RESUMEN
PURPOSE: To evaluate the cosmetic outcome of breast conservative therapy and to examine the degree of agreement between the patients' and oncologists' ratings. We also analyze the influence of several factors on cosmesis. METHODS AND MATERIALS: We retrospectively evaluated 145 patients with primary breast cancer treated by local excision and radiotherapy between January 2000 and May 2001. Cosmetic outcome was evaluated by doctors and patients and was scored as excellent, good, fair or poor. RESULTS: 73% of patients rated cosmesis as excellent or good while the percentage was 71% when rated by radiation oncologists. The degree of cosmesis concordance evaluated by oncologists and patients was low (kappa = 0.3). In our study the variables which significantly influence on the cosmetic outcome were concomitant adjuvant chemotherapy (p = 0.04) and radiation therapy boost, either by electron beam or brachytherapy (p = 0.013). CONCLUSION: The cosmetic outcome of breast conserving therapy was good. There was a similar rating by the patient and radiation oncologist, but the level of concordance between patients and doctors was low. Factors that significantly influence the cosmesis appear to be concomitant adjuvant chemotherapy and radiation therapy boost.
Asunto(s)
Neoplasias de la Mama/cirugía , Estética , Mastectomía Segmentaria , Pacientes/psicología , Médicos/psicología , Oncología por Radiación , Radioterapia Adyuvante , Adulto , Anciano , Braquiterapia/psicología , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/psicología , Neoplasias de la Mama/radioterapia , Quimioterapia Adyuvante , Radioisótopos de Cobalto , Terapia Combinada , Femenino , Humanos , Mastectomía Segmentaria/psicología , Persona de Mediana Edad , Aceptación de la Atención de Salud/estadística & datos numéricos , Fotones , Teleterapia por Radioisótopo/psicología , Radioterapia Adyuvante/psicología , Radioterapia de Alta Energía/psicología , Estudios RetrospectivosRESUMEN
Eighty-five patients with small cell lung cancer (limited disease = LD in 39, extensive disease = ED in 46) received the combination of cyclophosphamide, methotrexate, vincristine and CCNU, and mediastinal radiotherapy given simultaneously after the third course of chemotherapy. The duration of treatment was approximately 12 months. A complete response was obtained in 41% of LD and in 15% of ED patients, and a partial response in 38 and 22%, respectively. Median survival was 55 weeks for LD and 37 weeks for ED patients. Two patients (5%) with LD have survived free of disease more than 3 years since their diagnosis.
Asunto(s)
Carcinoma de Células Pequeñas/terapia , Neoplasias Pulmonares/terapia , Mediastino/efectos de la radiación , Carcinoma de Células Pequeñas/mortalidad , Terapia Combinada , Humanos , Neoplasias Pulmonares/mortalidad , Factores de TiempoRESUMEN
In order to know the behavior of the tissue polypeptide antigen (TPA) as a tumor marker, the authors determine its amount in serum by means of radioimmunoassay (TPA Prolifigen RIA) in 441 patients having respiratory, digestive, urogenital, hematopoietic, mammary and other malignant tumors. The obtained results indicate that: TPA has no tumor specificity; however it increases in tumors without any other known tumor marker. TPA has no diagnostic value, but it is useful for the following up of digestive, mammary, respiratory, ovarian and testicular cancer; amounts of TPA comprised between 90 and 120 U/l are not specific and have no clinical significance; and it is very useful the simultaneous determination of CEA and TPA in the respiratory, digestive and mammary malignant neoplasms to help the clinical data in the evaluation of tumor mass (CEA) and tumor activity (TPA) without indication of tumor localization.
Asunto(s)
Antígenos de Neoplasias/análisis , Neoplasias/inmunología , Péptidos/análisis , Adulto , Antígeno Carcinoembrionario/análisis , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radioinmunoensayo , Valores de Referencia , Antígeno Polipéptido de TejidoRESUMEN
Creatine kinase B (CK-B) was evaluated as a tumor marker by radioimmunoassay determination of the isoenzyme in 518 persons (control group, malignant tumors, and several other diseases). Amounts higher than 8 ng/ml (upper normal limit) was observed in 12.6 per 100 of the digestive tumors, 6.1 per 100 of the mammary tumors, 37.7 per 100 of the respiratory tumors, and 22.2 per 100 of the prostatic tumors. A relation exists between CK-B and sigmoid flexure, liver, pancreas and esophagus tumors, between CK-B and acid phosphatase in prostate tumors, and between CK-B and evolution of digestive tumor. The determination of CK-B is useful in the case of tumors lacking known tumor markers, and also as a complementary sign in the diagnosis and evolution of sigmoid flexure and prostate neoplasms.
Asunto(s)
Creatina Quinasa/sangre , Proteínas de Neoplasias/sangre , Neoplasias/enzimología , Adolescente , Adulto , Pruebas Enzimáticas Clínicas , Femenino , Humanos , Isoenzimas , Masculino , Persona de Mediana Edad , Neoplasias/diagnósticoRESUMEN
The pregnancy specific beta-1-glycoprotein (SP1) was measured by radioimmunoassay in 854 persons (control group 103, non-tumoral diseases 212, germinal tumors 30, and non-germinal tumors 509). Amounts higher than 2.5 ng/ml (upper normal limit) were observed in 35 cases with non tumoral diseases (specially chronic liver diseases), 97 of the non-germinal tumors (specially mammary, respiratory and digestive tumors), and 10 of the germinal tumors (pure and mixed choriocarcinomas, and embryonic carcinoma with yolk sac component). SP1 rarely is higher than 5 ng/ml in non-tumoral diseases and non-germinal tumors, while it is higher than 5 ng/ml in germinal tumors. SP1 is a good marker for trophoblastic neoplasms and shows a correlation with HCG-beta.