transfusions. In one patient, the treatment appeared to delay progression to leukaemia. CONCLUSIONS: 5-Azacitidine might be considered an effective and relatively safe drug, and may have contributed to controlling peripheral cytopenias, improving the quality of life and delaying progression to leukaemia. Additional studies with more patients are needed to support these results.
