Search

Li Dai,* Xiangren Jin,* Liuxing Wang, Haibin Wang, Zhiqiang Yan, Guanghai Wang, Baichuang Liang, Fu Huang, Yuling Luo, Taichun Chen, Qian Wang Department of Gastrointestinal Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qian Wang, Tel +8615885004333, Email Wangqian118@outlook.comAbstract: Currently, effective therapies for advanced gastric cancer with systemic metastasis are lacking. Pharmacological research has been slowly progressing over the past decades. Here, we report the case of a 56-year-old female with human epidermal growth factor receptor 2 (HER2) expression (IHC 2+/FISH-) in gastric cancer with systemic metastasis. The first-line therapeutic regime consisted of systemic administration of camrelizumab, local arterial infusion of oxaliplatin and arterial embolization, oral apatinib, and PS scheme (oral tegafur-gimeracil-oteracil (S-1) and paclitaxel (PTX), which was administered both intraperitoneally and systemically). After the treatment, a 3-month progression-free survival (PFS) was observed. Due to the occurrence of CTCAE grade 4 adverse reactions, the patient could not tolerate chemotherapy. In the second line of treatment, we replaced the PS scheme with disitamab vedotin and continued the use of carrilizumab and apatinib. After four cycles, efficacy evaluation showed that it was stable disease (SD), only CTCAE 1/2 grade adverse reactions occurred, and endoscopy examination showed local tumor control with a reduction in the ulcer lesion. At the time of submission of the current manuscript, a 6-month PFS was achieved and the treatment was continued. Due to the safety and efficacy of disitamab vedotin observed in our case, we propose that disitamab vedotin could be a promising drug for the treatment of advanced gastric cancer patients with HER2 expression.Keywords: gastric cancer, human epidermal growth factor receptor 2, disitamab vedotin

Objective To build a vomit-free ward of scientific and standardized management mode, and to evaluate its clinical effects on preventing nausea and vomiting in patients undergoing chemotherapy. Methods A total of 200 patients suffering from nausea and vomiting were randomly selected from the registration system, from which 120 cases were enrolled according to the inclusion and exclusion criteria. These subjects were divided into control group and observation group (60 patients in each). Both of the two groups received routine nursing care, while the treatment group subjects lived in the vomit-free wards where extra nursing interventions were applied to prevent chemotherapy-induced nausea and vomiting (CINV), with constant observation of the frequency and severity of nausea and vomiting. The outcomes of the subjects from both the groups as well as nurses’ cognition level of CINV were compared after four chemotherapy cycles. Results The difference in the scoring for the frequency and severity of nausea and vomiting in two groups was statistically significant (P < 0.05). The scores of nurses’ cognition level of CINV were compared between before and after the interventions, and the difference had statistical significance (P < 0.05). Conclusion The management mode aiming to build vomit-free wards could decrease the incidence of CINV in patients during chemotherapy, and at the same time increased the cognitive level of nursing staff toward CINV, which is of great value in clinical practice and is worthy of further application.