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1.
Article in English | WPRIM | ID: wpr-880619

ABSTRACT

OBJECTIVES@#Neoadjuvant chemotherapy combined with radical surgery has become the treatment model for locally advanced rectal cancer. The purpose of this study was to evaluate the safety and efficacy of postoperative mFOLFOX6 regimen chemotherapy for locally resectable advanced rectal cancer.@*METHODS@#This was a prospective study. A total of 82 patients with locally advanced rectal cancer admitted to Affiliated Nanhua Hospital, University of South China from February 2015 to December 2017 were selected as the subjects. The patients received 4 courses of mFOLFOX6 chemotherapy and underwent surgery within 4-6 weeks after chemotherapy. The incidences of chemotherapy-related adverse reactions, postoperative complications, and clinical pathological reactions were analyzed.@*RESULTS@#In the period from mFOLFOX6 chemotherapy to preoperative, 82 patients with locally advanced rectal cancer was reported chemotherapy-related adverse reactions, including Grade 4 neutropenia (2.4%), catheter related infection (2.4%), and anorexia (2.4%), Grade 3 nausea (2.4%) and anorexia (2.4%), Grade 2 neutropenia (14.6%) and peripheral neuropathy (7.3%). Finally, 76 patients with locally advanced rectal cancer completed surgery, including 56 (73.7%) with anterior rectum resection, 16 (21.1%) with abdominal perineal resection, and 72 (94.7%) with pelvic nerve preservation. A total of 22 (28.9%) patients had surgical complications, including 8 (10.5%) with complications of Grade 3 or above. The complications with high incidence were intestinal obstruction, anastomotic leakage, and sepsis. Among the 76 patients who completed chemotherapy and surgery, T stage was decreased in 28 (36.8%) and N stage was decreased in 44 (57.9%); forty-two (55.3%) were in pathological Stage I, 20 (26.3%) in Stage IIA, 12 (15.8%) in Stage IIB, and 2 (2.6%) in Stage IIIA. Ten patients were suspected of tumor invasion of surrounding organs before chemotherapy, of which 4 patients did not need to extend the resection of surrounding organs after chemotherapy and achieved R0 resection of tumor; 2 in T@*CONCLUSIONS@#Preoperative mFOLFOX6 regimen chemotherapy for locally resectable advanced rectal cancer is a safe and feasible treatment strategy, and it is worthy of clinical application.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , China , Fluorouracil/adverse effects , Humans , Neoadjuvant Therapy , Neoplasm Staging , Prospective Studies , Rectal Neoplasms/surgery , Treatment Outcome
2.
Article in English | WPRIM | ID: wpr-880600

ABSTRACT

OBJECTIVES@#To observe the efficacy and adverse reactions of the combination of endostar with chemotherapy in the treatment of advanced (IVb) and recurrent metastatic cervical cancer.@*METHODS@#Forty-four patients with recurrent and metastatic cervical cancer, who were admitted to the Second Xiangya Hospital, Central South University from December 2016 to December 2018 were randomly divided into an experimental group and a control group (22 cases in each group). The control group was given gemcitabine plus cisplatin (GP) or docetaxel plus cisplatin (DP) treatment, the experimental group was treated with endostar on the basis of the control group.@*RESULTS@#The objective response rate (ORR) was 42.9% in the experimental group and 22.7% in the control group. There was no significant difference between the 2 groups (@*CONCLUSIONS@#Compared with chemotherapy alone, endostar combined with chemotherapy can prolong the median progression-free survival, with higher ORR and similar adverse reactions.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Cisplatin/therapeutic use , Endostatins , Female , Humans , Lung Neoplasms/pathology , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Recombinant Proteins , Uterine Cervical Neoplasms
3.
Medwave ; 20(7): e8010, 2020.
Article in English, Spanish | LILACS | ID: biblio-1122665

ABSTRACT

Las terapias target constituyen hoy en día una alternativa terapéutica cada vez más utilizada para el manejo de pacientes con melanoma metastásico. Sin embargo, se han descrito múltiples efectos farmacológicos adversos asociados a su uso, siendo los cutáneos los de mayor prevalencia. Se presenta el caso de un hombre de 55 años con diagnóstico de melanoma cutáneo metastásico etapa IV, BRAFV600E mutado, en tratamiento con dabrafenib/trametinib que consultó por desarrollo de lesiones nodulares eritematosas sensibles en extremidades superiores e inferiores, asociadas a sensación febril durante el curso del tratamiento. Se descartó alguna infección sobreagregada. Se realizó una biopsia de las lesiones cutáneas, con confirmación diagnóstica histopatológica de una paniculitis mixta de predominio septal, granulomatosa y con vasculitis leucocitoclástica. La paniculitis asociada a esta terapia ha sido descrita en la literatura y se ha considerado un efecto farmacológico inmunomediado adverso, relacionándose a un mejor pronóstico para el melanoma metastásico en tratamiento. Por lo tanto, así como en el caso presentado, se evita la suspensión del fármaco y se asocia terapia sintomática en caso de mayores molestias del paciente. Es de alta relevancia para el dermatólogo conocer e interpretar adecuadamente este efecto adverso farmacológico, y así indicar el manejo más adecuado para el paciente.


Target therapies are currently a therapeutic option increasingly used for the management of patients with metastatic melanoma. However, there are multiple adverse pharmacological effects associated with their use that have been described. Cutaneous adverse reactions are the most frequent. We report the case of a 55-year-old man with a diagnosis of stage IV BRAFV600E-mutated metastatic cutaneous melanoma undergoing treatment with dabrafenib/trametinib, who consulted due to the development of erythematous nodular lesions in the upper and lower limbs associated with febrile sensation during the course of treatment. Infection was ruled out and a biopsy of the skin lesions was done, which provided the histopathological confirmation of a predominantly septal, granulomatous with leukocytoclastic vasculitis, mixed panniculitis. Panniculitis associated with this therapy has been described in the literature and has been considered an immune-mediated pharmacological adverse effect. It is considered to be related to a better prognosis in the treatment of metastatic melanoma. Consequently, as shown in this case report, target therapy should not be discontinued and symptomatic medication should be given to alleviate patient discomfort. The dermatologist should know and properly interpret this adverse effect and prescribe the most appropriate management for the patient.


Subject(s)
Humans , Male , Middle Aged , Panniculitis/chemically induced , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Molecular Targeted Therapy/methods , Oximes/administration & dosage , Pyridones/administration & dosage , Pyrimidinones/administration & dosage , Skin Neoplasms/drug therapy , Panniculitis/diagnosis , Panniculitis/therapy , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Molecular Targeted Therapy/adverse effects , Dermatologists , Imidazoles/administration & dosage , Melanoma/drug therapy
4.
Int. braz. j. urol ; 45(2): 332-339, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002209

ABSTRACT

ABSTRACT Purpose: To explore the potential association between renal mass characteristics and a history of chemotherapy. Materials and methods: A retrospective review of records of patients surgically treated for a localized renal mass between 2000 and 2012 was undertaken following an institutional review board approval. Patients age and sex, renal mass clinical characteristics (radiological size and mode of presentation) and pathological characteristics (diagnosis, renal cell carcinoma subtype, Fuhrman grade and stage) were compared between patients with and without a history of chemotherapy, using Fisher's exact test, Student's t-test and Wilcoxon rank sum test. A multivariate logistic analysis was performed to evaluate the independent association of chemotherapy and tumor pathology. Results: Of the 1,038 eligible patients, 33 (3%) had a history of chemotherapy. The distribution of clinical stage, renal mass diagnosis, renal cell carcinoma subtype, Fuhrman grade, pathological stage, sex and median age were similar between the general population and the chemotherapy group. However, the latter had a higher rate of incidental presentation (P = 0.003) and a significantly smaller median radiological tumor size (P = 0.01). In a subset analysis of T1a renal cell carcinoma, the chemotherapy group presented an increased rate of high Fuhrman grade (P = 0.03). On multivariate analysis adjusted for radiological tumor size, sex and age the chemotherapy cohort had a 3.92 higher odds for high Fuhrman grade. Conclusion: Patients with a history of chemotherapy typically present with smaller renal masses that, if malignant, have higher odds of harboring a high Fuhrman grade and thus may not be suitable for active surveillance.


Subject(s)
Humans , Male , Female , Adult , Aged , Carcinoma, Renal Cell/pathology , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Kidney/pathology , Kidney Neoplasms/pathology , Carcinoma, Renal Cell/surgery , Carcinoma, Renal Cell/drug therapy , Survival Analysis , Retrospective Studies , Cohort Studies , Follow-Up Studies , Kidney/surgery , Kidney Neoplasms/surgery , Kidney Neoplasms/drug therapy , Middle Aged , Neoplasm Staging
5.
Rev. Assoc. Med. Bras. (1992) ; 64(3): 230-233, Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-896447

ABSTRACT

Summary Objective: The current study aimed to investigate the clinical efficacy of paclitaxel combined with avastin for non-small cell lung cancer (NSCLC) patients diagnosed with malignant pleural effusion (MPE). Method: Total of 33 patients diagnosed with NSCLC as well as malignant pleural effusion were included. All of them received paclitaxel (175 mg/m2) and avastin (5 mg/kg). Clinical efficacy was evaluated using the total response rate, overall survival, progression-free survival and changes in MPE volume. Adverse events and rates of toxicities were examined as well. Results: The total response rate reached 77% while the overall survival and the median progression-free survival were respectively 22.2 months and 8.4 months. Toxicities of grade 3-4 consisted of neutropenia in 57% of patients, anemia in 17% of them, febrile neutropenia in 11%, as well as anorexia in 7%. No treatment-correlated deaths were found. Conclusion: Paclitaxel combined with avastin decreased MPE volume and increased survival rate of NSCLC patients via inhibiting vascular endothelial growth factor expression.


Subject(s)
Humans , Male , Female , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Paclitaxel/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Angiogenesis Inhibitors/therapeutic use , Bevacizumab/therapeutic use , Lung Neoplasms/drug therapy , Antineoplastic Agents, Phytogenic/therapeutic use , Quality of Life , Safety , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Survival Analysis , Pleural Effusion, Malignant/drug therapy , Treatment Outcome , Paclitaxel/adverse effects , Disease-Free Survival , Angiogenesis Inhibitors/adverse effects , Bevacizumab/adverse effects , Middle Aged , Antineoplastic Agents, Phytogenic/adverse effects
6.
Einstein (Säo Paulo) ; 16(1): eRW4007, 2018. tab, graf
Article in English | LILACS | ID: biblio-891455

ABSTRACT

ABSTRACT This review aimed to analyze the scientific production on severity of oral mucositis as an adverse effect of chemotherapy. To this end, we performed a search at PubMed databases combining the keywords "oral mucositis" and "chemotherapy protocol". To describe the investigation, the following variables were considered: journal, year/place, study design, sample, protocol used and incidence of oral mucositis. A total of 547 articles were retrieved, of which 26 were selected. Out of these 26, only 2 reported severity of oral mucositis; the others only reported the presence of the condition. Protocols for treating different types of carcinoma were evaluated in 16 (61.53%) studies, for hematological malignancies in 6 (23.07%), and for hematopoietic stem cell transplantation in 4 (15.4%). Protocols for hematopoietic stem cell transplantation entail a high risk for oral mucositis, just as chemotherapy with cytarabine and high-dose 5-fluorouracil, alkylating agents and platinumbased compounds. To provide the best prevention and treatment for oral mucositis, it is essential to know the chemotherapy protocols used and their effects on the oral cavity.


RESUMO Esta revisão teve como objetivo analisar a produção científica sobre a gravidade da mucosite oral como efeito adverso da quimioterapia. Para tal, nos bancos de dados do PubMed, foi realizada uma busca com a associação dos descritores "oral mucositis" com "chemotherapy protocol". Para descrição da investigação, foram consideradas como variáveis: periódico, ano/local, delineamento da pesquisa, amostra, protocolo utilizado e incidência de mucosite oral. Foram analisados 547 artigos e, destes, 26 foram selecionados. Destes 26, apenas 2 tinham como objetivo avaliar a gravidade de mucosite oral; nos outros, a mucosite oral foi apenas relatada. Protocolos para tratamento de diferentes tipos de carcinoma foram avaliados em 16 (61,53%) estudos, para neoplasias hematológicas, em 6 (23,07%), e para transplante de células tronco hematopoiéticas em 4 (15,4%). Protocolos para transplante de células tronco hematopoiéticas são de alto risco para o desenvolvimento de mucosite oral, da mesma forma que os quimioterápicos citarabina e 5-fluorouracil em altas doses, agentes alquilantes e compostos derivados da platina. A fim de oferecer prevenção e tratamento mais adequados para mucosite oral, é imprescindível que se conheçam os protocolos quimioterápicos utilizados e seus efeitos sobre a cavidade oral.


Subject(s)
Humans , Stomatitis/chemically induced , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Agents/adverse effects
9.
Arq. bras. cardiol ; 107(5): 411-419, Nov. 2016. tab, graf
Article in English | LILACS | ID: biblio-827867

ABSTRACT

Abstract Background: Atrial electromechanical delay (EMD) is used to predict atrial fibrillation, measured by echocardiography. Objectives: The aim of this study was to assess atrial EMD and mechanical function after anthracycline-containing chemotherapy. Methods: Fifty-three patients with breast cancer (48 ± 8 years old) who received 240 mg/m2of Adriamycin, 2400 mg/m2 of cyclophosphamide, and 960 mg/m2 of paclitaxel were included in this retrospective study, as were 42 healthy subjects (47 ± 9 years old). Echocardiographic measurements were performed 11 ± 7 months (median 9 months) after treatment with anthracyclines. Results: Left intra-atrial EMD (11.4 ± 6.0 vs. 8.1 ± 4.9, p=0.008) and inter-atrial EMD (19.7 ± 7.4 vs. 14.7 ± 6.5, p=0.001) were prolonged; LA passive emptying volume and fraction were decreased (p=0.0001 and p=0.0001); LA active emptying volume and fraction were increased (p=0.0001 and p=0.0001); Mitral A velocity (0.8 ± 0.2 vs. 0.6 ± 0.2, p=0.0001) and mitral E-wave deceleration time (201.2 ± 35.6 vs. 163.7 ± 21.8, p=0.0001) were increased; Mitral E/A ratio (1.0 ± 0.3 vs. 1.3 ± 0.3, p=0.0001) and mitral Em (0.09 ± 0.03 vs. 0.11 ± 0.03, p=0.001) were decreased; Mitral Am (0.11 ± 0.02 vs. 0.09 ± 0.02, p=0.0001) and mitral E/Em ratio (8.8 ± 3.2 vs. 7.6 ± 2.6, p=0.017) were increased in the patients. Conclusions: In patients with breast cancer after anthracycline therapy: Left intra-atrial, inter-atrial electromechanical intervals were prolonged. Diastolic function was impaired. Impaired left ventricular relaxation and left atrial electrical conduction could be contributing to the development of atrial arrhythmias.


Resumo Fundamento: Atraso eletromecânico atrial (AEA) é utilizado para prever fibrilação atrial, medido pela ecocardiografia. Objetivos: O propósito deste estudo era verificar o AEA e a função mecânica após quimioterapia com antraciclinas. Métodos: Cinquenta e três pacientes com câncer de mama (48 ± 8 anos) que receberam 240 mg/m2 de adriamicina, 2400 mg/m2 de ciclofosfamida, e 960 mg/m2 de paclitaxel foram incluídas neste estudo retrospectivo, além de 42 indivíduos saudáveis (47 ± 9 anos). Medidas ecocardiográficas foram realizadas por aproximadamente 11 ± 7 meses (média de 9 meses) após tratamento com antraciclinas. Resultados: AEA esquerdo intra-atrial (11,4 ± 6,0 vs. 8,1 ± 4,9, p=0,008) e AEA interarterial (19,7 ± 7,4 vs. 14,7 ± 6,5, p=0,001) foram prolongados; Volume de esvaziamento passivo e fracionamento de AE diminuíram (p=0,0001 e p=0,0001); Volume de esvaziamento ativo e fracionamento de AE (p=0,0001 e p=0,0001); Tempo de aceleração mitral A (0,8 ± 0,2 vs. 0,6 ± 0,2, p=0,0001) e de desaceleração de onda-E mitral (201,2 ± 35,6 vs. 163,7 ± 21,8, p=0,0001) aumentarão; Razão mitral E/A (1,0 ± 0,3 vs. 1,3 ± 0,3, p=0,0001) e mitral Em (0,09 ± 0,03 vs. 0,11 ± 0,03, p=0,001) diminuíram; Razão mitral Am (0,11 ± 0,02 vs. 0,09 ± 0,02, p=0,0001) e mitral E/Em (8,8 ± 3,2 vs. 7,6 ± 2,6, p=0,017) aumentaram nos pacientes. Conclusões: Em pacientes com câncer de mama após terapia com antraciclina: intervalos eletromecânicos intra-atriais esquerdos, intra-atriais foram prolongados. A função diastólica foi prejudicada. O relaxamento ventricular esquerdo foi prejudicado, e a condução elétrica atrial esquerda pode estar contribuindo para o desenvolvimento de arritmias atriais.


Subject(s)
Humans , Female , Adult , Middle Aged , Arrhythmias, Cardiac/etiology , Breast Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Ventricular Function, Left/physiology , Anthracyclines/adverse effects , Atrial Fibrillation/etiology , Atrial Fibrillation/physiopathology , Systole , Blood Pressure/physiology , Echocardiography , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Predictive Value of Tests , Retrospective Studies , Paclitaxel/administration & dosage , Paclitaxel/adverse effects , Ventricular Dysfunction, Left/physiopathology , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Diastole
10.
Rev. enferm. UERJ ; 24(5): e15577, set./out. 2016. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-948045

ABSTRACT

Objetivo: identificar os sintomas mais prevalentes durante o tratamento quimioterápico em mulheres com câncer de mama. Método: trata-se de um estudo descritivo, prospectivo e com abordagem quantitativa, constituído por 15 mulheres avaliadas no dia da infusão e semanalmente via telefone. A pesquisa ocorreu no período de março a dezembro de 2014 numa central de quimioterapia no Rio de Janeiro. O projeto foi aprovado pelo Comitê de Ética em Pesquisa, número do parecer: 544.459 e Certificado de Apresentação para Apreciação Ética: 26054613.5.0000.5285. Resultado: os sintomas mais frequentes foram alteração do paladar, ansiedade, artralgia, fadiga, inapetência, mialgia e náusea. Conclusão: a identificação dos sintomas mais prevalentes, em determinados momentos do tratamento quimioterápico, permite ao enfermeiro otimizar as orientações sobre os efeitos adversos. Intervenções mais precisas no cuidado, considerando as diversas drogas empregadas e a multiplicidade de sintomas, favorecem a adesão ao tratamento, na medida em que contribuem para a manutenção do bem-estar das pacientes.


Objective: to identify the most prevalent symptoms during chemotherapy treatment of women with breast cancer. Method: this quantitative, descriptive, prospective study evaluated 15 women on day of infusion, and then weekly by telephone, between March and December 2014, at a chemotherapy center in Rio de Janeiro. The project was approved by the research ethics committee (opinion number: 544,459 and Certificate of Presentation for Ethical Evaluation: 26054613.5.0000.5285). Result: the most frequent symptoms were altered taste, anxiety, arthralgia, fatigue, inappetence, myalgia and nausea. Conclusion: identification of the symptoms most prevalent at certain times of chemotherapy treatment allows nurses to optimize guidelines on adverse effects. More precise care interventions, considering the various drugs employed and the multiple symptoms, favor adherence to treatment in that they contribute to maintenance of patient wellbeing.


Objetivo: identificar los síntomas más prevalentes durante la quimioterapia en mujeres con cáncer de mama. Método: Se trata de un estudio descriptivo, con enfoque prospectivo y cuantitativo, constituido por 15 mujeres evaluadas en el día de la infusión y de forma semanal por vía telefónica. La encuesta se llevó a cabo entre marzo y diciembre de 2014 en un centro de quimioterapia en Río de Janeiro. El proyecto fue aprobado por el Comité de Ética de Investigación, número de dictamen: 544459 y Certificado de Presentación para Apreciación Ética: 26054613.5.0000.5285. Resultados: los síntomas más frecuentes fueron la alteración de gustos, la ansiedad, artralgias, fatiga, pérdida de apetito, mialgias y náuseas. Conclusión: la identificación de los síntomas más prevalentes, en determinados momentos de la quimioterapia, le permite al enfermero optimizar las directrices sobre los efectos adversos. Intervenciones más precisas en la atención, teniendo en cuenta los diversos fármacos utilizados y la multiplicidad de síntomas, favorecen la adherencia al tratamiento, ya que contribuyen a mantener el bienestar de los pacientes.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Breast Neoplasms , Breast Neoplasms/drug therapy , Nursing , Continuity of Patient Care , Drug Therapy , Drug Therapy/psychology , Drug-Related Side Effects and Adverse Reactions , Nursing Care , Telephone , Breast Neoplasms/complications , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Evaluation Studies as Topic , Epidemiology, Descriptive , Nurse's Role , Drug Therapy/psychology , Telenursing
11.
Säo Paulo med. j ; 134(5): 465-466, Sept.-Oct. 2016.
Article in English | LILACS | ID: biblio-830886

ABSTRACT

ABSTRACT BACKGROUND: Approximately 50% of patients with newly diagnosed non-small cell lung cancer (NSCLC) are over 70 years of age at diagnosis. Despite this fact, these patients are underrepresented in randomized controlled trials (RCTs). As a consequence, the most appropriate regimens for these patients are controversial, and the role of single-agent or combination therapy is unclear. In this setting, a critical systematic review of RCTs in this group of patients is warranted. OBJECTIVES: To assess the effectiveness and safety of different cytotoxic chemotherapy regimens for previously untreated elderly patients with advanced (stage IIIB and IV) NSCLC. To also assess the impact of cytotoxic chemotherapy on quality of life. METHODS: Search methods: We searched the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 10), MEDLINE (1966 to 31 October 2014), EMBASE (1974 to 31 October 2014), and Latin American Caribbean Health Sciences Literature (LILACS) (1982 to 31 October 2014). In addition, we handsearched the proceedings of major conferences, reference lists from relevant resources, and the ClinicalTrial.gov database. Selection criteria: We included only RCTs that compared non-platinum single-agent therapy versus non-platinum combination therapy, or non-platinum therapy versus platinum combination therapy in patients over 70 years of age with advanced NSCLC. We allowed inclusion of RCTs specifically designed for the elderly population and those designed for elderly subgroup analyses. Data collection and analysis: Two review authors independently assessed search results, and a third review author resolved disagreements. We analyzed the following endpoints: overall survival (OS), one-year survival rate (1yOS), progression-free survival (PFS), objective response rate (ORR), major adverse events, and quality of life (QoL). MAIN RESULTS: We included 51 trials in the review: non-platinum single-agent therapy versus non-platinum combination therapy (seven trials) and non-platinum combination therapy versus platinum combination therapy (44 trials). Non-platinum single-agent versus non-platinum combination therapy Low-quality evidence suggests that these treatments have similar effects on overall survival (hazard ratio (HR) 0.92, 95% confidence interval (CI) 0.72 to 1.17; participants = 1062; five RCTs), 1yOS (risk ratio (RR) 0.88, 95% CI 0.73 to 1.07; participants = 992; four RCTs), and PFS (HR 0.94, 95% CI 0.83 to 1.07; participants = 942; four RCTs). Non-platinum combination therapy may better improve ORR compared with non-platinum single-agent therapy (RR 1.79, 95% CI 1.41 to 2.26; participants = 1014; five RCTs; low-quality evidence). Differences in effects on major adverse events between treatment groups were as follows: anemia: RR 1.10, 95% 0.53 to 2.31; participants = 983; four RCTs; very low-quality evidence; neutropenia: RR 1.26, 95% CI 0.96 to 1.65; participants = 983; four RCTs; low-quality evidence; and thrombocytopenia: RR 1.45, 95% CI 0.73 to 2.89; participants = 914; three RCTs; very low-quality evidence. Only two RCTs assessed quality of life; however, we were unable to perform a meta-analysis because of the paucity of available data. Non-platinum therapy versus platinum combination therapy Platinum combination therapy probably improves OS (HR 0.76, 95% CI 0.69 to 0.85; participants = 1705; 13 RCTs; moderate-quality evidence), 1yOS (RR 0.89, 95% CI 0.82 to 0.96; participants = 813; 13 RCTs; moderate-quality evidence), and ORR (RR 1.57, 95% CI 1.32 to 1.85; participants = 1432; 11 RCTs; moderate-quality evidence) compared with non-platinum therapies. Platinum combination therapy may also improve PFS, although our confidence in this finding is limited because the quality of evidence was low (HR 0.76, 95% CI 0.61 to 0.93; participants = 1273; nine RCTs). Effects on major adverse events between treatment groups were as follows: anemia: RR 2.53, 95% CI 1.70 to 3.76; participants = 1437; 11 RCTs; low-quality evidence; thrombocytopenia: RR 3.59, 95% CI 2.22 to 5.82; participants = 1260; nine RCTs; low-quality evidence; fatigue: RR 1.56, 95% CI 1.02 to 2.38; participants = 1150; seven RCTs; emesis: RR 3.64, 95% CI 1.82 to 7.29; participants = 1193; eight RCTs; and peripheral neuropathy: RR 7.02, 95% CI 2.42 to 20.41; participants = 776; five RCTs; low-quality evidence. Only five RCTs assessed QoL; however, we were unable to perform a meta-analysis because of the paucity of available data. AUTHORS' CONCLUSIONS: In people over the age of 70 with advanced NSCLC who do not have significant co-morbidities, increased survival with platinum combination therapy needs to be balanced against higher risk of major adverse events when compared with non-platinum therapy. For people who are not suitable candidates for platinum treatment, we have found low-quality evidence suggesting that non-platinum combination and single-agent therapy regimens have similar effects on survival. We are uncertain as to the comparability of their adverse event profiles. Additional evidence on quality of life gathered from additional studies is needed to help inform decision making


Subject(s)
Humans , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Antineoplastic Agents/therapeutic use , Quality of Life , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Randomized Controlled Trials as Topic , Platinum Compounds/adverse effects , Platinum Compounds/therapeutic use , Carcinoma, Non-Small-Cell Lung/mortality , Lung Neoplasms/mortality , Neoplasm Staging , Antineoplastic Agents/adverse effects
12.
Braz. j. med. biol. res ; 49(6): e5128, 2016. tab
Article in English | LILACS | ID: biblio-951686

ABSTRACT

In order to evaluate the main adverse effects of drug protocols using bortezomib and/or thalidomide for the treatment of multiple myeloma, we conducted a prospective study. Data were collected through interviews, clinical observation, and from hospital records. A total of 59 patients were included. There was a predominance of females, 36 (61%) vs 23 (39%) males, and of whites, 49 (83.1%) vs 10 (16.9%) blacks. Age ranged from 40 to 94 years, with a median of 65 years (SD=11.6). Regarding staging at diagnosis, 27 (45.7%) patients were in stage III-A, with 12 (20.3%) patients having serum creatinine ≥2 mg/dL. The main adverse effects in the bortezomib treatment group (n=40) were: neutropenia (42.5%), diarrhea (47.5%), and peripheral neuropathy in 60% of cases, with no difference between the iv (n=26) and sc (n=14) administration routes (P=0.343). In the group treated with thalidomide (n=19), 31.6% had neutropenia, 47.4% constipation, and 68.4% peripheral neuropathy. Neutropenia was associated with the use of alkylating agents (P=0.038). Of the 3 patients who received bortezomib in combination with thalidomide, only 1 presented peripheral neuropathy (33.3%). Peripheral neuropathy was the main adverse effect of the protocols that used bortezomib or thalidomide, with a higher risk of neutropenia in those using alkylating agents. Improving the identification of adverse effects is critical in multiple myeloma patient care, as the patient shows improvements during treatment, and requires a rational and safe use of medicines.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Thalidomide/adverse effects , Pharmacovigilance , Bortezomib/adverse effects , Immunosuppressive Agents/adverse effects , Multiple Myeloma/drug therapy , Antineoplastic Agents/adverse effects , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Prospective Studies , Risk Factors , Treatment Outcome , Peripheral Nervous System Diseases/chemically induced , Diarrhea/chemically induced , Neutropenia/chemically induced
13.
Rev. méd. Chile ; 143(10): 1269-1276, oct. 2015. graf, tab
Article in Spanish | LILACS | ID: lil-771710

ABSTRACT

Background: Acute myeloid leukemia (AML) is the most common acute leukemia in adults, emphasizing its high recurrence rate despite hematopoietic cell transplantation (HCT). Aim: To report the results of AML treatment at the Catholic University of Chile Clinical Hospital. Patients and Methods: Review of medical records of patients with AML. Results: 63 patients, median age 55.4 years (range:16-89), treated between 2010 and 2014. Admission laboratory values showed (median values): leukocytes 45.989/mm³, hemoglobin 9.1 g/dl, platelets 75.548/mm³, peripheral blood blasts 38% and bone marrow blasts 74%. According to cytogenetic risk classification we observed the following groups: favorable 8% (n = 5), intermediate 51% (n = 32), unfavorable 13% (n = 8) and unknown 28% (n = 17). Seventy five percent of patients received induction chemotherapy and 25% palliative care. Median survival of treated and palliative care patients was 27.3 and 1 month respectively. Induction chemotherapy (IC) mortality (ICM) was 4.2%. Seventy percent (n = 33) of patients who received IC had complete response (CR) with a 3-year relapse free survival (RFS) of 25% and overall survival (OS) of 31%. Multivariate analysis demonstrated that achievement of CR, cytogenetic risk group and receiving consolidation chemotherapy were significantly associated with better RFS and OS. Conclusions: AML treatment with standard chemotherapy in our center achieves similar results to what has been described in international series regarding induction rates and ICM, however RFS and OS are still very low, especially in intermediate and high cytogenetic risk groups.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Leukemia, Myeloid, Acute/drug therapy , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Chile , Disease-Free Survival , Induction Chemotherapy , Leukemia, Myeloid, Acute/mortality , Retrospective Studies , Treatment Outcome
14.
Braz. j. med. biol. res ; 48(7): 622-628, 07/2015. graf
Article in English | LILACS | ID: lil-751346

ABSTRACT

Posthemorrhagic shock mesenteric lymph (PHSML) is a key factor in multiple organ injury following hemorrhagic shock. We investigated the role of hydrogen sulfide (H2S) in PHSML drainage in alleviating acute kidney injury (AKI) by administering D,L-propargylglycine (PPG) and sodium hydrosulfide hydrate (NaHS) to 12 specific pathogen-free male Wistar rats with PHSML drainage. A hemorrhagic shock model was established in 4 experimental groups: shock, shock+drainage, shock+drainage+PPG (45 mg/kg, 0.5 h prehemorrhage), and shock+drainage+NaHS (28 µmol/kg, 0.5 h prehemorrhage). Fluid resuscitation was performed after 1 h of hypotension, and PHMSL was drained in the last three groups for 3 h after resuscitation. Renal function and histomorphology were assessed along with levels of H2S, cystathionine-γ-lyase (CSE), Toll-like receptor 4 (TLR4), interleukin (IL)-10, IL-12, and tumor necrosis factor (TNF)-α in renal tissue. Hemorrhagic shock induced AKI with increased urea and creatinine levels in plasma and higher H2S, CSE, TLR4, IL-10, IL-12, and TNF-α levels in renal tissue. PHSML drainage significantly reduced urea, creatinine, H2S, CSE, and TNF-α but not TLR4, IL-10, or IL-12. PPG decreased creatinine, H2S, IL-10, and TNF-α levels, but this effect was reversed by NaHS administration. In conclusion, PHSML drainage alleviated AKI following hemorrhagic shock by preventing increases in H2S and H2S-mediated inflammation.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Boronic Acids/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/pathology , Hydroxamic Acids/therapeutic use , Lung Neoplasms/drug therapy , Lung Neoplasms/pathology , Pyrazines/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Boronic Acids/adverse effects , Disease-Free Survival , Hydroxamic Acids/adverse effects , Pyrazines/adverse effects , Treatment Outcome
15.
Arq. bras. cardiol ; 104(6): 450-455, 06/2015. tab, graf
Article in English | LILACS | ID: lil-750703

ABSTRACT

Background: In chronic Chagas disease (ChD), impairment of cardiac autonomic function bears prognostic implications. Phase‑rectification of RR-interval series isolates the sympathetic, acceleration phase (AC) and parasympathetic, deceleration phase (DC) influences on cardiac autonomic modulation. Objective: This study investigated heart rate variability (HRV) as a function of RR-interval to assess autonomic function in healthy and ChD subjects. Methods: Control (n = 20) and ChD (n = 20) groups were studied. All underwent 60-min head-up tilt table test under ECG recording. Histogram of RR-interval series was calculated, with 100 ms class, ranging from 600–1100 ms. In each class, mean RR-intervals (MNN) and root-mean-squared difference (RMSNN) of consecutive normal RR-intervals that suited a particular class were calculated. Average of all RMSNN values in each class was analyzed as function of MNN, in the whole series (RMSNNT), and in AC (RMSNNAC) and DC (RMSNNDC) phases. Slopes of linear regression lines were compared between groups using Student t-test. Correlation coefficients were tested before comparisons. RMSNN was log-transformed. (α < 0.05). Results: Correlation coefficient was significant in all regressions (p < 0.05). In the control group, RMSNNT, RMSNNAC, and RMSNNDC significantly increased linearly with MNN (p < 0.05). In ChD, only RMSNNAC showed significant increase as a function of MNN, whereas RMSNNT and RMSNNDC did not. Conclusion: HRV increases in proportion with the RR-interval in healthy subjects. This behavior is lost in ChD, particularly in the DC phase, indicating cardiac vagal incompetence. .


Fundamento: Na doença de Chagas (DCh) crônica, a função autonômica cardíaca está frequentemente comprometida e traz implicações quanto ao prognóstico. A retificação de fase da série de intervalos RR isola as influências simpática (fase de aceleração – AC) e parassimpática (fase de desaceleração – DC) na modulação autonômica cardíaca. Objetivo: Este estudo investigou a variabilidade da frequência cardíaca (VRR) como função dos intervalos RR, para avaliar a função autonômica em indivíduos saudáveis e com DCh. Métodos: Os grupos controle (n = 20) e com DCh (n = 20) foram estudados. Todos fizeram o teste de inclinação ortostática de 60 minutos, com o registro do ECG. O histograma da série de intervalos RR dividido em classes de 100 ms, variando de 600 a 1100 ms foi calculado. Para cada classe, foram calculados os intervalos RR médios (MNN) e a diferença média quadrática (RMS) entre os intervalos RR normais que se encaixavam naquela classe. A média de todos os valores de RMS foi analisada como uma função dos MNN na série inteira (RMST) e nas fases de aceleração (RMSAC) e desaceleração (RMSDC). A inclinação das linhas de regressão linear foi comparada entre grupos através do teste t de Student. Os coeficientes de correlação foram testados antes das comparações. A RMS sofreu transformação logarítmica (α < 0,05). Resultados: O coeficiente de correlação foi significativo em todas as regressões (p < 0,05). No grupo controle, a RMST, a RMSAC e a RMSDC aumentaram de forma significativa proporcionalmente ao MNN (p < 0,05). No grupo com DCh, apenas a RMSAC mostrou um aumento significativo como função do MNN, enquanto a RMST e a RMSDC não aumentaram significativamente. Conclusão: A VRR aumenta proporcionalmente ao intervalo RR em indivíduos saudáveis. Este comportamento é perdido na DCh, especialmente na DC, indicando incompetência vagal cardíaca. .


Subject(s)
Adult , Female , Humans , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Breast Neoplasms/drug therapy , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Granulocyte Colony-Stimulating Factor/administration & dosage , Paclitaxel/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Breast Neoplasms/mortality , Breast Neoplasms/pathology , Chemotherapy, Adjuvant/methods , Disease-Free Survival , Follow-Up Studies , Lymphatic Metastasis , Pilot Projects , Recombinant Proteins
16.
Mem. Inst. Oswaldo Cruz ; 110(2): 166-173, 04/2015. tab, graf
Article in English | LILACS | ID: lil-744479

ABSTRACT

Despite recent advances in the treatment of some forms of leishmaniasis, the available drugs are still far from ideal due to inefficacy, parasite resistance, toxicity and cost. The wide-spectrum antimicrobial activity of 2-nitrovinylfuran compounds has been described, as has their activity against Trichomonas vaginalis and other protozoa. Thus, the aim of this study was to test the antileishmanial activities of six 2-nitrovinylfurans in vitro and in a murine model of leishmaniasis. Minimum parasiticide concentration (MPC) and 50% inhibitory concentration (IC50) values for these compounds against the promastigotes of Leishmania amazonensis, Leishmania infantum and Leishmania braziliensis were determined, as were the efficacies of two selected compounds in an experimental model of cutaneous leishmaniasis (CL) caused by L. amazonensis in BALB/c mice. All of the compounds were active against the promastigotes of the three Leishmania species tested. IC50 and MPC values were in the ranges of 0.8-4.7 µM and 1.7-32 µM, respectively. The compounds 2-bromo-5-(2-bromo-2-nitrovinyl)-furan (furvina) and 2-bromo-5-(2-methyl-2-nitrovinyl)-furan (UC245) also reduced lesion growth in vivo at a magnitude comparable to or higher than that achieved by amphotericin B treatment. The results demonstrate the potential of this class of compounds as antileishmanial agents and support the clinical testing of Dermofural(r) (a furvina-containing antifungal ointment) for the treatment of CL.


Subject(s)
Humans , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Hodgkin Disease/drug therapy , Hodgkin Disease/pathology , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Bleomycin/adverse effects , Bleomycin/therapeutic use , Combined Modality Therapy , Decision Making , Dacarbazine/adverse effects , Dacarbazine/therapeutic use , Doxorubicin/adverse effects , Doxorubicin/therapeutic use , Hodgkin Disease/mortality , Neoplasm Staging , Practice Guidelines as Topic , Risk Assessment , Treatment Outcome , Vinblastine/adverse effects , Vinblastine/therapeutic use
17.
Ciudad de México; Centro Nacional de Excelencia Tecnológica en Salud; 2015. 38 p. tab.(Guías de Práctica Clínica de Enfermería). (SS-760-15).
Monography in Spanish | LILACS, BDENF | ID: biblio-1037660

ABSTRACT

El tratamiento de quimioterapia promueve una serie de transformaciones en el niño con cancer, altera física y emocionalmente tanto al niño como a la familia. Los efectos colaterales más frecuentes son: apatía, pérdida del apetito, pérdida de peso, alopecia, mucositis, náuseas, vómitos y diarrea. Otro efecto colateral es la neutropenia, que aumenta significativamente los riesgos de morbilidad y mortalidad por procesos infecciosos. A través de esta Guía de Práctica Clínica se pretende contribuir a disminuir la incidencia de efectos secundarios y complicaciones durante el periodo de tratamiento con quimioterapía, determinar las intervenciones de enfermería que contribuyan a garantizar la calidad de los cuidados y del proceso de la atención durante el periodo de tratamiento con quimioterapia antineoplásica en el usuario pediátrico con cáncer. Métodos: Se plantea preguntas a responder por la GPC, se realiza búsqueda sistemática, recuperación de artículos científicos que den respuesta a las preguntas clínicas, para lo cual se seleccionaron las fuentes con mayor calidad en su metodología y mayor nivel de evidencia científica.Resultados: El protocolo sistematizado de búsqueda arrojó 275 artículos, de los cuales se utilizó 26 fuentes documentales que corresponden a 3 revisiones sistemáticas, 6 Ensayos Clínicos Aleatorizados, 4 estudios observacionales, 3 estudios de cohorte, 10 de tipo de estudios.Conclusiones: Para dar respuesta a las preguntas planteadas se consideran la valoración, cuidados, limitación del daño y educación en el manejo de los efectos secundarios del tratamiento con quimioterapia del niño con cáncer en el segundo y tercer nivel de atención.


Chemotherapy treatment promotes a series of transformations in children with cancer, physically and emotionally disturbed both the child and the family. The most common side effects are: apathy, loss of appetite, weight loss, alopecia, mucositis, nausea, vomiting and diarrhea. Another side effect is neutropenia, which significantly increases the risk of morbidity and mortality from infectious processes. Through this Clinical Practice Guideline is intended to help reduce the incidence of side effects and complications during the treatment with chemotherapy, determine nursing interventions that help ensure the quality of care and process of care during the treatment period with cancer chemotherapy in pediatric cancer user.Methods: It raises questions to answer for the GPC, systematic search, retrieval of scientific articles that answer clinical questions, is done for which the sources were selected with higher quality in their methodology and highest level of scientific evidence.Results: The systematic search protocol yielded 275 articles, of which 26 documentary sources corresponding to 3 systematic reviews, 6 randomized clinical trials, 4 observational studies, three cohort studies, 10 such studies was used.Conclusions: To answer the questions posed are considered the assessment, care, damage limitation and education in managing the side effects of chemotherapy treatment of children with cancer in the second and third levels of care.


O tratamento quimioterápico promove uma série de transformações em crianças com câncer, física e emocionalmente perturbado tanto a criança quanto a família. Os efeitos colaterais mais comuns são: apatia, perda de apetite, perda de peso, alopecia, mucosite, náuseas, vómitos e diarreia. Outro efeito colateral é a neutropenia, o que aumenta significativamente o risco de morbidade e mortalidade por processos infecciosos. Através desta diretriz de prática clínica destina-se a ajudar a reduzir a incidência de efeitos colaterais e complicações durante o tratamento com quimioterapia, determinar intervenções de enfermagem que ajudam a garantir a qualidade do cuidado e processo de atendimento durante o período de tratamento com quimioterapia de câncer em usuários câncer pediátrico.Métodos: levanta questões a responder pela GPC, busca sistemática, recuperação de artigos científicos que respondem a questões clínicas, é feito para as quais foram selecionadas as fontes com maior qualidade na sua metodologia e maior nível de evidência científica.Resultados: O protocolo de pesquisa sistemática rendeu 275 artigos, dos quais 26 fontes documentais, correspondentes a 3 revisões sistemáticas, 6 ensaios clínicos randomizados, 4 estudos observacionais, três estudos de coorte, foi usado 10 desses estudos.Conclusões: Para responder às questões colocadas são considerados na avaliação, cuidado, limitação de danos e educação na gestão dos efeitos colaterais do tratamento de quimioterapia de crianças com câncer nos segundo e terceiro níveis de atenção.


Subject(s)
Child , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Drug Therapy , Drug Therapy/nursing
18.
Article in English | WPRIM | ID: wpr-123435

ABSTRACT

OBJECTIVE: There is no research regarding the appropriate antiemetic agents for female patients, especially those receiving moderately emetogenic chemotherapy (MEC). We evaluated the antiemetic efficacy of a combination of 5-HT3 receptor with/without aprepitant in patients with gynecological cancer treated with the TC (paclitaxel and carboplatin) regimen of MEC. METHODS: We enrolled 38 patients diagnosed with gynecologic cancer and scheduled to receive the TC regimen. The patients were randomly assigned to receive a 5-HT3 receptor antagonist, either palonosetron in the first cycle followed by granisetron in the second cycle or vice versa. In the third cycle, all patients received a combination of the 5-HT3 receptor and dexamethasone with/without aprepitant. RESULTS: When three drugs were administered, palonosetron consistently produced an equivalent complete response (CR) rate to granisetron in the acute phase (89.5% vs. 86.8%, p=0.87) and delayed phase (60.5% vs. 65.8%, p=0.79). With regard to the change in dietary intake, palonosetron exhibited similar efficacy to granisetron in the acute phase (92.1% vs. 89.4%, p=0.19) and delayed phase (65.7% vs. 68.4%, p=0.14). However, in the delayed phase, the addition of aprepitant therapy with a 5-HT3 receptor antagonist and dexamethasone produced a higher CR rate than a 5-HT3 receptor antagonist with dexamethasone (93.3% vs. 47.8%, p<0.001) and allowed the patients to maintain a higher level of dietary intake (93.3% vs. 56.5%, p<0.001). CONCLUSION: The addition of aprepitant therapy was more effective than the control therapy of a 5-HT3 receptor antagonist, and dexamethasone in gynecological cancer patients treated with the TC regimen.


Subject(s)
Adult , Aged , Antiemetics/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carboplatin/administration & dosage , Cross-Over Studies , Diet , Drug Administration Schedule , Female , Genital Neoplasms, Female/drug therapy , Granisetron/administration & dosage , Humans , Isoquinolines/administration & dosage , Middle Aged , Morpholines/administration & dosage , Nausea/chemically induced , Paclitaxel/administration & dosage , Quinuclidines/administration & dosage , Serotonin 5-HT3 Receptor Antagonists , Vomiting/chemically induced
19.
Article in English | WPRIM | ID: wpr-111037

ABSTRACT

The radiologic findings of a single nodule from Pneumocystis jirovecii pneumonia (PJP) have been rarely reported. We described a case of granulomatous PJP manifesting as a solitary pulmonary nodule with a halo sign in a 69-year-old woman with diffuse large B cell lymphoma during chemotherapy. The radiologic appearance of the patient suggested an infectious lesion such as angioinvasive pulmonary aspergillosis or lymphoma involvement of the lung; however, clinical manifestations were not compatible with the diseases. The nodule was confirmed as granulomatous PJP by video-assisted thoracoscopic surgery biopsy.


Subject(s)
Aged , Antibodies, Monoclonal, Murine-Derived/adverse effects , Antineoplastic Agents/adverse effects , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Biopsy/methods , Cyclophosphamide/adverse effects , Doxorubicin/adverse effects , Female , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Pneumocystis carinii/pathogenicity , Pneumonia, Pneumocystis/diagnosis , Positron-Emission Tomography , Prednisone/adverse effects , Solitary Pulmonary Nodule/microbiology , Thoracic Surgery, Video-Assisted , Tomography, X-Ray Computed , Vincristine/adverse effects
20.
Article in English | WPRIM | ID: wpr-76675

ABSTRACT

BACKGROUND/AIMS: Among diffuse large B cell lymphoma (DLBCL) patients, determining the appropriate dose and chemotherapy schedule to balance toxicity and efficacy is harder in elderly than in younger patients. Moreover, there are no currently available clinical factors that consistently identify patients who are unfit to receive chemotherapy. Therefore, the clinical characteristics and outcomes of elderly patients with DLBCL and the causes of treatment-related death were investigated in this study. METHODS: The clinical characteristics and outcomes of 44 elderly (> or = 70 years of age) patients diagnosed with DLBCL between January 2005 and June 2013 were evaluated. Variable clinical data along with the response rate, overall survival (OS), and causes of treatment-related death or treatment interruption were investigated. RESULTS: The median OS was 18.6 months, and 19 patients completed curative treatment. The mean average relative dose intensity of adriamycin in patients who completed chemotherapy was 0.617, and of these patients, 16 achieved complete remission. Chemotherapy incompletion, infectious complications, ex tranoda l involvement, high lactate dehydrogenase, poor performance status, and low albumin level at diagnosis were related to a shorter OS. However, multivariate analysis revealed that only infections and chemotherapy incompletion were significantly related to poor prognosis. The most common cause of treatment-related death was infection, and patients who had experienced infectious complications tended to have lower albumin levels than those of patients without such complications. CONCLUSIONS: In the treatment of elderly lymphoma patients, the dose intensity of adriamycin is not as important as it is in young patients. However, in elderly patients, infections are particularly dangerous, especially in patients with low albumin levels.


Subject(s)
Age Factors , Aged , Aged, 80 and over , Antibiotics, Antineoplastic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Chi-Square Distribution , Communicable Diseases/blood , Disease Progression , Doxorubicin/administration & dosage , Female , Geriatric Assessment , Humans , Kaplan-Meier Estimate , Lymphoma, Large B-Cell, Diffuse/blood , Male , Multivariate Analysis , Proportional Hazards Models , Remission Induction , Republic of Korea , Retrospective Studies , Risk Factors , Serum Albumin/analysis , Time Factors , Treatment Outcome
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