Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report three cases of home palliative chemotherapy with an infuser pump (IP) for continuous infusion of anticancer drugs, which is as effective as being treated at the hospital. Cases are: A 74-year-old man with intraperitoneal metastasis after rectal operation, a 43-year-old woman with pelvis metastasis after a uterus cervical operation and a 70-year-old man with gastric cancer and massive metastases of the liver. Their performance status (PS) ranged from 3-4. All cases underwent continuous infusion of cisplatin 20-30 mg/w with IP and CPT-11:10-40 mg/w in 1 hour. For case 1/2, 5-FU 1,750 mg/w was carried out continuously, and TS-1 80 mg/day/body was administered for case 3. After 4 courses of chemotherapy, all cases indicated effective changes such as decrease of pain, reduction of metastatic tumor size, decrease of tumor bleeding and tumor makers. Their quality of life (QOL) improved. Palliative chemotherapy to improve QOL can be performed at home if used with IP for poor PS patients.
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PMID:[Three case reports of effective home palliative chemotherapy with an infuser pump]. 1746 74

Chemotherapy (5-FU) with concurrent radiotherapy is recommended as an effective treatment for locally unresectable pancreatic cancer. A phase I study of S-1 with concurrent radiotherapy demonstrated promising results in late years. A 70-year-old man was revealed to have metastatic pancreatic cancer (T 4 N 3 M 1 (PER), Stage IVb). Since a curative operation was impossible in this case, he was treated with systemic chemotherapy using S-1 combined with irinotecan hydrochloride (CPT-11) as first-line chemotherapy. Because the primary lesion was increased in size after two courses,he was then treated by radiotherapy combined with S-1 as second-line treatment. S-1 (80 mg/body/day) was orally administered (2 consecutive weeks, 1-week break), and concurrent radiotherapy was performed at a daily fraction of 1.8 Gy, 5 days/week, total amount 45 Gy. Although in the early period of chemoradiotherapy, transfusion for anemia and morphine hydrochloride for pain control were necessary, his symptoms gradually improved by the reduction of primary lesion. The patient has been receiving systemic chemotherapy as an outpatient for 12 months without deterioration of quality of life.
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PMID:[A case of unresectable advanced pancreatic cancer treated by S-1 with concurrent radiotherapy]. 1756 61

(1) Oral mucositis is a frequent adverse effect of cancer chemotherapy and radiotherapy. Fluorouracil, radiotherapy and conditioning regimens for haematopoietic stem cell grafting often cause severe oral mucositis, preventing patients from drinking and eating normally. (2) A randomised trial suggests that this complication can be attenuated by timely orodental care such as extraction of damaged teeth, treatment of tooth decay, and care of trauma due to dentures. (3) In 3 randomised controlled trials involving about 200 patients at high risk of severe oral mucositis, sucking ice during chemotherapy reduced the incidence of severe oral mucositis, from 14-74% to 4-21%. (4) Other treatments are no more effective and carry a risk of known or poorly documented adverse effects. (5) Analgesics (especially morphine) should be used to treat intense pain. Local anaesthetics have not been tested in patients with damaged oral mucosa, but they can cause a burning sensation and carry a risk of swallowing disorders due to anaesthesia of the oropharyngeal junction. (6) In practice, prevention of oral mucositis due to cancer chemotherapy or radiotherapy is based on orodental care and ice rather than drugs.
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PMID:Oral mucositis due to cancer treatments. Orodental hygiene and ice cubes. 1838 57

The majority of cancers are more prevalent in individuals aged >/= 65 years than in younger patients, and supportive care is the key to treatment tolerance and quality of life for these individuals. This article examines the management of common complications of chemotherapy and pain in older patients with cancer. In accordance with the National Cancer Center Network guidelines, it is recommended that individuals aged >/= 65 years be treated prophylactically with filgrastim or pegfilgrastim for the prevention of neutropenic infections when challenged by chemotherapy of dose intensity comparable to that of CHOP (cyclophosphamide/ doxorubicin/vincristine/prednisone) and that the levels of circulating hemoglobin be kept at >/= 12 g/dL. In addition, it is recommended that the dose of cytotoxic agents be adjusted to renal function and that low-toxicity treatment (ie, capecitabine in lieu of 5-fluorouracil [5-FU], pegylated liposomal doxorubicin in lieu of doxorubicin) be used when feasible and indicated. For the management of pain, the following principles are established: age is not an absolute hindrance to pain assessment; a number of instruments and the observation of pain behaviors are reliable even in patients with dementia; cyclooxygenase (COX)-2 inhibitors are preferable to COX-1 inhibitors for individuals with bleeding diathesis, peptic ulcer, and Helicobacter pylori gastritis; and opioids should be slowly titrated because the effectiveness and toxicity become less predictable with age. In conclusion, with individualized supportive care, the survival and quality of life of older patients with cancer may be improved.
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PMID:Supportive care of elderly patients with cancer. 1862 77

A 52-year-old woman was referred to our hospital for treatment of urachal cancer. She complained of supurapubic dull pain and gross hematuria. Computed tomography and magnetic resonance imaging showed a non-papillary sessile tumor, which was located on the dome of the bladder and invaded the small intestine. The tumor was diagnosed as Sheldon's stage IIIC urachal cancer. After three courses of neoadjuvant chemotherapy with FOLFOX4 (oxaliplatin, 5-FU and leukovolin), the tumor was reduced from 7 x 6 cm to 5.5 x 5 cm in size. Consequently, the patient underwent an en-bloc resection of the urachal tumor with the dome of the bladder and the parts of the ileum invaded by the tumor. One course of adjuvant chemotherapy (FOLFOX4) was performed. Surgical specimen revealed histologically well differentiated squamous carcinoma and invasion to the propria of the ileum. The surgical margins were negative for the cancer. For 1.5 years after the surgery, no local recurrence or distant metastasis has been observed.
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PMID:[Case of urachal cancer treated by neoadjuvant chemotherapy with FOLFOX4 (oxaliplatin, 5-FU and leukovolin)]. 1878 47

Hepatic portal venous gas(HPVG)is a rare condition with a poor prognosis. A 40-year-old man underwent esophagectomy for stage IV esophageal cancer followed by chemotherapy. Four months later, he admitted to our hospital because of the increases of residual tumors and started chemoradiotherapy(CRT)with 5-FU, CDDP and radiation. Computed tomography(CT)scan revealed PR, and blood examination showed decreases in WBC and platelet counts. Fourty days after CRT, he suddenly complained severe pain in the left chest and abdomen, and vomiting. CT scan showed HPVG in the left lobe of the liver and pneumatosis cystoides intestinalis in the wall of the gastric tube. He died of multiple organ failure. To our knowledge, this is a first case of HPVG associated with CRT for esophageal cancer.
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PMID:[A case of hepatic portal venous gas caused by chemo-radiation therapy for an advanced esophageal cancer]. 1884 Sep 89

Warts are a common pediatric skin disease. Most treatments show only modest benefit, and some are poorly tolerated because of pain. 5-fluorouracil interferes with deoxyribonucleic acid and ribonucleic acid synthesis, and is used to treat genital warts in adults. Efficacy, safety, and tolerability of topical 5% 5-fluorouracil for treatment of common warts were examined in an open-label pilot study with pediatric patients. Thirty-nine children who have at least two hand warts applied 5% 5-fluorouracil cream (Efudex, Valeant Pharmaceuticals International) once or twice daily, under occlusion for 6 weeks. Assessment of treatment response and side effects was performed at baseline, treatment completion, and 3- and 6-month follow-ups. Hematology measures, liver function tests, and medication blood levels were reassessed at treatment completion. Eighty-eight percent of treated warts improved after 6 weeks of treatment, and 41% of subjects had complete resolution of at least one wart. Treatment response did not differ between once or twice daily applications. Tolerability and patient satisfaction were excellent. No subject had clinically significant blood levels of 5-fluorouracil. At 6 month follow-up, 87% of complete responders had no wart recurrence. Topical 5% 5-fluorouracil is a safe, effective, and well-tolerated treatment for warts in children.
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PMID:5% 5-Fluorouracil cream for treatment of verruca vulgaris in children. 1970 88

A 64-year-old man was admitted to our hospital with complaints of jaundice, upper abdominal distension and pain. He had a history of laparoscopic-assisted distal gastrectomy for gastric cancer about 11 months ago. The stage was IB and pathological examination was poorly differentiated adenocarcinoma. The upper gastrointestinal fiberscope showed a continuous duodenal stenosis between an anastomotic region and the third portion. The pathological diagnosis was recurrent of gastric cancer. The abdominal CT scan showed a dilatation of bile duct due to duodenal invasion. After percutaneous transhepatic cholangio drainage (PTCD) and jejunotomy, the chemotherapy with low-dose CDDP and 5-FU followed by weekly paclitaxel was performed. The stenosis of duodenum and dilatation of bile duct were improved. The patient lived for 8 months after chemotherapy. It is important to understand that gastric cancer diagnosed poorly differentiated adenocarcinoma pathologically sometimes occurs duodenal invasion and obstructive jaundice.
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PMID:[A case of duodenal invasion due to recurrent gastric cancer with obstructive jaundice treated by chemotherapy]. 2122 91

A 62-year-old man with internal piles tested positive for infection with HIV and was admitted to our hospital. He presented with an anal tumor with bilateral inguinal nodal metastasis and pain in the anus; the tumor was diagnosed as stage IIIb (cA1N2M0). The patient's immune system was unstable. Therefore, he was administered chemoradiotherapy [low dose 5-fluorouracil plus cisplatin (FP) and radiotherapy (RT)] following HAART. Chemoradiotherapy resulted in complete response. However, CT performed 2 years after the diagnosis showed a recurrence in the hilar and mediastinal lymph node. The patient was administered chemotherapy with 5-fluorouracil and cisplatin (5-FU/CDDP) to the metastatic lymph node. However, the treatment response was graded as progressive disease, and the treatment was changed from CDDP to mitomycin C (MMC). The patient developed non-hematologic toxicity and died within 3 years of the diagnosis. We report a case of squamous cell carcinoma of the anus with associated HIV infection.
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PMID:[A case of squamous cell carcinoma of the anal cancer with associated human immunodeficiency virus]. 2122 70

The chloroethylnitrosourea derivate diethyl-1-(3-(2-chloroethyl)-3-nitroso-ureido)-ethyl phosphonate fotemustine (FM) was investigated in a open monocentric clinical-pharmacological trial. Seventeen patients, with a median age of 57 years and progressive hepatic metastases from colorectal carcinoma received regional treatment with a stepwise dose-escalated regimen of FM to define the maximally tolerated dose. Thrombo- and leukocytopenia were dose-limiting with median nadir at day 29 (range, 19-79) and day 39 (range, 19-78), respectively. Local side-effects in the liver were mild with only transiently elevated enzymes. No other severe side-effects, except pain (WHO grade III) in one patient after the infusion of FM was noted. The maximally tolerated dose was 125 mg/m(2)/day. Plasma profiles followed a mono-exponential law (one-compartment-model). Systemic concentrations measured as area under the time-concentration curve (AUG) indicated a short plasma half-life (t(1/2)=25.8+/-11.5 min) and a high body clearance (C-L=2.193+/-870 ml/min) with large inter- and intra-individual variations. Of fifteen evaluable patients examined with CT-scan, one complete, three partial, one minor response and seven patients with stable disease were observed [ORR=27%, IC95% (4.5-49.5%)]. In summary, hepatic arterial infusion of FM appears to be effective treatment for liver metastases from colorectal carcinoma. Considering the absence of mucositis/diarrhea and hepatic toxicity, FM could be explored as an alternative to 5-FUDR or 5-FU in previously untreated patients with isolated liver metastases.
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PMID:Hepatic arterial infusion of the nitrosourea derivate fotemustine for the treatment of liver metastases from colorectal carcinoma. 2159 35


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