[Pharmacoeconomic assessment of taxanes as first-line therapy for advanced or metastatic non-microcytic lung cancer]. / Evaluación farmacoeconómica de los taxanos en el cáncer de pulmón no microcítico avanzado o metastásico como primera línea de tratamiento.

OBJECTIVE: The goal of this study was to determine the effectiveness of taxane-containing regimens versus non-taxane-containing regimens using a metanalysis and its subsequent pharmacoeconomic assessment to define the role of taxanes as first-line therapy for non micro-cytic lung cancer. METHOD: A search of the MEDLINE database from 2000 to June 2005 was performed. The search was restricted to phase-III clinical trials, and 29 papers were selected. Effectivity measures considered included: objective response, 1- and 2-year survival. Maentel-Haenszel combined odds ratio (OR) was estimated in the metanalysis. The statistical analysis of effectiveness across categories was performed using a one-way analysis of variance (ANOVA). Differences were statistically considered for p values = 0.01. All results obtained were weighted according to number of patients. RESULTS: OR estimates for the various effectiveness variables showed statistically significant differences when 2-year survival was considered both for taxanes in general and docetaxel specifically versus non-taxane regimens. These same results are seen when the effectiveness analysis is performed using ANOVA. For the pharmacoeconomic analysis taxane-free regimens were considered as reference, this being of choice for comparisons versus paclitaxel-containing regimens whereas the selection of docetaxel-containing schemes represents additional costs per extra effectiveness unit that oscillate between 26,559 and 96,527 (2-year survival and objective response, respectively) versus taxane-free regimens. The sensitivity analysis ultimately confirmed our study s results. CONCLUSIONS: To conclude, taxane-containing schemes are valid therapeutic options, but at a very high cost.

Evaluación farmacoeconómica de los taxanos en el cáncer de pulmón no microcítico avanzado o metastásico como primera línea de tratamiento / Pharmacoeconomic assessment of taxanes as first-line therapy for advanced or metastatic non-microcytic lung cancer

Objetivo: El objetivo de este estudio es determinar la efectividadde los esquemas con taxanos respecto a los esquemas sin taxanos,mediante un metanálisis y su posterior evaluación farmacoeconómicapara definir su papel como tratamiento de 1ª línea en el cáncer depulmón no microcítico.Método: Se realizó una búsqueda bibliográfica mediante labase de datos MEDLINE desde 2000 hasta junio 2005. La búsquedase restringió a ensayos clínicos en fase III, seleccionándose 29artículos. Las efectividades consideradas fueron: respuesta objetiva,supervivencia al año y dos años. En el metanálisis se estima laodds ratio (OR) combinada de Maentel-Haenszel. El análisis estadísticode la efectividad por categorías se realizó mediante análisisde varianza de una vía (ANOVA). Las diferencias se consideraronestadísticamente para valores de p ≤ 0,01. Todos los resultadosobtenidos fueron ponderados por el número de pacientes.Resultados: La obtención del OR para las diferentes variablesde efectividad mostró diferencias estadísticamente significativas alconsiderar la supervivencia a los dos años, tanto para los taxanosen general como para el docetaxel en particular, respecto a losesquemas sin taxanos. Estos mismos resultados se observan cuandoel análisis de la efectividad se realiza mediante análisis de laANOVA. Para la realización del análisis farmacoeconómico seconsideró como esquema de referencia los esquemas sin taxanos,siendo este el de elección cuando se compara con los esquemascon paclitaxel, mientras que la elección de esquemas con docetaxelsupone un coste adicional por unidad extra de efectividad queoscila entre 26.559 y 96.527 euros (supervivencia a los 2 años yrespuesta objetiva respectivamente) respecto a los esquemas sintaxanos. El análisis de sensibilidad viene a confirmar los resultadosde nuestro estudio.Conclusiones: En conclusión, los esquemas con taxanos sonalternativas terapéuticas válidas pero a un coste muy elevado

Objective: The goal of this study was to determine the effectivenessof taxane-containing regimens versus non-taxane-containingregimens using a metanalysis and its subsequent pharmacoeconomicassessment to define the role of taxanes as first-linetherapy for non micro-cytic lung cancer.Method: A search of the MEDLINE database from 2000 toJune 2005 was performed. The search was restricted to phase-IIIclinical trials, and 29 papers were selected. Effectivity measuresconsidered included: objective response, 1- and 2-year survival.Maentel-Haenszel combined odds ratio (OR) was estimated in themetanalysis. The statistical analysis of effectiveness across categorieswas performed using a one-way analysis of variance (ANOVA).Differences were statistically considered for p values ≤ 0.01.All results obtained were weighted according to number of patients.Results: OR estimates for the various effectiveness variablesshowed statistically significant differences when 2-year survival wasconsidered both for taxanes in general and docetaxel specificallyversus non-taxane regimens. These same results are seen when theeffectiveness analysis is performed using ANOVA. For the pharmacoeconomicanalysis taxane-free regimens were considered as reference,this being of choice for comparisons versus paclitaxel-containingregimens whereas the selection of docetaxel-containingschemes represents additional costs per extra effectiveness unit thatoscillate between 26,559 and 96,527 (2-year survival and objectiveresponse, respectively) versus taxane-free regimens. The sensitivityanalysis ultimately confirmed our study's results.Conclusions: To conclude, taxane-containing schemes arevalid therapeutic options, but at a very high cost

[Principles of phototherapy and its use in cancer patients]. / Principios de la fototerapia y su aplicación en el paciente oncológico.

Phototherapy (PHOT) is a therapeutic option whose effectiveness is determined by its capability to destroy cells, with the benefit of discrimination between healthy and diseased tissue. It is based on the previous administration of a drug acting as a photosensitizing agent, and subsequent laser radiation, which brings about cellular destruction. The objective of this study is to review the principles and methods on which this therapeutic modality is based, as well as its use in the cancer field. To this end, we reviewed the MEDLINE database from 2000 to March 2003. Results show a limited effectiveness in small-sized tumours alone, and as a palliative measure, rather than as a healing therapy.

Principios de la fototerapia y su aplicación en el paciente oncológico / Principles of phototherapy and its use in cancer patients

La fototerapia (FOT) es una alternativa terapéutica cuya eficacia viene determinada por su capacidad de destrucción celular, con la ventaja de poder discriminar entre tejido sano y enfermo. Se basa en la administración previa de un fármaco que actúa como agente fotosensibilizador y la posterior irradiación con un láser, lo que provoca la destrucción celular. El objetivo de este estudio es revisar los principios y metodología en las que se fundamenta esta modalidad terapéutica, así como sus aplicaciones en el campo de la oncología. Para ello hemos realizado una revisión mediante la base de datos MEDLINE desde el año 2000 hasta marzo de 2003. Los resultados obtenidos muestran una eficacia limitada únicamente a tumores de pequeño tamaño y cuando se utiliza como medida paliativa, más que como terapia curativa (AU)