Gan to kagaku ryoho. Cancer & chemotherapy
-
Gan To Kagaku Ryoho · Sep 2009
[An appropriate opioid rotation method for treatment of cancer pain--nationwide usage survey of opioid analgesics].
The use of opioid for treatment of cancer pain has become common with the spread of the WHO method for relief of cancer pain. However, it cannot yet be said whether such usage is appropriate. ⋯ Results indicate that at opioid rotation to fentanyl patch due to insufficient effect, the second opioid is used in a potency equianalgesic or less of the first, so the efficacy of the second is often insufficient. In cases where previous medication had an insufficient effect, taking rescue doses into account, we believe it is important to rotate opioid at 30- 50% above the equianalgesic dose.
-
Gan To Kagaku Ryoho · Aug 2009
Review[Prevention of gastric cancer by Helicobacter pylori eradication].
Though the relationship between Helicobacter pylori (H. pylori) infection and gastric cancer has been proved in epidemiological studies and animal experiments, the prophylactic effect of H. pylori eradication is controversial in human studies. A large-scale clinical study performed by the JAPANGAST Study Group has confirmed that the eradication of H. pylori undoubtedly decreases the incidence of metachronous gastric cancer after endoscopic mucosal resection as published in The Lancet (372: 392-397, 2008). This study shows gastric cancer is a kind of infectious disease, not a lifestyle-related disease, and can thus be averted by preventing or curing the infection, suggesting the eradication of H. pylori might be indicated to prevent development of gastric cancers.
-
Gan To Kagaku Ryoho · Jul 2009
Review[Small-molecule inhibitors against KIT and PDGFRs especially in GISTs].
Gastrointestinal stromal tumors (GISTs) are one of the representative diseases for which we now use small-molecule inhibitors against KIT and PDGFRs. Most GISTs have gain-of-function mutations of the c-kit or PDGFRA gene. The mutations result in constitutive receptor activation, and the activated receptor stimulates downstream signaling pathways. ⋯ Although molecular target therapy has been very effective, secondary resistance to imatinib often develops during long-term imatinib administration. Secondary mutations of the c-kit gene in addition to primary c-kit gene mutation are a major cause of secondary resistance to imatinib. Now, we can use sunitinib for patients with imatinib-resistant GIST.
-
Gan To Kagaku Ryoho · Jun 2009
Case Reports[A case of multiple hepatic metastases of gastric cancer that showed complete regression by systemic chemotherapy using paclitaxel and UFT-E].
We report a case of gastric cancer with simultaneous multiple liver metastasis that was successfully treated by paclitaxel and UFT-E. A 54-year-old man with gastric cancer was admitted to our hospital for further examination and treatment. A type III gastric cancer was located in the lower to middle part of the gastric body. ⋯ Seven months after the operation, abdominal CT showed a complete regression of the multiple liver metastasis, and the serum levels of tumor markers were also reduced within the normal range. During chemotherapy at an outpatient clinic, critical adverse effects did not appear. Paclitaxel or paclitaxel combined with UFT-E might be an effective regimen as second- or third-line chemotherapy for the liver metastases of gastric cancer.
-
Gan To Kagaku Ryoho · Jun 2009
[Clinical diagnosis of primary unknown cancer-the present situation and problems].
The first step of diagnosis of primary unknown cancer(PUC)the detailed history intake and physical examination including breast, genitourinary system and rectum. Laboratory test, chest X-p and systemic computed tomography are allowed to be performed for all patients with PUC. ⋯ There is not enough evidence on the utility of FDG-PTT or FDG-PET/CT for patients with PUC. Diagnosis of PUC should be made within one month from a patient's first visit to a hospital.