[Efficacy of supportive care for albumin-bound paclitaxel(nab-paclitaxel)in 20 patients with metastatic breast cancer].

PURPOSE: The objective of this retrospective study was to evaluate the efficacy of albumin-bound paclitaxel(nab-paclitaxel) treatment and the required supportive care for severe adverse events. METHODS: A total of 20 patients with advanced or recurrent breast cancer received nab-paclitaxel every 3 weeks between February 1, 2011 and December 31, 2012. The treatment course was repeated for 6 cycles thereafter, until evidence of disease progression or unacceptable toxicity was noted. RESULTS: The median number of treatment cycles was 6.0(range 2-6), the median cumulative dose was 1,560(range 440- 1,560)mg/m / / 2, and the median delivered dose intensity was 82.3(range 65.0-86.7)mg/m2week. Primary chemotherapy was associated with higher response rates than second-line or subsequent chemotherapy(42.9% v 23.1%). The response rate was 26.7% for cases with taxane pretreatment. Adverse events included neutropenia in 15 cases(75%), of Grade 4 severity in 4 cases(20%), and febrile neutropenia after 1 cycle in 1 patient(5%). In addition, Grade 3 peripheral neuropathy was observed in 2 cases(10%)during the treatment period. CONCLUSION: Nab-paclitaxel therapy was efficacious as primary chemotherapy and was effective for patients pretreated with taxanes. To prevent severe adverse events, supportive care is important, primarily for febrile neutropenia and neuropathy.

[The current status of nausea, vomiting and food intake in outpatients with cancer chemotherapy].

A survey on chemotherapy-induced nausea, vomiting and food intake was conducted on 126 outpatients receiving chemotherapy during a days from February 1 to February 12, 2010 in our hospital. Responses were obtained from 66 outpatients. In the acute phase, 11%of the patients developed nausea. In the late phase, 35%patients developed nausea. The development of nausea was significantly increased in the late phase, compared to the acute phase(p=0. 0008). Though nobody developed vomiting in the acute phase, 3% of the patients developed vomiting in the late phase. For food intake, in the acute phase, nobody showed a"reduced amount of diet", and 12% showed"not eating". In the late phase, 26% of the patients showed"reduced amount of food", and 8%"not eating". Food intake was significantly decreased in the late phase, compared in acute phase(p=0. 0001). Currently, in our hospital, steroids and/or 5-HT3 antagonists are given for antiemetic therapy, but the effect is not enough. We should add other antiemetics, which act in the late phase.

[Breast cancer during pregnancy--a case report].

Pregnancy-associated breast carcinoma is generally defined as cancer that occurs during pregnancy or within 1 year of delivery, although treatment options are the most complicated when the disease is diagnosed during pregnancy. We report the case of a 30-year-old woman who was diagnosed with breast cancer at her 9th week of pregnancy. The patient initially had mastectomy with axillary lymph node dissection. She began adjuvant therapy with 3 courses of epirubicin/cyclophosphamide at 19 weeks of gestation. After delivery of a healthy child, she received one course of epirubicin/cyclophosphamide and 4 courses of docetaxel. Although the data are limited, pregnant patients with cancer can be treated with systemic chemotherapy with minimal risks to the fetus during the second or third trimester. Management of breast cancer during pregnancy requires an interdisciplinary care team and careful consideration of the patient's stage of disease, the gestational age of the fetus, and the preferences of the patient and her family.