Tas, Demet;Uncu, Dogan;Sendur, Mehmet Ali;Koca, Nuran;Zengin, Nurullah
Asian Pacific Journal of Cancer Prevention
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제15권7호
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pp.3139-3144
/
2014
Background: Medical treatment for eliminating the side effects of cancer therapy may not always be efficacious. Acupuncture is one of the most widely accepted alternative and complementary therapies in use today. In this study, we investigated the efficacy of acupuncture in patients experiencing cancer treatment side effects, including nausea, vomiting, pain, poor sleep quality and anxiety. Materials and Methods: A total of 45 inpatients who underwent chemotherapy between February and April 2013 in the Oncology Department of Numune Hospital were included in our study. Acupuncture was administered to the patients one day prior to chemotherapy, on the day of chemotherapy and one day after chemotherapy. The patients were evaluated on nausea, vomiting, pain, sleep quality and anxiety before the chemotherapy and on the $4^{th}$ day of chemotherapy. Results: Of the 45 patients included in the study, 18 (40%) were female and 27 (60%) were male. A total of 25 (55.6%) had an elementary school education; 32 patients (71%) had stage 4 cancer and were treated with palliative chemotherapy (the patient characteristics are shown in Table 1). Statistically significant decreases (p<0.001) in pain, nausea, vomiting, insomnia and anxiety scores were observed after the acupuncture treatment compared to baseline. There were no differences in the age, gender, education level, stage or metastasis levels between the patient groups whose symptoms improved or were unchanged. Conclusions: Our study showed that acupuncture has positive effects in cancer treatment patients who experience nausea, vomiting, pain, poor sleep quality and anxiety as side effects of chemotherapy. Chemotherapy-related side effects in cancer patients could be decreased by the concurrent use of acupuncture.
Purpose: The purpose of this study was to identify over time the changes of cancer symptom, depression and quality of life (QOL) among people who had stomach or colorectal cancer. Methods: Of the 74 participants recruited, 67 participated in the study. Participants were asked to complete three instruments at three different time. The instruments were the M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module, Hospital Anxiety Depression Scale, and the Functional Assessment of Cancer Therapy-General. The questionnaires were administered before chemotherapy, toward the end of chemotherapy, and six months after the completion of adjuvant therapy. Data were analyzed using descriptive statistics and repeated measure ANOVA. Results: At the immediately after chemotherapy point, the most frequent symptom was lack of appetite, followed by fatigue and problem with remembering things. The mean score for depression was 8.27 with a prevalence of 31.3%. The mean score for quality of life was 61.88 out of 135. Repeated measures ANOVA showed a significant increase in cancer symptom (F=23.22, p<.001) and depression (F=35.29, p<.001) after chemotherapy. However, improvement was observed 6 months after the completion of chemotherapy. QOL (F=33.73, p<.001) also showed similar patterns as observed with cancer symptom and depression. Cancer symptom was the strongest predictor of QoL at pre-chemotherapy point. but depression was the strongest predictor at immediately after chemotherapy point. Conclusion: Chemotherapy is highly associated with cancer symptom, depression and QOL in patients with cancer. The nursing intervention is needed to relieve depression as well as cancer symptoms to improve QOL in patients undergoing chemotherapy from baseline to follow-up.
Purpose: To highlight the potential factors that could predict the response rate of patients with metastatic colorectal cancer (mCRC) treated with pemetrexed combined chemotherapy after first- or second-line chemotherapy using the FOLFOX regimen. Materials and Methods: Between January 2007 and July 2014, 54 patients diagnosed and pathologically-confirmed with advanced colorectal cancer in Jiangsu Cancer Hospital and Research Institute, were enrolled. They received pemetrexed at a dose of $500mg/m^2$ by 10 minute infusion on day 1, repeated every 3 weeks. Doses were modified depending on nadir counts of blood cells. Combined chemotherapeutic agents included irinotecan, lobaplatin, carboplatin, oxaliplatin, gemcitabine, cis-platinum or bevacizumab. Multiple variables (age, sex, hemoglobin, platinum drugs combined, metastasis sites, LDH, ALP, CEA>40 ug/ml) reported earlier were selected. We used logistic regression analysis to evaluate relationships between these and tumor response. Results: On multivariable analysis, we found that age was significant in predicting the responsiveness to pemetrexed (p<0.05) combined with oxaliplatin. We did not find any other factors which were significantly associated with the response rate to chemotherapy with pemetrexed and irinotecan. Conclusions: By multivariate analysis, we found that age had significant impact on the responsiveness of pemetrexed when combined with oxaliplatin. Additional research based on genomic properties of host and tumors are needed to clarify markers for better selection of patients who could benefit from pemetrexed combined chemotherapy.
Background: Despite recent advances in first-line chemotherapy for advanced pancreatic cancer, standard treatment after the failure of initial chemotherapy has not been established. Hence, we aimed to retrospectively analyze the clinical characteristics and outcomes of second-line chemotherapy in patients with advanced pancreatic cancer. Methods: We reviewed the clinical data of patients with advanced pancreatic cancer who underwent palliative chemotherapy at Kosin University Gospel Hospital between January 2013 and October 2020. Results: Among 366 patients with advanced pancreatic cancer who had received palliative chemotherapy, 104 (28.4%) underwent at least one cycle of second-line chemotherapy. The median age of the patients at the time of initiating second-line treatment was 62 years (interquartile range, 57-62 years), and 58.7% (61 patients) of them were male. The common second-line chemotherapy regimens were 5-fluorouracil (FU) plus leucovorin, irinotecan, and oxaliplatin (33 patients, 31.7%); gemcitabine/nab-paclitaxel (29, 27.9%), gemcitabine±erlotinib (13, 12.5%); and oxaliplatin and 5-FU/leucovorin (12, 11.5%). The median overall survival (OS) and progression-free survival were 6.4 months (95% confidence interval [CI], 4.5-8.6 months) and 4.5 months (95% CI, 2.7-6.3 months), respectively. In a multivariate analysis, poor performance status (PS) (hazard ratio [HR], 2.247; p=0.021), metastatic disease (HR, 2.745; p=0.011), and elevated carcinoembryonic antigen (CEA) levels (HR, 1.939; p=0.030) at the beginning of second-line chemotherapy were associated with poor OS. Conclusion: The survival outcome of second-line chemotherapy for advanced pancreatic cancer remains poor. However, PS, disease extent (locally advanced or metastatic), and CEA level may help determine patients who could benefit from second-line treatment.
Gastric cancer is the second cause of cancer that is related to death and the fourth most common cancer, worldwide. Complete resection of cancer is the only curative treatment for gastric cancer. However, even if complete resection is possible, recurrence is frequently observed in Gastric patients. Therefore, adjuvant treatment modality for resectable gastric cancer is needed to increase the survival of patients. This study wants to describe the role of adjuvant chemotherapy for resectable gastric cancer, with updated data of recent studies. Several meta-analysis studies demonstrated a benefit of adjuvant chemotherapy for resectable gastric cancer. Due to the heterogeneity of the population and regimens, there is no consensus regarding the adjuvant chemotherapy. Recently published, well designed phase III studies demonstrated the statistically significance of adjuvant chemotherapy for the resectable gastric cancer, with the extended lymph node dissection. Further phase III trials, to determine the best regimen and schedule of adjuvant chemotherapy, was suggested to use the fluoropyrimidine based regimen as control group.
Although recent advances in molecular targeted therapy and immuno-oncology have revolutionized the landscape of lung cancer therapeutics, cytotoxic chemotherapy remains an essential component of lung cancer treatment. Extensive evidence has demonstrated the clinical benefit of chemotherapy, either alone or in combination with other treatment modalities, on survival and quality of life of patients with early and advanced lung cancer. Combinational approaches with other classes of anti-neoplastic agents and new drug-delivery systems have revealed promising data and are areas of active investigation. Chemotherapy is recommended as a standard of care in patients that have progressed after tyrosine kinase inhibitors or immune checkpoint inhibitors. Chemotherapy remains the fundamental means of lung cancer management and keeps expanding its clinical implication. This review will discuss the current position and future role of chemotherapy, and specific consideration for its clinical application in the era of precision medicine.
It is important to choose the appropriate treatment option for patients with colorectal cancer (CRC), because it could affect the prognosis of patients. Chemotherapy is effective in prolonging survival and time to progression in patients with advanced CRC. Adjuvant chemotherapy have been reported to reduce the recurrence rate of colorectal cancer by 30% in patients with stage 3 or high risk of stage 2 CRC. Although palliative chemotherapy does not offer long-term benefits, as life expectancy remains below 12 months in most of those receiving treatment, recent developments in the treatment including target agents and immunotherapy have improved the median overall survival time in patients with metastatic CRC by up to 30 months. Chemotherapy for patients with CRC is classified into neoadjuvant, adjuvant, and palliative therapy according to the status of patients. In this review, I summarized the chemotherapy for patients with CRC, which applying in clinical practice.
Chemotherapy of transmissible venereal tumor (TVT) in a dog has been tried, using vincritstine, cyclophosphamide, and methotrexate. The dog was hiven an combination chemotherapy and underwent complete regression of the tumors with on recurrence. The result of our clinical trial indicates that combination chemotherapy is an effective modality for dogs with TVT.
The purpose of this study was to identify side effects of the vesicant chemotherapy. The study was designed to be a descriptive survey. The subjects of this study were 88 patients with various types of cancer, primary lung cancer(25.0%), advanced gastric cancer(25.0%), breast cancer(20.5%), etc. The mean age was 44.8 years old(range: 16-68). The questionnaire was completed by nurses of the outpatient unit and chemotherapy ward, and intravenous nurse specialist. The results of the study were as follows: 1) Chemotherapy was administered with a 23G scalp needle and 24G insyte. Injection site was dorsum of hands(64.7%), cephalic vein(19.3%). Successful rate for the first attempt was 88.6%. The first & second cycle chemotherapy was 29.5% each.. Mainly used drugs were Navelbine(34.1%), Adriamycin(20.5%). 2) Venous Problems after chemotherapy were pain(13.6%) incurred by venous, mainly due to the administration of Navelbine; redness at the inravenous site(12.5%) and itching sense 2.3% Non-venous problems were nausea (18.2%), dullness(14.8%), vomiting(8.0%), facial flushing(6.8%), anxiety(5.7%). Subjective discomforts after chemotherapy were generalized arm pain at the injection side(14.8%), dizziness(6.8%), weakness(5.7%) and general bodyache(5.7%). Systemic anaphylactic reaction and extravasation did not occur. 3) Non-venous problem after chemotherapy were nausea, vomiting & anorexia. Frequency of chemotherapy related to side effects were itching, facial flushing, and nausea(p< .05). Day of chemotherapy related to side effects were nausea & vomiting(p< .05). Site of chemotherapy related to side effects were redness(p< .05). Frequency of venipuncture related to side effects were redness(p< .05). Conclusively, cancer chemotherapy patients have had some venous problem. They need appropriate venous access devices for chemotherapy. And other non-venous problem will be managed appropriately. Further research was required to identify the rate of venous complication or side effects of vesicant chemotherapy.
Purpose: To compare the safety and efficacy of first-line chemotherapy regimen with or without doxorubicin in treating patients with advanced soft tissue sarcoma (STS). Patients and Methods: We retrospectively analyzed a cohort of 56 patients histologically confirmed with STS who were treated at Jiangsu Cancer Hospital and Research Institute from July 2011 to June 2012.The basic element of first line chemotherapy contained epirubicin in group B and lacked epirubicin in group A. Response was assessed using RECIST criteria. The Kaplan-Meier method was used to estimate progress free survival (PFS). Results: According to RECIST criteria, patients in group treated by chemotherapy without epirubicin, the objective response (OR) ratio was 6.5 % (CR0%+PR6.5%). Disease control rate (DCR=CR+PR+SD) was 25.8% with a median follow-up of 14.6 months, including 2 patients achieving a partial response (PR 6.5%) and a stable response (SD 19.4%) in 6. In group B with epirubicin based regimens, no patient had complete response, PR (28 %) was observed in 7 and SD (24 %) in 6. DCR was observed in 13 patients (52%). By Fisher's exact test, the DCR difference between the two groups was statistically significant (p=0.046). In group A, median PFS was 3.0 months (95%CI:2.1-3.8), compared with 4.0 months (95% CI:3.03-4.97) in group B (p=0.0397 by log-rank test). Epirubicin based chemotherapy and ECOG performance status 0-1 were identified as favorable factors for progression in our cohort of patients. Differences of nonhematologic and hematologic toxicities were not statistically significant between the two groups, and the addition of epirobicin was not associated with cardiac toxicity (p=0.446). Conclusion: Our study demonstrates that epirubicin-based chemotherapy is effective and well tolerated, and is superior to chemotherapy without epirubicin regarding efficacy. Therefore it is recommended that epirubicin-based chemotherapy should be considered as first line for patients with advanced STS.
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