ABSTRACT
Aproximadamente un 60% de los pacientes diagnosticados de cáncer requiere, en algún momento de su enfermedad, radioterapia. Aunque suelen ser tratamientos bien tolerados, en ocasiones los pacientes presentan dolor de intensidad moderada-severa en relación con la irradiación de determinadas localizaciones o al realizar dolorosos procedimientos necesarios para administrar el tratamiento. Este trabajo describe 2 situaciones clínicas con dolor irruptivo frecuentes en la asistencia diaria de los servicios de radioterapia: en primer lugar, el dolor secundario a la mucositis, que conlleva pérdida de peso y detrimento de la calidad de vida del paciente y, en segundo lugar, el dolor incidental producido por los posicionamientos y maniobras necesarias para administrar el tratamiento. Para ambas situaciones, en la Fundación Jiménez Díaz se diseñaron 2 estudios prospectivos introduciendo el fentanilo intranasal con pectina, con eficacia y resultados satisfactorios para pacientes y profesionales sanitarios. Estos 2 estudios continúan abiertos y se sigue reclutando pacientes para confirmar estos resultados
Approximately 60% of patients with a cancer diagnosis require radiotherapy. Although usually well tolerated, this treatment can sometimes produce radiation-related moderate-to-severe pain in certain locations or during painful procedures required for radiotherapy administration. This article describes two clinical situations of breakthrough pain in routine practice in radiotherapy departments: firstly, pain secondary to mucositis, which leads to weight loss and impaired quality of life; secondly, incidental pain caused by positioning and the maneuvers required for treatment administration. In both situations, we designed two prospective studies of fentanyl pectin nasal spray in the Fundación Jiménez Días. The results were satisfactory for both patients and healthcare professionals. These two studies remain open and are recruiting patients to confirm these results
Subject(s)
Humans , Fentanyl/administration & dosage , Breakthrough Pain/drug therapy , Pain Management/methods , Head and Neck Neoplasms/complications , Mucositis/drug therapy , Radiotherapy/adverse effects , Administration, IntranasalABSTRACT
Merkel cell carcinoma (MCC) is a rare primary cutaneous carcinoma of the skin who has high aggressiveness, high risk of locoregional and distant spread, a mortality rate considerably higher than that of cutaneous melanoma and a poor survival. Its incidence has increased during the past twenty years. The studies published from 2008 to early 2012 have introduced interesting changes in the understanding of its epidemiology, pathogenesis and consequently in the diagnostic codes and the therapeutic approach. Early and detailed nodal diagnosis with posterior multidisciplinary decision is mandatory. Surgery and Radiotherapy play a fundamental role in the management of this tumor. Both are associated with improved locoregional control and disease free survival; but patients continue to have distant failure because, currently, there is no effective systemic treatment available. Consequently, there remain controversies about its appropriate management, and this review is an attempt to contribute to their clarification.
Subject(s)
Carcinoma, Merkel Cell/diagnosis , Carcinoma, Merkel Cell/therapy , Skin Neoplasms/diagnosis , Skin Neoplasms/therapy , Carcinoma, Merkel Cell/pathology , Humans , Skin Neoplasms/pathologyABSTRACT
The presentation of scalp metastases from leiomyosarcoma of the vena cava is an extremely infrequent event. There are no other publications that describe such finding and very few of leiomyosarcoma in vessels. About this event we have reviewed the English literature describing studies on scalp metastases and skin metastases in general: their incidence, origin, clinical appearance, meaning, and diagnosis. The case we describe would be the second one presented worldwide because, as far as we know, it has been only one more published in 2005.
ABSTRACT
Merkel cell carcinoma (MCC) is a rare primary cutaneous carcinoma of the skin that is highly aggressive, and has a high risk of locoregional and distant spread, a mortality rate considerably higher than that of cutaneous melanoma and poor survival. Its incidence has increased during the past twenty years. The studies published since 2008 have introduced changes in the understanding of its epidemiology and pathogenesis, and consequently the therapeutic approach. Despite this, there is still controversy surrounding its optimal management, which requires clarification. This is the purpose of this review.
