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Objective:To explore the therapeutic efficacy and toxicity of oral Etoposide chemotherapy in children with disseminated medulloblastoma (MB) after the standard treatment plan.Methods:The clinical data of 86 children with disseminated MB admitted in the Department of Pediatrics, Beijing Shijitan Hospital of Capital Medical University from January 2016 to May 2020 were analyzed retrospectively.The median age of children was 8.8 (3.0-16.7) years old.Among them, 33 children treated with maintenance chemotherapy via oral Etoposide were included in the chemotherapy group, and 53 children without oral maintenance chemotherapy were included in the non-chemotherapy group.The gender distribution, surgical resection range, pathological type, molecular classification, postoperative mutism, M-stage and survival[progression-free survival (PFS) and overall survival (OS)] of the 2 groups were compared.The main adverse events of oral Etoposide chemotherapy were recorded. Chi- square test is used for data comparison, Kaplan-Meier method was used to plot the survival curve of disseminated MB patients, followed by the Log- rank test. Results:There were no significant differences in gender, surgical resection range, pathological type, molecular typing, postoperative mutism and M-stage between the 2 groups (all P>0.05). Of 86 patients, the median PFS and OS were 3.0 (0.2-6.3) years, and 3.6 (0.5-6.3) years, respectively.Twenty five cases (29.1%) relapsed, 13 cases (15.1%) died.The 3-year[(65.8±6.8)% vs.(82.0±7.3)%] and 5-year PFS[(56.8±7.7)% vs.(82.0±7.3)%] in non-chemotherapy group were significantly lower than those of chemotherapy group ( P=0.037). The 3-year[(81.6±5.6)% vs.100.0%] and 5-year OS[(71.2±7.7)% vs.(92.3±7.4)%] in non-chemotherapy group were significantly lower than those of chemotherapy group ( P=0.025). Among the children with the SHH subtype, the PFS of children with oral Etoposide maintenance chemotherapy after a regular treatment was significantly higher than that without oral maintenance chemotherapy (100.0% vs.57.1%)( P=0.021). The major adverse events of oral Etoposide were myelosuppression and gastrointestinal symptoms, which were mostly relieved after a symptomatic treatment.Treatment-related deaths were not reported. Conclusions:The prognosis of disseminated MB in children is relatively poor.Oral Etoposide for maintenance therapy after a standard treatment is beneficial in reducing relapse and improving the 5-year survival, which is well tolerated.
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La quimioterapia oral comenzó a surgir entre 1940 y 1950, se estima que al menos el 25% de los agentes neoplásicos existentes, están previstos para ser orales y de este modo se espera que su administración aumente en los próximos años. El uso de estas drogas oncológicas oral trae ventajas para el paciente como mayor comodidad, participación activa en su tratamiento, menor interferencia con la vida laboral y social y aumento de la calidad de vida. Objetivo: diseñar un programa educativo sobre el autocuidado en el tratamiento de quimioterapia oral en los pacientes adultos oncológicos en su hogar. diseño metodológico: se realizó una búsqueda de diferentes bases de datos como PUBMED, BVS, SCIELO, obteniendo como resultados 104 artículos de los cuales se seleccionan 10 que respondían a la pregunta de investigación. Resultados: tras el análisis de los artículos seleccionados podemos asegurar que educar a los pacientes y sus familias sobre quimioterapia oral, es un gran desafío que necesita de ajustes y mejoras permanentemente. La educación al paciente debe ser constante y permanente[AU]
Oral chemotherapy began to emerge between 1940 and 1950, it is estimated that at least 25% of existing neoplastic agents are expected to be oral and thus its administration is expected to increase in the coming years. The use of these oral cancer drugs brings advantages for the patient such as greater comfort, active participation in their treatment, less interference with work and social life and increased quality of life. Objective: To design an educational program on self-care in the treatment of oral chemotherapy in adult cancer patients at home. Methodological Design: A search of different databases such as Pubmed, BVS, Scielo was carried out, obtaining as results 104 articles of which 10 were selected that responded to the research question. Results: After analyzing the selected articles, we can ensure that educating patients and their families about oral chemotherapy is a great challenge that needs permanent adjustments and improvements. Patient education must be constant and permanent[AU]
A quimioterapia oral começou a surgir entre 1940 e 1950, estima-se que pelo menos 25% dos agentes neoplásicos existentes sejam orais e, portanto, sua administração deverá aumentar nos próximos anos. O uso desses medicamentos para o câncer oral NE | 22Plan educativo a pacientes adultos que reciben citostáticos orales en el hogar / Paola Natalia Oyola / Trabajo recibido: 2 de febrero 2021 · Trabajo aprobado: 29 de abril 2021traz vantagens para o paciente como maior conforto, participação ativa no seu tratamento, menor interferência no trabalho e na vida social e aumento da qualidade de vida. Objetivo: Elaborar um programa educacional sobre autocuidado no tratamento da quimioterapia oral em pacientes adultos com câncer no domicílio. Delineamento metodológico: Foi realizada uma busca em diferentes bases de dados como Pubmed, BVS, Scielo, obtendo-se como resultados 104 artigos dos quais 10 foram selecionados que responderam à questão de pesquisa. Resultados: Após a análise dos artigos selecionados, podemos assegurar que educar os pacientes e seus familiares sobre a quimioterapia oral é um grande desafio que necessita de ajustes e melhorias permanentes. A educação do paciente deve ser constante e permanente[AU]
Subject(s)
Humans , Self Care , Patient Education as Topic , Drug Therapy , Cytostatic Agents/administration & dosage , Cytostatic Agents/therapeutic use , Treatment Adherence and ComplianceABSTRACT
Objective To construct a novel thiolated chitosan modified poly(lactide-co-ε-caprolactone)-d-α-tocopheryl polyethylene glycol 1 000 succinate (PLA-PCL-TPGS) nanoparticle,and investigate the feasibility of its use as an oral carrier for lung cancer chemotherapy.Methods The PLA-PCL-TPGS random copolymer was synthesized and characterized.Then three types of nanoparticles from commercial PCL and PLA-PCL-TPGS random copolymer were prepared for oral carrier of paclitaxel,including 5％ thiolated chitosan-modified PCL nanoparticles (CNPs),unmodified PLA-PCL-TPGS nanoparticles (UNPs),and 5％ thiolated chitosan-modified PLA-PCL-TPGS nanoparticles (TNPs).The prepared nanoparticles were characterized in terms of size,Zeta potential,morphology,drug loading and encapsulation efficiency.The in vitro drug release profiles and cellular uptake of the nanoparticles by human lung cancer cell lines A549 cells were investigated,and cytotoxicity against A549 cells was also evaluated.The evened sac method was used for the measurement of transportation of paclitaxel across the intestine barrier.Results The field emission scanning electron microscopy results showed that the three types of paclitaxel-loaded nanoparticles were spherical with a diameter about 200 nm.The surface charge of PLA-PCL-TPGS nanoparticles was reversed from negative to positive charge after thiolated chitosan modification.The UNPs and TNPs achieved higher drug loading,encapsulation efficiency and drug release after 32 d than CNP (all P＜0.05).The TNPs had significantly higher cell uptake efficiency than that of CNPs and UNPs (all P＜0.05).In vitro cell viability studies showed advantages of TNPs over a clinically available paclitaxel injection in terms of cytotoxicity against A549 cells.Ex vivo absorption studies revealed that the TNPs can increase paclitaxel transport by opening tight junctions and bypassing the efflux pump of P-glycoprotein.Conclusion PLA-PCL-TPGS nanoparticles modified by thiolated chitosan can enhance the cellular uptake and cytotoxicity,which reveals a potential application for oral chemotherapy of lung cancer.
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PURPOSE: In 2008, the Korean Oncology Nursing Society (KONS) published standards for the safe use of chemotherapy in clinical settings, including extravastion management. Although the medical environment has rapidly changed, KONS standards have not been revised since then. In 2017, the KONS planned to revise the practice guidelines on oral chemotherapy METHODS: A clinical expert group developed recommended guidelines, using officially accepted standards based on all relevant publications. The draft was discussed and accepted in a consensus conference. The final recommendations were reviewed and approved by the KONS Boards of Directors. RESULTS: There were 4 chapters and 50 recommendations in the final version of the guidelines. Recommendations include those associated with general practice, patient consent and education, order assessment and administration, and side effects and complication management. CONCLUSION: The revised KONS guidelines on oral chemotherapy will contribute to the improvement of staff and patient safety related to oral chemotherapy. KONS guidelines revisions should be carried out at regular intervals.
Subject(s)
Humans , Consensus , Drug Therapy , Education , General Practice , Oncology Nursing , Patient Safety , Personal Protective Equipment , Safety ManagementABSTRACT
Adherence refers to the extent to which a patient′s behavior coincides with medical advice without missing a dose or overdosing and taking drugs at the right time. Good adherence could assure the effect of the therapy and reduce neoplasm metastasis and recurrence as well. In this article, status of oral chemotherapy adherence in cancer patients, impact factors and measurement tools had been reviewed. Adherence of oral chemotherapy in cancer patients and measurement tools of oral chemotherapy adherence needed further study. Besides, nursing should also focus on impact factors of the adherence of cancer patients during the oral chemotherapy, and take effective interventions to improve the adherence, so as to ensure the effect of chemotherapy, and improve the survival rate of cancer patients.
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Hepatocellular carcinoma (HCC) is a global health problem, the fifth most common cancer in the world.. HCC occurs in a histologically abnormal liver due to underlying chronic liver disease resulting as a sequele of the chronic viral infections, hepatitis B and C. Since these two viral infections are endemic in Asia and Africa, more than 80% of cases are encountered in these regions. In India, a large proportion of the population is “at risk” for developing chronic liver disease and, therefore, HCC. Due to the lack of screening programmes in the country, the majority of HCC patients are diagnosed at an advanced stage of the disease, and thus treatment remains a challenge. Palliative therapy forms the mainstay of treatment for this group of patients. The current era provides a plethora of options for the palliative management of HCC. This review concisely summarises the historical perspective and the current status of palliative treatment in advanced HCC.