Biomedical subjects
D López-Aguado
Publications and source records attributed to D López-Aguado.
[A new case of craniofacial fibrous dysplasia and cytogenetic study].
Fibrous dysplasia is an uncommon condition, which most obvious expression is the disorder of the osseous tissue setting up. Craniofacial bones are preferential sitting targets. We report a new case, in a 14-year-old boy, whose cytogenetic study neither in peripheral blood nor in tumor cells showed significantly differences.
[Concomitant hyperfractionation of drugs and irradiation in the treatment of advanced ENT cancers].
Considering the limited results achieved up to now in the treatment of advanced ENT-cancer, with the classic customary procedures, the AA. suggest a new therapeutic schedule (within the concurrent radio-chemotherapy context) in which the selected cytotoxic drug, the carboplatin, is a part of each therapeutic fraction. A group of 36 patients suffering advanced ENT-cancer (2 cases stage III and 34 stage IV) were studied between Mars 1993 and September 1995, and the outcomes assessed after a 18 months mean follow-up (30 months maximum). There were 11% surgically rescued cases, being the full dosage administered twice daily 8.050 cGy plus 700 mg carboplatin. Tolerance was very good, so 100% of the patients received a complete treatment. Initial response was also fine resulting 93% full remissions on primaries, 96% on neck adenopathies (6% surgical rescues). Regarding the actuarial control after 30 months were controlled 88% of neck adenopathies, control loco-regional amounted for 69%, control on primaries 63% and actuarial survival amounted 55%. The AA. drawn out 10 conclusions, underlining the good tolerance of the therapeutic sketch proposed, because the antineoplastic results are by far better than those experienced with whichever modality of management of tumors of these sites and staging.
[Influence of the necessity of transfusion in anemia on the prognosis of ENT cancer in the protocol with concurrent hyperfractionation of carboplatin and irradiation].
Because of the determinant role of hemoglobin level in blood to the response of treatment (viewpoint admitted whether for irradiation or chemotherapic agents) the AA. have lead an analysis of a group of 36 patients suffering an advanced head and neck cancer (18 months mid-follow up and 30 months maximum) which underwent a program of concomitant radio-chemotherapy hyperfraccionated with carboplatin (the cytostatic) as part of each therapeutic fraction. The results in patients being transfused with an erytrocyte concentrate were compared with those from patients not having had any transfusion. The purpose of this study was the assessment of which are the influence on the prognostic of ENT-cancer resulting of the compulsory necessity of transfunding erytrocyte concentrates aroused by serious anemia presenting during the development of the schedule treatment. In brief, in that kind of patients needing transfusions of red blood cells concentrates because of serious anemia during the treatment (17% of the totality treated) were recorded 50% local failures, 33% metastases and only 17% of the totality were free of neoplasma at the end of the follow-up fixed. Instead between patients not having had transfusions (for treating anemia) the differences registered were 20% failures of loco-regional control and 13% metastases, whereas 67% were free of tumor at the end of the study. The conclusion drawn out is: the important influence on the prognostic of these tumors, when in the course of the scheduled treatment, appear severe anemia making the transfusions compulsory.
Incidence of dehiscences in the fallopian canal.
Fifty human temporal bones from necropsies were used to study the frequency of canal dehiscences in detail along the course of the facial nerve. Specifically, the study focused on bony dehiscences in the fallopian canal and vascular communications between the facial nerve and the surrounding bone. High frequency of dehiscences at the oval window (60%) and in the pyramidal segment (54%) were found. These dehiscence rates are in agreement with published reports. A 20% rate of dehiscences at the most anterior segment of the tympanic segment was noted and a non-reported high rate (20%) of multiple dehiscences along the course of the fallopian canal in the same temporal bone in specimens of newborns and young children. The significance of these findings in terms of clinical implications is discussed.
[Facial nerve anomaly. A morphohistological study. Apropos a case].
A malformation of the facial nerve in the temporal bone of an otherwise normal adult is reported. The abnormality consisted in the facial nerve obstructing the oval window in the second part of its intrapetrosal section.
[The effects of thymostimulin in a protocol of concurrent hyperfractionated carboplatin and irradiation].
To evaluate the effect of thymostimulin in a treatment schedule of concurrent hyperfractionated chemoradiation therapy, with the cytostatic forming part of each therapeutic fraction, the authors included in this protocol 36 patients with advanced head and neck carcinomas randomized into two groups. Group A received 115 cGy + 5 mg/m2 of carboplatin per fraction in two daily fractions for a total dose of 8.050 cGy + 700 mg of carboplatin, while group B received the same treatment associated with thymostimulin, with the following schedule: 1.5 mg/kg/day in the week before chemoradiation + 1.5 mg/kg twice a week during treatment + 1 mg/kg twice a week for two years or until recurrence. The results were evaluated upon reaching 18 months of follow-up (30 maximum). A smaller decrease in lymphocyte levels was observed in group B, but no differences were seen in toxicity between the groups. Patients included in the B group had a slightly longer disease-free-survival interval, but 17% of recurrences and 11% of distant metastases were observed in the A group, whereas 22% of recurrences and 22% of distant metastases were seen in the B group. The number of complete remissions (94%) was the same in both groups.
[Auditory assessment in a protocol of concurrent carboplatin and irradiation use in fractionated therapy].
Possible ototoxicity related with a hyperfractionated concurrent chemo-radiation schedule was studied in 36 patients with head and neck cancer. The schedule consisted of two daily fractions, each consisting of 5 mg/m2 of carboplatin plus 115 cGy. Therapy was given 5 days a week for 7 weeks up to a total dose of 700 mg carboplatin and 8050 cGy. Tonal audiograms and superliminal tests were carried out before treatment, at conclusion, six months post-treatment, and every year thereafter. After a mean follow-up of 18 months (maximum 30 months), no treatment-related sensorineural hearing loss was observed. However, recruitment disappeared in post-treatment superliminal tests in 37% of patients who presented sensorineural deafness with recruitment, although it reappeared in audiograms recorded six months later. We attributed this to transient demyelinization. After treatment, a previous tympanosclerosis reactivated in 1 case and effusive otitis media occurred in 8 patients. Previous effusive otitis media disappeared in 1 patient (nasopharyngeal tumor).