Assuntos
Analgésicos Opioides/administração & dosagem , Fentanila/administração & dosagem , Naloxona/efeitos adversos , Síndrome da Mioclonia Noturna/induzido quimicamente , Osteoartrite do Joelho/tratamento farmacológico , Síndrome das Pernas Inquietas/complicações , Síndrome de Abstinência a Substâncias/complicações , Tilidina/efeitos adversos , Idoso de 80 Anos ou mais , Combinação de Medicamentos , Humanos , Masculino , Naloxona/administração & dosagem , Osteoartrite do Joelho/complicações , Síndrome das Pernas Inquietas/tratamento farmacológico , Automedicação/efeitos adversos , Tilidina/administração & dosagemRESUMO
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.
Assuntos
Antineoplásicos Alquilantes/uso terapêutico , Neoplasias do Sistema Nervoso Central/tratamento farmacológico , Neoplasias do Sistema Nervoso Central/genética , Metilases de Modificação do DNA/metabolismo , Enzimas Reparadoras do DNA/metabolismo , Dacarbazina/análogos & derivados , Linfoma/tratamento farmacológico , Proteínas Supressoras de Tumor/metabolismo , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Sistema Nervoso Central/mortalidade , Metilação de DNA/efeitos dos fármacos , Dacarbazina/uso terapêutico , Intervalo Livre de Doença , Feminino , Geriatria , Humanos , Linfoma/genética , Linfoma/metabolismo , Masculino , Pessoa de Meia-Idade , Regiões Promotoras Genéticas/efeitos dos fármacos , Estudos Retrospectivos , Análise de Sobrevida , TemozolomidaRESUMO
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.
