[Study of decreased oral intake in patients receiving neoadjuvant chemotherapy for esophageal cancer].

Patients often experience decreased oral intake due to primary systemic therapy (DCF [docetaxel, cisplatin, and fluorouracil ] therapy) administered during the treatment of esophageal carcinoma; measures to cope with this problem have been sought. We therefore examined the relationship between the presence or absence of decreased oral intake and blood biochemistry( serum albumin[ Alb] level, white blood cell[ WBC] count, neutrophil count, and serum sodium[ Na] level) during the 12 courses of DCF therapy administered as primary systemic therapy to 6 patients with esophageal carcinoma. Decreased oral intake occurred frequently from day 6 to day 12 after the initiation of DCF therapy. During this period, decreased serum Alb levels were observed in patients with decreased oral intake but not in patients without decreased oral intake. The incidence of decreased oral intake was 100% in patients whose serum Alb levels decreased to <3.5 g/dL, but it did not exceed 33.3% in patients whose serum Alb levels were ≥3.5 g/dL. The serum Na level, WBC count, and neutrophil count were less affected than the serum Alb level, suggesting that decreased oral intake was associated with decreased serum Alb level.

A randomized-controlled trial of blonanserin and olanzapine as adjunct to antipsychotics in the treatment of patients with schizophrenia and dopamine supersensitivity psychosis: The ROADS study.

Dopamine supersensitivity psychosis (DSP) is a key factor contributing to the development of antipsychotic treatment-resistant schizophrenia. We examined the efficacy and safety of blonanserin (BNS) and olanzapine (OLZ) as adjuncts to prior antipsychotic treatment in patients with schizophrenia and DSP in a 24-week, multicenter (17 sites), randomized, rater-blinded study with two parallel groups (BNS and OLZ add-on treatments) in patients with schizophrenia and DSP: the ROADS Study. The primary outcome was the change in the Positive and Negative Syndrome Scale (PANSS) total score from baseline to week 24. Secondary outcomes were changes in the PANSS subscale scores, Clinical Global Impressions, and Extrapyramidal Symptom Rating Scale (ESRS), and changes in antipsychotic doses. The 61 assessed patients were allocated into a BNS group (n = 26) and an OLZ group (n = 29). The PANSS total scores were reduced in both groups (mean ± SD: -14.8 ± 24.0, p = 0.0042; -10.5 ± 12.9, p = 0.0003; respectively) with no significant between-group difference (mean, -4.3, 95 %CI 15.1-6.4, p = 0.42). The BNS group showed significant reductions from week 4; the OLZ group showed significant reductions from week 8. The ESRS scores were reduced in the BNS group and the others were reduced in both groups. The antipsychotic monotherapy rates at the endpoint were 26.3 % (n = 6) for BNS and 23.8 % (n = 5) for OLZ. The concomitant antipsychotic doses were reduced in both groups with good tolerability. Our results suggest that augmentations with BNS and OLZ are antipsychotic treatment options for DSP patients, and BNS may be favorable for DSP based on the relatively quick responses to BNS observed herein.