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1.
Med. clín (Ed. impr.) ; 150(4): 138-140, feb. 2018. graf
Article in Spanish | IBECS | ID: ibc-170609

ABSTRACT

Fundamento y objetivo: Se presentan datos de supervivencia relativa (SR) (cociente entre la supervivencia observada y la esperada) a 5 años en las siguientes neoplasias: mama, pulmón, colorrectal (CCR), linfoma no Hodgkin de células grandes tipo B (LNHB) y mieloma múltiple (MM) tratados en el Institut Català d'Oncologia (ICO) en el período 2010-2011 y se comparan con los obtenidos en una cohorte especial histórica de los años 1998-1999. Material y métodos: Para el segundo estudio, se creó una base de datos donde se introdujeron 5.000 registros con datos de la historia clínica. Para el análisis de resultados se utilizó el paquete estadístico R®para la SR. Resultados: Las SR globales a 5 años del segundo período (2010-2011) fueron: CCR 67%, mama 93,6%, pulmón 28%, LNHB 68,3% y MM 61,7% y para el primero (1998-1999) fueron: CCR 61,8%, mama 88,8%, pulmón 23,1%, LNHB 67,7% y MM 43,4%. Conclusiones: Se registró una mejoría de la SR, de alrededor del 5%, en los 3 tumores sólidos, un incremento significativo en el MM y una estabilización en los LNHB (AU)


Background and objective: Five years' data relative survival (RS) is presented in 3 solid tumours: breast, colorectal (CRC) and lung and 2 haematologic neoplasms: large B cell lymphoma (NHL-B) and multiple myeloma (MM) treated at Institut Català d'Oncologia between 2010-2011 in comparison with the results obtained in a historical special cohort from 1998-1999. Material and methods: A database was created in a common safe and accessible repository. We have introduced more than 5,000 medical records. To analyse the results the statistical package R® was used for RS. Results: The overall RS at 5 years for 2010-2011 was: CRC 67%, breast 93.6%, lung 28%, NHL-B 68% and MM 62%, while for 1998-1999 is was: CRC 61.8%, breast 88.8%, lung 23.1%, NHL-B 67.7%, and MM 43.4%. Conclusions: Comparative results have shown a 5% overall improvement in RS for the 3 solid tumours, a significant increase in MM and a stabilisation in the NHL-B (AU)


Subject(s)
Humans , Neoplasms/epidemiology , Reproducibility of Results , Medical Records/statistics & numerical data , Survival Rate , Academies and Institutes/organization & administration , Academies and Institutes/statistics & numerical data , Cohort Studies , Breast Neoplasms/epidemiology , Colorectal Neoplasms/epidemiology , Lung Neoplasms/epidemiology , Multiple Myeloma/epidemiology , Retrospective Studies
2.
Med Clin (Barc) ; 150(4): 138-140, 2018 02 23.
Article in English, Spanish | MEDLINE | ID: mdl-28947298

ABSTRACT

BACKGROUND AND OBJECTIVE: Five years' data relative survival (RS) is presented in 3 solid tumours: breast, colorectal (CRC) and lung and 2 haematologic neoplasms: large B cell lymphoma (NHL-B) and multiple myeloma (MM) treated at Institut Català d'Oncologia between 2010-2011 in comparison with the results obtained in a historical special cohort from 1998-1999. MATERIAL AND METHODS: A database was created in a common safe and accessible repository. We have introduced more than 5,000 medical records. To analyse the results the statistical package R® was used for RS. RESULTS: The overall RS at 5 years for 2010-2011 was: CRC 67%, breast 93.6%, lung 28%, NHL-B 68% and MM 62%, while for 1998-1999 is was: CRC 61.8%, breast 88.8%, lung 23.1%, NHL-B 67.7%, and MM 43.4%. CONCLUSIONS: Comparative results have shown a 5% overall improvement in RS for the 3 solid tumours, a significant increase in MM and a stabilisation in the NHL-B.


Subject(s)
Breast Neoplasms/mortality , Colorectal Neoplasms/mortality , Lung Neoplasms/mortality , Lymphoma, B-Cell/mortality , Multiple Myeloma/mortality , Female , Humans , Male , Retrospective Studies , Spain/epidemiology , Survival Analysis
3.
J Cancer Res Clin Oncol ; 136(11): 1681-9, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20165956

ABSTRACT

PURPOSE: Chemoradiotherapy using 5-fluorouracil has shown to be effective treatment for rectal cancer. Thymidylate synthase (TS) is an important target enzyme for the fluoropyrimidines. However, the predictive role of TS levels in early stage rectal cancer is not yet well understood. We analyzed the value of TS gene polymorphisms as a predictive marker in patients with stage II and III rectal cancer treated with preoperative concomitant radiotherapy and fluoropyrimidine-based chemotherapy. METHODS AND MATERIALS: Between 1998 and 2007, blood samples were obtained from 51 patients with stage II/III rectal cancer. Forty patients were T2-3 (78%), 11 were T4 (22%), and 59% were N+. DNA was extracted from peripheral blood, and the genotypes were analyzed using PCR-restriction fragment length polymorphism and automated sequencing techniques. RESULTS: The *3/*3 thymidylate synthase genotype was associated with a higher response rate (pathological complete remission and microfoci residual tumor; 61 vs. 22% in *2/*2 and *2/*3; P = 0.013). In the multivariate analysis, the *3/*3 thymidylate synthase genotype was also an independent prognostic factor for better survival (P < 0.05). CONCLUSIONS: The thymidylate synthase genotype might help to identify patients with stage II/III rectal cancer who could benefit from pre- and postoperative fluorouracil-based chemotherapy.


Subject(s)
Fluorouracil/therapeutic use , Germ-Line Mutation , Polymorphism, Genetic , Rectal Neoplasms/genetics , Thymidylate Synthase/genetics , Adult , Aged , Aged, 80 and over , Antimetabolites, Antineoplastic/therapeutic use , Base Sequence , Combined Modality Therapy , DNA, Neoplasm/blood , DNA, Neoplasm/genetics , DNA, Neoplasm/isolation & purification , Female , Genotype , Humans , Male , Middle Aged , Minisatellite Repeats , Neoplasm Staging , Patient Selection , Polymerase Chain Reaction/methods , Rectal Neoplasms/drug therapy , Rectal Neoplasms/mortality , Rectal Neoplasms/pathology , Rectal Neoplasms/radiotherapy , Survival Rate
4.
Int J Radiat Oncol Biol Phys ; 66(5): 1391-8, 2006 Dec 01.
Article in English | MEDLINE | ID: mdl-16965868

ABSTRACT

PURPOSE: Pancreatic cancers are resistant to radiotherapy (RT) and current chemotherapy agents. Epidermal growth factor receptor is overexpressed in pancreatic cancer, and in vitro studies have shown that epidermal growth factor receptor inhibitors can overcome radio- and chemoresistance. The aim of the study was to determine whether the addition of gefitinib to RT and gemcitabine for patients with locally advanced pancreatic carcinoma (LAPC) was feasible and safe. METHODS AND MATERIALS: Eighteen patients with pathologically proven LAPC, based on major vascular invasion based on helical computed tomography (CT) and endoscopic ultrasound, were entered into the study. The targeted irradiated volume included the tumor and 2-cm margin. Prophylactic irradiation of regional nodes was not allowed. Patients with >500 cm(3) of planning tumor volume were excluded. An initial cohort of 6 patients was treated with RT (45 Gy/25 fractions/5 weeks) plus concomitant gefitinib (250 mg/day). Successive cohorts of patients received 100, 150, and 200 mg/m(2)/day of gemcitabine in a 2-h infusion over Weeks 1, 2, 3, 4, and 5 with gefitinib (250 mg/day) and RT. Gefitinib was continued after RT until progression. A pharmacodynamic study of angiogenic markers was also performed to evaluate a possible antiangiogenic effect. RESULTS: There were no dose-limiting toxicities. Common toxicities were mild neutropenia, asthenia, diarrhea, cutaneous rash and nausea/vomiting. The median (95% confidence interval [CI]) progression-free survival was 3.7 (95% CI = 1.9-5.5) months, and the median overall survival was 7.5 (95% CI = 5.2-9.9) months. No significant reduction of vascular endothelial growth factor and interleukin-8 was observed after treatment. CONCLUSION: Our results support that the combination of gefitinib, RT, and gemcitabine has an acceptable toxicity but with modest activity in LAPC.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/radiotherapy , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Combined Modality Therapy/methods , Deoxycytidine/administration & dosage , Deoxycytidine/adverse effects , Deoxycytidine/analogs & derivatives , Drug Administration Schedule , Feasibility Studies , Female , Gefitinib , Humans , Interleukin-8/blood , Male , Middle Aged , Pancreatic Neoplasms/blood , Pancreatic Neoplasms/pathology , Quinazolines/administration & dosage , Quinazolines/adverse effects , Radiotherapy Dosage , Vascular Endothelial Growth Factor A/blood , Gemcitabine
5.
Strahlenther Onkol ; 179(4): 241-8, 2003 Apr.
Article in English | MEDLINE | ID: mdl-12707713

ABSTRACT

BACKGROUND: Prospective analysis of local tumor control, survival and treatment complications in 67 consecutive patients treated with fractionated photon and proton radiation for chordoma or chondrosarcoma of the base of the skull and the cervical spine. PATIENTS AND METHODS: Between December 1995 and January 2000, 67 patients with a median age of 52 years (range: 14-85 years), were treated at the Centre de Protonthérapie d'Orsay (CPO), France, using the 201-MeV proton beam, 49 for chordoma and 18 for chondrosarcoma. Irradiation combined high-energy photons and protons. Photons represented two thirds of the total dose and protons one third. The median total dose delivered within gross tumor volume (GTV) was 67 Cobalt Gray Equivalents (CGE; range: 60-70 CGE). RESULTS: Within a median follow-up of 29 months (range: 4-71 months), the 3-year local control rates were 71% and 85% for chordomas and chondrosarcomas, respectively, and the 3-year overall survival rates 88% and 75%, respectively. 14 tumors (21.5%) failed locally (eight within the GTV, four within the clinical target volume [CTV], and two without further assessment). Seven patients died from their tumor and another one from a nonrelated condition (pulmonary embolism). The maximum tumor diameter and, similarly, the GTV were larger in relapsing patients, compared with the rest of the population: 56 mm vs 44 mm (p = 0.024) and 50 ml vs 22 ml (p = 0.0083), respectively. In univariate analysis, age < or = 52 years at the time of radiotherapy (p = 0.002), maximum diameter < 45 mm (p = 0.02), and GTV < 28 ml (p = 0.02) impacted positively on local control. On multivariate analysis, only age was an independent prognostic factor of local control. CONCLUSION: In chordomas and chondrosarcomas of the skull base and cervical spine, combined photon and proton radiation therapy offers excellent chances of cure. In two thirds of the cases, relapses are located in the GTV. Maximum diameter, GTV, and age are prognostic indicators of local control. These results should be confirmed during a longer follow-up.


Subject(s)
Cervical Vertebrae , Chondrosarcoma/radiotherapy , Chordoma/radiotherapy , Skull Base Neoplasms/radiotherapy , Spinal Neoplasms/radiotherapy , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Chondrosarcoma/mortality , Chordoma/mortality , Data Interpretation, Statistical , Dose Fractionation, Radiation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Multivariate Analysis , Neoplasm Recurrence, Local , Photons/therapeutic use , Prognosis , Prospective Studies , Proton Therapy , Radiotherapy Dosage , Sex Factors , Skull Base Neoplasms/mortality , Spinal Neoplasms/mortality , Time Factors
6.
Bull Cancer ; 89(7-8): 713-23, 2002.
Article in French | MEDLINE | ID: mdl-12206985

ABSTRACT

PURPOSE: Prospective analysis of local tumour control, survival and treatment complications in 67 consecutive patients treated with fractionated photon and proton radiation for a chordoma or a chondrosarcoma of the base of the skull and of the cervical spine. PATIENTS AND METHODS: Between December 1995 and January 2000, 67 patients with a median age of 52.3 years (14-85), were treated using 201 MeV proton beam of the centre de protonthérapie d'Orsay (CPO), 49 for a chordoma and 18 for a chondrosarcoma. Irradiation combined high-energy photons and protons. Photons represented 2/3 of the total dose and protons 1/3. The median total dose delivered within gross tumour volume was 67 Cobalt Gray Equivalent (CGE) (60-70). RESULTS: With a mean follow-up of 32 months (4-71), the 3-year local control rates were for chordomas and chondrosarcomas of 70.8% and 85.2%, respectively and 4-year overall survival rates of 87.7% and 75%, respectively. Fourteen tumours (21.5%) failed locally (eight within the gross tumor volume, four into the CTV and 2 in an unknown site). Seven patients died of tumour and one of intercurrent disease. In univariate analysis, age inférieur ou égal à 52.3 years (p = 0.002), maximum tumoral diameter < 44.7 mm (p = 0.02) and GTV < 28.4 mL (0.02), at time of radiotherapy, influenced positively the local control. According to multivariate analysis, only age was an independent prognostic factor of local control. Only five (7.7%) patients presented grade 3 or 4 complications. CONCLUSION: In base of skull chordomas and chondrosarcomas, the combined photon and proton therapy offers excellent chances of cure at the price of an acceptable toxicity. These results should be confirmed with a longer follow-up.


Subject(s)
Cervical Vertebrae , Chondrosarcoma/radiotherapy , Chordoma/radiotherapy , Radiotherapy, High-Energy/methods , Skull Base Neoplasms/radiotherapy , Adolescent , Adult , Aged , Aged, 80 and over , Dose Fractionation, Radiation , Humans , Middle Aged , Photons/adverse effects , Photons/therapeutic use , Prospective Studies , Proton Therapy , Protons/adverse effects , Radiotherapy, High-Energy/adverse effects
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