Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer

Germ cell tumors present contrasting biological and molecular features compared to many solid tumors, which may partially explain their unusual sensitivity to chemotherapy. Reduced DNA repair capacity and enhanced induction of apoptosis appear to be key factors in the sensitivity of germ cell tumors to cisplatin. Despite substantial cure rates, some patients relapse and subsequently die of their disease. Intensive doses of chemotherapy are used to counter mechanisms of drug resistance. So far, high-dose chemotherapy with hematopoietic stem cell support for solid tumors is used only in the setting of testicular germ cell tumors. In that indication, high-dose chemotherapy is given as the first or late salvage treatment for patients with either relapsed or progressive tumors after initial conventional salvage chemotherapy. High-dose chemotherapy is usually given as two or three sequential cycles using carboplatin and etoposide with or without ifosfamide. The administration of intensive therapy carries significant side effects and can only be efficiently and safely conducted in specialized referral centers to assure optimum patient care outcomes. In breast and ovarian cancer, most studies have demonstrated improvement in progression-free survival (PFS), but overall survival remained unchanged. Therefore, most of these approaches have been dropped. In germ cell tumors, clinical trials are currently investigating novel therapeutic combinations and active treatments. In particular, the integration of targeted therapies constitutes an important area of research for patients with a poor prognosis.

Algunos aspectos histopatologicos de la endoftalmitis y panoftalmitis. / Some histopathologic aspects of endophtalmitis and panophtalmitis

Se estudiaron algunos aspectos hispatologicos de la endotalmitis y panoftalmitis.Se revisaron 50 especimenes de la seccion de patologia oftalmica del Intituto de Anatomia Patologica de la Facultad de Medicina de la U.C.V. Obervamos que el sexo masculino fue el mas afectado, que la infiltracion celular del tipo cronico fue la regla en las estructuras oculares y en las diferentes entidades clinicas estudiadas y el tejido uveal presento las lesiones mas severas. Recalcamos la conveniencia del tratamiento precoz a fin de evitar secuelas que van a comprometer la vision

Lesiones retinianas perifericas en una muestra de la poblacion general. / Peripheric retinal lesions in a sample of general population

Se revisaron 100 personass escogidas al azar sin antecedentes de patologia retiniana, encontrandose 56 pacientes con lesiones retinianas perifericas, de las cuales 60% eran bilaterales. La degeneracion retiniana mas frecuencia fue la reticular, con un 25% y 68% de bilateralidad. Las menos frecuentes: Nevus de coroides y Atrofia corioretinal focal, con 5%. De acuerdo a los resultados vemos la necesidad de revisar exhaustivamente periferica en busca de degeneraciones retinianas