[Four Cases Who Experienced Extravasation of Anthracyclines and Had Dexrazoxane Therapy].

We analyzed 4 cases who experienced extravasation of anthracyclines and had dexrazoxane therapy in our hospital. Concerned drugs were 2 adriamycin and 2 amrubicin cases and all cases received steroid ointment therapy, and no cases showed severe condition such as skin ulcer. As dexrazoxane is known to enhance bone marrow suppression of anti-cancer drugs, the nadir of neutropenia and thrombocytopenia was observed from day 10 to 17 in our cases. We made a domestic manual and have used in various professionals. Dexrazoxane would contribute to the reduction of skin damage due to extravasation if we could manage bone marrow suppression successfully.

[Surgical treatment outcomes of multimodality therapy for locally recurrent rectal cancer].

The aim of this study was to clarify the status of multimodality therapy for locally recurrent rectal cancer. Between 2000 and 2012, 27 patients with locally recurrent rectal cancer underwent surgical resection. We examined 18 patients treated with preoperative chemo-radiotherapy (CRT group) and 9 patients treated with surgery alone (surgical group). The rate of R0 - resection was 89% in the CRT group and 78% in the surgical group. The mean operative durations for the CRT and surgical groups were 323 min and 289 min, respectively. The mean amount of bleeding was 1,462 g for the CRT group and 2,846 g for the surgical group. There was no significant difference in the rate of postoperative complications between both groups (CRT group: 78%, surgical group: 78%). Regarding local recurrences, the recurrence rate of the CRT group was 28%, whereas that of the surgical group was 67%. The 3-year and 5-year overall survival rates of the CRT group were 71%and 44%, respectively, whereas those of the surgical group were 58% and 22%, respectively. These results showed that CRT treatment was associated with an improvement in prognosis. Preoperative CRT and surgical resection should be the standard treatment for patients with local recurrence.

[Bevacizumab in combination with mFOLFOX6 or FOLFIRI for previously treated metastatic colorectal cancer].

We retrospectively investigated the safety and efficacy on outpatient chemotherapy including bevacizumab(BV)as secondline therapy for inoperable metastatic colorectal cancer. Analytical subjects were thirty patients treated with chemotherapy including BV as second-line therapy after first disease progression. All patients were treated with BV 5mg/kg. Concurrent therapy was given mFOLFOX6(2 patients)and FOLFIRI(28 patients). The BV treatment frequency and all course treatment frequency including the prior regimens averaged 20 and 37 times, respectively. The overall response rate was 24. 1%(PR, 7 patients; SD, 17 patients; PD, 5 patients), and the median duration of progression-free survival was 8. 0 months. The median duration of survival after addition of BV was 20. 3 months. The adverse events were 84%(>grade 3, 9%), BV-associated adverse events were GI perforation(1 patient), GI hemorrhage(1 patient), grade 3 hypertension(1 patient)and grade 2 epitaxis(2 patient). Although it is necessary to be careful about GI hemorrhage and GI perforation, we could safely continue the treatment with BV on outpatient chemotherapy. We confirmed that the chemotherapy including BV as second-line therapy had high antitumor effect and patient benefit.

[Survey on the compliance of patients with continuous infusion of 5-fluorouracil via portable infusion pumps].

A portable infusion pump is essential to sustain the 46-hour continuous administration of 5-fluorouracil in the folinic acid, fluorouracil, and oxaliplatin (FOLFOX) and folinic acid, fluorouracil, and irinotecan (FOLFIRI) protocols in colorectal cancer chemotherapy. However,the accuracy of the 5-fluorouracil dose administered via the infusion pump and patient compliance varies because the infusion rate changes depending on the viscosity of the drug, temperature, etc. In addition, the termination of administration based on the patient's judgment may influence these factors. In the present study, the amount of 5-fluorouracil remaining in the infusion pump and the administration time were investigated. As a result, the median amount that was found to remain in the pump was 49 mg, which was 2.0% of the average dosage, and an median administration time delay of 70 min was obtained. A questionnaire survey revealed that a majority of the patients felt insecurity about in adequate administration and administration time delays. These results indicate that customizing capacity modulation in the infusion pump corresponding to the patient's usage or seasonal variability of air temperature, and patient education may be important to improve patient compliance.

[Change in patient satisfaction in outpatient chemotherapy unit--comparison in 2005 and 2008].

We investigated the influences of the treatment environment, in terms of the increased number of treatments, introduction of regimen assessment and registration system, and the levels of specialization of the concerned medical professionals on patient satisfaction. We compared our results with those of a previous survey conducted in the outpatient chemotherapy unit of Hirosaki University Hospital. The patients were satisfied with respect to the privacy considerations and waiting time. However, a decrease in the patient instruction time led to slightly lower patient satisfaction. We concluded that it is useful to evaluate the quality of treatment in terms of patient satisfaction in a hospital.