Valor pronóstico de determinados marcadores biológicos en la supervivencia global y la respuesta al tratamiento del cáncer de mama con metástasis pleurales / Prognostic value of specific biological markers in the global survival rate and response to treatment of breast cancer with pleural metastasis

Objetivo: 1. Estudiar qué tipo de marcadores biológicos tienen valor pronóstico en la supervivencia global y la respuesta al tratamiento en el cáncer de mama, a partir del descubrimiento de metástasis pleurales. 2. Examinar la influencia de la aplicación de talco intrapleural. 3. Establecer un esquema de abordaje terapéutico en base a los diferentes factores pronósticos. Pacientes y métodos: estudiamos una serie de 126 pacientes con cáncer de mama y afectación pleural metastásica. Se examinaron exhaustivamente los factores clásicos del cáncer de mama. Así mismo se calcularon el intervalo libre de enfermedad (ILE), el intervalo entre la aparición del derrame pleural y el abordaje toracoscópico del mismo, el intervalo entre la realización de la pleurodesis con talco y el exitus y el intervalo desde el diagnóstico del tumor primario hasta el exitus. Los factores biológicos (polimorfismos)fueron estudiados a partir del ADN de muestras de sangre periférica o líquido pleural crio conservado. Resultados: el derrame pleural era en el 77% de los casos la primera manifestación de recidiva de la enfermedad. El intervalo libre de enfermedad (ILE) fue de 57,9 meses (13,6-83,3). La supervivencia(expresada como mediana) desde el momento del diagnóstico del tumor primario fue de 77,5 meses (0,83-384). La media de seguimiento tras el talcaje fue de 14,6 meses. Encontramos correlación entre la edad temprana de presentación del cáncer de mama (..) (AU)

Objective: 1. To study what type of biological markers have prognostic value in the global survival rate and response to treatment of breast cancer, regarding discovery of pleural metastases. 2. To examine the influence of the application of intrapleural talc. 3. To establish a therapeutic approach outline based on the different prognosticfactors. Patients and methods: we studied a series of 126 patients with breast cancer and pleural metastasis. The classic factors of breast cancer were thoroughly examined. Also, we calculated the disease-free interval(DFI), the interval between the appearance of the pleural effusion and its thoracoscopic approach, the interval between pleurodesis with talc and death and the interval between the diagnosis of the first tumour and death. The biological factors (polymorphisms) were studied starting with the DNA of peripheral blood samples or cryopreservation of pleural liquid samples. Results: the pleural effusion was the first manifestation of a relapse of the disease in 77% of the cases. The disease-free interval (DFI) was57.9 months (13.6-83.3). The survival rate (expressed as median)from the diagnosis of the first tumour was 77.5 months (0.83-384).The average follow-up after the application of talc was 14.6 months. We found a correlation between the appearance of breast cancer(p=0.003) at a young age and the presence of the A2/A2 allele(homozygote of the CYP-17).Conclusions: the ideal profile for candidates for pleurodesis is those patients with an age >50 years, long DFI, short interval of time between the appearance of the pleural effusion and the application oftalc, absence of other metastasis at the time of thoracoscopy, positive ER (estrogen receptors) and PR (progesterone receptors) and a percentage of lymph nodes infiltrated/extracted less than 50%. The presence of mutated GSTM1 will be related with a more effective (..) (AU)

Spanish Society of Medical Oncology consensus on the use of erythropoietic stimulating agents in anaemic cancer patients

Treatment of anaemia is a very important aspect in the management of cancer patients. In order to carry out a consensus process about the use of erythropoietic stimulating agents (ESAs) in cancer patients, the Spanish Society of Medical Oncology (SEOM) elaborated a working group which coordinated a panel of medical oncology specialists. This working group has reviewed the main issues about the use of ESAs. In addition a consensus meeting was held in Madrid on 25 April 2007. The following conclusions were made: Since ESA treatment increases the haemoglobin (Hb) level and decreases the red blood cell (RBC) transfusion requirements, ESAs should be used within the approved indications in patients undergoing chemotherapy treatment, beginning at a Hb level below 11 g/dl and maintaining it around 12 g/dl, with iron supplements if necessary. Neither increasing the ESA dose in nonresponders nor the use of ESAs in the treatment of chronic cancer-related anaemia is recommended (AU)

No disponible

[Treatment of indolent non-Hodgkin's lymphomas]. / Tratamiento de los linfomas no hodgkinianos indolentes.

Non-Hodgkin's Lymphomas (NHLs) are a heterogeneous group of entities with different pathologies. A total of 80% of these lymphomas are B-cell origin and only 20% T-cell. B-cell lymphomas express CD-20 antigen, a specific target for the current treatment with monoclonal antibodies. Indolent lymphomas in localized stages (I and II) account for 20%, only 10% being in pathological stages. The possibilities for cure with radiotherapy and/or chemotherapy are approximately 50-70%. Advanced stages (IIB, III and IV) of phenotype B types account for 80-90% of the cases and are candidates for systemic treatments with immunochemotherapy for those of phenotype B. Rescue treatment is one of the most important problems in this type of lymphomas, many of them needing second line treatments, with survival rates under five years, in spite of the 50% response rate. In these cases, immunochemotherapy includes more aggressive regimens, high-dose chemotherapy and combined chemoimmunoradiotherapy.

Tratamiento de los linfomas no hodgkinianos indolentes / Treatment of indolent non-Hodgkin’s Lymphomas

Los linfomas no hodgkinianos (LNH) son un conjunto muy heterogéneo de procesos con distintas características clínicas y anatomopatológicas. El 80% de estos linfomas son de origen B y sólo un 20% T. Los B expresan el antígeno CD20, una diana clave para el tratamiento actual con anticuerpos monoclonales. En el grupo de linfomas indolentes, los estadios clínicos localizados (estadios I y II) representan el 20%, siendo sólo estadios patológicos un 10%. Las posibilidades de curación se sitúan en un 50-70% con radioterapia y/o quimioterapia. Los estadios avanzados III-IV, incluyendo el IIB, representan el 80-90% de los casos y son candidatos a tratamientos sistémicos con inmunoquimioterapia para los de fenotipo B. El tratamiento de rescate es uno de los problemas más importantes en estos linfomas, muchos requieren tratamiento de segunda línea, con supervivencias inferiores a cinco años, a pesar del 50% de respuestas. Contempla protocolos más agresivos de inmunoquimioterapia, incluyendo las altas dosis y radioinmunoquimioterapia (AU)

Non-Hodgkin’s Lymphomas (NHLs) are a heterogeneous group of entities with different pathologies. A total of 80% of these lymphomas are B-cell origin and only 20% T-cell. B-cell lymphomas express CD-20 antigen, a specific target for the current treatment with monoclonal antibodies. Indolent lymphomas in localized stages (I and II) account for 20%, only 10% being in pathological stages. The possibilities for cure with radiotherapy and/or chemotherapy are approximately 50-70%. Advanced stages (IIB, III and IV) of phenotype B types account for 80-90% of the cases and are candidates for systemic treatments with immunochemotherapy for those of phenotype B. Rescue treatment is one of the most important problems in this type of lymphomas, many of them needing second line treatments, with survival rates under five years, in spite of the 50% response rate. In these cases, immunochemotherapy includes more aggressive regimens, high-dose chemotherapy and combined chemoim-munoradiotherapy (AU)

Symptom management, supportive and palliative care: the continuum of care in the cancer patient. The SEOM's continuing care section

No disponible

No disponible