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=> array:1 [ 0 => array:4 [ "autoresLista" => "Federico Gordo, Carmen Beato" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Federico" "apellidos" => "Gordo" "email" => array:1 [ 0 => "fgordo5@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Carmen" "apellidos" => "Beato" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:1 [ "colaborador" => "on behalf of the SEOM-SEMICYUC Working Group" ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Grupo de Investigación en Patología Crítica, Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Oncología Médica, Hospital Universitario Virgen de la Macarena, Sevilla, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Necesidad de cambios en los planes de tratamiento de los pacientes con cáncer" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have read the article published in <span class="elsevierStyleSmallCaps">Medicina Clínica</span> by Calvo Villas JM<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> on tumour lysis syndrome (TLS). The article discusses how this syndrome is a potentially fatal emergency characterized by massive cell death with the release of mediators that can lead to a multi-organ dysfunction syndrome. The author, aptly states that a systematic and multidisciplinary strategy should be established aimed at the early detection of complications, correction of metabolic and clinical abnormalities and prevention of complications in order to improve this entity's poor prognosis.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the article, the author also states how the group of patients with intermediate-high risk have an indication of admission to an intensive care department (ICD) during a period of 48–72<span class="elsevierStyleHsp" style=""></span>h with multidisciplinary participation that allows proper monitoring and treatment of this clinical entity.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Actually, the treatment of patients with cancer or haematological diseases has changed in recent years and, in fact, the group of patients with cancer constitutes a vulnerable group, exposed to different complications, sometimes derived from the cancer itself or its treatment, or derived from its increased life expectancy and the occurrence of potentially serious common medical complications. In recent years, the prognosis of these individuals has improved substantially thanks to several advances, such as immunotherapy, specific molecular therapies, surgical techniques or the development of maintenance therapy.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> This translates into increased survival of cancer patients hospitalized in the ICU and taken care of by intensivists. Therefore, the time has come to review intensive care support for these patients, which poses new professional and organizational challenges.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In this framework, an agreement was signed in 2017 between the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Intensive Medicine (SEMICYUC)<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> with the aim of improving the quality of care of cancer patients with critical complications. This initiative seeks to help in decision making, standardize criteria, reduce subjectivity, generate communication channels and deepen the ethical and scientific understanding of these situations.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Undoubtedly, what is stated in the article by Calvo Villas JM is one of the clinical entities to consider as a reason for admission to ICD, and these patients can also benefit from early management and interdisciplinary strategies that allow early detection of clinical deterioration signs. Especially in the case of respiratory failure and sepsis, in which adequate early management is key to guarantee a good prognosis.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The agreement between SEMICYUC and SEOM is applicable to other scientific societies,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> and we believe it is time to develop a common strategy in the clinical management of these patients to achieve the best standards of clinical care, and the best outcomes with the new treatments available to us.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gordo F, Beato C. Necesidad de cambios en los planes de tratamiento de los pacientes con cáncer. Med Clin (Barc). 2019;153:e53.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Síndrome de lisis tumoral" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.M. Calvo Villas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medcli.2018.10.029" "Revista" => array:2 [ "tituloSerie" => "Med Clin" "fecha" => "2019" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Survival of patients with advanced metastatic melanoma: the impact of novel therapies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. 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Molina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2017.06.008" "Revista" => array:6 [ "tituloSerie" => "Med Intensiva" "fecha" => "2018" "volumen" => "42" "paginaInicial" => "47" "paginaFinal" => "49" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28736083" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intensive care in cancer patients in the age of immunotherapy and molecular therapies: commitment of the SEOM-SEMICYUC [Article in English, Spanish]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Carmona-Bayonas" 1 => "F. Gordo" 2 => "C. Beato" 3 => "J. Castaño Pérez" 4 => "P. Jiménez-Fonseca" 5 => "J. Virizuela Echaburu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2018.01.008" "Revista" => array:7 [ "tituloSerie" => "Med Intensiva" "fecha" => "2018" "volumen" => "42" "paginaInicial" => "363" "paginaFinal" => "369" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29519710" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0890856709617342" "estado" => "S300" "issn" => "08908567" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complexity and uncertainty in the critical care of cancer patients in the era of immunotherapy and targeted therapies [Article in English, Spanish]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Carmona-Bayonas" 1 => "F. Gordo" 2 => "C. Beato" 3 => "J. Castaño Pérez" 4 => "P. Jiménez-Fonseca" 5 => "J. 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