Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Aug 2007
Case Reports[Gabapentin mitigates neuropathic pain in cancer patients--a case report].
A 64-year-old male underwent low anterior resection of the rectum for rectal cancer. Five years later, he suffered neuropathic cancer pain on the left-posterior surface of his thigh caused by sacral invasion of the recurrence site. ⋯ No adverse effect was seen during this treatment. The present case indicates that gabapentin would be one of the most effective adjuvant analgesics for neuropathic cancer pain.
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Gan To Kagaku Ryoho · Jun 2007
Multicenter Study[Validity of recommended minimum dose of prior morphine to initiate transdermal fentanyl patch in prescribing information - multicenter survey of on prescriptions by palliative care specialists in Japan].
For initiating the minimum-size (0.25 microg/hour) transdermal fentanyl patch (TDF), 45 mg a day of oral morphine is the recommended minimum dose (RMD) in Japan according to the prescribing information. However, little is known about the validity of the RMD, and we can presume there are many cases where clinicians are inclined to initiate the minimum-size TDF at the early stage contrary to the RMD due to the high morbidity rate of digestive system cancer in Japan. In order to verify the validity of the RMD, we collected 71 retrospective cases where the minimum-size TDF was initiated against the restriction of RMD. ⋯ According to the Numeric Rating Scale (from 0: no pain to 10: the worst pain), the pain intensity decreased from 6.6 on the 1st day to 2.8 on the 2nd day, 3.3 on the 3rd day, and 2.9 (p < 0.001) on the 4th day. We conclude that, although introducing the minimum-size TDF against the RMD served to decrease the pain intensity,it raised the side effects on the respiratory system even when prescribed by palliative care specialists. Therefore,the RMD regulation is valid for general practitioners from a medical safety standpoint.
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Gan To Kagaku Ryoho · Jun 2007
Case Reports[A case of liver failure associated with liver damage due to mFOLFOX 6 after resection for multiple liver metastases from colorectal cancer].
A case of colorectal cancer in a 60-year-old man became resectable after downstaging was achieved with mFOLFOX 6 for multiple liver metastases from colorectal cancer. The patient received 8 cycles of mFOLFOX 6 on the basis of a diagnosis of multiple liver metastases in the right and left lobes and a single metastasis in the right lung. After chemotherapy, the liver metastases showed partial response, and the lung metastasis stable disease. ⋯ The needle biopsy specimens of the liver taken on readmission showed bile duct occlusion, portal hypertension, and perisinusoidal fibrosis, and histopathology of the surgical non-tumoral liver specimen showed the same findings. We think that liver failure was triggered by resection of the liver which had been damaged by mFOLFOX 6. Recently, liver damage due to oxaliplatin was reported, and evaluation of liver injury is considered important before liver resection for colorectal liver metastases with neoadjuvant FOLFOX.
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Gan To Kagaku Ryoho · May 2007
[Clinical study of low-dose cisplatin and 5-fluorouracil chemotherapy via implanted fusion port in 20 patients with advanced hepatocellular carcinoma with portal vein tumor thrombosis].
We experienced 20 cases of advanced hepatocellular carcinoma with portal vein tumor thrombosis treated with low-dose cisplatin and 5-fluorouracil (5-FU) chemotherapy via implanted fusion port between August 1999 and September 2003. A fusion port was implanted by inserting an intraarterial catheter into the hepatic artery. Cisplatin (10 mg/day, 5 times/week, 4 weeks) and 5-FU (250 mg/day, 5 times/week, 4 weeks) were administered for one cycle. ⋯ CLIP score and TM were also significantly reflected in life convalescence on multivariate analysis. While low-dose cisplatin and 5-FU chemotherapy via an implanted fusion port were regarded as a useful therapeutic regimen to improve life convalescence for cases of progressive hepatocellular carcinoma with portal vein tumor thrombosis (Vp 3/4), life convalescence in those with a CLIP score of 3 and above,particularly in the TM 2 group, was poor. We consider that treatment in such cases should be decided carefully, taking into consideration their quality of life.
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Gan To Kagaku Ryoho · Apr 2007
[A way of thinking of a MAB therapy for local/locally advanced prostate cancer: the theory and recent evaluation].
The MAB (Maximal Androgen Blockade) therapy is a treatment to exert maximal effects of hormone therapy, inhibiting androgen activity derived from both testes and adrenal gland that promotes proliferation of prostate cancer, being proposed by Dr. Labrie et al. in 1980s. For efficacy of the MAB therapy, a meta-analysis of randomized control studies with metastatic prostate cancer realized primarily in Europe and America showed the survival benefit of MAB therapy using nonsteroidal antiandrogen agent, which have placed it as a standard therapy for metastatic prostate cancer. ⋯ Labrie et al. suggested that the patients where the cure was expected did exist by continuing long-term MAB therapy against local prostate cancer. In this discussion meeting, inviting Dr. Labrie, the importance of MAB therapy among the hormone therapy against prostate cancer, the possibility of MAB therapy as a curative treatment against local/locally advanced prostate cancer and the ideal way of application of hormone therapy were discussed, and the significance was showed to conduct a most effective hormone therapy (MAB therapy) in earlier stage where the androgen sensitivity was noted.