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Munemoto Y.,Fukuiken Saiseikai Hospital | Kanda M.,Nagoya University | Ishibashi K.,Saitama University | Hata T.,Osaka University | And 11 more authors.
BMC Cancer | Year: 2015

Background: Although number of elderly patients with metastatic colorectal cancer (mCRC) is rapidly increasing, this population is often underrepresented in clinical trials. Recently, a phase II trial demonstrated that capecitabine and oxaliplatin (XELOX) combined with bevacizumab XELOX plus bevacizumab was effective and well tolerated by elderly patients with mCRC who reside in Western countries. The aim of this study was to evaluate the safety and efficacy of XELOX plus bevacizumab for Japanese patients aged ≤75years with mCRC. Methods: This prospective, open-label phase II trial recruited patients aged ≤75years with previously untreated mCRC between March 2010 and January 2012. Treatment consisted of 7.5mg/kg of intravenous bevacizumab and 130mg/m2 of oxaliplatin on day 1 of each cycle combined with 2000mg/m2 of oral capecitabine per day on days 1-14 of each cycle. Treatment was repeated every 3weeks until disease progression or termination of the study. The primary endpoint was progression-free survival; the secondary endpoints were toxicity, overall response rate, time-to-treatment failure, and overall survival. Results: Thirty-six patients (male 58%; median age 78years; colon cancer 67%) met all eligibility criteria and received at least one course of the planned treatment. The median time-to-treatment failure was 7.0months. Twelve patients (33.3%) experienced adverse effects (AEs)≤grade 3 and frequent AEs≤grade 3, including neutropenia (22.2%) and neuropathy (13.9%). Hypertension was the most frequent AE≤grade 3 associated with bevacizumab (11.1%). Low baseline creatinine clearance associated significantly with the incidence of AEs≤grade 3. Response and disease control rates were 55.6 and 91.7%, respectively. Median progression-free and overall survival times were 11.7months (95% confidence interval, 8.0-13.4months) and 22.9months, respectively. Conclusion: XELOX combined with bevacizumab was well tolerated by selected Japanese patients aged ≤75years with mCRC patients, and controlled clinical trials are now required to determine the survival benefit. © 2015 Munemoto et al. Source

Miyake Y.,Minoh City Hospital Gastrointestinal Research Center
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

An 80-year-old woman complaining of a right inguinal induration and pain was performed an inguinal lymph node resection. Histological examination with immnohistochemistry revealed that the lymph node was metastasis of colon carcinoma. With total colonoscopy, she was diagnosed as advanced transvers colon cancer with right inguinal lymph node metastasis. She was performed a right hemi-colectomy. She was dead with peritoneal metastasis of colon cancer 2 years and 1 month later. We report this case that was diagnosed having transverse colon cancer with inguinal lymph node metastasis. Source

Miyake Y.,Minoh City Hospital Gastrointestinal Research Center
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

As an adjuvant treatment for Dukes B2 and C colon cancer, adding oxaliplatin (L-OHP) to a regimen of fluorouracil and Leucovorin improved disease-free survival in Western countries. In Japan, however, adjuvant chemotherapy with L-OHP is not commonly used to treat Stage III colon cancer. We report the present condition of adjuvant treatment for colon cancer in our hospital. Between September 2009 and December 2011, 66 patients with Stage III colon cancer were enrolled after curative surgery. The details of adjuvant therapy with fluoropyrimidines with and without L-OHP were explained to the patients. After the explanation, 33.3% of the patients(IIIa: 18.9%, IIIb: 55.5%) selected L-OHP chemotherapy. Regardless of the side effects, adjuvant chemotherapy including L-OHP is expected to protect against cancer recurrence in patients with Stage IIIb colon cancer. Source

Miyake Y.,Minoh City Hospital Gastrointestinal Research Center
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013

The median survival time following chemotherapy for unresectable metastatic colorectal cancer (mCRC) is approximately 2 years. Although palliative care during the chemotherapy period is very important, it has not been reported in detail. Patients and methods: Information on the palliative care of 110 patients with Stage IV mCRC, who were treated from September 2007 to March 2011, was retrospectively examined. Following an explanation of their recurrence or metastases of mCRC, all the patients received mental care from nurses or psychiatrists. They also needed care to prevent the side effects of chemotherapy. Some patients experienced pain associated with tumor growth. Thus, they required NSAIDs or opioids to reduce the cancer-related pain. After they could not be taken chemotherapy, 87.5% of these patients consulted medical social workers to discuss where they would live. The patients required palliative care depending on the duration of chemotherapy for mCRC. Thus, we believe that palliative care is an important part of treatment for advanced cancer. Source

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