[Cisplatin administration for outpatients with short hydration of less than four hours].

BACKGROUND: The administration of cisplatin (CDDP)-containing regimens for outpatients has been popularized with the development of supportive care such as antiemetics. Currently, the number of chemotherapies available for outpatients has increased for many kinds of cancer, and administration with a shorter duration is desirable even in CDDP-containing regimens. METHODS: Between January 2008 and October 2011, we retrospectively evaluated 22 outpatients who received B 50mg/m² of cisplatin with a short hydration of within 4 hours. We instructed the patients to drink water(1, 000mL/day) on days 2 and 3 instead of receiving a drip infusion. The first course of chemotherapy was usually introduced on admission, and subsequent courses were administered in outpatient clinics. RESULTS: Thirteen cases of lung cancer, eight with gastric cancer, and one with esophageal cancer, were retrospectively evaluated. Thirteen CDDP+S-1 regimens, four CDDP+gemcitabine regimens, and five other types of regimens were administered. The median dose of CDDP was 60mg/m² (range, 50-75mg/m²), the median amount of drip infusion was 1, 600 mL (range, 1, 350-2, 000mL), and the median duration of drip infusion was 4 hours (range 3-4 hours). The decision to use antiemetics and diuretics was made on a case-by-case basis. The average creatinine level before the initiation of a CDDP-containing regimen was 0. 778±0. 212mg/dL, and the lebel four weeks after completion of the regimen was 0. 847±0. 200mg/dL. Among these 22 patients, 20 completed cisplatin-containing regimens. However, cisplatin was reduced in one patient due to renal dysfunction, and the cisplatin regimen was interrupted in one patient due to intolerable nausea and vomiting. CONCLUSIONS: CDDP administration at doses of 50-60mg/m² for outpatients was suggested to be safe with optimal patient selection, a total duration of administration of less than four hours, and with 2, 000 mL of hydration on day 1 and without drip infusion from day 2.

[Direct low-dose fentanyl patch (2.1mg) introduction for opioid naïve outpatients with cancer pain].

BACKGROUND: The administration of opioids to outpatients with cancer pain can be difficult because the constant dose modification and treatments of side effects involved are occasionally impossible. Therefore, more effective and safer drugs with better patients compliance are needed to complete a successful opioid introduction. Compared with other opioids, low-dose fentanyl has been suggested to produce milder side effects such as nausea, constipation, and somnolence. Further more, compliance can be improved because the drug is a patch,administered transdermally. METHODS: Between July 2008 and December 2009, we investigated the safety and analgesic effect of a fentanyl patch (2.1 mg) as a direct opioid introduction for 36 outpatients with cancer pain without titrations of other opioids. RESULTS: Side effects of constipation, nausea, somnolence, and dizziness were observed in 17 (47%), 6 (17%), 4 (11%), and 3 (8%) patients, respectively, and no respiratory suppression was observed. Regarding the analgesic effect, 23 (64%) patients reported improvement on pain scales one week after the initiation of the fentanyl patch. CONCLUSIONS: Opioid introduction to opioid-naÏve outpatients with cancer pain using the low-dose fentanyl patch (2.1 mg) may be effective.