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Barcelona, Spain

Lopez J.L.,University of Seville | Amezcua S.,Hospital Del Mar | Pascual J.,Hospital Del Mar | Algara M.,Hospital de la Esperanza
Reports of Practical Oncology and Radiotherapy

Aim: Assessment of the association of an acute motor axonal neuropathy with a squamous cell anal carcinoma. Background: Paraneoplastic neurologic syndromes are not a direct consequence of neither primary tumor nor its metastasis. They often parallel the course of the malignancy but may be the presenting sign of an occult cancer. Sometimes it is very difficult to distinguish if it is a paraneoplastic syndrome or just a coincidence. Materials and methods: We report a 60-year-old man that presented with an acute motor deficit of the four limbs. Clinical examination found a pure and severe motor deficit in the four limbs. No sensory abnormality was found and all motor nerves were unexcitable. Electromyography suggested the diagnosis of acute motor axonal neuropathy (AMAN). Four months after developing the AMAN, blood in the stool revealed anal carcinoma. The patient was treated with concurrent chemoradiotherapy. Radiation was given to the tumor and to the pelvis, including inguinal nodes, over a five-week period plus fluorouracil and mitomycin. We investigated the presence of antiganglioside antibodies as studies suggest that carcinomas can express antigens shared with Schwann cells. Results: Anti-GM1 IgG antibodies were detected by an enzyme-linked immunosorbent assay method. Other antibodies, including antinuclear nucleoprotein antibody (anti-Hu), anti-Tr, anti-Ri, anti-CV2, anti-amphiphysin and anti-Yo, were negative. Clinical improvement of the motor state was observed at the fourth week of oncologic treatment. Conclusion: The presence of anti-GM1 IgG antibodies and the clinical improvement of the motor state after concurrent chemoradiotherapy lead us to believe there is an association between anal carcinoma and this severe impairment. © 2011 Greater Poland Cancer Centre, Poland. Source

Gomez A.,University of Santiago de Compostela | Gonzalez J.A.,Grupo IMO | Counago F.,Hospital Universitario Quiron Madrid | Vallejo C.,Hospital Universitario Ramon y Cajal | And 4 more authors.
Clinical and Translational Oncology

Locally advanced non-small cell lung cancer (NSCLC) is a diversified illness in which postoperative radiation therapy (PORT) for complete resection with positive hiliar (pN1) and/or mediastinal (pN2) lymph nodes is controversial. Although several studies have shown that PORT has beneficial effects, randomized trials are needed to demonstrate its impact on overall survival. In this review, the Spanish Radiation Oncology Group for Lung Cancer describes the most relevant literature on PORT in NSCLC patients stage pN1–2. In addition, we have outlined the current recommendations of different national and international clinical guidelines and have also specified practical issues regarding treatment volume definition, doses and fractionation. © 2015, Federación de Sociedades Españolas de Oncología (FESEO). Source

Counago F.,Hospital Universitario Quiron | Rodriguez A.,Hospital Ruber Internacional | Calvo P.,University of Santiago de Compostela | Luna J.,Hospital Universitario Fundacion Jimenez Diaz | And 6 more authors.
Clinical and Translational Oncology

In recent years, major advances in our understanding of the molecular biology of lung cancer, together with significant improvements in radiotherapy technologies, have revolutionized the treatment of non-small cell lung cancer (NSCLC). This has led to the development of new therapies that target molecular mutations specific to each tumor type, acting on the cell surface antigens or intracellular signaling pathways, or directly affecting cell survival. At the same time, ablative dose radiotherapy can be delivered safely in the context of metastatic disease. In this article, the GOECP/SEOR (Oncological Group for Study of Lung Cancer/Spanish Society of Radiation Oncology) reviews the role of new targeted therapies used in combination with radiotherapy in patients with locally advanced (stage III) NSCLC and in patients with advanced, metastatic (stage IV) NSCLC. © 2016 Federación de Sociedades Españolas de Oncología (FESEO) Source

Warner A.,London Health Sciences Center | Dahele M.,VU University Amsterdam | Hu B.,London Health Sciences Center | Palma D.A.,London Health Sciences Center | And 13 more authors.
International Journal of Radiation Oncology Biology Physics

Purpose Concurrent chemoradiation therapy (con-CRT) is recommended for fit patients with locally advanced non-small cell lung cancer (LA-NSCLC) but is associated with toxicity, and observed survival continues to be limited. Identifying factors associated with early mortality could improve patient selection and identify strategies to improve prognosis. Methods and Materials Analysis of a multi-institutional LA-NSCLC database consisting of 1245 patients treated with con-CRT in 13 institutions was performed to identify factors predictive of 180-day survival. Recursive partitioning analysis (RPA) was performed to identify prognostic groups for 180-day survival. Multivariate logistic regression analysis was used to create a clinical nomogram predicting 180-day survival based on important predictors from RPA. Results Median follow-up was 43.5 months (95% confidence interval [CI]: 40.3-48.8) and 127 patients (10%) died within 180 days of treatment. Median, 180-day, and 1- to 5-year (by yearly increments) actuarial survival rates were 20.9 months, 90%, 71%, 45%, 32%, 27%, and 22% respectively. Multivariate analysis adjusted by region identified gross tumor volume (GTV) (odds ratio [OR] ≥100 cm3: 2.61; 95% CI: 1.10-6.20; P=.029) and pulmonary function (forced expiratory volume in 1 second [FEV1], defined as the ratio of FEV1 to forced vital capacity [FVC]) (OR <80%: 2.53; 95% CI: 1.09-5.88; P=.030) as significant predictors of 180-day survival. RPA resulted in a 2-class risk stratification system: low-risk (GTV <100 cm3 or GTV ≥100 cm3 and FEV1 ≥80%) and high-risk (GTV ≥100 cm3 and FEV1 <80%). The 180-day survival rates were 93% for low risk and 79% for high risk, with an OR of 4.43 (95% CI: 2.07-9.51; P<.001), adjusted by region. A clinical nomogram predictive of 180-day survival, incorporating FEV1, GTV, N stage, and maximum esophagus dose yielded favorable calibration (R2 = 0.947). Conclusions This analysis identified several risk factors associated with early mortality and suggests that future research in the optimization of pretreatment pulmonary function and/or functional lung avoidance treatment may alter the therapeutic ratio in this patient population. © 2016 Elsevier Inc. Source

Villanueva Boloix R.,Hospital de la Esperanza | Gonzalez Gonzalez R.D.M.,Hospital de la Esperanza
Index de Enfermeria

Communication is a basic tool in the professional development of nursing staff, with positive or negative consequences depending on the various communicative styles and group dynamics. The purpose of this paper is communication among nursing staff (intraprofessional) within the surgical departments of a hospital, with the identification of conduct models and factors that generate satisfaction or dissatisfaction, among others. Methodology: Ethnographic study. Results: The greatest point of satisfaction and the commitment associated with the interprofessional communication are the social relationships that are established above the autonomy, mainly the amount of work, to work under pressure of time. Conclusions: It's really important to realize how necessary it's to convey the knowledge in our profession, with the feed-back, being empathic and recognize our needs to increase our efficiency in our field. © 2016 Fundación Index. Source

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