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Puente Nacional, Colombia

Vazquez O.G.,National Autonomous University of Mexico | Castillo E.R.,Servicio de Psico Oncologia | Ponce J.L.A.,Subdireccion de Medicina Interna | Avitia M.A.A.,Servicio Oncologia Medica | Aguilar S.A.,Servicio de Psico Oncologia

Introduction: Depressive symptomatology is a major mental health problem in cancer patients. The Beck Anxiety Scale (BAI) has proven to be a reliable and valid instrument. However, until now has not been documented it’s psychometric properties in Mexican population with cancer. Objetives: Determine the psychometric properties of the Beck Anxiety Scale BAI in a sample of cancer patients. Material and methods: Involved 250 patients from the National Cancer Institute, of which 112 were women (55.2[%]) were male and 138 (44.82[%]); the average age was 46.6 ± 14.3 years. Participants answered the BAI, and also the Anxiety Sub-scale of HADS. Results: A varimax factor analysis with 21 items show a structure of 4 factors: Subjective, Neurophysiological, Autonomic and vaso-motor symptoms that explain 46.38[%] of the variance. The internal consistency of the overall scale was satisfactory (a=0.82). The validity through correlations with the HADS-A showed significant associations (Pearson r=0.58, p <0.05) and ECOG (Pearson -0.36, p <0.05). Conclusions: The BAI in Mexican population with cancer showed adequate psychometric characteristics. Detection of anxiety symp-toms through BAI provides benefts to the cancer population and facilitates the development of adequate and cost-effective care strategies. © 2015 Spanish Association of Anglo-American Studies. All rights reserved. Source

Navarro Mendivil A.,Servicio Oncologia Medica | Felip Font E.,Servicio Oncologia Medica
Revisiones en Cancer

Lung cancer is the leading cause of cancer related mortality worlwide. Non small cell lung cancer (NSCLC) accounts 85 % of cases, the remaining 15 % is due to small cell lung cancer (SCLC). Nearly half of the patients diagnosed of NSCLC are 70 years old. However, the elderly patients are under-represented in clinical trials. Due to they usually have concomitant comorbidities and poor general condition, clinicians must carefully optimize the treatment, taking into account the expected benefits and the potential risks. Surgical treatment is the cornstone of localized-stage NSCLC and the elderly should not be denie to receive surgery if indicated after performing an adecuate evaluation of risks. Stereotactic ablative radiotherapy seems to be a good alternative to surgery. Adjuvant chemotherapy in selected elderly patients may lead to the same benefit than the younger counterpart. Concurrent chemo-radiation for locally-advanced NSCLC is the preferred option if possible. In the advanced setting, if there is a driver alteration such as EGFR mutation or ALK translocation, targeted therapy is the treatment of choice. If not, doublet-platinum based chemotherapy or single-agent monotherapy may be indicated according to patient's overall condition. SCLC in the elderly with good performance status should be managed as in younger patients, but there is a lack of prospective data to clarify this issue. Copyright © 2014 ARAN EDICIONES, S.L. Source

Noguera J.G.,Servicio Oncologia Medica | Evgenyeva E.,Servicio de Anatomia Patologica | Raga M.G.,Servicio Oncologia Medica | Marroqui A.J.,Servicio Oncologia Medica | And 6 more authors.
Journal of Analytical Oncology

Purpose: To analyze the impact of primary tumour resection on treatment outcomes in patients with advanced colorectal cancer (CRC) and inoperable metastases at diagnosis in combination with optimal systemic therapy. Methods: A retrospective study was carried out in four hospitals in Valencia (Spain) including all consecutive patients diagnosed between 1/2009 and 12/2010 of advanced CRC with inoperable metastasis and treated with a fluoropyrimidine and oxaliplatin combination chemotherapy regimens with or without bevacizumab (B). Treatment outcomes were compared between patients undergoing or not primary tumour resection. Results: A total of 112 patients met inclusion criteria: 62 patients underwent resection of the primary tumour (Group 1) and 50 were treated with exclusive chemotherapy (Group 2). Globally, patients in group 2 presented more disfavorable characteristics. Forty-five (72%) and 31 (62%) patients received chemotherapy with bevacizumab respectively. Overall response rate (ORR) were 67% in Group 1 and 56% in Group 2. There were no statistically significant differences between the two groups in progression free survival (PFS) (12 vs. 10 months; p =0.11) and overall survival (OS) (27 vs. 22 months; p 0.1). B regimens increased ORR (73% vs. 42%; p = 0.003) and PFS (12 vs. 11 months; p = 0.019) but not OS. Complications were higher in the group of patients without primary tumour resection, particularly when associated to B regimens. Conclusions: Primary tumour resection offers no survival gain for patients with advanced CRC and inoperable metastases. Benefits of adding Bevacizumab to standard chemotherapy were similar in both groups, but it increases the risk of complications in non-resected patients. © 2013 Lifescience Global. Source

Gomez A.,University of Santiago de Compostela | Salgado M.,Servicio Oncologia Medica | Valladares-Ayerbes M.,Servicio Oncologia Medica | Jorge M.,Servicio Oncologia Medica | And 4 more authors.
Cancer Chemotherapy and Pharmacology

Purpose: Anemia is common during anticancer treatment. This study aimed to evaluate the response and safety of treatment with epoetin-beta (EB) in patients with neoadjuvant therapy prior to primary digestive tract tumor surgery. Patients: and methods In this open-label, single-arm study, patients (n = 22) with hemoglobin (Hb) levels below 11 g/dl who received epoetin-beta 450 IU/kg (30,000 IU) weekly until the hemoglobin level reached 12 g/dl. Results: After treatment with EB, a mean absolute increment of 2.6 g/dl was attained. The mean hemoglobin values during the study were pretreatment 10.1 g/dl, half-way through treatment 12.3 g/dl, 4 weeks after concomitant radiochemotherapy 12.7 g/dl, the week prior to surgery 12.5 g/dl, and after surgery 10.9 g/dl. No patient required transfusion before or after surgery. The probability or risk of postoperative complications was 27.3%, and included one rectovaginal fistula, one parastomal hernia, one case of ileus and two surgical wound infections. In this series, downstaging was observed in 81.8% of patients, and downsizing in 90.9%. Most interestingly, histopathological complete response rate was achieved by 18.2%. Conclusions: Epoetin-beta (EB) treatment in our series of patients with digestive malignancies subjected to neoadjuvant radiochemotherapy proved effective and safe, avoiding the need for transfusion during surgery. © Springer-Verlag 2009. Source

Bermejo-Perez M.J.,Servicio Oncologia Medica | Villar-Chamorro E.,Servicio Oncologia Medica | Lemos-Simosomo M.,Servicio Oncologia Medica | Garcia-Gonzalez C.,Servicio Oncologia Medica | Galeote-Miguel A.M.,Servicio Oncologia Medica
Anales del Sistema Sanitario de Navarra

Background. The management of patients with disseminated disease is a difficult problem. There is currently no consensus on the standard first-line treatment for metastatic melanoma. We present a case because of his exceptional evolution. Results. A 43 year old male diagnosed in 1999 with malignant melanoma stage IIA. In May 2000, hepatic and splenic metastases were detected. He received 6 cycles of biochemotherapy (cisplatin and DTIC, plus interleukin-2 and interferon-α) and another 6 cycles with single immunotherapy (interleukin-2 and interferon-α). Today, the patient is still alive and without evidence of disease. Conclusion. Metastatic cutaneous melanoma, sometimes, presents and unusual and favourable evolution. In the near future, the methods of detection of molecular markers are expected to identify factors involved in this type of response. Furthermore, new targeted therapies may become essential to maintain this positive trend. Source

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