ABSTRACT
El cáncer colorrectal es una de las enfermedades oncológicas más frecuentes. Al principio, para los estadios clinicos IIb y IIIa se usaba 5FU/LV de manera adyuvante, con el advenimiento del oxaliplatino se comenzó a utilizar quimioterapia con esquema FOLFOX 4. El objetivo fue conocer si hubo mejoría en la supervivencia de pacientes que recibieron FOLFOX 4 vs. 5FU/LV. Se realizó un estudio de cohorte histórica mediante revisión de historias clínicas de pacientes con diagnóstico histopatológico de adenocarcinoma de colon estadio clínico II y III en el Hospital SOLCA- Quito, entre los años 2000-2013, tratados con esquema de quimioterapia 5FU/LV vs. FOLFOX 4. Se estudiaron 939 pacientes, de los cuales 177 cumplieron los criterios de inclusión, 69 (38%) recibieron esquema 5FU/LV y 108 (62%) recibieron FOLFOX 4. La supervivencia al primer año fue mayor con FOLFOX 4 (89.8%. IC 95%: 84.32-95.68) que con 5FU/LV (81.2%. IC 95%: 73.16 - 88.84). Sin embargo, no existió diferencia estadísticamente significativa entre ambos esquemas con respecto a la supervivencia durante el periodo estudiado a 13 años (3.169, p: 0.0751). En cuanto al riesgo de recaídas en enfermedad, se observó que FOLFOX 4 desarrolla menos riesgo (OR: 1.91. IC 95%: 0.9655-3.7734,p: 0.04367). No existe una ventaja terapéutica significativa en la adición de oxaliplatino al esquema 5FU/LV.
Colorectal cancer is one of the most frequent oncologicaldiseases. Initially for stages IIb -IIIa was used 5FU/LV asadjuvant way; with the advent of oxilaplatin began usingchemotherapy with FOLFOX 4 scheme. The objective wasto know if there was improvement in survival of patientswho received FOLFOX 4 vs. 5FU/LV. A historical cohort studywas conducted by reviewing medical records of patientswith histopathological diagnosis of colon adenocarcinomaclinical stage II and III at SOLCA Hospital - Quito, treatedwith scheme 5FU/LV vs. FOLFOX 4 chemotherapy betweenthe years 2000-2013. We studied 939 patients, of whom177 were included in the study, 69 (38%) received 5FU/LV and 108 (62%) received FOLFOX 4 scheme. Survivalto first year was higher with FOLFOX 4 (89.8%. CI 95%:84.32-95.68) than 5FU/LV. There is no statistically significantdifference between the two schemes with respect totheir survival during of 13 years periods studied (3.169, p:0.0751). However, with the diseases relapses, FOLFOX 4was better than 5FU/LV protocol and the patients developless relapses (OR: 1.91. CI 95%: 0.9655-3.7734, p: 0.04367).There is not a significant therapeutic benefit of addingoxaliplatin to 5FU/LV.
Subject(s)
Humans , Adenocarcinoma , Colorectal Neoplasms , Drug Therapy , Colon , Fluorouracil , LeucovorinABSTRACT
Cervical pregnancy is one of most rare form of ectopic pregancy in which the blastocyst implants within the cervical canal below the internal os of uterine cervix. Most cervical pregnancy result in early spontaneous abortion, complicated by severe hemorrhage frm the eroded blood vessels within the cervix. Because of fear of rofuse hemorrhage, abdominal hysterectomy has been historically considered the standard therapy. However, a number of new therapies have been aimed at uterine preservation, conservative treatment is highly desirable for young women who want to be pregnancy in the future. Methotrexate has been utilized recently for the successful management of tubal, interstitial, and cervical ectopic gestations. We report a case of a cervical preganncy that was successfully managed with methotrexate and leucovorine.