Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Mar 2015
Case Reports[A rare case of lymphangitis carcinomatosa of the lung due to primary pulmonary adenocarcinoma with intestinal differentiation successfully treated with chemotherapy].
We report a rare case of lymphangitis carcinomatosa in a 66-year-old man with a relatively long survival of 18 months following chemotherapy. The patient initially presented with dyspnea and lower abdominal pain. Subsequent colonoscopy detected adenocarcinoma of the descending colon, and computed tomography (CT) demonstrated indications of lymphangitis carcinomatosa of the lung. ⋯ However, subsequent immunocytochemistry analysis using the cell transfer method in bronchoalveolar lavage fluid specimens revealed diffuse positivity for cytokeratin (CK) 7, while the colon carcinoma was negative for CK7. The difference in CK7 immunoreactivity between the bronchoalveolar lavage fluid and biopsy specimen of the colon indicated that the lymphangitis carcinomatosa in this patient could be reasonably postulated to be caused by a synchronous primary pulmonary adenocarcinoma with intestinal differentiation. However, an autopsy could not be performed to test this hypothesis.
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Gan To Kagaku Ryoho · Mar 2015
Multicenter Study[Talking about home hospices with terminally ill cancer patients -- a multicenter survey of bereaved families].
Communicating with patients is clearly an integral part of physicians' practice, and introducing home hospice care is sometimes a difficult task for oncologists. The primary aims of this study were to clarify family-reported degree of emotional distress and the necessity for improvement in communication when introducing home hospice care, and to identify factors contributing to distress levels. ⋯ In receiving information about transition of home care, a considerable number of families experienced high levels of emotional distress and felt a need for improvement in the communication style. This study proposes 6 strategies to alleviate family distress.
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Gan To Kagaku Ryoho · Mar 2015
[Methods of preventing phlebitis induced by infusion of fosaprepitant].
At our hospital, we use aprepitant for nausea and vomiting when administering highly emetic anticancer agents, according to "Guidelines for the Appropriate Use of Antiemetic Agents" given by the Japan Society of Clinical Oncology. We initiated the intravenous administration of fosaprepitant for better compliance compared with aprepitant; however, we observed phlebitis after the infusion of fosaprepitant. Therefore, we investigated measures to reduce phlebitis associated with the infusion of fosaprepitant. ⋯ For the modified premedication, fosaprepitant, dexamethasone, and 5- HT(3) antagonist were dissolved in 100 mL of saline and administered for 30 minutes. The modified premedication was administered to a total of 27 patients; 5 patients developed mild phlebitis (grade 1), but infusion could be continued by treating their phlebitis with a hot pack. We used a combination of dexamethasone and 5-HT(3) antagonist with fosaprepitant as a modified premedication in order to avoid drug-induced vascular damage, which resulted in the pH decreasing to 6.20-7.55 (close to neutral) and a shorter infusion time.
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Gan To Kagaku Ryoho · Mar 2015
Case Reports[Case report of disseminated carcinomatosis of the bone marrow originating from gastric cancer with cancer-related disseminated intravascular coagulation successfully treated with recombinant human soluble thrombomodulin].
A 62-year-old man, who underwent distal gastrectomy due to gastric cancer, was diagnosed with disseminated carcinomatosis of the bone marrow 8 years later. Chemotherapy was administered following treatment with recombinant human soluble thrombomodulin (rTM), and as a result, he successfully recovered from his disseminated intravascular coagulation (DIC) status and experienced improvement of his severe cancer-related pain. The use of rTM may enable the safe continuation of chemotherapy, and rTM may also be a useful treatment for DIC associated with solid cancer, such as gastric cancer.