Asunto(s)
Analgésicos Opioides/administración & dosificación , Fentanilo/administración & dosificación , Naloxona/efectos adversos , Síndrome de Mioclonía Nocturna/inducido químicamente , Osteoartritis de la Rodilla/tratamiento farmacológico , Síndrome de las Piernas Inquietas/complicaciones , Síndrome de Abstinencia a Sustancias/complicaciones , Tilidina/efectos adversos , Anciano de 80 o más Años , Combinación de Medicamentos , Humanos , Masculino , Naloxona/administración & dosificación , Osteoartritis de la Rodilla/complicaciones , Síndrome de las Piernas Inquietas/tratamiento farmacológico , Automedicación/efectos adversos , Tilidina/administración & dosificaciónRESUMEN
This retrospective series explores temozolomide monotherapy in elderly patients with primary CNS lymphoma (PCNSL) and severe comorbidities. In 17 patients (62-90 years old), the complete response rate was 47%, median progression-free survival was 5 months, and median overall survival was 21 months. Five of 17 patients (29.4%) had prolonged responses for at least 12 months and survived for more than 24 months. Three of these patients had a methylated O(6)-methylguanine-DNA methyltransferase (MGMT) promoter, while the MGMT status was not assessable in the remaining two patients. Temozolomide monotherapy appears to be effective in a subgroup of elderly PCNSL patients and deserves further evaluation.
Asunto(s)
Antineoplásicos Alquilantes/uso terapéutico , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/genética , Metilasas de Modificación del ADN/metabolismo , Enzimas Reparadoras del ADN/metabolismo , Dacarbazina/análogos & derivados , Linfoma/tratamiento farmacológico , Proteínas Supresoras de Tumor/metabolismo , Anciano , Anciano de 80 o más Años , Neoplasias del Sistema Nervioso Central/mortalidad , Metilación de ADN/efectos de los fármacos , Dacarbazina/uso terapéutico , Supervivencia sin Enfermedad , Femenino , Geriatría , Humanos , Linfoma/genética , Linfoma/metabolismo , Masculino , Persona de Mediana Edad , Regiones Promotoras Genéticas/efectos de los fármacos , Estudios Retrospectivos , Análisis de Supervivencia , TemozolomidaRESUMEN
Cases of extracranial metastases of glioblastoma multiforme to sites such as bones, spleen, lung, liver and kidneys have been reported but available information about treatment of organ and bone metastases is extremely scarce. In this report a case of glioblastoma multiforme (GBM) of the temporal lobe with subsequent liver and bone metastases is described and the success of different chemotherapy regimens is discussed. Liver and bone metastases were effectively treated with temozolomide and later with carboplatin and docetaxel. Two years after first diagnosis symptomatic local recurrence occurred. Therefore a stereotactic fractionated radiotherapy was performed. As a result of relapse of liver metastases the patient received chemotherapy with adriamycin, cyclophosphamide and etoposide. Visceral metastases were stable, but nevertheless the patient died from local progression 3 years after first diagnosis. In conclusion, liver metastases of GBM can be effectively treated by chemotherapy. This case report suggests suitable substances which can be chosen according to clinical circumstances.