Treatment guidelines in ovarian cancer.

National and international specialists have met with the aim of writing down the guidelines for the treatment of epithelial ovarian cancer (in the Spanish Castilian language). These guidelines are based on the International Consensus that was published in English in the Annals of Oncology in 2005. This condition is the leading cause of death from gynaecological cancer in western countries. Its low rate of survival, barely 30% at 5 years, is above all due to late diagnosis and inappropriate surgery, so emphasis is put on these aspects. After describing the methodology for early detection and a scheme of surgical diagnostic procedures in view of the staging of an ovarian mass, the following therapeutic strategies will be recommended: cytoreductive surgery together with platinum chemotherapy under normal conditions, and also in the case of relapse. Likewise, very recent models of treatment focused on molecular targets are presented, and a broad section on methodology of clinical assays. As for this, co-operation among groups is crucial in order to make the conclusions of these studies valid for the development of new therapies.

Treatment guidelines in ovarian cancer

National and international specialists have met with the aim of writing down the guidelines for the treatment of epithelial ovarian cancer (in the Spanish Castilian language). These guidelines are based on the International Consensus that was published in English in the Annals of Oncology in 2005. This condition is the leading cause of death from gynaecological cancer in western countries. Its low rate of survival, barely 30% at 5 years, is above all due to late diagnosis and inappropriate surgery, so emphasis is put on these aspects. After describing the methodology for early detection and a scheme of surgical diagnostic procedures in view of the staging of an ovarian mass, the following therapeutic strategies will be recommended: cytoreductive surgery together with platinum chemotherapy under normal conditions, and also in the case of relapse. Likewise, very recent models of treatment focused on molecular targets are presented, and a broad section on methodology of clinical assays. As for this, co-operation among groups is crucial in order to make the conclusions of these studies valid for the development of new therapies (AU)

[The clinico-mammographic follow-up of breast cancer after conservative treatment]. / Seguimiento clínico-mamográfico del cáncer de mama tras tratamiento conservador.

Clinical and mammographic follow-up of 149 patients diagnosed of stage I and II breast neoplasm and treated with conservative surgery and irradiation between January 1986 and December 1988 was reviewed to determine clinical and radiographic recurrence pattern. Follow-up controls included a clinical examination and a mammogram at 6-9 months, a second at 10-16, a third at 17-22, a fourth at 23-24 and a mammogram yearly and a clinical examination every 6 months thereafter. To December 1991 18 patients recurred. 12 had a metastatic spread, 3 a unique local recurrence and 3 a local recurrence with a metastasis spread. Clinical recurrence was as a carcinomatous mastitis in three patients and a solid nodule in two. Radiologic recurrence was as an augmented skin thickness in three patients. Mammogram was not performed in one patient because an associated poor prognostic metastatic spread. Mammographic skin thickness secondary to irradiation appeared in 93% of the patients at 6-9 first control, 62% at second, 50% at third and 35% at fourth. The number of recurrences is scarce to achieve any clinical, pathological or treatment factor associated with greater risk of recurrence. We suggest that first mammogram should be delayed after 12 months of treatment because we would not obtain any relevant clinical information before, once observed skin thickness persistence at 6 months and most frequent recurrence radiologic pattern.

[Does total androgen suppression in advanced prostatic cancer induce a greater number of complete remissions? A phase II trial]. / Induce la supresión androgénica total en cáncer de próstata avanzado mayor no. de remisiones completas? Un ensayo en fase II.

The present Phase II study's main objective was to evaluate the rate of complete responses (CR) obtained through total androgenic suppression (TAS) in patients with disseminated prostate carcinoma. Twenty consecutive patients were recruited of which 19 were evaluable for response and toxicity. Treatment consisted in an association of orchiectomy or the analogous LH-RH Buselerin with the antiandrogenic Flutamide. There was 1 CR (5%) and 17 partial responses (PR). Sixteen patients with symptomatic disease had subjective improvement, usually during the first month of treatment. After an average follow-up of 20 months (range 7-29), 1 patient remains CR and 7 have regressed following PR, 4 of which have died. Tolerance was good, and side effects secondary to hypoandrogenism were frequent, although mild, requiring treatment discontinuation in 1 case. It is concluded that TAS is an excellent palliative approach in disseminated prostate carcinoma though the rate of CRs obtained is sensibly lower to that reported by Labrie (28.3%) and in the range of 0-8% achieved in most studies. It is questionable whether it will become standard therapy for metastatic prostate carcinoma.

[Cerebral metastasis from breast cancer. Treatment with irradiation. Results]. / Metástasis cerebral por cáncer de mama. Tratamiento con irradiación. Resultados.

The authors describe the results of cranial radiotherapy in 22 patients with brain metastases due to mammary cancer; 77.5% of the patients responded to treatment, 45.5% showing a complete response. The mean survival attained was 6.4 months for all the patients and 18 months for those with complete response. The presence of cerebellar metastases makes worse the prognosis.