RESUMO
Here, we discuss the safety and management of adverse events associated with pembrolizumab plus axitinib combination therapy for metastatic renal cell carcinoma in patients on hemodialysis. A 76-year-old man was diagnosed with cT3aN0M0 renal cell carcinoma due to gross hematuria. Stereoscopic radiotherapy for metastatic lesions of the ipsilateral kidney was performed 9 years after right laparoscopic radical nephrectomy. Soon after, the patient started to receive hemodialysis due to end-stage renal disease. Further stereoscopic radiotherapy was needed for metastasis of the ipsilateral kidney and lung. Fifteen years after diagnosis, systemic therapy was necessary to control new metastases, such as in the right scapular bone. We selected pembrolizumab plus axitinib combination therapy as the first-line systemic therapy for any risk as defined by the International Metastatic RCC Database Consortium. Although we needed to pay attention to the adverse events unique to hemodialysis, he underwent this combination therapy without any difficulty for 6 months. Here, we report the practice of combination therapy in patients on hemodialysis in light of the literature.
RESUMO
We have fabricated a new device for applying uniaxial strain to an individual suspended SWNT, and the form and the photoluminescence (PL) of an individual suspended SWNT under stretching are investigated. The processes of deformation and break of a SWNT under stretching are directly observed by scanning electron microscopy (SEM). From the PL measurements, the emission energy shifts due to the band gap change are measured under the elastic strain. The behaviors of the emission shifts can be related to the deformation processes observed by SEM. Moreover, the emission intensity reduction due to the elastic strain of a SWNT is also observed just before breaking.