Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Sep 2019
Review[Risk Classification and Nivolumab plus Ipilimumab Combination Therapy for Treatment of Renal Cell Carcinoma].
The International Metastatic Renal Cell Carcinoma Database Consortium(IMDC)classification is often used to predict the prognosis of patients treated with molecularly targeted agents. In this review, the authors describe the prognostic value of the neutrophil-lymphocyte ratio and C-reactive protein for Japanese patients with renal cell carcinoma. ⋯ As a consequence, the combination of nivolumab plus ipilimumab is now positioned as standard first-line treatment for renal cell carcinoma, and the IMDCclassification is recommended as an aid in treatment decisions. Although careful management of immune-related adverse events is necessary, nivolumab plus ipilimumab combination therapy is expected to improve the outcomes of renal cell carcinoma for which the prognosis is otherwise generally poor.
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Gan To Kagaku Ryoho · Jun 2019
[Efficacy and Management of Adverse Events of Ipilimumab Including Combination Therapy with Nivolumab].
The treatment of cancer has been greatly improved in recent years by immune checkpoint inhibitors. Anti-CTLA-4 and anti- PD-1 antibodies, two types of immune checkpoint inhibitors, have great potential to prolong survival, while they have different characteristics of efficacy and safety profiles. Combination therapy with the anti-CTLA-4 antibody ipilimumab and the anti-PD-1 antibody nivolumab has better efficacy than monotherapy. ⋯ Such irAE includes that of the gastrointestinal tract, liver, and endocrine system, and is increased in incidence and severity when combined with ipilimumab and nivolumab. It is known that clinical characteristics of irAEs are different from those of typical autoimmune diseases. Therefore, irAEs should be managed in line with the algorithms and the appropriate use guides specifically for these drugs.
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Gan To Kagaku Ryoho · May 2019
[Project for Self-Help Tableware Involving Local Traditional Arts and Crafts of Japan].
To improve the quality ofmeals in communities, "Keiji study group on dysphagia" was founded in 2010. With the "Project for Self-Help Tableware involving Traditional Arts and Crafts," we will introduce an innovative community collaboration of cultural specialists,. The existing self-help tableware are not suitable for traditional feasts. ⋯ In the future, the need for food that ameliorates swallowing will increase. This new eating culture is not only concerned with the production off ood, but also with the presentation ofits tableware. We are planning to support the development ofsuch a cuisine through a sponsored project, which will encourage collaboration between local manufacturing of traditional culture and occupational therapy.
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Gan To Kagaku Ryoho · May 2019
[Investigation of the Cases of Deaths at Home after Discharge from Palliative Care Unit].
Recently, palliative care units are required to provide home-care support. In our palliative care unit, we support withh ospital discharge according to patient's wishes. In 2 years since April 2016, 104 of 536 hospitalized patients were discharged home (home discharge rate 19.4%). ⋯ As reasons for home discharge,"Advanced understanding of medical condition" and"Recognition of the goodness of home"was cited. The median time from discharge to death at home is as short as 14 days, and so cooperation between the hospital and the home medical team is indispensable. To that end, the hospital guarantees emergency hospitalization, and the home medical team needs to accept discharge of the patient who is approaching death.
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Gan To Kagaku Ryoho · Dec 2018
Case Reports[A Case of Complete Response to Computed Tomography-Guided Celiac Plexus Neurolysis of Pain Associated with Postoperative Recurrence of Colon Cancer].
The patient was a man in his 40s, who had undergone laparoscopic ileocecal resection with lymph node dissection(D3)for cecal cancer in January 2012. Histopathological examination of the resected specimens had revealed StageⅡ primary tumor with subserosal invasion and positive metastasis in 1-3 regional lymph nodes(pT2[SS]n1[+]). The pathological stage was Ⅲa(fStage Ⅲa), and the tumor showed RAS gene mutation. ⋯ The patient was discharged without major complications, and the base opioid dose was gradually reduced. Since the patient did not require any rescue medication during daytime on some days, the reduction of the base opioid dose was significantly effective in improving the patient's quality of life(QOL). In patients with pain possibly caused by metastasis to the para-aortic nodes, this local therapy technique may be considered.