Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Dec 2008
[Problems of home hospice care related to duration--home hospice care for cancer patients who died at home within a week after the start of home hospice care].
The following results regarding the frequencies of home visits by nurses were obtained by comparing a group consisting of those who died within a week after the initiation of home hospice care (Short cases) and of those who had lived more than two weeks after starting the home hospice care (Control cases). 1) The frequencies of both scheduled and emergency home visits in Short cases were statistically higher than in Control ones. 2) Among the nurse's visits, scheduled home visits were of great importance leading not only to lessening the frequency of emergency visits but also to the palliation of anxiety for the patient/family. If the scheduled home visits were done appropriately, the frequency of emergency visits for the Short cases was just as low as for the Control cases. Thus, we reached the conclusion that home hospice care should start as soon as possible and that prolongation of inpatient care should be avoided.
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Gan To Kagaku Ryoho · Dec 2008
[The outpatient palliative care conference aimed at "home palliative care shift"].
The association of doctors of Shizuoka City started a conference (S-NET) for cancer diagnosis and treatment in order to enhance a home palliative care for terminal cancer patients. At the same time, we introduced a system called "home palliative care shift" for inpatients. However, we felt that an intervention was necessary at the earliest stage of home palliative care due primarily to difficulties our home palliative team faced in its intervention for inpatients to "home palliative care shift." The outpatient palliative conference started to begin centering in the outpatient chemotherapy room because we thought it was important to have a seamless transition for terminal cancer patients. ⋯ Through the participation of multiple different back ground professionals at the time, the patients were treated well with better understandings. Furthermore, by sharing the patient's objective and information, we could enhance some relationship with the patient as well as going along with patient intensions what they want us to do for them at the final moment of their life. We thought that the system that verifies patient's intentions at the earliest stage of home palliative care was clearly needed most.
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Gan To Kagaku Ryoho · Nov 2008
Case Reports[A case of diffusely infiltrating rectal cancer with pulmonary lymphangitis carcinomatosa successfully treated with mFOLFOX6 chemotherapy as salvage].
We report a case of diffusely infiltrating rectal cancer with pulmonary lymphangitis carcinomatosa that responded to mFOLFOX6 chemotherapy and enabled survival for 19 months. A 68-year-old man was admitted to our hospital for a dry cough and dyspnea. Chest X-ray and CT examination revealed prominent pulmonary markings and abnormal infiltrating shadows. ⋯ After 7 courses, pulmonary markings and abnormal infiltrating shadows had disappeared on chest X-ray and CT. This condition was maintained for 19 months by ambulant chemotherapy without sacrificing high quality of life. Thus, mFOLFOX6 chemotherapy could be an effective salvage regimen in cases of diffusely infiltrating rectal cancer with pulmonary lymphangitis carcinomatosa.
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Gan To Kagaku Ryoho · Oct 2008
Case Reports[A case of gastric gastrointestinal stromal tumor operated after low-dose chemotherapy with imatinib mesylate].
A 76-year-old man was admitted to our hospital because of tarry motions. Endoscopic findings showed an ulcer on a large submucosal tumor in the stomach. Abodminal CT scan showed a protruding lesion of approximately 13 cm at the lumen of the gastric body. ⋯ However, the drug was discontinued for arthritis(grade 3). Partial gastrectomy with sampling peritoneal nodules was performed in June 2007. The present case suggests that low-dose chemotherapy with imatinib mesylate may be useful as a preoperative therapy for a minimal surgery.
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Combination therapy with platinum preparations still occupies a central position in chemotherapy for lung cancer. Third-generation regimens that combine an anticancer drug and a platinum preparation that were published in the 1990s remain standard therapy for untreated non-small-cell lung cancer today. Cisplatin or carboplatin is used as the platinum preparation, but combination therapy with cisplatin has been found to have a greater antitumor effect than combination therapy with carboplatin. ⋯ EGFR tyrosine kinase inhibitors have been demonstrated to have a very high cytoreductive effect on lung cancers that have EGFR gene mutations. The frequency of EGFR gene mutations is high in East Asia, including Japan, whereas it is very low in Western countries. Thus, the future course of development of chemotherapy for non-small-cell lung cancer may differ in Western countries and Asia, and the method of using EGFR tyrosine kinase inhibitors is expected to have great implications in Asia.