1
Análisis'retrospectivo'de'
supervivencia'y'toxicidad'en'
pacientes'con'adenocarcinoma'
gástrico'avanzado'tratados'con'
el'esquema'DCF:''
Experiencia'de'un'centro'
Trabajo de investigación
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Maria!Fonfria!Esparcia!
! !
!
!
"#$%&'($)!Dr.!Joan!Carles!Galceran!
*$(+%,,($!-,,(&#.'!/%0!"%1.$'2%3'!/%!4%/#&#3.!/%!0.!5-6!
!
7(8/#$%&'($)!Dr.!Jorge!Antonio!Aparicio!Urtasún!!
9%+%!/%!:%&&#;3!/%0!<(,1#'.0!53#=%$,#'.$#!>.!?%!/%!@.0A3&#.!
!
!
7B$,(!CDED8CDEEF!7(3=(&.'($#.!/%!:%1'#%2G$%!
"%1.$'.2%3'!/%!4%/#&#3.H53#=%$,#'.'!-B'I3(2.!/%!6.$&%0(3.!
!
2
ÍNDICE!
!
!
7%$'#+#&./(,!
!
JF K%,B2%3LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLFFFFFFF!!!M!
JJF J3'$(/B&&#;3LLLLLLLLLLLLLLLLLLLLLLLLLLLLFFFFFFF!!!N!
JJJF 4.'%$#.0!O!2P'(/(,LLLLLLLLLLLLLLLLLLLLLLLLLLL!!!!Q!
J@F -3R0#,#,!/%!$%,B0'./(,LLLLLLLLLLLLLLLLLLLLLLLLLL!!!!S!
@F "#,&B,#;3LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL!!!EC!
@JF 7(3&0B,#(3%,LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL!!ES!
@JJF 6#G0#(T$.+U.LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLFF!!!CD!
@JJJF !V.G0.,!O!+#TB$.,LLLLLLLLLLLLLLLLLLLLLLLLLLLLL!!!CM!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
3
RESUMEN!
:%!W.!.3.0#X./(!/%!+($2.!$%'$(,1%&'#=.!B3.!,%$#%!/%!YC!1.&#%3'%,!/#.T3(,'#&./(,!/%!
./%3(&.$&#3(2.! TR,'$#&(! .=.3X./(! O! '$.'./(,! &(3! %0! %,ZB%2.! /%! ZB#2#('%$.1#.! /%!
&(2G#3.&#;3!"7?![/(&%'.\%0]!&#,10.'#3(]!Y8+0B($(B$.&#0(^!%3'$%!0(,!._(,!!CDDY!O!CDEE!%3!
%0!<(,1#'.0!53#=%$,.$#(!0.!?%!/%!@.0%3&#.F!>.!2%/#.3.!/%!,B1%$=#=%3&#.!W.!,#/(!/%!Q`YM!
2%,%,!O!%0!'#%21(!W.,'.!0.!1$(T$%,#;3!/%!N`MM!2%,%,F!>.,!'(\#&#/./%,!2R,!1$%=.0%3'%,!
W.3! ,#/(! 0.! /#T%,'#=.! O! 0.! W%2.'(0;T#&.F! 7(2(! +.&'($%,! 1$(3;,'#&(,! #3/%1%3/#%3'%,!
W%2(,! (G'%3#/(! %0! *%$+($2.3&%! :'.'B,! [*:^! .0! #3#&#(! /%0! '$.'.2#%3'(! O! %0! ,%\(F! >(,!
1.&#%3'%,!&(3!B3!*:!G.,.0!/%!C8M!1$%,%3'.3!B3!$#%,T(!/%!2B%$'%!/%!C`Qa!=%&%,!2.O($!
$%,1%&'(!.0!*:!G.,.0!/%!D8E]!&(3!B3.!2%/#.3.!/%!,B1%$=#=%3&#.!/%!N`MM!2%,%,]!+$%3'%!.!0.!
/%!S`bM!2%,%,!ZB%!,%!(G,%$=.!%3!0(,!1.&#%3'%,!&(3!B3!*:!/%!D8EF!c0!%,ZB%2.!"7?!%3!
&.$&#3(2.! TR,'$#&(! .=.3X./(! /%G%! $%,%$=.$,%! 1.$.! 0(,! 1.&#%3'%,! ! &(3! B3! GB%3! %,'./(!
T%3%$.0!G.,.0F!
Palabras! Clave:!7.$&#3(2.!TR,'$#&(!.=.3X./(F!dB#2#('%$.1#.F!"(&%'.\%0F!
*%$+($2.3&%!:'.'B,F!
RESUM!
!<%2! .3.0#'X.'!/%!2.3%$.!$%'$(,1%&'#=.!B3.!,A$#%!/%!YC!1.&#%3',!/#.T3(,'#&.',!
/`B3! ./%3(&.$&#3(2.! Te,'$#&! .=.3f.'! #! '$.&'.',! .2G! %0! %,ZB%2.! /%! ZB#2#('%$e1#.! /%!
&(2G#3.&#;! "7?! [/(&%'.\%0]! &#,10.'U]! Y8+0B($(B$.&#0^!%3'$%!%0,!.3O,!CDDY!#!CDEE!.!
0`<(,1#'.0! 53#=%$,#'.$#! >.! ?%! /%! @.0A3&#.F! >.! 2#'g.3.!/%! ,B1%$=#=A3&#.! W.! %,'.'!/%!Q`YM!
2%,(,!#!%0!'%21,!+#3,!.!0.!1$(T$%,,#;!/%!N`MM!2%,(,F!>%,!'(\#&#'.',!2P,!1$%=.0%3',!W.3!
%,'.'!0.!/#T%,'#=.!#!0.!W%2.'(0IT#&.F!7(2!.!+.&'($,!1$(3I,'#&,!#3/%1%3/%3',!W%2!(G'#3TB'!
%0!*%$+($2.3&%!:'.'B,![*:^!.!0h#3#&#!/%0!'$.&'.2%3'!#!%0!,%\%F!c0,!1.&#%3',!.2G!B3!*:!G.,.0!
/%!C8M!1$%,%3'%3!B3!$#,&!/%!2($'!/%!C]Qa!=%T./%,!2P,!T$.3!$%,1%&'%!.0!*:!G.,.0!/%!D8E]!
.2G! B3.! 2#'g.3.! /%! ,B1%$=#=A3&#.! /%! NhMM! 2%,(,]! %3+$(3'! /%! 0.! /%! ShbM!2%,(,!ZB%!
,h(G,%$=.!%3!%0,!1.&#%3',!.2G!B3!*:!/%!D8EF!>h%,ZB%2.!"7?!%3!&.$&#3(2.!Te,'$#&!.=.3f.'!
,hW.!/%!$%,%$=.$!1%$!.0,!1.&#%3',!.2G!B3!G(3!%,'.'!T%3%$.0!G.,.0F!
Paraules! Clau:!7.$&#3(2.! Te,'$#&! .=.3f.'F! dB#2#('%$e1#.F! "(&%'.\%0F!
*%$+($2.3&%!:'.'B,!
!
4
INTRODUCCIÓN!
!
c0! &R3&%$! TR,'$#&(! %,! B3.! /%! 0.,! 3%(10.,#.,! 2R,! +$%&B%3'%,! .! 3#=%0!
2B3/#.0]!&(3!.1$(\#2./.2%3'%!SaSDDD!/#.T3;,'#&(,!O!bMaDDD!2B%$'%,!.3B.0%,]!
0(!ZB%!,%!'$./B&%!%3!%0!&B.$'(!&R3&%$!2R,!+$%&B%3'%!%3!#3&#/%3&#.!O!%0!,%TB3/(!
%3!2($'.0#/./!.!3#=%0!2B3/#.0!iEjF!
c,'(!,B1(3%!B3!U3/#&%!/%!0%'.0#/./![J>^!/%!D`bY]!2B&W(!2.O($!ZB%! %0!/%!
('$.,!3%(10.,#.,! +$%&B%3'%,]!&(2(!%0! &R3&%$!/%! &(0(3![J>!/%!D`YC^]!%0! &R3&%$!/%!
2.2.![J>!/%!D`MQ^!(!%0!&R3&%$!/%!1;,'.'.![J>!/%!D`MM^iCjF!
c0! ./%3(&.$&#3(2.! TR,'$#&(! %,! B3.! /%! 0.,! 3%(10.,#.,! ZB%! 2R,! &.2G#(,!
%1#/%2#(0;T#&(,! W.! %\1%$#2%3'./(! %3! 0.,! k0'#2.,! /P&./.,F! c3! 1$#2%$! 0BT.$! 0.!
#3&#/%3&#.!=.$U.!%3!+B3&#;3!/%!0.!0(&.0#X.&#;3!T%(T$R+#&.F!c0!%,'%!/%!-,#.]!%0!%,'%!
/%! cB$(1.! O! :B/.2P$#&.! 1$%,%3'.3! 0.,! '.,.,! 2R,! %0%=./.,]! 2#%3'$.,! ZB%! %3!
l($'%! -2P$#&.! O! %3! .0TB3(,! 0BT.$%,! /%! m+$#&.! ,%! %3&B%3'$.3! 0.,! '.,.,! 2R,!
G.g.,iEjF!n'$(!/.'(!00.2.'#=(!%,!0.!$R1#/.!/#,2#3B&#;3!(G,%$=./.!%3!0.!#3&#/%3&#.!
2B3/#.0!%3!0.!,%TB3/.!2#'./!/%0!,#T0(!oo]!%,1%&#.02%3'%!/%G#/(!.0!/%,&%3,(!/%0!
&R3&%$! TR,'$#&(! 3(! 0(&.0#X./(! %3! %0! &.$/#.,]! 2#%3'$.,! ZB%! 0.! #3&#/%3&#.! /%! %,'%!
k0'#2(! W.! %\1%$#2%3'./(! B3! .B2%3'(! 2BO! ,#T3#+#&.'#=(! %3! 0(,! 1.U,%,!
/%,.$$(00./(,]!,#TB#%3/(!0.!/#,'$#GB&#;3!/%0!&.$&#3(2.!%,(+RT#&(iMjF!*($!k0'#2(]!%0!
1.'$;3! W#,'(0;T#&(! '.2G#P3! %,'R! &.2G#.3/(]! &(3! B3.! /#,2#3B&#;3! /%! 0(,!
./%3(&.$&#3(2.,!/%!'#1(!#3'%,'#3.0!2B&W(!2R,!2.$&./.!ZB%!0.!(G,%$=./.!%3!0(,!
./%3(&.$&#3(2.,! /%! '#1(! /#+B,(]! 0(! ZB%! W.! W%&W(! ZB%! 0.! 1$(1($&#;3! /%! %,'(,!
k0'#2(,! .B2%3'%! W.,'.! %0! MDpiNjF! >.,! &.B,.,! /%! %,'.,! =.$#.&#(3%,! ,(3!
2B0'#+.&'($#.0%,]! O! .B3ZB%! 3(! &(210%'.2%3'%! %0B&#/./.,]! ,%! W.3! .'$#GB#/(! .!
/#+%$%3&#.,!%3!0.!%\1(,#&#;3!/%!+.&'($%,!%'#(0;T#&(,F!
c3!%0!2B3/(!(&&#/%3'.0]!2R,!/%0!YDp!/%!0(,!1.&#%3'%,!=.!.!1$%,%3'.$!B3.!
%3+%$2%/./!0(&.02%3'%!.=.3X./.]!#$$%,%&.G0%!(!2%'.,'R,#&.]!%3!%0!2(2%3'(!/%0!
/#.T3;,'#&(F! "%! 0(,! 1.&#%3'%,! &(3! %3+%$2%/./! 0(&.0#X./.! ZB%! #3#&#.02%3'%! ,%!
,(2%'%3!.!B3.!$%,%&&#;3!&(3!#3'%3&#;3!&B$.'#=.]!W.,'.!%0!ND8QDp!=.!.!/%,.$$(00.$!
B3.! $%&#/#=.iYjF! >(! ZB%! &(300%=.! .! ZB%! W.,'.! %0! aDp!/%! 0(,! 1.&#%3'%,! &(3! %0!
5
/#.T3;,'#&(! /%! ./%3(&.$&#3(2.! TR,'$#&(! 1$%,%3'.$R! B3.! %3+%$2%/./! .=.3X./.!
/B$.3'%!,B!%=(0B&#;3F!
c,'(! W.&%! ZB%! %0! 1$(3;,'#&(! /%0! &R3&%$! TR,'$#&(! 1.$.! '(/(,! 0(,! %,'./#(,!
,%.!1(G$%]!&(3!B3.!,B1%$=#=%3&#.!.!Y!._(,!/%0!CDp!%3!0(,!1.U,%,!/%,.$$(00./(,]!
,#%3/(!.k3!2%3($!%3!0(,!1.U,%,!%3!=U.,!/%!/%,.$$(00(F!c3!.ZB%00(,!1.U,%,!&(3!B3.!
.0'.!1$%=.0%3&#.!&(2(!9.1;3]!/(3/%!,%!W.3!#3,'.B$./(!1$(T$.2.,!/%!/%'%&&#;3!
1$%&(X]!!0.!,B1%$=#=%3&#.!.!Y!._(,!.0&.3X.!W.,'.!%0!QDpiQjF!
>(,! 1.&#%3'%,! &(3! 'B2($%,! #3(1%$.G0%,]! $%&B$$%3'%,! (! 2%'.,'R,#&(,!
'#%3%3!B3! 1$(3;,'#&(! 1(G$%!&(3!B3.! 2%/#.3.! /%!,B1%$=#=%3&#.! ,#3! '$.'.2#%3'(!
/%! %3'$%! M! O! Y! 2%,%,ibj!iajF! >.! ZB#2#('%$.1#.! ,#,'P2#&.! %,! %0! '$.'.2#%3'(! /%!
%0%&&#;3! %3! %,'(,! &.,(,! O! ,B! (Gg%'#=(! %,! .0#=#.$! 0(,! ,U3'(2.,! O! 1$(0(3T.$! 0.!
,B1%$=#=%3&#.]!1%$(!.!&(,'.!/%!B3!.B2%3'(!/%!0.!'(\#&#/./!iSjF!
-&'B.02%3'%! 3(! %\#,'%! B3! %,ZB%2.! /%! ZB#2#('%$.1#.! /%! &(2G#3.&#;3!!
B3#=%$,.02%3'%!.&%1'./(!%3!%0!'$.'.2#%3'(!/%!1$#2%$.!0U3%.!/%0!&R3&%$!TR,'$#&(!
.=.3X./(F!
"%,/%!0.!1BG0#&.&#;3!/%0!%,'B/#(!+.,%!JJJ!V-o8MCY!%0!%,ZB%2.!/%!&(2G#3.&#;3!
"7?![/(&%'.\%0]!&#,10.'#3(!O!Y8+0B($(B$.&#0(^!,%!W.!1(,#&#(3./(!&(2(!B3(!/%!0(,!
%,'R3/.$.$%,!/%!'$.'.2#%3'(FiEDj!c3!%,'%!.3R0#,#,!,%!1$%'%3/%!.3.0#X.$!3B%,'$(,!
/.'(,!/%!'(\#&#/./!O!,B1%$=#=%3&#.!1.$.!&(3(&%$!0.!$%.0#/./!/%!%,'%!%,ZB%2.!%3!
%0!&(3'%\'(!.,#,'%3&#.0F!
!
!
!
!
!
!
!
!
!
!
1 / 29 100%
La catégorie de ce document est-elle correcte?
Merci pour votre participation!

Faire une suggestion

Avez-vous trouvé des erreurs dans linterface ou les textes ? Ou savez-vous comment améliorer linterface utilisateur de StudyLib ? Nhésitez pas à envoyer vos suggestions. Cest très important pour nous !