• Title/Summary/Keyword: Chemotherapy induced Nausea & Vomiting

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Cost-Effectiveness Analysis of Granisetron-Based versus Standard Antiemetic Regimens in Low-Emetogenic Chemotherapy: A Hospital-based Perspective from Malaysia

  • Keat, Chan Huan;Ghani, Norazila Abdul
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7701-7706
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    • 2013
  • Background: In a prospective cohort study of antiemetic therapy conducted in Malaysia, a total of 94 patients received low emetogenic chemotherapy (LEC) with or without granisetron injections as the primary prophylaxis for chemotherapy-induced nausea and vomiting (CINV). This study is a retrospective cost analysis of two antiemetic regimens from the payer perspective. Materials and Methods: This cost evaluation refers to 2011, the year in which the observation was conducted. Direct costs incurred by hospitals including the drug acquisition, materials and time spent for clinical activities from prescribing to dispensing of home medications were evaluated (MYR 1=$0.32 USD). As reported to be significantly different between two regimens (96.1% vs 81.0%; p=0.017), the complete response rate of acute emesis which was defined as a patient successfully treated without any emesis episode within 24 hours after LEC was used as the main indicator for effectiveness. Results: Antiemetic drug acquisition cost per patient was 40.7 times higher for the granisetron-based regimen than for the standard regimen (MYR 64.3 vs 1.58). When both the costs for materials and clinical activities were included, the total cost per patient was 8.68 times higher for the granisetron-based regimen (MYR 73.5 vs 8.47). Considering the complete response rates, the mean cost per successfully treated patient in granisetron group was 7.31 times higher (MYR 76.5 vs 10.5). The incremental cost-effectiveness ratio (ICER) with granisetron-based regimen, relative to the standard regimen, was MYR 430.7. It was found to be most sensitive to the change of antiemetic effects of granisetron-based regimen. Conclusions: While providing a better efficacy in acute emesis control, the low incidence of acute emesis and high ICER makes use of granisetron as primary prophylaxis in LEC controversial.

Effectiveness of acupuncture as an adjunctive therapy for lung cancer: A systematic review and meta-analysis

  • Shen, Lei;Gwak, Si Ra;Joo, Jong Cheon;Park, Soo Jung
    • 대한암한의학회지
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    • 제25권1호
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    • pp.25-39
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    • 2020
  • Objectives : Lung cancer is one of the most common cancer and the leading cause of cancer deaths worldwide. This study aimed to evaluate the role of acupuncture as an adjunctive therapy for lung cancer. Methods : We conducted a systematic review and meta-analysis on the role of acupuncture therapy in lung cancer treatment by electronic and manual searching in ninedatabases, including PubMed, Cochrane library, Embase, Korean databases, and Chinese medical databases. Results : A total of 21 trials were included in the meta-analysis. The study results showed that acupuncture therapy had significant efficacy in immuneregulation, including CD3 andCD4. Further analysis revealed that acupuncture therapy significant improvements in quality of life, including Karnofsky performance status(KPS)score, functional assessment of cancer therapy-lung cancer subscale (FACT-L) and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). In addition, the pooled studies also showed that acupuncture therapy reduced cancer pain and chemotherapy-induced nausea and vomiting. Conclusions : Our study provides moderate evidence of the efficacy of the acupuncture therapy in the treatment of lung cancer.

소아암의 한의약치료 임상 동향 - 대조군 임상연구를 중심으로 (Traditional Asian Medicine Treatment for Childhood Cancer - Review of Controlled Clinical Studies)

  • 김윤환;김한슬;오정명;이혜윤;민유리;윤영주
    • 대한예방한의학회지
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    • 제24권2호
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    • pp.17-30
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    • 2020
  • Objectives : To find treatment techniques and design clinical studies, this study reviewed controlled clinical studies on traditional Asian medicine treatment for childhood cancer. Methods : Literature searches were performed on four databases, such as NDSL, OASIS, PubMed, and CNKI. Studies were categorized and analyzed according to the treatment goal and we also assessed the quality of the randomized controlled trials (RCT) using Van Tulder Scale. Results : Twenty-seven studies met our inclusion criteria: 21 RCTs, 4 controlled trials, 2 Cohort studies, however only 6 among the 21 RCTs got the scores of high quality. Various interventions were used, such as herbal medicine, acupuncture, acupressure, and chuna. 7 studies were focused on cure of leukemia or solid cancer. 11 studies were performed to alleviate chemotherapy induced nausea and vomiting. 9 studies were focused on other complications of chemotherapy. Conclusions : Most of the studies reported significant effectiveness of traditional medicine treatment compared to controlled group. However we could not made a definite conclusion because of the low quality and heterogeneity of the studies included. More studies should be performed to introduce traditional Asian medicine to childhood cancer treatment.

조프란 정(온단세트론 8mg)에 대한 온프란 정의 생물학적동등성 (Bioequivalence of Onfran Tablet to Zofran Tablet (Ondansetron 8mg))

  • 신인철;홍정욱;박윤영;고현철
    • Biomolecules & Therapeutics
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    • 제11권1호
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    • pp.58-64
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    • 2003
  • Ondansetron is a potent, highly selective 5-hydroxytryptamin $e_3$(5-H $T_3$) receptor-antagonist, for the management of nausea and vomiting induced by cytotoxic chemotherapy and radiography, and the treatment of post-operative nausea and vomiting. The purpose of the present study was to evaluate the bioequivalence of two ondansetron tablets, Zofran (Glaxo Smithcline Korea Ltd.) and Onfran (Korea United Pharmaceutical Co., Ltd.), according to the guidelines of Korea Food and Drug Administration (KFDA). Eighteen normal male volunteers, 24.39$\pm$1.69 year in age and 69.00$\pm$6.74kg in body weight, were divided into two groups and a randomized 2${\times}$2 cross-over study was employed. After one tablet containing 8mg of ondansetron was orally administered, blood was taken at predetermined time intervals and the concentrations of ondansetron in plasma were determined using HPLC with UV detector. Pharmacokinetic parameters such as AVC, $C_{max}$ and $T_{max}$ were calculated and ANOVA test was utilized for the statistical analysis of the parameters. The results showed that the differences in AUC, $C_{max}$ and T max between two tablets were 5.83%, 5.75% and -5.71%, respectively when calculated against the Zofran, tablet. The powers (1-$\beta$) for AUC, $C_{max}$ and $T_{max}$ were above 90%, above 90% and below 60%, respectively. Minimum detectable differences($\Delta$) at alpha=0.1 and 1-$\beta$=0.8 were less than 20% (e.g., 12.74% and 11.78% for AUC and $C_{max}$ respectively). But minimum detectable differences($\Delta$) at alpha=0.1 and 1-$\beta$=0.8 for $T_{max}$ were more than 20% (e.g., 34.22%). The 90% confidence intervals were within $\pm$20% (e.g., -2.73∼14.39 and -2.16∼13.67 for AUC and $C_{max}$ respectively). But 90% confidence intervals for $T_{max}$ were not within $\pm$20% (e.g., -28.71∼17.28). Another ANOVA test was conducted for logarithmically transformed AUC and $C_{max}$. These results showed that there are no significant difference in AUC and $C_{max}$ between the two formulations: The differences between the formulations in these log transformed parameters were all for less than 20% (e.g., 5.83% and 5.75% for AUC and $C_{max}$ respectively). The 90% confidence intervals for the log transformed data were the acceptance range of log 0.8 to log 1.25 (e.g., log 0.99∼log 1.15 and log 0.98∼log 1.15 for AUC and $C_{max}$ respectively). The major parameters, AUC and $C_{max}$, met the criteria of KFDA for bioequivalence although $T_{max}$ did not meet the criteria of KFDA for bioequivalence, indicating that Onfran tablet is bioequivalent to Zofrm1 tablet.t is bioequivalent to Zofrm1 tablet.m1 tablet.m1 tablet.m1 tablet.

조프란 정(온단세트론 8 mg)에 대한 하나 온단세트론 정의 생물학적 동등성 (Bioequivalence of Hana Ondansetron Tablet to Zofran Tablet (Ondansetron 8 mg))

  • 조혜영;김수진;심영순;임동구;오인준;문재동;이용복
    • Journal of Pharmaceutical Investigation
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    • 제30권3호
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    • pp.213-218
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    • 2000
  • Ondansetron is a potent, highly selective 5-hydroxytryptamine3(5-HT3) receptor- antagonist, for the management of nausea and vomiting induced by cytotoxic chemotherapy and radiography, and the treatment of post-operative nausea and vomiting. The purpose of the present study was to evaluate the bioequivalence of two ondansetron tablets, $Zofran^{TM}$, (Glaxo Wellcome Korea Ltd.) and Hana ondansetron (Hana Pharmaceutical Co., Ltd.), according to the guidelines of Korea Food and Drug Administration (KFDA). Eighteen normal male volunteers, $23.56{\pm}1.79$ year in age and $67.35{\pm}8.35\;kg$ in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After one tablet containing 8 mg of ondansetron was orally administered, blood was taken at predetermined time intervals and the concentrations of ondansetron in serum were determined using HPLC with UV detector. Pharmacokinetic parameters such as $AUC_t,\;C_{max}\;and\;T_{max}$ were calculated and ANOVA test was utilized for the statistical analysis of the parameters. The results showed that the differences in $AUC_t,\;C_{max}\;and\;T_{max}$ between two tablets were 7.53%, -0.23% and -3.92%, respectively when calculated against the $Zofran^{TM}$, tablet. The powers $(1-{\beta})$ for $AUC_t,\;C_{max}\;and\;T_{max}$ were above 99.00%, above 99.00% and 84.99%, respectively. Minimum detectable differences $(\Delta)\;at\;{\alpha}=0.1\;and\;1-{\beta}=0.8$ were all less than 20% (e.g., 12.25%, 10.88% and 18.37% for $AUC_t,\;C_{max}\;and\;T_{max}$, respectively). The 90% confidence intervals were all within ${\pm}20%$ (e.g., $-0.70{\sim}15.76,\;-7.53{\sim}7.08\;and\;-16.27{\sim}8.42\;for\;AUC_t,\;C_{max}\;and\;T_{max}$, respectively). All of the above parameters met the criteria of KFDA for bioequivalence, indicating that Hana ondansetron tablet is bioequivalent to $Zofran^{TM}$, tablet.

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Dexamethasone Disrupts Cytoskeleton Organization and Migration of T47D Human Breast Cancer Cells by Modulating the AKT/mTOR/RhoA Pathway

  • Meng, Xian-Guo;Yue, Shou-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권23호
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    • pp.10245-10250
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    • 2015
  • Background: Glucocorticoids are commonly co-administered with chemotherapy to prevent drug-induced allergic reactions, nausea, and vomiting, and have anti-tumor functions clinically; however, the distinct effects of GC on subtypes of tumor cells, especially in breast cancer cells, are still not well understood. In this study, we aimed to clarify the effect of GC on subtypes of T47D breast cancer cells by focusing on apoptosis, cell organization and migration, and underluing molecular mechanisms. Materials and Methods: The cell scratch test was performed to observe the cell migration rate in T47D cells treated with dexamethasone (Dex). Hoechst and MTT assays were conducted to detect cell survival and rhodamine-labeled phalloidin staining to observe cytoskeleton dynamics. Related factors in the AKT/mTOR pathway were determined by Western blotting. Results: Dex treatment could effectively inhibit T47D breast cancer cell migration with disruption of the cytoskeletal dynamic organization. Moreover, the effect of Dex on cell migration and cytoskeleton may be mediated by AKT/mTOR/RhoA pathway. Although Dex inhibited T47D cell migration, it alone may not induce cell apoptosis in T47D cells. Conclusions: Dex in T47D human breast cancer cells could effectively inhibit cell migration by disrupting the cytoskeletal dynamic organization, which may be mediated by the AKT/mTOR/RhoA pathway. Our work suggests that glucocorticoid/Dex clinical use may prove helpful for the treatment of breast cancer metastasis.

국한된 페소세포암의 방사선 치료성적 (The Results of Radiation Therapy of Limited Stage Small Cell Lung Cancer)

  • 김성환;최병옥;길학준;윤세철;박용휘;신경섭;김훈교;이경식
    • Radiation Oncology Journal
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    • 제11권1호
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    • pp.97-102
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    • 1993
  • 1983년 4월부터 1991년 9월까지 가톨릭 의과대학 강남성모병원 치료방사선과에서 국한된 폐소세포암으로 확진되어 방사선치료받은 32명의 환자를 대상으로 치료성적을 후향 분석하였다. 이중 5명은 방사선 치료 단독으로 치료받았으며 27명은 화학요법과 방사선치료 병용요법을 하였다. 남녀의 비는 4.3:1 이었으며 연령분포는 24세에서 78세였다(중앙값 : 63세). 6 MV X 선에의한 방사선치료선량은 일일 160-180 cGy씩 치료하여 총 1000-6660 cGy (중앙값 4500 cGy)였다. 치료 후 완전관해율은 $37.5{\%}$ (12/32), 부분관해율은 $34.4{\%}$(11/32)였고, 무반응은 $28.1{\%}$(0/32)였다. 생존기간의 중앙값은 10개월이었고 1년생존율과 2년생존율은 각각 $59.4{\%}$$28.1{\%}$였다. 1년생존율을 유의하게 증가시키는 요소로서는 70이상의 Karnofsky수행상태(p<0.04), 화학요법의 병행(CAV, PV, CAV+PV) (p<0.04), 화학요법 6회 이상(p<0.007) , 45 Gy 이상의 방사선량(p<0.03)와 방사선치료에 반응있었던 경우(CR+PR) (p<0.003)등이었다. 나이, 성별, 상대정맥증후군, 예방적 전뇌조사 및 방사선 치료기간은 유의한 영향을 미치지 않았다. 방사선 치료에의한 부작용은 식도염이 $34{\%}$(11명), 전신피로 $28{\%}$(9명)에서 있었으며 오심 구토 같은 위장관 증상은 $15{\%}$(5명) 그리고 백혈구감소증이 $3{\%}$(1명)에서 관찰되었다.

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재발성 또는 국소진행된 위암의 방사선치료 -35예의 치료성적 분석 (Role of Radiation Therapy for Locally Advanced Gastric Carcinoma Management)

  • 윤세철;오윤경;신경섭;박용휘;김인철;이경식
    • Radiation Oncology Journal
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    • 제6권1호
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    • pp.41-47
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    • 1988
  • 가톨릭의대 강남성모병원 방사선치료실에서는 1983년 5월부터 1987년 5월 사이 수술 후 재발되거나 국소적으로 진행되어 절제 불가능한 위암환자 35예에 대하여 외부방사선치료를 실시하였다. 방사선치료는 6MV선형가속기를 사용하여 매일 $160\~180cGy$씩, 주 5회 분할 조사하여 총 $4500\~5500cGy$를 시도하였으며, 전예에서 Box Technique을 이용하였다. 방사선치료만을 실시하였다. 3예를 제외한 전예에서 5-FU 또는 FAM 화학요법을 병행하였다. 1. 총 35예는 남자 25명 여자 10명이었으며 연령은 38세에서 80세사이에(평균 56세)분포하였다. 조직학적으로는 전 예가 선세포암이었다. 2. 수술후 재발되어 방사선치료하기까지의 기간은 수술후 1년이내에 $18(51\%)$명, $1\~2$년내 $8(23\%)$명, 그리고 $2\~3$년내에 $5(14\%)$명이었다. 3. 방사선치료를 하게된 주된 증상으로는 통증 30명$(86\%)$, 종괴 29명$(85\%)$, 위장관폐쇄 11$(31\%)$명 및 폐쇄성 황달이 9$(26\%)$명이었다. 4. 이증상들의 방사선치료 후 반응은 총 치료선량에 따라 $40\~50Gy$에서 14/16$(88\%)$, 50Gy이상에서 8/10$(80\%)$, $30\~40 Gy$에서 6/8$(75\%)$, 및 $20\~30Gy$에서 8/15$(53\%)$의 호전율을 관찰할 수 있었다. 5. 국소 진행된 위암환자의 방사선치료 후 평균 생존율은 3.6개월이었으며 방사선치료에 의한 부작용으로서는 오심, 구토$(46\%)$, 설사$(20\%)$, 백혈구 감소증$(27\%)$, 그리고 빈철 및 폐염$(9\%)$등의 순을 보였다.

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