Quimioterapia intra-arterial para el tratamiento del retinoblastoma: Experiencia de 8 años (2013 – 2020) en Clínica Foscal – Foscal Internacional

Objetivo: Evaluar la eficacia y seguridad del tratamiento con quimioterapia intraarterial a través de la arteria oftálmica en pacientes con retinoblastoma en FOSCAL- FOSCAL INTERNACIONAL en el periodo 2013-2020. Justificación: La quimioterapia intraarterial cambió la estrategia de tratamiento para e...

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Autores:
Rueda Badillo, Edward Yesid
Tipo de recurso:
Fecha de publicación:
2022
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/16058
Acceso en línea:
http://hdl.handle.net/20.500.12749/16058
Palabra clave:
Medical sciences
Health sciences
Radiology
Diagnostic imaging
Intra-arterial chemotherapy
Ophthalmic artery
Pharmacology
Eye neoplasms
Eye diseases
Ciencias médicas
Radiología
Diagnóstico para imágenes
Farmacología
Neoplasmas de los ojos
Enfermedades de los ojos
Ciencias de la salud
Quimioterapia intraarterial
Retinoblastoma
Arteria oftálmica
Rights
License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id UNAB2_c508438d873656fc64d79778ecde20eb
oai_identifier_str oai:repository.unab.edu.co:20.500.12749/16058
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Quimioterapia intra-arterial para el tratamiento del retinoblastoma: Experiencia de 8 años (2013 – 2020) en Clínica Foscal – Foscal Internacional
dc.title.translated.spa.fl_str_mv Intra-arterial chemotherapy for the treatment of retinoblastoma: 8-year experience (2013 – 2020) at Clínica Foscal – Foscal Internacional
title Quimioterapia intra-arterial para el tratamiento del retinoblastoma: Experiencia de 8 años (2013 – 2020) en Clínica Foscal – Foscal Internacional
spellingShingle Quimioterapia intra-arterial para el tratamiento del retinoblastoma: Experiencia de 8 años (2013 – 2020) en Clínica Foscal – Foscal Internacional
Medical sciences
Health sciences
Radiology
Diagnostic imaging
Intra-arterial chemotherapy
Ophthalmic artery
Pharmacology
Eye neoplasms
Eye diseases
Ciencias médicas
Radiología
Diagnóstico para imágenes
Farmacología
Neoplasmas de los ojos
Enfermedades de los ojos
Ciencias de la salud
Quimioterapia intraarterial
Retinoblastoma
Arteria oftálmica
title_short Quimioterapia intra-arterial para el tratamiento del retinoblastoma: Experiencia de 8 años (2013 – 2020) en Clínica Foscal – Foscal Internacional
title_full Quimioterapia intra-arterial para el tratamiento del retinoblastoma: Experiencia de 8 años (2013 – 2020) en Clínica Foscal – Foscal Internacional
title_fullStr Quimioterapia intra-arterial para el tratamiento del retinoblastoma: Experiencia de 8 años (2013 – 2020) en Clínica Foscal – Foscal Internacional
title_full_unstemmed Quimioterapia intra-arterial para el tratamiento del retinoblastoma: Experiencia de 8 años (2013 – 2020) en Clínica Foscal – Foscal Internacional
title_sort Quimioterapia intra-arterial para el tratamiento del retinoblastoma: Experiencia de 8 años (2013 – 2020) en Clínica Foscal – Foscal Internacional
dc.creator.fl_str_mv Rueda Badillo, Edward Yesid
dc.contributor.advisor.none.fl_str_mv Mantilla García, Daniel Eduardo
Ochoa Vera, Miguel Enrique
dc.contributor.author.none.fl_str_mv Rueda Badillo, Edward Yesid
dc.contributor.cvlac.spa.fl_str_mv Mantilla García, Daniel Eduardo [0001437130]
Ochoa Vera, Miguel Enrique [0000898465]
dc.contributor.googlescholar.spa.fl_str_mv Mantilla García, Daniel Eduardo [PUqdPK8AAAAJ]
dc.contributor.orcid.spa.fl_str_mv Ochoa Vera, Miguel Enrique [0000-0002-4552-3388]
dc.contributor.scopus.spa.fl_str_mv Mantilla García, Daniel Eduardo [6641574500]
Ochoa Vera, Miguel Enrique [36987156500]
dc.contributor.researchgate.spa.fl_str_mv Ochoa Vera, Miguel Enrique [Miguel-Ochoa-6]
dc.subject.keywords.spa.fl_str_mv Medical sciences
Health sciences
Radiology
Diagnostic imaging
Intra-arterial chemotherapy
Ophthalmic artery
Pharmacology
Eye neoplasms
Eye diseases
topic Medical sciences
Health sciences
Radiology
Diagnostic imaging
Intra-arterial chemotherapy
Ophthalmic artery
Pharmacology
Eye neoplasms
Eye diseases
Ciencias médicas
Radiología
Diagnóstico para imágenes
Farmacología
Neoplasmas de los ojos
Enfermedades de los ojos
Ciencias de la salud
Quimioterapia intraarterial
Retinoblastoma
Arteria oftálmica
dc.subject.lemb.spa.fl_str_mv Ciencias médicas
Radiología
Diagnóstico para imágenes
Farmacología
Neoplasmas de los ojos
Enfermedades de los ojos
dc.subject.proposal.spa.fl_str_mv Ciencias de la salud
Quimioterapia intraarterial
Retinoblastoma
Arteria oftálmica
description Objetivo: Evaluar la eficacia y seguridad del tratamiento con quimioterapia intraarterial a través de la arteria oftálmica en pacientes con retinoblastoma en FOSCAL- FOSCAL INTERNACIONAL en el periodo 2013-2020. Justificación: La quimioterapia intraarterial cambió la estrategia de tratamiento para el retinoblastoma, proporciona una alta tasa de éxito para salvar el globo ocular y controlar el tumor. Con el fin de ampliar el conocimiento sobre la factibilidad de este sofisticado procedimiento en un país de ingresos medios como el nuestro, queremos presentar nuestra experiencia en pacientes del noreste de Colombia con retinoblastoma intraocular manejados con quimioterapia intraarterial supraselectiva. Tipo de estudio: Se trata de un estudio descriptivo de cohortes basado en datos secundarios. Población: Se incluirán todos los pacientes elegibles con diagnóstico de retinoblastoma desde el 1 de enero de 2013 hasta el 1 de septiembre de 2020 sometidos a quimioterapia intraarterial selectiva a través de la arteria oftálmica en FOSCAL- FOSCAL INTERNACIONAL, será un estudio censal. Resultados: Al evaluar el total de ojos de los 10 niños afectados por retinoblastoma fue del 65% (13/20 ojos), de los cuales 11 fueron tratados con quimioembolización. Se realizó la categorización de estadios según la clasificación internacional de retinoblastoma, observándose que de los 11 ojos llevados al QIA, el 63,64% (n=7) eran categoría D, seguido de la categoría E 27,27% (n=3) y la categoría C 9,09% (n=1). Al evaluar la supervivencia global, ningún paciente falleció y la mediana de seguimiento fue de 53 meses. La supervivencia media libre de enucleación fue de 23 meses, la primera enucleación de los 11 ojos después de la quimioembolización fue a los 6 meses. Conclusiones: La quimioterapia intraarterial es una modalidad potente, segura y eficaz que puede reducir la tasa de enucleación en pacientes con retinoblastoma. Se observó mejor respuesta en el grupo C; sin embargo, sería ideal definir el riesgo/beneficio de dicho tratamiento para un mayor número de pacientes en etapas tempranas. Todos los pacientes del grupo E acabaron en enucleación, lo que refuerza los hallazgos de los diferentes estudios en los que la eficacia en estadios avanzados es baja y se prefiere la enucleación.
publishDate 2022
dc.date.accessioned.none.fl_str_mv 2022-03-25T19:13:50Z
dc.date.available.none.fl_str_mv 2022-03-25T19:13:50Z
dc.date.issued.none.fl_str_mv 2022
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv Tesis
dc.type.redcol.none.fl_str_mv http://purl.org/redcol/resource_type/TM
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/16058
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unab.edu.co
url http://hdl.handle.net/20.500.12749/16058
identifier_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
dc.language.iso.spa.fl_str_mv spa
language spa
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dc.coverage.spatial.spa.fl_str_mv Floridablanca (Santander, Colombia)
dc.coverage.temporal.spa.fl_str_mv 2013-2022
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dc.publisher.faculty.spa.fl_str_mv Facultad Ciencias de la Salud
dc.publisher.program.spa.fl_str_mv Especialización en Radiología e Imágenes Diagnósticas
institution Universidad Autónoma de Bucaramanga - UNAB
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spelling Mantilla García, Daniel Eduardo02f2cc58-14df-4196-a68a-08dc2290cdc0-1Ochoa Vera, Miguel Enriquebf83ca83-93c9-401e-91d3-b424889e868f-1Rueda Badillo, Edward Yesid9625cfa6-b2ff-4c2e-b8d5-1e066e9f225d-1Mantilla García, Daniel Eduardo [0001437130]Ochoa Vera, Miguel Enrique [0000898465]Mantilla García, Daniel Eduardo [PUqdPK8AAAAJ]Ochoa Vera, Miguel Enrique [0000-0002-4552-3388]Mantilla García, Daniel Eduardo [6641574500]Ochoa Vera, Miguel Enrique [36987156500]Ochoa Vera, Miguel Enrique [Miguel-Ochoa-6]Floridablanca (Santander, Colombia)2013-20222022-03-25T19:13:50Z2022-03-25T19:13:50Z2022http://hdl.handle.net/20.500.12749/16058instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coObjetivo: Evaluar la eficacia y seguridad del tratamiento con quimioterapia intraarterial a través de la arteria oftálmica en pacientes con retinoblastoma en FOSCAL- FOSCAL INTERNACIONAL en el periodo 2013-2020. Justificación: La quimioterapia intraarterial cambió la estrategia de tratamiento para el retinoblastoma, proporciona una alta tasa de éxito para salvar el globo ocular y controlar el tumor. Con el fin de ampliar el conocimiento sobre la factibilidad de este sofisticado procedimiento en un país de ingresos medios como el nuestro, queremos presentar nuestra experiencia en pacientes del noreste de Colombia con retinoblastoma intraocular manejados con quimioterapia intraarterial supraselectiva. Tipo de estudio: Se trata de un estudio descriptivo de cohortes basado en datos secundarios. Población: Se incluirán todos los pacientes elegibles con diagnóstico de retinoblastoma desde el 1 de enero de 2013 hasta el 1 de septiembre de 2020 sometidos a quimioterapia intraarterial selectiva a través de la arteria oftálmica en FOSCAL- FOSCAL INTERNACIONAL, será un estudio censal. Resultados: Al evaluar el total de ojos de los 10 niños afectados por retinoblastoma fue del 65% (13/20 ojos), de los cuales 11 fueron tratados con quimioembolización. Se realizó la categorización de estadios según la clasificación internacional de retinoblastoma, observándose que de los 11 ojos llevados al QIA, el 63,64% (n=7) eran categoría D, seguido de la categoría E 27,27% (n=3) y la categoría C 9,09% (n=1). Al evaluar la supervivencia global, ningún paciente falleció y la mediana de seguimiento fue de 53 meses. La supervivencia media libre de enucleación fue de 23 meses, la primera enucleación de los 11 ojos después de la quimioembolización fue a los 6 meses. Conclusiones: La quimioterapia intraarterial es una modalidad potente, segura y eficaz que puede reducir la tasa de enucleación en pacientes con retinoblastoma. Se observó mejor respuesta en el grupo C; sin embargo, sería ideal definir el riesgo/beneficio de dicho tratamiento para un mayor número de pacientes en etapas tempranas. Todos los pacientes del grupo E acabaron en enucleación, lo que refuerza los hallazgos de los diferentes estudios en los que la eficacia en estadios avanzados es baja y se prefiere la enucleación.1. INTRODUCCIÓN ................................................................................................... 10 2. DESCRIPCIÓN DEL PROBLEMA ...................................................................... 11 2.1 PLANTEAMIENTO DEL PROBLEMA ..................................................................................... 11 2.2 JUSTIFICACIÓN .................................................................................................................. 12 3.1 GENERALIDADES................................................................................................................ 13 3.2 EPIDEMIOLOGÍA ................................................................................................................ 13 3.3 ETIOLOGÍA ......................................................................................................................... 15 3.4 PATOGENÍA ....................................................................................................................... 16 3.5 PATRÓN DE CRECIMIENTO ................................................................................................ 17 3.6 DIAGNÓSTICO.................................................................................................................... 18 3.7 CLASIFICACIÓN .................................................................................................................. 23 3.8 ANATOMÍA DE LA ARTERIA OFTÁLMICA ............................................................................ 24 Variantes anatómicas:............................................................................................................. 26 Curso de la arteria oftálmica: .................................................................................................. 28 Ramas de la arteria oftálmica: ................................................................................................ 29 3.9 TRATAMIENTO .................................................................................................................. 31 3.9.1 Quimioterapia intraarterial (QIA) ................................................................................... 33 3.9.1.1 Indicaciones:................................................................................................................ 34 3.9.1.2 Contraindicaciones: ..................................................................................................... 35 3.9.1.4 Técnica: .................................................................................................................... 37 3.9.1.5 Complicaciones: .......................................................................................................... 41 Efectos secundarios sistémicos ............................................................................................... 42 Efectos adversos oculares ....................................................................................................... 42 Resultado visual ...................................................................................................................... 43 4. ESTADO DEL ARTE. ............................................................................................... 45 5. OBJETIVOS .............................................................................................................. 47 6. METODOLOGÍA ....................................................................................................... 48 7. ALMACENAMIENTO ELECTRÓNICO DE LA INFORMACIÓN ......................... 52 8. CONSIDERACIONES ÉTICAS ............................................................................... 54 CRONOGRAMA DE ACTIVIDADES .......................................................................... 55 9. RESULTADOS.......................................................................................................... 56 9.1 CARACTERIZACIÓN GENERAL DE LA POBLACIÓN ESTUDIADA ..................... 56 9.2 ANALISIS BIVARIADO ................................................................................................. 60 10. DISCUSIÓN............................................................................................................. 64 11. CONCLUSIONES ................................................................................................... 68 12. FORTALEZAS Y LIMITACIONES ........................................................................ 69 13. FINANCIACIÓN Y CONFLICTOS DE INTERÉS ................................................ 70 14. BIBLIOGRAFIA ...................................................................................................... 71EspecializaciónObjective: To evaluate the efficacy and safety of treatment with intra-arterial chemotherapy through the ophthalmic artery in patients with retinoblastoma in FOSCAL- FOSCAL INTERNACIONAL in the period between 2013-2020. Justification: Intra-arterial chemotherapy changed the treatment strategy for retinoblastoma, it provides a high success rate for salvage of the eyeball and for tumor control. In order to expand knowledge about the feasibility of this sophisticated procedure in a middle-income country like ours, we want to present our experience in patients from northeastern Colombia with intraocular retinoblastoma managed with supraselective intra-arterial chemotherapy. Type of study: This is a descriptive cohort study based on secondary data. Population: All eligible patients diagnosed with retinoblastoma from January 1, 2013 to September 1, 2020 undergoing selective intra-arterial chemotherapy through the ophthalmic artery in FOSCAL- FOSCAL INTERNATIONAL will be included, it will be a census study. Results: When evaluating the total number of eyes for the 10 children affected by retinoblastoma, it was 65% (13/20 eyes), of which 11 were treated with chemoembolization. Stage categorization was performed according to the international classification of retinoblastoma, observing that of the 11 eyes taken to QIA, 63.64% (n=7) were category D, followed by category E 27.27% (n=3) and category C 9.09% (n=1). When evaluating overall survival, no patient died and the median follow-up was 53 months. The mean enucleation-free survival was 23 months, the first enucleation of the 11 eyes after chemoembolization was at 6 months. Conclusions: Intra-arterial chemotherapy is a powerful, safe, and effective modality that can reduce the rate of enucleation in patients with retinoblastoma. Better response was observed in group C; however, it would be ideal to define the risk/benefit of such treatment for a larger number of patients in early stages. Group E patients all ended up in enucleation, which reinforces the findings of the different studies in which the efficacy in advanced stages is low and enucleation is preferre.application/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Quimioterapia intra-arterial para el tratamiento del retinoblastoma: Experiencia de 8 años (2013 – 2020) en Clínica Foscal – Foscal InternacionalIntra-arterial chemotherapy for the treatment of retinoblastoma: 8-year experience (2013 – 2020) at Clínica Foscal – Foscal InternacionalEspecialistas en Radiología e Imágenes DiagnósticasUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Radiología e Imágenes Diagnósticasinfo:eu-repo/semantics/masterThesisTesishttp://purl.org/redcol/resource_type/TMMedical sciencesHealth sciencesRadiologyDiagnostic imagingIntra-arterial chemotherapyOphthalmic arteryPharmacologyEye neoplasmsEye diseasesCiencias médicasRadiologíaDiagnóstico para imágenesFarmacologíaNeoplasmas de los ojosEnfermedades de los ojosCiencias de la saludQuimioterapia intraarterialRetinoblastomaArteria oftálmica1. 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