AIM To investigate the relationship between the onsets of multikinase inhibitor(MKI)-associated hand-foot skin reaction(HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib.METHODS...AIM To investigate the relationship between the onsets of multikinase inhibitor(MKI)-associated hand-foot skin reaction(HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib.METHODS We conducted a retrospective study involving 40 patients treated with sorafenib. Intervention by pharmacists began at the time of treatment introduction and continued until the appearance of symptomatic exacerbation or non-permissible adverse reactions. We examined the relationship between MKI-associated HFSR and overall survival(OS) after the initiation of treatment.RESULTS The median OS was 10.9 mo in the MKI-associated HFSR group and 3.4 mo in the no HFSR group, showing a significant difference in multivariate analysis. A multivariate analysis of the time to treatment failure indicated that the intervention by pharmacists and MKI-associated HFSR were significant factors. The median cumulative dose and the mean medication possession ratio were significantly higher in the intervention group than in the non-intervention group. A borderline significant difference was observed in terms of OS in this group.CONCLUSION Intervention by pharmacists increased drug adherence. Under increased adherence, MKI-associated HFSR was an advantageous surrogate marker. Intervention by healthcare providers needs to be performed for adequate sorafenib treatment.展开更多
目的为提高在Orfit板+体表标线固定技术下的乳腺癌保乳术后调强放疗患者摆位治疗精准度,提出一种基于计划床值的改良摆位方法。方法选取29例在Orfit板+体表标线固定技术下接受保乳术后调强放疗病例,同一患者分别按体表治疗标记点(常规...目的为提高在Orfit板+体表标线固定技术下的乳腺癌保乳术后调强放疗患者摆位治疗精准度,提出一种基于计划床值的改良摆位方法。方法选取29例在Orfit板+体表标线固定技术下接受保乳术后调强放疗病例,同一患者分别按体表治疗标记点(常规摆位组)与计划床值(试验摆位组)进行摆位,并通过锥形束计算机断层扫描(cone⁃beam computed tomography,CBCT)自动配准方式获取两组在左右(lateral,Lat)方向、头脚(longitudinal,Lng)方向和腹背(vertical,Vrt)方向的配准误差,同时收集患者治疗前的体质量指数(body mass index,BMI)、乳房最大厚度值,与各方向误差值进行相关性Pearson分析。结果常规摆位组在左右(Lat)方向、头脚(Lng)方向和腹背(Vrt)方向的摆位误差分别为(-0.01±0.32)cm、(-0.03±0.23)cm和(-0.20±0.38)cm;试验摆位组摆位误差依次为(-0.04±0.31)cm、(0.04±0.22)cm和(-0.06±0.23)cm。两组在头脚(Lng)方向和腹背(Vrt)方向的摆位误差(P<0.05)有统计学意义;而左右(Lat)方向的(P>0.05)无统计学意义。BMI值与常规摆位误差存在相关性[腹背(Vrt)方向r=-0.435,P=0.018],与试验组各方向摆位误差均不存在相关(P>0.05);乳房厚度与两组各方向摆位误差均不存在相关(P>0.05)。结论计划床值摆位精度优于体表治疗标记点,提示对Orfit板+体表标线固定技术下的保乳术后患者放疗具有潜在的临床获益。展开更多
文摘AIM To investigate the relationship between the onsets of multikinase inhibitor(MKI)-associated hand-foot skin reaction(HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib.METHODS We conducted a retrospective study involving 40 patients treated with sorafenib. Intervention by pharmacists began at the time of treatment introduction and continued until the appearance of symptomatic exacerbation or non-permissible adverse reactions. We examined the relationship between MKI-associated HFSR and overall survival(OS) after the initiation of treatment.RESULTS The median OS was 10.9 mo in the MKI-associated HFSR group and 3.4 mo in the no HFSR group, showing a significant difference in multivariate analysis. A multivariate analysis of the time to treatment failure indicated that the intervention by pharmacists and MKI-associated HFSR were significant factors. The median cumulative dose and the mean medication possession ratio were significantly higher in the intervention group than in the non-intervention group. A borderline significant difference was observed in terms of OS in this group.CONCLUSION Intervention by pharmacists increased drug adherence. Under increased adherence, MKI-associated HFSR was an advantageous surrogate marker. Intervention by healthcare providers needs to be performed for adequate sorafenib treatment.
文摘目的为提高在Orfit板+体表标线固定技术下的乳腺癌保乳术后调强放疗患者摆位治疗精准度,提出一种基于计划床值的改良摆位方法。方法选取29例在Orfit板+体表标线固定技术下接受保乳术后调强放疗病例,同一患者分别按体表治疗标记点(常规摆位组)与计划床值(试验摆位组)进行摆位,并通过锥形束计算机断层扫描(cone⁃beam computed tomography,CBCT)自动配准方式获取两组在左右(lateral,Lat)方向、头脚(longitudinal,Lng)方向和腹背(vertical,Vrt)方向的配准误差,同时收集患者治疗前的体质量指数(body mass index,BMI)、乳房最大厚度值,与各方向误差值进行相关性Pearson分析。结果常规摆位组在左右(Lat)方向、头脚(Lng)方向和腹背(Vrt)方向的摆位误差分别为(-0.01±0.32)cm、(-0.03±0.23)cm和(-0.20±0.38)cm;试验摆位组摆位误差依次为(-0.04±0.31)cm、(0.04±0.22)cm和(-0.06±0.23)cm。两组在头脚(Lng)方向和腹背(Vrt)方向的摆位误差(P<0.05)有统计学意义;而左右(Lat)方向的(P>0.05)无统计学意义。BMI值与常规摆位误差存在相关性[腹背(Vrt)方向r=-0.435,P=0.018],与试验组各方向摆位误差均不存在相关(P>0.05);乳房厚度与两组各方向摆位误差均不存在相关(P>0.05)。结论计划床值摆位精度优于体表治疗标记点,提示对Orfit板+体表标线固定技术下的保乳术后患者放疗具有潜在的临床获益。