Background: The early detection of anthracycline- induced cardiotoxicity is very important since it might be useful in prevention of cardiac decompensation. This study was designed with the intent of assessing the usefulness of cardiac troponin T (cTnT) and NT- Pro BNP estimation in early prediction of anthracycline induced cardiotoxicity. Materials and Methods: In this prospective study histologically proven breast cancer patients who were scheduled to receive anthracycline containing combination chemotherapy as a part of multimodality treatment were enrolled. Baseline cardiac evaluation was performed by echocardiography (ECHO) and biomarkers like cardiac troponin T (cTnT) and N terminal- pro brain natriuretic peptide (NT- Pro BNP). All patients underwent cTnT and NT- Pro BNP estimation within 24 hours of each cycle of chemotherapy and were followed up after 6 months of initiation of chemotherapy. Any changes in follow up ECHO were compared to ECHO at baseline and cTnT and NT- Pro BNP levels after each cycle of anthracycline-based chemotherapy. Results: Initial data were obtained for 33 patients. Mean change in left ventricular diastolic diameter (LVDD) within 6 months was $0.154{\pm}0.433cms$ (p value=0.049). Seven out of 33 patients had an increase in biomarker cTnT levels (p value=0.5). A significant change in baseline and follow up LVDD was observed in patients with raised cTnT levels (p value=0.026) whereas no change was seen in ejection fraction (EF) and left atrial diameters (LAD) within 6 months of chemotherapy. NT- Pro BNP levels increased in significant number of patients (p value ${\leq}0.0001$) but no statistically significant change was observed in the ECHO parameters within 6 months. Conclusions: Functional monitoring is a poorly effective method in early estimation of anthracycline induced cardiac dysfunction. Estimation of biomarkers after chemotherapy may allow stratification of patients in various risk groups, thereby opening window for interventional strategies in order to prevent permanent damage to the myocardium.
Journal of Korean Academy of Nursing Administration
/
v.14
no.3
/
pp.352-363
/
2008
Purpose: The purpose of this study was to investigate nursing services of Oncology Advanced Practice Nurses(OAPNs) from the view point of structure and process. Methods: Roles and practices of OAPNs for cancer patients on chemotherapy were investigated by semi-structured interview and survey. Subjects were 14 OAPNs in 3 hospitals. Results: OAPNs had high level of education and certification than registered nurses. Most subjects of OAPNs were patients on chemotherapy and OAPNs used most of their time in education and expert nursing practice. 57.1% of OAPNs used delegated order. They were satisfied with their job in general, but satisfaction in communication with nurse manager or resident doctor was low. Conclusion: These results will be the concrete explanation for the nursing services of OAPNs. On the basis of theses results, more study about effects of OAPNs will be needed.
Neutropenia is a major dose-limiting side effect of cancer chemotherapy. The therapeutic effects of CJ-50001 were examined on neutropenia caused by anticancer agents. Neutropenia was induced by cyclophosphomide (130 mg/kg), doxorubicin (4.5 mg/kg), and vincristine (1 mg/kg) in normal ICR mice and by cyclophosphamide (200 mg/kg) in CT26 adenocarcinoma bearing BALB/C mice. After the subcutaneous injection of anticancer agents, we administered subcutaneously recombinant human granulocyte-colonystimulating factor (100$\mu$g/kg/day) to mice in order to stimulate neutrophil production. In normal and tumor-bearing mice, neutrophil production efficacy of CJ-50001 (rG-CSF) was similar to that of Grasin. These results suggest that CJ-50001 could be effective in its clinical use for neutropenia treatment.
Purpose: Recently, chemosensitivity tests have become widely used for the selection of effective drugs in gastric cancer patients. In this study, a chemosensitivity test was performed to select agents to increase the effectiveness of adjuvant chemotherapy. Materials and Methods: Chemosensitivity testing was performed in 81 gastric cancer patients that received a gastrectomy at the Yeungnam University Hospital. An ATP (adenosine triphosphate) based chemotherapy response assay was used. Clinicopatholgical factors such as sex, age, expression of tumor markers (CEA and CA19-9 levels), location of the tumor, morphology of advanced cancer, histological type, cell differentiation, depth of invasion, Lauren classification, Ming classification, lymphatic invasion, vascular invasion, neural invasion, lymph node metastasis and TNM stage were used to correlate the chemosensitivity and clinicopathological factors. Results: The most effective antitumor agents in gastric cancer patients were (in order of effectiveness) 5-FU, Epirubicin, lrinotecan and Oxaliplatin in our series. The chemosensitivity test showed a significant difference in susceptibility according to clinicopathological factors. Conclusion: Further studies on multidrug therapy are needed to evaluate synergistic effects of drugs. Therefore, for effective chemotherapy, it is more efficacious to select a chemosensitive drug than continue to use the same drug regimen.
Purpose : We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. Materials and Methods : Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. Results : The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia In 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. Conclusion : A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.
Background and Objectives : This study is an observational study of nonequivalent control group based on time lag design in order to determine the effectiveness of gargling Hwangryunhaedok-tang (HRHDT) on stomatitis caused by chemotherapy. Methods : The study period is from July 1st, 2010 to September 30th, 2010. The subjects are 13 patients who fit the profile of the study and who are admitted in the tumor department of the regional cancer center of C University Hospital which is located in Chung-Joo City. When stomatitis occurs after chemotherapy, the level of stomatitis is assessed using oral assessment guide score and oral discomfort score. Then mix 5 g of powered HRHDT and 60 ml of distilled water, and 15 ml of the solution is given to patients 4 times per day to gargle for 1 minute. For the control group, 60 ml of Chlorohexidin gargling solution is used; everyday for one week, 4 times per day, 15 ml per gargle and gargled for 1 minute. Oral Assessment Guide score and Oral Discomfort Score are assessed at same hour everyday. Crosstabulation analysis $X^2$(${\rho}$) was used to examine the demographic characteristics and difference of the two groups by using SPSS/WIN 12.0. For mean and standard deviation, descriptive statistical analysis was used. T-test was used to determine the difference of the oral discomfort scores. Result : The study has shown that the Oral Assessment Guide score of the experimental group has decreased more with more regularity. On the third day, the score of the control group is 20.16 and the score of the experimental group was 18.75, which showed a statistically significant difference with the level of significance of p<0.05. Oral Discomfort Score of the control group's score was 13.60 on the first day and 6.80 on the seventh day and the experimental group's score was 13.00 on the first day and 2.25 on the seventh day. The experimental group's score 2.25 is statistically significantly lower than the control group's score of 6.80 with the level of significance of p<0.05. Conclusions : The HRHDT gargling solution showed more regular effectiveness compared to Chlorohexidin solution on chemotherapy-caused stomatitis. Therefore this study has shown that HRHDT gargling solution can be used as an alternative medicine.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.2
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pp.562-570
/
2019
The purpose of this study was to identify the factors influencing the quality of sleep in breast cancer patients receiving chemotherapy in the outpatient settings. The data were collected from 203 patients with breast cancer receiving chemotherapy in the outpatient settings at one tertiary hospital in B City. Stress, fatigue and depression were negatively correlated with quality of sleep (r=-.369, p=.001; r=-.565, p=.001; r=-.526, p=.001, respectively). Fatigue(${\beta}=-.387$, p<.001) was one of the biggest impact factors on quality of sleep which explained 31.6% of the variance of the sleep quality, followed by the experience of sleep disturbances prior to the diagnosis of breast cancer(${\beta}=-.178$, p<.002) and depression(${\beta}=-.231$, p<.004). In total, all of the antecedent variables explained significantly 37.4% of the variance of the sleep quality. Thus, in order to improve the quality of sleep, integrative nursing interventions need to be developed to reduce fatigue and depression among them, including an proactive system to screen out the patients with the experience of sleep disturbances prior to the diagnosis with breast cancer and to provide adequate pharmacological and/or non-pharmacological sleep interventions prior to the chemotherapy.
Hae Jin Shin;Hyun Yong Jeong;Hee Seok Moon;Jae Kyu Sung;Sun Hyung Kang
Journal of Digestive Cancer Research
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v.3
no.1
/
pp.30-34
/
2015
We report a case of a 55-year-old man who diagnosed with advanced gastric cancer (AGC), with A review of the literature. A 55-year old man was transferred to our hospital for further evaluation and treatment after being diagnosed with adenocarcinoma through endoscopic biopsy during a regular health examination. An abdominal computed tomography (CT) showed AGC, stage IIA (T3N3M0), while an endoscopic examination showed AGC, Borrmann type 2. The patient is currently under observation after undergoing radical subtotal gastrectomy with gastroduodenostomy and subsequent administration of oral chemotherapeutic agents. As an abdominal CT response assessment performed after surgery revealed new metastasis to the liver, the patient received palliative chemotherapy as progressive disease was suspected. After receiving chemotherapy in the order of FOLFOX (5-fluorouracil (5-FU)) + Leucovorin + Oxaliplatin), FOLFIRI (5-FU + Leucovorin + Irinotecan), EAP-II (Etoposide + Doxorubicin + Cisplatin), ELF (Etoposide + Leucovorin + 5-FU), TS-1 (Tegafur + Gimeracil) + Cisplatin, an abdominal CT response assessment showed progressive disease for which the regimen was altered to PFL (Paclitaxel + 5-FU + Leucovorin). The patient has currently completed his second cycle of chemotherapy and after an abdominal CT response assessment, further course of therapy will be decided.
Purpose: This study is to assess the quality of life(QOL) of hematic cancer survivors after hematopoietic stem cell transplantation(HSCT) and received chemotherapy(RC) to prepare basic information for nursing interventions in order to improve the patients' QOL. Method: The data were collected by self-reporting questionnaire from January to March, 2003 intended for outpatients at the Cancer center of D university hospital in Busan. All 44 of them were diagnosed as hematic cancer and had spent 100 days after getting HSCT and complete remission(CR) throughout RC. The collected data were analyzed with descriptive statistics, t-test, ANOVA using SPSS/WIN 10.0 program. Results: The total mean score of the QOL was moderate. In case of survivors in HSCT, the total mean score of the QOL was $5.81{\pm}1.08$, and that of survivors in RC was $5.94{\pm}1.13$. The facts above has not been considered statistically as the result of analysis of differences in each domain of the QOL depending on the general characteristics of the objects of this study. Conclusion: The total mean score of the QOL was at moderate levels, indicating that the survivors after HSCT and RC were perceiving their QOL as moderate. In the nursing business aspect, the most important thing is to understand the QOL which the 2 groups of the survivors perceive, and the plans of nursing intervention that can be helpful to more qualitative life should be studied constantly.
Purpose: The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL). Methods: A convenient sample of 303 patients was recruited from an oncology-specialized hospital. Results: Two distinct clusters were identified: A gastrointestinal- fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL. Conclusion: Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.
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