Eficacia de la quimioterapia en pacientes con cáncer de pulmón no microcítico : estadios III y IV, Instituto Oncológico Nacional SOLCA Dr. Juan Tanca Marengo
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2013
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Objetivo: Determinar la eficacia de la quimioterapia en el cáncer de pulmón no microcítico (CPNM) en estados avanzados en el Hospital Oncológico "Juan Tanca Marengo" Guayaquil.
Métodos: Estudio de diseño no experimental, retrospectivo. Se obtuvo información con datos de historias clínicas de pacientes con diagnóstico de CPNM en formato electrónico y en papel, y variables se analizaron con el programa Medcalc, las mismas se expresaron con promedio, media, razón e intervalo de confianza (IC). La estatificación se realizó con la TC, como medida de respuesta se usó los Criterios de RECIST (Response Evaluation Criteria in Solid Tumors). Se midió el tiempo hasta la progresión de la enfermedad (PE) y la supervivencia global (SG) con el método de Kaplan Meier.
Resultados: La muestra fue de 99 pacientes cuyo promedio de edad fue de 64 años, con predominio de varones (51.5%). La exposición al tabaco sigue siendo el principal factor de riesgo. Se confirmó que el adenocarcinoma (60.6%) es la estirpe histopatológica más frecuente. Después de recibir primera línea de quimioterapia, se obtuvo el 17.86% de respuesta parcial (RP), el 78.57% progresión de la enfermedad (PE), un solo paciente con enfermedad estable (EE). El protocolo estándar (taxano/bases de platino) asociado a un anticuerpo monoclonal (Bevacizumab) y gemcitabina/platino mantuvieron la mayor promedio de supervivencia aun cuando tuvieron progresión de la enfermedad, con un IC 95% (p=0.01 <0,001). De la muestra solo el 27% pasaron a segunda línea de quimioterapia, obteniéndose el 17.86% de RP, el 78.5% de PE, sin obtener RC. La asociación de un anticuerpo monoclonal con inhibidor de la tirosin cinasa como el erlotinib y este como monoterapia dieron un mayor promedio de supervivencia global pero no impide la progresión de la enfermedad con un IC 95% (p=0,0087<0,01), llegando a la cronicidad de la misma.
Conclusiones: La combinación de taxano/platino/Bevacizumab, gemcitabina/platino y Erlotinib/Bevacizumab, aumentan la supervivencia global aun cuando no impiden la progresión de la enfermedad.
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Objective: To determine the efficacy of chemotherapy in lung cancer (NSCLC) at advanced stages in the Hospital Cancer "Juan Tanca Marengo" Guayaquil. Methods: A non-experimental, retrospective. Information was obtained using data from medical records of patients diagnosed with NSCLC in electronic and paper format, and variables were analyzed with the program Medcalc, they were expressed as mean, median, reason and confidence interval (CI). The stratification was performed with CT, as a measure of response used the RECIST criteria (Response Evaluation Criteria in Solid Tumors). We measured the time to progression of disease (PD) and overall survival (OS) with the Kaplan Meier method. Results: The sample consisted of 99 patients whose average age was 64 years, with a predominance of males (51.5%). Snuff exposure remains the main risk factor. Confirmed that the adenocarcinoma (60.6%) is the most common histopathological lineage. After receiving first-line chemotherapy, we obtained 17.86% partial response (PR), the 78.57% progression of disease (PD), one patient with stable disease (SD). The standard protocol (taxane / platinum base) associated with a monoclonal antibody (bevacizumab) and gemcitabine / platinum maintained higher survival rate even when they had disease progression, a 95% (p = 0.01 <0.001). Of the sample, only 27% went to second-line chemotherapy, yielding 17.86% PR, 78.5% of PE, without obtaining RC. The association of a monoclonal antibody with tyrosine kinase inhibitor erlotinib as monotherapy and this gave a higher average overall survival but does not prevent progression of the disease with a 95% (p= 0.0087<0.01), reaching the chronicity of it. Conclusions: The combination of taxane / platinum / Bevacizumab, gemcitabine / erlotinib platinum / Bevacizumab, increase overall survival even when not prevent disease progression.
Objective: To determine the efficacy of chemotherapy in lung cancer (NSCLC) at advanced stages in the Hospital Cancer "Juan Tanca Marengo" Guayaquil. Methods: A non-experimental, retrospective. Information was obtained using data from medical records of patients diagnosed with NSCLC in electronic and paper format, and variables were analyzed with the program Medcalc, they were expressed as mean, median, reason and confidence interval (CI). The stratification was performed with CT, as a measure of response used the RECIST criteria (Response Evaluation Criteria in Solid Tumors). We measured the time to progression of disease (PD) and overall survival (OS) with the Kaplan Meier method. Results: The sample consisted of 99 patients whose average age was 64 years, with a predominance of males (51.5%). Snuff exposure remains the main risk factor. Confirmed that the adenocarcinoma (60.6%) is the most common histopathological lineage. After receiving first-line chemotherapy, we obtained 17.86% partial response (PR), the 78.57% progression of disease (PD), one patient with stable disease (SD). The standard protocol (taxane / platinum base) associated with a monoclonal antibody (bevacizumab) and gemcitabine / platinum maintained higher survival rate even when they had disease progression, a 95% (p = 0.01 <0.001). Of the sample, only 27% went to second-line chemotherapy, yielding 17.86% PR, 78.5% of PE, without obtaining RC. The association of a monoclonal antibody with tyrosine kinase inhibitor erlotinib as monotherapy and this gave a higher average overall survival but does not prevent progression of the disease with a 95% (p= 0.0087<0.01), reaching the chronicity of it. Conclusions: The combination of taxane / platinum / Bevacizumab, gemcitabine / erlotinib platinum / Bevacizumab, increase overall survival even when not prevent disease progression.
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Neoplasias pulmonares, Quimioterapia, Supervivencia global, Progresión de la enfermedad, Hospital SOLCA de Guayaquil, Cantón Guayaquil, Ecuador, Estudios retrospectivos