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PERSPECTIVAS ACTUALES SOBRE UN ESQUEMA DE DOSIFICACION SEMANAL DE DOCETAXEL PARA EL CANCER DE MAMA

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El esquema de dosificación semanal de docetaxel, en lugar del trisemanal, podría evitar los efectos adversos graves en el tratamiento del cáncer de mama avanzado.
kuroi9.jpg Autor:
Katsumasa Kuroi
Columnista Experto de SIIC

Institución:
Department of Surgery Showa University Toyousu Hospital


Artículos publicados por Katsumasa Kuroi
Coautor
Masakazu Toi* 
MD, PhD. Division of Clinical Trial and Research, Metropolitan Cancer Center and Infectious Diesase Center, Komagome Hospital*
Recepción del artículo
17 de Mayo, 2005
Aprobación
13 de Junio, 2005
Primera edición
3 de Febrero, 2006
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
El docetaxel es un agente quimioterapéutico muy efectivo que se emplea para el tratamiento paliativo del cáncer de mama avanzado o metastásico y también como quimioterapia adyuvante o neoadyuvante. Existen diversos estudios publicados sobre el uso de docetaxel en forma semanal en lugar de la administración trisemanal. En esos estudios se demostró que el uso de docetaxel semanal es un régimen viable y efectivo en el contexto de los cuidados paliativos y que se puede administrar combinado con trastuzumab. La dosificación semanal es el esquema de elección tanto para los facultativos como para las pacientes, en particular en aquellas con puntajes de desempeño desfavorables o que son mayores, y porque la administración semanal también reduce el riesgo de efectos colaterales agudos como la mielosupresión. No obstante, la dosificación semanal con docetaxel puede presentar efectos tóxicos colaterales acumulativos que limitan el tratamiento, entre ellos figuran fatiga, astenia, cambios ungueales, retención de líquidos y lagrimeo excesivo. La información acerca del papel de la dosificación semanal como adyuvante o neoadyuvante es todavía insuficiente así como lo es la combinación con otros tratamientos como la terapia radiante y los agentes citotóxicos.

Palabras clave
Docetaxel, esquema semanal, toxicidad, respuesta, cáncer de mama


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Abstract
Docetaxel is a highly effective chemotherapeutic agent that is used for palliation of advanced or metastatic breast cancer as well as for adjuvant or neoadjuvant chemotherapy. There have been several reported studies on the use of docetaxel on a weekly rather than tri-weekly basis. In these studies, weekly docetaxel was found to be a feasible and effective regimen in the palliative-care setting and it can be administered in combination with trastuzumab. Weekly dosing is the schedule of choice for both physicians and patients, particularly for patients who have poor performance status scores or who are elderly, and weekly dosing also reduces the risk of acute adverse events such as myelosuppression. However, weekly dosing with docetaxel may have cumulative treatment-limiting toxic side effects such as fatigue, asthenia, nail changes, fluid retention, and hyperlacrimation. There is still insufficient information about the role of weekly dosing in the adjuvant or neoadjuvant setting and in combination with other treatment modalities such as radiation and cytotoxic agents.

Key words
Docetaxel, weekly schedule, toxicity, response, breast cancer


Full text
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Clasificación en siicsalud
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página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Oncología
Relacionadas: Farmacología, Medicina Farmacéutica, Medicina Interna, Obstetricia y Ginecología



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