Beatriz Losada Vila*, Ignacio Juez Martel, David Gutierrez Abad and Juan Antonio Guerra Martinez
Medical Oncologists in Fuenlabrada Hospital, Spain
*Corresponding author: Beatriz Losada Vila, Medical Oncologists in Fuenlabrada Hospital, Madrid, Spain
Submission: November 11, 2017;Published: April 17, 2018
ISSN: 2578-0239Volume1 Issue3
Mesenchymal tumors are very rare tumors that need a specialized hospital to take care of them, with also a good medical team and recourses because survival depends on it.
Peter Mc Callum Cancer Center (PMCC) is the only public cancer hospital in Australia (a reference for sarcomas and one of the 10 best hospitals in the world), which is why, thanks to the MariPaz Casado Foundation Scholarship, I explored the organization for 2 months, types of treatment and ideas that could be extrapolated to Spain.
Organization of the consultation has an average of 30 minutes, close consultations with Plastic Surgeon, Traumatologist and Radiation Oncologist. There are also weekly Multidisciplinary Committees with> 30 patients. Also agility (2-3 days) of diagnostic test reports . Patients know the existence of centralized clinical trials in webs like www.australiansarcomagroup.org
Nursing support (appointment management, telephone contact / email to avoid visits to the Emergency Department) and counselors of teenagers (On Trac) are essential. Given that many are> 500km away, the government covers travel expenses and provides apartments near the hospital.
Anthracyclines or combination in 1st line metastatic disease? Doxorubicin 75mg/m2 three-weekly followed by 1 dose of pegfigalstrim. Only if very sensitive to chemotherapy, high tumor or synovial load is added Ifosfamide.
Talking about histological subtypes, doxorubicin is the most well known chemo scheme. For leiomyosarcoma, gemcitabine + docetaxel are a good one [2-4]. Also Doxorubicin + Ifosfamide for liposarcoma. In second and third lines, Ifosfamide, Trabectidine, Eribulin or Pazopanib are good ones too. Some tumor types as Ewing of Osteosarcoma need to have a good relation between specialists because they need surgery at 9-10 weeks, RT just afterwards. Toxic chemo is used among them.
New oral drugs are used in some of them, as inhibitors of tyrosine kinase (imatinib) in metastatic Cordoma, Dermatofibrosarcoma protuberans, villonodular synovitis . Also Clinical Trials is very important in these rare tumors like Olaratumumab, Immunotherapy and inhibitors of NOTCH for desmoid (good results in Phase 1).
Management in Reference Centers benefits the patient’s survival and makes the doctor more experienced. The proximity of the Consultations with other specialists, agility in the Tumor Committees, support from Nursing and the help of the Government are aspects that could be improved in our country. The centralization of clinical trials and dissemination (websites) is key to progress.
© 2018 Beatriz Losada Vila, et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially.