Gan to kagaku ryoho. Cancer & chemotherapy
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Adjuvant systemic therapy has contributed to a significant improvement of disease-free and overall survival in addition to surgery and irradiation to the local disease. The adjuvant therapy to a patient is determined integrating the information on estimated risk of recurrence, benefit and harm of the therapy and the patient's value. In this review, the state of the art of adjuvant therapy is discussed from several aspects, such as interpretation and evaluation of risk, the best available evidences on adjuvant systemic therapy, the future direction of primary therapy for breast cancer, and patient-oriented decision making.
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To investigate the mental and physical changes of bereaved caregivers. ⋯ We provided bereavement care to 5 caregivers. It is suggested that in some cases long-term bereavement care is necessary.
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Gan To Kagaku Ryoho · Dec 2002
[Assistance for improving QOL of patients with terminal disease cared at home].
A visiting nursing service was provided for a female patient with the terminal stage of transverse colon cancer. The patient, who strongly wanted to stay at home, was discharged from hospital under continuous subcutaneous injection of morphine hydrochloride in late April 2001. The visiting nurse supported her life including the procedures for the continuous subcutaneous injection for attenuating pain as the main symptom. ⋯ She became able to walk to the rest room and take a shower and have increased ADL while regaining the strength of will. Family members were concerned with the potential sudden change in her conditions or intensification of pain at home but the worry was contained by understanding the procedures to follow in such cases. QOL can be improved even at the terminal stage if: 1. the patient understand the pathological condition; 2. the patient discloses his/her worry; 3. the patient can choose the way of living; 4. caregiver can cope with the change; 5. caregiver can maintain the nursing capability; 6. the medical provider's assistance system is established.
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Gan To Kagaku Ryoho · Dec 2002
Case Reports[A patient with mantle cell lymphoma who successfully underwent auto-PBSCT in combination with in vivo purging of tumor cells using rituximab].
The chimeric anti-CD20 monoclonal antibody rituximab was recently approved for the treatment of malignant B cell lymphoma. We report the case of a 49 year-old female with advanced mantle cell lymphoma (MCL), who successfully underwent auto-peripheral blood stem cell transplant (auto-PBSCT) in combination with in vivo purging of tumor cells using rituximab. Systemic swelling was detected in her lymph nodes, and she was histologically diagnosed with MCL. ⋯ Subsequently, a pretreatment regimen of CBDCA at 350 mg/m2 x 4, ETP at 500 mg/m2 x 3, MCNU at 200 mg/m2 x 1, and CPA at 2,000 mg/m2 x 2 was adopted to condition the transplant, followed by auto-PBSCT. After the transplant, the patient achieved an uncertain complete response (CRu). The present case suggests in vivo purging with rituximab is effective, and that this method may have a role as a first-line therapy in MCL patients who respond poorly to standard treatment.