The journal of supportive oncology
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Review Case Reports
Endoscopic ultrasound-guided celiac plexus neurolysis for pancreatic cancer pain: a single-institution experience and review of the literature.
Pancreatic cancer is a common gastrointestinal malignancy with a poor prognosis. The primary goal for caregivers is effective palliative care, especially pain control, which is routinely managed by administration of narcotic analgesics. ⋯ Recent advances in the use of endoscopic ultrasonography (EUS) have made it an attractive guidance technique for CPN while allowing for a simultaneous tissue diagnosis. We report our experience using EUS-guided CPN and review the available literature regarding this modality.
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The objective of this multicenter, phase II, open-label study was to evaluate the safety and efficacy of the newest 5-hydroxytryptamine3 (5-HT3) receptor antagonist, palonosetron, plus dexamethasone and aprepitant in preventing nausea and vomiting in patients receiving moderately emetogenic chemotherapy. Eligible patients received a single intravenous dose of palonosetron (0.25 mg on day 1 of chemotherapy), along with 3 daily oral doses of aprepitant (125 mg on day 1,80 mg on days 2 and 3) and dexamethasone (12 mg on day 1,8 mg on days 2 and 3). Efficacy and safety data were obtained from patient diaries and adverse event reporting. ⋯ More than 90% of patients during all time intervals had no emetic episodes, and between 57% and 71% of patients reported no nausea during each of the 5 days post chemotherapy. Treatment was well tolerated, with no unexpected adverse events. These data demonstrate that palonosetron in combination with dexamethasone and aprepitant is safe and highly effective in preventing chemotherapy-induced nausea and vomiting in the days following administration of moderately emetogenic chemotherapy.
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Depending on their frequency and severity, hot flashes can be a major source of distress for individuals with cancer, particularly women with a history of breast cancer and men with prostate cancer. Characterized by increased skin temperature, skin conductance, and heart rate, hot flashes are associated with somatic, behavioral, and emotional manifestations. In this article, the authors review the prevailing theories on the pathophysiology of hot flashes and assess the major treatment interventions, such as hormonal agents, nonhormonal pharmacotherapy (including antidepressants), and complementary/alternative medicine options.
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Intravenous bisphosphonates are effective in reducing the incidence of skeletal-related events (SREs) in women with bone metastases of breast cancer. The cost-effectiveness of such therapy depends in part on the potential cost savings achieved by preventing these events. However, estimates of the costs of SREs in women with bone metastases of breast cancer in typical US clinical practice are unavailable. ⋯ Total medical care costs were $48,173 (95% CI, $19,068-$77,684) greater in SRE versus no-SRE patients (P = 0.001). The costs of clinically significant SREs in patients with breast cancer and bone metastases seen in typical clinical practice are substantial. Treatments that reduce the incidence of SREs, such as intravenous bisphosphonates, should reduce these costs.