Catálogo de publicaciones - libros

Several chemotherapy agents have shown minor activity in MPM. Most of the studies supporting their use as single agents or in combination are misleading because of the sample size, lack of uniform measures of response, and lack of reproducibility. However, the combination of cisplatin with pemetrexed has demonstrated improved survival in phase III studies and is now considered standard therapy for mesothelioma.

Non-bronchiogenic lung carcinomas, although rare, are of great importance for the clinician. Most of these tumors are asymptomatic or present with non-specific symptoms. As a result, the indication of disease is set incidentally in routine radiological examination, sometimes a long time after the onset of the disease. The X-ray findings are similar if not identical with those of a bronchiogenic malignancy, thus leading to incorrect diagnoses. Definite diagnosis in all cases is made by histopathological examination with additional information acquired by immunohistochemistry. Treatment strategies, involve surgical excision that may be followed by adjuvant chemotherapy and/or radiotherapy for non-metastatic disease, and chemotherapy (frequently combination regimens) for metastatic disease. Nevertheless, prognosis remains exceedingly dismal with the exceptions of low-grade PPL and carcinoid tumors.

Bone metastases are among the most difficult problems to manage in patients with lung cancer. The identification of molecular mechanisms responsible for the tropism of some lung cancer cells to the bones, using gene arrays and proteomics, could help in the earlier detection of bone metastases in these patients. Furthermore, the better understanding of the interactions between lung cancer cells and the bone marrow microenvironment that mediate the process of bone destruction should result in the development of therapeutic agents, such as recombinant human OPG, RANK-Fc, and anti-PTHrP, to treat and possibly prevent this devastating complication of lung cancer.

Dyspnea is the awareness of uncomfortable breathing, and constitutes one of the most frightening and distressing symptoms for patients with cancer. Dyspnea is common in patients with advanced cancer and may affect as many as 90% of them. Both etiologic and palliative treatments are deemed to be useful when the benefits are greater than the risks. Specific therapeutic issues should be considered and include the treatment of pleural effusions, bronchoscopic methods for central airway obstruction, and pharmacologic measures for reversible super-imposed conditions. The pharmacologic approaches for its relief may include oxygen, bronchodilators, corticosteroids, anxiolytics, analgesics, and opioids.