Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Jun 2010
Review[Progress in the World and challenges in Japan on HPV vaccination for cervical cancer prevention].
For cervical cancer prevention, Cervarix(HPV-16/18)was approvedin Japan andvaccination programs against HPV-16/18 were startedin December, 2009. This vaccine is almost 100% effective in preventing high-grade precancer associated with the HPV types; it is safe and well tolerated. In Japan, universal vaccination of females between 11 and 14 years is recommended. We all look forward to eradicating cervical cancer in the not too distant future.
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The primary aim of this study is to clarify the participant-evaluated usefulness of an outreach program by a palliative care team. The palliative care team participated in a community conference and clinical activity in collaboration with a community home care clinic once a month during one year. ⋯ Usefulness for advising symptom control and developing collaborative relationship was high during the study periods, and usefulness for advising psychological care/communication and coordination of location of death gradually increased. In conclusion, an outreach program by a palliative care team could be useful for health care professionals in a community home clinic, and could contribute to better outcomes for cancer patients at home.
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Gan To Kagaku Ryoho · May 2010
Review[How to plan and execute multinational clinical studies properly-management of ethnic differences, private information, and genetic testing].
The need for multinational clinical studies in the oncology field has grown stronger not only for the purpose of registration but also the creation of scientific evidence for proper use of anti-cancer agents. Now almost all clinical study has been planned and executed under international collaboration, including Japan. Multinational study has several advantages to enhance faster accrual from more sites for patients with common malignancies and even with rare tumors, to provide scientific data for the approvals of participating countries, and to deliver meaningful information to medical sites in a broader range at reasonable cost. ⋯ From the study management viewpoint, the regulations in each region may differ to some extent, although efforts of harmonization has been initiated. Therefore, at the study planning stage, the ethnic or regional differences and those in regulations should be taken into consideration in the preparation of study protocol, and several measures should be prepared and implemented for the smooth conduction of the study. It is also recommended that Japan be involved in the development activity at an earlier phase, so that appropriate alternatives, including Asian collaborative studies, could be considered when needed.
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Gan To Kagaku Ryoho · May 2010
[Fever profile of febrile neutropenia in patients treated with cancer chemotherapy for hematological malignancies].
It is important to diagnose infectious events in cancer patients during chemotherapy. Since many of them have complications of febrile neutropenia (FN), determining its cause is critical for their treatment course. We analyzed all febrile events (>38.0 degrees C, single axillary temperature) in hospitalized cancer patients treated at Shizuoka Cancer Center over a period of 8 months. ⋯ In eleven of 18 infection-proven cases, we successfully predicted the infection focus at the onset of fever. Multivariate analysis revealed that initial high fever, antimicrobial prophylaxis, cutaneous findings and severe neutropenia were important influencing factors in predicting infectious disease during FN. Physical examination can support the diagnosis of the cause of fever in FN patients.
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Gan To Kagaku Ryoho · Apr 2010
Case Reports[Successful desensitization protocol for patients with hypersensitivity reactions caused by carboplatin].
We report the successful desensitization of a patient with a hypersensitivity reaction to carboplatin. A 54-year-old woman with advanced ovarian cancer went into remission after 10 courses of paclitaxel plus carboplatin (TC). After 7 months, cancer recurred in the vaginal cuff, and surgery was performed. ⋯ The desensitization procedure was successful, and the patient subsequently tolerated four additional courses of TC, with no further signs or symptoms of hypersensitivity. A complete response was achieved. A carboplatin desensitization regimen may allow patients with platinum-sensitive ovarian cancer to continue to benefit from therapy.