Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Dec 2007
[The home palliative care transition manual for the regional cooperation from the general ward at Shizuoka Red Cross Hospital].
Recently, a home palliative care has been recommended for terminal stage cancer patients. However, a few clinics are available providing a home palliative care. As a result of that, there have been many cases of the terminal stage cancer patients who could not receive a peace of mind care and die peacefully at home. ⋯ We intervened 8 cases from April to July 2007. Six out of 8 cases were transferred to home, and 2 patients were died at home. The home care transition manual will be shared with other hospitals from now on.
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It is essentially important for home hospice care, which provides hospice care at home to palliate the patient's sufferings, such as pain for example, and to provide cares in the form of the interdisciplinary team approach. Though the actual way of providing hospice care at home is principally based upon an institutional hospice care, there are some which are peculiar to home hospice care. The principles of symptom control in case of home hospice care are: (1) to take account of patient's daily life, (2) to make much of the natural course of the disease, (3) to palliate the patient's sufferings by focusing on the subjective complaints and (4) to provide relief on medical aspect at home. As for the interdisciplinary team approach, a special consideration of the members to visit the patient's home as few as possible in order to keep the patient's life quiet.
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Gan To Kagaku Ryoho · Nov 2007
[The treatment strategy for type 4 gastric cancer with positive lavage cytology--a decision making of the therapeutic strategy by the change of the result of the lavage cytology].
It has been difficult to improve the prognosis of the type 4 advanced gastric cancer because the peritoneal dissemination develops frequently. In the present study, the therapeutic strategy, an administration of chemotherapy followed by gastrectomy, for the type 4 advanced gastric cancer with positive lavage cytology (CY) was discussed. ⋯ It may be important to perform re-staging laparoscopy with the evaluation of CY after preoperative chemotherapy for the type 4 advanced gastric cancer with positive CY, because the survival was comparatively better in cases with the change from positive CY to negative CY after the treatment. In conclusion, the treatment strategy for the type 4 advanced gastric cancer with positive CY was to administer chemotherapy followed by curative intent surgery for the case with negative CY after pre-operative treatment, while the other regimen of chemotherapy administration for the case with positive CY remained.
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In primary bone sarcomas, the efficacy of chemotherapy varies according to the histological types. Prognoses are poor in patients with osteosarcoma or Ewing's sarcoma, when surgery alone is performed. However, because these sarcomas are chemosensitive, their prognoses have been improved with adjuvant chemotherapy. ⋯ Low-grade bone sarcomas, e. g., parosteal osteosarcoma, central low-grade osteosarcoma, are well cured only by surgical excision, and adjuvant chemotherapy is not performed for these low-grade sarcomas. To enhance the efficacy of preoperative chemotherapy, various modalities have been used e. g., intraarterial infusion, caffeine-assisted chemotherapy, and local perfusion with hyperthermia. Good clinical results have been reported.
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Gan To Kagaku Ryoho · Nov 2007
Case Reports[Successful treatment of huge peritoneal metastasis from duodenal gastrointestinal stromal tumor resistant for imatinib mesylate].
Constitutive activation of KIT receptor tyrosine kinase is a critical factor in the pathogenesis of gastrointestinal stromal tumors. Imatinib mesylate (IM, Glivec), a selective tyrosine kinase inhibitor, has been shown in clinical studies to work against such tumors. But there is little information on whether combination of IM and surgical treatment can prolong survival in cases with unresectable multiple liver metastases. ⋯ IM-resistant GIST are treated with combination of novel molecular targeted-drug, RF, TAE, however, the effect is not enough. Surgical treatment is one of the successful treatments of huge peritoneal metastasis from duodenal gastrointestinal stromal tumor resistant for IM. Further examination in more cases of recurrent GIST is also necessary to estimate the effectiveness of treatment with IM.