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Cristina Grávalos,
Javier Salvador,
Joan Albanell,
Agustín Barnadas,
Pablo Borrega, Jesús García-Mata,
Pilar Garrido,
Encarnación González-Flores,
Dolores Isla,
María Lomas,
Álvaro Rodríguez-Lescure,
Juan Jesús Cruz,
Emilio Alba
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ABSTRACT: The functions and workload of medical oncologists are becoming increasingly relevant as cancer is a priority health issue in our country. Taking into account the specific characteristics and complexity of caring for cancer patients, the time of physicians attached to Medical Oncology could be distributed as follows: 70% for consultation (including participation in tumour committees and multidisciplinary units), 15% for research and 15% for training, teaching and clinical sessions. The time distribution for Heads of Services or Heads of Units is different, since it must also include their clinical management tasks, team coordination, and relations with other services and institutions. The average time, calculated in minutes, spent on each activity per patient is as follows: first visit and "second visit or results visit" 60-90 min; successive visits at the day hospital 15 min; successive visits of patients for follow-up or checkups 20 min; visits with family members 15-20 min; telephone or e-mail consultations 5-10 min; hospitalisation 20 min; and interconsultation 30-60 min. Also, participation in multidisciplinary committees takes up 60-120 min of an oncologist's time each week. When new technologies such as electronic medical records, e-mail and other software are used, these times increase with a correction factor that is still to be defined and which could vary according to the centre. Finally, the ratio recommended by SEOM is one medical oncologist for every 83 new patients a year.
Clinical and Translational Oncology 06/2012; 14(6):423-9. · 1.33 Impact Factor
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ABSTRACT: The objective was to evaluate a dose-dense schedule of docetaxel followed by doxorubicin and cyclophosphamide (AC) as neoadjuvant treatment for patients with locally advanced breast cancer.
Ninety-nine patients were included and received 100 mg/m(2) of docetaxel every two weeks for four cycles followed by 60 mg/m(2) of doxorubicin and 600 mg/m(2) of cyclophosphamide every two weeks for four cycles. Primary prophylaxis with granulocyte colony-stimulating factor (G-CSF) was administered systematically to all patients.
Efficacy and toxicity analyses were carried out on an intention-to-treat basis. After treatment, complete pathological response in the breast and lymph nodes was confirmed in 15 patients (15%, 95% confidence interval [CI]: 8.4-22.9). Clinical response rate was 74% (95% CI: 65-82), of which 19% were complete responses. Breast-conserving surgery could be performed in 41% of patients. The dose-dense schedule was generally well tolerated. The most important grade 3/4 toxicities per patient were cutaneous toxicity (12.1%) and hepatic dysfunction (9.1%) during docetaxel administration, and neutropenia (28.1%) and leucopenia (8.3%) with AC.
A dose-dense schedule of docetaxel followed by AC as neoadjuvant treatment is an effective and safe treatment for locally advanced breast cancer. Primary prophylaxis with G-CSF, and possibly the change in the sequence of drug administration, appears to play a major role in avoiding the excessive toxicity of dose-dense schedules.
Clinical and Translational Oncology 09/2011; 13(9):686-91. · 1.33 Impact Factor
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ABSTRACT: Chemotherapy-induced emesis is one of the most frequent side effects that affect the quality of life of cancer patients undergoing chemotherapy. In recent years, clinical research has allowed us to increase our therapeutic arsenal with new drugs that have increased efficiency in the control of nausea and vomiting associated with chemo. This guide provides and update of the earlier published by our society and represents the continued commitment of SEOM to move forward and improve in the supportive care of cancer patients.
Clinical and Translational Oncology 11/2010; 12(11):770-4. · 1.33 Impact Factor
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I Tusquets,
L García-Estévez,
E Adrover,
L Calvo,
I Alvarez, J García Mata,
Y Fernández,
M Margueli,
M A Seguí,
M Muñoz,
C Rodríguez,
A Rodríguez Lescure,
R Colomer,
P Gascón,
M Martín,
E Alba,
A Barnadas,
A Llombart,
J Albanell,
A Lluch
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ABSTRACT: The following manuscript summarises the content of the Breast Symposium that was held in May 2008 in Barcelona in which four controversies regarding the management of breast cancer were discussed. The design of the symposium included two speakers per controversy, one in favour and one diverging, and the audience had to vote before and after the presentations to assess changes in the participants' views. The four controversies included: (1) the role of non-conventional predictive factors in selecting treatment for breast cancer; (2) the role of surgery in disseminated disease; (3) are taxanes indicated in the adjuvant treatment of patients with lymph-node-negative disease?; (4) is treatment with tamoxifen (TAM) always required after surgery in patients with ductal carcinoma in situ (DCIS)? The symposium concluded with the presentation titled: 'Features of a well designed clinical trial in the adjuvant treatment of breast cancer'.
Clinical and Translational Oncology 04/2010; 12(4):278-86. · 1.33 Impact Factor
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ABSTRACT: Sarcoidosis (SA) is accompanied by malignancy more than can be explained by chance. Cancer can occur in patients with an established diagnosis of SA and SA can subsequently develop in a cancer patient. Malignancy can also be associated with the occurrence of sarcoid reactions (SR), which are typically restricted to the regional lymph nodes. Problems may also arise in distinguishing between tumour-related SRs and true systemic SA. Here we present a case with both SA and pancreatic cancer, and we discuss the result of distinguishing between SA and SRs in a patient with concurrent cancer.
Clinical and Translational Oncology 07/2009; 11(6):396-8. · 1.33 Impact Factor
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ABSTRACT: To evaluate the efficacy and safety profile of the concomitant dose-dense administration of doxorubicin and docetaxel as primary chemotherapy for patients with large or locally advanced breast cancer.
Forty-seven patients were included and received 50 mg/m(2) of doxorubicin and 75 mg/m(2) of docetaxel every two weeks for four cycles. Primary prophylaxis with granulocyte colony stimulating factor was administered.
Patients included had mainly stage III disease (66%). Efficacy and toxicity analyses were carried out on an intention-to-treat basis. After study treatment, the rate of clinical responses was 85% (95% CI: 75-95) with 6% judged as clinical complete responses. Surgery was performed on 94% patients for whom the breast was conserved in 27%. Only one patient obtained a pathological complete response (with no evidence of invasive or non-invasive tumour in the breast and the lymph nodes). In three additional patients, malignant cells were detected only in one lymph node. The single severe haematological toxicity was neutropenia, occurring in one patient (2%) and two cycles (1%), being grade 3 in one and grade 4 in the other. Severe non-haematological toxicities were grade 3, and the most common was asthenia (8% of patients), followed by cutaneous toxicity, arthromyalgia and stomatitis, which occurred in fewer than 4% of patients in each case.
The concomitant dose-dense administration of doxorubicin and docetaxel as neoadjuvant chemotherapy with granulocyte colony stimulating factor support is a feasible and effective schedule with a safe toxicity profile for women with large or locally advanced breast cancer.
Clinical and Translational Oncology 12/2008; 10(11):739-44. · 1.33 Impact Factor
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L G Estévez,
M Martín,
E Alba,
R Colomer,
F Lobo,
A Lluch,
E Adrover,
J Albanell,
A Barnadas, J García-Mata,
A Llombart,
M Muñoz,
C Rodríguez,
P Sánchez-Rovira,
M A Seguí,
I Tusquets
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ABSTRACT: Medical professionals in general, and medical oncologists in particular, have highly stressful practices because they are under constant pressure to have the highest-quality, up-to-date evidence available in order to make the right decision for each individual patient. From a practical point of view, being updated on oncological and other medical specialties may seem an insurmountable task because the number of scientific publications has increased dramatically. The use of systematic reviews of randomised controlled trials or the application of results obtained from high-quality randomised controlled trials are some of the most common ways to address this need. Unfortunately, they do not cover all complex clinical situations that the majority of medical oncologists face in their outpatient consultations. In this review, we report the conclusions achieved in a multiexpert meeting where five important controversies in the treatment of breast cancer were analysed. Five highly experienced medical oncologists were required to defend an affirmative answer and another five were required to defend a negative answer for each of the clinical questions. After that, a one-day meeting was organised to debate each clinical question and to reach a consensus. We report here the content of this multi-expert meeting along with the conclusions drawn.
Clinical and Translational Oncology 07/2007; 9(6):375-84. · 1.33 Impact Factor
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ABSTRACT: To report a case of synchronous prostatic cancer with multiple myeloma as inusual neoplasm presentation. To indicate the clinical data that they help to suspect the myeloma presence in the prostate bone metastatic disease.
Patient 63 years old diagnosed of prostatic carcinoma with bone metastasis and BAC good responsive, who have clinical deterioration, hypercalcemia and renal insufficiency.
The presacred mass biopsy and extension study to find one second tumour (myeloma).
The presence of multiple myeloma must be to rule out when there are bone lytics injuries, well biochemical evolution with therapy and clinical deterioration, hypercalcemia and quickly progressive renal insufficiency.
Actas urologicas españolas 03/2007; 31(2):157-9. · 0.46 Impact Factor
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ABSTRACT: To report a case of Wilms' tumor in an adult patient.
The records of an adult patient with renal tumor is reviewed.
A 23-year-old male consulted for hematuria. Physical examination and patient assessment by ultrasound and CT showed a solid tumor in the right kidney. The patient was submitted to radical surgery. Pathological analysis demonstrated a biphasic nephroblastoma (Wilms' tumor) with infiltration of renal hilar fat (stage II). After surgery, adjuvant chemotherapy with vincristine-actinomycin D was administered for 60 weeks.
Although rare in adults, Wilms' tumor should be included in the differential diagnosis of all renal tumors. Treatment is usually by surgery and chemotherapy with or without radiotherapy, depending on tumor stage.
Archivos españoles de urología 06/2001; 54(4):370-4.
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ABSTRACT: Metastasis is the most frequent cause of death in patients with breast cancer. The nm23-H1 and p53 genes have been involved in the development of breast cancer metastasis. We have analyzed the correlation between the expression of nm23 protein and several established clinicopathologic factors. Our results show that the antimetastatic role of nm23-H1 is not related to the cell proliferative status or tumor grade and that it is not associated with the expression of p53. We also demonstrate a strong inverse relationship between the expression of nm23-H1 protein, lymph node metastasis and vascular invasion. These data support the antimetastatic role of the nm23-H1 gene and suggest that nm23-H1 and p53 genes may be involved in different steps of the metastatic process.
Cancer Letters 04/1996; 101(2):137-42. · 4.24 Impact Factor
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ABSTRACT: Metastasis is the most frequent cause of death in patients with breast cancer. The nm23-H1 and p53 genes have been involved in the development of breast cancer metastasis. We have analyzed the correlation between the expression of nm23 protein and several established clinicopathologic factors. Our results show that the antimetastatic role of nm23-H1 is not related to the cell proliferative status or tumor grade and that it is not associated with the expression of p53. We also demonstrate a strong inverse relationship between the expression of nm23-H1 protein, lymph node metastasis and vascular invasion. These data support the antimetastatic role of the nm23-H1 gene and suggest that nm23-H1 and p53 genes may be involved in different steps of the metastatic process.
Cancer Letters.
