Thai cancer journal

The Role of Nurses in Caring for Patients with Diarrhea from EGFR Inhibitors

Akradach Bamrungnam — Wed, 19 Feb 2025 00:00:00 +0700

The treatment of non-small cell lung cancer with Epidermal Growth Factor Receptor (EGFR) gene mutations using EGFR inhibitors has played an increasingly important role. Due to the mechanism of action of the drugs, gastrointestinal side effects often occur, with diarrhea being the most common. If not managed properly, this condition can result in complications. Nurses play a crucial role in the care of these patients as part of the healthcare team. To fulfill this role effectively, they must have a deep understanding of the condition and be able to apply that knowledge in patient care. This article discusses the pathology of diarrhea, the classification of severity, treatment guidelines, and the role of nurses in assessing patients and providing self-care advice regarding diarrhea caused by EGFR inhibitors.

Comparison of Radiotherapy Positioning Deviations in Head and Neck Cancer Patients With and Without the Use of Dental Impression Fixation Devices

Fri, 17 Jan 2025 00:00:00 +0700

At present, the use of advanced 3D techniques to fix head and neck cancer patients undergoing radiation therapy treatment (Volumetric Modulated Arc Therapy: VMAT) is very important for the accuracy and precision of the radiation location both during the radiation treatment and every day until the prescribed treatment plan is complete. Objectives of the study for choosing to use of fixation device is an important factor. Therefore, a comparison of the positioning errors of head and neck cancer patients from the use of 2 groups of fixation devices: Group 1 (Tooth impression device + standard headrest) and Group 2 (Standard headrest). Study of patients irradiated with the VMAT technique by examining the location of the irradiation using 3D X-Ray cone beam computed tomography (CBCT). This study had a sample groups of head and cancer patients 15 patients per group, with a total of 112 and 119 CBCT images, respectively, for compare with reference image (Digital Reconstructed Radiography: DRR) from the treatment plan. The horizontal plane (X, Y, and Z) and rotational plane (sagittal, coronal, and transverse) tolerance and the number of repeated irradiation setup was assessed. All data for the two fixation groups were compared. The results of the study found that the rates of re-irradiation setup in patients in group 1 was 25.9 percent and group 2 was 48.7 percent, which were significantly different (P<0.001) and the rates of re-irradiation patient setup in the sagittal direction were 5.4 percent and 25.2 percent (P<0.001) and the ratio of re-irradiation setup comparing the two groups was 0.5 (P=0.023). Summary of the use of fixation devices for head and neck cancer patients undergoing radiation therapy using the VMAT technique with a dental impression set together with standard fixation devices help to reduce re-irradiation patient setup with statistical significance, especially in the head-foot direction can reduce the rate of re-irradiation positions up to 5 times and reduce the total time spent on radiation treatment each day. Importantly, it reduces the patient's exposure to unnecessary radiation doses for repeat CBCT procedures and reduces the cost of purchasing fixation equipment.

Early Symptoms and Factors Effect on Hypersensitivity Reaction of Cancer Patients with Receiving Paclitaxel and Carboplatin Chemotherapy

nalinee jantajit, Kamolchanok Pornpitak, Somsri thipprasopchock — Mon, 10 Feb 2025 00:00:00 +0700

Hypersensitivity reactions (HSRs) during chemotherapy can be life-threatening if not properly managed. This retrospective descriptive study, conducted at the National Cancer Institute from September 1, 2019, to August 11, 2022, examined the symptoms and factors associated with HSRs to paclitaxel and carboplatin. The study involved 57 paclitaxel patients and 41 carboplatin patients. Symptoms in the paclitaxel group appeared 8 to 20 minutes after administration, with chest tightness being the most common (62.5%). In the carboplatin group, reactions occurred within 12 to 90 minutes, with itching of palms and soles (31.3%) as the most frequent symptom. Factors associated with hypersensitivity included increasing age and patients receiving chemotherapy on a tri-weekly schedule had more reactions than those on a weekly regimen. Paclitaxel showed the highest incidence in the second cycle, while carboplatin was most frequent during the sixth cycle. Both paclitaxel and carboplatin have multiple risk factors and varying initial symptoms for hypersensitivity. Establishing screening protocols and providing education for high-risk patients is essential before chemotherapy administration.