RESUMEN
BACKGROUND: Retrospective analysis of 70 patients with Hodgkin's disease (HD) and treated consecutively in our center between 1979 and 1993. PATIENTS AND METHODS: All ganglionar biopsies were reviewed and finally 60 patients were selected: 43 males and 17 females with a median age of 39 years (12-79) and the following features: 55% III-IV stages, 25% extranodal involvement, 32% bulky mediastinum and 57% B-symptoms. Scheme of treatment: Only radiotherapy in 9 patients with localized stages and no adverse factors; only chemotherapy in 25 with advanced stages and combined therapy in 15 with localized stages and any adverse factor and in 7 with advanced stage and bulky disease. Chemotherapy was mainly based on MOPP until 1987 and MOPP/ABVD afterwards. Only four patients did not follow this scheme: 2 due to progression, 1 due to toxicity and 1 due to medical decision. RESULTS: Fifty patients achieved complete remission (CR), 2 partial and 8 minimal response or progression under therapy. Eleven patients have died: 6 due to HD, 4 of second neoplasias and 1 of an opportunistic infection. With a median follow-up for surviving patients of 4.8 years (1-2), the estimated overall survival at 8 years is 67.7% (SD 9%), tumor mortality 82.6% (SD 7%) and progression free survival 66.7% (SD 7%). Disease free survival for CR patients is 78.4% (SD 9%). Response to treatment was the only factor significantly associated with survival (p = 0.0001). The estimated survival for CR patients who relapsed is 92.3% versus 28% for those who did not obtain a CR (p = 0.0001). CONCLUSION: In our experience, first line therapy adjusted to clinical features at diagnosis has good results. Response to treatment has been the determinant factor for survival, mostly because salvage treatments, including high-dose chemotherapy approaches, have been of little effectiveness.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Enfermedad de Hodgkin/epidemiología , Adolescente , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Bleomicina/administración & dosificación , Bleomicina/efectos adversos , Niño , Terapia Combinada , Dacarbazina/administración & dosificación , Dacarbazina/efectos adversos , Supervivencia sin Enfermedad , Doxorrubicina/administración & dosificación , Doxorrubicina/efectos adversos , Femenino , Enfermedad de Hodgkin/tratamiento farmacológico , Enfermedad de Hodgkin/patología , Enfermedad de Hodgkin/radioterapia , Humanos , Tablas de Vida , Masculino , Mecloretamina/administración & dosificación , Mecloretamina/efectos adversos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/epidemiología , Neoplasias Primarias Secundarias/epidemiología , Neoplasias Primarias Secundarias/etiología , Prednisona/administración & dosificación , Prednisona/efectos adversos , Procarbazina/administración & dosificación , Procarbazina/efectos adversos , Teleterapia por Radioisótopo/efectos adversos , Inducción de Remisión , Estudios Retrospectivos , Terapia Recuperativa , España/epidemiología , Tasa de Supervivencia , Resultado del Tratamiento , Vinblastina/administración & dosificación , Vinblastina/efectos adversos , Vincristina/administración & dosificación , Vincristina/efectos adversosRESUMEN
Two types of benzodiazepine dependence have been described: high vs. therapeutic dose dependence. So far, no systematic research has been conducted regarding the frequency with which the various benzodiazepines are represented in one type or the other. In this study, 153 dependent patients using 14 different benzodiazepines were evaluated to assess the prevalence of their use among high vs. therapeutic dose dependents. Triazolam was the single drug most frequently used by high-dose dependents, followed by Lorazepam. No significant differences were found among benzodiazepines regarding their use by therapeutic dose dependents. Our data shows that pharmacokinetic and pharmacodynamic factors appear to be related to the frequency with which the different benzodiazepines are used by high and therapeutic dose dependents.