Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Apr 1992
[Benefits of totally implanted central venous access in patients with cancer].
A totally implanted system for improved central venous access has been investigated during 44 procedures in 38 patients (37 with cancer and one with cerebral infarction). Most of them lacked peripheral venous sites, and ten per cent of the patients had a prior chronic external central venous catheter. This system is implanted using local anesthesia and consists of a port connected to a central venous catheter threaded through the subclavian vein into the superior vena cava. ⋯ Four systems became occluded and two of them were replaced. Overall patient acceptance was excellent. This system can be assigned to an appropriate setting that facilitates management of the cancer patient.
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Gan To Kagaku Ryoho · Apr 1992
Multicenter Study Clinical Trial[A phase II clinical study of cis-diammine glycolato platinum, 254-S, for gastrointestinal cancers. 254-S Gastrointestinal Cancer Study Group].
A phase II clinical study of 254-S, a new anticancer platinum complex for gastrointestinal cancers, was conducted by the 254-S Gastrointestinal Cancer Study Group consisting of 16 institutions. 254-S was administered at 100 mg/m2 by intravenous drip infusion. This administration was repeated at 4-week intervals. The cases in which 254-S could be administered at least two times were regarded as complete cases evaluable for tumor response; of 75 cases registered, 53 were complete cases (29 cases with esophageal cancer, 12 with stomach cancer and 12 with colon cancer). ⋯ Major toxic effects observed were hematotoxicity including thrombocytopenia (59.0%), leukopenia (68.9%) and anemia (57.4%) and gastrointestinal toxicity such as nausea and vomiting (63.9%) and anorexia (41.0%); since grade 3 or 4 thrombocytopenia was observed with an incidence of 27.9%, careful monitoring seems to be required during the treatment with this product. Abnormal parameter changes on renal function included elevations of BUN (18.0%) and serum creatinine (9.8%). Based on these results, it was concluded that 254-S is a useful anticancer agent for the treatment of esophageal cancer.
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The accurate assessment of pain is essential in cancer pain treatment. As pain is a subjective experience, there is no precise method to quantitate it objectively. There are two approaches: the first is the use of laboratory techniques to measure the patient's reaction to experimental pain, such as sensory decision theory analysis. ⋯ Listening carefully to the patient's complaint is required not only for the precise assessment of pain, but also is a form of psychological treatment. Cancer pain should be relieved as soon as possible. Although WHO cancer pain relief is the first choice, nerve blocks and intraoperative radiotherapy, if indicated, must be taken into consideration in the early phase of the pain treatment.
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Gan To Kagaku Ryoho · Aug 1991
[Trans-arterial infusion chemotherapy through the inferior epigastric artery for malignant abdominal tumors without laparotomy].
A new technique of intra-arterial catheterization through the inferior epigastric artery using a subcutaneously-implanted silicon reservoir was tried for arterial infusion chemotherapy in patients with cancer located in specific lesions. Eight surgically uncontrollable tumors, consisting of 6 hepatic metastasis, one surgically incurable gastric cancer and one recurrent rectal cancer, were treated by continuous arterial infusion of cis-diamminedichloroplatinum (CDDP) using this new method. ⋯ No significant difference in CDDP levels in serum was found between CR plus PR and NC cases. Since this method can be done without laparotomy, more patients may benefits from arterial infusion chemotherapy.
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The establishment of the starting dose and the dose escalation are the principal issues of the Phase I trials of anticancer agents. We report the procedures and results of the Phase I studies we participated in Japan in the 1980's concerning 17 intravenous anticancer agents. The drugs indicated a correlation between the mouse LD10 and the man MTD (maximum tolerated dose) in mg/m2. ⋯ The real steps were more than the Fibonacci's ones in the late 1980's. It showed the tendency of a more careful and safer dose escalation, however, to put it critically, the dose escalation was not efficient enough. It is expected that the contradictory problem between safety and efficacy in the Phase I studies will be solved by developing methods like pharmacokinetic study in animals and man.