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INTRODUCTION: Pain catastrophizing scale (PCS) is the most used scale to measure pain catastrophizing. In breast cancer survivors (BCS), pain catastrophizing is related to upper-limbs dysfunction and disability. This study aimed to assess the internal consistency, internal structure, and convergent validity of the Spanish version of the PCS in Spanish BCS. MATERIAL AND METHODS: Breast cancer survivors were recruited from the service of Medical Oncology of the University Clinical Hospital Virgen de la Victoria, in Málaga (Spain). The psychometric properties were evaluated with analysis factor structure by maximum likelihood extraction (MLE), internal consistency, and construct validity by confirmatory factor analysis (CFA). RESULTS: Factor structure was three-dimensional, and one item was removed due to cross-loading. The new 12-item PCS showed a high internal consistency for the total score (α = 0.91) and a good homogeneity, and CFA revealed a satisfactory fit. PCS showed an acceptable correlation with FACS (r = 0.53, p < 0.01). CONCLUSION: Pain catastrophizing scale is a valid and reliable instrument to evaluate pain catastrophizing in Spanish BCS. This tool may help clinicians in the management of pain by assessing pain and by measuring the effect of interventions.
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Neoplasias da Mama , Sobreviventes de Câncer , Humanos , Feminino , Catastrofização/diagnóstico , Medição da Dor/métodos , Reprodutibilidade dos Testes , Neoplasias da Mama/complicações , Psicometria/métodos , Dor , Inquéritos e QuestionáriosRESUMO
The adverse effects associated to traditional chemotherapy are well known and broadly studied. In the recent years several tyrosine kinase inhibitors have been approved for cancer treatment and numerous are under investigation. These drugs target specific mutated/overexpressed tyrosin kinase receptors and frecuently their pharmacokinetic/pharmacodinamic behavior is not fully elucidated. These new drugs may interact with non-antineoplastic drugs leading to undesirable adverse effects. In this article, we will discuss different types of drug interactions and briefly review the pharmacokinetics and mechanisms of action of tyrosine kinase inhibitors in clinical use, with a particular emphasis on the risk of the occurrence of such interactions based on currently available scientific evidence.
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Neoplasias/tratamento farmacológico , Neoplasias/enzimologia , Inibidores de Proteínas Quinases/uso terapêutico , Proteínas Tirosina Quinases/antagonistas & inibidores , Animais , Interações Medicamentosas , HumanosRESUMO
INTRODUCTION: Desmoid tumours are a rare group of tumours arising in the deep musculoaponeurotic structures and although they have no metastatic potential they can be locally aggressive with relapse rates of between 23-40%. Three sub-sites are reported: extra-abdominal, abdominal wall and intra-abdominal. The purpose of this study was to analyze patients with these tumours treated and followed at our institution and to determine factors influencing disease free survival. MATERIAL AND METHODS: We conducted a retrospective study of 20 patients treated between 1997 and 2009. Data was compiled to include age, gender, surgical history, familial adenomatous polyposis (FAP), contraceptives, tumour site, first-line treatment, positive margins and adjuvant radiotherapy. A descriptive and survival statistical analysis was also performed. RESULTS: Most patients were women, with a median age of 36 years, with abdominal wall involvement and treated with complete surgery without adjuvant radiotherapy. With a median follow-up of 35 months (range 0-188), local control at 5 years for any kind of treatment was 80%. Overall survival (OS) and 5-year progression-free survival (PFS) were 100% and 86%, respectively. CONCLUSION: Desmoid tumours are group of rare tumours. Although complete surgical resection remains the cornerstone of treatment for resectable lesions, there is still substantial risk of recurrence. Our outcomes are comparable to those reported in the few series published to date.
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Fibromatose Agressiva/mortalidade , Fibromatose Agressiva/terapia , Adolescente , Adulto , Terapia Combinada , Intervalo Livre de Doença , Feminino , Fibromatose Agressiva/patologia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
Fibromatosis is a rare, locally aggressive and bening breast tumor that presents problems in the diagnosis and may mimic breast cancer on physical examination, mammography and breast ultrasound. Definitive diagnosis is reached by histologic findings. This case shows the unusual presentation in our patient and management of this unfrecuent desmoid tumor.
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Neoplasias da Mama/diagnóstico , Fibroma/diagnóstico , Fibromatose Agressiva/diagnóstico , Dor/diagnóstico , Adulto , Neoplasias da Mama/complicações , Diagnóstico Diferencial , Feminino , Fibroma/complicações , HumanosRESUMO
INTRODUCTION: Ovarian cancer is a chemosensitive tumour, but two thirds of women have a recurrence during the follow- up, even after an optimal surgical debulking followed by chemotherapy with a platinum and a taxane compound. Cytotoxic drugs are used in a second- or third-line setting but tumour progression is the rule. Also patients with the same histology achieve different outcomes in terms of survival. We decided to study gonadotropin and steroid receptors and to consider if these histological markers could select patients with different prognosis. MATERIALS AND METHODS: In our study we have measured by immunohistochemistry oestrogen, progestin and gonadotropin- releasing hormone receptors (Gn-RHRs) in paraffinembedded ovarian cancer tissue in a sample of 62 consecutive patients with advanced ovarian cancer treated with surgery and adjuvant chemotherapy. Descriptive methods, a survival analysis (Kaplan-Meier) and a Cox regression analysis were done. RESULTS: Oestrogen receptors (ERs) were positive in 65% of patients and the same positivity was obtained for progestin receptors (PRs), with 74% showing some positivity for Gn-RHR receptors. Maximal cytoreduction and ERs, but not gonadotropin receptors, were independently associated with overall survival, with better survival for oestrogennegative tumours. No association was established for progression- free survival. CONCLUSIONS: We can conclude that ER status in our series is an independent prognostic factor for ovarian cancer with better survival for oestrogen-negative receptor tumours. PRs could also have a prognostic role in association with ERs.
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Gonadotropinas/metabolismo , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/metabolismo , Receptores de Esteroides/metabolismo , Adulto , Idoso , Progressão da Doença , Intervalo Livre de Doença , Feminino , Humanos , Imuno-Histoquímica/métodos , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Receptores de Estrogênio/metabolismo , Receptores LHRH/metabolismo , Receptores de Progesterona/metabolismo , Estudos RetrospectivosRESUMO
INTRODUCTION: Metronomic chemotherapy combined with bevacizumab has proved to be effective in various tumour types. The aim of this study is to review our experience in recurrent ovarian carcinomas treated with low-dose cyclophosphamide and bevacizumab. MATERIALS AND METHODS: Retrospective analysis of pre-treated ovarian cancer patients, i.e., > or =2 previous chemotherapy regimens who received treatment with oral cyclophosphamide 50 mg/day and bevacizumab 10 mg/kg IV every two weeks. Patients with a performance status 0-2 were included. The endpoints were response rates, progressionfree disease and safety profile. RESULTS: Nine patients with advanced, measurable ovarian cancer were included. Of these, 8 were platinum-resistant and had received prior regimens with gemcitabine (88%), topotecan (77%) and liposomal doxorubicin (66%). There was a mean of 5 previous lines of chemotherapy, range 2-7. Applying RECIST criteria, the efficacy data were as follows: objective response (OR) 44%; 4/9 (CR 2/9 and PR 2/9), SD 2/9 and DP 3/9. At 6 months, 33% of patients were progression free. Response lasted for 12.5 months in three patients treated for 12 months; a further two patients who were re-treated achieved complete response. Mean time to progression was 5.5 months (95% CI 4.5-5.5). No severe adverse effects were reported. Only one patient had to delay several cycles due to G3 haematuria. Other toxicities observed include G3 abdominal pain (1 case); G2 mucositis and G2 dyspnoea in one patient. CONCLUSIONS: Combined bevacizumab and metronomic oral cyclophosphamide is a safe and effective regimen for heavily pre-treated ovarian cancer patients. Further research is needed on predictive factors to screen for those patients who will benefit from anti-angiogenic therapy.