RESUMEN
Background/objectives The incidence of pancreatic cancer is increasing in developed countries. The incorporation of new therapies, to the first-line treatment of patients with good performance status led to better survival in clinical trials. However, there is a wide variability in their use and some concerns about the treatment of elderly patients who were not included in the clinical trials. Methods This is a retrospective multicenter study. Data from consecutive patients diagnosed with metastatic pancreatic cancer (mPC) treated with FOLFIRINOX (FFX) or gemcitabine plus nab-paclitaxel (GnP) were analysed to evaluate efficacy (overall survivalOS) and toxicity. Results A total of 119 patients were included. 49.6% were treated with FFX and 50.4% with GNP in first-line. The median OS was 12 months with no statistically significant differences between both regimens (12.7 m for FFX vs 10.2 m for GnP). Elevated Ca 19.9 levels and neutrophillymphocyte ratio (NLR) increased the risk of death. Patients who received both regimens in first/second line had a median OS longer than 15 months whichever the sequence. 32 patients (27%) were older than 70-y. 54% patients received a second-line treatment, 56% in the FFX group and 44% in the GnP group. The median OS for patients older than 70 was 9.5 m versus 12.3 m for patients younger than 70. Progression of the disease was the cause of death in 67.6% of the patients. Conclusions In our setting, the use of FFX and GnP for treating mPC is quite similar, but superiority could not be demonstrated for any of the schemes in the first line. OS was determined by basal levels of Ca 19.9 and NLR. Patients receiving both regimens in first/second line whichever the sequence, exhibited the best survival rates. In our series, elderly patients had poorer survival rates (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica , Desoxicitidina/uso terapéutico , Fluorouracilo/uso terapéutico , Irinotecán/uso terapéutico , Leucovorina/uso terapéutico , Paclitaxel/uso terapéutico , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias Pancreáticas/secundario , Análisis de Supervivencia , Resultado del Tratamiento , Estudios RetrospectivosRESUMEN
BACKGROUND/OBJECTIVES: The incidence of pancreatic cancer is increasing in developed countries. The incorporation of new therapies, to the first-line treatment of patients with good performance status led to better survival in clinical trials. However, there is a wide variability in their use and some concerns about the treatment of elderly patients who were not included in the clinical trials. METHODS: This is a retrospective multicenter study. Data from consecutive patients diagnosed with metastatic pancreatic cancer (mPC) treated with FOLFIRINOX (FFX) or gemcitabine plus nab-paclitaxel (GnP) were analysed to evaluate efficacy (overall survival-OS) and toxicity. RESULTS: A total of 119 patients were included. 49.6% were treated with FFX and 50.4% with GNP in first-line. The median OS was 12 months with no statistically significant differences between both regimens (12.7 m for FFX vs 10.2 m for GnP). Elevated Ca 19.9 levels and neutrophil-lymphocyte ratio (NLR) increased the risk of death. Patients who received both regimens in first/second line had a median OS longer than 15 months whichever the sequence. 32 patients (27%) were older than 70-y. 54% patients received a second-line treatment, 56% in the FFX group and 44% in the GnP group. The median OS for patients older than 70 was 9.5 m versus 12.3 m for patients younger than 70. Progression of the disease was the cause of death in 67.6% of the patients. CONCLUSIONS: In our setting, the use of FFX and GnP for treating mPC is quite similar, but superiority could not be demonstrated for any of the schemes in the first line. OS was determined by basal levels of Ca 19.9 and NLR. Patients receiving both regimens in first/second line whichever the sequence, exhibited the best survival rates. In our series, elderly patients had poorer survival rates.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Desoxicitidina/análogos & derivados , Paclitaxel/uso terapéutico , Neoplasias Pancreáticas/tratamiento farmacológico , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Causas de Muerte , Desoxicitidina/efectos adversos , Desoxicitidina/uso terapéutico , Progresión de la Enfermedad , Femenino , Fluorouracilo/efectos adversos , Fluorouracilo/uso terapéutico , Humanos , Irinotecán/efectos adversos , Irinotecán/uso terapéutico , Leucovorina/efectos adversos , Leucovorina/uso terapéutico , Masculino , Persona de Mediana Edad , Oxaliplatino/efectos adversos , Oxaliplatino/uso terapéutico , Paclitaxel/efectos adversos , Neoplasias Pancreáticas/mortalidad , Neoplasias Pancreáticas/patología , Estudios Retrospectivos , Tasa de Supervivencia , GemcitabinaRESUMEN
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Asunto(s)
Masculino , Humanos , Deficiencia de Magnesio/etiología , Hipocalcemia/etiología , Anticuerpos Monoclonales/efectos adversos , Neoplasias Colorrectales/tratamiento farmacológicoRESUMEN
- Propósitos: El cáncer de mama en el varón es una patología muy poco frecuente. Debido a ello, casi todos los trabajos al respecto son retrospectivos y en general son series pequeñas. En el presente trabajo se describe una serie retrospectiva de casos, comparándolos con la literatura y viendo cómo ha cambiado a lo largo de 40 años.- Métodos: Se ha analizado una serie de 68 varones con cáncer de mama estudiados y tratados en el Hospital Gregorio Marañón en los periodos comprendidos entre los años 1963-1981, 19821988 y 1989-2001.- Resultados: En los últimos años ha cambiado el tratamiento del cáncer de mama en el varón, siendo casi constante la administración de radioterapia y quimioterapia adyuvante e incluso de hormonoterapia. En este sentido es llamativa la elevada positividad de receptores hormonales en estos pacientes.- Conclusiones: Es difícil extraer conclusiones debido el escaso número de casos y a la diferencia en cuanto a tratamientos. Sin embargo, ahora que se va homogeneizando el tratamiento del cáncer de mama en el varón se podrán comparar mejor tanto la supervivencia como otras características de estos pacientes (AU)
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Adulto , Anciano , Masculino , Persona de Mediana Edad , Humanos , Neoplasias de la Mama Masculina/epidemiología , Estudios Retrospectivos , Neoplasias de la Mama Masculina/terapiaRESUMEN
INTRODUCTION: Jaundice in Hodgkin's disease can be due to several causes. Ductal lesions and ductopenia, which we describe below, have rarely been reported. CASE REPORT: We describe 2 cases of idiopathic cholestasis associated with Hodgkin's disease in which duction lesions and ductopenia were found. In one case, the ductal lesion progressed to ductopenia and the patient died from complications of her oncological disease while in the second case, outcome was favorable with improvement of cholestasis and remission of Hodgkin's lymphoma. DISCUSSION: Ductopenia should be included in the differential diagnosis of cholestasis associated with Hodgkin's disease, for which a high degree of suspicion is required. Hodgkin's disease should be suspected when ductopenia is found.