Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Feb 2005
[Possible approaches to cancer chemotherapy in palliative care medicine].
We discussed our attitude, ideas, and treatment practices, and presented several problems concerning palliative chemotherapy under the palliative medical environment in patients with advanced cancer in our hospital. We thought that, in many cases, they could be given further chemotherapy. Because of the clear availability of so-called palliative therapy, these patients tend not to elect another chemotherapy using more effective anti-tumor agents in the name of "acceptance." The clinical practice of palliative chemotherapy, however, really needs the passion of skillful medical oncologists, palliative care doctors, and other staff including surgeons and radiologists. The most important issue is that all the medical staff sincerely empathize with the wishes of patients and their families with a common hospice spirit.
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Gan To Kagaku Ryoho · Feb 2005
[Quality of life and psychological traits of patients undergoing surgery for gastrointestinal cancer].
The purpose of this study was to assess the pre- and post-operative quality of life (QOL) of patients with gastrointestinal cancer and to investigate the relationship between QOL and various psychological and clinical factors. Eighty-five patients who underwent surgery for gastrointestinal cancer and 26 control patients undergoing surgery for digestive diseases other than cancer were interviewed. Two tests were administered to assess QOL and psychological status, respectively: the Japanese-language version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C 30 and the Japanese-language version of the Hospital Anxiety and Depression Scale (HADS). ⋯ All groups showed significant changes in subscale scores of QOL. The scores of the advanced-phase group indicated worse QOL than the early-phase and control groups in many areas. The results suggest that QOL in gastrointestinal cancer patients is variable over time and is influenced by various clinical factors including the depression and anxiety.
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Some three hundred thousand patients die from cancer in a year, most of whom end their lives at a general hospital. Considering this situation, the general hospital has to provide palliative care and make up interdisciplinary Palliative Care Team (PCT). Since April 2002, we established a PCT at Akita City Hospital. ⋯ The PCT provides support for doctors and nurses in the general unit. We general doctors must learn more about how to provide palliative care medicine for at least cancer pain as well as cancer treatment. A team approach is needed for all cancer patients.
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Gan To Kagaku Ryoho · Jan 2005
Multicenter Study Clinical Trial[VNCOP-B (etoposide, mitoxantrone, cyclophosphamide, vincristine, predonisolone, bleomycin) therapy in elderly patients with aggressive non-Hodgkin lymphoma--a study of efficacy and safety, final report].
We experienced the VNCOP-B (etoposide, mitoxantrone, cyclophosphamide, vincristine, predonisolone, bleomycin) combination regimen for the treatment of elderly patients with aggressive non-Hodgkin lymphoma (NHL) in a multicenter study by 6 collaborative institutions. Patients were previously untreated > or = 60 years of age and received prophylactic G-CSF. Twenty patients entered this trial, and all of them were evaluated for feasibility, toxicity, and efficacy. ⋯ Our trial was promising and well-tolerated. According to IPI, high/high-intermediate risk was associated with significantly worse OS and PFS than low/low-intermediate risk (2-year OS: 51.8% versus 100.0%, p=0.0118; 2-year PFS: 33.3% versus 80.0%, p=0.0125). Grade 3/4 infections occurred in 3 patients, but no patients experienced it with predonisolone reduced.
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Gan To Kagaku Ryoho · Dec 2004
Case Reports[Home palliative care--2 case reports: a long-term cancer pain management with transdermal fentanyl].
Transdermal Fentanyl was released in March 2002 in Japan after the acceptance of the insurance under the office of public health. Transdermal therapy is especially effective for patients having difficulty of oral intakes, and for home care cancer patients who suffer from chronic pain only if the therapy is feasible on the long-term basis. We report our cases for long-term cancer pain management with transdermal fentanyl. ⋯ Only a little rescue powder morphine was needed as an adjuvant during the duration of transdermal therapy. In these 2 cases of long-term cancer pain management, transdermal therapy has resulted in good pain reduction and the side effects with transdermal therapy were not noted. Transdermal fentanyl can be recommended for treatment of palliative cancer pain at home.