We demonstrated contamination of the home setting and exposure of family members to cyclophosphamide via the excreta of outpatient receiving chemotherapy. Exposure of the family member of the patient administered 5-fluorouracil was also demonstrated. These findings indicate the importance of strict precautions by the members of treated cancer patients as well as healthcare workers, to reduce the risk of exposure to antineoplastic drugs.
Nurses should educate patients and their family members about preventing exposure to antineoplastic drugs in the home setting.
Cancer patients are at high risk of venous thromboembolism (VTE), and the combination of these two conditions is well known as Trousseau's syndrome. Here we present four cases of Trousseau's syndrome associated with advanced lung adenocarcinoma. In addition to fibrinogen degradation products (FDP) and Ddimer, the levels of mucin-producing markers, such as KL-6, were elevated. There is a possibility that mucin production may be associated with cancer-related VTE.
Purpose: To monitor the urinary excretion of cyclophosphamide by five patients during the first 48 hours after cyclophosphamide administration and to evaluate surface contamination with cyclophosphamide in the patients' homes via their excreta 48 hours after the completion of chemotherapy. Methods: Urine samples were taken from five female patients with breast cancer at their homes during the 48 hours after administration of cyclophosphamide. Wipe samples were also collected from their home settings. All samples were analyzed for cyclophosphamide using gas chromatography with mass spectroscopy-mass spectrometry. Results: Fifty-three urine samples were collected from the five patients during two days after cyclophosphamide treatment. Cyclophosphamide was positive in all urine samples. The quantity of cyclophosphamide excreted in each urine sample ranged from 0.09 to 65.99 mg. The urinary excretion of cyclophosphamide accounted for 9%-34% of the dose for four of the patients. Cyclophosphamide was measured at levels of 0.01-8.35 in 17 of the 28 wipe samples from all five patients. The areas contaminated with cyclophosphamide, common to all patients, were the toilet seat (0.04-8.35 ng/cm 2) and the toilet floor (0.08-1.53 ng/cm 2). Conclusions: Surface contamination of the home settings of outpatients treated with cyclophosphamide was demonstrated 48 hours after cyclophosphamide administration. Contamination of the home setting with antineoplastic drugs administered to outpatients risks exposure to family members.
BackgroundErlotinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, which is an effective treatment for patients with non-small cell lung cancer (NSCLC), especially those harboring activating EGFR mutations. A previous phase III trial suggested that patients with EGFR wild-type (EGFR-wt) NSCLC or elderly patients with disease progression after cytotoxic chemotherapy might benefit from erlotinib monotherapy. However, few studies have prospectively evaluated the efficacy and safety of second- or third-line erlotinib monotherapy for elderly patients with EGFR-wt advanced or recurrent NSCLC.MethodsPretreated patients aged ≥70 years with EGFR-wt stage IIIB/IV NSCLC or those with postoperative recurrence were enrolled and received oral erlotinib at a dose of 150 mg/day until disease progression. Primary outcome was the objective response rate (ORR). Secondary end points included the disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and toxicity profile.ResultsThis study was terminated early because of the results from a Japanese phase III trial (DELTA trial). Sixteen patients were enrolled between April 2010 and May 2013. The median age was 78 years (range 70–84 years). Six patients were female. Five patients had an Eastern Cooperative Oncology Group performance status of 0. Eleven (69%) patients had adenocarcinoma. Fifteen (94%) patients were treated with erlotinib as a second-line therapy. The ORR was 0% [95% confidence interval (CI) 0–17.1]. DCR was 56.3% (95% CI 33.2–76.9). The median PFS and OS were 1.7 months (95% CI 1.3–2.2) and 7.2 months (95% CI 5.6–8.7), respectively. The most commonly occurring adverse events included acneiform eruption (31.3%) and skin rash (25.0%). One patient developed grade 3 interstitial lung disease, which improved following steroid therapy.ConclusionsIn pretreated elderly patients with advanced or recurrent EGFR-wt NSCLC, daily oral erlotinib was well tolerated; however, administration of the drug should not be considered as a second line therapy.Trial registration: University Hospital Medical Information Network (UMIN) Clinical Trials Registry UMIN000004561 (Date of registration: November 15th, 2010)Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1214-9) contains supplementary material, which is available to authorized users.
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