1.Diagnosis and management of opioid-induced constipation
Hongyi LI ; Zhenjun WEI ; Duanqi LIU
Chinese Journal of Clinical Oncology 2015;(12):603-607
Opioid-induced constipation (OIC) is the most common side effect of opioid. OIC influences the quality of life of pa-tients suffering from cancer pain. However, given that the drug is often overlooked and underappreciated, most of the time, the patients would avoid or abandon using opioid and, as a result, they continuously suffer from cancer pain. Therefore, OIC prevention and man-agement must be made before opioid use. The consensus on the diagnosis of OIC has only been reached recently. Thus, a unified defini-tion of OIC must be developed to exchange therapeutic option among departments in hospitals and compare treatment outcome. The di-agnosis of OIC is discussed, and the management of OIC, including medicinal and non-medicinal treatment, is summarized. Mean-while, the initial program for prevention and treatment of OIC is established to make OIC management more convenient for clinical physicians. Much work is still needed to establish a consensus on OIC diagnosis and a suitable program for prevention and treatment of OIC.
2.Reasonable naloxone administration in cancer pain management
Huilong LIU ; Hongyi LI ; Duanqi LIU
Chinese Journal of Clinical Oncology 2013;(24):1487-1491
Naloxone is a synthetic pan-opioid receptor competitive antagonist of the opioid receptors inside and outside the cen-tral nervous system. After systemic administration, it reverses almost all opioid effects. Systemically administered naloxone is used to reverse the life-threatening opioid toxicity. A number of studies have analyzed the importance of oral naloxone as a peripheral opioid an-tagonist in cancer patients. Naloxone has shown satisfactory efficacy for opioid-induced constipation (OIC). Ultra-low dose of naloxone has been reported to enhance the anti-nociceptive effect of morphine and reduce morphine consumption. We summarize the results from current studies of naloxone administration in cancer pain management.
3.Opioid overdose in advanced cancer patients antagonized by nalox-one:a report of 15 cases
Huilong LIU ; Hongyi LI ; Duanqi LIU
Chinese Journal of Clinical Oncology 2013;(24):1502-1505
Objective: To analyze the clinical characteristics of opioid overdose in naloxone-antagonized advanced cancer pa-tients. Methods:Fifteen patients with moderate to severe cancer pain were diagnosed with opioid overdose. Five of the patients were treated with transdermal fentanyl, six with prolonged-release morphine sulfate tablets, and four with prolonged-release oxycodone hy-drochloride tablets. Naloxone was immediately administered upon discovery of opioid overdose. The reasons behind opioid overdose as well as the naloxone efficacy and patient prognosis were investigated. Results:In the patients of the group, the equivalent dosage of morphine, the treatment dosage is 10 mg/d to 640 mg/d, and the median dosage is 360 mg/d. The therapeutic dose of naloxone is 0.2 mg to 0.8 mg, and the median dosage is 0.4 mg. After naloxone use, the pupils of the patients were recovered in the first few min-utes, and respiratory depression improved within 10 min to 30 min. However, blood pressure recovery was slow for at least 1 hour. Two fever-afflicted patients were diagnosed with transdermal fentanyl overdose and impaired liver function, which exhibited rapid deteriora-tion immediately before the opioid overdose. Seven patients with poor pain control were diagnosed with opioid overdose during drug ti-tration. These patients were given poor prognosis, and their median overall survival time was 1.9 months. Conclusion: Opioid over-dose, which is shown to be common in advanced cancer patients, can be safely and effectively treated by naloxone. Early diagnosis and treatment of this condition would significantly improve the quality of pain control for the patient.
4.Application of pain assessment tools in cancer pain patients
Xiaomei LI ; Hongyi LI ; Wenhua XIAO ; Duanqi LIU
Chinese Journal of Clinical Oncology 2013;(24):1482-1486
Cancer pain is an inherently subjective feeling. As such, a patient's report of pain is the basis of assessment. Self-re-ported questionnaires are extensively used in clinical practice and research. Single-item unidimensional rating scales are often used to assess pain intensity. Numerical rating scale is recommended by the European Palliative Care Research Collaborative. Multidimension-al measurements, such as brief pain inventory and short-form McGill pain questionnaire (revised version), can also be used for more comprehensive pain assessments than other questionnaires. Furthermore, specific tools can be applied when cancer-related break-through pain or neuropathic pain is assessed. For patients with cognitive function impairments, face rating scale is a useful tool to screen pain. Multidimensional measurements should also be used for further evaluation. In cancer pain evaluation, the development of simple and practical computer-administered questionnaires is a new trend. Repeated cancer pain assessment is strongly recommended regardless of the applied scale.
5.The diagnosis and treatnent of 91 cases of testicular tumor
Hongyan ZHANG ; Feng LIANG ; Zhiling JIA ; Chang LIU ; Duanqi LIU
Cancer Research and Clinic 2011;23(9):607-609
ObjectiveTo summarize the diagnosis,treatment and prognosis of testicular tumor.MethodsThe clinical and followed data of 91 cases of testicular tumor were retrospectively studied. Results In 91 patients, was in 18-40 years old 70.3 % (64/91) and 91.2 % (83/91) cases were germ cell tumor. 18-40years old germ cell tumor was 75.6 % (28/37), there was no case below 17 years old, the older than 60 years was 2.7 %(1/37). The percentage of below 5 years and 18-40 years was 16.1% (5/31) and 67.7 % (21/31),respectively.The interstitial tissue tumor developed in each age section,the number was least.The mixed tumor cases of 18-40 years percent was 93.3 %(14/15).The early symptom of testicular tumor was indolent swelling in one side testis or testis nodus.Combined therapy,including radical orchiectomy,retroperitoneal lymph node dissection, chemotherapy and radiotherapy, were taken. The one year, three years and five years survival rate were 97.3 %, 91.8 %, 91.8 %, respectively. The percentage of Ⅰ, Ⅱ, Ⅲ stage survived 5 years was 83.6 %, 52.3 %, 33.3 %. ConclusionThe peak age of testicular tumor patients was 18-40 years old.The different pathological type is distributed in different ages,and the prognosis is related to pathology and stage. The survival time of germ cell tumor or early stage tumor is longer.
6.Treatment for cancerous pain in the elderly with Oxy-Codone hydrochloride controlled-release tablets.
Yanfang LIU ; Duanqi LIU ; Hongying LI ; Xia ZHANG
Clinical Medicine of China 2010;26(12):1236-1238
Objective To evaluate effectiveness and side effects, as well as its safety, of Oxy-Codone hydrochloride controlled-release tablets (Oxycontin) for the elderly patients with moderate to severe cancerous pain. Methods From March 2005 to February 2009,106 elderly patients ( aged more than 60 years) suffered from moderate to severe cancerous pain were treated with Oxycontin,at initial dose of 10 mg/12 h. For the patients using making them pain-free or pain relieved mostly. Every patient was treated for 4 weeks at least. Severity of pain,sleeping status, appetite, fatigue, mental status, daily life, scores of understanding and cooperation, and side effects were .observed.Results The minimal effective dose of Oxycontin was 10 mg/d for the elderly patients with cancerous pain. Twenty-three patients (21.7%) were treated with it at dose of ≥200 mg/d,30 patients (28. 2% )at dose of 100 - 180 mg/d,and 53 patients (50. 0% ) at dose of 10 -90 mg/d. Pain was relieved in 97. 16% of the patients after treatment, with common side effects of constipation, nausea, vomiting;and drug treatment was needed for 24. 53% (26/106) of the patients with more common constipation. Conclusions Oxycontin is effective,tolerable,less side-effects for the elderly patients with moderate to severe cancerous pain, and can improve their quality of life.
7.Study progress of EGFR-targeting antibody related biomarkers
Cancer Research and Clinic 2009;21(8):501-503
With the emerging of EGFR-targeting antibody, there is a new choice for malignant tumors. Several studies indicate that cetuximab combined with chemotherapy have a role in the first-line treatment of metastatic colorectal and lung cancer, with a 10% to 20% absolute increase in response rates reported. But, cosily price and partly responsive rate restrict the reasonable use of the drug. If the predictive biomarker works, clinician can identify patients who can benefit from the regimen and relieve the economic and toxic burden of null patients and avoid wasting time and money. The study progress of the biomarkers related to EGFR-targeting antibody was reviewed.
8.EXPRESSION OF THE DMBT1 GENE IN COLON CARCINOMA AND ITS CLINICAL SIGNIFICANCE
Xiangqing YUAN ; Duanqi LIU ; Yueyin WANG
Medical Journal of Chinese People's Liberation Army 2001;0(10):-
To study the relationship between the expression of the DMBT1 gene in colon carcinoma and its clinical significance. Expression of the DMBT1 gene in colon carcinoma was measured by reverse transcriptase polymerase chain reaction (PT PCR). RT PCR amplification demonstrated that 13 of 36 (36 1%) cases showed an apparent reduction in DMBT1 mRNA in tumor tissues compared with paired normal tissues. Furthermore, the expression of the DMBT1 gene mRNA was reduced in the tumor tissues with lymph nodes metastasis, depth invasion and Dukes`s classification ( P
9.Evaluation of clinical physical examination, ultrasonography and mammography in the diagnosis of breast cancer in Chinese
Hongyan ZHANG ; Feng LIANG ; Duanqi LIU
Medical Journal of Chinese People's Liberation Army 2001;0(11):-
Objective To evaluate the significance of clinical physical examination, breast ultrasonography, and mammography in the diagnosis of breast cancer in Chinese, to compare their sensitivity, specificity and accuracy, and to elucidate the significance of combined application of the 3 methods. Methods A total of 112 patients suspected to have breast cancer as a result of mass screening (38 cases) and OPD examination (74 cases), were subjected to clinical physical examination, breast ultrasonography and mammography, and biopsy specimens were obtained from all the cases by puncture or surgery, then the final diagnosis was confirmed by pathological examination. The diagnosis made from clinical physical examination, breast ultrasonography or mammography was compared with pathological findings, and the sensitivity, specificity, accuracy, positive predictive value, and Kappa index of the 3 methods were then calculated. Results 61 cases of breast cancer and 51 cases of benign breast disease were identified. The diagnostic sensitivity of clinical physical examination, ultrasonography and mammography was respectively 68.85%, 88.52% and 72.13%, the specificity was respectively 88.23%, 21.57% and 56.86%, while the accuracy was respectively 77.68%, 58.04% and 65.18%. The combined use of ultrasonography and mammography yielded the highest sensitivity of 98.36% (P
10.Gemcitabine plus cisplatin for the treatment of anthracycine-resistant advanced breast cancer
Binghe XU ; Kai LI ; Duanqi LIU
China Oncology 2000;0(06):-
Purpose:To evaluate the efficacy and safety of combination chemotherapy of gemcitabine(GEM) and cisplatin(DDP) for anthracycine(ANT)-resistant advanced breast cancer(ABC). (GEM 1 200 mg/m 2 on day1 and 8,DDP 30mg/m 2 on day 3 to 5 in cycles of 21 days) Methods:From January 2000 to April 2003,fifty patients with ANT-resistant ABC were treated with combination chemotherapy of GEM and DDP. The median number of cycles was 3(range 2-4). Results:The overall response rate was 42.6%,The median time to progression was 4.5 months. The main side effect included gastrointestinal and hematologic toxicities,related grade 3 to 4 clinical adverse effect was nausea and vomiting in 12 cases (24%),anemia in 2 cases (4), leukopenia in 7 cases (14%),neutropenia in 4 cases (8%) and thrombocytopenia in 16 cases (32%).Conclusions:GEM and DDP combination is active in ANT-resistant ABC with an acceptable toxicity pattern and may well represent an interesting therapeutic choice after ANT regimen.

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