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Id: biblio-1284173
Autor: Gobbi, Paolo.
Título: Evalúan la quimioterapia con vinblastina, bleomicina y metotrexato en el linfoma de Hodgkin / Assessment of chemotherapy with vinblastine, bleomicine and methotrexate in Hodgkin's lymphoma
Fonte: Salud(i)ciencia (Impresa) = Salud(i)ciencia (En linea);14(4):189-193, jun. 2006. tab., graf..
Idioma: es.
Resumo: Background: VBM chemotherapy (vinblastine, bleomycin and methotrexate) plus irradiation is an effective therapeutic combination in early-stage Hodgkin's lymphoma, but conflicting results have been collected on the toxicity of and correct indication for this combination. Patients and methods: The GISL treated 169 evaluable patients with early-stage, favorable presentation Hodgkin's disease in two successive trials. In the first (MH-1), conducted between 1988-1995, 87 patients were administered the original VBM schedule coupled with extended-field radiotherapy (EF-RT). In the subsequent study (MH1b), performed between 1996-2004, the doses of vinblastine and methotrexate were intensified, the dose of bleomycin was reduced, and small amounts of prednisone were given contemporaneously with any infusion of antitumoral drug (VbMp); irradiation was delivered to involved sites only and had to begin at least 25 days after the end of chemotherapy. Of the 82 patients treated with the MH-1b protocol, 67 were < 65 years old (MH-1b ≤ 65) and 15 were > 65 years old (MH-1b > 65). Results: Complete remission was achieved by 96, 91 and 80% of the patients in the MH-1, MH-1b ≤ 65 and MH-1b > 65 trials, respectively; relapse rates were 12, 9 and 0%, with median follow-ups of 111, 55 and 49 months. Hematological and pulmonary toxicity were acceptable on the whole in the MH-1 group, but more severe when chemotherapy followed radiotherapy than vice versa. In the MH-1b ≤ 65 both these toxicities were abated, while in the MH-1b > 65 severe infections affected 3/15 patients. Conclusions: VbMp followed by involvedfield radiotherapy shows negligible hematological and pulmonary toxicity. The modified protocol appeared as effective as the original VBM + EF-RT protocol, with minimal and not statistically significant differences. The addition of cyclophosphamide to VbMp is under investigation to improve the cell-killing potential of the regimen. The purpose is to cure even early unfavorable presentations of the disease maintaining radiotherapy to involved sites only and avoiding the risk of late cardiotoxicity given by combinations including anthracyclines

Antecedentes: La quimioterapia con vinblastina, bleomicina y metotrexato (VBM) asociada a la irradiación constituye una combinación terapéutica efectiva en el estadio temprano del linfoma de Hodgkin, aunque se publicaron resultados contradictorios respecto de la toxicidad y la indicación adecuada de esta asociación. Pacientes y métodos: El GISL trató y evaluó ­en dos ensayos clínicos­ 169 pacientes en fases tempranas de la enfermedad de Hodgkin con presentación favorable. En el primer estudio (MH-1), realizado entre 1998 y 1995, 87 pacientes fueron medicados con el esquema VBM original asociado a radioterapia de campo extendido (RCE). En el ensayo siguiente (MH-1b), llevado a cabo entre 1996 y 2004, se incrementaron las do-sis de vinblastina y metotrexato, se redujeron las de bleomicina y se administró una pequeña cantidad de prednisona junto con la infusión de cualquier droga antitumoral (VbMp); la irradiación se limitó solamente a los sitios afectados y debía comenzar al menos 25 días después de la finalización de la quimioterapia. De los 82 pacientes tratados con el protocolo MH-1b, 67 tenían 65 años o menos (MH-1b ≤ 65) y 15 eran mayores (MH-1b > 65). Resultados: La remisión completa fue obtenida por 96%, 91% y 80% de los pacientes de los estudios MH-1, MH-1b ≤ 65 y MH1b > 65, respectivamente; las tasas de recaída fueron del 12%, 9% y 0 y las medianas de los períodos de seguimiento de 111, 55 y 49 meses. Para la totalidad del grupo MH-1, la toxicidad pulmonar fue aceptable y más grave cuando la quimioterapia siguió a la radioterapia y no a la inversa. En el grupo M-1b ≤ 65, estas toxicidades fueron mitigadas y en el MH-1b > 65, 3 de 15 pacientes fueron afectados por infecciones graves. Conclusiones: La VbMp seguida de radioterapia del sitio afectado (RSA) presenta una toxicidad hematológica y pulmonar casi nula. El protocolo modificado pareció tan efectivo como el original VBM + RCE y las diferencias fueron mínimas y estadísticamente no significativas. En fases de investigación se estudia el agregado de ciclofosfamida al régimen VbMp con el fin de mejorar su poder citodestructor. El objetivo está constituido por la curación, incluso de las formas tempranas y no favorables de la enfermedad, a través de la aplicación de radioterapia exclusivamente a los sitios afectados y evitar el riesgo de cardiotoxicidad tardía que se observa en las asociaciones con antraciclinas
Descritores: Vimblastina
Bleomicina
Doença de Hodgkin
Metotrexato
Tratamento Farmacológico
Toxicidade
-Linfoma
Limites: Humanos
Masculino
Feminino
Responsável: AR392.1 - Biblioteca


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Id: biblio-961424
Autor: Peña, Camila; Voisin, Javier; González, José Tomás; Villegas, Pablo.
Título: Necrolisis epidérmica tóxica en el curso de un síndrome hemofagocítico secundario a linfoma de Hodgkin: caso clínico / Toxic epidermal necrolysis during a hemophagocytic syndrome secondary to Hodgkin lymphoma: report of one case
Fonte: Rev. méd. Chile;146(4):523-527, abr. 2018. graf.
Idioma: es.
Resumo: Toxic epidermal necrolysis (TEN) is a lethal entity, characterized by extensive epidermal necrosis and multiorgan failure. Hemophagocytic syndrome (HFS) is also a rare and lethal syndrome characterized by hyperinflammation that leads to the appearance of fever, pancytopenia, organomegaly and hemophagocytosis. The concomitance of these diseases is extremely uncommon. We report a 38 years old female, who during the course of a HFS secondary to Hodgkin Lymphoma (HL), presented a TEN secondary to antibiotics. She was admitted due to a consumptive syndrome, lymphadenopathy, visceromegaly and severe pancytopenia. Laboratory and bone marrow tests confirmed HFS. Due to constant fever, imipenem was indicated. On the third day she started with pain and skin rash. She evolved with positive Nikolsky sign. Cutaneous biopsy was concordant with extensive TEN, which was managed with intravenous immunoglobulin and dexamethasone. A complete response and normalization of the blood count were achieved. Finally, the lymph node biopsy showed HL of mixed cellularity type, which was managed with 8 cycles of ABVD chemotherapy, achieving complete remission.
Descritores: Doença de Hodgkin/complicações
Síndrome de Stevens-Johnson/etiologia
Linfo-Histiocitose Hemofagocítica/etiologia
-Vimblastina
Bleomicina
Doença de Hodgkin/patologia
Doença de Hodgkin/tratamento farmacológico
Protocolos de Quimioterapia Combinada Antineoplásica
Doxorrubicina
Imipenem/efeitos adversos
Síndrome de Stevens-Johnson/patologia
Síndrome de Stevens-Johnson/tratamento farmacológico
Resultado do Tratamento
Dacarbazina
Linfo-Histiocitose Hemofagocítica/patologia
Linfo-Histiocitose Hemofagocítica/tratamento farmacológico
Antibacterianos/efeitos adversos
Limites: Humanos
Feminino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: lil-718189
Autor: Rabello, Felipe Bettini; Souza, Cleyton Dias; Farina Júnior, Jayme Adriano.
Título: Update on hypertrophic scar treatment
Fonte: Clinics;69(8):565-573, 8/2014. graf.
Idioma: en.
Resumo: Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury. Hypertrophic scars and keloids are pathological scars resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability. The current review will focus on the definition of hypertrophic scars, distinguishing them from keloids and on the various methods for treating hypertrophic scarring that have been described in the literature, including treatments with clearly proven efficiency and therapies with doubtful benefits. Numerous methods have been described for the treatment of abnormal scars, but to date, the optimal treatment method has not been established. This review will explore the differences between different types of nonsurgical management of hypertrophic scars, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin. .
Descritores: Cicatriz Hipertrófica/terapia
Queloide/terapia
-Cicatrização
Bleomicina/uso terapêutico
Injeções Intralesionais
Cicatriz Hipertrófica/etiologia
Cicatriz Hipertrófica/patologia
Corticosteroides/uso terapêutico
Géis de Silicone/uso terapêutico
Trajes Gravitacionais
Queloide/patologia
Limites: Humanos
Tipo de Publ: Revisão
Responsável: BR1.1 - BIREME


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Id: biblio-1144505
Autor: Fernández García, Sergio; González Díaz, Donel; Cruz Vera, Yaquelín; Díaz Toledo, Manuel; Díaz Garrido, Drialis; Díaz González, Lorena.
Título: Uso de bleomicina en el manejo del derrame pleural recidivante maligno / Bleomycin in the management of malignant recurrent pleural effusion
Fonte: Rev. cuba. med;59(4):e1577, oct.-dic. 2020. tab, graf.
Idioma: es.
Resumo: Introducción: El derrame pleural recidivante maligno se reproduce en breve tiempo y requiere el diagnóstico etiológico positivo de malignidad, la etiología más frecuente es el cáncer de pulmón. La pleurodesis química es el tratamiento de elección con la aplicación intrapleural de sustancias sinfisiantes. Objetivo: Describir la respuesta clínica y radiológica de los enfermos con derrame pleural recidivante maligno con el uso de bleomicina. Método: Estudio observacional comparativo en 30 pacientes con derrame pleural recidivante maligno divididos en dos grupos, en uno se aplicó la bleomicina intrapleural y al otro yodo povidona. Resultado: El 33,3 por ciento fueron del sexo masculino, 60 por ciento perteneció al grupo de edades de 60-69 años. El grupo tratado con bleomicina presentó una respuesta clínica favorable en los síntomas, p<0,005 después de la pleurodesis. En la evaluación de la respuesta radiológica, 66,6 por ciento pacientes tratados con la bleomicina tuvieron una resolución completa. Conclusiones: Se logró una buena respuesta clínica-radiológica con la pleurodesis química similar entre ambas modalidades de tratamiento. Se obtuvieron mejores resultados y menos reacciones adversas con la bleomicina intrapleural(AU)

Introduction: The malignant recurrent pleural effusion reproduces in short time and it requires a positive etiological diagnosis of malignancy, the most frequent etiology is lung cancer. Chemical pleurodesis is the treatment of choice with the intrapleural application of symphysiating substances. Objective: To describe the clinical and radiological response of patients with malignant recurrent pleural effusion with the use of bleomycin. Method: A comparative observational study in 30 patients with recurrent malignant pleural effusion was carried out. They were divided into two groups, one used intrapleural bleomycin and the other group used povidone iodine. Result: 33.3 percent were male, 60 percent belonged to the 60-69 age group. The group treated with bleomycin presented favorable clinical response in symptoms, p <0.005 after pleurodesis. At the evaluation of the radiological response, 66.6 percent patients treated with bleomycin had a complete resolution. Conclusions: Good clinical-radiological response was achieved with similar chemical pleurodesis between both treatment modalities. Better results and fewer adverse reactions were obtained with intrapleural bleomycin(AU)
Descritores: Bleomicina/uso terapêutico
Derrame Pleural Maligno/tratamento farmacológico
Neoplasias Pulmonares/etiologia
-Estudo Observacional
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Estudo Comparativo
Estudo Observacional
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-989965
Autor: Leon-Rodriguez, Eucario; Rivera-Franco, Monica M; Lacayo-Leñero, Dennis; Campos-Castro, Andrea; Meneses-Medina, Monica I.
Título: First - line, non - cryopreserved autologous stem cell transplant for poor - risk germ - cell tumors: Experience in a developing country
Fonte: Int. braz. j. urol;45(1):74-82, Jan.-Feb. 2019. tab, graf.
Idioma: en.
Resumo: ABSTRACT Purpose: The current first - line treatment for non - seminomatous germ cell tumor (NSGCT) consists of four cycles of cisplatin, etoposide, and bleomycin (BEP), which results in 5 - year overall survival < 60% in patients with poor - risk features. Autologous hematopoietic stem cell transplantation (auto - HSCT) as a method for overcoming high toxicity after high dose chemotherapy (HDC) has been explored in different solid tumors, but has remained standard practice only for NSGCT. Our objective was to describe outcomes of patients with poor - risk NSGCT who underwent first - line autologous HSCT in a tertiary center in Mexico. Patients and Methods: Twenty nine consecutive patients with NSGCT who received first - line, non - cryopreserved autologous HSCT at the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, Mexico, from November 1998 to June 2016, were retrospectively analyzed. Results: The median age at transplantation was 23 (15 - 39) years. Most patients (n = 18, 62%) had testicular primary tumor, and 23 had metastases (79%). Complete response after auto - HSCT was observed in 45%. Non - relapse mortality was 0. Five - year relapse / progression free and overall survival were 67% and 69%, respectively. Conclusions: This small single limited - resource institution study demonstrated that patients with poor - risk NSGCT are curable by first - line HDC plus autologous HSCT and that this procedure is feasible and affordable to perform using non - cryopreserved hematopoietic stem cells.
Descritores: Neoplasias Testiculares/terapia
Bleomicina/administração & dosagem
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Cisplatino/administração & dosagem
Neoplasias Embrionárias de Células Germinativas/terapia
Transplante de Células-Tronco Hematopoéticas/métodos
Etoposídeo/administração & dosagem
-Estudos Retrospectivos
Resultado do Tratamento
Terapia Combinada
Estimativa de Kaplan-Meier
Responsável: BR1.1 - BIREME


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Id: biblio-974931
Autor: Eder-Czembirek, Christina; Rechinger, Sascha; Kornek, Gabriela; Selzer, Edgar; Seemann, Rudolf.
Título: Experience in intra-arterial chemotherapy using two protocols for the treatment of OSCC over two decades at the University Hospital Vienna
Fonte: Clinics;73:e433, 2018. tab, graf.
Idioma: en.
Resumo: OBJECTIVES: This retrospective study performed a comprehensive analysis of the usage of intra-arterial chemotherapy (iaCh) for locally recurrent UICC stage IV oral squamous cell carcinoma (OSCC) over two decades at the Department of Cranio-Maxillofacial and Oral Surgery at the University Hospital Vienna to assess the utility of its future use. METHODS: Between 1994 and 2014, iaCh was indicated in 48 OSCC cases. In these, the two most frequent iaCh schemes, cisplatin/5-fluorouracil (Cis/5-FU) and methotrexate/bleomycin (MTX/Bleo), were chosen for further analysis. The effect on survival of two distinct intra-arterial protocols and their covariates were analyzed with the Kaplan-Meier method as well as univariate and multivariate Cox proportional hazard regression models. RESULTS: The mean follow-up period was 29.91 months. The two intra-arterial chemotherapy groups did not differ significantly in sample size, demographic data or therapeutic covariates. The Cis/5-FU iaCh regimen was associated with significantly better overall survival (median OS 2.6 years vs. 1.3 years; p=0.002) and had a beneficial effect on survival (HR=3.62, p=0.015). Side effects occurred at a frequency similar to that described in the literature for intravenous chemotherapy (ivCh). CONCLUSIONS: These results suggest a preference for administering Cis/5-FU for iaCh. Nevertheless, due to economic considerations in healthcare expenditures, there is no future for iaCh in the treatment of head and neck carcinomas because ivCh is known to be equivalent.
Descritores: Neoplasias Bucais/tratamento farmacológico
Carcinoma de Células Escamosas/tratamento farmacológico
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
-Bleomicina/administração & dosagem
Infusões Intra-Arteriais
Metotrexato/administração & dosagem
Estudos Retrospectivos
Cisplatino/administração & dosagem
Resultado do Tratamento
Estimativa de Kaplan-Meier
Fluoruracila/administração & dosagem
Recidiva Local de Neoplasia
Estadiamento de Neoplasias
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Adulto Jovem
Tipo de Publ: Estudo Comparativo
Responsável: BR1.1 - BIREME


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Id: biblio-1014244
Autor: Cabrera C, María Elena; Puga L, Bárbara; Torres, Vivianne; Salinas, Mauricio.
Título: Evaluación del tratamiento de linfoma de Hodgkin con esquema ABVD en Chile / Treatment of Hodgkin lymphoma: analysis of 915 patients
Fonte: Rev. méd. Chile;147(4):437-443, abr. 2019. tab, graf.
Idioma: es.
Resumo: Background: Hodgkin lymphoma has a high rate of curability, even in advanced stages. Aim: To assess the results of Hodgkin lymphoma treatment using the ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy regimen. Material and Methods: Analysis of a database held by the Chilean Ministry of Health, including all patients treated at accredited cancer treatment centers. Results: Data for 915 patients, median age 35 years (range 15-86 years) and followed for a median of 97 months (range 1-347 months) were analyzed. Forty-one percent had localized disease. Overall survival at five years for localized and advanced stages was 92% and 74%, respectively. The figures for progression free survival were 87% and 64%, respectively. Patients with relapse who received autologous stem cell transplantation (ASCT) had a five year overall survival of 92%, compared to 64% among those who did not undergo this procedure (p < 0.01). The Guarantees in Health Program set up by the Ministry of Health, was associated with earlier stage disease at diagnosis. Conclusions: The ABVD regimen achieves high rates of cure in localized stages of the disease but the results in advanced stages are not optimal. ASCT significantly improves survival in patients with relapse. The Guarantees in Health Program is associated with earlier diagnosis of the disease.
Descritores: Doença de Hodgkin/tratamento farmacológico
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
-Fatores de Tempo
Vimblastina/uso terapêutico
Bleomicina/uso terapêutico
Doença de Hodgkin/mortalidade
Doença de Hodgkin/patologia
Doxorrubicina/uso terapêutico
Chile
Resultado do Tratamento
Transplante de Células-Tronco Hematopoéticas/métodos
Intervalo Livre de Doença
Dacarbazina/uso terapêutico
Estimativa de Kaplan-Meier
Limites: Humanos
Masculino
Feminino
Adolescente
Adulto
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Adulto Jovem
Responsável: CL1.1 - Biblioteca Central


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Id: lil-785826
Autor: Grau, Juan José; Caballero, Miguel; Langdon, Cristobal; Bernal-Sprekelsen, Manuel; Blanch, Jose Luis.
Título: Electrochemotherapy as palliative treatment in patients with thyroid papillary carcinoma / Eletroquimioterapia como tratamento paliativo em pacientes com carcinoma papilar da tireoide
Fonte: Braz. j. otorhinolaryngol. (Impr.);82(3):285-288graf.
Idioma: en.
Resumo: ABSTRACT INTRODUCTION: Local progression of papillary thyroid carcinoma (PTC) after failure of standard therapies may cause pain, ulceration, and bleeding. As patients are fully aware of the tumor growth, they might suffer high grade anxiety. Electrochemotherapy (ECT) is a new local palliative treatment for skin metastases of malignant melanoma or other tumors, including squamous head e neck cancer patients. OBJECTIVE: To evaluate the impact of ECT in patients with local progression of PTC. METHODS: Four patients with local progression of PTC were treated with ECT based on Bleomycin, and evaluated according to tumor response, local pain and side effects. RESULTS: In all cases, some grade of tumor response was observed, lasting 6, 7, 12 and 8 months, respectively. Also, reduction of local pain and anxiety was registered in all patients. Tumor infiltrated skin necrosis was the only collateral effect of the treatment. ECT induced a tumor response in all PTC patients with improvement of symptoms. CONCLUSIONS: ECT may be an option for local palliative treatment in PTC patients with local tumor progression.

Resumo Introdução: A progressão local do carcinoma papilífero de tireoide (CPT) após a falha da terapia de rotina pode causar dor, ulceração e sangramento. Considerando que os pacientes estão perfeitamente cientes do crescimento tumoral, podem apresentar um alto grau de ansiedade. A eletroquimioterapia (EQT) é um novo tratamento paliativo para metástases de pele de melanoma maligno ou de outros tumores, inclusive em pacientes com carcinoma escamoso de cabeça e pescoço. Objetivo: Avaliar o impacto da EQT em pacientes com progressão local de CPT. Método: Quatro pacientes com progressão local de CPT foram tratados com EQT com base em bleomicina, e avaliados em relação ao grau de resposta tumoral, dor local, efeitos colaterais. Resultados: Em todos os casos, foi observado algum grau de resposta tumoral, que perdurou por 6, 7, 12 e 8 meses, respectivamente. Da mesma forma, foi registrada diminuição da dor local e da ansiedade em todos os pacientes. Necrose cutânea na infiltração tumoral foi o único efeito colateral do tratamento. EQT induziu resposta tumoral em todos os pacientes com CPT, com melhora dos sintomas. Conclusões: EQT pode ser uma opção para o tratamento paliativo tópico em pacientes com CPT com progressão tumoral local.
Descritores: Cuidados Paliativos
Bleomicina/administração & dosagem
Neoplasias da Glândula Tireoide/tratamento farmacológico
Carcinoma/tratamento farmacológico
Eletroquimioterapia
Antibióticos Antineoplásicos/administração & dosagem
-Carcinoma Papilar
Resultado do Tratamento
Câncer Papilífero da Tireoide
Recidiva Local de Neoplasia
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Tipo de Publ: Estudo Comparativo
Responsável: BR1.1 - BIREME


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Id: lil-521884
Autor: Castaños, C; Aguerre, V; Zubizarreta, P; Braier, J; Grenoville, M.
Título: Secuelas pulmonares del tratamiento de la enfermedad de Hodgkin / Pulmonary sequelae of therapy for Hodgkin´s disease
Fonte: Med. infant;8(2):97-101, jun. 2001. tab.
Idioma: es.
Resumo: En las últimas décadas se ha producido un incremento en la sobrevida de las enfermedades malignas pediátricas. En la enfermedad de Hodgkin (EH) esta ha alcanzado el 90 por ciento, sin embargo la morbilidad secundaria al tratamiento persiste. Objetivos: determinar la incidencia de enfermedad pulmonar secundaria al tratamiento de la EH en pacientes pediátricos que reciben el protocolo COPP/ABV. Material y métodos: desde el año 1996 gasta el 2000 se diagnosticaron 55 pacientes con diagnóstico de EH que fueron enrolados en este protocolo. Se incluyeron en el estudio 22 pacientes con estudio funcional respiratorio completo. Los pacientes se dividieron en cuatro estadios y estos en A o B de acuerdo a si presentaron síntomas o no al momento del diagnóstico. Las drogas utilizadas fueron Vincristina, Ciclofosfamida. Procarbazina, Prednisona, Doxorrubicina, Bleomicina y Vinblastina. En todos los pacientes se realizaron pruebas de función pulmonar completas. Resultados: se estudiaron 22 pacientes con EH desde el punto de vista respiratorio. Once varones, edad x 12.1 (r6.1 -16.4); 3 pacientes fueron estadio 1.7 estadio II, 2 estadio III y 10 estadio IV. Todos recibieron quimioterapia (QMT) y 13 además radioterapia (RDT). La CVF estubo disminuida en forma significativa en 1/22 luego del 4º ciclo, en 4/22 la DLCO disminuyó más del 20 por ciento, y la CPT presentó caída en 1/22. De los pacientes que recibieron RDT, 10 completaron los estudios funcionales, 6/10 presentaron disminución de la CVF y 4/10 de la DLCO y la CPT. Conclusión: la quimioterapia y la radioterapia producen morbilidad pulmonar. Nosotros creemos necesario monitorear la toxicidad pulmonar mediante pruebas de función pulmonar seriadas en los niños con EH.
Descritores: Bleomicina/uso terapêutico
Doença de Hodgkin/tratamento farmacológico
Doença de Hodgkin/radioterapia
Doença de Hodgkin/terapia
Morbidade
Testes de Função Respiratória
-Estudos Prospectivos
Limites: Masculino
Feminino
Criança
Adolescente
Responsável: AR94.1 - Centro de Información Pediatrica


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Id: lil-559690
Autor: Pecho Silva, Samuel; Valenzuela Rodríguez, German; Quispe Antúncar, Luis; Crossa, Aldo; Pineda Bonilla, josé.
Título: Estudio comparativo de la eficacia y seguridad entre la belomicina, tetraciclina o ambas en el tratamiento d elos derrames pleurales malignos metastáticos mediante pleurodesis / Comparative study of the efficiency and safety between the belomicina, tetracycline or both in the treatment d elos pleural malignant spillages metastáticos by means of pleurodesis
Fonte: Enfer. tórax (Lima);53(1):16-22, ene.-jun. 2009. tab, graf.
Idioma: es.
Resumo: Obrjetivo: Comparar la eficacia y la seguridad de los agentes esclerosantes empleados en nuestro medio en le manejo de los derrames pleurales malignos metastásicos: tetraciclina, bleomicina o su combinación. Material y métodos: Se llevó a cabo un estudio prospectivo, asignación secuencial, comparativo. Se incluyeron a todos los pacientes que requirieron colocación de tubo de drenaje para posterior pleurodesis como manejo del derrame pleural maligno metatásicos durante el periódo de julio a diciembre del 2006. Los agentes a comparar fueron la tetraciclina sola, la bleomicina sola o el uso combinado de ambas. En todos los casos el seguimiento prospectivo se hizo con al realizacion de una radiografía de tórax cada 30 días por un periódo de 180 días para cada paciente (Agosto 2006 - Junio 2007). Se analizaron los datos comparando la sobrevida, los efectos adversos relacionados al agente esclerosante y la realización de una pleurodesis óptima definida como la ausencia total de recidiva del derrame pleural o el derrame pleural que no requiere toracocentesis o una nueva colocación de tubo de drenaje. Resultados: 27 pacientes de un total de 38 cumplian con los criterios de inclusión y no de exclusión. Obteniéndose que la sobrevida total a seis meses fue de 37 por ciento. No hubo diferencias estadísticamente significativas en cuanto al agente estudiado y la sobrevida. No se encontraron diferencias estadísticamente significativas de efectos adversos en los diferentes grupos. Al excluir a los fallecidos para cada grupo, la tetraciclina tuvo mejor efecto esclerosante siendo esta diferencia estadísticamente significativa. Conclusiones: El derrame pleural maligno matastásico es un signo ominoso de la enfermedad. En este tipo de pacientesla tetraciclina demostró tener un mejor perfil como agente esclerosantem un número de efectos adversos comparables al otro agente o a la combinación y no demostró diferencias en cuanto a la sobrevida.

Objective: To compare the effectiveness and security of sclerosing agents used in tha management of metastatic malignant pleural effusion: tetracycline, bleomycin or the combination of both. Patient and methods: A prospective, sequential, comparative study was performed. All patients who required drainage tube placement followed by pleurodesis as management of metastatic malignant pleural effusion during the period from july to december 2006 were included. The agents to compare were tetracycline, bleomycin or the combined used of both. In all cases the prospective surveillance was made with a chest X - ray every 30 days in a 180 days period for each patient (august 2006 to june 2007). Data were analyzed comparing survival rate, adverse events related with the sclerosing agent and optimal pleurodesis defined as the complete absence of recurrent pleural effusion or pleural effusion that not requires thoracocentesis or a new drainage tube placement. Results: From a total of 38 patients, 27 filled the inclusion but not the exclusion criteria of the study. The survival rate at six months was of 37 per cent. There were no statistically significant differences between the studied agent and teh survival rate. No adverse events. After excluding those who had died in each group, tetracycline had the best sclerosing effect being this difference statistically significant. Conclusions: Metestatic malignant pleural effusion is an ominous sign of the disease. In this kind of patients, tetracycline had a better profile as sclerosing agent, the number of adverse events in comparison with the other agent or their combination showed no differences in the survival rate.
Descritores: Bleomicina/uso terapêutico
Doenças Pleurais/terapia
Pleurodese
Tetraciclina/uso terapêutico
Limites: Humanos
Masculino
Adulto
Feminino
Pessoa de Meia-Idade
Tipo de Publ: Estudo Comparativo
Responsável: PE1.1 - Oficina Universitária de Biblioteca



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