• Journal of Gastric Cancer
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• 제17권2호
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• pp.120-131
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• 2017

Purpose: Tumor bleeding is a major complication in inoperable gastric cancer. The study aim was to investigate the effects of proton pump inhibitor (PPI) treatment for the prevention of gastric tumor bleeding. Materials and Methods: This study was a prospective double-blind, randomized, placebo-controlled trial. Patients with inoperable gastric cancer were randomly assigned to receive oral lansoprazole (30 mg) or placebo daily. The primary endpoint was the occurrence of tumor bleeding, and the secondary endpoints were transfusion requirement and overall survival (OS). Results: This study initially planned to enroll 394 patients, but prematurely ended due to low recruitment rate. Overall, 127 patients were included in the analyses: 64 in the lansoprazole group and 63 in the placebo group. During the median follow-up of 6.4 months, tumor bleeding rates were 7.8% and 9.5%, in the lansoprazole and placebo groups, respectively, with the cumulative bleeding incidence not statistically different between the groups (P=0.515, Gray's test). However, during the initial 4 months, 4 placebo-treated patients developed tumor bleeding, whereas there were no bleeding events in the lansoprazole-treated patients (P=0.041, Gray's test). There was no difference in the proportion of patients who required transfusion between the groups. The OS between the lansoprazole (11.7 months) and the placebo (11.0 months) groups was not statistically different (P=0.610). Study drug-related serious adverse event or bleeding-related death did not occur. Conclusions: Treating patients with inoperable gastric cancer with lansoprazole did not significantly reduce the incidence of tumor bleeding. However, further studies are needed to evaluate whether lansoprazole can prevent tumor bleeding during earlier phases of chemotherapy (ClinicalTrial.gov, identifier No. NCT02150447).

• 대한한의학회지
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• 제35권4호
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• pp.116-122
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• 2014

Objectives: Rectal cancer bleeding occurs approximately 20% of overall rectal cancer patients. The current standard treatments cannot cover minor bleeding enough. Failures of the local or systemic approaches to stop bleeding are frequently reported. Methods: we reported a case of male rectal cancer patient who was treated with herbal decoction and significantly improved on symptoms, such as, loose stools and rectal bleeding. Previous to first visiting to our clinic, he was prescribed to use oral tranexamic acids, which failed to relieve his symptoms. He was administered with an herbal decoction, Inhyungtang, clinically known to have hemostastic effect in hematochezia. Results & Conclusion: The prescription showed significant improvement on his symptom, in particular, his bleeding. Thus, we report his case and we expect further experiences and experimental studies to support efficacy of Inhyungtang.

• 셀메드
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• 제13권9호
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• pp.37.1-37.5
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• 2023

Objective: Case report of improvement in joint pain and gum bleeding in a breast cancer patient using OCNT. Methods: A Korean woman in her 60s was diagnosed with breast cancer. After being diagnosed with stage 2 breast cancer, her quality of life has greatly deteriorated due to the side effects of the drugs administered. Results: Improved joint pain and bleeding gums after OCNT Conclusion: The application of OCNT to patients with above problem can help improve symptoms.

• 대한암한의학회지
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• 제14권1호
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• pp.29-35
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• 2009

Approximately 10 percent of advanced stomach cancer patients have internal bleeding in their stomach. It is crucial to treat internal bleeding since it severely deteriorates patient's condition, and disturbs process of chemotherapy. There are hemostatic agents and dressing, radiotherapy, endoscopic ligation and coagulation, surgical methods to treat bleeding. However, these methods cannot be executed in some cases in which patient is in terminal stage or not in desirable condition to take these treatments. We are going to introduce a case of advanced gastric cancer patient having stomach bleeding who made a choice to take oriental medical treatments. The patient was on third stage of stomach cancer, had 3200cc of blood transfusion for five times. After diagnosed as not being able to have resection, he started to oriental medical treatments to stop bleeding. From March 28, 2009 to April 16, 2009, we administer 120cc Bojungikgi-tang gamibang to the patient in 90minutes after each meal. During 19days of having Bojungikgi-tang gamibang, we observed that the patient needed significantly lower amount blood transfusion, to 640cc. The patient improves in performance, and was able to eat more. Despite of short period of observation, this case indicates that Bojungikgi-tang gamibang treatment to the patient could work as hemostat, further improved quality of patient's life.

• 한국임상약학회지
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• 제26권3호
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• pp.195-200
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• 2016

Background: Venous thromboembolism (VTE) is a common and life-threating condition in cancer patients. Low molecular weight heparins (LMWH), such as dalteparin, are recommended in the treatment of VTE. Also, rivaroxaban, an orally administered direct factor Xa inhibitor, was approved for the treatment of VTE. It showed similar efficacy to standard therapy (LMWH or warfarin) and was associated with significantly lower rates of major bleedings. However, in the real world, bleeding has been reported to occur frequently in cancer patient receiving rivaroxaban. The goal of this research was to analyze bleeding risks between rivaroxaban and dalteparin for treatment of VTE in cancer patients. Methods: Medical records of oncology patients who were treated with rivaroxaban or dalteparin for VTE from July 2012 to June 2014 were retrospectively reviewed. Data collected were as follows: age, sex, weight, height, cancer types and stages, ECOG (eastern cooperative oncology group) PS (performance score), VTE types, concurrently used medications, study drug information (dose and duration of therapy), INR (international normalized ratio), PT (prothrombin time), and platelet counts. Bleeding was classified into major bleedings, clinically relevant non-major bleedings, and minor bleedings. Results: A total of 399 patients were included in the study. Of these patients, 246 were treated with rivaroxaban and 153 with dalteparin. Bleeding rates were significantly higher in the rivaroxaban group than in the dalteparin group (adjusted odds ratio (AOR) 2.09, 95% CI 1.22-3.60) after adjusting for confounders. In addition, rivaroxaban remained independently associated with 1.78-fold (95% CI 1.14-2.76) shorter time to bleeding compared to dalteparin after adjusting other factors known to be associated with poor outcomes. Conclusion: This study suggested that rivaroxaban was associated with an increased risk of bleedings in cancer patients.

• International journal of thyroidology
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• 제11권2호
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• pp.71-74
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• 2018

Adverse events such as hemoptysis and gastrointestinal hemorrhage during tyrosine kinase inhibitor treatment are relatively rare, but the severity of the bleeding can be higher than other common adverse events. It is necessary to educate patients about its possibility so that they can be found early. In this case report of radioiodine refractory thyroid cancer patient, hemoptysis and gastrointestinal bleeding has occurred following lenvatinib administration. Drug interruption and dose modification and dose interruption were required in addition to management for bleeding itself. It is necessary to confirm the high risk of bleeding before the administration of tyrosine kinase inhibitors, and to appropriately control the follow-up interval and drug dosage accordingly.

• Journal of Gastric Cancer
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• 제22권1호
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• pp.47-55
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• 2022

Purpose: The use of direct oral Xa inhibitors (DXaIs) to prevent venothrombotic events is increasing. However, gastrointestinal bleeding, including that related to endoscopic resection, is a concern. In this study, we evaluated bleeding and coagulation times during the perioperative period of gastric endoscopic submucosal dissection (ESD). Materials and Methods: Patients who consecutively underwent gastric ESD from August 2016 to December 2018 were analyzed. Bleeding rates were compared among the 3 groups (antiplatelet, DXaIs, and control). DXaI administration was discontinued on the day of the procedure. Prothrombin time (PT), activated partial thromboplastin time, and the ratio of inhibited thrombin generation (RITG), which was based on dilute PT, were determined before and after ESD. Results: During the study period, 265 gastric ESDs were performed in 239 patients, where 23 and 50 patients received DXaIs and antiplatelets, respectively. Delayed bleeding occurred in 17 patients (7.4%) and 21 lesions (7.1%). The bleeding rate in the DXaI group was significantly higher than that in the other groups (30.4%, P<0.01), and the adjusted odds ratio of bleeding was 5.7 (95% confidence interval, 1.4-23.7; P=0.016). In patients using DXaIs, there was a significant (P=0.046) difference in the median RITG between bleeding cases (18.6%) and non-bleeding cases (3.8%). Conclusions: A one-day cessation of DXaIs was related to a high incidence of bleeding after gastric ESD, and monitoring of residual coagulation activity at trough levels might enable the predicted risk of delayed bleeding in patients using DXaIs.

• 대한한의학회지
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• 제37권2호
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• pp.104-109
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• 2016

Objectives: A 74-year-old male patient with unresectable advanced gastric cancer (clinical initial stage T3N+, Borrmann type III) admitted due to gastric bleeding at tumor site. On first admission day, hemoglobin level was 5.7g/dl and performance status was grade 3 according to Eastern Cooperative Oncology Group Performance Status(ECOG-PS). After performing red blood cell transfusion as an emergency treatment, hemoglobin level was increased up to 9.5g/dl. However, bleeding of oozing site was continued. For hemostasis, decoction of notoginseng radix (30g/day) was administered since day 7 after admission. The dose was elevated to 40g/day after hemoglobin level was decreased to 6.5g/dl on day 11. Since then, melena was stopped and hemoglobin level was maintained over 9.1g/dl. This case shows the hemostasis effect of decoction of notoginseng radix on gastric bleeding in unresectable advanced gastric cancer.

• 대한영상의학회지
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• 제84권3호
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• pp.606-614
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• 2023

목적 자궁체부암 출혈에 대한 경카테터 동맥 색전술의 효과와 안전성을 평가하였다. 대상과 방법 20년 동안 자궁체부암 출혈로 경카테터 동맥 색전술(transcatheter arterial embolization; 이하 TAE)을 시행 받은 여섯 명의 환자들의 자료를 후향적으로 수집하였다. 혈관조영술 및 단면 영상 소견, TAE의 세부사항과 임상 경과를 탐구하였으며, TAE의 기술적, 임상적 성공률(technical and clinical success rate)을 각각 계산하였다. 결과 환자군은 자궁내막양 선암종, 육종, 그리고 임신융모종양으로 이루어졌으며, 대부분이 말기 암 환자들이었다. 출혈은 네 명의 환자에서 질출혈로 나타났다. 여섯 명의 환자들에서 일곱 번의 TAE가 시행되었고, 모든 TAE 시술에서 기술적 성공이 달성되었다. 자궁절제술을 받은 두 명의 환자들에서는 골반강 내 재발한 종양의 출혈이 혈변으로 나타났고, 이 환자들에서도 TAE는 기술적 성공을 보였다. 임상적 성공률은 50%로 절반의 환자에서 일주일 이상 출혈 조절이 되었다. 재출혈은 한 명의 환자에서 사망과 직접적으로 연관되었다. 한 명의 환자에서 시술 다음 날 경미한 부작용이 있었다. 결론 TAE는 자궁체부암 출혈에 대한 효과적이고 안전한 방법이며 특히 진행암, 말기암 환자들의 질병 경과 중의 위험한 시기에서 고려될 수 있다.

• Journal of Gastric Cancer
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• 제22권1호
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• pp.1-2
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• 2022