• Journal of Digestive Cancer Research
• /
• v.7 no.2
• /
• pp.61-64
• /
• 2019

We report two cases of patients with unresectable pancreatic cancer treated with neoadjuvant chemotherapy and surgical resection. In the first case, main mass was located at the neck of the pancreas, encasing superior mesenteric artery and peritoneal seeding was suspected. In the second case, main mass was located at the body of pancreas and superior mesenteric artery was encased. Both patients received FOLFIRINOX chemotherapy regimen, consisting of 5-FU, folinic acid, irinotecan and oxaliplatin. In both cases, tumor size decreased and vascular involvement regressed in response to chemotherapy. After subsequent chemoradiation therapy, both patients underwent surgical resection with negative resection margin. The pathological stages were ypT1cN0 and ypT1aN0, respectively. Both patients received postoperative adjuvant chemotherapy with 6 cycles of 5-FU/folinic acid and remained without evidence of disease for more than 6 months after the surgery.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.7
• /
• pp.3335-3341
• /
• 2014

Background: Severe toxicity is commonly observed in cancer patients receiving irinotecan (CPT-11) UDPglucuronosyltransferase1A1 (UGT1A1) catalyzes the glucuronidation of the active metabolite SN-38 but the relationship between UGT1A1 and severe toxicity remains unclear. Our study aimed to assess this point to guide clinical use of CPT-11. Materials and Methods: 89 cancer patients with advanced disease received CPT-11-based chemotherapy for at least two cycles. Toxicity, including GI and hematologic toxicity was recorded in detail and UGT1A1 variants were genotyped. Regression analysis was used to analyse relationships between these variables and tumor response. Results: The prevalence of grade III-IV diarrhea was 10.1%, this being more common in patients with the TA 6/7 genotype (5 of 22 patients, 22.7%) (p<0.05). The prevalence of grade III-IV neutropenia was 13.4%and also highest in patients with the TA 6/7 genotype (4 of 22 patients; 18.2%) but without significance (p>0.05). The retreatment total bilirubin levels were significantly higher in TA6/7 patients (mean, $12.75{\mu}mol/L$) with compared to TA6/6 (mean, $9.92{\mu}mol/L$) with p<0.05. Conclusions: Our study support the conclusion that patients with a $UGT1A1^*28$ allele (s) will suffer an increased risk of severe irinotecan-induced diarrhea, whether with mid-or low-dosage. However, the $UGT1A1^*28$ allele (s) did not increase severe neutropenia. Higher serum total bilirubin is an indication that patients UGT1A1 genotype is not wild-type, with significance for clinic usage of CPT-11.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.9
• /
• pp.3951-3954
• /
• 2014

Objective: To investigate the electronic anti-nausea instrument (EANI) combined with hydrochloride palonosetron for prevention of chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy. Methods: Patients who received highly emetogenic chemotherapy were randomly assigned to a treatment group (60 patients) treated with EANI combined with hydrochloride palonosetron, and control group (also 60 patients) given only hydrochloride palonosetron. Chemotherapy related nausea and vomiting were observed and recorded in both groups of patients from the start till the end of chemotherapy. Results: Complete control rates of vomiting in treatment and control group were 40%, and 35%, respectively, without any statistical ly significant difference (p>0.05); however the response rates are 95.0%, 78.3%, respectively, with statistical difference (p<0.05). Complete control rates of nausea in treatment and control group were 36.7%, 30%, respectively, without statistical difference (p>0.05); but the response rates are 90.0%, 76.7%, respectively, with statistical difference (p<0.05). Conclusion: EANI combined with hydrochloride palonosetron for prevention of nausea and vomiting induced by chemotherapy could be more effective than hydrochloride palonosetron alone, and can be recommended for use in prevention and treatment of chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.5
• /
• pp.1863-1867
• /
• 2012

Background: Maintenance chemotherapy is one strategy pursued in recent years with intent to break through the chemotherapy plateau for advanced non-small cell lung cancer (NSCLC). However, given the toxicity, platinum-based combinations are rarely given for this purpose. We carried out the present prospective study of triplet platinum-based combination sequential chemotherapy in advanced NSCLC to investigate if patients could tolerate and benefit from such intensive treatment. Methods: From Dec 2003 to Dec 2007, 190 stage IIIB and IV NSCLC patients in Sun yat-sen University sequentially received the 3 platinum-based combination (TP-NP-GP) treatment (T: paclitaxol175$mg/m^2$ d1; N: vinorelbine25$mg/m^2$ d1 and 8; G: gemcitabine1$g/m^2$ d1 and 8; P: cisplatin20$mg/m^2$ d1-5; repeated every 3 weeks). Patients were followed up to at least 3 years to obtain survival data. Treatment toxicities and the quality of life (QOL) were assessed during the whole treatment. Results: There were 187 patients evaluable. The TP, NP and GP response rates with sequential use were 42.8% (80/187), 41.1% (65/158) and 28.8% (21/73) respectively. Median survival time was 18.2 months and the 1, 2 and 3 year overall survival (OS) rates were 78.7%, 38.5% and 21.3%. Patients receiving > 6 cycles of chemotherapy had significantly longer OS and TTP (MST 25.3 vs. 14.5 months, TTP 15.1 vs. 9.1 months). The QOL on the whole for the patients was improved after chemotherapy. Conclusions: The sequential chemotherapy strategy with triplet platinum-based combination regimens can improve the survival outcome and the quality of life of advanced non-small cell lung cancer patients.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.1
• /
• pp.29-32
• /
• 2014

Background and Objective: Lung cancer is one of the malignant diseases which most seriously threat humansurvival and development. This study aimed to assess osteopontin (OPN) expression in non-small cell lung cancer (NSCLC) and any relationship with clinicopathological features. Methods: Immunohistochemistry was used to determine OPN expression and microvascular density (MVD) in 120 cases of NSCLC also undergoing clinical assessment. Results: Moderately positive expression of OPN was found in 34.6% (41/120) and strong expression in 47.5% (57/120) of the NSCLCs; OPN expression in carcinomas was higher than in pericarcinoma tissues (P<0.05). While no obvious association was observed with NSCLC patient age, gender, maximum diameter of the tumor and pathological type, OPN expression was more commonly detected in poorly differentiated carcinoma tissue and lymph node metastasis as well as at advanced clinical stage (P<0.05); OPN expression in cancer tissue was positively correlated with MVD (r = 0.839, P = 0.000). Conclusion: OPN plays an important role in promoting tumor angiogenesis and progress of NSCLCs and has the possibility to become the new target for therapy.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.1
• /
• pp.381-386
• /
• 2013

Aims: The aim of this study was to investigate the effects of adjuvant chemotherapy cycles on the prognosis of patients with post-operative stomach cancer through retrospective analysis. Methods: A total of 128 patients with gastric cancer who underwent gastrectomy, followed by adjuvant chemotherapy consisting of epirubicin, cisplatin or oxaliplatin, leucovorin, and 5-fluorouracil, according to a defined schedule, were divided into three groups according to the number of chemotherapy cycles: Group I (<6 cycles); Group II (6 cycles); and Group III (>6 cycles). Results: The 5-year overall survival (OS) was 20.8% in Group I, 45.0% in Group II, and 42.9% in Group III, with a median follow-up of 43 months. The 5-year relapse-free survival (RFS) was 15.1% in Group I, 40% in Group II, and 40% in Group III. The OS and RFS in Groups II and III were significantly better than in Group I (OS, p = 0.002 and p=0.003; RFS, P<0.001 and P=0.002). There was no difference in OS (p = 0.970) or in RFS (p = 0.722) between Groups II and III. Multivariate Cox hazard analysis determined that the number of adjuvant chemotherapy cycles was an independent factor that influenced OS and RFS. Conclusion: Six cycles of adjuvant chemotherapy gave encouraging outcomes in patients with resectable gastric cancer. Further prospective randomized controlled investigations are warranted in a multi-center setting.

• Asian Oncology Nursing
• /
• v.10 no.2
• /
• pp.163-170
• /
• 2010

Purpose: This study was conducted to examine understanding of chemotherapy of cancer patients after they received individual education on it and their execution of self-care for symptoms. Methods: Thirty-two participants who received individual education on chemotherapy from nurses specializing in education for cancer patients when they started to take chemotherapy were asked to complete the questionnaire on their understanding in education and execution of self-care. Results: Understanding on chemotherapy education of the participants recorded 4.30 on a scale of one to five with five the highest. Regarding self-care for symptoms, all participants carried out one or more methods of self-care except for one person each for vomiting, diarrhea, and constipation. Conclusion: This study showed that cancer patients who received individual education on chemotherapy performed self-care for their symptoms.

• Journal of Korean Clinical Nursing Research
• /
• v.20 no.1
• /
• pp.75-89
• /
• 2014

Purpose: This study was done to identify conditions of cancer patients who visited an emergency department (ED) with the side effects of chemotherapy. Methods: Data were collected retrospectively from medical records of 294 cancer patients who visited a tertiary hospital in 2009 for treatment of side effects of chemotherapy. Records were reviewed for characteristics of participants and side effects of chemotherapy. Data were analyzed using SPSS software. Results: ED Triage grade 3 was 81.6%. The hospitalization ratio was 72.8%, and 6.5% died during the admission. Most frequent side effects were thrombocytopenia (80.6%), anemia (74.5%), pain (52.0%), neutropenia (50.7%), and leucopenia (46.3%). The hospitalization group showed more severe leucopenia than the discharge group (p=.020). Patients in the group who died had higher scores for dyspnea compared to patients discharged or hospitalized (p<.05). Conclusion: Results of the study suggest that there is a special need to develop a system to manage side effects of chemotherapy. Also it is necessary to provide appropriate care and treatment with prompt initial evaluation when cancer patients with side effects of chemotherapy present in the ED. More effective educational discharge programs should also be developed to help these patients cope with various side effects of chemotherapy.

• Journal of Korean Academy of Nursing Administration
• /
• v.4 no.1
• /
• pp.151-181
• /
• 1998

This study purports to find out the meanings of chemotherapy among cancer patients. The subjects of this study were selected from those patients who have taken chemotherapy at least twice at a hospital affiliated with a university. The twelve subjects agreed to join the present study and had no problem in communication with others. The data were collected through observations and interviews by the researcher. The phenomenological analysis method proposed by Giorgi was adopted for analyzing the data. The experiences of the subjects to chemotherapy were classified into 24 atributes. These attributes were also categorized into four groups such as hope, pain, fear, and ordea according to their meanings. The subjects expressed hope through the attributes such as "the wish for a new life." "the wish for healing." "the plasure form improvement of cancer." "the wish for being discharged form a hospital." "the interest in dietectic treatment." and "the trust in medical staff." Pain was represented by such attributes as "the physical pain", "the suffering from intravenous injection." "the discomfort of hospital environment." and "the economic burden." As for the attributes represention fear, "fear of being hospitalized." "tehr obscurity of uncertain situations." "the fear of side effects." "the fear of recurrence of cancer," "the lack of knowledge of the disease." Finally, nine attributes werw frouped to ordeal "the will endeavouring to recover cancer" "the adaptation to the present situation." "the giving up of being healthy," "the regret of the past life." "the recognition of significant others." "the physical changes." "the emotional changes." "the social changes." "the recollection of illness experiences." The above findings indicate that chemotherapy means hope, pain, fear, and ordeal to those cancer patinests under treatment. Hence, the nursing interventions for those cancer patients need to be directed to maintaining hope, alleviating pain and fear, and overcoming ordeal. There are some suggestions in achieving these goals : (1) the nurses caring for cancer patients need to understand the meaning of chemotherapy experienced by those patients, (2) a nursing specialty of intravenous injection needs to be developed, (3) interventions for providing emotional support should be devised, (4) nursing care should also be available to those cancer patients being dischaged at home.

• Journal of Digestive Cancer Research
• /
• v.5 no.1
• /
• pp.66-69
• /
• 2017

Approximately 40% of patients with colorectal cancer have metastatic lesions at the time of diagnosis, and chemotherapy is generally prescribed for these patients. Though several drugs are used, 5-FU has long been the backbone of chemotherapy for colorectal cancer. Capecitabine is an oral 5-FU prodrug approved by the FDA in 2005 and is used alone or in combination for treatment of colorectal cancer. Recently, capecitabine has been used for a number of off-label indications, including the treatment of advanced or metastatic colorectal cancer. Here, we report a rare case of a 59-year-old woman, diagnosed with metastatic colorectal cancer who first presented with abdominal discomfort and dyspepsia. She showed a partial response to palliative first line FOLFOX chemotherapy, which had to be stopped due to peripheral neuropathy, as a side effect. She was next put on a second line chemotherapy regimen with capecitabine alone, since then she showed good treatment response without any disease progression.