Gan to kagaku ryoho. Cancer & chemotherapy
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Leptomeningeal carcinomatosis is a serious complication leading to a fatal outcome in patients with gastric cancer. We tried to treat leptomeningeal carcinomatosis from gastric cancer with intrathecal chemotherapy using methotrexate (MTX)and cytosine arabinoside(Ara-C). We described and discussed the therapeutic strategy. ⋯ The survival of the intrathecal chemotherapy group was from 39 to 367 days, whereas the survival of the conservative treatment group was from 10 to 31 days. The intrathecal chemotherapy improved not only survival but also clinical symptoms dramatically. Intrathecal chemotherapy is thus recommended for leptomeningeal carcinomatosis from gastric cancer.
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Sunitinib malate(SU11248)is an oral multitargeted receptor tyrosine kinase inhibitor(MTI)that has antitumor activities for patients with gastrointestinal stromal tumor; GIST after failure of Imatinib. Sunitinib has demonstrated significant clinical benefits, including PFS, RR and OS in the USA and Japan. ⋯ Now, clinical trials of several new MTIs are ongoing in Western countries. Inhibition of the KIT gene cis-mutations and antiangiogenesis activities may be essential for the strategy for Imatinib/Sunitinibresistant GIST.
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Gan To Kagaku Ryoho · Mar 2009
Controlled Clinical Trial[Efficacy of oral cavity care in preventing stomatitis (mucositis) in cancer chemotherapy].
Stomatitis is a common side effect during cancer chemotherapy. We hypothesized that careful oral cavity care using patient guidance and cleanliness index prevents stomatitis in cancer chemotherapy. We introduced oral care patient guidance including teaching good brushing methods, O'Leary's Plaque Control Record(PCR)as a cleanliness index, and Eilers' Oral Assessment Guide(OAG)as an overall index after April 2006. ⋯ Introduction of oral care patient guidance decreased the incidence of stomatitis. Both PCR and OAG indexes were useful in evaluating the objective condition of the oral cavity and in sharing patients' information among a medical team. These indexes encouraged the patients to clean their oral cavities.
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Patients with malignancies are subject to developing a set of complications that require emergency evaluation and treatment. Emergencies in the cancer patients are particularly complex. Since the severity of emergency situations varies individually, the appropriate treatment should be determined based on the clinical condition of individual patients. ⋯ An oncogenic emergency involving respiratory malignant disease is rare, but special medical knowledge and skills are required. Therefore, we should train for that situation in a medical examination. In this review, we suggest the diagnosis and initial therapy for common emergencies involving respiratory malignant disease, such as severe airway obstruction, massive hemoptysis, pneumothorax, and hemoneumothorax.
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Gan To Kagaku Ryoho · Dec 2008
[Clinical effectiveness of anti-cholinergic agents for respiratory impediment in the home palliative care setting].
Dyspnea is one of the most common problems we encounter in the palliative care setting of patients with life-threatening illness including malignancy. Dyspnea is considered especially a troublesome symptom in the management of in-home hospice care services. ⋯ According to the outcome of this study, anti-cholinergic drugs may be effective for alleviating the suffering of terminally-ill patients due to dyspnea. Further investigation would be expected to clarify the usefulness of anti-cholinergic agents in the field of palliative care.