Acevedoedmondson1452

A 77-year-old man was diagnosed with small cell lung cancer (SCLC cT3N3M1b, Stage ⅣA)with bone metastases 1 year and 9 months ago. Although partial response was obtained after 6 courses of chemotherapy with carboplatin(CBDCA)and etoposide(VP-16), multiple brain metastases were observed 5 months after the completion of chemotherapy. The multiple brain metastases completely disappeared after whole brain irradiation. However, the patient experienced lower extremity weakness, predominantly in the left side, 5 months after irradiation. Contrast-enhanced magnetic resonance imaging(MRI) revealed an abnormal nodular lesion at the Th10 level, indicative of intramedullary spinal cord metastasis originating from the SCLC. After the patient was admitted to our hospital, his neurological symptoms progressed rapidly and he began to experience difficulty in standing, along with bowel and bladder dysfunction. Chemotherapy with CBDCA plus VP-16 improved the neurological symptoms, and MRI after 1 course of chemotherapy revealed a decrease in the size of the metastatic lesion in the spinal cord. OSI-906 manufacturer Although neurological symptoms are common in patients with lung cancer, intramedullary metastases often promote irreversible neurological dysfunction. Herein, we report a patient with SCLC who developed intramedullary spinal cord metastasis and whose neurological symptoms dramatically improved after systemic chemotherapy.Often, co-medical staff are asked questions or consultations that are difficult to answer from cancer patients. However, as for the reply contents, each co-medical staff responded in various ways, there was no place to discuss an appropriate reply. At our hospital, we decided to hold a"Cancer Patient Response Conference"to enable us to respond appropriately regardless of years of service or occupation. This time, we investigated the effect of"Cancer Patient Response Conference"on the approach at Ishikiriseiki Hospital. As a result, it is possible for the co-medical staff to respond to empathy of the patient's feelings and to confirm the understanding of the patient, but it seemed that the response from the attending physician was good for the question about the life expectancy and the treatment effect etc. However, it was suggested that collaborative staff sharing patient problems and information at"Cancer Patient Response Conference"will be useful for future cancer patient response.Patients treated with anticancer drugs are likely to have serious physical and mental anxieties due to severe adverse events. Continuous information provision with the expertise of pharmacists will lead to the improvement of quality of life (QOL) of patients and efficient administration of chemotherapy. At Koyama Memorial Hospital, a pre-consultation service by pharmacists has been initiated to reduce adverse events in patients undergoing breast cancer chemotherapy. The service has allowed pharmacists to continuously intervene with treatment from the start and if necessary, suggest that physicians change supportive care or conduct additional tests. Pre-consultations were provided for 503 breast cancer patients who received outpatient chemotherapy between January 2016 and October 2017. For 68(13.5%)of the 503 cases, pharmacists suggested prescriptions or tests. In the 68 cases, the adoption rate of suggestions among physicians was 95.6%(65/68). As a result of the adopted suggestions, adverse events disappeared or were alleviated in 89.2%(58/65)of the patients. Therefore, in breast cancer patients undergoing chemotherapy, adverse events associated with chemotherapy may be alleviated early through pharmacist-led pre-consultation and provision of appropriate pharmaceutical interventions based on the preconsultations.Standard regimens for extrapulmonary neuroendocrine carcinomas(EPNEC)are not established. Treatment used for small cell lung cancer is also used for EPNECs. Amrubicin(AMR) monotherapy is used as salvage therapy for small cell lung cancer, but its efficacy in EPNEC is not clear. The aim of this study was to estimate the efficacy of AMR monotherapy in EPNEC. We retrospectively investigated patients with EPNEC who received first-line platinum-based chemotherapy between April 2007 and March 2019. The time to treatment failure(TTF)and the efficacy and toxicity was analyzed in the patients who received AMR monotherapy. Among 43 patients with EPNEC, 14(13 males, one female; median age, 58 years)received AMR monotherapy. Primary site included the pancreas(n=3), stomach(n=3), rectum(n=1), anal canal(n=1), salivary glands(n= 1), urothelial(n=1), bladder(n=1), prostate(n=1), and 2 patients had primary unknown cancer. Pathological type included small cell(n=4), large cell(n=2), and other types(n=8). Prior chemotherapy comprised CDDP plus CPT-11(n =5), CDDP plus ETP(n=2), and CBDCA plus ETP(n=6). The median TTF was 49(20-61)days. One patient had a partial response and the disease control rate was 33%. The common adverse events of >Grade 3 were leukopenia(69%), neutropenia(62%), and febrile neutropenia(23%). AMR monotherapy was clinically effective and safe for EPNEC.Brain metastasis(BM)is the final stage of metastatic breast cancer(MBC), but its course and outcomes after the first metastasis(FM)to various sites are not fully clarified. Furthermore, the survival of patients with BM appears to be improving with the recent development in MBC control according to the subtype analysis. The present study included 35 patients with BM between 2008 and 2018, and was designed to clarify the effects of the FM sites and subtypes on the outcome of these patients. Subtypes included 8 Luminal(L), 8 L-HER2+(LH), 8 HER2(H), and 11 triple-negative(TN)types, and FM sites included 14 lungs or pleurae, 4 livers, 4 brains, 4 bones, and 9 local or lymph node(LN)metastases. The median interval between FM and BM(IFB)was 33 months(M)for overall patients; 50M for LH, 37M for L, 22M for H, and 19M for TN (p=0.0463); and 24M for the high risk(HR)FM(lung, pleura, liver)and 47M for the low risk(LR)FM group(bone, local, LN)(p=0.0385). The median overall survival(OS)after BM diagnosis was 13M for overall patients; 27M for LH, 13M for H, 10M for L, and 5M for TN(p=0.