RESUMEN
La osificación del ligamento anterior longitudinal vertebral, conocida como enfermedad de Forestier o hiperostosis esquelética idiopática difusa, es una enfermedad que suele cursar de forma asintomática. Se produce sobre todo en la región torácica, seguida por la lumbar y cervical. Cuando existe afectación cervical, en caso de producir clínica, los síntomas más frecuentes son disfagia, disnea o disfonía y, de forma excepcional, obstrucción aguda de la vía aérea. Este proceso patológico supone un reto anestésico en el manejo de la vía aérea de estos pacientes. Por ello presentamos el caso de un paciente de 85 años con obstrucción aguda de vía aérea asociada a enfermedad de Forestier, al que se le realizó intubación mediante fibroscopio bajo anestesia inhalada con sevoflurano manteniendo ventilación espontánea para la posterior realización de traqueotomía por los otorrinolaringólogos
Ossification of the anterior longitudinal ligament of the spine, known as Forestier disease or diffuse idiopathic skeletal hyperostosis, is usually an asymptomatic disorder. The area most frequently affected is the thoracic spine, followed by lumbar and cervical regions. In the case of cervical involvement with clinical manifestations, the most common symptoms include dysphagia, dyspnoea, dysphonia, and can exceptionally cause an acute airway obstruction. The airway management of these patients represents a great anaesthetic challenge. The case is reported of an eighty-five-year-old patient who had an acute airway obstruction associated with Forestier disease. A fibre-optic-assisted intubation was accomplished under sevoflurane inhaled anaesthesia, maintaining spontaneous ventilation, with subsequent tracheostomy performed by ENT surgeons
Asunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Obstrucción de las Vías Aéreas/diagnóstico , Hiperostosis Esquelética Difusa Idiopática/complicaciones , Intubación Intratraqueal/métodos , Traqueotomía/métodos , Resultado del Tratamiento , Antiinflamatorios/uso terapéutico , Relajantes Musculares Centrales/uso terapéutico , Delirio/diagnósticoRESUMEN
INTRODUCTION: Many methods used to assess the effectiveness of immune checkpoint (programmed death-ligand 1 or cytotoxic T-lymphocyte-associated protein 4) inhibitors for non-small cell lung cancer (NSCLC) are insufficient, as the therapeutic benefit of these agents is often underestimated. Consequently, immune-related evaluation criteria have been developed to better reflect their efficacy. The aim of this consensus was to obtain the opinion of lung cancer experts on the adequacy of immune-response criteria for evaluating the efficacy of these treatments. METHODS: Through two rounds of a modified Delphi consensus, 18 Spanish lung cancer experts participated in a 15-item questionnaire regarding the use of immunotherapies for NSCLC and the assessment criteria used to evaluate their effectiveness. RESULTS: Consensus was achieved on 80% of the items in the questionnaire. The panelists agreed that although the Response Evaluation Criteria in Solid Tumors (RECIST) are standard for the evaluation of solid tumors, immune-related response criteria would be useful for measuring the efficacy of immunotherapy. In addition, they considered that an overall survival (OS) rate at 2-5 years is the most useful end point for assessing the benefit of immunotherapy, as clinical benefit may extend beyond the RECIST criteria-defined progression of disease. CONCLUSIONS: Although immune-related response criteria have been developed to better evaluate the efficacy of immunotherapy, their use has not been validated and is restricted to investigational applications. However, they may prove to be a useful tool for measuring the efficacy of immunotherapy agents in NSCLC, especially the OS rate at 2-5 years.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/terapia , Consenso , Inmunoterapia/métodos , Neoplasias Pulmonares/terapia , Antígeno B7-H1/antagonistas & inhibidores , Antígeno CTLA-4/antagonistas & inhibidores , Carcinoma de Pulmón de Células no Pequeñas/inmunología , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Técnica Delphi , Progresión de la Enfermedad , Humanos , Neoplasias Pulmonares/inmunología , Neoplasias Pulmonares/mortalidad , Criterios de Evaluación de Respuesta en Tumores Sólidos , Tasa de Supervivencia , Factores de TiempoRESUMEN
Ossification of the anterior longitudinal ligament of the spine, known as Forestier disease or diffuse idiopathic skeletal hyperostosis, is usually an asymptomatic disorder. The area most frequently affected is the thoracic spine, followed by lumbar and cervical regions. In the case of cervical involvement with clinical manifestations, the most common symptoms include dysphagia, dyspnoea, dysphonia, and can exceptionally cause an acute airway obstruction. The airway management of these patients represents a great anaesthetic challenge. The case is reported of an eighty-five-year-old patient who had an acute airway obstruction associated with Forestier disease. A fibre-optic-assisted intubation was accomplished under sevoflurane inhaled anaesthesia, maintaining spontaneous ventilation, with subsequent tracheostomy performed by ENT surgeons.
Asunto(s)
Obstrucción de las Vías Aéreas/etiología , Hiperostosis Esquelética Difusa Idiopática/complicaciones , Enfermedad Aguda , Anciano de 80 o más Años , Humanos , MasculinoRESUMEN
Este estudio analiza las acciones ofensivas que terminan en gol a lo largo de las temporadas 2.012-2.013 y 2.013-2.014 en la liga de fútbol sala profesional español determinando las relaciones entre las variables anteriores que están involucrados en estas acciones. Los goles totales analizados han sido 2.449. El método utilizado fue una metodología observacional a través del programa Lince vl.2. Para el análisis estadístico se utilizó el programa IBM SPSS 19.0.0 para determinar la asociación o independencia entre las variables zona de tiro-superficie de contacto-tipo de tiro y tipo de acción-número de pases-jugadores involucrados. Los resultados muestran que la mayoría de los goles en fútbol sala se producen en jugadas rápidas de 1-2 pases con 1-2 jugadores participantes y que con defensas organizadas se requiere un mayor número de pases y la participación de 3 jugadores para encontrar líneas de pase antes de disparar con opciones de hacer gol (AU)
This article analyse the offensive actions ending goal along the seasons 2.012-2.013 and 2.013-2.014 of the Spanish professional futsal league and determine the relationships between the previous variables which are involved in these actions and influence goal. The total goals analyzed have been 2.449. The method used in this study was observational methodology. For the observational process, it has been used the observational software Lince vl.2.1. It has been carried out using the IBM SPSS 19.0.0 program to determine the association or independence between variables zone from which the shot is taken-contact surface-type of shot and type of play-number of passes-players involved. The results show with organized defenses, a bigger number of passes and the participation of 3 players touching the ball to find passing lanes before shooting with goal options are required and most of the goals in actual futsal occur in fast moves of 1-2 passes with 1 or 2 players involved in it (AU)
Asunto(s)
Humanos , Fútbol/psicología , Conducta Competitiva , Rendimiento Atlético/psicología , Estudio Observacional , Procesos de GrupoRESUMEN
Background. The WORLD07 project is a female specific database to assess the characteristics of women with lung cancer. Methods. WORLD07 database sets up in 2007, and prospectively stores clinical characteristics, treatment, outcome, and follow-up of lung cancer women. All women with epidermal growth factor receptor (EGFR) mutation non-small cell lung cancer (NSCLC) were selected for this analysis. Results. From October 2007 to December 2012, a total of 1775 NSCLC women were recruited. EGFR mutation was identified in 34.4% of patients. Upfront EGFR tyrosine kinase inhibitor (TKI) reported a response rate of 60%, a median progression-free survival of 11.7 months, and median overall survival of 23.0 months. EGFR TKI, EGFR-mutation type, and smoking status did not impact in the outcome of treated women. Conclusion. Prevalence of EGFR mutation in women with NSCLC is higher than overall population with NSCLC. Efficacy of EGFR TKI in this real-world setting is similar to that previously reported (AU)
No disponible
Asunto(s)
Humanos , Femenino , Neoplasias Pulmonares/tratamiento farmacológico , Proteínas Tirosina Quinasas/antagonistas & inhibidores , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Receptores ErbB/análisis , Biomarcadores de Tumor/análisisRESUMEN
BACKGROUND: The WORLD07 project is a female specific database to assess the characteristics of women with lung cancer. METHODS: WORLD07 database sets up in 2007, and prospectively stores clinical characteristics, treatment, outcome, and follow-up of lung cancer women. All women with epidermal growth factor receptor (EGFR) mutation non-small cell lung cancer (NSCLC) were selected for this analysis. RESULTS: From October 2007 to December 2012, a total of 1775 NSCLC women were recruited. EGFR mutation was identified in 34.4% of patients. Upfront EGFR tyrosine kinase inhibitor (TKI) reported a response rate of 60%, a median progression-free survival of 11.7 months, and median overall survival of 23.0 months. EGFR TKI, EGFR-mutation type, and smoking status did not impact in the outcome of treated women. CONCLUSION: Prevalence of EGFR mutation in women with NSCLC is higher than overall population with NSCLC. Efficacy of EGFR TKI in this real-world setting is similar to that previously reported.
Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Células Escamosas/tratamiento farmacológico , Receptores ErbB/genética , Neoplasias Pulmonares/tratamiento farmacológico , Mutación , Inhibidores de Proteínas Quinasas/uso terapéutico , Adenocarcinoma/genética , Adenocarcinoma/patología , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/genética , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patología , Bases de Datos Factuales , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Tasa de Supervivencia , Salud de la Mujer , Adulto JovenRESUMEN
Lung cancer is the most common cancer globally and has the highest mortality. Although this disease is not associated with a particular gender, its incidence is rising among women, who are diagnosed at an increasingly younger age compared with men. One of the main reasons for this rise is women taking up smoking. However, many non-smoking women also develop this disease. Other risk factors implicated in the differential development of lung cancer in women are genetic predisposition, tumour histology and molecular profile. Proportionally more women than men with lung cancer have a mutation in the EGFR gene. This consensus statement reviews the available evidence about the epidemiological, biological, diagnostic, therapeutic, social and psychological aspects of lung cancer in women (AU)
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Neoplasias Pulmonares/epidemiología , Calidad de Vida , Genes erbB-1/genética , Neoplasias Pulmonares/genética , Fumar/efectos adversos , Consenso , Género y Salud , Fumar/genética , Inmunoterapia/tendencias , Infertilidad/inducido químicamente , Infertilidad/complicaciones , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/complicaciones , Indicadores de MorbimortalidadRESUMEN
Background/Aim. First-line bevacizumab-based therapies have been shown to improve clinical outcomes in patients with non-squamous non-small-cell lung cancer (NSCLC). We aimed to descriptively analyse patients with non-squamous NSCLC who received a long-term period of maintenance bevacizumab. Patients and methods. This retrospective study included 104 patients who had already reached a progression-free survival (PFS) of at least 9 months. Results. Median overall survival and PFS were 30.7 and 15.1 months, respectively. The overall response rate was 83 %. Weight loss ≤5 %, ECOG PS = 0, or low number of metastatic sites seem to be predictive factors of good evolution. The incidence of bevacizumab-related adverse events appeared to be similar as the previous studies. Conclusion. Our findings show that there is a long-term survivor group whom the administration of bevacizumab resulted in a relevant prolongation of response without new safety signals. Due to the population heterogeneity, it was not possible to identify the standardised predictive factors (AU)
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Bevacizumab/uso terapéutico , Quimioterapia de Mantención/métodos , Supervivencia/fisiología , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Estudios Retrospectivos , Declaración de Helsinki , 28599 , Análisis Multivariante , Estimación de Kaplan-MeierRESUMEN
BACKGROUND/AIM: First-line bevacizumab-based therapies have been shown to improve clinical outcomes in patients with non-squamous non-small-cell lung cancer (NSCLC). We aimed to descriptively analyse patients with non-squamous NSCLC who received a long-term period of maintenance bevacizumab. PATIENTS AND METHODS: This retrospective study included 104 patients who had already reached a progression-free survival (PFS) of at least 9 months. RESULTS: Median overall survival and PFS were 30.7 and 15.1 months, respectively. The overall response rate was 83 %. Weight loss ≤5 %, ECOG PS = 0, or low number of metastatic sites seem to be predictive factors of good evolution. The incidence of bevacizumab-related adverse events appeared to be similar as the previous studies. CONCLUSION: Our findings show that there is a long-term survivor group whom the administration of bevacizumab resulted in a relevant prolongation of response without new safety signals. Due to the population heterogeneity, it was not possible to identify the standardised predictive factors.
Asunto(s)
Adenocarcinoma/mortalidad , Inhibidores de la Angiogénesis/uso terapéutico , Bevacizumab/uso terapéutico , Carcinoma de Células Grandes/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Neoplasias Pulmonares/mortalidad , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/patología , Anciano , Carcinoma de Células Grandes/tratamiento farmacológico , Carcinoma de Células Grandes/patología , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/patología , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Metástasis de la Neoplasia , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia , SobrevivientesRESUMEN
Lung cancer is the most common cancer globally and has the highest mortality. Although this disease is not associated with a particular gender, its incidence is rising among women, who are diagnosed at an increasingly younger age compared with men. One of the main reasons for this rise is women taking up smoking. However, many non-smoking women also develop this disease. Other risk factors implicated in the differential development of lung cancer in women are genetic predisposition, tumour histology and molecular profile. Proportionally more women than men with lung cancer have a mutation in the EGFR gene. This consensus statement reviews the available evidence about the epidemiological, biological, diagnostic, therapeutic, social and psychological aspects of lung cancer in women.
Asunto(s)
Neoplasias Pulmonares/epidemiología , Factores Sexuales , Femenino , Humanos , Neoplasias Pulmonares/etiología , Masculino , Factores de RiesgoRESUMEN
Lung cancer incidence is decreasing worldwide among men but rising among women due to recent changes in smoking patterns in both sexes. In Europe, the smoking epidemic has evolved different rates and times, and policy responses to it, vary substantially between countries. Differences in smoking prevalence are much more evident among European women reflecting the heterogeneity in cancer incidence rates. Other factors rather than smoking and linked to sex may increase women's susceptibility to lung cancer, such as genetic predisposition, exposure to sex hormones and molecular features, all of them linked to epidemiologic and clinical characteristics of lung cancer in women. However, biological bases of sex-specific differences are controversial and need further evaluation. This review focuses on the epidemiology and outcome concerning non-small cell lung cancer in women, with emphasis given to the Spanish population (AU)
No disponible
Asunto(s)
Humanos , Femenino , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/metabolismo , Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Fumar/mortalidad , Europa (Continente)RESUMEN
Lung cancer incidence is decreasing worldwide among men but rising among women due to recent changes in smoking patterns in both sexes. In Europe, the smoking epidemic has evolved different rates and times, and policy responses to it, vary substantially between countries. Differences in smoking prevalence are much more evident among European women reflecting the heterogeneity in cancer incidence rates. Other factors rather than smoking and linked to sex may increase women's susceptibility to lung cancer, such as genetic predisposition, exposure to sex hormones and molecular features, all of them linked to epidemiologic and clinical characteristics of lung cancer in women. However, biological bases of sex-specific differences are controversial and need further evaluation. This review focuses on the epidemiology and outcome concerning non-small cell lung cancer in women, with emphasis given to the Spanish population.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/epidemiología , Neoplasias Pulmonares/epidemiología , Femenino , Humanos , Incidencia , Masculino , España/epidemiologíaRESUMEN
INTRODUCTION: Cisplatin plus oral vinorelbine, one of the standard treatments for metastatic non-small-cell lung cancer (NSCLC), is associated with a high rate of neutropenia, and a hemogram is performed on day 8. We analyzed the oncologists' opinions and the result of the hemogram on day 8 to address the question of whether this hemogram could be avoided. MATERIALS AND METHODS: Fifty-eight chemotherapy-naive, advanced NSCLC patients were included. Each received intravenous doses of 75 mg/m(2) cisplatin on day 1 plus oral vinorelbine [60 mg/m(2) in the first cycle (80 mg/m(2) in subsequent cycles) on days 1 and 8], every 3 weeks, for a maximum of six cycles. RESULTS: Out of 257 cycles analyzed, oral vinorelbine was administered on day 8 in 214 (83.2 %) and the dose was canceled in 6 cycles (2.3 %) due to hematological toxicity. On analyzing the patients to whom chemotherapy had been administered on day 8, based on medical opinion without the doctor knowing the hemogram result, we found that the cycle had been administered with a hemogram showing fewer than 1,500 × 10(6) neutrophils in only 3 of the 185 evaluable cycles [event rate of 1.6 %, with confidence interval 95 % = (0.34-4.67 %)]. CONCLUSION: The hemogram on day 8 can be avoided and oral vinorelbine administered in relative safety in patients with good performance status, when confirmed by the clinician's perception, thereby making this regimen more comfortable for the patient. This is the first prospective study to examine this issue (AU)
Asunto(s)
Humanos , Masculino , Femenino , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundarioRESUMEN
INTRODUCTION: Cisplatin plus oral vinorelbine, one of the standard treatments for metastatic non-small-cell lung cancer (NSCLC), is associated with a high rate of neutropenia, and a hemogram is performed on day 8. We analyzed the oncologists' opinions and the result of the hemogram on day 8 to address the question of whether this hemogram could be avoided. MATERIALS AND METHODS: Fifty-eight chemotherapy-naive, advanced NSCLC patients were included. Each received intravenous doses of 75 mg/m(2) cisplatin on day 1 plus oral vinorelbine [60 mg/m(2) in the first cycle (80 mg/m(2) in subsequent cycles) on days 1 and 8], every 3 weeks, for a maximum of six cycles. RESULTS: Out of 257 cycles analyzed, oral vinorelbine was administered on day 8 in 214 (83.2 %) and the dose was canceled in 6 cycles (2.3 %) due to hematological toxicity. On analyzing the patients to whom chemotherapy had been administered on day 8, based on medical opinion without the doctor knowing the hemogram result, we found that the cycle had been administered with a hemogram showing fewer than 1,500 × 10(6) neutrophils in only 3 of the 185 evaluable cycles [event rate of 1.6 %, with confidence interval 95 % = (0.34-4.67 %)]. CONCLUSION: The hemogram on day 8 can be avoided and oral vinorelbine administered in relative safety in patients with good performance status, when confirmed by the clinician's perception, thereby making this regimen more comfortable for the patient. This is the first prospective study to examine this issue.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/patología , Cisplatino/administración & dosificación , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Vinblastina/administración & dosificación , Vinblastina/análogos & derivados , VinorelbinaRESUMEN
BACKGROUND: The purpose of the Spanish Lung Cancer Anaemia Survey (SLCAS) was to thoroughly investigate lung cancer-associated anaemia management, and describe the profile of lung cancer patients in relation to anaemia incidence and tumour type in Spain. PATIENTS AND METHODS: This survey collected data from 1089 randomly recruited patients gathered by 50 Spanish physicians at 38 sites. In addition, a qualitative assay was performed through 16 one-to-one and 2 one-to-two interviews, and a discussion group of 4 cancer specialists participating in the survey. RESULTS: Lung cancer patients undergoing chemotherapy treatment had haemoglobin (Hb) levels <12.0 g/dl in 58.0% of the cases, in contrast to 39.0% of patients receiving no chemotherapy. Anaemia was treated in 53.0% of patients with Hb<12 g/dl (45.0% epoetin, 3.9% transfusion, 4.1% iron). Mean Hb level trigger was 9.7 g/dl for administration of epoetin and 8.2 g/dl for blood transfusion. CONCLUSIONS: SLCAS reveals a significant change in the management of anaemia and clinical practice pattern in the use of erythropoiesis-stimulating agents (45.0% vs. 18.0%) and much less use of blood transfusions (3.9% vs. 15.0%) since the European Cancer Anaemia Survey performed five years ago (AU)
Asunto(s)
Humanos , Masculino , Adulto , Persona de Mediana Edad , Anciano , Anemia/etiología , Anemia/terapia , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Anemia/complicaciones , Antineoplásicos/efectos adversos , Transfusión Sanguínea/métodos , Transfusión Sanguínea , Hematínicos/uso terapéutico , Oncología Médica/métodos , Calidad de Vida , Encuestas y Cuestionarios , España/epidemiologíaAsunto(s)
Obstrucción de las Vías Aéreas/terapia , Anestesiología/métodos , Guías de Práctica Clínica como Asunto , Obstrucción de las Vías Aéreas/diagnóstico , Algoritmos , Anestesiología/normas , Susceptibilidad a Enfermedades , Humanos , Intubación Intratraqueal/métodos , Máscaras Laríngeas , Laringoscopía , Valor Predictivo de las Pruebas , Respiración Artificial , VigiliaRESUMEN
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Asunto(s)
Humanos , Masculino , Femenino , Algoritmos , Valor Predictivo de las Pruebas , Respiración Artificial , Laringoscopía/tendencias , Laringoscopía , Anestesia/estadística & datos numéricos , Anestesia/tendencias , Intubación/métodos , Intubación/tendencias , Intubación Intratraqueal/tendenciasAsunto(s)
Dolor Abdominal/etiología , Clostridioides difficile , Enterocolitis Seudomembranosa/complicaciones , Norfloxacino/efectos adversos , Anciano , Infección Hospitalaria/tratamiento farmacológico , Diarrea/etiología , Enterocolitis Seudomembranosa/inducido químicamente , Enterocolitis Seudomembranosa/tratamiento farmacológico , Enterocolitis Seudomembranosa/patología , Femenino , Fiebre/etiología , Humanos , Metronidazol/uso terapéutico , Necrosis , Norfloxacino/uso terapéutico , Infecciones Urinarias/tratamiento farmacológicoRESUMEN
No disponible
Asunto(s)
Femenino , Anciano , Humanos , Dolor Abdominal/etiología , Clostridioides difficile , Enterocolitis Seudomembranosa/complicaciones , Norfloxacino/efectos adversos , Infección Hospitalaria/tratamiento farmacológico , Diarrea/etiología , Enterocolitis Seudomembranosa/inducido químicamente , Enterocolitis Seudomembranosa/tratamiento farmacológico , Enterocolitis Seudomembranosa/patología , Fiebre/etiología , Metronidazol/uso terapéutico , Necrosis , Norfloxacino/uso terapéutico , Infecciones Urinarias/tratamiento farmacológicoRESUMEN
BACKGROUND: The purpose of this study was to evaluate the tolerability and efficacy of BMS-184476, an analog of paclitaxel, in patients with advanced non-small-cell lung cancer (NSCLC) progressing or relapsing following at least one prior chemotherapy regimen. PATIENTS AND METHODS: Fifty-six previously treated advanced NSCLC patients received BMS-184476 at a dose of 60 mg/m(2) administered intravenously over 1 h every 21 days. RESULTS: The median number of cycles delivered per patient was five (range one to 17). Dose reduction was required in only 3.8% of cycles. Grade 4 neutropenia occurred in 19.6% of patients, but no grade 4 thrombocytopenia or anemia was reported. Febrile neutropenia was observed in only two (3.6%) patients and there were no life-threatening events. Grade 3/4 peripheral sensory-motor neuropathy was reported in 9% of patients. Other non-hematological toxicities, such as nausea and vomiting, myalgia and arthralgia, diarrhea, and mucositis, were uncommon. Partial responses were observed in eight (14.3%) patients and stable disease in 33 (58.9%). Median progression-free survival was 3.7 months [95% confidence interval (CI) 2.7-5.4] and median overall survival was 10 months (95% CI 6-13.4). CONCLUSIONS: BMS-184476 was well tolerated at the dose of 60 mg/m(2) and showed evidence of antitumor activity in previously treated NSCLC.