ABSTRACT: Thirty percent to ninety percent of cancer patients suffer from pain, including neuropathic pain (NP), which results in great burden for cancer patients. Thus, it was of great interest to determine NP prevalence in cancer patients in Spain, to raise awareness of the condition, and aiming to improve management of cancer NP.
A 1-month follow-up prospective epidemiological multicenter study was conducted to assess prevalence and management of NP in Spanish oncologic units. The first 10 cancer patients at each unit diagnosed with NP by the validated Douleur Neuropathique 4 questionnaire (DN4) were recruited.
Of 8615 screened patients, 2567 (30%) suffered from pain. From these, 33% had NP according to investigators and 19% according to DN4 test. Three hundred and sixty-six patients (mean age 62.6 years; 61.2% male) were recruited. Pain decrease at 1 month was greater in patients with metastases (P<0.01) and depended on treatment (P<0.05), with 'oxycodone' showing 50.4% pain relief.
NP prevalence in cancer pain is 33%. DN4 reports only about half the cancer NP cases diagnosed by clinicians. Pharmaceutical treatment of cancer pain, including NP, has a greater effect in patients with metastases and seems to depend on the specific treatment used.
Annals of Oncology 10/2010; 22(4):924-30. · 6.43 Impact Factor
ABSTRACT: The aim of the study was to analyse the toxicity and health related quality of life (HRQoL) of breast cancer patients treated with FAC (5-fluorouracil, doxorubicin, cyclophosphamide) and TAC (docetaxel, doxorubicin, cyclophosphamide) with and without primary prophylactic G-CSF (PPG).
This was a phase III study to compare FAC and TAC as adjuvant treatment of high-risk node-negative breast cancer patients. After the entry of the first 237 patients, the protocol was amended to include PPG in the TAC arm due to the high incidence of febrile neutropenia. A total of 1047 evaluable patients from 49 centres in Spain, two in Poland and four in Germany were included in the trial. Side-effects and the scores of the EORTC QLQ-C30 and QLQ BR-23 questionnaires were compared in the three groups (FAC, TAC pre-amendment and TAC post-amendment).
The addition of PPG to TAC significantly reduced the incidence of neutropenic fever, grade 2-4 anaemia, asthenia, anorexia, nail disorders, stomatitis, myalgia and dysgeusia. Patient QoL decreased during chemotherapy, more with TAC than FAC, but returned to baseline values afterwards. The addition of PPG to TAC significantly reduced the percentage of patients with clinically relevant Global Health Status deterioration (10 or more points over baseline value) at the end of chemotherapy (64% versus 46%, P<0.03).
The addition of PPG significantly reduces the incidence of neutropenic fever associated with TAC chemotherapy as well as that of some TAC-induced haematological and extrahaematological side-effects. The HRQoL of patients treated with TAC is worse than that of those treated with FAC but improves with the addition of PPG, particularly in the final part of chemotherapy treatment.
Annals of Oncology 08/2006; 17(8):1205-12. · 6.43 Impact Factor
ABSTRACT: The aim of this study was to analyze the results obtained in the treatment of small cell lung cancer (SCLC) with the PAVI chemotherapy protocol (cisplatin, adriamycin, etoposide and ifosfamide).
Over a period of 3 years, 41 patients with a mean age of 57 years were treated. Twenty-two patients were considered as having limited disease (LD) and 19 disseminated disease (DD). Survival was studied by the Kaplan and Meier method.
The percentage of complete response (CR) achieved was 42%, LD 52% and 27% for DD, with partial responses (PR) being achieved in 50%, 43% in LD and 60% in DD. With a mean follow up of 32 months, the mean 2 length of response was 13 months in the patients with CR and 9 months in those with PR. The median of survival in LD was 22 months and 10 months for patients with DD. Prolonged survival of over 2 years, was only achieved in LD (16%). Five patients died in relation with the treatment. Hematologic toxicity was doses-limited with the greatest toxicity being found in patients with DD under the Karnofsky index (KI).
The PAVI protocol is effective in the treatment of small cell lung cancer and a good median of survival may be achieved in patients with limited disease. Toxicity is elevated and is fundamentally found in patients with disseminated disease and under the Karnofsky index, with its use not being recommended in these cases.
Medicina Clínica 10/1992; 99(8):289-93. · 1.38 Impact Factor