Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gynecologic cancers have been mainly treated by surgery and radiotherapy. Recently, many antineoplastic medications are available and chemotherapy becomes an important therapeutic method in the treatment of cervical, endometrial and ovarian cancer. Platinum derivatives, taxanes, alkylating agents and irinotecan are usually used. Because these chemotherapeutic agents have many toxicities such as myelo-suppression, hypersensitivity reaction, nausea, vomiting and diarrhea, the treatment was scheduled for an inpatient setting. During the recent 10 years, new chemotherapeutic agents without severe toxicity were applied and effective supportive therapies to prevent toxicity were investigated. Under these conditions, chemotherapy in an outpatient setting is available and an Outpatient Chemotherapy Center was established at Kitasato University Hospital. Patients with gynecologic cancers mainly receive weekly chemotherapeutic regimen at the Outpatient Chemotherapy Center and the number is increasing gradually. For safe and comfortable outpatient chemotherapy, it is important to control regimens and to go into partnership with co-medicals.
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PMID:[Outpatient chemotherapy in gynecologic oncology]. 1746 90

Women dying of ovarian cancer vary considerably in their complications and in the types of health care they receive. The objective of this study was to describe the complications of ovarian cancer, other than pain, and their treatment at the end of life. This study used a cohort of 421 enrollees in three nonprofit managed-care organizations who died with ovarian cancer during 1995-2000. Data were collected from abstraction of paper and electronic medical records. Proportions of women experiencing complications and undergoing treatments were calculated. Logistic regression was used to evaluate the association of patient characteristics with the probability of receiving an intervention for complications. The most common complications recorded in the medical record were fatigue or weakness (75%), nausea or vomiting (71%), constipation (49%), edema of the extremities (44%), and anemia (34%). The prevalence of major complications was as follows: ascites, 28%; bowel obstruction, 12%; pleural effusion, 10%; bladder obstruction, 3%; and disordered nutrition that required support with parenteral nutrition, 9%. Patients may not always have received interventions for major complications; for example, pleural effusion apparently was left untreated in almost half of the women with this problem. After adjustment, women who died at younger ages were more likely to receive an intervention, compared to older women (odds ratio for each decade of age, 0.71, 95% confidence interval=0.53, 0.94, P for trend=0.02). The study, which preceded the establishment of palliative care programs, suggests that care given to ovarian cancer patients at the end of life may be inadequate.
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PMID:Complications at the end of life in ovarian cancer. 1760 60

ICON3 trial results have suggested that CAP and carboplatin-taxol regimens as first-line treatment of advanced ovarian cancer (AOC) yield similar survival. We explored the impact of increased dose of cyclophosphamide in a modified CAP regimen on the disease-free survival (DFS) and overall survival (OS) of AOC patients. From February 1994 to June 1997, 164 patients were randomised to receive six cycles every 3 weeks of either standard CEP (S) combining cyclophosphamide (C), 500 mg m(-2), epirubicin (E) 50 mg m(-2), and cisplatin (P) 75 mg m(-2) or intensive CEP (I) with E and P at the same doses, but with (C) 1800 mg m(-2) and filgrastim 5 mug kg(-1) per day x 10 days. Response was evaluated at second-look surgery. Patient characteristics were well balanced. Except for grade 3-4 neutropaenia (S: 54%, I: 38% of cycles), Arm1 presented a significantly more important toxicity: infection requiring antibiotics, grade 3-4 thrombocytopaenia, anaemia, nausea-vomiting, diarrhoea, mucositis. Median follow-up was 84 months. DFS (15.9 vs 14.8 months) and OS (33 vs 30 months) were not significantly different between S and I (P>0.05). Increasing cyclophosphamide dose by more than 3 times with filgrastim support in the modified CAP regimen CEP induces more toxicity but not better efficacy in AOC.
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PMID:Intensified dose of cyclophosphamide with G-CSF support versus standard dose combined with platinum in first-line treatment of advanced ovarian cancer a randomised study from the GINECO group. 1792 67

The objective of this study was to determine the objective response rate in patients with platinum-sensitive and platinum-resistant recurrent ovarian cancer to treatment with trabectedin (Yondelis) administered as a 3-h infusion weekly for 3 weeks of a 4-week cycle. We carried out a multicentre Phase II trial of trabectedin in patients with advanced recurrent ovarian cancer. Trabectedin (0.58 mg m(-2)) was administered via a central line, after premedication with dexamethasone, to 147 patients as a 3-h infusion weekly for 3 weeks followed by 1-week rest. Major eligibility criteria included measurable relapsed advanced ovarian cancer and not more than two prior platinum-containing regimens. Patients were stratified according to the treatment-free interval (TFI) between having either platinum-sensitive (>/=6 months TFI) or platinum-resistant disease (<6 months TFI)/platinum-refractory disease (progression during first line therapy). In the platinum-sensitive cohort, 62 evaluable patients with measurable disease had an overall response rate (ORR) of 29.0% (95% CI: 18.2-41.9%) and median progression-free survival (PFS) was 5.1 months (95% CI: 2.8-6.2). Four patients with measurable disease per Response Evaluation Criteria in Solid Tumours (RECIST) criteria had no follow-up scans at the end of treatment. In the platinum-resistant/refractory cohort, 79 patients were evaluable with an ORR of 6.3% (95% CI: 2.1-14.2%). Median PFS was 2.0 months (95% CI: 1.7-3.5 months). Two patients with measurable disease per RECIST criteria had no follow-up scans at the end of treatment. The most frequent (>/=2% of patients) drug-related treatment-emergent grade 3/4 adverse events were reversible liver alanine transferase elevation (10%), neutropaenia (8%), nausea, vomiting, and fatigue (5% each). Trabectedin is an active treatment, with documented responses in patients with platinum sensitive advanced relapsed ovarian cancer, and has a manageable toxicity profile.
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PMID:A Phase II study of trabectedin single agent in patients with recurrent ovarian cancer previously treated with platinum-based regimens. 1800 May 4

The aim of the investigation was to assess 12 cases of brain recurrences among ovarian cancer patients who had undergone surgery followed by platinum-based chemotherapy. Brain lesions were the first recurrence in 4 (33%) patients, the second recurrence in 7 (58%), and the fourth recurrence in one patient. The median time from ovarian cancer diagnosis to brain metastasis detection was 33.5 months (range, 13.5-86.5 months), brain metastases were multiple in 6 (50%) cases, and extra-cranial disease was present in 7 (58%) cases. Brain recurrence was symptomatic in 10 patients and the clinical presentation included impaired deambulation, extremity weakness, seizure, headache, nausea/vomiting and visual disturbance. Out of the 6 patients with single brain metastases, one underwent surgery, one had surgical excision followed by whole brain irradiation, 3 patients received stereotactic radiotherapy (followed by chemotherapy for coexistent extra-abdominal recurrence in one), and one had only symptomatic treatment. Out of the 6 patients with multiple brain metastases, four received whole brain irradiation (followed by chemotherapy for concomitant extra-cranial recurrence in one case), one patient had gamma-knife irradiation of three cerebral lesions (followed by chemotherapy for concurrent abdominal recurrence), and one patient had only symptomatic treatment. The median overall survival from diagnosis of brain metastasis was 8.3 months (range, 1-28 months), and it was not related to the number of brain metastases (multiple versus single), presence or absence of extra-cranial disease, or interval between ovarian cancer diagnosis and brain metastasis detection (<33.5 months versus > or =33.5 months). In conclusion, brain metastasis from ovarian cancer can represent a late manifestation of the disease, associated with a very poor prognosis.
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PMID:Brain recurrences in patients with ovarian cancer: report of 12 cases and review of the literature. 1821 52

Treatment with opioid analgesics often causes adverse reactions that may make continuous use of such drugs difficult. We investigated the efficacy and safety of controlled-release oxycodone in the treatment of gynecologic cancer pain. The patients included 14 with cervical cancer, 6 with corpus cancer, and 17 with ovarian cancer. Treatment with controlled-release oxycodone was started at 5 mg/dose when pain control using nonsteroidal anti-inflammatory drugs became ineffective. The dose was titrated to the optimal level over a mean duration of 2.34 +/- 1.13 days, and the initially optimal dose was 18.92 +/- 5.23 mg/day. Although no patients experienced confusion, vomiting, or respiratory depression, 17 patients experienced adverse events, including constipation in 14 patients and nausea in 9 patients. The incidence of nausea was low in patients receiving oxycodone and prochlorperazine. In the present study, patients with moderate to severe pain caused by gynecologic cancer could successfully be treated with controlled-release oxycodone.
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PMID:Analgesic efficacy of controlled-release oxycodone in patients with uterine or ovarian cancer. 1822 51

The safety and maximum tolerated dose (MTD) of erlotinib with docetaxel/carboplatin were assessed in patients with ovarian cancer. Chemonaive patients received intravenous docetaxel (75 mg m(-2)) and carboplatin (area under the curve 5) on day 1 of a 3-week cycle, and oral erlotinib at 50 (cohort 1), 100 (cohort 2a) or 75 mg day(-1) (cohort 2b) for up to six cycles. Dose-limiting toxicities were determined in cycle 1. Forty-five patients (median age 59 years) received treatment. Dose-limiting toxicities occurred in 1/5/5 patients (cohorts 1/2a/2b). The MTD of erlotinib in this regimen was determined to be 75 mg day(-1) (cohort 2b; the erlotinib dose was escalated to 100 mg day(-1) in 11 out of 19 patients from cycle 2 onwards). Neutropaenia was the predominant grade 3/4 haematological toxicity (85/100/95% respectively). Common non-haematological toxicities were diarrhoea, fatigue, nausea and rash. There were five complete and seven partial responses in 23 evaluable patients (52% response rate). Docetaxel/carboplatin had no measurable effect on erlotinib pharmacokinetics. In subsequent single-agent maintenance, erlotinib was given at 100-150 mg day(-1), with manageable toxicity, until tumour progression. Further investigation of erlotinib in epithelial ovarian carcinoma may be warranted, particularly as maintenance therapy.
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PMID:A phase Ib trial of docetaxel, carboplatin and erlotinib in ovarian, fallopian tube and primary peritoneal cancers. 1850 81

The progression of the neoplastic disease is characterized by specific alterations of energy metabolism and by symptoms like fatigue, anorexia, nausea, anaemia, immunodepression and poor performance status (PS). The main cause of these symptoms and metabolic abnormalities is the chronic action of proinflammatory cytokines released both by tumour and immune cells. The present study aimed to assess the relationship between markers of inflammation (C-Reactive Protein, Fibrinogen, proinflammatory cytokines) and energy metabolic status (BMI, leptin, oxidative stress) according to clinical parameters in 104 ovarian cancer patients at different stage and, moreover, to evaluate prospectively the changes of these parameters in accordance to tumour response in a subgroup of 70 advanced stage ovarian cancer patients. Advanced stage and poor PS were associated to high-grade inflammation and impaired energy metabolism. Among inflammatory mediators, interleukin (IL)-6 had a central role as predictive factor of leptin, reactive oxygen species and glutathione peroxidase. In turn, leptin considered the key marker of the nutritional status and energy metabolism, was independently determined from stage and IL-6, not only from BMI. Moreover, the evaluation of the changes of these parameters during the course of the neoplastic disease in the subgroup of advanced ovarian cancer patients clearly unveils the central role of IL-6 and leptin as early markers of the metabolic alterations and symptoms associated to disease progression in advanced stage ovarian cancer. Their assessment should be included in monitoring disease outcome, especially when cancer is no longer curable and quality of life becomes the primary endpoint.
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PMID:Interleukin-6 and leptin as markers of energy metabolic changes in advanced ovarian cancer patients. 1862 49

A 45-year-old female with a background of poorly differentiated ovarian adenocarcinoma treated with bilateral salpingo-oophorectomy presented with one week history of nausea, vomiting and decreased urine output. On examination, she was mildly dehydrated but haemodynamically stable. Abdominal examination revealed tender swelling in upper abdomen. Biochemistry revealed that she had acute renal failure and interestingly the acute renal failure was out of proportion to the degree of dehydration. Abdominal ultrasound showed marked distension of the stomach without any evidence of renal tract obstruction. She was aggressively treated with volume replacement and careful monitoring of input and output. She responded very well to fluid replacement and her renal failure resolved within four days of treatment. This case illustrates a case of acute renal failure secondary to gastroparesis which resolved after treatment of renal failure. Patients with chronic renal failure are prone to develop gastroparesis but it is extremely rare to have gastric stasis following acute renal failure. This case also illustrates the importance of aggressive treatment of a reversible but potentially fatal medical condition which could have been easily overlooked in view of patient's poorly differentiated ovarian cancer.
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PMID:A case report of gastroparesis secondary to acute renal failure. 1902 8

Advanced ovarian carcinoma in early progression (<6 months) (AOCEP) is considered resistant to most cytotoxic drugs. Gemcitabine (GE) and oxaliplatin (OXA) have shown single-agent activity in relapsed ovarian cancer. Their combination was tested in patients with AOCEP in phase II study. Fifty patients pre-treated with platinum-taxane received q3w administration of OXA (100 mg m(-2), d1) and GE (1000 mg m(-2), d1, d8, 100-min infusion). Patient characteristics were a : median age 64 years (range 46-79),and 1 (84%) or 2 (16%) earlier lines of treatment. Haematological toxicity included grade 3-4 neutropaenia (33%), anaemia (8%), and thrombocytopaenia (19%). Febrile neutropaenia occurred in 3%. Non-haematological toxicity included grade 2-3 nausea or vomiting (34%), grade 3 fatigue (25%),and grade 2 alopecia (24%). Eighteen (37%) patients experienced response. Median progression-free (PF) and overall survivals (OS) were 4.6 and 11.4 months, respectively. The OXA-GE combination has high activity and acceptable toxicity in AOCEP patients. A comparison of the doublet OXA-GE with single-agent treatment is warranted.
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PMID:Gemcitabine-oxaliplatin combination for ovarian cancer resistant to taxane-platinum treatment: a phase II study from the GINECO group. 1919 Jun 32


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