RESUMO
INTRODUCTION: Anemia is the most common haematological complication in cancer patients. OBJECTIVE: Analysis of the incidence, prevalence and treatment of anemia in oncologic patients treated in Radiation Oncology Departments in Spain (ROD) and monitoring of the existing recommendations for the treatment of anemia. MATERIAL AND METHODS: Observational, prospective, multicenter study which involved 19 Spanish ROD. The study was approved by the CEIC Central Defense Hospital. 477 patients with solid tumors, subsidiary of RT with radical intent referred to such centers within a period of one month (5/5/09 to 5/6/09) and gave their consent to participate in the study. We gathered the main characteristics of patients and their oncologic disease. All patients underwent a determination of Hb levels before RT, upon reaching 25-35 Gy and at the end treatment. In patients with anemia we assessed the existence of related symptoms and its treatment. RESULTS: Basal situation: The prevalence of anemia was 34.8% (166 patients). Mean Hb in patients with anemia was 11.17 ± 1.07 g/dl. Anemia-related symptoms were present in 34% of the patients. Anemia predisposing factors were: stage of the disease, previously received chemotherapy, and hormonal therapy. 39% (66 patients) received anemia treatment, with a mean Hb of 10.43 ± 1.04 g/dl. During RT: The prevalence of anemia was 38.9% (182 patients) with a mean Hb of 11.24 ± 1.21 g/dl. Predisposing factors for anemia during RT treatment were: age, male sex, chemotherapy prior to RT, basal anemia and chemotherapy during RT. 36.3% (66 patients) had anemia-related symptoms. 34.6% (63 patients) with a mean Hb of 10.5 ± 1.37 g/dl received treatment for anemia. The prevalence of anemia at the end of the RT was 38.1% (177 patients) with a mean Hb of 11.19 ± 1.18 g/dl. The predisposing factors for the appearance of anemia at the end of RT were: male sex, anemia at basal situation and during treatment and chemotherapy during RT. 34% (61 patients) had anemia-related symptoms and 73 patients (41.2%) with a mean Hb of 10.5 ± 1.22 g/dl received treatment for anemia. The presence of anemia-related symptoms was significantly correlated with the beginning of treatment for anemia. The incidence of anemia (new cases) during radiotherapy was 17.5%. CONCLUSION: The prevalence of anemia in basal situation, during RT and at the end of RT is 34.8%, 38.9% and 38.1%. During RT the incidence of anemia is 17.5%. 39.8%-41.2% of patients with anemia and 64.2%-68% of patients with anemia-related symptoms received treatment. Treatment of anemia starts with Hb<11 g/dl and the goal is to achieve Hb 12 g/dl. In our Radiotherapy Oncology Departments, the treatment of anemia complies with the current recommendations and guidelines in use.
Assuntos
Anemia/epidemiologia , Anemia/etiologia , Neoplasias/radioterapia , Radioterapia/efeitos adversos , Idoso , Anemia/terapia , Feminino , Humanos , Incidência , Masculino , Oncologia , Pessoa de Meia-Idade , Neoplasias/complicações , Prevalência , Estudos Prospectivos , Radioterapia (Especialidade)/métodos , Radioterapia/métodos , EspanhaRESUMO
El trauma en Chile es la primera causa de muerte en pacientes menores de 45 años, siendo el trauma penetrante torácico especialmente importante debido a su alta frecuencia en nuestro medio. Este es un estudio observacional censal descriptivo, en el cual se revisaron los libros de protocolo operatorio del Hospital Carlos Van Burén de Valparaíso, desde Diciembre de 1997 hasta enero del 2006, obteniendo el total de pacientes ingresados por trauma penetrante torácico a los que se les realizó pleurotomía mínima, siendo estos 203 pacientes. Se revisaron las fichas con el objetivo de determinar cuántos pacientes respondieron adecuadamente sólo con pleurotomía mínima y cuántos requirieron toracotomia de urgencia o electiva. Los resultados se describen en porcentajes obteniendo que del total de pacientes 92,6 por ciento corresponden a hombres y 7,39 por ciento corresponden a mujeres. De los 203 pacientes estudiados 10,8 por ciento requirieron toracotomia y 89,2 por ciento evolucionaron favorablemente sólo con pleurotomía mínima. La causa más frecuente de toracotomia fue el hemotórax masivo (50 por ciento), el cual fue manejado satisfactoriamente, siendo diagnosticado y tratado precozmente. El trauma penetrante torácico es más frecuente en el sexo masculino, sobre todo jóvenes, siendo la mayoría resueltos exitosamente con la pleurotomía mínima en la Unidad de Emergencias.
Background: Trauma is the first cause of death among subjects of less than 45 years of age in Chile. Penetrating chest trauma is common. Aim: To assess the need for thoracotomy among patients with penetrating chest trauma. Material and methods: Retrospective review of operative protocols of all tube thoracostomies performed in a General Hospital from 1997 to 2006. Results: In the study period, 275 protocols of tube thoracostomy were found and 72 had to be discarded. Therefore, 203 patients, aged 15 to 80 years (188 males), were included in the study. Eleven percent of patients required a surgical thoracotomy and the rest only required the tube thoracostomy. The most common reason to perform a thoracotomy was massive hemothorax in 50 percent of cases. Conclusions: Most cases of penetrating chest trauma occur in men and can be successfully treated with a tube thoracostomy.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Tubos Torácicos , Ferimentos Penetrantes/cirurgia , Toracostomia/estatística & dados numéricos , Toracotomia/estatística & dados numéricos , Traumatismos Torácicos/cirurgia , Emergências , Epidemiologia Descritiva , Hemotórax/cirurgia , Pneumotórax/cirurgia , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Distribuição por SexoAssuntos
Adenocarcinoma/secundário , Neoplasias da Medula Óssea/secundário , Carcinoma Pulmonar de Células não Pequenas/secundário , Vértebras Cervicais/patologia , Neoplasias Pulmonares/patologia , Neoplasias da Coluna Vertebral/secundário , Vértebras Torácicas/patologia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/radioterapia , Adenocarcinoma/cirurgia , Neoplasias da Medula Óssea/tratamento farmacológico , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/cirurgia , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Cisplatino/administração & dosagem , Terapia Combinada , Irradiação Craniana , Craniotomia , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Docetaxel , Lobo Frontal/patologia , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Taxoides/administração & dosagem , Vimblastina/administração & dosagem , Vimblastina/análogos & derivados , Vinorelbina , GencitabinaRESUMO
Prognosis in prostate cancer is determined, in greater part, by the presence of metastases. Bone metastases can occur in any part of the skeleton even, for example, at the base of the skull. We present a case of a 78 year old male who, in December 2001, presented with paralysis of the third cranial nerve. The NMR and CAT scans were normal and circulating levels of PSA were elevated. He was referred to the Urology Service where the treatment guidelines included complete androgen block. Subsequently, he developed retro-orbital pain, divergent strabismus and palpebral ptosis. CAT and NMR indicated a soft tissue mass at the sphenoid level. Treatment was Gamma Knife Radio-surgery. Since August 2004, in conjunction with the latest rise in PSA, the patients general status deteriorated considerably and he was referred to the Oncology Service. There was an increase in the paralysis of the third, fourth and sixth cranial nerve (complete left ophthalmoplegia) and left-central facial paralysis. Metastases from prostate cancer can be disseminated via the lymphatic or the blood system. Currently, there are more metastases from large-size tumours. Metastases are critical in prostate cancer because of their adverse effect on the patients survival. Measurements of circulating levels of prostate specific antigen and prostate acid phosphatase are very useful in the clinical diagnosis of the primary tumour, or its metastases.