Valoración clínica del estado dental y periodontal en un grupo de pacientes oncológicos, previo inicio de la quimioterapia

Objetivos: Valorar el estado bucodental en 88 pacientes con cánceres corporales, previo al inicio de su tratamiento quimioterápico. Diseño del estudio: Estudiamos 88 pacientes con cánceres de diferentes localizaciones corporales y los comparamos con un grupo control. Analizamos la placa dental (mediante el índice de Silness y Löe), el estado dental (mediante el índice CAO.D) y el estado periodontal (índice CPI modificado). Resultados: En el grupo de pacientes oncológicos, la media del índice de placa de Silnness y Löe fue de 1,28±0,11. Los pacientes presentaban múltiples ausencias dentarias, siendo la media de dientes ausentes por caries de 7,55±0,80. También se observó que la media de caries por paciente era de 2,10±0,36 y de dientes obturados de 2,27±0,37; por lo que respecta al estado periodontal, el valor del índice CPI modificado fue de 1,45±0,11. En el grupo control, la media del índice de placa de Silnness y Löe fue de 0,94±0,00. Por lo que respecta a los dientes cariados, la media era de 1,21±0,25; la media de dientes ausentes por caries era de 4,97±0,67 y el valor de la media de los dientes obturados era de 4,82±0,44. La media del índice periodontal CPI modificado, en el grupo control, fue de 1,29±0,10. Conclusiones: Los pacientes oncológicos de nuestro estudio presentaron mayor cantidad de placa dental que los pacientes sanos. Además tenían más dientes cariados y ausentes que los individuos sanos. En cambio, los pacientes del grupo control presentaron más dientes obturados que los pacientes afectos de cáncer. El estado periodontal estudiado en ambos grupos de pacientes, mediante el índice CPI modificado, demostró que era similar en los individuos sanos y en los oncológicos.Objective: To evaluate the dental status of 88 cancer patients before chemotherapy. Material and methods: Eighty-eight patients with cancer in different body locations were studied and compared with a control group. Dental plaque was assessed by means of the Silness and Löe index, dental status with the DMFT index, and periodontal status with the modified CPI index. Results: In the oncological patients the mean Silness and Löe index was 1.28±0.11. Patients showed multiple missing teeth (mean number 7.55±0.80); the mean number of decayed teeth was 2.10±0.36; and the mean number of filled teeth was 2.27±0.37. As to periodontal status, the mean modified CPI index was 1.45±0.11. In the control group, the mean Silness and Löe index was 0.94±0.00. The mean number of decayed teeth was 1.21±0.25; the mean number of missing teeth was 4.97±0.67; and the mean number of filled teeth was 4.82±0.44. The mean modified CPI index was 1.29±0.10. Conclusions: Oncological patients in our study showed more dental plaque versus healthy patients and more decayed and missing teeth. However, patients in the control group showed more filled teeth than cancer patients. Periodontal status as determined by the modified CPI index was similar in both patient groups

Clinical evaluation of dental and periodontal status in a group of oncological patients before chemotherapy

Objective: To evaluate the dental status of 88 cancer patients before chemotherapy. Material and methods: Eighty-eight patients with cancer in different body locations were studied and compared with a control group. Dental plaque was assessed by means of the Silness and Löe index, dental status with the DMFT index, and periodontal status with the modified CPI index. Results: In the oncological patients the mean Silness and Löe index was 1.28±0.11. Patients showed multiple missing teeth (mean number 7.55±0.80); the mean number of decayed teeth was 2.10±0.36; and the mean number of filled teeth was 2.27±0.37. As to periodontal status, the mean modified CPI index was 1.45±0.11. In the control group, the mean Silness and Löe index was 0.94±0.00. The mean number of decayed teeth was 1.21±0.25; the mean number of missing teeth was 4.97±0.67; and the mean number of filled teeth was 4.82±0.44. The mean modified CPI index was 1.29±0.10. Conclusions: Oncological patients in our study showed more dental plaque versus healthy patients and more decayed and missing teeth. However, patients in the control group showed more filled teeth than cancer patients. Periodontal status as determined by the modified CPI index was similar in both patient groups

Treatment patterns for metastatic colorectal cancer in Spain

Abstract Purpose The primary aim of this retrospective study was to describe the treatment patterns according to the type of treatment received by patients with metastatic colorectal cancer (mCRC) in Spain. Methods This was a retrospective, observational, multicenter study performed by 33 sites throughout Spain that included consecutive patients aged 18 years or older who had received or were receiving treatment for mCRC. Results At the time of inclusion, of the 873 evaluable patients, 507 (58%) had received two lines, 235 (27%) had received three lines, 106 (12%) had received four lines, and the remaining patients had received up to ten lines. The most frequent chemotherapy schemes were the FOLFOX or CAPOX regimens (66%) for frst-line treatment, FOLFOX, CAPOX or FOLFIRI (70%) for second-line treatment, and FOLFOX, FOLFIRI or other fuoropyrimidine-based regimens for third- and fourth-line (over 60%) treatment. Sixty percent of patients received targeted therapy as part of their frst-line treatment, and this proportion increased up to approximately 70% of patients as part of the second-line of treatment. A relevant proportion of patients were treated with unknown KRAS, and especially the BRAF, mutation statuses. Conclusions This study reveals inconsistencies regarding adherence to the recommendations of the ESMO guidelines for the management of mCRC in Spain. Improved adherence to the standard practice described in such guidelines for the determination of RAS and BRAF mutation statuses and the use of targeted therapies in frst-line treatment should be considered to guarantee that patients can beneft from the best therapeutic approaches available. Keywords Colorectal cancer · Metastatic · Treatment patterns · KRAS/BRAF mutation status · Clinical practice guidelin

Postural Alterations in Breast Cancer Patients Undergoing Chemotherapy Treatment

Breast cancer (BC) is the most common malignant neoplasm in women worldwide. Chemotherapy (CT) remains essential in the treatment of this type of tumour. Patients may present musculoskeletal disorders due to the side effects of CT, which can lead to inability to walk, fall, or fractures associated with balance disorders. The objective of the present review is to analyse postural alterations in patients with BC undergoing CT. Previous reports both prospective and retrospective cohort studies from 2010 to 2020, were included. The results show a strong relationship between postural alterations and patients with BC undergoing CT treatment. These data suggest that exposure to CT is an important factor not only for the presence of balance alterations and risk of falls but also for the decrease of quality of life in these patients. These results point out the need to diagnose and assess postural alterations to prevent functional impact in BC patients through exercise programs

Relation of Malnutrition and Nosocomical Infections in Cancer Patients in Hospital: An Observational Study

Aim. To investigate the relation between malnutrition and nosocomial infections (NI) in hospitalized cancer patients. Methods. This observational, cross-sectional, noninterventional, descriptive study was conducted in a 500-bed university hospital in Valencia (Spain). Adult cancer patients admitted to the oncology ward were consecutively enrolled regardless of their nutritional status between November 2019 and March 2020. Patients were nutritionally assessed 24 to 48 hours after admission. Body weight, height and BMI, body composition through measurement of bioelectrical impedance analysis (BIA), and muscle strength and functionality using hand grip strength (HGS) were prospectively collected. The diagnosis of malnutrition and sarcopenia was assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria and the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, respectively. Patients were followed up during their hospital stay or outpatient oncology visits to identify possible NI. Results. A total of 107 patients were included in this study (mean age 66 years; 66.4% were men). The most frequent reason for admission was cancer treatment (19.6%), followed by infections (18.7%) and digestive tract symptoms (18.7%). Overall, 77.5% (83/107) of the patients were malnourished at admission according to the GLIM criteria, while 52.3% (56/107) were sarcopenic. Nosocomial infections (NI) were significantly more frequent in malnourished (52.1%; 25/48) and severely malnourished (42.1%; 8/19) patients, compared with well-nourished patients without malnutrition (25%; 10/40; ). The mean length of hospital stay was 13.9 days, significantly longer in patients with an NI compared to those without infections (18.6 vs. 10.8 days, ). Conclusion. This study evidenced the need to implement a routine protocol for the nutritional assessment and support of cancer patients at risk of malnutrition and sarcopenia to reduce the risk of NI during their hospital stay

Valoración e intervención nutricional en pacientes oncológicos hospitalizados en riesgo de desnutrición o con desnutrición : evaluación del efecto sobre parámetros antropométricos y de composición corporal

Introducción: la desnutrición es un problema frecuente en los pacientes oncológicos que empeora durante la hospitalización y se asocia con mayor morbimortalidad y deterioro de la calidad de vida. Objetivos: describir el efecto de la implantación de un protocolo de valoración y soporte nutricional sobre el estado nutricional de pacientes oncológicos hospitalizados. Métodos: estudio prospectivo, no controlado y cuasiexperimental en pacientes oncológicos ingresados en un servicio de oncología de forma consecutiva, independientemente de su estado nutricional, entre septiembre de 2019 y marzo de 2020. Se determinaron los parámetros antropométricos, la composición corporal y la fuerza prensora de la mano al ingreso y al alta. Se calculó el porcentaje de pacientes con desnutrición, dinapenia y sarcopenia al ingreso y al alta. Resultados: un total de 90 pacientes oncológicos participaron en este estudio (edad media: 66 años, 67,8 % hombres). El 33,2 % de los pacientes presentaban un tumor en el tracto gastrointestinal y el 73,3 % de los pacientes se encontraban en estadio IV. El 95 % necesitaron soporte nutricional (suplementación nutricional, nutrición enteral o nutrición parenteral). Tras la intervención nutricional no se encontraron diferencias en los parámetros antropométricos, con una pérdida de peso media de 0,1, aunque se observaron mejorías en la composición corporal. El porcentaje de pacientes desnutridos se mantuvo estable al ingreso y al alta independientemente del criterio empleado Conclusiones: la implementación de un protocolo de valoración y soporte nutricional al ingreso en pacientes oncológicos puede ayudar a evitar o retrasar el empeoramiento de su estado nutricional durante la hospitalización

Soluble galectin-3 as a microenvironment-relevant immunoregulator with prognostic and predictive value in lung adenocarcinoma

Despite the success of therapies in lung cancer, more studies of new biomarkers for patient selection are urgently needed. The present study aims to analyze the role of galectin-3 (GAL-3) in the lung tumor microenvironment (TME) using tumorspheres as a model and explore its potential role as a predictive and prognostic biomarker in non-small cell lung cancer (NSCLC) patients. For in vitro studies, lung adenocarcinoma (LUAD) and lung squamous carcinoma (LUSC) primary cultures from early-stage patients and commercial cell lines were cultured, using tumorsphere-forming assays and adherent conditions for the control counterparts. We analyzed the pattern of secretion and expression of GAL-3 using reverse transcription-quantitative real-time PCR (RTqPCR), immunoblot, immunofluorescence, flow cytometry and immunoassay analysis. Our results using three-dimensional (3D) models of lung tumor cells revealed that soluble GAL-3 (sGAL-3) is highly expressed and secreted. To more accurately mimic the TME, a co-culture of tumorspheres and fibroblasts was used, revealing that GAL-3 could be important as an immunomodulatory molecule expressed and secreted in the TME, modulating immunosuppression through regulatory T cells (TREGS). In the translational phase, we confirmed that patients with high expression levels of GAL-3 had more TREGS, which suggests that tumors may be recruiting this population through GAL-3. Next, we evaluated levels of sGAL-3 before surgery in LUAD and LUSC patients, hypothesizing that sGAL-3 could be used as an independent prognostic biomarker for overall survival and relapse-free survival in early-stage LUAD patients. Additionally, levels of sGAL-3 at pretreatment and first response assessment from plasma to predict clinical outcomes in advanced LUAD and LUSC patients treated with first-line pembrolizumab were evaluated, further supporting that sGAL-3 has a high efficiency in predicting durable clinical response to pembrolizumab with an area under curve (AUC) of 0.801 (p=0.011). Moreover, high levels might predict decreased progression-free survival and overall survival to anti-PD-1 therapy, with sGAL-3 being a prognosis-independent biomarker for advanced LUAD

Update on systemic treatment in early triple negative breast cancer

Triple negative breast cancer (TNBC) is a heterogeneous disease representing about 15% of all breast cancers. TNBC are usually high-grade histological tumors, and are generally more aggressive and difficult to treat due to the lack of targeted therapies available, and chemotherapy remains the standard treatment. There is a close relationship between pathological complete response after chemotherapy treatment and higher rates of disease-free survival and overall survival. In this review of systemic treatment in early triple negative breast cancer, our purpose is to analyze and compare different therapies, as well as to highlight the novelties of treatment in this breast cancer subtype.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors acknowledge grant CB16-12-00350 from CIBEROnc, the AMACMA foundation, and Lopez Trigo 2017.Medicin

Recensiones [Revista de Historia Económica Año XXI otoño-invierno 2003 n. 3 pp. 657-694]

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